Sample records for examination laboratory testing

  1. 76 FR 61153 - Robert Raymond Reppy, D.O.; Decision and Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... diagnostic and laboratory tests consistent with good medical care,'' ``[f]ormulate[] a therapeutic plan... examination and appropriate diagnostic and laboratory testing.'' Id. In May 2000, the Louisiana State Board of..., examination, physical examination and appropriate diagnostic and laboratory testing; Discussing with the...

  2. Ethics in the laboratory examination of patients

    PubMed Central

    Nyrhinen, T.; Leino-Kilpi, H.

    2000-01-01

    Various value problems are connected with the clinical examination of patients. The purpose of this literature review is to clarify: 1) in which patient examinations ethical problems are generally found; 2) what kind of ethical problems are found in the different phases of the examination process, and 3) what kind of ethical problems are found in connection with the use of examination results. Genetic testing, autopsy, prenatal and HIV examinations were ethically the most problematic laboratory examinations. The most problematic phase in the laboratory examination process proved to be the pre-analytic phase. At present the results of laboratory examination are used more and more often for the prediction of diseases. The problems appear when the examination results are used for discrimination and stigmatisation. Because of the lack of empirical ethical research, it is important to chart empirical knowledge about present value conflict situations involved in the laboratory examination process. Key Words: Ethic • laboratory • test • examination • diagnosis • patient PMID:10701173

  3. Congenital syphilis in neonates with nonreactive nontreponemal test results.

    PubMed

    Wozniak, P S; Cantey, J B; Zeray, F; Leos, N K; Sheffield, J S; Wendel, G D; Sánchez, P J

    2017-10-01

    Infants whose mothers had syphilis during pregnancy were studied to determine how often exposed newborns with normal physical examinations and nonreactive nontreponemal serologic tests had abnormal laboratory or radiographic studies. Retrospective analysis of prospectively collected data from infants born to mothers with syphilis and had a normal examination and a nonreactive nontreponemal test. Some infants had IgM immunoblotting, PCR testing or rabbit infectivity testing (RIT) performed. From 1984 to 2002, 115 infants had a nonreactive serum Venereal Disease Research Laboratory (VDRL)/rapid plasma reagin (RPR) test and a normal physical examination at birth. Among 87 infants born to mothers who had untreated syphilis, 4 had a positive serum IgM immunoblot or PCR test, but none had spirochetes recovered by RIT. Two infants had anemia, one had an elevated serum alanine aminotransferase concentration and one with Down's syndrome had direct hyperbilirubinemia. Among 14 infants born to mothers treated <4 weeks before delivery, none had abnormal laboratory or radiographic tests, although 1 of 11 had a reactive serum IgM immunoblot. Among 14 infants born to mothers treated ⩾4 weeks before delivery, none had abnormal laboratory or radiographic tests. Newborns with normal physical examination and nonreactive nontreponemal test results are unlikely to have abnormalities detected on conventional laboratory and radiographic testing.

  4. 46 CFR 160.064-6 - Examinations, tests and inspections.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... labeled water safety buoyant devices shall maintain quality control of the materials used, manufacturing... available to the recognized laboratory inspector or to the Coast Guard marine inspector, or both, for review upon request. (b) Laboratory inspections and tests. Such examinations, inspections and tests as are...

  5. [How to Interpret and Use Routine Laboratory Data--Our Methods to Interpret Routine Laboratory Data--Chairmen's Introductory Remarks].

    PubMed

    Honda, Takayuki; Tozuka, Minoru

    2015-09-01

    In the reversed clinicopathological conference (R-CPC), three specialists in laboratory medicine interpreted routine laboratory data independently in order to understand the detailed state of a patient. R-CPC is an educational method to use laboratory data appropriately, and it is also important to select differential diagnoses in a process of clinical reasoning in addition to the present illness and physical examination. Routine laboratory tests can be performed repeatedly at a relatively low cost, and their time-series analysis can be performed. Interpretation of routine laboratory data is almost the same as taking physical findings. General findings are initially checked and then the state of each organ is examined. Although routine laboratory tests cost little, we can gain much more information from them about the patient than physical examinations.

  6. An examination of the usefulness of repeat testing practices in a large hospital clinical chemistry laboratory.

    PubMed

    Deetz, Carl O; Nolan, Debra K; Scott, Mitchell G

    2012-01-01

    A long-standing practice in clinical laboratories has been to automatically repeat laboratory tests when values trigger automated "repeat rules" in the laboratory information system such as a critical test result. We examined 25,553 repeated laboratory values for 30 common chemistry tests from December 1, 2010, to February 28, 2011, to determine whether this practice is necessary and whether it may be possible to reduce repeat testing to improve efficiency and turnaround time for reporting critical values. An "error" was defined to occur when the difference between the initial and verified values exceeded the College of American Pathologists/Clinical Laboratory Improvement Amendments allowable error limit. The initial values from 2.6% of all repeated tests (668) were errors. Of these 668 errors, only 102 occurred for values within the analytic measurement range. Median delays in reporting critical values owing to repeated testing ranged from 5 (blood gases) to 17 (glucose) minutes.

  7. 46 CFR 164.012-13 - Examinations, tests, and inspections.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Examinations, tests, and inspections. 164.012-13 Section...-13 Examinations, tests, and inspections. (a) Manufacturer's inspection and tests. Manufacturers of... upon request. (b) Laboratory inspection and tests. Such examinations, inspections and tests as are...

  8. 19 CFR 151.71 - Laboratory testing for clean yield.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Wool and Hair § 151.71... director. (b) Notification to importer. Where samples of wool or hair have been tested in a Customs... laboratory test is not feasible, the wool or hair may be retested by a commercial laboratory in accordance...

  9. 19 CFR 151.71 - Laboratory testing for clean yield.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Wool and Hair § 151.71... director. (b) Notification to importer. Where samples of wool or hair have been tested in a Customs... laboratory test is not feasible, the wool or hair may be retested by a commercial laboratory in accordance...

  10. 19 CFR 151.71 - Laboratory testing for clean yield.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Wool and Hair § 151.71... director. (b) Notification to importer. Where samples of wool or hair have been tested in a Customs... laboratory test is not feasible, the wool or hair may be retested by a commercial laboratory in accordance...

  11. 19 CFR 151.71 - Laboratory testing for clean yield.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Wool and Hair § 151.71... director. (b) Notification to importer. Where samples of wool or hair have been tested in a Customs... laboratory test is not feasible, the wool or hair may be retested by a commercial laboratory in accordance...

  12. 19 CFR 151.71 - Laboratory testing for clean yield.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Wool and Hair § 151.71... director. (b) Notification to importer. Where samples of wool or hair have been tested in a Customs... laboratory test is not feasible, the wool or hair may be retested by a commercial laboratory in accordance...

  13. Continual planning and scheduling for managing patient tests in hospital laboratories.

    PubMed

    Marinagi, C C; Spyropoulos, C D; Papatheodorou, C; Kokkotos, S

    2000-10-01

    Hospital laboratories perform examination tests upon patients, in order to assist medical diagnosis or therapy progress. Planning and scheduling patient requests for examination tests is a complicated problem because it concerns both minimization of patient stay in hospital and maximization of laboratory resources utilization. In the present paper, we propose an integrated patient-wise planning and scheduling system which supports the dynamic and continual nature of the problem. The proposed combination of multiagent and blackboard architecture allows the dynamic creation of agents that share a set of knowledge sources and a knowledge base to service patient test requests.

  14. Pre-examination factors affecting molecular diagnostic test results and interpretation: A case-based approach.

    PubMed

    Payne, Deborah A; Baluchova, Katarina; Peoc'h, Katell H; van Schaik, Ron H N; Chan, K C Allen; Maekawa, Masato; Mamotte, Cyril; Russomando, Graciela; Rousseau, François; Ahmad-Nejad, Parviz

    2017-04-01

    Multiple organizations produce guidance documents that provide opportunities to harmonize quality practices for diagnostic testing. The International Organization for Standardization ISO 15189 standard addresses requirements for quality in management and technical aspects of the clinical laboratory. One technical aspect addresses the complexities of the pre-examination phase prior to diagnostic testing. The Committee for Molecular Diagnostics of the International Federation for Clinical Chemistry and Laboratory Medicine (also known as, IFCC C-MD) conducted a survey of international molecular laboratories and determined ISO 15189 to be the most referenced guidance document. In this review, the IFCC C-MD provides case-based examples illustrating the value of select pre-examination processes as these processes relate to molecular diagnostic testing. Case-based examples in infectious disease, oncology, inherited disease and pharmacogenomics address the utility of: 1) providing information to patients and users, 2) designing requisition forms, 3) obtaining informed consent and 4) maintaining sample integrity prior to testing. The pre-examination phase requires extensive and consistent communication between the laboratory, the healthcare provider and the end user. The clinical vignettes presented in this paper illustrate the value of applying select ISO 15189 recommendations for general laboratory to the more specialized area of Molecular Diagnostics. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Some new tests at the Gottingen laboratory

    NASA Technical Reports Server (NTRS)

    1921-01-01

    The tests at the Gottingen laboratory included: friction tests on a surface treated with omelette, verification tests on the M.V.A. 356 wing, and comparative tests of wing no. 36 at the Eiffel laboratory. The examination of all these experiments leads to the belief that, at large incidences, the speeds registered by the suction manometer of the testing chamber of the Eiffel laboratory wind tunnel are, owing to pressure drop, greater than the actual speeds. Therefore, the values of k(sub x) and k(sub y) measured at the Eiffel laboratory at large incidences are too low.

  16. Use of proficiency test performance to determine clinical laboratory director qualifications.

    PubMed

    Howanitz, P J

    1988-04-01

    Many activities and policies influence laboratory test quality. Proficiency test results are one measure of laboratory quality, and during the past 25 years, five studies have examined the relationship of laboratory director educational requirements to proficiency test results. Data from three studies support the association between director qualifications and quality as measured by proficiency test performance, whereas no relationship was found in the other two studies. Possible reasons for conflicting results include differences in database size and demographics; in addition, proficiency test results may be inappropriate, although widely used, as the sole measure of laboratory director performance.

  17. 21 CFR 58.210 - Actions upon disqualification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

  18. 21 CFR 58.210 - Actions upon disqualification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

  19. National Survey of Adult and Pediatric Reference Intervals in Clinical Laboratories across Canada: A Report of the CSCC Working Group on Reference Interval Harmonization.

    PubMed

    Adeli, Khosrow; Higgins, Victoria; Seccombe, David; Collier, Christine P; Balion, Cynthia M; Cembrowski, George; Venner, Allison A; Shaw, Julie

    2017-11-01

    Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group that examines variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada. Data on reference intervals currently used by 37 laboratories were collected through a national survey to examine the variation in reference intervals for seven common laboratory tests. Additionally, 40 clinical laboratories participated in a baseline assessment by measuring six analytes in a reference sample. Of the seven analytes examined, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and creatinine reference intervals were most variable. As expected, reference interval variation was more substantial in the pediatric population and varied between laboratories using the same instrumentation. Reference sample results differed between laboratories, particularly for ALT and free thyroxine (FT4). Reference interval variation was greater than test result variation for the majority of analytes. It is evident that there is a critical lack of harmonization in laboratory reference intervals, particularly for the pediatric population. Furthermore, the observed variation in reference intervals across instruments cannot be explained by the bias between the results obtained on instruments by different manufacturers. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  20. 42 CFR 493.643 - Fee for determination of program compliance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... laboratory's scope and volume of testing (excluding tests performed for quality control, quality assurance... procedure or examination for a single analyte. (Tests performed for quality control, quality assurance, and... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS General Administration...

  1. Obtaining patient test results from clinical laboratories: a survey of state law for pharmacists.

    PubMed

    Witry, Matthew J; Doucette, William R

    2009-01-01

    To identify states with laws that restrict to whom clinical laboratories may release copies of laboratory test results and to describe how these laws may affect pharmacists' ability to obtain patient laboratory test results. Researchers examined state statutes and administrative codes for all 50 states and the District of Columbia at the University of Iowa Law Library between June and July 2007. Researchers also consulted with lawyers, state Clinical Laboratory Improvement Amendments officers, and law librarians. Laws relating to the study objective were analyzed. 34 jurisdictions do not restrict the release of laboratory test results, while 17 states have laws that restrict to whom clinical laboratories can send copies of test results. In these states, pharmacists will have to use alternative sources, such as physician offices, to obtain test results. Pharmacists must consider state law before requesting copies of laboratory test results from clinical laboratories. This may be an issue that state pharmacy associations can address to increase pharmacist access to important patient information.

  2. 20 CFR 404.1519n - Informing the medical source of examination scheduling, report content, and signature requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ventilatory function tests, treadmill exercise tests, or audiological tests. The medical report must be... other abnormalities or lack thereof reported or found during examination or laboratory testing; (4) The...

  3. 19 CFR 151.54 - Testing by Customs laboratory.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 2 2014-04-01 2014-04-01 false Testing by Customs laboratory. 151.54 Section 151.54 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Metal-Bearing Ores and...

  4. 19 CFR 151.54 - Testing by Customs laboratory.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Testing by Customs laboratory. 151.54 Section 151.54 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Metal-Bearing Ores and...

  5. 19 CFR 151.54 - Testing by Customs laboratory.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 2 2013-04-01 2013-04-01 false Testing by Customs laboratory. 151.54 Section 151.54 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Metal-Bearing Ores and...

  6. National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

    PubMed

    Zhang, Xiaoyan; Fei, Yang; Wang, Wei; Zhao, Haijian; Wang, Minqi; Chen, Bingquan; Zhou, Jie; Wang, Zhiguo

    2018-02-01

    This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT. 738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT. Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%~60% of laboratories were above 4, while 15%~20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs. Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously. © 2017 Wiley Periodicals, Inc.

  7. 46 CFR 163.002-27 - Production tests and examination.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Production tests and examination. 163.002-27 Section 163... examination. Each pilot hoist manufactured under Coast Guard approval must be tested as prescribed in § 163... laboratory must also conduct the visual examination described in § 163.002-21(b). The hoist may not be sold...

  8. Altering Test Environments for Reducing Test Anxiety and for Improving Academic Performance.

    ERIC Educational Resources Information Center

    Bushnell, Don D.

    To test the effects of altering situational variables in stressful examinations on high test anxious and low test anxious undergraduates, mid-terms and final examinations were administered in two environmental settings: large lecture halls and small language laboratories. Mean test scores for high test anxious students in the language labs were…

  9. Quantitative and Qualitative Changes in Teaching Histology by Means of Virtual Microscopy in an Introductory Course in Human Anatomy

    ERIC Educational Resources Information Center

    Husmann, Polly R.; O'Loughlin, Valerie Dean; Braun, Mark W.

    2009-01-01

    This study compares overall laboratory averages and individual test scores along with a student survey to determine the effects of using virtual microscopy in place of optical microscopes in a large undergraduate human anatomy course. T-tests revealed that the first two laboratory examinations (of four) and the overall laboratory averages were…

  10. 9 CFR 147.30 - Laboratory procedure recommended for the polymerase chain reaction (PCR) test for Mycoplasma...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the polymerase chain reaction (PCR) test for Mycoplasma gallisepticum and M. synoviae. 147.30 Section... Examination Procedures § 147.30 Laboratory procedure recommended for the polymerase chain reaction (PCR) test... should consist of the following sequences: ER12JA07.005 (c) Polymerase chain reaction. (1) Treat each...

  11. 9 CFR 147.30 - Laboratory procedure recommended for the polymerase chain reaction (PCR) test for Mycoplasma...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the polymerase chain reaction (PCR) test for Mycoplasma gallisepticum and M. synoviae. 147.30 Section... Examination Procedures § 147.30 Laboratory procedure recommended for the polymerase chain reaction (PCR) test... should consist of the following sequences: ER12JA07.005 (c) Polymerase chain reaction. (1) Treat each...

  12. Reporting Results of Molecular Tests: A Retrospective Examination of BRAF Mutation Reporting.

    PubMed

    Treece, Amanda L; Gulley, Margaret L; Vasalos, Patricia; Paquette, Cherie; Lindeman, Neal I; Jennings, Lawrence J; Bartley, Angela N

    2017-05-01

    - With enormous growth in the field of molecular pathology, the reporting of results gleaned from this testing is essential to guide patient care. - To examine molecular reports from laboratories participating in proficiency testing for required elements to convey molecular laboratory test results to clinicians and patients. - Molecular laboratories participating in the College of American Pathologists (CAP) proficiency testing program for BRAF mutation analysis were solicited to submit examples of final reports from 2 separate proficiency testing reporting cycles. Reports were reviewed for the presence or absence of relevant components. - A total of 107 evaluable reports were received (57 demonstrating a positive result for the BRAF V600E mutation and 50 negative). Methods for BRAF testing varied, with 95% (102 of 107) of reports adequately describing their assay methods and 87% (93 of 107) of reports adequately describing the target(s) of their assays. Information on the analytic sensitivity of the assay was present in 74% (79 of 107) of reports and 83% (89 of 107) reported at least 1 assay limitation, though only 34% (36 of 107) reported on variants not detected by their assays. Analytic and clinical interpretive comments were included in 99% (106 of 107) and 90% (96 of 107) of reports, respectively. Of participants that perform a laboratory-developed test, 88% (88 of 100) included language addressing the development of the assay. - Laboratories participating in BRAF proficiency testing through the CAP are including most of the required reporting elements to unambiguously convey molecular results. Laboratories should continue to strive to report these results in a concise and comprehensive manner.

  13. Collaborative Testing in Practical Laboratories: An Effective Teaching-Learning Method in Histology.

    PubMed

    Guo, Yuping; Li, Enzhong

    2016-01-01

    This article presents an experimental teaching and learning program used in histology with first-year students in the second term in the Faculty of Biology at Huanghuai University, China. Eighty-six students were divided randomly into two groups (n=43 per group). Tests were conducted at the end of each practical laboratory (10 laboratories in total) in which collaborative testing was used in the experimental group and traditional testing in the control group. To assess achievement, a final examination in histology was carried out at the end of the course. To determine students' attitude to the teaching styles, a questionnaire survey was conducted at the end of the term. Results showed that students preferred the collaborative testing format. In the experimental group, students' scores were significantly higher than those of students in the control group in final examinations. These findings indicate that collaborative testing enhances student learning and understanding of the material taught, and suggest that collaborative testing is an effective teaching-learning method in histology.

  14. CALiPER Report 24: OLED Luminaires

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Miller, N. J.; Leon, F. A.; Davis, J. L.

    2017-08-01

    This report documents an initial investigation of OLED luminaires and summarizes the key features of those products. In addition to photometric testing of four commercial products in independent laboratories, PNNL examined many of the products through teardown testing (disassemblies to identify parts and functionality) in PNNL laboratories. Results of these tests as well as results of stress testing of several OLED luminaires at RTI International have been included.

  15. [Reversed clinicopathological conference (R-CPC)--interpreting laboratory data in the same way as physical findings].

    PubMed

    Sugano, Mitsutoshi; Shimada, Masashi; Moriyoshi, Miho; Kitagawa, Kiyoki; Nakashima, Hiromi; Wada, Hideo; Yanagihara, Katsunori; Fujisawa, Shinya; Yonekawa, Osamu; Honda, Takayuki

    2012-05-01

    Routine laboratory data are discussed by time series analysis in reversed clinicopathological conferences (R-CPC) at Shinshu University School of Medicine. We can identify fine changes in the laboratory data and the importance of negative data (without any changes) using time series analysis. Routine laboratory tests can be performed repeatedly and relatively cheaply, and time series analysis can be performed. The examination process of routine laboratory data in the R-CPC is almost the same as the process of taking physical findings. Firstly, general findings are checked and then the state of each organ is examined. Although routine laboratory data are cheap, we can obtain much more information about a patient's state than from physical examinations. In this R-CPC, several specialists in the various fields of laboratory medicine discussed the routine laboratory data of a patient, and we tried to understand the detailed state of the patient. R-CPC is an educational method to examine laboratory data and we, reconfirmed the usefulness of R-CPC to elucidate the clinical state of the patient.

  16. External quality assessment of medical laboratories in Croatia: preliminary evaluation of post-analytical laboratory testing.

    PubMed

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana

    2017-02-15

    Proper standardization of laboratory testing requires assessment of performance after the tests are performed, known as the post-analytical phase. A nationwide external quality assessment (EQA) scheme implemented in Croatia in 2014 includes a questionnaire on post-analytical practices, and the present study examined laboratory responses in order to identify current post-analytical phase practices and identify areas for improvement. In four EQA exercises between September 2014 and December 2015, 145-174 medical laboratories across Croatia were surveyed using the Module 11 questionnaire on the post-analytical phase of testing. Based on their responses, the laboratories were evaluated on four quality indicators: turnaround time (TAT), critical values, interpretative comments and procedures in the event of abnormal results. Results were presented as absolute numbers and percentages. Just over half of laboratories (56.3%) monitored TAT. Laboratories varied substantially in how they dealt with critical values. Most laboratories (65-97%) issued interpretative comments with test results. One third of medical laboratories (30.6-33.3%) issued abnormal test results without confirming them in additional testing. Our results suggest that the nationwide post-analytical EQA scheme launched in 2014 in Croatia has yet to be implemented to the full. To close the gaps between existing recommendations and laboratory practice, laboratory professionals should focus on ensuring that TAT is monitored and lists of critical values are established within laboratories. Professional bodies/institutions should focus on clarify and harmonized rules to standardized practices and applied for adding interpretative comments to laboratory test results and for dealing with abnormal test results.

  17. Destructive Physical Analysis of Flight- and Ground-Tested Sodium-Sulfur Cells

    NASA Technical Reports Server (NTRS)

    Wasz, Margot L.; Carter, Boyd J.; Donet, Charles M.; Baldwin, Richard S.

    1999-01-01

    Destructive physical analysis (DPA) was used to study the effects of microgravity on the sulfur electrode in sodium-sulfur cells. The cells examined in this work were provided by the Air Force Research Laboratory (AFRL) from their program on sodium-sulfur technology. The Naval Research Laboratory (NRL) provided electrical characterization of the flight-tested and ground-tested cells.

  18. Development and Validation of Targeted Next-Generation Sequencing Panels for Detection of Germline Variants in Inherited Diseases.

    PubMed

    Santani, Avni; Murrell, Jill; Funke, Birgit; Yu, Zhenming; Hegde, Madhuri; Mao, Rong; Ferreira-Gonzalez, Andrea; Voelkerding, Karl V; Weck, Karen E

    2017-06-01

    - The number of targeted next-generation sequencing (NGS) panels for genetic diseases offered by clinical laboratories is rapidly increasing. Before an NGS-based test is implemented in a clinical laboratory, appropriate validation studies are needed to determine the performance characteristics of the test. - To provide examples of assay design and validation of targeted NGS gene panels for the detection of germline variants associated with inherited disorders. - The approaches used by 2 clinical laboratories for the development and validation of targeted NGS gene panels are described. Important design and validation considerations are examined. - Clinical laboratories must validate performance specifications of each test prior to implementation. Test design specifications and validation data are provided, outlining important steps in validation of targeted NGS panels by clinical diagnostic laboratories.

  19. Harmonization activities of Noklus - a quality improvement organization for point-of-care laboratory examinations.

    PubMed

    Stavelin, Anne; Sandberg, Sverre

    2018-05-16

    Noklus is a non-profit quality improvement organization that focuses to improve all elements in the total testing process. The aim is to ensure that all medical laboratory examinations are ordered, performed and interpreted correctly and in accordance with the patients' needs for investigation, treatment and follow-up. For 25 years, Noklus has focused on point-of-care (POC) testing in primary healthcare laboratories and has more than 3100 voluntary participants. The Noklus quality system uses different tools to obtain harmonization and improvement: (1) external quality assessment for the pre-examination, examination and postexamination phase to monitor the harmonization process and to identify areas that need improvement and harmonization, (2) manufacturer-independent evaluations of the analytical quality and user-friendliness of POC instruments and (3) close interactions and follow-up of the participants through site visits, courses, training and guidance. Noklus also recommends which tests that should be performed in the different facilities like general practitioner offices, nursing homes, home care, etc. About 400 courses with more than 6000 delegates are organized annually. In 2017, more than 21,000 e-learning programs were completed.

  20. Trends in Testing for Mycobacterium tuberculosis Complex From US Public Health Laboratories, 2009-2013.

    PubMed

    Tyrrell, Frances; Stafford, Cortney; Yakrus, Mitchell; Youngblood, Monica; Hill, Andrew; Johnston, Stephanie

    We investigated data from US public health laboratories funded through the Centers for Disease Control and Prevention's Tuberculosis Elimination and Laboratory Cooperative Agreement to document trends and challenges in meeting national objectives in tuberculosis (TB) laboratory diagnoses. We examined data on workload and turnaround time from public health laboratories' progress reports during 2009-2013. We reviewed methodologies, laboratory roles, and progress toward rapid detection of Mycobacterium tuberculosis complex through nucleic acid amplification (NAA) testing. We compared selected data with TB surveillance reports to estimate public health laboratories' contribution to national diagnostic services. During the study period, culture and drug susceptibility tests decreased, but NAA testing increased. Public health laboratories achieved turnaround time benchmarks for drug susceptibility tests at lower levels than for acid-fast bacilli smear and identification from culture. NAA positivity in laboratories among surveillance-reported culture-positive TB cases increased from 26.6% (2355 of 8876) in 2009 to 40.0% (2948 of 7358) in 2013. Public health laboratories provided an estimated 50.9% (4285 of 8413 in 2010) to 57.2% (4210 of 7358 in 2013) of culture testing and 88.3% (6822 of 7727 in 2011) to 94.4% (6845 of 7250 in 2012) of drug susceptibility tests for all US TB cases. Public health laboratories contribute substantially to TB diagnoses in the United States. Although testing volumes mostly decreased, the increase in NAA testing indicates continued progress in rapid M tuberculosis complex detection.

  1. Test set readings predict clinical performance to a limited extent: preliminary findings

    NASA Astrophysics Data System (ADS)

    Soh, BaoLin P.; Lee, Warwick M.; Kench, Peter L.; Reed, Warren M.; McEntee, Mark F.; Brennan, Patrick C.

    2013-03-01

    Aim: To investigate the level of agreement between test sets and actual clinical reading Background: The performance of screen readers in detecting breast cancer is being assessed in some countries by using mammographic test sets. However, previous studies have provided little evidence that performance assessed by test sets strongly correlate to performance in clinical reading. Methods: Five clinicians from BreastScreen New South Wales participated in this study. Each clinician was asked to read 200 de-identified mammographic examinations gathered from their own case history within the BreastScreen NSW Digital Imaging Library. All test sets were designed with specific proportions of true positive, true negative, false positive and false negative examinations from the previous actual clinical reads of each reader. A prior mammogram examination for comparison (when available) was also provided for each case. Results: Preliminary analyses have shown that there is a moderate level of agreement (Kappa 0.42-0.56, p < 0.001) between laboratory test sets and actual clinical reading. In addition, a mean increase of 38% in sensitivity in the laboratory test sets as compared to their actual clinical readings was demonstrated. Specificity is similar between the laboratory test sets and actual clinical reading. Conclusion: This study demonstrated a moderate level of agreement between actual clinical reading and test set reading, which suggests that test sets have a role in reflecting clinical performance.

  2. Effect of Population Heterogenization on the Reproducibility of Mouse Behavior: A Multi-Laboratory Study

    PubMed Central

    Richter, S. Helene; Garner, Joseph P.; Zipser, Benjamin; Lewejohann, Lars; Sachser, Norbert; Touma, Chadi; Schindler, Britta; Chourbaji, Sabine; Brandwein, Christiane; Gass, Peter; van Stipdonk, Niek; van der Harst, Johanneke; Spruijt, Berry; Võikar, Vootele; Wolfer, David P.; Würbel, Hanno

    2011-01-01

    In animal experiments, animals, husbandry and test procedures are traditionally standardized to maximize test sensitivity and minimize animal use, assuming that this will also guarantee reproducibility. However, by reducing within-experiment variation, standardization may limit inference to the specific experimental conditions. Indeed, we have recently shown in mice that standardization may generate spurious results in behavioral tests, accounting for poor reproducibility, and that this can be avoided by population heterogenization through systematic variation of experimental conditions. Here, we examined whether a simple form of heterogenization effectively improves reproducibility of test results in a multi-laboratory situation. Each of six laboratories independently ordered 64 female mice of two inbred strains (C57BL/6NCrl, DBA/2NCrl) and examined them for strain differences in five commonly used behavioral tests under two different experimental designs. In the standardized design, experimental conditions were standardized as much as possible in each laboratory, while they were systematically varied with respect to the animals' test age and cage enrichment in the heterogenized design. Although heterogenization tended to improve reproducibility by increasing within-experiment variation relative to between-experiment variation, the effect was too weak to account for the large variation between laboratories. However, our findings confirm the potential of systematic heterogenization for improving reproducibility of animal experiments and highlight the need for effective and practicable heterogenization strategies. PMID:21305027

  3. Effect of implementing instructional videos in a physical examination course: an alternative paradigm for chiropractic physical examination teaching.

    PubMed

    Zhang, Niu; Chawla, Sudeep

    2012-01-01

    This study examined the effect of implementing instructional video in ophthalmic physical examination teaching on chiropractic students' laboratory physical examination skills and written test results. Instructional video clips of ophthalmic physical examination, consisting of both standard procedures and common mistakes, were created and used for laboratory teaching. The video clips were also available for student review after class. Students' laboratory skills and written test results were analyzed and compared using one-way analysis of variance (ANOVA) and post hoc multiple comparison tests among three study cohorts: the comparison cohort who did not utilize the instructional videos as a tool, the standard video cohort who viewed only the standard procedure of video clips, and the mistake-referenced video cohort who viewed video clips containing both standard procedure and common mistakes. One-way ANOVA suggested a significant difference of lab results among the three cohorts. Post hoc multiple comparisons further revealed that the mean scores of both video cohorts were significantly higher than that of the comparison cohort (p < .001). There was, however, no significant difference of the mean scores between the two video cohorts (p > .05). However, the percentage of students having a perfect score was the highest in the mistake-referenced video cohort. There was no significant difference of written test scores among all three cohorts (p > .05). The instructional video of the standard procedure improves chiropractic students' ophthalmic physical examination skills, which may be further enhanced by implementing a mistake-referenced instructional video.

  4. Students' perceptions of laboratory science careers: changing ideas with an education module.

    PubMed

    Haun, Daniel; Leach, Argie; Lawrence, Louann; Jarreau, Patsy

    2005-01-01

    To assess the effectiveness of a Web-based education module in changing students' perceptions of laboratory science careers. Perception was measured with a short examination and then a Web-based exercise was presented. Following the exercise, the test was administered again. Frequency data from the pre-test and post-test were compared for changes in perception. The correlated pre-test/post-test pairs were also examined for opinion changes and these were analyzed for significance. Large parochial high schools in New Orleans, Louisiana. A small team visited the schools during their appointed class times for biology. Study participants were high school biology students in grades 9-10. Two-hundred-forty-five students participated (149 male and 96 female). A Web-based exercise on blood film examination was presented to the students in a classroom setting (www.mclno.org/labpartners/index_03.htm). The exercise contained focused messages about: (1) the numbers of healthcare workers acquiring AIDS from on-the-job exposure and (2) common career paths available to the laboratory science workforce. The shift in perception of: What medical service generates the most diagnostic data. Which professional group performs laboratory tests. The risk of acquiring AIDS while working in the healthcare setting. Interest in a science-related career. How much education is required to work in a science-related field. The intervention significantly shifted perception in all areas measured except that of interest in a science-related career. Many students perceive that the risk of acquiring AIDS while working in the healthcare setting is "high". Web-based presentations and similar partnerships with science teachers can change perceptions that might lead to increased interest in clinical laboratory science careers.

  5. An Examination of Career Satisfaction for Medical Laboratory Professionals Using Wlodkowski's Motivational Framework

    ERIC Educational Resources Information Center

    Kenwright, Kathleen M.

    2016-01-01

    Medical laboratory science professionals are healthcare practitioners who provide laboratory data that aids in the diagnosis, treatment, and prevention of disease. However, there is a large shortage of these professionals who perform the laboratory tests behind the scenes with very minimal patient contact. The purpose of this research was to…

  6. Filtrates and Residues: Qualitative Analysis of Some Transition Metals.

    ERIC Educational Resources Information Center

    Kilner, Cary

    1985-01-01

    Describes a qualitative analysis laboratory in which students examine specific precipitates that can be used to identify copper, cobalt, nickel, and iron cations. The objective of the laboratory is to determine which test or sequence of tests unambiguously identifies each cation and to use the results to identify several unknowns. (JN)

  7. The British Society for Clinical Cytology Certificate of Competence in Cytology Screening: a report of the first 3 years' experience.

    PubMed

    McGoogan, E; Chapman, P A

    1992-01-01

    In 1988 the Department of Health (DOH) recognized the cytology screener grade of laboratory staff. Cytology screeners have a 2 year training period after which they must sit a 'competence examination'. The British Society for Clinical Cytology offers an examination to meet the DOH specification. It consists of a written paper, a practical screening test, a spot test and a short viva voce. The screening test is paramount and candidates who miss a dyskaryotic smear cannot be successful. In the first 3 years there have been 22 examinations, 294 candidates and a pass rate of 76%. The majority of candidates were Cytology Screeners of 2-3 years experience but significant numbers of Medical Laboratory Scientific Officers (MLSOs) and senior MLSOs also chose to sit the examination.

  8. [Examination of drinking water used in livestock production. Microbiological and physico-chemical methods. Ready to use test kits in field experiments].

    PubMed

    Sassen, J

    2000-08-01

    Livestock health care service is very much involved and interested in surveillance of the drinking water as well. However, in order to examine the water immediately "on the fly", test kits have to be provided, which offer results comparable to these obtained in the laboratories according to official prescription. The German Army was confronted with a similar situation during the secently performed mission in crisis regions. At the early state of a mission usually laboratory equipment is not yet established. Therefore a set of test kits was compiled suitable for mobile microbiological examination of drinking water. This set was excessively examined comparison with reference methods. In conclusion it is shown, that the mobile set gains equal or even better results compared to those obtained according to legally prescribed standard procedures.

  9. Inquiry-based laboratory investigations and student performance on standardized tests in biological science

    NASA Astrophysics Data System (ADS)

    Patke, Usha

    Achievement data from the 3rd International Mathematics and Sciences Study and Program for International Student Assessment in science have indicated that Black students from economically disadvantaged families underachieve at alarming rates in comparison to White and economically advantaged peer groups. The study site was a predominately Black, urban school district experiencing underachievement. The purpose of this correlational study was to examine the relationship between students' use of inquiry-based laboratory investigations and their performance on the Biology End of Course Test, as well as to examine the relationship while partialling out the effects of student gender. Constructivist theory formed the theoretical foundation of the study. Students' perceived levels of experience with inquiry-based laboratory investigations were measured using the Laboratory Program Variable Inventory (LPVI) survey. LPVI scores of 256 students were correlated with test scores and were examined by student gender. The Pearson correlation coefficient revealed a small direct correlation between students' experience in inquiry-based laboratory investigation classes and standardized test scores on the Biology EOCT. A partial correlational analysis indicated that the correlation remained after controlling for gender. This study may prompt a change from teacher-centered to student-centered pedagogy at the local site in order to increase academic achievement for all students. The results of this study may also influence administrators and policy makers to initiate local, state, or nationwide curricular development. A change in curriculum may promote social change as students become more competent, and more able, to succeed in life beyond secondary school.

  10. Investigation of Primary Dew-Point Saturator Efficiency in Two Different Thermal Environments

    NASA Astrophysics Data System (ADS)

    Zvizdic, D.; Heinonen, M.; Sestan, D.

    2015-08-01

    The aim of this paper is to describe the evaluation process of the performance of the low-range saturator (LRS), when exposed to two different thermal environments. The examined saturator was designed, built, and tested at MIKES (Centre for Metrology and Accreditation, Finland), and then transported to the Laboratory for Process Measurement (LPM) in Croatia, where it was implemented in a new dew-point calibration system. The saturator works on a single-pressure-single-pass generation principle in the dew/frost-point temperature range between and . The purpose of the various tests performed at MIKES was to examine the efficiency and non-ideality of the saturator. As a test bath facility in Croatia differs from the one used in Finland, the same tests were repeated at LPM, and the effects of different thermal conditions on saturator performance were examined. Thermometers, pressure gauges, an air preparation system, and water for filling the saturator at LPM were also different than those used at MIKES. Results obtained by both laboratories indicate that the efficiency of the examined saturator was not affected either by the thermal conditions under which it was tested or by equipment used for the tests. Both laboratories concluded that LRS is efficient enough for a primary realization of the dew/frost-point temperature scale in the range from to , with flow rates between and . It is also shown that a considerable difference of the pre-saturator efficiency, indicated by two laboratories, did not have influence to the overall performance of the saturator. The results of the research are presented in graphical and tabular forms. This paper also gives a brief description of the design and operation principle of the investigated low-range saturator.

  11. Content of children's loss of control eating episodes assessed by self-report and laboratory test meal

    PubMed Central

    Theim, Kelly R.; Wilfley, Denise E.; Beach, Elizabeth; Tanofsky-Kraff, Marian; Goldschmidt, Andrea B.

    2014-01-01

    Pediatric loss of control (LOC) eating heightens risk for excessive weight gain and further disordered eating. Assessment of LOC typically involves self-report interview or laboratory test meal, although no study has concurrently examined data from both methods. We gathered eating episode data via interview (Child Eating Disorder Examination; ChEDE) and a laboratory test meal, among 22 overweight girls (aged 7-12 years) reporting LOC eating. Children consumed more energy during ChEDE episodes, although ChEDE and test meal episodes did not differ in macronutrient content. Episodes' correlation for amount consumed (grams) did not reach significance, p=.076. In exploratory analyses among the 7 children reporting LOC during the test meal, episodes were significantly correlated for grams consumed. Findings provide preliminary data to suggest that semi-structured interviews accurately capture children's LOC episode quantity. Episodes did not qualitatively differ, although children reported consuming more energy during self-reported episodes. Replication is warranted in larger studies. PMID:24019221

  12. Most routine laboratory testing of pediatric psychiatric patients in the emergency department is not medically necessary.

    PubMed

    Donofrio, J Joelle; Horeczko, Timothy; Kaji, Amy; Santillanes, Genevieve; Claudius, Ilene

    2015-05-01

    We examined the patient characteristics and hospital charges associated with routine medical clearance laboratory screening tests in 1,082 children younger than age eighteen who were brought to the emergency department (ED) for involuntary mental health holds--that is, each patient was brought to the ED to be evaluated for being a danger to him- or herself or to others, for being gravely disabled (unable to meet his or her basic needs due to a mental disorder), or both--from July 2009 to December 2010. Testing was performed on 871 of the children; all patients also received a clinical examination. The median charge for blood and urine testing together was $1,235, and the most frequent ordering pattern was the full comprehensive panel of tests. Of the patients with a nonconcerning clinical examination, 94.3 percent also had clinically nonsignificant test results. When we extrapolated cost savings to the national level, omitting routine screening laboratory tests in the population of pediatric patients presenting to the ED on an involuntary psychiatric hold with nonconcerning clinical exams could represent up to $90 million in savings annually, without reducing the ability to screen for emergency medical conditions. Provider-initiated diagnostic testing instead of routine screening would lead to significantly lower charges to the ED and the patient. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Proficiency Testing Activities of Frequency Calibration Laboratories in Taiwan, 2009

    DTIC Science & Technology

    2009-11-01

    cht.com.tw Abstract In order to meet the requirements of ISO 17025 and the demand of TAF (Taiwan Accreditation Foundation) for calibration inter... IEC 17025 General requirements for the competence of testing and calibration laboratories. The proficiency testing results are then important...on-site evaluation, an assessment team is organized to examine the technical competence of the labs and their compliance with the requirements of ISO

  14. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the real-time polymerase chain reaction test for Mycoplasma gallisepticum (MGLP ReTi). 147.31 Section... Examination Procedures § 147.31 Laboratory procedures recommended for the real-time polymerase chain reaction.... Following incubation, 100 µl of 100 percent ethanol is added to lysate. Wash and centrifuge following...

  15. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the real-time polymerase chain reaction test for Mycoplasma gallisepticum (MGLP ReTi). 147.31 Section... Examination Procedures § 147.31 Laboratory procedures recommended for the real-time polymerase chain reaction.... Following incubation, 100 µl of 100 percent ethanol is added to lysate. Wash and centrifuge following...

  16. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the real-time polymerase chain reaction test for Mycoplasma gallisepticum (MGLP ReTi). 147.31 Section... Examination Procedures § 147.31 Laboratory procedures recommended for the real-time polymerase chain reaction.... Following incubation, 100 µl of 100 percent ethanol is added to lysate. Wash and centrifuge following...

  17. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species - SETAC Abstract

    EPA Science Inventory

    We developed a toxicity database for unionid mussels to examine the extent of intra- and inter-laboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the two life stages; and the variation in sensitiv...

  18. [Progress in assays for and new developments in autoimmune pathophysioirmen's introductory remarks].

    PubMed

    Miyazawa, Yukihisa; Shimadu, Chisato; Ohi, Kayoko

    2005-11-01

    We examined the influence of a revision of health insurance in 2004 in Teikyo University Hospital in comparison with 2003. Out to the returns of most hematological tests, especially HbA1c and TK, being included in the treatment charges of outpatients, gross laboratory test sales decreased more than expected. Increased income from judgment charges and management charges could not make up for the deficit in test sales. Therefore, total laboratory test revenues decreased substantially. In 2006, the new revision of health insurance will worsen the revenues further. Hospital laboratory test departments should take appropriate and aggressive management steps in response to these revisions in health insurance.

  19. [ISO 15189 medical laboratory accreditation].

    PubMed

    Aoyagi, Tsutomu

    2004-10-01

    This International Standard, based upon ISO/IEC 17025 and ISO 9001, provides requirements for competence and quality that are particular to medical laboratories. While this International Standard is intended for use throughout the currently recognized disciplines of medical laboratory services, those working in other services and disciplines will also find it useful and appropriate. In addition, bodies engaged in the recognition of the competence of medical laboratories will be able to use this International Standard as the basis for their activities. The Japan Accreditation Board for Conformity Assessment (AB) and the Japanese Committee for Clinical Laboratory Standards (CCLS) are jointly developing the program of accreditation of medical laboratories. ISO 15189 requirements consist of two parts, one is management requirements and the other is technical requirements. The former includes the requirements of all parts of ISO 9001, moreover it includes the requirement of conformity assessment body, for example, impartiality and independence from any other party. The latter includes the requirements of laboratory competence (e.g. personnel, facility, instrument, and examination methods), moreover it requires that laboratories shall participate proficiency testing(s) and laboratories' examination results shall have traceability of measurements and implement uncertainty of measurement. Implementation of ISO 15189 will result in a significant improvement in medical laboratories management system and their technical competence. The accreditation of medical laboratory will improve medical laboratory service and be useful for patients.

  20. Clinical testing of BRCA1 and BRCA2: a worldwide snapshot of technological practices.

    PubMed

    Toland, Amanda Ewart; Forman, Andrea; Couch, Fergus J; Culver, Julie O; Eccles, Diana M; Foulkes, William D; Hogervorst, Frans B L; Houdayer, Claude; Levy-Lahad, Ephrat; Monteiro, Alvaro N; Neuhausen, Susan L; Plon, Sharon E; Sharan, Shyam K; Spurdle, Amanda B; Szabo, Csilla; Brody, Lawrence C

    2018-01-01

    Clinical testing of BRCA1 and BRCA2 began over 20 years ago. With the expiration and overturning of the BRCA patents, limitations on which laboratories could offer commercial testing were lifted. These legal changes occurred approximately the same time as the widespread adoption of massively parallel sequencing (MPS) technologies. Little is known about how these changes impacted laboratory practices for detecting genetic alterations in hereditary breast and ovarian cancer genes. Therefore, we sought to examine current laboratory genetic testing practices for BRCA1 / BRCA2 . We employed an online survey of 65 questions covering four areas: laboratory characteristics, details on technological methods, variant classification, and client-support information. Eight United States (US) laboratories and 78 non-US laboratories completed the survey. Most laboratories (93%; 80/86) used MPS platforms to identify variants. Laboratories differed widely on: (1) technologies used for large rearrangement detection; (2) criteria for minimum read depths; (3) non-coding regions sequenced; (4) variant classification criteria and approaches; (5) testing volume ranging from 2 to 2.5 × 10 5 tests annually; and (6) deposition of variants into public databases. These data may be useful for national and international agencies to set recommendations for quality standards for BRCA1/BRCA2 clinical testing. These standards could also be applied to testing of other disease genes.

  1. The Fulton County Medical Examiner's experience with the Federal Bureau of Investigation National Missing Person DNA Database Program, 2004-2007.

    PubMed

    Heninger, Michael; Hanzlick, Randy

    2011-03-01

    Medical examiners and coroners occasionally encounter unidentified human bodies, which remain unidentified for extended periods. In such cases, when traditional methods of identification have failed or cannot be used, DNA profiling may be used. The Federal Bureau of Investigation has a National Missing Person DNA database (NMPDD) laboratory to which samples may be submitted on such cases and from possible relatives or environments of unidentified decedents. This article describes the experience of the Fulton County Medical Examiner (FCME) in submitting samples to the NMPDD laboratory. A database was established at the FCME to track the submission of samples from unidentified decedents to the NMPDD laboratory for DNA testing along with the results and turnaround times. In December 2004, the FCME inventoried all cases for which samples were available and began to submit them to the NMPDD laboratory for testing. DNA testing and isolation rates, sample type, and turnaround times were tabulated in October 2006 for samples submitted between December 16, 2004 and December 16, 2005. An overall summary of data was also prepared concerning the status of all samples submitted as of April 17, 2007. During the 1-year study period, samples from 77 unidentified decedents were submitted to the laboratory. As of October 2006 (22 months after submission of the first samples and 10 months after submission of the last samples), testing had been completed on 53% of the samples submitted, and 68% of those tested resulted in a mitochondrial DNA profile. Turnaround times ranged from 66 to 557 days, improved with time, and had a mean of 107 days for specimens submitted during the latter part of the study period. As of April 17, 2007, we had submitted samples involving 84 unidentified decedents. Seventy-five percent of the samples have now been tested. Data from the NMPDD laboratory have resulted in 4 identifications by comparison with putative relatives, 4 exclusions, and no cold hits through comparison NMPDD DNA profiles from missing persons. More extensive data are presented in the body of this article. The NMPDD laboratory provides useful and free services to medical examiners, coroners, and law enforcement agencies that require DNA services regarding missing and unidentified persons. Turnaround times have improved. The success of the system in getting cold hits will be heavily dependent on law enforcement filing missing persons reports and submission of reference samples from putative relatives of the decedent. We recommend collecting specimens for DNA analysis early on in the postmortem investigation, submitting samples to the NMPDD laboratory or one of its participating laboratories when traditional methods for identification cannot be used or have failed, not burying bodies until a DNA profile has been obtained, and not cremating unidentified remains.

  2. Student laboratory presentations as a learning tool in anatomy education.

    PubMed

    Chollet, Madeleine B; Teaford, Mark F; Garofalo, Evan M; DeLeon, Valerie B

    2009-01-01

    Previous studies have shown that anatomy students who complete oral laboratory presentations believe they understand the material better and retain it longer than they otherwise would if they only took examinations on the material; however, we have found no studies that empirically test such outcomes. The purpose of this study was to assess the effectiveness of oral presentations through comparisons with other methods of assessment, most notably, examination performance. Specifically, we tested whether students (n = 256) performed better on examination questions on topics covered by their oral presentations than on other topics. Each student completed two graded, 12-minute laboratory presentations on two different assigned topics during the course and took three examinations, each of which covered a third of the course material. Examination questions were characterized by type (memorization, pathway, analytical, spatial). A two-way repeated measures analysis of variance revealed that students performed better on topics covered by their presentations than on topics not covered by their presentations (P < 0.005), regardless of presentation grade (P > 0.05) and question type (P > 0.05). These results demonstrate empirically that oral presentations are an effective learning tool.

  3. Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach.

    PubMed

    Antonelli, Giorgia; Padoan, Andrea; Aita, Ada; Sciacovelli, Laura; Plebani, Mario

    2017-08-28

    Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements.

  4. Accuracy of p53 Codon 72 Polymorphism Status Determined by Multiple Laboratory Methods: A Latent Class Model Analysis

    PubMed Central

    Walter, Stephen D.; Riddell, Corinne A.; Rabachini, Tatiana; Villa, Luisa L.; Franco, Eduardo L.

    2013-01-01

    Introduction Studies on the association of a polymorphism in codon 72 of the p53 tumour suppressor gene (rs1042522) with cervical neoplasia have inconsistent results. While several methods for genotyping p53 exist, they vary in accuracy and are often discrepant. Methods We used latent class models (LCM) to examine the accuracy of six methods for p53 determination, all conducted by the same laboratory. We also examined the association of p53 with cytological cervical abnormalities, recognising potential test inaccuracy. Results Pairwise disagreement between laboratory methods occurred approximately 10% of the time. Given the estimated true p53 status of each woman, we found that each laboratory method is most likely to classify a woman to her correct status. Arg/Arg women had the highest risk of squamous intraepithelial lesions (SIL). Test accuracy was independent of cytology. There was no strong evidence for correlations of test errors. Discussion Empirical analyses ignore possible laboratory errors, and so are inherently biased, but test accuracy estimated by the LCM approach is unbiased when model assumptions are met. LCM analysis avoids ambiguities arising from empirical test discrepancies, obviating the need to regard any of the methods as a “gold” standard measurement. The methods we presented here to analyse the p53 data can be applied in many other situations where multiple tests exist, but where none of them is a gold standard. PMID:23441193

  5. Rapid C-reactive protein and white cell tests decrease cost and shorten emergency visits.

    PubMed

    Kokko, Eeva; Korppi, Matti; Helminen, Merja; Hutri-Kähönen, Nina

    2014-10-01

    Elevated white blood cells (WBC) in blood and C-reactive protein (CRP) in serum are often used as non-specific markers for bacterial etiology of infection in children. The aim of the present study was to evaluate how rapid WBC and CRP testing influences patient flow and cost in the pediatric emergency room (ER). This study was a retrospective chart review. In all, 166 children who were treated during 3 months in the ER of a children's hospital, and in whom rapid tests for WBC and CRP were done, were included. The association between rapid testing and length of ER stay was evaluated, and the cost of rapid tests was compared with the corresponding cost if done in the hospital laboratory. Median ER stay was 147.5 min, if no examinations other than rapid CRP and WBC tests were done and if no emergency treatment was given, compared with 201.5 min for laboratory tests or emergency treatment given (P < 0.001). The respective figures were 142.5 min and 179.5 min in those 96 children discharged home (P = 0.003). The cost of rapid testing was only 41.5% of the corresponding laboratory cost. The simultaneous rapid testing of CRP and WBC in children with presumable infection decreased cost and shortened the length of ER stay, if no other examinations or emergency treatment were needed. The cost of rapid testing was less than half of the corresponding cost in laboratory. © 2014 Japan Pediatric Society.

  6. Laboratory-based versus non-laboratory-based method for assessment of cardiovascular disease risk: the NHANES I Follow-up Study cohort

    PubMed Central

    Gaziano, Thomas A; Young, Cynthia R; Fitzmaurice, Garrett; Atwood, Sidney; Gaziano, J Michael

    2008-01-01

    Summary Background Around 80% of all cardiovascular deaths occur in developing countries. Assessment of those patients at high risk is an important strategy for prevention. Since developing countries have limited resources for prevention strategies that require laboratory testing, we assessed if a risk prediction method that did not require any laboratory tests could be as accurate as one requiring laboratory information. Methods The National Health and Nutrition Examination Survey (NHANES) was a prospective cohort study of 14 407 US participants aged between 25–74 years at the time they were first examined (between 1971 and 1975). Our follow-up study population included participants with complete information on these surveys who did not report a history of cardiovascular disease (myocardial infarction, heart failure, stroke, angina) or cancer, yielding an analysis dataset N=6186. We compared how well either method could predict first-time fatal and non-fatal cardiovascular disease events in this cohort. For the laboratory-based model, which required blood testing, we used standard risk factors to assess risk of cardiovascular disease: age, systolic blood pressure, smoking status, total cholesterol, reported diabetes status, and current treatment for hypertension. For the non-laboratory-based model, we substituted body-mass index for cholesterol. Findings In the cohort of 6186, there were 1529 first-time cardiovascular events and 578 (38%) deaths due to cardiovascular disease over 21 years. In women, the laboratory-based model was useful for predicting events, with a c statistic of 0·829. The c statistic of the non-laboratory-based model was 0·831. In men, the results were similar (0·784 for the laboratory-based model and 0·783 for the non-laboratory-based model). Results were similar between the laboratory-based and non-laboratory-based models in both men and women when restricted to fatal events only. Interpretation A method that uses non-laboratory-based risk factors predicted cardiovascular events as accurately as one that relied on laboratory-based values. This approach could simplify risk assessment in situations where laboratory testing is inconvenient or unavailable. PMID:18342687

  7. 42 CFR 493.55 - Application for registration certificate and certificate of accreditation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... government laboratories that engage in limited (not more than a combination of 15 moderately complex or... performed by the laboratory including— (i) The name and total number of tests and examinations performed...

  8. Use of laboratory testing for genital chlamydial infection in Norway.

    PubMed Central

    Aavitsland, P

    1993-01-01

    OBJECTIVE--To assess the use of laboratory tests for genital chlamydial infection in Norway. DESIGN--Questionnaire survey of general practitioners' practice in chlamydial testing, retrospective survey of laboratory records, 1986-91, and prospective study of testing in one laboratory during four weeks. SETTING--All 18 microbiological laboratories in Norway (4.2 million population), including one serving all doctors in Vestfold county (0.2 million population). SUBJECTS--302 general practitioners. MAIN MEASURES--GPs' routine practice, methods used for testing, 1986-91, and sex specific and age group specific testing in 1991. RESULTS--201(69%) GPs replied to the questionnaire: 101(51%) would test all women younger than 25 years at routine pelvic examination, 107(54%) all girls at first pelvic examination, 131(66%) all pregnant women, and 106(54%) all men whose female partner had urogenital complaints. Nationwide in 1986, 122,000 tests were performed (2.9 per 100 population); 10% were positive and 51% were cell culture tests. In 1991, 341,000 tests were performed (8.0 per 100 population); 4.5% were positive and 15% were cell culture tests. 13,184 tests were performed in Vestfold in 1991 (6.6 per 100 population). The age group specific rates (per 100 population) among women were: age 15-19 years, 22.0(95% confidence interval 18.2 to 25.8); 20-24 years, 47.2(42.1 to 52.3); 25-29 years, 42.3(37.1 to 47.5); 30-34 years, 29.8(25.4 to 34.2); and 35-39 years, 12.5(9.5 to 15.5). CONCLUSIONS--GPs use liberal indications for testing. The dramatic increase in testing, especially by enzyme immunoassays, in populations with a low prevalence of infection results in low cost effectiveness and low predictive value of positive tests, which in women over 29 years is estimated as 17-36%. IMPLICATIONS--Doctors should be educated about the limitations of enzyme immunoassays in screening low prevalence populations, and laboratories should apply a confirmatory test to specimens testing positive with such assays. PMID:10131639

  9. 42 CFR 493.35 - Application for a certificate of waiver.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... moderately complex or waived tests per certificate) public health testing may file a single application. (3... laboratory including— (i) The name and the total number of test procedures and examinations performed...

  10. Validation of a laboratory and hospital information system in a medical laboratory accredited according to ISO 15189.

    PubMed

    Biljak, Vanja Radisic; Ozvald, Ivan; Radeljak, Andrea; Majdenic, Kresimir; Lasic, Branka; Siftar, Zoran; Lovrencic, Marijana Vucic; Flegar-Mestric, Zlata

    2012-01-01

    The aim of the study was to present a protocol for laboratory information system (LIS) and hospital information system (HIS) validation at the Institute of Clinical Chemistry and Laboratory Medicine of the Merkur University Hospital, Zagreb, Croatia. Validity of data traceability was checked by entering all test requests for virtual patient into HIS/LIS and printing corresponding barcoded labels that provided laboratory analyzers with the information on requested tests. The original printouts of the test results from laboratory analyzer(s) were compared with the data obtained from LIS and entered into the provided template. Transfer of data from LIS to HIS was examined by requesting all tests in HIS and creating real data in a finding generated in LIS. Data obtained from LIS and HIS were entered into a corresponding template. The main outcome measure was the accuracy of transfer obtained from laboratory analyzers and results transferred from LIS and HIS expressed as percentage (%). The accuracy of data transfer from laboratory analyzers to LIS was 99.5% and of that from LIS to HIS 100%. We presented our established validation protocol for laboratory information system and demonstrated that a system meets its intended purpose.

  11. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the real-time polymerase chain reaction test for Mycoplasma gallisepticum (MGLP ReTi). 147.31 Section... Examination Procedures § 147.31 Laboratory procedures recommended for the real-time polymerase chain reaction... lp gene. (c) MGLP ReTi. Primers and probe should be utilized in a 25 µl reaction containing 12.5 µl...

  12. 9 CFR 147.31 - Laboratory procedures recommended for the real-time polymerase chain reaction test for Mycoplasma...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the real-time polymerase chain reaction test for Mycoplasma gallisepticum (MGLP ReTi). 147.31 Section... Examination Procedures § 147.31 Laboratory procedures recommended for the real-time polymerase chain reaction... lp gene. (c) MGLP ReTi. Primers and probe should be utilized in a 25 µl reaction containing 12.5 µl...

  13. 7 CFR 97.100 - Examination of applications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... if there are fundamental defects in the application, as determined by the examiner, the examination...

  14. An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories.

    PubMed

    Alexander, C L; Currie, S; Pollock, K; Smith-Palmer, A; Jones, B L

    2017-06-01

    Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.

  15. Drugs in the Workplace: Legal Developments.

    ERIC Educational Resources Information Center

    Scholick, Gary P.

    1989-01-01

    An update on legal aspects of drug testing in the workplace looks at pre-employment screening, reasonable suspicion testing, routine testing in periodic physical examinations, random testing, and unionized employers. Practical guidelines are given for minimizing obtrusiveness, confirmatory tests, laboratory selection, notification of policy,…

  16. Battery testing at Argonne National Laboratory

    NASA Astrophysics Data System (ADS)

    Deluca, W. H.; Gillie, K. R.; Kulaga, J. E.; Smaga, J. A.; Tummillo, A. F.; Webster, C. E.

    1993-03-01

    Argonne National Laboratory's Analysis & Diagnostic Laboratory (ADL) tests advanced batteries under simulated electric and hybrid vehicle operating conditions. The ADL facilities also include a post-test analysis laboratory to determine, in a protected atmosphere if needed, component compositional changes and failure mechanisms. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The battery evaluations and post-test examinations help identify factors that limit system performance and life and the most-promising R&D approaches for overcoming these limitations. Since 1991, performance characterizations and/or life evaluations have been conducted on eight battery technologies: Na/S, Li/S, Zn/Br, Ni/MH, Ni/Zn, Ni/Cd, Ni/Fe, and lead-acid. These evaluations were performed for the Department of Energy's. Office of Transportation Technologies, Electric and Hybrid Propulsion Division (DOE/OTT/EHP), and Electric Power Research Institute (EPRI) Transportation Program. The results obtained are discussed.

  17. Interlaboratory evaluation of Hyalella azteca and Chironomus tentans short-term and long-term sediment toxicity tests

    USGS Publications Warehouse

    Norberg-King, T. J.; Sibley, P.K.; Burton, G.A.; Ingersoll, C.G.; Kemble, N.E.; Ireland, S.; Mount, D.R.; Rowland, C.D.

    2006-01-01

    Methods for assessing the long-term toxicity of sediments to Hyalella azteca and Chironomus tentans can significantly enhance the capacity to assess sublethal effects of contaminated sediments through multiple endpoints. Sublethal tests allow us to begin to understand the relationship between short-term and long-term effects for toxic sediments. We present an interlaboratory evaluation with long-term and 10-d tests using control and contaminated sediments in which we assess whether proposed and existing performance criteria (test acceptability criteria [TAC]) could be achieved. Laboratories became familiar with newly developed, long-term protocols by testing two control sediments in phase 1. In phase 2, the 10-d and long-term tests were examined with several sediments. Laboratories met the TACs, but results varied depending on the test organism, test duration, and endpoints. For the long-term tests in phase 1, 66 to 100% of the laboratories consistently met the TACs for survival, growth, or reproduction using H. azteca, and 70 to 100% of the laboratories met the TACs for survival and growth, emergence, reproduction, and hatchability using C. tentans. In phase 2, fewer laboratories participated in long-term tests: 71 to 88% of the laboratories met the TAC for H. azteca, whereas 50 to 67% met the TAC for C. tentans. In the 10-d tests with H. azteca, and C. tentans, 82 and 88% of the laboratories met the TAC for survival, respectively, and 80% met the TAC for C. tentans growth. For the 10-d and long-term tests, laboratories predicted similar toxicity. Overall, the interlaboratory evaluation showed good precision of the methods, appropriate endpoints were incorporated into the test protocols, and tests effectively predicted the toxicity of sediments.

  18. Total laboratory automation: Do stat tests still matter?

    PubMed

    Dolci, Alberto; Giavarina, Davide; Pasqualetti, Sara; Szőke, Dominika; Panteghini, Mauro

    2017-07-01

    During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions. In this laboratory department model, the short TAT for all first-line tests performed by TLA in the core laboratory represents the key paradigm, where no more stat testing is required because all samples are handled in real-time and (auto)validated results dispatched in a time that fulfills clinical needs. To optimally reach this goal, laboratories should be actively involved in managing all the steps covering the total examination process, speeding up also extra-laboratory phases, such sample delivery. Furthermore, to warrant effectiveness and not only efficiency, all the processes, e.g. specimen integrity check, should be managed by middleware through a predefined set of rules defined in light of the clinical governance. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  19. Laboratory Assays in Evaluation of Lynch Syndrome in Patients with Endometrial Carcinoma.

    PubMed

    Djordjevic, Bojana; Broaddus, Russell R

    2016-06-01

    This article reviews the main tissue testing modalities for Lynch Syndrome in the pathology laboratory, such as immunohistochemistry and PCR based analyses, and discusses their routine application, interpretation pitfalls, and troubleshooting of common technical performance issues. Discrepancies between laboratory and genetic testing may arise, and are examined in the context of the complexity of molecular abnormalities associated with Lynch Syndrome. The merits of targeted versus universal screening in a changing healthcare climate are addressed. In the absence of comprehensive screening programs, specific tumor topography and histological features that may prompt pathologist-initiated molecular tumor testing are outlined. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A bioaccumulation bioassay for freshwater sediments

    USGS Publications Warehouse

    Mac, Michael J.; Noguchi, George E.; Hesselberg, Robert J.; Edsall, Carol C.; Shoesmith, John A.; Bowker, James D.

    1990-01-01

    A laboratory bioassay is described for determining the bioavailability of contaminants from freshwater sediments. The bioassay consists of 10-d exposures to whole sediments under flow-through conditions. After testing five species, the fathead minnow (Pimephales promelas) and the earthworm (Lubricus terrestris) were recommended for use in the test. When the availability of polychlorinated biphenyls (PCBs), Hg and Zn from Great Lakes sediments was examined in laboratory exposures, only the PCBs were accumulated. A field validation study demonstrated that the magnitude of accumulation in laboratory exposures was similar to that in organisms caged in the field. A protocol is recommended for using the test as a standardized bioaccumulation bioassay.

  1. Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

    PubMed

    Froom, Paul; Barak, Mira

    2010-01-01

    Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

  2. Emerging Technologies for the Clinical Microbiology Laboratory

    PubMed Central

    Buchan, Blake W.

    2014-01-01

    SUMMARY In this review we examine the literature related to emerging technologies that will help to reshape the clinical microbiology laboratory. These topics include nucleic acid amplification tests such as isothermal and point-of-care molecular diagnostics, multiplexed panels for syndromic diagnosis, digital PCR, next-generation sequencing, and automation of molecular tests. We also review matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) and electrospray ionization (ESI) mass spectrometry methods and their role in identification of microorganisms. Lastly, we review the shift to liquid-based microbiology and the integration of partial and full laboratory automation that are beginning to impact the clinical microbiology laboratory. PMID:25278575

  3. Laboratory practice at the periphery in developing countries.

    PubMed

    Lewis, S M

    2002-08-01

    An effective national health service structure requires a comprehensive programme for primary health care in peripheral and rural areas. This is especially important in under-resourced countries where facilities are sparse, the population is widely dispersed and transport is limited. Haematology has a key role in diagnosis and patient management by selecting tests for their clinical relevance and utility for the specific circumstances, and ensuring their technical reliability when used in health clinics and point-of-care testing. WHO has proposed a basic menu of tests in three categories: (a) tests such as haemoglobin screen which can be performed by nurses, midwives, health-aides or community doctors, (b) tests such as haemoglobinometry, microhaematocrit and microscopic examination of stained preparations which can be performed by a technician or laboratory assistant in a health centre, (c) tests requiring greater technical expertise of a laboratory technician or trained doctor. The peripheral health clinics and district laboratories must be familiar with the guidelines on standardized methods for collecting and storing specimens and transporting them to a regional laboratory or a reference centre. A training syllabus should be provided at the health centres and district laboratories, and this should include on-site instruction from supervisors and access to training manuals and distance-learning material. A co-ordinated programme of quality assurance and standardization of test methods should be established by a reference centre or national health authority with a network which encompasses all laboratories and health clinics undertaking any tests. Each regional laboratory should foster lower level laboratories or clinics within its neighbourhood. Of particular concern is the reliable diagnosis and management of anaemia. WHO reports indicate that 40% of the world population suffer from anaemia, especially affecting pregnant women, and a high proportion of infants and children in developing countries. The Haemoglobin Colour Scale (HCS) was recently developed for WHO as a simple, cheap and portable device which reads haemoglobin within 1 g/dl of the true value. It has been validated in a number of studies and is now manufactured commercially in accordance with WHO specifications under control of a WHO Collaborating Centre. It has an important potential role in the resource-limited environment where anaemia screening presently usually depends on unreliable clinical examination.

  4. PIE on Safety-Tested Loose Particles from Irradiated Compact 4-4-2

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hunn, John D.; Gerczak, Tyler J.; Morris, Robert Noel

    2016-04-01

    Post-irradiation examination (PIE) is being performed in support of tristructural isotropic (TRISO) coated particle fuel development and qualification for High Temperature Gas-cooled Reactors (HTGRs). This work is sponsored by the Department of Energy Office of Nuclear Energy (DOE-NE) through the Advanced Reactor Technologies (ART) Office under the Advanced Gas Reactor Fuel Development and Qualification (AGR) Program. The AGR-1 experiment was the first in a series of TRISO fuel irradiation tests initiated in 2006. The AGR-1 TRISO particles and fuel compacts were fabricated at Oak Ridge National Laboratory (ORNL) in 2006 using laboratory-scale equipment and irradiated for 3 years in themore » Advanced Test Reactor (ATR) at Idaho National Laboratory (INL) to demonstrate and evaluate fuel performance under HTGR irradiation conditions. Post-irradiation examination was performed at INL and ORNL to study how the fuel behaved during irradiation, and to test fuel performance during exposure to elevated temperatures at or above temperatures that could occur during a depressurized conduction cooldown event. This report summarizes safety testing and post-safety testing PIE conducted at ORNL on loose particles extracted from irradiated AGR-1 Compact 4-4-2.« less

  5. 78 FR 76151 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... better allocate resources. Methodological tests will continue to be designed to examine the feasibility... reporting. Research will involve focus groups, cognitive laboratory testing, customer satisfaction surveys...

  6. Why the history and physical examination still matter.

    PubMed

    Schultz, Michele A; Doty, Maggie

    2016-03-01

    The history and physical examination (H/PE) have been the foundation of medical diagnosis for centuries. However, as laboratory tests and diagnostic imaging has expanded, physical examination skills have been deemphasized in medical education, and clinicians have become more reliant on tests and imaging. This article describes the historical contributions of the H/PE and its resurgence in a refined form to improve diagnosis.

  7. Hot Cell Installation and Demonstration of the Severe Accident Test Station

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Linton, Kory D.; Burns, Zachary M.; Terrani, Kurt A.

    A Severe Accident Test Station (SATS) capable of examining the oxidation kinetics and accident response of irradiated fuel and cladding materials for design basis accident (DBA) and beyond design basis accident (BDBA) scenarios has been successfully installed and demonstrated in the Irradiated Fuels Examination Laboratory (IFEL), a hot cell facility at Oak Ridge National Laboratory. The two test station modules provide various temperature profiles, steam, and the thermal shock conditions necessary for integral loss of coolant accident (LOCA) testing, defueled oxidation quench testing and high temperature BDBA testing. The installation of the SATS system restores the domestic capability to examinemore » postulated and extended LOCA conditions on spent fuel and cladding and provides a platform for evaluation of advanced fuel and accident tolerant fuel (ATF) cladding concepts. This document reports on the successful in-cell demonstration testing of unirradiated Zircaloy-4. It also contains descriptions of the integral test facility capabilities, installation activities, and out-of-cell benchmark testing to calibrate and optimize the system.« less

  8. 29 CFR 1910.7 - Definition and requirements for a nationally recognized testing laboratory.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., written testing procedures, and calibration and quality control programs) to perform: (i) Testing and... test standards; or (ii) Experimental testing and examining of equipment and materials for workplace..., labeled, or accepted, the following controls or services: (i) Implements control procedures for...

  9. [Unnecessary routine laboratory tests in patients referred for surgical services].

    PubMed

    Mata-Miranda, María del Pilar; Cano-Matus, Norberto; Rodriguez-Murrieta, Margarita; Guarneros-Zapata, Idalia; Ortiz, Mario

    2016-01-01

    To question the usefulness of the lab analysis considered routine testing for the identification of abnormalities in the surgical care. To determine the percentage of unnecessary laboratory tests in the preoperative assessment as well as to estimate the unnecessary expenses. A descriptive, cross-sectional study of patients referred for surgical evaluation between January 1st and March 31st 2013. The database of laboratory testing and electronic files were reviewed. Reference criteria from surgical services were compared with the tests requested by the family doctor. In 65% of the patients (n=175) unnecessary examinations were requested, 25% (n=68) were not requested the tests that they required, and only 10% of the patients were requested laboratory tests in accordance with the reference criteria (n=27). The estimated cost in unnecessary examinations was $1,129,552 in a year. The results were similar to others related to this theme, however, they had not been revised from the perspective of the first level of attention regarding the importance of adherence to the reference criteria which could prevent major expenditures. It is a priority for leaders and operational consultants in medical units to establish strategies and lines of action that ensure compliance with institutional policies so as to contain spending on comprehensive services, and which in turn can improve the medical care. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  10. Validation of a laboratory and hospital information system in a medical laboratory accredited according to ISO 15189

    PubMed Central

    Biljak, Vanja Radisic; Ozvald, Ivan; Radeljak, Andrea; Majdenic, Kresimir; Lasic, Branka; Siftar, Zoran; Lovrencic, Marijana Vucic; Flegar-Mestric, Zlata

    2012-01-01

    Introduction The aim of the study was to present a protocol for laboratory information system (LIS) and hospital information system (HIS) validation at the Institute of Clinical Chemistry and Laboratory Medicine of the Merkur University Hospital, Zagreb, Croatia. Materials and methods: Validity of data traceability was checked by entering all test requests for virtual patient into HIS/LIS and printing corresponding barcoded labels that provided laboratory analyzers with the information on requested tests. The original printouts of the test results from laboratory analyzer(s) were compared with the data obtained from LIS and entered into the provided template. Transfer of data from LIS to HIS was examined by requesting all tests in HIS and creating real data in a finding generated in LIS. Data obtained from LIS and HIS were entered into a corresponding template. The main outcome measure was the accuracy of transfer obtained from laboratory analyzers and results transferred from LIS and HIS expressed as percentage (%). Results: The accuracy of data transfer from laboratory analyzers to LIS was 99.5% and of that from LIS to HIS 100%. Conclusion: We presented our established validation protocol for laboratory information system and demonstrated that a system meets its intended purpose. PMID:22384522

  11. Evaluation of FEM engineering parameters from insitu tests

    DOT National Transportation Integrated Search

    2001-12-01

    The study looked critically at insitu test methods (SPT, CPT, DMT, and PMT) as a means for developing finite element constitutive model input parameters. The first phase of the study examined insitu test derived parameters with laboratory triaxial te...

  12. Cost analysis in the toxicology laboratory.

    PubMed

    Travers, E M

    1990-09-01

    The process of determining laboratory sectional and departmental costs and test costs for instrument-generated and manually generated reportable results for toxicology laboratories has been outlined in this article. It is hoped that the basic principles outlined in the preceding text will clarify and elucidate one of the most important areas needed for laboratory fiscal integrity and its survival in these difficult times for health care providers. The following general principles derived from this article are helpful aids for managers of toxicology laboratories. 1. To manage a cost-effective, efficient toxicology laboratory, several factors must be considered: the laboratory's instrument configuration, test turnaround time needs, the test menu offered, the analytic methods used, the cost of labor based on time expended and the experience and educational level of the staff, and logistics that determine specimen delivery time and costs. 2. There is a wide variation in costs for toxicologic methods, which requires that an analysis of capital (equipment) purchase and operational (test performance) costs be performed to avoid waste, purchase wisely, and determine which tests consume the majority of the laboratory's resources. 3. Toxicologic analysis is composed of many complex steps. Each step must be individually cost-accounted. Screening test results must be confirmed, and the cost for both steps must be included in the cost per reportable result. 4. Total costs will vary in the same laboratory and between laboratories based on differences in salaries paid to technical staff, differences in reagent/supply costs, the number of technical staff needed to operate the analyzer or perform the method, and the inefficient use of highly paid staff to operate the analyzer or perform the method. 5. Since direct test costs vary directly with the type and number of analyzers or methods and are dependent on the operational mode designed by the manufacturer, laboratory managers should construct an actual test-cost data base for instrument or method in use to accurately compare costs using the "bottom-up" approach. 6. Laboratory expenses can be examined from three perspectives: total laboratory, laboratory section, and subsection workstation. The objective is to track all laboratory expenses through each of these levels. 7. In the final analysis, a portion of total laboratory expenses must be allocated to each unit of laboratory output--the billable procedure or, in laboratories where tests are not billed, the tests produced.(ABSTRACT TRUNCATED AT 400 WORDS)

  13. [ISO 15189, Up-To-Date Information and Prospective View].

    PubMed

    Shimoda, Katsuji

    2016-02-01

    "Accreditation Activities for Medical Laboratories in Japan" Audits for transition to ISO 15189:2012 continue to progress. Besides the continual increase of accreditations for medical laboratory testing and pathological examinations, preparations for the addition of physiological testing to the scope of accreditation have finally been completed. As a part of the revision to Japan's Medical Service Act, the external evaluation of medical laboratories is now a requirement to approve clinical trial core hospitals. Accordingly, the importance of third-party accreditation in medical laboratory testing is attracting a growing level of attention. World Accreditation Day 2015 "Accreditation: Supporting the Delivery of Health and Social Care" JAB is being used to make every effort to contribute to this system in order to improve the quality of healthcare in Japan and the health of its citizens.

  14. [Infection control team (ICT) in cooperation with microbiology laboratories].

    PubMed

    Okazaki, Mitsuhiro

    2012-10-01

    Infection control as a medical safety measure is an important issue in all medical facilities. In order to tackle this measure, cooperation between the infection control team (ICT) and microbiological laboratory is indispensable. Multiple drug-resistant bacteria have shifted from Gram-positive bacteria to Gram-negative bacilli within the last ten years. There are also a variety of bacilli, complicating the examination method and test results further. Therefore, cooperation between the ICT and microbiological laboratory has become important to understand examination results and to use them. In order to maintain functional cooperation, explanatory and communicative ability between the microbiological laboratory and ICT is required every day. Such positive information exchange will develop into efficient and functional ICT activity.

  15. Recommendations for Filler Material Composition and Delivery Method for Bench-Scale Testing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hardin, Ernest; Brady, Patrick Vane

    This report supplements Joint Workplan on Filler Investigations for DPCs (SNL 2017) providing new and some corrected information for use in planning Phase 1 laboratory testing of slurry cements as possible DPC fillers. The scope description is to "Describe a complete laboratory testing program for filler composition, delivery, emplacement in surrogate canisters, and post-test examination. To the extent possible specify filler material and equipment sources." This report includes results from an independent expert review (Dr. Arun Wagh, retired from Argonne National Laboratory and contracted by Sandia) that helped to narrow the range of cement types for consideration, and to providemore » further guidance on mix variations to optimize injectability, durability, and other aspects of filler performance.« less

  16. Financial incentives and the supply of laboratory tests.

    PubMed

    Carlsen, Fredrik; Grytten, Jostein; Skau, Irene

    2003-11-01

    This study examined how the number of laboratory tests taken by a sample of Norwegian contract physicians is influenced by their private economy outside of the practice and by changes in remuneration. The data are drawn from 40,000 consultations carried out by 44 contract physicians in 1991-1994. Two factors which led to changes in the level of physicians' income are considered: changes in remuneration for consultations and laboratory tests and changes in interest rates on loans and bank deposits. The effect which changes in interest rates have on physicians' disposable income was calculated using information about their financial assets and debts obtained from tax assessments. The main finding was that changes in private economy and changes in remuneration have no or only a small effect on the number of laboratory tests taken. Our results suggest that fee regulation can be an effective means of controlling physicians' income and therefore government expenditure on primary physician services.

  17. Interlaboratory validation of the modified murine local lymph node assay based on adenosine triphosphate measurement.

    PubMed

    Omori, Takashi; Idehara, Kenji; Kojima, Hajime; Sozu, Takashi; Arima, Kazunori; Goto, Hirohiko; Hanada, Tomohiko; Ikarashi, Yoshiaki; Inoda, Taketo; Kanazawa, Yukiko; Kosaka, Tadashi; Maki, Eiji; Morimoto, Takashi; Shinoda, Shinsuke; Shinoda, Naoki; Takeyoshi, Masahiro; Tanaka, Masashi; Uratani, Mamoru; Usami, Masahito; Yamanaka, Atsushi; Yoneda, Tomofumi; Yoshimura, Isao; Yuasa, Atsuko

    2008-01-01

    The murine local lymph node assay (LLNA) is a well-established alternative to the guinea pig maximization test (GPMT) or Buehler test (BT) for the assessment of the skin sensitizing ability of drugs and chemicals. Daicel Chemical Industries Ltd. has developed a modified LLNA based on the adenosine triphosphate (ATP) content (LLNA-DA). We conducted 2 interlaboratory validation studies to evaluate the reliability and relevance of LLNA-DA. The experiment involved 17 laboratories, wherein 14 chemicals were examined under blinded conditions. In the first study, 3 chemicals were examined in 10 laboratories and the remaining 9 were examined in 3 laboratories. In the second study, 1 chemical was examined in 7 laboratories and the remaining 4 chemicals were examined in 4 laboratories. The data were expressed as the ATP content for each chemical-treated group, and the stimulation index (SI) for each chemical-treated group was determined as the increase in the ATP content relative to the concurrent vehicle control group. An SI of 3 was set as the cut-off value for exhibiting skin sensitization activity. The results of the first study obtained in the experiments conducted for the 3 chemicals that were examined in all the 10 laboratories and for 5 of the remaining 9 chemicals were sufficiently consistent with small variations in their SI values. The sensitivity, specificity, and accuracy of LLNA-DA against those of GPMT/BT were 7/8 (87.5%), 3/3 (100%), and 10/11 (90.9%), respectively. In the second study, all the 5 chemicals studied demonstrated acceptably small interlaboratory variations. In the first study, a large variation was observed for 2 chemicals; in the second study, this variation was small. It was attributed to the application of dimethylsulfoxide as the solvent for the metallic salts. In conclusion, these 2 studies provide good evidence for the reliability of the LLNA-DA.

  18. In-reactor performance of LWR-type tritium target rods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lanning, D.D.; Paxton, M.M.; Crumbaugh, L.

    Pacific Northwest Laboratory has conducted several 1-yr irradiation tests of light water reactor-type tritium target rods. These tests have been sponsored by the U.S. Department of Energy's Office of New Production Reactors. The first test, designated water capsule-1 (WC-1), was conducted in the Advanced Test Reactor (ATR) at the Idaho National Engineering Laboratory from November 1989 to December 1990. The test vehicle contained a single 4-ft target rod within a pressurized water capsule. The capsule maintained the rod at pressurized water reactor (PWR)-type water temperature and pressure conditions. Posttest nondestructive examinations of the WC-1 rod involved visual examinations, dimensional checks,more » gamma scanning, and neutron radiography. The results indicate that the rod maintained the integrity of its pressure seal and was otherwise unaltered both mechanically and dimensionally by its irradiation and posttest handling.« less

  19. Physical examination instead of laboratory tests for most infants born to mothers colonized with group B Streptococcus: support for the Centers for Disease Control and Prevention's 2010 recommendations.

    PubMed

    Cantoni, Luigi; Ronfani, Luca; Da Riol, Rosalia; Demarini, Sergio

    2013-08-01

    To compare 2 approaches in the management of neonates at risk for group B Streptococcus early-onset sepsis: laboratory tests plus standardized physical examination and standardized physical examination alone. Prospective, sequential study over 2 consecutive 12-month periods, carried out in the maternity hospitals of the region Friuli-Venezia Giulia (north-eastern Italy). All term infants were included (7628 in the first period, 7611 in the second). In the first period, complete blood count and blood culture were required for all infants at risk, followed by a 48-hour period of observation with a standardized physical examination. In the second period, only standardized physical examination was performed. Study outcomes were: (1) number of neonates treated with antibiotics; and (2) time between onset of signs of possible sepsis and beginning of treatment. There was no difference between the 2 periods in the rate of maternal colonization (19.7% vs 19.8%, P = .8), or in other risk factors. The interval between onset of signs of sepsis and starting of antibiotics was not different in the 2 periods. Significantly fewer infants were treated with antibiotics in the second period (0.5% vs 1.2%, P < .001). Laboratory tests together with standardized physical examination seem to offer no advantage over standardized physical examination alone; the latter was associated with fewer antibiotic treatments. Our results are in agreement with the Center for Disease Control and Prevention's 2010 recommendations. Copyright © 2013 Mosby, Inc. All rights reserved.

  20. Soil-cement study : final report.

    DOT National Transportation Integrated Search

    1973-11-01

    This study consisted of an examination of the compressive strengths of soil-cement mixtures on 15 construction projects from the standpoint of design and actual achievement. The laboratory design test was examined closely along with the present field...

  1. Interlaboratory comparability, bias, and precision for four laboratories measuring constituents in precipitation, November 1982-August 1983

    USGS Publications Warehouse

    Brooks, M.H.; Schroder, L.J.; Malo, B.A.

    1985-01-01

    Four laboratories were evaluated in their analysis of identical natural and simulated precipitation water samples. Interlaboratory comparability was evaluated using analysis of variance coupled with Duncan 's multiple range test, and linear-regression models describing the relations between individual laboratory analytical results for natural precipitation samples. Results of the statistical analyses indicate that certain pairs of laboratories produce different results when analyzing identical samples. Analyte bias for each laboratory was examined using analysis of variance coupled with Duncan 's multiple range test on data produced by the laboratories from the analysis of identical simulated precipitation samples. Bias for a given analyte produced by a single laboratory has been indicated when the laboratory mean for that analyte is shown to be significantly different from the mean for the most-probable analyte concentrations in the simulated precipitation samples. Ion-chromatographic methods for the determination of chloride, nitrate, and sulfate have been compared with the colorimetric methods that were also in use during the study period. Comparisons were made using analysis of variance coupled with Duncan 's multiple range test for means produced by the two methods. Analyte precision for each laboratory has been estimated by calculating a pooled variance for each analyte. Analyte estimated precisions have been compared using F-tests and differences in analyte precisions for laboratory pairs have been reported. (USGS)

  2. Integrated Data Collection Analysis (IDCA) Program - RDX Type II Class 5 Standard, Data Set 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    This document describes the results of the first reference sample material—RDX Type II Class 5—examined in the proficiency study for small-scale safety and thermal (SSST) testing of explosive materials for the Integrated Data Collection Analysis (IDCA) Program. The IDCA program is conducting proficiency testing on homemade explosives (HMEs). The reference sample materials are being studied to establish the accuracy of traditional explosives safety testing for each performing laboratory. These results will be used for comparison to results from testing HMEs. This effort, funded by the Department of Homeland Security (DHS), ultimately will put the issues of safe handling of thesemore » materials in perspective with standard military explosives. The results of the study will add SSST testing results for a broad suite of different HMEs to the literature, potentially suggest new guidelines and methods for HME testing, and possibly establish what are the needed accuracies in SSST testing to develop safe handling practices. Described here are the results for impact, friction, electrostatic discharge, and scanning calorimetry analysis of a reference sample of RDX Type II Class 5. The results from each participating testing laboratory are compared using identical test material and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. These results are then compared to historical data from various sources. The performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Air Force Research Laboratory/ RXQL (AFRL), Indian Head Division, Naval Surface Warfare Center, (IHD-NSWC), and Sandia National Laboratories (SNL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to understand how to compare results when test protocols are not identical.« less

  3. Expert Assessment of Conditions for Accredited Quality Management System Functioning in Testing Laboratories

    NASA Astrophysics Data System (ADS)

    Mytych, Joanna; Ligarski, Mariusz J.

    2018-03-01

    The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

  4. Equating Computerized Adaptive Certification Examinations: The Board of Registry Series of Studies.

    ERIC Educational Resources Information Center

    Lunz, Mary E.; Bergstrom, Betty A.

    The Board of Registry (BOR) certifies medical technologists and other laboratory personnel. The BOR has studied adaptive testing for over 6 years and now administers all 17 BOR certification examinations using computerized adaptive testing (CAT). This paper presents an overview of the major research efforts from 1989 to the present related to test…

  5. Pre-Service Science Teachers' Views on Laboratory Applications in Science Education: The Effect of a Two-Semester Course

    ERIC Educational Resources Information Center

    Harman, Gonca; Cokelez, Aytekin; Dal, Burckin; Alper, Umut

    2016-01-01

    The aim of this study was to examine pre-service science teachers' views about laboratory applications in science education and how their views changed through laboratory applications that were carried out for two semesters. 63 (52 females, 11 males) pre-service teachers participated in the study. The study was carried out by using pre-test and…

  6. Laboratory testing of a saliva-alcohol test device by Enzymatics, Inc.

    DOT National Transportation Integrated Search

    1992-12-01

    This study examined the accuracy of a new saliva-alcohol test device (Enzymatics, Inc. "Q.E.D.-A150") at nine different blood alcohol concentrations (BACs) under three temperature conditions. However, it did not assess the saliva collection procedure...

  7. SOP: physical examination and laboratory testing for men with erectile dysfunction.

    PubMed

    Ghanem, Hussein M; Salonia, Andrea; Martin-Morales, Antonio

    2013-01-01

    Physical examination and laboratory evaluation of men with erectile dysfunction (ED) are opportunities to identify potentially life-threatening etiologies and comorbid conditions. To review genital anatomy, identify any physical abnormalities, assess for comorbid conditions, and reveal significant risk factors for ED. Expert opinion was based on evidence-based medical literature and consensus discussions between members of this International Society for Sexual Medicine (ISSM) standards committee. For men with ED, a general examination including blood pressure and pulse measurements and a focused genital exam are advised. Fasting blood sugar, serum total testosterone, prolactin levels, and a lipid profile may reveal significant comorbid conditions. Though physical examination and laboratory evaluation of most men with ED may not reveal the exact diagnosis, these opportunities to identify critical comorbid conditions should not be missed. © 2012 International Society for Sexual Medicine.

  8. The changing face of clinical laboratories.

    PubMed

    Plebani, M

    1999-07-01

    Laboratory medicine has undergone a sea change, and medical laboratories must now adapt to, and meet new, customer-supplier needs springing from shifts in the patterns of disease prevalence, medical practice, and demographics. Managed care and other cost-containment processes have forced those involved in health care to cooperate to develop a full picture of patient care, and this has affected clinical laboratory objectives, the main focus now being on improvement in medical outcomes. More recently, the resource shortages in health care and results of cost/effectiveness analysis have demonstrated that the value of a laboratory test must be ascertained not only on the basis of its chemical or clinical performance characteristics, but also by its impact on patient management, the only true assessment of the quality of testing being quality of patient outcomes. The time is ripe for changing the vision of laboratory medicine, and some of the reasons for this are the availability of results in real-time, the introduction of more specific tests, and the trend to prevent diseases rather than cure them. The information from laboratory tests designed to evaluate biochemical or genetic risk and/or prognostic factors cannot be replaced either by physical examination and/or the assessment of symptoms. Today, the importance of laboratory scientists must be proven in three broad areas: a) guaranteeing the quality of tests, irrespective of where they are performed; b) improving the quality of the service; c) maximizing the impact of laboratory information on patient management.

  9. Laboratory Capacity for Antimicrobial Susceptibility Surveillance of Neisseria gonorrhoeae-District of Columbia, 2007-2012.

    PubMed

    Garrett, Tiana A; Davies-Cole, John; Furness, Bruce

    2015-08-01

    In the District of Columbia (DC), Neisseria gonorrhoeae (gonorrhea) infections accounted for more than 25% of 9321 incident sexually transmitted infections reported in 2011; untreated infections can lead to reproductive complications and a higher risk for HIV transmission. In DC, limited capacity to measure the prevalence of antibiotic-resistant N. gonorrhoeae is available; culture-based antibiotic susceptibility testing (AST) is needed to monitor antimicrobial resistance. We examined the capacity of laboratories that report to the DC Department of Health to perform AST for ongoing surveillance of antibiotic-resistant N. gonorrhoeae and to identify suspected treatment failures. We created a survey about diagnostic methods for gonorrhea testing and identified 33 laboratories that reported gonorrhea results to Department of Health in 2007 to 2012. Laboratories were assessed for use of bacterial culture or nucleic acid amplification testing (NAAT) for gonorrhea testing, prevalence of AST on gonorrhea-positive cultures, and types of antibiotics tested during AST. We estimated the prevalence of laboratory practices on the basis of self-report by staff. Nineteen (58%) laboratories completed the survey, representing 92% of the gonorrhea reporting. Seventeen (89%) of 19 laboratories conducted testing by culture; only 6 (35%) performed AST; 79% performed NAAT. Barriers to AST included longer completion times and limited number of provider requests for AST. Commercial laboratories (32%) were more likely to conduct both culture and NAAT, compared with health care facilities (11%). We report a low prevalence of laboratories performing AST because of multiple barriers. State-specific strategies addressing these barriers are needed to improve detection of antibiotic-resistant gonorrhea stains circulating among the population.

  10. Utility of laboratory studies in seizures of children older than one month of age.

    PubMed

    Karbasi, S Akhavan; Mosadegh, M Modares; Fallah, R

    2009-08-01

    Seizure is the most common paediatric neurological disease which occurs in ten percent of children. In approaching a convulsive patient, finding the causes of seizure is essential, and the patient's history as well as the physical examination are important. The role of routine laboratory tests for children's seizures (except neonates) is undetermined, but checking for serum sodium, glucose, calcium and urea routinely has been advised. The purpose of this study was to determine the diagnostic efficacy of these serum chemistry tests in the seizures of children older than one month of age. In this descriptive, retrospective study, medical records of 302 hospitalised children with seizure were reviewed. Results of laboratory tests, like sodium, calcium, blood glucose and urea levels, pertinent history and physical examination, and the change in patient management based on serum chemistry test results, were analysed. All the children in the study were classified as having seizure with or without fever. In 302 hospitalised children with seizure, about ten percent of 938 tests were abnormal. 27.7 percent of these abnormal results were seen in 1-12-month-old infants. Only 11 percent of abnormal tests (1.3 percent of total tests) might have caused a seizure. Also, 0.2 percent of the results could not be predicted from the history or physical examination, which was conducted in patients younger than one year of age. Routine determination of serum chemistry values in seizures of children does not contribute to therapy, and are costly and time-consuming. It may not be helpful and informative unless the patient is less than one year of age.

  11. Anatomy and humanity: Examining the effects of a short documentary film and first anatomy laboratory experience on medical students.

    PubMed

    Dosani, Farah; Neuberger, Lindsay

    2016-01-01

    Medical students begin their education inside a laboratory dissecting cadavers to learn human gross anatomy. Many schools use the course experience as a way to instill empathy and some have begun integrating video and recorded interviews with body donors to humanize the experience, but their impact has yet to be measured. This study examines the effects of a brief documentary film and the initial cadaver encounter on student perceptions and attitudes towards the laboratory experience. A pre-test, exposure, post-test design was used with 77 first-year medical students at the University of Central Florida. A previously validated questionnaire was adapted to measure attitudes, emotions, initial reaction to cadaver, perception of the donor as a person, and impressions of the film. An online questionnaire was completed before the first day of laboratory, in which students watched the film Anatomy and Humanity and handled their respective cadavers (no dissection was performed). The post-test was administered immediately following the activities of the first laboratory day. Results indicate an increase in negative attitudes towards dissection, but a more positive initial reaction to the cadaver than originally anticipated. Students also experienced a decrease in emotions like sadness and guilt regarding anatomy laboratory and were less likely to view the cadaver as a once-living person. Findings suggest a higher comfort level, but also greater detachment toward the cadavers from day one despite the video intervention. These results provide novel insight that may aid other interventions aimed at promoting humanism in the anatomy laboratory experience. © 2015 American Association of Anatomists.

  12. Inter-laboratory validation of bioaccessibility testing for metals.

    PubMed

    Henderson, Rayetta G; Verougstraete, Violaine; Anderson, Kim; Arbildua, José J; Brock, Thomas O; Brouwers, Tony; Cappellini, Danielle; Delbeke, Katrien; Herting, Gunilla; Hixon, Greg; Odnevall Wallinder, Inger; Rodriguez, Patricio H; Van Assche, Frank; Wilrich, Peter; Oller, Adriana R

    2014-10-01

    Bioelution assays are fast, simple alternatives to in vivo testing. In this study, the intra- and inter-laboratory variability in bioaccessibility data generated by bioelution tests were evaluated in synthetic fluids relevant to oral, inhalation, and dermal exposure. Using one defined protocol, five laboratories measured metal release from cobalt oxide, cobalt powder, copper concentrate, Inconel alloy, leaded brass alloy, and nickel sulfate hexahydrate. Standard deviations of repeatability (sr) and reproducibility (sR) were used to evaluate the intra- and inter-laboratory variability, respectively. Examination of the sR:sr ratios demonstrated that, while gastric and lysosomal fluids had reasonably good reproducibility, other fluids did not show as good concordance between laboratories. Relative standard deviation (RSD) analysis showed more favorable reproducibility outcomes for some data sets; overall results varied more between- than within-laboratories. RSD analysis of sr showed good within-laboratory variability for all conditions except some metals in interstitial fluid. In general, these findings indicate that absolute bioaccessibility results in some biological fluids may vary between different laboratories. However, for most applications, measures of relative bioaccessibility are needed, diminishing the requirement for high inter-laboratory reproducibility in absolute metal releases. The inter-laboratory exercise suggests that the degrees of freedom within the protocol need to be addressed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Requirements for diagnosis of malaria at different levels of the laboratory network in Africa.

    PubMed

    Long, Earl G

    2009-06-01

    The rapid increase of resistance to cheap, reliable antimalarials, the increasing cost of effective drugs, and the low specificity of clinical diagnosis has increased the need for more reliable diagnostic methods for malaria. The most commonly used and most reliable remains microscopic examination of stained blood smears, but this technique requires skilled personnel, precision instruments, and ideally a source of electricity. Microscopy has the advantage of enabling the examiner to identify the species, stage, and density of an infection. An alternative to microscopy is the rapid diagnostic test (RDT), which uses a labeled monoclonal antibody to detect circulating parasitic antigens. This test is most commonly used to detect Plasmodium falciparum infections and is available in a plastic cassette format. Both microscopy and RDTs should be available at all levels of laboratory service in endemic areas, but in peripheral laboratories with minimally trained staff, the RDT may be a more practical diagnostic method.

  14. DNA: The Strand that Connects Us All

    ScienceCinema

    Kaplan, Matt [Univ. of Arizona, Tucson, AZ (United States). Genetics Core Facility

    2018-04-26

    Learn how the methods and discoveries of human population genetics are applied for personal genealogical reconstruction and anthropological testing. Dr. Kaplan starts with a short general review of human genetics and the biology behind this form of DNA testing. He looks at how DNA testing is performed and how samples are processed in the University of Arizona laboratory. He also examines examples of personal genealogical results from Family Tree DNA and personal anthropological results from the Genographic Project. Finally, he describes the newest project in the UA laboratory, the DNA Shoah Project.

  15. LAPR: An experimental aircraft pushbroom scanner

    NASA Technical Reports Server (NTRS)

    Wharton, S. W.; Irons, J. I.; Heugel, F.

    1980-01-01

    A three band Linear Array Pushbroom Radiometer (LAPR) was built and flown on an experimental basis by NASA at the Goddard Space Flight Center. The functional characteristics of the instrument and the methods used to preprocess the data, including radiometric correction, are described. The radiometric sensitivity of the instrument was tested and compared to that of the Thematic Mapper and the Multispectral Scanner. The radiometric correction procedure was evaluated quantitatively, using laboratory testing, and qualitatively, via visual examination of the LAPR test flight imagery. Although effective radiometric correction could not yet be demonstrated via laboratory testing, radiometric distortion did not preclude the visual interpretation or parallel piped classification of the test imagery.

  16. Errors in clinical laboratories or errors in laboratory medicine?

    PubMed

    Plebani, Mario

    2006-01-01

    Laboratory testing is a highly complex process and, although laboratory services are relatively safe, they are not as safe as they could or should be. Clinical laboratories have long focused their attention on quality control methods and quality assessment programs dealing with analytical aspects of testing. However, a growing body of evidence accumulated in recent decades demonstrates that quality in clinical laboratories cannot be assured by merely focusing on purely analytical aspects. The more recent surveys on errors in laboratory medicine conclude that in the delivery of laboratory testing, mistakes occur more frequently before (pre-analytical) and after (post-analytical) the test has been performed. Most errors are due to pre-analytical factors (46-68.2% of total errors), while a high error rate (18.5-47% of total errors) has also been found in the post-analytical phase. Errors due to analytical problems have been significantly reduced over time, but there is evidence that, particularly for immunoassays, interference may have a serious impact on patients. A description of the most frequent and risky pre-, intra- and post-analytical errors and advice on practical steps for measuring and reducing the risk of errors is therefore given in the present paper. Many mistakes in the Total Testing Process are called "laboratory errors", although these may be due to poor communication, action taken by others involved in the testing process (e.g., physicians, nurses and phlebotomists), or poorly designed processes, all of which are beyond the laboratory's control. Likewise, there is evidence that laboratory information is only partially utilized. A recent document from the International Organization for Standardization (ISO) recommends a new, broader definition of the term "laboratory error" and a classification of errors according to different criteria. In a modern approach to total quality, centered on patients' needs and satisfaction, the risk of errors and mistakes in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services.

  17. Implementation of a virtual laboratory for training on sound insulation testing and uncertainty calculations in acoustic tests.

    PubMed

    Asensio, C; Gasco, L; Ruiz, M; Recuero, M

    2015-02-01

    This paper describes a methodology and case study for the implementation of educational virtual laboratories for practice training on acoustic tests according to international standards. The objectives of this activity are (a) to help the students understand and apply the procedures described in the standards and (b) to familiarize the students with the uncertainty in measurement and its estimation in acoustics. The virtual laboratory will not focus on the handling and set-up of real acoustic equipment but rather on procedures and uncertainty. The case study focuses on the application of the virtual laboratory for facade sound insulation tests according to ISO 140-5:1998 (International Organization for Standardization, Geneva, Switzerland, 1998), and the paper describes the causal and stochastic models and the constraints applied in the virtual environment under consideration. With a simple user interface, the laboratory will provide measurement data that the students will have to process to report the insulation results that must converge with the "virtual true values" in the laboratory. The main advantage of the virtual laboratory is derived from the customization of factors in which the student will be instructed or examined (for instance, background noise correction, the detection of sporadic corrupted observations, and the effect of instrument precision).

  18. The Effects of an Intensive Summer Laboratory Internship on Secondary Students' Understanding of the Nature of Science as Measured by the Test on Understanding of Science (TOUS).

    ERIC Educational Resources Information Center

    McComas, William F.

    This study examines the role of a 6- or 8-week summer university laboratory internship for 56 high ability secondary students in developing the views of these students with respect to the nature of science. Students were assessed using a gender-neutral version of the Test on Understanding Science (TOUS) as part of a pretest-posttest research…

  19. Is maternal plasma DNA testing impacting serum-based screening for aneuploidy in the United States?

    PubMed

    Palomaki, Glenn E; Ashwood, Edward R; Best, Robert G; Lambert-Messerlian, Geralyn; Knight, George J

    2015-11-01

    We sought to determine whether tests for fetal aneuploidy based on next-generation sequencing of cell-free DNA in maternal circulation have had an impact on routine serum-based screening in the general pregnant population. We compared results from laboratory surveys in 2011 and 2014 that reported types of prenatal serum screening tests and numbers of tests performed. Testing records from two prenatal serum screening laboratories examined temporal trends in the proportion of screened women 35 years of age and older from 2008 (or 2009) to 2014. The 82 laboratory survey results available for comparison showed that 1.7 million women were screened in 2014, a 5% increase over 2011. In the two screening laboratories, the proportion of screened women age 35 and older increased for several years but then experienced reductions of 8 and 18% by mid-2014 when compared with the highest rates observed. As of 2014, maternal plasma DNA testing appears to have had only a minor impact on serum screening rates in the United States. Ongoing surveillance has the potential to determine if, and when, DNA testing begins to replace serum testing as a primary screen for Down syndrome in the United States.

  20. Avian toxicologic diagnosis

    USGS Publications Warehouse

    Sigurdson, C.J.; Franson, J.C.; Fudge, A.M.

    2000-01-01

    This chapter describes the sources and pathophysiology of some potential poisons that affect birds and summarizes useful laboratory tests. The diagnosis of poisoning in birds, as in mammals, requires a complete and accurate history, careful observation of clinical signs, and a thorough necropsy evaluation. Appropriate sample handling and analysis, based on consultation with the diagnostic toxicologist, are critical (Table 19--1). Veterinary toxicology laboratories are becoming increasingly specialized, with only certain laboratories capable of analyzing for drug residues or anticoagulants, for example. Although a local laboratory may not be able to fulfill a specific test request, they may recommend an alternative laboratory or may be willing to forward the sample. As a general rule in suspect poisoning cases, large tissue samples of liver, kidney, brain, and subcutaneous fat and of crop, proventriculus, and ventriculus contents should be collected at necropsy and frozen. Appropriate samples should be submitted frozen, with the remainder held in the freezer for possible later testing. A second set of tissues should be placed in 10% formalin for histopathologic examination.

  1. Effects of surface chemistry on hot corrosion life

    NASA Technical Reports Server (NTRS)

    Fryxell, R. E.; Gupta, B. K.

    1984-01-01

    Hot corrosion life prediction methodology based on a combination of laboratory test data and field service turbine components, which show evidence of hot corrosion, were examined. Components were evaluated by optical metallography, scanning electron microscopy (SEM), and electron micropulse (EMP) examination.

  2. Cholera studies*

    PubMed Central

    Pollitzer, R.

    1956-01-01

    The first portion of this study describes in detail the different aspects of stool examinations, including the collection, preservation, and pooling of specimens, macroscopic and bacterioscopic examination, enrichment methods, and cultivation on a variety of solid media. The author also deals with the examination of vomits and of water. The performance and value of different identification tests (agglutination, haemolysis, and bacteriophage) and confirmatory tests are then considered. An annex is included on bacteriological procedures in the laboratory diagnosis of cholera. PMID:13356145

  3. [External quality control system in medical microbiology and parasitology in the Czech Republic].

    PubMed

    Slosárek, M; Petrás, P; Kríz, B

    2004-11-01

    The External Quality Control System (EQAS) of laboratory activities in medical microbiology and parasitology was implemented in the Czech Republic in 1993 with coded sera samples for diagnosis of viral hepatitis and bacterial strains for identification distributed to first participating laboratories. The number of sample types reached 31 in 2003 and the number of participating laboratories rised from 79 in 1993 to 421 in 2003. As many as 15.130 samples were distributed to the participating laboratories in 2003. Currently, almost all microbiology and parasitology laboratories in the Czech Republic involved in examination of clinical material participate in the EQAS. Based on the 11-year experience gained with the EQAS in the Czech Republic, the following benefits were observed: higher accuracy of results in different tests, standardisation of methods and the use of most suitable test kits.

  4. Quality management and accreditation in a mixed research and clinical hair testing analytical laboratory setting-a review.

    PubMed

    Fulga, Netta

    2013-06-01

    Quality management and accreditation in the analytical laboratory setting are developing rapidly and becoming the standard worldwide. Quality management refers to all the activities used by organizations to ensure product or service consistency. Accreditation is a formal recognition by an authoritative regulatory body that a laboratory is competent to perform examinations and report results. The Motherisk Drug Testing Laboratory is licensed to operate at the Hospital for Sick Children in Toronto, Ontario. The laboratory performs toxicology tests of hair and meconium samples for research and clinical purposes. Most of the samples are involved in a chain of custody cases. Establishing a quality management system and achieving accreditation became mandatory by legislation for all Ontario clinical laboratories since 2003. The Ontario Laboratory Accreditation program is based on International Organization for Standardization 15189-Medical laboratories-Particular requirements for quality and competence, an international standard that has been adopted as a national standard in Canada. The implementation of a quality management system involves management commitment, planning and staff education, documentation of the system, validation of processes, and assessment against the requirements. The maintenance of a quality management system requires control and monitoring of the entire laboratory path of workflow. The process of transformation of a research/clinical laboratory into an accredited laboratory, and the benefits of maintaining an effective quality management system, are presented in this article.

  5. Performance of different mono- and multiplex nucleic acid amplification tests on a multipathogen external quality assessment panel.

    PubMed

    Loens, K; van Loon, A M; Coenjaerts, F; van Aarle, Y; Goossens, H; Wallace, P; Claas, E J C; Ieven, M

    2012-03-01

    An external quality assessment (EQA) panel consisting of a total of 48 samples in bronchoalveolar lavage (BAL) fluid or transport medium was prepared in collaboration with Quality Control for Molecular Diagnostics (QCMD) (www.qcmd.org). The panel was used to assess the proficiency of the three laboratories that would be responsible for examining the 6,000 samples to be collected in the GRACE Network of Excellence (www.grace-lrti.org). The main objective was to decide on the best-performing testing approach for the detection of influenza viruses A and B, parainfluenza virus types 1 to 3, respiratory syncytial virus (RSV), human metapneumovirus, coronavirus, rhinovirus, adenovirus, Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila by nucleic acid amplification techniques (NAATs). Two approaches were chosen: (i) laboratories testing samples using their in-house procedures for extraction and amplification and (ii) laboratories using their in-house amplification procedures on centrally extracted samples. Furthermore, three commercially available multiplex NAAT tests-the ResPlex (Qiagen GmbH, Hilden, Germany), RespiFinder plus (PathoFinder, Maastricht, The Netherlands), and RespiFinder Smart 21 (PathoFinder) tests-were evaluated by examination of the same EQA panel by the manufacturer. No large differences among the 3 laboratories were noticed when the performances of the assays developed in-house in combination with the in-house extraction procedures were compared. Also, the extraction procedure (central versus local) had little effect on performance. However, large differences in amplification efficacy were found between the commercially available tests; acceptable results were obtained by using the PathoFinder assays.

  6. 21 CFR 118.8 - Testing methodology for Salmonella Enteritidis (SE).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Salmonella Web site is located at http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/ucm114716.htm... you may examine a copy at the Center for Food Safety and Applied Nutrition's Library, 5100 Paint... Edition, is located at http://www.fda.gov/Food/ScienceResearch/LaboratoryMethods/BacteriologicalAnalytical...

  7. The Synthetic Experiment: E. B. Titchener's Cornell Psychological Laboratory and the Test of Introspective Analysis.

    PubMed

    Evans, Rand B

    2017-01-01

    Beginning in 1 9a0, a major thread of research was added to E. B. Titchener's Cornell laboratory: the synthetic experiment. Titchener and his graduate students used introspective analysis to reduce a perception, a complex experience, into its simple sensory constituents. To test the validity of that analysis, stimulus patterns were selected to reprodiuce the patterns of sensations found in the introspective analyses. If the original perception can be reconstructed in this way, then the analysis was considered validated. This article reviews development of the synthetic method in E. B. Titchener's laboratory at Cornell University and examines its impact on psychological research.

  8. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds †

    PubMed Central

    Frank, Jared A.; Brill, Anthony; Kapila, Vikram

    2016-01-01

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability. PMID:27556464

  9. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds.

    PubMed

    Frank, Jared A; Brill, Anthony; Kapila, Vikram

    2016-08-20

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability.

  10. Laboratory facility for testing electric-vehicle batteries Test rig for simulating duty cycles with different discharge modes

    NASA Astrophysics Data System (ADS)

    Hamilton, J. A.; Rand, D. A. J.

    1983-03-01

    A test rig has been designed and constructed to examine the performance of batteries under laboratory conditions that simulate the power characteristics of electric vehicles. Each station in the rig subjects a battery to continuous charge/discharge cycles, with an equalising charge every eighth cycle. The battery discharge follows the current-verse-time profile of a given vehicle operating under a driving schedule normal to road service. The test rig allows both smooth- and pulsed-current discharge to be investigated. Data collection is accomplished either with multi-pen recorders or with a computer-based information logger.

  11. The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

    PubMed

    Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

    2017-03-01

    Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

  12. 32 CFR 199.13 - TRICARE Dental Program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., beneficiary pre-authorization and marketing procedures, and care for beneficiaries residing in distant areas... examinations; and (iii) Diagnostic laboratory tests and examinations provided in connection with other dental...) Initial determination. A formal written decision on a TDP claim, a request for TDP benefit pre...

  13. 32 CFR 199.13 - TRICARE Dental Program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., beneficiary pre-authorization and marketing procedures, and care for beneficiaries residing in distant areas... examinations; and (iii) Diagnostic laboratory tests and examinations provided in connection with other dental...) Initial determination. A formal written decision on a TDP claim, a request for TDP benefit pre...

  14. P300: Waves Identification with and without Subtraction of Traces

    PubMed Central

    Romero, Ana Carla Leite; Reis, Ana Cláudia Mirândola Barbosa; Oliveira, Anna Caroline Silva de; Oliveira Simões, Humberto de; Oliveira Junqueira, Cinthia Amorim de; Frizzo, Ana Cláudia Figueiredo

    2017-01-01

    Introduction  The P300 test requires well-defined and unique criteria, in addition to training for the examiners, for a uniform analysis of studies and to avoid variations and errors in the interpretation of measurement results. Objectives  The objective of this study is to verify whether there are differences in P300 with and without subtraction of traces of standard and nonstandard stimuli. Method  We conducted this study in collaboration with two research electrophysiology laboratories. From Laboratory 1, we selected 40 tests of subjects between 7–44 years, from Laboratory 2, we selected 83 tests of subjects between 18–44 years. We first performed the identification with the nonstandard stimuli; then, we subtracted the nonstandard stimuli from the standard stimuli. The examiners identified the waves, performing a descriptive and comparative analysis of traces with and without subtraction. Results  After a comparative analysis of the traces with and without subtraction, there was no significant difference when compared with analysis of traces in both laboratories, within the conditions, of right ears ( p  = 0.13 and 0.28 for differences between latency and amplitude measurements) and left ears ( p  = 0.15 and 0.09 for differences between latency and amplitude measurements) from Laboratory 1. As for Laboratory 2, when investigating both ears, results did not identify significant differences ( p  = 0.098 and 0.28 for differences between latency and amplitude measurements). Conclusion  There was no difference verified in traces with and without subtraction. We suggest the identification of this potential performed through nonstandard stimuli. PMID:29018497

  15. Changes in serial laboratory test results in snakebite patients: when can we safely exclude envenoming?

    PubMed

    Ireland, Graham; Brown, Simon G A; Buckley, Nicholas A; Stormer, Jeff; Currie, Bart J; White, Julian; Spain, David; Isbister, Geoffrey K

    2010-09-06

    To determine which laboratory tests are first associated with severe envenoming after a snakebite, when (ie, how long after the bite) the test results become abnormal, and whether this can determine a safe observation period after suspected snakebite. Prospective cohort study of 478 patients with suspected or confirmed snakebite recruited to the Australian Snakebite Project from January 2002 to April 2009, who had at least three sets of laboratory test results and at least 12 hours of observation in hospital after the bite. Severe envenoming was defined as venom-induced consumption coagulopathy (VICC), myotoxicity, neurotoxicity or thrombotic microangiopathy. International normalised ratio (INR), activated partial thromboplastin time (aPTT), creatine kinase (CK) level, and neurological examination. There were 240 patients with severe envenoming, 75 with minor envenoming and 163 non-envenomed patients. Of 206 patients with VICC, 178 had an INR > 1.2 (abnormal) on admission, and the remaining 28 had an INR > 1.2 within 12 hours of the bite. Of 33 patients with myotoxicity, a combination of CK > 250 U/L and an abnormal aPTT identified all but two cases by 12 hours; one of these two was identified within 12 hours by leukocytosis. Nine cases of isolated neurotoxicity had a median time of onset after the bite of 4 hours (range, 35 min - 12 h). The combination of serial INR, aPTT and CK tests and repeated neurological examination identified 213 of 222 severe envenoming cases (96%) by 6 hours and 238 of 240 (99%) by 12 hours. Laboratory parameters (INR, aPTT and CK) and neurological reassessments identified nearly all severe envenoming cases within 12 hours of the bite, even in this conservative analysis that assumed normal test results if the test was not done.

  16. Performance of Clinical Laboratories in South African Parasitology Proficiency Testing Surveys between 2004 and 2010

    PubMed Central

    Dini, Leigh; Frean, John

    2012-01-01

    Performance in proficiency testing (PT) schemes is an objective measure of a laboratory's best performance. We examined the performance of participants in two parasitology PT schemes in South Africa from 2004 through 2010. The average rates of acceptable scores over the period were 58% and 66% for the stool and blood parasite schemes, respectively. In our setting, participation in PT alone is insufficient to improve performance; a policy that provides additional resources and training seems necessary. PMID:22814470

  17. Clinical utility of routine laboratory testing to identify possible secondary causes in older men with osteoporosis: the Osteoporotic Fractures in Men (MrOS) Study

    PubMed Central

    Fink, Howard A.; Litwack-Harrison, Stephanie; Taylor, Brent C.; Bauer, Douglas C.; Orwoll, Eric S.; Lee, Christine G.; Barrett-Connor, Elizabeth; Schousboe, John T.; Kado, Deborah M.; Garimella, Pranav S.; Ensrud, Kristine E.

    2016-01-01

    Purpose To evaluate the utility of recommended laboratory testing to identify secondary causes in older men with osteoporosis, we examined prevalence of laboratory abnormalities in older men with and without osteoporosis. Methods 1572 men aged ≥65 years in the Osteoporotic Fractures in Men study completed bone mineral density (BMD) testing and a battery of laboratory measures, including serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), 25-OH vitamin D, total testosterone, spot urine calcium/creatinine ratio, spot urine albumin-creatinine ratio, creatinine-derived estimate glomerular filtration rate, 24-hour urine calcium, and 24-hour urine free cortisol. Using cross-sectional analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association of any and specific laboratory abnormalities with osteoporosis, and the number of men with osteoporosis needed to test to identify one additional laboratory abnormality compared to testing men without osteoporosis. Results Approximately 60% of men had ≥1 laboratory abnormality in both men with and without osteoporosis. Among individual tests, only vitamin D insufficiency (PR, 1.13; 95% CI, 1.05–1.22) and high alkaline phosphatase (PR, 3.05; 95% CI, 1.52–6.11) were more likely in men with osteoporosis. Hypercortisolism and hyperthyroidism were uncommon and not significantly more frequent in men with osteoporosis. No osteoporotic men had hypercalciuria. Conclusions Though most of these older men had ≥1 laboratory abnormality, few routinely recommended individual tests were more common in men with osteoporosis than in those without osteoporosis. Possibly excepting vitamin D and alkaline phosphatase, benefit of routine laboratory testing to identify possible secondary causes in older osteoporotic men appears low. Results may not be generalizable to younger men or to older men in whom history and exam findings raise clinical suspicion for a secondary cause of osteoporosis. PMID:26458388

  18. Beamed Energy Propulsion by Means of Target Ablation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rosenberg, Benjamin A.

    2004-03-30

    This paper describes hundreds of pendulum tests examining the beamed energy conversion efficiency of different metal targets coated with multiple liquid enhancers. Preliminary testing used a local laser with photographic paper targets, with no liquid, water, canola oil, or methanol additives. Laboratory experimentation was completed at Wright-Patterson AFB using a high-powered laser, and ballistic pendulums of aluminum, titanium, or copper. Dry targets, and those coated with water, methanol and oil were repeatedly tested in laboratory conditions. Results were recorded on several high-speed digital video cameras, and the conversion efficiency was calculated. Paper airplanes successfully launched using BEP were likewise recorded.

  19. The demand for pregnancy testing: The Aschheim–Zondek reaction, diagnostic versatility, and laboratory services in 1930s Britain

    PubMed Central

    Olszynko-Gryn, Jesse

    2014-01-01

    The Aschheim–Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the ‘heroic age’ of reproductive endocrinology. Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim–Zondek test launched a ‘modern era’ of obstetric knowledge, which asserted its superiority over that of pregnant women. This article reconsiders Oakley’s claim by examining how pregnancy testing worked in practice. It explains the British adoption of the test in terms less of the medicalisation of pregnancy than of clinicians’ increasing general reliance on laboratory services for differential diagnosis. Crucially, the Aschheim–Zondek reaction was a test not directly for the fetus, but for placental tissue. It was used, less as a yes-or-no test for ordinary pregnancy, than as a versatile diagnostic tool for the early detection of malignant tumours and hormonal deficiencies believed to cause miscarriage. This test was as much a product of oncology and the little-explored world of laboratory services as of reproductive medicine. PMID:24388014

  20. Current Landscape and New Paradigms of Proficiency Testing and External Quality Assessment for Molecular Genetics

    PubMed Central

    Kalman, Lisa V.; Lubin, Ira M.; Barker, Shannon; du Sart, Desiree; Elles, Rob; Grody, Wayne W.; Pazzagli, Mario; Richards, Sue; Schrijver, Iris; Zehnbauer, Barbara

    2015-01-01

    Context Participation in proficiency testing (PT) or external quality assessment (EQA) programs allows the assessment and comparison of test performance among different clinical laboratories and technologies. In addition to the approximately 2300 tests for individual genetic disorders, recent advances in technology have enabled the development of clinical tests which quickly and economically analyze the entire human genome. New PT/EQA approaches are needed to ensure the continued quality of these complex tests. Objective To review the availability and scope of PT/EQA for molecular genetic testing for inherited conditions in Europe, Australasia and the United States; to evaluate the successes and demonstrated value of available PT/EQA programs; and to examine the challenges to the provision of comprehensive PT/EQA posed by new laboratory practices and methodologies. Data Sources The available literature on this topic was reviewed and supplemented with personal experiences of several PT/EQA providers. Conclusions PT/EQA schemes are available for common genetic disorders tested in many clinical laboratories, but are not available for most genetic tests offered by only one or a few laboratories. Provision of broad, method-based PT schemes, such as DNA sequencing, would allow assessment of a large number of tests for which formal PT is not currently available. Participation in PT/EQA improves the quality of testing by identifying inaccuracies that laboratories can trace to errors in the testing process. Areas of research and development to ensure that PT/EQA programs can meet the needs of new and evolving genetic tests and technologies are identified and discussed. PMID:23808472

  1. Theoretical and practical considerations for teaching diagnostic electronic-nose technologies to clinical laboratory technicians

    Treesearch

    Alphus D. Wilson

    2012-01-01

    The rapid development of new electronic technologies and instruments, utilized to perform many current clinical operations in the biomedical field, is changing the way medical health care is delivered to patients. The majority of test results from laboratory analyses, performed with these analytical instruments often prior to clinical examinations, are frequently used...

  2. Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study.

    PubMed

    Ong, Mei-Sing; Magrabi, Farah; Coiera, Enrico

    2018-05-16

    Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients' age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.

  3. Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time.

    PubMed

    Valenstein, P N; Emancipator, K

    1989-04-01

    The authors studied the performance of four measures of laboratory turnaround time: the mean, median, 90th percentile, and proportion of tests reported within a predetermined cut-off interval (proportion of acceptable tests [PAT]). Measures were examined with the use of turnaround time data from 11,070 stat partial thromboplastin times, 16,761 urine cultures, and 28,055 stat electrolyte panels performed by a single laboratory. For laboratories with long turnaround times, the most important quality of a turnaround time measure is high reproducibility, so that improvement in reporting speed can be distinguished from random variation resulting from sampling. The mean was found to be the most reproducible of the four measures, followed by the median. The mean achieved acceptable precision with sample sizes of 100-500 tests. For laboratories with normally rapid turnaround times, the most important quality of a measure is high sensitivity and specificity for detecting whether turnaround time has dropped below standards. The PAT was found to be the best measure of turnaround time in this setting but required sample sizes of at least 500 tests to achieve acceptable accuracy. Laboratory turnaround time may be measured for different reasons. The method of measurement should be chosen with an eye toward its intended application.

  4. Failure analysis of electronic parts: Laboratory methods. [for destructive and nondestructive testing

    NASA Technical Reports Server (NTRS)

    Anstead, R. J. (Editor); Goldberg, E. (Editor)

    1975-01-01

    Failure analysis test methods are presented for use in analyzing candidate electronic parts and in improving future design reliability. Each test is classified as nondestructive, semidestructive, or destructive. The effects upon applicable part types (i.e. integrated circuit, transitor) are discussed. Methodology is given for performing the following: immersion tests, radio graphic tests, dewpoint tests, gas ambient analysis, cross sectioning, and ultraviolet examination.

  5. The Classic Approach to Diagnosis of Vulvovaginitis: A Critical Analysis

    PubMed Central

    Lakovsky, Yaniv; Lavi, Idit; Bar-Am, Amiram; Abramovici, Haim

    2001-01-01

    Objective: To correlate the symptoms, signs and clinical diagnosis in women with vaginal discharge, based on the combined weight of the character of the vaginal discharge and bedside tests, with the laboratory diagnosis. Methods: Women presenting consecutively to the women's health center with vaginal discharge were interviewed and examined for assessment of the quantity and color of the discharge. One drop of the material was then examined for pH and the whiff test was done; a wet mount in saline and in 10% KOH was examined microscopically. The clinical diagnosis was based on the results of these assessments. Gram stain and cultures of the discharge were sent to the microbiology laboratory. Results: One hundred and fifty-threewomen with vaginal discharge with a clinical diagnosis of vulvovaginitis participated in the study. Fifty-five (35.9%) had normal flora and the other 98 (64.1%) had true infectious vulvovaginitis (k agreement = 18%). According to the laboratory, the principal infectious micro-organism causing the vulvovaginitis was Candida species. Candida infection was associated with pH levels of less than 4.5 (p < 0.0001, odds ratio = 4.74, 95% confidence interval: 2.35–9.5, positive predictive value 68.4%). The whiff test was positive in only a small percentage of bacterial vaginosis (BV) (p = not significant (NS)). Clue cells were documented in 53.3% of patients with a laboratory diagnosis of BV (p < 0.02, positive predictive value 26.7%). Conclusions: The current approach to the diagnosis of vulvovaginitis should be further studied. The classical and time-consuming assessments were shown not to be reliable diagnostic measures. PMID:11495550

  6. Comparison between point-of-care dermatophyte test medium and mycology laboratory culture for diagnosis of dermatophytosis in dogs and cats.

    PubMed

    Kaufmann, Ronnie; Blum, Shlomo E; Elad, Daniel; Zur, Gila

    2016-08-01

    Point-of-care Dermatophyte Test Medium (PoC-DTM) is a diagnostic procedure to rule in/rule out dermatophytosis in veterinary clinics. To evaluate the performance of PoC-DTM in the clinic compared to DTM plate culture in a mycology laboratory and to compare results obtained by general practitioners and referral clinicians. Hair samples were collected from 47 cats and 54 dogs with suspected dermatophytosis and from nine healthy controls (seven cats and two dogs). This was a multicentre blinded study. In one group (65 suspected cases, 9 healthy controls), PoC-DTM results were evaluated by clinicians in a referral clinic (SP group) who examined the colony morphology macroscopically and microscopically. In the other group (36 suspected cases) PoC-DTM results were evaluated by clinicians from general practice for colour change only, with no macroscopic or microscopic examination (GP group). All hair samples were also cultured on DTM plates in a mycology laboratory. Laboratory culture was considered the gold standard for comparison. Agreements between tests were 97% (two false positive; κ = 0.839) and 80.6% (five false positives and two false negatives; κ = 0.466) in the SP and GP groups, respectively. This difference between groups was significant (P = 0.024). When applying macroscopic and microscopic evaluation of the colony, PoC-DTM is accurate for diagnosing dermatophytes with only a 3% chance of error. However, when macroscopic and microscopic examination is not included there is significant (19.4%) chance for an incorrect diagnosis. © 2016 ESVD and ACVD.

  7. The standardization of urine particle counting in medical laboratories--a Polish experience with the EQA programme.

    PubMed

    Cwiklińska, Agnieszka; Kąkol, Judyta; Kuchta, Agnieszka; Kortas-Stempak, Barbara; Pacanis, Anastasis; Rogulski, Jerzy; Wróblewska, Małgorzata

    2012-02-01

    Given the common problems with the standardization of urine particle counting methods and the great variability in the results obtained by Polish laboratories under international Labquality External Quality Assessment (EQA), we initiated educational recovery activities. Detailed instructions on how to perform the standardized examination were sent to EQA participants, as was a questionnaire forms which enabled information to be gathered in respect to the procedures being applied. Laboratory results were grouped according to the method declared on the EQA 'Result' form or according to a manual examination procedure established on the basis of the questionnaire. The between-laboratory CVs for leukocyte and erythrocyte counts were calculated for each group and compared using the Mann-Whitney test. Significantly lower between-laboratory CVs (p = 0.03) were achieved for leukocyte counting among the laboratories that analysed control specimens in accordance with standardized procedures as compared with those which used non-standardized procedures. We also observed a visible lower variability for erythrocyte counting. Unfortunately despite our activities, only a few of the Polish laboratories applied the standardized examination procedures, and only 29% of the results could have been considered to be standardized (16% - manual methods, 13% - automated systems). The standardization of urine particle counting methods continues to be a significant problem in medical laboratories and requires further recovery activities which can be conducted using the EQA scheme.

  8. Biomagnetic Pair Therapy and Typhoid Fever: A Pilot Study.

    PubMed

    Frank, Bryan L

    2017-10-01

    Objective: This pilot study examined the laboratory responses of patients with laboratory-documented typhoid fever who were treated with Biomagnetic Pair Therapy (BPT; medical biomagnetism), a specific application of pairs of magnets for various ailments that are infectious and otherwise. Materials and Methods: This study was an assessment of patients' response to treatment with only BPT for Salmonella typhi infections (typhoid fever) using standard conventional laboratory techniques. The research was conducted in an outpatient village clinic in Kenya. There were 52 participants who were evaluated for possible systemic illness, including typhoid fever, from an open-label study. Participants who felt sick and requested testing for possible typhoid fever were tested with a standard Widal test by a certified laboratory technician. Participants who tested positive (13 patients) were then treated with BPT (a "First Aid" approach) only. These participants then returned for follow-up laboratory and clinical evaluations after 2 days. Results: Most of the participants (10 of 13) retested as negative, and all patients reported symptomatic clinical improvement. Conclusions: As a significant majority of participants demonstrated clearing of their S. typhi after BPT, this technique should be studied further in larger trials for its efficacy in treating typhoid fever.

  9. PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

    ERIC Educational Resources Information Center

    Office of Economic Opportunity, Washington, DC.

    HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

  10. The availability and functional status of focused antenatal care laboratory services at public health facilities in Addis Ababa, Ethiopia.

    PubMed

    Desalegn, Daniel Melese; Abay, Serebe; Taye, Bineyam

    2016-08-11

    Provision of quality laboratory services is an essential aspect of a promoting safe motherhood and better outcomes for newborn. Therefore; this study was intended to assess status of focused antenatal care (FANC) laboratory services at public health facilities in Addis Ababa, Ethiopia. Institution based, descriptive cross-sectional study was conducted from April to May 2015. The study included 13 randomly selected health facilities and 13 purposively selected laboratory service providers. The status of FANC laboratory service was assessed by using pre-tested structured questionnaire and observation checklist. The study supplemented with qualitative data through in-depth interview of laboratory service providers. The quantitative data were coded and analysed by using SPSS Version 20 software and qualitative data was transcribed, coded, categorized and thematically analysed by the principal investigator. Only 5 (38.5 %) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine microscopy and stool examination were available in all institutions. However, only 7 (53.8 %) of the health facilities reported the availability of hepatitis B virus screening test. Rapid syphilis (RPR) test was found in 10 (76.9 %) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption for more than a day within the last 1 year due to shortage of reagent and electric power disruption. Majority of the health facilities reported incomplete provision of FANC laboratory investigations. Laboratory supply shortage and electric power disruption were the facilities' major challenge to screen pregnant women for pregnancy related health conditions. Since such conditions may affect the outcome of pregnancy, therefore extensive efforts should be targeted to avoid services interruption by taking improvement measures including the fulfilment of all FANC laboratory resources.

  11. Health and Nutritional Status of Working and Non-Working Mothers in Poverty Groups.

    ERIC Educational Resources Information Center

    Roe, Daphne A.; Eickwort, Kathleen R.

    The aim of this study was to examine the health and nutritional status of low-income women in Upstate New York and to identify problems that interfere with their employment. Questionnaires on health and work, complete medical and employment histories, physical examination, laboratory tests, dental examination and diet recalls were obtained for 469…

  12. Laboratory diagnosis of Ebola virus disease and corresponding biosafety considerations in the China Ebola Treatment Center.

    PubMed

    Huang, Qing; Fu, Wei-Ling; You, Jian-Ping; Mao, Qing

    2016-10-01

    Ebola virus disease (EVD), caused by Ebola virus (EBOV), is a potent acute infectious disease with a high case-fatality rate. Etiological and serological EBOV detection methods, including techniques that involve the detection of the viral genome, virus-specific antigens and anti-virus antibodies, are standard laboratory diagnostic tests that facilitate confirmation or exclusion of EBOV infection. In addition, routine blood tests, liver and kidney function tests, electrolytes and coagulation tests and other diagnostic examinations are important for the clinical diagnosis and treatment of EVD. Because of the viral load in body fluids and secretions from EVD patients, all body fluids are highly contagious. As a result, biosafety control measures during the collection, transport and testing of clinical specimens obtained from individuals scheduled to undergo EBOV infection testing (including suspected, probable and confirmed cases) are crucial. This report has been generated following extensive work experience in the China Ebola Treatment Center (ETC) in Liberia and incorporates important information pertaining to relevant diagnostic standards, clinical significance, operational procedures, safety controls and other issues related to laboratory testing of EVD. Relevant opinions and suggestions are presented in this report to provide contextual awareness associated with the development of standards and/or guidelines related to EVD laboratory testing.

  13. Sex and stress: Men and women show different cortisol responses to psychological stress induced by the Trier social stress test and the Iowa singing social stress test.

    PubMed

    Reschke-Hernández, Alaine E; Okerstrom, Katrina L; Bowles Edwards, Angela; Tranel, Daniel

    2017-01-02

    Acute psychological stress affects each of us in our daily lives and is increasingly a topic of discussion for its role in mental illness, aging, cognition, and overall health. A better understanding of how such stress affects the body and mind could contribute to the development of more effective clinical interventions and prevention practices. Over the past 3 decades, the Trier Social Stress Test (TSST) has been widely used to induce acute stress in a laboratory setting based on the principles of social evaluative threat, namely, a judged speech-making task. A comparable alternative task may expand options for examining acute stress in a controlled laboratory setting. This study uses a within-subjects design to examine healthy adult participants' (n = 20 men, n = 20 women) subjective stress and salivary cortisol responses to the standard TSST (involving public speaking and math) and the newly created Iowa Singing Social Stress Test (I-SSST). The I-SSST is similar to the TSST but with a new twist: public singing. Results indicated that men and women reported similarly high levels of subjective stress in response to both tasks. However, men and women demonstrated different cortisol responses; men showed a robust response to both tasks, and women displayed a lesser response. These findings are in line with previous literature and further underscore the importance of examining possible sex differences throughout various phases of research, including design, analysis, and interpretation of results. Furthermore, this nascent examination of the I-SSST suggests a possible alternative for inducing stress in the laboratory. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Laboratory comparison of several tests for evaluating the transport properties of concrete.

    DOT National Transportation Integrated Search

    2006-01-01

    The transport properties of concrete are a primary element in determining the durability of concrete. In this study, several new test methods that directly measure aspects of fluid and ionic transport in concrete were examined. ASTM C 1543 and ASTM C...

  15. On use of the multistage dose-response model for assessing laboratory animal carcinogenicity

    PubMed Central

    Nitcheva, Daniella; Piegorsch, Walter W.; West, R. Webster

    2007-01-01

    We explore how well a statistical multistage model describes dose-response patterns in laboratory animal carcinogenicity experiments from a large database of quantal response data. The data are collected from the U.S. EPA’s publicly available IRIS data warehouse and examined statistically to determine how often higher-order values in the multistage predictor yield significant improvements in explanatory power over lower-order values. Our results suggest that the addition of a second-order parameter to the model only improves the fit about 20% of the time, while adding even higher-order terms apparently does not contribute to the fit at all, at least with the study designs we captured in the IRIS database. Also included is an examination of statistical tests for assessing significance of higher-order terms in a multistage dose-response model. It is noted that bootstrap testing methodology appears to offer greater stability for performing the hypothesis tests than a more-common, but possibly unstable, “Wald” test. PMID:17490794

  16. Mindfulness, anxiety, and high-stakes mathematics performance in the laboratory and classroom.

    PubMed

    Bellinger, David B; DeCaro, Marci S; Ralston, Patricia A S

    2015-12-01

    Mindfulness enhances emotion regulation and cognitive performance. A mindful approach may be especially beneficial in high-stakes academic testing environments, in which anxious thoughts disrupt cognitive control. The current studies examined whether mindfulness improves the emotional response to anxiety-producing testing situations, freeing working memory resources, and improving performance. In Study 1, we examined performance in a high-pressure laboratory setting. Mindfulness indirectly benefited math performance by reducing the experience of state anxiety. This benefit occurred selectively for problems that required greater working memory resources. Study 2 extended these findings to a calculus course taken by undergraduate engineering majors. Mindfulness indirectly benefited students' performance on high-stakes quizzes and exams by reducing their cognitive test anxiety. Mindfulness did not impact performance on lower-stakes homework assignments. These findings reveal an important mechanism by which mindfulness benefits academic performance, and suggest that mindfulness may help attenuate the negative effects of test anxiety. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Rapid Automated Antimicrobial Susceptibility Testing of Streptococcus pneumoniae by Use of the bioMerieux VITEK 2

    PubMed Central

    Jorgensen, James H.; Barry, Arthur L.; Traczewski, M. M.; Sahm, Daniel F.; McElmeel, M. Leticia; Crawford, Sharon A.

    2000-01-01

    The VITEK 2 is a new automated instrument for rapid organism identification and susceptibility testing. It has the capability of performing rapid susceptibility testing of Streptococcus pneumoniae with specially configured cards that contain enriched growth medium and antimicrobial agents relevant for this organism. The present study compared the results of testing of a group of 53 challenge strains of pneumococci with known resistance properties and a collection of clinical isolates examined in two study phases with a total of 402 and 416 isolates, respectively, with a prototype of the VITEK 2. Testing was conducted in three geographically separate laboratories; the challenge collection was tested by all three laboratories, and the unique clinical isolates were tested separately by the individual laboratories. The VITEK 2 results of tests with 10 antimicrobial agents were compared to the results generated by the National Committee for Clinical Laboratory Standards reference broth microdilution MIC test method. Excellent interlaboratory agreement was observed with the challenge strains. The overall agreement within a single twofold dilution of MICs defined by the VITEK 2 and reference method with the clinical isolates was 96.3%, although there were a number of off-scale MICs that could not be compared. The best agreement with the clinical isolates was achieved with ofloxacin and chloramphenicol (100%), and the lowest level of agreement among those drugs with sufficient on-scale MICs occurred with trimethoprim-sulfamethoxazole (89.7%). Overall there were 1.3% very major, 6.6% minor, and no major interpretive category errors encountered with the clinical isolates, although >80% of the minor interpretive errors involved only a single log2 dilution difference. The mean time for generation of susceptibility results with the clinical isolates was 8.1 h. The VITEK 2 provided rapid, reliable susceptibility category determinations with both the challenge and clinical isolates examined in this study. PMID:10921932

  18. Soil-contact decay tests using small blocks : a procedural analysis

    Treesearch

    Rodney C. De Groot; James W. Evans; Paul G. Forsyth; Camille M. Freitag; Jeffrey J. Morrell

    Much discussion has been held regarding the merits of laboratory decay tests compared with field tests to evaluate wood preservatives. In this study, procedural aspects of soil jar decay tests with 1 cm 3 blocks were critically examined. Differences among individual bottles were a major source of variation in this method. The reproducibility and sensitivity of the soil...

  19. Classification of anemia for gastroenterologists

    PubMed Central

    Moreno Chulilla, Jose Antonio; Romero Colás, Maria Soledad; Gutiérrez Martín, Martín

    2009-01-01

    Most anemia is related to the digestive system by dietary deficiency, malabsorption, or chronic bleeding. We review the World Health Organization definition of anemia, its morphological classification (microcytic, macrocytic and normocytic) and pathogenic classification (regenerative and hypo regenerative), and integration of these classifications. Interpretation of laboratory tests is included, from the simplest (blood count, routine biochemistry) to the more specific (iron metabolism, vitamin B12, folic acid, reticulocytes, erythropoietin, bone marrow examination and Schilling test). In the text and various algorithms, we propose a hierarchical and logical way to reach a diagnosis as quickly as possible, by properly managing the medical interview, physical examination, appropriate laboratory tests, bone marrow examination, and other complementary tests. The prevalence is emphasized in all sections so that the gastroenterologist can direct the diagnosis to the most common diseases, although the tables also include rare diseases. Digestive diseases potentially causing anemia have been studied in preference, but other causes of anemia have been included in the text and tables. Primitive hematological diseases that cause anemia are only listed, but are not discussed in depth. The last section is dedicated to simplifying all items discussed above, using practical rules to guide diagnosis and medical care with the greatest economy of resources and time. PMID:19787825

  20. [Complicated urinary tract infections--from the perspective of the medical technologist].

    PubMed

    Nagasawa, Zenzo

    2002-07-01

    We would like to propose re-establishment of the protocol for ordering a clinical microbiology laboratory test after a bedside screening test using urine reagent strip when urinary tract infection is suspected. Media for isolation shall be chosen by the clinical microbiology laboratory after checking turbidity and microscopic examination of the urine specimen. In cases of complicated urinary tract infections, quantitative culture should be performed to investigate changes in the number of microorganism to grasp condition of super infection. In such infections, there are many cases in which multiple microorganism growth including glucose non-fermenting gram-negative bacilli can be recognized. Therefore, it is necessary to inspect colonies on media as long as possible (24 hrs culture may be short in some cases). The protocol for microorganism identification and susceptibility test for such specimen varies in each laboratory, considering the Health Insurance Point System (reimbursement system by MHW). It is necessary to communicate with physicians and to refer to past results to proceed with the laboratory test properly. Therefore, a Certified Clinical Microbiology Medical Technologist is needed and the role played by such staff is important.

  1. An examination of speech reception thresholds measured in a simulated reverberant cafeteria environment.

    PubMed

    Best, Virginia; Keidser, Gitte; Buchholz, Jörg M; Freeston, Katrina

    2015-01-01

    There is increasing demand in the hearing research community for the creation of laboratory environments that better simulate challenging real-world listening environments. The hope is that the use of such environments for testing will lead to more meaningful assessments of listening ability, and better predictions about the performance of hearing devices. Here we present one approach for simulating a complex acoustic environment in the laboratory, and investigate the effect of transplanting a speech test into such an environment. Speech reception thresholds were measured in a simulated reverberant cafeteria, and in a more typical anechoic laboratory environment containing background speech babble. The participants were 46 listeners varying in age and hearing levels, including 25 hearing-aid wearers who were tested with and without their hearing aids. Reliable SRTs were obtained in the complex environment, but led to different estimates of performance and hearing-aid benefit from those measured in the standard environment. The findings provide a starting point for future efforts to increase the real-world relevance of laboratory-based speech tests.

  2. An examination of speech reception thresholds measured in a simulated reverberant cafeteria environment

    PubMed Central

    Best, Virginia; Keidser, Gitte; Buchholz, J(x004E7)rg M.; Freeston, Katrina

    2016-01-01

    Objective There is increasing demand in the hearing research community for the creation of laboratory environments that better simulate challenging real-world listening environments. The hope is that the use of such environments for testing will lead to more meaningful assessments of listening ability, and better predictions about the performance of hearing devices. Here we present one approach for simulating a complex acoustic environment in the laboratory, and investigate the effect of transplanting a speech test into such an environment. Design Speech reception thresholds were measured in a simulated reverberant cafeteria, and in a more typical anechoic laboratory environment containing background speech babble. Study Sample The participants were 46 listeners varying in age and hearing levels, including 25 hearing-aid wearers who were tested with and without their hearing aids. Results Reliable SRTs were obtained in the complex environment, but led to different estimates of performance and hearing aid benefit from those measured in the standard environment. Conclusions The findings provide a starting point for future efforts to increase the real-world relevance of laboratory-based speech tests. PMID:25853616

  3. Corrections of clinical chemistry test results in a laboratory information system.

    PubMed

    Wang, Sihe; Ho, Virginia

    2004-08-01

    The recently released reports by the Institute of Medicine, To Err Is Human and Patient Safety, have received national attention because of their focus on the problem of medical errors. Although a small number of studies have reported on errors in general clinical laboratories, there are, to our knowledge, no reported studies that focus on errors in pediatric clinical laboratory testing. To characterize the errors that have caused corrections to have to be made in pediatric clinical chemistry results in the laboratory information system, Misys. To provide initial data on the errors detected in pediatric clinical chemistry laboratories in order to improve patient safety in pediatric health care. All clinical chemistry staff members were informed of the study and were requested to report in writing when a correction was made in the laboratory information system, Misys. Errors were detected either by the clinicians (the results did not fit the patients' clinical conditions) or by the laboratory technologists (the results were double-checked, and the worksheets were carefully examined twice a day). No incident that was discovered before or during the final validation was included. On each Monday of the study, we generated a report from Misys that listed all of the corrections made during the previous week. We then categorized the corrections according to the types and stages of the incidents that led to the corrections. A total of 187 incidents were detected during the 10-month study, representing a 0.26% error detection rate per requisition. The distribution of the detected incidents included 31 (17%) preanalytic incidents, 46 (25%) analytic incidents, and 110 (59%) postanalytic incidents. The errors related to noninterfaced tests accounted for 50% of the total incidents and for 37% of the affected tests and orderable panels, while the noninterfaced tests and panels accounted for 17% of the total test volume in our laboratory. This pilot study provided the rate and categories of errors detected in a pediatric clinical chemistry laboratory based on the corrections of results in the laboratory information system. A direct interface of the instruments to the laboratory information system showed that it had favorable effects on reducing laboratory errors.

  4. Medical errors arising from outsourcing laboratory and radiology services.

    PubMed

    Chasin, Brian S; Elliott, Sean P; Klotz, Stephen A

    2007-09-01

    Document errors and the nuisance factor inherent in the informational exchange that occurs with the outsourcing of laboratory and radiology examinations. Three infectious diseases physicians at a tertiary care hospital recorded problems involving data transmitted by telephone or fax from outsource providers for 4 months. This included in- and outpatients, and those in transition from one status to another. Outsourcing laboratory and radiology examinations of insured outpatients is a common practice. Insurance companies determine which healthcare facility performs these tests based on contractual agreements with outsource providers. This leads to confusion and frustration for the doctor and patient alike, and occasionally, to medical error. The exchange of patient data involved in outsourcing is subject to systemic errors that do not allow of easy solution.

  5. Importance of patient history and physical examination in rheumatoid arthritis compared to other chronic diseases: results of a physician survey.

    PubMed

    Castrejón, Isabel; McCollum, Lauren; Tanriover, Mine Durusu; Pincus, Theodore

    2012-08-01

    To survey physicians' opinions concerning the relative importance of 5 clinical encounter components-vital signs, patient history, physical examination, laboratory tests, and ancillary studies-in the diagnosis and management of 8 chronic diseases. A SurveyMonkey internet survey was e-mailed to 7,265 US physicians, including 3,542 rheumatologists and 3,723 nonrheumatologists, with the following query: "Please indicate the relative importance of 5 sources of information-vital signs, patient history, physical examination, laboratory tests, and ancillary studies-in diagnosis of congestive heart failure (CHF), diabetes mellitus, hypercholesterolemia, hypertension, lymphoma, pulmonary fibrosis, rheumatoid arthritis (RA), and ulcerative colitis." The response options were 0-20%, 21-40%, 41-60%, 61-80%, and 81-100%. A second query with an identical structure addressed management of the 8 diseases. The proportions of physicians who estimated each component as most (or tied for most) important in diagnosis or in management were computed. The survey was completed by 313 physicians (154 rheumatologists and 159 nonrheumatologists). More than 90% estimated vital signs as most important for hypertension, and laboratory tests for diabetes mellitus and hypercholesterolemia. More than 70% estimated ancillary studies as most important for lymphoma, pulmonary fibrosis, and ulcerative colitis. Patient history and physical examination were estimated as most important for RA and CHF by ≥50% of nonrheumatologists. RA and CHF were the only 2 of the 8 diseases studied for which ≥50% of nonrheumatologists estimated a patient history and physical examination as most important for diagnosis and management. Confirmation and extension of these observations in actual care may have implications for reimbursement and organization of clinical care. Copyright © 2012 by the American College of Rheumatology.

  6. 29 CFR 1910.1020 - Access to employee exposure and medical records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... results of medical examinations (pre-employment, pre-assignment, periodic, or episodic) and laboratory tests (including chest and other X-ray examinations taken for the purposes of establishing a base-line...), the employer shall prominently post a copy of the written access order and its accompanying cover...

  7. 29 CFR 1910.1020 - Access to employee exposure and medical records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... results of medical examinations (pre-employment, pre-assignment, periodic, or episodic) and laboratory tests (including chest and other X-ray examinations taken for the purposes of establishing a base-line...), the employer shall prominently post a copy of the written access order and its accompanying cover...

  8. 29 CFR 1910.1020 - Access to employee exposure and medical records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... results of medical examinations (pre-employment, pre-assignment, periodic, or episodic) and laboratory tests (including chest and other X-ray examinations taken for the purposes of establishing a base-line...), the employer shall prominently post a copy of the written access order and its accompanying cover...

  9. 10 CFR 712.3 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... test. Alcohol use disorder means a maladaptive pattern in which a person's intake of alcohol is great... licensed Ph.D., or Psy.D., in clinical psychology who has been nominated by the SOMD and approved by the... examination; (4) Appropriate laboratory tests and measurements; and (5) Appropriate psychological and...

  10. 42 CFR 493.945 - Cytology; gynecologic examinations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... morphology consistent with Candida spp., Actinomyces spp. or Herpes simplex virus). (3) Reactive and...)(7)(i)(A) and 493.1274(f)(2). If slide preparations are still subject to retention by the laboratory... achieved within and between proficiency testing providers. (2) To be approved for proficiency testing in...

  11. The concordance of serial ANA tests in an Australian tertiary hospital pathology laboratory.

    PubMed

    Lee, Adrian Y S; Hudspeth, Andrew R; Adelstein, Stephen

    2016-10-01

    The antinuclear antibody (ANA) tests are some of the more frequently requested tests for the diagnosis of autoimmunity. Although they are used primarily as diagnostic blood tests, multiple requests on the same patient continue to be encountered in the laboratory. This retrospective analysis of serial ANA testing at one pathology laboratory in Australia is the first study that examines the statistical concordance and possible implications of this on clinical practice. High-titred ANA have quite good repeatability for titre and pattern, and low-titred ANA, which can be non-specific, have poor repeatability. Staining patterns are, in general, almost random in nature on serial tests when compared to the first-obtained ANA pattern for each patient. This study confirms that there is little benefit in serial ANA testing, and only if there is a clear change in the patient's clinical picture would repeat of an initial low-titred ANA be useful. The findings reinforce the need for pathology stewardship to minimise costs, wasted resources and unnecessary referrals. Copyright © 2016 Royal College of Pathologists of Australasia. All rights reserved.

  12. Significance of Iron(II,III) Hydroxycarbonate Green Rust in Arsenic Remediation Using Zerovalent Iron in Laboratory Column Tests

    EPA Science Inventory

    We examined the corrosion products of zerovalent iron used in three column tests for removing arsenic from water under dynamic flow conditions. Each column test lasted three- to four-months using columns consisting of a 10.3-cm depth of 50 : 50 (w : w, Peerless iron : sand) in t...

  13. Proceedings of the Symposium on Nondestructive Testing of Wood.

    Treesearch

    1964-01-01

    This report summarizes the main points considered and the conclusions reached during the Symposium on Nondestructive Testing, October 7 to 9, 1963, at the Forest Products Laboratory. The purpose of this symposium was to bring research and industry leaders together to examine what is being done in nondestructive testing and discuss its applications to the wood products...

  14. Overview of platelet physiology and laboratory evaluation of platelet function.

    PubMed

    Rodgers, G M

    1999-06-01

    Appropriate laboratory testing for the platelet-type bleeding disorders hinges on an adequate assessment in the history and physical examination. Patients with histories and screening laboratory results consistent with coagulation disorders (hemophilia, disseminated intravascular coagulation) are not appropriate candidates for platelet function testing. In contrast, patients with a lifelong history of platelet-type bleeding symptoms and perhaps a positive family history of bleeding would be appropriate for testing. Figure 6 depicts one strategy to evaluate these patients. Platelet morphology can easily be evaluated to screen for two uncommon qualitative platelet disorders: Bernard-Soulier syndrome (associated with giant platelets) and gray platelet syndrome, a subtype of storage pool disorder in which platelet granulation is morphologically abnormal by light microscopy. If the bleeding disorder occurred later in life (no bleeding with surgery or trauma early in life), the focus should be on acquired disorders of platelet function. For those patients thought to have an inherited disorder, testing for vWD should be done initially because approximately 1% of the population has vWD. The complete vWD panel (factor VIII coagulant activity, vWf antigen, ristocetin cofactor activity) should be performed because many patients will have abnormalities of only one particular panel component. Patients diagnosed with vWD should be classified using multimeric analysis to identify the type 1 vWD patients likely to respond to DDAVP. If vWD studies are normal, platelet aggregation testing should be performed, ensuring that no antiplatelet medications have been ingested at least 1 week before testing. If platelet aggregation tests are normal and if suspicion for an inherited disorder remains high, vWD testing should be repeated. The evaluation of thrombocytopenia may require bone marrow examination to exclude primary hematologic disorders. If future studies with thrombopoietin assays confirm preliminary results, however, the bone marrow examination of certain patients may be replaced by a thrombopoietin level.

  15. PIE on Safety-Tested AGR-1 Compact 5-1-1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hunn, John D.; Morris, Robert Noel; Baldwin, Charles A.

    Post-irradiation examination (PIE) is being performed in support of tristructural isotropic (TRISO) coated particle fuel development and qualification for High-Temperature Gas-cooled Reactors (HTGRs). AGR-1 was the first in a series of TRISO fuel irradiation experiments initiated in 2006 under the Advanced Gas Reactor (AGR) Fuel Development and Qualification Program; this work continues to be funded by the Department of Energy's Office of Nuclear Energy as part of the Advanced Reactor Technologies (ART) initiative. AGR-1 fuel compacts were fabricated at Oak Ridge National Laboratory (ORNL) in 2006 and irradiated for three years in the Idaho National Laboratory (INL) Advanced Test Reactormore » (ATR) to demonstrate and evaluate fuel performance under HTGR irradiation conditions. PIE is being performed at INL and ORNL to study how the fuel behaved during irradiation, and to examine fuel performance during exposure to elevated temperatures at or above temperatures that could occur during a depressurized conduction cooldown event. This report summarizes safety testing of irradiated AGR-1 Compact 5-1-1 in the ORNL Core Conduction Cooldown Test Facility (CCCTF) and post-safety testing PIE.« less

  16. Designation, diligence and drift: understanding laboratory expenditure increases in British Columbia, 1996/97 to 2005/06.

    PubMed

    Sivananthan, Saskia N; Peterson, Sandra; Lavergne, Ruth; Barer, Morris L; McGrail, Kimberlyn M

    2012-12-21

    Laboratory testing is one of the fastest growing areas of health services spending in Canada. We examine the extent to which increases in laboratory expenditures might be explained by testing that is consistent with guidelines for the management of chronic conditions, by analyzing fee-for-service physician payment data in British Columbia from 1996/97 and 2005/06. We used direct standardization to quantify the effect on laboratory expenditures from changes in: fee levels; population growth; population aging; treatment prevalence; expenditure on recommended tests for those conditions; and expenditure on other tests. The chronic conditions selected were those with guidelines containing laboratory recommendations developed by the BC Guidelines and Protocol Advisory Committee: diabetes, hypertension, congestive heart failure, renal failure, liver disease, rheumatoid arthritis, osteoarthritis and dementia. Laboratory service expenditures increased by $98 million in 2005/06 compared to 1996/97, or 3.6% per year after controlling for population growth and aging. Testing consistent with guideline-recommended care for chronic conditions explained one-third (1.2% per year) of this growth. Changes in treatment prevalence were just as important, contributing 1.5% per year. Hypertension was the most common condition, but renal failure and dementia showed the largest changes in prevalence over time. Changes in other laboratory expenditure including for those without chronic conditions accounted for the remaining 0.9% growth per year. Increases in treatment prevalence were the largest driver of laboratory cost increases between 1996/97 and 2005/06. There are several possible contributors to increasing treatment prevalence, all of which can be expected to continue to put pressure on health care expenditures.

  17. Electronic laboratory data quality and the value of a health information exchange to support public health reporting processes.

    PubMed

    Dixon, Brian E; McGowan, Julie J; Grannis, Shaun J

    2011-01-01

    There is increasing interest in leveraging electronic health data across disparate sources for a variety of uses. A fallacy often held by data consumers is that clinical data quality is homogeneous across sources. We examined one attribute of data quality, completeness, in the context of electronic laboratory reporting of notifiable disease information. We evaluated 7.5 million laboratory reports from clinical information systems for their completeness with respect to data needed for public health reporting processes. We also examined the impact of health information exchange (HIE) enhancement methods that attempt to improve completeness. The laboratory data were heterogeneous in their completeness. Fields identifying the patient and test results were usually complete. Fields containing patient demographics, patient contact information, and provider contact information were suboptimal. Data processed by the HIE were often more complete, suggesting that HIEs can support improvements to existing public health reporting processes.

  18. The bogus taste test: Validity as a measure of laboratory food intake.

    PubMed

    Robinson, Eric; Haynes, Ashleigh; Hardman, Charlotte A; Kemps, Eva; Higgs, Suzanne; Jones, Andrew

    2017-09-01

    Because overconsumption of food contributes to ill health, understanding what affects how much people eat is of importance. The 'bogus' taste test is a measure widely used in eating behaviour research to identify factors that may have a causal effect on food intake. However, there has been no examination of the validity of the bogus taste test as a measure of food intake. We conducted a participant level analysis of 31 published laboratory studies that used the taste test to measure food intake. We assessed whether the taste test was sensitive to experimental manipulations hypothesized to increase or decrease food intake. We examined construct validity by testing whether participant sex, hunger and liking of taste test food were associated with the amount of food consumed in the taste test. In addition, we also examined whether BMI (body mass index), trait measures of dietary restraint and over-eating in response to palatable food cues were associated with food consumption. Results indicated that the taste test was sensitive to experimental manipulations hypothesized to increase or decrease food intake. Factors that were reliably associated with increased consumption during the taste test were being male, have a higher baseline hunger, liking of the taste test food and a greater tendency to overeat in response to palatable food cues, whereas trait dietary restraint and BMI were not. These results indicate that the bogus taste test is likely to be a valid measure of food intake and can be used to identify factors that have a causal effect on food intake. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. The National Ballistics Imaging Comparison (NBIC) project.

    PubMed

    Song, J; Vorburger, T V; Ballou, S; Thompson, R M; Yen, J; Renegar, T B; Zheng, A; Silver, R M; Ols, M

    2012-03-10

    In response to the guidelines issued by the American Society of Crime Laboratory Directors/Laboratory Accreditation Board (ASCLD/LAB-International) to establish traceability and quality assurance in U.S. crime laboratories, a NIST/ATF joint project entitled National Ballistics Imaging Comparison (NBIC) was initialized in 2008. The NBIC project aims to establish a National Traceability and Quality System for ballistics identifications in crime laboratories within the National Integrated Ballistics Information Network (NIBIN) of the U.S. NIST Standard Reference Material (SRM) 2460 bullets and 2461 cartridge cases are used as reference standards. 19 ballistics examiners from 13 U.S. crime laboratories participated in this project. They each performed 24 periodic image acquisitions and correlations of the SRM bullets and cartridge cases over the course of a year, but one examiner only participated in Phase 1 tests of SRM cartridge case. The correlation scores were collected by NIST for statistical analyses, from which control charts and control limits were developed for the proposed Quality System and for promoting future assessments and accreditations for firearm evidence in U.S. forensic laboratories in accordance with the ISO 17025 Standard. Published by Elsevier Ireland Ltd.

  20. Cerebrospinal fluid protein and glucose examinations and tuberculosis:
Will laboratory safety regulations force a change of practice?

    PubMed

    Tormey, William P; O'Hagan, Christopher

    2015-01-01

    Cerebrospinal fluid (CSF) protein and glucose examinations are usually performed in chemical pathology departments on autoanalysers. Tuberculosis (TB) is a group 3 biological agent under Directive 2000/54/EC of the European Parliament but in the biochemistry laboratory, no extra precautions are taken in its analysis in possible TB cases. The issue of laboratory practice and safety in the biochemical analyses of CSF specimens, when tuberculosis infection is in question is addressed in the context of ambiguity in the implementation of current national and international health and safety regulations. Additional protective measures for laboratory staff during the analysis of CSF TB samples should force a change in current laboratory practice and become a regulatory issue under ISO 15189. Annual Mantoux skin test or an interferon-γ release assay for TB should be mandatory for relevant staff. This manuscript addresses the issue of biochemistry laboratory practice and safety in the biochemical analyses of CSF specimens when tuberculosis infection is in question in the context of the ambiguity of statutory health and safety regulations.

  1. Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

    PubMed

    Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

    2016-01-01

    Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist's work station (caused by a preference for microbiological testing prior to CSF chemistry). A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

  2. Valid methods: the quality assurance of test method development, validation, approval, and transfer for veterinary testing laboratories.

    PubMed

    Wiegers, Ann L

    2003-07-01

    Third-party accreditation is a valuable tool to demonstrate a laboratory's competence to conduct testing. Accreditation, internationally and in the United States, has been discussed previously. However, accreditation is only I part of establishing data credibility. A validated test method is the first component of a valid measurement system. Validation is defined as confirmation by examination and the provision of objective evidence that the particular requirements for a specific intended use are fulfilled. The international and national standard ISO/IEC 17025 recognizes the importance of validated methods and requires that laboratory-developed methods or methods adopted by the laboratory be appropriate for the intended use. Validated methods are therefore required and their use agreed to by the client (i.e., end users of the test results such as veterinarians, animal health programs, and owners). ISO/IEC 17025 also requires that the introduction of methods developed by the laboratory for its own use be a planned activity conducted by qualified personnel with adequate resources. This article discusses considerations and recommendations for the conduct of veterinary diagnostic test method development, validation, evaluation, approval, and transfer to the user laboratory in the ISO/IEC 17025 environment. These recommendations are based on those of nationally and internationally accepted standards and guidelines, as well as those of reputable and experienced technical bodies. They are also based on the author's experience in the evaluation of method development and transfer projects, validation data, and the implementation of quality management systems in the area of method development.

  3. Extrapolating non-target risk of Bt crops from laboratory to field.

    PubMed

    Duan, Jian J; Lundgren, Jonathan G; Naranjo, Steve; Marvier, Michelle

    2010-02-23

    The tiered approach to assessing ecological risk of insect-resistant transgenic crops assumes that lower tier laboratory studies, which expose surrogate non-target organisms to high doses of insecticidal proteins, can detect harmful effects that might be manifested in the field. To test this assumption, we performed meta-analyses comparing results for non-target invertebrates exposed to Bacillus thuringiensis (Bt) Cry proteins in laboratory studies with results derived from independent field studies examining effects on the abundance of non-target invertebrates. For Lepidopteran-active Cry proteins, laboratory studies correctly predicted the reduced field abundance of non-target Lepidoptera. However, laboratory studies incorporating tri-trophic interactions of Bt plants, herbivores and parasitoids were better correlated with the decreased field abundance of parasitoids than were direct-exposure assays. For predators, laboratory tri-trophic studies predicted reduced abundances that were not realized in field studies and thus overestimated ecological risk. Exposure to Coleopteran-active Cry proteins did not significantly reduce the laboratory survival or field abundance of any functional group examined. Our findings support the assumption that laboratory studies of transgenic insecticidal crops show effects that are either consistent with, or more conservative than, those found in field studies, with the important caveat that laboratory studies should explore all ecologically relevant routes of exposure.

  4. Critical Value Reporting at Egyptian Laboratories.

    PubMed

    Mosallam, Rasha; Ibrahim, Samaa Zenhom

    2015-06-12

    To examine critical value reporting policies and practices and to identify critical value ranges for selected common laboratory assays at inpatient division of laboratories of Alexandria hospitals. A cross-sectional descriptive study design was used. Subjects were from inpatient division of all laboratories of Alexandria hospitals (40 laboratories). Data were collected using a questionnaire composed of 4 sections. The first section explored hospital and laboratory characteristics. The second section assessed policies and procedures of critical value reporting. The third section explored the reporting process. The fourth section explored critical value ranges for selected common laboratory assays. Written procedure for reporting of critical values was present in 77.5% of laboratories and a comprehensive list of critical values in 72.55%. For laboratories having a critical value list, the number of tests in the list ranged from 7 to 40. Three-fifths of laboratories had a policy for assessing the timeliness of reporting and 3 quarters stated that the laboratory policy requires feedback (60.0% and 75.0%, respectively). The hospital laboratory physician was responsible for critical value reporting followed by the laboratory technician (75.0% and 50.0%, respectively). The call is received mainly by nurses and physicians ordering the test (67.5% and 55.0%, respectively) and the channel of reporting is mainly the telephone or through sending test report to the ward (67.5% and 50.0%, respectively). Wireless technologies are used in reporting in only 10.0% of hospitals. The cutoff limits for reporting different assays showed considerable interlaboratory variation. Critical value policies and practices showed interinstitutional variation with deficiencies in some reporting practices. Selection of critical assays for notification and setting the limits of notification exhibited wide variation as well.

  5. Understanding the 'Silver Book' - An important reference for standardised nomenclature in clinical laboratory sciences.

    PubMed

    Flatman, Robert; Férard, Georges; Dybkaer, René

    2017-04-01

    Clinical laboratories perform a wide menu of testing (examinations). Successful requesting, examination, and ordering in this environment requires clear standardised nomenclature. The Silver Book (SB) is an IUPAC (International Union of Pure and Applied Chemistry) publication, produced with the support of both IUPAC and the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine), that makes recommendations on logical standardised nomenclature, symbols, properties, and units in many disciplines of the clinical laboratory sciences. These recommendations are founded on and in agreement with the principles and work of the International Organization for Standardization (ISO), Bureau International des Poids et Mesures (BIPM), IUPAC, and the IFCC. Practical applications described are based on those scientific principles. The SB recommendations apply to all types of examination, not only to measurement of quantities but also examination of nominal properties where no magnitude is involved. The SB is applicable not only to clinical chemistry, but to many other clinical laboratory disciplines. For examples, reports regarding haemostasis, toxicology, clinical microbiology, reproduction and fertility, clinical pharmacology, clinical allergology, clinical molecular biology, and clinical immunohaematology have been published by the IUPAC and the IFCC. Peak scientific bodies such as the IUPAC and the IFCC have important roles in the development of sound international standards for nomenclature of examinations. Such standards support safe and effective representation of patient health information, foster portability, and empower future decision support systems. Copyright © 2016. Published by Elsevier B.V.

  6. Effect of Simulation on the Confidence of University Nursing Students in Applying Cardiopulmonary Assessment Skills: A Randomized Controlled Trial.

    PubMed

    Tawalbeh, Loai I

    2017-08-01

    Simulation is an effective teaching strategy. However, no study in Jordan has examined the effect of simulation on the confidence of university nursing students in applying heart and lung physical examination skills. The current study aimed to test the effect of simulation on the confidence of university nursing students in applying heart and lung physical examination skills. A randomized controlled trial design was applied. The researcher introduced the simulation scenario regarding cardiopulmonary examination skills. This scenario included a 1-hour PowerPoint presentation and video for the experimental group (n= 35) and a PowerPoint presentation and a video showing a traditional demonstration in the laboratory for the control group (n = 34). Confidence in applying cardiopulmonary physical examination skills was measured for both groups at baseline and at 1 day and 3 months posttest. A paired t test showed that confidence was significantly higher in the posttest than in the pretest for both groups. An independent t test showed a statistically significant difference (t(67) = -42.95, p < .001) between the two groups in terms of the difference between the first posttest and second posttest scores (t(67) = -43.36, p < .001) for confidence in applying physical examination skills. Both simulation and traditional training in the laboratory significantly improved the confidence of participants in applying cardiopulmonary assessment skills. However, the simulation training had a more significant effect than usual training in enhancing the confidence of nursing students in applying physical examination skills.

  7. Manual for Courts-Martial United States. 2002 Edition

    DTIC Science & Technology

    2002-01-01

    are enlistment papers, physical exam- ination papers, outline-figure and fingerprint cards, forensic laboratory reports, chain of custody docu- ments...physical examination papers, outline figure and fin- gerprint cards, forensic laboratory reports, chain of custody documents, morning reports and...Para. 142 e of the 1969 Manual, “Polygraph tests and drug- induced or hypnosis -induced interviews,” has been deleted as a result of the adoption of

  8. Manual for Courts-Martial United States 1998 Edition.

    DTIC Science & Technology

    1998-01-01

    exam- ination papers, outline-figure and fingerprint cards, forensic laboratory reports, chain of custody docu- ments, morning reports and other...examination papers, outline figure and fin- gerprint cards, forensic laboratory reports, chain of custody documents, morning reports and other per...the 1969 Manual, "Polygraph tests and drug- induced or hypnosis -induced interviews," has been deleted as a result of the adoption of Rule 702. Para

  9. Round robin investigation of methods for the recovery of poliovirus from drinking water.

    PubMed Central

    Melnick, J L; Safferman, R; Rao, V C; Goyal, S; Berg, G; Dahling, D R; Wright, B A; Akin, E; Stetler, R; Sorber, C

    1984-01-01

    Six laboratories actively involved in water virology research participated in a methods evaluation study, conducted under the auspices of the American Society for Testing and Materials Committee on Viruses in the Aquatic Environment, Task Force on Drinking Water. Each participant was asked to examine the Viradel (virus adsorption-elution) method with cartridge-type Filterite filters for virus adsorption and organic flocculation and aluminum hydroxide-hydroextraction for reconcentration. Virus was adsorbed to filter media at pH 3.5 and eluted with either glycine buffer (pH 10.5) or beef extract-glycine (pHG 9.0). Considerable variation was noted in the quantity of virus recovered from four 100-liter samples of dechlorinated tapwater seeded with low (350 to 860 PFU) and high (1,837 to 4,689 PFU) doses of poliovirus type 1. To have a more uniform standard of comparison, all the test samples were reassayed in one laboratory, where titers were also determined for the virus seed. Test results of the Viradel-organic flocculation method indicated that the average percentage of virus recovery for low-input experiments was 66%, with a range of 8 to 20% in two laboratories, 49 to 63% in three laboratories, and 198% in one laboratory. For the high-input experiments, two laboratories reported recoveries of 6 to 12%, and four laboratories reported recoveries of 26 to 46%. For the Viradel aluminum hydroxide-hydroextraction procedure, two laboratories recovered 9 to 11%, whereas four obtained 17 to 34% for low-input experiments. For the high-input tests, two laboratories reported a recovery of 3 to 5%, and four recovered 11 to 18% of the seeded virus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6320720

  10. Mean Abnormal Result Rate: Proof of Concept of a New Metric for Benchmarking Selectivity in Laboratory Test Ordering.

    PubMed

    Naugler, Christopher T; Guo, Maggie

    2016-04-01

    There is a need to develop and validate new metrics to access the appropriateness of laboratory test requests. The mean abnormal result rate (MARR) is a proposed measure of ordering selectivity, the premise being that higher mean abnormal rates represent more selective test ordering. As a validation of this metric, we compared the abnormal rate of lab tests with the number of tests ordered on the same requisition. We hypothesized that requisitions with larger numbers of requested tests represent less selective test ordering and therefore would have a lower overall abnormal rate. We examined 3,864,083 tests ordered on 451,895 requisitions and found that the MARR decreased from about 25% if one test was ordered to about 7% if nine or more tests were ordered, consistent with less selectivity when more tests were ordered. We then examined the MARR for community-based testing for 1,340 family physicians and found both a wide variation in MARR as well as an inverse relationship between the total tests ordered per year per physician and the physician-specific MARR. The proposed metric represents a new utilization metric for benchmarking relative selectivity of test orders among physicians. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Impact of providing fee data on laboratory test ordering: a controlled clinical trial.

    PubMed

    Feldman, Leonard S; Shihab, Hasan M; Thiemann, David; Yeh, Hsin-Chieh; Ardolino, Margaret; Mandell, Steven; Brotman, Daniel J

    2013-05-27

    Inpatient care providers often order laboratory tests without any appreciation for the costs of the tests. To determine whether we could decrease the number of laboratory tests ordered by presenting providers with test fees at the time of order entry in a tertiary care hospital, without adding extra steps to the ordering process. Controlled clinical trial. Tertiary care hospital. All providers, including physicians and nonphysicians, who ordered laboratory tests through the computerized provider order entry system at The Johns Hopkins Hospital. We randomly assigned 61 diagnostic laboratory tests to an "active" arm (fee displayed) or to a control arm (fee not displayed). During a 6-month baseline period (November 10, 2008, through May 9, 2009), we did not display any fee data. During a 6-month intervention period 1 year later (November 10, 2009, through May 9, 2010), we displayed fees, based on the Medicare allowable fee, for active tests only. We examined changes in the total number of orders placed, the frequency of ordered tests (per patient-day), and total charges associated with the orders according to the time period (baseline vs intervention period) and by study group (active test vs control). For the active arm tests, rates of test ordering were reduced from 3.72 tests per patient-day in the baseline period to 3.40 tests per patient-day in the intervention period (8.59% decrease; 95% CI, -8.99% to -8.19%). For control arm tests, ordering increased from 1.15 to 1.22 tests per patient-day from the baseline period to the intervention period (5.64% increase; 95% CI, 4.90% to 6.39%) (P < .001 for difference over time between active and control tests). Presenting fee data to providers at the time of order entry resulted in a modest decrease in test ordering. Adoption of this intervention may reduce the number of inappropriately ordered diagnostic tests.

  12. Undergraduate Students' Achievement Goals for Conducting Research: Examining the Motivational Benefits of Laboratory Classroom Affiliation

    ERIC Educational Resources Information Center

    Deemer, Eric D.; Dotterer, Aryn M.; Morel, Samantha A.; Bastnagel, Abigail E.

    2017-01-01

    Rooted in achievement goal theory, the buffering hypothesis posits that contextual factors serve to moderate the deleterious effects of personal achievement goals on relevant outcomes. The present study sought to test this hypothesis by examining the interactive effects of classroom affiliation perceptions and personal achievement goals for…

  13. 42 CFR 493.945 - Cytology; gynecologic examinations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... dysplasia/CIN-2 and severe dysplasia/carcinoma in-situ/CIN-3. (2) Squamous cell carcinoma. (3... gynecologic examinations (Pap smears) in cytology, a program must provide test sets composed of 10- and 20..., provided the slides have been retained by the laboratory for the required period specified in §§ 493.1105(a...

  14. Testing-adjusted chlamydia notification trends in New South Wales, Australia, 2000 to 2010.

    PubMed

    Cretikos, Michelle; Mayne, Darren; Reynolds, Roderick; Spokes, Paula; Madeddu, Daniel

    2014-01-01

    Between 2005 and 2010, Australian notification rates for chlamydia infection increased by 64% from 203 to 333 per 100 000 population. Interpreting this trend is difficult without examining rates and local patterns of testing. We examined the effect of adjusting for local testing rates on chlamydia notification trends in New South Wales (NSW), Australia from 2000 to 2010. We used testing data for NSW residents for Medicare Benefits Schedule items for chlamydia from 1 July 1999 to 30 June 2005 and 1 July 2007 to 30 June 2010. This data set excluded testing by public sector laboratories. We also obtained laboratory-confirmed genital chlamydia notifications in NSW residents for 1 July 1999 to 30 June 2010 and excluded notifications from public laboratories. We used negative binomial regression to assess trends in chlamydia notification rates by age and sex after adjusting for local government area (LGA)-level Medicare-funded testing rates, socioeconomic disadvantage, remoteness and Medicare provider density. Testing-adjusted rates of chlamydia notifications declined by 5.2% per annum (rate ratio [RR] = 0.95, 95% confidence interval (CI) = 0.93-0.96) for women overall, and 2.3% (RR = 0.98, 95% CI = 0.96-1.00) and 5.0% per annum (RR = 0.95, 95% CI = 0.93-0.98) for men in LGAs with moderate and high densities of Medicare providers, respectively. Notification rates remained stable for men in low Medicare provider density LGAs (RR = 1.01, 95% CI = 0.96-1.07). It is likely that increased testing for chlamydia has driven increases in chlamydia notification in NSW over the last decade. Notification data provide no evidence for a general increase in the prevalence of chlamydia in the NSW community for this period. Notification-based chlamydia surveillance should be routinely adjusted for local testing rates.

  15. Determining the hydraulic properties of saturated, low-permeability geological materials in the laboratory: Advances in theory and practice

    USGS Publications Warehouse

    Zhang, M.; Takahashi, M.; Morin, R.H.; Endo, H.; Esaki, T.; ,

    2002-01-01

    The accurate hydraulic characterization of low-permeability subsurface environments has important practical significance. In order to examine this issue from the perspective of laboratory-based approaches, we review some recent advancements in the theoretical analyses of three different laboratory techniques specifically applied to low-permeability geologic materials: constant-head, constant flow-rate and transient-pulse permeability tests. Some potential strategies for effectively decreasing the time required to confidently estimate the permeability of these materials are presented. In addition, a new and versatile laboratory system is introduced that can implement any of these three test methods while simultaneously subjecting a specimen to high confining pressures and pore pressures, thereby simulating in situ conditions at great depths. The capabilities and advantages of this innovative system are demonstrated using experimental data derived from Shirahama sandstone and Inada granite, two rock types widely encountered in Japan.

  16. Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mitchell, S.W.; McCormick, J.B.

    1984-09-01

    Clinical specimens from patients infected with Lassa, Ebola, or Marburg virus may present a serious biohazard to laboratory workers. The authors have examined the effects of heat, alteration of pH, and gamma radiation on these viruses in human blood and on the electrolytes, enzymes, and coagulation factors measured in laboratory tests that are important in the care of an infected patient. Heating serum at 60 degrees C for 1 h reduced high titers of these viruses to noninfectious levels without altering the serum levels of glucose, blood urea nitrogen, and electrolytes. Dilution of blood in 3% acetic acid, diluent formore » a leukocyte count, inactivated all of these viruses. All of the methods tested for viral inactivation markedly altered certain serum proteins, making these methods unsuitable for samples that are to be tested for certain enzyme levels and coagulation factors.« less

  17. An unusual cause of central retinal artery occlusion: acquired immunodeficiency syndrome.

    PubMed

    Erdol, H; Turk, A; Caylan, R

    2007-01-01

    In patients with acquired immunodeficiency syndrome (AIDS), disturbances in the circulation of retinal vessels are mostly encountered at the microvascular level. Rarely observed large retinal vessel occlusions frequently affect retinal veins. A 32-year-old woman was admitted to the authors' clinic with sudden loss of vision. Her clinical and ophthalmologic examinations and laboratory tests were carried out and the results were evaluated. The patient's history revealed a diagnosis of AIDS established 5 years ago. Her corrected visual acuity was limited to light perception in the right eye and 20/60 in the left eye. There was afferent pupillary defect in the right eye. Posterior segment examination demonstrated central retinal artery occlusion in the right eye and cotton-wool spots in the left eye. The clinical examination and laboratory test results did not reveal any comorbid disease state that can contribute to this presentation. As thrombi may develop in patients with human immunodeficiency virus infection, they should be closely followed up for the development of vasoocclusive disease.

  18. A study of the impact of collaborative learning on student learning of major concepts in a microbiology laboratory exercise

    NASA Astrophysics Data System (ADS)

    Baumgarten, Kristyne A.

    This study investigated the possible relationship between collaborative learning strategies and the learning of core concepts. This study examined the differences between two groups of nursing students enrolled in an introductory microbiology laboratory course. The control group consisted of students enrolled in sections taught in the traditional method. The experimental group consisted of those students enrolled in the sections using collaborative learning strategies. The groups were assessed on their degrees of learning core concepts using a pre-test/post-test method. Scores from the groups' laboratory reports were also analyzed. There was no difference in the two group's pre-test scores. The post-test scores of the experimental group averaged 11 points higher than the scores of the control group. The lab report scores of the experimental group averaged 15 points higher than those scores of the control group. The data generated from this study demonstrated that collaborative learning strategies can be used to increase students learning of core concepts in microbiology labs.

  19. Viability testing of material derived from Mycobacterium tuberculosis prior to removal from a containment level-III laboratory as part of a Laboratory Risk Assessment Program.

    PubMed

    Blackwood, Kym S; Burdz, Tamara V; Turenne, Christine Y; Sharma, Meenu K; Kabani, Amin M; Wolfe, Joyce N

    2005-01-24

    In the field of clinical mycobacteriology, Mycobacterium tuberculosis (MTB) can be a difficult organism to manipulate due to the restrictive environment of a containment level 3 (CL3) laboratory. Tests for rapid diagnostic work involving smears and molecular methods do not require CL3 practices after the organism has been rendered non-viable. While it has been assumed that after organism deactivation these techniques can be performed outside of a CL3, no conclusive study has consistently confirmed that the organisms are noninfectious after the theoretical 'deactivation' steps. Previous studies have shown that initial steps (such as heating/chemical fixation) may not consistently kill MTB organisms. An inclusive viability study (n = 226) was undertaken to determine at which point handling of culture extraction materials does not necessitate a CL3 environment. Four different laboratory protocols tested for viability included: standard DNA extractions for IS6110 fingerprinting, crude DNA preparations for PCR by boiling and mechanical lysis, protein extractions, and smear preparations. For each protocol, laboratory staff planted a proportion of the resulting material to Bactec 12B medium that was observed for growth for 8 weeks. Of the 208 isolates initially tested, 21 samples grew within the 8-week period. Sixteen (7.7%) of these yielded positive results for MTB that included samples of: deactivated culture resuspensions exposed to 80 degrees C for 20 minutes, smear preparations and protein extractions. Test procedures were consequently modified and tested again (n = 18), resulting in 0% viability. This study demonstrates that it cannot be assumed that conventional practices (i.e. smear preparation) or extraction techniques render the organism non-viable. All methodologies, new and existing, should be examined by individual laboratories to validate the safe removal of material derived from MTB to the outside of a CL3 laboratory. This process is vital to establish in house biosafety-validated practices with the aim of protecting laboratory workers conducting these procedures.

  20. Aerosol and nucleation research in support of NASA cloud physics experiments in space. [ice nuclei generator for the atmospheric cloud physics laboratory on Spacelab

    NASA Technical Reports Server (NTRS)

    Vali, G.; Rogers, D.; Gordon, G.; Saunders, C. P. R.; Reischel, M.; Black, R.

    1978-01-01

    Tasks performed in the development of an ice nucleus generator which, within the facility concept of the ACPL, would provide a test aerosol suitable for a large number and variety of potential experiments are described. The impact of Atmospheric Cloud Physics Laboratory scientific functional requirements on ice nuclei generation and characterization subsystems was established. Potential aerosol generating systems were evaluated with special emphasis on reliability, repeatability and general suitability for application in Spacelab. Possible contamination problems associated with aerosol generation techniques were examined. The ice nucleating abilities of candidate test aerosols were examined and the possible impact of impurities on the nucleating abilities of those aerosols were assessed as well as the relative merits of various methods of aerosol size and number density measurements.

  1. Cherenkov and Scintillation Properties of Cubic Zirconium

    NASA Technical Reports Server (NTRS)

    Christl, M.J.; Adams, J.H.; Parnell, T.A.; Kuznetsov, E.N.

    2008-01-01

    Cubic zirconium (CZ) is a high index of refraction (n =2.17) material that we have investigated for Cherenkov counter applications. Laboratory and proton accelerator tests of an 18cc sample of CZ show that the expected fast Cherenkov response is accompanied by a longer scintillation component that can be separated by pulse shaping. This presents the possibility of novel particle spectrometers which exploits both properties of CZ. Other high index materials being examined for Cherenkov applications will be discussed. Results from laboratory tests and an accelerator exposure will be presented and a potential application in solar energetic particle instruments will be discussed

  2. Particle Size Measurements From the First Fundamentals of Ice Crystal Icing Physics Test in the NASA Propulsion Systems Laboratory

    NASA Technical Reports Server (NTRS)

    King, Michael C.; Bachalo, William; Kurek, Andrzej

    2017-01-01

    This paper presents particle measurements by the Artium Technologies, Inc. Phase Doppler Interferometer and High Speed Imaging instruments from the first Fundamental Ice Crystal Icing Physics test conducted in the NASA Propulsion Systems Laboratory. The work focuses on humidity sweeps at a larger and a smaller median volumetric diameter. The particle size distribution, number density, and water content measured by the Phase Doppler Interferometer and High Speed Imaging instruments from the sweeps are presented and compared. The current capability for these two instruments to measure and discriminate ICI conditions is examined.

  3. Particle Size Measurements from the first Fundamentals of Ice Crystal Icing Physics Test in the NASA Propulsion Systems Laboratory

    NASA Technical Reports Server (NTRS)

    King, Michael C.; Bachalo, William; Kurek, Andrzej

    2017-01-01

    This presentation shows particle measurements by the Artium Technologies, Inc. Phase Doppler Interferometer and High Speed Imaging instruments from the first Fundamental Ice Crystal Icing Physics test conducted in the NASA Propulsion Systems Laboratory. The work focuses on humidity sweeps at a larger and a smaller median volumetric diameter. The particle size distribution, number density, and water content measured by the Phase Doppler Interferometer and High Speed Imaging instruments from the sweeps are presented and compared. The current capability for these two instruments to measure and discriminate ICI conditions is examined.

  4. 78 FR 44142 - Modification of Two National Customs Automation Program (NCAP) Tests Concerning Automated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... efforts are accomplished through phased releases of ACE component functionality designed to introduce new... designed to evaluate planned components of the NCAP. This test is authorized pursuant to Sec. 101.9(b) of... import meat, poultry, or egg products or ``Samples for Laboratory Examination, Research, Evaluative...

  5. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species

    EPA Science Inventory

    The authors developed a toxicity database for unionid mussels to examine the extent of intra- and interlaboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the 2 life stages; and the variation in se...

  6. A Standardized Soil Ecotoxicological Test Using Red Worms (Eisenia fetida).

    ERIC Educational Resources Information Center

    Paradise, Christopher J.

    2001-01-01

    Describes a simple, inexpensive test for soil contamination that can be used in a variety of courses to examine the effects of soil toxicity, to practice standardized laboratory procedures, to study experimental design and data analysis, or to investigate earthworm ecology. Presents background information along with details regarding equipment,…

  7. Psychological opportunities and hazards in predictive genetic testing for cancer risk.

    PubMed

    Codori, A M

    1997-03-01

    Although the availability of genetic tests seems like an unequivocally favorable turn of events, they are, in fact, not without controversy. At the center of the controversy is a question regarding the risks and benefits of genetic testing. Many geneticists, ethicists, psychologists, and persons at risk for cancer are concerned about the potentially adverse psychological effects of genetic testing on tested persons and their families. In addition, the screening and interventions that are useful in the general population remain to be shown effective in those with high genetic cancer risk. Consequently, there have been calls for caution in moving genetic testing out of research laboratories and into commercial laboratories until their impact and the effectiveness of cancer prevention strategies can be studied. This article examines the arguments and data for and against this caution, citing examples related to hereditary nonpolyposis colon cancer and drawing upon literature on testing for other genetic diseases.

  8. Naval Research Laboratory Industrial Chemical Analysis and Respiratory Filter Standards Development

    DTIC Science & Technology

    2017-09-29

    Filter Standards Development September 29, 2017 Approved for public release; distribution is unlimited. Thomas E. suTTo Materials and Systems Branch...LIMITATION OF ABSTRACT Naval Research Laboratory Industrial Chemical Analysis and Respiratory Filter Standards Development Thomas E. Sutto Naval Research...approach, developed by NRL, is tested by examining the filter behavior against a number of chemicals to determine if the NRL approach resulted in the

  9. Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital

    PubMed Central

    Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

    2016-01-01

    Introduction Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. Materials and methods A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. Results A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist’s work station (caused by a preference for microbiological testing prior to CSF chemistry). Conclusion A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction. PMID:27346964

  10. Proficiency testing of Hb A1c: a 4-year experience in Taiwan and the Asian Pacific region.

    PubMed

    Shiesh, Shu-Chu; Wiedmeyer, Hsiao-Mei; Kao, Jau-Tsuen; Vasikaran, Samuel D; Lopez, Joseph B

    2009-10-01

    The correlation between hemoglobin A(1c) (Hb A(1c)) and risk for complications in diabetic patients heightens the need to measure Hb A(1c) with accuracy. We evaluated the current performance for measuring Hb A(1c) in the Asian and Pacific region by examining data submitted by laboratories participating in the Taiwan proficiency-testing program. Five fresh-pooled blood samples were sent to participating laboratories twice each year. The results were evaluated against target values assigned by the National Glycohemoglobin Standardization Program network laboratories; a passing criterion of +/-7% of the target value was used. Measurement uncertainty at Hb A(1c) concentrations of 7.0% and 8.0% were determined. A total of 276 laboratories from 11 countries took part in the Hb A(1c) survey. At the Hb A(1c) concentrations tested method-specific interlaboratory imprecision (CVs) were 1.1%-13.9% in 2005, 1.3%-10.1% in 2006, 1.2%-8.2% in 2007, and 1.1%-6.1% in 2008. Differences between target values and median values from the commonly used methods ranged from -0.24% to 0.22% Hb A(1c) in 2008. In 2005 83% of laboratories passed the survey, and in 2008 93% passed. At 7.0% Hb A(1c), measurement uncertainty was on average 0.49% Hb A(1c). The use of accuracy-based proficiency testing with stringent quality criteria has improved the performance of Hb A(1c) testing in the Asian and Pacific laboratories during the 4 years of assessment.

  11. Management of laboratory data and information exchange in the electronic health record.

    PubMed

    Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

    2015-03-01

    In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

  12. Behaviour in captivity predicts some aspects of natural behaviour, but not others, in a wild cricket population

    PubMed Central

    Fisher, David N.; James, Adèle; Rodríguez-Muñoz, Rolando; Tregenza, Tom

    2015-01-01

    Examining the relevance of ‘animal personality’ involves linking consistent among- and within-individual behavioural variation to fitness in the wild. Studies aiming to do this typically assay personality in captivity and rely on the assumption that measures of traits in the laboratory reflect their expression in nature. We examined this rarely tested assumption by comparing laboratory and field measurements of the behaviour of wild field crickets (Gryllus campestris) by continuously monitoring individual behaviour in nature, and repeatedly capturing the same individuals and measuring their behaviour in captivity. We focused on three traits that are frequently examined in personality studies: shyness, activity and exploration. All of them showed repeatability in the laboratory. Laboratory activity and exploration predicted the expression of their equivalent behaviours in the wild, but shyness did not. Traits in the wild were predictably influenced by environmental factors such as temperature and sunlight, but only activity showed appreciable within-individual repeatability. This suggests that some behaviours typically studied as personality traits can be accurately assayed in captivity, but the expression of others may be highly context-specific. Our results highlight the importance of validating the relevance of laboratory behavioural assays to analogous traits measured in the wild. PMID:26019161

  13. [Analysis on 2011 quality control results on aerobic plate count of microbiology laboratories in China].

    PubMed

    Han, Haihong; Li, Ning; Li, Yepeng; Fu, Ping; Yu, Dongmin; Li Zhigang; Du, Chunming; Guo, Yunchang

    2015-01-01

    To test the aerobic plate count examining capability of microbiology laboratories, to ensure the accuracy and comparability of quantitative bacteria examination results, and to improve the quality of monitoring. The 4 different concentration aerobic plate count piece samples were prepared and noted as I, II, III and IV. After homogeneity and stability tests, the samples were delivered to monitoring institutions. The results of I, II, III samples were logarithmic transformed, and evaluated with Z-score method using the robust average and standard deviation. The results of IV samples were evaluated as "satisfactory" when reported as < 10 CFU/piece or as "not satisfactory" otherwise. Pearson χ2 test was used to analyze the ratio results. 309 monitoring institutions, which was 99.04% of the total number, reported their results. 271 institutions reported a satisfactory result, and the satisfactory rate was 87.70%. There was no statistical difference in satisfactory rates of I, II and III samples which were 81.52%, 88.30% and 91.40% respectively. The satisfactory rate of IV samples was 93.33%. There was no statistical difference in satisfactory rates between provincial and municipal CDC. The quality control program has provided scientific data that the aerobic plate count capability of the laboratories meets the requirements of monitoring tasks.

  14. Quality of the clinical laboratory department in a specialized hospital in Alexandria, Egypt.

    PubMed

    Elhoseeny, T A; Mohammad, E K

    2013-01-01

    Assessment and improvement of turnaround times (TAT) as well as customer satisfaction is essential for laboratory quality management. This study in a specialized hospital in Alexandria, Egypt measured the current TAT for outpatient department bilirubin samples and evaluated the satisfaction of physicians with aspects of clinical laboratory services. While the mean TAT for 110 bilirubin tests [58.1 (SD 31.8) min] was within the College of American Pathologists' benchmark, the 90th percentile was long (96.7 min); 62.7% of tests were reported within 60 min. The mean overall satisfaction score of physicians (range 1-5) was 3.46 (SD 0.49). The highest satisfaction rating was for staff courtesy while the lowest ratings were for laboratory management responsiveness, outpatient stat TAT and critical value notification. Quality or reliability of results was judged by physicians as the most important factor (32.3%), followed by routine test TAT (18.5%). Further analysis of the different steps of the TAT would be helpful and follow-up through examining outliers is recommended

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    None, None

    This report is concerned with the nature and scope of the technical services to be rendered and the general plan proposed for operation of Building 3525, High Radiation Level Examination Laboratory (HRLEL). The role of postirradiation examination in implementing the over- all task of irradiation testing for various programs under way at the Oak Ridge National Laboratory (ORNL) and the importance of this effort to the United Stat es reactor development program are stressed . The shielded-cell complex with provisions for remote decontamination, hot-equipment storage, and maintenance is described, as well as other supporting activities which are incorporated into themore » facility. The proposed technical functions include general observation, mensuration, nondestructive testing, burnup and induced-activity measurements, fission-gas sampling and analysis, corrosion evaluation and related measurements, disassembly and cutup, metallographic examination, mechanical-property determinations , and x -ray diffraction analyses. Equipment design and operational features to improve detection and measurement of selected properties in radioactive material s are described, also. The current status on design, procurement, construction, and preoperational testing of in- cell equipment in the mockup is presented along with a forecast of future needs. The mode of operation, manpower requirements, and management of the facility are discussed.« less

  16. Radiometric calibration of an airborne multispectral scanner. [of Thematic Mapper Simulator

    NASA Technical Reports Server (NTRS)

    Markham, Brian L.; Ahmad, Suraiya P.; Jackson, Ray D.; Moran, M. S.; Biggar, Stuart F.; Gellman, David I.; Slater, Philip N.

    1991-01-01

    The absolute radiometric calibration of the NS001 Thematic Mapper Simulator reflective channels was examined based on laboratory tests and in-flight comparisons to ground measurements. The NS001 data are calibrated in-flight by reference to the NS001 internal integrating sphere source. This source's power supply or monitoring circuitry exhibited greater instability in-flight during 1988-1989 than in the laboratory. Extrapolating laboratory behavior to in-flight data resulted in 7-20 percent radiance errors relative to ground measurements and atmospheric modeling. Assuming constancy in the source's output between laboraotry and in-flight resulted in generally smaller errors. Upgrades to the source's power supply and monitoring circuitry in 1990 improved its in-flight stability, though in-flight ground reflectance based calibration tests have not yet been performed.

  17. Response of bed mobility to sediment supply in natural gravel bed channels: A detailed examination and evaluation of mobility parameters

    Treesearch

    T. E. Lisle; J. M. Nelson; B. L. Barkett; J. Pitlick; M. A. Madej

    1998-01-01

    Recent laboratory experiments have shown that bed mobility in gravel bed channels responds to changes in sediment supply, but detailed examinations of this adjustment in natural channels have been lacking, and practical methodologies to measure bed mobility have not been tested. We examined six gravel-bed, alternate-bar channels which have a wide range in annual...

  18. 42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supportive of the facility as a whole and of benefit to patients in general. Examples of administrative... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre...

  19. 42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... are supportive of the facility as a whole and of benefit to patients in general. Examples of... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre...

  20. 42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre-dialysis or post-dialysis basis. (4) Insertion of catheters for patients who are on peritoneal dialysis and... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...

  1. 42 CFR 414.310 - Determination of reasonable charges for physician services furnished to renal dialysis patients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Pre-dialysis and post-dialysis examinations, or examinations that could have been furnished on a pre-dialysis or post-dialysis basis. (4) Insertion of catheters for patients who are on peritoneal dialysis and... laboratory test results, nurses' notes and any other medical documentation, as a basis for— (i) Adjustment of...

  2. Modeling Canadian Quality Control Test Program for Steroid Hormone Receptors in Breast Cancer: Diagnostic Accuracy Study.

    PubMed

    Pérez, Teresa; Makrestsov, Nikita; Garatt, John; Torlakovic, Emina; Gilks, C Blake; Mallett, Susan

    The Canadian Immunohistochemistry Quality Control program monitors clinical laboratory performance for estrogen receptor and progesterone receptor tests used in breast cancer treatment management in Canada. Current methods assess sensitivity and specificity at each time point, compared with a reference standard. We investigate alternative performance analysis methods to enhance the quality assessment. We used 3 methods of analysis: meta-analysis of sensitivity and specificity of each laboratory across all time points; sensitivity and specificity at each time point for each laboratory; and fitting models for repeated measurements to examine differences between laboratories adjusted by test and time point. Results show 88 laboratories participated in quality control at up to 13 time points using typically 37 to 54 histology samples. In meta-analysis across all time points no laboratories have sensitivity or specificity below 80%. Current methods, presenting sensitivity and specificity separately for each run, result in wide 95% confidence intervals, typically spanning 15% to 30%. Models of a single diagnostic outcome demonstrated that 82% to 100% of laboratories had no difference to reference standard for estrogen receptor and 75% to 100% for progesterone receptor, with the exception of 1 progesterone receptor run. Laboratories with significant differences to reference standard identified with Generalized Estimating Equation modeling also have reduced performance by meta-analysis across all time points. The Canadian Immunohistochemistry Quality Control program has a good design, and with this modeling approach has sufficient precision to measure performance at each time point and allow laboratories with a significantly lower performance to be targeted for advice.

  3. [Importance of electromiographic examination in diagnostification and monitoring of chronic inflammatory demyelinating polyneuropathy].

    PubMed

    Damjan, Igor; Cvijanović, Milan; Erak, Marko

    2010-01-01

    Polyneuropathies or peripheral neuropathies present a dysfunction or disease of larger number of peripheral nerves or their dysfunction. Considering their morbidity - mortality characteristics they present an important aspect in daily clinical practice. One particular polyneuropathy that deserves special review is chronic inflammatory demyelinating polyneuropathy, which, due to its clinical-laboratory presentation, does not include the group of "simple" neuropathies, thus requiring further examinations. Neurophysiological testing should be performed using the protocol for neuropathy examinations. Neurophysiological examination, during the electroneurographic examination, shows neurographic parameters referring to polyneuropatic demyelinating type of lesion, while the electromyographic finding records the presence of neuropathic lesions (denervation activity, great action potentials with a reduced sample). A 54-year-old patient was diagnosed to have a "complicated" demyelinating polyneuropathy according to the clinical-laboratory findings and electromyographic examination. Exclusion criteria, targeted diagnostic examinations, considering the mentioned peripheral neuropathies, pointed to acute inflammatory demyelinating polyneuropathy. However, the chronic inflammatory demyelinating polyneuropathy was finally differentiated during the clinical and electromyographic monitoring.

  4. Diagnostic Accuracy of History, Physical Examination, Laboratory Tests, and Point-of-care Ultrasound for Pediatric Acute Appendicitis in the Emergency Department: A Systematic Review and Meta-analysis.

    PubMed

    Benabbas, Roshanak; Hanna, Mark; Shah, Jay; Sinert, Richard

    2017-05-01

    Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. The aim of this study was to determine the utility of history, physical examination, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients. We performed a systematic review and meta-analysis and used a test-treatment threshold model to identify diagnostic findings that could rule in/out AA and obviate the need for further imaging studies, specifically computed tomography (CT) scan, magnetic resonance imaging (MRI), and radiology department ultrasound (RUS). We searched PubMed, EMBASE, and SCOPUS up to October 2016 for studies on ED pediatric patients with abdominal pain. Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality and applicability of included studies. Positive and negative likelihood ratios (LR+ and LR-) for diagnostic modalities were calculated and when appropriate data was pooled using Meta-DiSc. Based on the available literature on the test characteristics of different imaging modalities and applying the Pauker-Kassirer method we developed a test-treatment threshold model. Twenty-one studies were included encompassing 8,605 patients with weighted AA prevalence of 39.2%. Studies had variable quality using the QUADAS-2 tool with most studies at high risk of partial verification bias. We divided studies based on their inclusion criteria into two groups of "undifferentiated abdominal pain" and abdominal pain "suspected of AA." In patients with undifferentiated abdominal pain, history of "pain migration to right lower quadrant (RLQ)" (LR+ = 4.81, 95% confidence interval [CI] = 3.59-6.44) and presence of "cough/hop pain" in the physical examination (LR+ = 7.64, 95% CI = 5.94-9.83) were most strongly associated with AA. In patients suspected of AA none of the history or laboratory findings were strongly associated with AA. Rovsing's sign was the physical examination finding most strongly associated with AA (LR+ = 3.52, 95% CI = 2.65-4.68). Among different PAS cutoff points, PAS ≥ 9 (LR+ = 5.26, 95% CI = 3.34-8.29) was most associated with AA. None of the history, physical examination, laboratory tests findings, or PAS alone could rule in or rule out AA in patients with undifferentiated abdominal pain or those suspected of AA. ED-POCUS had LR+ of 9.24 (95% CI = 6.24-13.28) and LR- of 0.17 (95% CI = 0.09-0.30). Using our test-treatment threshold model, positive ED-POCUS could rule in AA without the use of CT and MRI, but negative ED-POCUS could not rule out AA. Presence of AA is more likely in patients with undifferentiated abdominal pain migrating to the RLQ or when cough/hop pain is present in the physical examination. Once AA is suspected, no single history, physical examination, laboratory finding, or score attained on PAS can eliminate the need for imaging studies. Operating characteristics of ED-POCUS are similar to those reported for RUS in literature for diagnosis of AA. In ED patients suspected of AA, a positive ED-POCUS is diagnostic and obviates the need for CT or MRI while negative ED-POCUS is not enough to rule out AA. © 2017 by the Society for Academic Emergency Medicine.

  5. Outcomes assessment of the regional health information exchange: a five-year follow-up study.

    PubMed

    Mäenpää, T; Asikainen, P; Gissler, M; Siponen, K; Maass, M; Saranto, K; Suominen, T

    2011-01-01

    The implementation of a technology such as health information exchange (HIE) through a Regional Health Information System (RHIS) may improve the mobilization of health care information electronically across organizations. There is a need to coordinate care and bring together regional and local stakeholders. To describe how HIE had influenced health care delivery in one hospital district area in Finland. Trend analysis was used to evaluate the influence of a regional HIE. We conducted a retrospective, longitudinal study for the period 2004-2008 for the eleven federations of municipalities in the study area. We reviewed statistical health data from the time of implementation of an RHIS. The t-test was used to determine statistical significance. The selected outcomes were the data obtained from the regional database on total appointments, emergency department visits, laboratory tests and radiology examinations, and selected laboratory tests and radiology examinations carried out in both primary care and special health care. Access to HIE may have influenced health care delivery in the study area. There are indications that there is a connection between access to regional HIE and the number of laboratory tests and radiology examinations performed in both primary care and specialized health care, as observed in the decreased frequency in outcomes such as radiology examinations, number of appointments, and emergency department visits in the study environment. The decreased frequencies of the latter suggest an increased efficiency of outpatient care, but we were not able to estimate to what extent the readily available comprehensive clinical information contributed to these trends. Outcome assessment of HIE through an RHIS is essential for the success of health information technology (HIT) and as evidence to use in the decision-making process. As health care information becomes more digital, it increases the potential for a strong HIE effect on health care delivery.

  6. Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study.

    PubMed

    Gillis, Jennifer; Bayoumi, Ahmed M; Burchell, Ann N; Cooper, Curtis; Klein, Marina B; Loutfy, Mona; Machouf, Nima; Montaner, Julio Sg; Tsoukas, Chris; Hogg, Robert S; Raboud, Janet

    2015-10-26

    As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities. We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements. Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements. Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.

  7. An evaluation of outcomes following the replacement of traditional histology laboratories with self-study modules.

    PubMed

    Thompson, Andrew R; Lowrie, Donald J

    2017-06-01

    Changes in medical school curricula often require educators to develop teaching strategies that decrease contact hours while maintaining effective pedagogical methods. When faced with this challenge, faculty at the University of Cincinnati College of Medicine converted the majority of in-person histology laboratory sessions to self-study modules that utilize multiple audiovisual modalities and a virtual microscope platform. Outcomes related to this shift were investigated through performance on in-house examinations, results of the United States Medical Licensing Examination ® (USMLE ® ) Step 1 Examination, and student feedback. Medical School College Admissions Test ® (MCAT ® ) scores were used as a covariate when comparing in-house examinations. Results revealed no significant change in performance on in-house examinations when the content being assessed was controlled (F(2, 506) = 0.676, P = 0.51). A significant improvement in overall practical examination grade averages was associated with the self-study modules (F(6, 1164) = 10.213, P < 0.01), but gradual changes in examination content may explain this finding. The histology and cell biology portion of USMLE Step 1 Examination remained consistent throughout the time period that was investigated. Student feedback regarding the self-study modules was positive and suggested that features such as instructor narrated videos were an important component of the self-study modules because they helped recreate the experience of in-person laboratory sessions. Positive outcomes from the student perspective and no drop in examination performance suggests that utilizing self-study modules for histology laboratory content may be an option for educators faced with the challenge of reducing contact hours without eliminating content. Anat Sci Educ 10: 276-285. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  8. Transient Testing of Nuclear Fuels and Materials in the United States

    NASA Astrophysics Data System (ADS)

    Wachs, Daniel M.

    2012-12-01

    The United States has established that transient irradiation testing is needed to support advanced light water reactors fuel development. The U.S. Department of Energy (DOE) has initiated an effort to reestablish this capability. Restart of the Transient Testing Reactor (TREAT) facility located at the Idaho National Laboratory (INL) is being considered for this purpose. This effort would also include the development of specialized test vehicles to support stagnant capsule and flowing loop tests as well as the enhancement of postirradiation examination capabilities and remote device assembly capabilities at the Hot Fuel Examination Facility. It is anticipated that the capability will be available to support testing by 2018, as required to meet the DOE goals for the development of accident-tolerant LWR fuel designs.

  9. Microbiologic Testing for 503A Sterile-Compounding Pharmacies.

    PubMed

    Mixon, William; Roth, Abby

    2017-01-01

    Compounding pharmacists must ensure that the sterile preparations they dispense are free of microbiologic contamination. Working in a cleanroom under controlled conditions (proper differential air pressure, temperature, and humidity; acceptable levels of viable and nonviable airborne particles and surface counts, etc.) and testing the efficacy of cleaning and disinfecting practices via environmental monitoring (viable-air and surface testing, glove-fingertip-thumb testing, etc.) are essential to preparing contamination-free medications. Sterile-compounding pharmacists must understand how to monitor their cleanroom environment and, if they perform testing in house, to interpret the results of simple microbiologic tests (a skill helpful even when tests are outsourced to a contract laboratory). In this article, which pertains to 503A sterile compounding, and is based on the current version of United States Pharmacopeia (USP) Chapter <797>, basic concepts in microbiology and the microbial tests that can be performed and interpreted in house and those that must be outsourced are discussed. Streamlining communication with contract laboratory personnel is reviewed. Requirements for an inhouse microbiology laboratory are presented, and the advantages and disadvantages of inhouse and outsourced testing are examined. A list of suggested reading is provided for easy reference. In a subsequent article, environmental monitoring and analysis will be addressed in detail. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  10. [The development and implementation of polymerase chain reaction to detect in real-time operation mode yersinia pestis in field material].

    PubMed

    Afanas'ev, M V; Chipanin, E V; Shestakov, V E; Denisov, A V; Fomina, L A; Ostiak, A S; Balakhonov, S V

    2013-03-01

    The article presents the results of development and practical implementation of system of polymerase chain reaction testing in real-time operation mode to detect agent of plague infield material. In laboratory conditions the system demonstrated good results and hence it was applied in conditions of field laboratory of epidemiologic team during planned epizootologic examination of Gorno-Altaisk hot spot of plague. The sampling consisted of more than 1400 objects. It was demonstrated that high sensitivity and specificity is immanent to proposed system. The adaptation of the system to the real time amplifier "Smart Cycler" (Cephid, USA) having some specific technical characteristics makes it possible to consider the proposed test-system as an effective sensitive and precise instrument for screening studies in the process of regular epizootologic examinations of hot spots of plague.

  11. Varicella Zoster Virus Necrotizing Retinitis in Two Patients with Idiopathic CD4 Lymphocytopenia.

    PubMed

    Gupta, Meenakashi; Jardeleza, Maria Stephanie R; Kim, Ivana; Durand, Marlene L; Kim, Leo; Lobo, Ann-Marie

    2016-10-01

    Progressive outer retinal necrosis (PORN) associated with varicella zoster virus (VZV) is usually diagnosed in HIV positive or immunosuppressed patients. We report two cases of immunocompetent patients with necrotizing viral retinitis found to have idiopathic CD4 lymphocytopenia. Clinical presentation, examination, imaging, and laboratory testing of two patients with VZV retinitis are presented. An HIV negative patient with history of herpes zoster presented with rapid loss of vision and examination consistent with PORN. PCR testing confirmed VZV. Lymphocytopenia was noted with a CD4 count of 25/mm(3). A second HIV negative patient presented with blurred vision and lid swelling and was found to have peripheral VZV retinitis confirmed by PCR. Laboratory workup revealed lymphocytopenia with a CD4 count of 133/mm(3). VZV necrotizing retinitis classic for PORN can occur in HIV negative patients. Idiopathic CD4 lymphocytopenia should be considered healthy patients who develop ocular infections seen in the immunocompromised.

  12. Impact of nonintrusive clinical decision support systems on laboratory test utilization in a large academic centre.

    PubMed

    Eaton, Kevin P; Chida, Natasha; Apfel, Ariella; Feldman, Leonard; Greenbaum, Adena; Tuddenham, Susan; Kendall, Emily A; Pahwa, Amit

    2018-06-01

    The near-universal prevalence of electronic health records (EHRs) has made the utilization of clinical decision support systems (CDSS) an integral strategy for improving the value of laboratory ordering. Few studies have examined the effectiveness of nonintrusive CDSS on inpatient laboratory utilization in large academic centres. Red blood cell folate, hepatitis C virus viral loads and genotypes, and type and screens were selected for study. We incorporated the appropriate indications for these labs into text that accompanied the laboratory orders in our hospital's EHR. Providers could proceed with the order without additional clicks. An interrupted time-series analysis was performed, and the primary outcome was the rate of tests ordered on all inpatient medicine floors. The rate of folate tests ordered per monthly admissions showed no significant level change at the time of the intervention with only a slight decrease in rate of 0.0109 (P = .07). There was a 43% decrease in the rate of hepatitis C virus tests per monthly admissions immediately after the intervention with a decrease of 0.0135 tests per monthly admissions (P = .02). The rate of type and screens orders per patient days each month had a significant downward trend by 0.114 before the intervention (P = .04) but no significant level change at the time of the intervention or significant change in rate after the intervention. Our study suggests that nonintrusive CDSS should be evaluated for individual laboratory tests to ensure only effective alerts continue to be used so as to avoid increasing EHR fatigue. © 2018 John Wiley & Sons, Ltd.

  13. [Establishing biological reference intervals of alanine transaminase for clinical laboratory stored database].

    PubMed

    Guo, Wei; Song, Binbin; Shen, Junfei; Wu, Jiong; Zhang, Chunyan; Wang, Beili; Pan, Baishen

    2015-08-25

    To establish an indirect reference interval based on the test results of alanine aminotransferase stored in a laboratory information system. All alanine aminotransferase results were included for outpatients and physical examinations that were stored in the laboratory information system of Zhongshan Hospital during 2014. The original data were transformed using a Box-Cox transformation to obtain an approximate normal distribution. Outliers were identified and omitted using the Chauvenet and Tukey methods. The indirect reference intervals were obtained by simultaneously applying nonparametric and Hoffmann methods. The reference change value was selected to determine the statistical significance of the observed differences between the calculated and published reference intervals. The indirect reference intervals for alanine aminotransferase of all groups were 12 to 41 U/L (male, outpatient), 12 to 48 U/L (male, physical examination), 9 to 32 U/L (female, outpatient), and 8 to 35 U/L (female, physical examination), respectively. The absolute differences when compared with the direct results were all smaller than the reference change value of alanine aminotransferase. The Box-Cox transformation combined with the Hoffmann and Tukey methods is a simple and reliable technique that should be promoted and used by clinical laboratories.

  14. Some Remarks on Practical Aspects of Laboratory Testing of Deep Soil Mixing Composites Achieved in Organic Soils

    NASA Astrophysics Data System (ADS)

    Kanty, Piotr; Rybak, Jarosław; Stefaniuk, Damian

    2017-10-01

    This paper presents the results of laboratory testing of organic soil-cement samples are presented in the paper. The research program continues previously reported the authors’ experiences with cement-fly ash-soil sample testing. Over 100 of compression and a dozen of tension tests have been carried out altogether. Several samples were waiting for failure test for over one year after they were formed. Several factors, like: the large amount of the tested samples, a long observation time, carrying out the tests in complex cycles of loading and the possibility of registering the loads and deformation in the axial and lateral direction - have made it possible to take into consideration numerous interdependencies, three of which have been presented in this work: the increments of compression strength, the stiffness of soil-cement in relation to strength and the tensile strength. Compressive strength, elastic modulus and tensile resistance of cubic samples were examined. Samples were mixed and stored in the laboratory conditions. Further numerical analysis in the Finite Element Method numerical code Z_Soil, were performed on the basis of laboratory test results. Computations prove that cement-based stabilization of organic soil brings serious risks (in terms of material capacity and stiffness) and Deep Soil Mixing technology should not be recommended for achieving it. The numerical analysis presented in the study below includes only one type of organic and sandy soil and several possible geometric combinations. Despite that, it clearly points to the fact that designing the DSM columns in the organic soil may be linked with a considerable risk and the settlement may reach too high values. During in situ mixing, the organic material surrounded by sand layers surely mixes with one another in certain areas. However, it has not been examined and it is difficult to assume such mixing already at the designing stage. In case of designing the DSM columns which goes through a thin layer of organic soil it is recommended to carry out each time the core drilling which checks the degree of material mixing and their strength.

  15. [Comparative analysis of malaria detection ability of laboratories in Shanghai City from 2012 to 2015].

    PubMed

    Zhen-Yu, Wang; Li, Jiang; Yao-Guang, Zhang; Min, Zhu; Xiao-Ping, Zhang; Xiao-Jiang, Ma; Qian, Zhu; Yan-Yan, He; Shou-Fu, Jiang; Li, Cai

    2017-02-27

    To compare the application effects of three methods, namely microscopic examination, antigen detection (RDT) and nucleic acid test (PCR) in malaria detection between municipal and districts/counties centers for disease control and prevention in Shanghai, and analyze the malaria detection ability of the laboratories in Shanghai. The blood smears, whole blood samples, case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention, and the detection results were analyzed and compared. A total of 212 samples with complete data were submitted by all districts (counties) in Shanghai from 2012 to 2015, the samples submitted by Jinshan Districts were the most (41.98%), and among the first diagnosis hospitals, those submitted by the tertiary hospitals were the most (82.07%). The submitted samples in the whole year were increased gradually from January to October. All the 212 samples were detected by three methods (the microscopic examination, RDT and PCR) in the laboratory of Shanghai Municipal Center for Disease Control and Prevention, and 167 were tested and confirmed comprehensively as positives, accounting for 78.77%, and 45 were confirmed as negatives, accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level, totally 153 were tested as positives, accounting for 72.17%, 41 were unclassified, accounting for 19.34%, 53 were negative, accounting for 25.00%, and 6 were undetected, accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%, and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests between those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention, 37 samples were misjudged by the laboratories of district/county level. Almost all (99.37%) of the confirmed malaria cases were imported overseas, including Africa (85.44%), Asia (13.92%) and America (0.63%). The surveillance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource integration.

  16. Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering behaviour.

    PubMed

    Meidani, Z; Mousavi, G A; Kheirkhah, D; Benar, N; Maleki, M R; Sharifi, M; Farrokhian, A

    2017-12-01

    Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians' behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour.

  17. Experience with specifications applicable to certification. [of photovoltaic modules for large-scale application

    NASA Technical Reports Server (NTRS)

    Ross, R. G., Jr.

    1982-01-01

    The Jet Propulsion Laboratory has developed a number of photovoltaic test and measurement specifications to guide the development of modules toward the requirements of future large-scale applications. Experience with these specifications and the extensive module measurement and testing that has accompanied their use is examined. Conclusions are drawn relative to three aspects of product certification: performance measurement, endurance testing and safety evaluation.

  18. The Performance of Left-Handed Participants on a Preferential Reaching Test

    ERIC Educational Resources Information Center

    Mamolo, Carla M.; Roy, Eric A.; Bryden, Pamela J.; Rohr, Linda E.

    2005-01-01

    Previous research in our laboratory has examined the distribution of preferred hand (PH) reaches in working space with right-handed participants. In one study, we examined the effects of tool position and task demands on the frequency of PH reaches with right-handers (Mamolo, Roy, Bryden, & Rohr, 2004). We found that PH reaches were at a maximum…

  19. Microgliomatosis in a Schnauzer dog.

    PubMed

    Willard, M D; Delahunta, A

    1982-04-01

    Microgliomatosis was found in the central nervous system of a 7-year-old male Standard Schnauzer. History, neurologic examination, laboratory tests and electrodiagnostics could not localize the disease process in the central nervous system. The animal was not treated, continued to deteriorate, and was euthanatized approximately 8 weeks after clinical signs were first detected. Diagnosis was made upon histologic examination of the brain.

  20. Laboratory ultrasonic pulse velocity logging for determination of elastic properties from rock core

    NASA Astrophysics Data System (ADS)

    Blacklock, Natalie Erin

    During the development of deep underground excavations spalling and rockbursting have been recognized as significant mechanisms of violent brittle failure. In order to predict whether violent brittle failure will occur, it is important to identify the location of stiffness transitions that are associated with geologic structure. One approach to identify the effect of geologic structures is to apply borehole geophysical tools ahead of the tunnel advance. Stiffness transitions can be identified using mechanical property analysis surveys that combine acoustic velocity and density data to calculate acoustic estimates of elastic moduli. However, logistical concerns arise since the approach must be conducted at the advancing tunnel face. As a result, borehole mechanical property analyses are rarely used. Within this context, laboratory ultrasonic pulse velocity testing has been proposed as a potential alternative to borehole mechanical property analysis since moving the analysis to the laboratory would remove logistical constraints and improve safety for the evaluators. In addition to the traditional method of conducting velocity testing along the core axis, two new methodologies for point-focused testing were developed across the core diameter, and indirectly along intact lengths of drill core. The indirect test procedure was implemented in a continuous ultrasonic velocity test program along 573m of drill core to identify key geologic structures that generated transitions in ultrasonic elastic moduli. The test program was successful at identifying the location of geologic contacts, igneous intrusions, faults and shear structures. Ultrasonic values of Young's modulus and bulk modulus were determined at locations of significant velocity transitions to examine the potential for energy storage and energy release. Comparison of results from different ultrasonic velocity test configurations determined that the indirect test configuration provided underestimates for values of Young's modulus. This indicated that the test procedure will require modifications to improve coupling of the transducers to the core surface. In order to assess whether laboratory testing can be an alternative to borehole surveys, laboratory velocity testing must be directly assessed with results from acoustic borehole logging. There is also potential for the laboratory velocity program to be used to assess small scale stiffness changes, differences in mineral composition and the degree of fracturing of drill core.

  1. A comparison of traditional physical laboratory and computer-simulated laboratory experiences in relation to engineering undergraduate students' conceptual understandings of a communication systems topic

    NASA Astrophysics Data System (ADS)

    Javidi, Giti

    2005-07-01

    This study was designed to investigate an alternative to the use of traditional physical laboratory activities in a communication systems course. Specifically, this study examined whether as an alternative, computer simulation is as effective as physical laboratory activities in teaching college-level electronics engineering education students about the concepts of signal transmission, modulation and demodulation. Eighty undergraduate engineering students participated in the study, which was conducted at a southeastern four-year university. The students were randomly assigned to two groups. The groups were compared on understanding the concepts, remembering the concepts, completion time of the lab experiments and perception toward the laboratory experiments. The physical group's (n = 40) treatment was to conduct laboratory experiments in a physical laboratory. The students in this group used equipment in a controlled electronics laboratory. The Simulation group's (n = 40) treatment was to conduct similar experiments in a PC laboratory. The students in this group used a simulation program in a controlled PC lab. At the completion of the treatment, scores on a validated conceptual test were collected once after the treatment and again three weeks after the treatment. Attitude surveys and qualitative study were administered at the completion of the treatment. The findings revealed significant differences, in favor of the simulation group, between the two groups on both the conceptual post-test and the follow-up test. The findings also revealed significant correlation between simulation groups' attitude toward the simulation program and their post-test scores. Moreover, there was a significant difference between the two groups on their attitude toward their laboratory experience in favor of the simulation group. In addition, there was significant difference between the two groups on their lab completion time in favor of the simulation group. At the same time, the qualitative research has uncovered several issues not explored by the quantitative research. It was concluded that incorporating the recommendations acquired from the qualitative research, especially elements of incorporating hardware experience to avoid lack of hands-on skills, into the laboratory pedagogy should help improve students' experience regardless of the environment in which the laboratory is conducted.

  2. [Diagnosis and treatment options in vertigo syndromes].

    PubMed

    Strupp, M; Dieterich, M; Zwergal, A; Brandt, T

    2015-10-01

    The key to diagnosing vertigo and balance disorders is systematic analysis of case history with clinical examination of the vestibular, oculomotor, and cerebral systems in particular. Important criteria for differentiating between the various vertigo syndromes are 1) the time course of symptoms, 2) the type of symptoms, 3) modulating factors, and 4) associated symptoms. For clinical examination of the vestibular system, six important tests are available: assessment of spontaneous nystagmus, head impulse test, dynamic visual acuity, subjective visual verticality, positioning manoeuvre, and the Romberg test/gait analysis with eyes open and closed. On the basis of five clinical signs (vertical divergence, central fixation nystagmus, gaze-evoked nystagmus, saccades, normal head impulse test), the clinical examination is able to differentiate between acute central and peripheral vestibular syndromes with a sensitivity and specificity of over 90%. The most relevant laboratory examinations are caloric irrigation and the video head-impulse test for canal function and the vestibular evoked myogenic potentials for otolith function. Finally, treatment is based upon four therapeutic principles: physiotherapy, pharmacotherapy, psychotherapy, and in rare cases, surgery.

  3. 7 CFR 97.12 - Number and filing date of an application.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... LABORATORY TESTING PROGRAMS PLANT VARIETY AND PROTECTION The Application § 97.12 Number and filing date of an... request made by the examiner. If a foreign application is not in the English language, an English...

  4. Evaluation of thin asphalt overlay practice preserving Nebraska's asphalt pavements.

    DOT National Transportation Integrated Search

    2015-06-01

    This study examined the current thin asphalt overlay practices implemented in Nebraska. To that end, the mechanical : properties and performance characteristics of the two mixtures (i.e., SLX and SPH) were compared by carrying out : laboratory tests ...

  5. Hepatitis C Testing Practices and Prevalence in a High-risk Urban Ambulatory Care Setting

    PubMed Central

    Southern, William N.; Drainoni, Mari-Lynn; Smith, Bryce D.; Christiansen, Cindy L.; McKee, Diane; Gifford, Allen L.; Weinbaum, Cindy M.; Thompson, Devin; Koppelman, Elisa; Maher, Stacia; Litwin, Alain H.

    2010-01-01

    Approximately 3.2 million persons are chronically infected with the hepatitis C virus (HCV) in the U.S; most are not aware of their infection. Our objectives were to examine HCV testing practices to determine which patient characteristics are associated with HCV testing and positivity, and to estimate the prevalence of HCV infection in a high-risk urban population. The study subjects were all patients included in the baseline phase of the Hepatitis C Assessment and Testing Project (HepCAT), a serial cross-sectional study of HCV screening strategies. We examined all patients with a clinic visit to Montefiore Medical Center from 1/1/08 to 2/29/08. Demographic information, laboratory data and ICD-9 diagnostic codes from 3/1/97 – 2/29/08 were extracted from the electronic medical record. Risk factors for HCV were defined based on birth date, ICD-9 codes and laboratory data. The prevalence of HCV infection was estimated assuming that untested subjects would test positive at the same rate as tested subjects, based on risk-factors. Of 9579 subjects examined, 3803 (39.7%) had been tested for HCV and 438 (11.5%) were positive. The overall prevalence of HCV infection was estimated to be 7.7%. Risk factors associated with being tested and anti-HCV positivity included: born in the high-prevalence birth-cohort (1945-64), substance abuse, HIV infection, alcohol abuse, diagnosis of cirrhosis, end-stage renal disease, and ALT elevation. In a high-risk urban population, a significant proportion of patients were tested for HCV and the prevalence of HCV infection was high. Physicians appear to use a risk-based screening strategy to identify HCV infection. PMID:20497311

  6. Electronic medical records and efficiency and productivity during office visits.

    PubMed

    Furukawa, Michael F

    2011-04-01

    To estimate the relationship between electronic medical record (EMR) use and efficiency of utilization and provider productivity during visits to US office-based physicians. Cross-sectional analysis of the 2006-2007 National Ambulatory Medical Care Survey. The sample included 62,710 patient visits to 2625 physicians. EMR systems included demographics, clinical notes, prescription orders, and laboratory and imaging results. Efficiency was measured as utilization of examinations, laboratory tests, radiology procedures, health education, nonmedication treatments, and medications. Productivity was measured as total services provided per 20-minute period. Survey-weighted regressions estimated association of EMR use with services provided, visit intensity/duration, and productivity. Marginal effects were estimated by averaging across all visits and by major reason for visit. EMR use was associated with higher probability of any examination (7.7%, 95% confidence interval [CI] = 2.4%, 13.1%); any laboratory test (5.7%, 95% CI = 2.6%, 8.8%); any health education (4.9%, 95% CI = 0.2%, 9.6%); and fewer laboratory tests (-7.1%, 95% CI = -14.2%, -0.1%). During pre/post surgery visits, EMR use was associated with 7.3% (95% CI= -12.9%, -1.8%) fewer radiology procedures. EMR use was not associated with utilization of nonmedication treatments and medications, or visit duration. During routine visits for a chronic problem, EMR use was associated with 11.2% (95% CI = 5.7%, 16.8%) more diagnostic/screening services provided per 20-minute period. EMR use had a mixed association with efficiency and productivity during office visits. EMRs may improve provider productivity, especially during visits for a new problem and routine chronic care.

  7. Posttest examination of Sodium Loop Safety Facility experiments. [LMFBR

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Holland, J.W.

    In-reactor, safety experiments performed in the Sodium Loop Safety Facility (SLSF) rely on comprehensive posttest examinations (PTE) to characterize the postirradiation condition of the cladding, fuel, and other test-subassembly components. PTE information and on-line instrumentation data, are analyzed to identify the sequence of events and the severity of the accident for each experiment. Following in-reactor experimentation, the SLSF loop and test assembly are transported to the Hot Fuel Examination Facility (HFEF) for initial disassembly. Goals of the HFEF-phase of the PTE are to retrieve the fuel bundle by dismantling the loop and withdrawing the test assembly, to assess the macro-conditionmore » of the fuel bundle by nondestructive examination techniques, and to prepare the fuel bundle for shipment to the Alpha-Gamma Hot Cell Facility (AGHCF) at Argonne National Laboratory.« less

  8. Evaluation of an inhouse rapid ELISA test for detection of giardia in domestic sheep (Ovis aries).

    PubMed

    Wilson, Jolaine M; Hankenson, F Claire

    2010-11-01

    Sheep (Ovis aries) are increasingly used at our institution as models of human disease. Within the research environment, routine husbandry and handling of sheep has potential for transmission of zoonotic agents, including Giardia. The prevalence of Giardia in sheep may approach 68%. Classic diagnostic testing involves microscopic examination for fecal cysts or trophozoites; however, limitations of microscopy include time, labor, and potential false-negative results due to intermittent shedding. We wished to determine whether a commercial rapid ELISA used for Giardia detection in dogs and cats could be used in sheep. Fecal samples collected from sheep (n = 93) were tested with a combination of 6 methods: reference laboratory fecal flotation, reference laboratory ELISA, inhouse fecal flotation, and commercially available tests (enzyme immunoassay, direct fluorescence antibody assay, and rapid ELISA). Prevalence of Giardia infection in facility sheep was 11.8% (11 of 93 animals). Of the 11 samples considered positive, 3 were confirmed by multiple testing methods, and 5 were positive by microscopy alone. Inhouse fecal flotation for 8 samples was positive on only 1 of 2 consecutive testing days. The rapid ELISA test exhibited 0% sensitivity for sheep giardiasis. Overall, the examined methods had low sensitivities and low positive predictive values. Despite limitations, microscopic analysis of repeat fecal samples remained the most accurate diagnostic method for ovine giardiasis among the methods tested.

  9. Milliwatt Generator Project

    NASA Astrophysics Data System (ADS)

    Latimer, T. W.; Rinehart, G. H.

    1992-05-01

    This report covers progress on the Milliwatt Generator Project from April 1986 through March 1988. Activities included fuel processing and characterization, production of heat sources, fabrication of pressure-burst test units, compatibility studies, impact testing, and examination of surveillance units. The major task of the Los Alamos Milliwatt Generator Project is to fabricate MC2893A heat sources (4.0 W) for MC2730A radioisotope thermoelectric generators (RTG's) and MC3599 heat sources (4.5 W) for MC3500 RTG's. The MWG Project interfaces with the following contractors: Sandia National Laboratories, Albuquerque (designer); E.I. du Pont de Nemours and Co. (Inc.), Savannah River Plant (fuel); Monsanto Research Corporation, Mound Facility (metal hardware); and General Electric Company, Neutron Devices Department (RTG's). In addition to MWG fabrication activities, Los Alamos is involved in (1) fabrication of pressure-burst test units, (2) compatibility testing and evaluation, (3) examination of surveillance units, and (4) impact testing and subsequent examination of compatibility and surveillance units.

  10. ADHD Dimensions and Sluggish Cognitive Tempo Symptoms in Relation to Self-Report and Laboratory Measures of Neuropsychological Functioning in College Students.

    PubMed

    Jarrett, Matthew A; Rapport, Hannah F; Rondon, Ana T; Becker, Stephen P

    2017-06-01

    This study examined ADHD and sluggish cognitive tempo (SCT) symptoms in relation to self-report and laboratory measures of neuropsychological functioning in college students. College students ( N = 298, aged 17-25, 72% female) completed self-reports of ADHD, SCT, depression, sleep, functional impairment, and executive functioning (EF). Participants also completed a visual working memory task, a Stroop test, and the Conners' Continuous Performance Test-II (CPT-II). ADHD inattentive and SCT symptoms were strong predictors of self-reported EF, with inattention the strongest predictor of Time Management and Motivation and SCT the strongest predictor of Self-Organization/Problem Solving. SCT (but not inattention) was associated with Emotion Regulation. No relationships were found between self-reported symptoms and laboratory task performance. Between-group analyses were largely consistent with regression analyses. Self-reported ADHD and SCT symptoms are strongly associated with college students' self-reported EF, but relationships with laboratory task measures of neuropsychological functioning are limited.

  11. Pretest expectations strongly influence interpretation of abnormal laboratory results and further management

    PubMed Central

    2010-01-01

    Background Abnormal results of diagnostic laboratory tests can be difficult to interpret when disease probability is very low. Although most physicians generally do not use Bayesian calculations to interpret abnormal results, their estimates of pretest disease probability and reasons for ordering diagnostic tests may - in a more implicit manner - influence test interpretation and further management. A better understanding of this influence may help to improve test interpretation and management. Therefore, the objective of this study was to examine the influence of physicians' pretest disease probability estimates, and their reasons for ordering diagnostic tests, on test result interpretation, posttest probability estimates and further management. Methods Prospective study among 87 primary care physicians in the Netherlands who each ordered laboratory tests for 25 patients. They recorded their reasons for ordering the tests (to exclude or confirm disease or to reassure patients) and their pretest disease probability estimates. Upon receiving the results they recorded how they interpreted the tests, their posttest probability estimates and further management. Logistic regression was used to analyse whether the pretest probability and the reasons for ordering tests influenced the interpretation, the posttest probability estimates and the decisions on further management. Results The physicians ordered tests for diagnostic purposes for 1253 patients; 742 patients had an abnormal result (64%). Physicians' pretest probability estimates and their reasons for ordering diagnostic tests influenced test interpretation, posttest probability estimates and further management. Abnormal results of tests ordered for reasons of reassurance were significantly more likely to be interpreted as normal (65.8%) compared to tests ordered to confirm a diagnosis or exclude a disease (27.7% and 50.9%, respectively). The odds for abnormal results to be interpreted as normal were much lower when the physician estimated a high pretest disease probability, compared to a low pretest probability estimate (OR = 0.18, 95% CI = 0.07-0.52, p < 0.001). Conclusions Interpretation and management of abnormal test results were strongly influenced by physicians' estimation of pretest disease probability and by the reason for ordering the test. By relating abnormal laboratory results to their pretest expectations, physicians may seek a balance between over- and under-reacting to laboratory test results. PMID:20158908

  12. Pretest expectations strongly influence interpretation of abnormal laboratory results and further management.

    PubMed

    Houben, Paul H H; van der Weijden, Trudy; Winkens, Bjorn; Winkens, Ron A G; Grol, Richard P T M

    2010-02-16

    Abnormal results of diagnostic laboratory tests can be difficult to interpret when disease probability is very low. Although most physicians generally do not use Bayesian calculations to interpret abnormal results, their estimates of pretest disease probability and reasons for ordering diagnostic tests may--in a more implicit manner--influence test interpretation and further management. A better understanding of this influence may help to improve test interpretation and management. Therefore, the objective of this study was to examine the influence of physicians' pretest disease probability estimates, and their reasons for ordering diagnostic tests, on test result interpretation, posttest probability estimates and further management. Prospective study among 87 primary care physicians in the Netherlands who each ordered laboratory tests for 25 patients. They recorded their reasons for ordering the tests (to exclude or confirm disease or to reassure patients) and their pretest disease probability estimates. Upon receiving the results they recorded how they interpreted the tests, their posttest probability estimates and further management. Logistic regression was used to analyse whether the pretest probability and the reasons for ordering tests influenced the interpretation, the posttest probability estimates and the decisions on further management. The physicians ordered tests for diagnostic purposes for 1253 patients; 742 patients had an abnormal result (64%). Physicians' pretest probability estimates and their reasons for ordering diagnostic tests influenced test interpretation, posttest probability estimates and further management. Abnormal results of tests ordered for reasons of reassurance were significantly more likely to be interpreted as normal (65.8%) compared to tests ordered to confirm a diagnosis or exclude a disease (27.7% and 50.9%, respectively). The odds for abnormal results to be interpreted as normal were much lower when the physician estimated a high pretest disease probability, compared to a low pretest probability estimate (OR = 0.18, 95% CI = 0.07-0.52, p < 0.001). Interpretation and management of abnormal test results were strongly influenced by physicians' estimation of pretest disease probability and by the reason for ordering the test. By relating abnormal laboratory results to their pretest expectations, physicians may seek a balance between over- and under-reacting to laboratory test results.

  13. Development of fire test methods for airplane interior materials

    NASA Technical Reports Server (NTRS)

    Tustin, E. A.

    1978-01-01

    Fire tests were conducted in a 737 airplane fuselage at NASA-JSC to characterize jet fuel fires in open steel pans (simulating post-crash fire sources and a ruptured airplane fuselage) and to characterize fires in some common combustibles (simulating in-flight fire sources). Design post-crash and in-flight fire source selections were based on these data. Large panels of airplane interior materials were exposed to closely-controlled large scale heating simulations of the two design fire sources in a Boeing fire test facility utilizing a surplused 707 fuselage section. Small samples of the same airplane materials were tested by several laboratory fire test methods. Large scale and laboratory scale data were examined for correlative factors. Published data for dangerous hazard levels in a fire environment were used as the basis for developing a method to select the most desirable material where trade-offs in heat, smoke and gaseous toxicant evolution must be considered.

  14. Fitness testing of tennis players: How valuable is it?

    PubMed Central

    Fernandez-Fernandez, Jaime; Ulbricht, Alexander; Ferrauti, Alexander

    2014-01-01

    In tennis, sport-specific technical skills are predominant factors, although a complex profile of physical performance factors is also required. The fitness test batteries assist in examining tennis players’ capabilities for performance at different levels in the laboratory as well as in the field, in the junior or elite level. While laboratory tests can be, and are, used to evaluate basic performance characteristics of athletes in most individual sports, in a more specific approach, field-based methods are better suited to the demands of complex intermittent sports like tennis. A regular test battery performed at different periods of the year allows to obtain an individual's performance profile, as well as the ability to prescribe individual training interventions. Thus, the aim of the present review was to describe and evaluate the different physical tests recommended and used by practitioners, sports scientists and institutions (national tennis federations). PMID:24668375

  15. Sensor set-up for wireless measurement of automotive rim and wheel parameters in laboratory conditions

    NASA Astrophysics Data System (ADS)

    Borecki, M.; Prus, P.; Korwin-Pawlowski, M. L.; Rychlik, A.; Kozubel, W.

    2017-08-01

    Modern rims and wheels are tested at the design and production stages. Tests can be performed in laboratory conditions and on the ride. In the laboratory, complex and costly equipment is used, as for example wheel balancers and impact testers. Modern wheel balancers are equipped with electronic and electro-mechanical units that enable touch-less measurement of dimensions, including precision measurement of radial and lateral wheel run-out, automatic positioning and application of the counterweights, and vehicle wheel set monitoring - tread wear, drift angles and run-out unbalance. Those tests are performed by on-wheel axis measurements with laser distance meters. The impact tester enables dropping of weights from a defined height onto a wheel. Test criteria are the loss of pressure of the tire and generation of cracks in the wheel without direct impact of the falling weights. In the present paper, a set up composed of three accelerometers, a temperature sensor and a pressure sensor is examined as the base of a wheel tester. The sensor set-up configuration, on-line diagnostic and signal transmission are discussed.

  16. Evaluation of acoustic testing techniques for spacecraft systems

    NASA Technical Reports Server (NTRS)

    Cockburn, J. A.

    1971-01-01

    External acoustic environments, structural responses, noise reductions, and the internal acoustic environments have been predicted for a typical shroud/spacecraft system during lift-off and various critical stages of flight. Spacecraft responses caused by energy transmission from the shroud via mechanical and acoustic paths have been compared and the importance of the mechanical path has been evaluated. Theoretical predictions have been compared extensively with available laboratory and in-flight measurements. Equivalent laboratory acoustic fields for simulation of shroud response during the various phases of flight have been derived and compared in detail. Techniques for varying the time-space correlations of laboratory acoustic fields have been examined, together with methods for varying the time and spatial distribution of acoustic amplitudes. Possible acoustic testing configurations for shroud/spacecraft systems have been suggested and trade-off considerations have been reviewed. The problem of simulating the acoustic environments versus simulating the structural responses has been considered and techniques for testing without the shroud installed have been discussed.

  17. Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion.

    PubMed

    Pham, Thao; Gossec, Laure; Fautrel, Bruno; Combe, Bernard; Flipo, René-Marc; Goupille, Philippe; Le Loët, Xavier; Mariette, Xavier; Puéchal, Xavier; Wendling, Daniel; Schaeverbeke, Thierry; Sibilia, Jean; Sany, Jacques; Dougados, Maxime

    2005-05-01

    To develop recommendations for the physical and laboratory-test follow-up of patients with rheumatoid arthritis (RA) seen in everyday practice, using evidence from the literature, supplemented with expert opinion when needed. A scientific committee selected 7-10 questions using the Delphi consensus procedure. Evidence-based responses to each question were sought in the literature and were then used by a panel to develop recommendations. To fill in gaps in knowledge from the literature, the panelists relied on their personal opinion. The seven questions dealt with the physical and laboratory-test follow-up of RA and the factors predicting disease severity. The literature review identified 799 articles whose title and abstract suggested relevance to the study. Elimination of articles that provided no data on the study topic left 128 original articles. The panel developed seven recommendations, one for each question, which were accepted by consensus. Recommendations about the physical and laboratory-test follow-up of patients with RA seen in everyday practice were developed. Because they constitute an objective foundation built by consensus among experts, should improve the uniformity and quality of care provided to RA patients in everyday practice.

  18. A survey of current practices for genomic sequencing test interpretation and reporting processes in US laboratories.

    PubMed

    O'Daniel, Julianne M; McLaughlin, Heather M; Amendola, Laura M; Bale, Sherri J; Berg, Jonathan S; Bick, David; Bowling, Kevin M; Chao, Elizabeth C; Chung, Wendy K; Conlin, Laura K; Cooper, Gregory M; Das, Soma; Deignan, Joshua L; Dorschner, Michael O; Evans, James P; Ghazani, Arezou A; Goddard, Katrina A; Gornick, Michele; Farwell Hagman, Kelly D; Hambuch, Tina; Hegde, Madhuri; Hindorff, Lucia A; Holm, Ingrid A; Jarvik, Gail P; Knight Johnson, Amy; Mighion, Lindsey; Morra, Massimo; Plon, Sharon E; Punj, Sumit; Richards, C Sue; Santani, Avni; Shirts, Brian H; Spinner, Nancy B; Tang, Sha; Weck, Karen E; Wolf, Susan M; Yang, Yaping; Rehm, Heidi L

    2017-05-01

    While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization. Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews. Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data. This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.

  19. Quantitative and qualitative changes in teaching histology by means of virtual microscopy in an introductory course in human anatomy.

    PubMed

    Husmann, Polly R; O'Loughlin, Valerie Dean; Braun, Mark W

    2009-10-01

    This study compares overall laboratory averages and individual test scores along with a student survey to determine the effects of using virtual microscopy in place of optical microscopes in a large undergraduate human anatomy course. T-tests revealed that the first two laboratory examinations (of four) and the overall laboratory averages were significantly increased compared with the previous year. We hypothesize that this is due to students' ability to use and understand the technology quickly as opposed to learning how to maneuver an optical microscope. Students also responded positively in a survey about the virtual microscope, indicating that increased accessibility, ease of use, and the ability to understand the material were important components of the virtual microscope. In addition, an increase in student collaboration was noted because multiple students were able to view the image at a time. This level of acceptance of virtual microscopy has been reported in previous studies, though this level of increased examination scores is rare. We attribute this to differences between the medical students, with whom this technology has been researched in the past, and undergraduate introductory students.

  20. Viability testing of material derived from Mycobacterium tuberculosis prior to removal from a Containment Level-III Laboratory as part of a Laboratory Risk Assessment Program

    PubMed Central

    Blackwood, Kym S; Burdz, Tamara V; Turenne, Christine Y; Sharma, Meenu K; Kabani, Amin M; Wolfe, Joyce N

    2005-01-01

    Background In the field of clinical mycobacteriology, Mycobacterium tuberculosis (MTB) can be a difficult organism to manipulate due to the restrictive environment of a containment level 3 (CL3) laboratory. Tests for rapid diagnostic work involving smears and molecular methods do not require CL3 practices after the organism has been rendered non-viable. While it has been assumed that after organism deactivation these techniques can be performed outside of a CL3, no conclusive study has consistently confirmed that the organisms are noninfectious after the theoretical 'deactivation' steps. Previous studies have shown that initial steps (such as heating /chemical fixation) may not consistently kill MTB organisms. Methods An inclusive viability study (n = 226) was undertaken to determine at which point handling of culture extraction materials does not necessitate a CL3 environment. Four different laboratory protocols tested for viability included: standard DNA extractions for IS6110 fingerprinting, crude DNA preparations for PCR by boiling and mechanical lysis, protein extractions, and smear preparations. For each protocol, laboratory staff planted a proportion of the resulting material to Bactec 12B medium that was observed for growth for 8 weeks. Results Of the 208 isolates initially tested, 21 samples grew within the 8-week period. Sixteen (7.7%) of these yielded positive results for MTB that included samples of: deactivated culture resuspensions exposed to 80°C for 20 minutes, smear preparations and protein extractions. Test procedures were consequently modified and tested again (n = 18), resulting in 0% viability. Conclusions This study demonstrates that it cannot be assumed that conventional practices (i.e. smear preparation) or extraction techniques render the organism non-viable. All methodologies, new and existing, should be examined by individual laboratories to validate the safe removal of material derived from MTB to the outside of a CL3 laboratory. This process is vital to establish in house biosafety-validated practices with the aim of protecting laboratory workers conducting these procedures. PMID:15667662

  1. Laboratory aspects of tick-borne diseases: lyme, human granulocytic ehrlichiosis and babesiosis.

    PubMed

    Aguero-Rosenfeld, Marie E

    2003-05-01

    Lyme disease, human granulocytic ehrlichiosis (HGE) and babesiosis are emerging infections in the northeastern and midwestern United States, where Ixodes scapularis ticks are prevalent. Lyme disease and babesiosis have also been reported on the West Coast, but less frequently. Lyme disease presents frequently with a skin lesion known as erythema migrans (EM), and diagnostic tests are not necessary if the lesion is classical. Those patients presenting without EM or with atypical skin lesions may need laboratory confirmation. The most frequently used laboratory modality consists of the 2-step serological assays, employing a sensitive ELISA as a first step, followed by IgG and/or IgM immunoblots. Current guidelines for interpretation are those recommended by the CDC. HGE and babesiosis are febrile illnesses with non-specific signs and symptoms. Both infections may present with routine laboratory abnormalities, including leukopenia and/or thrombocytopenia in HGE and anemia in babesiosis. Moderate elevations of liver enzymes may occur in all three tick-borne infections. Specific diagnostic modalities for acute-phase HGE include buffy coat smear examination, culture and PCR. Culture appears to have the greatest sensitivity of the three tests. Babesiosis can be diagnosed by peripheral blood examination for the intraerythrocytic parasites, PCR or serology. Co-infections with these agents exist, but they should be documented by detection of the organisms rather than by serology, since seroprevalence rates are high in endemic areas.

  2. Development of CO2 laser Doppler instrumentation for detection of clear air turbulence, volume 1

    NASA Technical Reports Server (NTRS)

    Harris, C. E.; Jelalian, A. V.

    1979-01-01

    Modification, construction, test and operation of an advanced airborne carbon dioxide laser Doppler system for detecting clear air turbulence are described. The second generation CAT program and those auxiliary activities required to support and verify such a first-of-a-kind system are detailed: aircraft interface; ground and flight verification tests; data analysis; and laboratory examinations.

  3. MSFC Skylab Orbital Workshop, volume 1. [systems analysis and equipment specifications for orbital laboratory

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The technical aspects of the Skylab-Orbital Workshop are discussed. Original concepts, goals, design philosophy, hardware, and testing are reported. The final flight configuration, overall test program, and mission performance are analyzed. The systems which are examined are: (1) the structural system, (2) the meteoroid shield systems, and (3) the environmental/thermal control subsystem.

  4. Test facilities of the structural dynamics branch of NASA Lewis Research Center

    NASA Technical Reports Server (NTRS)

    Montague, Gerald T.; Kielb, Robert E.

    1988-01-01

    The NASA Lewis Research Center Structural Dynamics Branch conducts experimental and analytical research related to the structural dynamics of aerospace propulsion and power systems. The experimental testing facilities of the branch are examined. Presently there are 10 research rigs and 4 laboratories within the branch. These facilities are described along with current and past research work.

  5. Achievement of Audi-Tutorial and Conventional Biology Students, A Comparative Study

    ERIC Educational Resources Information Center

    Sparks, Phillip D.; Unbehaun, Laraine M.

    1971-01-01

    Students studying a biology course by audio-tutorial or conventional lecture-laboratory methods differed in achievement on course examinations, with the A-T group scoring significantly higher on the total test and 3 of the 9 subtests. (AL)

  6. Fundamental evaluation of the interaction between RAS/RAP and virgin asphalt binders.

    DOT National Transportation Integrated Search

    2017-08-01

    A comprehensive laboratory testing program was conducted in this research project to examine the blending between reclaimed asphalt pavement (RAP)/recycled asphalt shingles (RAS) and virgin asphalt binders and to evaluate the factors that may affect ...

  7. Changes in laboratory test results and diagnostic imaging presentation before the detection of occupational cholangiocarcinoma.

    PubMed

    Kubo, Shoji; Takemura, Shigekazu; Sakata, Chikaharu; Urata, Yorihisa; Nishioka, Takayoshi; Nozawa, Akinori; Kinoshita, Masahiko; Hamano, Genya; Nakanuma, Yasuni; Endo, Ginji

    2014-01-01

    A cholangiocarcinoma outbreak among workers of an offset color proof-printing department in a printing company was recently reported. It is important to understand the clinical course leading to occupational cholangiocarcinoma development for investigation of the carcinogenesis process and for surveillance and early detection. We evaluated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma. We investigated the changes in laboratory test results and diagnostic imaging presentation before the detection of cholangiocarcinoma in 2 patients because the data were available. Results The clinical courses observed in the 2 participating patients showed persistent elevation of serum γ-glutamyl transpeptidase levels with or without elevated serum levels of alanine aminotransferase and/or aspartate aminotransferase before cholangiocarcinoma detection. Dilatation of the bile ducts without tumor-induced stenosis was observed several years before cholangiocarcinoma detection and progressed gradually in both patients. The serum concentration of carbohydrate 19-9 also increased prior to cholangiocarcinoma detection in both patients. Eventually, observation of stenosis of the bile duct and a space-occupying lesion strongly suggested cholangiocarcinoma. Pathological examination of the resected specimens showed chronic bile duct injury and neoplastic lesions, such as "biliary intraepithelial neoplasia" and "intraductal papillary neoplasm of the bile duct" in various sites of the bile ducts, particularly in the dilated bile ducts. The changes in laboratory test results and diagnostic imaging might be related to the development of cholangiocarcinoma. It is important to monitor diagnostic imaging presentation and laboratory test results in workers with extended exposure to organic solvents.

  8. Implementing secure laptop-based testing in an undergraduate nursing program: a case study.

    PubMed

    Tao, Jinyuan; Lorentz, B Chris; Hawes, Stacey; Rugless, Fely; Preston, Janice

    2012-07-01

    This article presents the implementation of secure laptop-based testing in an undergraduate nursing program. Details on how to design, develop, implement, and secure tests are discussed. Laptop-based testing mode is also compared with the computer-laboratory-based testing model. Five elements of the laptop-based testing model are illustrated: (1) it simulates the national board examination, (2) security is achievable, (3) it is convenient for both instructors and students, (4) it provides students hands-on practice, (5) continuous technical support is the key.

  9. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    PubMed

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  10. The Outpatient Physical Examination.

    PubMed

    Artandi, Maja K; Stewart, Rosalyn W

    2018-05-01

    The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Integration of a zebrafish research project into a molecular biology course to support critical thinking and course content goals.

    PubMed

    Felzien, Lisa K

    2016-11-12

    Engaging undergraduates in research is essential for teaching them to think like scientists, and it has become a desired component of classroom and laboratory instruction. Research projects that span an entire semester expose students to a variety of concepts and techniques and allow students to use experiments to learn scientific principles, understand why specific techniques are applicable, critically analyze varied data, and examine how experimentation leads to acquiring knowledge. To provide an experience with these features, a semester long research project was integrated into a combined lecture and laboratory course, Molecular Biology. The project utilized the zebrafish model to examine gene expression during embryonic development and required students to develop and test hypotheses about the timing of expression of previously uncharacterized genes. The main goals for the project were to provide opportunities for students to develop critical thinking skills required for conducting research and to support the content goals of the course. To determine whether these goals were met, student performance on the steps of the project and related pre-test and post-test questions was examined. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):565-573, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

  12. Assessing variability in chemical acute toxicity of unionid mussels: Influence of intra- and inter-laboratory testing, life stage, and species

    USGS Publications Warehouse

    Raimondo, Sandy; Lilavois, Crystal R.; Lee, Larisa; Augspurger, Tom; Wang, Ning; Ingersoll, Christopher G.; Bauer, Candice R.; Hammer, Edward J.; Barron, Mace G.

    2016-01-01

    We developed a toxicity database for unionid mussels to examine the extent of intra- and inter-laboratory variability in acute toxicity tests with mussel larvae (glochidia) and juveniles; the extent of differential sensitivity of the two life stages; and the variation in sensitivity among commonly tested mussels (Lampsilis siliquoidea, Utterbackia imbecillis, Villosa iris), commonly tested cladocerans (Daphnia magna, Ceriodaphnia dubia) and fish (Oncorhynchus mykiss, Pimephales promelas, Lepomis macrochirus). The results of these analyses indicate intra-laboratory variability for median effect concentrations (EC50) averaged about 2 fold for both life stages, while inter-laboratory variability averaged 3.6 fold for juvenile mussels and 6.3 fold for glochidia. The EC50s for juveniles and glochidia were within a factor of 2 of each other for 50% of paired records across chemicals, with juveniles more sensitive than glochidia by more than 2 fold for 33% of the comparisons made between life stages. There was a high concurrence of the sensitivity of commonly tested L. siliquoidea, U. imbecillis, and V. iris to that of other mussels. However, this concurrence decreases as the taxonomic distance of the commonly tested cladocerans and fish to mussels increases. The compiled mussel database and determination of data variability will advance risk assessments by including more robust species sensitivity distributions, interspecies correlation estimates, and availability of taxon-specific empirically derived application factors for risk assessment.

  13. Rabies direct fluorescent antibody test does not inactivate rabies or eastern equine encephalitis viruses.

    PubMed

    Jarvis, Jodie A; Franke, Mary A; Davis, April D

    2016-08-01

    An examination using the routine rabies direct fluorescent antibody test was performed on rabies or Eastern equine encephalitis positive mammalian brain tissue to assess inactivation of the virus. Neither virus was inactivated with acetone fixation nor the routine test, thus laboratory employees should treat all samples as rabies and when appropriate Eastern equine encephalitis positive throughout the whole procedure. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. 20 CFR 404.1519k - Purchase of medical examinations, laboratory tests, and other services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Standards for the Type of Referral and for Report Content § 404.1519k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 404.1624 and 404.1626 of this part. (b) If a physician's...

  15. 20 CFR 416.919k - Purchase of medical examinations, laboratory tests, and other services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... for the Type of Referral and for Report Content § 416.919k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 416.1024 and 416.1026 of this part. (b) If a physician's...

  16. Correlates of learning in introductory biomechanics.

    PubMed

    Knudson, Duane; Bauer, Jeff; Bahamonde, Rafael

    2009-04-01

    Characteristics hypothesized to be related to learning in introductory biomechanics classes were examined. Data from a 2003 national study were supplemented by additional instructor-reported data about experience, tests, laboratory hours, and average course-related expenditures. The number of credit hours of the course (r = .15) and money spent by departments on laboratory classes per year (r = -.18) were significantly and uniquely correlated with learning. Increasing credit hours from 3 to 4 with laboratory experience doubled learning. The results supported national standards for a 4-credit course and an emphasis on conceptual understanding rather than quantitative problem-solving. Researchers should seek to confirm these results as well as explore whether contact hours or the nature of laboratory learning experiences contribute to this effect.

  17. Plans and Preliminary Results of Fundamental Studies of Ice Crystal Icing Physics in the NASA Propulsion Systems Laboratory

    NASA Technical Reports Server (NTRS)

    Struk, Peter; Tsao, Jen-Ching; Bartkus, Tadas

    2016-01-01

    This presentation accompanies the paper titled Plans and Preliminary Results of Fundamental Studies of Ice Crystal Icing Physics in the NASA Propulsion Systems Laboratory. NASA is evaluating whether PSL, in addition to full-engine and motor-driven-rig tests, can be used for more fundamental ice-accretion studies that simulate the different mixed-phase icing conditions along the core flow passage of a turbo-fan engine compressor. The data from such fundamental accretion tests will be used to help develop and validate models of the accretion process. This presentation (and accompanying paper) presents data from some preliminary testing performed in May 2015 which examined how a mixed-phase cloud could be generated at PSL using evaporative cooling in a warmer-than-freezing environment.

  18. Understanding the extraocular muscles and oculomotor, trochlear, and abducens nerves through a simulation in physical examination training: an innovative approach.

    PubMed

    Zhang, Niu; He, Xiaohua

    2010-01-01

    The purpose of this study was to investigate the effect of an innovative exhibitory eye model simulation in a physical examination laboratory format on explaining Listing's Law concerning the individual extraocular muscle action and the rationale for cranial nerve testing. Participants were 71 volunteers in the third quarter of a chiropractic training program. The study involved a specially designed eyeball model used to explain the movements of individual extraocular muscles based on Listing's law and their cranial innervations in conjunction with the physical examination. Pre- and post-written tests were used to assess participants' understanding of the subjects taught. The test results were compared with those of nonparticipants who also took the same pre- and posttests. An independent samples t-test of the posttest showed a significant difference between the groups. The study group students achieved higher scores than their counterparts in the control group. Using an innovative approach to explain Listing's law and rationale for cranial nerve tests can improve physical examination skill and help produce more effective written test results.

  19. Study of Dominant Factors Affecting Cerchar Abrasivity Index

    NASA Astrophysics Data System (ADS)

    Rostami, Jamal; Ghasemi, Amireza; Alavi Gharahbagh, Ehsan; Dogruoz, Cihan; Dahl, Filip

    2014-09-01

    The Cerchar abrasion index is commonly used to represent rock abrasion for estimation of bit life and wear in various mining and tunneling applications. Although the test is simple and fast, there are some discrepancies in the test results related to the equipment used, condition of the rock surface, operator skills, and procedures used in conducting and measuring the wear surface. This paper focuses on the background of the test and examines the influence of various parameters on Cerchar testing including pin hardness, surface condition of specimens, petrographical and geomechanical properties, test speed, applied load, and method of measuring wear surface. Results of Cerchar tests on a set of rock specimens performed at different laboratories are presented to examine repeatability of the tests. In addition, the preliminary results of testing with a new device as a potential alternative testing system for rock abrasivity measurement are discussed.

  20. Inter-laboratory validation of the modified murine local lymph node assay based on 5-bromo-2'-deoxyuridine incorporation.

    PubMed

    Kojima, Hajime; Takeyoshi, Masahiro; Sozu, Takashi; Awogi, Takumi; Arima, Kazunori; Idehara, Kenji; Ikarashi, Yoshiaki; Kanazawa, Yukiko; Maki, Eiji; Omori, Takashi; Yuasa, Atsuko; Yoshimura, Isao

    2011-01-01

    The murine local lymph node assay (LLNA) is a well-established alternative to the guinea pig maximization test (GPMT) or Buehler test (BT) for the assessment of the skin sensitizing ability of a drug, cosmetic material, pesticide or industrial chemical. Instead of radioisotope using in this method, Takeyoshi M. et al. (2001) has developed a modified LLNA based on the 5-bromo-2'-deoxyuridine (BrdU) incorporation (LLNA:BrdU-ELISA). The LLNA:BrdU-ELISA is practically identical to the LLNA methodology excluding the use of BrdU, for which a single intraperitoneal injection of BrdU is made on day 4, and colorimetric detection of cell turnover. We conducted the validation study to evaluate the reliability and relevance of LLNA:BrdU-ELISA. The experiment involved 7 laboratories, wherein 10 chemicals were examined under blinded conditions. In this study, 3 chemicals were examined in all laboratories and the remaining 7 were examined in 3 laboratories. The data were expressed as the BrdU incorporation using an ELISA method for each group, and the stimulation index (SI) for each chemical-treated group was determined as the increase in the BrdU incorporation relative to the concurrent vehicle control group. An SI of 2 was set as the cut-off value for exhibiting skin sensitization activity. The results obtained in the experiments conducted for all 10 chemicals were sufficiently consistent with small variations in their SI values. The sensitivity, specificity, and accuracy of LLNA:BrdU-ELISA against those of GPMT/BT were 7/7 (100%), 3/3 (100%), and 10/10 (100%), respectively. Copyright © 2010 John Wiley & Sons, Ltd.

  1. ASSESSING STRESSORS IN COASTAL ECOSYSTEMS: AN APPROACH TO THE PATIENT.

    EPA Science Inventory

    Medicine employs an approach to diagnose, give a prognosis, and develop a treatment for human patients. Specific signs and symptoms determined from medical examinations, laboratory tests, and patient history are utilized to predict the outcome of a potential pathological disorder...

  2. Comparison Between Simulated and Experimentally Measured Performance of a Four Port Wave Rotor

    NASA Technical Reports Server (NTRS)

    Paxson, Daniel E.; Wilson, Jack; Welch, Gerard E.

    2007-01-01

    Performance and operability testing has been completed on a laboratory-scale, four-port wave rotor, of the type suitable for use as a topping cycle on a gas turbine engine. Many design aspects, and performance estimates for the wave rotor were determined using a time-accurate, one-dimensional, computational fluid dynamics-based simulation code developed specifically for wave rotors. The code follows a single rotor passage as it moves past the various ports, which in this reference frame become boundary conditions. This paper compares wave rotor performance predicted with the code to that measured during laboratory testing. Both on and off-design operating conditions were examined. Overall, the match between code and rig was found to be quite good. At operating points where there were disparities, the assumption of larger than expected internal leakage rates successfully realigned code predictions and laboratory measurements. Possible mechanisms for such leakage rates are discussed.

  3. The Pathology Laboratory Act 2007 explained.

    PubMed

    Looi, Lai-Meng

    2008-06-01

    The past century has seen tremendous changes in the scope and practice of pathology laboratories in tandem with the development of the medical services in Malaysia. Major progress was made in the areas of training and specialization of pathologists and laboratory technical staff. Today the pathology laboratory services have entered the International arena, and are propelled along the wave of globalization. Many new challenges have emerged as have new players in the field. Landmark developments over the past decade include the establishment of national quality assurance programmes, the mushrooming of private pathology laboratories, the establishment of a National Accreditation Standard for medical testing laboratories based on ISO 15189, and the passing of the Pathology Laboratory Act in Parliament in mid-2007. The Pathology Laboratory Act 2007 seeks to ensure that the pathology laboratory is accountable to the public, meets required standards of practice, participates in Quality Assurance programmes, is run by qualified staff, complies with safety requirements and is subject to continuous audit. The Act is applicable to all private laboratories (stand alone or hospital) and laboratories in statutory bodies (Universities, foundations). It is not applicable to public laboratories (established and operated by the government) and side-room laboratories established in clinics of registered medical or dental practitioners for their own patients (tests as in the First and Second Schedules respectively). Tests of the Third Schedule (home test blood glucose, urine glucose, urine pregnancy test) are also exempted. The Act has 13 Parts and provides for control of the pathology laboratory through approval (to establish and maintain) and licensing (to operate or provide). The approval or license may only be issued to a sole proprietor, partnership or body corporate, and then only if the entity includes a registered medical practitioner. Details of personnel qualifications and laboratory practices are left to be specified by the Director-General of Health, providing for a formal recognition process and room for revision as pathology practices evolve. Encompassed in the responsibilities of the licensee is the requirement that samples are received and results issued through, and management vested in, a registered medical or dental practitioner. This effectively prohibits "walk-ins" to the laboratory and indiscriminate public screening. The requirement for a person-in-charge in accordance with class and speciality of laboratory ensures that the laboratory is under the charge of the pathology profession. Examined carefully, the requirements of the Act are similar to laboratory accreditation, but are backed by legislation. Many of these details will be spelt out in the Regulations, and these in turn are likely to fall back on National professional guidelines, as accreditation does. Although not at first obvious, enforcement of the Act is based on self-regulation by pathology laboratory professionals. Sincere professional input is thus required to embrace its philosophy, ensure rational and transparent enforcement of legislation, and develop National guidelines for good pathology practices upon which enforcement may be based.

  4. News from the Biological Stain Commission.

    PubMed

    Lyon, H O; Kiernan, J A

    2008-12-01

    In the three earlier editions of News from the Biological Stain Commission (BSC), under the heading of "Regulatory affairs," the BSC's International Affairs Committee reported on the work of Technical Committee 212, Clinical Laboratory Testing and in Vitro Diagnostic Test Systems of the International Standards Organization (ISO/TC 212) and its working groups, WG 1, WG 2 and WG 3. In this issue of News from the BSC, H.O. Lyon provides information from the annual meeting of ISO/TC 212 that took place June 2-4, 2008 in Vancouver, British Columbia, Canada. In addition, under the heading of "Certification," J.A. Kiernan examines the certification procedure for thionine used by the BSC laboratory in Rochester, NY.

  5. Effects of reinforcement on test-enhanced learning in a large, diverse introductory college psychology course.

    PubMed

    Trumbo, Michael C; Leiting, Kari A; McDaniel, Mark A; Hodge, Gordon K

    2016-06-01

    A robust finding within laboratory research is that structuring information as a test confers benefit on long-term retention-referred to as the testing effect. Although well characterized in laboratory environments, the testing effect has been explored infrequently within ecologically valid contexts. We conducted a series of 3 experiments within a very large introductory college-level course. Experiment 1 examined the impact of required versus optional frequent low-stakes testing (quizzes) on student grades, revealing students were much more likely to take advantage of quizzing if it was a required course component. Experiment 2 implemented a method of evaluating pedagogical intervention within a single course (thereby controlling for instructor bias and student self-selection), which revealed a testing effect. Experiment 3 ruled out additional exposure to information as an explanation for the findings of Experiment 2 and suggested that students at the college level, enrolled in very large sections, accept frequent quizzing well. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.

    PubMed

    Smith, Mark W; Owens, Pamela L; Andrews, Roxanne M; Steiner, Claudia A; Coffey, Rosanna M; Skinner, Halcyon G; Miyamura, Jill; Popescu, Ioana

    2016-04-18

    Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95% CI 1.03-1.43 and 1.55, 95% CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95% CI 0.94-1.32 and 1.43, 95% CI 1.15-1.78, respectively). Heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data.

  7. Where are the history and the physical?

    PubMed Central

    Bordage, G

    1995-01-01

    In clinical practice, the history and physical examination are being superseded by laboratory tests and biomedical technology. The author discusses the importance of the clinical examination as the basis for clinical reasoning and of direct observation of students at the patients' bedside in order to assess their diagnostic reasoning. Greater attention to the clinical examination would lead not only to improved clinical skills but also to more cost-effective use of ancillary investigations and, moreover, to a better understanding of the patient by the physician. PMID:7743445

  8. Infrared thermography for examination of paper structure

    NASA Astrophysics Data System (ADS)

    Kiiskinen, Harri T.; Pakarinen, Pekka I.

    1998-03-01

    The paper industry has used IR cameras primarily for troubleshooting, where the most common examples include the examination of the condition of dryer fabrics and dryer cylinders and the analysis of moisture variations in a paper web. Another application extensively using IR thermography is non-destructive testing of composite materials. This paper presents some recently developed laboratory methods using an IR camera to examine paper structure. Specific areas include cockling, moisture content, thermal uniformity, mechanism of failure, and an analysis of the copying process.

  9. Fire extinguishing tests -80 with methyl alcohol gasoline

    NASA Astrophysics Data System (ADS)

    Holmstedt, G.; Ryderman, A.; Carlsson, B.; Lennmalm, B.

    1980-10-01

    Large scale tests and laboratory experiments were carried out for estimating the extinguishing effectiveness of three alcohol resistant aqueous film forming foams (AFFF), two alcohol resistant fluoroprotein foams and two detergent foams in various poolfires: gasoline, isopropyl alcohol, acetone, methyl-ethyl ketone, methyl alcohol and M15 (a gasoline, methyl alcohol, isobutene mixture). The scaling down of large scale tests for developing a reliable laboratory method was especially examined. The tests were performed with semidirect foam application, in pools of 50, 11, 4, 0.6, and 0.25 sq m. Burning time, temperature distribution in the liquid, and thermal radiation were determined. An M15 fire can be extinguished with a detergent foam, but it is impossible to extinguish fires in polar solvents, such as methyl alcohol, acetone, and isopropyl alcohol with detergent foams, AFFF give the best results; and performances with small pools can hardly be correlated with results from large scale fires.

  10. The Influence of Laboratory Instruction on Science Achievement and Attitude Toward Science across Gender Differences

    NASA Astrophysics Data System (ADS)

    Freedman, Michael P.

    This study investigated the use of a hands-on laboratory program to improve attitudes toward science and increase achievement levels in science knowledge among students in a ninth grade physical science course. An objective final examination measured achievement in science knowledge, and a Q sort survey measured attitude toward science. A t test compared the groups' differences in achievement and attitude toward science. An analysis of covariance determined the effect of the laboratory treatment on the dependent variable, with attitude toward science as the covariable. The findings showed that students with regular laboratory instruction scored significantly higher (p < .05) on achievement in science knowledge than those without laboratory instruction, girls with regular laboratory instruction scored significantly higher (p < .05) on achievement in science knowledge than those without laboratory instruction, and girls and boys within the treatment group did not differ significantly on achievement in science knowledge. No significant differences were reported in attitude toward science between or within groups.

  11. The Boulby Geoscience Project Underground Research Laboratory: Initial Results of a Rock Mechanics Laboratory Testing Programme

    NASA Astrophysics Data System (ADS)

    Brain, M. J.; Petley, D. N.; Rosser, N.; Lim, M.; Sapsford, M.; Barlow, J.; Norman, E.; Williams, A.; Pybus, D.

    2009-12-01

    The Boulby Mine, which is situated on the northeast coast of England, is a major source of potash, primarily for use as a fertiliser, with a secondary product of rock salt (halite), used in highway deicing. The deposits are part of the Zechstein formation and are found at depths of between c.1100 and 1135 m below sea level. The evaporite sequence also contains a range of further lithologies, including anhydrite, dolomite and a mixed evaporate deposit. From a scientific perspective the dry, uncontaminated nature of the deposits, the range of lithologies present and the high stress conditions at the mine provide a unique opportunity to observe rock deformation in situ in varying geological and stress environments. To this end the Boulby Geoscience Project was established to examine the feasibility of developing an underground research laboratory at the mine. Information regarding the mechanical properties of the strata at the Boulby Mine is required to develop our understanding of the strength and deformation behaviour of the rock over differing timescales in response to variations in the magnitude and duration of applied stresses. As such data are currently limited, we have developed a laboratory testing programme that examines the behaviour of the deposits during the application of differential compressive stresses. We present the initial results of this testing programme here. Experiments have been carried out using a high pressure Virtual Infinite Strain (VIS) triaxial apparatus (250 kN maximum axial load; 64 MPa maximum cell pressure) manufactured by GDS Instruments. Conventional compression tests under uniaxial and triaxial conditions have been undertaken to determine the effects of axial stress application rate, axial strain rate and confining pressure on behaviour and failure mechanisms. The experimental programme also includes advanced testing into time-dependent creep behaviour under constant deviatoric stress; the effects of variations in temperature and stress path loading on peak shear strength and deformation behaviour; and the effects of low frequency cyclic loading on evolution of material properties. We compare the results of the testing programme with similar published data on evaporite rocks and existing models of material deformation and briefly discuss the implications for the design of sub-surface excavations.

  12. Challenging the Wigglesworthia, Sodalis, Wolbachia symbiosis dogma in tsetse flies: Spiroplasma is present in both laboratory and natural populations.

    PubMed

    Doudoumis, V; Blow, F; Saridaki, A; Augustinos, A; Dyer, N A; Goodhead, I; Solano, P; Rayaisse, J-B; Takac, P; Mekonnen, S; Parker, A G; Abd-Alla, A M M; Darby, A; Bourtzis, K; Tsiamis, G

    2017-07-05

    Profiling of wild and laboratory tsetse populations using 16S rRNA gene amplicon sequencing allowed us to examine whether the "Wigglesworthia-Sodalis-Wolbachia dogma" operates across species and populations. The most abundant taxa, in wild and laboratory populations, were Wigglesworthia (the primary endosymbiont), Sodalis and Wolbachia as previously characterized. The species richness of the microbiota was greater in wild than laboratory populations. Spiroplasma was identified as a new symbiont exclusively in Glossina fuscipes fuscipes and G. tachinoides, members of the palpalis sub-group, and the infection prevalence in several laboratory and natural populations was surveyed. Multi locus sequencing typing (MLST) analysis identified two strains of tsetse-associated Spiroplasma, present in G. f. fuscipes and G. tachinoides. Spiroplasma density in G. f. fuscipes larva guts was significantly higher than in guts from teneral and 15-day old male and female adults. In gonads of teneral and 15-day old insects, Spiroplasma density was higher in testes than ovaries, and was significantly higher density in live versus prematurely deceased females indicating a potentially mutualistic association. Higher Spiroplasma density in testes than in ovaries was also detected by fluorescent in situ hybridization in G. f. fuscipes.

  13. An analysis of laboratory activities found in "Applications In Biology/Chemistry: A Contextual Approach to Laboratory Science"

    NASA Astrophysics Data System (ADS)

    Haskins, Sandra Sue

    The purpose of this study was to quantitatively determine whether the material found in ABC promotes scientific inquiry through the inclusion of science process skills, and to quantitatively determine the type (experimental, comparative, or descriptive) and character (wet-lab, paper and pencil, model, or computer) of laboratory activities. The research design allowed for an examination of the frequency and type of science process skills required of students in 79 laboratory activities sampled from all 12 units utilizing a modified 33-item laboratory analysis inventory (LAI) (Germane et al, 1996). Interrater reliability for the science process skills was completed on 19 of the laboratory activities with a mean score of 86.1%. Interrater reliability for the type and character of the laboratory, on the same 19 laboratory activities, was completed with mean scores of 79.0% and 96.5%, respectively. It was found that all laboratory activities provide a prelaboratory activity. In addition, the science process skill category of student performance is required most often of students with the skill of learning techniques or manipulating apparatus occurring 99% of the time. The science process skill category observed the least was student planning and design, occurring only 3% of the time. Students were rarely given the opportunity to practice science process skills such as developing and testing hypotheses through experiments they have designed. Chi-square tests, applied at the .05 level of significance, revealed that there was a significant difference in the type of laboratory activities; comparative laboratory activities appeared more often (59%). In addition the character of laboratory activities, "wet-lab" activities appeared more often (90%) than any of the others.

  14. A Directed Research Project Investigating Territoriality and Aggression in Crickets.

    ERIC Educational Resources Information Center

    Darling, Ruth A.

    2001-01-01

    Describes a directed research project that examines the territorial and aggressive behavior of crickets. Presents behavioral ecology laboratory experiments in which students test the hypothesis that crickets with established territories are more likely to win confrontations that intruding crickets. (Contains 11 references.) (ASK)

  15. Mother-Child and Father-Child Play.

    ERIC Educational Resources Information Center

    Roopnarine, Jaipaul L.; Mounts, Nina S.

    1985-01-01

    Examines mother-child and father-child play and the relationship between parents' fantasy play initiations and their children's receptive vocabulary skills. The sex of parent effects during play initiations and the influence on children's cooperativeness toward the parent behaviors were tested in a laboratory playroom setting. (DT)

  16. EFFECTIVENESS AND SAFETY OF STRATEGIES FOR OIL SPILL BIOREMEDIATION: POTENTIAL AND LIMITATION, LABORATORY TO FIELD (RESEARCH BRIEF)

    EPA Science Inventory

    Several important additional research efforts were identified during the development of test systems and protocols for assessing the effectiveness and environmental safety of oil spill commercial bioremediation agents (CBAs). Research that examined CBA efficacy issues included: (...

  17. 42 CFR 121.6 - Organ procurement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... laboratory tests and clinical examinations of potential organ donors are performed to determine any... 42 Public Health 1 2010-10-01 2010-10-01 false Organ procurement. 121.6 Section 121.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT ORGAN...

  18. Results and Analysis of the Infrastructure Request for Information (DE-SOL-0008318)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heidrich, Brenden John

    2015-07-01

    The Department of Energy (DOE) Office of Nuclear Energy (NE) released a request for information (RFI) (DE-SOL-0008318) for “University, National Laboratory, Industry and International Input on Potential Office of Nuclear Energy Infrastructure Investments” on April 13, 2015. DOE-NE solicited information on five specific types of capabilities as well as any others suggested by the community. The RFI proposal period closed on June 19, 2015. From the 26 responses, 34 individual proposals were extracted. Eighteen were associated with a DOE national laboratory, including Argonne National Laboratory (ANL), Brookhaven National Laboratory (BNL), Idaho National Laboratory (INL), Los Alamos National Laboratory (LANL), Pacificmore » Northwest National Laboratory (PNNL) and Sandia National Laboratory (SNL). Oak Ridge National Laboratory (ORNL) was referenced in a proposal as a proposed capability location, although the proposal did not originate with ORNL. Five US universities submitted proposals (Massachusetts Institute of Technology, Pennsylvania State University, Rensselaer Polytechnic Institute, University of Houston and the University of Michigan). Three industrial/commercial institutions submitted proposals (AREVA NP, Babcock and Wilcox (B&W) and the Electric Power Research Institute (EPRI)). Eight major themes emerged from the submissions as areas needing additional capability or support for existing capabilities. Two submissions supported multiple areas. The major themes are: Advanced Manufacturing (AM), High Performance Computing (HPC), Ion Irradiation with X-Ray Diagnostics (IIX), Ion Irradiation with TEM Visualization (IIT), Radiochemistry Laboratories (RCL), Test Reactors, Neutron Sources and Critical Facilities (RX) , Sample Preparation and Post-Irradiation Examination (PIE) and Thermal-Hydraulics Test Facilities (THF).« less

  19. Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sheryl Morton; Carl Baily; Tom Hill

    Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a lowtemperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less

  20. Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.

    Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. Itmore » provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.« less

  1. Feasibility of Ground Testing a Moon and Mars Surface Power Reactor in EBR-II

    NASA Astrophysics Data System (ADS)

    Morton, Sheryl L.; Baily, Carl E.; Hill, Thomas J.; Werner, James E.

    2006-01-01

    Ground testing of a surface fission power system would be necessary to verify the design and validate reactor performance to support safe and sustained human exploration of the Moon and Mars. The Idaho National Laboratory (INL) has several facilities that could be adapted to support a ground test. This paper focuses on the feasibility of ground testing at the Experimental Breeder Reactor II (EBR-II) facility and using other INL existing infrastructure to support such a test. This brief study concludes that the INL EBR-II facility and supporting infrastructure are a viable option for ground testing the surface power system. It provides features and attributes that offer advantages to locating and performing ground testing at this site, and it could support the National Aeronautics and Space Administration schedules for human exploration of the Moon. This study used the initial concept examined by the U.S. Department of Energy Inter-laboratory Design and Analysis Support Team for surface power, a low-temperature, liquid-metal, three-loop Brayton power system. With some facility modification, the EBR-II can safely house a test chamber and perform long-term testing of the space reactor power system. The INL infrastructure is available to receive and provide bonded storage for special nuclear materials. Facilities adjacent to EBR-II can provide the clean room environment needed to assemble and store the test article assembly, disassemble the power system at the conclusion of testing, and perform posttest examination. Capability for waste disposal is also available at the INL.

  2. Results of Laboratory Tests on Surficial Sediments from the Upper Continental Slope Northern Gulf of Mexico

    USGS Publications Warehouse

    Booth, James S.

    1979-01-01

    The purpose of this report is to present the results of geo­technical, textural, and chemical tests performed on samples from the upper Continental Slope, northern Gulf of Mexico.The samples were collected by a piston corer up to 12 m (40 ft.} in length with a head weight of 908 kg (one ton}. The inside diameter of the C. A. B. liner was 89 mm (3.5 inches}. Upon retrieval, the cores were cut in 1.5 m sections, examined for evidence of disturbance, then, if in acceptable condition, were sealed and placed in their in situ vertical position in a refrigerated van. Once ashore, the sections were opened, sealed with wax, recapped and stored as before.The cores were split lengthwise for analysis. One half of the core was X-rayed and the radiograph was carefully examined as a further check for disturbance. This half was then archived. The other half of the core was used for the laboratory work.

  3. The effects of an educational meeting and subsequent computer reminders on the ordering of laboratory tests by rheumatologists: an interrupted time series analysis.

    PubMed

    Lesuis, Nienke; den Broeder, Nathan; Boers, Nadine; Piek, Ester; Teerenstra, Steven; Hulscher, Marlies; van Vollenhoven, Ronald; den Broeder, Alfons A

    2017-01-01

    To examine the effects of an educational meeting and subsequent computer reminders on the number of ordered laboratory tests. Using interrupted time series analysis we assessed whether trends in the number of laboratory tests ordered by rheumatologists between September 2012 and September 2015 at the Sint Maartenskliniek (the Netherlands) changed following an educational meeting (September 2013) and the introduction of computer reminders into the Computerised Physician Order Entry System (July 2014). The analyses were done for the set of tests on which both interventions had focussed (intervention tests; complement, cryoglobulins, immunoglobins, myeloma protein) and a set of control tests unrelated to the interventions (alanine transferase, anti-cyclic citrullinated peptide, C-reactive protein, creatine, haemoglobin, leukocytes, mean corpuscular volume, rheumatoid factor and thrombocytes). At the start of the study, 101 intervention tests and 7660 control tests were ordered per month by the rheumatologists. After the educational meeting, both the level and trend of ordered intervention and control tests did not change significantly. After implementation of the reminders, the level of ordered intervention tests decreased by 85.0 tests (95%-CI -133.3 to -36.8, p<0.01), the level of control tests did not change following the introduction of reminders. In summary, an educational meeting alone was not effective in decreasing the number of ordered intervention tests, but the combination with computer reminders did result in a large decrease of those tests. Therefore, we recommend using computer reminders in addition to education if reduction of inappropriate test use is aimed for.

  4. Evaluation of patients diagnosed with fascioliasis: A six-year experience at a university hospital in Turkey.

    PubMed

    Boşnak, Vuslat Keçik; Karaoğlan, İlkay; Sahin, Handan Haydaroğlu; Namiduru, Mustafa; Pehlivan, Mustafa; Okan, Vahap; Mete, Ayşe Özlem

    2016-04-28

    In this study, clinical, laboratory, radiological, and serological examinations of fascioliasis patients were analyzed, and data with a significant impact on differential diagnosis were evaluated. Clinical, radiological, and laboratory findings and treatment responses of a total of 22 fascioliasis patients, treated between October 2009 and September 2014, were evaluated. Nineteen patients were diagnosed with fascioliasis at the invasive phase and three patients at the chronic phase. Patients were followed up for clinical, laboratory, and radiology findings for a period of three months to one year after treatment. The most frequent complaints in both groups were abdominal pain, and the most common physical examination finding was epigastric tenderness. In the performed examination, an eosinophil elevation in whole blood count was detected in 19 patients (100%) in the hepatic phase, and in 2 patients (66.6%) in the biliary phase. The results of the Fasciola hepatica indirect hemagglutination assay (IHA) test ordered in the diagnosis were positive in all patients. Treatment with 10 mg/kg/day triclabendazole for two consecutive days was effective. Live parasites were extracted from patients in the biliary phase with endoscopic retrograde cholangiopancreatography. In the follow-ups, remission in IHA titer and clinical and radiological improvement was achieved in all patients. If hypereosinophilia is detected by peripheral smear in patients who are admitted with complaints such as abdominal pain, weakness, nausea, myalgia, and weight loss, radiological evaluation and serological tests should be performed and fascioliasis should be considered in the differential diagnosis.

  5. Contemporary bloodletting in cardiac surgical care.

    PubMed

    Koch, Colleen G; Reineks, Edmunds Z; Tang, Anne S; Hixson, Eric D; Phillips, Shannon; Sabik, Joseph F; Henderson, J Michael; Blackstone, Eugene H

    2015-03-01

    Health care providers are seldom aware of the frequency and volume of phlebotomy for laboratory testing, bloodletting that often leads to hospital-acquired anemia. Our objectives were to examine the frequency of laboratory testing in patients undergoing cardiac surgery, calculate cumulative phlebotomy volume from time of initial surgical consultation to hospital discharge, and propose strategies to reduce phlebotomy volume. From January 1, 2012 to June 30, 2012, 1,894 patients underwent cardiac surgery at Cleveland Clinic; 1,867 had 1 hospitalization and 27 had 2. Each laboratory test was associated with a test name and blood volume. Phlebotomy volume was estimated separately for the intensive care unit (ICU), hospital floors, and cumulatively. A total of 221,498 laboratory tests were performed, averaging 115 tests per patient. The most frequently performed tests were 88,068 blood gas analyses, 39,535 coagulation tests, 30,421 complete blood counts, and 29,374 metabolic panels. Phlebotomy volume differed between ICU and hospital floors, with median volumes of 332 mL and 118 mL, respectively. Cumulative median volume for the entire hospital stay was 454 mL. More complex procedures were associated with higher overall phlebotomy volume than isolated procedures; eg, combined coronary artery bypass grafting (CABG) and valve procedure median volume was 653 mL (25th/75th percentiles, 428 of 1,065 mL) versus 448 mL (284 of 658 mL) for isolated CABG and 338 mL (237 of 619) for isolated valve procedures. We were astonished by the extent of bloodletting, with total phlebotomy volumes approaching amounts equivalent to 1 to 2 red blood cell units. Implementation of process improvement initiatives can potentially reduce phlebotomy volumes and resource utilization. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Reasons for testing women for genital Chlamydia trachomatis infection in the Calgary region

    PubMed Central

    Church, Deirdre L; Zentner, Ali; Semeniuk, Heather; Henderson, Elizabeth; Read, Ron

    2003-01-01

    OBJECTIVE: To determine the clinical reason(s) for screening women with varying degrees of risk for genital Chlamydia trachomatis (CT) in the Calgary region. DESIGN: Women aged 15 to 75 years were enrolled at various patient care locations. Pertinent risk factors for genital CT infection were recorded and a gynecological examination was performed. Two endocervical swabs and a first-void urine sample were collected for CT detection using two different nucleic acid amplification test methods. SETTING: Calgary is an urban region that provides healthcare services to a population of almost one million people. Microbiology services are provided by Calgary Laboratory Services through a centralized regional laboratory service. MAIN RESULTS: 504 women with a mean age of 28.1 ±SD 8.22 years were enrolled. Two hundred ninety-one women (57.8%) were at high risk for acquiring genital CT infection. Twenty-eight (5.6%) tested positive for CT infection and almost all of these women (26 of 28, 93%) had risk factors for acquiring infection. Of the high-risk women, 9.8% were CT positive versus only 1.3% of women at low risk (P=0.0001). Only two of 152 (1.3%) women older than 30 years had genital CT infections. Although most women were asymptomatic, those with laboratory-confirmed CT infection were more likely to have genitourinary symptoms. Three hundred forty-three of 476 (72%) women who did not have genital CT infection had no risk factors, and screening was done as part of a routine gynecological examination for other purposes (prenatal visit, Pap smear). CONCLUSION: Women without risk factors are being screened routinely for genital CT infection as part of a routine gynecological examination done for other reasons. Elimination of the routine screening of low-risk women older than 30 years of age would decrease the current regional utilization of CT tests by as much as one-third. PMID:18159423

  7. Biological false-positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis - a case-control study.

    PubMed

    Zheng, S; Lin, R J; Chan, Y H; Ngan, C C L

    2018-03-01

    There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG. During the study period, a total of 1254 specimens underwent VDRL-CSF examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL-CSF. Of the 53 patients, 42 (79.2%) were true-positive cases and 11 (20.8%) were false-positive cases. In our setting, a positive non-treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true-positive VDRL-CSF based on our laboratory definition. HIV seropositivity was an independent predictor of a true-positive VDRL-CSF. Biological false-positive VDRL-CSF is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF evaluation for neurosyphilis. © 2017 European Academy of Dermatology and Venereology.

  8. Occupational dermatoses at a film laboratory.

    PubMed

    Lidén, C

    1984-02-01

    During the period January 1980-June 1981, an investigation was made of skin diseases among employees of a film laboratory. The investigation was carried out in 5 stages. (I) Questionnaire (II) Clinical examination and interview with all employees who stated that they had had skin disease at some time (III) Patch testing at the laboratory of all cases of suspected occupational dermatoses, and control tests in hospital of 200 non-exposed eczema patients (IV) Investigation of protective gloves by patch testing and in a chemical bath (V) Allergy test on guinea pigs (GPMT) of one agent (PBA-1). The firm had 114 employees and the questionnaire was answered by 103. Altogether 43 persons at some time had been exposed to chemicals in their work, and 21 of them had had occupational dermatoses. In 12 cases, contact allergy was found to one or more of the photographic chemicals CD-2, CD-3, Metol and PBA-1. GPMT with PBA-1 showed it to be a potent sensitizer. The colour developing agents may also give rise to lichenoid reactions and 2 such cases were seen in this investigation. Other causes of occupational dermatoses are indicated, as well as the occurrence of non-occupational skin diseases.

  9. Measurements for certification of chlortetracycline reference materials within the European Union Standards, Measurements and Testing programme.

    PubMed

    Juhel-Gaugain, M; McEvoy, J D; VanGinkel, L A

    2000-12-01

    The experimental design of a material certification programme is described. The matrix reference materials (RMs) comprised chlortetracycline (CTC)-containing and CTC-free lyophilised porcine liver, kidney and muscle produced under the European Commission's Standards Measurements and Testing (SMT) programme. The aim of the certification programme was to determine accurately and precisely the concentration of CTC and 4-epi-chlortetracycline (epi-CTC) contained in the RMs. A multi-laboratory approach was used to certify analyte concentrations. Participants (n = 19) were instructed to strictly adhere to previously established guidelines. Following the examination of analytical performance criteria, statistical manipulation of results submitted by 13 laboratories, (6 withdrew) allowed an estimate to be made of the true value of the analyte content. The Nalimov test was used for detection of outlying results. The Cochran and Bartlett tests were employed for testing the homogeneity of variances. The normality of results distribution was tested according to the Kolmogorov-Smirnov-Lilliefors test. One-way analysis of variance (ANOVA) was employed to calculate the within and between-laboratory standard deviations, the overall mean and confidence interval for the CTC and epi-CTC content of each of the RMs. Certified values were within or very close to the target concentration ranges specified in the SMT contract. These studies have demonstrated the successful production and certification of CTC-containing and CTC-free porcine RMs.

  10. [Assessment of the quality of laboratory diagnosis of intestinal parasitic diseases by the laboratories participating in the Federal System of External Quality Assessment of Clinical Laboratory Testing].

    PubMed

    Malakhov, V N; Dovgalev, A S; Astanina, S Iu; Serdiuk, A P

    2014-01-01

    In 2010-2013, the quality of microscopic detection of the causative agents ofparasitic diseases in the feces has been assessed by the specialists of the laboratories of the therapeutic-and-prophylactic institutions (TPIs) and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, which are participants of the Federal System of External Quality Assessment of Clinical Laboratory Testing. Thirty-two specimens containing 16 species of human helminths and 4 species of enteric protozoa in different combinations were examined. The findings suggest that the quality of microscopic detection of the causative agents of parasitic diseases is low in the laboratories of health care facilities and that the specialists of the laboratories of TPIs and Hygiene and Epidemiology Centers, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, do not not possess the knowledge and skills necessary to make a laboratory diagnosis of helminths and enteric protozoa. The average detection rates of helminths and protozoa were at a level of 64 and 36%, respectively. The correct results showed that the proportion of helminths and protozoa were 94.5 and 5.5%, respectively. According to the biological and epidemiological classification of helminths, there were higher detection rates for contact group parasites (Enterobius vermicularis and Hymenolepis nana) and geohelminths (Ascaris, Trichuris trichiura, and others). Biohelminths (Opisthorchis, tapeworms, and others) Were detectable slightly worse.

  11. Survival of Escherichia coli with and without ColE1::Tn5 after aerosol dispersal in a laboratory and a farm environment.

    PubMed Central

    Marshall, B; Flynn, P; Kamely, D; Levy, S B

    1988-01-01

    The survival of a laboratory strain and a naturally occurring fecal strain of Escherichia coli, with and without a Tn5-containing derivative of ColE1, was examined after aerosol dispersal in a laboratory office and a barn under ambient temperature and humidity conditions. Following the release of paired strains, air and diverse types of surfaces were assayed for the test organisms. In both environments, the number of airborne bacteria declined rapidly within the first 2 h. Longer survival was found on surfaces and varied with surface type: recovery was greatest from wood products. Organisms persisted for 1 day in the office and for up to 20 days in the barn. Survival of the fecal strain was better than that of the laboratory strain in both test environments. In general, plasmid-bearing strains fared similarly to their plasmidless parents, but in several comparisons the ColE1::Tn5-containing strain showed enhanced survival. These studies have implications for the present and proposed release of genetically engineered organisms with and without plasmid vectors. PMID:2843099

  12. Teaching about genetic testing issues in the undergraduate classroom: a case study.

    PubMed

    Rogers, Jill Cellars; Taylor, Ann T S

    2011-06-01

    Educating undergraduates about current genetic testing and genomics can involve novel and creative teaching practices. The higher education literature describes numerous pedagogical approaches in the laboratory designed to engage science and liberal arts students. Often these experiences involve students analyzing their own genes for various polymorphisms, some of which are associated with disease states such as an increased risk for developing cancer. While the literature acknowledges possible ethical ramifications of such laboratory exercises, authors do not present recommendations or rubrics for evaluating whether or not the testing is, in fact, ethical. In response, we developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of ethical concerns, so the discussion served to replace actual genetic testing in the class. A basic scientist led the laboratory portion of the assignment. A genetic counselor facilitated the discussion, which centered around existing ethical guidelines for clinical genetic testing and possible challenges of human genotyping outside the medical setting. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human gene testing seems important and timely, and introduces an additional role genetic counselors can play in educating consumers about genomics.

  13. A Comparison of Laboratory and Clinical Working Memory Tests and Their Prediction of Fluid Intelligence

    PubMed Central

    Shelton, Jill T.; Elliott, Emily M.; Hill, B. D.; Calamia, Matthew R.; Gouvier, Wm. Drew

    2010-01-01

    The working memory (WM) construct is conceptualized similarly across domains of psychology, yet the methods used to measure WM function vary widely. The present study examined the relationship between WM measures used in the laboratory and those used in applied settings. A large sample of undergraduates completed three laboratory-based WM measures (operation span, listening span, and n-back), as well as the WM subtests from the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale-III. Performance on all of the WM subtests of the clinical batteries shared positive correlations with the lab measures; however, the Arithmetic and Spatial Span subtests shared lower correlations than the other WM tests. Factor analyses revealed that a factor comprising scores from the three lab WM measures and the clinical subtest, Letter-Number Sequencing (LNS), provided the best measurement of WM. Additionally, a latent variable approach was taken using fluid intelligence as a criterion construct to further discriminate between the WM tests. The results revealed that the lab measures, along with the LNS task, were the best predictors of fluid abilities. PMID:20161647

  14. Systems integration for the Kennedy Space Center (KSC) Robotics Applications Development Laboratory (RADL)

    NASA Technical Reports Server (NTRS)

    Davis, V. Leon; Nordeen, Ross

    1988-01-01

    A laboratory for developing robotics technology for hazardous and repetitive Shuttle and payload processing activities is discussed. An overview of the computer hardware and software responsible for integrating the laboratory systems is given. The center's anthropomorphic robot is placed on a track allowing it to be moved to different stations. Various aspects of the laboratory equipment are described, including industrial robot arm control, smart systems integration, the supervisory computer, programmable process controller, real-time tracking controller, image processing hardware, and control display graphics. Topics of research include: automated loading and unloading of hypergolics for space vehicles and payloads; the use of mobile robotics for security, fire fighting, and hazardous spill operations; nondestructive testing for SRB joint and seal verification; Shuttle Orbiter radiator damage inspection; and Orbiter contour measurements. The possibility of expanding the laboratory in the future is examined.

  15. Turning the Page: Advancing Paper-Based Microfluidics for Broad Diagnostic Application.

    PubMed

    Gong, Max M; Sinton, David

    2017-06-28

    Infectious diseases are a major global health issue. Diagnosis is a critical first step in effectively managing their spread. Paper-based microfluidic diagnostics first emerged in 2007 as a low-cost alternative to conventional laboratory testing, with the goal of improving accessibility to medical diagnostics in developing countries. In this review, we examine the advances in paper-based microfluidic diagnostics for medical diagnosis in the context of global health from 2007 to 2016. The theory of fluid transport in paper is first presented. The next section examines the strategies that have been employed to control fluid and analyte transport in paper-based assays. Tasks such as mixing, timing, and sequential fluid delivery have been achieved in paper and have enabled analytical capabilities comparable to those of conventional laboratory methods. The following section examines paper-based sample processing and analysis. The most impactful advancement here has been the translation of nucleic acid analysis to a paper-based format. Smartphone-based analysis is another exciting development with potential for wide dissemination. The last core section of the review highlights emerging health applications, such as male fertility testing and wearable diagnostics. We conclude the review with the future outlook, remaining challenges, and emerging opportunities.

  16. Managing demand for laboratory tests: a laboratory toolkit.

    PubMed

    Fryer, Anthony A; Smellie, W Stuart A

    2013-01-01

    Healthcare budgets worldwide are facing increasing pressure to reduce costs and improve efficiency, while maintaining quality. Laboratory testing has not escaped this pressure, particularly since pathology investigations cost the National Health Service £2.5 billion per year. Indeed, the Carter Review, a UK Department of Health-commissioned review of pathology services in England, estimated that 20% of this could be saved by improving pathology services, despite an average annual increase of 8%-10% in workload. One area of increasing importance is managing the demands for pathology tests and reducing inappropriate requesting. The Carter Review estimated that 25% of pathology tests were unnecessary, representing a huge potential waste. Certainly, the large variability in levels of requesting between general practitioners suggests that inappropriate requesting is widespread. Unlocking the key to this variation and implementing measures to reduce inappropriate requesting would have major implications for patients and healthcare resources alike. This article reviews the approaches to demand management. Specifically, it aims to (a) define demand management and inappropriate requesting, (b) assess the drivers for demand management, (c) examine the various approaches used, illustrating the potential of electronic requesting and (d) provide a wider context. It will cover issues, such as educational approaches, information technology opportunities and challenges, vetting, duplicate request identification and management, the role of key performance indicators, profile composition and assessment of downstream impact of inappropriate requesting. Currently, many laboratories are exploring demand management using a plethora of disparate approaches. Hence, this review seeks to provide a 'toolkit' with the view to allowing laboratories to develop a standardised demand management strategy.

  17. COLLOID MOBILIZATION AND TRANSPORT IN CONTAMINANT PLUMES: FILED EXPERIMENTS, LABORATORY EXPERIMENTS, AND MODELING

    EPA Science Inventory

    The major hypothesis driving this research, that the transport of colloids in a contaminant plume is limited by the advance of the chemical agent causing colloid mobilization, was tested by (1) examining the dependence of colloid transport and mobilization on chemical perturbatio...

  18. PKU and Maternal PKU: The Cure and the Problem.

    ERIC Educational Resources Information Center

    Henderson, Robert A.

    1989-01-01

    A longitudinal study is evaluating the efficacy of a phenylalanine-restricted diet in reducing disabling conditions associated with maternal hyperphenylalaninemia. Titled the Maternal PKU Collaborative Study, it is studying 162 American and Canadian women and involves diet therapy, prenatal examinations, laboratory tests, nutritional evaluation,…

  19. Specialized sperm function tests in varicocele and the future of andrology laboratory.

    PubMed

    Majzoub, Ahmad; Esteves, Sandro C; Gosálvez, Jaime; Agarwal, Ashok

    2016-01-01

    Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele.

  20. Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals.

    PubMed

    Bogart, Laura M; Howerton, Devery; Lange, James; Setodji, Claude Messan; Becker, Kirsten; Klein, David J; Asch, Steven M

    2010-06-01

    We examined provider-reported barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs), and hospitals. 12 primary metropolitan statistical areas (PMSAs; three per region) were sampled randomly, with sampling weights proportional to AIDS case reports. Across PMSAs, all 671 hospitals and a random sample of 738 clinics/CBOs were telephoned for a survey on rapid HIV test availability. Of the 671 hospitals, 172 hospitals were randomly selected for barriers questions, for which 158 laboratory and 136 department staff were eligible and interviewed in 2005. Of the 738 clinics/CBOs, 276 were randomly selected for barriers questions, 206 were reached, and 118 were eligible and interviewed in 2005-2006. In multivariate models, barriers regarding translation of administrative/quality assurance policies into practice were significantly associated with rapid HIV testing availability. For greater rapid testing diffusion, policies are needed to reduce administrative barriers and provide quality assurance training to non-laboratory staff.

  1. ICP measurement accuracy: the effect of temperature drift. Design of a laboratory test for assessment of ICP transducers.

    PubMed

    Morgalla, M H; Mettenleiter, H; Katzenberger, T

    1999-01-01

    Intracranial pressure (ICP) monitoring has become the mainstay of multimodal neuromonitoring of comatous patients after head injury. In the presence of rising ICP and faced with pressures, difficult to control, aggressive measures, such as hypothermia may be used. The ICP readings should not be influenced by temperature changes. A laboratory test was designed to simulate temperature variations between 20 degrees C and 45 degrees C at different pressure levels under physiological conditions. Five types of transducers were examined: Epidyn Braun Melsungen, ICT/B-Titan Gaeltec, Camino-OLM-110-4B, Codman MicroSensor ICP-Transducer, Neurovent ICP transducer Rehau Ag+Co. Tests were performed at 6 different pressure levels between 0 mmHg and 50 mmHg. The results show very low drifts of less than 0.15 mmHg degree C-1 for Codman, Epidyn and Neurovent. Gaeltec and Camino exhibited higher drifts of 0.18 mmHg and 0.2 mmHg degree C-1 respectively. Within the temperature range from 35 degrees C to 42 degrees C all probes tested show insignificant temperature drift. Whether these results also apply to other types of transducers needs further evaluation. Problems and requirements related to the design of a laboratory test for the in vitro assessment of ICP transducers are discussed in detail.

  2. Audit of Use and Overuse of Serum Protein Immunofixation Electrophoresis and Serum Free Light Chain Assay in Tertiary Health Care: A Case for Algorithmic Testing to Optimize Laboratory Utilization.

    PubMed

    Heaton, Christopher; Vyas, Shikhar G; Singh, Gurmukh

    2016-04-01

    Overuse of laboratory tests is a persistent issue. We examined the use and overuse of serum immunofixation electrophoresis and serum free light chain assays to develop an algorithm for optimizing utilization. A retrospective review of all tests, for investigation of monoclonal gammopathies, for all patients who had any of these tests done from April 24, 2014, through July 25, 2014, was carried out. The test orders were categorized as warranted or not warranted according to criteria presented in the article. A total of 237 patients were tested, and their historical records included 1,503 episodes of testing for one or more of serum protein electrophoresis, serum immunofixation electrophoresis, and serum free light chain assays. Only 46% of the serum immunofixation and 42% serum free light chain assays were warranted. Proper utilization, at our institution alone, would have obviated $64,182.95/year in health care costs, reduced laboratory cost of reagent alone by $26,436.04/year, and put $21,904.92/year of part B reimbursement at risk. Fewer than half of the serum immunofixation and serum free light chain assays added value. The proposed algorithm for testing should improve utilization. Risk to part B billing may be a disincentive to reducing test utilization. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center.

    PubMed

    MacMillan, Donna; Lewandrowski, Elizabeth; Lewandrowski, Kent

    2004-01-01

    Utilization of outside reference laboratories for selected laboratory testing is common in the United States. However, relatively little data exist in the literature describing the scope and impact of these services. In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts. A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002. Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002. Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital. The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house. The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory. Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays. Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu. Reference laboratory testing comprises a major component of hospital clinical laboratory services. Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

  4. Economic challenges associated with tuberculosis diagnostic development

    PubMed Central

    Hanrahan, Colleen F.; Shah, Maunank

    2015-01-01

    Tuberculosis remains a global health crisis in part due to underdiagnosis. Technological innovations are needed to improve diagnostic test accuracy and reduce the reliance on expensive laboratory infrastructure. However, there are significant economic challenges impeding the development and implementation of new diagnostics. The aim of this piece is to examine the current state of TB diagnostics, outline the unmet needs for new tests, and detail the economic challenges associated with development of new tests from the perspective of developers, policy makers and implementers. PMID:24766367

  5. Smart Home Test Bed: Examining How Smart Homes Interact with the Power Grid

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    This fact sheet highlights the Smart Home Test Bed capability at the Energy Systems Integration Facility. The National Renewable Energy Laboratory (NREL) is working on one of the new frontiers of smart home research: finding ways for smart home technologies and systems to enhance grid operations in the presence of distributed, clean energy technologies such as photovoltaics (PV). To help advance this research, NREL has developed a controllable, flexible, and fully integrated Smart Home Test Bed.

  6. Economic challenges associated with tuberculosis diagnostic development.

    PubMed

    Hanrahan, Colleen F; Shah, Maunank

    2014-08-01

    Tuberculosis remains a global health crisis in part due to underdiagnosis. Technological innovations are needed to improve diagnostic test accuracy and reduce the reliance on expensive laboratory infrastructure. However, there are significant economic challenges impeding the development and implementation of new diagnostics. The aim of this piece is to examine the current state of TB diagnostics, outline the unmet needs for new tests, and detail the economic challenges associated with development of new tests from the perspective of developers, policy makers and implementers.

  7. An audit of immunofixation requesting practices at a South African referral laboratory

    PubMed Central

    Rampursat, Yashna

    2014-01-01

    Background It is common practice in most chemical pathology laboratories for reflective immunofixation electrophoresis (IFE) to occur following the detection or suspicion of a paraprotein on serum protein electrophoresis (SPEP). The chemical pathology laboratory at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, South Africa, is currently the only non-private laboratory in the KwaZulu Natal province that performs SPEP analysis, with current practice requiring that the clinician request IFE following suggestion by the laboratory after a suspicious SPEP result. Objectives To review the current process for IFE at IALCH in the context of reflective testing and to examine the use of the alpha-2-globulin/alpha-1-globulin ratio as a predictor of a positive IFE result. Methods Data for 1260 consecutive SPEP tests performed at the IALCH National Health Laboratory Service were collected between February and July 2011. SPEP and IFE were performed with a Sebia Hydrasys automated electrophoresis system. The alpha-2-globulin/alpha-1-globulin ratio was calculated using density of corresponding fractions on SPEP. Results Analysis revealed that of the 1260 SPEPs performed during the analysis period, 304 IFEs were suggested by the reviewing pathologist. A total of 45 (15%) of the suggested IFEs were subsequently requested by the attending clinicians. Almost half (46.5%) (n = 20) of the suggested IFEs that were performed revealed the presence of a paraprotein. There was no statistically-significant difference between the alpha-2-globulin/alpha-1-globulin ratio for patients with positive or negative IFEs (p-value = 0.2). Conclusions This study reveals the need for reflective addition of IFE testing by the laboratory following suspicious findings on SPEP. PMID:29043173

  8. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Demas, Nicholaos G.; Erck, Robert A.; Lorenzo-Martin, Cinta

    The effect of two nanoparticle oxides on friction and wear was studied under laboratory test conditions using a reciprocating test machine and two test configurations. The addition of these nanoparticles in base stock oil under certain conditions reduced the coefficient of friction and improved wear, but that depended on the test configuration. Examination of the rubbed surfaces showed the pronounced formation of a tribofilm in some cases, while polishing on the surface was also observed in other cases. Contact configuration is important when oxide nanoparticles are being evaluated and the conclusions about their efficacy can be vastly different.

  9. Methodology in diagnostic laboratory test research in clinical chemistry and clinical chemistry and laboratory medicine.

    PubMed

    Lumbreras-Lacarra, Blanca; Ramos-Rincón, José Manuel; Hernández-Aguado, Ildefonso

    2004-03-01

    The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term "sensitivity and specificity" (exploded) with the text words "specificity", "false negative", and "accuracy". We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645-51) of papers published in general medical journals. Three observers evaluated each article independently. Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.

  10. [National External Quality Assessment for medical biology laboratories in Burkina Faso: an overview of three years of activity].

    PubMed

    Sakande, Jean; Nikièma, Abdoulaye; Kabré, Elie; Nacoulma, Eric; Sawadogo, Charles; Lingani, Virginie; Traoré, Lady Kady; Kouanda, Abdoulaye; Kientéga, Youssouf; Somda, Joseph; Kagambéga, Faustin; Sanou, Mahamoudou; Sangaré, Lassana; Traoré-Ouédraogo, Rasmata

    2010-01-01

    We report results of the National External Quality Assessment for (NEQA) laboratories in Burkina Faso, a country with limited resources located in West Africa whose epidemiology is dominated by infectious diseases. The national laboratory network consists of 160 laboratories including 40 private. The Government of Burkina Faso has adopted a national laboratory policy. One of the objectives of this policy is to improve the quality of laboratory results. One of the strategies to achieve this objective is the establishment of a NEQA. The NEQA is a panel testing also called proficiency testing. It is mandatory for all laboratories to participate to the NEQA. The NEQA is organized twice a year and covers all areas of laboratories (bacteriology-virology, biochemistry, hematology, parasitology and immunology). The review of three years of activity (2006-2008) shows the following results: (1) for microscopic examination of bacteria after Gram staining, the error rate decreased from 24.7% in 2006 to 13.1% in 2007 and 13% in 2008; (2) errors rate in reading slides for the microscopic diagnosis of malaria were 23.4%, 14.6% and 10.2% respectively in 2006, 2007 and 2008; (3) for biochemistry, the percentages of unsatisfactory results were respectively 12.5%, 14.8% and 13.8% in 2006, 2007 and 2008 for the overall parameters assessed. The analysis of the results generated by the laboratories during these three years shows a quality improvement. However, the NEQA should be strengthened through ongoing training and quality control of reagents and equipment.

  11. Laboratory systems integration: robotics and automation.

    PubMed

    Felder, R A

    1991-01-01

    Robotic technology is going to have a profound impact on the clinical laboratory of the future. Faced with increased pressure to reduce health care spending yet increase services to patients, many laboratories are looking for alternatives to the inflexible or "fixed" automation found in many clinical analyzers. Robots are being examined by many clinical pathologists as an attractive technology which can adapt to the constant changes in laboratory testing. Already, laboratory designs are being altered to accommodate robotics and automated specimen processors. However, the use of robotics and computer intelligence in the clinical laboratory is still in its infancy. Successful examples of robotic automation exist in several laboratories. Investigators have used robots to automate endocrine testing, high performance liquid chromatography, and specimen transportation. Large commercial laboratories are investigating the use of specimen processors which combine the use of fixed automation and robotics. Robotics have also reduced the exposure of medical technologists to specimens infected with viral pathogens. The successful examples of clinical robotics applications were a result of the cooperation of clinical chemists, engineers, and medical technologists. At the University of Virginia we have designed and implemented a robotic critical care laboratory. Initial clinical experience suggests that robotic performance is reliable, however, staff acceptance and utilization requires continuing education. We are also developing a robotic cyclosporine which promises to greatly reduce the labor costs of this analysis. The future will bring lab wide automation that will fully integrate computer artificial intelligence and robotics. Specimens will be transported by mobile robots. Specimen processing, aliquotting, and scheduling will be automated.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Flat panel display test and evaluation: procedures, standards, and facilities

    NASA Astrophysics Data System (ADS)

    Jackson, Timothy W.; Daniels, Reginald; Hopper, Darrel G.

    1997-07-01

    This paper addresses flat panel display test and evaluation via a discussion of procedures, standards and facilities. Procedures need to be carefully developed and documented to ensure that test accomplished in separate laboratories produce comparable results. The tests themselves must not be a source of inconsistency in test results when such comparisons are made in the course of procurements or new technology prototype evaluations. Standards are necessary to expedite the transition of the new display technologies into applications and to lower the costs of custom parts applied across disparate applications. The flat panel display industry is in the course of ascertaining and formulating such standards as they are of value to designers, manufacturers, marketers and users of civil and military products and equipment. Additionally, in order to inform the DoD and industry, the test and evaluation facilities of the Air Force Research Laboratory Displays Branch are described. These facilities are available to support procurements involving flat panel displays and to examine new technology prototypes. Finally, other government display testing facilities within the Navy and the Army are described.

  13. Lyme Disease Testing in a High-Incidence State: Clinician Knowledge and Patterns.

    PubMed

    Conant, Joanna L; Powers, Julia; Sharp, Gregory; Mead, Paul S; Nelson, Christina A

    2018-02-17

    Lyme disease (LD) incidence is increasing, but data suggest some clinicians are not fully aware of recommended procedures for ordering and interpreting diagnostic tests. The study objective was to assess clinicians' knowledge and practices regarding LD testing in a high-incidence region. We distributed surveys to 1,142 clinicians in the University of Vermont Medical Center region, of which 144 were completed (12.6% response rate). We also examined LD laboratory test results and logs of calls to laboratory customer service over a period of 2.5 years and 6 months, respectively. Most clinicians demonstrated basic knowledge of diagnostic protocols, but many misinterpreted Western blot results. For example, 42.4% incorrectly interpreted a positive immunoglobulin M result as an overall positive test in a patient with longstanding symptoms. Many also reported receiving patient requests for unvalidated tests. Additional education and modifications to LD test ordering and reporting systems would likely reduce errors and improve patient care. © American Society for Clinical Pathology, 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  14. Pericardiocentesis in massive pericardial effusions due to hypothyroidism

    NASA Astrophysics Data System (ADS)

    Nainggolan, F. H.; Dalimunthe, N. N.; Harahap, S.; Isnanta, R.; Realsyah, T.; Safri, Z.; Hasan, R.

    2018-03-01

    Pericardial effusion is the accumulation of abnormal fluid in the pericardial cavity. The symptoms are not specific and associated with the underlying disease. It was reported that a 53-year-old male patient entered the Emergency Room with a shortness of breath, and getting worse during activity and position. There was weight loss and smoking history. The history of diabetic, hypertension and malignancy were denied. On physical examination showed the enlarged right and left heart border and weakened heartbeat sheer off is found and edema pretibial and normal the other. The laboratory results;blood routine, renal and liver function within normal; lipid profile: hypercholesterolemia; viral marker is non-reactive.Rontgen thorax suggests cardiomegaly, but there was no infiltrate or nodules. Electrocardiogram (ECG) showed a low voltage. Echocardiography examination showed massive pericardial effusion. Pericardiosynthetis performed produces 750 cc of clear yellow liquid and showed transudate. Other laboratory tests such as ANA test, anti ds-DNA, cyfra were a normal impression. Thyroid function: hypothyroid, Mantoux test is negative. Finally, the patient is a massive pericardial effusion caused by hypothyroidism. The pericardiocentesis took, and the hypothyroid drug of euthirax is administered. The patient was well done and continued for recontrol.

  15. Theory of an experiment in an orbiting space laboratory to determine the gravitational constant.

    NASA Technical Reports Server (NTRS)

    Vinti, J. P.

    1972-01-01

    An experiment is discussed for determining the gravitational constant with the aid of an isolated system consisting of an artificial satellite moving around an artificial planet. The experiment is to be conducted in a spherical laboratory traveling in an orbit around the earth. Difficulties due to the gravity-gradient term are considered, and the three-tunnel method proposed by Wilk (1969) is examined. The rotation of the sphere is discussed together with aspects of the reference systems used, the equations of motion of the spacecraft and of the test objects, the field from the earth's gravity gradient at the test object, higher harmonic terms in the gravity gradient force, gravitational effects of the spacecraft itself, and a computer simulation.

  16. CALiPER Report 22.1: Photoelectric Performance of LED MR16 Lamps

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Royer, Michael P.; Poplawski, Michael E.; Brown, Charles C.

    This report is a follow-up to CALiPER Application Summary Report 22, which investigated the photometric performance of LED MR16 lamps. The initial report found that many of the LED MR16 lamps did not perform as required by ENERGY STAR based on their equivalency claims, although they generally did provide substantial efficacy advantages compared to halogen MR16 lamps. All testing was completed using laboratory power supplies, with all but one product tested at 12 V AC. In contrast, this report examined the photoelectric performance of the same set of lamps, using commercially available transformers and dimmers as well as laboratory powermore » supplies providing both AC and DC power.« less

  17. INHERITED NEUROPATHIES: CLINICAL OVERVIEW AND UPDATE

    PubMed Central

    KLEIN, CHRISTOPHER J.; DUAN, XIAOHUI; SHY, MICHAEL E.

    2014-01-01

    Inherited neuropathy is a group of common neurologic disorders with heterogeneous clinical presentations and genetic causes. Detailed neuromuscular evaluations, including nerve conduction studies, laboratory testing, and histopathologic examination, can assist in identification of the inherited component beyond family history. Genetic testing increasingly enables definitive diagnosis of specific inherited neuropathies. Diagnosis, however, is often complex, and neurologic disability may have both genetic and acquired components in individual patients. The decision of which genetic test to order or whether to order genetic tests is often complicated, and the strategies to maximize the value of testing are evolving. Apart from rare inherited metabolic neuropathies, treatment approaches remain largely supportive. We provide a clinical update of the various types of inherited neuropathies, their differential diagnoses, and distinguishing clinical features (where available). A framework is provided for clinical evaluations, including the inheritance assessment, electrophysiologic examinations, and specific genetic tests. PMID:23801417

  18. Results from Testing of Two Rotary Percussive Drilling Systems

    NASA Technical Reports Server (NTRS)

    Kriechbaum, Kristopher; Brown, Kyle; Cady, Ian; von der Heydt, Max; Klein, Kerry; Kulczycki, Eric; Okon, Avi

    2010-01-01

    The developmental test program for the MSL (Mars Science Laboratory) rotary percussive drill examined the e ect of various drill input parameters on the drill pene- tration rate. Some of the input parameters tested were drill angle with respect to gravity and percussive impact energy. The suite of rocks tested ranged from a high strength basalt to soft Kaolinite clay. We developed a hole start routine to reduce high sideloads from bit walk. The ongoing development test program for the IMSAH (Integrated Mars Sample Acquisition and Handling) rotary percussive corer uses many of the same rocks as the MSL suite. An additional performance parameter is core integrity. The MSL development test drill and the IMSAH test drill use similar hardware to provide rotation and percussion. However, the MSL test drill uses external stabilizers, while the IMSAH test drill does not have external stabilization. In addition the IMSAH drill is a core drill, while the MSL drill uses a solid powdering bit. Results from the testing of these two related drilling systems is examined.

  19. Cutaneous tuberculosis: diagnosis, histopathology and treatment - part II.

    PubMed

    Santos, Josemir Belo dos; Figueiredo, Ana Roberta; Ferraz, Cláudia Elise; Oliveira, Márcia Helena de; Silva, Perla Gomes da; Medeiros, Vanessa Lucília Sileira de

    2014-01-01

    The evolution in the knowledge of tuberculosis' physiopathology allowed not only a better understanding of the immunological factors involved in the disease process, but also the development of new laboratory tests, as well as the establishment of a histological classification that reflects the host's ability to contain the infectious agent. At the same time, the increasing bacilli resistance led to alterations in the basic tuberculosis treatment scheme in 2009. This article critically examines laboratory and histological investigations, treatment regimens for tuberculosis and possible adverse reactions to the most frequently used drugs.

  20. Linking Informant Discrepancies to Observed Variations in Young Children's Disruptive Behavior

    ERIC Educational Resources Information Center

    De Los Reyes, Andres; Henry, David B.; Tolan, Patrick H.; Wakschlag, Lauren S.

    2009-01-01

    Prior work has not tested the basic theoretical notion that informant discrepancies in reports of children's behavior exist, in part, because different informants observe children's behavior in different settings. We examined patterns of observed preschool disruptive behavior across varying social contexts in the laboratory and whether they…

  1. 20 CFR 10.5 - What definitions apply to these regulations?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... physical limitations due to his or her work-related injury or illness is withdrawn (except when such... operations conducted under a statute relating to tribal timber and logging operations on that reservation; (4... examinations (and related laboratory tests), x-rays performed to diagnose a subluxation of the spine and...

  2. The Stress Response and Adolescents' Adjustment: The Impact of Child Maltreatment

    ERIC Educational Resources Information Center

    Cook, Emily C.; Chaplin, Tara M.; Sinha, Rajita; Tebes, Jacob K.; Mayes, Linda C.

    2012-01-01

    Experience with and management of stress has implications for adolescents' behavioral and socioemotional development. This study examined the relationship between adolescents' physiological response to an acute laboratory stressor (i.e., Trier Social Stress Test; TSST) and anger regulation and interpersonal competence in a sample of 175 low-income…

  3. Modification of a Microwave Oven for Laboratory Use.

    ERIC Educational Resources Information Center

    Andrews, Judith; Atkinson, George F.

    1984-01-01

    Discusses use of a domestic microwave oven for drying analytical samples with time savings compared to conventional ovens, providing a solution to the problem of loss of load as samples dry. Presents a system for examining emitted gases from drying process and reports results of several test dryings. (JM)

  4. Verbal Skills in Children with ADHD. Short Report

    ERIC Educational Resources Information Center

    Andreou, G.; Agapitou, P.; Karapetsas, A.

    2005-01-01

    The present study examined whether ADHD children exhibit low verbal IQ (VIQ) and distinguishable test profile on the Verbal comprehension (VC) and Freedom from distractibility (FFD) factors, and whether gender influences their verbal abilities. At the Laboratory of Neuropsychology of the Department of Special Education, University of Thessaly,…

  5. Performance of forty-one microbial source tracking methods: A twenty-seven lab evaluation study

    EPA Science Inventory

    The last decade has seen development of numerous new microbial source tracking (MST) methodologies, but many of these have been tested in just a few laboratories with a limited number of fecal samples. This method evaluation study examined the specificity and sensitivity of 43 ...

  6. Effect of Flooding on the Survival of Formosan Subterranean Termites (Isoptera: Rhinotermitidae) in Laboratory Tests

    USDA-ARS?s Scientific Manuscript database

    Underground monitoring stations were active with Formosan subterranean termites, Coptotermes formosanus Shiraki, less than a month after the flood waters receded from an urban park, City Park, New Orleans, Louisiana. This study examines whether the presence of galleries in soil or wood increases su...

  7. Using the arthroscopic surgery skill evaluation tool as a pass-fail examination.

    PubMed

    Koehler, Ryan J; Nicandri, Gregg T

    2013-12-04

    Examination of arthroscopic skill requires evaluation tools that are valid and reliable with clear criteria for passing. The Arthroscopic Surgery Skill Evaluation Tool was developed as a video-based assessment of technical skill with criteria for passing established by a panel of experts. The purpose of this study was to test the validity and reliability of the Arthroscopic Surgery Skill Evaluation Tool as a pass-fail examination of arthroscopic skill. Twenty-eight residents and two sports medicine faculty members were recorded performing diagnostic knee arthroscopy on a left and right cadaveric specimen in our arthroscopic skills laboratory. Procedure videos were evaluated with use of the Arthroscopic Surgery Skill Evaluation Tool by two raters blind to subject identity. Subjects were considered to pass the Arthroscopic Surgery Skill Evaluation Tool when they attained scores of ≥ 3 on all eight assessment domains. The raters agreed on a pass-fail rating for fifty-five of sixty videos rated with an interclass correlation coefficient value of 0.83. Ten of thirty participants were assigned passing scores by both raters for both diagnostic arthroscopies performed in the laboratory. Receiver operating characteristic analysis demonstrated that logging more than eighty arthroscopic cases or performing more than thirty-five arthroscopic knee cases was predictive of attaining a passing Arthroscopic Surgery Skill Evaluation Tool score on both procedures performed in the laboratory. The Arthroscopic Surgery Skill Evaluation Tool is valid and reliable as a pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. This study demonstrates that the Arthroscopic Surgery Skill Evaluation Tool may be a useful tool for pass-fail examination of diagnostic arthroscopy of the knee in the simulation laboratory. Further study is necessary to determine whether the Arthroscopic Surgery Skill Evaluation Tool can be used for the assessment of multiple arthroscopic procedures and whether it can be used to evaluate arthroscopic procedures performed in the operating room.

  8. Review of Pre-Analytical Errors in Oral Glucose Tolerance Testing in a Tertiary Care Hospital.

    PubMed

    Nanda, Rachita; Patel, Suprava; Sahoo, Sibashish; Mohapatra, Eli

    2018-03-13

    The pre-pre-analytical and pre-analytical phases form a major chunk of the errors in a laboratory. The process has taken into consideration a very common procedure which is the oral glucose tolerance test to identify the pre-pre-analytical errors. Quality indicators provide evidence of quality, support accountability and help in the decision making of laboratory personnel. The aim of this research is to evaluate pre-analytical performance of the oral glucose tolerance test procedure. An observational study that was conducted overa period of three months, in the phlebotomy and accessioning unit of our laboratory using questionnaire that examined the pre-pre-analytical errors through a scoring system. The pre-analytical phase was analyzed for each sample collected as per seven quality indicators. About 25% of the population gave wrong answer with regard to the question that tested the knowledge of patient preparation. The appropriateness of test result QI-1 had the most error. Although QI-5 for sample collection had a low error rate, it is a very important indicator as any wrongly collected sample can alter the test result. Evaluating the pre-analytical and pre-pre-analytical phase is essential and must be conducted routinely on a yearly basis to identify errors and take corrective action and to facilitate their gradual introduction into routine practice.

  9. Biosecurity through Public Health System Design.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beyeler, Walter E.; Finley, Patrick D.; Arndt, William

    We applied modeling and simulation to examine the real-world tradeoffs between developingcountry public-health improvement and the need to improve the identification, tracking, and security of agents with bio-weapons potential. Traditionally, the international community has applied facility-focused strategies for improving biosecurity and biosafety. This work examines how system-level assessments and improvements can foster biosecurity and biosafety. We modeled medical laboratory resources and capabilities to identify scenarios where biosurveillance goals are transparently aligned with public health needs, and resource are distributed in a way that maximizes their ability to serve patients while minimizing security a nd safety risks. Our modeling platform simulatesmore » key processes involved in healthcare system operation, such as sample collection, transport, and analysis at medical laboratories. The research reported here extends the prior art by provided two key compone nts for comparative performance assessment: a model of patient interaction dynamics, and the capability to perform uncertainty quantification. In addition, we have outlined a process for incorporating quantitative biosecurity and biosafety risk measures. Two test problems were used to exercise these research products examine (a) Systemic effects of technological innovation and (b) Right -sizing of laboratory networks.« less

  10. Introduction to ISO 15189: a blueprint for quality systems in veterinary laboratories.

    PubMed

    Freeman, Kathleen P; Bauer, Natali; Jensen, Asger L; Thoresen, Stein

    2006-06-01

    A trend in human and veterinary medical laboratory management is to achieve accreditation based on international standards. The International Organization for Standardization (ISO) 15189 standard is the first developed especially for accreditation of medical laboratories, and emphasizes the laboratory-client interface. European veterinary laboratories seeking to train candidates for the certification examination of the European College of Veterinary Clinical Pathology (ECVCP) require approval by the ECVCP Laboratory Standards Committee, which bases its evaluation in part on adherence to quality systems described in the ISO 15189 standards. The purpose of this article was to introduce the latest ISO quality standard and describe its application to veterinary laboratories in Europe, specifically as pertains to accreditation of laboratories involved in training veterinary clinical pathologists. Between 2003 and 2006, the Laboratory Standards Committee reviewed 12 applications from laboratories (3 commercial and 9 university) involved in training veterinary clinical pathologists. Applicants were asked to provide a description of the facilities for training and testing, current methodology and technology, health and safety policy, quality assurance policy (including internal quality control and participation in an external quality assurance program), written standard operating procedures (SOPs) and policies, a description of the laboratory information system, and personnel and training. Also during this time period multiple informal and formal discussions among ECVCP diplomates took place as to current practices and perceived areas of concern with regard to laboratory accreditation requirements. Areas in which improvement most often was needed in veterinary laboratories applying for ECVCP accreditation were the written quality plan, defined quality requirements for the tests performed, written SOPs and policies, training records, ongoing audits and competency assessments, and processes for identifying and addressing opportunities for improvement. Recommendations were developed for a stepwise approach towards achieving ISO 15189 standards, including 3 levels of quality components. The ISO 15189 standard provides a sound framework for veterinary laboratories aspiring to meet international quality standards.

  11. Diagnosis and treatment of dementia: 2. Diagnosis

    PubMed Central

    Feldman, Howard H.; Jacova, Claudia; Robillard, Alain; Garcia, Angeles; Chow, Tiffany; Borrie, Michael; Schipper, Hyman M.; Blair, Mervin; Kertesz, Andrew; Chertkow, Howard

    2008-01-01

    Background Dementia can now be accurately diagnosed through clinical evaluation, cognitive screening, basic laboratory evaluation and structural imaging. A large number of ancillary techniques are also available to aid in diagnosis, but their role in the armamentarium of family physicians remains controversial. In this article, we provide physicians with practical guidance on the diagnosis of dementia based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, held in March 2006. Methods We developed evidence-based guidelines using systematic literature searches, with specific criteria for study selection and quality assessment, and a clear and transparent decision-making process. We selected studies published from January 1996 to December 2005 that pertained to key diagnostic issues in dementia. We graded the strength of evidence using the criteria of the Canadian Task Force on Preventive Health Care. Results Of the 1591 articles we identified on all aspects of dementia diagnosis, 1095 met our inclusion criteria; 620 were deemed to be of good or fair quality. From a synthesis of the evidence in these studies, we made 32 recommendations related to the diagnosis of dementia. There are clinical criteria for diagnosing most forms of dementia. A standard diagnostic evaluation can be performd by family physicians over multiple visits. It involves a clinical history (from patient and caregiver), a physical examination and brief cognitive testing. A list of core laboratory tests is recommended. Structural imaging with computed tomography or magnetic resonance imaging is recommended in selected cases to rule out treatable causes of dementia or to rule in cerebrovascular disease. There is insufficient evidence to recommend routine functional imaging, measurement of biomarkers or neuropsychologic testing. Interpretation The diagnosis of dementia remains clinically integrative based on history, physical examination and brief cognitive testing. A number of core laboratory tests are also recommended. Structural neuroimaging is advised in selected cases. Other diagnostic approaches, including functional neuroimaging, neuropsychological testing and measurement of biomarkers, have shown promise but are not yet recommended for routine use by family physicians. PMID:18362376

  12. Good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders.

    PubMed

    2012-04-06

    Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn screening laboratories. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process (which consists of the preanalytic, analytic, and postanalytic phases), confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations. This report complements Good Laboratory Practices for Molecular Genetic Testing for Heritable Diseases and Conditions (CDC. Good laboratory practices for molecular genetic testing for heritable diseases and conditions. MMWR 2009;58 [No. RR-6]) to provide guidance for ensuring and improving the quality of genetic laboratory services and public health outcomes. Future recommendations for additional areas of genetic testing will be considered on the basis of continued monitoring and evaluation of laboratory practices, technology advancements, and the development of laboratory standards and guidelines.

  13. The bats of Wyoming

    USGS Publications Warehouse

    Bogan, Michael A.; Cryan, Paul M.; Choate, Jerry R.

    2000-01-01

    We examined 1280 bats of 12 species submitted to the Wyoming State Veterinary Laboratory (WSVL) for ra­bies testing between 1981 and 1992. The most abundant species in the sample was Myotis lucifugus, followed by Epte­sicus fuscus, Lasionycteris noetivagans, M. ciliolabrum, and M. volans. Using the WSVL sample and additional museum specimens, we summarized available records and knowledge for 17 species of bats in Wyoming, Records of the WSVL show that, between 1981 and 1992, 113 bats actually tested positive for rabies. We examined 45 of those rabies­ positive bats; E. fuscus had the highest incidence (60%) in the sample, followed by L. noctivagans (11 %) and L. cinereus (9%).

  14. Operational trial of ParaSight-F (dipstick) in the diagnosis of falciparum malaria at the primary health care level.

    PubMed

    Banchongaksorn, T; Prajakwong, S; Rooney, W; Vickers, P

    1997-06-01

    The rapid manual ParaSight-F test of Plasmodium falciparum malaria, an antigen capture test for detecting trophozoite-derived histidine rich protein-2 (PF HRP-2), is simple to perform and provides a definite diagnosis within 10 minutes. During an operational trial at health centers and mobile malaria units where microscopical diagnosis is not available and using defined symptom screening criteria, 3,361 subjects were tested yielding 618 positives (18.4%) for PF-HRP-2 by ParaSight-F. Microscopic examination of the same subjects by thick blood film examined 7 days later at a malaria clinic showed 578 falciparum, and 349 vivax and mixed infection (F+V) 41. The technology proved highly effective in detecting falciparum malaria at the peripheral levels where access to malaria laboratory services are difficult, thus allowing immediate administration of a complete course of treatment in the absence of a microscopic examination.

  15. MDMA effects consistent across laboratories

    PubMed Central

    Kirkpatrick, Matthew G.; Baggott, Matthew J.; Mendelson, John E.; Galloway, Gantt P.; Liechti, Matthias E.; Hysek, Cédric M.; de Wit, Harriet

    2014-01-01

    Rationale Several laboratories have conducted placebo-controlled drug challenge studies with MDMA, providing a unique source of data to examine the reliability of the acute effects of the drug across subject samples and settings. We examined the subjective and physiological responses to the drug across three different laboratories, and investigated the influence of prior MDMA use. Methods Overall, 220 healthy volunteers with varying levels of previous MDMA experience participated in laboratory-based studies in which they received placebo or oral MDMA (1.5 mg/kg or 125 mg fixed dose) under double blind conditions. Cardiovascular and subjective effects were assessed before and repeatedly after drug administration. The studies were conducted independently by investigators in Basel, San Francisco and Chicago. Results Despite methodological differences between the studies and differences in the subjects' drug use histories, MDMA produced very similar cardiovascular and subjective effects across the sites. The participants' prior use of MDMA was inversely related to feeling `Any Drug Effect' only at sites testing more experienced users. Conclusions These data indicate that the pharmacological effects of MDMA are robust and highly reproducible across settings. There was also modest evidence for tolerance to the effects of MDMA in regular users. PMID:24633447

  16. Shock Waves Mitigation at Blunt Bodies Using Needles and Shells Against a Supersonic Flow

    NASA Technical Reports Server (NTRS)

    Gilinsky, M.; Blankson, I. M.; Sakharov, V. I.; Shvets, A. I.

    2004-01-01

    The paper contains some experimental and numerical simulation test results on cylindrical blunt body drag reduction using thin spikes or shell mounted in front of a body against a supersonic flow. Experimental tests were conducted using the Aeromechanics and Gas Dynamics Laboratory facilities at the Institute of Mechanics of Moscow State University (IMMSU). Numerical simulations utilizing NASA and IM/MSU codes were conducted at the Hampton University Fluid Mechanics and Acoustics Laboratory. The main purpose of this research is to examine the efficiency of application of multiple spikes for drag reduction and flow stability at the front of a blunt body in different flight conditions, i.e. Mach number, angle of attack, etc. The principal conclusions of these test results are: multiple spike/needle application leads to decrease of drag reduction benefits by comparison with the case of one central mounted needle at the front of a blunt body, but increase lift benefits.

  17. Ocular sarcoidosis masked by positive IgM for toxoplasmosis.

    PubMed

    Peres, Murilo Bertazzo; Sousa, Jacqueline Martins de; Nascimento, Heloisa

    2017-01-01

    We report a case of ocular sarcoidosis with positive immunoglobulin (Ig) M and IgG serology for toxoplasmosis. The patient was a young female with red painful eyes, bilateral eyelid edema, and panuveitis with periphlebitis. In laboratory testing, she was IgM and IgG positive for toxoplasmosis and anergic in the tuberculin test. Topical treatment for anterior uveitis and oral antibiotics for toxoplasmosis were started, without improvement. Orbit tomography showed increased lacrimal glands bilaterally, and chest X-ray radiographic findings were consistent with pulmonary sarcoidosis, which supported the presumed ocular sarcoidosis diagnosis. The patient was treated with oral prednisone and methotrexate without antibiotics. She showed clinical and vision improvement without recurrences during the 1-year follow-up. Ocular sarcoidosis is an important differential diagnosis requiring careful anamnesis and ophthalmological examinations. Ancillary tests, such as X-ray radiography, tomography, and clinical and laboratory evaluations may help rule out other causes. Treatment mainly consists of corticosteroids and immunosuppression.

  18. Inter-rater reliability of three standardized functional tests in patients with low back pain

    PubMed Central

    Tidstrand, Johan; Horneij, Eva

    2009-01-01

    Background Of all patients with low back pain, 85% are diagnosed as "non-specific lumbar pain". Lumbar instability has been described as one specific diagnosis which several authors have described as delayed muscular responses, impaired postural control as well as impaired muscular coordination among these patients. This has mostly been measured and evaluated in a laboratory setting. There are few standardized and evaluated functional tests, examining functional muscular coordination which are also applicable in the non-laboratory setting. In ordinary clinical work, tests of functional muscular coordination should be easy to apply. The aim of this present study was to therefore standardize and examine the inter-rater reliability of three functional tests of muscular functional coordination of the lumbar spine in patients with low back pain. Methods Nineteen consecutive individuals, ten men and nine women were included. (Mean age 42 years, SD ± 12 yrs). Two independent examiners assessed three tests: "single limb stance", "sitting on a Bobath ball with one leg lifted" and "unilateral pelvic lift" on the same occasion. The standardization procedure took altered positions of the spine or pelvis and compensatory movements of the free extremities into account. The inter-rater reliability was analyzed by Cohen's kappa coefficient (κ) and by percentage agreement. Results The inter-rater reliability for the right and the left leg respectively was: for the single limb stance very good (κ: 0.88–1.0), for sitting on a Bobath ball good (κ: 0.79) and very good (κ: 0.88) and for the unilateral pelvic lift: good (κ: 0.61) and moderate (κ: 0.47). Conclusion The present study showed good to very good inter-rater reliability for two standardized tests, that is, the single-limb stance and sitting on a Bobath-ball with one leg lifted. Inter-rater reliability for the unilateral pelvic lift test was moderate to good. Validation of the tests in their ability to evaluate lumbar stability is required. PMID:19490644

  19. Economic evaluation of different screening alternatives for patients with clinically suspected acute deep vein thrombosis.

    PubMed

    Bogavac-Stanojević, Natasa; Dopsaj, Violeta; Jelić-Ivanović, Zorana; Lakić, Dragana; Vasić, Dragan; Petrova, Guenka

    2013-01-01

    We examined the cost-effectiveness of the three different D-dimer measurements in the screening of DVT in models with and without calculation of pre-test probability (PTP) score. Moreover, we calculated the minimal cost in DVT detection. In the group of 192 patients with clinically suspected acute DVT, we examined the three different D-dimer measurements (Innovance D-dimer, Hemosil D-dimer HS and Vidas D-dimer Exclusion II) in combination with and without PTP assessment. The diagnostic alternative employing Vidas D-dimer Exclusion II assay without and with PTP calculation gave lower incremental cost-effectiveness ratio (ICER) than the alternative employing Hemosil D-dimer HS assay (0.187 Euros vs. 0.998 Euros per one additional DVT positive patient selected for CUS in model without PTP assessment and 0.450 vs. 0.753 Euros per one DVT positive patient selected for CUS in model with PTP assessment). According to sensitivity analysis, the Hemosil D-dimer HS assay was the most cost effective alternative when one patient was admitted to the vascular ambulance per day. Vidas D-dimer Exclusion II assay was the most cost effective alternative when more than one patient were admitted to the vascular ambulance per day. Cost minimisation analysis indicated that selection of patients according to PTP score followed by D-dimer analysis decreases the cost of DVT diagnosis. ICER analysis enables laboratories to choose optimal laboratory tests according to number of patients admitted to laboratory. Results support the feasibility of using PTP scoring and D-dimer measurement before CUS examination in DVT screening.

  20. Oral Anatomy Laboratory Examinations in a Physical Therapy Program

    ERIC Educational Resources Information Center

    Fabrizio, Philip A.

    2013-01-01

    The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days.…

  1. Initial clinical laboratory experience in noninvasive prenatal testing for fetal aneuploidy from maternal plasma DNA samples.

    PubMed

    Futch, Tracy; Spinosa, John; Bhatt, Sucheta; de Feo, Eileen; Rava, Richard P; Sehnert, Amy J

    2013-06-01

    The aim of this study is to report the experience of noninvasive prenatal DNA testing using massively parallel sequencing in an accredited clinical laboratory. Laboratory information was examined for blood samples received for testing between February and November 2012 for chromosome 21 (Chr21), Chr18, and Chr13. Monosomy X (MX) testing was available from July 2012 for cystic hygroma indication. Outcomes were collected from providers on samples with positive results. There were 5974 samples tested, and results were issued within an average of 5.1 business days. Aneuploidy was detected in 284 (4.8%) samples (155 Chr21, 66 Chr18, 19 Chr13, 40 MX, and four double aneuploidy). Follow-ups are available for 245/284 (86%), and 77/284 (27.1%) are confirmed, including one double-aneuploidy case concordant with cytogenetics from maternal malignancy. Fourteen (0.2%) discordant (putative false-positive) results (one Chr21, six Chr18, three Chr13, three MX, and one Chr21/13) have been identified. Five (0.08%) false-negative cases are reported (two trisomy 21, two trisomy 18, and one MX). In 170 (2.8%) cases, the result for a single chromosome was indefinite. This report suggests that clinical testing of maternal cell-free DNA for fetal aneuploidy operates within performance parameters established in validation studies. Noninvasive prenatal testing is sensitive to biological contributions from placental and maternal sources. ©2013 Verinata Health, Inc. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

  2. Fire extinguishing tests -80 with methyl alcohol gasoline (in MIXED)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Holmstedt, G.; Ryderman, A.; Carlsson, B.

    1980-01-01

    Large scale tests and laboratory experiments were carried out for estimating the extinguishing effectiveness of three alcohol resistant aqueous film forming foams (AFFF), two alcohol resistant fluoroprotein foams and two detergent foams in various poolfires: gasoline, isopropyl alcohol, acetone, methyl-ethyl ketone, methyl alcohol and M15 (a gasoline, methyl alcohol, isobutene mixture). The scaling down of large scale tests for developing a reliable laboratory method was especially examined. The tests were performed with semidirect foam application, in pools of 50, 11, 4, 0.6, and 0.25 sq m. Burning time, temperature distribution in the liquid, and thermal radiation were determined. An M15more » fire can be extinguished with a detergent foam, but it is impossible to extinguish fires in polar solvents, such as methyl alcohol, acetone, and isopropyl alcohol with detergent foams, AFFF give the best results, and performances with small pools can hardly be correlated with results from large scale fires.« less

  3. [Microbiology--laboratory examinations for bacterias].

    PubMed

    Hen, Renjun; Imafuku, Yuji; Yoshida, Hiroshi

    2002-11-01

    As it has been required to identify pathogenic microbes in shorter times, simple and rapid methods have been developed and used. Here, we summarized the present situation of rapid diagnostic testing in clinical microbiology in Japan, and also presented our results on PBP2' detection. The rapid test kits available in Japan for E. coli, Helicobacter pylori, Salmonella, Streptococcus and Staphylococcus aureus were described. Rapid examination methods are based mainly on immunologic reactions, which included slide agglutination using latex particle, immunochromatography and ELISA. Times required for the identification are 10 to 15 minutes. Moreover, rapid test kits employing PCR are also marketed. Further, we evaluated MRSA-LA "Seiken" which is a rapid detection kit for PBP2' produced by MRSA. The test was shown to be highly sensitive and specific. For the rapid identification of pathogenic microbes, simple and rapid test kits described here will be used more in clinical diagnosis.

  4. Point-of-care CD4 testing to inform selection of antiretroviral medications in south african antenatal clinics: a cost-effectiveness analysis.

    PubMed

    Ciaranello, Andrea L; Myer, Landon; Kelly, Kathleen; Christensen, Sarah; Daskilewicz, Kristen; Doherty, Katie; Bekker, Linda-Gail; Hou, Taige; Wood, Robin; Francke, Jordan A; Wools-Kaloustian, Kara; Freedberg, Kenneth A; Walensky, Rochelle P

    2015-01-01

    Many prevention of mother-to-child HIV transmission (PMTCT) programs currently prioritize antiretroviral therapy (ART) for women with advanced HIV. Point-of-care (POC) CD4 assays may expedite the selection of three-drug ART instead of zidovudine, but are costlier than traditional laboratory assays. We used validated models of HIV infection to simulate pregnant, HIV-infected women (mean age 26 years, gestational age 26 weeks) in a general antenatal clinic in South Africa, and their infants. We examined two strategies for CD4 testing after HIV diagnosis: laboratory (test rate: 96%, result-return rate: 87%, cost: $14) and POC (test rate: 99%, result-return rate: 95%, cost: $26). We modeled South African PMTCT guidelines during the study period (WHO "Option A"): antenatal zidovudine (CD4 ≤350/μL) or ART (CD4>350/μL). Outcomes included MTCT risk at weaning (age 6 months), maternal and pediatric life expectancy (LE), maternal and pediatric lifetime healthcare costs (2013 USD), and cost-effectiveness ($/life-year saved). In the base case, laboratory led to projected MTCT risks of 5.7%, undiscounted pediatric LE of 53.2 years, and undiscounted PMTCT plus pediatric lifetime costs of $1,070/infant. POC led to lower modeled MTCT risk (5.3%), greater pediatric LE (53.4 years) and lower PMTCT plus pediatric lifetime costs ($1,040/infant). Maternal outcomes following laboratory were similar to POC (LE: 21.2 years; lifetime costs: $23,860/person). Compared to laboratory, POC improved clinical outcomes and reduced healthcare costs. In antenatal clinics implementing Option A, the higher initial cost of a one-time POC CD4 assay will be offset by cost-savings from prevention of pediatric HIV infection.

  5. [Virus detection, clinical signs, and laboratory findings in dogs with acute hemorrhagic diarrhea: a retrospective study of 935 cases].

    PubMed

    Kempf, C; Schulz, B S; Strauch, C; Sauter-Louis, C; Truyen, U; Hartmann, K

    2010-01-01

    The study evaluated which viruses can be detected in dogs with acute hemorrhagic diarrhea and compared signalment, clinical signs, and laboratory abnormalities among groups of dogs infected with different viruses and those that tested virus-negative. Fecal samples from 935 dogs with acute hemorrhagic diarrhea were examined by electron microscopy. The medical records of these patients were retrospectively evaluated for clinical and laboratory parameters. Virus was detected in 44.2% of the dogs presented with acute bloody diarrhea. The highest prevalence for a virus infection was demonstrated for canine parvovirus (19.9%), followed by coronavirus (17.3%), and paramyxovirus (13.9%). More than one virus species was detected in 6.5% of all fecal samples. Dogs with a virus-positive fecal sample were significantly younger than dogs that tested negative on electron microscopy. Among virus-positive dogs, dogs with parvovirus infection were significantly younger when compared to dogs infected with other enteric viruses. Parvovirus-infected patients also showed significantly lower leukocyte and erythrocyte counts as well as hematocrit, total protein, and albumin levels compared to all other groups. No significant differences were seen when evaluating sex, clinical parameters, character of diarrhea or vomiting among all groups. Young dogs are more likely to suffer from viral enteritis. Based on clinical parameters it is not possible to differentiate a virus-positive from a virus-negative dog or to diagnose a certain virus species. Besides the young age, parvovirus infection is associated with typical changes in laboratory parameters, but not with specific clinical signs. A virologic fecal examination is always indicated.

  6. Fuel Cell Development and Test Laboratory | Energy Systems Integration

    Science.gov Websites

    Facility | NREL Fuel Cell Development and Test Laboratory Fuel Cell Development and Test Laboratory The Energy System Integration Facility's Fuel Cell Development and Test Laboratory supports fuel a fuel cell test in the Fuel Cell Development and Test Laboratory. Capability Hubs The Fuel Cell

  7. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2013-10-01 2013-10-01 false What drugs do laboratories test for? 40.85 Section...

  8. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  9. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2014-10-01 2014-10-01 false What drugs do laboratories test for? 40.85 Section...

  10. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  11. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  12. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  13. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2011-10-01 2011-10-01 false What drugs do laboratories test for? 40.85 Section...

  14. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2012-10-01 2012-10-01 false What drugs do laboratories test for? 40.85 Section...

  15. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2010-10-01 2010-10-01 false What drugs do laboratories test for? 40.85 Section...

  16. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  17. Education on electrical phenomena involved in electroporation-based therapies and treatments: a blended learning approach.

    PubMed

    Čorović, Selma; Mahnič-Kalamiza, Samo; Miklavčič, Damijan

    2016-04-07

    Electroporation-based applications require multidisciplinary expertise and collaboration of experts with different professional backgrounds in engineering and science. Beginning in 2003, an international scientific workshop and postgraduate course electroporation based technologies and treatments (EBTT) has been organized at the University of Ljubljana to facilitate transfer of knowledge from leading experts to researches, students and newcomers in the field of electroporation. In this paper we present one of the integral parts of EBTT: an e-learning practical work we developed to complement delivery of knowledge via lectures and laboratory work, thus providing a blended learning approach on electrical phenomena involved in electroporation-based therapies and treatments. The learning effect was assessed via a pre- and post e-learning examination test composed of 10 multiple choice questions (i.e. items). The e-learning practical work session and both of the e-learning examination tests were carried out after the live EBTT lectures and other laboratory work. Statistical analysis was performed to compare and evaluate the learning effect measured in two groups of students: (1) electrical engineers and (2) natural scientists (i.e. medical doctors, biologists and chemists) undergoing the e-learning practical work in 2011-2014 academic years. Item analysis was performed to assess the difficulty of each item of the examination test. The results of our study show that the total score on the post examination test significantly improved and the item difficulty in both experimental groups decreased. The natural scientists reached the same level of knowledge (no statistical difference in total post-examination test score) on the post-course test take, as do electrical engineers, although the engineers started with statistically higher total pre-test examination score, as expected. The main objective of this study was to investigate whether the educational content the e-learning practical work presented to the students with different professional backgrounds enhanced their knowledge acquired via lectures during EBTT. We compared the learning effect assessed in two experimental groups undergoing the e-learning practical work: electrical engineers and natural scientists. The same level of knowledge on the post-course examination was reached in both groups. The results indicate that our e-learning platform supported by blended learning approach provides an effective learning tool for populations with mixed professional backgrounds and thus plays an important role in bridging the gap between scientific domains involved in electroporation-based technologies and treatments.

  18. Impact of add-on laboratory testing at an academic medical center: a five year retrospective study.

    PubMed

    Nelson, Louis S; Davis, Scott R; Humble, Robert M; Kulhavy, Jeff; Aman, Dean R; Krasowski, Matthew D

    2015-01-01

    Clinical laboratories frequently receive orders to perform additional tests on existing specimens ('add-ons'). Previous studies have examined add-on ordering patterns over short periods of time. The objective of this study was to analyze add-on ordering patterns over an extended time period. We also analyzed the impact of a robotic specimen archival/retrieval system on add-on testing procedure and manual effort. In this retrospective study at an academic medical center, electronic health records from were searched to obtain all add-on orders that were placed in the time period of May 2, 2009 to December 31, 2014. During the time period of retrospective study, 880,359 add-on tests were ordered on 96,244 different patients. Add-on testing comprised 3.3 % of total test volumes. There were 443,411 unique ordering instances, leading to an average of 1.99 add-on tests per instance. Some patients had multiple episodes of add-on test orders at different points in time, leading to an average of 9.15 add-on tests per patient. The majority of add-on orders were for chemistry tests (78.8 % of total add-ons) with the next most frequent being hematology and coagulation tests (11.2 % of total add-ons). Inpatient orders accounted for 66.8 % of total add-on orders, while the emergency department and outpatient clinics had 14.8 % and 18.4 % of total add-on orders, respectively. The majority of add-ons were placed within 8 hours (87.3 %) and nearly all by 24 hours (96.8 %). Nearly 100 % of add-on orders within the emergency department were placed within 8 hours. The introduction of a robotic specimen archival/retrieval unit saved an average of 2.75 minutes of laboratory staff manual time per unique add-on order. This translates to 24.1 hours/day less manual effort in dealing with add-on orders. Our study reflects the previous literature in showing that add-on orders significantly impact the workload of the clinical laboratory. The majority of add-on orders are clinical chemistry tests, and most add-on orders occur within 24 hours of original specimen collection. Robotic specimen archival/retrieval units can reduce manual effort in the clinical laboratory associated with add-on orders.

  19. Processing eutectics in space

    NASA Technical Reports Server (NTRS)

    Douglas, F. C.; Galasso, F. S.

    1974-01-01

    Studies which have been done in an earth-based laboratory environment have generally not yielded specimens with the degree of perfection required of the eutectic microstructure to provide test data to evaluate their nonstructural applications. It has been recognized that the low-g environment of an orbiting space laboratory provides a unique environment to re-examine the process of solidification with the goal of producing better microstructures. The objective of this program is to evaluate the feasibility of using the space environment for producing eutectics with microstructures which can be of value on earth. In carrying out this objective, evaluative investigations were carried out on the technology of solidification in a 1-g environment to provide sound baseline data for planning space laboratory experiments.

  20. Soil examination for a forensic trace evidence laboratory-Part 3: A proposed protocol for the effective triage and management of soil examinations.

    PubMed

    Woods, Brenda; Lennard, Chris; Kirkbride, K Paul; Robertson, James

    2016-05-01

    In the past, forensic soil examination was a routine aspect of forensic trace evidence examinations. The apparent need for soil examinations then went through a period of decline and with it the capability of many forensic laboratories to carry out soil examinations. In more recent years, interest in soil examinations has been renewed due-at least in part-to soil examinations contributing to some high profile investigations. However, much of this renewed interest has been in organisations with a primary interest in soil and geology rather than forensic science. We argue the need to reinstate soil examinations as a trace evidence sub-discipline within forensic science laboratories and present a pathway to support this aim. An examination procedure is proposed that includes: (i) appropriate sample collection and storage by qualified crime scene examiners; (ii) exclusionary soil examinations by trace evidence scientists within a forensic science laboratory; (iii) inclusionary soil examinations by trace evidence scientists within a forensic science laboratory; and (iv) higher-level examination of soils by specialist soil scientists and palynologists. Soil examinations conducted by trace evidence scientists will be facilitated if the examinations are conducted using the instrumentation routinely used by these examiners. Hence, the proposed examination protocol incorporates instrumentation in routine use in a forensic trace evidence laboratory. Finally, we report on an Australian soil scene variability study and a blind trial that demonstrate the utility of the proposed protocol for the effective triage and management of soil samples by forensic laboratories. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Evaluation of the HISCL Anti-Treponema pallidum Assay as a Screening Test for Syphilis

    PubMed Central

    An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting

    2015-01-01

    The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive samples, 704 fresh syphilis-negative samples, 48 preselected potentially interfering samples, and 30 “borderline” samples and was compared head to head with the commercially available Lumipulse G TP-N. In this study, the HISCL anti-TP assay was in perfect agreement with the applied testing algorithms with an overall agreement of 100%, comparable to that of Lumipulse G TP-N (99.63%). The sensitivity and specificity of the HISCL anti-TP assay were 100% (95% confidence interval [CI], 98.42% to 100%) and 100% (95% CI, 99.37% to 100%), respectively. Considering the excellent ease of use and automation, high throughput, and its favorable sensitivity and specificity, the HISCL anti-TP assay may represent a new choice for syphilis screening in high-volume laboratories. PMID:25972403

  2. Evaluation of the HISCL Anti-Treponema pallidum Assay as a Screening Test for Syphilis.

    PubMed

    An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting; Tao, Chuanmin; Wang, Lanlan

    2015-07-01

    The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive samples, 704 fresh syphilis-negative samples, 48 preselected potentially interfering samples, and 30 "borderline" samples and was compared head to head with the commercially available Lumipulse G TP-N. In this study, the HISCL anti-TP assay was in perfect agreement with the applied testing algorithms with an overall agreement of 100%, comparable to that of Lumipulse G TP-N (99.63%). The sensitivity and specificity of the HISCL anti-TP assay were 100% (95% confidence interval [CI], 98.42% to 100%) and 100% (95% CI, 99.37% to 100%), respectively. Considering the excellent ease of use and automation, high throughput, and its favorable sensitivity and specificity, the HISCL anti-TP assay may represent a new choice for syphilis screening in high-volume laboratories. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Estimating the outcome of a pregnancy test: women's judgements in foresight and hindsight.

    PubMed

    Pennington, D C; Rutter, D R; McKenna, K; Morley, I E

    1980-11-01

    Previous research on judgement under uncertainty has suggested that, when we know the outcome of some event, we perceive that outcome as more likely than when we do not have outcome knowledge. That is, in comparison with judgements made in foresight, judgements made in hindsight are biased in the direction of the outcome the judge believes to have happened. While the effect appears to be robust in the laboratory, it has very seldom been tested in real life. This experiment therefore went outside the laboratory, and examined women's estimates of the outcome of a pregnacy test. It was predicted that those who knew the result of their test (hindsight) would perceive that outcome as more likely than those asked to make the estimate before they knew the result (foresight). The prediction was supported only for women whose result was positive and, furthermore, the positive group made consistently higher estimates than the negative group, both in hindsight and foresight. The findings were therefore less marked and more complex than in previous laboratory research, and support the argument that experiments and materials must be constructed with salience for the subjects. The findings are interpreted in the light ot Tversky & Kahneman's (1974) work on heuristic rules of thinking.

  4. Home-Based Versus Laboratory-Based Robotic Ankle Training for Children With Cerebral Palsy: A Pilot Randomized Comparative Trial.

    PubMed

    Chen, Kai; Wu, Yi-Ning; Ren, Yupeng; Liu, Lin; Gaebler-Spira, Deborah; Tankard, Kelly; Lee, Julia; Song, Weiqun; Wang, Maobin; Zhang, Li-Qun

    2016-08-01

    To examine the outcomes of home-based robot-guided therapy and compare it to laboratory-based robot-guided therapy for the treatment of impaired ankles in children with cerebral palsy. A randomized comparative trial design comparing a home-based training group and a laboratory-based training group. Home versus laboratory within a research hospital. Children (N=41) with cerebral palsy who were at Gross Motor Function Classification System level I, II, or III were randomly assigned to 2 groups. Children in home-based and laboratory-based groups were 8.7±2.8 (n=23) and 10.7±6.0 (n=18) years old, respectively. Six-week combined passive stretching and active movement intervention of impaired ankle in a laboratory or home environment using a portable rehabilitation robot. Active dorsiflexion range of motion (as the primary outcome), mobility (6-minute walk test and timed Up and Go test), balance (Pediatric Balance Scale), Selective Motor Control Assessment of the Lower Extremity, Modified Ashworth Scale (MAS) for spasticity, passive range of motion (PROM), strength, and joint stiffness. Significant improvements were found for the home-based group in all biomechanical outcome measures except for PROM and all clinical outcome measures except the MAS. The laboratory-based group also showed significant improvements in all the biomechanical outcome measures and all clinical outcome measures except the MAS. There were no significant differences in the outcome measures between the 2 groups. These findings suggest that the translation of repetitive, goal-directed, biofeedback training through motivating games from the laboratory to the home environment is feasible. The benefits of home-based robot-guided therapy were similar to those of laboratory-based robot-guided therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Laboratories | Energy Systems Integration Facility | NREL

    Science.gov Websites

    laboratories to be safely divided into multiple test stand locations (or "capability hubs") to enable Fabrication Laboratory Energy Systems High-Pressure Test Laboratory Energy Systems Integration Laboratory Energy Systems Sensor Laboratory Fuel Cell Development and Test Laboratory High-Performance Computing

  6. The future of viral hepatitis testing: innovations in testing technologies and approaches.

    PubMed

    Peeling, Rosanna W; Boeras, Debrah I; Marinucci, Francesco; Easterbrook, Philippa

    2017-11-01

    A large burden of undiagnosed hepatitis virus cases remains globally. Despite the 257 million people living with chronic hepatitis B virus infection, and 71 million with chronic viraemic HCV infection, most people with hepatitis remain unaware of their infection. Advances in rapid detection technology have created new opportunities for enhancing access to testing and care, as well as monitoring of treatment. This article examines a range of other technological innovations that can be leveraged to provide more affordable and simplified approaches to testing for HBV and HCV infection and monitoring of treatment response. These include improved access to testing through alternative sampling methods (use of dried blood spots, oral fluids, self-testing) and combination rapid diagnostic tests for detection of HIV, HBV and HCV infection; more affordable options for confirmation of virological infection (HBV DNA and HCV RNA) such as point-of-care molecular assays, HCV core antigen and multi-disease polyvalent molecular platforms that make use of existing centralised laboratory based or decentralised TB and HIV instrumentation for viral hepatitis testing; and finally health system improvements such as integration of laboratory services for procurement and sample transportation and enhanced data connectivity to support quality assurance and supply chain management.

  7. Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda.

    PubMed

    Schroeder, Lee F; Elbireer, Ali; Jackson, J Brooks; Amukele, Timothy K

    2015-01-01

    Diagnostic laboratory tests are routinely defined in terms of their sensitivity, specificity, and ease of use. But the actual clinical impact of a diagnostic test also depends on its availability and price. This is especially true in resource-limited settings such as sub-Saharan Africa. We present a first-of-its-kind report of diagnostic test types, availability, and prices in Kampala, Uganda. Test types (identity) and availability were based on menus and volumes obtained from clinical laboratories in late 2011 in Kampala using a standard questionnaire. As a measure of test availability, we used the Availability Index (AI). AI is the combined daily testing volumes of laboratories offering a given test, divided by the combined daily testing volumes of all laboratories in Kampala. Test prices were based on a sampling of prices collected in person and via telephone surveys in 2015. Test volumes and menus were obtained for 95% (907/954) of laboratories in Kampala city. These 907 laboratories offered 100 different test types. The ten most commonly offered tests in decreasing order were Malaria, HCG, HIV serology, Syphilis, Typhoid, Urinalysis, Brucellosis, Stool Analysis, Glucose, and ABO/Rh. In terms of AI, the 100 tests clustered into three groups: high (12 tests), moderate (33 tests), and minimal (55 tests) availability. 50% and 36% of overall availability was provided through private and public laboratories, respectively. Point-of-care laboratories contributed 35% to the AI of high availability tests, but only 6% to the AI of the other tests. The mean price of the most commonly offered test types was $2.62 (range $1.83-$3.46). One hundred different laboratory test types were in use in Kampala in late 2011. Both public and private laboratories were critical to test availability. The tests offered in point-of-care laboratories tended to be the most available tests. Prices of the most common tests ranged from $1.83-$3.46.

  8. Geotechnical studies relevant to the containment of underground nuclear explosions at the Nevada Test Site

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Heuze, F.E.

    1982-05-01

    The Department of Energy and the Department of Defense are actively pursuing a program of nuclear weapons testing by underground explosions at the Nevada Test Site (NTS). Over the past 11 years, scores of tests have been conducted and the safety record is very good. In the short run, emphasis is put on preventing the release of radioactive materials into the atmosphere. In the long run, the subsidence and collapse of the ground above the nuclear cavities also are matters of interest. Currently, estimation of containment is based mostly on empiricism derived from extensive experience and on a combination ofmore » physical/mechanical testing and numerical modeling. When measured directly, the mechanical material properties are obtained from short-term laboratory tests on small, conventional samples. This practice does not determine the large effects of scale and time on measured stiffnesses and strengths of geological materials. Because of the limited data base of properties and in situ conditions, the input to otherwise fairly sophisticated computer programs is subject to several simplifying assumptions; some of them can have a nonconservative impact on the calculated results. As for the long-term, subsidence and collapse phenomena simply have not been studied to any significant degree. This report examines the geomechanical aspects of procedures currently used to estimate containment of undergroung explosions at NTS. Based on this examination, it is concluded that state-of-the-art geological engineering practice in the areas of field testing, large scale laboratory measurements, and numerical modeling can be drawn upon to complement the current approach.« less

  9. The Relationship between Executive Functioning, Central Coherence, and Repetitive Behaviors in the High-Functioning Autism Spectrum

    ERIC Educational Resources Information Center

    South, Mikle; Ozonoff, Sally; McMahon, William M.

    2007-01-01

    This study examined the relationship between everyday repetitive behavior (primary symptoms of autism) and performance on neuropsychological tests of executive function and central coherence (secondary symptoms). It was hypothesized that the frequency and intensity of repetitive behavior would be positively correlated with laboratory measures of…

  10. Hybrid Implementation Model of Community-Partnered Early Intervention for Toddlers with Autism: A Randomized Trial

    ERIC Educational Resources Information Center

    Shire, Stephanie Y.; Chang, Ya-Chih; Shih, Wendy; Bracaglia, Suzanne; Kodjoe, Maria; Kasari, Connie

    2017-01-01

    Background: Interventions found to be effective in research settings are often not as effective when implemented in community settings. Considering children with autism, studies have rarely examined the efficacy of laboratory-tested interventions on child outcomes in community settings using randomized controlled designs. Methods: One hundred and…

  11. VISION AND COLLEGE READING - A REVIEW OF THE LITERATURE AND REPORT OF A SURVEY.

    ERIC Educational Resources Information Center

    MAXWELL, MARTHA J.

    THE AMERICAN OPTICAL (AO) COMPANY'S SIGHT SCREENER, A PORTABLE BINOCULAR INSTRUMENT DESIGNED FOR MASS VISION TESTING, WAS EVALUATED AT THE UNIVERSITY OF MARYLAND READING AND STUDY SKILLS LABORATORY TO DETERMINE ITS CAPACITY TO IDENTIFY STUDENTS NEEDING PROFESSIONAL EYE EXAMINATIONS PRIOR TO READING INSTRUCTION. DATA FROM 106 PROBATIONARY FRESHMEN,…

  12. COLLOID MOBILIZATION AND TRANSPORT IN CONTAMINANT PLUMES: FIELD EXPERIMENTS, LABORATORY EXPERIMENTS, AND MODELING (EPA/600/S-99/001)

    EPA Science Inventory

    The major hypothesis driving this research, that the transport of colloids in a contaminant plume is limited by the advance of the chemical agent causing colloid mobilization, was tested by (1) examining the dependence of colloid transport and mobilization on chemical perturbatio...

  13. Acquisition and Retention of Esperanto: The Case for Error Correction and Immediate Feedback

    ERIC Educational Resources Information Center

    Brosvic, Gary M.; Epstein, Michael L.; Dihoff, Roberta E.; Cook, Michael J.

    2006-01-01

    Participants completed 5 laboratory examinations during which the number of responses permitted (1 response, up to 4 responses) and the timing of feedback (no feedback control: Scantron form; delayed feedback: end-of-test, 24-hr delay; immediate feedback: assistant, response form) were manipulated. Participants completed a 100-item cumulative…

  14. School on Alert over Water Quality

    ERIC Educational Resources Information Center

    Bowman, Darcia Harris

    2004-01-01

    This article examines the issue on the quality of water in Seattle's school districts. Seattle's water woes became public when four little containers of rust-colored water from fountains in the city district's Wedgewood Elementary School, collected by concerned parents, were tested by a certified laboratory and found to exceed federal lead limits.…

  15. Oral anatomy laboratory examinations in a physical therapy program.

    PubMed

    Fabrizio, Philip A

    2013-01-01

    The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days. During the time that a tagged examination is being created, student productivity may be reduced as the anatomy laboratory is inaccessible to students. Further, the type of questions that can be asked in a tagged laboratory examination may limit student assessment to lower level cognitive abilities and may limit the instructors' ability to assess the students' understanding of anatomical and clinical concepts. Anatomy is a foundational science in the Physical Therapy curriculum and a thorough understanding of anatomy is necessary to progress through the subsequent clinical courses. Physical therapy curricula have evolved to reflect the changing role of physical therapists to primary caregivers by introducing a greater scope of clinical courses earlier in the curriculum. Physical therapy students must have a thorough understanding of clinical anatomy early in the education process. However, traditional anatomy examination methods may not be reflective of the clinical thought processes required of physical therapy students. Traditional laboratory examination methods also reduce student productivity by limiting access during examination set-up and breakdown. To provide a greater complexity of questions and reduced overall laboratory time required for examinations, the Physical Therapy Program at Mercer University has introduced oral laboratory examinations for the gross anatomy course series. © 2012 American Association of Anatomists.

  16. Risky Decision Making Assessed With the Gambling Task in Adults with HIV

    PubMed Central

    Hardy, David J.; Hinkin, Charles H.; Castellon, Steven A.; Levine, Andrew J.; Lam, Mona N.

    2010-01-01

    Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV−) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the “risky” or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. PMID:16719628

  17. [Laboratory analysis of the first case of imported oval malaria in Rizhao City].

    PubMed

    Chao, Li; Ying, Zhang; Ting, Xiao

    2016-01-25

    To diagnose the first imported case of Plasmodium ovale infection by laboratory detection. The epidemiological data and blood samples of the case were collected, and the samples were detected by the microscopic examination, rapid diagnostic test (RDT) and nested PCR. The patient was a construction worker backing from Congo, Africa. He experienced the symptoms of irregular fever and weakness one month after returning in Lingyang Town, Junxian County. The results of RDT only suggested no- Plasmodium falciparum infection. Under the microscope, it was seen that the infected RBC were obviously disfigured and in irregular shape, the ring forms were thick and big, and also thick granulas in big trophozoite stage and schizont stage were found. The results of PCR showed that the size of amplified product was about 800 bp, which was conformed to that of P. ovale . Though microscopic examination is the golden standard for malaria diagnosis, as P. ovale is difficult to be identified under microscope, the microscopic method combined with PCR test can be used for definite diagnosis.

  18. [Yersiniosis as a cause of acute tubulointerstitial nephritis and acute renal failure--case report].

    PubMed

    Runowski, Dariusz; Szymoniak, Norbert; Zaniew, Marcin; Piatkowska-Kopczyk, Małgorzata; Wozniak, Aldona; Kroll, Paweł; Zachwieja, Jacek

    2005-01-01

    Tubulointerstitial nephritis (TN) is a heterogenous disease, where disturbances of the interstitial tissue and renal tubules are found. Different immunological and nonimmunological mechanisms initiated by infectious and non-infectious factors may lead to TN. A case of 13-years-old girl with primary diagnosis of acute pyelonephritis is presented. The abdominal pain, headache, pain in lumbar region and intermittent fever with loss of appetite were observed in this girl a few weeks before admission. Microcytic anemia, proteinuria and glucosuria, azotemia and elevated markers of inflammatory response were found. In ultrasound examination heterogenous cortex echogenicity of both kidneys and disturbances in parenchymal blood flow were observed. In renal scintigraphy the discriminated catch index was found. Kidney biopsy revealed the edema of the interstitial space with mononuclear and lymphocyte infiltration. The diagnosis of TN was established upon the history, clinical examination, results of laboratory tests, kidney imaging and biopsy. After steroid and doxycycline treatment an improvement and normalization of the results of laboratory tests were observed. It seems to be justified to consider Yersinia infection as a cause of acute tubulointerstitial nephritis.

  19. Multi-scale analytical investigation of fly ash in concrete

    NASA Astrophysics Data System (ADS)

    Aboustait, Mohammed B.

    Much research has been conducted to find an acceptable concrete ingredient that would act as cement replacement. One promising material is fly ash. Fly ash is a by-product from coal-fired power plants. Throughout this document work on the characterization of fly ash structure and composition will be explored. This effort was conducted through a mixture of cutting edge multi-scale analytical X-ray based techniques that use both bulk experimentation and nano/micro analytical techniques. Furtherly, this examination was coupled by performing Physical/Mechanical ASTM based testing on fly ash-enrolled-concrete to examine the effects of fly ash introduction. The most exotic of the cutting edge characterization techniques endorsed in this work uses the Nano-Computed Tomography and the Nano X-ray Fluorescence at Argonne National Laboratory to investigate single fly ash particles. Additional Work on individual fly ash particles was completed by laboratory-based Micro-Computed Tomography and Scanning Electron Microscopy. By combining the results of individual particles and bulk property tests, a compiled perspective is introduced, and accessed to try and make new insights into the reactivity of fly ash within concrete.

  20. Physical dimensions, torsional performance, bending properties, and metallurgical characteristics of rotary endodontic instruments. VI. Canal Master drills.

    PubMed

    Luebke, N H; Brantley, W A; Sabri, Z I; Luebke, F L; Lausten, L L

    1995-05-01

    A laboratory study was performed on machine-driven Canal Master drills to determine their physical dimensions, torsional performance, bending properties, and metallurgical characteristics in fracture. Physical dimensions were determined for each of the available sizes (#50 to #100) of Canal Master drills from the manufacturer that distributes these instruments in the United States. Samples were also tested in clockwise torsion using a Maillefer memocouple. Bending properties of cantilever specimens were measured with a Tinius Olsen stiffness tester. Bending fatigue testing was performed on a unique laboratory apparatus. Scanning electron microscope examination confirmed visual observations that the stainless steel Canal Master drills exhibited ductile torsional fracture. This study is part of a continuing investigation to establish standards for all machine-driven rotary endodontic instruments.

  1. Lost sleep and cyberloafing: Evidence from the laboratory and a daylight saving time quasi-experiment.

    PubMed

    Wagner, David T; Barnes, Christopher M; Lim, Vivien K G; Ferris, D Lance

    2012-09-01

    The Internet is a powerful tool that has changed the way people work. However, the ubiquity of the Internet has led to a new workplace threat to productivity-cyberloafing. Building on the ego depletion model of self-regulation, we examine how lost and low-quality sleep influence employee cyberloafing behaviors and how individual differences in conscientiousness moderate these effects. We also demonstrate that the shift to Daylight Saving Time (DST) results in a dramatic increase in cyberloafing behavior at the national level. We first tested the DST-cyberloafing relation through a national quasi-experiment, then directly tested the relation between sleep and cyberloafing in a closely controlled laboratory setting. We discuss the implications of our findings for theory, practice, and future research.

  2. Telehealth physician oversight over direct to consumer testing: doctors working with patients towards patient empowerment.

    PubMed

    Chung, Rick

    2012-06-01

    Patient empowerment has increased the demand for direct to consumer (DTC) laboratory testing. Multiple professional societies and advocacy groups have raised concerns over how DTC laboratory testing is being offered to consumers without proper physician oversight. Physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner. Using telehealth protocols and standards established by professional health organizations and state regulators, physician telehealth oversight in DTC laboratory test ordering can be effective to increase patient access to healthcare services. With proper physician oversight in test interpretation, post-test counseling, and information collaboration, DTC laboratory testing can remain a reliable and convenient option for consumers. Working within the channel of distribution of most DTC laboratory testing, physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner to ensure that proper test interpretation, counseling, and information collaboration are achieved. Physician telehealth services can properly oversee DTC laboratory testing to ensure that proper test interpretation, counseling, and information collaboration are achieved.

  3. Systemic lupus erythematosus in a male patient

    NASA Astrophysics Data System (ADS)

    Sibarani, H.; Zubir, Z.

    2018-03-01

    Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a broad spectrum of clinical presentations. Female to male ratio is approximately 9:1.A 20 years old male was admitted to HAM Hospital 3 months ago with chief complaint pain in both knees joint. After anamneses, physical examination and laboratory test the patient was diagnosed with systemic lupus erythematosus. The patient tested positive for ANA and anti-ds-DNA antibody test. The patient was with giving non-biologic DMARDS @myfortic 360mg, methylprednisolone, chloroquine and other symptomatic drugs.

  4. A 2-year study of Gram stain competency assessment in 40 clinical laboratories.

    PubMed

    Goodyear, Nancy; Kim, Sara; Reeves, Mary; Astion, Michael L

    2006-01-01

    We used a computer-based competency assessment tool for Gram stain interpretation to assess the performance of 278 laboratory staff from 40 laboratories on 40 multiple-choice questions. We report test reliability, mean scores, median, item difficulty, discrimination, and analysis of the highest- and lowest-scoring questions. The questions were reliable (KR-20 coefficient, 0.80). Overall mean score was 88% (range, 63%-98%). When categorized by cell type, the means were host cells, 93%; other cells (eg, yeast), 92%; gram-positive, 90%; and gram-negative, 88%. When categorized by type of interpretation, the means were other (eg, underdecolorization), 92%; identify by structure (eg, bacterial morphologic features), 91%; and identify by name (eg, genus and species), 87%. Of the 6 highest-scoring questions (mean scores, > or = 99%) 5 were identify by structure and 1 was identify by name. Of the 6 lowest-scoring questions (mean scores, < 75%) 5 were gram-negative and 1 was host cells. By type of interpretation, 2 were identify by structure and 4 were identify by name. Computer-based Gram stain competency assessment examinations are reliable. Our analysis helps laboratories identify areas for continuing education in Gram stain interpretation and will direct future revisions of the tests.

  5. Distribution and presentation of Lyme borreliosis in Scotland - analysis of data from a national testing laboratory.

    PubMed

    Mavin, S; Watson, E J; Evans, R

    2015-01-01

    This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland. Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period. Results The number of laboratory-confirmed cases of Lyme borreliosis in Scotland peaked at 440 in 2010. From 2008 to 2013 the estimated average annual incidence was 6.8 per 100,000 (44.1 per 100,000 in NHS Highland). Of 594 questionnaires from NHS Highland patients: 76% had clinically confirmed Lyme borreliosis; 48% erythema migrans; 17% rash, 25% joint, 15% neurological and 1% cardiac symptoms. Only 61% could recall a tick bite. Conclusion The incidence of Lyme borreliosis may be stabilising in Scotland but NHS Highland remains an area of high incidence. Lyme borreliosis should be considered in symptomatic patients that have had exposure to ticks and not just those with a definite tick bite.

  6. Acceleration to failure in geophysical signals prior to laboratory rock failure and volcanic eruptions (Invited)

    NASA Astrophysics Data System (ADS)

    Main, I. G.; Bell, A. F.; Greenhough, J.; Heap, M. J.; Meredith, P. G.

    2010-12-01

    The nucleation processes that ultimately lead to earthquakes, volcanic eruptions, rock bursts in mines, and landslides from cliff slopes are likely to be controlled at some scale by brittle failure of the Earth’s crust. In laboratory brittle deformation experiments geophysical signals commonly exhibit an accelerating trend prior to dynamic failure. Similar signals have been observed prior to volcanic eruptions, including volcano-tectonic earthquake event and moment release rates. Despite a large amount of effort in the search, no such statistically robust systematic trend is found prior to natural earthquakes. Here we describe the results of a suite of laboratory tests on Mount Etna Basalt and other rocks to examine the nature of the non-linear scaling from laboratory to field conditions, notably using laboratory ‘creep’ tests to reduce the boundary strain rate to conditions more similar to those in the field. Seismic event rate, seismic moment release rate and rate of porosity change show a classic ‘bathtub’ graph that can be derived from a simple damage model based on separate transient and accelerating sub-critical crack growth mechanisms, resulting from separate processes of negative and positive feedback in the population dynamics. The signals exhibit clear precursors based on formal statistical model tests using maximum likelihood techniques with Poisson errors. After correcting for the finite loading time of the signal, the results show a transient creep rate that decays as a classic Omori law for earthquake aftershocks, and remarkably with an exponent near unity, as commonly observed for natural earthquake sequences. The accelerating trend follows an inverse power law when fitted in retrospect, i.e. with prior knowledge of the failure time. In contrast the strain measured on the sample boundary shows a less obvious but still accelerating signal that is often absent altogether in natural strain data prior to volcanic eruptions. To test the forecasting power of such constitutive rules in prospective mode, we examine the forecast quality of several synthetic trials, by adding representative statistical fluctuations, due to finite real-time sampling effects, to an underlying accelerating trend. Metrics of forecast quality change systematically and dramatically with time. In particular the model accuracy increases, and the forecast bias decreases, as the failure time approaches.

  7. [Continuous challenges in Japanese forensic toxicology practice: strategy to address specific goals].

    PubMed

    Kageura, Mitsuyoshi

    2002-09-01

    In this paper, the status quo of forensic toxicology in Japan and the West is surveyed and a strategy to address future goals of Japanese forensic toxicology is proposed. Forensic toxicology in the West consists of three main areas--post-mortem forensic toxicology, human-performance forensic toxicology and forensic urine drug testing. In Japan, post-mortem forensic toxicology is practiced in university forensic medicine departments while most of the human-performance forensic toxicology is carried out in police laboratories. However, at least at present, strictly controlled workplace urine drug testing is not being performed, despite the abuse of drugs even by uniformed members of the National Defence Forces and police. For several years, the author has been introducing Western forensic toxicology guidelines and recommendations, translated into Japanese with the help of Western forensic toxicologists, to Japanese forensic toxicologists. Western forensic toxicology practice is at an advanced stage, whereas Japanese practice is in a critical condition and holds many problems awaiting solution, as exemplified by the urine drug testing in police laboratories. There is never any sample left for re-examination by the defence in all cases, though the initial volume of the urine sample available for examination is 30-50 ml. Only one organisation carries out everything from sampling to reporting and, in addition, the parent drug and its metabolites are not quantified. It is clear that the police laboratories do not work within good laboratory practice guidelines, nor do they have quality manuals or standard operating procedures manuals. A basic change in Japanese forensic toxicology practice is now essential. The author strongly recommends that, first of all, Japanese toxicologists should prepare forensic toxicology guidelines based on the Western models. The guidelines would progress the following objectives for forensic toxicology laboratories: 1) to have documented good laboratory practice standards; 2) to have a quality control system including a quality manual and standard operating procedures manual; 3) to have some degree of compulsion to implement quality assurance both through their own internal efforts and by appropriate remedial actions based on the results of an external proficiency testing scheme. For forensic toxicologists, the implications are that they should be: 1) responsible for ensuring that laboratory practices are performed under satisfactory conditions and 2) required to be certified as a forensic toxicology specialist in order to prove their forensic toxicology ability. For their part, governments should: 1) carry out administrative reforms related to forensic toxicology; 2) simplify the procedure for obtaining certified reference materials; 3) introduce a strict workplace urine drug testing programme for government employees, at least for those related to law enforcement. When all of these objectives have been realised, the specific goal will be achieved through which Japanese forensic toxicology is able, in practice, to fulfill its responsibility to society.

  8. Updated procedures for using drill cores and cuttings at the Lithologic Core Storage Library, Idaho National Laboratory, Idaho

    USGS Publications Warehouse

    Hodges, Mary K.V.; Davis, Linda C.; Bartholomay, Roy C.

    2018-01-30

    In 1990, the U.S. Geological Survey, in cooperation with the U.S. Department of Energy Idaho Operations Office, established the Lithologic Core Storage Library at the Idaho National Laboratory (INL). The facility was established to consolidate, catalog, and permanently store nonradioactive drill cores and cuttings from subsurface investigations conducted at the INL, and to provide a location for researchers to examine, sample, and test these materials.The facility is open by appointment to researchers for examination, sampling, and testing of cores and cuttings. This report describes the facility and cores and cuttings stored at the facility. Descriptions of cores and cuttings include the corehole names, corehole locations, and depth intervals available.Most cores and cuttings stored at the facility were drilled at or near the INL, on the eastern Snake River Plain; however, two cores drilled on the western Snake River Plain are stored for comparative studies. Basalt, rhyolite, sedimentary interbeds, and surficial sediments compose most cores and cuttings, most of which are continuous from land surface to their total depth. The deepest continuously drilled core stored at the facility was drilled to 5,000 feet below land surface. This report describes procedures and researchers' responsibilities for access to the facility and for examination, sampling, and return of materials.

  9. A comparison of theory and experiment for coupled rotor body stability of a bearingless rotor model in hover and forward flight

    NASA Technical Reports Server (NTRS)

    Mirick, Paul H.

    1988-01-01

    Seven cases were selected for correlation from a 1/5.86 Froude-scale experiment that examined several rotor designs which were being considered for full-scale flight testing as part of the Bearingless Main Rotor (BMR) program. The model rotor hub used in these tests consisted of back-to-back C-beams as flexbeam elements with a torque tube for pitch control. The first four cases selected from the experiment were hover tests which examined the effects on rotor stability of variations in hub-to-flexbeam coning, hub-to-flexbeam pitch, flexbeam-to-blade coning, and flexbeam-to-blade pitch. The final three cases were selected from the forward flight tests of optimum rotor configuration as defined during the hover test. The selected cases examined the effects of variations in forward speed, rotor speed, and shaft angle. Analytical results from Bell Helicopter Textron, Boeing Vertol, Sikorsky Aircraft, and the U.S. Army Aeromechanics Laboratory were compared with the data and the correlations ranged from poor-to-fair to fair-to-good.

  10. Definition of Throw-Away Detectors (TADs) and VLF antenna for the AMPS laboratory

    NASA Technical Reports Server (NTRS)

    Koons, H. C.; Fennell, J. F.

    1975-01-01

    A Throw Away Detector (TAD)/subsatellite to be used as an experiment platform for the test flights to map the EMI from the shuttle and during the AMPS science flights is defined. A range of instrument platforms of varying capabilities is examined with emphasis on the EMI test vehicle. The operational support requirements of TAD/subsatellites are determined. The throw away detector is envisioned as a simple instrument package for supporting specific experiments.

  11. The efficacy of World Wide Web-mediated microcomputer-based laboratory activities in the high school physics classroom

    NASA Astrophysics Data System (ADS)

    Slykhuis, David A.

    This research project examined the efficacy of an online microcomputer-based laboratory based (MBL) physics unit. One hundred and fifty physics students from five high schools in North Carolina were divided into online and classroom groups. The classroom group completed the MBL unit in small groups with assistance from their teachers. The online groups completed the MBL unit in small groups using a website designed for this project for guidance. Pre- and post-unit content specific tests and surveys were given. Statistical analysis of the content tests showed significant development of conceptual understanding by the online group over the course of the unit. There was not a significant difference between the classroom and online group with relation to the amount of conceptual understanding developed. Correlations with post-test achievement showed that pre-test scores and math background were the most significant correlates with success. Computer related variables, such as computer comfort and online access, were only mildly correlated with the online group. Students' views about the nature of physics were not well developed prior to the unit and did not significantly change over the course of the unit. Examination of the students' physics conceptions after instruction revealed common alternative conceptions such as confusing position and velocity variables and incorrect interpretations of graphical features such as slope.

  12. Evaluation of vaginal complaints.

    PubMed

    Anderson, Matthew R; Klink, Kathleen; Cohrssen, Andreas

    2004-03-17

    Vaginal symptoms are one of the most common reasons for gynecological consultation. Clinicians have traditionally diagnosed vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis using some combination of physical examination, pH, the wet mount, and the whiff test. To evaluate the role of the clinical examination and determine the positive and negative likelihood ratios (LRs) for the diagnosis of vaginal candidiasis, bacterial vaginosis, and vaginal trichomoniasis. Using a structured literature review, we abstracted information on sensitivity and specificity for symptoms, signs, and office laboratory procedures. We chose published (1966 to April 2003) articles that appeared in the MEDLINE database and were indexed under the combined search terms of diagnosis with vaginitis, vaginal discharge, candidiasis, bacterial vaginosis, and trichomoniasis. Included studies of symptomatic premenopausal women seen in primary care settings. Tests were evaluated only if they would provide diagnostic information during the office visit and were compared with an acceptable criterion standard. All 3 authors extracted the data and computed sensitivity and specificity from each article independently. The absence of standard definitions for symptoms and signs made it impossible to combine results across studies. Symptoms alone do not allow clinicians to distinguish confidently between the causes of vaginitis. However, a patient's lack of itching makes candidiasis less likely (range of LRs, 0.18 [95% confidence interval [CI], 0.05-0.70] to 0.79 [95% CI, 0.72-0.87]) and lack of perceived odor makes bacterial vaginosis unlikely (LR, 0.07 [95% CI, 0.01-0.51]). Similarly, physical examination signs are limited in their diagnostic power. The presence of inflammatory signs is associated with candidiasis (range of LRs, 2.1 [95% CI, 1.5-2.8] to 8.4 [95% CI, 2.3-31]). Presence of a "high cheese" odor on examination is predictive of bacterial vaginosis (LR, 3.2 [95% CI, 2.1-4.7]) while lack of odor is associated with candidiasis (LR, 2.9 [95% CI, 2.4-5.0]). Office laboratory tests, particularly microscopy of vaginal discharge, are the most useful way of diagnosing these 3 conditions. The cause of vaginal complaints may be easily diagnosed when typical findings appear in microscopy. However, the poor performance of individual symptoms, signs, and office laboratory tests often makes it problematic to identify the cause of vaginal symptoms.

  13. Factors Influencing Laboratory Information System Effectiveness Through Strategic Planning in Shiraz Teaching Hospitals.

    PubMed

    Bahador, Fateme; Sharifian, Roxana; Farhadi, Payam; Jafari, Abdosaleh; Nematolahi, Mohtram; Shokrpour, Nasrin

    This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

  14. Specialized sperm function tests in varicocele and the future of andrology laboratory

    PubMed Central

    Majzoub, Ahmad; Esteves, Sandro C; Gosálvez, Jaime; Agarwal, Ashok

    2016-01-01

    Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele. PMID:26780873

  15. Field of Genes: An Investigation of Sports-Related Genetic Testing

    PubMed Central

    Wagner, Jennifer K.; Royal, Charmaine D.

    2012-01-01

    Sports-related genetic testing is a sector of the diverse direct-to-consumer (DTC) industry that has not yet been examined thoroughly by academic scholars. A systematic search was used to identify companies in this sector and content analysis of online information was performed. More than a dozen companies were identified. Marketing practices observed generally did not target parents for child testing, and marketing images were mild compared to images used in popular media. Information was provided at a high reading level (industry-wide Flesh-Kincaid Grade Levels > 11). While ~75% of companies provide privacy policies and terms of service prior to purchase and ~40% provide scientific citations for their tests, <25% reported using American Association of Blood Banks (AABB) accredited or the Clinical Laboratory Improvement Amendments of 1988 (CLIA) certified laboratories. Tests ranged considerably in price (~$100–$1,100) and were substantively diverse. These findings highlight the need to appreciate nuances and avoid broad generalizations of this and other DTC sectors. Utilization of consumer protections available for e-commerce generally may adequately protect DTC genetics consumers without new federal legislation or regulation. PMID:25562204

  16. Aglycosuric Diabetes

    PubMed Central

    Spaulding, W. B.; Spitzer, W. O.; Truscott, P. W.

    1963-01-01

    The usefulness of urine tests for glucose was compared with that of blood sugar determinations in detecting diabetes mellitus in 2000 medical outpatients. Eighty-five patients proved to be diabetic, but 33 of these had no glycosuria on their first visit and would not have been detected by laboratory tests had the blood glucose levels not been measured. Exactly one-half of the new diabetics discovered would have been missed (15 of 30) had only urine tests been performed. The new diabetics who were aglycosuric at their initial examination had a mild form of the disease, were predominantly elderly, and were controlled, in nearly every case, by diet alone. Most of these patients had evidence of an elevated renal threshold for glucose. These results indicate that there is a large group of patients with mild, asymptomatic, diabetes mellitus who remain undetected unless blood tests are employed routinely. Because they have little or no glycosuria these patients do not have polydipsia, polyphagia, polyuria, or loss of weight. Automation in the medical laboratory has made routine blood tests for glucose feasible and rewarding in detecting diabetes mellitus. PMID:20327667

  17. GeoLab: A Geological Workstation for Future Missions

    NASA Technical Reports Server (NTRS)

    Evans, Cynthia; Calaway, Michael; Bell, Mary Sue; Li, Zheng; Tong, Shuo; Zhong, Ye; Dahiwala, Ravi

    2014-01-01

    The GeoLab glovebox was, until November 2012, fully integrated into NASA's Deep Space Habitat (DSH) Analog Testbed. The conceptual design for GeoLab came from several sources, including current research instruments (Microgravity Science Glovebox) used on the International Space Station, existing Astromaterials Curation Laboratory hardware and clean room procedures, and mission scenarios developed for earlier programs. GeoLab allowed NASA scientists to test science operations related to contained sample examination during simulated exploration missions. The team demonstrated science operations that enhance theThe GeoLab glovebox was, until November 2012, fully integrated into NASA's Deep Space Habitat (DSH) Analog Testbed. The conceptual design for GeoLab came from several sources, including current research instruments (Microgravity Science Glovebox) used on the International Space Station, existing Astromaterials Curation Laboratory hardware and clean room procedures, and mission scenarios developed for earlier programs. GeoLab allowed NASA scientists to test science operations related to contained sample examination during simulated exploration missions. The team demonstrated science operations that enhance the early scientific returns from future missions and ensure that the best samples are selected for Earth return. The facility was also designed to foster the development of instrument technology. Since 2009, when GeoLab design and construction began, the GeoLab team [a group of scientists from the Astromaterials Acquisition and Curation Office within the Astromaterials Research and Exploration Science (ARES) Directorate at JSC] has progressively developed and reconfigured the GeoLab hardware and software interfaces and developed test objectives, which were to 1) determine requirements and strategies for sample handling and prioritization for geological operations on other planetary surfaces, 2) assess the scientific contribution of selective in-situ sample characterization for mission planning, operations, and sample prioritization, 3) evaluate analytical instruments and tools for providing efficient and meaningful data in advance of sample return and 4) identify science operations that leverage human presence with robotic tools. In the first year of tests (2010), GeoLab examined basic glovebox operations performed by one and two crewmembers and science operations performed by a remote science team. The 2010 tests also examined the efficacy of basic sample characterization [descriptions, microscopic imagery, X-ray fluorescence (XRF) analyses] and feedback to the science team. In year 2 (2011), the GeoLab team tested enhanced software and interfaces for the crew and science team (including Web-based and mobile device displays) and demonstrated laboratory configurability with a new diagnostic instrument (the Multispectral Microscopic Imager from the JPL and Arizona State University). In year 3 (2012), the GeoLab team installed and tested a robotic sample manipulator and evaluated robotic-human interfaces for science operations.

  18. An evaluation of community college student perceptions of the science laboratory and attitudes towards science in an introductory biology course

    NASA Astrophysics Data System (ADS)

    Robinson, Nakia Rae

    The science laboratory is an integral component of science education. However, the academic value of student participation in the laboratory is not clearly understood. One way to discern student perceptions of the science laboratory is by exploring their views of the classroom environment. The classroom environment is one determinant that can directly influence student learning and affective outcomes. Therefore, this study sought to examine community college students' perceptions of the laboratory classroom environment and their attitudes toward science. Quantitative methods using two survey instruments, the Science Laboratory Environment Instrument (SLEI) and the Test of Science Related Attitudes (TORSA) were administered to measure laboratory perceptions and attitudes, respectively. A determination of differences among males and females as well as three academic streams were examined. Findings indicated that overall community college students had positive views of the laboratory environment regardless of gender of academic major. However, the results indicated that the opportunity to pursue open-ended activities in the laboratory was not prevalent. Additionally, females viewed the laboratory material environment more favorably than their male classmates did. Students' attitudes toward science ranged from favorable to undecided and no significant gender differences were present. However, there were significantly statistical differences between the attitudes of nonscience majors compared to both allied health and STEM majors. Nonscience majors had less positive attitudes toward scientific inquiry, adoption of scientific attitudes, and enjoyment of science lessons. Results also indicated that collectively, students' experiences in the laboratory were positive predicators of their attitudes toward science. However, no laboratory environment scale was a significant independent predictor of student attitudes. .A students' academic streams was the only significant independent predictor of attitudes toward science, albeit negatively. The results from this study indicated that there is a need to increase the opportunity for inquiry in the science laboratory. The data also suggest that although all academic streams may have similar views of the laboratory experiences, more needs to be implemented to improve the scientific attitudes of nonscience majors enrolled in a course for science majors.

  19. Strength, Endurance, Throwing Velocity and in-Water Jump Performance of Elite German Water Polo Players

    PubMed Central

    Zinner, Christoph; Sperlich, Billy; Krueger, Malte; Focke, Tim; Reed, Jennifer; Mester, Joachim

    2015-01-01

    The purpose of this study was threefold: 1) to assess the eggbeater kick and throwing performance using a number of water polo specific tests, 2) to explore the relation between the eggbeater kick and throwing performance, and 3) to investigate the relation between the eggbeater kick in the water and strength tests performed in a controlled laboratory setting in elite water polo players. Fifteen male water polo players of the German National Team completed dynamic and isometric strength tests for muscle groups (adductor, abductor, abdominal, pectoralis) frequently used during water polo. After these laboratory strength tests, six water polo specific in-water tests were conducted. The eggbeater kick assessed leg endurance and agility, maximal throwing velocity and jump height. A 400 m test and a sprint test examined aerobic and anaerobic performance. The strongest correlation was found between jump height and arm length (p < 0.001, r = 0.89). The laboratory diagnostics of important muscles showed positive correlations with the results of the in-water tests (p < 0.05, r = 0.52–0.70). Muscular strength of the adductor, abdominal and pectoralis muscles was positively related to in-water endurance agility as assessed by the eggbeater kick (p < 0.05; r = 0.53–0.66). Findings from the current study emphasize the need to assess indices of water polo performance both in and out of the water as well as the relation among these parameters to best assess the complex profile of water polo players. PMID:25964818

  20. A Clinical Approach to Vulvar Ulcers.

    PubMed

    Stewart, Kristen M A

    2017-09-01

    This article discusses the differential diagnosis of vulvar ulcers and describes a general clinical approach to this common but nonspecific examination finding. The differential diagnosis includes sexually and nonsexually transmitted infections, dermatitides, trauma, neoplasms, hormonally induced ulcers, and drug reactions. Patient history and physical examination provide important clues to the cause of a vulvar ulcer. However, laboratory testing is usually required for accurate diagnosis because the clinical presentation is often nonspecific and may be atypical due to secondary conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jordan, Amy B.; Boukhalfa, Hakim; Caporuscio, Florie Andre

    To gain confidence in the predictive capability of numerical models, experimental validation must be performed to ensure that parameters and processes are correctly simulated. The laboratory investigations presented herein aim to address knowledge gaps for heat-generating nuclear waste (HGNW) disposal in bedded salt that remain after examination of prior field and laboratory test data. Primarily, we are interested in better constraining the thermal, hydrological, and physicochemical behavior of brine, water vapor, and salt when moist salt is heated. The target of this work is to use run-of-mine (RoM) salt; however during FY2015 progress was made using high-purity, granular sodium chloride.

  2. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  3. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  4. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  5. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  6. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  7. Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study

    PubMed Central

    Gundersen, Guri Holmen; Norekval, Tone M; Haug, Hilde Haugberg; Skjetne, Kyrre; Kleinau, Jens Olaf; Graven, Torbjorn; Dalen, Havard

    2016-01-01

    Objectives Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic. Methods HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order. Each nurse worked in a team with a cardiologist. The influence of the different diagnostic tests on diuretic dosing was assessed descriptively and in linear regression analyses. Results Sixty-two patients were included and 119 examinations were performed. Mean±SD age was 74±12 years, EF was 34±14%, and N-terminal pro-brain natriuretic peptide (NT-proBNP) value was 3761±3072 ng/L. Dosing of diuretics differed between the teams in 31 out of 119 consultations. Weight change and volume status assessed clinically with and without ultrasound predicted dose adjustment of diuretics at follow-up (p<0.05). Change of oedema, NT-proBNP, creatinine, and symptoms did not (p≥0.10). In adjusted analyses, only volume status based on ultrasound predicted dose adjustments of diuretics at first visit and follow-up (all ultrasound p≤0.01, all other p≥0.2). Conclusions Ultrasound examinations of the pleural cavities and IVC by nurses may improve diagnostics and patient care in HF patients at an outpatient clinic, but more studies are needed to determine whether these examinations have an impact on clinical outcomes. Trial registration number NCT01794715. PMID:26438785

  8. Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study.

    PubMed

    Gundersen, Guri Holmen; Norekval, Tone M; Haug, Hilde Haugberg; Skjetne, Kyrre; Kleinau, Jens Olaf; Graven, Torbjorn; Dalen, Havard

    2016-01-01

    Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic. HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order. Each nurse worked in a team with a cardiologist. The influence of the different diagnostic tests on diuretic dosing was assessed descriptively and in linear regression analyses. Sixty-two patients were included and 119 examinations were performed. Mean±SD age was 74±12 years, EF was 34±14%, and N-terminal pro-brain natriuretic peptide (NT-proBNP) value was 3761±3072 ng/L. Dosing of diuretics differed between the teams in 31 out of 119 consultations. Weight change and volume status assessed clinically with and without ultrasound predicted dose adjustment of diuretics at follow-up (p<0.05). Change of oedema, NT-proBNP, creatinine, and symptoms did not (p≥0.10). In adjusted analyses, only volume status based on ultrasound predicted dose adjustments of diuretics at first visit and follow-up (all ultrasound p≤0.01, all other p≥0.2). Ultrasound examinations of the pleural cavities and IVC by nurses may improve diagnostics and patient care in HF patients at an outpatient clinic, but more studies are needed to determine whether these examinations have an impact on clinical outcomes. NCT01794715. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Examining hydrogen transitions.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Plotkin, S. E.; Energy Systems

    2007-03-01

    This report describes the results of an effort to identify key analytic issues associated with modeling a transition to hydrogen as a fuel for light duty vehicles, and using insights gained from this effort to suggest ways to improve ongoing modeling efforts. The study reported on here examined multiple hydrogen scenarios reported in the literature, identified modeling issues associated with those scenario analyses, and examined three DOE-sponsored hydrogen transition models in the context of those modeling issues. The three hydrogen transition models are HyTrans (contractor: Oak Ridge National Laboratory), MARKAL/DOE* (Brookhaven National Laboratory), and NEMS-H2 (OnLocation, Inc). The goals ofmore » these models are (1) to help DOE improve its R&D effort by identifying key technology and other roadblocks to a transition and testing its technical program goals to determine whether they are likely to lead to the market success of hydrogen technologies, (2) to evaluate alternative policies to promote a transition, and (3) to estimate the costs and benefits of alternative pathways to hydrogen development.« less

  10. Laboratories | NREL

    Science.gov Websites

    | Z A Accelerated Exposure Testing Laboratory Advanced Optical Materials Laboratory Advanced Thermal Laboratory Structural Testing Laboratory Surface Analysis Laboratory Systems Performance Laboratory T Thermal Storage Materials Laboratory Thermal Storage Process and Components Laboratory Thin-Film Deposition

  11. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  12. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  13. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  14. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  15. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  16. Human Toxocariasis: Prevalence and Factors Associated with Biosafety in Research Laboratories.

    PubMed

    Mattos, Gabriela Torres; Santos, Paula Costa Dos; Telmo, Paula de Lima; Berne, Maria Elisabeth Aires; Scaini, Carlos James

    2016-12-07

    Human toxocariasis is a neglected parasitic disease worldwide. Researchers studying this disease use infectious strains of Toxocara for experiments. Health workers are at risk in the course of their daily routine and must adhere to biosafety standards while carrying out the activities. Researchers on biosafety concerning working with these parasites are insufficient. The aim of this study was to determine the rate of seroprevalence of Toxocara species among health-care research laboratory workers (professors, technicians, and students), and to investigate the risk factors of Toxocara infection associated with laboratory practices. This cross-sectional study involved 74 researchers at two federal universities in southern Brazil from February 2014 to February 2015; 29 researchers manipulated infective strains of Toxocara canis (test group) and 45 did not (control group). Serum samples were examined using enzyme-linked immunosorbent assay. Epidemiological data were obtained via a questionnaire containing information about laboratory routine, eating behavior, and contact with dogs. The seroprevalence of anti-T. canis IgG was 14.9% (11/74; 13.8% [4/29] in the test group and 15.6% [7/45] in the control group). Most individuals in the test group correctly understood the primary mode of infection; however, 13.8% did not use gloves while manipulating T. canis eggs. Knowledge of biosafety must be well understood by health-care professionals doing laboratory work with biological agents. To our knowledge, this is the first study to investigate the rate of seroprevalence of IgG against Toxocara spp. among professionals and students who handle infective forms of the nematode T. canis. © The American Society of Tropical Medicine and Hygiene.

  17. Human Toxocariasis: Prevalence and Factors Associated with Biosafety in Research Laboratories

    PubMed Central

    Mattos, Gabriela Torres; dos Santos, Paula Costa; Telmo, Paula de Lima; Berne, Maria Elisabeth Aires; Scaini, Carlos James

    2016-01-01

    Human toxocariasis is a neglected parasitic disease worldwide. Researchers studying this disease use infectious strains of Toxocara for experiments. Health workers are at risk in the course of their daily routine and must adhere to biosafety standards while carrying out the activities. Researchers on biosafety concerning working with these parasites are insufficient. The aim of this study was to determine the rate of seroprevalence of Toxocara species among health-care research laboratory workers (professors, technicians, and students), and to investigate the risk factors of Toxocara infection associated with laboratory practices. This cross-sectional study involved 74 researchers at two federal universities in southern Brazil from February 2014 to February 2015; 29 researchers manipulated infective strains of Toxocara canis (test group) and 45 did not (control group). Serum samples were examined using enzyme-linked immunosorbent assay. Epidemiological data were obtained via a questionnaire containing information about laboratory routine, eating behavior, and contact with dogs. The seroprevalence of anti-T. canis IgG was 14.9% (11/74; 13.8% [4/29] in the test group and 15.6% [7/45] in the control group). Most individuals in the test group correctly understood the primary mode of infection; however, 13.8% did not use gloves while manipulating T. canis eggs. Knowledge of biosafety must be well understood by health-care professionals doing laboratory work with biological agents. To our knowledge, this is the first study to investigate the rate of seroprevalence of IgG against Toxocara spp. among professionals and students who handle infective forms of the nematode T. canis. PMID:27698276

  18. Factor VII assay performance: an analysis of the North American Specialized Coagulation Laboratory Association proficiency testing results.

    PubMed

    Zantek, N D; Hsu, P; Refaai, M A; Ledford-Kraemer, M; Meijer, P; Van Cott, E M

    2013-06-01

    The performance of factor VII (FVII) assays currently used by clinical laboratories was examined in North American Specialized Coagulation Laboratory Association (NASCOLA) proficiency tests. Data from 12 surveys conducted between 2008 and 2010, involving 20 unique specimens plus four repeat-tested specimens, were analyzed. The number of laboratories per survey was 49-54 with a total of 1224 responses. Numerous reagent/instrument combinations were used. For FVII > 80 or <40 U/dL, 99.5% of results (859/863) were correctly classified by laboratories as normal/abnormal. Classification of specimens with 40-73 U/dL FVII was heterogeneous. Interlaboratory precision was better for normal specimens (coefficient of variation (CV) 10.7%) than for FVII<20 U/dL (CV 33.1%), with a mean CV of 17.2% per specimen. Intralaboratory precision for repeated specimens demonstrated no significant difference between the paired survey results (mean absolute difference 2.5-5.0 U/dL). For specimens with FVII >50 U/dL, among commonly used methods, one thromboplastin and one calibrator produced results 5-6 U/dL higher and another thromboplastin and calibrator produced results 5-6 U/dL lower than all other methods, and human thromboplastin differed from rabbit by +7.6 U/dL. Preliminary evidence suggests these differences could be due to the calibrator. For FVII <50 U/dL, differences among the commonly used reagents and calibrators were generally not significant. © 2013 Blackwell Publishing Ltd.

  19. Towards an evaluation framework for Laboratory Information Systems.

    PubMed

    Yusof, Maryati M; Arifin, Azila

    Laboratory testing and reporting are error-prone and redundant due to repeated, unnecessary requests and delayed or missed reactions to laboratory reports. Occurring errors may negatively affect the patient treatment process and clinical decision making. Evaluation on laboratory testing and Laboratory Information System (LIS) may explain the root cause to improve the testing process and enhance LIS in supporting the process. This paper discusses a new evaluation framework for LIS that encompasses the laboratory testing cycle and the socio-technical part of LIS. Literature review on discourses, dimensions and evaluation methods of laboratory testing and LIS. A critical appraisal of the Total Testing Process (TTP) and the human, organization, technology-fit factors (HOT-fit) evaluation frameworks was undertaken in order to identify error incident, its contributing factors and preventive action pertinent to laboratory testing process and LIS. A new evaluation framework for LIS using a comprehensive and socio-technical approach is outlined. Positive relationship between laboratory and clinical staff resulted in a smooth laboratory testing process, reduced errors and increased process efficiency whilst effective use of LIS streamlined the testing processes. The TTP-LIS framework could serve as an assessment as well as a problem-solving tool for the laboratory testing process and system. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  20. Research and test facilities

    NASA Technical Reports Server (NTRS)

    1993-01-01

    A description is given of each of the following Langley research and test facilities: 0.3-Meter Transonic Cryogenic Tunnel, 7-by 10-Foot High Speed Tunnel, 8-Foot Transonic Pressure Tunnel, 13-Inch Magnetic Suspension & Balance System, 14-by 22-Foot Subsonic Tunnel, 16-Foot Transonic Tunnel, 16-by 24-Inch Water Tunnel, 20-Foot Vertical Spin Tunnel, 30-by 60-Foot Wind Tunnel, Advanced Civil Transport Simulator (ACTS), Advanced Technology Research Laboratory, Aerospace Controls Research Laboratory (ACRL), Aerothermal Loads Complex, Aircraft Landing Dynamics Facility (ALDF), Avionics Integration Research Laboratory, Basic Aerodynamics Research Tunnel (BART), Compact Range Test Facility, Differential Maneuvering Simulator (DMS), Enhanced/Synthetic Vision & Spatial Displays Laboratory, Experimental Test Range (ETR) Flight Research Facility, General Aviation Simulator (GAS), High Intensity Radiated Fields Facility, Human Engineering Methods Laboratory, Hypersonic Facilities Complex, Impact Dynamics Research Facility, Jet Noise Laboratory & Anechoic Jet Facility, Light Alloy Laboratory, Low Frequency Antenna Test Facility, Low Turbulence Pressure Tunnel, Mechanics of Metals Laboratory, National Transonic Facility (NTF), NDE Research Laboratory, Polymers & Composites Laboratory, Pyrotechnic Test Facility, Quiet Flow Facility, Robotics Facilities, Scientific Visualization System, Scramjet Test Complex, Space Materials Research Laboratory, Space Simulation & Environmental Test Complex, Structural Dynamics Research Laboratory, Structural Dynamics Test Beds, Structures & Materials Research Laboratory, Supersonic Low Disturbance Pilot Tunnel, Thermal Acoustic Fatigue Apparatus (TAFA), Transonic Dynamics Tunnel (TDT), Transport Systems Research Vehicle, Unitary Plan Wind Tunnel, and the Visual Motion Simulator (VMS).

  1. Trends in testing behaviours for hepatitis C virus infection and associated determinants: results from population-based laboratory surveillance in Alberta, Canada (1998-2001).

    PubMed

    Jayaraman, G C; Lee, B; Singh, A E; Preiksaitis, J K

    2007-04-01

    Little is currently known about hepatitis C virus (HCV) test seeking behaviours at the population level. Given the centralized nature of testing for HCV infection in the province of Alberta, Canada, we had an opportunity to examine HCV testing behaviour at the population level on all newly diagnosed HCV-positive cases using laboratory data to validate the time and number of prior tests for each case. Record linkage identified 3323, 2937, 2660 and 2703 newly diagnosed cases of HCV infections in Alberta during 1998, 1999, 2000 and 2001, respectively, corresponding to age-adjusted rates of 149.8, 129, 114.3 and 113.7 per 100,000 population during these years, respectively. Results from secondary analyses of laboratory data suggest that the majority of HCV cases (95.3%) who were newly diagnosed between 1998 and 2001 were first-time testers for HCV infection. Among repeat testers, analysis of a negative test result within 1 year prior to a first of a positive test report suggests that 211 (38.4%) may be seroconvertors. These findings suggest that 339 or 61.7% of repeat testers may not have discovered their serostatus within 1 year of infection. Among this group, HCV testing was sought infrequently, with a median interval of 2.3 years between the last negative and first positive test. This finding is of concern given the risks for HCV transmission, particularly if risk-taking behaviours are not reduced because of unknown serostatus. These findings also reinforce the need to make the most of each test-seeking event with proper counselling and other appropriate support services.

  2. Student performance on practical gross anatomy examinations is not affected by assessment modality.

    PubMed

    Meyer, Amanda J; Innes, Stanley I; Stomski, Norman J; Armson, Anthony J

    2016-01-01

    Anatomical education is becoming modernized, not only in its teaching and learning, but also in its assessment formats. Traditional "steeplechase" examinations are being replaced with online gross anatomy examinations. The aims of this study were to: (1) determine if online anatomy practical examinations are equivalent to traditional anatomy practical examinations; and (2) to examine if students' perceptions of the online or laboratory testing environments influenced their performance on the examinations. In phase one, 10 third-year students were interviewed to generate perception items to which five anatomy lecturers assigned content validity. In phase two, students' gross anatomical knowledge was assessed by examinations in two modes and their perceptions were examined using the devised survey instrument. Forty-five second-year chiropractic students voluntarily participated in Phase Two. The two randomly allocated groups completed the examinations in a sequential cross-over manner. Student performance on the gross anatomy examination was not different between traditional "steeplechase" (mean ± standard deviation (SD): 69 ± 11%) and online (68 ± 15%) modes. The majority of students (87%) agreed that they felt comfortable using computers for gross anatomy examinations. However, fewer students found it easy to orientate images of cadaver specimens online. The majority of students (85%) agreed that they felt comfortable working with cadavers but there was less agreement on the effect of moving around the laboratory during practical examinations. This data will allow anatomists to confidently implement online assessments without fear of jeopardizing academic rigor or student performance. © 2015 American Association of Anatomists.

  3. [Laboratory accreditation and proficiency testing].

    PubMed

    Kuwa, Katsuhiko

    2003-05-01

    ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

  4. Hepatotoxicity induced by methimazole in a previously healthy patient.

    PubMed

    Gallelli, Luca; Staltari, Orietta; Palleria, Caterina; De Sarro, Giovambattista; Ferraro, Maria

    2009-09-01

    We report a case of hepatotoxicity induced by methimazole treatment in a patient affected by hyperthyroidism. A 54-year-old man, presented to our observation for palpitations, excessive sweating, weakness, heat intolerance and weight loss. On physical examination, his blood pressure was 140/90 mmHg and heart beat was 100/min regular. He had mild tremors and left exophthalmos. Laboratory test revealed a significant increase in serum thyroid hormone levels with a decrease in thyroid stimulating hormone levels. A diagnosis of hyperthyroidism was made and he began treatment with methimazole (30 mg/day). Fourteen days later, he returned for the development of scleral icterus, followed by dark urine, and abdominal pain in the right upper quadrant. Laboratory examinations and liver biopsy performed a diagnosis of cholestatic hepatitis, secondary to methimazole usage. Methimazole was promptly withdrawn and cholestyramine, ursodeoxycholic acid, and chlorpheniramine were given. After five days, abdominal pain resolved and laboratory parameters returned to normal. Naranjo probability scale indicated a probable relationship between hepatotoxicity and methimazole therapy. In conclusion physicians should be aware the risk of hepatotoxicity related with methimazole.

  5. The ethical implications of genetic testing in the classroom.

    PubMed

    Taylor, Ann T S; Rogers, Jill Cellars

    2011-07-01

    The development of classroom experiments where students examine their own DNA is frequently described as an innovative teaching practice. Often these experiences involve students analyzing their genes for various polymorphisms associated with disease states, like an increased risk for developing cancer. Such experiments can muddy the distinction between classroom investigation and medical testing. Although the goals and issues surrounding classroom genotyping do not directly align with those of clinical testing, instructors can use the guidelines and standards established by the medical genetics community when evaluating the ethics of human genotyping. We developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of the ethical concerns presented in this paper, so the discussion replaced the actual genetic testing in the class. A science faculty member led the laboratory portion, while a genetic counselor facilitated the discussion of the ethical concepts underlying genetic counseling: autonomy, beneficence, confidentiality, and justice. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human genetic testing is important and timely. Moreover, incorporating a genetic counselor in the classroom discussion provided a rich and dynamic discussion of human genetic testing. Copyright © 2011 Wiley Periodicals, Inc.

  6. Sexual Self-Schemas in the Real World: Investigating the Ecological Validity of Language-Based Markers of Childhood Sexual Abuse

    PubMed Central

    Stanton, Amelia M.; Meston, Cindy M.

    2017-01-01

    Abstract This is the first study to examine language use and sexual self-schemas in natural language data extracted from posts to a large online forum. Recently, two studies applied advanced text analysis techniques to examine differences in language use and sexual self-schemas between women with and without a history of childhood sexual abuse. The aim of the current study was to test the ecological validity of the differences in language use and sexual self-schema themes that emerged between these two groups of women in the laboratory. Archival natural language data were extracted from a social media website and analyzed using LIWC2015, a computerized text analysis program, and other word counting approaches. The differences in both language use and sexual self-schema themes that manifested in recent laboratory research were replicated and validated in the large online sample. To our knowledge, these results provide the first empirical examination of sexual cognitions as they occur in the real world. These results also suggest that natural language analysis of text extracted from social media sites may be a potentially viable precursor or alternative to laboratory measurement of sexual trauma phenomena, as well as clinical phenomena, more generally. PMID:28570129

  7. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2013-10-01 2013-10-01 false What is validity testing, and are laboratories...

  8. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2011-10-01 2011-10-01 false What is validity testing, and are laboratories...

  9. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2010-10-01 2010-10-01 false What is validity testing, and are laboratories...

  10. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2012-10-01 2012-10-01 false What is validity testing, and are laboratories...

  11. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2014-10-01 2014-10-01 false What is validity testing, and are laboratories...

  12. The European Spacelab structural design evolution

    NASA Technical Reports Server (NTRS)

    Thirkettle, A. J.

    1982-01-01

    Spacelab is a manned, reusable laboratory which is being developed for the European Space Agency (ESA). In its working mode it will fly in low earth orbit in the cargo bay of the Shuttle Transportation System (STS) Orbiter. A description is presented of the structural development of the various features of Spacelab. System requirements are considered along with structural requirements, quasi-static loads, acoustic loads, pressure loads, crash loads, ground loads, and the fatigue profile. Aspects of thermal environment generation are discussed, and questions regarding the design evolution of the pallet structure are examined. Details of pallet structure testing are reported, taking into account static strength tests, acoustic tests, the modal survey test, crash tests, and fatigue/fracture mechanics testing.

  13. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or...

  14. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or...

  15. What do physicians tell laboratories when requesting tests? A multi-method examination of information supplied to the microbiology laboratory before and after the introduction of electronic ordering.

    PubMed

    Georgiou, Andrew; Prgomet, Mirela; Toouli, George; Callen, Joanne; Westbrook, Johanna

    2011-09-01

    The provision of relevant clinical information on pathology requests is an important part of facilitating appropriate laboratory utilization and accurate results interpretation and reporting. (1) To determine the quantity and importance of handwritten clinical information provided by physicians to the Microbiology Department of a hospital pathology service; and (2) to examine the impact of a Computerized Provider Order Entry (CPOE) system on the nature of clinical information communication to the laboratory. A multi-method and multi-stage investigation which included: (a) a retrospective audit of all handwritten Microbiology requests received over a 1-month period in the Microbiology Department of a large metropolitan teaching hospital; (b) the administration of a survey to laboratory professionals to investigate the impact of different clinical information on the processing and/or interpretation of tests; (c) an expert panel consisting of medical staff and senior scientists to assess the survey findings and their impact on pathology practice and patient care; and (d) a comparison of the provision and value of clinical information before CPOE, and across 3 years after its implementation. The audit of handwritten requests found that 43% (n=4215) contained patient-related clinical information. The laboratory survey showed that 97% (84/86) of the different types of clinical information provided for wound specimens and 86% (43/50) for stool specimens were shown to have an effect on the processing or interpretation of the specimens by one or more laboratory professionals. The evaluation of the impact of CPOE revealed a significant improvement in the provision of useful clinical information from 2005 to 2008, rising from 90.1% (n=749) to 99.8% (n=915) (p<.0001) for wound specimens and 34% (n=129) to 86% (n=422) (p<.0001) for stool specimens. This study showed that the CPOE system provided an integrated platform to access and exchange valuable patient-related information between physicians and the laboratory. These findings have important implications for helping to inform decisions about the design and structure of CPOE screens and what data entry fields should be designated or made voluntary. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Influence of precracked specimen configuration and starting stress intensity on the stress corrosion cracking of 4340 steel

    NASA Technical Reports Server (NTRS)

    Lisagor, W. B.

    1984-01-01

    Since the pioneer work of Brown (1966), precracked specimens and related fracture mechanics analyses have been extensively used to study stress corrosion cracking. Certain questions arose in connection with initial attempts to prepare standardized recommended practices by ASTM Committee G-1 on Corrosion of Metals. These questions were related to adequacy of test control as it pertains to acceptable limits of variability, and to validity of expressions for stress intensity and crack-surface displacements for both specimen configurations. An interlaboratory test program, was, therefore, planned with the objective to examine the validity of KIscc testing for selected specimen configurations, materials,and environmental systems. The results reported in the present paper include details of a single laboratory test program. The program was conducted to determine if the threshold value of stress intensity for onset and arrest of stress corrosion cracking was independent for the two specimen configurations examined.

  17. Joint and fascial chronic graft-vs-host disease: correlations with clinical and laboratory parameters

    PubMed Central

    Vukić, Tamara; Smith, Sean Robinson; Ljubas Kelečić, Dina; Desnica, Lana; Prenc, Ema; Pulanić, Dražen; Vrhovac, Radovan; Nemet, Damir; Pavletic, Steven Z.

    2016-01-01

    Aim To determine if there are correlations between joint and fascial chronic graft-vs-host disease (cGVHD) with clinical findings, laboratory parameters, and measures of functional capacity. Methods 29 patients were diagnosed with cGVHD based on National Institutes of Health (NIH) Consensus Criteria at the University Hospital Centre Zagreb from October 2013 to October 2015. Physical examination, including functional measures such as 2-minute walk test and hand grip strength, as well as laboratory tests were performed. The relationship between these evaluations and the severity of joint and fascial cGVHD was tested by logistical regression analysis. Results 12 of 29 patients (41.3%) had joint and fascial cGVHD diagnosed according to NIH Consensus Criteria. There was a significant positive correlation of joint and fascial cGVHD and skin cGVHD (P < 0.001), serum C3 complement level (P = 0.045), and leukocytes (P = 0.032). There was a significant negative correlation between 2-minute walk test (P = 0.016), percentage of cytotoxic T cells CD3+/CD8+ (P = 0.022), serum albumin (P = 0.047), and Karnofsky score (P < 0.001). Binary logistic regression model found that a significant predictor for joint and fascial cGVHD was cGVHD skin involvement (odds ratio, 7.79; 95 confidence interval 1.87-32.56; P = 0.005). Conclusion Joint and fascial cGVHD manifestations correlated with multiple laboratory measurements, clinical features, and cGVHD skin involvement, which was a significant predictor for joint and fascial cGVHD. PMID:27374828

  18. North Pole Marathon Laboratory Lessons and Field Success.

    PubMed

    Barwood, Martin J; Burrows, Holly; Cessford, Jessica

    2016-05-01

    This case study documents the training, laboratory preparation, and in-race performance data from Great Britain's top finisher in the 13(th) edition of the UVU North Pole Marathon. We report data from a preparatory laboratory test in simulated cold conditions (-15°C) with and without wind chill during high- and low-intensity expected 'race pace' running. These tests examined the adequacy of the selected clothing assembly and provided recommendations for the race. The tests established that there was no risk of hypothermia, as the clothing assembly provided too much insulation; terminal rectal temperature was 39.25°C. Skin temperature (Tsk) data revealed no impending risk of frostbite; nadir Tsk was 20.2°C at the hamstring. Oxygen consumption data revealed the self-selected high intensity was potentially not sustainable based on estimates of substrate utilization. We recommended: 1) a maximum running speed; 2) some of the clothing base layers could be removed pre-race; 3) vents and/or zips could be used to offload or retain heat; and 4) an even pacing profile should be adopted. The participant completed the race in 6:55:24 (h:mm:ss) in temperatures of -41°C. GPS data revealed a positive pacing template (i.e., marginally quicker in the first half). Neither hypothermia nor frostbite occurred. Peak pace from the laboratory tests was not consistently exceeded. Marathon performance can be undertaken in one of the world's most inhospitable environments when careful consideration is given to clothing insulation and exercise intensity by planning for the dynamic thermal changes that may occur as the race ensues.

  19. 3. VIEW LOOKING NORTH, COMPONENTS TEST LABORATORY, DYNAMIC TEST FACILITY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. VIEW LOOKING NORTH, COMPONENTS TEST LABORATORY, DYNAMIC TEST FACILITY (SATURN V IN BACKGROUND). - Marshall Space Flight Center, East Test Area, Components Test Laboratory, Huntsville, Madison County, AL

  20. Susceptibility of different life stage of Tribolium confusum and Oryzaephilus surinamensis to cold treatment

    USDA-ARS?s Scientific Manuscript database

    Laboratory tests were carried out to examine the efficacy of different exposure intervals (2 h, 4 h, 8 h, 1 d, 2 d, 3 d and 7 d) on different life stages (adults, pupae, larvae, eggs) of Tribolium confusum Jacquelin du Val (Coleoptera: Tenebrionidae), the confused flour beetle, and O. surinamensis (...

  1. Field performance of Populus expressing somaclonal variation in resistance to Septoria musiva

    Treesearch

    M. E. Ostry; K. T. Ward

    2003-01-01

    Over 1500 trees from two hybrid poplar clones regenerated from tissue culture and expressing somatic variation in leaf disease resistance in a laboratory leaf disk bioassay were field-tested for 5-11 years to examine their resistance to Septoria leaf spot and canker and to assess their growth characteristics compared with the source clones....

  2. Language and Academic Abilities in Children with Selective Mutism

    ERIC Educational Resources Information Center

    Nowakowski, Matilda E.; Cunningham, Charles E.; McHolm, Angela E.; Evans, Mary Ann; Edison, Shannon; St. Pierre, Jeff; Boyle, Michael H.; Schmidt, Louis A.

    2009-01-01

    We examined receptive language and academic abilities in children with selective mutism (SM; n = 30; M age = 8.8 years), anxiety disorders (n = 46; M age = 9.3 years), and community controls (n = 27; M age = 7.8 years). Receptive language and academic abilities were assessed using standardized tests completed in the laboratory. We found a…

  3. Improving Student Concern for Safety in a Production Technology Lab through the Use of Teambuilding.

    ERIC Educational Resources Information Center

    Lacina, Dale Robert

    The effectiveness of team building as a strategy for improving students' concern for safety in a production technology laboratory was examined in a study involving a group of grade 9 and 10 production technology students from an urban, lower-middle-class community in western Illinois. Students' safety test scores, teacher checklists, and…

  4. Vulvovaginitis: Find the cause to treat it.

    PubMed

    Goje, Oluwatosin; Munoz, Jessian L

    2017-03-01

    Vulvar and vaginal disorders are among the most common problems seen in ambulatory care. The cause is usually infectious, but noninfectious causes should also be considered, and differentiating them can be challenging. Accurate diagnosis based on patient history, physical examination, and laboratory testing is necessary so that effective therapy can be chosen. Copyright © 2017 Cleveland Clinic.

  5. Ectomycorrihizae of Table Mountain Pine and the Influence of Prescribed Burning on their Survival

    Treesearch

    Lisa E. Ellis; Thomas A. Waldrop; Frank H. Tainter

    2002-01-01

    High-intensity prescribed fires have been recommended to regenerate Table Mountain pine (Pinus pungens). However, tests of these burns produced few seedlings, possibly due to soil sterilization. This study examined abundance of mycorrhizal root tips in the field after a high-intensity fire and in the laboratory after exposing rooting media to...

  6. Cone calorimeter tests of wood-based decking materials

    Treesearch

    Robert H. White; Mark A. Dietenberger; Nicole M. Stark

    2007-01-01

    New technologies in building materials have resulted in the use of a wide variety of materials in decks. As part of our effort to address fire concerns in the wildland-urban interface, the Forest Products Laboratory has been examining the fire performance of decking products. In addition to preservative-treated wood, decking products include wood-plastic composites and...

  7. 42 CFR 457.520 - Cost sharing for well-baby and well-child care services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Adolescents.” (3) Laboratory tests associated with the well-baby and well-child routine physical examinations... 42 Public Health 4 2010-10-01 2010-10-01 false Cost sharing for well-baby and well-child care... well-baby and well-child care services. (a) A State may not impose copayments, deductibles, coinsurance...

  8. Results of Screening of Apparently Healthy Senior and Geriatric Dogs.

    PubMed

    Willems, A; Paepe, D; Marynissen, S; Smets, P; Van de Maele, I; Picavet, P; Duchateau, L; Daminet, S

    2017-01-01

    There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited. To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy. Hundred client-owned dogs. Dogs were prospectively recruited. Owners completed a questionnaire. SBP measurement, physical, orthopedic and neurologic examination, direct fundoscopy and Schirmer tear test were performed. Complete blood count, serum biochemistry, and urinalysis were evaluated. Forty-one senior and 59 geriatric dogs were included. Mean SBP was 170 ± 38 mmHg, and 53 dogs had SBP > 160 mmHg. Thirty-nine animals were overweight. A heart murmur was detected in 22, severe calculus in 21 and 1 or more (sub)cutaneous masses in 56 dogs. Thirty-two dogs had increased serum creatinine, 29 hypophosphatemia, 27 increased ALP, 25 increased ALT, and 23 leukopenia. Crystalluria, mostly amorphous crystals, was commonly detected (62/96). Overt proteinuria and borderline proteinuria were detected in 13 and 18 of 97 dogs, respectively. Four dogs had a positive urine bacterial culture. Frequency of orthopedic problems, frequency of (sub)cutaneous masses, and platelet count were significantly higher in geriatric compared with senior dogs. Body temperature, hematocrit, serum albumin, and serum total thyroxine concentration were significantly lower in geriatric compared with senior dogs. Physical and laboratory abnormalities are common in apparently healthy elderly dogs. Veterinarians play a key role in implementing health screening and improving health care for elderly pets. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  9. The effects of laboratory housing and spatial enrichment on brain size and metabolic rate in the eastern mosquitofish, Gambusia holbrooki

    PubMed Central

    Turschwell, Mischa P.; White, Craig R.

    2016-01-01

    ABSTRACT It has long been hypothesised that there is a functional correlation between brain size and metabolic rate in vertebrates. The present study tested this hypothesis in wild-caught adult mosquitofish Gambusia holbrooki by testing for an intra-specific association between resting metabolic rate (RMR) and brain size while controlling for variation in body size, and through the examination of the effects of spatial enrichment and laboratory housing on body mass-independent measures of brain size and RMR. Controlling for body mass, there was no relationship between brain size and RMR in wild-caught fish. Contrary to predictions, spatial enrichment caused a decrease in mass-independent brain size, highlighting phenotypic plasticity in the adult brain. As expected, after controlling for differences in body size, wild-caught fish had relatively larger brains than fish that had been maintained in the laboratory for a minimum of six weeks, but wild-caught fish also had significantly lower mass-independent RMR. This study demonstrates that an organisms' housing environment can cause significant plastic changes to fitness related traits including brain size and RMR. We therefore conclude that current standard laboratory housing conditions may cause captive animals to be non-representative of their wild counterparts, potentially undermining the transferability of previous laboratory-based studies of aquatic ectothermic vertebrates to wild populations. PMID:26794608

  10. Photocatalytic destruction of chlorinated solvents in water with solar energy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pacheco, J.E.; Prairie, M.R.; Yellowhorse, L.

    1993-08-01

    Sandia National Laboratories and the National Renewable Energy Laboratory are developing a photocatalytic process to destroy organic contaminants in water. Tests with common water pollutants have been conducted at Sandia's Solar Thermal Facility using a near commercial scale, single-axis tracking parabolic trough system with a glass pipe reactor mounted at its focus. Experiments at this scale provide verification of laboratory studies and allow examination of design and operation issues at a real-lifescale. The catalyst, titanium dioxide (TiO[sub 2]), is a harmless material found in paint, cosmetics, and toothpaste. Experiments were conducted to determine the effects of key process parameters onmore » destruction rates of chlorinated organic compounds that are common water pollutants. This paper summarizes the engineering-scale results of these experiments and analyses.« less

  11. Can an Inquiry Approach Improve College Student Learning in a Teaching Laboratory?

    PubMed Central

    Cogan, John G.

    2009-01-01

    We present an inquiry-based, hands-on laboratory exercise on enzyme activity for an introductory college biology course for science majors. We measure student performance on a series of objective and subjective questions before and after completion of this exercise; we also measure performance of a similar cohort of students before and after completion of an existing, standard, “direct” exercise over the same topics. Although student performance on these questions increased significantly after completion of the inquiry exercise, it did not increase after completion of the control, standard exercise. Pressure to “cover” many complex topics as preparation for high-stakes examinations such as the Medical College Admissions Test may account for persistence of highly efficient, yet dubiously effective “cookbook” laboratory exercises in many science classes. PMID:19255136

  12. The ad-libitum alcohol 'taste test': secondary analyses of potential confounds and construct validity.

    PubMed

    Jones, Andrew; Button, Emily; Rose, Abigail K; Robinson, Eric; Christiansen, Paul; Di Lemma, Lisa; Field, Matt

    2016-03-01

    Motivation to drink alcohol can be measured in the laboratory using an ad-libitum 'taste test', in which participants rate the taste of alcoholic drinks whilst their intake is covertly monitored. Little is known about the construct validity of this paradigm. The objective of this study was to investigate variables that may compromise the validity of this paradigm and its construct validity. We re-analysed data from 12 studies from our laboratory that incorporated an ad-libitum taste test. We considered time of day and participants' awareness of the purpose of the taste test as potential confounding variables. We examined whether gender, typical alcohol consumption, subjective craving, scores on the Alcohol Use Disorders Identification Test and perceived pleasantness of the drinks predicted ad-libitum consumption (construct validity). We included 762 participants (462 female). Participant awareness and time of day were not related to ad-libitum alcohol consumption. Males drank significantly more alcohol than females (p < 0.001), and individual differences in typical alcohol consumption (p = 0.04), craving (p < 0.001) and perceived pleasantness of the drinks (p = 0.04) were all significant predictors of ad-libitum consumption. We found little evidence that time of day or participant awareness influenced alcohol consumption. The construct validity of the taste test was supported by relationships between ad-libitum consumption and typical alcohol consumption, craving and pleasantness ratings of the drinks. The ad-libitum taste test is a valid method for the assessment of alcohol intake in the laboratory.

  13. Predicting psychopharmacological drug effects on actual driving performance (SDLP) from psychometric tests measuring driving-related skills.

    PubMed

    Verster, Joris C; Roth, Thomas

    2012-03-01

    There are various methods to examine driving ability. Comparisons between these methods and their relationship with actual on-road driving is often not determined. The objective of this study was to determine whether laboratory tests measuring driving-related skills could adequately predict on-the-road driving performance during normal traffic. Ninety-six healthy volunteers performed a standardized on-the-road driving test. Subjects were instructed to drive with a constant speed and steady lateral position within the right traffic lane. Standard deviation of lateral position (SDLP), i.e., the weaving of the car, was determined. The subjects also performed a psychometric test battery including the DSST, Sternberg memory scanning test, a tracking test, and a divided attention test. Difference scores from placebo for parameters of the psychometric tests and SDLP were computed and correlated with each other. A stepwise linear regression analysis determined the predictive validity of the laboratory test battery to SDLP. Stepwise regression analyses revealed that the combination of five parameters, hard tracking, tracking and reaction time of the divided attention test, and reaction time and percentage of errors of the Sternberg memory scanning test, together had a predictive validity of 33.4%. The psychometric tests in this test battery showed insufficient predictive validity to replace the on-the-road driving test during normal traffic.

  14. An audit of the cervical cancer screening histories of 246 women with carcinoma.

    PubMed

    Duggan, Máire A; Nation, Jill

    2012-07-01

    Women with cervical carcinoma and residing in the Calgary Health Region between 1996 and 2001 were audited to characterize factors in the opportunistic cervical cancer screening pathway contributing to screening failures. The cohort consisted of 246 women. Information on their Pap tests and colposcopic/gynecologic examinations was obtained from the files of Calgary Laboratory Services and their colposcopic/cancer center treatment charts. Screening failure factors were defined, and frequencies were calculated. Screening failure factors were as follows: (1) 41 (16.7%) were not screened, that is, no Pap test screening; (2) 29 (11.8%) were underscreened, that is, no Pap test within 12 months of diagnosis; (3) 28 (13.7%) were undersampled, that is, the Pap test result was negative; (4) 34 (13.8%) had no referral for a colposcopy/gynecology examination, and/or it was delayed for more than 3 months; (5) 18 (13.2%) had delayed referral for examination of an atypical glandular cell-high-grade squamous intraepithelial lesion and higher Pap test for more than 3 months; and (6) 73 (55.3%) were underdiagnosed, that is, the diagnosis in colposcopy examination was less than malignant. Underreported Pap tests and delayed Pap test reporting could not be fully investigated, but limited evidence suggested that underreporting contributed to some failures. Factors other than recruitment to cytological screening need targeted improvement if the region's cervical cancer prevention program is to be more effective.

  15. 1. VIEW EAST, COMPONENTS TEST LABORATORY SHOWING CATCH BASINS, TURBINE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW EAST, COMPONENTS TEST LABORATORY SHOWING CATCH BASINS, TURBINE TESTING AREA, AND PUMP TESTING TOWER. - Marshall Space Flight Center, East Test Area, Components Test Laboratory, Huntsville, Madison County, AL

  16. [How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

    PubMed

    Kawano, Seiji

    2014-12-01

    As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).

  17. Microbiological and Hydrogeochemical Controls on Anaerobic Biodegradation of Petroleum Hydrocarbons: Case Study from Fort McCoy, WI

    NASA Astrophysics Data System (ADS)

    Schreiber, M. E.; Zwolinski, M. D.; Taglia, P. J.; Bahr, J. M.; Hickey, W. J.

    2001-05-01

    We are investigating the role of anaerobic processes that control field-scale BTEX loss using a variety of experimental and numerical techniques. Tracer tests, laboratory microcosms, and in situ microcosms (ISMs) were designed to examine BTEX biodegradation under intrinsic and enhanced anaerobic conditions in a BTEX plume at Fort McCoy, WI. In the tracer tests, addition of nitrate resulted in loss of toluene, ethylbenzene, and m, p-xylenes but not benzene. Laboratory microcosm and ISM experiments confirmed that nitrate addition is not likely to enhance benzene biodegradation at the site. Excess nitrate losses were observed in both field and laboratory experiments, indicating that reliance on theoretical stoichiometric equations to estimate contaminant mass losses should be re-evaluated. To examine changes in microbial community during biodegradation of BTEX under enhanced nitrate-reducing conditions, DNA was extracted from laboratory microcosm sediment, the 16S-rRNA gene was amplified using eubacterial primers, and products were separated by denaturing gradient gel electrophoresis. Banding patterns suggest that nitrate caused more of a community change than BTEX. These data suggest that nitrate plays an important role in microbial population selection. Numerical simulations were conducted to simulate the evolution of the BTEX plume and to quantify BTEX losses due to intrinsic and nitrate-enhanced biodegradation. Results suggest that the majority of intrinsic BTEX mass loss has occurred under aerobic and iron-reducing conditions. Due to depletion of solid-phase Fe(III) over time, however, future BTEX losses under iron-reducing conditions will decrease, and methanogenesis will play an increasingly important role in controlling biodegradation. The simulations also suggest that although nitrate addition will decrease TEX concentrations, source removal with intrinsic biodegradation is likely the most effective treatment method for the site.

  18. Capability of the Gas Analysis and Testing Laboratory at the NASA Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Broerman, Craig; Jimenez, Javier; Sweterlitsch, Jeff

    2012-01-01

    The Gas Analysis and Testing Laboratory is an integral part of the testing performed at the NASA Johnson Space Center. The Gas Analysis and Testing Laboratory is a high performance laboratory providing real time analytical instruments to support manned and unmanned testing. The lab utilizes precision gas chromatographs, gas analyzers and spectrophotometers to support the technology development programs within the NASA community. The Gas Analysis and Testing Laboratory works with a wide variety of customers and provides engineering support for user-specified applications in compressed gas, chemical analysis, general and research laboratory.

  19. Capability of the Gas Analysis and Testing Laboratory at the NASA Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Broerman, Craig; Jimenez, Javier; Sweterlitsch, Jeff

    2011-01-01

    The Gas Analysis and Testing Laboratory is an integral part of the testing performed at the NASA Johnson Space Center. The Gas Analysis and Testing Laboratory is a high performance laboratory providing real time analytical instruments to support manned and unmanned testing. The lab utilizes precision gas chromatographs, gas analyzers and spectrophotometers to support the technology development programs within the NASA community. The Gas Analysis and Testing Laboratory works with a wide variety of customers and provides engineering support for user-specified applications in compressed gas, chemical analysis, general and research laboratory

  20. [Quality control assessments of feces examination for schistosomiasis in province-level laboratories of Zhejiang Province].

    PubMed

    Chen, Wen; Zhu, Ming-Dong; Yan, Xiao-Lan; Lin, Li-Jun; Zhang, Jian-Feng; Li, Li; Wen, Li-Yong

    2011-06-01

    To understand and evaluate the quality of feces examination for schistosomiasis in province-level laboratories of Zhejiang Province. With the single-blind method, the stool samples were detected by the stool hatching method and sediment detection method. In the 3 quality control assessments in 2006, 2008 and 2009, most laboratories finished the examinations on time. The accordance rates of detections were 88.9%, 100% and 93.9%, respectively. The province-level laboratories for schistosomiasis feces examination of Zhejiang Province is coming into standardization, and the techniques of schistosomiasis feces examination are optimized gradually.

  1. High-Temperature Strain Sensing for Aerospace Applications

    NASA Technical Reports Server (NTRS)

    Piazza, Anthony; Richards, Lance W.; Hudson, Larry D.

    2008-01-01

    Thermal protection systems (TPS) and hot structures are utilizing advanced materials that operate at temperatures that exceed abilities to measure structural performance. Robust strain sensors that operate accurately and reliably beyond 1800 F are needed but do not exist. These shortcomings hinder the ability to validate analysis and modeling techniques and hinders the ability to optimize structural designs. This presentation examines high-temperature strain sensing for aerospace applications and, more specifically, seeks to provide strain data for validating finite element models and thermal-structural analyses. Efforts have been made to develop sensor attachment techniques for relevant structural materials at the small test specimen level and to perform laboratory tests to characterize sensor and generate corrections to apply to indicated strains. Areas highlighted in this presentation include sensors, sensor attachment techniques, laboratory evaluation/characterization of strain measurement, and sensor use in large-scale structures.

  2. Photocatalytic destruction of chlorinated solvents with solar energy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pacheco, J.; Prairie, M.; Yellowhorse, L.

    1990-01-01

    Sandia National Laboratories and the Solar Energy Research Institute are developing a photocatalytic process to destroy organic contaminants in water. Tests with common water pollutants are being conducted at Sandia's Solar Thermal Test Facility using a near commercial-scale single-axis tracking parabolic trough system with glass pipe mounted at its focus. Experiments at this scale provide verification of laboratory studies and allow examination of design and operation issues at a real-life scale. The catalyst, titanium dioxide (TiO{sub 2}), is a harmless material found in paint, cosmetics and toothpaste. Experiments were conducted to determine the effect of key process parameters on destructionmore » rates of two chlorinated organic compounds which are common water pollutants: trichloroethylene and trichloroethane. In this paper, we summarize the engineering-scale results of these experiments and analyses. 21 refs., 8 figs.« less

  3. Confidence Intervals for Laboratory Sonic Boom Annoyance Tests

    NASA Technical Reports Server (NTRS)

    Rathsam, Jonathan; Christian, Andrew

    2016-01-01

    Commercial supersonic flight is currently forbidden over land because sonic booms have historically caused unacceptable annoyance levels in overflown communities. NASA is providing data and expertise to noise regulators as they consider relaxing the ban for future quiet supersonic aircraft. One deliverable NASA will provide is a predictive model for indoor annoyance to aid in setting an acceptable quiet sonic boom threshold. A laboratory study was conducted to determine how indoor vibrations caused by sonic booms affect annoyance judgments. The test method required finding the point of subjective equality (PSE) between sonic boom signals that cause vibrations and signals not causing vibrations played at various amplitudes. This presentation focuses on a few statistical techniques for estimating the interval around the PSE. The techniques examined are the Delta Method, Parametric and Nonparametric Bootstrapping, and Bayesian Posterior Estimation.

  4. Advances Afoot in Microbiology

    PubMed Central

    Karon, Brad S.

    2017-01-01

    ABSTRACT In 2016, the American Academy of Microbiology convened a colloquium to examine point-of-care (POC) microbiology testing and to evaluate its effects on clinical microbiology. Colloquium participants included representatives from clinical microbiology laboratories, industry, and the government, who together made recommendations regarding the implementation, oversight, and evaluation of POC microbiology testing. The colloquium report is timely and well written (V. Dolen et al., Changing Diagnostic Paradigms for Microbiology, 2017, https://www.asm.org/index.php/colloquium-reports/item/6421-changing-diagnostic-paradigms-for-microbiology?utm_source=Commentary&utm_medium=referral&utm_campaign=diagnostics). Emerging POC microbiology tests, especially nucleic acid amplification tests, have the potential to advance medical care. PMID:28539341

  5. Experimental Evaluation of Oxide Nanoparticles as Friction and Wear Improvement Additives in Motor Oil

    DOE PAGES

    Demas, Nicholaos G.; Erck, Robert A.; Lorenzo-Martin, Cinta; ...

    2017-01-30

    The effect of two nanoparticle oxides on friction and wear was studied under laboratory test conditions using a reciprocating test machine and two test configurations. The addition of these nanoparticles in base stock oil under certain conditions reduced the coefficient of friction and improved wear, but that depended on the test configuration. Examination of the rubbed surfaces showed the pronounced formation of a tribofilm in some cases, while polishing on the surface was also observed in other cases. Contact configuration is important when oxide nanoparticles are being evaluated and the conclusions about their efficacy can be vastly different.

  6. Energy Systems High-Pressure Test Laboratory | Energy Systems Integration

    Science.gov Websites

    Facility | NREL Energy Systems High-Pressure Test Laboratory Energy Systems High-Pressure Test Laboratory In the Energy Systems Integration Facility's High-Pressure Test Laboratory, researchers can safely test high-pressure hydrogen components. Photo of researchers running an experiment with a hydrogen fuel

  7. Syphilis testing in antenatal care: Policies and practices among laboratories in the Americas.

    PubMed

    Luu, Minh; Ham, Cal; Kamb, Mary L; Caffe, Sonja; Hoover, Karen W; Perez, Freddy

    2015-06-01

    To asses laboratory syphilis testing policies and practices among laboratories in the Americas. Laboratory directors or designees from PAHO member countries were invited to participate in a structured, electronically-delivered survey between March and August, 2014. Data on syphilis tests, algorithms, and quality control (QC) practices were analyzed, focusing on laboratories receiving specimens from antenatal clinics (ANCs). Surveys were completed by 69 laboratories representing 30 (86%) countries. Participating laboratories included 36 (52%) national or regional reference labs and 33 (48%) lower-level laboratories. Most (94%) were public sector facilities and 71% reported existence of a national algorithm for syphilis testing in pregnancy, usually involving both treponemal and non-treponemal testing (72%). Less than half (41%) used rapid syphilis tests (RSTs); and only seven laboratories representing five countries reported RSTs were included in the national algorithm for pregnant women. Most (83%) laboratories serving ANCs reported using some type of QC system; 68% of laboratories reported participation in external QC. Only 36% of laboratories reported data to national/local surveillance. Half of all laboratories serving ANC settings reported a stockout of one or more essential supplies during the previous year (median duration, 30days). Updating laboratory algorithms, improving testing standards, integrating data into existing surveillance, and improved procurement and distribution of commodities may be needed to ensure elimination of MTCT of syphilis in the Americas. Copyright © 2015. Published by Elsevier Ireland Ltd.

  8. [What's the point of cost management in clinical laboratories?].

    PubMed

    Setoyama, Tomokazu; Yamauchi, Kazuyoshi; Katsuyama, Tsutomu

    2006-11-01

    Clinical laboratories need to know and manage the costs of laboratory tests, because they need financial data (1) to estimate costs per patient, (2) to request a budget to buy equipment, and (3) to improve their work; however, less than 40% laboratories practice cost management. In 2002, Shinshu University Hospital began to assess the costs of laboratory tests, but it was difficult to evaluate the quality of our cost management because there are few data and papers about the costs of laboratory tests in Japan. In this article, we practiced cost analysis using Shinshu University Hospital's data for 3 years (2002-2004), and studied the features of laboratory test costs and the problems of laboratory cost management. As a result, we listed 7 points to check cost management in clinical laboratories. This check list was established using only one data from our hospital. So, we suggest the benchmarking laboratory test costs between laboratories of the same type of hospitals or various laboratories.

  9. Mercury toxicity in the aquatic oligochaete Sparganophilus pearsei: I. Variation in resistance among populations.

    PubMed

    Vidal, D E; Horne, A J

    2003-08-01

    Mercury contamination has become a problem in many San Francisco Bay Area watersheds due to its elevated presence in sediments and aquatic organisms. The present study used laboratory lethal toxicity (LC50) tests to examine the mercury tolerance of aquatic oligochaete worms, Sparganophilus pearsei, from contaminated and uncontaminated areas. The oligochaetes were collected in the following fresh water reservoirs: Sandy Wool (reference area), San Pablo, Lake Anza, Lake Herman, and Guadalupe. These last four reservoirs were contaminated with levels of mercury that ranged from 1.5 to 2 mg/kg (wet weight). Mercury concentrations in sediment and tissue from Sandy Wool were below detection limits and worms from this site were the least tolerant of mercury in laboratory exposures (LC50 = 0.22 mg/L). Worms from the other, more contaminated, reservoirs contained elevated tissue mercury concentrations and were more tolerant in laboratory tests (LC50 = 1.48-2.19 mg/L). The present study demonstrates that different populations of the aquatic oligochaete S. pearsei have developed different tolerances to mercury depending on their previous history of exposure to mercury contamination.

  10. Exploring the effectiveness of engagement in a broad range of disciplinary practices on learning of Turkish high-school chemistry students

    NASA Astrophysics Data System (ADS)

    Seda Cetin, Pinar; Eymur, Guluzar; Southerland, Sherry A.; Walker, Joi; Whittington, Kirby

    2018-03-01

    This study examines the influence of laboratory instruction that engages students in a wide range of the practices of science on Turkish high-school students' chemistry learning. In this mixed methods study, student learning in two different laboratory settings was compared, one that featured an instruction that engaged students in a wide range of disciplinary practices (through Argument-driven Inquiry - ADI) and similar laboratories in which a more traditional Structured Inquiry (SI) approach was employed. The data sources included a Chemistry Concept test, an Argumentative Writing Assessment, and Semi-structured interviews. After seven weeks of chemistry instruction, students experiencing ADI instruction scored higher on the Chemistry Concept test and the Argumentative Writing Assessment than students experiencing SI instruction. Furthermore, girls who experienced ADI instruction scored higher on the assessments than their majority peers in the same class. The results suggest that Turkish students can substantially improve their chemistry proficiency if they have an opportunity to engage in instruction featuring a broad array of the practices of science.

  11. The changing landscape of genetic testing and its impact on clinical and laboratory services and research in Europe.

    PubMed

    Hastings, Ros; de Wert, Guido; Fowler, Brian; Krawczak, Michael; Vermeulen, Eric; Bakker, Egbert; Borry, Pascal; Dondorp, Wybo; Nijsingh, Niels; Barton, David; Schmidtke, Jörg; van El, Carla G; Vermeesch, Joris; Stol, Yrrah; Carmen Howard, Heidi; Cornel, Martina C

    2012-09-01

    The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the 'Changing landscape of genetic testing', co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research.

  12. [Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

    PubMed

    Ishibashi, Midori

    2015-01-01

    The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

  13. Posttest destructive examination of the steel liner in a 1:6-scale reactor containment model

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lambert, L.D.

    A 1:6-scale model of a nuclear reactor containment model was built and tested at Sandia National Laboratories as part of research program sponsored by the Nuclear Regulatory Commission to investigate containment overpressure test was terminated due to leakage from a large tear in the steel liner. A limited destructive examination of the liner and anchorage system was conducted to gain information about the failure mechanism and is described. Sections of liner were removed in areas where liner distress was evident or where large strains were indicated by instrumentation during the test. The condition of the liner, anchorage system, and concretemore » for each of the regions that were investigated are described. The probable cause of the observed posttest condition of the liner is discussed.« less

  14. Mild balanoposthitis.

    PubMed Central

    Fornasa, C V; Calabrŏ, A; Miglietta, A; Tarantello, M; Biasinutto, C; Peserico, A

    1994-01-01

    AIM--To identify and study cases of mild balanoposthitis (MBP) with penile pathology among patients observed at a dermatology clinic over an 18-month period. MATERIALS--The study included 321 patients with penile pathology. The term MBP was used to describe balanoposthitis of a localised, inflammatory nature with few, non-specific symptoms and a tendency to become chronic or recur. Two hundred and seventy had diseases clearly identifiable by clinical examination or laboratory tests; 51 cases were diagnosed as MBP and these patients had blood tests (to evaluate immune status) and microbiological examination; when these proved negative, a series of patch tests was also used. RESULTS--Of the 51 patients diagnosed as having MBP, the cause was ascertained in 34 cases (infection, mechanical trauma, contact irritation, contact allergy, etc.), whereas no specific aetiological factor was detected to explain the symptoms in the remaining 17 cases. PMID:8001949

  15. Using Phased Array Ultrasonic Testing in Lieu of Radiography for Acceptance of Carbon Steel Piping Welds

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Moran, Traci L.; Anderson, Michael T.; Cinson, Anthony D.

    2014-08-01

    The Pacific Northwest National Laboratory (PNNL) is conducting studies for the U.S. Nuclear Regulatory Commission (NRC) to assess the capability, effectiveness, and reliability of ultrasonic testing (UT) as a replacement method for radiographic testing (RT) for volumetric examination of nuclear power plant (NPP) components. This particular study focused on evaluating the use of UT on carbon steel plate welds. Welding fabrication flaws included a combination of planar and volumetric types, e.g., incomplete fusion, lack of penetration, cracks, porosity, and slag inclusions. The examinations were conducted using phased-array (PA) UT techniques applied primarily for detection and flaw type characterization. This papermore » will discuss the results of using UT in lieu of RT for detection and classification of fabrication flaws in carbon steel plate welds.« less

  16. Effect of a depilatory agent on cotton, polyester, and rayon versus human hair in a laboratory setting.

    PubMed

    Plesa, Jocelyn A; Shoup, Kelly; Manole, Mioara D; Hickey, Robert W

    2015-03-01

    We examine the ability of a depilatory agent, Nair, to dissolve strands of hair, cotton, polyester, and rayon. We conducted a bench laboratory study in which we tested single strands of hair and natural and synthetic fibers under static tension with a 10.8-g weight and application of Nair. The dependent variable, time until breakage, was recorded. If the strand did not break within 8 hours, the experiment was discontinued. Three types of hair were tested (thin, medium, and thick, as recorded per diameter). Three types of natural and synthetic fibers were tested (cotton, polyester, and rayon). All types of hair had breakage within 10 minutes of the Nair application. Synthetic materials had no breakage after 8 hours with application of Nair. Depilatory agents dissolve hair under tension within minutes. However, they do not dissolve cotton, polyester, and rayon even after many hours of application. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  17. Apollo Contour Rocket Nozzle in the Propulsion Systems Laboratory

    NASA Image and Video Library

    1964-07-21

    Bill Harrison and Bud Meilander check the setup of an Apollo Contour rocket nozzle in the Propulsion Systems Laboratory at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The Propulsion Systems Laboratory contained two 14-foot diameter test chambers that could simulate conditions found at very high altitudes. The facility was used in the 1960s to study complex rocket engines such as the Pratt and Whitney RL-10 and rocket components such as the Apollo Contour nozzle, seen here. Meilander oversaw the facility’s mechanics and the installation of test articles into the chambers. Harrison was head of the Supersonic Tunnels Branch in the Test Installations Division. Researchers sought to determine the impulse value of the storable propellant mix, classify and improve the internal engine performance, and compare the results with analytical tools. A special setup was installed in the chamber that included a device to measure the thrust load and a calibration stand. Both cylindrical and conical combustion chambers were examined with the conical large area ratio nozzles. In addition, two contour nozzles were tested, one based on the Apollo Service Propulsion System and the other on the Air Force’s Titan transtage engine. Three types of injectors were investigated, including a Lewis-designed model that produced 98-percent efficiency. It was determined that combustion instability did not affect the nozzle performance. Although much valuable information was obtained during the tests, attempts to improve the engine performance were not successful.

  18. Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border.

    PubMed

    Lutterloh, Emily; Likaka, Andrew; Sejvar, James; Manda, Robert; Naiene, Jeremias; Monroe, Stephan S; Khaila, Tadala; Chilima, Benson; Mallewa, Macpherson; Kampondeni, Sam D; Lowther, Sara A; Capewell, Linda; Date, Kashmira; Townes, David; Redwood, Yanique; Schier, Joshua G; Nygren, Benjamin; Tippett Barr, Beth; Demby, Austin; Phiri, Abel; Lungu, Rudia; Kaphiyo, James; Humphrys, Michael; Talkington, Deborah; Joyce, Kevin; Stockman, Lauren J; Armstrong, Gregory L; Mintz, Eric

    2012-04-01

    Salmonella enterica serovar Typhi causes an estimated 22 million cases of typhoid fever and 216 000 deaths annually worldwide. We investigated an outbreak of unexplained febrile illnesses with neurologic findings, determined to be typhoid fever, along the Malawi-Mozambique border. The investigation included active surveillance, interviews, examinations of ill and convalescent persons, medical chart reviews, and laboratory testing. Classification as a suspected case required fever and ≥1 other finding (eg, headache or abdominal pain); a probable case required fever and a positive rapid immunoglobulin M antibody test for typhoid (TUBEX TF); a confirmed case required isolation of Salmonella Typhi from blood or stool. Isolates underwent antimicrobial susceptibility testing and subtyping by pulsed-field gel electrophoresis (PFGE). We identified 303 cases from 18 villages with onset during March-November 2009; 214 were suspected, 43 were probable, and 46 were confirmed cases. Forty patients presented with focal neurologic abnormalities, including a constellation of upper motor neuron signs (n = 19), ataxia (n = 22), and parkinsonism (n = 8). Eleven patients died. All 42 isolates tested were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; 4 were also resistant to nalidixic acid. Thirty-five of 42 isolates were indistinguishable by PFGE. The unusual neurologic manifestations posed a diagnostic challenge that was resolved through rapid typhoid antibody testing in the field and subsequent blood culture confirmation in the Malawi national reference laboratory. Extending laboratory diagnostic capacity, including blood culture, to populations at risk for typhoid fever in Africa will improve outbreak detection, response, and clinical treatment.

  19. Evaluation of selected clinical and diagnostic parameters in girls with anorexia nervosa (I).

    PubMed

    Nogal, Paweł; Pniewska-Siark, Barbara; Lewiński, Andrzej

    2008-08-01

    Body weight loss in patients with anorexia nervosa (AN) is accompanied by a number of hormonal and metabolic disorders. The scope and intensity of these disorders may have a considerable influence on the prognosis in this disease. The goal of the study was an evaluation of selected diagnostic examinations in comparison with clinical data of female patients with AN. Retrospective studies involved eighty-seven (87) patients with AN. On therapy commencement, routine laboratory tests (full blood cell count, serum concentrations of sodium, potassium, glucose, cholesterol, triglycerides, total calcium, phosphates, total protein and the urea) and hormonal tests (TSH, TSH, FT4, FT3, E2, T, cortisol measured at 8(00), 17(00) and 24(00), LH and FSH in stimulation test with GnRH) were performed in each patient. Correlations were determined between clinical data and the measured hormone concentrations. In the studied girls, the mean values of routine laboratory tests, performed at the beginning of the therapy, were within the normal ranges (except hypernatremia). The mean concentrations of LH, FSH and FT4 were below reference values; the mean concentration of cortisol considerably exceeded the standard range. Statistically significant relations were demonstrated between BMI values and the concentrations of LH, E2 and cortisol. Body weigh loss is not significantly reflected by abnormal results of routinely performed laboratory tests. Hypogonadotropic hypogonadism and hypercortisolemia are the most characteristic hormonal symptoms in girls with AN.

  20. Laboratory- and field-based testing as predictors of skating performance in competitive-level female ice hockey.

    PubMed

    Henriksson, Tommy; Vescovi, Jason D; Fjellman-Wiklund, Anncristine; Gilenstam, Kajsa

    2016-01-01

    The purpose of this study was to examine whether field-based and/or laboratory-based assessments are valid tools for predicting key performance characteristics of skating in competitive-level female hockey players. Cross-sectional study. Twenty-three female ice hockey players aged 15-25 years (body mass: 66.1±6.3 kg; height: 169.5±5.5 cm), with 10.6±3.2 years playing experience volunteered to participate in the study. The field-based assessments included 20 m sprint, squat jump, countermovement jump, 30-second repeated jump test, standing long jump, single-leg standing long jump, 20 m shuttle run test, isometric leg pull, one-repetition maximum bench press, and one-repetition maximum squats. The laboratory-based assessments included body composition (dual energy X-ray absorptiometry), maximal aerobic power, and isokinetic strength (Biodex). The on-ice tests included agility cornering s-turn, cone agility skate, transition agility skate, and modified repeat skate sprint. Data were analyzed using stepwise multivariate linear regression analysis. Linear regression analysis was used to establish the relationship between key performance characteristics of skating and the predictor variables. Regression models (adj R (2)) for the on-ice variables ranged from 0.244 to 0.663 for the field-based assessments and from 0.136 to 0.420 for the laboratory-based assessments. Single-leg tests were the strongest predictors for key performance characteristics of skating. Single leg standing long jump alone explained 57.1%, 38.1%, and 29.1% of the variance in skating time during transition agility skate, agility cornering s-turn, and modified repeat skate sprint, respectively. Isokinetic peak torque in the quadriceps at 90° explained 42.0% and 32.2% of the variance in skating time during agility cornering s-turn and modified repeat skate sprint, respectively. Field-based assessments, particularly single-leg tests, are an adequate substitute to more expensive and time-consuming laboratory assessments if the purpose is to gain knowledge about key performance characteristics of skating.

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