PACS clinical experience at Georgetown University

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for 3.5 years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for 3 years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.     

The impact of PACS on research and education

Picture Archiving and Communication Systems (PACS) are rapidly evolving and the total digital radiology department may be a reality within the next decade. PACS can have a major impact on the educational and research responsibilities of a medical institution. The possibility of correlating real patient data with existing radiological teaching files opens up numerous possibilities. Multi-institutional research can be strengthened by employing the PACS as the means to the end. This paper discusses the representative examples of how teaching and research can be enhanced with PACS and the technical requirements to achieve the inter-connectivity.     

Benefits of coordinated action in PACS evaluation

PACS, a health care technology still in its developmental stage, aims to improve the management of diagnostic imaging investigations. As the technology has not been comprehensively assessed, data and facts to justify its clinical, economic and other benefits are to date insufficient. Through internationally coordinated action, it is expected to obtain a faster and more comprehensive technology assessment of PACS as well as recommendations for optimization of the system and guidelines for its rational use in various health care environments.     

Overview of some methodological problems in assessment of PACS

The purpose of technology assessment of picture archiving and communications systems (PACS) is to establish the need for the technology, provide a measure of functionality and to establish the costs and benefits associated with the introduction of the system. Given concerns about the clinical acceptability of PACS, it is unlikely that radiologists will change from existing film based systems until a clear demonstration of costs and benefits has been performed. The major need at present is to quantify the benefits which may flow from the introduction of PACS system in a standard manner which can be accepted by all parties involved.     

Computer-aided three-dimensional graphic reconstructions in a radiological and anatomical setting

With the aid of a relatively simple computer system three-dimensional graphic reconstruction models have been prepared. The procedure was applied in anatomy on a fixed embryonic specimen and in radiology on living subjects by using computed tomography scans. The results are useful for embryological research as well as for clinical evaluation.     

规范医学影像诊断报告书写,提高医学生及住院医师临床技能

医学影像诊断报告是正确行使医疗行为和保证医疗质量的依据,书写高质量的医学影像学诊断报告是医学生及住院医师必须掌握的一项基本功和基本技能。本文将结合我院长期的医学生及住院医师临床教学经验和实际,以神经系统影像报告为例,从医学影像诊断报告的重要性、医学生及住院医师医学影像诊断报告技能教学的现状、规范化医学影像报告书写技能的培养、评估、反馈和评价进行探讨,以期在医学生和住院医师的培养中提高其临床技能,供广大同道在医学教育与实践中借鉴和改进。     

Computer assisted semen analyzers in andrology research and veterinary practice.

The evaluation of sperm cell motility and morphology is an essential parameter in the examination of sperm quality and in the establishment of correlations between sperm quality and fertility. Computer-assisted sperm analysis (CASA) allows an objective assessment of different cell characteristics: motion, velocity, and morphology. The development and problems related to this technology are raised in this review, paying particular attention to the biases and standardization requirements absolutely needed to obtain useful results. Although some interesting results, mainly in humans, have already been obtained, many questions remain, which have to be answered to allow for further development of this technology in veterinary medicine, clinical fertility settings, physiological, and toxicology research activities. The main problem is related to the standardization and optimization of the equipment and procedures. The different CASA instruments have all demonstrated high levels of precision and reliability using different sperm classification methodology. Their availability gives us a great tool to objectively compare sperm motility and morphology and to improve our knowledge and ability to manipulate spermatozoa.     

磁性细胞分选技术的应用与生物学评价

磁性细胞分选技术是一种利用超顺磁性纳米复合材料进行细胞分选的细胞高度特异性快速分选技术,在免疫学、干细胞学、肿瘤学和临床医学等领域应用广泛。本文综合阐述了磁性细胞分选技术的分类和应用,讨论了近几年出现的几项基于磁性细胞分选的新技术和面临的挑战。重点分析了磁性细胞分选产品生物学评价的必要性,并提出了10项与磁性细胞分选产品相关的生物学评价技术参数：得率、纯度、无菌、细胞毒性、细胞形态、活率、细胞的光散射特性、细胞的荧光抗体标记能力、细胞活化、细胞增殖,该评价技术参数的提出对磁性细胞分选规范化应用具有重要的推动作用。     

Artificial intelligence and machine learning for medical imaging: A technology review

Artificial intelligence (AI) has recently become a very popular buzzword, as a consequence of disruptive technical advances and impressive experimental results, notably in the field of image analysis and processing. In medicine, specialties where images are central, like radiology, pathology or oncology, have seized the opportunity and considerable efforts in research and development have been deployed to transfer the potential of AI to clinical applications. With AI becoming a more mainstream tool for typical medical imaging analysis tasks, such as diagnosis, segmentation, or classification, the key for a safe and efficient use of clinical AI applications relies, in part, on informed practitioners. The aim of this review is to present the basic technological pillars of AI, together with the state-of-the-art machine learning methods and their application to medical imaging. In addition, we discuss the new trends and future research directions. This will help the reader to understand how AI methods are now becoming an ubiquitous tool in any medical image analysis workflow and pave the way for the clinical implementation of AI-based solutions.     

PBL教学法联合PACS系统在医学影像学教学中的应用

目的:探讨采用PBL和PACS相结合的教学模式在影像学实习教学中的应用效果。方法:对我院2010级临床本科生40人采用传统教学法授课,另40人采用PBL和PACS相结合的教学法授课。课程结束后以考试成绩作为教学效果的评价指标,评价两种教学方法的教学效果;以调查问卷的方法评价学生对两种教学方法的感兴趣程度,并对结果进行统计学分析。结果:我们的研究结果显示,采用PBL和PACS相结合的方法进行教学的学生与传统教学法相比,理论考试成绩有所提高,但缺乏统计学意义(p0.05),病例分析成绩显著提高,差异有统计学意义(P0.05)。问卷调查显示,PBL和PACS结合的教学方法更受同学欢迎,更能培养学生的自学能力和团队合作能力(P0.05)。结论:采用PBL和PACS相结合的教学方法,有助于提高学生的学习兴趣,提高学习成绩,值得在教学中应用。     

Federated ontology-based queries over cancer data

BACKGROUND: Personalised medicine provides patients with treatments that are specific to their genetic profiles. It requires efficient data sharing of disparate data types across a variety of scientific disciplines, such as molecular biology, pathology, radiology and clinical practice. Personalised medicine aims to offer the safest and most effective therapeutic strategy based on the gene variations of each subject. In particular, this is valid in oncology, where knowledge about genetic mutations has already led to new therapies. Current molecular biology techniques (microarrays, proteomics, epigenetic technology and improved DNA sequencing technology) enable better characterisation of cancer tumours. The vast amounts of data, however, coupled with the use of different terms - or semantic heterogeneity - in each discipline makes the retrieval and integration of information difficult. RESULTS: Existing software infrastructures for data-sharing in the cancer domain, such as caGrid, support access to distributed information. caGrid follows a service-oriented model-driven architecture. Each data source in caGrid is associated with metadata at increasing levels of abstraction, including syntactic, structural, reference and domain metadata. The domain metadata consists of ontology-based annotations associated with the structural information of each data source. However, caGrid's current querying functionality is given at the structural metadata level, without capitalising on the ontology-based annotations. This paper presents the design of and theoretical foundations for distributed ontology-based queries over cancer research data. Concept-based queries are reformulated to the target query language, where join conditions between multiple data sources are found by exploiting the semantic annotations. The system has been implemented, as a proof of concept, over the caGrid infrastructure. The approach is applicable to other model-driven architectures. A graphical user interface has been developed, supporting ontology-based queries over caGrid data sources. An extensive evaluation of the query reformulation technique is included. CONCLUSIONS: To support personalised medicine in oncology, it is crucial to retrieve and integrate molecular, pathology, radiology and clinical data in an efficient manner. The semantic heterogeneity of the data makes this a challenging task. Ontologies provide a formal framework to support querying and integration. This paper provides an ontology-based solution for querying distributed databases over service-oriented, model-driven infrastructures.     

Technology Resource,Distribution, and Development Characteristics of Global Influenza Virus Vaccine: A Patent Bibliometric Analysis

Influenza virus vaccine (IVV) is a promising research domain that is closely related to global health matters, which has been acknowledged not only by scientists and technology developers, but also by policy-makers. Meanwhile, patents encompass valuable technological information and reflect the latest technological inventions as well as the innovative capability of a nation. However, little research has examined this up-and-coming research field using patent bibliometric method. Thus, this paper (a) designs the technology classification system and search strategy for the identification of IVV; and (b) presents a longitudinal analysis of the global IVV development based on the European Patent Office (EPO) patents. Bibliometric analysis is used to rank countries, institutions, inventors and technology subfields contributing to IVV technical progress. The results show that the global trends of IVV are a multi-developing feature of variety but an uneven technical resource distribution. Although the synthetic peptide vaccine is a comparatively young field, it already demonstrates the powerful vitality and the enormous development space. With the worldwide competition increasing, all nations especially China should be looking to increase devotion, enhance capability and regard effectiveness of technological innovation.     

Agreement Between Clinical and Radiological Diagnosis

Agreement between radiological and clinical diagnosis and the incidence of unexpected findings has been used as an indicator of the diagnostic contribution of radiology. The overall incidence of agreement was 33% — 533 out of 1,604 x-ray examinations. The wide variation in agreement in different radiological examinations is clearly related to the pathological nature of disease and the limitations of radiological techniques. If diagnostic radiology is to be effective its application rather than interpretation in the clinical situation must be emphasized in training programmes.     

Introductory biology courses: a framework to support active learning in large enrollment introductory science courses

Active learning and research-oriented activities have been increasingly used in smaller, specialized science courses. Application of this type of scientific teaching to large enrollment introductory courses has been, however, a major challenge. The general microbiology lecture/laboratory course described has been designed to incorporate published active-learning methods. Three major case studies are used as platforms for active learning. Themes from case studies are integrated into lectures and laboratory experiments, and in class and online discussions and assignments. Students are stimulated to apply facts to problem-solving and to learn research skills such as data analysis, writing, and working in teams. This course is feasible only because of its organizational framework that makes use of teaching teams (made up of faculty, graduate assistants, and undergraduate assistants) and Web-based technology. Technology is a mode of communication, but also a system of course management. The relevance of this model to other biology courses led to assessment and evaluation, including an analysis of student responses to the new course, class performance, a university course evaluation, and retention of course learning. The results are indicative of an increase in student engagement in research-oriented activities and an appreciation of real-world context by students.     

临床医学学科建设评价指标现状分析

在对目前现有常用的学科建设评价系统进行分析的基础上，提出学科评价应体现临床学科的核心任务－医疗水平和技术特色，应正确把握和评价临床学科建设中科研的作用，要凝练学科建设的评价指标，构成精炼、要点突出、指向明确。     

中药毒性评价的技术方法与应用

中药的安全性近年来受到了广泛的关注和重视,但是相应的理论和实验研究还不够充分。中药的毒性是中药安全性的关键问题之一,参照国际惯例和西方植物药研究的标准规范,依据中医药理论,应用现代新技术新方法,结合基础研究的成果,制定相应的评价体系和研究规范,是解决这个关键问题的可行思路。对近年来课题组按照上述研究思路开展的有关中药毒性评价的技术方法与应用研究的结果进行了概述,希望能为中药毒性的评价方法和技术指导原则提供理论基础,也可为雷公藤等典型中毒中药的毒性研究提供研究示范,推动中药毒性研究的发展。     

海洋污损生物数据管理系统的设计与构建

固着或栖息在船舶和人工设施水下部位的海洋污损生物, 会对人们的涉海活动产生不利影响, 其群落的形成和发展过程与温度、盐度、深度、季节、海域、浸海时间、离岸距离和附着基类型等多种因素密切相关。为便于系统分析和综合处理各海区污损生物资料, 理清各要素之间的内在关系, 需要一个能将上述因子与生物群落参数有机地结合起来的数据平台, 将分散、零星的资料予以归纳整合并通过网络共享, 以更好地为生产实践和科学研究服务。本研究采用Internet技术, 应用ASP.NET框架和MySQL数据库, 使用MS Visual Studio 2013设计并开发了服务端部署在Windows 7或Windows Server 2008 R2 (推荐)操作系统上的海洋污损生物数据管理系统, 实现了基于网络的海洋污损生物数据集成、储存与管理, 可完成来源不同、时相变化和海区多样的污损生物数据资料的集成与储存, 能通过单一或多种组合条件进行查询和检索, 并可根据用户的需要导出多种格式的检索结果报表。该系统具备操作简便、方便网络共享、易于升级更新和开拓新功能等特点, 能有效满足科研、生产和管理部门的需要。     

PACS的高级预防维护技术

目的 通过讨论PACS高级预防维护技术,供同他人在日常维护过程中有一定地借鉴作用.方法 从PACS数据库性能检测与优化,存储设备检测及PACS各应用软件模块三方面进行阐述.结果 经过医院一线安装维护人员和PACS厂家多年实践的总结,拥有一定的可参考依据.结论 PACS的高级预防维护是一个复杂的系统工程,包括一般维护和高级维护在内的实践理论才刚刚起步,科学的、规范化的预防维护需要不断地完善和发展.     

我国园林行业建筑信息模型发展前景探讨

随着BIM技术在建筑等工程行业内迅猛发展,园林业内也在对BIM相关技术进行探索。但与其它工程行业相比,园林行业BIM的发展相对迟缓,主要是因为来自业主、施工方等方面的需求不足、规划设计中缺乏分析与评价体系、行业规模限制、以及技术难度等因素的制约。但是园林规划设计及施工阶段对BIM技术的需求也很急切。园林工程独有的特色使得开发BIM技术的难度较大,需要充分利用相关行业BIM技术的成果,按园林工程的要求进行改造和扩展。