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PubMedDate not supplied

Preparing a business justification for going electronic.

Exponential advances in the technology sector and computer industry have benefited the science and practice of radiology. Modalities such as digital radiography, computed radiography, computed tomography, magnetic resonance imaging, ultrasound, digital angiography, and gamma cameras are all capable of producing DICOM compliant images. Text can likewise be acquired using voice recognition technology (VRT) and efficiently rendered into a digital format. All of these digital data sets can subsequently be transferred over a network between machines for display and further manipulation on workstations. Large capacity archiving units are required to store these voluminous data sets. The enterprise components of radiology departments and imaging centers--radiology information systems (RIS) and picture archiving and communications systems (PACS)--have thus undergone a transition from hardcopy to softcopy. When preparing to make transition to a digital environment, the first step is introspective. A detailed SWOT (strengths, weaknesses, opportunities and threats) analysis, with a focus on the status of "electronic preparedness," ensues. The next step in the strategic planning process is to formulate responses to the following questions: Will this technology acquisition provide sufficient value to my organization to justify the expense? Is there a true need for the new technology? What issues or problems does this technology address? What customer needs will this technology satisfy today and tomorrow? How will the organization's shareholders benefit from this technology? The answers to these questions and the questions that they in turn generate will stimulate the strategic planning process to define demands, investigate technology and investment options, identify resources and set goals. The mission of your radiology center will determine what you will demand from the electronic environment. All radiology practices must address the demand of clinical service. Additional demands based on your mission may include education and research. The investigation of options is probably the most time consuming portion of the analysis. It is in this stage where the system architecture is drafted. Important contributions must be solicited from your information technology division, radiologists and other physicians, hospital administration and any other service where the use of imaging technology information is required and beneficial. Vendors and consultants can be extremely valuable in generating workflow diagrams, which include imaging acquisition components and imaging display components. A request for proposal (RFP) may facilitate this step. A detailed inventory of imaging equipment, imaging equipment locations and use, imaging equipment DICOM compatibility, imaging equipment upgrade requirements, reading locations and user locations must be obtained and confirmed. It is a good idea to take a careful inventory of your resources during the process of investigating system architecture and financial options. An often-ignored issue is the human resource allocation that is required to implement, maintain and upgrade the system. These costs must be estimated and included in the financial analysis. Further, to predict the finances of your operation in the future, a solid understanding of your center's historical financial data is required. This will enable you to make legitimate and reasonable financial calculations using incremental volumes. The radiology center must formulate and articulate discrete clinical and business goals for the transition to a digital environment that are consistent with the institutional or enterprise mission. Once goals are set, it is possible to generate a strategic plan. It is necessary to establish individual accountability for all aspects of the planning and implementation process. A realistic timetable should be implemented. Keep in mind that this is a dynamic process; technology is rapidly changing, as are clinical service demands and regulatory initiatives. It is therefore prudent to monitor the process, make appropriate revisions when necessary and address contingencies as they arise.

Capital Expenditures↗
PubMed2003

Contrasting effects of age of acquisition in lexical decision and letter detection.

Two experiments studied attention in beginning and skilled readers of Dutch to letter information in function words and content words. Early and late acquired nouns and function words were presented to third-grade students and skilled adolescent readers. Target words were presented in short story contexts, as in the study of Greenberg, Koriat, and Vellutino (1998). Target nouns were matched on word frequency. Predictions of the structural account hypothesis of letter detection (Koriat, Greenberg, & Goldshmid, 1991) were confirmed. No age-of-acquisition effect was found. In contrast, a separately conducted lexical decision experiment using the same content word stimulus sets showed shorter decision latencies for early acquired words. The combined results suggest that during silent reading, when attention is focused on meaning, phonological processes may play a less prominent role than in lexical decision tasks that demand explicit control of phonological codes. The letter detection results confirmed predictions of the structural account hypothesis for both beginning and skilled readers. Taken together, these studies demonstrate that phonological processes in silent reading may play a less prominent role and that the structural account of letter processing is valid for languages other than Hebrew and English but probably is not the unique mechanism involved in letter detection.

Adolescent↗
PubMed1997

Technetium-99m-tetrofosmin for parathyroid scintigraphy: a comparison with sestamibi.

UNLABELLED: Parathyroid scintigraphy with the new myocardial perfusion radiopharmaceutical 99mTc-tetrofosmin was compared with 99mTc-sestamibi scintigraphy using early and delayed imaging. METHODS: The two preparations were administered on different days to the same 16 patients suffering from primary hyperparathyroidism. Anterior view gamma camera planar imaging (10-min acquisition) was performed in the period between 5 min and 3 hr after administration of the radiopharmaceutical. For most of the patients, a pertechnetate image of the thyroid was available for eyeball comparison when reading the tetrofosmin and sestamibi images. Imaging results were compared with those from histopathological examination after surgery. RESULTS: On early images, all the adenomas visualized with sestamibi were equally well seen with tetrofosmin and vice versa. In 6 of 11 scintigraphically detected neck adenomas, delayed imaging improved the adenoma visualization with sestamibi. In contrast, this differential washout was never seen with tetrofosmin. Histopathological examination of excised tissue specimens after neck exploration (15 patients) or thoracotomy (one patient) revealed a parathyroid adenoma in all 16 patients. Our 12 scintigraphic findings were true-positives, while the remaining four scintigraphies were false-negatives, giving a diagnostic sensitivity of 75% with both preparations. The mediastinal adenoma was detected in a patient with a history of two unsuccessful neck explorations and one unsuccessful thoracotomy. CONCLUSION: Tetrofosmin has the same success rate as sestamibi for detection of parathyroid adenomas on scintigrams acquired immediately after injection. In contrast to sestamibi, delayed imaging has no diagnostic impact. Moreover, the thyroid/ parathyroid differential washout of sestamibi failed in 5 of 11 neck adenomas here detected, indicating that delayed sestamibi washout is an unreliable diagnostic criterion. Therefore, whether sestamibi or tetrofosmin is preferred for parathyroid scintigraphy, thyroid scintigraphy seems mandatory.

Adenoma↗
PubMed1998

SPECT imaging of feet using uniplanar fad-beam collimators.

BACKGROUND: This study was performed to assess the utility of bone SPECT in the feet using a new commercially available uniplanar fan-beam collimator originally designed for cardiac imaging. METHODS: 18 patients with symptoms or signs of probable skeletal pathology in either the foot or ankle were imaged using a two headed gamma camera fitted with uniplanar fan-beam collimators. All patients were imaged 2.5-4 h after administration of 500-750 MBq 99mTc MDP. If indicated planar dynamic and blood pool images were also obtained. The SPECT acquisition was performed in a 128 x 128 matrix, giving a pixel size of 2.00-2.30 mm depending on the radius of orbit. Images were displayed as transaxial, coronal and sagittal slices and a three dimensional volume rendered image and displayed for reading by three readers blind to the clinical results. Sites of abnormal uptake on the foot SPECT scan were then compared with the site of known or suspected pathology and in 17 patients with planar radiology. RESULTS: The SPECT images produced using the uniplanar fan-beam collimators were of good quality in all patients with all three readers finding localisation easiest on the sagittal and three-dimensional images. In 10 patients abnormalities were found which could explain the patient's symptoms or signs and at the site expected from the patient's clinical history. In 5 patients there were abnormalities on the bone scan in the ipsilateral foot but at a different site, all were interpreted as degenerative disease. 2 patients had contralateral degenerative disease to side suggested by the clinical history and no abnormality in the bones of the foot with symptoms. One patient had bilateral degenerative disease. Planar radiology was normal or unhelpful in 13 of the 17 patients in which it was performed. CONCLUSION: SPECT imaging of feet is possible and provides accurate localisation of abnormal uptake when performed using uniplanar fan-beam collimators with a standard acquisition time of 15 min for a double headed gamma camera.

Journal Article↗
PubMed2002

Phonological awareness: one key to the reading proficiency of deaf children.

A case is made for the importance of children's development of phonological awareness--whether they are hearing or deaf--if they are to reach their potential as readers. Relevant terms are defined (i.e., phonological awareness, phonological processes, and phonics) to assist the reader with the research review, which covers (a) the typical stages in the acquisition of phonological awareness and (b) phonological awareness and deafness. Suggestions for phonological awareness assessment are offered, along with the recommendation that the use of recently developed formal and informal measures of phonological awareness might facilitate the setting of goals and objectives when deaf educators or speech-language pathologists are evaluating the skills of deaf students and planning instruction for these students. Such tools yield information about skills that have been shown to correlate with literacy attainment and that are not commonly addressed by deaf educators or speech-language pathologists serving deaf students. Finally, research concerning the facilitation of phonological awareness and its application is explained.

Awareness↗
PubMed1998

A method for visualization of ventricular fibrillation: Design of a cooled fiberoptically coupled image intensified CCD data acquisition system incorporating wavelet shrinkage based adaptive filtering.

The measurement of cardiac transmembrane potential changes with voltage sensitive dyes is in increasing use. Detection of these very small fluorescent alterations using large multiplexed arrays, such as charge coupled device (CCD) cameras at high sampling rates, has proven challenging and usually requires significant averaging to improve the signal-to-noise ratio. To minimize the damage of living tissue stained with voltage sensitive dyes, excitation photon exposure must be limited, with the inevitable consequence of diminishing the fluorescence that is generated. State-of-the-art high frame rate CCD cameras have read noise levels in the 5-10 e(-) rms range, which is at least two orders of magnitude above that required to detect voltage sensitive dye alterations at individual pixels corresponding to 1 mm(2) heart regions illuminated with levels of 100 mW/cm(2) at frame rates approaching 1000 frames/sec. Image intensification is thus required prior to photon quantification. We report here the development of such a data acquisition system using commercially available hardware. Additionally, in the past ten years, a mathematical theory of multiresolution has been developed, and new building blocks called wavelets, allow a signal to be observed at different resolutions. Wavelet analysis also makes possible a new method of extricating signals from noise. We have incorporated spatially adaptive filters based on wavelet denoising of individual pixels to significantly reduce the multiple noise sources present in the acquired data. (c) 1998 American Institute of Physics.

Journal Article↗
PubMed2000

Challenges associated with interfacing computed tomography to a picture archiving and communication system at the Baltimore Veterans Affairs Medical Center--a historical perspective.

The interfacing of digital image acquisition modalities to the picture archiving and communication system (PACS) plays a major part in the conversion from a traditional film-based radiology practice to one that relies almost entirely on soft-copy reading. The Baltimore Veterans Affairs Medical Center (VAMC) is one of the first filmless hospitals in the world. Since 1993, it has used computed tomography (CT) scanners connected to a commercial PACS to provide digitized patient images for filmless reading. Over the years, the evolution of Digital Imaging and Communications in Medicine (DICOM) standards, advances in networking technologies, and enhancements in PACS and hospital information system (HIS) software have greatly improved this system's robustness and patient/study identification accuracy. The result has been a major increase in productivity.

Baltimore↗
PubMed1981

Training speech pathologists through microtherapy.

Two microtraining methods were evaluated for training speech pathologists in the acquisition of skills utilized in treating misarticulations. Fifteen subjects in an introductory class in speech pathology were randomly placed in two groups (modeling, video replay, and counseling versus video replay and counseling). The training included reading a manual about the skills and a sequence of three teach sessions. The control group did not view the video model. According to the results, the model group made a greater gain score (M = 8.38) than the nonmodel group (M = 3.88). Significant gains were made for both experimental groups between teach sessions one and two, but no significant gains were made between the second and third teach sessions.

Books↗
PubMed1989

Computer acquisition and analysis of skin temperature and heat flow data from heat flux transducers.

A computer-controlled system for the collection and analysis of skin temperature and heat flow data originating from an array of heat flux transducers is described. The system is based on a program ('THERMAL') that reads, stores, prints and displays skin temperatures and heat flow data every 2 min for up to 4 h. It also simultaneously calculates important environmental physiology parameters such as mean skin and mean body temperatures as well as mean heat flow according to four different combinations of transducers such as the established 3-, 4-, 7- and 12-point (site) formulae. Core temperature, heart rate and environmental condition indices such as dry bulb, wet bulb and globe temperatures are also continuously monitored.

Body Temperature↗
PubMed1997

Does intelligence account for the link between maternal literacy and child survival?

The strong and consistent correlation between maternal education and child health is now well known, and numerous studies have shown that wealth and income cannot explain the link. Policy-makers have therefore assumed that the relationship is causal and explicitly advocate schooling as a child health intervention. However, there are other factors which could account for the apparent effect of maternal education on child morbidity and mortality, one of which is intelligence. This paper examines the effect of maternal intelligence on child health and looks at the degree to which it can explain the literacy associations with child survival and risk of malnutrition. The data are from a retrospective cohort study of 1294 mothers and their 7475 offspring, of whom 454 were women who had learned to read and write as adults in Nicaragua's literacy programme, 457 were illiterate, and 383 had become literate as young girls attending school. The women's intelligence was tested using Raven's Coloured Progressive Matrices. Acquisition of literacy was strongly related to intelligence. Statistically significant associations with maternal literacy were found for under five mortality, infant mortality, and the risk of low mid-upper-arm circumference (MUAC) for age, before and after controlling for a wide range of socio-economic factors. Under five, child (one to four years), infant and post-neonatal mortality plus the risk of low height for age were significantly correlated with intelligence, but only with infant and under mortality rates did the association remain significant after controlling for socio-economic factors. A significant interaction between intelligence and literacy for under five mortality was due to literacy having a strong effect in the women of low intelligence, and a negligible effect among those of high intelligence. This study provides evidence that intelligence is an important determinant of child health among the illiterate, and that education may have the greatest impact on child health for mothers of relatively low intelligence.

Adult↗
PubMed2001

Alternative voice after laryngectomy using a sound-producing voice prosthesis.

OBJECTIVE: To improve the voice quality of female laryngectomees and/or laryngectomees with a hypotonic pharyngoesophageal (PE) segment by means of a pneumatic artificial source of voice incorporated in a regular tracheoesophageal (TE) shunt valve. STUDY DESIGN: Experimental, randomized, crossover trial. METHODS: The new sound source consists of a single silicone lip, which performs an oscillatory movement driven by expired pulmonary air flowing along the outward-striking lip through the TE shunt valve. A prototype of this pneumatic sound source is evaluated in vitro and in six laryngectomees. In vivo evaluation includes speech rate, maximal phonation time, perceptual voice evaluation of read-aloud prose by an expert listener, speech intelligibility measurements with 12 listeners, and self-assessment by the patients. Moreover, extensive acoustical and aerodynamic in vivo registrations are performed using a newly developed data acquisition system. RESULTS: The current prototype seems beneficial in female laryngectomees with a hypotonic PE segment only. For them the sound-producing voice prosthesis improves voice quality and increases the average pitch of voice, without decreasing intelligibility or necessitating other pressure and airflow rates than regular TE shunt speech. Pitch regulation of this prosthetic voice is possible, yet limited. CONCLUSIONS: The mechanism is feasible and does not result in unacceptable airflow resistance. For this new mechanism of alaryngeal voice to become an established technique for postlaryngectomy voice restoration, a voice suitably pitched for male laryngectomees has to be generated and a large part of the melodic and dynamic range of the sound source has to be attainable within physiological airflow rates.

Aged↗
PubMed2006

An alternate line erasure and readout (ALER) method for implementing slot-scan imaging technique with a flat-panel detector--initial experiences.

This paper describes and demonstrates an electronic collimation method, referred to as the alternate line erasure and readout (ALER) technique, for implementing slot-scan digital radiography technique with an amorphous silicon (a-Si) thin-film transistor (TFT) array based flat-panel detector. An amorphus selenium (a-Se) flat-panel detector was modified to implement the ALER technique for slot-scan imaging. A stepping-motor driven fore-collimator was mounted in front of an X-ray tube to generate a scanning X-ray fan beam. The scanning speed and magnification were adjusted to synchronize the fan beam motion with the image line readout rate. The image lines on the leading and trailing edges of the fan beam were tracked and alternately reset and read out, respectively. The former operation resulted in the erasure of the scatter signals accumulated in the leading edge image line prior to the arrival of the fan beam. The latter operation resulted in the acquisition of fan beam exposure data integrated in the trailing edge image line right after the fan beam passed. To demonstrate the scatter rejection capability of this technique, an anthropomorphic chest phantom was placed in PA position and scanned at a speed of 576 lines (8.0 cm)/s at 117 kVp and 32 mA. A tungsten bar is placed at the entrance side of the chest phantom to measure the scatter-to-primary ratio (SPR), scatter reduction factor (SRF), and contrast-to-noise ratio degradation factor (CNRDF) in the slot-scan images to evaluate the effectiveness of scatter rejection and the resultant improvement of image quality. SPR and CNRDF in the open-field images were also measured and used as the reference for comparison. A scatter reduction by 86.4 to 95.4% across lower lung and heart regions has been observed with slot-scan imaging. The CNRs have been found to be improved by a factor of 2 in the mediastinum areas over the open-field image as well.

Algorithms↗
PubMed1996

X-ray imaging with amorphous selenium: optimal spectra for digital mammography.

The optimum x-ray spectra for acquisition of digital mammographic images using an amorphous selenium (a-Se) photoconductor are investigated. The recorded images consist of latent charge distributions on the surface of an a-Se plate, which are then read out using two methods, laser discharge, or flat panel recharge. The investigation is based on a model of the breast previously developed for a phosphor-based digital readout system, and has been extended to include the effects specific to the use of photoconductors. The effects of plate thickness, x-ray scatter, readout noise, dose, and the kind of breast tissue on the nature of the optimum spectrum are explored for the two readout methods. The results indicate that use of a kilovoltage setting in the current mammographic range, and a molybdenum target spectrum is appropriate for digital readout of a-Se detectors. This conclusion contrasts with the appreciably higher kilovoltages traditionally used with the xerographic (toner) readout of latent charge images on a-Se.

Biophysical Phenomena↗
PubMed1998

A comparison of seven visual fatigue assessment techniques in three data-acquisition VDT tasks.

We compared 7 methods of measuring visual fatigue--accommodation power, visual acuity, pupil diameter, critical fusion frequency (CFF), eye movement velocity, subjective rating of visual fatigue, and task performance--for their sensitivity to visual load. In the experiment, 10 participants performed a monitoring task at 2 viewing distances, read articles under 2 levels of screen contrast, and tracked visual targets at 2 different speeds. The same measurement techniques, excluding pupil diameter and eye movement velocity, were compared by extending the task time from 20 to 60 min with the same VDT tasks to test for possible improvement in sensitivity. The results indicated that sensitivities of accommodation power, visual acuity, and CFF were greatly improved by a longer task period, but these 3 measurement techniques did not distinguish among tasks. Pupil diameter, eye movement velocity, and subjective rating of visual fatigue were sensitive in differentiating tracking from reading and monitoring tasks. Eye movement velocity and subjective rating were sensitive to the changes in target velocity of the tracking task. Although task performance was not directly comparable to other measurement techniques, it helped to ensure that participants maintained the same performance level by devoting more resources to the high-load conditions. Actual or potential applications of this research include using some of these assessment techniques for the design of adaptive displays.

Accommodation, Ocular↗
PubMed1983

Comprehension of English syntax by profoundly deaf children.

Seventy-nine profoundly deaf 8 to 12-year-olds were tested for comprehension of spoken, written and signed (Paget-Gorman Sign System, PGSS) English grammatical contrasts. Understanding of spoken language was below the 4-year-old level, with few deaf children understanding enough vocabulary to attempt the test. On written and signed forms, many children responded to content words with little understanding of grammar. Others would interpret word order sequentially, producing characteristic errors. PGSS can provide a viable communication channel and does not hinder oral or written language acquisition, but it does not overcome the grammatical problems of deaf children.

Child↗
PubMed2002

Word naming times and psycholinguistic norms for Italian nouns.

The present study describes normative measures for 626 Italian simple nouns. The database (LEXVAR.XLS) is freely available for down-loading on the Web site http://wwwistc.ip.rm.cnr.it/materia/database/. For each of the 626 nouns, values for the following variables are reported: age of acquisition, familiarity, imageability, concreteness, adult written frequency, child written frequency, adult spoken frequency, number of orthographic neighbors, mean bigram frequency, length in syllables, and length in letters. A classification of lexical stress and of the type of word-initial phoneme is also provided. The intercorrelations among the variables, a factor analysis, and the effects of variables and of the extracted factors on word naming are reported. Naming latencies were affected primarily by a factor including word length and neighborhood size and by a word frequency factor. Neither a semantic factor including imageability, concreteness, and age of acquisition nor a factor defined by mean bigram frequency had significant effects on pronunciation times. These results hold for a language with shallow orthography, like Italian, for which lexical nonsemantic properties have been shown to affect reading aloud. These norms are useful in a variety of research areas involving the manipulation and control of stimulus attributes.

Databases as Topic↗
PubMed1998

Replication and integration of a Vibrio cholerae cryptic plasmid linked to the CTX prophage.

We identified a 4.7kb cryptic plasmid in all ctxAB+ Vibrio cholerae strains we tested. An isolate of the V. cholerae classical biotype strain 0395 that harbours the cryptic plasmid at high copy number was found. Hybridization analysis demonstrated that sequences highly related or identical to this plasmid exist in all toxigenic strains of V. cholerae but were notably absent in all non-toxigenic environmental isolates that lacked the genes for toxin-co-regulated pili and the filamentous CTX prophage. Accordingly, we have named the cryptic plasmid pTLC for toxin-linked cryptic. The complete nucleotide sequence of pTLC from the high-copy-number isolate was determined. The largest open reading frame in the plasmid is predicted to encode a protein similar to the replication initiation protein (pII) of Escherichia coli F-specific filamentous phages. The nucleotide sequence of pTLC also facilitated the structural characterization of the DNA homologous to pTLC in other strains of V. cholerae. pTLC-related DNA exists in these strains as both low-copy-number, covalently closed circular DNA and tandemly duplicated, chromosomally integrated DNA. Remarkably, the chromosomally integrated form of pTLC is adjacent to the CTX prophage. The strain distribution, chromosomal location and DNA sequence of pTLC suggests that it may be a genetic element that plays some role in the biology of CTXphi, perhaps facilitating either its acquisition or its replication.

Amino Acid Sequence↗