Implementation and evaluation of a multifunctional telemedicine system in NTUH

In this article, we proposed a multifunctional telemedicine system supporting both telediagnosis and teleconsultation services. We attempted not only to insure that the implementation of this system satisfied most requirements, but also to evaluate the impact of the system. With regard to system architecture, we designed a unified multimedia database to store all types of data and used two kinds of network (ATM and ISDN) for different possible applications. As for data transmission, the REFRESH and PREFETCH mechanisms were implemented to enhance data transfer efficiency. A total of 1107 consultations employing the telemedicine system were performed during the past 3 years. This technology was used most frequently for radiology consultation (32.7%, n = 362) and ultrasonic examination (19.5%, n = 216). An evaluation of the impact on diagnosis (507 valid cases) indicated that the diagnosis in 80 cases (15.78%) were altered on the basis of second opinions from a medical center; and the number of patients transferred to the medical center was reduced from 24 (4.7%) to eight cases. Most of the rural-site physicians (97%) thought that they did benefit from specialists' experience and knowledge via the telemedicine system. Based on 431 valid questionnaires, the number of the patients with confidence in the telemedicine system at their local healthcare center increased from 72.6% to 87.5%. Overall, more than 90% of patients and physicians believed that the system was valuable and provided satisfactory services.     

Association of Opioid Use Disorder With 2016 Presidential Voting Patterns: Cross-sectional Study in New York State at Census Tract Level

BackgroundOpioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD).ObjectiveWe aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State.MethodsThis cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation.ResultsSeveral areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (P<.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors.ConclusionsAt the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic.     

口腔链球丙酮酸氧化酶的克隆和序列分析

目的 阐明血链球菌产生过氧化氢及其调节的分子机理。方法 根据已知的肺炎链球菌丙酮酸氧化酶基因（spxB）序列设计PCR引物,扩增血链球菌ATCC10557的丙酮酸氧化酶基因,以pUC18及M13mp18、M13mp19为载体进行克隆和亚克隆,并进行序列分析。结果 成功地从血链球菌ATCC10557扩增出丙酮酸氧化酶基因,获得该基因的全部序列（1788bp),具有完整的开放读框,能编码591个氨基酸的多肽。结论 血链球菌丙酮酸氧化酶基因的克隆和序列分析,为进一步研究调节血链球菌产生过氧化氢的分子机理打下了基础。     

Safety and efficacy of ultrasound-guided low-pressure perfusion mini-percutaneous nephrolithotomy in children aged 1–7 years: a retrospective observational study

International Urology and Nephrology - This article analyzed the safety and efficacy of ultrasound-guided mini-percutaneous nephrolithotomy (MPCNL) with low-pressure perfusion for the treatment of...     

细胞膜和细胞骨架在细胞受力过程中的保护作用

力作用下的细胞保护反应是细胞机械力转导研究中的一个重要领域。细胞膜维持细胞内离子平衡，并通过牵张活化离子通道和机械力敏感酶调控力诱导的细胞骨架重排对细胞骨架产生保护作用；而细胞骨架给细胞膜提供结构支撑、加强受力部分的皮层网络结构、调控机械力敏感离子通道，在受力破坏后的细胞膜重新封闭的过程中也发挥着潜在的作用。就细胞膜和细胞骨架在细胞受力过程中的保护作用进行综述。     

Interior Reconstruction from Truncated Projection Data in Cone-beam Computed Tomography

Journal of Digital Imaging - The interior reconstruction of completely truncated projection data is a frontier research hotspot in cone-beam computed tomography (CBCT) application. It is difficult...     

A Novel Deep Learning Model Based on Multi-Scale and Multi-View for Detection of Pulmonary Nodules

Journal of Digital Imaging - Lung cancer manifests as pulmonary nodules in the early stage. Thus, the early and accurate detection of these nodules is crucial for improving the survival rate of...     

Optimization of fast acquisition methods for whole-brain relative cerebral blood volume (rCBV) mapping with susceptibility contrast agents

Fast gradient-echo magnetic resonance scan techniques with spiral and rectilinear (echoplanar) k-space trajectories were optimized to perform bolus-tracking studies of human brain. Cerebral hemodynamics were studied with full brain coverage, a spatial resolution of 4 mm, and a temporal resolution of 2 seconds. The sensitivity of the techniques to detect image signal-intensity changes during the first pass of the contrast agent was studied at a range of TEs using dedicated experiments. For single-shot versions of spiral scanning and echoplanar imaging techniques with a 0.1-mmol/kg injection of gadolinium diethylenetriamine pentaacetic acid using a mechanical injector at 10 mL/sec under 1.5 T, the maximum sensitivity was obtained at TEs between 35 and 45 msec. At TEs less than 35 msec, signal-intensity artifacts were observed in the images. Analysis of the point-spread function revealed that susceptibility changes induced by the contrast agent can result in signal shifts to neighboring voxels. These artifacts are attributed to susceptibility-related signal changes during the acquisition window.     

Transforming Growth Factor-β2 mRNA Level in Unloaded Bone Analyzed by Quantitative In Situ Hybridization

The effects of tail suspension hypokinesia on the gene expression for TGF-β₂ at different sites within bone were evaluated. TGF-β₂ mRNA signal levels were determined quantitatively by an image analysis system. The osteopenia induced by tail suspension was verified by histomorphometry. In the periosteum of nonsuspended control rats, TGF-β₂ mRNA was highly expressed in the preosteoblasts and osteoblast-rich cambial layers; very little signal was present within the middle and outer fibroblastic layers. Gene expression was significantly reduced in suspended rats, and this was evident both in terms of the number of silver grains in unit area or length of tissue and in each osteoblast and preosteoblast. Hypokinesia also reduced the expression of TGF-β₂ mRNA level in cortical and trabecular bone osteocytes, but did not adversely affect the mRNA level in chondrocytes in growth plate. The results affirm the site-specific response of TGF-β₂ gene expression in rats, and suggest that the cortical and trabecular bone osteopenia associated with hypokinesia in rats may be associated with a deficit in osteoblastic and osteocytic TGF-β₂ level. Received: 6 February 1998 / Accepted: 10 November 1998