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Background: Traditional radiology education for medical students predominantly uses textbooks, PowerPoint files, and hard-copy radiographic images, which often lack student interaction. PACS (Picture Archiving and Communication System) is a crucial tool for radiologists in viewing and reporting images, but its use in medical student training remains limited. Objective: This study investigates the effectiveness of using PACS (Picture Archiving and Communication System) for teaching radiology to undergraduate medical students compared to traditional methods. Methods: Fifty-three medical students were divided into a control group (25 students) receiving traditional slide-based training and an intervention group (28 students) using PACS software to view complete patient images. Pre- and post-course tests and satisfaction surveys were conducted for both groups, along with self-evaluation by the intervention group. The validity and reliability of the assessment tools were confirmed through expert review and pilot testing. Results: No significant difference was found between the control and intervention groups regarding, gender, age, and GPA. Final multiple-choice test scores were similar (intervention: 10.89 ± 2.9; control: 10.76 ± 3.5; p = 0.883). However, the intervention group demonstrated significantly higher improvement in the short answer test for image interpretation (intervention: 8.8 ± 2.28; control: 5.35 ± 2.39; p = 0.001). Satisfaction with the learning method did not significantly differ between groups (intervention: 36.54 ± 5.87; control: 39.44 ± 7.76; p = 0.129). The intervention group reported high familiarity with PACS capabilities (75%), CT principles (71.4%), interpretation (64.3%), appropriate window selection (75%), and anatomical relationships (85.7%). Conclusion: PACS-based training enhances medical students' diagnostic and analytical skills in radiology. Further research with larger sample sizes and robust assessment methods is recommended to confirm and expand upon theses results [ABSTRACT FROM AUTHOR]

Introduction: A potential overlap in symptoms between post-acute COVID-19 syndrome and post-COVID-19 vaccination syndrome has been noted. We report a paired description of patients presenting with similar manifestations involving the central (CNS) or peripheral nervous system (PNS) following SARS-CoV-2 infection or vaccination, suggesting that both may have triggered similar immune-mediated neurological disorders in the presence of anti-idiotype antibodies directed against the ACE2 protein. Patients and methods: Four patients exhibited overlapping neurological manifestations following SARS-CoV-2 infection or vaccination: radiculitis, Guillain -- Barré syndrome, and MRI-negative myelitis, respectively, sharing positivity for anti-ACE2 antibodies. Autoantibodies against AQP-4, MOG, GlyR, GAD, and amphiphysin, onconeural antibodies for CNS syndromes, and anti-ganglioside antibodies for PNS syndromes tested negative in all patients. Discussion: Anti-idiotype antibodies against ACE2 have been detected in patients who recovered from COVID-19 infection, and it has been hypothesized that such antibodies may mediate adverse events following SARS-CoV-2 infection or vaccination, resulting in the activation of the immune system against cells expressing ACE2, such as neurons. Our data reveal clinically overlapping syndromes triggered by SARS-CoV-2 infection or vaccination, sharing positivity for anti-ACE2 antibodies. Their presence, in the absence of other classic autoimmune markers of CNS or PNS involvement, suggests that they might play an active role in the context of an aberrant immune response. Conclusion: Anti-idiotype antibodies directed against ACE2 may be triggered by both SARS-CoV-2 infection and vaccination, possibly contributing to neurological autoimmune manifestations. Their pathogenic role, however, remains to be demonstrated in large-scale, more structured studies. [ABSTRACT FROM AUTHOR]

The underlying pathogenesis of neurological sequelae in post-COVID-19 patients remains unclear. Here, we used multidimensional spatial immune phenotyping and machine learning methods on brains from initial COVID-19 survivors to identify the biological correlate associated with previous SARS-CoV-2 challenge. Compared to healthy controls, individuals with post-COVID-19 revealed a high percentage of TMEM119+P2RY12+CD68+Iba1+HLA-DR+CD11c+SCAMP2+ microglia assembled in prototypical cellular nodules. In contrast to acute SARS-CoV-2 cases, the frequency of CD8+ parenchymal T cells was reduced, suggesting an immune shift toward innate immune activation that may contribute to neurological alterations in post-COVID-19 patients. [ABSTRACT FROM AUTHOR]

Abstract Background Traditional radiology education for medical students predominantly uses textbooks, PowerPoint files, and hard-copy radiographic images, which often lack student interaction. PACS (Picture Archiving and Communication System) is a crucial tool for radiologists in viewing and reporting images, but its use in medical student training remains limited. Objective This study investigates the effectiveness of using PACS (Picture Archiving and Communication System) for teaching radiology to undergraduate medical students compared to traditional methods. Methods Fifty-three medical students were divided into a control group (25 students) receiving traditional slide-based training and an intervention group (28 students) using PACS software to view complete patient images. Pre- and post-course tests and satisfaction surveys were conducted for both groups, along with self-evaluation by the intervention group. The validity and reliability of the assessment tools were confirmed through expert review and pilot testing. Results No significant difference was found between the control and intervention groups regarding, gender, age, and GPA. Final multiple-choice test scores were similar (intervention: 10.89 ± 2.9; control: 10.76 ± 3.5; p = 0.883). However, the intervention group demonstrated significantly higher improvement in the short answer test for image interpretation (intervention: 8.8 ± 2.28; control: 5.35 ± 2.39; p = 0.001). Satisfaction with the learning method did not significantly differ between groups (intervention: 36.54 ± 5.87; control: 39.44 ± 7.76; p = 0.129). The intervention group reported high familiarity with PACS capabilities (75%), CT principles (71.4%), interpretation (64.3%), appropriate window selection (75%), and anatomical relationships (85.7%). Conclusion PACS-based training enhances medical students’ diagnostic and analytical skills in radiology. Further research with larger sample sizes and robust assessment methods is recommended to confirm and expand upon theses results

Background. In recent years, the topic of artificial intelligence (AI) in medicine has been actively discussed not just as a promising solution but the one that can help to improve some results. A significant growth of interest in AI systems all over the world began in the early-mid 2010s, which allowed us to consider the practical application of such systems. The aim of the study is to analyze all the software products (SP) registered in our country as a medical device, including those with AI technology, and to evaluate their applicability in traumatology and orthopedics. Methods. The study included all the SP having a registration certificate of a medical device according to the OKPD2 code 58.29.XX.XXX (services for publishing other software). In the state register of medical devices and organizations (individual entrepreneurs), which is engaged in the production and manufacturing of medical devices, we found 111 registered SP according to the inclusion criterion, as at February 14, 2024. Results. We proposed to categorize all registered SP as follows: systems working with the DICOM standard images (47 pcs, 42%), laboratory data (20 pcs, 18%), microscopy images (7 pcs, 6%), photographic images (5 pcs, 5%), medical information systems (4 pcs, 4%), text data mining systems (3 pcs, 3%), clinical decision support systems (3 pcs, 3%), Holter ECG analysis (2 pcs, 2%), other systems (16 pcs, 14%). Systems applicable to traumatology and orthopedics accounted for 4 pcs (4%). Conclusions. Unfortunately, the real-world applicability of existing solutions in the field of traumatology and orthopedics can be regarded as minimal in comparison with pulmonology, oncology, and laboratory diagnostics, where AI programs have already achieved significant success.

The study examined the loan repayment behavior of beneficiary farmers in Primary Agricultural Cooperative Societies in the State of Haryana, India.

Copyright of Economic & Regional Studies/Studia Ekonomiczne i Regionalne is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Some Polycyclic Aromatic Compounds (PACs) such as nitrated-PAHs (NPAHs), oxygenated-PAHs (OPAHs) and methyl-PAHs (MPAHs) have attracted significant concern due to derivatives have greater potential to be more toxic at low environmental concentrations compared to their PPAHs, particularly in petrochemical industrial region and its surrounding areas surface soils in China. Hence, this article provides an insight into the fate, sources, impacts, and relevance to the external environment of PAH-derivatives based on important emissions source. Moreover, prospective health risk due to their exposure has also been discussed. In this study, the concentration (10–3 ng/g) of Ʃ18PPAHs, Ʃ11MPAHs, Ʃ12NPAHs, and Ʃ4OPAHs in the park were 9.67 ± 1.40, 3.24 ± 0.54, 0.03 ± 0.02 and 0.19 ± 0.65, respectively, which were 4.47, 3.89, 2.04 and 1.17 times than of them surrounding the region. A decreasing trend of the low molecular weight (2-4Rings) contribution to the total amount of PAHs, while the fraction of high molecular weight (5-6Rings) species showed the opposite trend. According to the principal component analysis (PCA) and diagnostic ratios indicated PAHs in the soil samples have mixed sources from industrial activities, solid fuel combustion, and heavy traffic. Despite the high concentrations of MPAHs and OPAHs, the toxicity equivalency quotients (TEQs) of them were not calculated due to the lack of toxic equivalent factors (TEF), thus current studies on PAH and derivatives could have underestimated their exposure risks. The quality and sustainable management of soils are crucial for human health and sustainable development, while there is lack of public awareness of the severe issue of soil pollution. It is recommended to conduct more intensive monitoring and regional assessments in the future. [ABSTRACT FROM AUTHOR]

To investigate the long-term prognostic value of the left atrial (LA) strain indices – peak atrial longitudinal strain (PALS), peak conduit strain (PCS), and peak atrial contractile strain (PACS) in acute coronary syndrome (ACS) patients in relation to all-cause mortality. This retrospective study included ACS patients treated with percutaneous coronary intervention (PCI) and examined with echocardiography. Exclusion criteria were non-sinus rhythm during echocardiography, missing images, and inadequate image quality for 2D speckle tracking analysis of the LA. The endpoint was all-cause death. Multivariable Cox regression which included relevant clinical and echocardiographic measures was utilized to assess the relationship between LA strain parameters and all-cause mortality. A total of 371 were included. Mean age was 64 years and 76% were male. Median time to echocardiography was 2 days following PCI. During a median follow-up of 5.7 years, 83 (22.4%) patients died. Following multivariable analysis, PALS (HR 1.04, 1.01–1.06, p = 0.002, per 1% decrease) and PCS (HR 1.05, 1.01–1.09, p = 0.006, per 1% decrease) remained significantly associated with all-cause mortality. PALS and PCS showed a linear relationship with the outcome whereas PACS was associated with the outcome in a non-linear fashion such that the risk of death increased when PACS < 18.22%. All LA strain parameters remained associated with worse survival rate when restricting analysis to patients with left atrial volume index < 34 ml/m2. Reduced LA function as assessed by PALS, PCS, and PACS were associated with an increased risk of long-term mortality in patients with ACS. [ABSTRACT FROM AUTHOR]

IntroductionA potential overlap in symptoms between post-acute COVID-19 syndrome and post-COVID-19 vaccination syndrome has been noted. We report a paired description of patients presenting with similar manifestations involving the central (CNS) or peripheral nervous system (PNS) following SARS-CoV-2 infection or vaccination, suggesting that both may have triggered similar immune-mediated neurological disorders in the presence of anti-idiotype antibodies directed against the ACE2 protein.Patients and methodsFour patients exhibited overlapping neurological manifestations following SARS-CoV-2 infection or vaccination: radiculitis, Guillain–Barré syndrome, and MRI-negative myelitis, respectively, sharing positivity for anti-ACE2 antibodies. Autoantibodies against AQP-4, MOG, GlyR, GAD, and amphiphysin, onconeural antibodies for CNS syndromes, and anti-ganglioside antibodies for PNS syndromes tested negative in all patients.DiscussionAnti-idiotype antibodies against ACE2 have been detected in patients who recovered from COVID-19 infection, and it has been hypothesized that such antibodies may mediate adverse events following SARS-CoV-2 infection or vaccination, resulting in the activation of the immune system against cells expressing ACE2, such as neurons. Our data reveal clinically overlapping syndromes triggered by SARS-CoV-2 infection or vaccination, sharing positivity for anti-ACE2 antibodies. Their presence, in the absence of other classic autoimmune markers of CNS or PNS involvement, suggests that they might play an active role in the context of an aberrant immune response.ConclusionAnti-idiotype antibodies directed against ACE2 may be triggered by both SARS-CoV-2 infection and vaccination, possibly contributing to neurological autoimmune manifestations. Their pathogenic role, however, remains to be demonstrated in large-scale, more structured studies.

Since 2010, televised campaign ads have proliferated, raising questions about gender differences in the number of ads outside groups air. Assuming incumbent Democratic women and Democratic women with prior office-holding experience run with support from their party and interest groups, we expect Democratic-leaning groups air more favorable ads supporting Democrats in races that include experienced or incumbent Democratic women than they do in races that include experienced or incumbent Democratic men. Conversely, we assume Republican women receive less support from their party and interest groups. We expect outside groups air more favorable ads supporting Republicans in races featuring experienced or incumbent Republican men than races including experienced or incumbent Republican women. Given the potential for backlash to attack ads, we expect Democratic- and Republican-leaning groups air more ads in races including experienced or incumbent male opponents than in races that include experienced or incumbent female opponents. We test these hypotheses by focusing on 2010–2018 U.S. Senate races and combining original data with data from the Wesleyan Media Project, the U.S. Census, and the Cook Political Report. Democratic- and Republican-leaning groups both sponsor significantly fewer ads in races featuring experienced female Democratic candidates compared to races including experienced male Democratic candidates. [ABSTRACT FROM AUTHOR]

• Stratification of groups according to asymptomatic COVID19-survivor status and long-COVID with and without cognitive impairment. • Cortical thickness increase in prefronto-temporal areas, most pronounced in long-COVID subgroup with cognitive impairment. • Elevated levels of IL-10, IFNγ, and sTREM2 in long-COVID patients, especially when suffering from cognitive impairment. As the heterogeneity of symptoms is increasingly recognized among long-COVID patients, it appears highly relevant to study potential pathophysiological differences along the different subtypes. Preliminary evidence suggests distinct alterations in brain structure and systemic inflammatory patterns in specific groups of long-COVID patients. To this end, we analyzed differences in cortical thickness and peripheral immune signature between clinical subgroups based on 3 T-MRI scans and signature inflammatory markers in n = 120 participants comprising healthy never-infected controls (n = 30), healthy COVID-19 survivors (n = 29), and subgroups of long-COVID patients with (n = 26) and without (n = 35) cognitive impairment according to screening with Montreal Cognitive Assessment. Whole-brain comparison of cortical thickness between the 4 groups was conducted by surface-based morphometry. We identified distinct cortical areas showing a progressive increase in cortical thickness across different groups, starting from healthy individuals who had never been infected with COVID-19, followed by healthy COVID-19 survivors, long-COVID patients without cognitive deficits (MoCA ≥ 26), and finally, long-COVID patients exhibiting significant cognitive deficits (MoCA < 26). These findings highlight the continuum of cortical thickness alterations associated with COVID-19, with more pronounced changes observed in individuals experiencing cognitive impairment (p < 0.05, FWE-corrected). Affected cortical regions covered prefrontal and temporal gyri, insula, posterior cingulate, parahippocampal gyrus, and parietal areas. Additionally, we discovered a distinct immunophenotype, with elevated levels of IL-10, IFNγ, and sTREM2 in long-COVID patients, especially in the group suffering from cognitive impairment. We demonstrate lingering cortical and immunological alterations in healthy and impaired subgroups of COVID-19 survivors. This implies a complex underlying pathomechanism in long-COVID and emphasizes the necessity to investigate the whole spectrum of post-COVID biology to determine targeted treatment strategies targeting specific sub-groups. [ABSTRACT FROM AUTHOR]

Protective relays play a fundamental role in power systems, whose functions consist of three parts, namely protection, automation, and control, thus called the PAC altogether. It turns out that the architecture of a PACS (protection, automation, and control system) may exert a direct impact on the reliability of protective relay systems, previous studies of which are often conducted on the assumption that intelligent electronic devices (IEDs) have a constant fault rate with only mission reliability of the systems considered. To obtain a more accurate evaluation of system reliability bearing system maintenance in mind, this article proposes a novel method to appraise the reliability of PACSs with integrated consideration of basic and mission reliability. Firstly, the basic reliability of IEDs is calculated by parts count prediction, which will provide a more precise fault rate of IEDs. Secondly, the reliability of PACSs is analyzed by the reliability diagram and Markov model. By using the parts count prediction method to calculate the failure rate of the device, the steady-state probability rate will be accurate more than 0.0107%. At last, a quantitative criterion is finalized for selecting a suitable architecture easily. [ABSTRACT FROM AUTHOR]

Background: Τhe adherence of p-fimbriated Escherichia coli (E. coli) to urothelial cells leading to recurrent urinary tract infections (rUTIs) may be prevented by proanthocyanidins (PACs) contained in American cranberries. Purpose: The purpose of this clinical trial was to assess the clinical utility of prophylactic use of high-dose PACs daily in women with a history of rUTIs. Materials and methods: 172 adult women with a history of rUTIs, defined as ≥ 2 within a 6-month period or ≥ 3 within a 12-month period were enrolled and randomized in two groups to receive either Cysticlean™ 240 mg or placebo for a 12-month period. Urine samples, vaginal and rectal swabs were collected at initial and quarterly study visits. The primary study endpoints were the number of urinary tract infections (UTIs) and changes in Quality of Life (QoL), assessed by the 36-Item Short Form Survey (SF-36) questionnaire. Results: 160 adult women of median age 40 years old (range 19–82) were finally analyzed in this randomized, placebo-controlled, double-blinded clinical trial. In response to intervention, the number of UTIs was significantly lower (Incidence rate ratio IRR 0.49, p < 0.001) and QoL was slightly improved. The numbers of E. coli isolates detected in vaginal (IRR 0.71, p value < 0.001) and in rectal swabs (IRR 0.87, p value < 0.001) were also significantly decreased. No adverse events were reported. Conclusion: The daily use of Cysticlean™ 240 mg was associated with a reduction of UTIs and a prolongation of UTI-free survival compared to placebo treatment, supporting its use as prophylaxis in this patient population. Trial registration: Clinicaltrials.gov, identifier NCT03032003. [ABSTRACT FROM AUTHOR]

The current understanding of long COVID (LC) is still limited. This review highlights key findings regarding the role of gut microbiota, mitochondria, and the main pathophysiological aspects of LC revealed by clinical studies, related to the complex interplay between infection, intestinal dysbiosis, dysfunctional mitochondria, and systemic inflammation generated in a vicious circle, reflecting the molecular and cellular processes from the "leaky gut" to the "leaky electron transport chain (ETC)" into a quantum leap. The heterogeneity of LC has hindered progress in deciphering all the pathophysiological mechanisms, and therefore, the approach must be multidisciplinary, with a special focus not only on symptomatic management but also on addressing the underlying health problems of the patients. It is imperative to further assess and validate the effects of COVID-19 and LC on the gut microbiome and their relationship to infections with other viral agents or pathogens. Further studies are needed to better understand LC and expand the interdisciplinary points of view that are required to accurately diagnose and effectively treat this heterogeneous condition. Given the ability of SARS-CoV-2 to induce autoimmunity in susceptible patients, they should be monitored for symptoms of autoimmune disease after contracting the viral infection. One question remains open, namely, whether the various vaccines developed to end the pandemic will also induce autoimmunity. Recent data highlighted in this review have revealed that the persistence of SARS-CoV-2 and dysfunctional mitochondria in organs such as the heart and, to a lesser extent, the kidneys, liver, and lymph nodes, long after the organism has been able to clear the virus from the lungs, could be an explanation for LC. [ABSTRACT FROM AUTHOR]

Background: Post-acute COVID-19 syndrome patients complain of sensory alterations, mainly positive symptoms such as paresthesia or neuropathic pain but also decreased tactile sensation. Using the Semmes-Weinstein monofilament test (SWMT), our study aims to confront recently infected SARS-CoV2 subjects with a control group. Methods: This is a cross-sectional, single-centric study. We performed the SWMT (North Coast Medical Inc.) on 30 patients with previous SARS-CoV2 infection (COVID group) and 46 controls (control group). These patients did not present comorbidities or sensory impairment and did not take any medications. The control group tested negative for SARS-CoV2 infection since the COVID-19 pandemic; the COVID group was examined for this study after the resolution of the infection. We tested the threshold of tactile sensation of the tips of the thumb, index, and little finger of each hand, one hand at a time; the dorsum and the hypothenar regions were also tested. Results: Both groups presented the perception of tactile sensation within the reference value. Despite this result, subclinical changes suggestive of the involvement in peripheral sensory nerve function have been identified in the tested sites in the COVID group compared to the control group. The overall mean target force (grams) was higher in the COVID group than in the control group: 27 (7) vs. 19 (10) mg, p < 0.001. Conclusion: Controls and the COVID group infection had normal tactile sensation thresholds. However, the COVID group presented a higher threshold than the control group, suggesting a possible subclinical perception of tactile sensation involvement of A-beta nerve fibers. [ABSTRACT FROM AUTHOR]

Political scientists have repeatedly failed to establish a relationship between the money companies funnel into political campaigns and how members of Congress vote. Notably, studies have mainly examined how campaign contributions affect the voting of their direct recipients. However, considering the partisan divide and intense power struggle between the two major American parties, this paper proposes that the influence of campaign contributions operates at the party level. That means a member of Congress is more likely to side with a firm whose donations favor her party, even if the firm has not given to the member's own campaign. Correspondingly, legislators should be less likely to vote in line with the policy preferences of firms whose donations predominately go to the other party. A quantitative analysis of campaign contributions, corporate policy positions, and roll-call votes in Congress bears out these propositions. While the paper also uncovers a recipient effect, the party effect is more substantial. [ABSTRACT FROM AUTHOR]

In decentralized finance (Defi), market participants are allowed to have the right to manage their own funds as opposed to centralized finance (Cefi) with a central custodian, centralized exchanges (CEX). Most Defi projects provide their own service and simultaneously issue a unique token that can be traded in decentralized exchanges (DEX). However, the values of these tokens have rarely been studied. We confirm that the prices of tokens in the Defi market have a persistent tendency to move together. We also demonstrate that the correlation gradually increased from the Defi market's inception and the price co-movement increased in a bear market, and conversely, decreased in a bull market. Specifically, we find a notable difference in the level of price co-movement between CEX cryptocurrencies and DEX tokens. [ABSTRACT FROM AUTHOR]

Since the start of the COVID-19 pandemic, it has become increasingly clear that the disease can have relevant multisystemic and long-term effects, and several studies have attempted to identify key determinants of the disease course. Here we discuss recent evidence suggesting that, in long COVID patients, combined magnesium and vitamin D deficiencies associate with a higher number of clinical manifestations, as compared to patients with normal levels of both nutrients. We highlight the potential synergistic effects of these deficiencies and propose that future studies should explore a causal link with the risk of developing long COVID. Most importantly, randomized clinical trials are needed to determine if magnesium and vitamin D supplementation can improve long COVID symptoms, providing a safe and affordable support therapy to the benefit of patients and society. [ABSTRACT FROM AUTHOR]

Innovative technologies can improve user usability and satisfaction in computer-based activities in the work environment, including surgeons working in the operating room (OR). A scrubbed surgeon must ask unscrubbed staff to retrieve medical images from a surgical PACS system on a monitor in a hybrid operating room. The study aimed to check users' usability and satisfaction with the designed and developed Ortho_Kinect_OR application, which enables contactless control of access to medical images during surgery. The application also facilitates access to telemedicine applications such as intraoperative telementoring during orthopedic procedures or tele-education. The application's usability was tested by assigning standardized tasks to surgeons for PACS and teleconferencing in the operating room. Hand gestures were recognized and translated to function like mouse buttons. Field tests conducted among orthopedic surgeons showed high usability and user satisfaction. PACS access in the operating room did not distract the orthopedic surgeon during orthopedic surgery procedures. All surgeons completed the tests and tasks without any problems. OR field test results showed high agreement among users and were very satisfactory. Junior surgeons and residents pointed out that people with average computer knowledge could use the application. It has been shown that the contactless system designed and built based on the Kinect sensor available on the shelves meets the requirements of the operating room environment and is easy to use. Touchless controller technology provides the opportunity to increase the use of intraoperative imaging previews and improve the safety of surgical patients by improving sterility and reducing unnecessary staff in the operating room. Using the Ortho_Kinect_OR application and the Kinect sensor, it is possible to provide contactless access to videoconference telementoring and PACS in the operating room without an orthopedic surgeon's unnecessary distraction in the operating room environment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cubana de Ciencias Informáticas is the property of Universidad de las Ciencias Informaticas (UCI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Teleradiology, according to Ministry of Health Regulation No. 20 of 2019, is a diagnostic radiology service that utilizes electronic transmission of images from all radiology modalities, along with supporting data, from Consultation Requesting Health Facilities to Consultation Provider Health Facilities. The goal is to analyze the implementation of teleradiology service policies in healthcare facilities and assess the supporting and inhibiting factors for the implementation of teleradiology service policies in healthcare facilities. The research method used in this study is descriptive qualitative. A total of 12 informants were interviewed, including individuals from Batin Mangunang Hospital, PON Hospital, and X Tambun Bekasi Hospital. Purposive and snowball techniques were employed to identify informants in this study, along with the use of data triangulation and ATLAS.ti software. The results of the implementation of teleradiology service policies at Batin Mangunang Hospital currently involve the use of the WhatsApp application for teleradiology services. Previously, in 2016, the hospital had used applications from the Ministry of Health, but this only lasted for a few months. The inhibiting factor is that the implementers do not fully understand and implement teleradiology services, mainly because they did not continue to provide funding sources and infrastructure facilities. The implementation of teleradiology service policies at PON Hospital for teleradiology services previously used teleradiology from the Ministry of Health and only ran for a few months. Currently, they use Picture Archiving And Communication System (PACS) facilities. The supporting factor is that the implementors understand teleradiology service policies related to DICOM usage standards. [ABSTRACT FROM AUTHOR]

The study outlines some of the limitations in four selected security components in the medical imaging standard, Digital Imaging and Communications in Medicine (DICOM), and proposes a set of actions to be taken to resolve the specified issues. The critical requirement of DICOM servers for smooth hospital functionality is discussed while stressing areas such as telemedicine. Furthermore, reviews of past research have been done shedding the spotlight on existing vulnerabilities in the DICOM standard; the root cause of the vulnerabilities while demonstrating proofs of concept to better understand how to resolve the security issues. The method incorporated in presenting the fixes to the issues is discussed in technical terms, for each security component of DICOM. [ABSTRACT FROM AUTHOR]

Pathological Anatomy is moving toward computerizing processes mainly due to the extensive digitization of histology slides that resulted in the availability of many Whole Slide Images (WSIs). Their use is essential, especially in cancer diagnosis and research, and raises the pressing need for increasingly influential information archiving and retrieval systems. Picture Archiving and Communication Systems (PACSs) represent an actual possibility to archive and organize this growing amount of data. The design and implementation of a robust and accurate methodology for querying them in the pathology domain using a novel approach are mandatory. In particular, the Content-Based Image Retrieval (CBIR) methodology can be involved in the PACSs using a query-by-example task. In this context, one of many crucial points of CBIR concerns the representation of images as feature vectors, and the accuracy of retrieval mainly depends on feature extraction. Thus, our study explored different representations of WSI patches by features extracted from pre-trained Convolution Neural Networks (CNNs). In order to perform a helpful comparison, we evaluated features extracted from different layers of state-of-the-art CNNs using different dimensionality reduction techniques. Furthermore, we provided a qualitative analysis of obtained results. The evaluation showed encouraging results for our proposed framework. [ABSTRACT FROM AUTHOR]

The objective of the study was to identify the constraints in credit accessibility from Primary Agricultural Cooperative Societies in Haryana State, India.

Tomi Nissinen,1,2 Reijo Sund,3 Sanna Suoranta,2,4 Heikki Kröger,3,5 Sami P Väänänen1,2 1Department of Technical Physics, University of Eastern Finland, Kuopio, Finland; 2Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; 3Kuopio Musculoskeletal Research Unit, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; 4Division of Clinical Radiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; 5Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, FinlandCorrespondence: Tomi Nissinen, Department of Technical Physics, University of Eastern Finland, PO Box1627, Kuopio, 70211, Finland, Tel +358 40 756 9303, Email tomi.nissinen@uef.fiPurpose: To evaluate how comprehensively wrist fractures can be tracked from the national medical registers, and to propose a method for complementing the register data using time stamps of wrist radiography visits recorded in the radiological image archive.Patients and Methods: For the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort of 14220 post-menopausal women, we analysed the data from the Care Register for Health Care, Register for Primary Health Care Visits, self-reports, radiological image archive PACS, and patient records to identify the wrist fractures occurred between 2011 and 2021. Using this gold standard of fractures, we validated the coverage of the registers and image archive and created algorithms to automatically identify fracture events from the registers and/or metadata of wrist radiography visits.Results: We show that wrist fractures cannot be comprehensively identified based on national registers. To remedy this, our proposed method of combining register and image archive data can lift the coverage from 81% to 94% and reduce false discoveries from 6% to 2%.Conclusion: The proposed method offers a more reliable way of gathering fracture information. Comprehensive fracture identification is essential in many research settings, such as incidence statistics, prevention studies, and risk assessment models.Keywords: medical register, image archive, picture archiving and communication system, PACS

Medical imaging plays a crucial role in modern healthcare, providing essential information for accurate diagnosis and treatment planning. The Digital Imaging and Communications in Medicine (DICOM) standard has revolutionized the storage, transmission, and sharing of medical images and related data. Despite its advantages, implementation and deployment of the DICOM protocol often suffers from incomplete understanding, leading to vulnerabilities within the healthcare ecosystem. This research paper presents an implementation of DICOM communication and the development of a practical demonstration for simulation purposes The simulation can be used for conducting cybersecurity tests in the context of DICOM communication. Overall, the simulation provides a digital environment that can help in retrieving valuable insights into the practical aspects of DICOM communication and PACS integration, serving as a valuable resource for medical imaging professionals, researchers, and developers. These research results provide practical insights, and the DICOM simulation can be used in realistic contexts to showcase a variety of security scenarios. [ABSTRACT FROM AUTHOR]

This study presents indoor and outdoor levels of airborne fine particles (PM2.5), particle bound polycyclic aromatic compounds (PACs) including parent-, alkylated-, nitro-, and oxy-PAHs. Week-long simultaneous measurements were conducted inside and outside 15 occupied homes in southern Sweden during wintertime. The homes were single-family houses or apartments located in urban, semi-urban, and rural areas. The PM2.5 and PACs levels were low compared to studies worldwide. There was great variation in concentrations between sites, which likely is due to proximity to road and traffic intensity. The lower concentrations of nitro and oxy-PAHs compared to parent PAHs in this study, compared to other studies, could possibly be due to lower atmospheric photochemical formation outdoors because the cold climate. This assumption could not be confirmed and need to be further tested. The results point to that particle PAC levels found inside arise primarily from outdoor. This correlation was not as clear for PM2.5. The results of a comparison between residences before and after energy renovation did not indicate an improvement in indoor air regarding PACs. To understand exposure and assess risks it is important to measure wide range of PACs both in gas and particle phase. [ABSTRACT FROM AUTHOR]

The objective of the study was to identify the constraints in credit accessibility from Primary Agricultural Cooperative Societies in Haryana State, India. The primary data were used for achieving the objective of the study. The primary data were collected in the second quarter of 2022 by employing the schedule. The multistage purposive cum proportionate random sampling techniques were adopted to select a sample of 540 respondents. The percentage was used for data analysis. The constraints in accessing credit are identified faced by beneficiary farmers and nonbeneficiary farmers. The major constraints faced by the beneficiary farmers in accessing credit from PACS are inadequate credit limit (87.40%), short time to repayment of loan (66.29%), high penalty rate (55.92%), and unavailability of medium-term loans (50.00%). While inadequate credit limit (80.00%), no new accounts opened (72.22%) and fear of being a defaulter (47.78%) were the major constraints faced by the non-beneficiary farmers in accessing credit from PACS. The various constraints were identified in accessing credit from PACS. Credit limits should be extended on the basis of the scale of the finance. Medium-term loans need to be increased. [ABSTRACT FROM AUTHOR]

Modern medical imaging techniques, e.g., CT and MRI, can produce many privacy-sensitive images, which are usually stored or transmitted through Picture Archiving and Communication Systems (PACS). To prevent image disclosure, various encryption algorithms for protecting medical images have been introduced, such as chaotic encryption with satisfying security. Considering a practical application, we observe that medical images are usually generated in a batch manner for a particular patient. Yet, existing encryption algorithms are mostly designed for a single image, resulting in low encryption efficiency in a batch setting. Specifically, when encrypting multiple images, a qualified algorithm should be sensitive to any tiny changes of an image, i.e., spreading encryption influence of this change to the whole image set. Besides, parallel encryption naturally adapts to the batching images for speeding up, which should be considered. Thus, we aim at medical scenarios and propose a fast-and-practical cryptosystem by employing chaotic encryption and parallel computing. Our idea builds on a "permutation-substitution" architecture of chaotic encryption. In the permutation stage, the batch images are divided into multiple groups. Next, multi-threads can generate permutation coordinates parallelly in each group for saving time, in which multiple images are shuffled at one go. In the substitution stage, encryption over neighboring images via extended cipher-block-chaining (CBC) mode guarantees desirable diffusion in the whole image set. Our solution not only saves encryption time largely but also strengthens the individual's privacy. The time complexity shows superior efficiency to counterparts, say, speeding up permutation by ∼ 60 % . And the results of security analyses confirm that our cryptosystem can resist various attacks. [ABSTRACT FROM AUTHOR]

BackgroundReproducible approaches are needed to bring AI/ML for medical image analysis closer to the bedside. Investigators wishing to shadow test cross-sectional medical imaging segmentation algorithms on new studies in real-time will benefit from simple tools that integrate PACS with on-premises image processing, allowing visualization of DICOM-compatible segmentation results and volumetric data at the radiology workstation.PurposeIn this work, we develop and release a simple containerized and easily deployable pipeline for shadow testing of segmentation algorithms within the clinical workflow.MethodsOur end-to-end automated pipeline has two major components- 1. A router/listener and anonymizer and an OHIF web viewer backstopped by a DCM4CHEE DICOM query/retrieve archive deployed in the virtual infrastructure of our secure hospital intranet, and 2. An on-premises single GPU workstation host for DICOM/NIfTI conversion steps, and image processing. DICOM images are visualized in OHIF along with their segmentation masks and associated volumetry measurements (in mL) using DICOM SEG and structured report (SR) elements. Since nnU-net has emerged as a widely-used out-of-the-box method for training segmentation models with state-of-the-art performance, feasibility of our pipleine is demonstrated by recording clock times for a traumatic pelvic hematoma nnU-net model.ResultsMean total clock time from PACS send by user to completion of transfer to the DCM4CHEE query/retrieve archive was 5 min 32 s (± SD of 1 min 26 s). This compares favorably to the report turnaround times for whole-body CT exams, which often exceed 30 min, and illustrates feasibility in the clinical setting where quantitative results would be expected prior to report sign-off. Inference times accounted for most of the total clock time, ranging from 2 min 41 s to 8 min 27 s. All other virtual and on-premises host steps combined ranged from a minimum of 34 s to a maximum of 48 s.ConclusionThe software worked seamlessly with an existing PACS and could be used for deployment of DL models within the radiology workflow for prospective testing on newly scanned patients. Once configured, the pipeline is executed through one command using a single shell script. The code is made publicly available through an open-source license at “https://github.com/vastc/,” and includes a readme file providing pipeline config instructions for host names, series filter, other parameters, and citation instructions for this work.

Dermatology is one of the medical fields outside the radiology service that uses image acquisition and analysis in its daily medical practice, mostly through digital dermoscopy imaging modality. The acquisition, transfer, and storage of dermatology images has become an important issue to resolve. We aimed to describe our experience in integrating dermoscopic images into PACS using DICOM as a guide for the health informatics and dermatology community. During 2022 we integrated the video dermoscopy equipment through a strategic plan with an 8-step procedure. We used the DICOM standard with Modality Worklist and Storage commitment. Three systems were involved (video dermoscopy software, the EHR, and PACS). We identified critical steps and faced many challenges, such as the lack of a final model of DICOM standard for dermatology images. [ABSTRACT FROM AUTHOR]

ObjectivesTo determine if radiomics analysis based on preoperative computed tomography (CT) can predict early postoperative recurrence of giant cell tumor of bone (GCTB) in the spine.MethodsIn a retrospective review, 62 patients with pathologically confirmed spinal GCTB from March 2008 to February 2018, with a minimum follow-up of 24 months, were identified. The mean follow-up was 73.7 months (range, 28.7-152.1 months). The clinical information including age, gender, lesion location, multi-vertebral involvement, and surgical methods, were obtained. CT images acquired before the operation were retrieved for radiomics analysis. For each case, the tumor regions of interest (ROI) was manually outlined, and a total of 107 radiomics features were extracted. The features were selected via the sequential selection process by using the support vector machine (SVM), then used to construct classification models with Gaussian kernels. The differentiation between recurrence and non-recurrence groups was evaluated by ROC analysis, using 10-fold cross-validation.ResultsOf the 62 patients, 17 had recurrence with a recurrence rate of 27.4%. None of the clinical information was significantly different between the two groups. Patients receiving curettage had a higher recurrence rate (6/16 = 37.5%) compared to patients receiving TES (6/26 = 23.1%) or intralesional spondylectomy (5/20 = 25%). The final radiomics model was built using 10 selected features, which achieved an accuracy of 89% with AUC of 0.78.ConclusionsThe radiomics model developed based on pre-operative CT can achieve a high accuracy to predict the recurrence of spinal GCTB. Patients who have a high risk of early recurrence should be treated more aggressively to minimize recurrence.

Protective relays play a fundamental role in power systems, whose functions consist of three parts, namely protection, automation, and control, thus called the PAC altogether. It turns out that the architecture of a PACS (protection, automation, and control system) may exert a direct impact on the reliability of protective relay systems, previous studies of which are often conducted on the assumption that intelligent electronic devices (IEDs) have a constant fault rate with only mission reliability of the systems considered. To obtain a more accurate evaluation of system reliability bearing system maintenance in mind, this article proposes a novel method to appraise the reliability of PACSs with integrated consideration of basic and mission reliability. Firstly, the basic reliability of IEDs is calculated by parts count prediction, which will provide a more precise fault rate of IEDs. Secondly, the reliability of PACSs is analyzed by the reliability diagram and Markov model. By using the parts count prediction method to calculate the failure rate of the device, the steady-state probability rate will be accurate more than 0.0107%. At last, a quantitative criterion is finalized for selecting a suitable architecture easily.