PACS is only in the Beginning of Being Used as Clinical Research Tools

The PACS concept was introduced in 19821, after more than twenty years of technical advancements;it has become an integrated component of today’s healthcare delivery system.PACS is now in the beginning of being used as a clinical research tool.2Among others,this paper describes four PACS-based research activities: medical imaging informatics, medical imaging Data Grid, combining PACS and teleradiology operations, and computer-assisted detection and diagnosis(CAD). In medical imaging informatics (MII), we first introduce its infrastructure and the five layer of software architecture. The description of a new MII training program supported by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), National institutes of Health (NIH), USA is followed. The training program accepts candidates with medical and or biomedical engineering background. The goal is to cross-train multi-disciplinary individuals to be future leaders in the field of medical imaging informatics. Grid computing is a new paradigm combining computing, networking, information and storage technologies to advance the conventional distributing computing to the next level. One resource in Grid Computing is the Data Grid. We describe the use of Data Grid concept in medical imaging applications based on the five layer of the open source Globus toolkit 4 (GT4). Three examples are given. First, a Data Grid specifically designed for PACS image backup and disaster recovery developed at the Imaging and Informatics Laboratory (IPI), USC is illustrated. The second application is for image-based clinical trials using three international sites at IPI, USC, USA; the PACS Lab, Hong Kong Polytechnic University, Hong Kong; and the Heart Institute, Sao Paulo, Brazil In combining PACS and teleradiology operations , a Data Grid model is proposed to combinetwo disjoint ,and yet ,daily used PACS and telera-diology operations as one integrated system in a large-scale enterprise level . Methods of combining workflows ,storage ,and reading of PACS and teleradiology i mages are detailed .The last work-in-progress research is the in-tegration of CAD results with daily PACS workflow. The integration methods are based on DICOMScreen Captured and Structured Report Stan-dards ; and several IHE (Integrating the Healthcare Enterprise) Workflow Profiles .

Identifying Driver Genes Mutations with Clinical Significance in Thyroid Cancer

Advances in technology are enabling gene mutations in papillary thyroid carcinoma(PTC)to be analyzed and clinical outcomes,such as recurrence,to be predicted.To date,the most common genetic mutation in PTC is in BRAF kinase(BRAF).However,whether mutations in other genes coincide with those in BRAF remains to be clarified.The aim of this study was to find mutations in other genes that co-exist with mutated BRAF,and to analyze their frequency and clinical relevance in PTC.Clinical and genetic data were collected from 213 PTC patients with a total of 36,572 mutation sites in 735 genes.After matching with genes from PTC entries in a global database(NCBI Gene),69 genes with mutations in coding regions were chosen for further study.Through frequency-based analysis,we identified commonly mutated genes co-existing with mutated BRAF and,using the mutation count correlation matrix(MCCM)method,analyzed their incidence according to age and gender.We designed Chord diagrams to reveal gene relationships concerning age and gender,and found that mutations in ALK,ATM,COL1A1,MSTIR,PRKCA,and WNK1 most commonly coincide with mutated BRAF,followed by APC,AURKA,and AURKB.These findings provide further insight into the genetic profile of PTC.

Recognition and Detection of Diabetic Retinopathy Using Densenet-65 Based Faster-RCNN

Diabetes is a metabolic disorder that results in a retinal complication called diabetic retinopathy(DR)which is one of the four main reasons for sightlessness all over the globe.DR usually has no clear symptoms before the onset,thus making disease identication a challenging task.The healthcare industry may face unfavorable consequences if the gap in identifying DR is not lled with effective automation.Thus,our objective is to develop an automatic and cost-effective method for classifying DR samples.In this work,we present a custom Faster-RCNN technique for the recognition and classication of DR lesions from retinal images.After pre-processing,we generate the annotations of the dataset which is required for model training.Then,introduce DenseNet-65 at the feature extraction level of Faster-RCNN to compute the representative set of key points.Finally,the Faster-RCNN localizes and classies the input sample into ve classes.Rigorous experiments performed on a Kaggle dataset comprising of 88,704 images show that the introduced methodology outperforms with an accuracy of 97.2%.We have compared our technique with state-of-the-art approaches to show its robustness in term of DR localization and classication.Additionally,we performed cross-dataset validation on the Kaggle and APTOS datasets and achieved remarkable results on both training and testing phases.

Methodology in improving antibiotic implementation policies

The basic requirements of antibiotic prescribing are components of methodology; knowledge, logical reasoning, and analysis. Antimicrobial drugs are valuable but limited resources, different from other drugs and they are among the most commonly prescribed drugs all over the world. They are the only drugs which do not intentionally affect the patient. They affect the pathogens which invade the host. The emergence and spread of antibiotic-resistant pathogens are accelerated by heavy antibiotic usage. The effective antimicrobial stewardship and infection control program have been shown to limit the emergence of antimicrobial-resistant bacteria. In this respect, education for antibiotic prescribing could be designed by going through the steps of scientific methodology. A defined leadership and a coordinated multidisciplinary approach are necessary for optimizing the indication, selection, dosing, route of administration, and duration of antimicrobial therapy. In scenarios, knowledge is also as important as experience for critical decision making as is designated. In this setting, the prevalence and resistance mechanisms of antimicrobials, and their interactions with other drugs need to be observed. In this respect, infectious disease service should play an important role in improving antimicrobial use by giving advice on the appropriate use of antimicrobial agents, and implementing evidencebased guidelines.

COVID-19 and thyroid disease: An infodemiological pilot study

BACKGROUND Google Trends searches for symptoms and/or diseases may reflect actual disease epidemiology.Recently,Google Trends searches for coronavirus disease 2019(COVID-19)-associated terms have been linked to the epidemiology of COVID-19.Some studies have linked COVID-19 with thyroid disease.AIM To assess COVID-19 cases per se vs COVID-19-associated Google Trends searches and thyroid-associated Google Trends searches.METHODS We collected data on worldwide weekly Google Trends searches regarding“COVID-19”,“severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)”,“coronavirus”,“smell”,“taste”,“cough”,“thyroid”,“thyroiditis”,and“subacute thyroiditis”for 92 wk and worldwide weekly COVID-19 cases'statistics in the same time period.The study period was split in half(approximately corresponding to the preponderance of different SARS-COV-2 virus variants)and in each time period we performed cross-correlation analysis and mediation analysis.RESULTS Significant positive cross-correlation function values were noted in both time periods.More in detail,COVID-19 cases per se were found to be associated with no lag with Google Trends searches for COVID-19 symptoms in the first time period and in the second time period to lead searches for symptoms,COVID-19 terms,and thyroid terms.COVID-19 cases per se were associated with thyroidrelated searches in both time periods.In the second time period,the effect of“COVID-19”searches on“thyroid”searches was significantly mediated by COVID-19 cases(P=0.048).CONCLUSION Searches for a non-specific symptom or COVID-19 search terms mostly lead Google Trends thyroid-related searches,in the second time period.This time frame/sequence particularly in the second time period(noted by the preponderance of the SARSCOV-2 delta variant)lends some credence to associations of COVID-19 cases per se with(apparent)thyroid disease(via searches for them).

Evidence-based Practice Method of Integrative Chinese and Western Medicine Based on Literature Retrieval through PICO Question and Complementary and Alternative Medicine Topics

An evidence-based practice method according to literature retrieval through PICO （Patients,Intervention,Comparison,Outcome） questions and complementary and alternative medicine （CAM） topics,which can obtain helpful evidence for guiding clinical practice,was introduced with a practical example in this paper.The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question,while searching by CAM topics may provide evidence for Chinese medicine （CM）.Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidencebased practice method for integrative Chinese and Western medicine （ICWM）.However,since the standard in CM evidence hierarchy is still under study,the value of the CAM thematic retrieval method remains very limited.In the future,studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.