text:
|Publication number
|Publication type
|Application number
|Publication date
|Jan 19, 2010
|Filing date
|Oct 21, 2004
|Priority date
|Oct 21, 2004
|Fee status
|Also published as
|Publication number
|Roger S. Zimmerman, Paul Egerman, Benjamin Chigier
|Original Assignee
|Escription, Inc.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (37), Non-Patent Citations (2), Referenced by (9), Classifications (8), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
Healthcare costs in the United States account for a significant share of the GNP. The affordability of healthcare is of great concern to many Americans. Technological innovations offer an important leverage to reduce healthcare costs.
Many Healthcare institutions require doctors to keep accurate and detailed records concerning diagnosis and treatment of patients. Motivation for keeping such records include government regulations (such as Medicare and Medicaid regulations), desire for the best outcome for the patient, and mitigation of liability. The records include patient notes that reflect information that a doctor or other person adds to a patient record after a given diagnosis, patient interaction, lab test or the like.
Record keeping can be a time-consuming task, and the physician's time is valuable. The time required for a physician to hand-write or type patient notes can represent a significant expense. Verbal dictation of patient notes offers significant time savings to physicians, and is becoming increasingly prevalent in modern healthcare organizations.
Over time, a significant industry has evolved around the transcription of medical dictation. Several companies produce special-purpose voice mailbox systems for storing medical dictation. These centralized systems hold voice mailboxes for a large number of physicians, each of whom can access a voice mailbox by dialing a phone number and putting in his or her identification code. These dictation voice mailbox systems are typically purchased or shared by healthcare institutions. Prices can be over $100,000 per voice mailbox system. Even at these prices, these centralized systems save healthcare institutions vast sums of money over the cost of maintaining records in a more distributed fashion.
Using today's voice mailbox medical dictation systems, when a doctor completes an interaction with a patient, the doctor calls a dictation voice mailbox, and dictates the records of the interaction with the patient. The voice mailbox is later accessed by a medical transcriptionist who listens to the audio and transcribes the audio into a text record. The playback of the audio data from the voice mailbox may be controlled by the transcriptionist through a set of foot pedals that mimic the action of the "forward", "play", and "rewind" buttons on a tape player. Should a transcriptionist hear an unfamiliar word, the standard practice is to stop the audio playback and look up the word in a printed dictionary.
The medical transcriptionist's time is less costly for the hospital than the doctor's time, and the medical transcriptionist is typically much more familiar with the computerized record-keeping systems than the doctor is, so this system offers a significant overall cost saving to the hospital.
The information dictated by the doctor often includes sensitive or confidential information, such as patient name, age, visit dates, medical record numbers, account numbers, referring physicians, consulting physicians, and other provider names and addresses, for example. Furthermore, recent federal regulations under the Health Insurance Portability and Accountability Act (HIPAA) increase the importance of maintaining the confidentiality of patient information. For example, HIPAA describes data called "Protected Health Information (PHI)". Protected Health Information includes medical records data in which the patient is identified. As a result of this Act, many security measures are being created to protect this data.
Embodiments of the invention may provide security that is useful for medical records documents that include patient identification material. A mechanism may be provided that permits documents to be separated from the patient identification during transmission. Thus, an interceptor of a document during transmission will preferably not have enough information to identify the patient to which the document refers. Even if a document and its patient identification information are both intercepted, determining that the two portions of information belong with each other may be difficult. Security may be further enhanced by separating the patient identifying material from the text of the document.
In general, in an aspect, the invention provides a computer program product for use with dictated medical patient information, the computer program product residing on a computer-readable medium and comprising computer-readable instructions for causing a computer to analyze the dictated information, identify likely confidential information in the dictated medical patient information, and treat the likely confidential information disparately from likely non-confidential information in the dictated medical patient information.
Embodiments of the invention may include one or more of the following features. The computer program can be configured to cause the computer to restrict access to the likely confidential information. The instructions for causing the computer to treat the likely confidential information disparately from likely non-confidential information can cause the computer to store the likely confidential information and the likely non-confidential information such that which information is the likely confidential information is discernable. The instructions for causing the computer to treat the likely confidential information disparately from likely non-confidential information can also cause the computer to store a confidential indication in association with the likely-confidential information. The instructions for causing the computer to treat the likely confidential information disparately from likely non-confidential information can further cause the computer to transmit the likely confidential information separately from the likely non-confidential information to a communication network. The instructions for causing the computer to transmit the likely confidential information separately from the likely non-confidential information to a communication network can cause the computer to transmit likely confidential audio dictated information separately from likely non-confidential audio dictated information and to transmit likely confidential transcribed textual information corresponding to the likely confidential audio information separately from likely non-confidential transcribed textual information corresponding to the likely non-confidential audio dictated information.
Embodiments of the invention may further include one or more of the following features. The instructions for causing the computer to identify likely confidential information in the dictated medical patient information can cause the computer to identify particular phrases, containing at least one word, as the likely confidential information. The instructions for causing the computer to identify likely confidential information in the dictated medical patient information can further cause the computer to identify a boundary between a body of a transcribed document associated with the dictated information and at least one of a header and a footer of the transcribed document. The instructions for causing the computer to identify the boundary can further cause the computer to apply a statistical trigger model to the dictated information. The instructions for causing the computer to identify the boundary can also cause the computer to search for trigger phrases, of at least one word, associated with the boundary and compare boundary likelihoods associated with found trigger phrases. The instructions for causing the computer to identify the boundary can cause the computer to determine boundary likelihoods associated with the found trigger phrases by analyzing positions of the found trigger phrases in the dictated information relative to a beginning or an end of the dictated information.
In general, in another aspect, the invention provides a computer program product for use with text transcribed from audio information, the computer program product residing on a computer-readable medium and comprising computer-readable instructions for causing a computer to differentiate between a first portion and a second portion of the text, display the first portion of the text transcribed from audio information, inhibit the second portion of the text from being displayed, and display an indication that the second portion of the text exists.
Embodiments of the invention may include one or more of the following features. The indication that the second portion of the text exists can be a box. The box can be of a fixed size regardless of an amount of text contained in the second portion of the text. The indication that the second portion of the text exists can be an audible indicator. The instructions can be configured to cause the computer to display the indication in a location within the text using a token-alignment file that associates portions of the audio information with portions of the text.
Embodiments of the invention may further include one or more of the following features. The computer product may further include instructions for displaying the second portion of the text in response to a second-portion request for display of the second portion, distinct from a text request for display of the transcribed text. The computer product can include instructions for causing the computer to display the second portion of the text in response to provision of authorization information. Further, the computer product can include instructions for causing the computer to securely store the second portion of the text.
In general, in another aspect, the invention provides a method of processing text transcribed from an audio file regarding a patient, the method comprising displaying a portion of the transcribed text containing non-confidential patient information on a monitor, playing portions of an audio file associated with the transcribed text, and inhibiting a portion of the transcribed text containing confidential patient information from being displayed on the monitor.
Embodiments of the invention can include one or more of the following features. The inhibiting can comprise displaying an indication on the monitor that confidential information is being concealed. The indication can be disposed at a location within the transcribed text corresponding to where the confidential information belongs in the text. The indication can comprise a shaded box. The box can be of a fixed size regardless of an amount of confidential information being concealed. The indication can be an alias for the confidential information. The method can further comprise displaying the confidential information in response to a request to display the confidential information that is distinct from an initial request to display the transcribed text.
In general, in another aspect, the invention provides a method of processing a medical patient dictation, the method comprising analyzing the dictated information, identifying likely confidential information in the dictated medical patient information, and treating the likely confidential information disparately from likely non-confidential information in the dictated medical patient information.
Embodiments of the invention can include one or more of the following features. The method may further comprise labeling a portion of the dictated information to distinguish the likely confidential information from the likely non-confidential information. The method may further comprise inhibiting access to the likely confidential information. The method may also comprise transmitting the likely confidential information and the likely non-confidential information separately over a communication network. The method still further may comprise identifying a boundary between a body of a transcribed document associated with the medical patient dictation and at least one of a header and a footer of the transcribed document. Identifying the boundary can comprise applying a statistical trigger model to the medical patient dictation. Applying the statistical trigger model may comprise searching for trigger phrases, of at least one word, associated with the boundary and comparing boundary likelihoods associated with found trigger phrases.
Aspects of the invention may include one or more of the following capabilities. Confidential information is removed or concealed from the body of a medical record document. The confidential information is accessible to authorized users by listening to audio associated with a medical record document, or by accessing a secure database. Separate audio files having various levels of confidential information can be transmitted and/or stored separately from non-confidential information. Separate text files having various levels of confidential information can be transmitted and/or stored separately from non-confidential transcribed information. The confidential information is secured by associating it with a medical record document via a unique identifier. Medical records information contained in clinician audio dictations are de-identified from the resulting transcriptions. Transcribed information can be added or changed at a transcription device without revealing the confidential information. The cost of medical transcription is reduced. Information associated with a patient's identity can be inhibited from being paired with information of a patient's medical exam by an interceptor of information transmitted over a public network.
These and other capabilities of the invention, along with the invention itself, will be more fully understood after a review of the following figures, detailed description, and claims.
Embodiments of the invention can provide a secure database for the storage of confidential information related to documents associated with a digital audio signal of speech to be transcribed. Confidential information can be removed from the body of a medical records document. Authorized users access the confidential information by listening to the audio associated with the document. Confidential information is stored separately in textual form in a medical records database, and associated with a medical record document. Confidential information is concealed from view in a text document being edited. The private information is accessible to authorized persons via a login or a password. Other embodiments are within the scope of the disclosure.
Referring to
Preferably, the voice mailbox system 16, the administrative console 18, and the editing device 20 are situated "off site" from the database server 24 and the automatic transcription device 30. These systems/devices 16, 18, 20, however, could be located "on site," and communications between them may take place, e.g., over a local area network. Similarly, it is possible to locate the automatic transcription device 30 off-site, and have the device 30 communicate with the database server 24 over the network 22.
The network 14 is configured to convey dictation from the speaker 12 to the voice mailbox system 16. Preferably, the speaker 12 dictates into an audio transducer such as a telephone, and the transduced audio is transmitted over the telephone network 14 into the voice mailbox system 16, such as the Intelliscript™ product made by eScription™ of Needham, Mass. The speaker 12 may, however, use means other than a standard telephone for creating a digital audio file for each dictation. For example, the speaker 12 may dictate into a handheld PDA device that includes its own digitization mechanism for storing the audio file. Or, the speaker 12 may use a standard "dictation station," such as those provided by many vendors. Still other devices may be used by the speaker 12 for dictating, and possibly digitizing the dictation, and sending it to the voice mailbox system 16.
The voice mailbox system 16 is configured to digitize audio from the speaker 12 to produce a digital audio file of the dictation. For example, the system 16 may use the Intelliscript™ product made by eScription.
The voice mailbox system 16 is further configured to prompt the speaker 12 to enter an identification code and a worktype code. The speaker 12 can enter the codes, e.g., by pressing buttons on a telephone to send DTMF tones, or by speaking the codes into the telephone. The system 16 may provide speech recognition to convert the spoken codes into a digital identification code and a digital worktype code. The mailbox system 16 is further configured to store the identifying code and the worktype code in association with the dictation. The system 16 preferably prompts the speaker 12 to provide the worktype code at least for each dictation related to the medical field. The worktype code designates a category of work to which the dictation pertains, e.g., for medical applications this could include Office Note, Consultation, Operative Note, Discharge Summary, Radiology report, etc. The worktype code may be used to refine speed settings, such that settings may be specific not only to speaker-transcriptionist pairings, but further to worktype of dictations provided by the speaker, and/or to other parameters or indicia. The following discussion, however, focuses on using only speaker-transcriptionist pairings.
The voice mailbox system 16 is further configured to transmit the digital audio file and speaker identification code over the network 22 to the database server 24 for storage. This transmission is accomplished by the system 16 product using standard network transmission protocols communicating with the database server 24.
The database server 24 is configured to store the incoming data from the voice mailbox system 16, as well as from other sources. For example, information such as patient Medical Record Number (MRN), date of dictation, date of encounter, account number, and other information can originate from the voice mailbox system 16, from a hospital billing system, or from another source. The database server 24 may include the EditScript Server™ database product from eScription. Software of the database server is configured to produce a database record for the dictation, including a file pointer to the digital audio data, and a field containing the identification code for the speaker 12. If the audio and identifying data are stored on a PDA, the PDA may be connected to a computer running the HandiScript™ software product made by eScription that will perform the data transfer and communication with the database server 24 to enable a database record to be produced for the dictation.
Preferably, all communication with the database server 24 is intermediated by a "servlet" application 32 that includes an in-memory cached representation of recent database entries. The servlet 32 is configured to service requests from the voice mailbox system 16, the automatic transcription device 30, the editing device 20, and the administrative console 18, reading from the database when the servlet's cache does not contain the required information. The servlet 32 includes a separate software module that helps ensure that the servlet's cache is synchronized with the contents of the database. This helps allow the database to be off-loaded of much of the real-time data-communication and to grow to be much larger than otherwise possible. For simplicity, however, the below discussion does not refer to the servlet, but all database access activities may be realized using the servlet application 32 as an intermediary.
The automatic transcription device 30 may access the database 40 in the database server 24 over the data network 26 for transcribing the stored dictation. The automatic transcription device 30 uses an automatic speech recognition (ASR) device (e.g., software) to produce a draft transcription for the dictation. An example of ASR technology is the AutoScript™ product made by eScription that also uses the speaker and, optionally, worktype identifying information to access speaker and speaker-worktype dependent ASR models with which to perform the transcription.
The device 30 transmits the draft transcription over the data network 26 to the database server 24 for storage in the database and to be accessed, along with the digital audio file, by the editing device 20.
The device 30 is further configured to affect the presentation of the draft transcription. The device 30, as part of speech recognition or as part of post-processing after speech recognition, can add or change items affecting document presentation such as formats, abbreviations, and other text features. The device 28 includes a speech recognizer and may also include a post-processor for performing operations in addition to the speech recognition, although the speech recognizer itself may perform some or all of these additional functions.
Automatic speech recognition (ASR) models in the device 30 used to produce draft transcriptions include different types of grammars for recognizing the speaker's dictation. The grammars can be, for example, generic, specific, or intermediate. Generic grammars are designed to recognize speech from a random speaker. Specific grammars are designed/adapted for a particular speaker, either being designed from scratch for the speaker 12 or having been adapted from a more general grammar in response to previous dictations and edited transcriptions. An example of an intermediate grammar is a grammar designed not for a particular speaker, but for speakers that are likely to follow a particular pattern. For example, doctors from a particular institution may be instructed to dictate patient records with a particular format, and the grammar can be designed to improve recognition based on knowledge of expected phrases and/or organization of the patient record.
The automatic transcription device 30 is further configured to identify confidential portions of dictations, including particular data, header regions, and footer regions. Confidential/private patient information includes, e.g., patient name, medical record number, and/or other information from which a patient's identity may be discerned, at least to reasonable (or unacceptable) degree of certainty. The ASR models can be used to identify particular data, such as portions of the dictation that includes the provider name, patient name, patient names spelled out, date of encounter, worktype and/or Medical Record Number (MRN). The device 30 also preferably is able to identify header and footer portions of a dictation as these introductory and closing portions often contain confidential information. The device 30 can analyze the text for the manner in which the speaker begins the dictation. For example, the device 30 may include a grammar such as, "This is Dr. <PROVIDER NAME> dictating an office note on <PATIENT NAME>, medical record number <MRN>. Date of visit is <DATE OF ENCOUNTER>". The device 30 can additionally analyze the text for the manner in which a speaker 12 begins the body of a dictation, which indicates the completion of the header. For example, the device 30 may include a grammar such as, "CHIEF COMPLAINT: Mr. <PATIENT_LAST_NAME> comes in today complaining of chest pain." The device 30 may also include a grammar related to the manner in which a speaker 12 dictates the end of a note, or footer. For example, the device 30 may include a grammar such as, "This is <PROVIDER NAME>. Please send a copy to <CONTACT1> and <CONTACT2>, as well as to my office."
Preferably, the device 30 uses the grammars to identify the location of the header and footer in a dictation. These grammars provide trigger words or phrases that indicate the boundary from the header to the body of the dictation or from the body of the dictation to the footer. Examples of additional end-of-header (i.e. beginning-of-body) trigger phrases include: "The patient is a", followed by an age; "The patient comes in today complaining of . . . "; "history". Examples of footer (i.e. end-of-body) trigger phrases include: "That's all"; "Please send a copy of this to . . . ". In many cases, these triggers by themselves will be sufficient to reliably identify the end of the header and beginning of the footer. These phrases may, however, be supplemented by a statistical trigger model to help identify the boundaries. The model is statistical in that it determines the likelihood of one or more locations being a header/body or body/footer transition, and uses the most likely location as the actual location of the transition. A statistical trigger model can be used alone, or can be combined with a duration model, such as a specified number of words, for the header, body, and footer in order to resolve ambiguities in determining whether particular grammar is a part of the header or the footer. For example, a statistical analysis may include that the phrase "Please send a copy to . . . " has a 90% probability of being a boundary phrase when it occurs within the final thirty words of a dictation. The statistical trigger model may be constrained by the structure of the document, for example, requiring that the footer follows the body, which follows the header.
The header and footer region of the dictation can alternatively be identified by the transcription device 30 in one of the following ways. The header and footer may be identified by using an instance of a listened-to/transcribed header/footer to form the grammar which is used to remove the header/footer from subsequent dictations. A catalog of grammars from a database of providers may be employed to identify headers/footers. The grammars can be scored to determine likely instances of headers/footers in different grammars. A generalized search for words associated with tags in the token-alignment file, discussed below, can be conducted, and may be narrowed using the current date or medical record numbers.
In the event that speech recognition errors occur, a) known or common errors from speech recognition can be explicitly included; b) "wild-cards" that model words which are known to cause recognition errors can be utilized. For example, instead of "the patient comes in today complaining of", the grammar might be "* patient comes * complaining *", since the non-wildcarded words are known to be reliably recognized. The identified confidential information, including header and footer information, are stored separately and treated differently than non-confidential information for the editing process discussed below. Portions of the dictation that include confidential information can be stored separately from non-confidential information in the database 40. For example, the database 40 may include multiple databases, and the confidential information may be stored in a database separate from a database in which non-confidential information is stored. Confidential information can be stored in the same database, but in a separate portion (e.g., a separate file), as non-confidential information. The confidential information is stored separately in that access to the confidential information is inhibited/restricted such that a user that has access to non-confidential information in the database 40 does not necessarily have access to the confidential information. For example, access to the confidential information may require a password or other security measure. Further, the confidential information that appears in the body of the dictation document is tagged, e.g., to help inhibit access to the confidential information even if it is not contained in the header or footer. Additional security can include encrypting the data before sending the data to the user terminal for the editing process, or encrypting the data while the data is en route to the user terminal.
The transcription device 30 is further configured to produce a token-alignment file that synchronizes the audio with the corresponding text. This file comprises a set of token records, with each record preferably containing a token, a begin index, and an end index. The token comprises a character or a sequence of characters that are to appear on the screen during a word-processing session, or one or more sounds that may or may not appear as text on a screen. A begin index comprises an array reference into the audio file corresponding to the place in the audio file where the corresponding token begins. The end index comprises an array reference into the digital audio file corresponding to the point in the audio file where the corresponding token ends. As an alternative, the end index may not exist separately, with it being assumed that the starting point of the next token (the next begin index) is also the ending point of the previous token. The transcription device 30 can store the token-alignment file in the database 40.
The token-alignment file may contain further information, such as a display indicator and/or a playback indicator. The display indicator's value indicates whether the corresponding token is to be displayed, e.g., on a computer monitor, while the transcription is being edited. Using non-displayed tokens can help facilitate editing of the transcription while maintaining synchronization between on-screen tokens and the digital audio file. For example, a speaker may use an alias, e.g., for a heading, and standard heading (e.g., Physical Examination) may be displayed while the words actually spoken by the speaker (e.g., "On exam today") are audibly played but not displayed as text (hidden). The playback indicator's value indicates whether the corresponding token has audio associated with the token. Using the playback indicator can also help facilitate editing the transcription while maintaining synchronization between on-screen tokens and the digital audio file. The playback indicator's value may be adjusted dynamically during audio playback, e.g., by input from the transcriptionist. The adjustment may, e.g., cause audio associated with corresponding tokens (e.g., hesitation words) to be skipped partially or entirely, that may help increase the transcriptionist's productivity.
The tokens stored in the token-alignment file may or may not correspond to words. Instead, a token may represent one or more characters that appear on a display during editing of the transcription, or sounds that occur in the audio file. Thus, the written transcription may have a different form and/or format than the exact words that were spoken by the person 12. For example, a token may represent conventional words such as "the," "patient," or "esophagogastroduodenoscopy," multiple words, partial words, abbreviations or acronyms, numbers, dates, sounds (e.g., a cough, a yawn, a bell), absence of sound (silence), etc. For example, the speaker 12 may say "USA" and the automatic transcription device 30 may interpret and expand this into "United States of America." In this example, the token is "United States of America" and the begin index would point to the beginning of the audio signal for "USA" and, if the token-alignment file uses end indexes, the end index would point to the end of the audio signal "USA." As another example, the speaker 12 might say "April 2 of last year," and the text might appear on the display as "04/02/2003." The tokens, however, can synchronize the text "04/02/2003" with the audio of "April 2 of last year." As another example, the speaker 12 might say "miles per hour" while the text is displayed as "MPH." Using the tokens, the speech recognizer 30, or a post-processor in or separate from the device 30, may alter, expand, contract, and/or format the spoken words when converting to text without losing the audio synchronization. Tokens preferably have variable lengths, with different tokens having different lengths.
The token-alignment file provides an environment with many features. Items may appear on a screen but not have any audio signal associated with them (e.g., implicit titles and headings). Items may have audio associated with them and may appear on the screen but may not appear as words (e.g., numeric tokens such as "120/88"). Items may have audio associated with them, appear on the screen, and appear as words contained in the audio (e.g., "the patient showed delayed recovery"). Multiple words may appear on the screen corresponding to audio that is an abbreviated form of what appears on the screen (e.g., "United States of America" may be displayed corresponding to audio of "USA"). Items may have audio associated with them but not have corresponding symbols appear on the screen (e.g., a cough, an ending salutation such as "that's all," commands or instructions to the transcriptionist such as "start a new paragraph," etc.).
In addition, in the token-alignment file, XML tags, such as <Header>, </Header> and <Footer>, </Footer> are included as zero-duration, non-playable, non-displayable records. Tags are also added around other data contained in the headers and footers. For example, tags can be added to identify <MRN>, <DATE OF ENCOUNTER>, and <CONTACTS>. In the body of the dictation, tags are added around recognized information, including but not limited to <PATIENT NAME>, <PROVIDER NAME>, and <CONTACTS>. The tags allow identification of words in the dictation that contain specific information. The specified words can be manipulated due to the tag assigned to the words. For example, the words having specified tags associated with private/confidential information can be blocked from view in a transcribed document. At the time of editing, tagged words can be obfuscated. For example, <PATIENT NAME> can be changed to "the patient" or to "Mr. ???" for instances of its occurrence throughout the transcribed document to protect the identity of the patient.
Referring further to
The edited text document can be transmitted directly to a customer's medical record system or accessed over the data network 22 from the database by the administrative console 18. The console 18 may include an administrative console software product such as Emon™ made by eScription.
Referring to
The editing software includes the database interaction module 41, the user interface module 42, the word processing module 44, the audio playback module 46, the audio file pointer adjustment module 48 and the multi-cursor control module 50. The interaction module 41 regulates communications between database server 24 and the editing device 20 via the network 22. The control module 50 regulates the interaction between the interface module 42 and the word processors 44, the audio playback modules 46, and the audio file pointer 48. The control module 50 regulates the flow of actions relating to processing of a transcription, including playing audio and providing cursors in the transcribed text. The user interface module 42 controls the activity of the other modules and includes keyboard detection 56, mouse detection 58, and foot pedal detection 60 sub-modules for processing input from a keyboard 62, a mouse 64, and a foot-pedal 66. The foot pedal 66 is a standard transcription foot pedal and is connected to the editing device computer through the computer's serial port. The foot pedal 66 preferably includes a "fast forward" portion and a "rewind" portion.
The transcriptionist is permitted to access dictations downloaded to the user interface module 42 based on provider (or groups of providers) and patient identification. The transcriptionist logs onto the user interface module 42 with a logon name and a password so that dictations assigned to a particular transcriptionist are visible in a work queue. The transcriptionist can request a job from the database by selecting on-screen icon with the mouse 64. The user interface module 42 interprets this mouse click and invokes the database interaction module 41 to request the next job from the database 40. The database server 24 (
The audio playback module 46 is configured to play the audio file associated with the body of the dictation 43 and the audio associated with the header/footer 45. The transcriptionist accesses the audio files 43 and 45 when prepared for editing. For initial playback, the module 46 plays the audio file sequentially. The playback module 46 can, however, jump to audio corresponding to an indicated portion of the transcription and begin playback from the indicated location. For example, the playback module 46 can request the header audio and begin playback of the header. The location may be indicated by a transcriptionist using appropriate portions of the editing device 20 such as the keyboard 62, or the mouse 64. For playback that starts at an indicated location, the playback module 46 uses the token-alignment file to determine the location in the audio file corresponding to the indicated transcription text. Since many audio playback programs play audio in fixed-sized sections (called "frames"), the audio playback module 46 may convert the indicated begin index to the nearest preceding frame for playback. For example, an audio device 54 may play only frames of 128 bytes in length. In this example, the audio playback module uses the token-alignment file to find the nearest prior starting frame that is a multiple of 128 bytes from the beginning of the audio file. Thus, the starting point for audio playback may not correspond precisely to the selected text in the transcription.
The transcriptionist can review and edit a document by appropriately controlling portions of the editing device 20. The transcriptionist can regulate the playback using the foot pedal 66, and listen to the audio corresponding to the text as played by the playback module 46 and converted to sound by the audio device 54. Further, the transcriptionist can move a cursor to a desired portion of the display of the monitor 52 using the keyboard 62 and/or mouse 64, and can make edits at the location of the cursor using the keyboard 62 and/or mouse 64.
The user interface 42 downloads the text of the document to the word processor 44 according to the editing program, which provides restricted access and display of header/footer data and other confidential information. If the transcriptionist positions the cursor for playback of confidential information, then the transcriptionist can be prompted to enter a password, or otherwise fulfill a security measure (e.g., provide bioinformatic information such as a fingerprint) in order to be provided with the text and/or audio corresponding to the confidential information.
Referring to
A second hot key sequence is used by the transcriptionist to reveal recognized words in the body of the document which have been obfuscated by internal tags. The transcriptionist may use the hot key sequence to call forth and edit the protected language.
While the transcriptionist is editing the document, the user interface module 42 can service hardware interrupts from all three of its sub-modules 56, 58, 60. The transcriptionist can use the foot pedal 66 to indicate that the audio should be "rewound," or "fast-forwarded" to a different time point in the dictation. These foot-pedal presses are serviced as hardware interrupts by the user interaction module 42. Most standard key presses and on-document mouse-clicks are sent to the word processing module 44 to perform the document editing functions indicated and to update the monitor display. Some user interaction, however, may be directed to the audio-playback oriented modules 46, 48, 50, e.g., cursor control, audio position control, and/or volume control. The transcriptionist may indicate that editing is complete by clicking another icon. In response to such an indication, the final text file is sent through the database interaction module 42 to the database server 24.
In operation, referring to
At stage 102, the automatic transcription device 30 seeks to transcribe the audio file, and to extract the header and footer from a dictation audio file stored in the database 40. The automatic transcription device 30 accesses and retrieves the audio file from the database through the LAN 26. The dictation is accompanied by the speaker name (and variants), the patient name (and variants), date information, MRN, as well as other available information.
At stage 104, a speech recognizer of the device 30 analyzes the audio file in accordance with ASR models to produce a draft text document from the audio file. The ASR model includes information on the manner in which physicians dictate to decode word sequence.
At stage 106, the device 30 identifies the header of the dictation using model grammars associated with header language. The identified header is removed from the dictation for separate storage in the database 40. Confidential terms in the header are separately tagged.
At stage 108, the device 30 identifies the footer of the dictation using model grammars associated with footer language. The identified footer is removed from the dictation for separate storage in the database 40. Confidential terms in the header are separately tagged.
At stage 110, the device 30 also produces a corresponding token-alignment file that includes the draft documents and associated portions of the audio file with the transcribed text of the documents. The token-alignment files include XML tags, such as <HEADER></HEADER> and <FOOTER></FOOTER> as meta information for the editing software, described below. The device 30 stores the token-alignment file in the database 40 via the LAN 26.
At stage 112, the header and the footer are stored in the database separate from other portions of the dictation. The header and footer are stored in a secure portion of memory in the server 24. The remainder of the dictation is stored separately from the confidential information, e.g., in a separate file.
In operation, referring to
At stage 202, the speaker 12 dictates desired speech to be converted to text. The speaker can use, e.g., a hand-held device such as a personal digital assistant, to dictate audio that is transmitted over the network 14 to the voice mailbox 16. The audio is stored in the voice mailbox 16 as at least one audio file. The audio file is transmitted over the network 22 to the database server 24 and is stored in the database 40.
At stage 204, the automatic transcription device 30 seeks to transcribe the audio file according to the process 100 in
At stage 206, the transcriptionist reviews and edits the transcribed draft document as appropriate. The transcriptionist uses the editing device 20 to access the database 40 and retrieve the audio file and the token-alignment file that includes the draft text document. The editing of header and footer data is further described below with respect to
At stage 208, the track-changes information is provided to the automatic transcription device 30 for use in improving the speech models used by the speech recognizer of the device 30 by analyzing the transcribed draft text and what revisions were made by the transcriptionist. The models can be adjusted so that the next time the speech recognizer analyzes speech that was edited by the transcriptionist, the recognizer will transcribe the same or similar audio to the edited text instead of the draft text previously provided. At stage 210, the word processor provides a final, revised text document as edited by the transcriptionist. This final document can be stored in the database 40 and provided via the network 22 to interested parties, e.g., the speaker that dictated the audio file.
Referring to
At stage 302, the transcriptionist logs in with a user name and password, and dictations assigned to them are shown in the queue. When a dictation is chosen, the audio and document are downloaded, preferably separately, to the transcriptionist's computer. The audio is preferably stored in a secure location. The audio may be separated into more than one file, such as a file for the header, a file for the footer, and a file for the body. Information from the token alignment file is used to find the correct location in the audio file in order to accomplish the audio separation.
In exemplary embodiments, audio separation is employed to additionally alter the audio file to remove patient identification information. For example, the audio might sound a tone in lieu of a spoken patient name is spoken. The audio exchanged for the confidential information may alternatively be an alias for the confidential term, such as a generic name, or other desired sound masking/concealing the actual spoken audio.
When the document is being edited, particular audio files can be accessed. The file-read permissions on the audio files and the document can restrict access to anyone but the transcriptionist who has logged on.
At stage 306, the transcriptionist chooses an audio file associated with either the header, the footer, or the body. If the header or the footer are desired to be edited, the transcriptionist activates a hot key, at stage 312, to call forth the grey boxes 78, 79 so that the boxes appear on the monitor 52. At stage 314, the blocked access boxes 78, 79 are displayed, and at stage 316, the transcriptionist listens to audio associated with the header. A similar procedure would be used for editing other portions of a document containing confidential information. The transcriptionist may be required to enter a password or provide other security information before the grey boxes 78, 79 appear on the monitor.
At stage 318, the header fields are reviewed and/or edited. Data appearing in the grey boxes includes patient name and other confidential data that is reviewed for accuracy. Upon completion of editing, at stage 320, the grey boxes 78, 79 are hidden from view once again. Data entered into the boxes is no longer visible on the monitor 52.
Other embodiments are within the scope and spirit of the appended claims. For example, due to the nature of software, functions described above can be implemented using software, hardware, firmware, hardwiring, or combinations of any of these. Features implementing functions may also be physically located at various positions, including being distributed such that portions of functions are implemented at different physical locations. In exemplary embodiments of the invention, the header and footer data are identified and separately stored in a database. It is possible that only one of the header and the footer may be identified and separately stored, or both the header and the footer data can be stored, e.g., in a common file separate from the remainder of the document. Storage of the header and the footer may not be separate from the remainder of the document, but transmittal of the header and the footer may be separated from transmittal of the remainder of the document. In an alternative embodiment, the editing program can include a timeout portion which observes whether there has been a break in editing or audio playback for a given amount of time.
|Cited Patent
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|Kelly Properties, Inc.
|Universal automated training and testing software system
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|Compaq Computer Corporation
|Method and apparatus for providing secure and private keyboard communications in computer systems
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|Boys; Donald R.
|Data stream editing system including a hand-held voice-editing apparatus having a position-finding enunciator
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|Enounce, Incorporated
|Method and apparatus to prepare listener-interest-filtered works
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|Integrated handwriting and speed recognition systems
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|Automated transcription system and method using two speech converting instances and computer-assisted correction
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|Method and apparatus to determine and use audience affinity and aptitude
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|Infogation Corporation
|System and method for dynamic key assignment in enhanced user interface
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|Firewall providing enhanced network security and user transparency
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|Systems and methods of providing content protection for digital video products
|Mar 21, 2006
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|Protecting software environment in isolated execution
|Mar 29, 2006
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|Video communication call authorization
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|Processing of packet data in a communication system
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|Method of digitally signing a contract
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|Apparatus and method for speech recognition using a plurality of confidence score estimation algorithms
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|Method, apparatus, and medium for measuring confidence about speech recognition in speech recognizer
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|Mechanisms to control access to cryptographic keys and to attest to the approved configurations of computer platforms
|Batty et al., "The development of a portable real-time display of voice source characteristics", IEEE, 2:419-422 (2000).
|Batty, S.V.; Garner, P.E.; Howard, D.M.; Turner, P.; White, A.D., The development of a portable real-time display of voice source characteristics, vol. 2, Oct. 25-28, 2001 pp. 1449-1452.
|Citing Patent
|Filing date
|Publication date
|Dec 1, 2006
|Apr 10, 2012
|Cisco Technology, Inc.
|Establishing secure communication sessions in a communication network
|Jan 15, 2010
|Jun 3, 2014
|Nuance Communications, Inc.
|Transcription data security
|Dec 27, 2013
|Sep 16, 2014
|Google Inc.
|Variably controlling access to content
|Dec 29, 2006
|Oct 18, 2007
|Hill John E
|Flexible XML tagging
|Dec 1, 2006
|Jun 5, 2008
|Cisco Technology, Inc.
|Establishing secure communication sessions in a communication network
|Jan 15, 2010
|Jun 24, 2010
|Zimmerman Roger S
|Transcription data security
|Jun 18, 2010
|Oct 7, 2010
|Little Herbert A
|System and method for management of plaintext data in a mobile data processing device
|Aug 13, 2012
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|Escription Inc.
|Insertion of standard text in transcription
|Jun 26, 2013
|Jan 1, 2015
|International Business Machines Corporation
|Protecting confidential content in a user interface
|U.S. Classification
|726/2, 380/277
|International Classification
|Cooperative Classification
|Mar 18, 2008
Owner name: ESCRIPTION, INC., MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:EGERMAN, PAUL;CHIGIER, BENJAMIN;ZIMMERMAN, ROGER S;REEL/FRAME:020668/0876
Effective date: 20080310
|Nov 23, 2010
|Certificate of correction
|Sep 13, 2012
Owner name: NUANCE COMMUNICATIONS, INC., MASSACHUSETTS
Free format text: MERGER;ASSIGNOR:ESCRIPTION, INC.;REEL/FRAME:028951/0840
Effective date: 20080407
|Mar 13, 2013
|Fee payment
Year of fee payment: 4
|Jul 17, 2017
|Fee payment
Year of fee payment: 8


text:
What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
Convert form to fillable pdfAsked by TEDtest on January 13, 2016 at 09:06 PM
I don't see any way to do this. I see the steps iterated on your site but I have no Create PDF option under "More" on my form.
JotForm Support
I checked your account and I can see that there is indeed a Create PDF Form button on the MyForm page.
Can you check again if it is there? Also can you describe how you got the "Incomplete values" so we can further investigate if there are any errors?
I will wait for your reply,
Thanks, Christian. I appreciate the help. I finally was able to see that option as well. Now unfortunately I get an error when I try to submit the PDF-created version of the form. I really want to be able to use this product and eventually implement it widely enough to purchase a plan but I cannot do so unless/until I KNOW it will run smoothly. I can't have frustrated stakeholders, as collecting quality data is already tedious enough. Is there someone I could set up a tech support session with?
JotForm Support
Have you checked this guide: http://www.jotform.com/help/312-Fillable-PDF-Everything-you-need-to-know-about-JotForm-Fillable-PDF-Creator. There are limitations when using the fillable PDF.
Also, when submitting the PDF form, make sure you have downloaded the latest version of it and you are using Adobe Reader or Foxit when submitting the form. If you open the PDF form in a Chrome browser or on other applications, the submit function will most probably won't work.
Let us know if the suggestion above helps.

subset: commoncrawl


text:
This property is no longer available.Search for Available Property.
4.03 acres in Crow Wing County, Minnesota
This property speaks to your love for lake living! Traditional up north style beautifully frames each room. The kitchen is well planned and features a generously sized island. Hardwood flooring, easy care gas fireplace, wood vaulted ceilings, northern designed light fixtures and charming decor! The wrap around deck processes eastern exposure for breathtaking sunrises, moonrises and cool summer evenings while taking in the stunning views of the lake. 30 x 40 storage building with concrete floor.
From Emily- N. on #6 to Blue Lake Rd., L. 1.6 mile to sharp curve to the right. Left on Roosevelt Lane, right on Roosevelt Ridge to 20197.
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Other Land for Sale in Crow Wing County
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NOTE: The information contained herein is provided as general information only and has been obtained from sources deemed reliable. It is provided without any guaranty, warranty or representation, expressed or implied, made by Lands of America, or any related entity, as to the accuracy or completeness of the information. The information is presented subject to errors, omissions, change of price or conditions, prior sale or withdrawal without notice. Prospective purchasers should make their own investigations, projections and conclusions concerning the information.


text:
Login | Terms & Conds
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Online Catalogue | Isle of Man Brass Gifts / Souvenirs
Brass Three Legs of Man approx 155mm in diameter and complete with hook for hanging
Brass teapot stand approx 150mm in diameter. View Larger Image
Brass Three Legs paperweight approx 80mm diameter. View Larger Image
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Dimensions: 45mm (L) x 40mm (H) x 12mm (D)
Site created and maintained by Manannan's Web


text:
If you live near the Freehold, Neptune Township, Tinton Falls, or Brick, NJ area stop in at Toms River Volkswagen. The 2016 VW Touareg is here and available!
Those interested in the 2016 Volkswagen Touareg living in and around the Toms River, Freehold, Neptune Township, Tinton Falls, or Brick, NJ areas, will be thrilled to know that it is now available at Toms River Volkswagen. We have all five trim levels of the 2016 VW Touareg (V6 Sport, V6 Sport with Technology, V6 Lux, V6 Executive, and V6 Executive) available here at 256 Route 37 in East Toms River, NJ 08753 for you to test drive. Once you've driven the 2016 VW Touareg, head into our finance department to learn about your different lease and financing options. After, the only thing that'll be left is for you to pick one of the nine color options, which include Deep Black, Flint Gray and Moonlight Blue, and head over to Savor Restaurant for a celebratory meal!
2016 Volkswagen Touareg Performance Overview
If you're looking for a vehicle that has the power to get you through the winters in Toms River, NJ you'll appreciate the 2016 VW Touareg. This model is powered by a 3.6L V6 FSI® Engine that generates 280 hp and 266 lb-ft of torque with the help of an Eight-Speed Automatic Transmission with Tiptronic®. Each trim level of the 2106 VW Touareg also comes standard with a 4MOTION® Permanent All-Wheel Drive System.
2016 VW Touareg EPA Fuel Economy Estimates
The EPA estimated MPG is 17 city/23 highway/19 combined* for the 2016 Volkswagen Touareg lineup.
2016 Volkswagen Touareg Safety Feature Highlights
As always, safety is the top priority for Volkswagen and it's apparent on the 2016 VW Touareg. Standard features that will keep you and your family safe, even when you travel out of Freehold, NJ include Side Curtain Protection® Head Airbags, Brake Override System, Passenger Occupant Detection, Engine Braking Assist, Electronic Stability Control including Electronic Differential Lock, Anti-Slip Regulation, Electro-Mechanical Parking Brake, Automatic Post-Collision Braking System, Hydraulic Brake Assist, Hill Descent Assist, Rollover Sensor System, Automatic Locking Retractors, Crash-Optimized Front End, Tire Pressure Monitoring System, Intelligent Crash Response System, Child Safety Locks on Rear Doors, Anti-Theft Alarm System with Immobilizer, Reinforced Safety Cage Construction, Electronic Brake-Pressure Distribution, LATCH System, Crash-Optimized Pedal Controls, ABS, Standard Electronic Stability Control and Front and Side Thorax Airbag Supplemental Restraint System.
2016 VW Touareg V6 Sport Features
The first trim level of the 2016 VW Touareg is the V6 Sport. It comes with standard convenience features like Heated Windshield Washer Nozzles, Trailer Hitch Preparation, Rain-Sensing Variable Intermittent Windshield Wipers, Dual Chrome-Tipped Exhaust Tips, Remote Opening and Closing Power Tailgate with Closing Assist, Privacy Glass, Silver Roof Rails, Heated Side Mirrors with Integrated Flood Lighting, Blinker Control Stalk with Lane Change Feature, Bi-Xenon HID Adaptive Front-Lighting System, LED Daytime Running Lights, Automatic Headlights, HomeLink® Garage Door Opener, Four 12V Power Outlets, 115V Power Outlet, 60/40-Split Folding Rear Seat, Carpet Floor Mats, Leather-Wrapped Multifunction Steering Wheel, Interior Ambient Lighting, Premium Color Multifunction Instrument Cluster Display, 18" Aluminum Alloy Wheels, LED Taillights, Cruise Control, Self-Dimming Rearview Mirror, Silver Metallic Interior, Bluetooth® Technology and Audio Streaming, Eight Speakers, SiriusXM® Satellite Radio (three-month trial subscription), Media Device Interface with iPod® Cable, Lockable and Illuminated Glovebox with Adjustable Cooling Feature, RCD 550 Touchscreen Sound System, Heated Front Seats, V-Tex Leatherette Seating Surfaces, 6.5" Color Display, HD Radio, SD Memory Card Reader, AUX Port, Leather-Wrapped Shift Knob and Eight-Way Power-Adjustable Front Seats.
MSRP starts at $42,705** for the 2016 VW Touareg V6 Sport.
2016 Volkswagen Touareg V6 Sport with Technology Features
The 2016 Volkswagen Touareg V6 Sport with Technology trim level adds to the VW Touareg V6 Sport with Keyless Access with Push-Button Start, SiriusXM Traffic™ (four-year subscription), RNS 850 Premium Touchscreen Navigation, 8" Color Display, 3D Landmarks, Hands-Free Easy Open Liftgate, and a 60GB Hard Drive. The Lane Change Assistant and Rearview Camera System will alert you to any obstructions in your way when merging or parking in Neptune Township, NJ.
MSRP starts at $46,745** for the 2016 Volkswagen Touareg V6 Sport with Technology.
2016 VW Touareg V6 Lux Features
The 2016 VW Touareg V6 Lux adds to the VW Touareg V6 Sport with Technology with Power Panoramic Sunroof, Park Distance Control, Electric Seat Release Buttons For Rear Seat, 14-Way Power-Adjustable Front Seats with Driver Seat Memory, Vienna Leather Seating Surfaces with Active Ventilation for Front Seats, Power-Folding Heated Side Mirrors with Memory, 19" Aluminum Alloy Wheels, Adjustable Whiplash-Optimized Head Restraints, and Sapelli Mahogany Interior Trim.
MSRP starts at $51,450** for the 2016 VW Touareg V6 Lux.
2016 Volkswagen Touareg V6 Executive Features
The 2016 Volkswagen Touareg V6 Executive adds to the VW Touareg V6 Lux with Roll-Up Sunshade for Rear Door Window Glass, 620W Stereo Dynaudio® Premium Sound System, Autonomous Emergency Braking, Adaptive Cruise Control, Ten Speakers, Overhead View Camera, 20" Aluminum Alloy Wheels, Forward Collision Warning, Stainless Steel Door Sill Protection, Brushed Aluminum Appearance Pedal Covers, and Engineered Ebony Interior Trim. No matter how chilly it gets in Tinton Falls, NJ, you and your passengers will be comfortable in your 2016 Volkswagen Touareg V6 Executive thanks to the Heated Front and Rear Seats.
MSRP starts at $59,745** for the 2016 Volkswagen Touareg V6 Executive.
2016 VW Touareg V6 Executive with 21" Mallory Features
The final trim level of the 2016 VW Touareg is the VW Touareg V6 Executive with 21" Mallory Wheels, which adds attention-grabbing 21" Aluminum Alloy Wheels to the VW Touareg V6 Executive trim level. When you take your new Touareg for a spin through Brick, NJ, you'll make heads turn with these eye-popping, alloy wheels.
MSRP starts at $60,185** for the 2016 VW Touareg V6 Executive with 21" Mallory Wheels.
Visit Toms River Volkswagen today - Test Drive YOUR favorite 2016 Volkswagen Touareg!
When you want luxury and versatility at an economy price, you want the 2016 Volkswagen Touareg. This model includes all the safety and convenience features you've come to expect from VW and so much more. Come into Toms River Volkswagen today to get a real feel for this model.
*2016 EPA estimates. Your mileage will vary and depends on several factors, including your driving habits and vehicle condition.
**Starting MSRP. Prices exclude transportation, taxes, title, other options and dealer charges. Dealer sets actual price.


text:
At first, finding furniture for your office may seem simple: you might think it's just a case of buying a few tables, some chairs and maybe even a couple of conference tables, but there's so much more to it than that. To give your business a unique flavour, you should be a little bit more creative: your office should be a comfortable space your staff will be happy to work in and your visitors will remember fondly. What should you keep in mind when buying furniture?
Focus on function first
While aesthetics are obviously key, your priority should be functionality. How many desks will you need to make sure each employee has their own space? How big and sturdy will they need to be to support their equipment (computer, phone, etc.)? How many of a particular size and shape will fit into your office? You should consider each of these points until you have a firm idea of the essential practical needs, and be sure to think about expansion: if you're likely to take on more staff, you'll need to leave enough space.
Mix it up
If your office is separated into various areas—by department, for example—each one could feature a different style of furniture. On a functional level, this could suit the different needs: a creative team may need larger tables or space for drawing boards, while a sales team will need room for a phone and paperwork. On an aesthetic level, mixing furniture styles can make for an eclectic design scheme.
Consider comfort for staff and the wow factor for clients
Your staff's comfort should be of paramount importance. To be happy, efficient and productive, your employees should be able to feel relaxed in their work environment, and the furniture they use all day should contribute to this. Quality chairs and desks should provide enough support and freedom to remain comfortable throughout each shift, and your visitors should also be comfortable throughout their stay. The furniture should also match the décor to leave them impressed.
Why not give ergonomics a try?
Ergonomic furniture is becoming more and more popular, as it offers more comfort and less strain on the body when sitting at a desk for long periods—sitting in an uncomfortable position, on seats offering no support for a proper posture, can lead to health problems.
Here at Furniture At Work, we have a huge range of office furniture suitable for all decors and needs. Feel free to get in touch if you need more information and buying advice.


text:
Yep! After six months of getting nowhere with Amazon and a third party over a petty squabble, physical copies being completely unavailable and not making any profit whatsoever from the digital editions, Mystery Science Storybook and Night of the Living Storybook are now back up for sale in paperback and digital form.
Mystery Science Storybook
Night of the Living Storybook
For those who don't know, this is what Mystery Science Storybook is all about...
"Mystery Science Storybook takes scenes from some of the cheesy films made famous by RiffTrax and Mystery Science Theater 3000 and reimagines them as bedtime stories. It's a graphic novel that puts a new spin on cult classics like Birdemic and "Manos" The Hands of Fate that's perfect for bad movie fans of all ages!" - RiffTrax.com
"[Mystery Science Storybook is] almost certainly what eyes and the English language were invented for. Buy a copy for your friend! Buy a copy for your enemy, who will then read it, love it, and become your friend, too. I'm not saying this book is the key to world peace, but isn't that too big a chance not to take?" - Matthew J. Elliott, RiffTrax Presents
"Before you is a veritable MSTie's playground with hilarious merry-go-rounds that will hurl you right into funny town. This love letter to all things riffing is a gift to the movie mockery community at large!" - Rikk Wolf, Incognito Cinema Warriors XP
I'd like to thank everybody who stood with us these last six months during these setbacks. Circumstances dictate that these books remain as independent projects, therefore resources are limited to how we can sell them and promote their existence. If you have already bought or read the book and liked it, please help us spread the word through social media. Also, please consider becoming a monthly contributor to our Patreon Campaign to keep the money coming so we can complete and publish Volume 3.


text:
Came in a red box labelled "SKYMASTER" which used to contain "RTL8139". Then the chip was changed to "ADICO FE3100".
The Floppy Disk is labelled "PCI FAST Ethernet Adapter Driver Diskette".
This file is the entire contents of the disk as purchased. All operating systems. Windows XP not mentioned.
|Discussion Thread
|Novell 9808 (Windows 98) [PCI / ISA] 1 reply
|Oct 31, 2011
|Novell pnic-100 fast ethernet (Windows 98SE) 1 reply
|Dec 19, 2005
|HELP NEEDED: Novell BD.#738-149-002 Rev.C Assy #810-149-002 Rev.D (DOS)
|Aug 31, 2005
|Novell NE/2 MCA (not ISA, not PCI) (OS/2)
|Aug 26, 2005
|novell ne2000tplus (Windows 98) 1 reply
|May 11, 2005


text:
Mascara open to offers
Giuseppe Mascara would consider his future at Catania if he was the subject of a tempting offer.
By James Dall
Last Updated: 21/06/09 12:25pm
Giuseppe Mascara has intimated that he would consider his future at Catania if he was the subject of a tempting offer.
The 30-year-old striker has reportedly caught the eye of a number of clubs, including Manchester City and Villarreal, after shining in Serie A last season.
Mascara is remaining calm over where he will be plying his trade next campaign but concedes he would weigh up his options should he receive a proposal from elsewhere.
"My priority is this. If an important proposal were to arrive that the club saw fit to evaluate, then we will see what happens," Mascara told La Gazzetta dello Sport.
"For now, I am enjoying my holidays."
Italian forward Mascara signed at Stadio Angelo Massimino from Palermo six years ago.


text:
|3,000 sq. ft.
|Property type
|Minimum Stay
|2 - 3 nights
Inside and out, this stunning hand crafted log home has many unique treatments and finishes; it is truly one of a kind. This beautiful log home is situated on a very private 1.25-acre site surrounded by quaking aspens and pine trees.
This cozy log home has five lovely bedrooms. On the upper level is the master suite with a king size log bed and a large flat screen TV. The master bathroom has a work of art extra large walk-in shower. The second beautifully appointed bedroom located on the main level is done in an early American theme with log bed and a flat screen TV. Additionally we offer two sofa sleepers; one in the upper level loft and one in the living room. The unique finishes in this home are too many to list.
The lower level offers three additional bedrooms: two with queen size beds and a bunk room with three single beds. There is also a full bathroom on this level with a spacious living room. You can access this lower level through stairs inside the house or through full light French doors which lead outside to a one acre lawn.
There is a fully equipped kitchen with an additional butlers kitchen outfitted with its own range and prep counters, one that a gourmet chef would enjoy. All the cabinets are in beautiful cherry wood and you will have all the necessary utensils in order to make a delectable meal. For the cooks in the group you will love this kitchen.
To keep the cabin warm and toasty in the winter, we have a Vermont Casting wood stove with plenty of firewood. Plus there is central heating and air with for those who want to be extra warm and not feel guilty.
To suit the adorable pet friends in your group, we offer a fully fenced area outside to keep your pet safe and happy! Also, after a great day in the outdoors relax in a large new hot tub equipped with a sound system you can use with your phone or other music device.
A short .75-mile away is the Leavenworth Ski Hill, offering downhill, cross country skiing and a great inner tube ride…wonderful for kids and adults! The quaint Bavarian village of Leavenworth is within a leisurely one-mile walk. We would be happy to recommend places to eat, things to do and sites to see.
***For business groups we have a separate meeting space equipped with a large conference table, white boards, wood stove and plenty of windows so you won't miss out on the view! This space is available for an additional fee and has it's own lockable entrance. If you are interested in adding the conference room to your rental, please inquire for the additional fee.
This home is one you will want to return to year after year. We look forward to having you!
Great confortable cabin in a wonderful location. Thanks for supporting our winter wonderland vacation.
The home is spacious and beautifully decorated. The location to downtown, sledding hills for the kids, and the ski resort made this home perfect for our little family reunion. We played in the snow and enjoyed the hot tub--but mostly just enjoyed our time together in the house. The kids played downstairs while the adults visited by the fireplace. We hope to return someday and stay here again!!
Our three nights couldn't have been better. There was plenty of room for our large family gathering. The kids were grinning ear to ear as they chased each other in and around playing in the snow and sliding on their own little hillside. The Cabin had fun touches throughout, making almost a game out of spying each one's location. Even being so spacious and kids running in and out, it was always warm and cozy feeling. The kitchen had all you need and then some with plenty of space as we had three or more preparing meals for our horde. Having a large downstairs area was especially nice as the kids sang karaoke and the adults relaxed upstairs! This is the place we will choose for our next family gathering, no matter what season!
The house is a beautiful log cabin. Not as clean as we like but good. The kitchen is large and easy to use. However, some things just didn't work. The oven door did not close properly so the temperature was hard to gauge. Older skillets, etc. close to town and skiing, hiking. The basement was not homey at all. Needs pictures and seating. Fabulous fireplace upstairs. Heat you out! Lots of wood. The dog area was perfect. Fenced and large. The views make the place.
We held our family reunion at the Morisoli property. It accommodated us all beautifully. Such fun for the cooks, those that lounge and plenty of space for the kids and pets to run. Enjoy the wonderful deck for both sunrise coffee and an evening dinner. Book this place for your next gathering and let the fun begin.
We were a multi-generational family of 8. We spent four nights. The house has everything you would need to prepare meals, relax on the multiple decks and have some friendly competition with croquette, badminton and corn hole games on the expansive lawn. House is well maintained and the location is awesome. It was hot outside, but the AC worked great inside. Once the sun goes down we really enjoyed sitting outside with the expansive views. The owners live nearby and I felt that if we had any issues, they would have addressed them immediately.
|Cleaning Fee
|Additional Guest Fee
|$25 per person per night
|Pet Fee
|Damage Deposit


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My company has 350+ users it wants to move from Exchange to RackSpace hosted email. Is there a faster way to do it other than putting each and every user manually into an excel document and uploading that to RackSpace? Those of you who did similar know what I mean.
Aug 29, 2011 at 9:22 UTC
Aren't you using the Migration App?
6 Replies
Aug 29, 2011 at 9:22 UTC
Aren't you using the Migration App?
Aug 31, 2011 at 10:23 UTC
The what?
Best I see offered is the ability to put every user into a CSV, and create accounts with that. Then we have to upload a different CSV with their Exchange email login/pass to sync. Do tell me of this app.
Aug 31, 2011 at 10:27 UTC
I'm looking for something a bit more automated. Something that will pull all the information from our AD and give it to Rackspace.
Aug 31, 2011 at 10:31 UTC
Verecloud is an IT service provider.
Is this a one-time push of user accounts, or are you looking to have your on-site Active Directory server integrated with hosted Exchange to facilitate single sign on and management of users?
Sep 1, 2011 at 1:55 UTC
It's a one time push of user accounts followed by inboxes. We have it working semi-auto at the moment, but no thanks to Rackspace sadly. We figured out how to pull AD to an excel spreadsheet and have the Rackspace template cross-reference it. The users get uploaded just fine, but the migration of users is just..... ya. Rackspace will talk to our Exchange server just fine, but it has to be done on a per user basis, and with that user's credentials, not a global admin. Which means we get to either get everyones password or reset them all (the option we are going with) on a per user basis. It's been fun.
Sep 1, 2011 at 5:45 UTC
Oh, I thought Rackspace has a Migration App for hosted Exchange. Maybe it's what you're describing: something for individual users.
Can you write a review of the service in Spiceworks describing this problem? Might help someone else down the road who's considering their service.
This discussion has been inactive for over a year.
You may get a better answer to your question by starting a new discussion.


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Any ideas for another Cars video game? My ideas are:
A game of Angry Birds and Cars
A LEGO Cars video game
Another Cars Toon video game
A game having the ability to explore places like London, Paris, Rio de Janeiro, New York and Radiator Springs (with correct locations of the roads, buildings and landmarks, to show landmarks like Big Ben, have proper names for stuff like Big Ben, especially in all of the other games (and the film of Cars 3), and could be included in the Cars 3 video game)
A Cars video game including Toy Box Mode, just like Toy Story 3: The Video Game
Another game having the players inside it like Kinect Rush: A Disney/Pixar Adventure
A racing game showing crossovers of characters from different films like Cars, Toy Story, Rio, Ice Age, Harry Potter, Star Wars, Sonic and others?
A game that has figures of the characters, just like Skylanders


text:
What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
When does our monthly allotted submissions renew?Asked by SMUOA on February 23, 2012 at 05:37 PM
Our understanding was that our forms submission limit would renew each month at or around the 18th. We are almost at our limit and it has surpassed 30 days from monthly date. Please provide an update.
For all users, the counts reset to 0 on the 1st day of every month.


text:
Supplier Homepage Product Red Oak Veneer HDF Door Skin (JHK-004)
Red Oak Veneer HDF Door Skin (JHK-004)
This product is currently unavailable, but you may contact the supplier directly, for further interest.
Basic Info
- Model NO.: JHK-004
- Material: Veneer
- Pressure Resistance: Better, Strive, Powerful
- Delivery: Within 20 Days
- Feature: Best Quality, Good Quality, High Quality
- Moisture: 6% ~ 10%
- Position / Type: Interior / Exterior, Internal / External .
- Style: Classic Style
- Open Style: Swing
- Glass: Without Glass
- Special Function: Detector
- Position: Interior
- Specification: (2000~2150mm)*(620~1050mm)*3.0mm
- HS Code: 4411121900
- Surface Finishing: Unfinished
- Density: >900g/cm3
- Packing: 270sheets/Pallet
- MOQ: 2000 Piece
- Hcho: E1
- Application: Hotel, Apartment, Hospital, School, Office
- Product Material: Solid Wood
- Type: Solid Wood Door
- Opening Direction: Inward
- Color: Red
- Handle Position: Right
- Trademark: JHK
- Origin: Jinhua China
Product Description
Engineered veneer is known as a reconstituted timber / veneer. It's made of fast-growing natural species on plantation. With the certain process of CAD and dyeing, reconstitution, de-bug treatment and pressing, a new high quality and technology product "engineered timber / veneer"is created.
|Height:1850~2150 mm
Width:600~650~700~760~830~870~920~970~1050 mm
Thickness:3.0-6.0 mm
Mold Depth:8mm-17mm
Embossed Design:17mm
|Beech,Ash,Teak,Black Walnut,Red Oak,Sapeli,Beech,Red Walnut,Wenge, etc.
|1)Moisture :8-9%
|2)Water absorption rate :<24%
|3)Modulus of elasticity :>45MPa
|4)Thickness tolerance :<0.1mm
|5)Width/length tolerance :<2.0mm
|1X20` Container, 2600~3100 PCS
|Term of Shippment
|Payment and Shipment
|1)Payment:By T/T or L/C at sight.
|2)Payment:35% deposit and Balance before loading
|3)Shipment:Within 25 days after receive the deposit
|Packing Detail
|250~270 PCS/Pallets, Extra Bundels are available
|Global market for making interior doors
|Wrapped with POLY bag or shrink film paper, then on pallets
Door Skin Type
Our Company


text:
The Encyclopedia of Animation Techniques: A Comprehensive Step-By-Step Directory of Techniques, with an Inspirational Gallery of Finished Works
This book is a fully illustrated, step-by-step guide to drawn, model, and computer-generated animation. It offers professional guidance on all aspects of animation- from conceptualization and script treatments to cutout animation and puppet-making. It also includes a gallery of more than 100 finished works from the world's leading contemporary animators.
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regarding ISBN / ISBN-10 / ISBN10, ISBN-13 / ISBN13, EAN / EAN-13, and Amazon
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text:
Jay Jackson, M.D.
Dr. Jackson is a plastic, reconstructive and bariatric surgeon who is Board Certified in General Surgery by the American Board of Surgery. He received his M.D. from the University of Oklahoma Medical School and his B.S. in Biology from Southwestern Adventist University where he graduated Cum Laude.
Dr. Jackson received his Fellowship from Wayne State University Plastic Surgery and his Residency from MSU/KCMS General Surgery Residency in Kalamazoo, MI.
Published in numerous medical research publications, Dr. Jackson is also listed in Who's Who Among American Universities and Colleges, and has presented at several medical conferences; including the annual American College of Surgeons Conference.
A serious athlete, Dr. Jackson played NAIA College Varsity basketball where he was team captain and starting point guard.Download pdf


text:
So, I send my son to the store and tell him "If they have a beef ribs (7 bone) at a decent price please pick some up". I don't know whether the butcher saw him coming or what but he came home with the thinnest rack of beef ribs I have ever seen. He said "The butcher said he had just taken off the ribeye so this should be tasty and they are fresh".
Not having the heart to send him back to the store I paid him, thanked him and put them in my freezer.
Fast forward 3 months...... I now have thawed out beef ribs that have minimal meat on them but I want to use them somehow.
All of you beef-eaters out there ----- other than throwing the out ---- any ideas?
Thanking anyone in advance for their ideas.......


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Win One of Ten Stardust Bracelets
Complete a Links of London leaflet, which can be picked up in any of our Swag Stores, and hand it to a member of staff to be in with a chance of winning.
*Terms and conditions apply. Prize draw ends 31st May 2014. The winner will be drawn at random and notified within 14 days of closing. Late, illegible or incomplete entries will not be accepted. No responsibility can be accepted for lost entries. Prize is subject to availability, non-transferable and there are no cash alternatives.


text:
What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
How to remove my email from the bounce list?Asked by gracebaptistoh on December 13, 2016 at 12:34 PM
JotForm Support
In order to remove your email from the bounce list, please follow our tutorial: https://www.jotform.com/help/262-How-to-Remove-Your-Email-Address-from-Bounce-List
If you need further assistance please let us know.


text:
Kuppath Homestay
Call us 1800-300-2400-1 (Toll Free) and Get additional Discount upto 50% for this Hotel.
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- About Hotel
- Reviews
Select Room
About Kuppath Homestay
Kuppath Homestay in Kochi provides a front desk to the patrons. Kunnumpuram Bus Stop is within 1 km reach and The Indo-Portuguese Museum is 1 km from this hotel. Room amenities include an air-conditioner, television, wake-up call, wardrobe, bottled/drinking water, attached bathroom with hot and cold running water supply, makeup mirror, telephone and a wardrobe.
No of floors: 2 | No of rooms: 4
Checkin Time: 1200 pm
Checkout Time: 1200 pm
Hotel Information and Amenities
Read More....
Hotel Amenities
- Laundry Facilities
- Front Desk
- Airport Transportation
- Internet Access
- Parking
- Breakfast Services
- H/C Running Water
- Bottled/drinking Water
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- Television-Room
- Reading Lamps
- Sofabed
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Hotel Location


text:
Question: a Define the term seropositivity and explain whether or not
a. Define the term seropositivity, and explain whether or not it develops at the same rate in all patients affected by the same microbe.
b. Would a high rate of false- positive reactions result from a decrease in the sensitivity or specificity of the test?
View Solution:
b. Would a high rate of false- positive reactions result from a decrease in the sensitivity or specificity of the test?
View Solution:
Answer to relevant Questionsa. Explain which type of ELISA can be used to determine an individual's past exposure to a pathogen.b. Discuss whether immunochromatographic assays are indirect or direct methods of testing.a. Conduct additional research, and discuss whether "pox parties" represent a safe method of developing immunity to varicella zoster virus.b. Provide evidence in support of or refuting the following statement: Shingles ...a. Explain why the nervous system is described as "immunologically privileged," and discuss whether this provides a beneficial or disadvantageous effect in this system.b. Discuss the defenses a pathogen encounters as it ...As you learned in chapter 8, many types of fruits and vegetables can be fermented into alcoholic beverages. Such was the case recently when prisoners in Utah attempted to make an illegal beverage called "pruno"; however, ...a. Compare and contrast various characteristics of hemorrhagic and non-hemorrhagic fever diseases.b. Provide an explanation for the observed increase in incidence of these zoonotic infections around the world today.
Post your question


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A reflection on the ideals of the sandbox gaming style in the context of a multithreaded RPG campaign
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- 4156 reads
Most role-playing rule-sets confuse narrative and strategic differences. In an attempt to make the experience of playing a different "type" of character feel different they introduce a multitude of rules to govern the same actions.
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- 12082 reads
Shot in the dark: has anyone ever attempted to play D&D (or any other game system) via a wiki INSTEAD of play-by-post or play-by-email? I'm not interested in comparing play-by-wiki with real-time digital solutions like Fantasy Grounds or Roll20 - I'm focussed on non-real-time comparisons only. There seems to be a healthy number of pros and cons to play-by-wiki vs. play-by-post, and I'm still compiling all the data, but I've seen very few examples of play-by-wiki in the wild - doesn't seem like a popular approach. Trying to understand why.
- 2 comments
- 15280 reads
In early roleplaying games equipment was king. We deliberated over who could carry the gear we needed. Pots, pans, tents, and bedrolls were packed carefully onto our character sheets. Iron rations were bought and consumed -- suppplemented with fresh food when the prospect arose. Our dreams weren't preoccupied with magic items -- a suit of plate armor was a treasure worth countless toil and adventure. Like kids at the pet store we did as much time shopping in windows as we spent acquiring goods. We knew the local blacksmith by name.
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- 72532 reads
The term "plot hook" can actually be more diminishing to your campaign than supportive. It immediately and clearly defines a few points at which the PCs can engage with the setting and the loose storyline you have in mind for the campaign. It limits the points of engagement to those few you planned out and sets you up to have to "wing it" far more than you have to if you're the type to give the PCs the freedom to go "off the map" as it were. Stop baiting plot hooks and instead just cast a net.
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- 62973 reads
In a world of short attention spans and the media that caters to them it can be challenging for a gamemaster to establish long term buy in from their players. It's easy to blame this on the players but as in all things the problem, and therefore the solution, often lies closer to home than many are willing to admit. Using the simple writing techniques of series writers from the world of fiction and understanding a bit about the psychology of your players (and yourself) you can set yourself up from the start to establish a campaign with longevity.
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- 49871 reads
Role-playing games use dice to resolve events and simulate results that are out of the control of the intentions of the character. When a character wants to say something, they can; when they want to pick up a stone and hurl it, they can. What they cannot control is whether the stone hits what they want -- or whether the words have the impact that they want. It the RPG world that is resolved by the dice.
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- 35199 reads
Unless you have lived in a cave somewhere for the past couple of years or rabidly avoid the Fantasy genre entirely, you have heard about George RR Martin's Song of Ice and Fire fantasy series published by Bantam Books. The novels regularly reside at #1 for Sci Fi/Fantasy when they debuted in the in the early '90's and the more recent books have made the top ten bestselling lists worldwide, despite being rather dark, adult oriented and dangerous to the lives of the main characters within it. Take note, this is not Tolkien or Jordan that we're talking about here.
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- 46176 reads
The Burning Wheel RPG is not another d20 clone. It is a roleplaying game designed to appeal to the narrative gamer who doesn't want to get bogged down in mechanics. While the game shows a lot of promise, I remain unconvinced that it will work at the game table. The elements of shared storytelling are broken by a number of mechanics that seem added to give the player the extra mechanisms that they expect in a roleplaying game. Tactical combat, skill advancement, character creation are expectations in a roleplaying game; and Burning Wheel addresses these in detail. But, I find these rules are arbitrarily appended to a core system that was not constructed to bear their weight. As a whole it left me wondering if the original intent was to end the rules at chapter two.
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- 69147 reads
As long as we're all back here together, let's catch up on some of what makes our campaigns so great; those moments that can never be forgotten as long as we game. Recent is what I'm looking for… not pining for the days of our campaigns years ago.
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text:
Need Appliance Repair Help? Ask a Technician for Answers ASAP
Thank you for using Just Answer.
I'm sorry to have to give you some information that you won't want to hear.
You stated that you everything else works. So, if you can hear the fan running when you try to heat something up then, we would (without taking the machine apart) state that the most likely problem is the magnetron tube. This is an expensive part and not worth doing a repair (even if you are trained to do it).
Please let me know if you would like more information by posting back to this question.


text:
Ya tebya lyublyu by JaraMoodyWatch
©2013-2017 JaraMoody
I actually cannot handle how cute you guys are ;u;
Ivan will never stap! (?)
Thank you <3 I'm happy you like it
Thank you <3 I'm happy you like it
I like this pic so much, I don't even like cosplay, but this one is pure WIN!~
; A ; I ship this so hard ; v ;
so lovely *w*
Sus como toditaaas <3
Soy to amor.


text:
If you visit the home page at tagged.com, you will see a login box towards the top-right of the screen. If you have an account, just enter your email address and Tagged.com password in the box highlighted in the image below.
If you don't have an account, you can make one using the account creation form, which you will also find on the home page.
Be careful about giving sites passwords to your email account or any other account.


text:
Most Helpful Guy
An eye patch and wooden leg.00|00|0
Most Helpful Girl
YOU KIDDING ME SISTA! im dying over here... come on!! i need a damn fan you so HOOOOT... nope i need A. C! You're so gorgeous i mean there is literally nothing just nothing you can do. Because you are already so beautiful.
And you are going to grow up one Fine woman!


text: EnvironmentEnvironmentalists fear Kazakhstan Olympic bid Kazakhstan hopes to host Winter Games in 2022, but activists believe the Games would endanger the environment. 07 Jul 2014 04:01 GMT | Environment, Asia, Kazakhstan The International Olympic Committee will meet on Monday to decide the shortlist for the 2022 Winter Games. Oslo, Beijing and Kazakhstan's Almaty remain in the running. Kazakhstan has the money to go ahead, but some critics say playing host may come at a high cost to the environment. Al Jazeera's Robin Forestier-Walker reports from Almaty.Source: Al Jazeera