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gateway Communication with the manufacturer should include the DICOM standard compliance statement in the equipment speci cations For the WS, radiologists and clinicians are the ultimate users approving the system For these reasons human interface and image work ow have an important role in planning the installation It is necessary to consider IHE work ow pro les in the planning; and to detail speci cations of the WSs and design proper environments to house them Input from radiologists and technologists is essential, and several revisions may be necessary to ensure user satisfaction Cabling We described the cabling and the hub room concept in Section 82 This section discusses the overall cable plan Proper cabling for the transmission of images and patient text information within the department and within the hospital is crucial for the success of a digital-based operation.

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The traditional method of cabling for computer terminals is not recommended because, as the magnitude of the digital-based operation grows, the web of connecting wires very quickly becomes unmanageable Cabling is much simpler if the entire department is on the same oor Greater complications ensue when the communication cable must traverse the whole hospital, which can occupy several oors or even several building complexes Layout of the cables that support the digital-based operation should be thought through carefully Intranet and high-speed Ethernet switches and routers should be strategically situated, and a conventional Ethernet backup system should be considered Air-Conditioning Most digital equipment in a digital-based operation requires additional air-conditioning (A/C) If a new radiology department is planned, adequate A/C should be supplied to the central computing, server, and image-processing facilities In general, WSs do not require special A/C considerations, but certain room temperature requirements are still necessary.

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Because hospitals are always limited in space, it may be dif cult to nd additional central A/Cs for the large area housing the PACS central facility Sometimes individual, smaller local A/C units can be installed The individual A/C can be a stand-alone oor unit or a ceiling-mounted unit Each time another A/C unit is installed, an additional cool water source from the hospital is required Thus the hospital s capacity for cooling water should be considered Also, as noted earlier, additional A/C units can create a lot of noise in a room To ensure that the room housing the WSs is suitable for viewing images, adequate sound proo ng should be used to insulate these areas from the extra noise created by the A/C and cooling system Staf ng The hospital or department should allocate special technical staff with proper training to support the digital-based operation.

In particular, system programming, digital engineering, and quality assurance personnel are necessary to make a digital-based operation run smoothly and ef ciently These new full-time equivalents (FTEs) can be re-allocated by terminating the existing FTEs in the lm-based operation Even if the manufacturer installs a department s digital-based operation and provides support and maintenance, the department is left with the responsibility of.

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Anabolism The above-named pathways are examples of how cells deal with sugars, thereby obtaining carbon, hydrogen and oxygen. As observed earlier, cells must also secure a supply of other elements from the medium. Nitrogen may be provided as amino acids (e.g. in the case of brewing yeast), urea or inorganic nitrogen forms, primarily as ammonium salts (often used in wine fermentations). Sulphur can variously be supplied in organic or inorganic forms. Brewing yeast, for example, can assimilate sulphate, but will also take up sulphurcontaining amino acids (Fig. 1.17). The major structural and functional molecules in cells are polymeric. These include (1) Polysaccharides notably the storage molecules such as glycogen in yeast, which has a structure closely similar to the amylopectin fraction of starch (see later), and the structural components of cell walls, for example, the mannans and glucans in yeast and the complex polysaccharides in bacterial cell walls.

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