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Is Your Website Ethical And Moral?
How do you increase your online visibility?
Talking about morals and ethics can be really tricky, due to its subjective nature. What makes a website development project unacceptable? Let's poke around the gray areas and see what we can find as morally questionable.
Websites of slaughterhouses versus vegan designers and developers: This type of website development project is clearly a dilemma between opposing principles and beliefs. However, this wouldn't budge a carnivorous web developer.
Websites of sex toys: A website development that requires an e-commerce platform for sex toys can easily offend or exploit women designers and developers.
Websites of blood and physical violence: A website development needing blood and gore to be displayed in its pages invites negativity and brutality. Something just isn't right.
Websites of slaves: If you are offered cold hard cash to do a website development project involving human trafficking, you must immediately turn down. Never entertain the slave-trader idea.
Several other questionable website development projects can be exposed if you would just do research. These includes work from home scams, spam mailers, government grant scams, MSN id harvesters, website clones, viruses, adware, religious websites, the list goes on.
The reality that there're a lot of these in the internet means that there are developers who have no trouble in completing such website development projects. They must be thinking of an acceptable reason why they did it, or maybe they simply don't care.
Do you know someone who accepts such website development projects? Do you have problems with your website's morality? Worry not, because there is a solution. WebFocus Solutions, Inc. When you see a website with stunning graphics and easy navigation, it must definitely be one of our masterpieces. It must definitely be one of our many website development flairs.
Need I say more?


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Preston Vacation Packages
Preston is within easy reach of many of Lancashire's attractions. The Harris Museum and Art Gallery and the Museum of Lancashire are two of the popular sights here, adored by locals and visitors alike. If time permits, be sure to also visit Avenham Park and Miller Park.
Take a break from sightseeing and indulge in a game of golf at the Preston Golf Club.
If you love sports, you'll love seeing local heroes, the Preston North End Football Club, doing battle in nearby Deepdale. On match days the stadium overflows with blue and white, as local soccer lovers gather to cheer on their beloved team.
When it's time to rest up after a long day exploring the charming streets of Preston, check in to one of the area's convenient bed-and-breakfast, hotel and short-stay apartment options. The Legacy Preston International Hotel, the Holiday Inn Preston and the Park Hotel Preston are just three of the best places to find a warm welcome and a good night's rest.

subset: commoncrawl


text:
I am happy that most of my positions are moving in the right direction. Looking back I botched the China trade and should have held. I sold VFC as it wasn't moving enough and sold 1/2 of JWN so I only have Apr DITM calls.
Sold too early but too late to chase
Maybe there will be another chance to jump in here
GLD finally moving in the right direction...down. I am almost at breakeven here
Settling nicely here but may dip back into the wedge
Wednesday, January 25, 2017
Jan 25 - NTNX, XBI moving
Posted by Greenlander at 9:50 AM
1 comment:
- Michel Vion said...
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Aug 29, 2013
|No. 10 Louisville at No. 20 Virginia
|Fri., Aug. 30, 2013 | 8 p.m.
|Charlottesville, Va. | Klockner Stadium
|Additional Information
|Purchase Tickets | Twitter | Facebook
CHARLOTTESVILLE, Va. - The Virginia men's soccer team starts its 2013 regular season Friday evening as it battles future ACC foe Louisville at Klöckner Stadium. Game time for the first-ever match between the No. 20 Cavaliers and No. 10 Cardinals is 8 p.m. The match is part of a great doubleheader with the UVa women's team as the No. 6 Cavaliers face No. 9 Penn State at 5:30 p.m.
Live statistics (GameTracker) will be available on VirginiaSports.com, as well the new Virginia Sports app, which is available free of charge through iTunes.
Tickets are $7 for adults and $5 for youth, seniors and faculty/staff; one ticket is good for admission into both matches. Group ticket orders of 20 or more tickets are $4. Free parking is available in the University Hall lots.
The Cavaliers are ranked 20th nationally in the preseason Soccer America rankings and 25th in the NSCAA coaches poll. Louisville brings a No. 10 national ranking according to the NSCAA and a No. 14 ranking in the Soccer America poll.
2013 Preseason and Introduction
Virginia posted a 2-0 home win over Radford on Aug. 20 in its exhibition opener before playing Rutgers to a scoreless draw last Saturday in Piscataway, N.J. UVa dominated possession in both matches and out-shot its foes, 27-4.
Virginia is beginning its 70th season of men's soccer. UVa is 701-322-102 all-time, including a 167-121-34 mark in ACC play. Head coach George Gelnovatch is beginning his 18th season at the helm of the program; UVa is 247-100-33 during his tenure.
The Cavaliers return 18 letterwinners, including 10 regular starters, from their 2012 side which went 10-7-4 and made the program's 32nd consecutive NCAA tournament appearance. UVa also welcomes a group of 12 newcomers (11 freshmen, one transfer).
Preseason ACC Poll
Virginia was selected fifth in the 2013 ACC Men's Soccer Preseason Coaches Poll, following a vote of the league's 12 coaches. UVa received 106 points in the poll, coming in behind Maryland (142), North Carolina (122), Wake Forest (114) and league newcomer Notre Dame (110).
Noting the Cavaliers
Virginia returns 10 starters from its primary 2012 lineup; forward Will Bates, now with the Seattle Sounders, is the lone Cavalier starter to depart. Juniors Eric Bird (Virginia Beach, Va.), Matt Brown (Charlotte, N.C.) and Spencer LaCivita (Raleigh, N.C.) are back, although LaCivita is expected to redshirt after offseason surgery.
After a baptism by fire as freshmen in 2012, seven sophomores are back for 2013, including ACC All-Freshman honorees Darius Madison (Philadelphia, Pa.), Marcus Salandy-Defour (Kensington, Md.) and Todd Wharton (Glen Allen, Va.). 2012 starters Zach Carroll (Grand Blanc, Mich.), Brian James (Sunrise, Fla.), Jordan Poarch (Middletown, Del.) and Scott Thomsen (Brick, N.J.) also return to the fold for their sophomore seasons. After suffering through an injury-plagued 2012 season and coming off the bench, junior Ryan Zinkhan (Fredericksburg, Va.), a starter in 2011, also returns.
Virginia welcomes in a decorated class of 12 newcomers this year, with 11 freshmen as well as goalkeeper Jeff Gal (R-So., Bartlett, Ill.), who transferred from Creighton after leading the Bluejays to the NCAA College Cup last season. The class was rated No. 2 nationally by College Soccer News in its 2013 recruiting rankings and is highlighted by two of the nation's top recruits, Nicko Corriveau (Potomac, Md.) and Jordan Allen (Rochester, N.Y.).
New-Look ACC for 2013
ACC Men's Soccer takes on a new look this year with the addition of Notre Dame, Pittsburgh and Syracuse; Louisville will join the league and replace Maryland (leaving for Big Ten) in 2014. The league will continue its traditional round-robin schedule, meaning each team will play 11 conference games out of 17 total regular-season games. There will be 10 weekends of conference play; each team also will play one midweek conference match.
The new teams add more firepower to what already was the nation's top soccer conference: Notre Dame was the top seed in the 2012 NCAA Tournament, while Syracuse advanced to the tournament's round of 16.
Touting Louisville
Louisville posted a 14-6-1 record last year and advanced to the NCAA quarterfinals before falling 3-1 at Maryland. UL went 1-0-2 in the 2013 preseason, downing Lindsey Wilson (3-1) and playing Michigan and Northwestern to draws.
The Cardinals were picked second in the inaugural American Athletic Conference poll. UL had a trio of players - forward Zack Foxhoven, midfielder Marlon Hairston and Daniel Keller - selected to the preseason all-conference team.
Labor Day Special
The Cavaliers are back in action on Labor Day (Monday, Sept. 2) with a 7 p.m. home match against St. John's. The Red Storm are ranked as high as 19th nationally by Soccer America.
2013 Season Ticket Information Season and single-game tickets are on sale now. To purchase tickets online, visit VirginiaSports.com/Tickets. In-person purchases can be made at the Virginia Athletics Ticket Office in Bryant Hall at Scott Stadium on weekdays between 9 a.m. and 5 p.m. Telephone purchases can be made by calling 1-800-542-UVA1 (8821) or locally at 434-924-UVA1 (8821).
General Admission All-Soccer Season Passes are available for adults ($40), Youth/Senior ($30) and UVa Faculty/Staff ($30).
UVA Athletics Information
In the NewsRecent Headlines News Archives
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Paulsons Eager to Help Elevate UVA WrestlingWrestling7/25/17UVA head coach Steve Garland's new assistants are twins Travis and Trent Paulson, former standouts at Iowa State.Sky's the Limit for UVA Pole VaulterTrack & Field, Cross Country7/20/17Jeff Jernigan, who over the course of his UVA career became one of the ACC's top pole vaulters, was commissioned in the U.S. Navy in May.Graduate Transfers Bolster Offensive LineFootball7/18/17Graduate transfers John Montelus and Brandon Pertile will compete for starting jobs on the offensive line when UVA opens training camp late this month.
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A 1985 graduate of UVA, White worked at the Richmond Times-Dispatch until July 2009. He was honored six times as the state's Sportswriter of the Year.
More Headlines
Men's Soccer Announces 2017 Schedule
M. Soccer | 5/17/2017
The Cavaliers will open up the 2017 season at home when they host Villanova on Friday, Aug. 25.
Jeff White: Afamefuna Thriving in New Role
M. Soccer | 4/24/2017
An ACC All-Freshman selection as a defender last fall, Virginia's Robin Afamefuna is looking to...
Caldwell, Lowe Named to All-ACC Academic Team
M. Soccer | 2/7/2017
Caldwell, a history major, earned his second All-ACC Academic Team distinction in as many seasons...
Claudio Reyna Named to Virginia Sports Hall of Fame
M. Soccer | 1/18/2017
UVA soccer alum played for 13 years with U.S. National Team and competed in four FIFA World Cups.
Opoku Named NSCAA Second-Team All-American
M. Soccer | 12/9/2016
Opoku finished second on the team with six goals in 2016, including five game-winning scores.
Opoku and Nus Earn NSCAA All-South Region Honors
M. Soccer | 12/6/2016
Opoku was a first-team selection at forward, while Nus earned a spot on the third team at defender.
Jeff White: Soccer Teams Turn Attention to 2017
M. Soccer | 12/02/2016
Virginia's soccer teams are fixtures in their respective NCAA tournaments, and 2017 should bring ...
UVA's Season Ends in Double OT Loss at Stanford
M. Soccer | 11/27/2016
Seeded No. 12 in the tournament, the Cavaliers finish their season with an 11-4-5 record.
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By far and away, the supreme undivided self-justification used today is; "I don't have the occurrence to exercise". The old mental representation that you have to athletics for 1 to 2 hours a day is righteous claptrap. A good, dense have course of therapy doesn't have to ultimate for much than 20 to 30 minutes a day to be exceedingly effective. If you can't find up to 30 written record a day to exercise, then how do you have power over to breakthrough up to 2 work time or more a day to survey TV?
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This talisman features a heart enclosing a skull and crossbones-the symbol of mortality, representing the transient nature of the material world.
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Review: The Spare part fitted fine!
I managed to break off a cover on the curved part of our Miele vacuum cleaner which you have to hold onto when you push the vaccum hose along the carpet. I googled the Miele spare and found prices for this part started at about £40 from Miele or £6.99 from yourspares.co.uk. Of course I chose yourspares.co.uk. I elected for free postage and the part arrived within 4 days. Took it out of the package and it fittedperfectly onto my Miele model hose. Brill and at a reasonable price!
03 Nov 2014 by Brian R
View all Reviews


text:
Alpinetrek expert Christian
"This product is no longer available."
This is either an older model or we can or will no longer reorder this product from the manufacturer.
Don't give up – we have some other alternatives for you to choose from:
GoPro - Grab Bag Of Mounts - Ersatzteile
Attributes & features
- Design:
- Replacement parts
- Recommended use:
- Replacement parts for GoPro camera mounts
- Extras:
- incl. curved and flat adhesive mount; Quick release buckle; vertical quick release buckle; Thumb screws; 3-way swivel arm mounting hardware; sealing cap; Camera tether
- Item No.:
- 570-0082


text:
I am trying to get the port information but when I look at a switch it says no open ports for this device were found to be responding.
I tried a different free trial software and it read from the same switch so I know SNMP is on. Could I be missing a setting somewhere?
Sep 8, 2011 at 8:36 UTC
God dammit! HAHAHA It REALLY helps if you allow SNMP out on the Windows firewall!!!!
Thanks for your help!!!
This topic was created during version 5.1.
The latest version is 7.5.00101.
16 Replies
Sep 7, 2011 at 3:45 UTC
Have you tried scanning the switch in it's own scan range and just used the SNMP credentials for the switch? Are it's DNS records clean?
Sep 7, 2011 at 7:16 UTC
What sort of switch are you working with?
Sep 7, 2011 at 8:06 UTC
As Tim wrote, SpiceWorks will scan using the credentials you provide and multiple credentials on a single scan entry is not supported. Create a separate scan entry with your switch range and provide the correct SNMP credentials and try that.
Sep 8, 2011 at 7:13 UTC
Didn't work. It's an HP Procurve
Sep 8, 2011 at 7:19 UTC
What happens when you run a test against one of the ProCurves following this guide,
Sep 8, 2011 at 7:25 UTC
Says failed. bad auth or device is offline.
It's the same info I put into the other program.
Sep 8, 2011 at 7:27 UTC
OK, and are the logs on the ProCurve showing any attempts from the SpiceWorks IP?
Sep 8, 2011 at 7:34 UTC
The intrusion log is empty
Event log is not showing anything either when I do a test
Sep 8, 2011 at 8:11 UTC
What SNMP version are you using on the switch?
Sep 8, 2011 at 8:16 UTC
I also found this thread that might shed some more possibilities,
Let me know
Sep 8, 2011 at 8:30 UTC
Read through it, I did several test. Created a new account, with a capitial P and one with a lower case p, still didn't work.
In the switch I created a new SNMP account all lower case and tried that and still nothing.
Sep 8, 2011 at 8:36 UTC
God dammit! HAHAHA It REALLY helps if you allow SNMP out on the Windows firewall!!!!
Thanks for your help!!!
Sep 8, 2011 at 8:36 UTC
LMAO, glad you got it and yes sometimes the simplest things slip past us.
Sep 8, 2011 at 10:16 UTC
Hey man can you help with one more thing? I am trying to setup now SSH to backup the configs.
The test says
"Test failed: Test failed with unknown error (Net::SSH::Disconnect). Please visit the Spiceworks Community Support forums for help"
I am using the same user\password to log into in the switch as what I put in the account. Do you need the enable account for this or just a normal limited account?
Sep 8, 2011 at 10:40 UTC
Hmmmm.....I have seen reports that updated versions have issues on the ProCurve as far as getting the config files. When I set security high on mine meaning only SFTP which in turn disables tftp my configs were not backed up. Not sure if they have gotten around that yet or not.
Brian from SpiceWorks has always been the one I have worked with when dealing with the ProCurve equipment, you could try PM'ing him to see if he has any info.
He will more than likely need some log files from you after running some scans against a single ProCurve device.
Let me know what you find out.
Sep 8, 2011 at 10:42 UTC
Yeah I am reading a thread right now with him troubleshooting. Didn't see a resolution in the thread though.
This discussion has been inactive for over a year.
You may get a better answer to your question by starting a new discussion.


text:
Taking you on a metaphorical road-trip along a winding coastal highway is Melbourne surf-pop five-piece Dirt Farmer. Their nostalgic new single, 'Delilah Lightning,' is the first taste of a forthcoming EP.
It sports a Real Estate (Brooklyn) meets Driffs (Sydney) kind of vibe:
Dirt Farmer will be playing a Melbourne and Sydney show over the coming weeks to promote 'Delilah Lightning' and the new EP.
Friday, April 12 – Ding Dong Lounge, Melbourne
Friday, May 10 – The Beresford Hotel, Sydney
Want more? Stream Dirt Farmer's debut self-titled EP from 2012. Our favourite is closing track 'Honey,' which screams "free love":
DirtFarmerBand.com | Facebook.com/DirtFarmerMusic | Soundcloud.com/Dirt-Farmer


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Use coupon code "friendsnfamily" for $5 tickets when purchased by February 9th.
INSIDE OUT from Imagination Stage
It's bedtime. But instead of getting ready for bed, two children use their imaginations to turn their room into a wonderland of mess. While playing dress-up, a glove becomes a dancing fish, a shirt becomes a fantastical creature, and a sock dance rocks the closet.
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Performances at 10 & 11:15 am
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Obama's action's speak loud and clear on home schooler
|Anonymous Coward
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United States
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Quoting: Anonymous Coward 662792
homeschool = educationQuoting: Anonymous Coward 932587
public school = indoctrination
choose one or the other.
Wrong, both are indoctrination, only difference if you homeschool your child you get to decide what they learn.
Home-schoolers still have to follow a curriculum set by the state. The biggest advantage is the individual attention the home-schooler receives in addition to a non-threatening environment
|Anonymous Coward
User ID: 59655640
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I did a stretch in public school.
Some of the worst experiences of my life, back then.
It wasn't just that it felt that I was being targeted by other kids for some reason I couldn't perceive, but it was like, nobody seemed to care. Not my parents, not my teachers, not my friends- who quickly showed a different face when the people that didn't like me came around.
I didn't really understand why, at the time. I was all like, treat people how you want to be treated, right? So why are you treating me like shit?
I still have trouble looking at an Aboriginal person and not feeling an edge of seething resentment for what their kids put me through.
Spent at least one day a week at home, reading books way above the comprehension levels of my peers. Kept me sane.
Dropped out in grade 10, when I realized half of my teachers didn't know my name, and none of them gave a shit whether I was there or not.
Not a lot of job ops for a guy who's considered functionally illiterate by the government. But I get by.


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25 posts this site
Sandra Day???
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text:
|Publication number
|Publication type
|Application number
|Publication date
|Jul 29, 2008
|Filing date
|May 16, 2003
|Priority date
|Nov 29, 2002
|Fee status
|Also published as
|Publication number
|Thomas J. Minyard, Morgan W. Nields, Ted V. Kremer
|Original Assignee
|Hologic, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (21), Referenced by (17), Classifications (24), Legal Events (13)
|External Links: USPTO, USPTO Assignment, Espacenet
This patent application is a continuation-in-part patent application and claims priority from U.S. patent application Ser. No. 10/307,214, which was filed on Nov. 29, 2002 now abandoned and is titled "Distributed Architecture for Mammographic Image Acquisition Processing".
The present invention relates generally to mammography and, in particular, to a distributed architecture that allows for decoupling of mammographic image acquisition and review, thereby enabling more efficient use of resources and enhanced processing.
Mammography, including x-ray imaging and other imaging modalities, is widely used in detection and analysis of cysts, lesions, microcalcifications and other areas of interest within a patient's breast. Because of its proved effectiveness in early detection and analysis, including detection of nonpalpable lesions, mammography continues to be recommended for many women. As a result, mammography equipment is available in many locations and such equipment, as well as clinicians and physicians experienced in using such equipment and analyzing the mammographic images, are typically kept busy meeting the demand.
Traditionally, mammography systems have been film-based. Film based mammography involves obtaining mammographic images on film which is typically loaded into a film tray positioned adjacent the patient's breast. The films can then be reviewed using a light box. More recently, digital mammography has been gaining acceptance. In digital mammography, images are acquired digitally and can be displayed on an electronic monitor.
A number of advantages associated with digital imaging have been recognized. First, digital imaging provides substantially real-time images. In some cases, follow-up views may be acquired based on real-time review of the digital images such that a return visit by the patient can be avoided. In addition, digital processing allows for image enhancement. In this regard, a physician may zoom in on an area of interest, adjust the image contrast or brightness or otherwise manipulate the image after acquisition. Moreover, it is sometimes possible to obtain improved diagnostic information by digital processing. For example, a digital image that is identified as being suspicious or is otherwise of interest can be exported to certain CAD systems that perform digital analyses. For example, such CAD systems may perform a pixel-by-pixel analysis of the digital image to identify areas of reduced intensity that may be missed upon review of the images using the naked eye. Such areas may indicate microcalcifications or other conditions of interest that the physician may desire to review more closely, such as by zooming in on that region of the image or otherwise enhancing the image.
Despite these advantages, certain perceived disadvantages have slowed the process of full digital acceptance. Some of the perceived disadvantages are specific to particular digital imaging equipment. In this regard, some current digital imaging systems do not provide a full field of view for a patient's breast. As a result, multiple images may be required for a screening analysis or the digital imaging system may be relegated to follow-up imaging of an area identified by film. In addition, some current digital imaging systems provide a limited resolution that may be deemed insufficient for certain applications. However, full field, high-resolution digital imaging systems are now being marketed, including the SenoScan system of Fischer Imaging Corp. of Thornton, Colo.
Other perceived disadvantages relate to operational restrictions of conventional digital mammography systems. Many conventional digital mammography systems are stand alone units that include the image acquisition equipment or gantry (e.g., the x-ray tube, compression paddles, detector and the like), a processor executing image processing logic and a display terminal that may include oversized high resolution monitors. In these cases, a physician may review images at the physical equipment site. This may tie up the equipment when needed, thereby reducing patient throughput or require that the physician plan around a schedule for accessing the equipment.
Moreover, the images available for review at the equipment may be limited. In this regard, physicians may desire to compare current images for a patient to images obtained for that patient at an earlier date, perhaps obtained using different equipment. Physicians may otherwise desire to review images obtained for multiple patients at different image acquisition sites, e.g., in connection with a large medical facility. In such cases, the images desired for a particular review session may not be readily available at the equipment site. Additionally, certain tools such as CAD processing or other diagnostic tools may not be available at each site where patient images reside.
The present invention is directed to a mammography system and associated processes that involve a distributed system architecture. Such architecture allows for decoupling of the image acquisition and review processes. As a result, the invention allows for more efficient and/or more convenient use of the image acquisition equipment and image processing stations. The distributed architecture also facilitates development of a central image repository with certain processing and analysis advantages. In addition, the present invention provides certain processing and workflow enhancements that allow for more full realization of potential digital mammography advantages in relation to film-based mammography.
According to one aspect of the present invention, a distributed architecture is employed to implement a mammographic image acquisition and review system. The system includes at least one image acquisition station associated with a digital image repository and at least one remotely located image review station where a physician can retrieve an image from the repository for review. The image acquisition station includes at least a detector for receiving an imaging signal from a patient's breast and providing digital imaging information based on the received signal. This station may further include a source for transmitting the imaging signal (such as an x-ray, ultrasound or other medical imaging source), an assembly for immobilizing the patient's breast as may be desired, a user interface such as a keyboard for entering patient information and managing acquisition Workflow, a processor for performing various processing functions and one or more monitors for displaying near real-time images to assist the user.
Among other things, the processor may assist in transmitting the imaging information to or storing the imaging information in the image repository. The image repository may be located at the image acquisition site, the remote image review site, or at another location. In one implementation, the image repository is associated with a server separate from the acquisition and review sites. Such a client-server architecture allows for more efficient and/or convenient utilization of the acquisition and review equipment and certain processing advantages as discussed below.
The remote image review station includes a user interface such as a keyboard and/or mouse for receiving user inputs, a processor for assisting in image review workflow management based on the user inputs and one or more displays for displaying selected mammographic images. This station is located separate from the image acquisition site and, preferably, can be operated independent of the image acquisition equipment. In one implementation, the image acquisition equipment and image review equipment can be operated concurrently such that images for one patient can be acquired while images for another patient are being reviewed. This distributed architecture thereby allows for more efficient use of imaging equipment, higher patient throughput and more convenient image review.
According to another aspect of the present invention, at least one image-processing tool is provided in connection with a mammographic image server. The associated mammographic imaging system includes image acquisition equipment, image review equipment and the server that is located separate from the image acquisition equipment and image review equipment. The server may be located at a separate location on the medical facility premises or off-site. The image acquisition equipment and image review equipment may be at the same location or at separate locations. The server is interconnected to the image acquisition equipment and the image review equipment for communication of imaging information therebetween and provides access to at least one tool for processing imaging information. In this regard, the tool may run on the server hardware or on a separate platform in communication with the server. Some examples of tools that may be provided in connection with the server include image repository database management tools, CAD tools, other diagnostic aids or medical information privacy and security tools. Providing such tools in connection with a server allows for beneficial resource sharing, improved access to image information and improved access to updated versions of processing logic.
According to a further aspect of the invention, a mammographic imaging system includes multiple image acquisition stations and/or multiple image review stations associated with a central server subsystem (i.e., a single server subsystem associated with one or more machines for serving the multiple stations). The number of image acquisition stations may be the same as or different than the number of image review stations. In the context of a large medical facility, one on-site server or a smaller number of on-site servers may thus support a larger number of image acquisition stations and/or image review stations. Alternatively, one or more off-site servers with appropriate privacy/security protection, e.g., operated by a mammographic equipment provider, may service image acquisition and review stations at separate facilities, each of which may be associated with the server by a high bandwidth connection. In this manner, the most updated versions of processing logic can be made readily available at each image acquisition and review station and alternate business models are possible for reducing medical facility costs and/or enhancing equipment provider revenues.
According to another aspect of the present invention, a mammographic image system includes an image repository associated with a database search engine. The image system includes multiple image acquisition stations for acquiring images and providing image information to the image repository and multiple image review stations (at the same location as or different locations than the image acquisition stations) for accessing image information from the repository. The search engine is operative for searching the image repository based on certain search fields to access responsive image information. In this regard, the image repository may be structured as a relational database where cross-indexed information corresponding to a single image is stored in multiple tables. Such indexing may be used to facilitate field-based searching. Examples of fields that may be searched include patient name, image record number, date (study), equipment operator/clinician, reviewing physician, medical facility, diagnosis/condition, etc. In this manner, various records can be readily accessed to facilitate image review, research and staff performance. Moreover, searches may be performed based on physical features or medical condition, e.g., microcalcifications, mass, mass location, to access similar images or image portions, for improved diagnosis.
According to a still further aspect of the present invention, a mammographic image system includes an image repository associated with a processing platform for enabling concurrent access to particular imaging information by multiple users. The processing platform may make instances of the imaging information available to each user for independent or collaborative processing. In this regard, individual users may wish to annotate information corresponding to a particular digital image, for example, to denote the image as having been reviewed, to tag the image for further review at a later time or to identify and/or characterize areas of interest. An annotated copy of the image may then be stored in the repository. The processing platform may further provide a collaboration utility whereby multiple users, e.g., physicians at different locations, can access and manipulate a single image record. Such concurrent access to image information thus enhances access to the information for more efficient or convenient review by individual users and enables collaborative processing with attendant advantages.
For a more complete understanding of the present invention, and further advantages thereof, reference is now made to the following Detailed Description, taken in conjunction with the drawings, in which:
In the following description, the invention is set forth in the context of a mammographic image system employing a distributed architecture based on a client server model. In particular, the invention is described below in connection with an implementation at a large medical facility that includes multiple mammographic image acquisition sites and multiple image review sites all associated with a central server and central image repository. While this implementation effectively illustrates the operation and advantages of the present invention, it will be appreciated that the invention is not limited to this implementation or similar contexts. For example, various aspects of the present invention are applicable to environments having a single image acquisition site and/or a single image review site. Additionally, it is not necessary that the acquisition equipment, review equipment and server be located at one site. In this regard, particular elements of the system or combinations of elements may be located at different sites that are interconnected by a wide area network or the like. Also, certain elements of the image processing discussed below may be conducted at an image acquisition site, an image review site, a server site or at another location or may be distributed across multiple platforms. Accordingly, the description that follows should be understood as exemplary and not as limiting the scope of the invention.
Referring first to
The image acquisition stations 102 are preferably interconnected to the server 104 by a wide bandwidth connection 103. This connection 103 may be provided as part of a Local Area Network or a Wide Area Network, e.g., a TCP/IP network. In addition, the image review stations 110 are also preferably interconnected to the server 104 by a wide bandwidth connection 107. This connection 107 may also be provided as part of a Local Area Network or Wide Area Network. In the latter regard, the illustrated system architecture allows a physician to review images from a remote location, such as a reviewing station 110 at a physician's office separate from the medical facility that includes the acquisition stations 102, or to review images from multiple acquisition stations 102 located at different medical facilities from one another.
The illustrated server 104 is operative to access an image repository 106 and patient information database 108, as will be discussed in more detail below. It is also operative to access a number of DICOM tools 112 via a standard DICOM interface 109. These tools 112 are schematically illustrated as residing behind a DICOM boundary 114 associated with the interface 109, but may physically reside at a local or remote location. A variety of such DICOM tools are available. The illustrated tools 112 include a picture archiving and communication system (PACS) database 116, a computer aided design (CAD) diagnostic tool 118, printers 120 and a hospital information system (HIS)/radiology information system (RIS) 122.
The stations 102 and 110 will be described in more detail below. The image repository 106 stores image information from the image acquisition stations 102 and the patient information database 108 stores associated patient information. The illustrated repository 106 and database 108, though schematically illustrated as separate components, are configured to form a composite searchable database structure such as a relational database system and may physically be embodied in any of various high-capacity data storage systems, such as a RAID system. That is, the images of the repository 106 are indexed to the patient information of database 108 and the patient information is organized in tables of cross-indexed data fields. Such fields may include information identifying the patient, the x-ray technique involved including dose estimates and compressed breast thickness, the available images, including images from ultrasound, MRI, PET or images of pathology relating to prior or current breast biopsies, the dates of images (study), the facility where the images were acquired, the x-ray technicians involved in the image acquisition, whether the images have been reviewed, any annotations or annotated image versions, the reviewing physician, and any other information that may be of interest.
This database structure may be searched by field(s) using a database management tool associated with server 104. Such tools are well known. For instance, by using such a tool a reviewer at an image review station 110 can query the database structure to obtain all images for a given patient or all such images acquired within a given date range. Alternatively, a physician may obtain all images acquired on a given date, all images for all patients acquired on a given date and associated with a particular acquisition station or stations 102, all images associated with a specific mammographic finding such as microcalcifications, or all images for all patients acquired on a given date and associated with an identified physician. Moreover, the search tool can be used to improve diagnosis or prognosis. In this regard, the database may be searched based in image features such as microcalcifications, mass, mass location etc. such a search may be conducted based on physician annotations, CAD annotations or other indications of the feature of interest. In this manner, similar images or image portions, or files that re otherwise of interest may be readily accessed by using the search tool.
The database structure may be used for purposes other than patient analysis. For example, the database structure may be queried by technician or acquisition site to obtain information regarding work performance or efficiency or to correct any recurring image acquisition or processing errors. The illustrated connection 105 between the server 104 and the repository 106 and database 108 may be, for example, an internal server connection (e.g., a data bus), a LAN connection or a WAN connection.
The illustrated DICOM tools 112 include a picture archiving and communication system (PACS) database 116. This database 116 is used to archive images that do not need to be kept in the repository for immediate access, but which may be desired for review. For example, a physician reviewing images for a patient may wish to review current images together with old images from a prior screening or screenings to identify any changes or signs of advancement of a condition. Such older images may be recalled from the PACS database 116 via the DICOM interface 109. Alternatively, such images may be stored, for example, on a storage device accessible at a review station 110 such as a magneto-optical (MO) drive. In either case, such archiving frees repository resources while providing flexibility for physicians to construct desired review workflows as discussed below. Moreover, the physician workflow protocols and other predictive logic of the system 100 allow the server 104 to predictively retrieve images from the repository 106 and database 116 as a background task for prompt display during a review session.
CAD tool 118 may be any of various commercially available, computer-based medical image analysis and diagnostic tools. These tools typically analyze a single image or multiple images, such as on a pixel-by-pixel basis to identify any features that may have diagnostic significance and apply diagnostic algorithms or heuristic engines to determine a possible diagnosis. In the context of mammography, such tools may identify a suspicious mass, e.g., based on a locally reduced detected signal intensity, and may further identify the possible nature of the mass (e.g., microcalcifications) based on features of the mass. Corresponding information may be annotated on the image. For example, a graphic such as a particular geometric shape (e.g., a cone or triangle) may indicate a particular potential condition and the location of the graphic on the image may indicate the location of the condition. A physician may use the graphic to zoom in on or otherwise further review the area of interest. Such an enlarged image may be automatically retrieved or otherwise prepared for display at station 110, e.g., stored in cache at the station 110. Thus, when the physician selects the associated graphic (which may comprise a graphical user interface element superimposed on the image), an associated image may appear instantaneously. This image may be optimized based on the nature of the associated condition of interest, e.g., enlarged, contrast/brightness enhanced, edge detection enhanced, etc.
In accordance with the present invention, the CAD tool 118 can be used for preprocessing images or otherwise automatically processing images, e.g. in the background during a review session. In this regard, the server 104 may be programmed to automatically, upon receiving an acquired image from any of the acquisition stations 102, store one instance of the image (e.g., the raw image information) in the image repository and forward another instance or copy of the image to the CAD tool 1118. This latter instance of the image may be formatted in accordance with standards of the DICOM interface 109. The image is then processed by the CAD tool 118 as discussed above and the processed image, including CAD annotations, is stored by the server 104 in the image repository 106 and indexed to the original image and corresponding patient information.
All of the noted CAD processing can occur automatically prior to the initiation of a review session by a physician. Accordingly, if desired, when the physician enters a query to gather images for a review session, the CAD-processed images may be provided from the image repository. The physician may alternatively or additionally access the raw (unpreprocessed) image, e.g., for comparison/confirmation purposes.
Similar CAD processing may occur during or after a review session. For example, upon an initial screening of an image, a physician may note a suspicious mass in the patient's breast. The physician may then tag the image or a location on the image for CAD processing so as to obtain the benefit of the CAD diagnostic tool. The user interface of the review station 110 may have defined keystrokes or graphical interface elements to facilitate such tagging. In response to these inputs, the processor of the review station 110 transmits the image or image portion to the server 104 which reformats the image information as necessary and forwards the information to the CAD tool 118 for analysis.
The server 104 or a processor of the review stations 110 may execute predictive algorithms, in connection with the noted CAD processing or otherwise, to anticipate the needs of the reviewing physician and improve workflow. In connection with CAD processing, the server 104 may monitor CAD processed images to anticipate such needs and automatically, as a background task, prepare enhanced images for display. For example, where a CAD annotation is included in the processed image indicating and characterizing a potential condition of interest, an enlarged view of the relevant image section with display parameters (e.g., contrast, brighteners, and enhanced edge definition) appropriate for the characterized condition may be prepared for automatic display on a monitor of the station 110 or may be stored for display upon receiving a prompt from the user. As discussed below, images may be prepared for display in a similar fashion based on protocols defined for a user, user type, review type or the like. Such protocols may also be developed or supplemental for a particular physician or on a user independent basis, using logic to monitor acquisition and review processes to empirically or heuristically learn patterns that may be used to predict physician needs.
The DICOM tools 112 also include printers 120 in the illustrated embodiment. These printers 120 receive image information via the DICOM interface 109 and provide hard copies of the images, e.g., on paper or transparencies for review on a light box or the like. This allows physicians the option of reviewing hard copy images and facilitates patient discussions in an office environment.
The HIS/RIS tool 122 provides access to HIS/RIS systems. The HIS/RIS systems include databases of patient information such as appointment dates and times and other information that may be imported into the patient information database 108 and used for populating fields of the image acquisition and image review protocols as discussed below, as well as in fashioning queries for image information. This information is readily handled by the processor 104 based on the DICOM standard. As will be appreciated by those skilled in the art, DICOM (Digital Imaging and Communications in Medicine) provides an industry standard for the exchange of digital imaging related information.
The server 104 or processors of the image review stations 110 may also execute logic for image display optimization. Such optimization may relate to optimally using the available display area for displaying the selected images (e.g. selecting a landscape, portrait, or other orientation, sizing the images, selecting zoom settings and image portions, and establishing a reference position or orientation for images to assist the physician), optimally setting display parameters (brightness, contrast, edge enhancement, etc.) or optimizing any other display-related characteristics. It will be appreciated that patient images may include imaging such as ultrasound, MRI, PET, or other molecular techniques relating to the specific patient undergoing radiologic review. Such functionality may be executed based on defined workflow protocols, CAD, or other annotations or other information available to the relevant processor(s). In this regard, optimization of a luminescence setting may be performed relative to a specific image or image portion. This may depend on a number of factors. For example, a human's ability to distinguish shades is dependent on the location of such shades within a gray scale range. That is, the ability to discern shades is not a linear function with respect to gray scale such that a given shade increment may be more readily distinguished by a viewer at a given point on the gray scale than the same increment at a different point on the gray scale. Presenting the image at an optimized luminescence may therefore enhance the viewer's ability to distinguish features of interest. So, the luminescence setting may be selected based on CAD or physician annotations indicating a condition of interest and may also take into account tissue density, source settings, exposure and other factors affecting optimal display parameters. Such display optimization may also take into consideration the size and resolution of the display as well as the display's aspect ratio including, in the case of rotatable displays as discussed below, whether the display is currently in a landscape or portrait orientation.
Additionally, special filtering may be used to optimize display parameters relative to specific areas of an image. For example, specific zoom or enlarged views of particular image areas may be provided, for example, based on a CAD annotation indicating a condition of potential interest. Moreover, the image resolution may be varied based on a feature of interest associated with a specific image area. Thus, a 25 mm resolution (as is available in the noted SenoScan system of Fischer Imaging) may be provided for an image area where microcalcifications re indicated and a lesser resolution may be provided for areas where a mass is indicated or where no annotation is indicated. This allows for reducing the size of the image file to be loaded so as to improve processing speed while providing high resolution where it may be desired. Relatedly, a high resolution mode or lower resolution mode may be determined by the processing logic for an overall image, or may be selected by a user as part of a protocol definition.
As noted above, the server 104 may store multiple instances of an image in the repository 106. Such instances may include CAD-processed images and user annotated instances. A user may annotate an image to mark the image as reviewed, identify areas of interest on the image, or include other information. The annotations or markings are specifically tagged to the physician or technologist creating a record including all other relevant parameters such as date, time, location, etc. Additionally, a user may utilize the server 104 to store a user-processed image or image portion that is enlarged, edge-enhanced, or otherwise modified based on user inputs. Alternatively, image modification information may be stored and indexed to an image so that modified images can be constructed as needed. Relatedly, high resolution and lower resolution versions of an image may be used for different purposes. For example, a high resolution version may be provided to a CAD system for enhanced analysis and a lower resolution version may be provided to a review station for display so as to reduce the file size and loading times.
The server 104 may also make a single image or copies of the same image available to multiple review stations 110. This may be desired for concurrent independent work or collaborative work. In the latter regard, the server 104 may include conventional collaboration logic for allowing multiple users to work on a common document and see changes entered by the other collaborator(s). Such collaboration may improve diagnosis.
An example of an acquisition station 200 is illustrated in
During a screening procedure, a physician or clinician may direct the process via inputs using the user interface 214. The inputs may identify the patient, the image projection view, the examination date, certain imaging parameters and any other information of interest. The interface 214 can also be used to initiate exposures and otherwise manage the image acquisition workflow. These inputs are received by the processor 216 which operates the imaging device 202, directly or in response to inputs from a server. The processor 216 also receives digital image information from the detector 210 and executes logic for forming a composite image for display on the monitor 212 and transmits the image information together with associated patient data and any other desired information to the server 104 (
As noted above, the mammographic image system may include at least one monitor, e.g., at an acquisition station or review station, that is rotatable. A physician may desire to rotate a monitor so as to obtain a different viewing area aspect ratio for viewing images arranged in a particular pattern or format. Such a rotatable monitor 400 is generally illustrated in
The orientation of the illustrated display 402 is reported to the processor 406 via link 408. For example, where the mount 404 includes a detent associated with each of the orientations, the orientation of the screen may be detected based on deployment of the detent associated with position registration (which may be converted to an electric signal via a contact switch). More sophisticated feedback mechanisms such as involving encoders may be employed to provide detection of a range of orientations. In any event, this orientation information can be used by the processor 406 or the server to appropriately orient displayed images, e.g., to orient images so that annotations or markings are right-side-up or to otherwise provide the desired image orientation with due regard for the current display orientation. Moreover, the display orientation may be automatically taken into consideration in sizing or orienting images so as to optimally utilize the display area. The display orientation may also be defined by a physician as part of an image review protocol. A motor 410 may be provided to automatically rotate the monitor 402 to the desired orientation. Moreover, the orientation of the monitor may be selected by the user as part of a protocol definition or selected by processing logic, e.g., to optimize monitor space utilization for a given layout of multiple images.
In connection with the monitors of the image acquisition stations and the image review stations, a number of screens may be provided to enable the user to define patient studies, and define workflows.
Referring to
The users drop down menu 502 shows the users and types of users that have been authorized to operate the image acquisition equipment. Users listed in this menu have been previously stored in the database.
To establish a projection listing for a particular user, the name of the user can be selected from the drop down menu to cause the selected name to appear in the header field at the top of the menu. The user may then construct the sequence listing for the selected user by using several of the illustrated screen features.
The user's sequence listing 504 shows the types of projections selected for association with the indicated user. The selections are added to the user sequence listing by selecting the projection attributes from the laterality 506, view 508, and modifier's 510 drop down menus and then clicking on the add button 512. Projections can be revised, added, removed, or reordered in this listing until the screen entries are saved into the system database by means of the save button 514. As the listing is being added to, the order in which a particular projection appears in the sequence can be changed by first selecting the projection in the listing, then clicking on the move up or move down button 516 as required.
The laterality drop down menu 506 allows the user to select the laterality of the projection. Selections include left, right, and both.
The view drop down menu 508 allows the user to select the view that is to be combined with the laterality as selected from the laterality drop down menu 506. The views that may be selected include medio-lateral, medio-lateral oblique, latero-medial, latero-medial oblique, cranial-caudal, cranial-caudal from below, superolateral to inferomedial oblique, CC exaggerated, CC exaggerated laterally, and CC exaggerated medially.
The modifiers drop down menu 510 allows the user to further modify the laterality and view selected. The modifiers that may be selected include magnification, clevage, axillary tail, rolled lateral, rolled medial, rolled superior, rolled inferior, implant displaced, spot compression, and tangential.
The add button 512 allows the user to add the projection, as thus defined, to the user's sequence listing.
The move up and move down buttons 516 allow the user to change the order in which the selected projections appear in the user's sequence listing 504. The remove button 518 allows the user to remove a projection from the user's sequence listing 504. Finally, the save button 514 saves the projection list for the indicated user to the system database.
The process for defining workflows may be understood by reference to the workflows screen 600 as shown in
The new workflow button 604 is used to enter a descriptive name for the new workflow configuration. From the patient progression area of the screen, the patients, studies, and viewed criteria that is to be used to select images for the new workflow can be selected. These selections determine the category of patients, the number of studies per patient, and which of the previous studies are to be selected.
The user may then define the protocol that is to be used for the first image projection and the new workflow. This protocol defines the overall configuration and progression of image formats that will be automatically displayed in sequence as the user increments through the review session. To define this protocol, the user selects the type for the first image display. The types that may be selected include blank, selected, or custom. If the user selects custom, the user may then specify the number of images that are to be displayed on the screen, by the number of rows and columns in which the exam images will be displayed. For example, the user can specify a screen display that can accommodate any desired format including ranges from, for example, one row by one column for a total of one image, up to three rows by three columns for a total of nine images in one implementation. It will be appreciated that images selected in this manner for display may include ultrasound, MRI and PET images relating to the patient undergoing review. The user may also select other image modifications that impact the workflow display format, such as view, tools, and zoom.
The user may then select the study number from which the images are to be selected for inclusion in the workflow. The display select menu 606 can then be used to select the display on which this image and the workflow is to be displayed. Once all the selections and image modifications have been made, the add button 608 can be used to add the current image configuration to the workflow. A box will appear in the display field selected from the display select menu 606. Each time the above process is repeated a new box will be displayed in the selected display field. If a specific projection is to be displayed at a particular step in the workflow sequence and on a particular display, it may be selected from the projection field and dragged to the desired location.
The screen illustrated in
The patients select menu 614 allows the user to select a category of patients to be filtered by the workflow algorithm. Available selections include all today's work, all pending work, all today's unread, all pending unread, user's today's work, and user's pending work. The studies select menu 616 provides a listing of studies from which images may be selected. The viewed select menu 618 allows the user to select images from specific exam histories that are to be included in the workflow. In this regard, it will be appreciated that particular users may wish to review current images against images from prior exams. The study number menu 620 allows the user to specify the exam study histories from which the images are to be obtained. These selections correspond to the number of exams for which images are available. The projection field 622 displays the projections that exist for each patient exam included in the studies selected for inclusion in the workflow.
The protocol may be defined in relation to any number of monitors that may be provided at an image review station. In this regard, the illustrated display 1 and display 2 fields 624 and 626 display the constructive workflow for a two monitor station. The workflow is presented as a series of blocks, each block representing a single screen display. The actual format or configuration of each block in the workflow is determined by the type, view, tools, zoom, and display selections selected by the user prior to adding the block to the workflow.
The display select menu 606 allows the user to select the display field into which the next workflow element will be added. This determines which monitor will display the image currently being added to the workflow sequence.
The type select menu 626 allows the user to specify the type of display to be added to the workflow sequence. Selections include blank, selected, and custom. If blank is selected, the specified monitor will display a blank screen for this step in the workflow. If selected is chosen, the specified monitor displays the image format that is the next image in the selected study for this step in the workflow or the image selected by the current button press to provide the desired enhancement, e.g., full resolution display. If custom is chosen, the specified monitor will display the image display format that meets the criteria established by this workflow. When custom is selected, the rows 628 and columns 630 buttons are active. The rows button 628 determines the number of rows of images that will be displayed on the monitor and the column button 630 determines the number of columns.
The view select menu 632 allows the user to specify how the image is fitted to the display. Selections include full resolution, fit window ("auto size"). In this manner, the available monitor space can be effectively utilized, with due regard for monitor orientation in the case of rotatable monitors.
The tools select menu 634 allows the user to select tool features that are to be applied to the image when it is displayed. The tools that may be selected include zoom, processed, annotation, CAD, patient information, invert, flip horizontal, flip vertical.
The zoom select menu 636 is used when the zoom tool is active to select a zoom multiplier. For example, zooms of 2� thru 6� may be selected.
When a user has made all the desired selections and modifications for the next element to be added to the workflow, the add button 608 may be used to save the element definition. The remove button 638 may be used to delete an element from the workflow. Finally, once the user is satisfied with the formatting and sequencing of the workflow, the save workflow button 640 can be used to save the workflow into the system database. It will be appreciated that this workflow information may be used for retrieving and caching images for improved image review efficiency. The remove workflow button 642 is used to remove and entire workflow from the system database. A start button (not shown) can be used to start a newly selected workflow sequence.
Those skilled in the art will now see that certain modifications can be made to the apparatus and methods herein disclosed with respect to the illustrated embodiments, without departing from the spirit of the instant invention. While the invention has been described above with respect to the preferred embodiments, it will be understood that the invention is adapted to numerous rearrangements, modifications, and alterations, and all such arrangements, modifications, and alterations are intended to be within the scope of the appended claims.
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|U.S. Classification
|378/37, 378/210
|International Classification
|Cooperative Classification
|European Classification
|Sep 26, 2003
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