Variability of creatinine measurements in clinical laboratories: results from the CRIC study.

PubMed

Joffe, Marshall; Hsu, Chi-yuan; Feldman, Harold I; Weir, Matthew; Landis, J R; Hamm, L Lee

2010-01-01

Estimating equations using serum creatinine (SCr) are often used to assess glomerular filtration rate (GFR). Such creatinine (Cr)-based formulae may produce biased estimates of GFR when using Cr measurements that have not been calibrated to reference laboratories. In this paper, we sought to examine the degree of this variation in Cr assays in several laboratories associated with academic medical centers affiliated with the Chronic Renal Insufficiency Cohort (CRIC) Study; to consider how best to correct for this variation, and to quantify the impact of such corrections on eligibility for participation in CRIC. Variability of Cr is of particular concern in the conduct of CRIC, a large multicenter study of subjects with chronic renal disease, because eligibility for the study depends on Cr-based assessment of GFR. A library of 5 large volume plasma specimens from apheresis patients was assembled, representing levels of plasma Cr from 0.8 to 2.4 mg/dl. Samples from this library were used for measurement of Cr at each of the 14 CRIC laboratories repetitively over time. We used graphical displays and linear regression methods to examine the variability in Cr, and used linear regression to develop calibration equations. We also examined the impact of the various calibration equations on the proportion of subjects screened as potential participants who were actually eligible for the study. There was substantial variability in Cr assays across laboratories and over time. We developed calibration equations for each laboratory; these equations varied substantially among laboratories and somewhat over time in some laboratories. The laboratory site contributed the most to variability (51% of the variance unexplained by the specimen) and variation with time accounted for another 15%. In some laboratories, calibration equations resulted in differences in eligibility for CRIC of as much as 20%. The substantial variability in SCr assays across laboratories necessitates calibration

Salt dissolution and sinkhole formation: Results of laboratory experiments

NASA Astrophysics Data System (ADS)

Oz, Imri; Eyal, Shalev; Yoseph, Yechieli; Ittai, Gavrieli; Elad, Levanon; Haim, Gvirtzman

2016-10-01

The accepted mechanism for the formation of thousands of sinkholes along the coast of the Dead Sea suggests that their primary cause is dissolution of a salt layer by groundwater undersaturated with respect to halite. This is related to the drop in the Dead Sea level, which caused a corresponding drop of the freshwater-saltwater interface, resulting in fresher groundwater replacing the brines that were in contact with the salt layer. In this study we used physical laboratory experiments to examine the validity of this mechanism by reproducing the full dynamic natural process and to examine the impact of different hydrogeological characteristics on this process. The experimental results show surface subsidence and sinkhole formation. The stratigraphic configurations of the aquifer, together with the mechanical properties of the salt layer, determine the dynamic patterns of the sinkhole formation (instantaneous versus gradual formation). Laboratory experiments were also used to study the potential impact of future stratification in the Dead Sea, if and when the "Red Sea-Dead Sea Canal" project is carried out, and the Dead Sea level remains stable. The results show that the dissolution rates are slower by 1 order of magnitude in comparison with a nonstratified saltwater body, and therefore, the processes of salt dissolution and sinkhole formation will be relatively restrained under these conditions.

The pediatric hematology/oncology educational laboratory in-training examination (PHOELIX): A formative evaluation of laboratory skills for Canadian pediatric hematology/oncology trainees.

PubMed

Leung, Elaine; Dix, David; Ford, Jason; Barnard, Dorothy; McBride, Eileen

2015-11-01

Pediatric hematologists/oncologists need to be skilled clinicians, and must also be adept and knowledgeable in relevant areas of laboratory medicine. Canadian training programs in this subspecialty have a minimum requirement for 6 months of training in acquiring "relevant laboratory diagnostic skills." The Canadian pediatric hematology/oncology (PHO) national specialty society, C17, recognized the need for an assessment method in laboratory skills for fellows graduating from PHO training programs. Canadian pediatric hematologists/oncologists were surveyed regarding what were felt to be the essential laboratory-related knowledge and skills deemed necessary for graduating pediatric hematology/oncology trainees. The PHOELIX (Pediatric hematology/oncology educational laboratory in-training examination) was then developed to provide an annual formative evaluation of laboratory skills in Canadian PHO trainees. The majority of PHO respondents (89%) felt that laboratory skills are important in clinical practice. An annual formative examination including review of glass slides was implemented starting in 2010; this provides feedback regarding knowledge of laboratory medicine to both trainees and program directors (PDs). We have successfully created a formative examination that can be used to evaluate and educate trainees, as well as provide PDs with a tool to gauge the effectiveness of their laboratory training curriculum. Feedback has been positive from both trainees and PDs. © 2015 Wiley Periodicals, Inc.

[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.

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

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.

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.

A Chance to Get Ahead: Proficiency Examinations for Clerical Laboratory Personnel. Final Report.

ERIC Educational Resources Information Center

Linehan, Jean D.

Four Proficiency Examinations for Clinical Laboratory Personnel were developed in Clinical Chemistry, Microbiology, Hematology, and Blood Banking. Purpose of project was to enable competent military laboratory technicians who lack credentials to demonstrate their job-related skills and knowledge for civilian positions, and also to help civilians…

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.

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.

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.

Teacher Immediacy and Student Learning: An Examination of Lecture/Laboratory and Self-Contained Course Sections

ERIC Educational Resources Information Center

LeFebvre, Luke; Allen, Mike

2014-01-01

This study examined teaching assistant's immediacy in lecture/laboratory and self-contained classes. Two hundred fifty-six students responded to instruments measuring teachers' immediacy behavior frequency, perceptions of instruction quality, and cognitive learning. No significant difference was identified when comparing lecture/laboratory and…

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.

Comparison of estrogen receptor results from pathology reports with results from central laboratory testing.

PubMed

Collins, Laura C; Marotti, Jonathan D; Baer, Heather J; Tamimi, Rulla M

2008-02-06

We compared estrogen receptor (ER) assay results abstracted from pathology reports with ER results determined on the same specimens by a central laboratory with an immunohistochemical assay. Paraffin sections were cut from tissue microarrays containing 3093 breast cancer specimens from women enrolled in the Nurses' Health Study, 1851 of which had both pathology reports and tissue available for central laboratory testing. All sections were immunostained for ER at the same time. The original assays were biochemical for 1512 (81.7%) of the 1851 specimens, immunohistochemical for 336 (18.2%), and immunofluorescent for three (0.2%). ER results from pathology reports and repeat central laboratory testing were in agreement for 87.3% of specimens (1615 of the 1851 specimens; kappa statistic = 0.64, P < .001). When the comparison was restricted to the specimens for which the ER assays were originally performed by immunohistochemistry, the agreement rate increased to 92.3% of specimens (310 of the 336 specimens; kappa statistic = 0.78, P < .001). Thus, ER assay results from pathology reports appear to be a reasonable alternative to central laboratory ER testing for large, population-based studies of patients with breast cancer.

Communicating laboratory results through a Web site: Patients' priorities and viewpoints.

PubMed

Sabahi, Azam; Ahmadian, Leila; Mirzaee, Moghademeh

2018-02-28

Patients can access laboratory results using various technologies. The aim of this study was to integrate the laboratory results into the hospital Web site based on patients' viewpoints and priorities and to measure patients' satisfaction. This descriptive-analytical study was conducted in 2015. First, a questionnaire was distributed among 200 patients to assess patients' priorities to receive laboratory results through the Web site. Second, those who agreed (n = 95) to receive their laboratory results through the Web site were identified. Then, the required changes were made to the hospital Web site based on patients' viewpoints and priorities. Third, patients were divided into two groups. The first group received their laboratory results through the Web site on the date had been announced during their visit to the laboratory. The second group was informed by SMS once their results were shown on the Web site. After receiving laboratory results, patients' satisfaction was evaluated. More than half of the participants (n = 53, 55.8%) were highly satisfied with receiving the results electronically. The higher number of people in SMS group (n = 9, 20.9%) reported that they were satisfied with time-saving compared to other group (n = 2, 3.8%) (P = .04). Participants after receiving the results through the Web site considered the functionalities of reprinting (P < .0001) and timeliness (P = .017) more important. Integrating laboratory results into the hospital Web site based on the patients' viewpoints and priorities can improve patient satisfaction and lower the patients' concern regarding confidentiality of their results. © 2018 Wiley Periodicals, Inc.

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

[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.

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

Protein crystal growth results from the United States Microgravity Laboratory-1 mission

NASA Technical Reports Server (NTRS)

Delucas, Lawrence J.; Moore, K. M.; Vanderwoerd, M.; Bray, T. L.; Smith, C.; Carson, M.; Narayana, S. V. L.; Rosenblum, W. M.; Carter, D.; Clark, A. D, Jr.

1994-01-01

Protein crystal growth experiments have been performed by this laboratory on 18 Space Shuttle missions since April, 1985. In addition, a number of microgravity experiments also have been performed and reported by other investigators. These Space Shuttle missions have been used to grow crystals of a variety of proteins using vapor diffusion, liquid diffusion, and temperature-induced crystallization techniques. The United States Microgravity Laboratory - 1 mission (USML-1, June 25 - July 9, 1992) was a Spacelab mission dedicated to experiments involved in materials processing. New protein crystal growth hardware was developed to allow in orbit examination of initial crystal growth results, the knowledge from which was used on subsequent days to prepare new crystal growth experiments. In addition, new seeding hardware and techniques were tested as well as techniques that would prepare crystals for analysis by x-ray diffraction, a capability projected for the planned Space Station. Hardware that was specifically developed for the USML-1 mission will be discussed along with the experimental results from this mission.

We are what we do: Examining learner-generated content in the anatomy laboratory through the lens of activity theory.

PubMed

Doubleday, Alison F; Wille, Sarah J

2014-01-01

Video and photography are often used for delivering content within the anatomical sciences. However, instructors typically produce these resources to provide instructional or procedural information. Although the benefits of learner-generated content have been explored within educational research, virtually no studies have investigated the use of learner-generated video and photograph content within anatomy dissection laboratories. This study outlines an activity involving learner-generated video diaries and learner-generated photograph assignments produced during anatomy laboratory sessions. The learner-generated photographs and videos provided instructors with a means of formative assessment and allowed instructors to identify evidence of collaborative behavior in the laboratory. Student questionnaires (n = 21) and interviews (n = 5), as well as in-class observations, were conducted to examine student perspectives on the laboratory activities. The quantitative and qualitative data were examined using the framework of activity theory to identify contradictions between student expectations of, and engagement with, the activity and the actual experiences of the students. Results indicate that learner-generated photograph and video content can act as a rich source of data on student learning processes and can be used for formative assessment, for observing collaborative behavior, and as a starting point for class discussions. This study stresses the idea that technology choice for activities must align with instructional goals. This research also highlights the utility of activity theory as a framework for assessing classroom and laboratory activities, demonstrating that this approach can guide the development of laboratory activities. © 2014 American Association of Anatomists.

21 CFR 58.185 - Reporting of nonclinical laboratory study results.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Reporting of nonclinical laboratory study results. 58.185 Section 58.185 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Reporting of nonclinical laboratory study results. (a) A final report shall be prepared for each nonclinical...

21 CFR 58.185 - Reporting of nonclinical laboratory study results.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Reporting of nonclinical laboratory study results. 58.185 Section 58.185 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Reporting of nonclinical laboratory study results. (a) A final report shall be prepared for each nonclinical...

21 CFR 58.185 - Reporting of nonclinical laboratory study results.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Reporting of nonclinical laboratory study results. 58.185 Section 58.185 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Reporting of nonclinical laboratory study results. (a) A final report shall be prepared for each nonclinical...

9 CFR 147.17 - Laboratory procedure recommended for the bacteriological examination of cull chicks and poults...

Code of Federal Regulations, 2013 CFR

2013-01-01

... the bacteriological examination of cull chicks and poults for salmonella. 147.17 Section 147.17... poults for salmonella. The laboratory procedure described in this section is recommended for the bacteriological examination of cull chicks from egg-type and meat-type chicken flocks and waterfowl, exhibition...

9 CFR 147.17 - Laboratory procedure recommended for the bacteriological examination of cull chicks and poults...

Code of Federal Regulations, 2011 CFR

2011-01-01

... the bacteriological examination of cull chicks and poults for salmonella. 147.17 Section 147.17... poults for salmonella. The laboratory procedure described in this section is recommended for the bacteriological examination of cull chicks from egg-type and meat-type chicken flocks and waterfowl, exhibition...

9 CFR 147.17 - Laboratory procedure recommended for the bacteriological examination of cull chicks and poults...

Code of Federal Regulations, 2012 CFR

2012-01-01

... the bacteriological examination of cull chicks and poults for salmonella. 147.17 Section 147.17... poults for salmonella. The laboratory procedure described in this section is recommended for the bacteriological examination of cull chicks from egg-type and meat-type chicken flocks and waterfowl, exhibition...

9 CFR 147.17 - Laboratory procedure recommended for the bacteriological examination of cull chicks and poults...

Code of Federal Regulations, 2010 CFR

2010-01-01

... the bacteriological examination of cull chicks and poults for salmonella. 147.17 Section 147.17... poults for salmonella. The laboratory procedure described in this section is recommended for the bacteriological examination of cull chicks from egg-type and meat-type chicken flocks and waterfowl, exhibition...

9 CFR 147.17 - Laboratory procedure recommended for the bacteriological examination of cull chicks and poults...

Code of Federal Regulations, 2014 CFR

2014-01-01

... the bacteriological examination of cull chicks and poults for salmonella. 147.17 Section 147.17... poults for salmonella. The laboratory procedure described in this section is recommended for the bacteriological examination of cull chicks from egg-type and meat-type chicken flocks and waterfowl, exhibition...

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.

Asynchronous automated electronic laboratory result notifications: a systematic review.

PubMed

Slovis, Benjamin H; Nahass, Thomas A; Salmasian, Hojjat; Kuperman, Gilad; Vawdrey, David K

2017-11-01

To systematically review the literature pertaining to asynchronous automated electronic notifications of laboratory results to clinicians. PubMed, Web of Science, and the Cochrane Collaboration were queried for studies pertaining to automated electronic notifications of laboratory results. A title review was performed on the primary results, with a further abstract review and full review to produce the final set of included articles. The full review included 34 articles, representing 19 institutions. Of these, 19 reported implementation and design of systems, 11 reported quasi-experimental studies, 3 reported a randomized controlled trial, and 1 was a meta-analysis. Twenty-seven articles included alerts of critical results, while 5 focused on urgent notifications and 2 on elective notifications. There was considerable variability in clinical setting, system implementation, and results presented. Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from >10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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.

The Galapagos archipelago: A natural laboratory to examine sharp hydroclimatic, geologic and anthropogenic gradients

USGS Publications Warehouse

Percy, Madelyn; Schmitt, Sarah; Riveros-Iregui, Diego; Mirus, Benjamin B.

2016-01-01

Poor understanding of the water cycle in tropical ecosystems has the potential to exacerbate water shortages and water crises in the region. We suggest that the Galápagos Islands provide an excellent proxy to regions across the tropics as a result of sharp hydroclimatic, anthropogenic, and pedohydrologic gradients across the archipelago. Hydroclimatic and pedohydrologic gradients are found across different elevations on single islands, as well as across the archipelago, whereas anthropogenic gradients reflect land use and land cover change across islands as population and growth in tourism have affected individual islands differently. This article highlights specific opportunities to further examine our understanding of the interactions between water and critical zone processes in tropical ecosystems, making connections between the Galápagos archipelago and much of the understudied tropics. The Galápagos archipelago offers a natural laboratory through which we can examine current threats to freshwater security as well as the dynamics of coupled natural and human systems.

The PIAA Coronagraph Prototype: First Laboratory Results.

NASA Astrophysics Data System (ADS)

Pluzhnik, Eugene; Guyon, O.; Colley, S.; Gallet, B.; Ridgway, S.; Woodruff, R.; Tanaka, S.; Warren, M.

2006-12-01

The phase-induced amplitude apodization (PIAA) coronagraph combines the main advantages of classical pupil apodization with high throughput ( 100%), high angular resolution ( 2λ/D) and low chromaticity. These advantages can allow direct imaging of nearby extrasolar planets with a 4-meter telescope. The PIAA coronagraph laboratory prototype has been successfully manufactured and starts to operate at the Subary Telescope facility. We present here our first laboratory results with this prototype where we have achieved 2x10-6 contrast within 2 λ/D. We also discuss the main constrains limiting the contrast and describe our future efforts. This work was carried out under JPL contract numbers 1254445 and 1257767 for Development of Technologies for the Terrestrial Planet Finder Mission, with the support and hospitality of the National Astronomical Observatory of Japan.

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

In-flight and laboratory vacuum-friction test results

NASA Technical Reports Server (NTRS)

Devine, E. J.; Evans, H. E.; Leasure, W. A.

1973-01-01

Coefficient of friction measurements were made for six unlubricated metal couples exposed to the space environment aboard the OV-1-13 spacecraft and exposed to laboratory vacuum. Materials studied included mutually soluble, partially soluble, and insoluble metal combinations. Two samples of each material couple were tested in space and in the laboratory using the disk and rider technique. Linear velocity was 0.10 cm/s (2.5 in/min) and rider normal load was 4.45 N (1 lb) for the gold versus silver couples and 8.90 N (2lb) for the other combinations. Results showed that friction data obtained in a clean ion-pumped laboratory vacuum of 10 to the minus 10 power materials with low mutual solubility can be correlated to operation in the vicinity of a typical scientific spacecraft that is exposed to an ambient pressure as low as 10 to the minus 12 power torr. The expected increase in coefficient of friction with solubility was shown. Material couples with high mutual solubility present the hazard of unpredictable drastic friction increase in orbit which may not be evident in laboratory testing at levels down to 10 to the minus 10 power torr. It was also shown that gross cold welding of unlubricated metals exposed to a satellite environment does not occur.

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.

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.

A comparison of results from two mycology laboratories for the diagnosis of onychomycosis: a study of 85 cases in a geriatric population.

PubMed

Scherer, William P; Scherer, Michael D

2004-01-01

An investigative study was performed to compare the results from two mycology laboratories for the diagnosis of onychomycosis in a geriatric population and to determine the possible pharmacologic treatments based on the two laboratories' results. In this study, 85 cases of suspected onychomycosis involving men and women 65 years and older from a nursing home setting in South Florida were used. Samples were taken from the hallux toenail and sent to two different mycology laboratories for fluorescent potassium hydroxide preparation and microscopic examination of a fungal culture. Of the 85 cases studied, the two mycology laboratories reported similar potassium hydroxide preparation results for 58.8% of the patients and similar fungal culture results for genus and species identification for 37.6% of the patients. When the potassium hydroxide preparation and fungal culture results were combined, the two mycology laboratories reported similar results for only 27.1% of the patients. As a result of the two mycology laboratories' findings, the possible US Food and Drug Administration-approved pharmacologic treatments may differ for 43.5% of the patients studied. The discrepancy between the two independent laboratories leaves physicians to question the reproducibility of fluorescent potassium hydroxide preparation and fungal culture analysis in a geriatric patient population for the diagnosis of onychomycosis.

Role and Evaluation of Interlaboratory Comparison Results in Laboratory Accreditation

NASA Astrophysics Data System (ADS)

Bode, P.

2008-08-01

Participation in interlaboratory comparisons provides laboratories an opportunity for independent assessment of their analytical performance, both in absolute way and in comparison with those by other techniques. However, such comparisons are hindered by differences in the way laboratories participate, e.g. at best measurement capability or under routine conditions. Neutron activation analysis laboratories, determining total mass fractions, often see themselves classified as `outliers' since the majority of other participants employ techniques with incomplete digestion methods. These considerations are discussed in relation to the way results from interlaboratory comparisons are evaluated by accreditation bodies following the requirements of Clause 5.9.1 of the ISO/IEC 17025:2005. The discussion and conclusions come largely forth from experiences in the author's own laboratory.

Leaf Degradation, Macroinvertebrate Shredders & Energy Flow in Streams: A Laboratory-Based Exercise Examining Ecosystem Processes

ERIC Educational Resources Information Center

Sparkes, Timothy C.; Mills, Colleen M.; Volesky, Lisa; Talkington, Jennifer; Brooke, Joanna

2008-01-01

A laboratory-based exercise that demonstrates mechanisms underlying leaf degradation in streams. Students examine the effects of "leaf conditioning" on the feeding behavior of invertebrate shredders. The exercise is completed in two sessions and can be adapted to both high school and college levels.

13 CFR 120.1055 - Review and examination results.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Review and examination results... Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports... result of the SBA Lender review or examination (“Report”). The Report may contain findings, conclusions...

13 CFR 120.1055 - Review and examination results.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Review and examination results... Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports... result of the SBA Lender review or examination (“Report”). The Report may contain findings, conclusions...

13 CFR 120.1055 - Review and examination results.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Review and examination results... Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports... result of the SBA Lender review or examination (“Report”). The Report may contain findings, conclusions...

13 CFR 120.1055 - Review and examination results.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Review and examination results... Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports... result of the SBA Lender review or examination (“Report”). The Report may contain findings, conclusions...

[Quality Management System in Pathological Laboratory].

PubMed

Koyatsu, Junichi; Ueda, Yoshihiko

2015-07-01

Even compared to other clinical laboratories, the pathological laboratory conducts troublesome work, and many of the work processes are also manual. Therefore, the introduction of the systematic management of administration is necessary. It will be a shortcut to use existing standards such as ISO 15189 for this purpose. There is no standard specialized for the pathological laboratory, but it is considered to be important to a pathological laboratory in particular. 1. Safety nianagement of the personnel and environmental conditions. Comply with laws and regulations concerning the handling of hazardous materials. 2. Pre-examination processes. The laboratory shall have documented procedures for the proper collection and handling of primary samples. Developed and documented criteria for acceptance or rejection of samples are applied. 3. Examination processes. Selection, verification, and validation of the examination procedures. Devise a system that can constantly monitor the traceability of the sample. 4. Post-examination processes. Storage, retention, and disposal of clinical samples. 5. Release of results. When examination results fall within established alert or critical intervals, immediately notify the physicians. The important point is to recognize the needs of the client and be aware that pathological diagnoses are always "the final diagnoses".

LabRS: A Rosetta stone for retrospective standardization of clinical laboratory test results.

PubMed

Hauser, Ronald George; Quine, Douglas B; Ryder, Alex

2018-02-01

Clinical laboratories in the United States do not have an explicit result standard to report the 7 billion laboratory tests results they produce each year. The absence of standardized test results creates inefficiencies and ambiguities for secondary data users. We developed and tested a tool to standardize the results of laboratory tests in a large, multicenter clinical data warehouse. Laboratory records, each of which consisted of a laboratory result and a test identifier, from 27 diverse facilities were captured from 2000 through 2015. Each record underwent a standardization process to convert the original result into a format amenable to secondary data analysis. The standardization process included the correction of typos, normalization of categorical results, separation of inequalities from numbers, and conversion of numbers represented by words (eg, "million") to numerals. Quality control included expert review. We obtained 1.266 × 109 laboratory records and standardized 1.252 × 109 records (98.9%). Of the unique unstandardized records (78.887 × 103), most appeared <5 times (96%, eg, typos), did not have a test identifier (47%), or belonged to an esoteric test with <100 results (2%). Overall, these 3 reasons accounted for nearly all unstandardized results (98%). Current results suggest that the tool is both scalable and generalizable among diverse clinical laboratories. Based on observed trends, the tool will require ongoing maintenance to stay current with new tests and result formats. Future work to develop and implement an explicit standard for test results would reduce the need to retrospectively standardize test results. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Examining the Effects of Reflective Journals on Pre-Service Science Teachers' General Chemistry Laboratory Achievement

ERIC Educational Resources Information Center

Cengiz, Canan; Karatas, Faik Özgür

2015-01-01

The general chemistry laboratory is an appropriate place for learning chemistry well. It is also effective for stimulating higher-order thinking skills, including reflective thinking, a skill that is crucial for science teaching as well as learning. This study aims to examine the effects of feedback-supported reflective journal-keeping activities…

European external quality control study on the competence of laboratories to recognize rare sequence variants resulting in unusual genotyping results.

PubMed

Márki-Zay, János; Klein, Christoph L; Gancberg, David; Schimmel, Heinz G; Dux, László

2009-04-01

Depending on the method used, rare sequence variants adjacent to the single nucleotide polymorphism (SNP) of interest may cause unusual or erroneous genotyping results. Because such rare variants are known for many genes commonly tested in diagnostic laboratories, we organized a proficiency study to assess their influence on the accuracy of reported laboratory results. Four external quality control materials were processed and sent to 283 laboratories through 3 EQA organizers for analysis of the prothrombin 20210G>A mutation. Two of these quality control materials contained sequence variants introduced by site-directed mutagenesis. One hundred eighty-nine laboratories participated in the study. When samples gave a usual result with the method applied, the error rate was 5.1%. Detailed analysis showed that more than 70% of the failures were reported from only 9 laboratories. Allele-specific amplification-based PCR had a much higher error rate than other methods (18.3% vs 2.9%). The variants 20209C>T and [20175T>G; 20179_20180delAC] resulted in unusual genotyping results in 67 and 85 laboratories, respectively. Eighty-three (54.6%) of these unusual results were not recognized, 32 (21.1%) were attributed to technical issues, and only 37 (24.3%) were recognized as another sequence variant. Our findings revealed that some of the participating laboratories were not able to recognize and correctly interpret unusual genotyping results caused by rare SNPs. Our study indicates that the majority of the failures could be avoided by improved training and careful selection and validation of the methods applied.

Sandia National Laboratories: Search Results

Science.gov Websites

Programs Nuclear Weapons About Nuclear Weapons Safety & Security Weapons Science & Technology Robotics R&D 100 Awards Laboratory Directed Research & Development Technology Deployment Centers Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios

Students' Progression in Monitoring Anomalous Results Obtained in Inquiry-Based Laboratory Tasks

NASA Astrophysics Data System (ADS)

Crujeiras-Pérez, Beatriz; Jiménez-Aleixandre, Maria Pilar

2017-07-01

This paper examines students' engagement in monitoring anomalous results across a 2-year longitudinal study with 9th and 10th graders (14-15 and 15-16 years of age). The context is a set of five inquiry-based laboratory tasks, requiring students to plan and carry out investigations. The study seeks to examine students' interpretation of data, in particular anomalous results generated by them during the process of solving the tasks, and their ability to monitor them. Data collected include video and audio recordings as well as students' written products. For the analysis, two rubrics were developed drawing on Chinn and Brewer (Cognition and Instruction, 19, 323-393, 2001) and Hmelo-Silver et al. (Science Education, 86, 219-243, 2002). The findings point to a pattern of progress in students' responses across the 2 years: (a) responses revealing a low capacity of monitoring due to not recognizing the data as anomalous or recognizing it as anomalous but being unable to explain their causes are more frequent in the first tasks and (b) responses revealing an improved capacity of monitoring are more frequent in the last tasks. The factors influencing students' regulation of their performances, as the requirement of planning, and specific scaffolding based on activity theory are discussed.

[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.

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.

Instructor Quality and EMT Certification Examination Results

ERIC Educational Resources Information Center

Russ-Eft, Darlene; Dickison, Phil; Levine, Roger

2007-01-01

The Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) provides a representative sampling of EMTs throughout the United States. This study examines the relationship between instructor quality and National Registry of Emergency Medical Technicians certification examination outcomes. Results show significant…

[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.

Cognitive Responses to Mass Communication: Results from Laboratory Studies and a Field Experiment.

ERIC Educational Resources Information Center

Ward, Scott; Ray, Michael L.

This paper examines some of the cognitive responses people experience while attending to messages. Two laboratory studies and a field experiment were conducted. In the lab studies, three different audience groups (junior and senior high school students and parents) were shown three different anti-drug abuse messages. Various levels of audio…

13 CFR 120.1055 - Review and examination results.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Review and examination results. 120.1055 Section 120.1055 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1055 Review and examination results. (a) Written Reports...

Labtracker+, a medical smartphone app for the interpretation of consecutive laboratory results: an external validation study.

PubMed

Hilderink, Judith M; Rennenberg, Roger J M W; Vanmolkot, Floris H M; Bekers, Otto; Koopmans, Richard P; Meex, Steven J R

2017-09-01

When monitoring patients over time, clinicians may struggle to distinguish 'real changes' in consecutive blood parameters from so-called natural fluctuations. In practice, they have to do so by relying on their clinical experience and intuition. We developed Labtracker+ , a medical app that calculates the probability that an increase or decrease over time in a specific blood parameter is real, given the time between measurements. We presented patient cases to 135 participants to examine whether there is a difference between medical students, residents and experienced clinicians when it comes to interpreting changes between consecutive laboratory results. Participants were asked to interpret if changes in consecutive laboratory values were likely to be 'real' or rather due to natural fluctuations. The answers of the study participants were compared with the calculated probabilities by the app Labtracker+ and the concordance rates were assessed. Medical students (n=92), medical residents from the department of internal medicine (n=19) and internists (n=24) at a Dutch University Medical Centre. Concordance rates between the study participants and the calculated probabilities by the app Labtracker+ were compared. Besides, we tested whether physicians with clinical experience scored better concordance rates with the app Labtracker+ than inexperienced clinicians. Medical residents and internists showed significantly better concordance rates with the calculated probabilities by the app Labtracker+ than medical students, regarding their interpretation of differences between consecutive laboratory results (p=0.009 and p<0.001, respectively). The app Labtracker+ could serve as a clinical decision tool in the interpretation of consecutive laboratory test results and could contribute to rapid recognition of parameter changes by physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

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.

Basic haemoglobinopathy diagnostics in Dutch laboratories; providing an informative test result.

PubMed

Kaufmann, J O; Smit, J W; Huisman, W; Idema, R N; Bakker, E; Giordano, P C

2013-08-01

After a first survey in 2001, the Dutch Association of Hematological Laboratory Research (VHL) advised its members to adopt a basic protocol for haemoglobinopathy carrier detection and to provide genetic information with all positive results to allow health-care professionals to inform carriers about potential genetic risks. This article reports on the compliance with these recommendations and their consequences. Clinical chemists of all 106 Dutch laboratories were invited to answer a survey on patient population, diagnostic techniques used, (self-reported) knowledge, use and effect of the additional information. The average increase in diagnostic output was over 60% and the recommended basic protocol was applied by 65% of the laboratories. Over 84% of the laboratories reported to be aware of the additional recommendations and 77% to be using them. Most laboratories with limited diagnostic requests were still sending their cases to other laboratories and included the genetic information received from these laboratories in their diagnostic reports. The effect of information on subsequent 'family analysis' was estimated to be between 26 and 50%. The present study shows an increase in diagnostic potential for haemoglobinopathy over the last decade, especially in the larger cities. Low 'family testing' rates were mostly found in areas with lower carrier prevalence or associated with local reluctance to pass the information to carriers. In spite of a dramatic improvement, too many carriers are still not informed because of lack of awareness among health-care providers and more education is needed. © 2012 John Wiley & Sons Ltd.

A Urinalysis Result Reporting System for a Clinical Laboratory

PubMed Central

Sullivan, James E.; Plexico, Perry S.; Blank, David W.

1987-01-01

A menu driven Urinalysis Result Reporting System based on multiple IBM-PC Workstations connected together by a local area network was developed for the Clinical Chemistry Section of the Clinical Pathology Department at the National Institutes of Health's Clinical Center. Two Network File Servers redundantly save the test results of each urine specimen. When all test results for a specimen are entered into the system, the results are transmitted to the Department's Laboratory Computer System where they are made available to the ordering physician. The Urinalysis Data Management System has proven easy to learn and use.

[Study of quality of a branch laboratory--an opinion of a laboratory manager].

PubMed

Yazawa, Naoyuki

2006-11-01

At the stage of establishing a branch laboratory, quality evaluation is extremely difficult. Even the results of a control survey by the headquarters of the branch laboratory are unhelpful. For a clinical laboratory, the most important function is to provide reliable data all the time, and to maintain the reliability of clinical doctors with informed responses. We mostly refer to control surveys and daily quality control data to evaluate a clinical laboratory, but we rarely check its fundamental abilities, such as planning events, preserving statistical data about the standard range, using the right method for quality control and others. This is generally disregarded and it is taken for granted that they will be correct the first time. From my six years of experience working with X's branch laboratory, I realized that there might be some relation between the quality of a branch laboratory and the fundamental abilities of the company itself. I would never argue that all branch laboratories are ineffective, but they should be conscious of fundamental activities. The referring laboratory, not the referral laboratory, should be responsible for ensuring that the referral laboratory's examination results and findings are correct.

Sickle-Cell Disease in Nigerian Children: Parental Knowledge and Laboratory Results.

PubMed

Obaro, Stephen K; Daniel, Yvonne; Lawson, Juliana O; Hsu, Wei-Wei; Dada, John; Essen, Uduak; Ibrahim, Khalid; Akindele, Adebayo; Brooks, Kevin; Olanipekun, Grace; Ajose, Theresa; Stewart, Claire E; Inusa, Baba P D

2016-01-01

Sickle-cell disease (SCD) is the most common inherited genetic disorder in sub-Saharan Africa, and it is associated with early mortality and lifelong morbidity. Early diagnosis is essential for instituting appropriate care and preventive therapy. To compare parental knowledge or perception of their offspring's hemoglobin phenotype prior to testing and actual validated laboratory test results. In a prospective community-based survey, we assessed parental knowledge of their children's hemoglobin phenotype and corroborated this with the results from a laboratory confirmatory test determined by high-performance liquid chromatography. We screened 10,126 children aged less than 5 years. A total of 163 (1.6%) parents indicated that their offspring had been previously tested and had knowledge of the child's hemoglobin genotype. However, 51 (31.2%) of 163 parents of children who had been previously tested did not know the result of their offspring's test, and 18 (35.3%) of these 51 children were found to have SCD. Of those who claimed previous knowledge, 25 (15.3%) of 163 reported incorrect results. Overall, we identified 272 (2.76%) new cases from 9,963 children who had not been previously tested. There is the need to promote public awareness about SCD and the benefit of early diagnosis, quality assurance in laboratory diagnosis and institution of sustainable patient care pathways. © 2016 S. Karger AG, Basel.

The Pitfalls of Companion Diagnostics: Evaluation of Discordant EGFR Mutation Results from a Clinical Laboratory and a Central Laboratory.

PubMed

Turner, Scott A; Peterson, Jason D; Pettus, Jason R; de Abreu, Francine B; Amos, Christopher I; Dragnev, Konstantin H; Tsongalis, Gregory J

2016-05-01

Accurate identification of somatic mutations in formalin-fixed, paraffin-embedded tumor tissue is required for enrollment into clinical trials for many novel targeted therapeutics, including trials requiring EGFR mutation status in non-small-cell lung carcinomas. Central clinical trial laboratories contracted to perform this analysis typically rely on US Food and Drug Administration-approved targeted assays to identify these mutations. We present two cases in which central laboratories inaccurately reported EGFR mutation status because of improper identification and isolation of tumor material and failure to accurately report assay limitations, resulting in enrollment denial. Such cases highlight the need for increased awareness by clinical trials of the limitation of these US Food and Drug Administration-approved assays and the necessity for a mechanism to reevaluate discordant results by alternative laboratory-developed procedures, including clinical next-generation sequencing. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

Effect of a laboratory result pager on provider behavior in a neonatal intensive care unit.

PubMed

Samal, L; Stavroudis, Ta; Miller, Re; Lehmann, Hp; Lehmann, Cu

2011-01-01

A computerized laboratory result paging system (LRPS) that alerts providers about abnormal results ("push") may improve upon active laboratory result review ("pull"). However, implementing such a system in the intensive care setting may be hindered by low signal-to-noise ratio, which may lead to alert fatigue. To evaluate the impact of an LRPS in a Neonatal Intensive Care Unit. Utilizing paper chart review, we tallied provider orders following an abnormal laboratory result before and after implementation of an LRPS. Orders were compared with a predefined set of appropriate orders for such an abnormal result. The likelihood of a provider response in the post-implementation period as compared to the pre-implementation period was analyzed using logistic regression. The provider responses were analyzed using logistic regression to control for potential confounders. The likelihood of a provider response to an abnormal laboratory result did not change significantly after implementation of an LRPS. (Odds Ratio 0.90, 95% CI 0.63-1.30, p-value 0.58) However, when providers did respond to an alert, the type of response was different. The proportion of repeat laboratory tests increased. (26/378 vs. 7/278, p-value = 0.02). Although the laboratory result pager altered healthcare provider behavior in the Neonatal Intensive Care Unit, it did not increase the overall likelihood of provider response.

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.

Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.

PubMed

Raebel, Marsha A; Shetterly, Susan; Lu, Christine Y; Flory, James; Gagne, Joshua J; Harrell, Frank E; Haynes, Kevin; Herrinton, Lisa J; Patorno, Elisabetta; Popovic, Jennifer; Selvan, Mano; Shoaibi, Azadeh; Wang, Xingmei; Roy, Jason

2016-07-01

Our purpose was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. Using the Mini-Sentinel Distributed Database from three sites, we selected three exposure-outcome scenarios with laboratory results as baseline confounders. We compared hazard ratios (HRs) or risk differences (RDs) and 95% confidence intervals (CIs) from models that omitted laboratory results, included only available results (complete cases), and included results after applying missing data methods (multiple imputation [MI] regression, MI predictive mean matching [PMM] indicator). Scenario 1 considered glucose among second-generation antipsychotic users and diabetes. Across sites, glucose was available for 27.7-58.9%. Results differed between complete case and missing data models (e.g., olanzapine: HR 0.92 [CI 0.73, 1.12] vs 1.02 [0.90, 1.16]). Across-site models employing different MI approaches provided similar HR and CI; site-specific models provided differing estimates. Scenario 2 evaluated creatinine among individuals starting high versus low dose lisinopril and hyperkalemia. Creatinine availability: 44.5-79.0%. Results differed between complete case and missing data models (e.g., HR 0.84 [CI 0.77, 0.92] vs. 0.88 [0.83, 0.94]). HR and CI were identical across MI methods. Scenario 3 examined international normalized ratio (INR) among warfarin users starting interacting versus noninteracting antimicrobials and bleeding. INR availability: 20.0-92.9%. Results differed between ignoring INR versus including INR using missing data methods (e.g., RD 0.05 [CI -0.03, 0.13] vs 0.09 [0.00, 0.18]). Indicator and PMM methods gave similar estimates. Multi-site studies must consider site variability in missing data. Different missing data methods performed similarly. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Reaching consensus on communication of critical laboratory results using a collective intelligence method.

PubMed

Llovet, Maria Isabel; Biosca, Carmen; Martínez-Iribarren, Alicia; Blanco, Aurora; Busquets, Glòria; Castro, María José; Llopis, Maria Antonia; Montesinos, Mercè; Minchinela, Joana; Perich, Carme; Prieto, Judith; Ruiz, Rosa; Serrat, Núria; Simón, Margarita; Trejo, Alex; Monguet, Josep Maria; López-Pablo, Carlos; Ibarz, Mercè

2018-02-23

There is no consensus in the literature about what analytes or values should be informed as critical results and how they should be communicated. The main aim of this project is to establish consensual standards of critical results for the laboratories participating in the study. Among the project's secondary objectives, establishing consensual procedures for communication can be highlighted. Consensus was reached among all participating laboratories establishing the basis for the construction of the initial model put forward for consensus in conjunction with the clinicians. A real-time Delphi, methodology "health consensus" (HC), with motivating and participative questions was applied. The physician was expected to choose a numeric value within a scale designed for each analyte. The medians of critical results obtained represent the consensus on critical results for outpatient and inpatient care. Both in primary care and in hospital care a high degree of consensus was observed for critical values proposed in the analysis of creatinine, digoxin, phosphorus, glucose, international normalized ratio (INR), leukocytes, magnesium, neutrophils, chloride, sodium, calcium and lithium. For the rest of critical results the degree of consensus obtained was "medium high". The results obtained showed that in 72% of cases the consensual critical value coincided with the medians initially proposed by the laboratories. The real-time Delphi has allowed obtaining consensual standards for communication of critical results among the laboratories participating in the study, which can serve as a basis for other organizations.

[Comparability study of analytical results between a group of clinical laboratories].

PubMed

Alsius-Serra, A; Ballbé-Anglada, M; López-Yeste, M L; Buxeda-Figuerola, M; Guillén-Campuzano, E; Juan-Pereira, L; Colomé-Mallolas, C; Caballé-Martín, I

2015-01-01

To describe the study of the comparability of the measurements levels of biological tests processed in biochemistry in Catlab's 4 laboratories. Quality requirements, coefficients of variation and total error (CV% and TE %) were established. Controls were verified with the precision requirements (CV%) in each test and each individual laboratory analyser. Fresh serum samples were used for the comparability study. The differences were analysed using a Microsoft Access® application that produces modified Bland-Altman plots. The comparison of 32 biological parameters that are performed in more than one laboratory and/or analyser generated 306 Bland-Altman graphs. Of these, 101 (33.1%) fell within the accepted range of values based on biological variability, and 205 (66.9%) required revision. Data were re-analysed based on consensus minimum specifications for analytical quality (consensus of the Asociación Española de Farmacéuticos Analistas (AEFA), the Sociedad Española de Bioquímica Clínica y Patología Molecular (SEQC), the Asociación Española de Biopatología Médica (AEBM) and the Sociedad Española de Hematología y Hemoterapia (SEHH), October 2013). With the new specifications, 170 comparisons (56%) fitted the requirements and 136 (44%) required additional review. Taking into account the number of points that exceeded the requirement, random errors, range of results in which discrepancies were detected, and range of clinical decision, it was shown that the 44% that required review were acceptable, and the 32 tests were comparable in all laboratories and analysers. The analysis of the results showed that the consensus requirements of the 4 scientific societies were met. However, each laboratory should aim to meet stricter criteria for total error. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Maize mono-digestion efficiency: results from laboratory tests.

PubMed

Ficara, Elena; Malpei, Francesca

2011-01-01

A laboratory experimental campaign was carried out in order to assess the optimal configuration for the anaerobic digestion of a mixture of sweet corn and ensiled maize. Batch hydrolysis tests were conducted at 35 and 55 °C and at four different particle sizes (2, 5, 20 and 50 mm) obtained by manual chopping and sieving. Chemical pre-treatment by 24 h incubation at various acid and alkaline pH was also considered for its potential to increase the maize methane yield. Results suggest that the hydrolytic phase proceeds significantly faster under thermophilic conditions. Significant differences in the solubilization rate were also observed when comparing coarse (20-50 mm) with fine (2-5 mm) particles, while 2 and 5 mm particles were solubilized at similar rates. No advantages from the chemical pre-treatment, in terms of solubilization efficiency and biomethanization potential were observed. According to these preliminary results, a two-stage semi-continuous laboratory plant consisting of a thermophilic hydrolytic reactor followed by a mesophilic methanogenic reactor was operated for 110 days. Steady state loading parameters were: influent concentration (maize mixture diluted in tap water) of 46 g VS/L, hydraulic retention time of 31 d, organic loading rate of 1.5 g VS/L/d. Alkalinity was dosed to the methanogenic reactor to avoid pH drops. Collected data allowed the average biodegradation efficiency to be estimated at around 60-65%.

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

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes

PubMed Central

Lingenfelter, Brandon M.; Jiang, Xuezhi; Schnatz, Peter F.; O'Sullivan, David M.; Minassian, Shahab S.; Forstein, David A.

2016-01-01

Background The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of “at risk” residents. Objective This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. Methods We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Results Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Conclusions Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify “at risk” residents for added learning and provide program elements in need of improvement. PMID:27413437

Electronic reporting of all reference laboratory results: An important step toward a truly all-encompassing, integrated health record.

PubMed

Kratz, Alexander

2016-09-01

Results from reference laboratories are often not easily available in electronic health records. This article describes a multi-pronged, long-term approach that includes bringing send-out tests in-house, upgrading the laboratory information system, interfacing more send-out tests and more reference laboratories, utilizing the "miscellaneous assay" option offered by some reference laboratories, and scanning all remaining paper reports from reference laboratories for display in the electronic health record. This allowed all laboratory results obtained in association with a patient visit, whether performed in-house or at a reference laboratory, to be available in the integrated electronic health record. This was achieved without manual data entry of reference laboratory results, thereby avoiding the risk of transcription errors. A fully integrated electronic health record that contains all laboratory results can be achieved by maximizing the number of interfaced reference laboratory assays and making all non-interfaced results available as scanned documents. © The Author(s) 2015.

Downtime procedures for the 21st century: using a fully integrated health record for uninterrupted electronic reporting of laboratory results during laboratory information system downtimes.

PubMed

Oral, Bulent; Cullen, Regina M; Diaz, Danny L; Hod, Eldad A; Kratz, Alexander

2015-01-01

Downtimes of the laboratory information system (LIS) or its interface to the electronic medical record (EMR) disrupt the reporting of laboratory results. Traditionally, laboratories have relied on paper-based or phone-based reporting methods during these events. We developed a novel downtime procedure that combines advance placement of orders by clinicians for planned downtimes, the printing of laboratory results from instruments, and scanning of the instrument printouts into our EMR. The new procedure allows the analysis of samples from planned phlebotomies with no delays, even during LIS downtimes. It also enables the electronic reporting of all clinically urgent results during downtimes, including intensive care and emergency department samples, thereby largely avoiding paper- and phone-based communication of laboratory results. With the capabilities of EMRs and LISs rapidly evolving, information technology (IT) teams, laboratories, and clinicians need to collaborate closely, review their systems' capabilities, and design innovative ways to apply all available IT functions to optimize patient care during downtimes. Copyright© by the American Society for Clinical Pathology.

Mapping Department of Defense laboratory results to Logical Observation Identifiers Names and Codes (LOINC).

PubMed

Lau, Lee Min; Banning, Pam D; Monson, Kent; Knight, Elva; Wilson, Pat S; Shakib, Shaun C

2005-01-01

The Department of Defense (DoD) has used a common application, Composite Health Care System (CHCS), throughout all DoD facilities. However, the master files used to encode patient data in CHCS are not identical across DoD facilities. The encoded data is thus not interoperable from one DoD facility to another. To enable data interoperability in the next-generation system, CHCS II, and for the DoD to exchange laboratory results with external organizations such as the Veterans Administration (VA), the disparate master file codes for laboratory results are mapped to Logical Observation Identifier Names and Codes (LOINC) wherever possible. This paper presents some findings from our experience mapping DoD laboratory results to LOINC.

History, Physical Examination, Laboratory Testing, and Emergency Department Ultrasonography for the Diagnosis of Acute Cholecystitis.

PubMed

Jain, Ashika; Mehta, Ninfa; Secko, Michael; Schechter, Joshua; Papanagnou, Dimitri; Pandya, Shreya; Sinert, Richard

2017-03-01

Acute cholecystitis (AC) is a common differential for patients presenting to the emergency department (ED) with abdominal pain. The diagnostic accuracy of history, physical examination, and bedside laboratory tests for AC have not been quantitatively described. We performed a systematic review to determine the utility of history and physical examination (H&P), laboratory studies, and ultrasonography (US) in diagnosing AC in the ED. We searched medical literature from January 1965 to March 2016 in PubMed, Embase, and SCOPUS using a strategy derived from the following formulation of our clinical question: patients-ED patients suspected of AC; interventions-H&P, laboratory studies, and US findings commonly used to diagnose AC; comparator-surgical pathology or definitive diagnostic radiologic study confirming AC; and outcome-the operating characteristics of the investigations in diagnosing AC were calculated. Sensitivity, specificity, and likelihood ratios (LRs) were calculated using Meta-DiSc with a random-effects model (95% CI). Study quality and risks for bias were assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies. Separate PubMed, Embase, and SCOPUS searches retrieved studies for H&P (n = 734), laboratory findings (n = 74), and US (n = 492). Three H&P studies met inclusion/exclusion criteria with AC prevalence of 7%-64%. Fever had sensitivity ranging from 31% to 62% and specificity from 37% to 74%; positive LR [LR+] was 0.71-1.24, and negative LR [LR-] was 0.76-1.49. Jaundice sensitivity ranged from 11% to 14%, and specificity from 86% to 99%; LR+ was 0.80-13.81, and LR- was 0.87-1.03. Murphy's sign sensitivity was 62% (range = 53%-71%), and specificity was 96% (range = 95%-97%); LR+ was 15.64 (range = 11.48-21.31), and LR- was 0.40 (range = 0.32-0.50). Right upper quadrant pain had sensitivity ranging from 56% to 93% and specificity of 0% to 96%; LR+ ranged from 0.92 to 14.02, and LR- from 0.46 to 7.86. One laboratory study met

Results of an inter and intra laboratory exercise on the assessment of complex autosomal DNA profiles.

PubMed

Benschop, Corina C G; Connolly, Edward; Ansell, Ricky; Kokshoorn, Bas

2017-01-01

The interpretation of complex DNA profiles may differ between laboratories and reporting officers, which can lead to discrepancies in the final reports. In this study, we assessed the intra and inter laboratory variation in DNA mixture interpretation for three European ISO17025-accredited laboratories. To this aim, 26 reporting officers analyzed five sets of DNA profiles. Three main aspects were considered: 1) whether the mixed DNA profiles met the criteria for comparison to a reference profile, 2) the actual result of the comparison between references and DNA profiling data and 3) whether the weight of the DNA evidence could be assessed. Similarity in answers depended mostly on the complexity of the tasks. This study showed less variation within laboratories than between laboratories which could be the result of differences between internal laboratory guidelines and methods and tools available. Results show the profile types for which the three laboratories report differently, which informs indirectly on the complexity threshold the laboratories employ. Largest differences between laboratories were caused by the methods available to assess the weight of the DNA evidence. This exercise aids in training forensic scientists, refining laboratory guidelines and explaining differences between laboratories in court. Undertaking more collaborative exercises in future may stimulate dialog and consensus regarding interpretation. For training purposes, DNA profiles of the mixed stains and questioned references are made available. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier Ireland Ltd. All rights reserved.

Progress in increasing electronic reporting of laboratory results to public health agencies--United States, 2013.

PubMed

2013-09-27

Electronic reporting of laboratory results to public health agencies can improve public health surveillance for reportable diseases and conditions by making reporting more timely and complete. Since 2010, CDC has provided funding to 57 state, local, and territorial health departments through the Epidemiology and Laboratory Capacity for Infectious Diseases cooperative agreement to assist with improving electronic laboratory reporting (ELR) from clinical and public health laboratories to public health agencies. As part of this agreement, CDC and state and large local health departments are collaborating to monitor ELR implementation in the United States by developing data from each jurisdiction regarding total reporting laboratories, laboratories sending ELR by disease category and message format, and the number of ELR laboratory reports compared with the total number of laboratory reports. At the end of July 2013, 54 of the 57 jurisdictions were receiving at least some laboratory reports through ELR, and approximately 62% of 20 million laboratory reports were being received electronically, compared with 54% in 2012. Continued progress will require collaboration between clinical laboratories, laboratory information management system (LIMS) vendors, and public health agencies.

Internal audit in a microbiology laboratory.

PubMed Central

Mifsud, A J; Shafi, M S

1995-01-01

AIM--To set up a programme of internal laboratory audit in a medical microbiology laboratory. METHODS--A model of laboratory based process audit is described. Laboratory activities were examined in turn by specimen type. Standards were set using laboratory standard operating procedures; practice was observed using a purpose designed questionnaire and the data were analysed by computer; performance was assessed at laboratory audit meetings; and the audit circle was closed by re-auditing topics after an interval. RESULTS--Improvements in performance scores (objective measures) and in staff morale (subjective impression) were observed. CONCLUSIONS--This model of process audit could be applied, with amendments to take local practice into account, in any microbiology laboratory. PMID:7665701

Participation of Bell Telephone Laboratories in Project Echo and Experimental Results

NASA Technical Reports Server (NTRS)

Jakes, William C., Jr.

1961-01-01

On August 12, 1960, Echo I, a 100-foot-diameter spherical balloon, was placed in orbit around the earth by the National Aeronautics and Space Administration. The objective was to demonstrate the feasibility of long-distance communication by microwave reflection from a satellite. A two-way coast-to-coast voice circuit was to be established between the Jet Propulsion Laboratory (JPL) facility in California and a station provided by Bell Telephone Laboratories (STL) in New Jersey. Similar tests were also planned with the Naval Research Laboratory and other stations. This paper describes the general organization and operation of the Holmdel, New Jersey, station, and discusses the results of the experiments performed between the balloon launching and March 1, 1961. Successful voice communication was achieved through a variety of modulation methods including frequency modulation with feedback, amplitude modulation, single-sideband modulation, and narrow-band phase modulation. Careful measurements were also made of the loss in the transmission path.

Medical Laboratory Technician and Technologist Training: Arizona Heeds the Call.

ERIC Educational Resources Information Center

Biehl, Ruth B.

Arizona's medical laboratory personnel training programs were examined in relation to the nationwide development and distribution of laboratory personnel classifications (Medical Technologist--MT, Medical Laboratory Technician--MLT, and Certified Laboratory Assistant--CLA) and the national educational response which has resulted in an increase in…

[Fistulography. Results of 126 examinations (author's transl)].

PubMed

Metges, P J; Silici, R; Kleitz, C; Delahaye, R P; Mine, J; Pailler, J L

1980-01-01

The authors describe the results obtained in a series of 126 patients examined by fistulography. This investigation should be conducted systematically after operative treatment of any type of fistula. The procedure involves perfusion of a water-soluble iodized contrast medium at low pressure, using a balloon sound to ensure that there are no leaks. The results supply the general or orthopedic surgeon with the information necessary for deciding the operative procedure to be used.

Analytical performances of food microbiology laboratories - critical analysis of 7 years of proficiency testing results.

PubMed

Abdel Massih, M; Planchon, V; Polet, M; Dierick, K; Mahillon, J

2016-02-01

Based on the results of 19 food microbiology proficiency testing (PT) schemes, this study aimed to assess the laboratory performances, to highlight the main sources of unsatisfactory analytical results and to suggest areas of improvement. The 2009-2015 results of REQUASUD and IPH PT, involving a total of 48 laboratories, were analysed. On average, the laboratories failed to detect or enumerate foodborne pathogens in 3·0% of the tests. Thanks to a close collaboration with the PT participants, the causes of outliers could be identified in 74% of the cases. The main causes of erroneous PT results were either pre-analytical (handling of the samples, timing of analysis), analytical (unsuitable methods, confusion of samples, errors in colony counting or confirmation) or postanalytical mistakes (calculation and encoding of results). PT schemes are a privileged observation post to highlight analytical problems, which would otherwise remain unnoticed. In this perspective, this comprehensive study of PT results provides insight into the sources of systematic errors encountered during the analyses. This study draws the attention of the laboratories to the main causes of analytical errors and suggests practical solutions to avoid them, in an educational purpose. The observations support the hypothesis that regular participation to PT, when followed by feed-back and appropriate corrective actions, can play a key role in quality improvement and provide more confidence in the laboratory testing results. © 2015 The Society for Applied Microbiology.

How does preclinical laboratory training impact physical examination skills during the first clinical year? A retrospective analysis of routinely collected objective structured clinical examination scores among the first two matriculating classes of a reformed curriculum in one Polish medical school

PubMed Central

Świerszcz, Jolanta; Stalmach-Przygoda, Agata; Kuźma, Marcin; Jabłoński, Konrad; Cegielny, Tomasz; Skrzypek, Agnieszka; Wieczorek-Surdacka, Ewa; Kruszelnicka, Olga; Chmura, Kaja; Chyrchel, Bernadeta; Surdacki, Andrzej; Nowakowski, Michał

2017-01-01

Objective As a result of a curriculum reform launched in 2012 at our institution, preclinical training was shortened to 2 years instead of the traditional 3 years, creating additional incentives to optimise teaching methods. In accordance with the new curriculum, a semester-long preclinical module of clinical skills (CS) laboratory training takes place in the second year of study, while an introductory clinical course (ie, brief introductory clerkships) is scheduled for the Fall semester of the third year. Objective structured clinical examinations (OSCEs) are carried out at the conclusion of both the preclinical module and the introductory clinical course. Our aim was to compare the scores at physical examination stations between the first and second matriculating classes of a newly reformed curriculum on preclinical second-year OSCEs and early clinical third-year OSCEs. Design Analysis of routinely collected data. Setting One Polish medical school. Participants Complete OSCE records for 462 second-year students and 445 third-year students. Outcome measures OSCE scores by matriculation year. Results In comparison to the first class of the newly reformed curriculum, significantly higher (ie, better) OSCE scores were observed for those students who matriculated in 2013, a year after implementing the reformed curriculum. This finding was consistent for both second-year and third-year cohorts. Additionally, the magnitude of the improvement in median third-year OSCE scores was proportional to the corresponding advancement in preceding second-year preclinical OSCE scores for each of two different sets of physical examination tasks. In contrast, no significant difference was noted between the academic years in the ability to interpret laboratory data or ECG — tasks which had not been included in the second-year preclinical training. Conclusion Our results suggest the importance of preclinical training in a CS laboratory to improve students’ competence in

Inter-laboratory consistency and variability in the buccal micronucleus cytome assay depends on biomarker scored and laboratory experience: results from the HUMNxl international inter-laboratory scoring exercise.

PubMed

Bolognesi, Claudia; Knasmueller, Siegfried; Nersesyan, Armen; Roggieri, Paola; Ceppi, Marcello; Bruzzone, Marco; Blaszczyk, Ewa; Mielzynska-Svach, Danuta; Milic, Mirta; Bonassi, Stefano; Benedetti, Danieli; Da Silva, Juliana; Toledo, Raphael; Salvadori, Daisy Maria Fávero; Groot de Restrepo, Helena; Filipic, Metka; Hercog, Klara; Aktas, Ayça; Burgaz, Sema; Kundi, Michael; Grummt, Tamara; Thomas, Philip; Hor, Maryam; Escudero-Fung, Maria; Holland, Nina; Fenech, Michael

2017-03-01

The buccal micronucleus cytome (BMNcyt) assay in uncultured exfoliated epithelial cells from oral mucosa is widely applied in biomonitoring human exposures to genotoxic agents and is also proposed as a suitable test for prescreening and follow-up of precancerous oral lesions. The main limitation of the assay is the large variability observed in the baseline values of micronuclei (MNi) and other nuclear anomalies mainly related to different scoring criteria. The aim of this international collaborative study, involving laboratories with different level of experience, was to evaluate the inter- and intra-laboratory variations in the BMNcyt parameters, using recently implemented guidelines, in scoring cells from the same pooled samples obtained from healthy subjects (control group) and from cancer patients undergoing radiotherapy (treated group). The results indicate that all laboratories correctly discriminated samples from the two groups by a significant increase of micronucleus (MN) and nuclear bud (NBUD) frequencies and differentiated binucleated (BN) cells, associated with the exposure to ionizing radiation. The experience of the laboratories was shown to play an important role in the identification of the different cell types and nuclear anomalies. MN frequency in differentiated mononucleated (MONO) and BN cells showed the greatest consistency among the laboratories and low variability was also detected in the frequencies of MONO and BN cells. A larger variability was observed in classifying the different cell types, indicating the subjectivity in the interpretation of some of the scoring criteria while reproducibility of the results between scoring sessions was very good. An inter-laboratory calibration exercise is strongly recommended before starting studies with BMNcyt assay involving multiple research centers. © The Author 2016. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society. All rights reserved. For permissions

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.

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.

How Do Experienced Physicians Access and Evaluate Laboratory Test Results for the Chronic Patient? A Qualitative Analysis.

PubMed

Torsvik, Torbjørn; Lillebo, Børge; Hertzum, Morten

2018-04-01

 Electronic health records may present laboratory test results in a variety of ways. Little is known about how the usefulness of different visualizations of laboratory test results is influenced by the complex and varied process of clinical decision making.  The purpose of this study was to investigate how clinicians access and utilize laboratory test results when caring for patients with chronic illness.  We interviewed 10 attending physicians about how they access and assess laboratory tests when following up patients with chronic illness. The interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively.  Informants preferred different visualizations of laboratory test results, depending on what aspects of the data they were interested in. As chronic patients may have laboratory test results that are permanently outside standardized reference ranges, informants would often look for significant change, rather than exact values. What constituted significant change depended on contextual information (e.g., the results of other investigations, intercurrent diseases, and medical interventions) spread across multiple locations in the electronic health record. For chronic patients, the temporal relations between data could often be of special interest. Informants struggled with finding and synthesizing fragmented information into meaningful overviews.  The presentation of laboratory test results should account for the large variety of associated contextual information needed for clinical comprehension. Future research is needed to improve the integration of the different parts of the electronic health record. Schattauer GmbH Stuttgart.

Estrogen and progesterone receptor testing in breast carcinoma: concordance of results between local and reference laboratories in Brazil.

PubMed

Wludarski, Sheila Cristina Lordelo; Lopes, Lisandro Ferreira; Duarte, Ivison Xavier; Carvalho, Filomena Marino; Weiss, Lawrence; Bacchi, Carlos Eduardo

2011-01-01

Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community) laboratories in Brazil. Retrospective study at a reference pathology laboratory. The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. There was concordance in 89.4% (447/500 cases) and 85.0% (425/500 cases) of the results from estrogen (κ = 0.744, P < 0.001) and progesterone (κ = 0.688, P < 0.001) receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7% and 14.4%, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5% and 16.0%, respectively. Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes.

PubMed

Lingenfelter, Brandon M; Jiang, Xuezhi; Schnatz, Peter F; O'Sullivan, David M; Minassian, Shahab S; Forstein, David A

2016-07-01

The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of "at risk" residents. This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify "at risk" residents for added learning and provide program elements in need of improvement.

[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.

Quantity quotient reporting. A proposal for a standardized presentation of laboratory results.

PubMed

Haeckel, Rainer; Wosniok, Werner

2009-01-01

Laboratory results are reported in different units (despite international recommendations for SI units) together with different reference limits, of which several exist for many quantities. It is proposed to adopt the concept of the intelligence quotient and to report quantitative results as a quantity quotient (QQ) in laboratory medicine. This quotient is essentially the difference (measured result minus mean or mode value of the reference interval) divided by the observed biological variation CV(o). Thus, all quantities are reported in the same unit system with the same reference limits (for convenience shifted to e.g., 80-120). The critical difference can also be included in this standardization concept. In this way the information of reference intervals and the original result are integrated into one combined value, which has the same format for all quantities suited for quotient reporting (QR). The proposal of QR does not interfere with neither the current concepts of traceability, SI units or method standardization. This proposal represents a further step towards harmonization of reporting. It provides simple values which can be interpreted easily by physicians and their patients.

Anatomy and Humanity: Examining the Effects of a Short Documentary Film and First Anatomy Laboratory Experience on Medical Students

ERIC Educational Resources Information Center

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…

Comparison of results of fluconazole disk diffusion testing for Candida species with results from a central reference laboratory in the ARTEMIS global antifungal surveillance program.

PubMed

Pfaller, M A; Hazen, K C; Messer, S A; Boyken, L; Tendolkar, S; Hollis, R J; Diekema, D J

2004-08-01

The accuracy of antifungal susceptibility tests is important for accurate resistance surveillance and for the clinical management of patients with serious infections. Our main objective was to compare the results of fluconazole disk diffusion testing of Candida spp. performed by ARTEMIS participating centers with disk diffusion and MIC results obtained by the central reference laboratory. A total of 2,949 isolates of Candida spp. were tested by NCCLS disk diffusion and reference broth microdilution methods in the central reference laboratory. These results were compared to the results of disk diffusion testing performed in the 54 participating centers. All tests were performed and interpreted following NCCLS recommendations. Overall categorical agreement between participant disk diffusion test results and reference laboratory MIC results was 87.4%, with 0.2% very major errors (VME) and 3.3% major errors (ME). The categorical agreement between the disk diffusion test results obtained in the reference laboratory with the MIC test results was similar: 92.8%. Likewise, good agreement was observed between participant disk diffusion test results and reference laboratory disk diffusion test results: 90.4%, 0.4% VME, and 3.4% ME. The disk diffusion test was especially reliable in detecting those isolates of Candida spp. that were characterized as resistant by reference MIC testing. External quality assurance data obtained by surveillance programs such as the ARTEMIS Global Antifungal Surveillance Program ensure the generation of useful surveillance data and result in the continued improvement of antifungal susceptibility testing practices.

How does preclinical laboratory training impact physical examination skills during the first clinical year? A retrospective analysis of routinely collected objective structured clinical examination scores among the first two matriculating classes of a reformed curriculum in one Polish medical school.

PubMed

Świerszcz, Jolanta; Stalmach-Przygoda, Agata; Kuźma, Marcin; Jabłoński, Konrad; Cegielny, Tomasz; Skrzypek, Agnieszka; Wieczorek-Surdacka, Ewa; Kruszelnicka, Olga; Chmura, Kaja; Chyrchel, Bernadeta; Surdacki, Andrzej; Nowakowski, Michał

2017-09-01

As a result of a curriculum reform launched in 2012 at our institution, preclinical training was shortened to 2 years instead of the traditional 3 years, creating additional incentives to optimise teaching methods. In accordance with the new curriculum, a semester-long preclinical module of clinical skills (CS) laboratory training takes place in the second year of study, while an introductory clinical course (ie, brief introductory clerkships) is scheduled for the Fall semester of the third year. Objective structured clinical examinations (OSCEs) are carried out at the conclusion of both the preclinical module and the introductory clinical course. Our aim was to compare the scores at physical examination stations between the first and second matriculating classes of a newly reformed curriculum on preclinical second-year OSCEs and early clinical third-year OSCEs. Analysis of routinely collected data. One Polish medical school. Complete OSCE records for 462 second-year students and 445 third-year students. OSCE scores by matriculation year. In comparison to the first class of the newly reformed curriculum, significantly higher (ie, better) OSCE scores were observed for those students who matriculated in 2013, a year after implementing the reformed curriculum. This finding was consistent for both second-year and third-year cohorts. Additionally, the magnitude of the improvement in median third-year OSCE scores was proportional to the corresponding advancement in preceding second-year preclinical OSCE scores for each of two different sets of physical examination tasks. In contrast, no significant difference was noted between the academic years in the ability to interpret laboratory data or ECG - tasks which had not been included in the second-year preclinical training. Our results suggest the importance of preclinical training in a CS laboratory to improve students' competence in physical examination at the completion of introductory clinical clerkships during

Undergraduate nursing students' experiences when examining nursing skills in clinical simulation laboratories with high-fidelity patient simulators: A phenomenological research study.

PubMed

Sundler, Annelie J; Pettersson, Annika; Berglund, Mia

2015-12-01

Simulation has become a widely used and established pedagogy for teaching clinical nursing skills. Nevertheless, the evidence in favour of this pedagogical approach is weak, and more knowledge is needed in support of its use. The aim of this study was (a) to explore the experiences of undergraduate nursing students when examining knowledge, skills and competences in clinical simulation laboratories with high-fidelity patient simulators and (b) to analyse these students' learning experiences during the examination. A phenomenological approach was used, and qualitative interviews were conducted among 23 second-year undergraduate nursing students-17 women and 6 men. The findings revealed that, irrespective of whether they passed or failed the examination, it was experienced as a valuable assessment of the students' knowledge and skills. Even if the students felt that the examination was challenging, they described it as a learning opportunity. In the examination, the students were able to integrate theory with practice, and earlier established knowledge was scrutinised when reflecting on the scenarios. The examination added aspects to the students' learning that prepared them for the real world of nursing in a safe environment without risking patient safety. The study findings suggest that examinations in clinical simulation laboratories can be a useful teaching strategy in nursing education. The use of high-fidelity patient simulators made the examination authentic. The reflections and feedback on the scenario were described as significant for the students' learning. Undergraduate nursing students can improve their knowledge, understanding, competence and skills when such examinations are performed in the manner used in this study. Copyright © 2015 Elsevier Ltd. All rights reserved.

Examining Student Outcomes in University Computer Laboratory Environments: Issues for Educational Management

ERIC Educational Resources Information Center

Newby, Michael; Marcoulides, Laura D.

2008-01-01

Purpose: The purpose of this paper is to model the relationship between student performance, student attitudes, and computer laboratory environments. Design/methodology/approach: Data were collected from 234 college students enrolled in courses that involved the use of a computer to solve problems and provided the laboratory experience by means of…

Examination of the Effects of Dimensionality on Cognitive Processing in Science: A Computational Modeling Experiment Comparing Online Laboratory Simulations and Serious Educational Games

NASA Astrophysics Data System (ADS)

Lamb, Richard L.

2016-02-01

Within the last 10 years, new tools for assisting in the teaching and learning of academic skills and content within the context of science have arisen. These new tools include multiple types of computer software and hardware to include (video) games. The purpose of this study was to examine and compare the effect of computer learning games in the form of three-dimensional serious educational games, two-dimensional online laboratories, and traditional lecture-based instruction in the context of student content learning in science. In particular, this study examines the impact of dimensionality, or the ability to move along the X-, Y-, and Z-axis in the games. Study subjects ( N = 551) were randomly selected using a stratified sampling technique. Independent strata subsamples were developed based upon the conditions of serious educational games, online laboratories, and lecture. The study also computationally models a potential mechanism of action and compares two- and three-dimensional learning environments. F test results suggest a significant difference for the main effect of condition across the factor of content gain score with large effect. Overall, comparisons using computational models suggest that three-dimensional serious educational games increase the level of success in learning as measured with content examinations through greater recruitment and attributional retraining of cognitive systems. The study supports assertions in the literature that the use of games in higher dimensions (i.e., three-dimensional versus two-dimensional) helps to increase student understanding of science concepts.

Size dependence of the disruption threshold: laboratory examination of millimeter-centimeter porous targets

NASA Astrophysics Data System (ADS)

Nakamura, Akiko M.; Yamane, Fumiya; Okamoto, Takaya; Takasawa, Susumu

2015-03-01

The outcome of collision between small solid bodies is characterized by the threshold energy density Q*s, the specific energy to shatter, that is defined as the ratio of projectile kinetic energy to the target mass (or the sum of target and projectile) needed to produce the largest intact fragment that contains one half the target mass. It is indicated theoretically and by numerical simulations that the disruption threshold Q*s decreases with target size in strength-dominated regime. The tendency was confirmed by laboratory impact experiments using non-porous rock targets (Housen and Holsapple, 1999; Nagaoka et al., 2014). In this study, we performed low-velocity impact disruption experiments on porous gypsum targets with porosity of 65-69% and of three different sizes to examine the size dependence of the disruption threshold for porous material. The gypsum specimens were shown to have a weaker volume dependence on static tensile strength than do the non-porous rocks. The disruption threshold had also a weaker dependence on size scale as Q*s ∝D-γ , γ ≤ 0.25 - 0.26, while the previous laboratory studies showed γ=0.40 for the non-porous rocks. The measurements at low-velocity lead to a value of about 100 J kg-1 for Q*s which is roughly one order of magnitude lower than the value of Q*s for the gypsum targets of 65% porosity but impacted by projectiles with higher velocities. Such a clear dependence on the impact velocity was also shown by previous studies of gypsum targets with porosity of 50%.

Clinical Examination Results in Individuals With Functional Ankle Instability and Ankle-Sprain Copers

PubMed Central

Wright, Cynthia J.; Arnold, Brent L.; Ross, Scott E.; Ketchum, Jessica; Ericksen, Jeffrey; Pidcoe, Peter

2013-01-01

Context: Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited. Objective: To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78). Intervention(s): Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded. Main Outcome Measure(s): Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM. Results: Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05). Conclusions: Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected

Laboratory analyses of micron-sized solid grains: Experimental techniques and recent results

NASA Technical Reports Server (NTRS)

Colangeli, L.; Bussoletti, E.; Blanco, A.; Borghesi, A.; Fonti, S.; Orofino, V.; Schwehm, G.

1989-01-01

Morphological and spectrophotometric investigations have been extensively applied in the past years to various kinds of micron and/or submicron-sized grains formed by materials which are candidate to be present in space. The samples are produced in the laboratory and then characterized in their physio-chemical properties. Some of the most recent results obtained on various kinds of carbonaceous materials are reported. Main attention is devoted to spectroscopic results in the VUV and IR wavelength ranges, where many of the analyzed samples show typical fingerprints which can be identified also in astrophysical and cometary materials. The laboratory methodologies used so far are also critically discussed in order to point out capabilities and present limitations, in the view of possible application to returned comet samples. Suggestions are given to develop new techniques which should overcome some of the problems faced in the manipulation and analysis of micron solid samples.

Test Results From The Idaho National Laboratory Of The NASA Bi-Supported Cell Design

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

C Stoots; J O'Brien; T Cable

The Idaho National Laboratory has been researching the application of solid-oxide fuel cell technology for large-scale hydrogen production. As a result, the Idaho National Laboratory has been testing various cell designs to characterize electrolytic performance. NASA, in conjunction with the University of Toledo, has developed a new cell concept with the goals of reduced weight and high power density. This paper presents results of the INL's testing of this new solid oxide cell design as an electrolyzer. Gas composition, operating voltage, and other parameters were varied during testing. Results to date show the NASA cell to be a promising designmore » for both high power-to-weight fuel cell and electrolyzer applications.« less

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

49 CFR 40.183 - What information do laboratories report to MROs regarding split specimen results?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false What information do laboratories report to MROs regarding split specimen results? 40.183 Section 40.183 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Split Specimen Tests § 40.183 What information do laboratories...

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.

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

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

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.

Key results of battery performance and life tests 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.

1991-12-01

Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory's & Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R & D programs, compare battery technologies, and provide basic data for modeling and continuing R & D to battery users, developers, and program managers.

National Media Laboratory media testing results

NASA Technical Reports Server (NTRS)

Mularie, William

1993-01-01

The government faces a crisis in data storage, analysis, archive, and communication. The sheer quantity of data being poured into the government systems on a daily basis is overwhelming systems ability to capture, analyze, disseminate, and store critical information. Future systems requirements are even more formidable: with single government platforms having data rate of over 1 Gbit/sec, greater than Terabyte/day storage requirements, and with expected data archive lifetimes of over 10 years. The charter of the National Media Laboratory (NML) is to focus the resources of industry, government, and academia on government needs in the evaluation, development, and field support of advanced recording systems.

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.

How well do general practitioners manage laboratory test results for patients with diabetes mellitus and cardiovascular disease?: A systematic review.

PubMed

McCaughey, Euan J; Li, Julie; Badrick, Tony C; Westbrook, Johanna I; Georgiou, Andrew

2017-10-01

To evaluate how well general practitioners (GPs) manage and respond to laboratory results for patients with diabetes mellitus (DM) and cardiovascular disease (CVD). MEDLINE, CINAHL, Embase, EBM reviews, ProQuest and Scopus. Peer-reviewed journal articles published between 2000 and 2015 that assessed GPs' management of laboratory results for patients with DM or CVD. Study design and demographics, laboratory tests and key findings relating to GP management of laboratory results were extracted from studies. Thirteen articles were included, comprising seven studies which utilized surveys, four observational studies, one cohort study and one randomized controlled trial. Findings indicate that GPs often overestimate the risk of complications associated with DM and CVD based on laboratory results and have unrealistically high expectations regarding the precision of laboratory tests. Considerable variation existed in the use of repeat testing for diagnostic confirmation and in GPs' identification of the difference between two consecutive results required to indicate a change in patient condition. GPs also often failed to initiate appropriate treatment for patients with DM and CVD based on laboratory results. Feedback to GPs about their test ordering patterns and educational messages on laboratory results improved clinical outcomes. Evidence about how well GPs manage results and its impact on patient outcomes remains weak and inconclusive. This review identified a number of areas where interventions could support GPs to improve the interpretation and management of laboratory test results, including feedback to GPs and educational messages on test result reports. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[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.

Benchmarking Glucose Results through Automation: The 2009 Remote Automated Laboratory System Report

PubMed Central

Anderson, Marcy; Zito, Denise; Kongable, Gail

2010-01-01

Background Hyperglycemia in the adult inpatient population remains a topic of intense study in U.S. hospitals. Most hospitals have established glycemic control programs but are unable to determine their impact. The 2009 Remote Automated Laboratory System (RALS) Report provides trends in glycemic control over 4 years to 576 U.S. hospitals to support their effort to manage inpatient hyperglycemia. Methods A proprietary software application feeds de-identified patient point-of-care blood glucose (POC-BG) data from the Medical Automation Systems RALS-Plus data management system to a central server. Analyses include the number of tests and the mean and median BG results for intensive care unit (ICU), non-ICU, and each hospital compared to the aggregate of the other hospitals. Results More than 175 million BG results were extracted from 2006–2009; 25% were from the ICU. Mean range of BG results for all inpatients in 2006, 2007, 2008, and 2009 was 142.2–201.9, 145.6–201.2, 140.6–205.7, and 140.7–202.4 mg/dl, respectively. The range for ICU patients was 128–226.5, 119.5–219.8, 121.6–226.0, and 121.1–217 mg/dl, respectively. The range for non-ICU patients was 143.4–195.5, 148.6–199.8, 145.2–201.9, and 140.7–203.6 mg/dl, respectively. Hyperglycemia rates of >180 mg/dl in 2008 and 2009 were examined, and hypoglycemia rates of <40 mg/dl (severe) and <70 mg/dl (moderate) in both 2008 and 2009 were calculated. Conclusions From these data, hospitals can determine the current state of glycemic control in their hospital and in comparison to other hospitals. For many, glycemic control has improved. Automated POC-BG data management software can assist in this effort. PMID:21129348

[External quality assessment in clinical biochemistry laboratories: pilot study in 11 laboratories of Lomé (Togo)].

PubMed

Kouassi, Kafui; Fétéké, Lochina; Assignon, Selom; Dorkenoo, Ameyo; Napo-Koura, Gado

2015-01-01

This study aims to evaluate the performance of a few biochemistry analysis and make recommendations to the place of the stakeholders. It is a cross-sectional study conducted between the October 1(st), 2012 and the July 31, 2013 bearing on the results of 5 common examinations of clinical biochemistry, provided by 11 laboratories volunteers opening in the public and private sectors. These laboratories have analysed during the 3 cycles, 2 levels (medium and high) of serum concentration of urea, glucose, creatinine and serum aminotransferases. The performance of laboratories have been determined from the acceptable limits corresponding to the limits of total errors, defined by the French Society of Clinical Biology (SFBC). A system of internal quality control is implemented by all laboratories and 45% of them participated in international programs of external quality assessment (EQA). The rate of acceptable results for the entire study was of 69%. There was a significant difference (p<0.002) between the performance of the group of laboratories engaged in a quality approach and the group with default implementation of the quality approach. Also a significant difference was observed between the laboratories of the central level and those of the peripheral level of our health system (p<0.047). The performance of the results provided by the laboratories remains relatively unsatisfactory. It is important that the Ministry of Health put in place a national program of EQA with mandatory participation.

Feature selection for examining behavior by pathology laboratories.

PubMed

Hawkins, S; Williams, G; Baxter, R

2001-08-01

Australia has a universal health insurance scheme called Medicare, which is managed by Australia's Health Insurance Commission. Medicare payments for pathology services generate voluminous transaction data on patients, doctors and pathology laboratories. The Health Insurance Commission (HIC) currently uses predictive models to monitor compliance with regulatory requirements. The HIC commissioned a project to investigate the generation of new features from the data. Feature generation has not appeared as an important step in the knowledge discovery in databases (KDD) literature. New interesting features for use in predictive modeling are generated. These features were summarized, visualized and used as inputs for clustering and outlier detection methods. Data organization and data transformation methods are described for the efficient access and manipulation of these new features.

First laboratory results with the LINC-NIRVANA high layer wavefront sensor.

PubMed

Zhang, Xianyu; Gaessler, Wolfgang; Conrad, Albert R; Bertram, Thomas; Arcidiacono, Carmelo; Herbst, Thomas M; Kuerster, Martin; Bizenberger, Peter; Meschke, Daniel; Rix, Hans-Walter; Rao, Changhui; Mohr, Lars; Briegel, Florian; Kittmann, Frank; Berwein, Juergen; Trowitzsch, Jan; Schreiber, Laura; Ragazzoni, Roberto; Diolaiti, Emiliano

2011-08-15

In the field of adaptive optics, multi-conjugate adaptive optics (MCAO) can greatly increase the size of the corrected field of view (FoV) and also extend sky coverage. By applying layer oriented MCAO (LO-MCAO) [4], together with multiple guide stars (up to 20) and pyramid wavefront sensors [7], LINC-NIRVANA (L-N for short) [1] will provide two AO-corrected beams to a Fizeau interferometer to achieve 10 milliarcsecond angular resolution on the Large Binocular Telescope. This paper presents first laboratory results of the AO performance achieved with the high layer wavefront sensor (HWS). This sensor, together with its associated deformable mirror (a Xinetics-349), is being operated in one of the L-N laboratories. AO reference stars, spread across a 2 arc-minute FoV and with aberrations resulting from turbulence introduced at specific layers in the atmosphere, are simulated in this lab environment. This is achieved with the Multi-Atmosphere Phase screen and Stars (MAPS) [2] unit. From the wavefront data, the approximate residual wavefront error after correction has been calculated for different turbulent layer altitudes and wind speeds. Using a somewhat undersampled CCD, the FWHM of stars in the nearly 2 arc-minute FoV has also been measured. These test results demonstrate that the high layer wavefront sensor of LINC-NIRVANA will be able to achieve uniform AO correction across a large FoV. © 2011 Optical Society of America

Social Comparison or Utility: An Experimental Examination.

ERIC Educational Resources Information Center

Rofe, Yacov; Lewin, Isaac

1988-01-01

Examined emotional comparison theory and utility theory in an analysis of effects of stress on affiliation in a laboratory setting. Two intense fear situations concerning the administration of painful electrical shocks were added to Schachter's (1959) original fear manipulation. Results showed that two new fear conditions resulted in marked…

Venipuncture versus peripheral catheter: do infusions alter laboratory results?

PubMed

Hambleton, Victoria Lerma; Gómez, Ignacio Arribas; Andreu, Francisco A Bernabeu

2014-01-01

Our aim was to evaluate the equivalence between analytic parameters from blood samples obtained from a saline solution lock device used for the infusion of drugs and those from venipuncture. In our emergency department, patients bearing a saline solution lock device have blood extracted by venipuncture to avoid possible contamination of the sample. Adults from the emergency department with a saline solution lock device who required laboratory tests were selected as candidates for this cross-sectional observational study. Infusions were halted and flushed with 0.9% saline solution; 2 minutes later, 2 mL of blood was drawn and discarded, and the corresponding laboratory tubes were filled. Immediately after, another sample was withdrawn from the opposite extremity by venipuncture. Both samples were analyzed for hematology, biochemistry, venous blood gases, and coagulation parameters. Concordance was evaluated by use of the intraclass correlation coefficient with its 95% confidence intervals; Bland-Altman plots were used to illustrate the percentage of samples with differences exceeding 2 SDs. The mean differences were also checked to detect those exceeding the laboratory's systematic error. An intraclass correlation coefficient of over 0.9 was achieved for all parameters except for pH, partial pressure of carbon dioxide, and partial pressure of oxygen. Differences of over 2 SDs were found in fewer than 10% of all parameters. None of them exceeded 3 SDs, except for pH and venous blood gases. All parameters showed differences below the laboratory's accepted systematic error except for pH and venous blood gases. Blood samples extracted from a peripheral catheter with or without drug infusions are valid for the analysis of hematology, biochemistry, and coagulation parameters but not for venous blood gases. Nurses should know the benefits of using an existing peripheral catheter for drawing blood samples for laboratory analysis even when infusing commonly used drugs

Performance of a Modern Glucose Meter in ICU and General Hospital Inpatients: 3 Years of Real-World Paired Meter and Central Laboratory Results.

PubMed

Zhang, Ray; Isakow, Warren; Kollef, Marin H; Scott, Mitchell G

2017-09-01

Due to accuracy concerns, the Food and Drug Administration issued guidances to manufacturers that resulted in Center for Medicare and Medicaid Services stating that the use of meters in critically ill patients is "off-label" and constitutes "high complexity" testing. This is causing significant workflow problems in ICUs nationally. We wished to determine whether real-world accuracy of modern glucose meters is worse in ICU patients compared with non-ICU inpatients. We reviewed glucose results over the preceding 3 years, comparing results from paired glucose meter and central laboratory tests performed within 60 minutes of each other in ICU versus non-ICU settings. Seven ICU and 30 non-ICU wards at a 1,300-bed academic hospital in the United States. A total of 14,763 general medicine/surgery inpatients and 20,970 ICU inpatients. None. Compared meter results with near simultaneously performed laboratory results from the same patient by applying the 2016 U.S. Food and Drug Administration accuracy criteria, determining mean absolute relative difference and examining where paired results fell within the Parkes consensus error grid zones. A higher percentage of glucose meter results from ICUs than from non-ICUs passed 2016 Food and Drug Administration accuracy criteria (p < 10) when comparing meter results with laboratory results. At 1 minute, no meter result from ICUs posed dangerous or significant risk by error grid analysis, whereas at 10 minutes, less than 0.1% of ICU meter results did, which was not statistically different from non-ICU results. Real-world accuracy of modern glucose meters is at least as accurate in the ICU setting as in the non-ICU setting at our institution.

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.

Quality-assurance results for routine water analysis in US Geological Survey laboratories, water year 1991

USGS Publications Warehouse

Maloney, T.J.; Ludtke, A.S.; Krizman, T.L.

1994-01-01

The US. Geological Survey operates a quality- assurance program based on the analyses of reference samples for the National Water Quality Laboratory in Arvada, Colorado, and the Quality of Water Service Unit in Ocala, Florida. Reference samples containing selected inorganic, nutrient, and low ionic-strength constituents are prepared and disguised as routine samples. The program goal is to determine precision and bias for as many analytical methods offered by the participating laboratories as possible. The samples typically are submitted at a rate of approximately 5 percent of the annual environmental sample load for each constituent. The samples are distributed to the laboratories throughout the year. Analytical data for these reference samples reflect the quality of environmental sample data produced by the laboratories because the samples are processed in the same manner for all steps from sample login through data release. The results are stored permanently in the National Water Data Storage and Retrieval System. During water year 1991, 86 analytical procedures were evaluated at the National Water Quality Laboratory and 37 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic (major ion and trace metal) constituent data for water year 1991 indicated analytical imprecision in the National Water Quality Laboratory for 5 of 67 analytical procedures: aluminum (whole-water recoverable, atomic emission spectrometric, direct-current plasma); calcium (atomic emission spectrometric, direct); fluoride (ion-exchange chromatographic); iron (whole-water recoverable, atomic absorption spectrometric, direct); and sulfate (ion-exchange chromatographic). The results for 11 of 67 analytical procedures had positive or negative bias during water year 1991. Analytical imprecision was indicated in the determination of two of the five National Water Quality Laboratory nutrient constituents: orthophosphate as phosphorus and

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.

International normalized ratio (INR) testing in Europe: between-laboratory comparability of test results obtained by Quick and Owren reagents.

PubMed

Meijer, Piet; Kynde, Karin; van den Besselaar, Antonius M H P; Van Blerk, Marjan; Woods, Timothy A L

2018-04-12

This study was designed to obtain an overview of the analytical quality of the prothrombin time, reported as international normalized ratio (INR) and to assess the variation of INR results between European laboratories, the difference between Quick-type and Owren-type methods and the effect of using local INR calibration or not. In addition, we assessed the variation in INR results obtained for a single donation in comparison with a pool of several plasmas. A set of four different lyophilized plasma samples were distributed via national EQA organizations to participating laboratories for INR measurement. Between-laboratory variation was lower in the Owren group than in the Quick group (on average: 6.7% vs. 8.1%, respectively). Differences in the mean INR value between the Owren and Quick group were relatively small (<0.20 INR). Between-laboratory variation was lower after local INR calibration (CV: 6.7% vs. 8.6%). For laboratories performing local calibration, the between-laboratory variation was quite similar for the Owren and Quick group (on average: 6.5% and 6.7%, respectively). Clinically significant differences in INR results (difference in INR>0.5) were observed between different reagents. No systematic significant differences in the between-laboratory variation for a single-plasma sample and a pooled plasma sample were observed. The comparability for laboratories using local calibration of their thromboplastin reagent is better than for laboratories not performing local calibration. Implementing local calibration is strongly recommended for the measurement of INR.

Mars Science Laboratory relative humidity observations: Initial results.

PubMed

Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, J A; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

2014-09-01

The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppmMSL relative humidity observation provides good dataHighest detected relative humidity reading during first MSL 100 sols is RH75.

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.

United States Medical Licensing Examination and American Board of Pediatrics Certification Examination Results: Does the Residency Program Contribute to Trainee Achievement.

PubMed

Welch, Thomas R; Olson, Brad G; Nelsen, Elizabeth; Beck Dallaghan, Gary L; Kennedy, Gloria A; Botash, Ann

2017-09-01

To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results. A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores. Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Improving laboratory results turnaround time by reducing pre analytical phase.

PubMed

Khalifa, Mohamed; Khalid, Parwaiz

2014-01-01

Laboratory turnaround time is considered one of the most important indicators of work efficiency in hospitals, physicians always need timely results to take effective clinical decisions especially in the emergency department where these results can guide physicians whether to admit patients to the hospital, discharge them home or do further investigations. A retrospective data analysis study was performed to identify the effects of ER and Lab staff training on new routines for sample collection and transportation on the pre-analytical phase of turnaround time. Renal profile tests requested by the ER and performed in 2013 has been selected as a sample, and data about 7,519 tests were retrieved and analyzed to compare turnaround time intervals before and after implementing new routines. Results showed significant time reduction on "Request to Sample Collection" and "Collection to In Lab Delivery" time intervals with less significant improvement on the analytical phase of the turnaround time.

Physical examination of swine.

PubMed

Masters, B J; Hamilton, M; Masters, P G

1992-07-01

Swine may be examined to evaluate a disease state or a lowered economic performance or as a herd health consultation. As much of the examination as possible should be performed without handling the animal. A thorough history, evaluation of herd records, environmental examination, and herd examination should be performed prior to the evaluation of an individual animal. All necessary equipment should be available when starting the individual examination. The animals is then restrained and examined, and necessary samples are taken. Post-mortem examinations or slaughter house evaluations are a very frequent part of a health examination on swine. All samples taken should be in accordance with the standards of the laboratory that you use. You should work closely with the laboratory to obtain the best results. Physical examination of swine can be rewarding for the veterinarian as well as the producer. The most important aspect to remember is to have enough information and the proper equipment available to handle the animals for the minimal amount of time to gain the maximum benefits. Vietnamese pot-bellied pigs are similar to domestic swine in terms of their diseases and health but are dissimilar in management; pot-bellied pigs are frequently brought to the veterinarian for individual examinations. History is the most valuable part of the examination, followed by observation. Pot-bellied pigs prefer to be held securely with a hand under the chin and rump. The examination is conducted similarly to the examination of any companion animal. Chemical restraint often is necessary for sampling or minor surgical procedures. Owners should be consulted prior to the use of any restraint. This will help win their approval and confidence when working on their pets. While performing the physical examination, look at the pig's overall health as well as specific breed characteristics. Try to stay abreast of swine vaccination recommendations; you may be consulted in this regard. Most

The Relationships between University Students' Chemistry Laboratory Anxiety, Attitudes, and Self-Efficacy Beliefs

ERIC Educational Resources Information Center

Kurbanoglu, N. Izzet; Akin, Ahmet

2010-01-01

The aim of this study is to examine the relationships between chemistry laboratory anxiety, chemistry attitudes, and self-efficacy. Participants were 395 university students. Participants completed the Chemistry Laboratory Anxiety Scale, the Chemistry Attitudes Scale, and the Self-efficacy Scale. Results showed that chemistry laboratory anxiety…

Restructuring the CS 1 classroom: Examining the effect of open laboratory-based classes vs. closed laboratory-based classes on Computer Science 1 students' achievement and attitudes toward computers and computer courses

NASA Astrophysics Data System (ADS)

Henderson, Jean Foster

The purpose of this study was to assess the effect of classroom restructuring involving computer laboratories on student achievement and student attitudes toward computers and computer courses. The effects of the targeted student attributes of gender, previous programming experience, math background, and learning style were also examined. The open lab-based class structure consisted of a traditional lecture class with a separate, unscheduled lab component in which lab assignments were completed outside of class; the closed lab-based class structure integrated a lab component within the lecture class so that half the class was reserved for lecture and half the class was reserved for students to complete lab assignments by working cooperatively with each other and under the supervision and guidance of the instructor. The sample consisted of 71 students enrolled in four intact classes of Computer Science I during the fall and spring semesters of the 2006--2007 school year at two southern universities: two classes were held in the fall (one at each university) and two classes were held in the spring (one at each university). A counterbalanced repeated measures design was used in which all students experienced both class structures for half of each semester. The order of control and treatment was rotated among the four classes. All students received the same amount of class and instructor time. A multivariate analysis of variance (MANOVA) via a multiple regression strategy was used to test the study's hypotheses. Although the overall MANOVA model was statistically significant, independent follow-up univariate analyses relative to each dependent measure found that the only significant research factor was math background: Students whose mathematics background was at the level of Calculus I or higher had significantly higher student achievement than students whose mathematics background was less than Calculus I. The results suggest that classroom structures that

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.

Performance of laboratories analysing welding fume on filter samples: results from the WASP proficiency testing scheme.

PubMed

Stacey, Peter; Butler, Owen

2008-06-01

This paper emphasizes the need for occupational hygiene professionals to require evidence of the quality of welding fume data from analytical laboratories. The measurement of metals in welding fume using atomic spectrometric techniques is a complex analysis often requiring specialist digestion procedures. The results from a trial programme testing the proficiency of laboratories in the Workplace Analysis Scheme for Proficiency (WASP) to measure potentially harmful metals in several different types of welding fume showed that most laboratories underestimated the mass of analyte on the filters. The average recovery was 70-80% of the target value and >20% of reported recoveries for some of the more difficult welding fume matrices were <50%. This level of under-reporting has significant implications for any health or hygiene studies of the exposure of welders to toxic metals for the types of fumes included in this study. Good laboratories' performance measuring spiked WASP filter samples containing soluble metal salts did not guarantee good performance when measuring the more complex welding fume trial filter samples. Consistent rather than erratic error predominated, suggesting that the main analytical factor contributing to the differences between the target values and results was the effectiveness of the sample preparation procedures used by participating laboratories. It is concluded that, with practice and regular participation in WASP, performance can improve over time.

LABORATORY AND FIELD RESULTS LINKING HIGH CONDUCTIVITIES TO THE MICROBIAL DEGRADATION OF PETROLEUM HYDROCARBONS

EPA Science Inventory

The results of a field and laboratory investigation of unconsolidated sediments contaminated by petroleum hydrocarbons and undergoing natural biodegradation are presented. Fundamental to geophysical investigations of hydrocarbon impacted sediments is the assessment of how microbi...

A Three-Year Feedback Study of a Remote Laboratory Used in Control Engineering Studies

ERIC Educational Resources Information Center

Chevalier, Amélie; Copot, Cosmin; Ionescu, Clara; De Keyser, Robin

2017-01-01

This paper discusses the results of a feedback study for a remote laboratory used in the education of control engineering students. The goal is to show the effectiveness of the remote laboratory on examination results. To provide an overview, the two applications of the remote laboratory are addressed: 1) the Stewart platform, and 2) the quadruple…

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…

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.

Laboratory test results for an airborne ASTER simulator

NASA Astrophysics Data System (ADS)

Ezaka, Teruya; Kannari, Yoshiaki; Mills, Franklin P.; Watanabe, Hiroshi; Sano, Masaharu; Chang, Sheng-Huei

1993-08-01

An airborne ASTER simulator (AAS) is being developed by the Geophysical Environmental Research Corporation (GER) to study land surface temperature and emittance in the thermal infrared. Laboratory tests in October 1992 at NASA's Stennis Space Center (SSC) measured the AAS's spectral, approximate NEdT, and approximate spatial response characteristics. The spectral FWHM for most channels is smaller than 0.3 micrometers ; the NEdT for most TIR channels is better than 0.4 K; and the nominal IFOV is 5 mrad. Flight data was collected over Cuprite and Goldfield, Nevada and near Valencia, California in November 1992. The silicified and opalized zones at Cuprite could be discriminated using decorrelation-stretch images. AAS decorrelation-stretch images agree, qualitatively, with data from NASA's thermal infrared mapping spectrometer (TIMS). These results indicate the AAS may be a good tool for remote sensing studies of geological materials. Lower noise detector arrays and linear variable (optical) filters for the TIR channels will be tested in flights over Cuprite, Nevada later this year. These and other improvements may reduce the NEdT and improve the signal-to-noise ratio.

Mars Science Laboratory relative humidity observations: Initial results

PubMed Central

Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, JA; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

2014-01-01

The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Key Points Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppm MSL relative humidity observation provides good data Highest detected relative humidity reading during first MSL 100 sols is RH75% PMID:26213667

Attachment Anxiety, Verbal Immediacy, and Blood Pressure: Results from a Laboratory-Analogue Study Following Marital Separation

PubMed Central

Lee, Lauren A.; Sbarra, David A.; Mason, Ashley E.; Law, Rita W.

2011-01-01

Marital separation and divorce increase risk for all-cause morbidity and mortality. Using a laboratory analogue paradigm, the present study examined attachment anxiety, language use, and blood pressure (BP) reactivity among 119 (n = 43 men, 76 women) recently separated adults who were asked to mentally reflect on their relationship history and separation experience. We created a language use composite of verbal immediacy from participants’ stream-of-consciousness recordings about their separation experience as a behavioral index of attachment-related hyperactivation. Verbal immediacy moderated the association between attachment anxiety and BP at the beginning of a divorce-specific activation task. Participants reporting high attachment anxiety who discussed their separation in a first-person, present-oriented and highly engaged manner evidenced the highest levels of BP at the start of the divorce-specific task. Results provide a deeper understanding of the association between marital dissolution and health and suggest that verbal immediacy may be a useful behavioral index of hyperactivating coping strategies. PMID:21647240

Attachment Anxiety, Verbal Immediacy, and Blood Pressure: Results from a Laboratory-Analogue Study Following Marital Separation.

PubMed

Lee, Lauren A; Sbarra, David A; Mason, Ashley E; Law, Rita W

2011-06-01

Marital separation and divorce increase risk for all-cause morbidity and mortality. Using a laboratory analogue paradigm, the present study examined attachment anxiety, language use, and blood pressure (BP) reactivity among 119 (n = 43 men, 76 women) recently separated adults who were asked to mentally reflect on their relationship history and separation experience. We created a language use composite of verbal immediacy from participants' stream-of-consciousness recordings about their separation experience as a behavioral index of attachment-related hyperactivation. Verbal immediacy moderated the association between attachment anxiety and BP at the beginning of a divorce-specific activation task. Participants reporting high attachment anxiety who discussed their separation in a first-person, present-oriented and highly engaged manner evidenced the highest levels of BP at the start of the divorce-specific task. Results provide a deeper understanding of the association between marital dissolution and health and suggest that verbal immediacy may be a useful behavioral index of hyperactivating coping strategies.

[Resistance of gonococci in the Netherlands; results of a survey of medical microbiology laboratories].

PubMed

van Loo, I H M; Spaargaren, J; van de Laar, M J W

2005-05-28

To collect information about the incidence ofgonorrhoea and gonococcal resistance in the Netherlands. A questionnaire was sent to 39 medical microbiology laboratories to obtain information on current diagnostics and the susceptibility testing method, and on the number of positive results and the susceptibility pattern of gonococcal isolates in 2002 and 2003 (up to and including November). 32 laboratories participated in this survey. 13 laboratories used culture alone and 19 laboratories used culture and/or a molecular test. Gonorrhoea was diagnosed 2,666 times in 2002 and 2,190 times in 2003, with an incidence of 33.5 and 27.0 per 100,000 inhabitants, respectively. The rate of resistance to beta-lactam antibiotics (penicillin and amoxicillin) was 12.2% and 10.7% in 2002 and 2003, respectively, and the rates of resistance to tetracycline were 18.5% and 20.6%. An increase in the resistance to quinolones was observed from 6.6% in 2002 to 9.5% in 2003. Resistance to cephalosporins was low (0.5% in 2002 and 1.2% in 2003). Furthermore, regional differences in susceptibility were found within the Netherlands. The observed gonococcal incidence and resistance form the basis for a gonorrhoea prevention and treatment programme in the Netherlands.

[Survey results of medical insurance reimbursement system for independent medical laboratories in Korea].

PubMed

Bae, Sook Young; Kwon, Jung Ah; Kim, Jang Su; Yoon, Soo Young; Lee, Chang Kyu; Lee, Kap No; Kim, Dae Won; Min, Won Ki; Cha, Young Joo; Chae, Seok Lae; Hwang, Yoo Sung

2007-04-01

A questionnaire survey was performed to perceive the problem of the current medical insurance reimbursement system for laboratory tests referred to independent medical laboratories; then, we intended to find a way to improve the reimbursement system. Questionnaires were distributed to 220 independent medical laboratories and 700 laboratory physicians from July through October 2005. Frequency analysis was used to analyse the replies from 109 respondents to 25 questionnaire items regarding the current medical insurance reimbursement system for referral tests, problems with the system, and suggestions for the improvement of the system. Among the 109 respondents to this survey, 49 (45.8%) considered the current reimbursement system to be unsatisfactory, while only 16 (15.0%) answered satisfactory. The problem was that the referral clinics-not the laboratories that performed the tests--would first receive their reimbursement for the laboratory tests from Health Insurance Review Agency (HIRA) and then give a portion of the laboratory test fees to the independent medical laboratories after the deduction of administrative fees. They (62.5% of the respondents) would prefer a separated reimbursement system by which the referral clinic-as well as the independent medical laboratory-would receive their reimbursement directly from HIRA through an Electronic Data Interchange (EDI) system. In this new system, 34% of the respondents expected the quality of the laboratory tests to be improved; however, 41.6% answered that the income of the referral clinic is expected to decrease. For the improvement of the medical insurance reimbursement system, the administrative fee for the referral clinic and the test fee for the independent medical laboratory should be reimbursed directly to the respective organizations. These changes could be made possible with the proper analysis of medical costs and the development of an effective EDI reimbursement system.

Validation of administrative and clinical case definitions for gestational diabetes mellitus against laboratory results.

PubMed

Bowker, S L; Savu, A; Donovan, L E; Johnson, J A; Kaul, P

2017-06-01

To examine the validity of International Classification of Disease, version 10 (ICD-10) codes for gestational diabetes mellitus in administrative databases (outpatient and inpatient), and in a clinical perinatal database (Alberta Perinatal Health Program), using laboratory data as the 'gold standard'. Women aged 12-54 years with in-hospital, singleton deliveries between 1 October 2008 and 31 March 2010 in Alberta, Canada were included in the study. A gestational diabetes diagnosis was defined in the laboratory data as ≥2 abnormal values on a 75-g oral glucose tolerance test or a 50-g glucose screen ≥10.3 mmol/l. Of 58 338 pregnancies, 2085 (3.6%) met gestational diabetes criteria based on laboratory data. The gestational diabetes rates in outpatient only, inpatient only, outpatient or inpatient combined, and Alberta Perinatal Health Program databases were 5.2% (3051), 4.8% (2791), 5.8% (3367) and 4.8% (2825), respectively. Although the outpatient or inpatient combined data achieved the highest sensitivity (92%) and specificity (97%), it was associated with a positive predictive value of only 57%. The majority of the false-positives (78%), however, had one abnormal value on oral glucose tolerance test, corresponding to a diagnosis of impaired glucose tolerance in pregnancy. The ICD-10 codes for gestational diabetes in administrative databases, especially when outpatient and inpatient databases are combined, can be used to reliably estimate the burden of the disease at the population level. Because impaired glucose tolerance in pregnancy and gestational diabetes may be managed similarly in clinical practice, impaired glucose tolerance in pregnancy is often coded as gestational diabetes. © 2016 Diabetes UK.

LABORATORY AND FIELD RESULTS LINKING HIGH CONDUCTIVITIES TO THE MICROBIAL DEGRADATION OF PETROLEUM HYDROCARBONS

EPA Science Inventory

The results of a l6-month field and l6-month meso-scale laboratory investigation of unconsolidated sandy environments contaminated by petroleum hydrocarbons that are undergoing natural biodegradation is presented. The purpose was to understand the processes responsible for causin...

RealTime Physics: Active learning laboratory

NASA Astrophysics Data System (ADS)

Thornton, Ronald K.; Sokoloff, David R.

1997-03-01

Our research shows that student learning of physics concepts in introductory physics courses is enhanced by the use of special guided discovery laboratory curricula which embody the results of educational research and which are supported by the use of the Tools for Scientific Thinking microcomputer-based laboratory (MBL) tools. In this paper we first describe the general characteristics of the research-based RealTime Physics laboratory curricula developed for use in introductory physics classes in colleges, universities and high schools. We then describe RealTime Physics Mechanics in detail. Finally we examine student learning of dynamics in traditional physics courses and in courses using RealTime Physics Mechanics, primarily by the use of correlated questions on the Force and Motion Conceptual Evaluation. We present considerable evidence that students who use the new laboratory curricula demonstrate significantly improved learning and retention of dynamics concepts compared to students taught by traditional methods.

Comprehensive Interpretation of the Laboratory Experiments Results to Construct Model of the Polish Shale Gas Rocks

NASA Astrophysics Data System (ADS)

Jarzyna, Jadwiga A.; Krakowska, Paulina I.; Puskarczyk, Edyta; Wawrzyniak-Guz, Kamila; Zych, Marcin

2018-03-01

More than 70 rock samples from so-called sweet spots, i.e. the Ordovician Sa Formation and Silurian Ja Member of Pa Formation from the Baltic Basin (North Poland) were examined in the laboratory to determine bulk and grain density, total and effective/dynamic porosity, absolute permeability, pore diameters size, total surface area, and natural radioactivity. Results of the pyrolysis, i.e., TOC (Total Organic Carbon) together with S1 and S2 - parameters used to determine the hydrocarbon generation potential of rocks, were also considered. Elemental composition from chemical analyses and mineral composition from XRD measurements were also included. SCAL analysis, NMR experiments, Pressure Decay Permeability measurements together with water immersion porosimetry and adsorption/ desorption of nitrogen vapors method were carried out along with the comprehensive interpretation of the outcomes. Simple and multiple linear statistical regressions were used to recognize mutual relationships between parameters. Observed correlations and in some cases big dispersion of data and discrepancies in the property values obtained from different methods were the basis for building shale gas rock model for well logging interpretation. The model was verified by the result of the Monte Carlo modelling of spectral neutron-gamma log response in comparison with GEM log results.

An Examination of Preservice Primary Teachers' Written Arguments in an Open Inquiry Laboratory Task

ERIC Educational Resources Information Center

McDonald, Christine V.

2013-01-01

This study assessed the quality of preservice primary teachers' written arguments in an open inquiry laboratory task. An analysis of the features of the laboratory task was also undertaken to ascertain the characteristics of the task that facilitated or constrained the development of participants' written arguments. Australian preservice primary…

Impact of a in situ laboratory on physician expectancy.

PubMed

Brulé, Romain; Sarazin, Marianne; Tayeb, Nicole; Roubille, Martine; Szymanowicz, Anton

2018-01-01

Biological examinations are essential for clinicians' medical care. The aim of this study is to assess clinicians' expectations in healthcare facilities and their perception of medical biology in different types of organization. We performed a prospective transversal study by electronic questionnaire conducted among 242 practitioners in four healthcare facilities. The aspects explored were as follows: quality, reliability, rendering time of examination results and biology platform support. Analyses were conducted after rectification of the sample by weight. Sixty one clinicians responded (25.2% [19.7-30.7]). The rendering time of examination is the main criterion mentioned with a requirement of less than one hour in case of emergency (81.5% [71.8-91.2] of the answers) to less than 72 hours for specialized examinations (81.5% [71.8-91.2] of the answers). Better collaboration with biologists is expected by clinicians (54.7% [50.9-58.5]). Satisfaction with the biology platform support and rendering time of emergency cases results was significantly (p <0.005) lower in facilities without an on-site laboratory. In conclusion, although medical biology performance is generally satisfactory within medical facilities, it remains nonetheless affected when the laboratory is not on site. The rendering time of examination, depending on the biology platform support functions and the proximity of the laboratory, remains the main criterion. Clinician-biologist collaboration, which increases of the medico-economic efficiency of patient's healthcare, appears as an essential criterion in a structural conception of medical biology.

46 CFR 162.039-5 - Recognized laboratory.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Recognized laboratory. (a) A recognized laboratory is one which is regularly engaged in the examination...' Laboratories, Inc., mailing address: Post Office Box 247, Northbrook, Ill., 60062. (2) [Reserved] (b) [Reserved] ...

46 CFR 162.039-5 - Recognized laboratory.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Recognized laboratory. (a) A recognized laboratory is one which is regularly engaged in the examination...' Laboratories, Inc., mailing address: Post Office Box 247, Northbrook, Ill., 60062. (2) [Reserved] (b) [Reserved] ...

46 CFR 162.039-5 - Recognized laboratory.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Recognized laboratory. (a) A recognized laboratory is one which is regularly engaged in the examination...' Laboratories, Inc., mailing address: Post Office Box 247, Northbrook, Ill., 60062. (2) [Reserved] (b) [Reserved] ...

46 CFR 162.039-5 - Recognized laboratory.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Recognized laboratory. (a) A recognized laboratory is one which is regularly engaged in the examination...' Laboratories, Inc., mailing address: Post Office Box 247, Northbrook, Ill., 60062. (2) [Reserved] (b) [Reserved] ...

46 CFR 162.039-5 - Recognized laboratory.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Recognized laboratory. (a) A recognized laboratory is one which is regularly engaged in the examination...' Laboratories, Inc., mailing address: Post Office Box 247, Northbrook, Ill., 60062. (2) [Reserved] (b) [Reserved] ...

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.

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

Relationship between Past Academic Performance and Results of Specialty In-Training Examinations.

ERIC Educational Resources Information Center

Ronai, Ann K.; And Others

1984-01-01

Records of 63 medical school graduates were examined for predictors of achievement on in-training examinations in anesthesia and orthopedic surgery. The previous academic records were found to contain little to predict examination results, and the correlation between college nonscience subjects and exam performance was negative. (Author/MSE)

Correspondence between maternal determination of child fullness and young children's self-determined fullness level: Results from a standardized laboratory protocol

USDA-ARS?s Scientific Manuscript database

This study examined maternal understanding and acceptance of young children's ability to self-assess fullness using a mixed-methods approach. Twenty low-income mothers of 5- to 7-year-olds participated in this semistructured laboratory study. After consumption of a buffet dinner meal, mothers were a...

Notification: Controls Over Results Produced by EPA Independent Laboratories

EPA Pesticide Factsheets

Project #OPE-FY16-0022, April 5, 2016. The EPA OIG plans to begin preliminary research on controls that the EPA’s Office of Land and Emergency Management’s Contract Laboratory Program (CLP) has in place to detect or prevent fraud.

The Contribution of a Virtual Biology Laboratory to College Students' Learning

ERIC Educational Resources Information Center

Swan, Aubrie E.; O'Donnell, Angela M.

2009-01-01

The virtual laboratories developed by a life sciences department at a public university in the US were designed for use by college students enrolled in an introductory biology course. The results analyses conducted to examine their effectiveness indicated that self-selected users of the virtual laboratories outperformed non-users on laboratory…

Determination of Passing Scores on Certification Examinations: An Unresolved Issue.

ERIC Educational Resources Information Center

Karni, Karen R.; Lofsness, Karen G.

1985-01-01

This study examined the results obtained from certification applicants and practitioners on a national certification examination for clinical laboratory scientists (medical technologists), using a modified Angoff procedure to establish the cut-off score. The major question of the investigation concerned whether the cut-off score was appropriate.…

Clinical examination results in individuals with functional ankle instability and ankle-sprain copers.

PubMed

Wright, Cynthia J; Arnold, Brent L; Ross, Scott E; Ketchum, Jessica; Ericksen, Jeffrey; Pidcoe, Peter

2013-01-01

Why some individuals with ankle sprains develop functional ankle instability and others do not (ie, copers) is unknown. Current understanding of the clinical profile of copers is limited. To contrast individuals with functional ankle instability (FAI), copers, and uninjured individuals on both self-reported variables and clinical examination findings. Cross-sectional study. Sports medicine research laboratory. Participants consisted of 23 individuals with a history of 1 or more ankle sprains and at least 2 episodes of giving way in the past year (FAI: Cumberland Ankle Instability Tool [CAIT] score = 20.52 ± 2.94, episodes of giving way = 5.8 ± 8.4 per month), 23 individuals with a history of a single ankle sprain and no subsequent episodes of instability (copers: CAIT score = 27.74 ± 1.69), and 23 individuals with no history of ankle sprain and no instability (uninjured: CAIT score = 28.78 ± 1.78). Self-reported disability was recorded using the CAIT and Foot and Ankle Ability Measure for Activities of Daily Living and for Sports. On clinical examination, ligamentous laxity and tenderness, range of motion (ROM), and pain at end ROM were recorded. Questionnaire scores for the CAIT, Foot and Ankle Ability Measure for Activities of Daily Living and for Sports, ankle inversion and anterior drawer laxity scores, pain with palpation of the lateral ligaments, ankle ROM, and pain at end ROM. Individuals with FAI had greater self-reported disability for all measures (P < .05). On clinical examination, individuals with FAI were more likely to have greater talar tilt laxity, pain with inversion, and limited sagittal-plane ROM than copers (P < .05). Differences in both self-reported disability and clinical examination variables distinguished individuals with FAI from copers at least 1 year after injury. Whether the deficits could be detected immediately postinjury to prospectively identify potential copers is unknown.

49 CFR 40.185 - Through what methods and to whom must a laboratory report split specimen results?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Through what methods and to whom must a laboratory... § 40.185 Through what methods and to whom must a laboratory report split specimen results? (a) As the... copy of the fully-completed Copy 1 of the CCF, which has been signed by the certifying scientist. (c...

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

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.

ABR Core examination preparation: results of a survey of fourth-year radiology residents who took the 2013 examination.

PubMed

Shetty, Anup S; Grajo, Joseph R; Decker, Summer; Heitkamp, Darel E; DeStigter, Kristen K; Mezwa, Duane G; Deitte, Lori

2015-01-01

A survey was administered to fourth-year radiology residents after receiving their results from the first American Board of Radiology (ABR) Core examination in 2013. The purpose was to gather information regarding resources and study strategies to share with program directors and future resident classes. An online survey was distributed to examinees nationwide. The survey included free-response and multiple choice questions that covered examination results, perceived value of enumerated study resources, case-based and didactic teaching conferences, board reviews, study materials for noninterpretive skills, multidisciplinary conference attendance, and free-form comments. Two hundred sixty-six of 1186 residents who took the Core examination responded to the survey. Some resources demonstrated a significant difference in perceived value between residents who passed the examination and residents who failed, including internal board reviews (1.10, P < .01), daily didactic conferences (1.51, P < .01), and daily case conferences (1.43, P < .01). Residents who passed reported that conferences and review sessions at their institutions were modified with multiple choice questions, audience response, and integration of clinical physics and patient safety topics compared to residents who failed. Radiology residents and residency programs have adapted their preparations for the ABR Core examination in a variety of ways. Certain practices and study tools, including daily conferences and internal board reviews, had greater perceived value by residents who passed the examination than by residents who failed. This survey provides insights that can be used to assess and modify current preparation strategies for the ABR Core examination. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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.

Laboratory Exercises to Teach Clinically Relevant Chemistry of Antibiotics

PubMed Central

Chelette, Candace T.

2014-01-01

Objectives. To design, implement, and evaluate student performance on clinically relevant chemical and spectral laboratory exercises on antibiotics. Design. In the first of 2 exercises, second-year pharmacy students enrolled in an integrated laboratory sequence course studied the aqueous stability of ß-lactam antibiotics using a spectral visual approach. In a second exercise, students studied the tendency of tetracycline, rifamycins, and fluoroquinolones to form insoluble chelate complexes (turbidity) with polyvalent metals. Assessment. On a survey to assess achievement of class learning objectives, students agreed the laboratory activities helped them better retain important information concerning antibiotic stability and interactions. A significant improvement was observed in performance on examination questions related to the laboratory topics for 2012 and 2013 students compared to 2011 students who did not complete the laboratory. A 1-year follow-up examination question administered in a separate course showed >75% of the students were able to identify rifamycins-food interactions compared with <25% of students who had not completed the laboratory exercises. Conclusion. The use of spectral visual approaches allowed students to investigate antibiotic stability and interactions, thus reinforcing the clinical relevance of medicinal chemistry. Students’ performance on questions at the 1-year follow-up suggested increased retention of the concepts learned as a result of completing the exercises. PMID:24672070

Laboratory exercises to teach clinically relevant chemistry of antibiotics.

PubMed

El Sayed, Khalid A; Chelette, Candace T

2014-03-12

To design, implement, and evaluate student performance on clinically relevant chemical and spectral laboratory exercises on antibiotics. In the first of 2 exercises, second-year pharmacy students enrolled in an integrated laboratory sequence course studied the aqueous stability of ß-lactam antibiotics using a spectral visual approach. In a second exercise, students studied the tendency of tetracycline, rifamycins, and fluoroquinolones to form insoluble chelate complexes (turbidity) with polyvalent metals. On a survey to assess achievement of class learning objectives, students agreed the laboratory activities helped them better retain important information concerning antibiotic stability and interactions. A significant improvement was observed in performance on examination questions related to the laboratory topics for 2012 and 2013 students compared to 2011 students who did not complete the laboratory. A 1-year follow-up examination question administered in a separate course showed >75% of the students were able to identify rifamycins-food interactions compared with <25% of students who had not completed the laboratory exercises. The use of spectral visual approaches allowed students to investigate antibiotic stability and interactions, thus reinforcing the clinical relevance of medicinal chemistry. Students' performance on questions at the 1-year follow-up suggested increased retention of the concepts learned as a result of completing the exercises.

FINAL ANALYTICAL RESULTS FROM THE EXAMINATION OF CORROSION ON SECTIONS OF CORROSION PROBE REMOVED FROM TANK 241-AN-107 ON 08/10/2006

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

DUNCAN JB; COOKE GA

2007-03-22

Tank Farms Operations removed an electrochemical noise probe from Tank 241-AN-107. In the field, the probe was cut into four sections, wrapped, and placed in a 55-gallon drum, This drum was delivered to the 222-S Laboratory. The 222 S Laboratory unpackaged the sections of the AN-107 electrochemical noise probe and examined the material for evidence of corrosion. Each of the four sections contained three C-ring and three bullet specimens. The specimens were examined for pitting corrosion, crevice corrosion, and stress corrosion cracking. No evidence of stress corrosion cracking was found in the stressed C-ring specimens. Minor pitting was evident onmore » some surfaces. Crevice corrosion was the dominant type of corrosion observed.« less

Providing critical laboratory results on time, every time to help reduce emergency department length of stay: how our laboratory achieved a Six Sigma level of performance.

PubMed

Blick, Kenneth E

2013-08-01

To develop a fully automated core laboratory, handling samples on a "first in, first out" real-time basis with Lean/Six Sigma management tools. Our primary goal was to provide services to critical care areas, eliminating turnaround time outlier percentage (TAT-OP) as a factor in patient length of stay (LOS). A secondary goal was to achieve a better laboratory return on investment. In 2011, we reached our primary goal when we calculated the TAT-OP distribution and found we had achieved a Six Sigma level of performance, ensuring that our laboratory service can be essentially eliminated as a factor in emergency department patient LOS. We also measured return on investment, showing a productivity improvement of 35%, keeping pace with our increased testing volume. As a result of our Lean process improvements and Six Sigma initiatives, in part through (1) strategic deployment of point-of-care testing and (2) core laboratory total automation with robotics, middleware, and expert system technology, physicians and nurses at the Oklahoma University Medical Center can more effectively deliver lifesaving health care using evidence-based protocols that depend heavily on "on time, every time" laboratory services.

TRUPACT-II 157 Examination Report

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

Barry H. O'Brien; Jeffrey M. Lacy; Kip E. Archibald

2003-12-01

This report presents the results of examination and recovery activities performed on the TRUPACT-II 157 shipping container. The container was part of a contact-handled transuranic waste shipment being transported on a truck to the Waste Isolation Pilot Plant in New Mexico when an accident occurred. Although the transport vehicle sustained only minor damage, airborne transuranic contamination was detected in air samples extracted from inside TRUPACT-II 157 at the Waste Isolation Pilot Plant. Consequently, the shipping container was rejected, resealed, and returned to the Idaho National Engineering and Environmental Laboratory where the payload was disassembled, examined, and recovered for subsequent reshipmentmore » to the Waste Isolation Pilot Plant. This report documents the results of those activities.« less

[Current biosafety in clinical laboratories in Japan: report of questionnaires' data obtained from clinical laboratory personnel in Japan].

PubMed

Goto, Mieko; Yamashita, Tomonari; Misawa, Shigeki; Komori, Toshiaki; Okuzumi, Katsuko; Takahashi, Takashi

2007-01-01

To determine the status of biosafety in clinical laboratories in Japan, we conducted a survey using questionnaires on the biosafety of laboratory personnel in 2004. We obtained data from 431 hospitals (response: 59.5%). Respondents were 301 institutions (70%) having biological safety cabinets (BSCs). BSCs were held in 78% of microbiological laboratories, 7.9% of genetic laboratories, 2.7% of histopathological laboratories, and 1% or less at other laboratories. A clean bench in examination rooms for acid-fast bacilli was applied at 20 hospitals. We found 28 cases of possible laboratory-associated tuberculosis infection, 25 of which were associated with lack of BSC. Other risk factors were immature skills and insufficiently skilled eguipment operation. The frequency of rupture accidents during specimen centrifugation was 67% in dealing with blood and 9.7% in collecting acid-fast bacilli. Half or more accidents were related to inadequate sample tube materials. Technologists were shown to be working on blood collection in many hospitals (75%), and 1,534 events of self-inflicted needle puncture developed in the last 5 years. These results suggest that biosafety systems are woefully lacking or inadequate in clinical laboratories in Japan and must be established at the earliest possible opportunity.

Examining High School Anatomy and Physiology Teacher Experience in a Cadaver Dissection Laboratory and Impacts on Practice

ERIC Educational Resources Information Center

Mattheis, Allison; Ingram, Debra; Jensen, Murray S.; Jackson, Jon

2015-01-01

This article describes the results of a study that investigated the experiences of a group of high school anatomy and physiology teachers who participated in a cadaver dissection laboratory workshop organized through a university-school partnership. Teacher feedback was collected before, during, and after the workshop through pre-arrival surveys,…

Initial experimental results from the Laboratory Biosphere closed ecological system facility

NASA Astrophysics Data System (ADS)

Alling, A.; Allen, J.; Dempster, W.; Nelson, M.; Silverstone, S.; van Thillo, M.

Results from the closure and initial closed ecological system research in the "Laboratory Biosphere" facility in Santa Fe, New Mexico (USA) will be presented. The facility was initially sealed in April 2002; and the first crop experiments with soybeans commenced in May 2002. The Laboratory Biosphere was created by the team which invented, built and operated Biosphere 2 during its years of closed ecological system functioning (1991-94) and is a testbed to build upon the lessons learned. It is an opportunity to continue experiments with a sustainable soil based agriculture system unlike most bioregenerative systems which use hydroponic systems dependent on a supply of nutrient solution. Because of the small volume of the system (34-45 m3), developing mechanisms to keep parameters like carbon dioxide within acceptable limits will be critical. Recycle of nutrients within the system to maintain soil fertility; and the ability of the inherent complex ecology of soils and a soil bed reactor to handle trace gas buildups are primary research goals. Other research goals are determination of short and long-term exchanges between soil, plants and atmosphere, especially for carbon dioxide, oxygen, nitrogen, NOX, and methane, impact of cultivation (tillage) on soil/atmospheric exchanges., investigation and development of strategies to return nutrients to the soil to maintain fertility, e.g. shredding biomass vs. composting, impact on soil chemistry of returning leachate water to the soil as irrigation water. The microbiological status of soils prior to experiments and over time will allow measurement of changes in microbial diversity and the determination of the role of soil microbes in biogeochemical cycles. Integration of automated sensor and control in the system with real-time modeling has importance for operation, research and educational outreach programs. The Laboratory Biosphere is intended to test and develop a "cybersphere" (network of shared intelligence) that may be

Harmonization of urine albumin/creatinine ratio (ACR) results: a study based on an external quality assessment program in Polish laboratories.

PubMed

Ćwiklińska, Agnieszka; Dąbrowska, Hanna; Kowalski, Robert; Kuchta, Agnieszka; Kortas-Stempak, Barbara; Fijałkowska, Aleksandra; Bednarczuk, Gabriela; Jankowski, Maciej

2018-05-11

The ratio of albumin to creatinine (ACR) is an important parameter used for detection of albuminuria in patients with early kidney damage. The aim of the study was to evaluate the harmonization of ACR results among Polish participants in an international external quality assessment (EQA) program, and to evaluate the impact of albumin and creatinine analytical performance on the harmonization of ACR results. We analyzed 182 results of albumin, 202 of creatinine, and 180 of ACR obtained from Polish laboratories in an EQA program organized by Labquality. The dispersion of the results in surveys and percentage differences between the results and target values were calculated. Moreover, differences between method groups were assessed. The inter-laboratory coefficient of variation (CV) for ACR was 36%. Only 74% of results of Polish laboratories were within the target limits; for 11% of the results, an incorrect albuminuria category would have been reported. The inter-laboratory CV for albumin was 20%, 2.6-fold higher than for creatinine. Significant differences between method groups for albumin determination have been observed, even when the same measurement technique was used. The greatest difference between two groups was 23%, 2.5-fold greater in comparison to creatinine. There is an insufficient harmonization of ACR values among Polish laboratories, caused mainly by urine albumin analytical performance. Given the important role of ACR in the classification, monitoring and treatment of kidney damage, the harmonization of albumin measurements is crucial and urgently needed.

Effective utilization of clinical laboratories.

PubMed

Murphy, J; Henry, J B

1978-11-01

Effective utilization of clinical laboratories requires that underutilization, overutilization, and malutilization be appreciated and eliminated or reduced. Optimal patient care service, although subjective to a major extent, is reflected in terms of outcome and cost. Increased per diem charges, reduced hospital stay, and increased laboratory workload over the past decade all require each laboratory to examine its internal operations to achieve economy and efficiency as well as maximal effectiveness. Increased research and development, an active managerial role on the part of pathologists, internal self-assessment, and an aggressive response to sophisticated scientific and clinical laboratory data base requirements are not only desirable but essential. The importance of undergraduate and graduate medical education in laboratory medicine to insure understanding as well as effective utilization is stressed. The costs and limitations as well as the accuracy, precision, sensitivity, specificity, and pitfalls of measurements and examinations must also be fully appreciated. Medical malpractice and defensive medicine and the use of critical values, emergency and routine services, and an active clinical role by the pathologist are of the utmost value in assuring effective utilization of the laboratory. A model for the optimal use of the laboratory including economy and efficiency has been achieved in the blood bank in regard to optimal hemotherapy for elective surgery, assuring superior patient care in a cost effective and safe manner.

Effect of Using Separate Laboratory and Lecture Courses for Introductory Crop Science on Student Performance.

ERIC Educational Resources Information Center

Wiebold, W. J.; Slaughter, Leon

1986-01-01

Reviews a study that examined the effects of laboratories on the grade performance of undergraduates in an introductory crop science course. Results indicated that students enrolled in lecture and laboratory concurrently did not receive higher lecture grades than students enrolled solely in lecture, but did have higher laboratory grades. (ML)

Quality Assessment of Urinary Stone Analysis: Results of a Multicenter Study of Laboratories in Europe

PubMed Central

Siener, Roswitha; Buchholz, Noor; Daudon, Michel; Hess, Bernhard; Knoll, Thomas; Osther, Palle J.; Reis-Santos, José; Sarica, Kemal; Traxer, Olivier; Trinchieri, Alberto

2016-01-01

After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction and chemical analysis. The aim of the present study was to assess the quality of urinary stone analysis of laboratories in Europe. Nine laboratories from eight European countries participated in six quality control surveys for urinary calculi analyses of the Reference Institute for Bioanalytics, Bonn, Germany, between 2010 and 2014. Each participant received the same blinded test samples for stone analysis. A total of 24 samples, comprising pure substances and mixtures of two or three components, were analysed. The evaluation of the quality of the laboratory in the present study was based on the attainment of 75% of the maximum total points, i.e. 99 points. The methods of stone analysis used were infrared spectroscopy (n = 7), chemical analysis (n = 1) and X-ray diffraction (n = 1). In the present study only 56% of the laboratories, four using infrared spectroscopy and one using X-ray diffraction, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis. PMID:27248840

Quality Assessment of Urinary Stone Analysis: Results of a Multicenter Study of Laboratories in Europe.

PubMed

Siener, Roswitha; Buchholz, Noor; Daudon, Michel; Hess, Bernhard; Knoll, Thomas; Osther, Palle J; Reis-Santos, José; Sarica, Kemal; Traxer, Olivier; Trinchieri, Alberto

2016-01-01

After stone removal, accurate analysis of urinary stone composition is the most crucial laboratory diagnostic procedure for the treatment and recurrence prevention in the stone-forming patient. The most common techniques for routine analysis of stones are infrared spectroscopy, X-ray diffraction and chemical analysis. The aim of the present study was to assess the quality of urinary stone analysis of laboratories in Europe. Nine laboratories from eight European countries participated in six quality control surveys for urinary calculi analyses of the Reference Institute for Bioanalytics, Bonn, Germany, between 2010 and 2014. Each participant received the same blinded test samples for stone analysis. A total of 24 samples, comprising pure substances and mixtures of two or three components, were analysed. The evaluation of the quality of the laboratory in the present study was based on the attainment of 75% of the maximum total points, i.e. 99 points. The methods of stone analysis used were infrared spectroscopy (n = 7), chemical analysis (n = 1) and X-ray diffraction (n = 1). In the present study only 56% of the laboratories, four using infrared spectroscopy and one using X-ray diffraction, fulfilled the quality requirements. According to the current standard, chemical analysis is considered to be insufficient for stone analysis, whereas infrared spectroscopy or X-ray diffraction is mandatory. However, the poor results of infrared spectroscopy highlight the importance of equipment, reference spectra and qualification of the staff for an accurate analysis of stone composition. Regular quality control is essential in carrying out routine stone analysis.

[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.

Students' motivation toward laboratory work in physiology teaching.

PubMed

Dohn, Niels Bonderup; Fago, Angela; Overgaard, Johannes; Madsen, Peter Teglberg; Malte, Hans

2016-09-01

The laboratory has been given a central role in physiology education, and teachers report that it is motivating for students to undertake experimental work on live animals or measuring physiological responses on the students themselves. Since motivation is a critical variable for academic learning and achievement, then we must concern ourselves with questions that examine how students engage in laboratory work and persist at such activities. The purpose of the present study was to investigate how laboratory work influences student motivation in physiology. We administered the Lab Motivation Scale to assess our students' levels of interest, willingness to engage (effort), and confidence in understanding (self-efficacy). We also asked students about the role of laboratory work for their own learning and their experience in the physiology laboratory. Our results documented high levels of interest, effort, and self-efficacy among the students. Correlation analyses were performed on the three motivation scales and exam results, yet a significant correlation was only found between self-efficacy in laboratory work and academic performance at the final exam. However, almost all students reported that laboratory work was very important for learning difficult concepts and physiological processes (e.g., action potential), as the hands-on experiences gave a more concrete idea of the learning content and made the content easier to remember. These results have implications for classroom practice as biology students find laboratory exercises highly motivating, despite their different personal interests and subject preferences. This highlights the importance of not replacing laboratory work by other nonpractical approaches, for example, video demonstrations or computer simulations. Copyright © 2016 The American Physiological Society.

49 CFR 40.105 - What happens if the laboratory reports a result different from that expected for a blind specimen?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.105 What happens if the laboratory reports a result different from that expected...

49 CFR 40.105 - What happens if the laboratory reports a result different from that expected for a blind specimen?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.105 What happens if the laboratory reports a result different from that expected...

49 CFR 40.105 - What happens if the laboratory reports a result different from that expected for a blind specimen?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.105 What happens if the laboratory reports a result different from that expected...

49 CFR 40.105 - What happens if the laboratory reports a result different from that expected for a blind specimen?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.105 What happens if the laboratory reports a result different from that expected...

49 CFR 40.105 - What happens if the laboratory reports a result different from that expected for a blind specimen?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.105 What happens if the laboratory reports a result different from that expected...

NASA Ames’ COSmIC Laboratory Astrophysics Facility: Recent Results and Progress

NASA Astrophysics Data System (ADS)

Salama, Farid; Sciamma-O'Brien, Ella; Bejaoui, Salma

2018-06-01

The COSmIC facility was developed at NASA Ames to study interstellar, circumstellar and planetary analogs in the laboratory [1, 2]. COSmIC stands for “Cosmic Simulation Chamber” and is dedicated to the study of molecules, ions and nanoparticles under the low temperature and high vacuum conditions that are required to simulate space environments. COSmIC integrates a variety of instruments that allow generating; processing and monitoring simulated space conditions in the laboratory. It is composed of a Pulsed Discharge Nozzle expansion that generates a plasma in a free supersonic jet expansion coupled to high-sensitivity, complementary in situ diagnostic tools, used for the detection and characterization of the species present in the expansion: a Cavity Ring Down Spectroscopy (CRDS) and fluorescence spectroscopy systems for photonic detection, and a Reflectron Time-Of-Flight Mass Spectrometer (ReTOF-MS) for mass detection [3, 4].Recent advances achieved in laboratory astrophysics using COSmIC will be presented, in particular in the domain of the diffuse interstellar bands (DIBs) [5, 6] and the monitoring, in the laboratory, of the formation of dust grains and aerosols from their gas-phase molecular precursors in environments as varied as circumstellar outflows [7] and planetary atmospheres [8, 9, 10]. Plans for future laboratory experiments on cosmic molecules and grains in the growing field of laboratory astrophysics (NIR-MIR CRDS, Laser Induced Fluorescence spectra of cosmic molecule analogs and the laser induced incandescence spectra of cosmic grain analogs) will also be addressed as well as the implications for astronomy.References: [1] Salama F., Proceed. IAU S251, Kwok & Sandford eds. CUP, 4, 357 (2008).[2] Salama F., et al., Proceed. IAU S332, Y. Aikawa, M. Cunningham, T. Millar, eds., CUP (2018)[3] Biennier L., et al., J. Chem. Phys., 118, 7863 (2003)[4] Ricketts C. et al. IJMS, 300, 26 (2011)[5] Salama F., et al., ApJ., 728, 154 (2011)[6] EDIBLES

Software Engineering Laboratory Ada performance study: Results and implications

NASA Technical Reports Server (NTRS)

Booth, Eric W.; Stark, Michael E.

1992-01-01

The SEL is an organization sponsored by NASA/GSFC to investigate the effectiveness of software engineering technologies applied to the development of applications software. The SEL was created in 1977 and has three organizational members: NASA/GSFC, Systems Development Branch; The University of Maryland, Computer Sciences Department; and Computer Sciences Corporation, Systems Development Operation. The goals of the SEL are as follows: (1) to understand the software development process in the GSFC environments; (2) to measure the effect of various methodologies, tools, and models on this process; and (3) to identify and then to apply successful development practices. The activities, findings, and recommendations of the SEL are recorded in the Software Engineering Laboratory Series, a continuing series of reports that include the Ada Performance Study Report. This paper describes the background of Ada in the Flight Dynamics Division (FDD), the objectives and scope of the Ada Performance Study, the measurement approach used, the performance tests performed, the major test results, and the implications for future FDD Ada development efforts.

Simplified Laboratory Procedures for Wastewater Examination. Second Edition.

ERIC Educational Resources Information Center

Water Pollution Control Federation, Washington, DC.

This booklet is for wastewater treatment plant operators who find it difficult to follow the detailed discussions and procedures found in "Standard Methods for the Examination of Water and Wastewater." It is intended to be used with "Standard Methods" available for reference. Included in this publication are chapters on…

Initial Experimental Results of a Laboratory Mini-Magnetosphere for Astronaut Protection

NASA Astrophysics Data System (ADS)

Bamford, R. A.; Bingham, R.; Gibson, K.; Thornton, A.; Bradford, J.; Hapgood, M.; Gargate, L.; Silva, L.; Norberg, C.; Todd, T.; Wilson, H.; Stamper, R.

2007-12-01

Radiation is a major scientific and technological challenge for manned missions to Mars. With an interplanetary flight time of months to years there is a high probability of Solar Energetic Particle events during the flight. Radiation damage to human tissue could result in acute sickness or death of the occupants of an unprotected spacecraft. Thus there is much interest in techniques to mitigate the effects of these events and of the exposure to cosmic rays. The experimental and modelling work presented here concerns one of several innovative "Active Shield" solutions being proposed [1]. The idea of generating an artificial magnetosphere to recreate the protective shield of the Earth's magnetic field for space craft travelling to the Moon or Mars was considered seriously in the 1960's during the Apollo era. With most of the space agencies around the world setting their sights returning to the Moon and then on to Mars, the idea of some sort of active field solution is experiencing a resurgence. Results from the laboratory experiment to determine the effectiveness of a mini-magnetosphere barrier to be able to expel a flowing energetic "solar wind" plasma will be presented. This is compared to a 3D hybrid simulation code that has been successfully compared to other astrophysical situations e.g. AMPTE artificial comet releases [2]. The experiment and modelling comparisons will demonstrate the scalability between the laboratory and astrophysical scale. [1] Adams, J.H. et al., "Revolutionary Concepts of Radiation Shielding for Human Exploration of Space", NASA/TM- 2005-213688, March 2005. [2] Gargate, L.; Bingham, R.; Fonseca, R. A.; Silva, L. O., "dHybrid: A massively parallel code for hybrid simulations of space plasmas", Computer Physics Communications, Volume 176, Issue 6, Pages 419-425, 15 March 2007, doi:10.1016/j.cpc.2006.11.013

Quality-assurance results for routine water analyses in U.S. Geological Survey laboratories, water year 1998

USGS Publications Warehouse

Ludtke, Amy S.; Woodworth, Mark T.; Marsh, Philip S.

2000-01-01

The U.S. Geological Survey operates a quality-assurance program based on the analyses of reference samples for two laboratories: the National Water Quality Laboratory and the Quality of Water Service Unit. Reference samples that contain selected inorganic, nutrient, and low-level constituents are prepared and submitted to the laboratory as disguised routine samples. The program goal is to estimate precision and bias for as many analytical methods offered by the participating laboratories as possible. Blind reference samples typically are submitted at a rate of 2 to 5 percent of the annual environmental-sample load for each constituent. The samples are distributed to the laboratories throughout the year. The reference samples are subject to the identical laboratory handling, processing, and analytical procedures as those applied to environmental samples and, therefore, have been used as an independent source to verify bias and precision of laboratory analytical methods and ambient water-quality measurements. The results are stored permanently in the National Water Information System and the Blind Sample Project's data base. During water year 1998, 95 analytical procedures were evaluated at the National Water Quality Laboratory and 63 analytical procedures were evaluated at the Quality of Water Service Unit. An overall evaluation of the inorganic and low-level constituent data for water year 1998 indicated 77 of 78 analytical procedures at the National Water Quality Laboratory met the criteria for precision. Silver (dissolved, inductively coupled plasma-mass spectrometry) was determined to be imprecise. Five of 78 analytical procedures showed bias throughout the range of reference samples: chromium (dissolved, inductively coupled plasma-atomic emission spectrometry), dissolved solids (dissolved, gravimetric), lithium (dissolved, inductively coupled plasma-atomic emission spectrometry), silver (dissolved, inductively coupled plasma-mass spectrometry), and zinc

[Trend survey of ocular infections with bacteria at Toyama University Hospital over the past six years--from the standpoint of laboratory examination].

PubMed

Kubota, Tomomi; Hayashi, Shirou; Niimi, Hideki; Kitajima, Isao

2012-07-01

Specimens of bacterial ocular infections are frequently received in the clinical laboratory. However, a comprehensive trend survey of ocular infections with bacteria is very rare. Our objective is to understand the current tendency of ocular infections with bacteria in patients at Toyama University Hospital from the standpoint of laboratory examination. We studied 263 cases of ocular infection with bacteria diagnosed at Toyama University Hospital from January 2006 to December 2011. 123 were male and 140 were female, with a mean age of 61.2(0-98) years. Specimens were subjected to direct microscopy and culture. Cultures were positive in 174(66.2%) patients. The most common bacterial isolate was Staphylococcus (28.1%), followed by Corynebacterium (19.3%), Streptococcus (9.3%), and Propionibacterium (8.6%). MRSA accounted for 18.8% of all S. aureus isolates, and has increased in recent years. The number of bacteria detected was larger in March, June, July, August, and October. Age distribution indicated that around 70% of bacterial isolates were detected from patients over 60 years old. The most common specimen of ocular infections with bacteria was eye discharge (detection rate; 87.8%), followed by corneal scraping(41%), aqueous humor (19%), and vitreous body (27%). Nearly 80% of bacterial isolates were detected from patients with keratitis, endophthalmitis, dacryocystitis, and conjunctivitis. As for the disease specific detection rate, endophthalmitis was very low (38.3%). The detection rate by years indicated that the way doctors pick up the specimens greatly affects the detection rate. Based on this survey, we need close cooperation with medical doctors concerning laboratory examination in ocular infection with bacteria, and we must improve the detection sensitivity of specimens from patients with endophthalmitis.

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.

Results from Sandia National Laboratories/Lockheed Martin Electromagnetic Missile Launcher (EMML).

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

Lockner, Thomas Ramsbeck; Skurdal, Ben; Gaigler, Randy

2005-05-01

Sandia national laboratories (SNL) and lockheed martin MS2 are designing an electromagnetic missile launcher (EMML) for naval applications. The EMML uses an induction coilgun topology with the requirement of launching a 3600 lb. missile up to a velocity of 40 m/s. To demonstrate the feasibility of the electromagnetic propulsion design, a demonstrator launcher was built that consists of approximately 10% of the propulsion coils needed for a tactical design. The demonstrator verified the design by launching a 1430 lb weighted sled to a height of 24 ft in mid-December 2004 (Figure 1). This paper provides the general launcher design, specificmore » pulsed power system component details, system operation, and demonstration results.« less

The role of total laboratory automation in a consolidated laboratory network.

PubMed

Seaberg, R S; Stallone, R O; Statland, B E

2000-05-01

In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies at all of its network hospitals, the North Shore-Long Island Health System recently established a Consolidated Laboratory Network with a Core Laboratory at its center. We established and implemented a centralized Core Laboratory designed around the Roche/Hitachi CLAS Total Laboratory Automation system to perform the general and esoteric laboratory testing throughout the system in a timely and cost-effective fashion. All remaining STAT testing will be performed within the Rapid Response Laboratories (RRLs) at each of the system's hospitals. Results for this laboratory consolidation and implementation effort demonstrated a decrease in labor costs and improved turnaround time (TAT) at the core laboratory. Anticipated system savings are approximately $2.7 million. TATs averaged 1.3 h within the Core Laboratory and less than 30 min in the RRLs. When properly implemented, automation systems can reduce overall laboratory expenses, enhance patient services, and address the overall concerns facing the laboratory today: job satisfaction, decreased length of stay, and safety. The financial savings realized are primarily a result of labor reductions.

Clinical laboratory sciences data transmission : the NPU coding system

PubMed Central

PONTET, Françoise; PETERSEN, Ulla MAGDAL; FUENTES-ARDERIU, Xavier; NORDIN, Gunnar; BRUUNSHUUS, Ivan; IHALAINEN, Jarkko; KARLSSON, Daniel; FORSUM, Urban; DYBKAER, René; SCHADOW, Gunther; KUELPMANN, Wolf; FÉRARD, Georges; KANG, Dongchon; McDONALD, Clement; HILL, Gilbert

2011-01-01

Introduction In health care services, technology requires that correct information be duly available to professionals, citizens and authorities, worldwide. Thus, clinical laboratory sciences require standardized electronic exchanges for results of laboratory examinations. Methods. The NPU (Nomenclature, Properties and Units) coding system provides a terminology for identification of result values (property values). It is structured according to BIPM, ISO, IUPAC and IFCC recommendations. It uses standard terms for established concepts and structured definitions describing: which part of the universe is examined, which component of relevance in that part, which kind-of-property is relevant. Unit and specifications can be added where relevant [System(spec) Component(spec); kind-of-property(spec) = ? unit]. Results. The English version of this terminology is freely accessible at http://dior.imt.liu.se/cnpu/ and http://www.labterm.dk, directly or through the IFCC and IUPAC websites. It has been nationally used for more than 10 years in Denmark and Sweden and has been translated into 6 other languages. Conclusions. The NPU coding system provides a terminology for dedicated kinds-of-property following the international recommendations. It fits well in the health network and is freely accessible. Clinical laboratory professionals worldwide will find many advantages in using the NPU coding system, notably with regards to an accreditation process. PMID:19745311

Components of laboratory accreditation.

PubMed

Royal, P D

1995-12-01

Accreditation or certification is a recognition given to an operation or product that has been evaluated against a standard; be it regulatory or voluntary. The purpose of accreditation is to provide the consumer with a level of confidence in the quality of operation (process) and the product of an organization. Environmental Protection Agency/OCM has proposed the development of an accreditation program under National Environmental Laboratory Accreditation Program for Good Laboratory Practice (GLP) laboratories as a supplement to the current program. This proposal was the result of the Inspector General Office reports that identified weaknesses in the current operation. Several accreditation programs can be evaluated and common components identified when proposing a structure for accrediting a GLP system. An understanding of these components is useful in building that structure. Internationally accepted accreditation programs provide a template for building a U.S. GLP accreditation program. This presentation will discuss the traditional structure of accreditation as presented in the Organization of Economic Cooperative Development/GLP program, ISO-9000 Accreditation and ISO/IEC Guide 25 Standard, and the Canadian Association for Environmental Analytical Laboratories, which has a biological component. Most accreditation programs are managed by a recognized third party, either privately or with government oversight. Common components often include a formal review of required credentials to evaluate organizational structure, a site visit to evaluate the facility, and a performance evaluation to assess technical competence. Laboratory performance is measured against written standards and scored. A formal report is then sent to the laboratory indicating accreditation status. Usually, there is a scheduled reevaluation built into the program. Fee structures vary considerably and will need to be examined closely when building a GLP program.

Laboratory investigation of lithium-bearing compounds for use in concrete.

DOT National Transportation Integrated Search

2002-06-01

Lithium nitrate and lithium hyroxide were evaluated in the laboratory to examine their effectiveness in controlling expansions resulting from alkali-silica reaction and their effect on concrete properties. The lithium compounds were more effective in...

Communication, Communication, Communication! Growth through Laboratory Instructing

ERIC Educational Resources Information Center

Peterson, Jamie J.; DeAngelo, Samantha; Mack, Nancy; Thompson, Claudia; Cooper, Jennifer; Sesma, Arturo, Jr.

2014-01-01

This study examined gains undergraduate students made in their communication and collaboration skills when they served as peer teachers, i.e., laboratory instructors (LIs), for a General Psychology laboratory. Self-ratings of communication and collaboration skills were completed before and after teaching the laboratory. When compared to before the…

Errors in clinical laboratories or errors in laboratory medicine?

PubMed

Plebani, Mario

2006-01-01

in pre- and post-examination steps must be minimized to guarantee the total quality of laboratory services.

Initial Results from the Bloomsburg University Goniometer Laboratory

NASA Technical Reports Server (NTRS)

Shepard, M. K.

2002-01-01

The Bloomsburg University Goniometer Laboratory (B.U.G. Lab) consists of three systems for studying the photometric properties of samples. The primary system is an automated goniometer capable of measuring the entire bi-directional reflectance distribution function (BRDF) of samples. Secondary systems include a reflectance spectrometer and digital video camera with macro zoom lens for characterizing and documenting other physical properties of measured samples. Works completed or in progress include the characterization of the BRDF of calibration surfaces for the 2003 Mars Exploration Rovers (MER03), Martian analog soils including JSC-Mars-1, and tests of photometric models.

AGR-1 Compact 1-3-1 Post-Irradiation Examination Results

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

Demkowicz, Paul Andrew

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance modeling, and fission product transport (INL 2015). A seriesmore » of fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously (Grover, Petti, and Maki 2010, Maki 2009).« less

AGR-1 Compact 5-3-1 Post-Irradiation Examination Results

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

Demkowicz, Paul; Harp, Jason; Winston, Phil

The Advanced Gas Reactor (AGR) Fuel Development and Qualification Program was established to perform the requisite research and development on tristructural isotropic (TRISO) coated particle fuel to support deployment of a high-temperature gas-cooled reactor (HTGR). The work continues as part of the Advanced Reactor Technologies (ART) TRISO Fuel program. The overarching program goal is to provide a baseline fuel qualification data set to support licensing and operation of an HTGR. To achieve these goals, the program includes the elements of fuel fabrication, irradiation, post-irradiation examination (PIE) and safety testing, fuel performance, and fission product transport (INL 2015). A series ofmore » fuel irradiation experiments is being planned and conducted in the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL). These experiments will provide data on fuel performance under irradiation, support fuel process development, qualify the fuel for normal operating conditions, provide irradiated fuel for safety testing, and support the development of fuel performance and fission product transport models. The first of these irradiation tests, designated AGR-1, began in the ATR in December 2006 and ended in November 2009. This experiment was conducted primarily to act as a shakedown test of the multicapsule test train design and provide early data on fuel performance for use in fuel fabrication process development. It also provided samples for post-irradiation safety testing, where fission product retention of the fuel at high temperatures will be experimentally measured. The capsule design and details of the AGR-1 experiment have been presented previously.« less

Mining the National Career Assessment Examination Result Using Clustering Algorithm

NASA Astrophysics Data System (ADS)

Pagudpud, M. V.; Palaoag, T. T.; Padirayon, L. M.

2018-03-01

Education is an essential process today which elicits authorities to discover and establish innovative strategies for educational improvement. This study applied data mining using clustering technique for knowledge extraction from the National Career Assessment Examination (NCAE) result in the Division of Quirino. The NCAE is an examination given to all grade 9 students in the Philippines to assess their aptitudes in the different domains. Clustering the students is helpful in identifying students’ learning considerations. With the use of the RapidMiner tool, clustering algorithms such as Density-Based Spatial Clustering of Applications with Noise (DBSCAN), k-means, k-medoid, expectation maximization clustering, and support vector clustering algorithms were analyzed. The silhouette indexes of the said clustering algorithms were compared, and the result showed that the k-means algorithm with k = 3 and silhouette index equal to 0.196 is the most appropriate clustering algorithm to group the students. Three groups were formed having 477 students in the determined group (cluster 0), 310 proficient students (cluster 1) and 396 developing students (cluster 2). The data mining technique used in this study is essential in extracting useful information from the NCAE result to better understand the abilities of students which in turn is a good basis for adopting teaching strategies.

Simulation and Laboratory results of the Hard X-ray Polarimeter: X-Calibur

NASA Astrophysics Data System (ADS)

Guo, Qingzhen; Beilicke, M.; Kislat, F.; Krawczynski, H.

2014-01-01

X-ray polarimetry promises to give qualitatively new information about high-energy sources, such as binary black hole (BH) systems, Microquasars, active galactic nuclei (AGN), GRBs, etc. We designed, built and tested a hard X-ray polarimeter 'X-Calibur' to be flown in the focal plane of the InFOCuS grazing incidence hard X-ray telescope in 2014. X-Calibur combines a low-Z Compton scatterer with a CZT detector assembly to measure the polarization of 20- 80 keV X-rays making use of the fact that polarized photons Compton scatter preferentially perpendicular to the E field orientation. X-Calibur achieves a high detection efficiency of order unity. We optimized of the design of the instrument based on Monte Carlo simulations of polarized and unpolarized X-ray beams and of the most important background components. We have calibrated and tested X-Calibur extensively in the laboratory at Washington University and at the Cornell High-Energy Synchrotron Source (CHESS). Measurements using the highly polarized synchrotron beam at CHESS confirm the polarization sensitivity of the instrument. In this talk we report on the optimization of the design of the instrument based on Monte Carlo simulations, as well as results of laboratory calibration measurements characterizing the performance of the instrument.

Spurious testosterone laboratory results in a patient taking synthetic alkaline phosphatase (asfotase alfa).

PubMed

Sofronescu, Alina G; Ross, Meredith; Rush, Eric; Goldner, Whitney

2018-04-27

We report a case of discordant total and free testosterone values in a patient with hypogonadism and juvenile hypophosphatasia after he initiated treatment with asfotase alfa, recombinant tissue non-specific alkaline phosphatase. Total testosterone was evaluated using immunoassay pre and post initiation of therapy with asfotase alfa, and free testosterone was evaluated using radioimmunoassay and LC-MS/MS while on asfotase alfa therapy. Total testosterone measured by immunoassay was normal prior to therapy with asfotase alfa, and was low post initiation of therapy. During the same time frame, free testosterone measured using RAI and total testosterone measured using LC-MS/MS were normal on asfotase alfa therapy. This suggests assay interference with the total testosterone immunoassay. When laboratory results are discordant or do not match the clinical impression, the possibility of assay interference should be considered. Alternative laboratory methods free of the interference should be selected to evaluate these patients. ALPL gene, Approved name: Alkaline phosphatase, liver/bone/kidney, Synonym: Tissue non-specific alkaline phosphatase (TNSAP). Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Influence of clinical and laboratory variables on faecal antigen ELISA results in dogs with canine parvovirus infection.

PubMed

Proksch, A L; Unterer, S; Speck, S; Truyen, U; Hartmann, K

2015-06-01

False negative faecal canine parvovirus (CPV) antigen ELISA results in dogs with CPV infection are common, but the factors that lead to these false negative results are still unknown. The aim of this study was to investigate whether dogs with a false negative faecal CPV antigen ELISA result have milder clinical signs and laboratory changes, a lower faecal virus load, higher faecal and serum CPV antibody titres and a faster recovery than dogs with a positive result. Eighty dogs with CPV infection, confirmed by the presence of clinical signs and a positive faecal CPV polymerase chain reaction (PCR), were assigned to two groups according to their faecal antigen ELISA result. Time until presentation, severity of symptoms, laboratory parameters, faecal virus load, faecal and serum antibody titres, and CPV sequencing data were compared between both groups. In 38/80 dogs that were hospitalised until recovery, the time to recovery, mortality, and the course of the disease were compared between dogs with positive and negative faecal antigen ELISA results. Of the 80 dogs included, 41 (51.3%) had a false negative faecal antigen ELISA result. ELISA-negative dogs had a significantly shorter time until presentation, lower frequency of defaecation, lower faecal virus load, and higher serum antibody concentrations than ELISA-positive dogs. Laboratory changes, CPV shedding, and outcomes were not associated with faecal antigen ELISA results. In conclusion, low faecal CPV load and antibodies binding to CPV antigen in faeces are likely to be important reasons for false negative faecal antigen ELISA results. Dogs with clinical signs of CPV infection should be retested by faecal PCR. Copyright © 2015 Elsevier Ltd. All rights reserved.

CUSUM-Logistic Regression analysis for the rapid detection of errors in clinical laboratory test results.

PubMed

Sampson, Maureen L; Gounden, Verena; van Deventer, Hendrik E; Remaley, Alan T

2016-02-01

The main drawback of the periodic analysis of quality control (QC) material is that test performance is not monitored in time periods between QC analyses, potentially leading to the reporting of faulty test results. The objective of this study was to develop a patient based QC procedure for the more timely detection of test errors. Results from a Chem-14 panel measured on the Beckman LX20 analyzer were used to develop the model. Each test result was predicted from the other 13 members of the panel by multiple regression, which resulted in correlation coefficients between the predicted and measured result of >0.7 for 8 of the 14 tests. A logistic regression model, which utilized the measured test result, the predicted test result, the day of the week and time of day, was then developed for predicting test errors. The output of the logistic regression was tallied by a daily CUSUM approach and used to predict test errors, with a fixed specificity of 90%. The mean average run length (ARL) before error detection by CUSUM-Logistic Regression (CSLR) was 20 with a mean sensitivity of 97%, which was considerably shorter than the mean ARL of 53 (sensitivity 87.5%) for a simple prediction model that only used the measured result for error detection. A CUSUM-Logistic Regression analysis of patient laboratory data can be an effective approach for the rapid and sensitive detection of clinical laboratory errors. Published by Elsevier Inc.

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)

How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia

PubMed Central

Widjanarko, Bagoes; Widyastari, Dyah Anantalia; Martini, Martini; Ginandjar, Praba

2016-01-01

Purpose Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians. Methods This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables. Results Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%–75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled. Conclusion Most of the laboratory technicians believed that they have an important role in TB patients’ treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program. PMID:27660502

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.

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.

Laboratory Demonstration of Axicon-Lens Coronagraph

NASA Astrophysics Data System (ADS)

Choi, Jaeho; Jea, Geonho

2018-01-01

The results of laboratory based experiments of the proposed coronagraph using axicon-lenses that is conjunction with a method of noninterferometric quantitative phase imaging for direct imaging of exoplanets is will present. The light source is passing through tiny holes drilled on the thin metal plate is used as the simulated stellar and its companions. Those diffracted light at the edge of the holes bears a similarity to the light from the bright stellar. Those images are evaginated about the optical axis after the maximum focal length of the first axicon lens. Then the evaginated images of have cut off using the motorized iris which means the suppressed the central stellar light preferentially. Various length between the holes which represent the angular distance are examined. The laboratory experimental results are shown that the axicon-lens coronagraph has feature of ability to achieve the smaller IWA than l/D and high-contrast direct imaging. The laboratory based axicon-lens coronagraph imaging support the symbolic computation results which has potential in direct imaging for finding exoplanet and various astrophysical activities. The setup of the coronagraph is simple to build and is durable to operate. Moreover it can be transported the planets images to a broadband spectrometric instrument that able to investigate the constituent of the planetary system.

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.

[Safety in the Microbiology laboratory].

PubMed

Rojo-Molinero, Estrella; Alados, Juan Carlos; de la Pedrosa, Elia Gómez G; Leiva, José; Pérez, José L

2015-01-01

The normal activity in the laboratory of microbiology poses different risks - mainly biological - that can affect the health of their workers, visitors and the community. Routine health examinations (surveillance and prevention), individual awareness of self-protection, hazard identification and risk assessment of laboratory procedures, the adoption of appropriate containment measures, and the use of conscientious microbiological techniques allow laboratory to be a safe place, as records of laboratory-acquired infections and accidents show. Training and information are the cornerstones for designing a comprehensive safety plan for the laboratory. In this article, the basic concepts and the theoretical background on laboratory safety are reviewed, including the main legal regulations. Moreover, practical guidelines are presented for each laboratory to design its own safety plan according its own particular characteristics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Current safety practices in nano-research laboratories in China.

PubMed

Zhang, Can; Zhang, Jing; Wang, Guoyu

2014-06-01

China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

Comparison of Estrogen Receptor Assay Results from Pathology Reports with Results from Central Laboratory Testing: Implications for Population-Based Studies of Breast Cancer

PubMed Central

Collins, LC; Marotti, J; Baer, HJ; Deitz, AC; Colditz, GA; Tamimi, RM

2014-01-01

Population-based studies of women with breast cancer commonly utilize information culled from pathology reports rather than central pathology review. The reliability of this information, particularly with regard to tumor biomarker results, is of concern. To address this, we evaluated the concordance between estrogen receptor (ER) results as determined from the original pathology reports and ER results obtained on the same specimens following testing in a single laboratory. Tissue microarrays (TMAs) were constructed from paraffin blocks of 3,167 breast cancers that developed in women enrolled in the Nurses’ Health Study. ER immunostains were performed on all TMA sections in single run. Results of ER immunostains performed on the TMA sections were compared with ER assay results abstracted from pathology reports. Among 1,851 cases of invasive breast cancer in which both ER results from pathology reports and central ER test results were available, the reported ER status and the ER status as determined from immunostains on TMAs were in agreement in 1,651 cases (87.3 %; kappa value 0.64, p<0.0001). When the comparison was restricted to ER assays originally performed by immunohistochemistry, the agreement rate increased to 92.3% (kappa value 0.78, p<0.0001). These results provide a framework for the accuracy of ER results abstracted from clinical records. Further, they suggest that utilizing ER assay results from pathology reports is a reasonable, albeit imperfect, alternative to central laboratory ER testing for large, population-based studies of patients with breast cancer. PMID:18230800

The Current State of Sustainability in Bioscience Laboratories: A Statistical Examination of a UK Tertiary Institute

ERIC Educational Resources Information Center

Wright, Hazel A.; Ironside, Joseph E.; Gwynn-Jones, Dylan

2008-01-01

Purpose: This study aims to identify the current barriers to sustainability in the bioscience laboratory setting and to determine which mechanisms are likely to increase sustainable behaviours in this specialised environment. Design/methodology/approach: The study gathers qualitative data from a sample of laboratory researchers presently…

Clinical laboratory sciences data transmission: the NPU coding system.

PubMed

Pontet, Françoise; Magdal Petersen, Ulla; Fuentes-Arderiu, Xavier; Nordin, Gunnar; Bruunshuus, Ivan; Ihalainen, Jarkko; Karlsson, Daniel; Forsum, Urban; Dybkaer, René; Schadow, Gunther; Kuelpmann, Wolf; Férard, Georges; Kang, Dongchon; McDonald, Clement; Hill, Gilbert

2009-01-01

In health care services, technology requires that correct information be duly available to professionals, citizens and authorities, worldwide. Thus, clinical laboratory sciences require standardized electronic exchanges for results of laboratory examinations. The NPU (Nomenclature, Properties and Units) coding system provides a terminology for identification of result values (property values). It is structured according to BIPM, ISO, IUPAC and IFCC recommendations. It uses standard terms for established concepts and structured definitions describing: which part of the universe is examined, which component of relevance in that part, which kind-of-property is relevant. Unit and specifications can be added where relevant [System(spec)-Component(spec); kind-of-property(spec) = ? unit]. The English version of this terminology is freely accessible at http://dior.imt.liu.se/cnpu/ and http://www.labterm.dk, directly or through the IFCC and IUPAC websites. It has been nationally used for more than 10 years in Denmark and Sweden and has been translated into 6 other languages. The NPU coding system provides a terminology for dedicated kinds-of-property following the international recommendations. It fits well in the health network and is freely accessible. Clinical laboratory professionals worldwide will find many advantages in using the NPU coding system, notably with regards to an accreditation process.

Los Alamos Scientific Laboratory energy-related history, research, managerial reorganization proposals, actions taken, and results. History report, 1945--1979

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

Hammel, E.F.

1997-03-01

This report documents the development of major energy-related programs at the Los Alamos Scientific Laboratory between 1945 and 1979. Although the Laboratory`s primary mission during that era was the design and development of nuclear weapons and most of the Laboratory`s funding came from a single source, a number of factors were at work that led to the development of these other programs. Some of those factors were affected by the Laboratory`s internal management structure and organization; others were the result of increasing environmental awareness within the general population and the political consequences of that awareness; still others were related tomore » the increasing demand for energy and the increasing turmoil in the energy-rich Middle East. This report also describes the various activities in Los Alamos, in Washington, and in other areas of the world that contributed to the development of major energy-related programs at Los Alamos. The author has a unique historical perspective because of his involvement as a scientist and manager at the Los Alamos Scientific Laboratory during the time period described within the report. In addition, in numerous footnotes and references, he cites a large body of documents that include the opinions and perspectives of many others who were involved at one time or another in these programs. Finally the report includes a detailed chronology of geopolitical events that led to the development of energy-related programs at Los Alamos.« less

Ink dating using thermal desorption and gas chromatography/mass spectrometry: comparison of results obtained in two laboratories.

PubMed

Koenig, Agnès; Bügler, Jürgen; Kirsch, Dieter; Köhler, Fritz; Weyermann, Céline

2015-01-01

An ink dating method based on solvent analysis was recently developed using thermal desorption followed by gas chromatography/mass spectrometry (GC/MS) and is currently implemented in several forensic laboratories. The main aims of this work were to implement this method in a new laboratory to evaluate whether results were comparable at three levels: (i) validation criteria, (ii) aging curves, and (iii) results interpretation. While the results were indeed comparable in terms of validation, the method proved to be very sensitive to maintenances. Moreover, the aging curves were influenced by ink composition, as well as storage conditions (particularly when the samples were not stored in "normal" room conditions). Finally, as current interpretation models showed limitations, an alternative model based on slope calculation was proposed. However, in the future, a probabilistic approach may represent a better solution to deal with ink sample inhomogeneity. © 2014 American Academy of Forensic Science.

Undergraduate Laboratory Module on Skin Diffusion

ERIC Educational Resources Information Center

Norman, James J.; Andrews, Samantha N.; Prausnitz, Mark R.

2011-01-01

To introduce students to an application of chemical engineering directly related to human health, we developed an experiment for the unit operations laboratory at Georgia Tech examining diffusion across cadaver skin in the context of transdermal drug delivery. In this laboratory module, students prepare mouse skin samples, set up diffusion cells…

[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.

Long term safety of methotrexate in routine clinical care: discontinuation is unusual and rarely the result of laboratory abnormalities

PubMed Central

Yazici, Y; Sokka, T; Kautiainen, H; Swearingen, C; Kulman, I; Pincus, T

2005-01-01

Objective: To analyse patients with rheumatoid arthritis, treated with methotrexate in a weekly academic rheumatology clinic over 13 years, for continuation of courses and reasons for discontinuation. Methods: All 248 patients with an analysable longitudinal course who took methotrexate in standard care between 1990 and 2003 were studied. Continuation of courses was analysed using life tables. All abnormal and severely abnormal values for aspartate aminotransferase (AST) >40 U/l, >80 U/l, albumin <35 g/l, <30 g/l, white blood cell (WBC) count <4.0x109/l, <3.0x109/l, and platelet count <150x109/l, <100x109/l, were identified. Responses of the clinician and subsequent laboratory values were reviewed. Results: Over 1007 person-years, the probability of continuing methotrexate over five years was 79% (95% confidence interval, 72% to 84%). Severe laboratory abnormalities occurred in 2.9 per 100 person-years, specifically 0.9 for AST >80 U/l, 1.1 for albumin <30 g/l, 0.7 for WBC <3.0x109/l, and 0.3 for platelets <100x109/l. No severe laboratory abnormality progressed to further severity or clinical disease. Permanent discontinuations of methotrexate occurred in 46 patients (19%), 26 (10% of all patients) for adverse effects, 15 (32.6%) for inefficacy; only two discontinuations resulted from laboratory abnormalities, both of WBC, possibly from other sources. Conclusions: Methotrexate was associated with a high rate of continuation, and few clinically significant laboratory abnormalities. Discontinuation primarily reflected clinical rather than laboratory findings. Vigilance for methotrexate toxicity is required but methotrexate appears among the safest treatments for rheumatoid arthritis. PMID:15208176

Examining Summer Laboratory Research Apprenticeships for High School Students as a Factor in Entry to MD/PhD Programs at Matriculation.

PubMed

Tai, Robert H; Kong, Xiaoqing; Mitchell, Claire E; Dabney, Katherine P; Read, Daniel M; Jeffe, Donna B; Andriole, Dorothy A; Wathington, Heather D

2017-01-01

Do summer laboratory research apprenticeships during high school have an impact on entry into MD/PhD programs? Apart from the nearly decade-long span of time between high school and matriculation into an MD/PhD program, young people have many life-shaping experiences that presumably impact their education and career trajectories. This quantitative study ( n = 236,432) examines the connection between early laboratory research apprenticeship experiences at the high school level and matriculation into one of the more rigorous educational programs for scientific research training. The span of time covered by this analysis reaches across more than a decade, examining the potential importance of research experiences during the precollege years in the educational trajectory of young people. Intertwined with this question on research experiences is a second major concern regarding diversity in the life sciences research corps. Diversity in this wide-ranging discipline refers specifically to the underrepresentation of Blacks/African Americans, Hispanics/Latino/as, and American Indians/Alaska Natives among the ranks of research scientists. Thus, this study includes analyses that specifically focus on research apprenticeships of Blacks/African Americans and Hispanics/Latino/as and their entrance into MD/PhD programs. © 2017 R. H. Tai et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Physiology Laboratories Quantifying Gas Exchange in Health and Disease.

ERIC Educational Resources Information Center

Olson, L. E.

1985-01-01

Describes two quantitatively-oriented physiology laboratories for veterinary students. The laboratory exercises incorporate the procedures of radiology and physical examination with measurement of pulmonary function. Specific laboratory objectives, procedures and equipment needed for diagnoses of the pathologies are listed. (ML)

Public health consequences of a false-positive laboratory test result for Brucella--Florida, Georgia, and Michigan, 2005.

PubMed

2008-06-06

Human brucellosis, a nationally notifiable disease, is uncommon in the United States. Most human cases have occurred in returned travelers or immigrants from regions where brucellosis is endemic, or were acquired domestically from eating illegally imported, unpasteurized fresh cheeses. In January 2005, a woman aged 35 years who lived in Nassau County, Florida, received a diagnosis of brucellosis, based on results of a Brucella immunoglobulin M (IgM) enzyme immunoassay (EIA) performed in a commercial laboratory using analyte specific reagents (ASRs); this diagnosis prompted an investigation of dairy products in two other states. Subsequent confirmatory antibody testing by Brucella microagglutination test (BMAT) performed at CDC on the patient's serum was negative. The case did not meet the CDC/Council of State and Territorial Epidemiologists' (CSTE) definition for a probable or confirmed brucellosis case, and the initial EIA result was determined to be a false positive. This report summarizes the case history, laboratory findings, and public health investigations. CDC recommends that Brucella serology testing only be performed using tests cleared or approved by the Food and Drug Administration (FDA) or validated under the Clinical Laboratory Improvement Amendments (CLIA) and shown to reliably detect the presence of Brucella infection. Results from these tests should be considered supportive evidence for recent infection only and interpreted in the context of a clinically compatible illness and exposure history. EIA is not considered a confirmatory Brucella antibody test; positive screening test results should be confirmed by Brucella-specific agglutination (i.e., BMAT or standard tube agglutination test) methods.

Diesel and CNG Transit Bus Emissions Characterization By Two Chassis Dynamometer Laboratories: Results and Issues

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

Nigel N. Clark, Mridul Gautam; Byron L. Rapp; Donald W. Lyons

1999-05-03

Emissions of six 32 passenger transit buses were characterized using one of the West Virginia University (WVU) Transportable Heavy Duty Emissions Testing Laboratories, and the fixed base chassis dynamometer at the Colorado Institute for Fuels and High Altitude Engine Research (CIFHAER). Three of the buses were powered with 1997 ISB 5.9 liter Cummins diesel engines, and three were powered with the 1997 5.9 liter Cummins natural gas (NG) counterpart. The NG engines were LEV certified. Objectives were to contrast the emissions performance of the diesel and NG units, and to compare results from the two laboratories. Both laboratories found thatmore » oxides of nitrogen and particulate matter (PM) emissions were substantially lower for the natural gas buses than for the diesel buses. It was observed that by varying the rapidity of pedal movement during accelerations in the Central Business District cycle (CBD), CO and PM emissions from the diesel buses could be varied by a factor of three or more. The driving styles may be characterized as aggressive and non-aggressive, but both styles followed the CBD speed command acceptably. PM emissions were far higher for the aggressive driving style. For the NG fueled vehicles driving style had a similar, although smaller, effect on NO{sub x}. It is evident that driver habits may cause substantial deviation in emissions for the CBD cycle. When the CO emissions are used as a surrogate for driver aggression, a regression analysis shows that NO{sub x} and PM emissions from the two laboratories agree closely for equivalent driving style. Implications of driver habit for emissions inventories and regulations are briefly considered.« less

Correspondence between Maternal Determination of Child Fullness and Young Children's Self-Determined Fullness Level: Results from a Standardized Laboratory Protocol

PubMed Central

Thompson, Debbe; Power, Thomas G.; Hughes, Sheryl O.

2015-01-01

Abstract Background: This study examined maternal understanding and acceptance of young children's ability to self-assess fullness using a mixed-methods approach. Methods: Twenty low-income mothers of 5- to 7-year-olds participated in this semistructured laboratory study. After consumption of a buffet dinner meal, mothers were asked to indicate their perception of their child's fullness level, and children were also asked to self-assess their fullness level. Results: Five of the 20 mothers in the study were initially correct in their assessment of their child's level of fullness. Half of the incorrect mothers were willing to change their rating when informed that the child's fullness rating was different than her own. Conclusions: Semistructured interview results provide suggestive evidence that some mothers believe they understand their child's fullness level better than their children. Given that mothers have the potential to override children's ability to self-regulate eating behavior, teaching mothers to understand and appreciate young children's ability to self-regulate eating is an important area for intervention. PMID:25692707

Standardization of glycohemoglobin results and reference values in whole blood studied in 103 laboratories using 20 methods.

PubMed

Weykamp, C W; Penders, T J; Miedema, K; Muskiet, F A; van der Slik, W

1995-01-01

We investigated the effect of calibration with lyophilized calibrators on whole-blood glycohemoglobin (glyHb) results. One hundred three laboratories, using 20 different methods, determined glyHb in two lyophilized calibrators and two whole-blood samples. For whole-blood samples with low (5%) and high (9%) glyHb percentages, respectively, calibration decreased overall interlaboratory variation (CV) from 16% to 9% and from 11% to 6% and decreased intermethod variation from 14% to 6% and from 12% to 5%. Forty-seven laboratories, using 14 different methods, determined mean glyHb percentages in self-selected groups of 10 nondiabetic volunteers each. With calibration their overall mean (2SD) was 5.0% (0.5%), very close to the 5.0% (0.3%) derived from the reference method used in the Diabetes Control and Complications Trial. In both experiments the Abbott IMx and Vision showed deviating results. We conclude that, irrespective of the analytical method used, calibration enables standardization of glyHb results, reference values, and interpretation criteria.

Dr. Grant Heikan examines lunar material in sieve from sample container

NASA Technical Reports Server (NTRS)

1969-01-01

Dr. Grant Heikan, Manned Spacecraft Center and a Lunar Sample preliminary Examination Team member, examines lunar material in a sieve from the bulk sample container which was opened in the Biopreparation Laboratory of the Lunar Receiving Laboratory.

Laboratory Information Management Systems for Forensic Laboratories: A White Paper for Directors and Decision Makers

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

Anthony Hendrickson; Brian Mennecke; Kevin Scheibe

2005-10-01

Modern, forensics laboratories need Laboratory Information Management Systems (LIMS) implementations that allow the lab to track evidentiary items through their examination lifecycle and also serve all pertinent laboratory personnel. The research presented here presents LIMS core requirements as viewed by respondents serving in different forensic laboratory capacities as well as different forensic laboratory environments. A product-development methodology was employed to evaluate the relative value of the key features that constitute a LIMS, in order to develop a set of relative values for these features and the specifics of their implementation. In addition to the results of the product development analysis,more » this paper also provides an extensive review of LIMS and provides an overview of the preparation and planning process for the successful upgrade or implementation of a LIMS. Analysis of the data indicate that the relative value of LIMS components are viewed differently depending upon respondents' job roles (i.e., evidence technicians, scientists, and lab management), as well as by laboratory size. Specifically, the data show that: (1) Evidence technicians place the most value on chain of evidence capabilities and on chain of custody tracking; (2) Scientists generally place greatest value on report writing and generation, and on tracking daughter evidence that develops during their analyses; (3) Lab. Managers place the greatest value on chain of custody, daughter evidence, and not surprisingly, management reporting capabilities; and (4) Lab size affects LIMS preference in that, while all labs place daughter evidence tracking, chain of custody, and management and analyst report generation as their top three priorities, the order of this prioritization is size dependent.« less

Certification standards transfer: from committee to laboratory.

PubMed

Lehmann, H P

1998-12-01

The ISO 9000 Standards series were developed to provide the international manufacturing industry with a framework to ensure purchased products meet quality criteria. Section 4 of ISO 9001, Quality System Model for Quality Assurance in Design, Development, Production, Installation and Servicing, contains 20 aspects of a quality system that must be addressed by an organization in order to receive ISO 9001 certification. This concept is extended to the clinical laboratory, where a quality system program establishes for the customer (patient/clinician) that the purchased product (requested information on a submitted specimen-test result) meets established quality norms. In order to satisfy the customer, the providing organization must have policies and procedures in place that ensure a quality product, and be certified. To become certified the organization must, through an inspection process, demonstrate to an independent accrediting agency that it meets defined standards. In the United States, the government through the Clinical Laboratory Improvement Amendment (CLIA) 1988 established quality standards for the clinical laboratory. The College of American Pathologists (CAP), through its Laboratory Accreditation Program (LAP), serves as an independent agency that certifies that laboratories meet standards. To demonstrate the applicability of an established clinical laboratory accreditation program to ISO 9001 certification, the standards and checklists of CLIA 1988 and the CAP LAP will be examined to determine their conformance to ISO 9001, Section 4.

Resitting or Compensating a Failed Examination: Does It Affect Subsequent Results?

ERIC Educational Resources Information Center

Arnold, Ivo

2017-01-01

Institutions of higher education commonly employ a conjunctive standard setting strategy, which requires students to resit failed examinations until they pass all tests. An alternative strategy allows students to compensate a failing grade with other test results. This paper uses regression discontinuity design to compare the effect of first-year…

How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia.

PubMed

Widjanarko, Bagoes; Widyastari, Dyah Anantalia; Martini, Martini; Ginandjar, Praba

2016-01-01

Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians. This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables. Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%-75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled. Most of the laboratory technicians believed that they have an important role in TB patients' treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program.

Survey of Forensic Document Examination Habit Areas: Degree of Use and Discriminatory Power

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

G Sperry; PA Manzolillo; RC Hanlan

Beginning in 1998, the Pacific Northwest National Laboratory (PNL), US Postal Inspection Service Forensic Laboratory (USPIS), and the Data Fusion Laboratory, Drexel University (DFL) have been collaborating on a large scale research project ''Handwriting Individuality--Moving From Art to Science''. In April 1998 a survey was distributed to the community of forensic document examiners (FDEs) requesting input on the habit areas used and their utility in distinguishing handwriting. The information obtained from this survey was intended to provide the data necessary to select the criteria and begin the evaluation of the handwriting samples currently in the project. Preliminary results of themore » survey were made available to the community at the American Society of Questioned Document Examiners (ASQDE) meeting in August 1998 and the American Academy of Forensic Sciences (AAFS) meeting in February 1999. This report provides final documentation of the survey and its results. This survey has two objectives: (1) to compile a list of handwriting features and characteristics used by professional forensic document examiners in the examination and comparison of handwriting and (2) to gather information about the significance of these features and characteristics. These objectives are met by having the FDEs provide an indication of their experience in the frequency of habit area evaluation and the utility of the habit area for discrimination.« less

[Computer optical topography: a study of the repeatability of the results of human body model examination].

PubMed

Sarnadskiĭ, V N

2007-01-01

The problem of repeatability of the results of examination of a plastic human body model is considered. The model was examined in 7 positions using an optical topograph for kyphosis diagnosis. The examination was performed under television camera monitoring. It was shown that variation of the model position in the camera view affected the repeatability of the results of topographic examination, especially if the model-to-camera distance was changed. A study of the repeatability of the results of optical topographic examination can help to increase the reliability of the topographic method, which is widely used for medical screening of children and adolescents.

NASA's Atmospheric Effects of Aviation Project: Results of the August 1999 Aerosol Measurement Intercomparison Workshop, Laboratory Phase

NASA Technical Reports Server (NTRS)

Cofer, W. Randy, III; Anderson, Bruce E.; Connors, V. S.; Wey, C. C.; Sanders, T.; Twohy, C.; Brock, C. A.; Winstead, E. L.; Pui, D.; Chen, Da-Ren

2001-01-01

During August 1-14, 1999, NASA's Atmospheric Effects of Aviation Project (AEAP) convened a workshop at the NASA Langley Research Center to try to determine why such a wide variation in aerosol emissions indices and chemical and physical properties have been reported by various independent AEAP-supported research teams trying to characterize the exhaust emissions of subsonic commercial aircraft. This workshop was divided into two phases, a laboratory phase and a field phase. The laboratory phase consisted of supplying known particle number densities (concentrations) and particle size distributions to a common manifold for the participating research teams to sample and analyze. The field phase was conducted on an aircraft run-up pad. Participating teams actually sampled aircraft exhaust generated by a Langley T-38 Talon aircraft at 1 and 9 m behind the engine at engine powers ranging from 48 to 100 percent. Results from the laboratory phase of this intercomparison workshop are reported in this paper.

Detection of Pathogenic Protozoa in the Diagnostic Laboratory: Result Reproducibility, Specimen Pooling, and Competency Assessment▿

PubMed Central

Libman, M. D.; Gyorkos, T. W.; Kokoskin, E.; MacLean, J. D.

2008-01-01

Stool microscopy as performed in clinical parasitology laboratories is a complex procedure with subjective interpretation. Quality assurance (QA) programs often emphasize proficiency testing as an assessment tool. We describe a result reproducibility assessment tool, which can form part of a broader QA program, and which is based on the blinded resubmission of selected clinical samples, using concordance between the reports of the initial and resubmitted specimen as an indicator. Specimens preserved in sodium acetate-acetic acid-formalin can be stored for several months for use in such a program. The presence of multiple protozoa in one specimen does not affect concordance. Some dilution of specimens occurs in this process, and this may explain poor concordance when specimens with low protozoal concentrations are resubmitted. Evaluation of this tool in a large parasitology laboratory revealed concordance rates for pathogenic protozoa (Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Dientamoeba fragilis) of about 80%, which may be considered for use as a benchmark value. We also used this tool to demonstrate that when pairs of specimens from one patient are pooled to create a single specimen, concordance between the results of the individual and pooled specimens is high. PMID:18448690

Laboratory Measurement Implications of Decreasing Childhood Blood Lead Levels

PubMed Central

Caldwell, Kathleen L.; Cheng, Po-Yung; Jarrett, Jeffery M.; Makhmudov, Amir; Vance, Kathryn; Ward, Cynthia D.; Jones, Robert L.; Mortensen, Mary E.

2017-01-01

In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLL) in children one to five years old from 2007–2010 National Health and Nutrition Examination Survey (NHANES) data. We calculated and updated selected percentiles, including the 97.5th percentile, using NHANES 2011–2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5% percentile BLL of 3.48 μg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤ 5 μg/dL. Review of five years of results for target blood lead values < 11 μg/dL for U.S. clinical laboratories participating in CDC’s voluntary Lead and Multi-Element Proficiency (LAMP) quality assurance program showed 40% unable to quantify and reported a non-detectable result at a target blood lead value of 1.48 μg/dL compared 5.5 % at a target blood lead of 4.60 μg/dL. We describe actions taken at CDC’s Environmental Health Laboratory in the Division of Laboratory Sciences, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis. PMID:28771411

Large-scale laboratory observations of wave forces on a highway bridge superstructure.

DOT National Transportation Integrated Search

2011-10-01

The experimental setup and data are presented for a laboratory experiment conducted to examine realistic wave forcing on a highway bridge : superstructure. The experiments measure wave conditions along with the resulting forces, pressures, and struct...

High variability in results of semen analysis in andrology laboratories in Tuscany (Italy): the experience of an external quality control (EQC) programme.

PubMed

Filimberti, E; Degl'Innocenti, S; Borsotti, M; Quercioli, M; Piomboni, P; Natali, I; Fino, M G; Caglieresi, C; Criscuoli, L; Gandini, L; Biggeri, A; Maggi, M; Baldi, E

2013-05-01

We report the results of the first three trials of an external quality control (EQC) programme performed in 71 laboratories executing semen analysis in Tuscany Region (Italy). At the end of the second trial, participants were invited to attend a teaching course illustrating and inviting to adhere to procedures recommended by WHO (V edition). Results of the first three trials of the EQC documented a huge variability in the procedures and the results. The highest variability was found for morphology (CV above 80% for all the trials), followed by count (CV of about 60% for all the trials) and motility (CV below 30% for all the trials). When results of sperm count and morphology were divided according to the used method, mean CV values did not show significant differences. CV for morphology dropped significantly at the third trial for most methods, indicating the usefulness of the teaching course for morphology assessment. Conversely, no differences were observed after the course for motility and for most methods to evaluate count, although CV values were lower at the second and third trial for the laboratories using the Burker cytometer. When results were divided according to tertiles of activity, the lowest mean bias values (difference between each laboratory result and the median value of the results) for count and morphology were observed for laboratories in the third tertile (performing over 200 semen analysis/year). Of interest, mean bias values for concentration dropped significantly at the third trial for low activity laboratories. In conclusion, lack of agreement of results of semen analysis in Tuscany is mainly because of the activity and the experience of the laboratory. Our study points out the importance of participating in EQC programmes and periodical teaching courses as well as the use of WHO recommended standardized procedures to increase precision and to allow the use of WHO reference values. © 2013 American Society of Andrology and European Academy

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories.

PubMed

Frey, Jodi Jacobson; Osteen, Philip J; Berglund, Patricia A; Jinnett, Kimberly; Ko, Jungyai

2015-04-01

Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. The Health and Work Performance Questionnaire-Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

Sensitisation to Aspergillus fumigatus and Penicillium notatum in laboratory workers.

PubMed

Boscolo, P; Piccolomini, R; Benvenuti, F; Catamo, G; Di Gioacchino, M

1999-01-01

Four workers in medical research laboratories, located in a basement level of a University facility equipped with a humidified air conditioning system, complained of cough and/or asthma and/or rhinitis during their normal working activities. Since exposure to toxic compounds was very low (similar to that of the outdoor environment) only microbiological monitoring was performed. Aspergillus fumigatus and Penicillium notatum were found in some laboratories. Eight laboratory workers (including the 4 symptomatic subjects) out of 26 investigated were found to be atopic. Specific IgE sensitisation to Aspergillus fumigatus was found in the 8 atopic and in the 6 non-atopic workers, while Penicililum notatum was found in 7 atopic and 4 non-atopic subjects. History, physical examination and laboratory data excluded the presence of aspergillosis or allergic bronchial aspergillosis in the sensitised subjects. Our results suggest that evaluation of immune parameters, along with monitoring of the working environment, may reduce the risk of sensitisation and/or allergic symptoms in atopic laboratory workers.

US Highway 84 chip seal field trials and laboratory test results.

DOT National Transportation Integrated Search

2009-03-23

This report contains laboratory and field testing of US Highway 84 in Lincoln county Mississippi. A full scale field test consisting of seven polymer modified asphalt emulsions and a CRS-2 control emulsion was constructed in September of 1989 and sub...

An international marine-atmospheric {sup 222}Rn measurement intercomparison in Bermuda. Part 2: Results for the participating laboratories

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

Colle, R.; Unterweger, M.P.; Hutchinson, J.M.R.

1996-01-01

As part of an international measurement intercomparison of instruments used to measure atmospheric {sup 222}Rn, four participating laboratories made nearly simultaneous measurements of {sup 222}Rn activity concentration in commonly sampled, ambient air over approximately a 2 week period, and three of these four laboratories participated in the measurement comparison of 14 introduced samples with known, but undisclosed (blind) {sup 222}Rn activity concentration. The exercise was conducted in Bermuda in October 1991. The {sup 222}Rn activity concentrations in ambient Bermudian air over the course of the intercomparison ranged from a few hundredths of a Bq {center_dot} m{sup {minus}3} to about 2more » Bq {center_dot} m{sup {minus}3}, while the standardized sample additions covered a range from approximately 2.5 Bq {center_dot} m{sup {minus}3} to 35 Bq {center_dot} m{sup {minus}3}. The overall uncertainty in the latter concentrations was in the general range of 10%, approximating a 3 standard deviation uncertainty interval. The results of the intercomparison indicated that two of the laboratories were within very good agreement with the standard additions, and almost within expected statistical variations. These same two laboratories, however, at lower ambient concentrations, exhibited a systematic difference with an averaged offset of roughly 0.3 Bq {center_dot} m{sup {minus}3}. The third laboratory participating in the measurement of standardized sample additions was systematically low by about 65% to 70%, with respect to the standard addition which was also confirmed in their ambient air concentration measurements. The fourth laboratory, participating in only the ambient measurement part of the intercomparison, was also systematically low by at least 40% with respect to the first two laboratories.« less

The ATLAS project: The effects of a constructionist digital laboratory project on undergraduate laboratory performance.

PubMed

Shoepe, Todd C; Cavedon, Dana K; Derian, Joseph M; Levy, Celine S; Morales, Amy

2015-01-01

Anatomical education is a dynamic field where developments in the implementation of constructive, situated-learning show promise in improving student achievement. The purpose of this study was to examine the effectiveness of an individualized, technology heavy project in promoting student performance in a combined anatomy and physiology laboratory course. Mixed-methods research was used to compare two cohorts of anatomy laboratories separated by the adoption of a new laboratory atlas project, which were defined as preceding (PRE) and following the adoption of the Anatomical Teaching and Learning Assessment Study (ATLAS; POST). The ATLAS project required the creation of a student-generated, photographic atlas via acquisition of specimen images taken with tablet technology and digital microscope cameras throughout the semester. Images were transferred to laptops, digitally labeled and photo edited weekly, and compiled into a digital book using Internet publishing freeware for final project submission. An analysis of covariance confirmed that student final examination scores were improved (P < 0.05) following the implementation of the laboratory atlas project (PRE, n = 75; POST, n = 90; means ± SE; 74.9 ± 0.9 versus 78.1 ± 0.8, respectively) after controlling for cumulative student grade point average. Analysis of questionnaires collected (n = 68) from the post group suggested students identified with atlas objectives, appreciated the comprehensive value in final examination preparation, and the constructionism involved, but recommended alterations in assignment logistics and the format of the final version. Constructionist, comprehensive term-projects utilizing student-preferred technologies could be used to improve performance toward student learning outcomes. © 2014 American Association of Anatomists.

Virtual laboratories: new opportunities for collaborative water science

NASA Astrophysics Data System (ADS)

Ceola, Serena; Arheimer, Berit; Bloeschl, Guenter; Baratti, Emanuele; Capell, Rene; Castellarin, Attilio; Freer, Jim; Han, Dawei; Hrachowitz, Markus; Hundecha, Yeshewatesfa; Hutton, Christopher; Lindström, Goran; Montanari, Alberto; Nijzink, Remko; Parajka, Juraj; Toth, Elena; Viglione, Alberto; Wagener, Thorsten

2015-04-01

Reproducibility and repeatability of experiments are the fundamental prerequisites that allow researchers to validate results and share hydrological knowledge, experience and expertise in the light of global water management problems. Virtual laboratories offer new opportunities to enable these prerequisites since they allow experimenters to share data, tools and pre-defined experimental procedures (i.e. protocols). Here we present the outcomes of a first collaborative numerical experiment undertaken by five different international research groups in a virtual laboratory to address the key issues of reproducibility and repeatability. Moving from the definition of accurate and detailed experimental protocols, a rainfall-runoff model was independently applied to 15 European catchments by the research groups and model results were collectively examined through a web-based discussion. We found that a detailed modelling protocol was crucial to ensure the comparability and reproducibility of the proposed experiment across groups. Our results suggest that sharing comprehensive and precise protocols and running the experiments within a controlled environment (e.g. virtual laboratory) is as fundamental as sharing data and tools for ensuring experiment repeatability and reproducibility across the broad scientific community and thus advancing hydrology in a more coherent way.

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.

Quality-assurance results for field pH and specific-conductance measurements, and for laboratory analysis, National Atmospheric Deposition Program and National Trends Network; January 1980-September 1984

USGS Publications Warehouse

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

1986-01-01

Five intersite comparison studies for the field determination of pH and specific conductance, using simulated-precipitation samples, were conducted by the U.S.G.S. for the National Atmospheric Deposition Program and National Trends Network. These comparisons were performed to estimate the precision of pH and specific conductance determinations made by sampling-site operators. Simulated-precipitation samples were prepared from nitric acid and deionized water. The estimated standard deviation for site-operator determination of pH was 0.25 for pH values ranging from 3.79 to 4.64; the estimated standard deviation for specific conductance was 4.6 microsiemens/cm at 25 C for specific-conductance values ranging from 10.4 to 59.0 microsiemens/cm at 25 C. Performance-audit samples with known analyte concentrations were prepared by the U.S.G.S.and distributed to the National Atmospheric Deposition Program 's Central Analytical Laboratory. The differences between the National Atmospheric Deposition Program and national Trends Network-reported analyte concentrations and known analyte concentrations were calculated, and the bias and precision were determined. For 1983, concentrations of calcium, magnesium, sodium, and chloride were biased at the 99% confidence limit; concentrations of potassium and sulfate were unbiased at the 99% confidence limit. Four analytical laboratories routinely analyzing precipitation were evaluated in their analysis of identical natural- and simulated precipitation samples. Analyte bias for each laboratory was examined using analysis of variance coupled with Duncan 's multiple-range test on data produced by these laboratories, from the analysis of identical simulated-precipitation samples. Analyte precision for each laboratory has been estimated by calculating a pooled variance for each analyte. Interlaboratory comparability results may be used to normalize natural-precipitation chemistry data obtained from two or more of these laboratories. (Author

Plasma creatinine in dogs: intra- and inter-laboratory variation in 10 European veterinary laboratories

PubMed Central

2011-01-01

Background There is substantial variation in reported reference intervals for canine plasma creatinine among veterinary laboratories, thereby influencing the clinical assessment of analytical results. The aims of the study was to determine the inter- and intra-laboratory variation in plasma creatinine among 10 veterinary laboratories, and to compare results from each laboratory with the upper limit of its reference interval. Methods Samples were collected from 10 healthy dogs, 10 dogs with expected intermediate plasma creatinine concentrations, and 10 dogs with azotemia. Overlap was observed for the first two groups. The 30 samples were divided into 3 batches and shipped in random order by postal delivery for plasma creatinine determination. Statistical testing was performed in accordance with ISO standard methodology. Results Inter- and intra-laboratory variation was clinically acceptable as plasma creatinine values for most samples were usually of the same magnitude. A few extreme outliers caused three laboratories to fail statistical testing for consistency. Laboratory sample means above or below the overall sample mean, did not unequivocally reflect high or low reference intervals in that laboratory. Conclusions In spite of close analytical results, further standardization among laboratories is warranted. The discrepant reference intervals seem to largely reflect different populations used in establishing the reference intervals, rather than analytical variation due to different laboratory methods. PMID:21477356

A laboratory examination of the three-equation model of ice-ocean interactions

NASA Astrophysics Data System (ADS)

McConnochie, Craig; Kerr, Ross

2017-11-01

Numerical models of ice-ocean interactions are typically unable to resolve the transport of heat and salt to the ice face. As such, models rely upon parameterizations that have not been properly validated by data. Recent laboratory experiments of ice-saltwater interactions allow us to test the standard parameterization of heat and salt transport to ice faces - the `three equation model'. We find a significant disagreement in the dependence of the melt rate on the fluid velocity. The three-equation model predicts that the melt rate is proportional to the fluid velocity while the experimental results typically show that the melt rate is independent of the fluid velocity. By considering a theoretical analysis of the boundary layer next to a melting ice face we suggest a resolution to this disagreement. We show that the three-equation model assumes that the thickness of the diffusive sublayer is set by a shear instability. However, at low flow velocities, the sublayer is instead set by a convective instability. This distinction leads to a threshold velocity of approximately 4 cm/s at geophysically relevant conditions, above which the form of the parameterization should be valid. In contrast, at flow speeds below 4 cm/s, the three-equation model will underestimate the melt rate. ARC DP120102772.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08835 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08778 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08775 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08773 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08822 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08831 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08805 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08784 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08836 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Bubble formed as a result of a Zeolite Crystal Growth experiment in the U.S. Laboratory

NASA Image and Video Library

2002-12-14

ISS006-E-08799 (14 December 2002) --- View of a bubble formed as a result of a Zeolite Crystal Growth (ZCG) experiment in the Destiny laboratory on the International Space Station (ISS). Expedition Six Commander Kenneth D. Bowersox used a Space Station drill to mix 12 Zeolite samples in clear tubes. Scientists on the ground watching on TV noticed bubbles in the samples. Bowersox used a modified mixing procedure to process autoclaves to isolate bubbles. He re-inserted the samples in the ZCG furnace in Express Rack 2 in the U.S. laboratory/Destiny. This experiment has shown that the bubbles could cause larger number of smaller deformed crystals to grow. Bowersox rotated the samples so that the heavier fluid was thrown to the outside while the lighter bubbles stayed on the inside.

Scoring life insurance applicants' laboratory results, blood pressure and build to predict all-cause mortality risk.

PubMed

Fulks, Michael; Stout, Robert L; Dolan, Vera F

2012-01-01

Evaluate the degree of medium to longer term mortality prediction possible from a scoring system covering all laboratory testing used for life insurance applicants, as well as blood pressure and build measurements. Using the results of testing for life insurance applicants who reported a Social Security number in conjunction with the Social Security Death Master File, the mortality associated with each test result was defined by age and sex. The individual mortality scores for each test were combined for each individual and a composite mortality risk score was developed. This score was then tested against the insurance applicant dataset to evaluate its ability to discriminate risk across age and sex. The composite risk score was highly predictive of all-cause mortality risk in a linear manner from the best to worst quintile of scores in a nearly identical fashion for each sex and decade of age. Laboratory studies, blood pressure and build from life insurance applicants can be used to create scoring that predicts all-cause mortality across age and sex. Such an approach may hold promise for preventative health screening as well.

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...

Results of using frequency banded SAFT for examining three types of defects

NASA Astrophysics Data System (ADS)

Clayton, Dwight; Barker, Alan; Santos-Villalobos, Hector

2017-02-01

A multitude of concrete-based structures are typically part of a light water reactor (LWR) plant to provide the foundation, support, shielding, and containment functions. Concrete has been used in the construction of nuclear power plants (NPPs) because of three primary properties; its low cost, structural strength, and ability to shield radiation. Examples of concrete structures important to the safety of LWR plants include the containment building, spent fuel pool, and cooling towers. This use has made concrete's long-term performance crucial for the safe operation of commercial NPPs. Extending reactor life to 60 years and beyond will likely increase susceptibility and severity of known forms of degradation. Additionally, new mechanisms of materials degradation are also possible. Specially designed and fabricated test specimens can provide realistic flaws that are similar to actual flaws in terms of how they interact with a particular Nondestructive Evaluation (NDE) technique. Artificial test blocks allow the isolation of certain testing problems as well as the variation of certain parameters. Because conditions in the laboratory are controlled, the number of unknown variables can be decreased, making it possible to focus on specific aspects, investigate them in detail, and gain further information on the capabilities and limitations of each method. To minimize artifacts caused by boundary effects, the dimensions of the specimens should not be too compact. In this paper, we apply the frequency banded Synthetic Aperture Focusing Technique (SAFT) technique to a 2.134 m × 2.134 m × 1.016 m concrete test specimen with twenty deliberately embedded defects. These twenty embedded defects simulate voids (honeycombs), delamination, and embedded organic construction debris. Using the time-frequency technique of wavelet packet decomposition and reconstruction, the spectral content of the signal can be divided into two resulting child nodes. The resulting two nodes can then

The stressed student: influence of written examinations and oral presentations on salivary cortisol concentrations in university students.

PubMed

Preuss, Diana; Schoofs, Daniela; Schlotz, Wolff; Wolf, Oliver T

2010-05-01

Laboratory research has demonstrated that social-evaluative threat has an influence on the hypothalamus pituitary adrenal axis (HPA). In two studies using independent samples, we evaluated the anticipatory cortisol response to a written university examination (n = 35) and to an oral presentation (n = 34). Saliva samples were collected before and after the examinations and on a control day. Additionally, saliva samples were collected on the day before the written examination and a control day. Results revealed significantly elevated cortisol concentrations on the day prior to the examination; however, this effect occurred only in those participants who had their control day after the examination. Cortisol concentrations were elevated on the examination day, with increased concentrations before but not after the examination. For the oral presentation study, the results revealed substantially elevated cortisol concentrations before and after the oral presentation. Taken together the results indicate that written examinations cause a mild anticipatory HPA response while oral presentations induce a strong HPA response. These findings appear to support the idea that social-evaluative threat is an important factor determining the size of the HPA response to laboratory stressors as well as to real-life stressors.

A Novel Simulation Technician Laboratory Design: Results of a Survey-Based Study

PubMed Central

Hughes, Patrick G; Friedl, Ed; Ortiz Figueroa, Fabiana; Cepeda Brito, Jose R; Frey, Jennifer; Birmingham, Lauren E; Atkinson, Steven Scott

2016-01-01

Objective  The purpose of this study was to elicit feedback from simulation technicians prior to developing the first simulation technician-specific simulation laboratory in Akron, OH. Background Simulation technicians serve a vital role in simulation centers within hospitals/health centers around the world. The first simulation technician degree program in the US has been approved in Akron, OH. To satisfy the requirements of this program and to meet the needs of this special audience of learners, a customized simulation lab is essential.  Method A web-based survey was circulated to simulation technicians prior to completion of the lab for the new program. The survey consisted of questions aimed at identifying structural and functional design elements of a novel simulation center for the training of simulation technicians. Quantitative methods were utilized to analyze data. Results Over 90% of technicians (n=65) think that a lab designed explicitly for the training of technicians is novel and beneficial. Approximately 75% of respondents think that the space provided appropriate audiovisual (AV) infrastructure and space to evaluate the ability of technicians to be independent. The respondents think that the lab needed more storage space, visualization space for a large number of students, and more space in the technical/repair area. Conclusions  A space designed for the training of simulation technicians was considered to be beneficial. This laboratory requires distinct space for technical repair, adequate bench space for the maintenance and repair of simulators, an appropriate AV infrastructure, and space to evaluate the ability of technicians to be independent. PMID:27096134

Zero-Gravity Atmospheric Cloud Physics Experiment Laboratory engineering concepts/design tradeoffs. Volume 1: Study results

NASA Technical Reports Server (NTRS)

Greco, R. V.; Eaton, L. R.; Wilkinson, H. C.

1974-01-01

The work is summarized which was accomplished from January 1974 to October 1974 for the Zero-Gravity Atmospheric Cloud Physics Laboratory. The definition and development of an atmospheric cloud physics laboratory and the selection and delineation of candidate experiments that require the unique environment of zero gravity or near zero gravity are reported. The experiment program and the laboratory concept for a Spacelab payload to perform cloud microphysics research are defined. This multimission laboratory is planned to be available to the entire scientific community to utilize in furthering the basic understanding of cloud microphysical processes and phenomenon, thereby contributing to improved weather prediction and ultimately to provide beneficial weather control and modification.

Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008–2010

PubMed Central

2014-01-01

Background Chlamydial infection is the most common notifiable disease in Australia, Europe and the US. Australian notifications of chlamydia rose four-fold from 20,274 cases in 2002 to 80,846 cases in 2011; the majority of cases were among young people aged less than 29 years. Along with test positivity rates, an understanding of the number of tests performed and the demographics of individuals being tested are key epidemiological indicators. The ACCESS Laboratory Network was established in 2008 to address this issue. Methods The ACCESS Laboratory Network collected chlamydia testing data from 15 laboratories around Australia over a three-year period using data extraction software. All chlamydia testing data from participating laboratories were extracted from the laboratory information system; patient identifiers converted to a unique, non-reversible code and de-identified data sent to a single database. Analysis of data by anatomical site included all specimens, but in age and sex specific analysis, only one testing episode was counted. Results From 2008 to 2010 a total of 628,295 chlamydia tests were referred to the 15 laboratories. Of the 592,626 individual episodes presenting for testing, 70% were from female and 30% from male patients. In female patients, chlamydia positivity rate was 6.4% overall; the highest rate in 14 year olds (14.3%). In male patients, the chlamydia positivity rate was 9.4% overall; the highest in 19 year olds (16.5%). The most common sample type was urine (57%). In 3.2% of testing episodes, multiple anatomical sites were sampled. Urethral swabs gave the highest positivity rate for all anatomical sites in both female (7.7%) and male patients (14%), followed by urine (7.6% and 9.4%, respectively) and eye (6.3% and 7.9%, respectively). Conclusions The ACCESS Laboratory Network data are unique in both number and scope and are representative of chlamydia testing in both general practice and high-risk clinics. The findings from these data

Smart garments for emergency operators: results of laboratory and field tests.

PubMed

Curone, Davide; Dudnik, Gabriela; Loriga, Giannicola; Magenes, Giovanni; Secco, Emanuele Lindo; Tognetti, Alessandro; Bonfiglio, Annalisa

2008-01-01

The first generation of ProeTEX prototypes has been completed at the end of August 2007. In the following period two main activities have involved the project partners. On one hand new technologies (in terms of sensors and devices) to be integrated in the next releases of prototypes have been developed; on the other hand intensive test sessions on the first prototype (both in laboratory conditions and simulating real operative scenarios) have been carried out. This paper is mainly focused on this second facet. Great efforts have been dedicated to the trials for different reasons: firstly to investigate the appropriateness and efficiency of the system in normal and harsh conditions; secondly to obtain useful indications regarding usability and efficacy by the end-users involved in the project. The results of the trials have been used to define the specifications of the second generation of prototypes, that will be released within the end of 2008.

A comparison between on-site immunoassay drug-testing devices and laboratory results.

PubMed

Grönholm, M; Lillsunde, P

2001-09-15

The aim with this study was to evaluate the accuracy of several on-site testing devices on the market. A part of this study is included in the European Union's (EU's) roadside testing assessment project (ROSITA). An other request for this kind of study came from the Finnish prison department in the Ministry of Justice. The evaluation was performed on both urine assays and oral fluid assays. The on-site test results were compared with laboratory results (gas chromatography-mass spectrometry (GC/MS)). The samples were tested on amphetamines (AMP), cannabinoids (THC), opiates (OPI) and cocaine metabolites (COC). Some of the tests also included a metamphetamine (MET) and a benzodiazepine (BZO) test. Both positive and negative samples were tested. A total of 800 persons and eight on-site devices for urine and two for oral fluid testing were included in this study. Good results were obtained for the urine on-site devices, with accuracies of 93-99% for amphetamines, 97-99% for cannabinoids, 94-98% for opiates and 90-98% for benzodiazepines. However, differences in the ease of performance and interpretation of test result were observed. It was possible to detect amphetamines and opiates in oral fluid by the used on-site devices, but the benzodiazepines and cannabinoids did not fulfil the needs of sensitivity.

The Effects of Web-Based Patient Access to Laboratory Results in British Columbia: A Patient Survey on Comprehension and Anxiety.

PubMed

Mák, Geneviève; Smith Fowler, Heather; Leaver, Chad; Hagens, Simon; Zelmer, Jennifer

2015-08-04

Web-based patient access to personal health information is limited but increasing in Canada and internationally. This exploratory study aimed to increase understanding of how Web-based access to laboratory test results in British Columbia (Canada), which has been broadly available since 2010, affects patients' experiences. In November 2013, we surveyed adults in British Columbia who had had a laboratory test in the previous 12 months. Using a retrospective cohort design, we compared reported wait-time for results, test result comprehension, and anxiety levels of "service users" who had Web-based access to their test results (n=2047) with those of a general population panel that did not have Web-based access (n=1245). The vast majority of service users (83.99%, 95% CI 82.31-85.67) said they received their results within "a few days", compared to just over a third of the comparison group (37.84%, 95% CI 34.96-40.73). Most in both groups said they understood their test results, but the rate was lower for service users than the comparison group (75.55%, 95% CI 73.58-77.49 vs 84.69%, 95% CI 82.59-86.81). There was no significant difference between groups in levels of reported anxiety after receiving test results. While most patients who received their laboratory test results online reported little anxiety after receiving their results and were satisfied with the service, there may be opportunities to improve comprehension of results.

Effect of a Virtual Chemistry Laboratory on Students' Achievement

ERIC Educational Resources Information Center

Tatli, Zeynep; Ayas, Alipasa

2013-01-01

It is well known that laboratory applications are of significant importance in chemistry education. However, laboratory applications have generally been neglected in recent educational environments for a variety of reasons. In order to address this gap, this study examined the effect of a virtual chemistry laboratory (VCL) on student achievement…

The Use of Occupational Licensure Examination Results in Outcomes Assessment. AIR 1994 Annual Forum Paper.

ERIC Educational Resources Information Center

Bragg, Theresa A.

This paper discusses the validity of licensure examination results as an indicator of the performance of higher educational institutions. Licensure examination scores are available to departments for a variety of disciplines and analysis is best performed within the departments. The quality of feedback may dictate the usefulness of results. Using…

Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour.

PubMed

Fraccaro, Paolo; Vigo, Markel; Balatsoukas, Panagiotis; van der Veer, Sabine N; Hassan, Lamiece; Williams, Richard; Wood, Grahame; Sinha, Smeeta; Buchan, Iain; Peek, Niels

2018-02-12

Patient portals are considered valuable instruments for self-management of long term conditions, however, there are concerns over how patients might interpret and act on the clinical information they access. We hypothesized that visual cues improve patients' abilities to correctly interpret laboratory test results presented through patient portals. We also assessed, by applying eye-tracking methods, the relationship between risk interpretation and visual search behaviour. We conducted a controlled study with 20 kidney transplant patients. Participants viewed three different graphical presentations in each of low, medium, and high risk clinical scenarios composed of results for 28 laboratory tests. After viewing each clinical scenario, patients were asked how they would have acted in real life if the results were their own, as a proxy of their risk interpretation. They could choose between: 1) Calling their doctor immediately (high interpreted risk); 2) Trying to arrange an appointment within the next 4 weeks (medium interpreted risk); 3) Waiting for the next appointment in 3 months (low interpreted risk). For each presentation, we assessed accuracy of patients' risk interpretation, and employed eye tracking to assess and compare visual search behaviour. Misinterpretation of risk was common, with 65% of participants underestimating the need for action across all presentations at least once. Participants found it particularly difficult to interpret medium risk clinical scenarios. Participants who consistently understood when action was needed showed a higher visual search efficiency, suggesting a better strategy to cope with information overload that helped them to focus on the laboratory tests most relevant to their condition. This study confirms patients' difficulties in interpreting laboratories test results, with many patients underestimating the need for action, even when abnormal values were highlighted or grouped together. Our findings raise patient safety

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.

Module Architecture for in Situ Space Laboratories

NASA Technical Reports Server (NTRS)

Sherwood, Brent

2010-01-01

The paper analyzes internal outfitting architectures for space exploration laboratory modules. ISS laboratory architecture is examined as a baseline for comparison; applicable insights are derived. Laboratory functional programs are defined for seven planet-surface knowledge domains. Necessary and value-added departures from the ISS architecture standard are defined, and three sectional interior architecture options are assessed for practicality and potential performance. Contemporary guidelines for terrestrial analytical laboratory design are found to be applicable to the in-space functional program. Densepacked racks of system equipment, and high module volume packing ratios, should not be assumed as the default solution for exploration laboratories whose primary activities include un-scriptable investigations and experimentation on the system equipment itself.

Establishment of National Laboratory Standards in Public and Private Hospital Laboratories

PubMed Central

ANJARANI, Soghra; SAFADEL, Nooshafarin; DAHIM, Parisa; AMINI, Rana; MAHDAVI, Saeed; MIRAB SAMIEE, Siamak

2013-01-01

In September 2007 national standard manual was finalized and officially announced as the minimal quality requirements for all medical laboratories in the country. Apart from auditing laboratories, Reference Health Laboratory has performed benchmarking auditing of medical laboratory network (surveys) in provinces. 12th benchmarks performed in Tehran and Alborz provinces, Iran in 2010 in three stages. We tried to compare different processes, their quality and accordance with national standard measures between public and private hospital laboratories. The assessment tool was a standardized checklist consists of 164 questions. Analyzing process show although in most cases implementing the standard requirements are more prominent in private laboratories, there is still a long way to complete fulfillment of requirements, and it takes a lot of effort. Differences between laboratories in public and private sectors especially in laboratory personnel and management process are significant. Probably lack of motivation, plays a key role in obtaining less desirable results in laboratories in public sectors. PMID:23514840

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

Placement into First College Mathematics Course: A Comparison of the Results of the Michigan State University Proctored Mathematics Placement Examination and the Unproctored Mathematics Placement Examination

ERIC Educational Resources Information Center

Drake, Samuel

2010-01-01

The primary purpose of this study was to compare the results of the Michigan State University (MSU) unproctored examination to the results of the proctored examination. Both examinations are used to determine whether first time freshmen at MSU are ready for a standard mathematics course or if a remedial course is necessary. In addition to…

Model-Based Reasoning in the Physics Laboratory: Framework and Initial Results

ERIC Educational Resources Information Center

Zwickl, Benjamin M.; Hu, Dehui; Finkelstein, Noah; Lewandowski, H. J.

2015-01-01

We review and extend existing frameworks on modeling to develop a new framework that describes model-based reasoning in introductory and upper-division physics laboratories. Constructing and using models are core scientific practices that have gained significant attention within K-12 and higher education. Although modeling is a broadly applicable…

Prostate needle biopsy processing: a survey of laboratory practice across Europe.

PubMed

Varma, Murali; Berney, Daniel M; Algaba, Ferran; Camparo, Philippe; Compérat, Eva; Griffiths, David F R; Kristiansen, Glen; Lopez-Beltran, Antonio; Montironi, Rodolfo; Egevad, Lars

2013-02-01

To determine the degree of variation in the handling of prostate needle biopsies (PBNx) in laboratories across Europe. A web based survey was emailed to members of the European Network of Uropathology and the British Association of Urological Pathologists. Responses were received from 241 laboratories in 15 countries. PNBx were generally taken by urologists (93.8%) or radiologists (23.7%) but in 8.7% were also taken by non-medical personnel such as radiographers, nurses or biomedical assistants. Of the responding laboratories, 40.8% received cores in separate containers, 42.3% processed one core/block, 54.2% examined three levels/block, 49.4% examined one H&E section/level and 56.1% retained spare sections for potential immunohistochemistry. Of the laboratories, 40.9% retained unstained spares for over a year while 36.2% discarded spares within 1 month of reporting. Only two (0.8%) respondents routinely performed immunohistochemistry on all PNBx. There were differences in laboratory practice between the UK and the rest of Europe (RE). Procurement of PNBx by non-medical personnel was more common in the UK. RE laboratories more commonly received each core in a separate container, processed one core/block, examined fewer levels/block and examined more H&E sections/level. RE laboratories also retained spares for potential immunohistochemistry less often and for shorter periods. Use of p63 as the sole basal cell marker was more common in RE. There are marked differences in procurement, handling and processing of PNBx in laboratories across Europe. This data can help the development of best practice guidelines.

Preservice laboratory education strengthening enhances sustainable laboratory workforce in Ethiopia

PubMed Central

2013-01-01

Background There is a severe healthcare workforce shortage in sub Saharan Africa, which threatens achieving the Millennium Development Goals and attaining an AIDS-free generation. The strength of a healthcare system depends on the skills, competencies, values and availability of its workforce. A well-trained and competent laboratory technologist ensures accurate and reliable results for use in prevention, diagnosis, care and treatment of diseases. Methods An assessment of existing preservice education of five medical laboratory schools, followed by remedial intervention and monitoring was conducted. The remedial interventions included 1) standardizing curriculum and implementation; 2) training faculty staff on pedagogical methods and quality management systems; 3) providing teaching materials; and 4) procuring equipment for teaching laboratories to provide practical skills to complement didactic education. Results A total of 2,230 undergraduate students from the five universities benefitted from the standardized curriculum. University of Gondar accounted for 252 of 2,230 (11.3%) of the students, Addis Ababa University for 663 (29.7%), Jimma University for 649 (29.1%), Haramaya University for 429 (19.2%) and Hawassa University for 237 (10.6%) of the students. Together the universities graduated 388 and 312 laboratory technologists in 2010/2011 and 2011/2012 academic year, respectively. Practical hands-on training and experience with well-equipped laboratories enhanced and ensured skilled, confident and competent laboratory technologists upon graduation. Conclusions Strengthening preservice laboratory education is feasible in resource-limited settings, and emphasizing its merits (ample local capacity, country ownership and sustainability) provides a valuable source of competent laboratory technologists to relieve an overstretched healthcare system. PMID:24164781

Application of flipped classroom pedagogy to the human gross anatomy laboratory: Student preferences and learning outcomes.

PubMed

Fleagle, Timothy R; Borcherding, Nicholas C; Harris, Jennie; Hoffmann, Darren S

2017-12-28

To improve student preparedness for anatomy laboratory dissection, the dental gross anatomy laboratory was transformed using flipped classroom pedagogy. Instead of spending class time explaining the procedures and anatomical structures for each laboratory, students were provided online materials to prepare for laboratory on their own. Eliminating in-class preparation provided the opportunity to end each period with integrative group activities that connected laboratory and lecture material and explored clinical correlations. Materials provided for prelaboratory preparation included: custom-made, three-dimensional (3D) anatomy videos, abbreviated dissection instructions, key atlas figures, and dissection videos. Data from three years of the course (n = 241 students) allowed for analysis of students' preferences for these materials and detailed tracking of usage of 3D anatomy videos. Students reported spending an average of 27:22 (±17:56) minutes preparing for laboratory, similar to the 30 minutes previously allocated for in-class dissection preparation. The 3D anatomy videos and key atlas figures were rated the most helpful resources. Scores on laboratory examinations were compared for the three years before the curriculum change (2011-2013; n = 242) and three years after (2014-2016; n = 241). There was no change in average grades on the first and second laboratory examinations. However, on the final semi-cumulative laboratory examination, scores were significantly higher in the post-flip classes (P = 0.04). These results demonstrate an effective model for applying flipped classroom pedagogy to the gross anatomy laboratory and illustrate a meaningful role for 3D anatomy visualizations in a dissection-based course. Anat Sci Educ. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Generation and composition of medical wastes from private medical microbiology laboratories.

PubMed

Komilis, Dimitrios; Makroleivaditis, Nikolaos; Nikolakopoulou, Eftychia

2017-03-01

A study on the generation rate and the composition of solid medical wastes (MW) produced by private medical microbiology laboratories (PMML) was conducted in Greece. The novelty of the work is that no such information exists in the literature for this type of laboratories worldwide. Seven laboratories were selected with capacities that ranged from 8 to 88 examinees per day. The study lasted 6months and daily recording of MW weights was done over 30days during that period. The rates were correlated to the number of examinees, examinations and personnel. Results indicated that on average 35% of the total MW was hazardous (infectious) medical wastes (IFMW). The IFMW generation rates ranged from 11.5 to 32.5g examinee -1 d -1 while an average value from all 7 labs was 19.6±9.6g examinee -1 d -1 or 2.27±1.11g examination -1 d -1 . The average urban type medical waste generation rate was 44.2±32.5g examinee -1 d -1 . Using basic regression modeling, it was shown that the number of examinees and examinations can be predictors of the IFMW generation, but not of the urban type MW generation. The number of examinations was a better predictor of the MW amounts than the number of examinees. Statistical comparison of the means of the 7PMML was done with standard ANOVA techniques after checking the normality of the data and after doing the appropriate transformations. Based on the results of this work, it is approximated that 580 tonnes of infectious MW are generated annually by the PMML in Greece. Copyright © 2017 Elsevier Ltd. All rights reserved.

Horizontal and vertical integration in hospital laboratories and the laboratory information system.

PubMed

Friedman, B A; Mitchell, W

1990-09-01

An understanding of horizontal and vertical integration and their quasi-integration variants is important for pathologists to formulate a competitive strategy for hospital clinical laboratories. These basic organizational concepts, in turn, are based on the need to establish control over critical laboratory inputs and outputs. The pathologist seeks greater control of mission-critical system inputs and outputs to increase the quality and efficiency of the laboratory operations. The LIS produces horizontal integration of the various hospital laboratories by integrating them vertically. Forward vertical quasi-integration of the laboratories is mediated primarily by the LIS through front-end valued-added features such as reporting of results and creating a long-term on-line test result archive. These features increase the value of the information product of pathology for clinicians and increase the cost of switching to another system. The LIS can also serve as a means for customizing the information product of the laboratories to appeal to new market segments such as hospital administrators.

Reducing Missed Laboratory Results: Defining Temporal Responsibility, Generating User Interfaces for Test Process Tracking, and Retrospective Analyses to Identify Problems

PubMed Central

Tarkan, Sureyya; Plaisant, Catherine; Shneiderman, Ben; Hettinger, A. Zachary

2011-01-01

Researchers have conducted numerous case studies reporting the details on how laboratory test results of patients were missed by the ordering medical providers. Given the importance of timely test results in an outpatient setting, there is limited discussion of electronic versions of test result management tools to help clinicians and medical staff with this complex process. This paper presents three ideas to reduce missed results with a system that facilitates tracking laboratory tests from order to completion as well as during follow-up: (1) define a workflow management model that clarifies responsible agents and associated time frame, (2) generate a user interface for tracking that could eventually be integrated into current electronic health record (EHR) systems, (3) help identify common problems in past orders through retrospective analyses. PMID:22195201

Laboratory examination of seronegative and seropositive rheumatoid arthritis.

PubMed

Sahatçiu-Meka, Vjollca; Anton, Kukeli

2010-01-01

In response to the continuing debate whether seronegative and seropositive rheumatoid arthritis (RA) are parts of the same disease spectrum or are distinct disorders, we performed a comparative analysis of some laboratory characteristics. The test group consisted of 125 seronegative RA(93 female, 32 male), with titers lower than 1/64 as defined by Rose-Waaler test. The control group consisted of 125 seropositive RA patients (93 female, 32 male), with titers of 1/64 or higher. Patients all belonged to the 2nd and 3rd functional classes (ARA), and were between 25-60 years of age. The duration of the disease was 1-27 years. Elevated average values of erythrosedimentation (ERS), C-reactive protein (PCR) and erythrocytes (Er) were found in seropositive patients, but they did not present statistically significant difference with regard to sero-status. Reduced values of hemoglobin (Hb) were found more frequently in seropositive patients (t = 2.26, p < 0.05), especially female seropositive patients (t = 4.38, p < 0.01), without correlation to disability and duration of the disease. Statistically significant difference was found in average values of fibrinogen in the seropositive subset (t = 2.10, p < 0.05), especially in female seropositive patients (t = 2.65, p < 0.01), and in average values of leukocytes (t = 1.37, p < 0.05) among male seropositive patients. Elevated immunoglobulin (IgM) values were more prominent in the seropositive subset (chi2 = 47.6, p < 0.01), especially among seropositive females (chi2 = 35.68, p < 0.01). Values of IgA and IgG did not present statistically significant difference with regard to sero-status. Levels of C3 and C4 components of the complement were reduced in seropositive tested subjects, without significant difference between sero-subsets. Increased values of gamma-globulin were confirmed with statistical significance (chi2 = 3.39, p < 0.05) in seropositive subjects, while alpha-2 globulin values were nearly equally distributed in both

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.

Comparing field investigations with laboratory models to predict landfill leachate emissions

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

Fellner, Johann; Doeberl, Gernot; Allgaier, Gerhard

2009-06-15

Investigations into laboratory reactors and landfills are used for simulating and predicting emissions from municipal solid waste landfills. We examined water flow and solute transport through the same waste body for different volumetric scales (laboratory experiment: 0.08 m{sup 3}, landfill: 80,000 m{sup 3}), and assessed the differences in water flow and leachate emissions of chloride, total organic carbon and Kjeldahl nitrogen. The results indicate that, due to preferential pathways, the flow of water in field-scale landfills is less uniform than in laboratory reactors. Based on tracer experiments, it can be discerned that in laboratory-scale experiments around 40% of pore watermore » participates in advective solute transport, whereas this fraction amounts to less than 0.2% in the investigated full-scale landfill. Consequences of the difference in water flow and moisture distribution are: (1) leachate emissions from full-scale landfills decrease faster than predicted by laboratory experiments, and (2) the stock of materials remaining in the landfill body, and thus the long-term emission potential, is likely to be underestimated by laboratory landfill simulations.« less

Laboratory assessment of novel oral anticoagulants: method suitability and variability between coagulation laboratories.

PubMed

Helin, Tuukka A; Pakkanen, Anja; Lassila, Riitta; Joutsi-Korhonen, Lotta

2013-05-01

Laboratory tests to assess novel oral anticoagulants (NOACs) are under evaluation. Routine monitoring is unnecessary, but under special circumstances bioactivity assessment becomes crucial. We analyzed the effects of NOACs on coagulation tests and the availability of specific assays at different laboratories. Plasma samples spiked with dabigatran (Dabi; 120 and 300 μg/L) or rivaroxaban (Riva; 60, 146, and 305 μg/L) were sent to 115 and 38 European laboratories, respectively. International normalized ratio (INR) and activated partial thromboplastin time (APTT) were analyzed for all samples; thrombin time (TT) was analyzed specifically for Dabi and calibrated anti-activated factor X (anti-Xa) activity for Riva. We compared the results with patient samples. Results of Dabi samples were reported by 73 laboratories (13 INR and 9 APTT reagents) and Riva samples by 22 laboratories (5 INR and 4 APTT reagents). Both NOACs increased INR values; the increase was modest, albeit larger, for Dabi, with higher CV, especially with Quick (vs Owren) methods. Both NOACs dose-dependently prolonged the APTT. Again, the prolongation and CVs were larger for Dabi. The INR and APTT results varied reagent-dependently (P < 0.005), with less prolongation in patient samples. TT results (Dabi) and calibrated anti-Xa results (Riva) were reported by only 11 and 8 laboratories, respectively. The screening tests INR and APTT are suboptimal in assessing NOACs, having high reagent dependence and low sensitivity and specificity. They may provide information, if laboratories recognize their limitations. The variation will likely increase and the sensitivity differ in clinical samples. Specific assays measure NOACs accurately; however, few laboratories applied them. © 2013 American Association for Clinical Chemistry.

Contextual Influences on Concordance between Maternal Report and Laboratory Observation of Toddler Fear

PubMed Central

Kiel, Elizabeth J.; Hummel, Alexandra C.

2016-01-01

Emotion and temperament researchers have faced an enduring issue of how to best measure children’s tendencies to express specific emotions. Inconsistencies between laboratory observation and parental report have made it challenging for researchers to determine the utility of these different forms of measurement. The current study examined the effect of laboratory episode characteristics (i.e., threat-level of the episode, maternal involvement) on concordance between maternal report and laboratory observation of toddler fear. The sample included 111 mother-toddler dyads who participated in a laboratory assessment when toddlers were approximately 24-months-old. Toddler fear was assessed both via maternal report and observation from a number of laboratory episodes that varied in their level of threat and whether mothers were free or constrained in their involvement in the task. Results indicated that maternal report related to the observed fear composites for low-threat, but not high-threat episodes. On the other hand, maternal involvement in the laboratory episodes did not moderate the relation between maternal report and laboratory observation of fear. These results suggest that the threat-level of laboratory episodes designed to elicit fear, but not maternal involvement in these episodes, may be important to take into consideration when assessing their relation to maternal report of fear and fearful temperament. PMID:27606826

Laboratory Medicine Education at U.S. Medical Schools: A 2014 Status Report

PubMed Central

Smith, Brian R.; Kamoun, Malek; Hickner, John

2017-01-01

Purpose To assess the current state of laboratory medicine education at U.S. medical schools. Method From 2013 to 2014, the authors surveyed the appropriate dean, department chair, or undergraduate education director at each U.S. medical school accredited by the Liaison Committee on Medical Education about the state of laboratory medicine education, curriculum and competency assessment, and barriers to education at his or her institution. The authors used descriptive statistics to analyze the results. Results The authors received 98 (75%) responses. Eighty-two schools (84%) offered course work in laboratory medicine; 76 (78%) required it. The median number of hours of required course work was 12.5, with 8.0 devoted to lectures and 4.5 to small-group, problem-based learning and/or laboratory sessions. Only 8 schools required training in a clinical setting. Fewer than half reported regular, formal review of the laboratory medicine curriculum. The assessment of students’ competency in laboratory medicine was rare (8 schools), and only half of respondents were aware of published curriculum guidelines. Barriers to teaching laboratory medicine included lack of sufficient time in the preclinical curriculum (86; 88%) or clinical curriculum (84; 86%), lack of knowledge of best laboratory practices by residents (70; 72%), lack of student interest (62; 63%), and lack of knowledge by attending physicians (58; 59%). Half of respondents were likely to use a national standardized examination to assess competency in laboratory medicine, if one was available. Conclusions Significant opportunities exist to improve laboratory medicine education, including in the proper use and interpretation of clinical laboratory testing. PMID:26200574

The laboratory diagnosis of testosterone deficiency.

PubMed

Paduch, Darius A; Brannigan, Robert E; Fuchs, Eugene F; Kim, Edward D; Marmar, Joel L; Sandlow, Jay I

2014-05-01

The evaluation and treatment of hypogonadal men has become an important part of urologic practice. Fatigue, loss of libido, and erectile dysfunction are commonly reported, but nonspecific symptoms and laboratory verification of low testosterone (T) are an important part of evaluation in addition to a detailed history and physical examination. Significant intraindividual fluctuations in serum T levels, biologic variation of T action on end organs, the wide range of T levels in human serum samples, and technical limitations of currently available assays have led to poor reliability of T measurements in the clinical laboratory setting. There is no universally accepted threshold of T concentration that distinguishes eugonadal from hypogonadal men; thus, laboratory results have to be interpreted in the appropriate clinical setting. This review focuses on clinical, biological, and technological challenges that affect serum T measurements to educate clinicians regarding technological advances and limitations of the currently available laboratory methods to diagnose hypogonadism. A collaborative effort led by the American Urological Association between practicing clinicians, patient advocacy groups, government regulatory agencies, industry, and professional societies is underway to provide optimized assay platforms and evidence-based normal assay ranges to guide clinical decision making. Until such standardization is commonplace in clinical laboratories, the decision to treat should be based on the presence of signs and symptoms in addition to serum T measurements. Rigid interpretation of T ranges should not dictate clinical decision making or define coverage of treatment by third party payers. Copyright © 2014 Elsevier Inc. All rights reserved.

Mars Science Laboratory Navigation Results

NASA Technical Reports Server (NTRS)

Martin-Mur, Tomas J.; Kruizingas, Gerhard L.; Burkhart, P. Daniel; Wong, Mau C.; Abilleira, Fernando

2012-01-01

The Mars Science Laboratory (MSL), carrying the Curiosity rover to Mars, was launched on November 26, 2011, from Cape Canaveral, Florida. The target for MSL was selected to be Gale Crater, near the equator of Mars, with an arrival date in early August 2012. The two main interplanetary navigation tasks for the mission were to deliver the spacecraft to an entry interface point that would allow the rover to safely reach the landing area, and to tell the spacecraft where it entered the atmosphere of Mars, so it could guide itself accurately to close proximity of the landing target. MSL used entry guidance as it slowed down from the entry speed to a speed low enough to allow for a successful parachute deployment, and this guidance allowed shrinking the landing ellipse to a 99% conservative estimate of 7 by 20 kilometers. Since there is no global positioning system in Mars, achieving this accuracy was predicated on flying a trajectory that closely matched the reference trajectory used to design the guidance algorithm, and on initializing the guidance system with an accurate Mars-relative entry state that could be used as the starting point to integrate the inertial measurement unit data during entry and descent. The pre-launch entry flight path angle (EFPA) delivery requirement was +/- 0.20 deg, but after launch a smaller threshold of +/- 0.05 deg was used as the criteria for late trajectory correction maneuver (TCM) decisions. The pre-launch requirement for entry state knowledge was 2.8 kilometers in position error and 2 meters per second in velocity error, but also smaller thresholds were defined after launch to evaluate entry state update opportunities. The biggest challenge for the navigation team was to accurately predict the trajectory of the spacecraft, so the estimates of the entry conditions could be stable, and late trajectory correction maneuvers or entry parameter updates could be waved off. As a matter of fact, the prediction accuracy was such that the last

This Is not Participatory Design - A Critical Analysis of Eight Living Laboratories.

PubMed

Bygholm, Ann; Kanstrup, Anne Marie

2017-01-01

Design of Health Technology for elderly and care personnel has a high priority because of a severe increase of elderly citizens in need of health care combined with a decrease of resources in the health care sector. Desires for maintaining and improving the quality of care while reducing costs has resulted in a search for approaches that support co-operation between technology designers, elderly persons and health care professionals on innovating future care technology. Living laboratories, where areas of a care environment are transformed into a so-called platform for technology innovation, are popular. Expectations for living laboratories are high but examinations of how such laboratories support the intended participatory innovation are few. This paper presents and examines eight living laboratories set up in Danish nursing homes for technology innovation. We present the notion of a living laboratory and explicate the aspirations and expectations of this approach, and discuss why these expectations are hard to meet both on a general level and in the investigated labs. We question the basic assumptions of the possibility of reconciling the different interests of the stakeholders involved. In our analysis we focus on users in the living laboratories. We use guiding principles developed within Participatory Design to reveal the role and participation of the users - the health care professionals and the elderly - in the eight living laboratories. In general, these users played a minor role, in the labs where technical problems turned out to be main activity. We conclude that living laboratories do not nullify different/conflicting interests and that a real-life setting by itself is no guarantee for user participation.

Transfer Standard Uncertainty Can Cause Inconclusive Inter-Laboratory Comparisons

PubMed Central

Wright, John; Toman, Blaza; Mickan, Bodo; Wübbeler, Gerd; Bodnar, Olha; Elster, Clemens

2016-01-01

Inter-laboratory comparisons use the best available transfer standards to check the participants’ uncertainty analyses, identify underestimated uncertainty claims or unknown measurement biases, and improve the global measurement system. For some measurands, instability of the transfer standard can lead to an inconclusive comparison result. If the transfer standard uncertainty is large relative to a participating laboratory’s uncertainty, the commonly used standardized degree of equivalence ≤ 1 criterion does not always correctly assess whether a participant is working within their uncertainty claims. We show comparison results that demonstrate this issue and propose several criteria for assessing a comparison result as passing, failing, or inconclusive. We investigate the behavior of the standardized degree of equivalence and alternative comparison measures for a range of values of the transfer standard uncertainty relative to the individual laboratory uncertainty values. The proposed alternative criteria successfully discerned between passing, failing, and inconclusive comparison results for the cases we examined. PMID:28090123

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.

[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.

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

Reliability on intra-laboratory and inter-laboratory data of hair mineral analysis comparing with blood analysis.

PubMed

Namkoong, Sun; Hong, Seung Phil; Kim, Myung Hwa; Park, Byung Cheol

2013-02-01

Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis. The objective of this study was to assess the reliability of intra-laboratory and inter-laboratory data at three commercial laboratories conducting hair mineral analysis, compared to serum mineral analysis. Two divided hair samples taken from near the scalp were submitted for analysis at the same time, to all laboratories, from one healthy volunteer. Each laboratory sent a report consisting of quantitative results and their interpretation of health implications. Differences among intra-laboratory and interlaboratory data were analyzed using SPSS version 12.0 (SPSS Inc., USA). All the laboratories used identical methods for quantitative analysis, and they generated consistent numerical results according to Friedman analysis of variance. However, the normal reference ranges of each laboratory varied. As such, each laboratory interpreted the patient's health differently. On intra-laboratory data, Wilcoxon analysis suggested they generated relatively coherent data, but laboratory B could not in one element, so its reliability was doubtful. In comparison with the blood test, laboratory C generated identical results, but not laboratory A and B. Hair mineral analysis has its limitations, considering the reliability of inter and intra laboratory analysis comparing with blood analysis. As such, clinicians should be cautious when applying hair mineral analysis as an ancillary tool. Each laboratory included in this study requires continuous refinement from now on for inducing standardized normal reference levels.

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.

Missed detection of significant positive and negative shifts in gentamicin assay: implications for routine laboratory quality practices.

PubMed

Koerbin, Gus; Liu, Jiakai; Eigenstetter, Alex; Tan, Chin Hon; Badrick, Tony; Loh, Tze Ping

2018-02-15

A product recall was issued for the Roche/Hitachi Cobas Gentamicin II assays on 25 th May 2016 in Australia, after a 15 - 20% positive analytical shift was discovered. Laboratories were advised to employ the Thermo Fisher Gentamicin assay as an alternative. Following the reintroduction of the revised assay on 12 th September 2016, a second reagent recall was made on 20 th March 2017 after the discovery of a 20% negative analytical shift due to erroneous instrument adjustment factor. The practices of an index laboratory were examined to determine how the analytical shifts evaded detection by routine internal quality control (IQC) and external quality assurance (EQA) systems. The ability of the patient result-based approaches, including moving average (MovAvg) and moving sum of outliers (MovSO) approaches in detecting these shifts were examined. Internal quality control data of the index laboratory were acceptable prior to the product recall. The practice of adjusting IQC target following a change in assay method resulted in the missed negative shift when the revised Roche assay was reintroduced. While the EQA data of the Roche subgroup showed clear negative bias relative to other laboratory methods, the results were considered as possible 'matrix effect'. The MovAvg method detected the positive shift before the product recall. The MovSO did not detect the negative shift in the index laboratory but did so in another laboratory 5 days before the second product recall. There are gaps in current laboratory quality practices that leave room for analytical errors to evade detection.

The Pathology Laboratory Act 2007 explained.

PubMed

Looi, Lai-Meng

2008-06-01

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.

Advanced Placement and International Baccalaureate Examination Results in Texas, 2009-10. Document No. GE11 601 07

ERIC Educational Resources Information Center

Texas Education Agency, 2011

2011-01-01

This report reviews Advanced Placement (AP) and International Baccalaureate (IB) examination participation and performance in Texas during the 2009-10 school year. Campus-, district-, and state-level examination results for students in Texas public schools are presented, as well as state-level examination results for students in Texas public and…

A blinded international study on the reliability of genetic testing for GGGGCC-repeat expansions in C9orf72 reveals marked differences in results among 14 laboratories

PubMed Central

Akimoto, Chizuru; Volk, Alexander E; van Blitterswijk, Marka; Van den Broeck, Marleen; Leblond, Claire S; Lumbroso, Serge; Camu, William; Neitzel, Birgit; Onodera, Osamu; van Rheenen, Wouter; Pinto, Susana; Weber, Markus; Smith, Bradley; Proven, Melanie; Talbot, Kevin; Keagle, Pamela; Chesi, Alessandra; Ratti, Antonia; van der Zee, Julie; Alstermark, Helena; Birve, Anna; Calini, Daniela; Nordin, Angelica; Tradowsky, Daniela C; Just, Walter; Daoud, Hussein; Angerbauer, Sabrina; DeJesus-Hernandez, Mariely; Konno, Takuya; Lloyd-Jani, Anjali; de Carvalho, Mamede; Mouzat, Kevin; Landers, John E; Veldink, Jan H; Silani, Vincenzo; Gitler, Aaron D; Shaw, Christopher E; Rouleau, Guy A; van den Berg, Leonard H; Van Broeckhoven, Christine; Rademakers, Rosa; Andersen, Peter M; Kubisch, Christian

2014-01-01

Background The GGGGCC-repeat expansion in C9orf72 is the most frequent mutation found in patients with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Most of the studies on C9orf72 have relied on repeat-primed PCR (RP-PCR) methods for detection of the expansions. To investigate the inherent limitations of this technique, we compared methods and results of 14 laboratories. Methods The 14 laboratories genotyped DNA from 78 individuals (diagnosed with ALS or FTD) in a blinded fashion. Eleven laboratories used a combination of amplicon-length analysis and RP-PCR, whereas three laboratories used RP-PCR alone; Southern blotting techniques were used as a reference. Results Using PCR-based techniques, 5 of the 14 laboratories got results in full accordance with the Southern blotting results. Only 50 of the 78 DNA samples got the same genotype result in all 14 laboratories. There was a high degree of false positive and false negative results, and at least one sample could not be genotyped at all in 9 of the 14 laboratories. The mean sensitivity of a combination of amplicon-length analysis and RP-PCR was 95.0% (73.9–100%), and the mean specificity was 98.0% (87.5–100%). Overall, a sensitivity and specificity of more than 95% was observed in only seven laboratories. Conclusions Because of the wide range seen in genotyping results, we recommend using a combination of amplicon-length analysis and RP-PCR as a minimum in a research setting. We propose that Southern blotting techniques should be the gold standard, and be made obligatory in a clinical diagnostic setting. PMID:24706941

[Computer graphic display of retinal examination results. Software improving the quality of documenting fundus changes].

PubMed

Jürgens, Clemens; Grossjohann, Rico; Czepita, Damian; Tost, Frank

2009-01-01

Graphic documentation of retinal examination results in clinical ophthalmological practice is often depicted using pictures or in handwritten form. Popular software products used to describe changes in the fundus do not vary much from simple graphic programs that enable to insert, scale and edit basic graphic elements such as: a circle, rectangle, arrow or text. Displaying the results of retinal examinations in a unified way is difficult to achieve. Therefore, we devised and implemented modern software tools for this purpose. A computer program enabling to quickly and intuitively form graphs of the fundus, that can be digitally archived or printed was created. Especially for the needs of ophthalmological clinics, a set of standard digital symbols used to document the results of retinal examinations was developed and installed in a library of graphic symbols. These symbols are divided into the following categories: preoperative, postoperative, neovascularization, retinopathy of prematurity. The appropriate symbol can be selected with a click of the mouse and dragged-and-dropped on the canvas of the fundus. Current forms of documenting results of retinal examinations are unsatisfactory, due to the fact that they are time consuming and imprecise. Unequivocal interpretation is difficult or in some cases impossible. Using the developed computer program a sketch of the fundus can be created much more quickly than by hand drawing. Additionally the quality of the medica documentation using a system of well described and standardized symbols will be enhanced. (1) Graphic symbols used to document the results of retinal examinations are a part of everyday clinical practice. (2) The designed computer program will allow quick and intuitive graphical creation of fundus sketches that can be either digitally archived or printed.

The laboratory workforce shortage: a managerial perspective.

PubMed

Cortelyou-Ward, Kendall; Ramirez, Bernardo; Rotarius, Timothy

2011-01-01

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the next decade. This article examines the current situation of the clinical laboratory workforce. It analyzes the different types of personnel; the managerial, supervision, and line positions that are key for different types of laboratories; the job outlook and recent projections for different types of staff; and the current issues, trends, and challenges of the laboratory workforce. Laboratory managers need to take action with strategies suggested for overcoming these challenges. Most importantly, they need to become transformational leaders by developing effective staffing models, fostering healthy and productive work environments, and creating value with a strategic management culture and implementation of knowledge management.

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.

49 CFR 40.185 - Through what methods and to whom must a laboratory report split specimen results?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Through what methods and to whom must a laboratory report split specimen results? 40.185 Section 40.185 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Split Specimen Tests § 40.185 Through what methods and to whom...

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...

Good Laboratory Practice. Part 3. Implementing Good Laboratory Practice in the Analytical Lab

ERIC Educational Resources Information Center

Wedlich, Richard C.; Pires, Amanda; Fazzino, Lisa; Fransen, Joseph M.

2013-01-01

Laboratories submitting experimental results to the Food and Drug Administration (FDA) or the Environmental Protection Agency (EPA) in support of Good Laboratory Practice (GLP) nonclinical laboratory studies must conduct such work in compliance with the GLP regulations. To consistently meet these requirements, lab managers employ a "divide…

Laboratory-associated infections and biosafety.

PubMed Central

Sewell, D L

1995-01-01

An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace. PMID:7553572

Do sediment type and test durations affect results of laboratory-based, accelerated testing studies of permeable pavement clogging?

PubMed

Nichols, Peter W B; White, Richard; Lucke, Terry

2015-04-01

Previous studies have attempted to quantify the clogging processes of Permeable Interlocking Concrete Pavers (PICPs) using accelerated testing methods. However, the results have been variable. This study investigated the effects that three different sediment types (natural and silica), and different simulated rainfall intensities, and testing durations had on the observed clogging processes (and measured surface infiltration rates) of laboratory-based, accelerated PICP testing studies. Results showed that accelerated simulated laboratory testing results are highly dependent on the type, and size of sediment used in the experiments. For example, when using real stormwater sediment up to 1.18 mm in size, the results showed that neither testing duration, nor stormwater application rate had any significant effect on PICP clogging. However, the study clearly showed that shorter testing durations generally increased clogging and reduced the surface infiltration rates of the models when artificial silica sediment was used. Longer testing durations also generally increased clogging of the models when using fine sediment (<300 μm). Results from this study will help researchers and designers better anticipate when and why PICPs are susceptible to clogging, reduce maintenance and extend the useful life of these increasingly common stormwater best management practices. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparing Two Examination Results Using Means of Sample Means and Control Charts

ERIC Educational Resources Information Center

Alabi-Labaika, A. Bisi; Ahani, E.

2015-01-01

Some examination candidates submit their scripts first, sometimes, for recognition as being brilliant, and some do for not knowing what to write. However, some equally submit last because they want to dot i's and cross t's. The objective of this research is to compare the results of both the earliest and latest submissions with the aim of finding…

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...

The Role of Hemoglobin Laboratory Test Results for the Detection of Upper Gastrointestinal Bleeding Outcomes Resulting from the Use of Medications in Observational Studies.

PubMed

Patorno, Elisabetta; Gagne, Joshua J; Lu, Christine Y; Haynes, Kevin; Sterrett, Andrew T; Roy, Jason; Wang, Xingmei; Raebel, Marsha A

2017-01-01

The identification of upper gastrointestinal (UGI) bleeding and perforated ulcers in claims data typically relies on inpatient diagnoses. The use of hemoglobin laboratory results might increase the detection of UGI events that do not lead to hospitalization. Our objective was to evaluate whether hemoglobin results increase UGI outcome identification in electronic databases, using non-steroidal anti-inflammatory drugs (NSAIDs) as a test case. From three data partner sites within the Mini-Sentinel Distributed Database, we identified NSAID initiators aged ≥18 years between 2008 and 2013. Numbers of events and risks within 30 days after NSAID initiation were calculated for four mutually exclusive outcomes: (1) inpatient UGI diagnosis of bleeding or gastric ulcer (standard claims-based definition without laboratory results); (2) non-inpatient UGI diagnosis AND ≥3 g/dl hemoglobin decrease; (3) ≥3 g/dl hemoglobin decrease without UGI diagnosis in any clinical setting; (4) non-inpatient UGI diagnosis, without ≥3 g/dl hemoglobin decrease. We identified 2,289,772 NSAID initiators across three sites. Overall, 45.3% had one or more hemoglobin result available within 365 days before or 30 days after NSAID initiation; only 6.8% had results before and after. Of 7637 potential outcomes identified, outcome 1 accounted for 21.7%, outcome 2 for 0.8%, outcome 3 for 34.3%, and outcome 4 for 43.3%. Potential cases identified by outcome 3 were largely not suggestive of UGI events. Outcomes 1, 2, and 4 had similar distributions of specific UGI diagnoses. Using available hemoglobin result values combined with non-inpatient UGI diagnoses identified few additional UGI cases. Non-inpatient UGI diagnostic codes may increase outcome detection but would require validation.

Strategies for basic laboratory diagnostics of the hemoglobinopathies in multi-ethnic societies: interpretation of results and pitfalls.

PubMed

Giordano, P C

2013-10-01

The consistent multi-ethnic migrations of the last decades have considerably changed the epidemiology of the hemoglobinopathies. Healthy carriers of these conditions are present today in many nonendemic parts of the world, and severely affected children are now born where these diseases were previously rare or unknown. Improving the competence in carrier diagnostics at the laboratory level is one of the first concerns when introducing management and primary prevention of the severe conditions in nonendemic areas. This review describes how and when carriers should be correctly diagnosed and informed. The essential technologies needed for basic carrier diagnostics in different situations are summarized in some detail, and interpretation of the results and a number of related problems are discussed. The role of the hematology laboratory is essential, particularly in nonendemic areas where the first line of health care is often insufficiently aware of hemoglobinopathy management. Carriers living in nonendemic areas can be appropriately diagnosed and informed regarding genetic risk and prevention by well-organized laboratories. Both basic and specialized diagnostics are needed for the correct treatment for the anemic carriers, for primary prevention in couples at risk and for state-of-the art care of severely affected patients. © 2012 John Wiley & Sons Ltd.

Laboratory Astrophysics White Paper: Summary of Laboratory Astrophysics Needs

NASA Technical Reports Server (NTRS)

2002-01-01

The NASA Laboratory Astrophysics Workshop (NASA LAW) met at NASA Ames Research Center from 1-3 May 2002 to assess the role that laboratory astrophysics plays in the optimization of NASA missions, both at the science conception level and at the science return level. Space missions provide understanding of fundamental questions regarding the origin and evolution of galaxies, stars, and planetary systems. In all of these areas the interpretation of results from NASA's space missions relies crucially upon data obtained from the laboratory. We stress that Laboratory Astrophysics is important not only in the interpretation of data, but also in the design and planning of future missions. We recognize a symbiosis between missions to explore the universe and the underlying basic data needed to interpret the data from those missions. In the following we provide a summary of the consensus results from our Workshop, starting with general programmatic findings and followed by a list of more specific scientific areas that need attention. We stress that this is a 'living document' and that these lists are subject to change as new missions or new areas of research rise to the fore.

The ideal laboratory information system.

PubMed

Sepulveda, Jorge L; Young, Donald S

2013-08-01

Laboratory information systems (LIS) are critical components of the operation of clinical laboratories. However, the functionalities of LIS have lagged significantly behind the capacities of current hardware and software technologies, while the complexity of the information produced by clinical laboratories has been increasing over time and will soon undergo rapid expansion with the use of new, high-throughput and high-dimensionality laboratory tests. In the broadest sense, LIS are essential to manage the flow of information between health care providers, patients, and laboratories and should be designed to optimize not only laboratory operations but also personalized clinical care. To list suggestions for designing LIS with the goal of optimizing the operation of clinical laboratories while improving clinical care by intelligent management of laboratory information. Literature review, interviews with laboratory users, and personal experience and opinion. Laboratory information systems can improve laboratory operations and improve patient care. Specific suggestions for improving the function of LIS are listed under the following sections: (1) Information Security, (2) Test Ordering, (3) Specimen Collection, Accessioning, and Processing, (4) Analytic Phase, (5) Result Entry and Validation, (6) Result Reporting, (7) Notification Management, (8) Data Mining and Cross-sectional Reports, (9) Method Validation, (10) Quality Management, (11) Administrative and Financial Issues, and (12) Other Operational Issues.

[An integrated model for examination of aphasic patients and evaluation of treatment results].

PubMed

Ansink, B J; Vanneste, J A; Endtz, L J

1980-02-01

This article is an overview of the literature on integrated, multidisciplinar examination of aphasic patients, its consequences for treatment and the evaluation of the results thereof; the need of virtually standardized methods of investigation for each language is stressed.

Predictors of smoking lapse in a human laboratory paradigm.

PubMed

Roche, Daniel J O; Bujarski, Spencer; Moallem, Nathasha R; Guzman, Iris; Shapiro, Jenessa R; Ray, Lara A

2014-07-01

During a smoking quit attempt, a single smoking lapse is highly predictive of future relapse. While several risk factors for a smoking lapse have been identified during clinical trials, a laboratory model of lapse was until recently unavailable and, therefore, it is unclear whether these characteristics also convey risk for lapse in a laboratory environment. The primary study goal was to examine whether real-world risk factors of lapse are also predictive of smoking behavior in a laboratory model of smoking lapse. After overnight abstinence, 77 smokers completed the McKee smoking lapse task, in which they were presented with the choice of smoking or delaying in exchange for monetary reinforcement. Primary outcome measures were the latency to initiate smoking behavior and the number of cigarettes smoked during the lapse. Several baseline measures of smoking behavior, mood, and individual traits were examined as predictive factors. Craving to relieve the discomfort of withdrawal, withdrawal severity, and tension level were negatively predictive of latency to smoke. In contrast, average number of cigarettes smoked per day, withdrawal severity, level of nicotine dependence, craving for the positive effects of smoking, and craving to relieve the discomfort of withdrawal were positively predictive of number of cigarettes smoked. The results suggest that real-world risk factors for smoking lapse are also predictive of smoking behavior in a laboratory model of lapse. Future studies using the McKee lapse task should account for between subject differences in the unique factors that independently predict each outcome measure.

IMAGE Project: Results of Laboratory Tests on Tracers for Supercritical Conditions.

NASA Astrophysics Data System (ADS)

Brandvoll, Øyvind; Opsahl Viig, Sissel; Nardini, Isabella; Muller, Jiri

2016-04-01

The use of tracers is a well-established technique for monitoring dynamic behaviour of water and gas through a reservoir. In geothermal reservoirs special challenges are encountered due to high temperatures and pressures. In this work, tracer candidates for monitoring water at supercritical conditions (temperature > 374°C, pressure ca 218 bar), are tested in laboratory experiments. Testing of tracers at supercritical water conditions requires experimental set-ups which tolerate harsh conditions with respect to high temperature and pressure. In addition stringent HES (health, environment and safety) factors have to be taken into consideration when designing and performing the experiments. The setup constructed in this project consists of a pressure vessel, high pressure pump, instrumentation for pressure and temperature control and instrumentation required for accurate sampling of tracers. In order to achieve accurate results, a special focus has been paid to the development of the tracer sampling technique. Perfluorinated cyclic hydrocarbons (PFCs) have been selected as tracer candidates. This group of compounds is today commonly used as gas tracers in oil reservoirs. According to the literature they are stable at temperatures up to 400°C. To start with, five PFCs have been tested for thermal stability in static experiments at 375°C and 108 bar in the experimental setup described above. The tracer candidates will be further tested for several months at the relevant conditions. Preliminary results indicate that some of the PFC compounds show stability after three months. However, in order to arrive at conclusive results, the experiments have to be repeated over a longer period and paying special attention to more accurate sampling procedures.

Inter-laboratory comparison measurements of radiochemical laboratories in Slovakia.

PubMed

Meresová, J; Belanová, A; Vrsková, M

2010-01-01

The first inter-laboratory comparison organized by the radiochemistry laboratory of Water Research Institute (WRI) in Bratislava was carried out in 1993 and since then is it realized on an annual basis and about 10 radiochemical laboratories from all over Slovakia are participating. The gross alpha and gross beta activities, and the activity concentrations of (222)Rn, tritium, and (226)Ra, and U(nat) concentration in synthetic water samples are compared. The distributed samples are covering the concentration range prevailing in potable and surface waters and are prepared by dilution of certified reference materials. Over the course of the years 1993-2008, we observed the improvement in the quality of results for most of the laboratories. However, the success rate of the gross alpha determination activity is not improving as much as the other parameters. Copyright 2009 Elsevier Ltd. All rights reserved.

Instructional Efficiency of Tutoring in an Outreach Gene Technology Laboratory

NASA Astrophysics Data System (ADS)

Scharfenberg, Franz-Josef; Bogner, Franz X.

2013-06-01

Our research objective focused on examining the instructional efficiency of tutoring as a form of instructional change as opposed to a non-tutoring approach in an outreach laboratory. We designed our laboratory based on cognitive load (CL) theory. Altogether, 269 twelfth-graders participated in our day-long module Genetic Fingerprinting. In a quasi-experimental design, the control group ( n = 121) followed the non-tutoring approach previously used, while the treatment group ( n = 148) followed the newly developed tutoring approach. Each tutor was in charge of two student work groups and recorded the tutoring activities requested by the tutees throughout the day. We measured the students' invested mental effort (as an index of CL), cognitive achievement (in a pre-post-follow-up design), and the students' cooperation in their work groups as well as calculated the student instructional involvement (as a motivational variable). Additionally, we examined which aspects of the hands-on phases were of particular relevance to the students' invested mental effort. Unexpectedly, the combined mental effort and cognitive achievement data indicated that our implemented tutoring approach resulted in a lower instructional efficiency despite the relevance of tutoring for students' mental effort invested during the experimental phases. Most of the tutor assistance was unnecessarily requested for performing the procedural steps and using the equipment. Our results indicate an assistance dilemma and consequently underscore the necessity for effective tutor preparation in outreach laboratories.

Ordering molecular genetic tests and reporting results: practices in laboratory and clinical settings.

PubMed

Lubin, Ira M; Caggana, Michele; Constantin, Carolyn; Gross, Susan J; Lyon, Elaine; Pagon, Roberta A; Trotter, Tracy L; Wilson, Jean Amos; McGovern, Margaret M

2008-09-01

Previous studies have suggested that patient care may be compromised as a consequence of poor communication between clinicians and laboratory professionals in cases in which molecular genetic test results are reported. To understand better the contributing factors to such compromised care, we investigated both pre- and postanalytical processes using cystic fibrosis mutation analysis as our model. We found that although the majority of test requisition forms requested patient/family information that was necessary for the proper interpretation of test results, in many cases, these data were not provided by the individuals filling out the forms. We found instances in which result reports for simulated diagnostic testing described individuals as carriers where only a single mutation was found with no comment pertaining to a diagnosis of cystic fibrosis. Similarly, reports based on simulated scenarios for carrier testing were problematic when no mutations were identified, and the patient's race/ethnicity and family history were not discussed in reference to residual risk of disease. Remarkably, a pilot survey of obstetrician-gynecologists revealed that office staff, including secretaries, often helped order genetic tests and reported test results to patients, raising questions about what efforts are undertaken to ensure personnel competency. These findings are reviewed in light of what efforts should be taken to improve the quality of test-ordering and result-reporting practices.

Strategies for the successful implementation of viral laboratory automation.

PubMed

Avivar, Cristóbal

2012-01-01

It has been estimated that more than 70% of all medical activity is directly related to information providing analytical data. Substantial technological advances have taken place recently, which have allowed a previously unimagined number of analytical samples to be processed while offering high quality results. Concurrently, yet more new diagnostic determinations have been introduced - all of which has led to a significant increase in the prescription of analytical parameters. This increased workload has placed great pressure on the laboratory with respect to health costs. The present manager of the Clinical Laboratory (CL) has had to examine cost control as well as rationing - meaning that the CL's focus has not been strictly metrological, as if it were purely a system producing results, but instead has had to concentrate on its efficiency and efficacy. By applying re-engineering criteria, an emphasis has had to be placed on improved organisation and operating practice within the CL, focussing on the current criteria of the Integrated Management Areas where the technical and human resources are brought together. This re-engineering has been based on the concepts of consolidating and integrating the analytical platforms, while differentiating the production areas (CORE Laboratory) from the information areas. With these present concepts in mind, automation and virological treatment, along with serology in general, follow the same criteria as the rest of the operating methodology in the Clinical Laboratory.

Mont Terri Underground Rock Laboratory, Switzerland-Research Program And Key Results

NASA Astrophysics Data System (ADS)

Nussbaum, C. O.; Bossart, P. J.

2012-12-01

scenarios and v) Evaluation of diffusion and retention parameters for long-lived radionuclides. Experiments related to repository-induced perturbations are focused on: i) Influence of rock liner on the disposal system and the buffering potential of the host rock; ii) Self-sealing processes in the excavation damaged zone; iii) Hydro-mechanical coupled processes (e.g. stress redistributions and pore pressure evolution during excavation); iv) Thermo-hydro-mechanical-chemical coupled processes (e.g. heating of bentonite and host rock) and v) Gas-induced transport of radionuclides in porewater and along interfaces in the engineered barrier system. A third research direction is to demonstrate the feasibility of repository construction and long-term safety after repository closure. Demonstration experiments can contribute to improving the reliability of the scientific basis for the safety assessment of future geological repositories, particularly if they are performed on a large scale and with a long duration. These experiments include the construction and installation of engineered barriers on a 1:1 scale: i) Horizontal emplacement of canisters; ii) Evaluation of the corrosion of container materials; repository re-saturation; iii) Sealing of boreholes and repository access tunnels and iv) Long-term monitoring of the repository. References Bossart, P. & Thury, M. (2008): Mont Terri Rock Laboratory. Project, Programme 1996 to 2007 and Results. - Rep. Swiss Geol. Surv. 3.

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.

The Effects of Resident Peer- and Self-Chart Review on Outpatient Laboratory Result Follow-up.

PubMed

Hale, Andrew J; Nall, Ryan W; Mukamal, Kenneth J; Libman, Howard; Smith, C Christopher; Sternberg, Scot B; Kim, Hans S; Kriegel, Gila

2016-05-01

Performing and teaching appropriate follow-up of outpatient laboratory results (LRs) is a challenge. The authors tested peer-review among residents as a potentially valuable intervention. Investigators assigned residents to perform self-review (n = 27), peer-review (n = 21), or self- + peer-review (n = 30) of outpatient charts. They also compared residence performance with that of historical controls (n = 20). In September 2012, residents examined 10 LRs from April 2012 onward. A second review in November 2012 ascertained whether performing chart review improved residents' practice behaviors. Initially, the least-square (LS) mean number of LRs without documentation of follow-up per resident in the self-, peer-, and self- + peer-review group was, respectively, 0.5 (SD 1.0), 1.0 (SD 1.7), and 0.9 (SD 1.3), and post intervention, this was 1.0 (SD 0.2), 0.3 (SD 0.2), and 0.6 (SD 0.2) (self- versus peer-review P = .03). Initially the LS mean follow-up time per resident in the self-, peer-, and self- + peer-review group was, respectively, 4.2 (SD 1.2), 6.9 (SD 1.4), and 5.9 (SD 1.2) days, and after the intervention, LS mean time was 5.0 (SD 0.5), 2.5 (SD 0.6), and 3.9 (SD 0.5) days (self- versus peer-review P < .01). Self-review was not associated with significant improvements in practice. In this comparison of self- and peer-review, only residents who performed peer-review demonstrated significant improvements in their documentation practices. These findings support the use of resident peer-review in improving LR follow-up, and potentially, in other, broader resident quality improvement initiatives.

Characterizing High School Students' Written Explanations in Biology Laboratories

NASA Astrophysics Data System (ADS)

Peker, Deniz; Wallace, Carolyn S.

2011-03-01

The purpose of this qualitative interpretive research study was to examine high school students' written scientific explanations during biology laboratory investigations. Specifically, we characterized the types of epistemologies and forms of reasoning involved in students' scientific explanations and students' perceptions of scientific explanations. Sixteen students from a rural high school in the Southeastern United States were the participants of this research study. The data consisted of students' laboratory reports and individual interviews. The results indicated that students' explanations were primarily based on first-hand knowledge gained in the science laboratories and mostly representing procedural recounts. Most students did not give explanations based on a theory or a principle and did not use deductive reasoning in their explanations. The students had difficulties explaining phenomena that involved intricate cause-effect relationships. Students perceived scientific explanation as the final step of a scientific inquiry and as an account of what happened in the inquiry process, and held a constructivist-empiricist view of scientific explanations. Our results imply the need for more explicit guidance to help students construct better scientific explanations and explicit teaching of the explanatory genre with particular focus on theoretical and causal explanations.

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

Examination of Pre-Productions Samples of UOP IONSIV(R) IE-910 and IE-911

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

Walker, D.D.

2001-07-10

This report includes results of the extensive examination of newly-prepared laboratory-scale and pre-production samples of caustic-washed CST [crystalline silicotitanate] as compared to similar performance data for commercially-available and baseline samples. Conclusions from this work include the following.

FACTORS DETERMINING THE RESULTS OF THE EXAMINATION OF THE WEST AFRICAN COLLEGE OF SURGEONS IN GENERAL SURGERY.

PubMed

Ajao, O G; Ajao, O O; Ugwu, B T; Yawe, Kdt; Ezeome, E R

2014-01-01

The general surgery results of the West African College of Surgeons (WACS) post-graduate fellowship examination could not be regarded as satisfactory when compared with the results of similar post-graduate examinations in some developed countries. For example the pass rate of the West African College of Surgeons examination was usually under 40% whereas the pass rate in oral examination in a similar post-graduate examination, the American Board of Surgery was 84% in 2006, 73% in 2012. The first time pass rate in general surgery of final year general surgery residents at the American Board of Surgery qualifying and certifying examinations were 74% - 78% between 2000 and 2007. To identify the factors responsible for the high failure rate at the general surgery fellowship examinations of the West African College of Surgeons. Descriptive study .We studied and analyzed the West African College of Surgeons examination results for April 2012, October 2012, April 2013 and October 2013 with emphasis on the results, the conduct of the examination and the opinion from fellows about the examiners. Well structured questionnaires were sent to fellows who had passed all the various fellowship examinations of the West African College of Surgeons in general surgery to indicate their opinion about the examination, and the examiners. University College Hospital, Ibadan, and Jos University Teaching Hospital, Jos, Nigeria. The first part of the study dealt with an analysis of each section of the examination prospectively studied over a 2-year period. This consisted of four sets of examination results. The second part was a questionnaire-based study administered to Fellows who had passed the WACS final fellowship examination in general surgery. The questionnaire had three sections: primary, part 1 and part 2 and included basic demographics, date at attempts in each grade of the examinations and the outcome. It also included the views of the respondents on the conduct of the examination

The OSHA hazardous chemical occupational exposure standard for laboratories.

PubMed

Armbruster, D A

1991-01-01

OSHA's chemical occupational exposure standard for laboratories is an outgrowth of the previously issued Hazard Communication Standard. The standard relieves laboratories from complying with general industry standards but does require compliance with specific laboratory guidelines. The heart of the standard is the creation of a Chemical Hygiene Plan (CHP). The CHP addresses major issues such as safety equipment and procedures, work practices, training, the designation of a chemical hygiene officer, and the provision of medical consultation and examination for affected employees. This new standard, in full effect as of January 31, 1991, presents yet another regulatory challenge to laboratory managers but also ensures a safer environment for laboratory workers.

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)

27 CFR 22.108 - Other laboratories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Other laboratories. 22.108... Other laboratories. Laboratories, other than pathological laboratories specified in § 22.107, may... products resulting from the use of tax-free alcohol shall be confined strictly to the laboratory premises...

27 CFR 22.108 - Other laboratories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Other laboratories. 22.108... Other laboratories. Laboratories, other than pathological laboratories specified in § 22.107, may... products resulting from the use of tax-free alcohol shall be confined strictly to the laboratory premises...

Post-irradiation-examination of irradiated fuel outside the hot cell

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

Dawn E. Janney; Adam B. Robinson; Thomas P. O'Holleran

Because of their high radioactivity, irradiated fuels are commonly examined in a hot cell. However, the Idaho National Laboratory (INL) has recently investigated irradiated U-Mo-Al metallic fuel from the Reduced Enrichment for Research and Test Reactors (RERTR) project using a conventional unshielded scanning electron microscope outside a hot cell. This examination was possible because of a two-step sample-preparation approach in which a small volume of fuel was isolated in a hot cell and shielding was introduced during later stages of sample preparation. The resulting sample contained numerous sample-preparation artifacts but allowed analysis of microstructures from selected areas.

49 CFR 40.129 - What are the MRO's functions in reviewing laboratory confirmed non-negative drug test results?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false What are the MRO's functions in reviewing laboratory confirmed non-negative drug test results? 40.129 Section 40.129 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Medical Review Officers and the Verification Proces...

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

Examination Of Sulfur Measurements In DWPF Sludge Slurry And SRAT Product Materials

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

Bannochie, C. J.; Wiedenman, B. J.

2012-11-29

Savannah River National Laboratory (SRNL) was asked to re-sample the received SB7b WAPS material for wt. % solids, perform an aqua regia digestion and analyze the digested material by inductively coupled plasma - atomic emission spectroscopy (ICP-AES), as well as re-examine the supernate by ICP-AES. The new analyses were requested in order to provide confidence that the initial analytical subsample was representative of the Tank 40 sample received and to replicate the S results obtained on the initial subsample collected. The ICP-AES analyses for S were examined with both axial and radial detection of the sulfur ICP-AES spectroscopic emission linesmore » to ascertain if there was any significant difference in the reported results. The outcome of this second subsample of the Tank 40 WAPS material is the first subject of this report. After examination of the data from the new subsample of the SB7b WAPS material, a team of DWPF and SRNL staff looked for ways to address the question of whether there was in fact insoluble S that was not being accounted for by ion chromatography (IC) analysis. The question of how much S is reaching the melter was thought best addressed by examining a DWPF Slurry Mix Evaporator (SME) Product sample, but the significant dilution of sludge material, containing the S species in question, that results from frit addition was believed to add additional uncertainty to the S analysis of SME Product material. At the time of these discussions it was believed that all S present in a Sludge Receipt and Adjustment Tank (SRAT) Receipt sample would be converted to sulfate during the course of the SRAT cycle. A SRAT Product sample would not have the S dilution effect resulting from frit addition, and hence, it was decided that a DWPF SRAT Product sample would be obtained and submitted to SRNL for digestion and sample preparation followed by a round-robin analysis of the prepared samples by the DWPF Laboratory, F/H Laboratories, and SRNL for S and

Evaluation of the Radar Stage Sensor manufactured by Forest Technology Systems—Results of laboratory and field testing

USGS Publications Warehouse

Kunkle, Gerald A.

2018-01-31

Two identical Radar Stage Sensors from Forest Technology Systems were evaluated to determine if they are suitable for U.S. Geological Survey (USGS) hydrologic data collection. The sensors were evaluated in laboratory conditions to evaluate the distance accuracy of the sensor over the manufacturer’s specified operating temperatures and distance to water ranges. Laboratory results were compared to the manufacturer’s accuracy specification of ±0.007 foot (ft) and the USGS Office of Surface Water (OSW) policy requirement that water-level sensors have a measurement uncertainty of no more than 0.01 ft or 0.20 percent of the indicated reading. Both of the sensors tested were within the OSW policy requirement in both laboratory tests and within the manufacturer’s specification in the distance to water test over tested distances from 3 to 15 ft. In the temperature chamber test, both sensors were within the manufacturer’s specification for more than 90 percent of the data points collected over a temperature range of –40 to +60 degrees Celsius at a fixed distance of 8 ft. One sensor was subjected to an SDI-12 communication test, which it passed. A field test was conducted on one sensor at a USGS field site near Landon, Mississippi, from February 5 to March 29, 2016. Water-level measurements made by the radar during the field test were in agreement with those made by the Sutron Accubar Constant Flow Bubble Gauge.Upon the manufacturer’s release of updated firmware version 1.09, additional SDI-12 and temperature testing was performed to evaluate added SDI-12 functions and verify that performance was unaffected by the update. At this time, an Axiom data logger is required to perform a firmware update on this sensor. The data confirmed the results of the original test. Based on the test results, the Radar Stage Sensor is a suitable choice for USGS hydrologic data collection.

Reflectance confocal microscopy of tinea nigra: comparing images with dermoscopy and mycological examination results.

PubMed

Veasey, John Verrinder; Avila, Ricardo Bertozzi de; Ferreira, Marcus Antônio Maia de Olivas; Lazzarini, Rosana

2017-01-01

Tinea nigra is a superficial mycosis whose diagnosis is confirmed by isolating the infectious agent Hortae werneckii through mycological examinations. In vivo reflectance confocal microscopy, initially used in melanocytic dermatosis, has been used with skin infectious diseases to identify the parasite at the cellular level. We report, for the first time in the scientific literature, the use of reflectance confocal microscopy in a case of tinea nigra and compare its findings to dermoscopy and mycological examination results.

Reflectance confocal microscopy of tinea nigra: comparing images with dermoscopy and mycological examination results*

PubMed Central

Veasey, John Verrinder; de Avila, Ricardo Bertozzi; Ferreira, Marcus Antônio Maia de Olivas; Lazzarini, Rosana

2017-01-01

Tinea nigra is a superficial mycosis whose diagnosis is confirmed by isolating the infectious agent Hortae werneckii through mycological examinations. In vivo reflectance confocal microscopy, initially used in melanocytic dermatosis, has been used with skin infectious diseases to identify the parasite at the cellular level. We report, for the first time in the scientific literature, the use of reflectance confocal microscopy in a case of tinea nigra and compare its findings to dermoscopy and mycological examination results. PMID:28954116

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.

[Clinical laboratory examination of diabetic patients in conjunction with metabolic syndrome].

PubMed

Kishitani, Yuzuru

2009-11-01

Diabetic patients tend to show a reduced QOL because of macrovascular complications such as cerebral and myocardial infarction, as well as marked microvascular complications. It is important for the prevention and amelioration of these complications to diagnose diabetes mellitus (DM) early and effectively control glycemia, the blood pressure, lipids, and body weight. We examine fasting plasma glucose (FPG) and HbA1c for a diagnosis of diabetes at any time, but examine 75gOGTT for impaired glucose tolerance or DM. Examination to be necessary for a pathologic classification of DM is islet-associated antibody, namely, GAD antibody, IA-2 antibody and the measurement of IRI, blood/urinary C-peptide to evaluate insulin secretory ability. HOMA-R is an index of insulin resistance, and HOMA-beta is an index of insulin secretory ability which can be calculated from FPG and IRI, but we need to be aware that the insulin secretory ability of the patient may have decreased already. HbA1c is a standard index of glycemic control, but glycoalbumin measurement is suitable for disease states such as anemia and liver cirrhosis, and 1,5-anhydroglucitol is suitable for detecting changes in levels of urinary glucose. Examinations necessary for the evaluation of diabetic nephropathy are microalbumin and 24hr Ccr in the urine, but eGFR has been recently recommended instead of 24hr Ccr. We measure small dense LDL-C, RLP-C, and Lp (a) as well as conduct conventional lipid analyses for dislipidemia combined with DM for qualitative as well as quantitative data. Metabolic syndrome is caused by the life habits of overeating and lack of exercise, leading to atherosclerotic disease, because insulin resistance advances from visceral fat accumulation. TNF-alpha and leptin levels as insulin resistance advances and adiponectin levels as insulin resistance improves are measured as adipocytokines secreted by visceral fat tissue.

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

Effects of vigorous mixing of blood vacuum tubes on laboratory test results.

PubMed

Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Montagnana, Martina; Gelati, Matteo; Volanski, Waldemar; Boritiza, Katia Cristina; Picheth, Geraldo; Guidi, Gian Cesare

2013-02-01

To evaluate the effect of tubes mixing (gentle vs. vigorous) on diagnostic blood specimens collected in vacuum tube systems by venipuncture. Blood was collected for routine coagulation, immunochemistry and hematological testing from one hundred volunteers into six vacuum tubes: two 3.6 mL vacuum tubes containing 0.4 mL of buffered sodium citrate (9NC) 0.109 mol/L: 3.2 W/V%; two 3.5 mL vacuum tubes with clot activator and gel separator; and two 3.0 mL vacuum tubes containing 5.9 mg K(2)EDTA (Terumo Europe, Belgium). Immediately after the venipuncture all vacuum tubes (each of one additive type) were processed through two different procedures: i) Standard: blood specimens in K(2)EDTA- or sodium citrate-vacuum tubes were gently inverted five times whereas the specimens in tubes with clot activator and gel separator were gently inverted ten times, as recommended by the manufacturer; ii) Vigorous mix: all blood specimens were shaken up vigorously during 3-5s independently of the additive type inside the tubes. The significance of the differences between samples was assessed by Student's t-test or Wilcoxon ranked-pairs test after checking for normality. The level of statistical significance was set at P<0.05. No significant difference (P<0.05) was detected between the procedures for all tested parameters. Surprisingly only a visual alteration (presence of foam on the top) was shown by all the tubes mixed vigorously before centrifugation (Fig. 1 A, B and C). Moreover the serum tubes from vigorous mixing procedure shows a "blood ring" on the tube top after stopper removal (Fig. 1 D). Our results drop out a paradigm suggesting that the incorrect primary blood tubes mixing promotes laboratory variability. We suggest that similar evaluation should be done using other brands of vacuum tubes by each laboratory manager. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Single-centre experience with Renal PatientView, a web-based system that provides patients with access to their laboratory results.

PubMed

Woywodt, Alexander; Vythelingum, Kervina; Rayner, Scott; Anderton, John; Ahmed, Aimun

2014-10-01

Renal PatientView (RPV) is a novel, web-based system in the UK that provides patients with access to their laboratory results, in conjunction with patient information. To study how renal patients within our centre access and use RPV. We sent out questionnaires in December 2011 to all 651 RPV users under our care. We collected information on aspects such as the frequency and timing of RPV usage, the parameters viewed by users, and the impact of RPV on their care. A total of 295 (45 %) questionnaires were returned. The predominant users of RPV were transplant patients (42 %) followed by pre-dialysis chronic kidney disease patients (37 %). Forty-two percent of RPV users accessed their results after their clinic appointments, 38 % prior to visiting the clinic. The majority of patients (76 %) had used the system to discuss treatment with their renal physician, while 20 % of patients gave permission to other members of their family to use RPV to monitor results on their behalf. Most users (78 %) reported accessing RPV on average 1-5 times/month. Most patients used RPV to monitor their kidney function, 81 % to check creatinine levels, 57 % to check potassium results. Ninety-two percent of patients found RPV easy to use and 93 % felt that overall the system helps them in taking care of their condition; 53 % of patients reported high satisfaction with RPV. Our results provide interesting insight into use of a system that gives patients web-based access to laboratory results. The fact that 20 % of patients delegate access to relatives also warrants further study. We propose that online access to laboratory results should be offered to all renal patients, although clinicians need to be mindful of the 'digital divide', i.e. part of the population that is not amenable to IT-based strategies for patient empowerment.

Results of the radiological survey at the ALCOA Research Laboratory, 600 Freeport Road, New Kensington, Pennsylvania (ANK001)

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

Foley, R.D.; Brown, K.S.

1992-10-01

At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted a radiological survey at the ALCOA Research Laboratory, 600 Freeport Road, New Kensington, Pennsylvania. The survey was performed on November 12, 1991. The purpose of the survey was to determine whether the property was contaminated with radioactive residues, principally [sup 238]U, as a result of work done for the Manhattan Engineer District in 1944. The survey included measurement of direct alpha and beta-gamma levels in the northeast comer of the basement of Building 29, and the collection of a debris sample frommore » a floor drain for radionuclide analysis. The survey area was used for experimental canning of uranium slugs prior to production activities at the former New Kensington Works nearby.« less

Emergency Physicians’ Views of Direct Notification of Laboratory and Radiology Results to Patients Using the Internet: A Multisite Survey

PubMed Central

2015-01-01

Background Patients are increasingly using the Internet to communicate with health care providers and access general and personal health information. Missed test results have been identified as a critical safety issue with studies showing up to 75% of tests for emergency department (ED) patients not being followed-up. One strategy that could reduce the likelihood of important results being missed is for ED patients to have direct access to their test results. This could be achieved electronically using a patient portal tied to the hospital’s electronic medical record or accessed from the relevant laboratory information system. Patients have expressed interest in accessing test results directly, but there have been no reported studies on emergency physicians’ opinions. Objective The aim was to explore emergency physicians’ current practices of test result notification and attitudes to direct patient notification of clinically significant abnormal and normal test results. Methods A cross-sectional survey was self-administered by senior emergency physicians (site A: n=50; site B: n=39) at 2 large public metropolitan teaching hospitals in Australia. Outcome measures included current practices for notification of results (timing, methods, and responsibilities) and concerns with direct notification. Results The response rate was 69% (61/89). More than half of the emergency physicians (54%, 33/61) were uncomfortable with patients receiving direct notification of abnormal test results. A similar proportion (57%, 35/61) was comfortable with direct notification of normal test results. Physicians were more likely to agree with direct notification of normal test results if they believed it would reduce their workload (OR 5.72, 95% CI 1.14-39.76). Main concerns were that patients could be anxious (85%, 52/61), confused (92%, 56/61), and lacking in the necessary expertise to interpret their results (90%, 55/61). Conclusions Although patients’ direct access to test

Laboratory performance in the Sediment Laboratory Quality-Assurance Project, 1996-98

USGS Publications Warehouse

Gordon, John D.; Newland, Carla A.; Gagliardi, Shane T.

2000-01-01

Analytical results from all sediment quality-control samples are compiled and statistically summarized by the USGS, Branch of Quality Systems, both on an intra- and interlaboratory basis. When evaluating these data, the reader needs to keep in mind that every measurement has an error component associated with it. It is premature to use the data from the first five SLQA studies to judge any of the laboratories as performing in an unacceptable manner. There were, however, some notable differences in the results for the 12 laboratories that participated in the five SLQA studies. For example, the overall median percent difference for suspended-sediment concentration on an individual laboratory basis ranged from –18.04 to –0.33 percent. Five of the 12 laboratories had an overall median percent difference for suspended-sediment concentration of –2.02 to –0.33 percent. There was less variability in the median difference for the measured fine-size material mass. The overall median percent difference for fine-size material mass ranged from –10.11 to –4.27 percent. Except for one laboratory, the median difference for fine-size material mass was within a fairly narrow range of –6.76 to –4.27 percent. The median percent difference for sand-size material mass differed among laboratories more than any other physical sediment property measured in the study. The overall median percent difference for the sand-size material mass ranged from –1.49 percent to 26.39 percent. Five of the nine laboratories that do sand/fine separations had overall median percent differences that ranged from –1.49 to 2.98 percent for sand-size material mass. Careful review of the data reveals that certain laboratories consistently produced data within statistical control limits for some or all of the physical sediment properties measured in this study, whereas other laboratories occasionally produced data that exceeded the control limits.

Implementation of an accelerated physical examination course in a doctor of pharmacy program.

PubMed

Ho, Jackie; Bidwal, Monica K; Lopes, Ingrid C; Shah, Bijal M; Ip, Eric J

2014-12-15

To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students' knowledge, attitudes, and confidence in performing physical examination. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory. Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students' perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination. An accelerated physical examination course using a flipped teaching approach was successful in improving students' knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice.

Implementation of an Accelerated Physical Examination Course in a Doctor of Pharmacy Program

PubMed Central

Ho, Jackie; Lopes, Ingrid C.; Shah, Bijal M.; Ip, Eric J.

2014-01-01

Objective. To describe the implementation of a 1-day accelerated physical examination course for a doctor of pharmacy program and to evaluate pharmacy students’ knowledge, attitudes, and confidence in performing physical examination. Design. Using a flipped teaching approach, course coordinators collaborated with a physician faculty member to design and develop the objectives of the course. Knowledge, attitude, and confidence survey questions were administered before and after the practical laboratory. Assessment. Following the practical laboratory, knowledge improved by 8.3% (p<0.0001). Students’ perceived ability and confidence to perform a physical examination significantly improved (p<0.0001). A majority of students responded that reviewing the training video (81.3%) and reading material (67.4%) prior to the practical laboratory was helpful in learning the physical examination. Conclusion. An accelerated physical examination course using a flipped teaching approach was successful in improving students’ knowledge of, attitudes about, and confidence in using physical examination skills in pharmacy practice. PMID:25657369

A Content Analysis of General Chemistry Laboratory Manuals for Evidence of Higher-Order Cognitive Tasks

NASA Astrophysics Data System (ADS)

Domin, Daniel S.

1999-01-01

The science laboratory instructional environment is ideal for fostering the development of problem-solving, manipulative, and higher-order thinking skills: the skills needed by today's learner to compete in an ever increasing technology-based society. This paper reports the results of a content analysis of ten general chemistry laboratory manuals. Three experiments from each manual were examined for evidence of higher-order cognitive activities. Analysis was based upon the six major cognitive categories of Bloom's Taxonomy of Educational Objectives: knowledge, comprehension, application, analysis, synthesis, and evaluation. The results of this study show that the overwhelming majority of general chemistry laboratory manuals provide tasks that require the use of only the lower-order cognitive skills: knowledge, comprehension, and application. Two of the laboratory manuals were disparate in having activities that utilized higher-order cognition. I describe the instructional strategies used within these manuals to foster higher-order cognitive development.

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.

Using Microcomputers in the Undergraduate Laboratory.

ERIC Educational Resources Information Center

Hovancik, John R.

1986-01-01

A computer-controlled experimental psychology investigation suitable for use in an undergraduate laboratory is described. The investigation examines the relationship between aesthetic preference and speed of reaction in making choices between colors generated on a video monitor. (Author)

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...

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...

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...

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...

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...

Examination of Bond Properties through Infrared Spectroscopy and Molecular Modeling in the General Chemistry Laboratory

ERIC Educational Resources Information Center

Csizmar, Clifford M.; Force, Dee Ann; Warner, Don L.

2012-01-01

A concerted effort has been made to increase the opportunities for undergraduate students to address scientific problems employing the processes used by practicing chemists. As part of this effort, an infrared (IR) spectroscopy and molecular modeling experiment was developed for the first-year general chemistry laboratory course. In the…

Emergency physicians' views of direct notification of laboratory and radiology results to patients using the Internet: a multisite survey.

PubMed

Callen, Joanne; Giardina, Traber Davis; Singh, Hardeep; Li, Ling; Paoloni, Richard; Georgiou, Andrew; Runciman, William B; Westbrook, Johanna I

2015-03-04

Patients are increasingly using the Internet to communicate with health care providers and access general and personal health information. Missed test results have been identified as a critical safety issue with studies showing up to 75% of tests for emergency department (ED) patients not being followed-up. One strategy that could reduce the likelihood of important results being missed is for ED patients to have direct access to their test results. This could be achieved electronically using a patient portal tied to the hospital's electronic medical record or accessed from the relevant laboratory information system. Patients have expressed interest in accessing test results directly, but there have been no reported studies on emergency physicians' opinions. The aim was to explore emergency physicians' current practices of test result notification and attitudes to direct patient notification of clinically significant abnormal and normal test results. A cross-sectional survey was self-administered by senior emergency physicians (site A: n=50; site B: n=39) at 2 large public metropolitan teaching hospitals in Australia. Outcome measures included current practices for notification of results (timing, methods, and responsibilities) and concerns with direct notification. The response rate was 69% (61/89). More than half of the emergency physicians (54%, 33/61) were uncomfortable with patients receiving direct notification of abnormal test results. A similar proportion (57%, 35/61) was comfortable with direct notification of normal test results. Physicians were more likely to agree with direct notification of normal test results if they believed it would reduce their workload (OR 5.72, 95% CI 1.14-39.76). Main concerns were that patients could be anxious (85%, 52/61), confused (92%, 56/61), and lacking in the necessary expertise to interpret their results (90%, 55/61). Although patients' direct access to test results could serve as a safety net reducing the likelihood of

Implementation of Gas Chromatography and Microscale Distillation into the General Chemistry Laboratory Curriculum as Vehicles for Examining Intermolecular Forces

ERIC Educational Resources Information Center

Csizmar, Clifford M.; Force, Dee Ann; Warner, Don L.

2011-01-01

As part of an NSF-funded Course Curriculum and Laboratory Improvement (CCLI) project that seeks, in part, to increase student exposure to scientific instrumentation, a gas chromatography experiment has been integrated into the second-semester general chemistry laboratory curriculum. The experiment uses affordable, commercially available equipment…

Assessment of Application Technology of Natural User Interfaces in the Creation of a Virtual Chemical Laboratory

NASA Astrophysics Data System (ADS)

Jagodziński, Piotr; Wolski, Robert

2015-02-01

Natural User Interfaces (NUI) are now widely used in electronic devices such as smartphones, tablets and gaming consoles. We have tried to apply this technology in the teaching of chemistry in middle school and high school. A virtual chemical laboratory was developed in which students can simulate the performance of laboratory activities similar to those that they perform in a real laboratory. Kinect sensor was used for the detection and analysis of the student's hand movements, which is an example of NUI. The studies conducted found the effectiveness of educational virtual laboratory. The extent to which the use of a teaching aid increased the students' progress in learning chemistry was examined. The results indicate that the use of NUI creates opportunities to both enhance and improve the quality of the chemistry education. Working in a virtual laboratory using the Kinect interface results in greater emotional involvement and an increased sense of self-efficacy in the laboratory work among students. As a consequence, students are getting higher marks and are more interested in the subject of chemistry.

A rapid review examining purchasing changes resulting from fiscal measures targeted at high sugar foods and sugar-sweetened drinks.

PubMed

Roberts, Katharine E; Ells, Louisa J; McGowan, Victoria J; Machaira, Theodora; Targett, Victoria C; Allen, Rachel E; Tedstone, Alison E

2017-12-15

To aim of the review was to examine the most recent (2010 onwards) research evidence on the health and behavioural impacts, in adults and children, of fiscal strategies that target high sugar foods and sugar-sweetened drinks (SSDs). A pragmatic rapid review was undertaken using a systematic search strategy. The review was part of a programme of work to support policy development in relation to high sugar food and SSDs. A total of 11 primary research publications were included, describing evidence from France (n = 1), the Netherlands (n = 3), and the United States of America (n = 7), assessed through a variety of study designs, with the majority in adult populations (n = 10). The evidence reviewed focused on consumer behaviour outcomes and suggested that fiscal strategies can influence purchases of high sugar products. Although the majority of studies (n = 10), including three field studies, demonstrated that an increase in the price of high sugar foods and SSDs resulted in a decrease in purchases, eight studies were conducted in a laboratory or virtual setting which may not reflect real-life situations.Findings from this review support evidence from the broader literature that suggests that fiscal measures can be effective in influencing the purchasing of high sugar foods and SSDs.

Soil erodibility variability in laboratory and field rainfall simulations

NASA Astrophysics Data System (ADS)

Szabó, Boglárka; Szabó, Judit; Jakab, Gergely; Centeri, Csaba; Szalai, Zoltán

2017-04-01

Rainfall simulation experiments are the most common way to observe and to model the soil erosion processes in in situ and ex situ circumstances. During modelling soil erosion, one of the most important factors are the annual soil loss and the soil erodibility which represent the effect of soil properties on soil loss and the soil resistance against water erosion. The amount of runoff and soil loss can differ in case of the same soil type, while it's characteristics determine the soil erodibility factor. This leads to uncertainties regarding soil erodibility. Soil loss and soil erodibility were examined with the investigation of the same soil under laboratory and field conditions with rainfall simulators. The comparative measurement was carried out in a laboratory on 0,5 m2, and in the field (Shower Power-02) on 6 m2 plot size where the applied slope angles were 5% and 12% with 30 and 90 mm/h rainfall intensity. The main idea was to examine and compare the soil erodibility and its variability coming from the same soil, but different rainfall simulator type. The applied model was the USLE, nomograph and other equations which concern single rainfall events. The given results show differences between the field and laboratory experiments and between the different calculations. Concerning for the whole rainfall events runoff and soil loss, were significantly higher at the laboratory experiments, which affected the soil erodibility values too. The given differences can originate from the plot size. The main research questions are that: How should we handle the soil erodibility factors and its significant variability? What is the best solution for soil erodibility determination?

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

Detection of malignancy in body fluids: a comparison of the hematology and cytology laboratories.

PubMed

Jerz, Jaclyn L; Donohue, Rachel E; Mody, Rayomond R; Schwartz, Mary R; Mody, Dina R; Zieske, Arthur W

2014-05-01

Body fluids submitted to the hematology laboratory for cell counts may also be examined for the presence of malignancy. Previous studies evaluating the hematology laboratory's performance at detecting malignancy in body fluids have reached conflicting conclusions. To investigate the hematology laboratory's ability to detect malignancy in body fluids by comparison with cytology. Retrospective analysis of 414 body fluid samples during an 18-month period, with introduction of new quality assurance measures after the first 210 cases. If no concurrent cytology was ordered, results were compared with recent previous and/or subsequent cytologic, histologic, or flow cytometric diagnoses. Of the initial 210 cases, the hematology laboratory detected 3 of 13 malignancies diagnosed by concurrent cytology (23% sensitivity), with no false-positives (100% specificity). Malignancy was not identified on retrospective review of the hematology slides in the 10 discrepant cases. After the initial study, educational sessions on morphology for the medical technologists and a more thorough hematology-cytology correlation policy were implemented. The subsequent 204 hematology laboratory cases had increased sensitivity for the detection of malignancy (60%; 6 of 10). Definitive features of malignancy were seen in only one discrepant hematology laboratory slide on retrospective review. This case had not been flagged for hematopathologist review. None of the discrepancies before or after implementation of the additional quality assurance measures impacted patient care. Body fluid processing by the hematology laboratory is not optimized for the detection of malignancy. Concurrent cytologic examination is critical for the detection of malignancy, and needs to be considered as cost-saving measures are increasingly implemented.

Results of Laboratory Tests of the Filtration Characteristics of Clay-Cement Concrete

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

Sol’skii, S. V., E-mail: solskiysv@vniig.ru; Lopatina, M. G., E-mail: LoptainaMG@vniig.ru; Legina, E. E.

Laboratory studies of the filtration characteristics of clay-cement concrete materials for constructing filtering diaphragms of earth dams by the method of secant piles are reported. Areas for further study aimed at improving the quality of construction, increasing operational safety, and developing a standards base for the design, construction, and operation of these systems are discussed.

Daily workload in the embryology laboratory and in vitro fertilization results.

PubMed

Expósito, Antonia; Matorras, Roberto; Mendoza, Rosario; Crisol, Lorena; Martínez-Astorquiza, Txanton; Prieto, Begoña

2010-01-01

To ascertain if the daily activity in the in vitro fertilization (IVF) laboratory is related to pregnancy rates (PR) and fertilization rates (FR) in an IVF program. A retrospective study was performed to compare the PR and the FR obtained in 845 oocyte retrievals (OR) and 713 embryo transfers (ET), according to the daily workload. Different cutoffs were established: < or = 3 OR per day vs. > 3 OR per day; < or = 3 ET per day vs. > 3 ET per day, and also a cutoff considering the global activity in 3 different categories: optimal (level I), overload (level II) and high overload (level III), both the day of OR and of ET. The PR on the days with < or = 3 OR and with > 3 OR were similar, as were the days with < or = 3 ET or > 3 ET. There were no differences in PR when the activity the day of OR was level I, II or III (24.4%, 25.2% and 28.3%, respectively) or when the activity on the day of ET was level I, II or III (29.6%, 37.3% and 23.7%, respectively). We failed to show any adverse results on our IVF program associated with the daily workload.

A Choice of Terminals: Spatial Patterning in Computer Laboratories

ERIC Educational Resources Information Center

Spennemann, Dirk; Cornforth, David; Atkinson, John

2007-01-01

Purpose: This paper seeks to examine the spatial patterns of student use of machines in each laboratory to whether there are underlying commonalities. Design/methodology/approach: The research was carried out by assessing the user behaviour in 16 computer laboratories at a regional university in Australia. Findings: The study found that computers…

Safety in laboratories: Indian scenario.

PubMed

Mustafa, Ajaz; Farooq, A Jan; Qadri, Gj; S A, Tabish

2008-07-01

Health and safety in clinical laboratories is becoming an increasingly important subject as a result of emergence of highly infectious diseases such as Hepatitis and HIV. A cross sectional study was carried out to study the safety measures being adopted in clinical laboratories of India. Heads of laboratories of teaching hospitals of India were subjected to a standardized, pretested questionnaire. Response rate was 44.8%. only 60% of laboratories had person in-charge of safety in laboratory. Seventy three percent of laboratories had safety education program regarding hazards. In 91% of laboratories staff is using protective clothing while working in laboratories. Hazardous material regulations are followed in 78% of laboratories. Regular health check ups are carried among laboratory staff in 43.4% of laboratories.Safety manual is available in 56.5% of laboratories. 73.9% of laboratories are equipped with fire extinguishers. Fume cupboards are provided in 34.7% of laboratories and they are regularly checked in 87.5% of these laboratories. In 78.26% of laboratories suitable measures are taken to minimize formation of aerosols.In 95.6% of laboratories waste is disposed off as per bio-medical waste management handling rules. Laboratory of one private medical college was accredited with NABL and safety parameters were better in that laboratory. Installing safety engineered devices apparently contributes to significant decrease in injuries in laboratories; laboratory safety has to be a part of overall quality assurance programme in hospitals. Accreditation has to be made necessary for all laboratories.

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

Comprehensive Examination of Bottom Ash, Soil Dust, and Direct Emissions and Aging of Laboratory Biomass Burning as Potential Sources of Ice Nucleating Particles

NASA Astrophysics Data System (ADS)

Polen, M.; Jahl, L.; Jahn, L.; Somers, J.; Sullivan, R. C.

2017-12-01

Recent laboratory and field studies have found that biomass burning can produce ice nucleating particles (INP) with varying efficiencies depending on fuel and burn conditions. Few studies have examined the ice nucleating potential of bottom ash, which has the potential to be lofted during intense burning events. To date, no publications have examined the impact of atmospheric aging or lofted soil particles on INP emitted from biomass burning. This study investigated each of these aspects through laboratory biomass fuel combustion studies. We burned a number of grasses from different locations, and collected filter samples of fresh and photochemically aged biomass burning aerosol, as well as bottom ash collected after the burn. Some burns included soil that the grasses grew in to test for the importance of soil dust to INP emissions lofting during intense fires. The composition and mixing state of the aerosol was determined using a suite of online and offline single-particle techniques. Our findings suggest that bottom ash is a relatively weak INP, but all samples froze consistently at -20 °C < T < -25 °C. We also found that oxidation of the biomass burning aerosol typically enhances ice nucleating activity over fresh, unaged particles, increasing the ice active site surface density by up to a factor of 3 at T = -25 °C. Lastly, the presence of soil dust can greatly enhance INP concentrations for biomass burning events with an increase in the freezing temperature spectrum by > 3 °C. Detailed analysis of these samples aims to provide a clearer understanding of what components of biomass burning increase the ambient concentrations of ice nucleation active particles, and how their ice nucleation properties evolve during atmospheric aging.

Legal Implications of Physical Examinations

PubMed Central

Felton, Jean Spencer

1978-01-01

With the new national emphasis on the prevention of occupationally incurred disease, legislative constraints have been placed in connection with the medical examination of employed persons at health risk. Concurrently, there is mandated a system of communication to the worker of the significant clinical findings encountered on his physical and laboratory inventories. PMID:636417

Temperament in bullheads: do laboratory and field explorative behaviour variables correlate?

NASA Astrophysics Data System (ADS)

Kobler, Alexander; Engelen, Brecht; Knaepkens, Guy; Eens, Marcel

2009-10-01

The relevance of temperament traits for life history strategy or productivity is increasingly acknowledged. Temperament traits are often either observed in captivity or in the wild, but studies combining both observations are very rare. We examine whether exploratory behaviour in the bullhead ( Cottus perifretum), assayed under laboratory conditions, predicts this behaviour under field conditions. Forty-three PIT-tagged individuals were first assayed for exploration of a novel environment in the aquarium and then released into an unfamiliar stream stretch, where they were later relocated using a mobile antenna. Explorative behaviour assayed in the laboratory was significantly positively related to the exploration in the field, thus predicting distance moved in the field release. Both in the laboratory and in the field, explorative behaviour was not related to individual body length. When bullheads that did not leave the refuge in the aquarium (laboratory assay) and, therefore, did not explore the new environment were excluded from the analysis, the correlation between laboratory and field explorative behaviour variables became weaker. However, overall, our results illustrate that exploration rate of bullheads in isolated single-individual experiments can be used to predict this behaviour in the natural ecosystem.

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

Preliminary Results From a Laboratory Study of Positive Streamer Discharges on Simulated Ice Hydrometeors

NASA Astrophysics Data System (ADS)

Petersen, D.; Bailey, M.; Hallett, J.; Beasley, W.

2007-12-01

The initiation of lightning remains an open question, due in large part to a deficit of in-situ observational evidence. Recent theoretical descriptions of lightning initiation have focused on runaway breakdown and related secondary processes, but have not convincingly explained the details of onset of the embryonic lightning leader channel. Among possible mechanisms contributing to the initial leader formation are positive streamer discharges from ice hydrometeors, themselves once favored as the primary explanation of lightning initiation. We present preliminary results from a new laboratory study of positive streamer discharges on simulated ice hydrometeors. Emphasis is given to precisely defining the minimum electric field strength required for onset of positive streamer generation, with variables of interest being ice crystal size, habit and environmental temperature.

Angioedema Spotlight: A Closer Examination of Sacubitril/Valsartan Safety Results.

PubMed

Owens, Ryan E; Oliphant, Carrie S

2017-01-01

Incorporation of neprilysin inhibition into heart failure pharmacotherapy regimens has recently been recommended by U.S. guidelines, based on results from the PARADIGM-HF trial comparing sacubitril/valsartan to enalapril. While most of the discussion has focused on efficacy, a closer examination of the safety results, particularly the incidence of angioedema during the run-in and double-blind periods, is also warranted. Although no major safety concerns were identified, an angioedema risk comparable to enalapril was found, primarily in the black population. Therefore, despite combination with an angiotensin receptor blocker, which historically has a lower incidence of angioedema, the addition of neprilysin inhibition yields an angioedema risk profile comparable to angiotensin converting enzyme (ACE) inhibitors. Clinicians should recognize this safety risk when prescribing sacubitril/valsartan and remain vigilant in counseling patients regarding the signs and symptoms of angioedema. As recommended by the guidelines, avoiding sacubitril/valsartan use concurrently or within 36 hours of the last dose of an ACE inhibitor or in patients with a history of angioedema is also crucial to minimize angioedema risk and prevent patient harm. © Copyright 2017 by the American Board of Family Medicine.

An SDS-PAGE Examination of Protein Quaternary Structure and Disulfide Bonding for a Biochemistry Laboratory

ERIC Educational Resources Information Center

Powers, Jennifer L.; Andrews, Carla S.; St. Antoine, Caroline C.; Jain, Swapan S.; Bevilacqua, Vicky L. H.

2005-01-01

Electrophoresis is a valuable tool for biochemists, yet this technique is often not included in biochemistry laboratory curricula owing to time constraints or lack of equipment. Protein structure is also a topic of interest in many disciplines, yet most undergraduate lab experiments focus only on primary structure. In this experiment, students use…

Consolidated clinical microbiology laboratories.

PubMed

Sautter, Robert L; Thomson, Richard B

2015-05-01

The manner in which medical care is reimbursed in the United States has resulted in significant consolidation in the U.S. health care system. One of the consequences of this has been the development of centralized clinical microbiology laboratories that provide services to patients receiving care in multiple off-site, often remote, locations. Microbiology specimens are unique among clinical specimens in that optimal analysis may require the maintenance of viable organisms. Centralized laboratories may be located hours from patient care settings, and transport conditions need to be such that organism viability can be maintained under a variety of transport conditions. Further, since the provision of rapid results has been shown to enhance patient care, effective and timely means for generating and then reporting the results of clinical microbiology analyses must be in place. In addition, today, increasing numbers of patients are found to have infection caused by pathogens that were either very uncommon in the past or even completely unrecognized. As a result, infectious disease specialists, in particular, are more dependent than ever on access to high-quality diagnostic information from clinical microbiology laboratories. In this point-counterpoint discussion, Robert Sautter, who directs a Charlotte, NC, clinical microbiology laboratory that provides services for a 40-hospital system spread over 3 states in the southeastern United States explains how an integrated clinical microbiology laboratory service has been established in a multihospital system. Richard (Tom) Thomson of the NorthShore University HealthSystem in Evanston, IL, discusses some of the problems and pitfalls associated with large-scale laboratory consolidation. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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...

Cutting of Gold Foil in the Genesis Laboratory

NASA Image and Video Library