A Filmless Radiology Department in a Full Digital Regional Hospital: Quantitative Evaluation of the Increased Quality and Efficiency

Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went “filmless” in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a “high level” and a “detailed” business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must

SCATTERING FROM PRISMATIC SURFACES

Les cylindres de forme prismatique peuvent être représentés par un assemblage de bandes rectilignes. A partir de la connaissance de la matrice de transition d'une bande élémentaire, la théorie de la diffusion multiple permet le calcul de la diffraction par un cylindre prismatique. On traite d'abord le cas d'un cylindre dont la frontière est fermée (cylindre à section carrée) et l'on compare les résultats à une résolution directe par équation intégrale de Helmholtz. On présente ensuite des résultats théoriques et expérimentaux sur des réflecteurs paraboliques formés de tubes compliants.Prismatic cylinders can be represented by an assembly of strips. The transition matrix of an individual strip being known, the scattering from a prismatic cylinder can be computed using the multiple scattering theory. Cases where the boundary of the cylinder is closed (square cylinder) are first presented and the results are compared to a direct solution using the Helmholtz integral equation. Then, theoretical and experimental results on parabolic reflectors formed with compliant tubes are given

Optimal gestational age at delivery for congenital diaphragmatic hernia.

OBJECTIVE: To evaluate the neonatal morbidity and mortality of babies with isolated congenital diaphragmatic hernia (CDH) according to gestational age at delivery. METHODS: We conducted a retrospective study in the University Hospitals of Antoine Béclère-Bicêtre and Leuven between January 1, 2010 and December 31, 2018. Isolated left-sided CDH cases were included. The Kaplan-Meier method was used to calculate cumulative survival at 28 days according to gestational age at delivery. The association between gestational age at delivery, as a continuous variable, and survival at 28 days was modeled using a fractional polynomial. Adjustment for position of the liver, management center, and mode of delivery was performed. The association was studied according to the severity of the CDH, defined by the o/e LHR, categorized in three classes: below 25%, between 25 and 45%, above 45%. RESULTS: We included 213 fetuses with isolated left-sided CDH, with a median gestational age at delivery of 38+2 WG [IQR: 37+0 -39+6 ]. Survival rates at 28 days and 6 months were 66.7% (142/213) and 64.3% (137/213), respectively. Kaplan-Meier curves showed higher survival up to 28 days for babies born between 37+0 and 39+0 WG than for those born after 39+0 WG (log-rank test, p<.001). In the subgroup of moderate forms, the survival rates at 28 days and 6 months were significantly higher for newborns delivered between 37+0 and 39+0 WG, compared to newborns delivered after 39+0 WG: 81.5% vs 61.5% (p=0.03). In this subgroup, 28-day survival significantly increased with advancing gestational age at birth until 38-39 WG (p=0.005) and significantly decreased from 39 WG. CONCLUSIONS: Delivery between 37+0 and 39+0 WG is associated with a higher survival rate at 28 days of life for moderate forms independently of intrathoracic liver, management center, and mode of delivery. This article is protected by copyright. All rights reserved.status: Published onlin

Corrigendum to "Expert management of congenital portosystemic shunts and their complications" [JHEP Reports 6 (2024)].

[This corrects the article DOI: 10.1016/j.jhepr.2023.100933.]