Automated Recognition of Lateral from PA Chest Radiographs: Saving Seconds in a PACS Environment

Images acquired in a two-view digital chest examination are frequently not electronically distinguishable. As a result the lateral and posterioanterio (PA) images are often improperly positioned on a PACS work station. A series of 1998 chest radiographs (999 lateral, 999 PA or AP) were used to develop a neural network classifier. The images were down-sampled to 16 × 16 matrices, and a feed-forward neural network was trained and tested using the leave-one-out method. Using five nodes in the hidden layer, the neural network correctly identified 987 of the 999 test cases (98.8%) (average of six runs). The simple architecture and speed of this technique suggests that it would be a useful addition to PACS work station software. The accumulated time saved by correctly positioning the lateral and PA chest images on the work station monitors in accordance with each radiologists hanging protocols was estimated to be about 1 week of radiologist time per year.     

How communication about risk and role affects women’s decisions about birth after caesarean

Objective

This study investigated how health care provider communication of risk information, and women’s role in decision-making, influenced women’s preferences for mode of birth after a previous caesarean birth.

Video analysis of communication in paediatric consultations in primary care.

BACKGROUND: There is a paucity of research evidence concerning communication in paediatric consultations between GPs, adults, and child patients. AIM: This study was carried out to identify features of the interaction between a doctor, a child patient aged 6-12 years, and their carer in the consultation associated with the child's participation. DESIGN OF STUDY: A qualitative analysis of video recordings of 31 primary care paediatric consultations was undertaken, using strategies from the methodology of conversation analysis. SETTING: Primary care, Suffolk, UK. METHOD: NHS GPs from three primary care trusts (PCTs), were invited to participate in this study. Sixteen volunteers from this sample took part. RESULTS: Analysis of the interaction in the consultations revealed that the children had little involvement. Children participated when invited to do so, and took more time than adults to answer a doctor's question. An adult carer was less likely to answer on behalf of a child, when they were in a position to see that the doctor's gaze was directed at the child, and the doctor addressed the child by name. Adult carers, who had not voiced their own concerns first, were seen to interrupt doctor-child talk. In consultations where the participants sat in a triangular arrangement, all parties being an equal distance apart, triadic talk was noted. CONCLUSION: Child involvement in the primary care consultation is associated with adult carers being able to voice their own concerns early in the consultation, and children being invited to speak with the appropriate recipient design.     

放疗计划系统网络体系的设计与实现

设计并建立一套连接医学影像采集设备(如CTM、RIP、ET等)、放疗计划系统(TPS)及医用加速器等大型设备的的放射治疗网络体系工作环境,更充分地发挥局域网络在放射治疗中的作用。在现有大型医疗设备、TPS及局域网环境的基础上,提出两种具有代表性的TPS网络体系解决方案,并结合各自的特点及实际应用情况对其进行了分析和比较。实践证明,放疗计划系统网络体系的建设推进了放射治疗全过程的数字化、网络化,在更大范围内实现了医疗信息资源的共享,在更大程度上发挥了TPS在肿瘤治疗过程中的作用。     

Regulation of cognitive activity and early communication development in young autistic, mentally retarded, and young normal children

Based on the Piagetian framework, this study examined regulation of cognitive activity and developmental communication profiles and their interrelationship in groups of autistic, mentally retarded, and normal children of comparable overall, verbal, and oculo-manual developmental ages (from 6 to 24 months). Regulation of activity was assessed with both an object permanence test and an original behavior grid, and development of communication skills with the Guidetti-Tourrette scales (French adaptation of the Seibert-Hogan scales). The results showed evidence of certain types of dysregulation of cognitive activity and a general delay in communication ability in autistic children compared to the other two groups. Moreover, although the intensity of some of these disorders decreased in relation to the developmental levels of social interaction and joint attention in normal children, they were related to both high and low levels of development of social interaction only in autistic children. These findings raise the hypothesis of a relationship between a disorder of disengaging from an activity and developmental levels of social interaction noted at two transitory periods of early development (12 and 24 months) only in children with autism. Developmental and neuropsychological interpretations of this particular pattern are proposed.     

Electronic patient-provider communication: will it offset office visits and telephone consultations in primary care?

BACKGROUND AND AIM: Electronic patient-provider communication promises to improve efficiency and effectiveness of clinical care. This study aims to explore whether a secure web-based messaging system is an effective way of providing patient care in general practices. METHOD: We conducted a randomised controlled trail and recruited 200 patients from the waiting area in one primary clinic in Norway. Participants were randomised to either the intervention group, which received access to a secure messaging system, or the control group receiving standard care without such access. Primary outcome measures were number of online consultations, telephone consultations and office visits in the two groups. Data were derived from patient records and collected 1 year prior to (baseline), and 1 year after the intervention. RESULTS: Forty-six percent of the patients who were given access to the messaging system (n=99) used the online communication system on at least one occasion (ranging from 1 to 17 messages per patient per year). A total of 147 electronic messages were sent to six general practitioners during a 1-year trial period. Eleven percent of the messages were to schedule an appointment. In 10% of the messages, the GP was unable to respond adequately and recommended an office visit. The reduction in office visits over time was greater for the intervention group than for the control group (P=0.034). There was however no significant difference in the number of telephone consultations between the groups during the study (P=0.258). CONCLUSION: The use of a secure electronic messaging system reduced the number of office visits at the general practice, but not phone consultations.     

大学生网络交往动机的差异研究

目的探讨大学生网络交往动机,为有效引导大学生认识和参与网络交往,同时为社会、学校、家长制定相应干预措施提供一定的心理依据。方法采用自编的大学生网络交往动机量表和Wrightsman编制的人性哲学量表—独立性分量表,对646名大学生的网络交往动机的差异进行研究。结果电大学生的网络交往动机更倾向于"交往/寻求帮助",而普通全日制高校学生更倾向于"消遣/娱乐";男生更倾向于"交往/寻求帮助"、"消遣/娱乐"、"好奇/追求时尚"、"网络优越感";理科学生更倾向于"交往/寻求帮助"、"网络优越感"、"消遣/娱乐"、"好奇/追求时尚";高年级大学生更倾向于"消遣/娱乐"、"好奇/追求时尚";独立性高的大学生网络交往的动机更倾向于"交往/寻求帮助"、"网络优越感"。结论大学生的网络交往动机因学校、专业、年级、性别、独立性人格特征不同而存在不同程度的差异。     

Avoiding problems in clinical practice after the pill scare

The publications of 1995 and 1996 on the risk of venous thrombosis associated with the use of the combined oral contraceptive pill (COC) suggested that the risks were lower than previous estimates. The debate, which ensued, ensured that the safety of the COC with regard to arterial and venous disease was reassessed. This review details the importance of contraception for public health. It reassesses critically current prescribing practice in the light of the new publications on Factor V Leiden, arterial and venous disease. Methods of communicating information about the COC are assessed, and the difficulties of transmitting complex scientific data to health care professionals and the general public are debated. The importance of attempting to quantify the benefits and risks of the COC and explaining them in the context of other life events is emphasized.     

三磷酸腺苷对人横纹肌肉瘤细胞系诱导分化作用的研究

为了探讨三磷酸腺苷（ＡＴＰ０对人横纹肌肉瘤细胞增殖和分化的影响，用ＡＴＰ作用于人横纹肌肉瘤细胞亚系（ＲＤＬ６）细胞，观察到ＡＴＰ可抑制ＲＤＬ６细胞的增殖，使其生长速度明显减慢，作用第５ｄ时增殖抑制率为８１％，流式光度术检测；观察到ＡＴＰ ＲＤＬ６细胞Ｓ期的细胞数明显增多，说明细胞停滞在Ｓ期，用罗氏黄荧光染料传法实，ＡＴ家恢复ＲＤＬ６细胞间隙加接通讯功能的作用。用 光细胞化学方法观察到经ＡＴＰ处理后     

Commentary: At the Center of Decision Making in Mental Health Services and Interventions Research: Patients,Clinicians, or Relationships?

Wills and Holmes-Rovner (2006) highlight the fact that despite growing interest in the role of patient preferences and shared decision making with clinicians in the general health services research community, relatively little is known about the impact of these preferences and processes on actual decisions, service delivery engagement, or intervention outcomes in the mental health field. This commentary expands on three important points raised in Wills and Holmes-Rovner's article: (a) the need for more and better research on values assessment, (b) contextual factors in the decision-making process, and (c) the measurement of patient preferences regarding their level of involvement in decision making.