The Radiology Virtual Reading Room: During and Beyond the COVID-19 Pandemic

The COVID-19 pandemic has disrupted the radiology reading room with a potentially lasting impact. This disruption could introduce the risk of obviating the need for the reading room, which would be detrimental to many of the roles of radiology that occur in and around the reading room. This disruption could also create the opportunity for accelerated evolution of the reading room to meet the strategic needs of radiology and health care through thoughtful re-design of the virtual reading room. In this article, we overview the impact of the COVID-19 pandemic on radiology in our institution and across the country, specifically on the dynamics of the radiology reading room. We introduce the concept of the virtual reading room, which is a redesigned alternative to the physical reading room that can serve the diverse needs of radiology and healthcare during and beyond the pandemic.     

Analysis of qualitative data from the investigation study in pregnancy of the ASSIST Version 3.0 (the Alcohol,Smoking and Substance Involvement Screening Test)

Objectiveto utilise qualitative data from investigation of the screening tool ASSIST Version 3.0 with pregnant women to help determine its appropriateness for this cohort, thus informing potential innovations to enhance the questionnaire׳s utility.Designpregnant women were co-administered the ASSIST Version 3.0 and three established substance use questionnaires (the T-ACE for alcohol, the Timeline FollowBack for cannabis and the Revised Fagerstrom Questionnaire for tobacco).Settingantenatal clinics and the antenatal ward of the Women׳s and Children׳s Hospital, Adelaide, South Australia.Participants104 pregnant substance-users.Measurements and findingsas well as the quantitative date (reported elsewhere), rich qualitative data documenting participants’ perspectives and experiences in antenatal care were thematically analysed. Women constantly reported friends and family urging them to stop use. Although care providers also advocated cessation or curtailment of use, this advice was reported as unpredictable, with only some providers strongly attuned to such recommendations. Some women voiced suggestions for the appropriate level of provider advice. While pregnancy was often reported as a motivator for changing substance-using behaviour, others reported continued attachment to use which was clearly linked to dependence. Those who reported successful control of use were in contrast to others who were more pragmatic, sceptical in relation to attributable harms, and disinterested in change. There were limited reports of experiences of discrimination directed to pregnant substance users. However, those instances were clearly linked with subsequent lack of honest discussions with care providers, resulting in an absence of appropriate support.Key conclusionscurrent absence of universal screening for substance use has the potential for less than optimal consequences for both mother and baby.Implications for practiceappropriate screening accompanied by honest, non-judgmental dialogue can guide the necessary interventions to achieve better outcomes. The recent development of the more concise and easier to administer ASSIST-LITE was partly informed by this investigation.     

3.0T MR高分辨增强扫描在缺血性脑卒中颅内动脉粥样硬化斑块中的诊断价值

目的探讨3.0 T MR高分辨增强扫描在缺血性脑卒中颅内动脉粥样硬化斑块中的诊断价值。方法选取2017年9月至2019年7月本院收治的60例缺血性脑卒中患者作为研究对象,按照头颅MR平扫(DWI高信号)至高分辨MR检查时间间隔进行分组,时间<4周设为早期组(n=26),时间为4~12周设为中期组(n=20),时间>12周设为晚期组(n=14)。观察比较3组检查结果。结果早期组患者斑块明显强化占比高于中期组和晚期组(P<0.05),轻度强化占比与中期组、晚期组比较差异无统计学意义;中期组轻度强化占比高于晚期组(P<0.05);晚期组无强化占比高于早期组、中期组(P<0.05)。3组斑块强化率随时间间隔的增加程度有所减低,差异有统计学意义(P<0.05)。结论采用3.0 T MR高分辨增强扫描可有效辨别斑块的强化程度与位置。     

Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial

ObjectiveTo investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke.DesignA single-blind, randomized controlled trial.SettingFour hospitals.ParticipantsOutpatients with chronic stroke and mild to moderate motor impairment (N=44).InterventionUHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks.Main Outcome MeasuresFugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment.ResultsThe results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01).ConclusionsBHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.     

Flash平台的数据库应用方法

文章将Flash与Access数据库结合,通过数据库中的数据来实时控制Flash动画的变动,实现Flash与数据库的互动,并将其应用于疾病统计和分析。Flash不能直接与数据库进行通信,以ASP为中间语言,将数据库数据生成XML树格式的数据文件,再利用ActionScript3．0脚本语言解析XML树格式的数据文件,从而实现与数据库的通信。     

南京医科大学第一附属医院RIS＆PACS项目实施要点

南京医科大学第一附属医院的放射信息管理系统（RIS）、医学影像的存储和传输系统（PACS）涵盖了主要的医技诊疗科室,大幅度地改善并优化了整个医院医疗工作的流程,在院内实现了无胶片化的应用模式,从而大大降低了医院的运营成本,提高了医院的运作效率。本文就此介绍并分析了系统安装与调试的成功经验和此类项目在实施过程中应注意的问题。     

Use of coronary anatomy and late enhancement information both derived from contrast-enhanced whole-heart coronary MRA at 3 T for the assessment of ischemic left ventricular dysfunction

Recognizing the etiology of patients with left ventricular dysfunction (LVD) is essential for the risk stratification and treatment selection. We report the case of a 59-year-old man suspected of ischemic LVD with non acute symptoms studied with whole-heart cardiac magnetic resonance imaging including noninvasive coronary angiography and in whom we obtained comprehensive information of both coronary artery stenosis and myocardial tissue damage.