suboptimal laboratory values: Topics by WorldWideScience.org

Sample records for suboptimal laboratory values

Suboptimal Choice in Pigeons: Stimulus Value Predicts Choice over Frequencies.

Directory of Open Access Journals (Sweden)

Aaron P Smith

Full Text Available Pigeons have shown suboptimal gambling-like behavior when preferring a stimulus that infrequently signals reliable reinforcement over alternatives that provide greater reinforcement overall. As a mechanism for this behavior, recent research proposed that the stimulus value of alternatives with more reliable signals for reinforcement will be preferred relatively independently of their frequencies. The present study tested this hypothesis using a simplified design of a Discriminative alternative that, 50% of the time, led to either a signal for 100% reinforcement or a blackout period indicative of 0% reinforcement against a Nondiscriminative alternative that always led to a signal that predicted 50% reinforcement. Pigeons showed a strong preference for the Discriminative alternative that remained despite reducing the frequency of the signal for reinforcement in subsequent phases to 25% and then 12.5%. In Experiment 2, using the original design of Experiment 1, the stimulus following choice of the Nondiscriminative alternative was increased to 75% and then to 100%. Results showed that preference for the Discriminative alternative decreased only when the signals for reinforcement for the two alternatives predicted the same probability of reinforcement. The ability of several models to predict this behavior are discussed, but the terminal link stimulus value offers the most parsimonious account of this suboptimal behavior.
Resolving the paradox of suboptimal choice.

Science.gov (United States)

Zentall, Thomas R

2016-01-01

When humans engage in commercial (totally probabilistic) gambling they are making suboptimal choices because the return is generally less than the investment. This review (a) examines the literature on pigeon suboptimal choice, (b) describes the conditions under which it occurs, (c) identifies the mechanisms that appear to be responsible for the effect, and (d) suggests that similar processes may be able to account for analogous suboptimal choice when humans engage in commercial gambling. Pigeons show suboptimal choice when they choose between 1 alternative that 20% of the time provides them with a signal that they will always get fed or 80% of the time with a signal that they will not get fed (overall 20% reinforcement) and a second alternative that 100% of the time provides them with a signal that they will get fed 50% of the time (overall 50% reinforcement). The pigeons' strong preference for the suboptimal choice was investigated in a series of experiments that found the preference for the suboptimal alternative was determined by the value of the signal that predicted reinforcement, rather its frequency and that the frequency of the signal that predicted nonreinforcement had little effect on the suboptimal choice. Paradoxically, this account makes the prediction that pigeons will be indifferent between an alternative that 50% of the time provides a fully predictive stimulus for reinforcement and an alternative that 100% of the time provides a fully predictive stimulus for reinforcement. The similarities and differences of this suboptimal choice task to human gambling are discussed. (c) 2016 APA, all rights reserved).
Ultimate explanations and suboptimal choice.

Science.gov (United States)

Vasconcelos, Marco; Machado, Armando; Pandeirada, Josefa N S

2018-07-01

Researchers have unraveled multiple cases in which behavior deviates from rationality principles. We propose that such deviations are valuable tools to understand the adaptive significance of the underpinning mechanisms. To illustrate, we discuss in detail an experimental protocol in which animals systematically incur substantial foraging losses by preferring a lean but informative option over a rich but non-informative one. To understand how adaptive mechanisms may fail to maximize food intake, we review a model inspired by optimal foraging principles that reconciles sub-optimal choice with the view that current behavioral mechanisms were pruned by the optimizing action of natural selection. To move beyond retrospective speculation, we then review critical tests of the model, regarding both its assumptions and its (sometimes counterintuitive) predictions, all of which have been upheld. The overall contention is that (a) known mechanisms can be used to develop better ultimate accounts and that (b) to understand why mechanisms that generate suboptimal behavior evolved, we need to consider their adaptive value in the animal's characteristic ecology. Copyright © 2018 Elsevier B.V. All rights reserved.
Suboptimal choice, reward-predictive signals, and temporal information.

Science.gov (United States)

Cunningham, Paul J; Shahan, Timothy A

2018-01-01

Suboptimal choice refers to preference for an alternative offering a low probability of food (suboptimal alternative) over an alternative offering a higher probability of food (optimal alternative). Numerous studies have found that stimuli signaling probabilistic food play a critical role in the development and maintenance of suboptimal choice. However, there is still much debate about how to characterize how these stimuli influence suboptimal choice. There is substantial evidence that the temporal information conveyed by a food-predictive signal governs its function as both a Pavlovian conditioned stimulus and as an instrumental conditioned reinforcer. Thus, we explore the possibility that food-predictive signals influence suboptimal choice via the temporal information they convey. Application of this temporal information-theoretic approach to suboptimal choice provides a formal, quantitative framework that describes how food-predictive signals influence suboptimal choice in a manner consistent with related phenomena in Pavlovian conditioning and conditioned reinforcement. Our reanalysis of previous data on suboptimal choice suggests that, generally speaking, preference in the suboptimal choice procedure tracks relative temporal information conveyed by food-predictive signals for the suboptimal and optimal alternatives. The model suggests that suboptimal choice develops when the food-predictive signal for the suboptimal alternative conveys more temporal information than that for the optimal alternative. Finally, incorporating a role for competition between temporal information provided by food-predictive signals and relative primary reinforcement rate provides a reasonable account of existing data on suboptimal choice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Critical laboratory values in hemostasis: toward consensus.

Science.gov (United States)

Lippi, Giuseppe; Adcock, Dorothy; Simundic, Ana-Maria; Tripodi, Armando; Favaloro, Emmanuel J

2017-09-01

The term "critical values" can be defined to entail laboratory test results that significantly lie outside the normal (reference) range and necessitate immediate reporting to safeguard patient health, as well as those displaying a highly and clinically significant variation compared to previous data. The identification and effective communication of "highly pathological" values has engaged the minds of many clinicians, health care and laboratory professionals for decades, since these activities are vital to good laboratory practice. This is especially true in hemostasis, where a timely and efficient communication of critical values strongly impacts patient management. Due to the heterogeneity of available data, this paper is hence aimed to analyze the state of the art and provide an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis, thus providing a basic document for future consultation that assists laboratory professionals and clinicians alike. KEY MESSAGES Critical values are laboratory test results significantly lying outside the normal (reference) range and necessitating immediate reporting to safeguard patient health. A broad heterogeneity exists about critical values in hemostasis worldwide. We provide here an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis.
Adding value to laboratory medicine: a professional responsibility.

Science.gov (United States)

Beastall, Graham H

2013-01-01

Laboratory medicine is a medical specialty at the centre of healthcare. When used optimally laboratory medicine generates knowledge that can facilitate patient safety, improve patient outcomes, shorten patient journeys and lead to more cost-effective healthcare. Optimal use of laboratory medicine relies on dynamic and authoritative leadership outside as well as inside the laboratory. The first responsibility of the head of a clinical laboratory is to ensure the provision of a high quality service across a wide range of parameters culminating in laboratory accreditation against an international standard, such as ISO 15189. From that essential baseline the leadership of laboratory medicine at local, national and international level needs to 'add value' to ensure the optimal delivery, use, development and evaluation of the services provided for individuals and for groups of patients. A convenient tool to illustrate added value is use of the mnemonic 'SCIENCE'. This tool allows added value to be considered in seven domains: standardisation and harmonisation; clinical effectiveness; innovation; evidence-based practice; novel applications; cost-effectiveness; and education of others. The assessment of added value in laboratory medicine may be considered against a framework that comprises three dimensions: operational efficiency; patient management; and patient behaviours. The profession and the patient will benefit from sharing examples of adding value to laboratory medicine.
Leveraging the real value of laboratory medicine with the value proposition.

Science.gov (United States)

Price, Christopher P; John, Andrew St; Christenson, Robert; Scharnhorst, Volker; Oellerich, Michael; Jones, Patricia; Morris, Howard A

2016-11-01

Improving quality and patient safety, containing costs and delivering value-for-money are the key drivers of change in the delivery of healthcare and have stimulated a shift from an activity-based service to a service based on patient-outcomes. The delivery of an outcomes-based healthcare agenda requires that the real value of laboratory medicine to all stakeholders be understood, effectively defined and communicated. The value proposition of any product or service is the link between the provider and the needs of the customer describing the utility of the product or service in terms of benefit to the customer. The framework of a value proposition for laboratory medicine provides the core business case that drives key activities in the evolution and maintenance of high quality healthcare from research through to adoption and quality improvement in an established service. The framework of a value proposition for laboratory medicine is described. The content is endorsed by IFCC and WASPaLM. Copyright © 2016 Elsevier B.V. All rights reserved.
Anatomy of a value proposition for laboratory medicine.

Science.gov (United States)

Price, Christopher P; St John, Andrew

2014-09-25

Value is now becoming a key driver in the ongoing development of healthcare delivery; key facets include the identification of what is valuable and how that value can be identified, leveraged, and delivered. The concept of a value proposition is widely used in business but can be used in healthcare as a statement of the benefits, costs and value that an organization can deliver to its customers. The foundation of this statement in laboratory medicine is evidence of clinical and cost effectiveness, not only for the patient, but also for other stakeholders involved in the delivery of healthcare, e.g., the carer, service provider, commissioner, purchaser, and the supplier of the test or device, as well as society as a whole. However the value of any laboratory medicine investigation is only achieved if the output (the test result(s)), is acted upon by the initiator of the investigation. Laboratory medicine is one part of a complex intervention, and so the value proposition should encompass the breadth of that intervention - from addressing the unmet need through the generation of clinical, operational and economic outcomes. A value proposition in laboratory medicine is central to successful innovation and quality improvement in healthcare. Copyright © 2014 Elsevier B.V. All rights reserved.
Design considerations for a suboptimal Kalman filter

Science.gov (United States)

Difilippo, D. J.

1995-06-01

In designing a suboptimal Kalman filter, the designer must decide how to simplify the system error model without causing the filter estimation errors to increase to unacceptable levels. Deletion of certain error states and decoupling of error state dynamics are the two principal model simplifications that are commonly used in suboptimal filter design. For the most part, the decisions as to which error states can be deleted or decoupled are based on the designer's understanding of the physics of the particular system. Consequently, the details of a suboptimal design are usually unique to the specific application. In this paper, the process of designing a suboptimal Kalman filter is illustrated for the case of an airborne transfer-of-alignment (TOA) system used for synthetic aperture radar (SAR) motion compensation. In this application, the filter must continuously transfer the alignment of an onboard Doppler-damped master inertial navigation system (INS) to a strapdown navigator that processes information from a less accurate inertial measurement unit (IMU) mounted on the radar antenna. The IMU is used to measure spurious antenna motion during the SAR imaging interval, so that compensating phase corrections can be computed and applied to the radar returns, thereby presenting image degradation that would otherwise result from such motions. The principles of SAR are described in many references, for instance. The primary function of the TOA Kalman filter in a SAR motion compensation system is to control strapdown navigator attitude errors, and to a less degree, velocity and heading errors. Unlike a classical navigation application, absolute positional accuracy is not important. The motion compensation requirements for SAR imaging are discussed in some detail. This TOA application is particularly appropriate as a vehicle for discussing suboptimal filter design, because the system contains features that can be exploited to allow both deletion and decoupling of error
Critical value reporting: a survey of 36 clinical laboratories in South Africa.

Science.gov (United States)

Schapkaitz, Elise; Mafika, Zipho

2013-10-11

Critical value policies are used by clinical laboratories to decide when to notify caregivers of life-threatening results. Despite their widespread use, critical value policies have not been published locally. A survey was designed to determine critical value policies for haematology tests in South Africa. A survey was carried out on 136 identified laboratories across South Africa in January 2013. Of these, 36 responded. Data collected included critical value policies, critical values for haematology parameters, and critical value reporting. Of the 36 laboratories surveyed, 11.1% (n=4) were private, 33.3% (n=12) were affiliated to academic institutions and 55.6% (n=20) were peripheral or regional National Health Laboratory Service laboratories. All the laboratories confirmed that they had a critical value policy, and 83.3% of such policies were derived from local clinical opinion. Mean low and high critical limits for the most frequently listed tests were as follows: haemoglobin 20 g/dl, platelet count 1 000 ×10(9)/l, white cell count 46 ×10(9)/l, activated partial thromboplastin time >101 seconds, and international normalised ratio >6. In almost all cases critical value reporting was performed by the technologist on duty (97.2%). The majority of laboratories required that the person notified of the critical value be the doctor who ordered the test or the caregiver directly involved in the patient's care (83.3%); 73.3% of laboratories indicated that they followed an algorithm if the doctor/caregiver could not be reached. Each laboratory is responsible for establishing clinically relevant critical limits. Clinicians should be involved in developing the laboratory's critical value policy. The findings of this survey may be of value to local laboratories that are in the process of establishing or reviewing critical value policies.
Suboptimal palliative sedation in primary care: an exploration.

Science.gov (United States)

Pype, Peter; Teuwen, Inge; Mertens, Fien; Sercu, Marij; De Sutter, An

2018-02-01

Palliative sedation is a therapeutic option to control refractory symptoms in terminal palliative patients. This study aims at describing the occurrence and characteristics of suboptimal palliative sedations in primary care and at exploring the way general practitioners (GPs) experience suboptimal palliative sedation in their practice. We conducted a mixed methods study with a quantitative prospective survey in primary care and qualitative semi-structured interviews with GPs. The research team defined suboptimal palliative sedation as a time interval until deep sleep >1.5 h and/ or >2 awakenings after the start of the unconsciousness. Descriptive statistics were calculated on the quantitative data. Thematic analysis was used to analyse interview transcripts. We registered 63 palliative sedations in 1181 home deaths, 27 forms were completed. Eleven palliative sedations were suboptimal: eight due to the long time span until deep sleep; three due the number of unintended awakenings. GPs' interview analysis revealed two major themes: the shifting perception of failure and the burden of responsibility. Suboptimal palliative sedation occurs frequently in primary palliative care. Efficient communication towards family members is needed to prevent them from having unrealistic expectations and to prevent putting pressure on the GP to hasten the procedure. Sharing the burden of decision-making during the procedure with other health care professionals might diminish the heavy responsibility as perceived by GPs.
How suboptimal are linear sharing rules?

DEFF Research Database (Denmark)

Jensen, Bjarne Astrup; Nielsen, Jørgen Aase

2016-01-01

that significant losses can arise when investors are diverse in their risk attitude. We also show that an investor with a low degree of risk aversion, like the logarithmic or the square root investor, often applied in portfolio choice models, can either inflict or be subject to severe losses when being forced...... two sources of suboptimal investment decisions as seen from each of the two investors individually. One is the suboptimal choice of portfolio, the other is the forced linear sharing rule. We measure the combined consequence for each investor by their respective loss in wealth equivalent. We show...
On the Origins of Suboptimality in Human Probabilistic Inference

Science.gov (United States)

Acerbi, Luigi; Vijayakumar, Sethu; Wolpert, Daniel M.

2014-01-01

Humans have been shown to combine noisy sensory information with previous experience (priors), in qualitative and sometimes quantitative agreement with the statistically-optimal predictions of Bayesian integration. However, when the prior distribution becomes more complex than a simple Gaussian, such as skewed or bimodal, training takes much longer and performance appears suboptimal. It is unclear whether such suboptimality arises from an imprecise internal representation of the complex prior, or from additional constraints in performing probabilistic computations on complex distributions, even when accurately represented. Here we probe the sources of suboptimality in probabilistic inference using a novel estimation task in which subjects are exposed to an explicitly provided distribution, thereby removing the need to remember the prior. Subjects had to estimate the location of a target given a noisy cue and a visual representation of the prior probability density over locations, which changed on each trial. Different classes of priors were examined (Gaussian, unimodal, bimodal). Subjects' performance was in qualitative agreement with the predictions of Bayesian Decision Theory although generally suboptimal. The degree of suboptimality was modulated by statistical features of the priors but was largely independent of the class of the prior and level of noise in the cue, suggesting that suboptimality in dealing with complex statistical features, such as bimodality, may be due to a problem of acquiring the priors rather than computing with them. We performed a factorial model comparison across a large set of Bayesian observer models to identify additional sources of noise and suboptimality. Our analysis rejects several models of stochastic behavior, including probability matching and sample-averaging strategies. Instead we show that subjects' response variability was mainly driven by a combination of a noisy estimation of the parameters of the priors, and by
On the origins of suboptimality in human probabilistic inference.

Directory of Open Access Journals (Sweden)

Luigi Acerbi

2014-06-01

Full Text Available Humans have been shown to combine noisy sensory information with previous experience (priors, in qualitative and sometimes quantitative agreement with the statistically-optimal predictions of Bayesian integration. However, when the prior distribution becomes more complex than a simple Gaussian, such as skewed or bimodal, training takes much longer and performance appears suboptimal. It is unclear whether such suboptimality arises from an imprecise internal representation of the complex prior, or from additional constraints in performing probabilistic computations on complex distributions, even when accurately represented. Here we probe the sources of suboptimality in probabilistic inference using a novel estimation task in which subjects are exposed to an explicitly provided distribution, thereby removing the need to remember the prior. Subjects had to estimate the location of a target given a noisy cue and a visual representation of the prior probability density over locations, which changed on each trial. Different classes of priors were examined (Gaussian, unimodal, bimodal. Subjects' performance was in qualitative agreement with the predictions of Bayesian Decision Theory although generally suboptimal. The degree of suboptimality was modulated by statistical features of the priors but was largely independent of the class of the prior and level of noise in the cue, suggesting that suboptimality in dealing with complex statistical features, such as bimodality, may be due to a problem of acquiring the priors rather than computing with them. We performed a factorial model comparison across a large set of Bayesian observer models to identify additional sources of noise and suboptimality. Our analysis rejects several models of stochastic behavior, including probability matching and sample-averaging strategies. Instead we show that subjects' response variability was mainly driven by a combination of a noisy estimation of the parameters of the
A national survey on pediatric critical values used in clinical laboratories across Canada.

Science.gov (United States)

Gong, Yanping; Adeli, Khosrow

2009-11-01

Notification of critical values to clinical staff is an important post-analytical process in all acute care clinical laboratories. No data are available however on how laboratories obtain or establish critical values, particularly in pediatric settings. This study was designed to examine and compare critical values used for pediatric patients in biochemistry laboratories in Canada and assess potential interlaboratory variability. Fourteen clinical laboratories, including two in pediatric hospitals and twelve in hospitals caring for both children and adults, participated in a survey that included 14 pre-selected STAT chemistry tests and 19 pre-selected therapeutic drug monitoring (TDM) tests. Among fourteen chemistry tests, good agreement was observed for critical values used for sodium and pH at both low and high levels within 14 participant laboratories. Significant interlaboratory variability existed for glucose critical values at the high end, magnesium at high end, and PO2 at the low end. For 19 TDM tests, the majority of laboratories did not have alert values to report values over the therapeutic level but not toxic. For critical values greater than the toxic range, significant variability existed at both trough and peak levels among laboratories surveyed. When asked to provide the source for critical values established at each site, only a limited number of laboratories identified their sources as either internal decision or published references. Although all laboratories have established and routinely use critical values to alert clinical staff, considerable variability exists in both the critical limits reported as well as the source of such values. There is a clear need for new national efforts to standardize pediatric critical value reporting and establish evidence-based critical limits for all medical laboratories across Canada.
Critical value reporting: A survey of 36 clinical laboratories in South ...

African Journals Online (AJOL)

A survey was carried out on 136 identified laboratories across South Africa in January 2013. Of these, 36 responded. Data collected included critical value policies, critical values for haematology parameters, and critical value reporting. Results. Of the 36 laboratories surveyed, 11.1% (n=4) were private, 33.3% (n=12) were ...
Laboratory assessment of novel oral anticoagulants: method suitability and variability between coagulation laboratories.

Science.gov (United States)

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 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.
High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition.

Science.gov (United States)

Fan, Shengxian; Ni, Xiaodong; Wang, Jian; Zhang, Yongliang; Tao, Shen; Kong, Wencheng; Li, Yousheng; Li, Jieshou

2017-04-01

Previous studies have noticed the high incidence of suboptimal vitamin D (VtD) status and bone loss in short bowel syndrome (SBS) with parenteral nutrition (PN) dependence. However, limited data have focused on adult SBS without PN dependence. Therefore, our objective was to investigate the incidence and risk factors of suboptimal VtD status and bone loss in adult SBS even after weaning off PN. We performed a prospective study of 60 adult patients with SBS. Serum 25-hydroxyvitamin D (25-OHD) was measured by radioimmunoassay. Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry (DEXA). Medical records and various laboratory parameters were collected in all participants. Suboptimal VtD status was identified in all individuals, including 3 (5.0%) with VtD insufficiency and 57 (95.0%) with VtD deficiency. Residual small bowel length (B, 0.072, P = .001) and duration of SBS (B, -0.066, P = .020) were both significantly correlated with suboptimal VtD levels. Overall, only 2 patients presented a normal BMD; osteopenia and osteoporosis were noted in 41 (68.3%) and 17 (28.3%) individuals, respectively. Low 25-OHD concentration was associated with a decreased BMD (B, 0.065, P = .029). There were no other demographic characteristics or clinical examinations associated with suboptimal VtD levels and bone loss. Suboptimal VtD status and bone loss were common in adult SBS even after weaning off PN. Despite routine oral VtD supplementation, most patients did not achieve satisfactory status. This emphasizes the critical importance of routine surveillance of 25-OHD and BMD, as well as consideration of alternative methods of supplementation after weaning off PN.
Suboptimal control for drag reduction in turbulent pipe flow

International Nuclear Information System (INIS)

Choi, Jung Il; Sung, Hyung Jin; Xu, Chun Xiao

2001-01-01

A suboptimal control law in turbulent pipe flow is derived and tested. Two sensing variables ∂ρ/∂θ / w and ∂ν θ /∂r / w are applied with two actuations φ θ and φ γ . To test the suboptimal control law, direct numerical simulations of turbulent pipe flow at Re τ =150 are performed. When the control law is applied, a 13∼23% drag reduction is achieved. The most effective drag reduction is made at the pair of ∂υ θ /∂r / w and φ γ . An impenetrable virtual wall concept is useful for analyzing the near-wall suction and blowing. The virtual wall concept is useful for analyzing the near-wall behavior of the controlled flow. Comparison of the present suboptimal control with that of turbulent channel flow reveals that the curvature effect is insignificant
Suboptimal maternal and paternal mental health are associated with child bullying perpetration.

Science.gov (United States)

Shetgiri, Rashmi; Lin, Hua; Flores, Glenn

2015-06-01

This study examines associations between maternal and paternal mental health and child bullying perpetration among school-age children, and whether having one or both parents with suboptimal mental health is associated with bullying. The 2007 National Survey of Children's Health, a nationally-representative, random-digit-dial survey, was analyzed, using a parent-reported bullying measure. Suboptimal mental health was defined as fair/poor (vs. good/very good/excellent) parental self-reported mental and emotional health. Of the 61,613 parents surveyed, more than half were parents of boys and were white, 20% were Latino, 15% African American, and 7% other race/ethnicity. Suboptimal maternal (OR 1.4; 95% CI 1.1-1.8) and paternal (OR 1.5; 95% CI 1.1-2.2) mental health are associated with bullying. Compared with children with no parents with suboptimal mental health, children with only one or both parents with suboptimal mental health have higher bullying odds. Addressing the mental health of both parents may prove beneficial in preventing bullying.

Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

NARCIS (Netherlands)

van Hout, Moniek S. E.; Schmand, Ben; Wekking, Ellie M.; Hageman, Gerard; Deelman, Betto G.

2003-01-01

Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure
Suboptimal performance on neuropsychological tests in patients with suspected chronic toxic encephalopathy

NARCIS (Netherlands)

van Hout, MSE; Schmand, B; Wekking, EM; Hageman, G; Deelman, BG

Suboptimal performance during neuropsychological testing can seriously complicate assessment in behavioral neurotoxicology. We present data on the prevalence of suboptimal performance in a group of Dutch patients with suspected chronic toxic encephalopathy (CTE) after long-term occupational exposure
Frequency and predictors of suboptimal glycemic control in an African diabetic population

Directory of Open Access Journals (Sweden)

Kibirige D

2017-02-01

Full Text Available Davis Kibirige,1 George Patrick Akabwai,2 Leaticia Kampiire,3 Daniel Ssekikubo Kiggundu,4 William Lumu5 1Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi, 2Baylor College of Medicine, Children’s Foundation, 3Infectious Diseases Research Collaboration, Kampala, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala, 5Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda Background: Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda. Methods: In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c level ≥7%. Multivariable analysis was applied to determine the predictors. Results: The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%. The median (interquartile range HbA1c level was 9% (6.8%–12.4%. Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1c levels of 7%–8%, 8.1%–9.9%, and ≥10% were noted in 56 (13.24%, 76 (17.97%, and 179 (42.32% study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21–0.63, p<0.005 and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41–4.12, p=0
Prevalence and Determinants of Suboptimal Vitamin D Levels in a Multiethnic Asian Population.

Science.gov (United States)

Man, Ryan Eyn Kidd; Li, Ling-Jun; Cheng, Ching-Yu; Wong, Tien Yin; Lamoureux, Ecosse; Sabanayagam, Charumathi

2017-03-22

This population-based cross-sectional study examined the prevalence and risk factors of suboptimal vitamin D levels (assessed using circulating 25-hydroxycholecalciferol (25(OH)D)) in a multi-ethnic sample of Asian adults. Plasma 25(OH)D concentration of 1139 Chinese, Malay and Indians (40-80 years) were stratified into normal (≥30 ng/mL), and suboptimal (including insufficiency and deficiency, 65 years), Malay and Indian ethnicities (compared to Chinese ethnicity), and higher body mass index, HbA1c, education and income levels were associated with suboptimal 25(OH)D concentration ( p < 0.05). In a population-based sample of Asian adults, approximately 75% had suboptimal 25(OH)D concentration. Targeted interventions and stricter reinforcements of existing guidelines for vitamin D supplementation are needed for groups at risk of vitamin D insufficiency/deficiency.
Utility of repeat testing of critical values: a Q-probes analysis of 86 clinical laboratories.

Science.gov (United States)

Lehman, Christopher M; Howanitz, Peter J; Souers, Rhona; Karcher, Donald S

2014-06-01

A common laboratory practice is to repeat critical values before reporting the test results to the clinical care provider. This may be an unnecessary step that delays the reporting of critical test results without adding value to the accuracy of the test result. To determine the proportions of repeated chemistry and hematology critical values that differ significantly from the original value as defined by the participating laboratory, to determine the threshold differences defined by the laboratory as clinically significant, and to determine the additional time required to analyze the repeat test. Participants prospectively reviewed critical test results for 4 laboratory tests: glucose, potassium, white blood cell count, and platelet count. Participants reported the following information: initial and repeated test result; time initial and repeat results were first known to laboratory staff; critical result notification time; if the repeat result was still a critical result; if the repeat result was significantly different from the initial result, as judged by the laboratory professional or policy; significant difference threshold, as defined by the laboratory; the make and model of the instrument used for primary and repeat testing. Routine, repeat analysis of critical values is a common practice. Most laboratories did not formally define a significant difference between repeat results. Repeated results were rarely considered significantly different. Median repeated times were at least 17 to 21 minutes for 10% of laboratories. Twenty percent of laboratories reported at least 1 incident in the last calendar year of delayed result reporting that clinicians indicated had adversely affected patient care. Routine repeat analysis of automated chemistry and hematology critical values is unlikely to be clinically useful and may adversely affect patient care.
Action-Dependent Photobiomodulation on Health, Suboptimal Health, and Disease

Directory of Open Access Journals (Sweden)

Timon Cheng-Yi Liu

2014-01-01

Full Text Available The global photobiomodulation (PBM on an organism was studied in terms of function-specific homeostasis (FSH and scale-free functional network in this paper. A function can be classified into a normal function in its FSH and a dysfunctional function far from its FSH. An FSH-specific stress (FSS disrupting an FSH can also be classified into a successful stress in its FSS-specific homeostasis (FSSH and a chronic stress far from its FSSH. The internal functions of an organism can be divided into essential, special nonessential, and general nonessential functions. Health may be defined as a state of an organism in which all the essential and special nonessential functions are normal or their stresses are successful. Suboptimal health may be defined as a state of a disease-free organism in which only some special nonessential functions are dysfunctional in comparison with its healthy state. Disease may be defined as a state of an organism which is not in both health and suboptimal health. The global PBM of health, suboptimal health, or disease suggested that the PBM may depend on the organism action.
Exogenous recombinant human growth hormone effects during suboptimal energy and zinc intake

Directory of Open Access Journals (Sweden)

Duro Debora

2005-04-01

Full Text Available Abstract Background Energy and Zinc (Zn deficiencies have been associated with nutritional related growth retardation as well as growth hormone (GH resistance. In this study, the relationship between suboptimal energy and/or Zn intake and growth in rats and their response to immunoreactive exogenous recombinant human GH (GHi, was determined. Results Rats treated with GHi and fed ad-libitum energy and Zn (100/100 had increased IGFBP-3 (p Conclusion These results suggest that GHi enhances weight gain in rats with suboptimal energy and Zn intake but does not modify energy expenditure or physical activity index. Suboptimal Zn intake did not exacerbate the reduced growth or decrease in energy expenditure observed with energy restriction.
Sacral Nerve Stimulation for Constipation: Suboptimal Outcome and Adverse Events

DEFF Research Database (Denmark)

Maeda, Yasuko; Lundby, Lilli; Buntzen, Steen

2010-01-01

Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events.......Sacral nerve stimulation is an emerging treatment for patients with severe constipation. There has been no substantial report to date on suboptimal outcomes and complications. We report our experience of more than 6 years by focusing on incidents and the management of reportable events....
Gibberellin Is Involved in Inhibition of Cucumber Growth and Nitrogen Uptake at Suboptimal Root-Zone Temperatures.

Directory of Open Access Journals (Sweden)

Longqiang Bai

Full Text Available Suboptimal temperature stress often causes heavy yield losses of vegetables by suppressing plant growth during winter and early spring. Gibberellin acid (GA has been reported to be involved in plant growth and acquisition of mineral nutrients. However, no studies have evaluated the role of GA in the regulation of growth and nutrient acquisition by vegetables under conditions of suboptimal temperatures in greenhouse. Here, we investigated the roles of GA in the regulation of growth and nitrate acquisition of cucumber (Cucumis sativus L. plants under conditions of short-term suboptimal root-zone temperatures (Tr. Exposure of cucumber seedlings to a Tr of 16°C led to a significant reduction in root growth, and this inhibitory effect was reversed by exogenous application of GA. Expression patterns of several genes encoding key enzymes in GA metabolism were altered by suboptimal Tr treatment, and endogenous GA concentrations in cucumber roots were significantly reduced by exposure of cucumber plants to 16°C Tr, suggesting that inhibition of root growth by suboptimal Tr may result from disruption of endogenous GA homeostasis. To further explore the mechanism underlying the GA-dependent cucumber growth under suboptimal Tr, we studied the effect of suboptimal Tr and GA on nitrate uptake, and found that exposure of cucumber seedlings to 16°C Tr led to a significant reduction in nitrate uptake rate, and exogenous application GA can alleviate the down-regulation by up regulating the expression of genes associated with nitrate uptake. Finally, we demonstrated that N accumulation in cucumber seedlings under suboptimal Tr conditions was improved by exogenous application of GA due probably to both enhanced root growth and nitrate absorption activity. These results indicate that a reduction in endogenous GA concentrations in roots due to down-regulation of GA biosynthesis at transcriptional level may be a key event to underpin the suboptimal Tr
Development of an evidence-based approach to external quality assurance for breast cancer hormone receptor immunohistochemistry: comparison of reference values.

Science.gov (United States)

Makretsov, Nikita; Gilks, C Blake; Alaghehbandan, Reza; Garratt, John; Quenneville, Louise; Mercer, Joel; Palavdzic, Dragana; Torlakovic, Emina E

2011-07-01

External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs. To explore reference values for estrogen receptor and progesterone receptor immunohistochemistry in order to develop an evidence-based analytic platform for external quality assurance. There were 31 participating laboratories, 4 of which were previously designated as "expert" laboratories. Each participant tested a tissue microarray slide with 44 breast carcinomas for estrogen receptor and progesterone receptor and submitted it to the Canadian Immunohistochemistry Quality Control Program for analysis. Nuclear staining in 1% or more of the tumor cells was a positive score. Five methods for determining reference values were compared. All reference values showed 100% agreement for estrogen receptor and progesterone receptor scores, when indeterminate results were excluded. Individual laboratory performance (agreement rates, test sensitivity, test specificity, positive predictive value, negative predictive value, and κ value) was very similar for all reference values. Identification of suboptimal performance by all methods was identical for 30 of 31 laboratories. Estrogen receptor assessment of 1 laboratory was discordant: agreement was less than 90% for 3 of 5 reference values and greater than 90% with the use of 2 other reference values. Various reference values provide equivalent laboratory rating. In addition to descriptive feedback, our approach allows calculation of technical test sensitivity and specificity, positive and negative predictive values, agreement rates, and κ values to guide corrective actions.
Sub-optimal birth weight in newborns of a high socioeconomic status population

Directory of Open Access Journals (Sweden)

Conceição Aparecida de Mattos Segre

2008-09-01

Full Text Available Objective: To compare sub-optimal birth weight (2,500 to 2,999 g term newborns to appropriate for gestational age (birth weight ≥ 3,000 g term newborns, regarding maternal data and newborn morbidity and mortality. Methods: Single term newborns, appropriate for gestational age from a high socioeconomic population (n = 1,242 with birth weight ranging from 2,500 to 2,999 g (Group I were compared to 4,907 newborns with birth weight ≥ than 3,000 g (Group II. Maternal and newborn characteristics were compared between the groups. The Mann-Whitney test, χ2 test and multivariate analysis were used. The significance level adopted was p < 0.05. Rresults: The frequency of sub-optimal birth weight newborns in the population studied was 20.2%. There was a significant association between sub-optimal birth weight and maternal weight before pregnancy and body mass index, maternal weight gain, height, smoking habit and hypertension. Newborns’ 1-minute Apgar score, neonatal hypoglycemia, jaundice, transient tachypnea, congenital pneumonia and hospital stay were significantly different between the groups (p < 0.05. A significant relationship could not be established with the 5-minute Apgar score and pulmonary hypertension in both groups. Neonatal mortality did not differ between the groups. Cconclusions: Socioeconomic status was not a risk factor for sub-optimal birth weight in the studied population. Genetic and environmental factors were associated to sub-optimal weight and neonatal diseases. According to these data, this group of newborns should receive special attention from the health team.
Nomogram for suboptimal cytoreduction at primary surgery for advanced stage ovarian cancer.

Science.gov (United States)

Gerestein, Cornelis G; Eijkemans, Marinus J; Bakker, Jeanette; Elgersma, Otto E; van der Burg, Maria E L; Kooi, Geertruida S; Burger, Curt W

2011-11-01

Maximal cytoreduction to minimal residual tumor is the most important determinant of prognosis in patients with advanced stage epithelial ovarian cancer (EOC). Preoperative prediction of suboptimal cytoreduction, defined as residual tumor >1 cm, could guide treatment decisions and improve counseling. The objective of this study was to identify predictive computed tomographic (CT) scan and clinical parameters for suboptimal cytoreduction at primary cytoreductive surgery for advanced stage EOC and to generate a nomogram with the identified parameters, which would be easy to use in daily clinical practice. Between October 2005 and December 2008, all patients with primary surgery for suspected advanced stage EOC at six participating teaching hospitals in the South Western part of the Netherlands entered the study protocol. To investigate independent predictors of suboptimal cytoreduction, a Cox proportional hazard model with backward stepwise elimination was utilized. One hundred and fifteen patients with FIGO stage III/IV EOC entered the study protocol. Optimal cytoreduction was achieved in 52 (45%) patients. A suboptimal cytoreduction was predicted by preoperative blood platelet count (p=0.1990; odds ratio (OR)=1.002), diffuse peritoneal thickening (DPT) (p=0.0074; OR=3.021), and presence of ascites on at least two thirds of CT scan slices (p=0.0385; OR=2.294) with a for-optimism corrected c-statistic of 0.67. Suboptimal cytoreduction was predicted by preoperative platelet count, DPT and presence of ascites. The generated nomogram can, after external validation, be used to estimate surgical outcome and to identify those patients, who might benefit from alternative treatment approaches.
Suboptimal investments and M&A deals in emerging capital markets

Directory of Open Access Journals (Sweden)

Cherkasova Victoria

2016-01-01

Full Text Available This paper focuses on the efficiency of target-company investment decisions before and after Merger & Acquisition deals. We study whether M&A deals help to solve the problem of suboptimal investment after the acquisition. Using a sample of 145 target companies from BRICS countries that were acquired during the period 2004-2014, we outline those that had over- or underinvested before the deal and show that more than half the companies managed to optimize the investment level after the deal. We determine the key factors that improve the inefficiency of investment decisions and demonstrate that the industry and country have an impact on the degree of suboptimal investment.
Suboptimal treatment adherence in bipolar disorder: impact on clinical outcomes and functioning

Directory of Open Access Journals (Sweden)

Montes JM

2013-01-01

Full Text Available Jose Manuel Montes1, Jorge Maurino2, Consuelo de Dios3, Esteban Medina21Department of Psychiatry, Hospital Universitario del Sureste, 2AstraZeneca Medical Department, 3Department of Psychiatry, Hospital Universitario La Paz, Madrid, SpainBackground: The primary aim of this study was to assess drug treatment adherence in patients with bipolar disorder and to identify factors associated with adherence. The secondary aim was to analyze the impact of suboptimal adherence on clinical and functional outcomes.Methods: A cross-sectional study was conducted in a sample of outpatients receiving an oral antipsychotic drug. Medication adherence was assessed combining the 10-item Drug Attitude Inventory, the Morisky Green Adherence Questionnaire, and the Compliance Rating Scale. Logistic regression was used to determine significant variables associated with suboptimal adherence to medication.Results: Three hundred and three patients were enrolled into the study. The mean age was 45.9 ± 12.8 years, and 59.7% were females. Sixty-nine percent of patients showed suboptimal adherence. Disease severity and functioning were significantly worse in the suboptimal group than in the adherent group. Multivariate analysis showed depressive polarity of the last acute episode, presence of subsyndromal symptoms, and substance abuse/dependence to be significantly associated with suboptimal treatment adherence (odds ratios 3.41, 2.13, and 1.95, respectively.Conclusion: A high prevalence of nonadherence was found in an outpatient sample with bipolar disorder. Identification of factors related to treatment adherence would give clinicians the opportunity to select more adequately patients who are eligible for potential adherence-focused interventions.Keywords: bipolar disorder, treatment adherence, functioning, polarity, subsyndromal symptoms
Suboptimal care and maternal mortality among foreign-born women in Sweden

DEFF Research Database (Denmark)

Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit

2014-01-01

that occurred in Sweden from 1988-2010. METHODS: A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases...... language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. CONCLUSIONS: Suboptimal care factors, major...
Visually suboptimal bananas: How ripeness affects consumer expectation and perception.

Science.gov (United States)

Symmank, Claudia; Zahn, Susann; Rohm, Harald

2018-01-01

One reason for the significant amount of food that is wasted in developed countries is that consumers often expect visually suboptimal food as being less palatable. Using bananas as example, the objective of this study was to determine how appearance affects consumer overall liking, the rating of sensory attributes, purchase intention, and the intended use of bananas. The ripeness degree (RD) of the samples was adjusted to RD 5 (control) and RD 7 (more ripened, visually suboptimal). After preliminary experiments, a total of 233 participants were asked to judge their satisfaction with the intensity of sensory attributes that referred to flavor, taste, and texture using just-about-right scales. Subjects who received peeled samples were asked after tasting, whereas subjects who received unpeeled bananas judged expectation and, after peeling and tasting, perception. Expected overall liking and purchase intention were significantly lower for RD 7 bananas. Purchase intention was still significantly different between RD 5 and RD 7 after tasting, whereas no difference in overall liking was observed. Significant differences between RD 5 and RD 7 were observed when asking participants for their intended use of the bananas. Concerning the sensory attributes, penalty analysis revealed that only the firmness of the RD 7 bananas was still not just-about-right after tasting. The importance that consumers attribute to the shelf-life of food had a pronounced impact on purchase intention of bananas with different ripeness degree. In the case of suboptimal bananas, the results demonstrate a positive relationship between the sensory perception and overall liking and purchase intention. Convincing consumers that visually suboptimal food is still tasty is of high relevance for recommending different ways of communication. Copyright © 2017 Elsevier Ltd. All rights reserved.
Relocation of blood gas laboratory to the emergency department helps decrease lactic acid values.

Science.gov (United States)

Brazg, Jared; Huang, Phyllis; Weiner, Corey; Singh, Guneet; Likourezos, Antonios; Salem, Linda; Dickman, Eitan; Marshall, John

2018-03-12

Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016. The study was exempt from institutional review board approval. Samples were separated into two groups: those which were drawn prior to and after relocation of the blood gas laboratory to the ED. The data, including patient demographic characteristics, acute illness severity indices, and blood gas results were compared within and between each group using t-test for continuous variables and chi-square test for categorical variables. The primary outcome was the mean lactate value measured in the SL group in 2015 compared to the ED group in 2016. Potassium and creatinine values were measured between the two groups as secondary outcomes. Of the 21,595 consecutive samples drawn, 10,363 samples were from the SL group and 11,232 from the ED group. The SL group included 5458 (52.7%) women; mean (SD) age was 61.8 (21.0). The ED group contained 5860 (52.2%) women; mean (SD) age was 61.7 (20.5). Mean Emergency Severity Index (ESI) were the same in each group at 2.31 and rates of Systemic Inflammatory Response Syndrome (SIRS) were also equivalent in each group at 22.2%. Significant differences were found between LA values in the SL group (mean 2.21mmol/L) and in the ED group (mean 1.99mmol/L) with a p value of values in the SL group (mean 3.98meq/L) compared to the ED Group (mean 3.96meq/L) with a p value of 0.022. No significant difference was found between the creatinine values. These results suggest that mean lactate values decreased when measured in an ED blood gas laboratory and may provide more
Relocation of blood gas laboratory to the emergency department helps decrease lactic acid values.

Science.gov (United States)

Brazg, Jared; Huang, Phyllis; Weiner, Corey; Singh, Guneet; Likourezos, Antonios; Salem, Linda; Dickman, Eitan; Marshall, John

2018-03-20

Emergency physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016. The study was exempt from institutional review board approval. Samples were separated into two groups: those which were drawn prior to and after relocation of the blood gas laboratory to the ED. The data, including patient demographic characteristics, acute illness severity indices, and blood gas results were compared within and between each group using t-test for continuous variables and chi-square test for categorical variables. The primary outcome was the mean lactate value measured in the SL group in 2015 compared to the ED group in 2016. Potassium and creatinine values were measured between the two groups as secondary outcomes. Of the 21,595 consecutive samples drawn, 10,363 samples were from the SL group and 11,232 from the ED group. The SL group included 5458 (52.7%) women; mean (SD) age was 61.8 (21.0). The ED group contained 5860 (52.2%) women; mean (SD) age was 61.7 (20.5). Mean Emergency Severity Index (ESI) were the same in each group at 2.31 and rates of Systemic Inflammatory Response Syndrome (SIRS) were also equivalent in each group at 22.2%. Significant differences were found between LA values in the SL group (mean 2.21mmol/L) and in the ED group (mean 1.99mmol/L) with a p value of values in the SL group (mean 3.98meq/L) compared to the ED Group (mean 3.96meq/L) with a p value of 0.022. No significant difference was found between the creatinine values. These results suggest that mean lactate values decreased when measured in an ED blood gas laboratory and may provide more
Hungry pigeons make suboptimal choices, less hungry pigeons do not.

Science.gov (United States)

Laude, Jennifer R; Pattison, Kristina F; Zentall, Thomas R

2012-10-01

Hungry animals will often choose suboptimally by being attracted to reliable signals for food that occur infrequently (they gamble) over less reliable signals for food that occur more often. That is, pigeons prefer an option that 50 % of the time provides them with a reliable signal for the appearance of food but 50 % of the time provides them with a reliable signal for the absence of food (overall 50 % reinforcement) over an alternative that always provides them with a signal for the appearance of food 75 % of the time (overall 75 % reinforcement). The pigeons appear to choose impulsively for the possibility of obtaining the reliable signal for reinforcement. There is evidence that greater hunger is associated with greater impulsivity. We tested the hypothesis that if the pigeons were less hungry, they would be less impulsive and, thus, would choose more optimally (i.e., on the basis of the overall probability of reinforcement). We found that hungry pigeons choose the 50 % reinforcement alternative suboptimally but less hungry pigeons prefer the more optimal 75 % reinforcement. Paradoxically, pigeons that needed the food more received less of it. These findings have implications for how level of motivation may also affect human suboptimal choice (e.g., purchase of lottery tickets and playing slot machines).
Clinical implications in laboratory parameter values in acute Kawasaki disease for early diagnosis and proper treatment.

Science.gov (United States)

Seo, Yu-Mi; Kang, Hyun-Mi; Lee, Sung-Churl; Yu, Jae-Won; Kil, Hong-Ryang; Rhim, Jung-Woo; Han, Ji-Whan; Lee, Kyung-Yil

2018-05-01

This study aimed to analyse laboratory values according to fever duration, and evaluate the relationship across these values during the acute phase of Kawasaki disease (KD) to aid in the early diagnosis for early-presenting KD and incomplete KD patients. Clinical and laboratory data of patients with KD (n=615) were evaluated according to duration of fever at presentation, and were compared between patients with and without coronary artery lesions (CALs). For evaluation of the relationships across laboratory indices, patients with a fever duration of 5 days or 6 days were used (n=204). The mean fever duration was 6.6±2.3 days, and the proportions of patients with CALs was 19.3% (n=114). C-reactive proteins (CRPs) and neutrophil differential values were highest and hemoglobin, albumin, and lymphocyte differential values were lowest in the 6-day group. Patients with CALs had longer total fever duration, higher CRP and neutrophil differential values and lower hemoglobin and albumin values compared to patients without CALs. CRP, albumin, neutrophil differential, and hemoglobin values at the peak inflammation stage of KD showed positive or negative correlations each other. The severity of systemic inflammation in KD was reflected in the laboratory values including CRP, neutrophil differential, albumin, and hemoglobin. Observing changes in these laboratory parameters by repeated examinations prior to the peak of inflammation in acute KD may aid in diagnosis of early-presenting KD patients.

The use of reference change values in clinical laboratories.

Science.gov (United States)

Bugdayci, Guler; Oguzman, Hamdi; Arattan, Havva Yasemin; Sasmaz, Guler

2015-01-01

The use of Reference Change Values (RCV) has been advocated as very useful for monitoring individuals. Most of these are performed for monitoring individuals in acute situations and for following up the improvement or deterioration of chronic diseases. In our study, we aimed at evaluating the RCV calculation for 24 clinical chemistry analytes widely used in clinical laboratories and the utilization of this data. Twenty-four serum samples were analyzed with Abbott kits (Abbott Laboratories, Abbott Park, IL, USA), manufactured for use with the Architect c8000 (Abbott Laboratories, Abbott Park, IL, USA) auto-analyzer. We calculated RCV using the following formula: RCV = Z x 2 1/2x (CVA2 + CVw2)1/2. Four reference change values (RCV) were calculated for each analyte using four statistical probabilities (0.95, and 0.99, unidirectional and bidirectional). Moreover, by providing an interval after identifying upper and lower limits with the Reference Change Factor (RCF), serially measured tests were calculated by using two formulas: exp (Z x 2 1/2 x (CV(A)2 + CVw2)½/100) for RCF(UP) and (1/RCF(UP)) for RCF(DOWN). RCVs of these analytes were calculated as 14.63% for glucose, 29.88% for urea, 17.75% for ALP, 53.39% for CK, 46.98% for CK-MB, 21.00% amylase, 8.00% for total protein, 8.70% for albumin, 51.08% for total bilirubin, 86.34% for direct bilirubin, 6.40% for calcium, 15.03% for creatinine, 21.47% for urate, 14.19% for total cholesterol, 46.62% for triglyceride, 20.51% for HDL-cholesterol, 29.59% for AST, 46.31% for ALT, 31.54% for GGT, 20.92% for LDH, 19.75% for inorganic phosphate, 3.05% for sodium, 11.75% for potassium, 4.44% for chloride (RCV, p laboratories. RCV could be available as a tool for making clinical decision, especially when monitoring individuals.
Comparative Performance Analysis of G-RAKE Receivers with Suboptimal Finger Placement

Directory of Open Access Journals (Sweden)

K. B. Baltzis

2014-07-01

Full Text Available Generalized RAKE (G-RAKE reception reduces the total amount of interference and provides enhanced diversity by comprising extra fingers to collect information about interference and further using channel and impairment correlation estimates for fingers allocation. However, the hardware complexity and the excessive computational requirements of GRAKE receivers may restrict their application in real systems; thus, suboptimal solutions are commonly used. In this paper, we propose and evaluate three maximum likelihood G-RAKE structures for colored noise with suboptimal finger placement. In all implementations, the fingers are optimally distributed within a time window that spans from several chip periods before the first arriving multipath to several chip periods after the latest one. The first receiver has its fingers at integer multiples of the chip period while in the rest two structures the search window is segmented in halves and tenths of the chip duration. This work also extends earlier studies by thoroughly investigating the impact of fractionally spaced finger placement on system performance. Our analysis shows that a suboptimal finger allocation reduces hardware complexity with negligible performance loss. The impact of channel delay spread and processing gain on system performance is also investigated and gives interesting results.
Sub-optimal breastfeeding and its associated factors in rural ...

African Journals Online (AJOL)

Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. Conclusion: In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were ...
Reducing suboptimal employee decisions can build the business case for employee benefits.

Science.gov (United States)

Goldsmith, Christopher; Cyboran, Steven F

2013-01-01

Suboptimal employee decisions are prevalent in employee benefit plans. Poor decisions have significant consequences for employees and employers. Improving participant decisions produces beneficial outcomes such as lower labor costs, higher productivity and better workforce management. The business case for employee benefits can be strengthened by applying lessons learned from the field of behavioral economics to employee benefit plan design and to workforce communication. This article explains the types of behavioral biases that influence suboptimal decisions and explores how enlightened employee benefit plan choice architecture and vivid behavioral messaging contribute to human and better organizational outcomes.
Suboptimality of Sales Promotions and Improvement Through Channel Coordination

NARCIS (Netherlands)

B. Wierenga (Berend); H. Soethoudt (Han)

2002-01-01

textabstractThis paper deals with sales promotions in the form of consumer price discounts in fast-moving consumer goods. First, we show analytically that suboptimality is to be expected with respect to the size of the consumer price discount. This is due to the separate decision making of the
The fate of suboptimal anastomosis after colon resection: An experimental study.

Science.gov (United States)

Yıldız, Mehmet Kamil; Okan, İsmail; Nazik, Hasan; Bas, Gurhan; Alimoglu, Orhan; İlktac, Mehmet; Daldal, Emin; Sahin, Mustafa; Kuvat, Nuray; Ongen, Betugul

2014-11-01

The fate of suboptimal anastomosis is unknown and early detection of anastomotic leakage after colon resection is crucial for the proper management of patients. Twenty-six rats were assigned to "Control", "Leakage" and "Suboptimal anastomosis" groups where they underwent either sham laparotomy, cecal ligation, and puncture or anastomosis with four sutures following colon resection, respectively. At the fifth hour and on the third and ninth days; peripheral blood and peritoneal washing samples through relaparotomy were obtained. The abdomen was inspected macroscopically for anastomotic healing. Polymerase chain reaction (PCR) with 16s rRNA and E.coli-specific primers were run on all samples along with aerobic and anaerobic cultures. The sensitivity and specificity of PCR on different bodily fluids with 16s rRNA and E.coli-specific primers were 100% and 78%, respectively. All samples of peritoneal washing fluids on the third and ninth days showed presence of bacteria in both PCR and culture. The inspection of the abdomen revealed signs of anastomotic leakage in eight rats (80%), whereas mortality related with anastomosis was detected in two (20%). Anastomotic leakage with suboptimal anastomosis after colon resection is high and the early detection is possible by running PCR on peritoneal samples as early as 72 hours.
Variations in biochemical values for common laboratory tests: a comparison among multi-ethnic Israeli women cohort.

Science.gov (United States)

Birk, Ruth; Heifetz, Eliyahu M

2018-04-28

Biochemical laboratory values are an essential tool in medical diagnosis, treatment, and follow-up; however, they are known to vary between populations. Establishment of ethnicity-adjusted reference values is recommended by health organizations. To investigate the ethnicity element in biochemical lab values studying women of different ethnic groups. Biochemical lab values (n = 27) of 503 adult Israeli women of three ethnicities (Jewish Ashkenazi, Jewish Sephardic, and Bedouin Arab) attending a single medical center were analyzed. Biochemical data were extracted from medical center records. Ethnic differences of laboratory biochemicals were studied using ANCOVA to analyze the center of the distribution as well as quartile regression analysis to analyze the upper and lower limits, both done with an adjustment for age. Significant ethnic differences were found in almost half (n = 12) of the biochemical laboratory tests. Ashkenazi Jews exhibited significantly higher mean values compared to Bedouins in most of the biochemical tests, including albumin, alkaline phosphatase, calcium, cholesterol, cholesterol LDL and HDL, cholesterol LDL calc., folic acid, globulin, and iron saturation, while the Bedouins exhibited the highest mean values in the creatinine and triglycerides. For most of these tests, Sephardic Jews exhibited biochemical mean levels in between the two other groups. Compared to Ashkenazi Jews, Sephardic Jews had a significant shift to lower values in cholesterol LDL. Ethnic subpopulations have distinct distributions in biochemical laboratory test values, which should be taken into consideration in medical practice enabling precision medicine.
The value of assessments in Lawrence Livermore National Laboratory's Waste Certification Programs

International Nuclear Information System (INIS)

Ryan, E.M.

1995-05-01

This paper will discuss the value of assessments in Lawrence Livermore National Laboratory's Waste Certification Programs by: introducing the organization and purpose of the LLNL Waste Certification Programs for transuranic, low-level, and hazardous waste; examining the differences in internal assessment/audit requirements for these programs; discussing the values and costs of assessments in a waste certification program; presenting practical recommendations to maximize the value of your assessment programs; and presenting improvements in LLNL's waste certification processes that resulted from assessments
Reoperation for suboptimal outcomes after deep brain stimulation surgery.

Science.gov (United States)

Ellis, Tina-Marie; Foote, Kelly D; Fernandez, Hubert H; Sudhyadhom, Atchar; Rodriguez, Ramon L; Zeilman, Pamela; Jacobson, Charles E; Okun, Michael S

2008-10-01

To examine a case series of reoperations for deep brain stimulation (DBS) leads in which clinical scenarios revealed suboptimal outcome from a previous operation. Suboptimally placed DBS leads are one potential reason for unsatisfactory results after surgery for Parkinson's disease (PD), essential tremor (ET), or dystonia. In a previous study of patients who experienced suboptimal results, 19 of 41 patients had misplaced leads. Similarly, another report commented that lead placement beyond a 2- to 3-mm window resulted in inadequate clinical benefit, and, in 1 patient, revision improved outcome. The goal of the current study was to perform an unblinded retrospective chart review of DBS patients with unsatisfactory outcomes who presented for reoperation. Patients who had DBS lead replacements after reoperation were assessed with the use of a retrospective review of an institutional review board-approved movement disorders database. Cases of reoperation for suboptimal clinical benefit were included, and cases of replacement of DBS leads caused by infection or hardware malfunction were excluded. Data points studied included age, disease duration, diagnosis, motor outcomes (the Unified Parkinson Disease Rating Scale III in PD, the Tremor Rating Scale in ET, and the Unified Dystonia Rating Scale in dystonia), quality of life (Parkinson's Disease Questionnaire-39 in PD), and the Clinician Global Impression scale. The data from before and after reoperation were examined to determine the estimated impact of repeat surgery. There were 11 patients with PD, 7 with ET, and 4 with dystonia. The average age of the PD group was 52 years, the disease duration was 10 years, and the average vector distance of the location of the active DBS contact was adjusted 5.5 mm. Six patients (54%) with PD had preoperative off medication on DBS Unified Parkinson Disease Rating Scale scores that could be compared with postoperative off medication on DBS scores. The average improvement across this
Values, food and bags: A study of consumption decisions in a laboratory supermarket

OpenAIRE

Astrid Matthey; Tim Kasser

2013-01-01

We study the relation between people's personal values and environmentally friendly consumption behavior. We first assessed subjects' personal values using the Aspiration Index. Then subjects participated in a laboratory supermarket offering organic and conventional food products and different kinds of bags. The results suggest that subjects' personal values are poor predictors of their ecologically-relevant consumption behavior. However, we find that subjects who spontaneously reflected upon...
Suboptimal Partial Transmit Sequence-Active Interference Cancellation with Particle Swarm Optimization

Directory of Open Access Journals (Sweden)

Tarasak Poramate

2010-01-01

Full Text Available Active interference cancellation (AIC is an effective technique to provide interference avoidance feature for an ultrawideband (UWB OFDM transmitter. Partial transmit sequence-AIC (PTS-AIC, which was recently proposed as an improvement of AIC, requires high computational complexity by doing the exhaustive search of all possible weighting factors whose number grows exponentially with the number of subblocks used. To reduce the complexity of PTS-AIC, this paper proposes a suboptimal way, called particle swarm optimization (PSO, to choose the weighting factors suboptimally without much performance degradation. Both continuous and discrete versions of PSO have been evaluated, and it has been shown that the discrete PSO is able to reduce the complexity significantly without sacrificing the performance of PTS-AIC in many cases.
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc PH; Schmand, Ben A; Kessels, Roy PC; Aldenkamp, Albert

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals...
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

OpenAIRE

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design.Method. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who ...
A non-destructive selection method for faster growth at suboptimal temperature in common bean (Phaseolus vulgaris)

NARCIS (Netherlands)

Drijfhout, E.; Oeveren, J.C. van; Jansen, R.C.

1991-01-01

A non-destructive method has been developed to select common bean (Phaseolus vulgaris L.) plants whose growth is less effected at a suboptimal temperature. Shoot weight was determined at a suboptimal (14°C) and optimal temperature (20°C), 38 days after sowing and accessions identified with a
Clinical Laboratory Values as Early Indicators of Ebola Virus Infection in Nonhuman Primates.

Science.gov (United States)

Reisler, Ronald B; Yu, Chenggang; Donofrio, Michael J; Warren, Travis K; Wells, Jay B; Stuthman, Kelly S; Garza, Nicole L; Vantongeren, Sean A; Donnelly, Ginger C; Kane, Christopher D; Kortepeter, Mark G; Bavari, Sina; Cardile, Anthony P

2017-08-01

The Ebola virus (EBOV) outbreak in West Africa during 2013-2016 demonstrated the need to improve Ebola virus disease (EVD) diagnostics and standards of care. This retrospective study compared laboratory values and clinical features of 3 nonhuman primate models of lethal EVD to assess associations with improved survival time. In addition, the study identified laboratory values useful as predictors of survival, surrogates for EBOV viral loads, and triggers for initiation of therapeutic interventions in these nonhuman primate models. Furthermore, the data support that, in nonhuman primates, the Makona strain of EBOV may be less virulent than the Kikwit strain of EBOV. The applicability of these findings as potential diagnostic and management tools for EVD in humans warrants further investigation.
Suboptimal bonding impairs hormonal, epigenetic and neuronal development in preterm infants, but these impairments can be reversed

NARCIS (Netherlands)

Kommers, D.R.; Oei, S.G.; Chen, W.; Feijs, L.M.G.; Bambang Oetomo, S.

This review aimed to raise awareness of the consequences of suboptimal bonding caused by prematurity. In addition to hypoxia–ischaemia, infection and malnutrition, suboptimal bonding is one of the many unnatural stimuli that preterm infants are exposed to, compromising their physiological
Statin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patients

Directory of Open Access Journals (Sweden)

Lumu W

2017-02-01

Full Text Available William Lumu,1 Leaticia Kampiire,2 George Patrick Akabwai,3 Daniel Ssekikubo Kiggundu,4 Davis Kibirige5 1Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, 2Infectious Disease Research Collaboration, 3Baylor College of Medicine Children’s Foundation, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, 5Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda Background: Hypertension is one of the recognized risk factors of cardiovascular diseases in adult diabetic patients. High prevalence of suboptimal blood pressure (BP control has been well documented in the majority of studies assessing BP control in diabetic patients in sub-Saharan Africa. In Uganda, there is a dearth of similar studies. This study evaluated the prevalence and correlates of suboptimal BP control in an adult diabetic population in Uganda.Patients and methods: This was a cross-sectional study that enrolled 425 eligible ambulatory adult diabetic patients attending three urban diabetic outpatient clinics over 11 months. Data about their sociodemographic characteristics and clinical history were collected using pre-tested questionnaires. Suboptimal BP control was defined according to the 2015 American Diabetes Association standards of diabetes care guideline as BP levels ≥140/90 mmHg.Results: The mean age of the study participants was 52.2±14.4 years, with the majority being females (283, 66.9%. Suboptimal BP control was documented in 192 (45.3% study participants and was independently associated with the study site (private hospitals; odds ratio 2.01, 95% confidence interval 1.18–3.43, P=0.01 and use of statin therapy (odds ratio 0.5, 95% confidence interval 0.26–0.96, P=0.037.Conclusion: Suboptimal BP control was highly prevalent in this study population. Strategies to improve optimal BP control, especially in the private hospitals, and the use of statin therapy should be encouraged in adult diabetic patients
Suboptimal control of pressurized water reactor power plant using approximate model-following method

International Nuclear Information System (INIS)

Tsuji, Masashi; Ogawa, Yuichi

1987-01-01

We attempted to develop an effective control system that can successfully manage the nuclear steam supply (NSS) system of a PWR power plant in an operational mode requiring relatively small variations of power. A procedure is proposed for synthesizing control system that is a simple, yet practiced, suboptimal control system. The suboptimal control system is designed in two steps; application of the optimal control theory, based on the linear state-feedback control and the use of an approximate model-following method. This procedure can appreciably reduce the complexity of the structure of the controller by accepting a slight deviation from the optimality and by the use of the output-feedback control. This eliminates the engineering difficulty caused by an incompletely state-feedback that is sometimes encountered in practical applications of the optimal state-feedback control theory to complex large-scale dynamical systems. Digital simulations and graphical studies based on the Bode-diagram demonstrate the effectiveness of the suboptimal control, and the applicability of the proposed design method as well. (author)
Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi

Science.gov (United States)

Mazenga, Alick C.; Simon, Katie; Yu, Xiaoying; Ahmed, Saeed; Nyasulu, Phoebe; Kazembe, Peter N.; Ngoma, Stanley; Abrams, Elaine J.

2018-01-01

Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; pBurnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the
Relationship between stress-related psychosocial work factors and suboptimal health among Chinese medical staff: a cross-sectional study.

Science.gov (United States)

Liang, Ying-Zhi; Chu, Xi; Meng, Shi-Jiao; Zhang, Jie; Wu, Li-Juan; Yan, Yu-Xiang

2018-03-06

The study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status. The cross-sectional study was conducted using clustered sampling method. Xuanwu Hospital, a 3A grade hospital in Beijing. Nine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population. The Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff. There was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), Pwork factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status. Among medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated

Sub-optimal control of fuzzy linear dynamical systems under granular differentiability concept.

Science.gov (United States)

Mazandarani, Mehran; Pariz, Naser

2018-05-01

This paper deals with sub-optimal control of a fuzzy linear dynamical system. The aim is to keep the state variables of the fuzzy linear dynamical system close to zero in an optimal manner. In the fuzzy dynamical system, the fuzzy derivative is considered as the granular derivative; and all the coefficients and initial conditions can be uncertain. The criterion for assessing the optimality is regarded as a granular integral whose integrand is a quadratic function of the state variables and control inputs. Using the relative-distance-measure (RDM) fuzzy interval arithmetic and calculus of variations, the optimal control law is presented as the fuzzy state variables feedback. Since the optimal feedback gains are obtained as fuzzy functions, they need to be defuzzified. This will result in the sub-optimal control law. This paper also sheds light on the restrictions imposed by the approaches which are based on fuzzy standard interval arithmetic (FSIA), and use strongly generalized Hukuhara and generalized Hukuhara differentiability concepts for obtaining the optimal control law. The granular eigenvalues notion is also defined. Using an RLC circuit mathematical model, it is shown that, due to their unnatural behavior in the modeling phenomenon, the FSIA-based approaches may obtain some eigenvalues sets that might be different from the inherent eigenvalues set of the fuzzy dynamical system. This is, however, not the case with the approach proposed in this study. The notions of granular controllability and granular stabilizability of the fuzzy linear dynamical system are also presented in this paper. Moreover, a sub-optimal control for regulating a Boeing 747 in longitudinal direction with uncertain initial conditions and parameters is gained. In addition, an uncertain suspension system of one of the four wheels of a bus is regulated using the sub-optimal control introduced in this paper. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.
Determination of Soil Moisture Content using Laboratory Experimental and Field Electrical Resistivity Values

Science.gov (United States)

Hazreek, Z. A. M.; Rosli, S.; Fauziah, A.; Wijeyesekera, D. C.; Ashraf, M. I. M.; Faizal, T. B. M.; Kamarudin, A. F.; Rais, Y.; Dan, M. F. Md; Azhar, A. T. S.; Hafiz, Z. M.

2018-04-01

The efficiency of civil engineering structure require comprehensive geotechnical data obtained from site investigation. In the past, conventional site investigation was heavily related to drilling techniques thus suffer from several limitations such as time consuming, expensive and limited data collection. Consequently, this study presents determination of soil moisture content using laboratory experimental and field electrical resistivity values (ERV). Field and laboratory electrical resistivity (ER) test were performed using ABEM SAS4000 and Nilsson400 soil resistance meter. Soil sample used for resistivity test was tested for characterization test specifically on particle size distribution and moisture content test according to BS1377 (1990). Field ER data was processed using RES2DINV software while laboratory ER data was analyzed using SPSS and Excel software. Correlation of ERV and moisture content shows some medium relationship due to its r = 0.506. Moreover, coefficient of determination, R2 analyzed has demonstrate that the statistical correlation obtain was very good due to its R2 value of 0.9382. In order to determine soil moisture content based on statistical correlation (w = 110.68ρ-0.347), correction factor, C was established through laboratory and field ERV given as 19.27. Finally, this study has shown that soil basic geotechnical properties with particular reference to water content was applicably determined using integration of laboratory and field ERV data analysis thus able to compliment conventional approach due to its economic, fast and wider data coverage.
Robotic fish tracking method based on suboptimal interval Kalman filter

Science.gov (United States)

Tong, Xiaohong; Tang, Chao

2017-11-01

Autonomous Underwater Vehicle (AUV) research focused on tracking and positioning, precise guidance and return to dock and other fields. The robotic fish of AUV has become a hot application in intelligent education, civil and military etc. In nonlinear tracking analysis of robotic fish, which was found that the interval Kalman filter algorithm contains all possible filter results, but the range is wide, relatively conservative, and the interval data vector is uncertain before implementation. This paper proposes a ptimization algorithm of suboptimal interval Kalman filter. Suboptimal interval Kalman filter scheme used the interval inverse matrix with its worst inverse instead, is more approximate nonlinear state equation and measurement equation than the standard interval Kalman filter, increases the accuracy of the nominal dynamic system model, improves the speed and precision of tracking system. Monte-Carlo simulation results show that the optimal trajectory of sub optimal interval Kalman filter algorithm is better than that of the interval Kalman filter method and the standard method of the filter.
Design Of Real-Time Implementable Distributed Suboptimal Control: An LQR Perspective

KAUST Repository

Jaleel, Hassan; Shamma, Jeff S.

2017-01-01

of establishing a communication link between two base stations with minimum energy consumption. We show through simulations that the performance under the proposed framework is close to the optimal performance and the suboptimal policy can be efficiently
Study of variables affecting critical value notification in a laboratory catering to tertiary care hospital.

Science.gov (United States)

Agarwal, Rachna; Chhillar, Neelam; Tripathi, Chandra B

2015-01-01

During post-analytical phase, critical value notification to responsible caregiver in a timely manner has potential to improve patient safety which requires cooperative efforts between laboratory personnel and caregivers. It is widely accepted by hospital accreditors that ineffective notification can lead to diagnostic errors that potentially harm patients and are preventable. The objective of the study was to assess the variables affecting critical value notification, their role in affecting it's quality and approaches to improve it. In the present study 1,187 critical values were analysed in the Clinical Chemistry Laboratory catering to tertiary care hospital for neuropsychiatric diseases. During 25 months of study period, we evaluated critical value notification with respect to clinical care area, caregiver to whom it was notified and timeliness of notification. During the study period (25 months), the laboratory obtained 1,279 critical values in clinical chemistry. The analytes most commonly notified were sodium and potassium (20.97 & 20.8 % of total critical results). Analysis of critical value notification versus area of care showed that critical value notification was high in ICU and emergency area followed by inpatients and 64.61 % critical values were notified between 30 and 120 min after receiving the samples. It was found that failure to notify the responsible caregiver in timely manner represent an important patient safety issue and may lead to diagnostic errors. The major area of concern are notification of critical value for outpatient samples, incompleteness of test requisition forms regarding illegible writing, lack of information of treating physician and location of test ordering and difficulty in contacting the responsible caregiver.
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV).

Science.gov (United States)

Bouman, Zita; Hendriks, Marc P H; Schmand, Ben A; Kessels, Roy P C; Aldenkamp, Albert P

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of suboptimal performance using an analogue study design. The patient group consisted of 59 mixed-etiology patients; the experimental malingerers were 50 healthy individuals who were asked to simulate cognitive impairment as a result of a traumatic brain injury; the last group consisted of 50 healthy controls who were instructed to put forth full effort. Experimental malingerers performed significantly lower on all WMS-IV-NL tasks than did the patients and healthy controls. A binary logistic regression analysis was performed on the experimental malingerers and the patients. The first model contained the visual working memory subtests (Spatial Addition and Symbol Span) and the recognition tasks of the following subtests: Logical Memory, Verbal Paired Associates, Designs, Visual Reproduction. The results showed an overall classification rate of 78.4%, and only Spatial Addition explained a significant amount of variation (p < .001). Subsequent logistic regression analysis and receiver operating characteristic (ROC) analysis supported the discriminatory power of the subtest Spatial Addition. A scaled score cutoff of <4 produced 93% specificity and 52% sensitivity for detection of suboptimal performance. The WMS-IV-NL Spatial Addition subtest may provide clinically useful information for the detection of suboptimal performance.
Detection of suboptimal effort with symbol span: development of a new embedded index.

Science.gov (United States)

Young, J Christopher; Caron, Joshua E; Baughman, Brandon C; Sawyer, R John

2012-03-01

Developing embedded indicators of suboptimal effort on objective neurocognitive testing is essential for detecting increasingly sophisticated forms of symptom feigning. The current study explored whether Symbol Span, a novel Wechsler Memory Scale-fourth edition measure of supraspan visual attention, could be used to discriminate adequate effort from suboptimal effort. Archival data were collected from 136 veterans classified into Poor Effort (n = 42) and Good Effort (n = 94) groups based on symptom validity test (SVT) performance. The Poor Effort group had significantly lower raw scores (p Span test. A raw score cutoff of Span can effectively differentiate veterans with multiple failures on established free-standing and embedded SVTs.
What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

Science.gov (United States)

Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

2018-02-17

For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal
Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana

Directory of Open Access Journals (Sweden)

James Tsai

2017-06-01

In conclusion, among adult ever users of marijuana, current tobacco use is high and strongly associated with suboptimal SRH; regular marijuana smoking with or without current tobacco use is significantly associated with suboptimal SRH.
Microarray labeling extension values: laboratory signatures for Affymetrix GeneChips

Science.gov (United States)

Lee, Yun-Shien; Chen, Chun-Houh; Tsai, Chi-Neu; Tsai, Chia-Lung; Chao, Angel; Wang, Tzu-Hao

2009-01-01

Interlaboratory comparison of microarray data, even when using the same platform, imposes several challenges to scientists. RNA quality, RNA labeling efficiency, hybridization procedures and data-mining tools can all contribute variations in each laboratory. In Affymetrix GeneChips, about 11–20 different 25-mer oligonucleotides are used to measure the level of each transcript. Here, we report that ‘labeling extension values (LEVs)’, which are correlation coefficients between probe intensities and probe positions, are highly correlated with the gene expression levels (GEVs) on eukayotic Affymetrix microarray data. By analyzing LEVs and GEVs in the publicly available 2414 cel files of 20 Affymetrix microarray types covering 13 species, we found that correlations between LEVs and GEVs only exist in eukaryotic RNAs, but not in prokaryotic ones. Surprisingly, Affymetrix results of the same specimens that were analyzed in different laboratories could be clearly differentiated only by LEVs, leading to the identification of ‘laboratory signatures’. In the examined dataset, GSE10797, filtering out high-LEV genes did not compromise the discovery of biological processes that are constructed by differentially expressed genes. In conclusion, LEVs provide a new filtering parameter for microarray analysis of gene expression and it may improve the inter- and intralaboratory comparability of Affymetrix GeneChips data. PMID:19295132
Sub-Optimal Management of Type 2 Diabetes Mellitus – A Local Audit

African Journals Online (AJOL)

Original Research: Sub-Optimal Management of Type 2 Diabetes Mellitus – A Local Audit ... despite clinical trial data documenting improved outcomes associated not ... were used to define the Metabolic Syndrome.9 Central obesity was.
Clinical value of component-resolved diagnostics in peanut-allergic patients

DEFF Research Database (Denmark)

Eller, E; Bindslev-Jensen, C

2013-01-01

As replacement for the oral food challenge, decision-points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported to be of v......As replacement for the oral food challenge, decision-points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported...... to be of value, but data on correlation with clinical data are sparse. Our aim was to correlate IgE values with the outcome of peanut challenges....
The Usefulness of Clinical-Practice-Based Laboratory Data in Facilitating the Diagnosis of Dengue Illness

Directory of Open Access Journals (Sweden)

Jien-Wei Liu

2013-01-01

Full Text Available Alertness to dengue and making a timely diagnosis is extremely important in the treatment of dengue and containment of dengue epidemics. We evaluated the complementary role of clinical-practice-based laboratory data in facilitating suspicion/diagnosis of dengue. One hundred overall dengue (57 dengue fever [DF] and 43 dengue hemorrhagic fever [DHF] cases and another 100 nondengue cases (78 viral infections other than dengue, 6 bacterial sepsis, and 16 miscellaneous diseases were analyzed. We separately compared individual laboratory variables (platelet count [PC] , prothrombin time [PT], activated partial thromboplastin time [APTT], alanine aminotransferase [ALT], and aspartate aminotransferase [AST] and varied combined variables of DF and/or DHF cases with the corresponding ones of nondengue cases. The sensitivity, specificity, accuracy, positive predictive value (PPV, and negative predictive value (NPV in the diagnosis of DF and/or DHF were measured based on these laboratory variables. While trade-off between sensitivity and specificity, and/or suboptimal PPV/NPV was found at measurements using these variables, prolonged APTT + normal PT + PC < 100 × 109 cells/L had a favorable sensitivity, specificity, PPV, and NPV in diagnosis of DF and/or DHF. In conclusion, these data suggested that prolonged APTT + normal PT + PC < 100 × 109 cells/L is useful in evaluating the likelihood of DF and/or DHF.
Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females

Science.gov (United States)

Ryden, Ingvar; Lind, Lars

2012-01-01

Background We have previously reported reference values for common clinical chemistry tests in healthy 70-year-old males and females. We have now repeated this study 5 years later to establish reference values also at the age of 75. It is important to have adequate reference values for elderly patients as biological markers may change over time, and adequate reference values are essential for correct clinical decisions. Methods We have investigated 31 frequently used laboratory markers in 75-year-old males (n = 354) and females (n = 373) without diabetes. The 2.5 and 97.5 percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry. Results Reference values are reported for 75-year-old males and females for 31 frequently used laboratory markers. Conclusion There were minor differences between reference intervals calculated with and without individuals with cardiovascular diseases. Several of the reference intervals differed from Scandinavian reference intervals based on younger individuals (Nordic Reference Interval Project). PMID:22300333
Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India.

Science.gov (United States)

Joshi, Beena; Chauhan, Sanjay; Pasi, Achhelal; Kulkarni, Ragini; Sunil, Nithya; Bachani, Damodar; Mankeshwar, Ranjit

2014-07-01

National Anti-retroviral treatment (ART) programme in India was launched in 2004. Since then, there has been no published country representative estimate of suboptimal adherence among people living with HIV (PLHIV) on first line ART in public settings. Hence a multicentric study was undertaken in 15 States of India to assess the level of suboptimal adherence and its determinants among PLHIV. Using a prospective observational study design, 3285 PLHIV were enrolled and followed up to six months across 30 ART centres in India. Adherence was assessed using pill count and self-reported recall method and determinants of suboptimal adherence were explored based on the responses to various issues as perceived by them. Suboptimal adherence was found in 24.5 per cent PLHIV. Determinants of suboptimal adherence were illiteracy (OR--1.341, CI--1.080-1.665), on ART for less than 6 months (OR--1.540, CI--1.280-1.853), male gender (OR for females--0.807, CI--0.662-0.982), tribals (OR--2.246, CI--1.134-4.447), on efavirenz (EFA) regimen (OR--1.479, CI--1.190-1.837), presence of anxiety (OR--1.375, CI--1.117-1.692), non-disclosure of HIV status to family (OR--1.549, CI--1.176-2.039), not motivated for treatment (OR--1.389, CI--1.093-1.756), neglect from friends (OR--1.368, CI--1.069-1.751), frequent change of residence (OR--3.373, CI--2.659-4.278), travel expenses (OR--1.364, CI--1.138-1.649), not meeting the PLHIV volunteer/community care coordinator at the ART center (OR--1.639, CI--1.330-2.019). To enhance identification of PLHIV vulnerable to suboptimal adherence, the existing checklist to identify the barriers to adherence in the National ART Guidelines needs to be updated based on the study findings. Quality of comprehensive adherence support services needs to be improved coupled with vigilant monitoring of adherence measurement.
Level of suboptimal adherence to first line antiretroviral treatment & its determinants among HIV positive people in India

Directory of Open Access Journals (Sweden)

Beena Joshi

2014-01-01

Full Text Available Background & objectives: National Anti-retroviral treatment (ART programme in India was launched in 2004. Since then, there has been no published country representative estimate of suboptimal adherence among people living with HIV (PLHIV on first line ART in public settings. Hence a multicentric study was undertaken in 15 States of India to assess the level of suboptimal adherence and its determinants among PLHIV. Methods: Using a prospective observational study design, 3285 PLHIV were enrolled and followed up to six months across 30 ART centres in India. Adherence was assessed using pill count and self-reported recall method and determinants of suboptimal adherence were explored based on the responses to various issues as perceived by them. Results: Suboptimal adherence was found in 24.5 per cent PLHIV. Determinants of suboptimal adherence were illiteracy (OR-1.341, CI-1.080-1.665 , on ART for less than 6 months (OR-1.540, CI- 1.280-1.853, male gender (OR for females -0.807, CI- 0.662-0.982, tribals (OR-2.246, CI-1.134-4.447, on efavirenz (EFA regimen (OR- 1.479, CI - 1.190 - 1.837, presence of anxiety (OR- 1.375, CI - 1.117 - 1.692, non-disclosure of HIV status to family (OR- 1.549, CI - 1.176 - 2.039, not motivated for treatment (OR- 1.389, CI - 1.093 - 1.756, neglect from friends (OR-1.368, CI-1.069-1.751, frequent change of residence (OR- 3.373, CI - 2.659 - 4.278, travel expenses (OR- 1.364, CI - 1.138-1.649, not meeting the PLHIV volunteer/community care coordinator at the ART center (OR-1.639, CI-1.330-2.019. Interpretation & conclusions: To enhance identification of PLHIV vulnerable to suboptimal adherence, the existing checklist to identify the barriers to adherence in the National ART Guidelines needs to be updated based on the study findings. Quality of comprehensive adherence support services needs to be improved coupled with vigilant monitoring of adherence measurement.
Classical swine fever virus detection: results of a real-time reverse transcription polymerase chain reaction ring trial conducted in the framework of the European network of excellence for epizootic disease diagnosis and control

DEFF Research Database (Denmark)

Hoffmann, Bernd; Blome, Sandra; Bonilauri, Paolo

2011-01-01

and specificity values. Nevertheless, some in-house systems had unspecific reactions or suboptimal sensitivity with only a single CSFV genotype. Follow-up actions involved either improvement of suboptimal assays or replacement of specific laboratory assays with the FLI protocol, with or without modifications......The current study reports on a real-time reverse transcription polymerase chain reaction (real-time RT-PCR) ring trial for the detection of Classical swine fever virus (CSFV) genomic RNA undertaken by 10 European laboratories. All laboratories were asked to use their routine in-house real-time RT...
Value of routine admission laboratory tests to predict thirty-day mortality in patients with acute myocardial infarction

NARCIS (Netherlands)

Sjauw, KD; Van der Horst, ICC; Nijsten, MWN; Nieuwland, W; Zijlstra, F

2006-01-01

Most risk-stratification instruments that have been developed to predict outcome after myocardial infarction do not make use of laboratory parameters, although several laboratory parameters have, been shown to be predictors of adverse outcome. To assess the prognostic value of routine admission
Application of the tuning algorithm with the least squares approximation to the suboptimal control algorithm for integrating objects

Science.gov (United States)

Kuzishchin, V. F.; Merzlikina, E. I.; Van Va, Hoang

2017-11-01

The problem of PID and PI-algorithms tuning by means of the approximation by the least square method of the frequency response of a linear algorithm to the sub-optimal algorithm is considered. The advantage of the method is that the parameter values are obtained through one cycle of calculation. Recommendations how to choose the parameters of the least square method taking into consideration the plant dynamics are given. The parameters mentioned are the time constant of the filter, the approximation frequency range and the correction coefficient for the time delay parameter. The problem is considered for integrating plants for some practical cases (the level control system in a boiler drum). The transfer function of the suboptimal algorithm is determined relating to the disturbance that acts in the point of the control impact input, it is typical for thermal plants. In the recommendations it is taken into consideration that the overregulation for the transient process when the setpoint is changed is also limited. In order to compare the results the systems under consideration are also calculated by the classical method with the limited frequency oscillation index. The results given in the paper can be used by specialists dealing with tuning systems with the integrating plants.
Assessment of laboratory values of thyroid function tests in Sudanese patients

International Nuclear Information System (INIS)

Farah, Mansour El Tahir

1997-01-01

Thyroid diseases comprise a major health problem in Sudan. Although clinical diagnosis of thyroid diseases often easy, there are many diagnostic difficulties. So, laboratory investigations are essential in certain conditions. 97 Sudanese subjects were included in this study. According to the clinical features, patients were divided into three groups, either hyper or hypothyroid, and the control group. Laboratory diagnosis of these individuals was established in the diagnostic and research laboratory centre in Khartoum teaching hospital. The thyroid hormones studied are T 3 , T 4 , FT 4 (by enzyme immunoassay) and TSH (by the ultrasensitive enzyme immunoassay). Serum T 3 concentration was found to be high in 66% of the hyperthyroid patients, and low in 75% of the hypothyroid patients, and normal in 66.7% of the control group. Serum T 4 concentration was normal in one-third of the hyperthyroid patients, and one-fourth of the hypothyroid patients, and 90.9% of the control group. FT 4 was normal in the control group, low in 95% for the hypothyroid patients, and high in 66% of the hyperthyroid patients. Signs of hyperthyroidism were associated with high hormonal levels more than symptoms do. Hyperkinesis and eye signs had a significant correlation with the hormonal levels. No significant correlation was found between symptoms and signs of hypothyroidism and hormonal levels. So, clinical evaluation of patients is very important before assessing the laboratory values, and the free T 4 is more specific in the diagnosis of thyroid diseases. (Author)

The paradoxical effect of low reward probabilities in suboptimal choice.

Science.gov (United States)

Fortes, Inês; Pinto, Carlos; Machado, Armando; Vasconcelos, Marco

2018-04-01

When offered a choice between 2 alternatives, animals sometimes prefer the option yielding less food. For instance, pigeons and starlings prefer an option that on 20% of the trials presents a stimulus always followed by food, and on the remaining 80% of the trials presents a stimulus never followed by food (the Informative Option), over an option that provides food on 50% of the trials regardless of the stimulus presented (the Noninformative Option). To explain this suboptimal behavior, it has been hypothesized that animals ignore (or do not engage with) the stimulus that is never followed by food in the Informative Option. To assess when pigeons attend to the stimulus usually not followed by food, we increased the probability of reinforcement, p, in the presence of that stimulus. Across 2 experiments, we found that the value of the Informative Option decreased with p. To account for the results, we added to the Reinforcement Rate Model (and also to the Hyperbolic Discounting Model) an engagement function, f(p), that specified the likelihood the animal attends to a stimulus followed by reward with probability p, and then derived the model predictions for 2 forms of f(p), a linear function, and an all-or-none threshold function. Both models predicted the observed findings with a linear engagement function: The higher the probability of reinforcement after a stimulus, the higher the probability of engaging the stimulus, and, surprisingly, the less the value of the option comprising the stimulus. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Applications of sub-optimality in dynamic programming to location and construction of nuclear fuel processing plant

International Nuclear Information System (INIS)

Thiriet, L.; Deledicq, A.

1968-09-01

First, the point of applying Dynamic Programming to optimization and Operational Research problems in chemical industries are recalled, as well as the conditions in which a dynamic program is illustrated by a sequential graph. A new algorithm for the determination of sub-optimal politics in a sequential graph is then developed. Finally, the applications of sub-optimality concept is shown when taking into account the indirect effects related to possible strategies, or in the case of stochastic choices and of problems of the siting of plants... application examples are given. (authors) [fr
Sub-optimal vitamin B-12 levels among ART-naive HIV-positive individuals in an urban cohort in Uganda.

Directory of Open Access Journals (Sweden)

Aggrey S Semeere

Full Text Available Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP or the Infectious Diseases Institute (IDI clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900. Sub-optimal vitamin B-12 levels (<300 pg/ml were found in 75/204 (36.8%. Twenty-one of 204 (10.3% had vitamin B-12 deficiency (<200 pg/ml while 54/204 (26.5% had marginal depletion (200-300 pg/ml. Irritable mood was observed more among individuals with sub-optimal vitamin B-12 levels (OR 2.5, 95% CI; 1.1-5.6, P=0.03. Increasing MCV was associated with decreasing serum B-12 category; 86.9 fl (± 5.1 vs. 83 fl (± 8.4 vs. 82 fl (± 8.4 for B-12 deficiency, marginal and normal B-12 categories respectively (test for trend, P=0.017. Compared to normal B-12, individuals with vitamin B-12 deficiency had a longer known duration of HIV infection: 42.2 months (± 27.1 vs. 29.4 months (± 23.8; P=0.02. Participants eligible for ART (CD4<350 cells/µl with sub-optimal B-12 had a higher mean rate of CD4 decline compared to counterparts with normal B-12; 118 (± 145 vs. 22 (± 115 cells/µl/year, P=0.01 respectively. The prevalence of a sub-optimal vitamin B-12 was high in this HIV-infected, ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal
Optimal inference with suboptimal models: Addiction and active Bayesian inference

Science.gov (United States)

Schwartenbeck, Philipp; FitzGerald, Thomas H.B.; Mathys, Christoph; Dolan, Ray; Wurst, Friedrich; Kronbichler, Martin; Friston, Karl

2015-01-01

When casting behaviour as active (Bayesian) inference, optimal inference is defined with respect to an agent’s beliefs – based on its generative model of the world. This contrasts with normative accounts of choice behaviour, in which optimal actions are considered in relation to the true structure of the environment – as opposed to the agent’s beliefs about worldly states (or the task). This distinction shifts an understanding of suboptimal or pathological behaviour away from aberrant inference as such, to understanding the prior beliefs of a subject that cause them to behave less ‘optimally’ than our prior beliefs suggest they should behave. Put simply, suboptimal or pathological behaviour does not speak against understanding behaviour in terms of (Bayes optimal) inference, but rather calls for a more refined understanding of the subject’s generative model upon which their (optimal) Bayesian inference is based. Here, we discuss this fundamental distinction and its implications for understanding optimality, bounded rationality and pathological (choice) behaviour. We illustrate our argument using addictive choice behaviour in a recently described ‘limited offer’ task. Our simulations of pathological choices and addictive behaviour also generate some clear hypotheses, which we hope to pursue in ongoing empirical work. PMID:25561321
Assessment of laboratory values of thyroid function tests in Sudanese patients

Energy Technology Data Exchange (ETDEWEB)

Farah, Mansour El Tahir [Faculty of Medicine, University of Khartoum, Khartoum (Sudan)

1998-12-31

Thyroid diseases comprise a major health problem in Sudan. Although clinical diagnosis of thyroid diseases often easy, there are many diagnostic difficulties. So, laboratory investigations are essential in certain conditions. 97 Sudanese subjects were included in this study. According to the clinical features, patients were divided into three groups, either hyper or hypothyroid, and the control group. Laboratory diagnosis of these individuals was established in the diagnostic and research laboratory centre in Khartoum teaching hospital. The thyroid hormones studied are T{sup 3}, T{sup 4}, FT{sup 4} (by enzyme immunoassay) and TSH (by the ultrasensitive enzyme immunoassay). Serum T{sup 3} concentration was found to be high in 66% of the hyperthyroid patients, and low in 75% of the hypothyroid patients, and normal in 66.7% of the control group. Serum T{sup 4} concentration was normal in one-third of the hyperthyroid patients, and one-fourth of the hypothyroid patients, and 90.9% of the control group. FT{sup 4} was normal in the control group, low in 95% for the hypothyroid patients, and high in 66% of the hyperthyroid patients. Signs of hyperthyroidism were associated with high hormonal levels more than symptoms do. Hyperkinesis and eye signs had a significant correlation with the hormonal levels. No significant correlation was found between symptoms and signs of hypothyroidism and hormonal levels. So, clinical evaluation of patients is very important before assessing the laboratory values, and the free T{sup 4} is more specific in the diagnosis of thyroid diseases. (Author) 97 refs. , 20 tabs. , 11 figs.
Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

Science.gov (United States)

Tan, Ming Yeong; Magarey, Judy

2008-08-01

To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.
Suboptimal Criterion Learning in Static and Dynamic Environments.

Directory of Open Access Journals (Sweden)

Elyse H Norton

2017-01-01

Full Text Available Humans often make decisions based on uncertain sensory information. Signal detection theory (SDT describes detection and discrimination decisions as a comparison of stimulus "strength" to a fixed decision criterion. However, recent research suggests that current responses depend on the recent history of stimuli and previous responses, suggesting that the decision criterion is updated trial-by-trial. The mechanisms underpinning criterion setting remain unknown. Here, we examine how observers learn to set a decision criterion in an orientation-discrimination task under both static and dynamic conditions. To investigate mechanisms underlying trial-by-trial criterion placement, we introduce a novel task in which participants explicitly set the criterion, and compare it to a more traditional discrimination task, allowing us to model this explicit indication of criterion dynamics. In each task, stimuli were ellipses with principal orientations drawn from two categories: Gaussian distributions with different means and equal variance. In the covert-criterion task, observers categorized a displayed ellipse. In the overt-criterion task, observers adjusted the orientation of a line that served as the discrimination criterion for a subsequently presented ellipse. We compared performance to the ideal Bayesian learner and several suboptimal models that varied in both computational and memory demands. Under static and dynamic conditions, we found that, in both tasks, observers used suboptimal learning rules. In most conditions, a model in which the recent history of past samples determines a belief about category means fit the data best for most observers and on average. Our results reveal dynamic adjustment of discrimination criterion, even after prolonged training, and indicate how decision criteria are updated over time.
Risk of suboptimal iodine intake in pregnant Norwegian women.

Science.gov (United States)

Brantsæter, Anne Lise; Abel, Marianne Hope; Haugen, Margaretha; Meltzer, Helle Margrete

2013-02-06

Pregnant women and infants are exceptionally vulnerable to iodine deficiency. The aims of the present study were to estimate iodine intake, to investigate sources of iodine, to identify predictors of low or suboptimal iodine intake (defined as intakes below 100 μg/day and 150 μg/day) in a large population of pregnant Norwegian women and to evaluate iodine status in a sub-population. Iodine intake was calculated based on a validated Food Frequency Questionnaire in the Norwegian Mother and Child Cohort. The median iodine intake was 141 μg/day from food and 166 μg/day from food and supplements. Use of iodine-containing supplements was reported by 31.6%. The main source of iodine from food was dairy products, contributing 67% and 43% in non-supplement and iodine-supplement users, respectively. Of 61,904 women, 16.1% had iodine intake below 100 μg/day, 42.0% had iodine intake below 150 μg/day and only 21.7% reached the WHO/UNICEF/ICCIDD recommendation of 250 μg/day. Dietary behaviors associated with increased risk of low and suboptimal iodine intake were: no use of iodine-containing supplements and low intake of milk/yogurt, seafood and eggs. The median urinary iodine concentration measured in 119 participants (69 μg/L) confirmed insufficient iodine intake. Public health strategies are needed to improve and secure the iodine status of pregnant women in Norway.
Suboptimal processor for anomaly detection for system surveillance and diagnosis

Energy Technology Data Exchange (ETDEWEB)

Ciftcioglu, Oe.; Hoogenboom, J.E.; Dam, H. van

1989-06-01

Anomaly detection for nuclear reactor surveillance and diagnosis is described. The residual noise obtained as a result of autoregressive (AR) modelling is essential to obtain high sensitivity for anomaly detection. By means of the method of hypothesis testing a suboptimal anomaly detection processor is devised for system surveillance and diagnosis. Experiments are carried out to investigate the performance of the processor, which is in particular of interest for on-line and real-time applications.
Laboratory evaluation of immunochromatographic rapid diagnostic tests for cholera in Haiti.

Directory of Open Access Journals (Sweden)

Wilfredo R Matias

Full Text Available Rapid diagnostic tests (RDT for cholera are promising tools for detecting cholera in areas with limited laboratory infrastructure. However, evidence on the characteristics of the many available RDTs is scarce, and their use has been limited by suboptimal performance. We evaluated the performance characteristics of three cholera RDTs from Span Diagnostics, Artron Laboratories, and Standard Diagnostics in a regional laboratory in Haiti.We retrospectively reviewed records from May 2014 to October 2015 of a laboratory-based surveillance program for Vibrio cholerae at Hôpital Saint-Nicolas in Saint-Marc, Haiti. We compared the results of 511 Crystal VC, 129 Artron and 451 SD Bioline RDTs to bacterial culture as the gold standard. Of 905 cultures, 477 (52.7% were positive for V. cholerae O1, of which 27.7% were serotype Inaba. No cultures grew V. cholerae O139. Sensitivity and specificity of Crystal VC were 98.6% (95%CI: 96.5%-99.6% and 71.1% (95%CI: 64.7%-76.9%, respectively. Artron demonstrated a sensitivity of 98.6% (95%CI: 92.7%-100% and specificity of 69.1% (95%CI: 55.2%-80.9%. SD Bioline demonstrated a sensitivity of 81.1% (95%CI: 75.6%-85.8% and specificity of 92.8% (95%CI: 88.4%-95.9%. Crystal VC and Artron frequently showed false positive O139 bands, whereas none were seen with SD Bioline.There is significant variation in the performance of different cholera diagnostic RDTs. Artron and Crystal VC RDTs have high sensitivity and low specificity, while SD Bioline RDT has low to moderate sensitivity and high specificity when performed by laboratory technicians in Haiti. Study limitations included its retrospective design. The suboptimal characteristics of these tests limit their use as clinical point-of-care tests; however, they may be useful in outbreak response, surveillance, and research in resource-limited settings.
Sub-optimal vitamin B-12 levels among ART-naïve HIV-positive individuals in an urban cohort in Uganda.

Science.gov (United States)

Semeere, Aggrey S; Nakanjako, Damalie; Ddungu, Henry; Kambugu, Andrew; Manabe, Yukari C; Colebunders, Robert

2012-01-01

Malnutrition is common among HIV-infected individuals and is often accompanied by low serum levels of micronutrients. Vitamin B-12 deficiency has been associated with various factors including faster HIV disease progression and CD4 depletion in resource-rich settings. To describe prevalence and factors associated with sub-optimal vitamin B-12 levels among HIV-infected antiretroviral therapy (ART) naïve adults in a resource-poor setting, we performed a cross-sectional study with a retrospective chart review among individuals attending either the Mulago-Mbarara teaching hospitals' Joint AIDS Program (MJAP) or the Infectious Diseases Institute (IDI) clinics, in Kampala, Uganda. Logistic regression was used to determine factors associated with sub-optimal vitamin B-12. The mean vitamin B-12 level was 384 pg/ml, normal range (200-900). Sub-optimal vitamin B-12 levels (ART (CD4ART-naïve adult clinic population in urban Uganda. We recommend prospective studies to further clarify the causal relationships of sub-optimal vitamin B-12, and explore the role of vitamin B-12 supplementation in immune recovery.
TECHNOLOGICAL INNOVATION AND BUSINESS DIVERSIFICATION: SUSTAINABILITY LIVELIHOODS IMPROVEMENT SCENARIO OF RICE FARMER HOUSEHOLD IN SUB-OPTIMAL LAND

Directory of Open Access Journals (Sweden)

Adriani D.

2017-09-01

Full Text Available The increased role of the sub-optimal land to support food security continue to be encouraged in Indonesia, given the more limited expansion for potential land. But until recently, development of sub-optimal land becomes not an easy thing. Ecological and technical barriers became the main issue. A series of these issues resulted in a high number of underemproleymeny and poverty in agriculture region. Technological inovation of agriculture and the business diversification can be seen be the solution to those issues. This research aims to analyze the impact of the technological innovation and business diversification on underemployment, working time, household income and also sustainable livelihoods of farmers on the sub-optimal land. The research was carried out in Pemulutan District, Ogan Ilir Regency, South Sumatra Province, Indonesia. The objects of research are farmers which adopter and non adopter technological innovation, and also work outside of paddy farming (business diversification. The research method is the survey. Method of sampling is stratified random sampling. Data obtained in the field analyses using descriptive statistics and inferesia. The results showed there are positive impact of technological innovation on the allocation of working time farmer households, the numbers underemployment, household income and livelihood sustainability. Determinant factors for farmers in applying technology and business diversification are paddy farming income, off-farm income, and age. The use of technology and business diversification proves to be one of the positive scenarios for sustainable livelihood of farmers in sub-optimal land.
Characteristics influencing therapy switch behavior after suboptimal response to first-line treatment in patients with multiple sclerosis.

Science.gov (United States)

Teter, Barbara; Agashivala, Neetu; Kavak, Katelyn; Chouhfeh, Lynn; Hashmonay, Ron; Weinstock-Guttman, Bianca

2014-06-01

Factors driving disease-modifying therapy (DMT) switch behavior are not well understood. The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal response to DMT. This retrospective study analyzed patients with relapsing-remitting multiple sclerosis (MS) and a suboptimal response to initial therapy with either interferon β or glatiramer acetate. Suboptimal responders were defined as patients with ≥1 MS event (clinical relapse, worsening disability, or MRI worsening) while on DMT. Switchers were defined as those who changed DMT within six to 12 months after the MS event. Of 606 suboptimal responders, 214 (35.3%) switched therapy. Switchers were younger at symptom onset (p = 0.012), MS diagnosis (p = 0.004), DMT initiation (p < 0.001), and first MS event (p = 0.011) compared with nonswitchers. Compared with one relapse alone, MRI worsening alone most strongly predicted switch behavior (odds ratio 6.3; 95% CI, 3.1-12.9; p < 0.001), followed by ≥2 relapses (2.8; 95% CI, 1.1-7.3; p = 0.040), EDSS plus MRI worsening (2.5; 95% CI, 1.1-5.9; p = 0.031) and EDSS worsening alone (2.2; 95% CI, 1.2-4.1; p = 0.009). Younger patients with disease activity, especially MRI changes, are more likely to have their therapy switched sooner than patients who are older at the time of MS diagnosis and DMT initiation. © The Author(s) 2013.
Prevalence and correlates of suboptimal vitamin D status in people living with psychotic disorders: Data from the Australian Survey of High Impact Psychosis.

Science.gov (United States)

Suetani, Shuichi; Saha, Sukanta; Eyles, Darryl W; Scott, James G; McGrath, John J

2017-09-01

Having sufficient sera concentrations of 25-hydroxyvitamin D is important for a range of health outcomes including cardiometabolic diseases. Clinical studies in people with psychotic disorders suggest that a sizable proportion has suboptimal vitamin D status (i.e. vitamin D deficiency or insufficiency). Individuals with psychosis also have many of the risk factors associated with suboptimal vitamin D status such as smoking, obesity, and reduced physical activity. The aim of this study was to examine the prevalence and socio-demographic and clinical correlates of vitamin D status using a large, population-based sample of adults with psychotic disorders. Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18-64 years with a psychotic disorder. 25-Hydroxyvitamin D concentration was measured in 463 participants. 25-Hydroxyvitamin D concentration was dichotomised into optimal (above 50 nmol/L) and suboptimal (below 50 nmol/L). The influence of a range of socio-demographic and clinical variables on vitamin D status was examined using logistic regression. Nearly half (43.6%) of the participants had suboptimal vitamin D status. Those with (a) increased physical activity or (b) positive symptoms had significantly reduced odds of having suboptimal vitamin D status. However, there were no significant associations between suboptimal vitamin D status and other psychiatric symptom measures or cardiometabolic risk factors. Many people with psychotic disorders have suboptimal vitamin D status. As part of the routine assessment of physical health status, clinicians should remain mindful of vitamin D status in this vulnerable population and encourage the use of appropriate vitamin D supplements.
Indications for suboptimal low-dose direct oral anticoagulants for non-valvular atrial fibrillation patients

Directory of Open Access Journals (Sweden)

Masahiko Umei, MD

2017-10-01

Conclusions: With good adherence, the clinical course associated with DOACs is comparatively good. In the future, suboptimal low-dose DOAC therapy may serve as an appropriate choice for some patients with a high risk of stroke and bleeding.
Design Of Real-Time Implementable Distributed Suboptimal Control: An LQR Perspective

KAUST Repository

Jaleel, Hassan

2017-09-29

We propose a framework for multiagent systems in which the agents compute their control actions in real time, based on local information only. The novelty of the proposed framework is that the process of computing a suboptimal control action is divided into two phases: an offline phase and an online phase. In the offline phase, an approximate problem is formulated with a cost function that is close to the optimal cost in some sense and is distributed, i.e., the costs of non-neighboring nodes are not coupled. This phase is centralized and is completed before the deployment of the system. In the online phase, the approximate problem is solved in real time by implementing any efficient distributed optimization algorithm. To quantify the performance loss, we derive upper bounds for the maximum error between the optimal performance and the performance under the proposed framework. Finally, the proposed framework is applied to an example setup in which a team of mobile nodes is assigned the task of establishing a communication link between two base stations with minimum energy consumption. We show through simulations that the performance under the proposed framework is close to the optimal performance and the suboptimal policy can be efficiently implemented online.
Clinical significance of suboptimal hormonal levels in men with prostate cancer treated with LHRH agonists.

Science.gov (United States)

Kawakami, Jun; Morales, Alvaro

2013-01-01

We examined the serum levels of testosterone (T) (total and bioavailable) dehydroepiandrosterone (DHEA), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prostate-specific antigen (PSA) in men receiving treatment with luteinizing hormone releasing-hormone (LHRH) agonists for metastatic prostate cancer. In doing this, we want to determine the efficacy of these agents in lowering T levels and whether a possible relationship exists between PSA values, as a surrogate measure of tumour activity, and hormone levels. This was a single centre prospective study of patients on LHRH agonists. Of all the 100 eligible patients, 31 did not qualify (10 were receiving their first injection, 13 were on intermittent hormonal therapy, 7 refused to enter the trial and 1 patient's blood sample was lost). Therefore in total, 69 patients were included in the final analysis. Each patient had their blood sample drawn immediately before the administration of a LHRH agonist. The new proposed criteria of values are more commonly found in patients with suboptimal levels of testosterone receiving LHRH analogs, but the clinical importance of this finding has not been established. There is no significant difference with respect to hormonal levels reached among patients on a variety of LHRH agonists. Total testosterone determinations should be considered in patients on LHRH agonist therapy, particularly when the PSA values begin to rise since it may lead to further beneficial hormonal manipulation.
The Behaviour of Laboratory Soil Electrical Resistivity Value under Basic Soil Properties Influences

International Nuclear Information System (INIS)

Hazreek, Z A M; Aziman, M; Azhar, A T S; Chitral, W D; Fauziah, A; Rosli, S

2015-01-01

Electrical resistivity method (ERM) was a popular indirect geophysical tools adopted in engineering, environmental and archaeological studies. In the past, results of the electrical resistivity value (ERV) were always subjected to a long discussion and debate among the related parties such as an engineers, geophysicists and geologists due to its lack of clarification and evidences in quantitative point of view. Most of the results produced in the past was always been justified using qualitative ways which difficult to be accept by certain parties. In order to reduce the knowledge gap between those parties, this study has performed a laboratory experiment of soil box resistivity test which supported by an additional basic geotechnical test as referred to particle size distribution test (d), moisture content test (w), density test (ρ bulk ) and Atterberg limit test (LL, PL and PI). The test was performed to establish a series of electrical resistivity value with different quantity of water content for Clayey SILT and Silty SAND soil. It was found that the ERV of Silty SAND (600 - 7300 Ωm) was higher than Clayey SILT (13 - 7700 Ωm) due to the different quantity of basic soil properties value obtained from the basic geotechnical test. This study was successfully demonstrated that the fluctuation of ERV has greatly influenced by the variations of the soil physical properties (d, w, ρ bulk , LL, PL and PI). Hence, the confidence level of ERV interpretation will be increasingly meaningful since it able to be proved by others parameter generated by laboratory direct test
Influence of Suboptimally and Optimally Presented Affective Pictures and Words on Consumption-Related Behavior

Science.gov (United States)

Winkielman, Piotr; Gogolushko, Yekaterina

2018-01-01

Affective stimuli can influence immediate reactions as well as spontaneous behaviors. Much evidence for such influence comes from studies of facial expressions. However, it is unclear whether these effects hold for other affective stimuli, and how the amount of stimulus processing changes the nature of the influence. This paper addresses these issues by comparing the influence on consumption behaviors of emotional pictures and valence-matched words presented at suboptimal and supraliminal durations. In Experiment 1, both suboptimal and supraliminal emotional facial expressions influenced consumption in an affect-congruent, assimilative way. In Experiment 2, pictures of both high- and low-frequency emotional objects congruently influenced consumption. In comparison, words tended to produce incongruent effects. We discuss these findings in light of privileged access theories, which hold that pictures better convey affective meaning than words, and embodiment theories, which hold that pictures better elicit somatosensory and motor responses. PMID:29434556
Investigating the prevalence, predictors, and prognosis of suboptimal statin use early after a non-ST elevation acute coronary syndrome.

Science.gov (United States)

Turner, Richard M; Yin, Peng; Hanson, Anita; FitzGerald, Richard; Morris, Andrew P; Stables, Rod H; Jorgensen, Andrea L; Pirmohamed, Munir

High-potency statin therapy is recommended in the secondary prevention of cardiovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occur in practice. To determine the prevalence and predictors of deviation from high-potency statin use early after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subsequent major adverse cardiovascular events (MACE) and all-cause mortality (ACM). A total of 1005 patients from a UK-based prospective NSTE-ACS cohort study discharged on high-potency statin therapy (atorvastatin 80 mg, rosuvastatin 20 mg, or 40 mg daily) were included. At 1 month, patients were divided into constant high-potency statin users, and suboptimal users incorporating statin discontinuation, dose reduction, switching statin to a lower equivalent potency, and/or statin nonadherence. Follow-up was a median of 16 months. There were 156 suboptimal (∼15.5%) and 849 constant statin users. Factors associated in multivariable analysis with suboptimal statin occurrence included female sex (odds ratio 1.75, 95% confidence interval [CI] 1.14-2.68) and muscular symptoms (odds ratio 4.28, 95% CI 1.30-14.08). Suboptimal statin use was associated with increased adjusted risks of time to MACE (hazard ratio 2.10, 95% CI 1.25-3.53, P = .005) and ACM (hazard ratio 2.46, 95% CI 1.38-4.39, P = .003). Subgroup analysis confirmed that the increased MACE/ACM risks were principally attributable to statin discontinuation or nonadherence. Conversion to suboptimal statin use is common early after NSTE-ACS and is partly related to muscular symptoms. Statin discontinuation or non-adherence carries an adverse prognosis. Interventions that preserve and enhance statin utilization could improve post NSTE-ACS outcomes. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Point prevalence of suboptimal footwear features among ambulant older hospital patients: implications for fall prevention.

Science.gov (United States)

Chari, Satyan R; McRae, Prue; Stewart, Matthew J; Webster, Joan; Fenn, Mary; Haines, Terry P

2016-09-01

Objective The aim of the present study was to establish the point prevalence of 'suboptimal' features in footwear reported to have been used by older hospital patients when ambulating, and to explore underpinning factors for their choice of footwear. Method A cross-sectional investigation was undertaken on 95 of 149 eligible in-patients across 22 high fall-risk wards in a large metropolitan hospital in Brisbane, Australia. Results Over 70% of participants experienced an unplanned admission. Although most participants had access to some form of footwear in hospital (92%), nearly all reported ambulating in footwear with 'suboptimal' features (99%). Examples included slippers (27%), backless slippers (16%) or bare feet (27%). For patients who ambulated in bare feet, only one-third reported 'lack of access to footwear' as the primary cause, with others citing foot wounds, pain, oedema and personal choice as the main reason for bare foot ambulation. Conclusions Admitted patients frequently use footwear with 'suboptimal' features for ambulation in hospital. While some footwear options (for example well-fitting slippers) could be suited for limited in-hospital ambulation, others are clearly hazardous and might cause falls. Since footwear choices are influenced by multiple factors in this population, footwear education strategies alone may be insufficient to address the problem of hazardous footwear in at-risk patients. Footwear requirements may be more effectively addressed within a multidisciplinary team approach encompassing foot health, mobility and safety. What is known about the topic? Accidental falls while ambulating are an important health and safety concern for older people. Because certain footwear characteristics have been negatively linked to posture and balance, and specific footwear types linked to falls among seniors, the use of footwear with fewer suboptimal characteristics is generally recommended as a means of reducing the risk of falling. While footwear
Predicting blood transfusion using automated analysis of pulse oximetry signals and laboratory values.

Science.gov (United States)

Shackelford, Stacy; Yang, Shiming; Hu, Peter; Miller, Catriona; Anazodo, Amechi; Galvagno, Samuel; Wang, Yulei; Hartsky, Lauren; Fang, Raymond; Mackenzie, Colin

2015-10-01

Identification of hemorrhaging trauma patients and prediction of blood transfusion needs in near real time will expedite care of the critically injured. We hypothesized that automated analysis of pulse oximetry signals in combination with laboratory values and vital signs obtained at the time of triage would predict the need for blood transfusion with accuracy greater than that of triage vital signs or pulse oximetry analysis alone. Continuous pulse oximetry signals were recorded for directly admitted trauma patients with abnormal prehospital shock index (heart rate [HR] / systolic blood pressure) of 0.62 or greater. Predictions of blood transfusion within 24 hours were compared using Delong's method for area under the receiver operating characteristic (AUROC) curves to determine the optimal combination of triage vital signs (prehospital HR + systolic blood pressure), pulse oximetry features (40 waveform features, O2 saturation, HR), and laboratory values (hematocrit, electrolytes, bicarbonate, prothrombin time, international normalization ratio, lactate) in multivariate logistic regression models. We enrolled 1,191 patients; 339 were excluded because of incomplete data; 40 received blood within 3 hours; and 14 received massive transfusion. Triage vital signs predicted need for transfusion within 3 hours (AUROC, 0.59) and massive transfusion (AUROC, 0.70). Pulse oximetry for 15 minutes predicted transfusion more accurately than triage vital signs for both time frames (3-hour AUROC, 0.74; p = 0.004) (massive transfusion AUROC, 0.88; p transfusion prediction (3-hour AUROC, 0.84; p transfusion AUROC, 0.91; p blood transfusion during trauma resuscitation more accurately than triage vital signs or pulse oximetry analysis alone. Results suggest automated calculations from a noninvasive vital sign monitor interfaced with a point-of-care laboratory device may support clinical decisions by recognizing patients with hemorrhage sufficient to need transfusion. Epidemiologic
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P. H.; Schmand, Ben A.; Kessels, Roy P. C.; Aldenkamp, Albert P.

2016-01-01

Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the identification of
Indicators of suboptimal performance embedded in the Wechsler Memory Scale : Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Z.; Hendriks, M.P.H.; Schmand, B.A.; Kessels, R.P.C.; Aldenkamp, A.P.

2016-01-01

INTRODUCTION: Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the
Indicators of suboptimal performance embedded in the Wechsler Memory Scale-Fourth Edition (WMS-IV)

NARCIS (Netherlands)

Bouman, Zita; Hendriks, Marc P.H.; Schmand, Ben A.; Kessels, Roy P.C.; Aldenkamp, Albert P.

2016-01-01

Introduction. Recognition and visual working memory tasks from the Wechsler Memory Scale-Fourth Edition (WMS-IV) have previously been documented as useful indicators for suboptimal performance. The present study examined the clinical utility of the Dutch version of the WMS-IV (WMS-IV-NL) for the
The Value of Laboratory Tests in Diagnosing Secondary Osteoporosis at a Fracture and Osteoporosis Outpatient Clinic

NARCIS (Netherlands)

de Klerk, Gijs; Hegeman, J. Han; van der Velde, Detlef; van der Palen, Jacobus Adrianus Maria; ten Duis, Henk J.

2013-01-01

Background: As more and more patients meeting the criteria for osteoporosis are referred to a fracture and osteoporosis outpatient clinic (FO clinic), the laboratory costs to screen for secondary osteoporosis also increases. This study was conducted to determine the value of screening on underlying
Risk-Based Maintenance Assessment in the Manufacturing Industry: Minimisation of Suboptimal Prioritisation

Directory of Open Access Journals (Sweden)

Ratnayake R.M. Chandima

2017-03-01

Full Text Available Manufacturing firms continuously strive to increase the efficiency and effectiveness in the maintenance management processes. Focus is placed on eliminating the unexpected failures which cause unnecessary costs and the production losses. Risk-based maintenance (RBM strategies enable to address the above through the identification of probability and consequences of potential failures whilst providing a way for prioritisation of maintenance actions based on the risk of possible failures. Such prioritisations enable to identify the optimal maintenance strategy, intervals of maintenance tasks, and optimal level of spare parts inventory. However, the risk assessment activities are performed with the support of a risk matrix. Suboptimal classifications and/or prioritisations arise due to the inherent nature of the risk matrix. This is caused by the fact that there are no means to incorporate actual circumstances at the boundary of the input ranges or at the levels of linguistic data and risk categories. In this paper, a risk matrix is first developed in collaboration with one of the manufacturing firms in Poland. Then, it illustrates the use of fuzzy logic for minimisation of suboptimal prioritisation and/or classifications using a fuzzy inference system (FIS together with illustrative membership functions and a rule base. Finally, an illustrative risk assessment is also demonstrated to illustrate the methodology.
High T-cell immune activation and immune exhaustion among individuals with suboptimal CD4 recovery after 4 years of antiretroviral therapy in an African cohort

Directory of Open Access Journals (Sweden)

Colebunders Robert

2011-02-01

Full Text Available Abstract Background Antiretroviral therapy (ART partially corrects immune dysfunction associated with HIV infection. The levels of T-cell immune activation and exhaustion after long-term, suppressive ART and their correlation with CD4 T-cell count reconstitution among ART-treated patients in African cohorts have not been extensively evaluated. Methods T-cell activation (CD38+HLA-DR+ and immune exhaustion (PD-1+ were measured in a prospective cohort of patients initiated on ART; 128 patient samples were evaluated and subcategorized by CD4 reconstitution after long-term suppressive treatment: Suboptimal [median CD4 count increase 129 (-43-199 cells/μl], N = 34 ], optimal [282 (200-415 cells/μl, N = 64] and super-optimal [528 (416-878 cells/μl, N = 30]. Results Both CD4+ and CD8 T-cell activation was significantly higher among suboptimal CD4 T-cell responders compared to super-optimal responders. In a multivariate model, CD4+CD38+HLADR+ T-cells were associated with suboptimal CD4 reconstitution [AOR, 5.7 (95% CI, 1.4-23, P = 0.014]. T-cell exhaustion (CD4+PD1+ and CD8+PD1+ was higher among suboptimal relative to optimal (P P = 0.022]. Conclusion T-cell activation and exhaustion persist among HIV-infected patients despite long-term, sustained HIV-RNA viral suppression. These immune abnormalities were associated with suboptimal CD4 reconstitution and their regulation may modify immune recovery among suboptimal responders to ART.
A PROCEDURE FOR DETERMINING OPTIMAL FACILITY LOCATION AND SUB-OPTIMAL POSITIONS

Directory of Open Access Journals (Sweden)

P.K. Dan

2012-01-01

Full Text Available
ENGLISH ABSTRACT: This research presents a methodology for determining the optimal location of a new facility, having physical flow interaction of various degrees with other existing facilities in the presence of barriers impeding the shortest flow-path as well as the sub-optimal iso-cost positions. It also determines sub-optimal iso-cost positions with additional cost or penalty for not being able to site it at the computed optimal point. The proposed methodology considers all types of quadrilateral barrier or forbidden region configurations to generalize and by-pass such impenetrable obstacles, and adopts a scheme of searching through the vertices of the quadrilaterals to determine the alternative shortest flow-path. This procedure of obstacle avoidance is novel. Software has been developed to facilitate computations for the search algorithm to determine the optimal and iso-cost co-ordinates. The test results are presented.
AFRIKAANSE OPSOMMING: Die navorsing behandel ‘n procedure vir die bepaling van optimum stigtingsposisie vir ‘n onderneming met vloei vanaf ander bestaande fasiliteite in die teenwoordigheid van ‘n verskeidenheid van randvoorwaardes. Die prodedure lewer as resultaat suboptimale isokoste-stigtingsplekke met bekendmaking van die koste wat onstaan a.g.v. afwyking van die randvoorwaardlose optimum oplossingskoste, die prosedure maak gebruik van ‘n vindingryke soekmetode wat toegepas word op niersydige meerkundige voorstellings vir die bepaling van korste roetes wat versperring omseil. Die prosedure word onderskei deur programmatuur. Toetsresultate word voorgehou.
A Suboptimal Scheme for Multi-User Scheduling in Gaussian Broadcast Channels

KAUST Repository

Zafar, Ammar; Alouini, Mohamed-Slim; Shaqfeh, Mohammad

2014-01-01

This work proposes a suboptimal multi-user scheduling scheme for Gaussian broadcast channels which improves upon the classical single user selection, while considerably reducing complexity as compared to the optimal superposition coding with successful interference cancellation. The proposed scheme combines the two users with the maximum weighted instantaneous rate using superposition coding. The instantaneous rate and power allocation are derived in closed-form, while the long term rate of each user is derived in integral form for all channel distributions. Numerical results are then provided to characterize the prospected gains of the proposed scheme.
A Suboptimal Scheme for Multi-User Scheduling in Gaussian Broadcast Channels

KAUST Repository

Zafar, Ammar

2014-05-28

This work proposes a suboptimal multi-user scheduling scheme for Gaussian broadcast channels which improves upon the classical single user selection, while considerably reducing complexity as compared to the optimal superposition coding with successful interference cancellation. The proposed scheme combines the two users with the maximum weighted instantaneous rate using superposition coding. The instantaneous rate and power allocation are derived in closed-form, while the long term rate of each user is derived in integral form for all channel distributions. Numerical results are then provided to characterize the prospected gains of the proposed scheme.
Suboptimal and optimal order policies for fixed and varying replenishment interval with declining market

Science.gov (United States)

Yu, Jonas C. P.; Wee, H. M.; Yang, P. C.; Wu, Simon

2016-06-01

One of the supply chain risks for hi-tech products is the result of rapid technological innovation; it results in a significant decline in the selling price and demand after the initial launch period. Hi-tech products include computers and communication consumer's products. From a practical standpoint, a more realistic replenishment policy is needed to consider the impact of risks; especially when some portions of shortages are lost. In this paper, suboptimal and optimal order policies with partial backordering are developed for a buyer when the component cost, the selling price, and the demand rate decline at a continuous rate. Two mathematical models are derived and discussed: one model has the suboptimal solution with the fixed replenishment interval and a simpler computational process; the other one has the optimal solution with the varying replenishment interval and a more complicated computational process. The second model results in more profit. Numerical examples are provided to illustrate the two replenishment models. Sensitivity analysis is carried out to investigate the relationship between the parameters and the net profit.
Consumer behaviour towards price-reduced suboptimal foods in the supermarket and the relation to food waste in households.

Science.gov (United States)

Aschemann-Witzel, Jessica; Jensen, Jacob Haagen; Jensen, Mette Hyldetoft; Kulikovskaja, Viktorija

2017-09-01

To combat food waste, supermarkets offer food items at a reduced price in-store when they are close to the expiration date or perceived as suboptimal. It is yet unknown, however, which considerations consumers engage in when deciding about the offer, and whether focusing particularly on the price during food purchase might be related to greater food waste at home. Knowledge about both the consumers' food purchase process for these price-reduced foods and the potential wastage of price-focused consumers can contribute to the assessment of whether or not offering suboptimal food at reduced prices in-store actually reduces food waste across the supply chain. We explore these questions in a mixed-method study including 16 qualitative accompanied shopping interviews and a quantitative online experimental survey with 848 consumers in Denmark. The interviews reveal that the consumers interviewed assess their ability to consume the price-reduced suboptimal food at home already while in the store. Consumers consider the relation between product-related factors of package unit, expiration date, and product quality, in interaction with household-related factors of freezing/storing, household size/demand, and possible meal/cooking. The survey shows that consumers who are more price-focused report lower food waste levels and lower tendency to choose the optimal food item first at home, than those who are not emphasizing the price-quality relation or do not search for price offers to the same extent. Higher age and high education also played a role, and the price-focus is lower in high-income groups and among single households. The findings allow deriving recommendations for retailers and policy makers to support both the marketability and the subsequent actual consumption of price-reduced suboptimal food, but they also raise questions for further research of this underexplored area. Copyright © 2017 Elsevier Ltd. All rights reserved.
Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the 'migration three delays' model.

Science.gov (United States)

Esscher, Annika; Binder-Finnema, Pauline; Bødker, Birgit; Högberg, Ulf; Mulic-Lutvica, Ajlana; Essén, Birgitta

2014-04-12

Several European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988-2010. A subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the 'migration three delays' framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context. Major and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups. Suboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women.
Cost-effectiveness of extended-release methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder sub-optimally treated with immediate release methylphenidate.

Directory of Open Access Journals (Sweden)

Jurjen van der Schans

Full Text Available Attention-Deficit/Hyperactivity Disorder (ADHD is a common psychiatric disorder in children and adolescents. Immediate-release methylphenidate (IR-MPH is the medical treatment of first choice. The necessity to use several IR-MPH tablets per day and associated potential social stigma at school often leads to reduced compliance, sub-optimal treatment, and therefore economic loss. Replacement of IR-MPH with a single-dose extended release (ER-MPH formulation may improve drug response and economic efficiency.To evaluate the cost-effectiveness from a societal perspective of a switch from IR-MPH to ER-MPH in patients who are sub-optimally treated.A daily Markov-cycle model covering a time-span of 10 years was developed including four different health states: (1 optimal response, (2 sub-optimal response, (3 discontinued treatment, and (4 natural remission. ER-MPH options included methylphenidate osmotic release oral system (MPH-OROS and Equasym XL/Medikinet CR. Both direct costs and indirect costs were included in the analysis, and effects were expressed as quality-adjusted life years (QALYs. Univariate, multivariate as well as probabilistic sensitivity analysis were conducted and the main outcomes were incremental cost-effectiveness ratios.Switching sub-optimally treated patients from IR-MPH to MPH-OROS or Equasym XL/Medikinet CR led to per-patient cost-savings of €4200 and €5400, respectively, over a 10-year treatment span. Sensitivity analysis with plausible variations of input parameters resulted in cost-savings in the vast majority of estimations.This study lends economic support to switching patients with ADHD with suboptimal response to short-acting IR-MPH to long-acting ER-MPH regimens.
Exogenous recombinant human growth hormone effects during suboptimal energy and zinc intake

OpenAIRE

Rising, Russell; Scaglia, Julio F; Cole, Conrad; Tverskaya, Rozalia; Duro, Debora; Lifshitz, Fima

2005-01-01

Abstract Background Energy and Zinc (Zn) deficiencies have been associated with nutritional related growth retardation as well as growth hormone (GH) resistance. In this study, the relationship between suboptimal energy and/or Zn intake and growth in rats and their response to immunoreactive exogenous recombinant human GH (GHi), was determined. Results Rats treated with GHi and fed ad-libitum energy and Zn (100/100) had increased IGFBP-3 (p < 0.05) as compared with NSS (215 ± 23 vs. 185 ± 17 ...
Inter-laboratory evaluation of instrument platforms and experimental workflows for quantitative accuracy and reproducibility assessment

Directory of Open Access Journals (Sweden)

Andrew J. Percy

2015-09-01

Full Text Available The reproducibility of plasma protein quantitation between laboratories and between instrument types was examined in a large-scale international study involving 16 laboratories and 19 LC–MS/MS platforms, using two kits designed to evaluate instrument performance and one kit designed to evaluate the entire bottom-up workflow. There was little effect of instrument type on the quality of the results, demonstrating the robustness of LC/MRM-MS with isotopically labeled standards. Technician skill was a factor, as errors in sample preparation and sub-optimal LC–MS performance were evident. This highlights the importance of proper training and routine quality control before quantitation is done on patient samples.
Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression

NARCIS (Netherlands)

Siefried, Krista J; Mao, Limin; Kerr, Stephen; Cysique, Lucette A; Gates, Thomas M; McAllister, John; Maynard, Anthony; de Wit, John; Carr, Andrew

2017-01-01

BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on
Sub-optimal parenting is associated with schizotypic and anxiety personality traits in adulthood.

Science.gov (United States)

Giakoumaki, S G; Roussos, P; Zouraraki, C; Spanoudakis, E; Mavrikaki, M; Tsapakis, E M; Bitsios, P

2013-05-01

Part of the variation in personality characteristics has been attributed to the child-parent interaction and sub-optimal parenting has been associated with psychiatric morbidity. In the present study, an extensive battery of personality scales (Trait Anxiety Inventory, Behavioural Inhibition/Activation System questionnaire, Eysenck Personality Questionnaire-Revised, Temperament and Character Inventory, Schizotypal Traits Questionnaire, Toronto Alexithymia Scale) and the Parental Bonding Instrument (PBI) were administered in 324 adult healthy males to elucidate the effects of parenting on personality configuration. Personality variables were analysed using Principal Component Analysis (PCA) and the factors "Schizotypy", "Anxiety", "Behavioural activation", "Novelty seeking" and "Reward dependence" were extracted. Associations between personality factors with PBI "care" and "overprotection" scores were examined with regression analyses. Subjects were divided into "parental style" groups and personality factors were subjected to categorical analyses. "Schizotypy" and "Anxiety" were significantly predicted by high maternal overprotection and low paternal care. In addition, the Affectionless control group (low care/high overprotection) had higher "Schizotypy" and "Anxiety" compared with the Optimal Parenting group (high care/low overprotection). These results further validate sub-optimal parenting as an important environmental exposure and extend our understanding on the mechanisms by which it increases risk for psychiatric morbidity. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Laboratory automation: trajectory, technology, and tactics.

Science.gov (United States)

Markin, R S; Whalen, S A

2000-05-01

Laboratory automation is in its infancy, following a path parallel to the development of laboratory information systems in the late 1970s and early 1980s. Changes on the horizon in healthcare and clinical laboratory service that affect the delivery of laboratory results include the increasing age of the population in North America, the implementation of the Balanced Budget Act (1997), and the creation of disease management companies. Major technology drivers include outcomes optimization and phenotypically targeted drugs. Constant cost pressures in the clinical laboratory have forced diagnostic manufacturers into less than optimal profitability states. Laboratory automation can be a tool for the improvement of laboratory services and may decrease costs. The key to improvement of laboratory services is implementation of the correct automation technology. The design of this technology should be driven by required functionality. Automation design issues should be centered on the understanding of the laboratory and its relationship to healthcare delivery and the business and operational processes in the clinical laboratory. Automation design philosophy has evolved from a hardware-based approach to a software-based approach. Process control software to support repeat testing, reflex testing, and transportation management, and overall computer-integrated manufacturing approaches to laboratory automation implementation are rapidly expanding areas. It is clear that hardware and software are functionally interdependent and that the interface between the laboratory automation system and the laboratory information system is a key component. The cost-effectiveness of automation solutions suggested by vendors, however, has been difficult to evaluate because the number of automation installations are few and the precision with which operational data have been collected to determine payback is suboptimal. The trend in automation has moved from total laboratory automation to a
Weak-value measurements can outperform conventional measurements

International Nuclear Information System (INIS)

Magaña-Loaiza, Omar S; Boyd, Robert W; Harris, Jérémie; Lundeen, Jeff S

2017-01-01

In this paper we provide a simple, straightforward example of a specific situation in which weak-value amplification (WVA) clearly outperforms conventional measurement in determining the angular orientation of an optical component. We also offer a perspective reconciling the views of some theorists, who claim WVA to be inherently sub-optimal for parameter estimation, with the perspective of the many experimentalists and theorists who have used the procedure to successfully access otherwise elusive phenomena. (invited comment)
The Cost-Effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing

Directory of Open Access Journals (Sweden)

Bogavac-Stanojevic Natasa

2017-09-01

Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with
Common experiences of patients following suboptimal treatment outcomes: implications for epilepsy surgery.

Science.gov (United States)

Fernando, Dinusha K; McIntosh, Anne M; Bladin, Peter F; Wilson, Sarah J

2014-04-01

Few studies have investigated the patient experience of unsuccessful medical interventions, particularly in the epilepsy surgery field. The present review aimed to gain insight into the patient experience of seizure recurrence after epilepsy surgery by examining the broader literature dealing with suboptimal results after medical interventions (including epilepsy surgery). To capture the patient experience, the literature search focused on qualitative research of patients who had undergone medically unsuccessful interventions, published in English in scholarly journals. Twenty-two studies were found of patients experiencing a range of suboptimal outcomes, including seizure recurrence, cancer recurrence and progression, unsuccessful joint replacement, unsuccessful infertility treatment, organ transplant rejection, coronary bypass graft surgery, and unsuccessful weight-loss surgery. In order of frequency, the most common patient experiences included the following: altered social dynamics and stigma, unmet expectations, negative emotions, use of coping strategies, hope and optimism, perceived failure of the treating team, psychiatric symptoms, and control issues. There is support in the epilepsy surgery literature that unmet expectations and psychiatric symptoms are key issues for patients with seizure recurrence, while other common patient experiences have been implied but not systematically examined. Several epilepsy surgery specific factors influence patient perceptions of seizure recurrence, including the nature of postoperative seizures, the presence of postoperative complications, and the need for increased postoperative medications. Knowledge of common patient experiences can assist in the delivery of patient follow-up and rehabilitation services tailored to differing outcomes after epilepsy surgery. Copyright © 2014 Elsevier Inc. All rights reserved.
Effect of different seed treatments on maize seed germination parameters under optimal and suboptimal temperature conditions

Directory of Open Access Journals (Sweden)

Vujošević Bojana

2017-01-01

Full Text Available The aim of this study was to determine the effect of different seed treatments on germination parameters of three maize genotypes under optimal and suboptimal temperature conditions. Seed was treated with recommended doses of three commercial pesticide formulations: metalaxyl-m 10 g/L + fludioxonil 25 g/L, metalaxyl 20 g/kg + prothioconazole 100 g/kg and thiacloprid 400 g/L. Testing was conducted at 25°C and 15°C. Results of the study indicate that there are differences in response of maize genotypes to applied seed treatments, as well as to a specific treatment at optimal and suboptimal temperatures. Some treatments, depending on the mixing partner and temperature conditions, can affect final germination. In other cases, germination rate can be accelerated or prolonged, but with no effect on final germination. In order to provide fast and uniform emergence under different temperature conditions, further examination of the response of maize genotypes to specific seed treatments would be beneficial.
Association of Suboptimal Antiretroviral Therapy Adherence With Inflammation in Virologically Suppressed Individuals Enrolled in the SMART Study

DEFF Research Database (Denmark)

Castillo-Mancilla, Jose R; Phillips, Andrew N; Neaton, James D

2018-01-01

Suboptimal (ie, <100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMAR...
Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015.

Directory of Open Access Journals (Sweden)

Fred Nsubuga

Full Text Available Disease surveillance is a critical component in the control and elimination of vaccine preventable diseases. The Uganda National Expanded Program on Immunization strives to have a sensitive surveillance system within the Integrated Disease Surveillance and Response (IDSR framework. We analyzed measles surveillance data to determine the effectiveness of the measles case-based surveillance system and estimate its positive predictive value in order to inform policy and practice.An IDSR alert was defined as ≥1 suspected measles case reported by a district in a week, through the electronic Health Management Information System. We defined an alert in the measles case-based surveillance system (CBS as ≥1 suspected measles case with a blood sample collected for confirmation during the corresponding week in a particular district. Effectiveness of CBS was defined as having ≥80% of IDSR alerts with a blood sample collected for laboratory confirmation. Positive predictive value was defined as the proportion of measles case-patients who also had a positive measles serological result (IgM +. We reviewed case-based surveillance data with laboratory confirmation and measles surveillance data from the electronic Health Management Information System from 2012-2015.A total of 6,974 suspected measles case-persons were investigated by the measles case-based surveillance between 2012 and 2015. Of these, 943 (14% were measles specific IgM positive. The median age of measles case-persons between 2013 and 2015 was 4.0 years. Between 2013 and 2015, 72% of the IDSR alerts reported in the electronic Health Management Information System, had blood samples collected for laboratory confirmation. This was however less than the WHO recommended standard of ≥80%. The PPV of CBS between 2013 and 2015 was 8.6%.In conclusion, the effectiveness of measles case-based surveillance was sub-optimal, while the PPV showed that true measles cases have significantly reduced in Uganda
Consumer perception and preference for suboptimal food under the emerging practice of expiration date based pricing in supermarkets

DEFF Research Database (Denmark)

Aschemann-Witzel, Jessica

2017-01-01

, it is unclear which contextual, individual, and product-related factors impact consumer likelihood of choice and thus acceptance of the practice in the long run. The study aimed at exploring the effect of communicating different motives for purchase, the product being organic, familiarity with the practice...... and the interaction with gender is observed for milk in particular. Overall, perceived quality and estimated likelihood of consumption at home majorly determine likelihood of choice. Consumer acceptance of expiration date based pricing of suboptimal food can be increased through furthering consumer familiarity......Consumers have been found to majorly prefer ‘optimal’ food over ‘suboptimal’ when purchasing food. To provide an incentive for consumers to select suboptimal food and thus decrease food waste in the supply chain, expiration date based pricing is suggested and increasingly applied. However...
Methanol degradation in granular sludge reactors at sub-optimal metal concentrations: role of iron, nickel and cobalt

NARCIS (Netherlands)

Zandvoort, M.H.; Geerts, R.; Lettinga, G.; Lens, P.N.L.

2003-01-01

The effect of sub-optimal trace metal concentrations on the conversion of methanol in an upflow anaerobic sludge bed (UASB) reactor was investigated by studying the effect of decreased influent trace metal concentrations on the reactor efficiency, methanol conversion route and sludge
Segmentation precedes face categorization under suboptimal conditions

Directory of Open Access Journals (Sweden)

Carlijn eVan Den Boomen

2015-05-01

Full Text Available Both categorization and segmentation processes play a crucial role in face perception. However, the functional relation between these subprocesses is currently unclear. The present study investigates the temporal relation between segmentation-related and category-selective responses in the brain, using electroencephalography (EEG. Surface segmentation and category content were both manipulated using texture-defined objects, including faces. This allowed us to study brain activity related to segmentation and to categorization. In the main experiment, participants viewed texture-defined objects for a duration of 800 ms. EEG results revealed that segmentation-related responses precede category-selective responses. Three additional experiments revealed that the presence and timing of categorization depends on stimulus properties and presentation duration. Photographic objects were presented for a long and short (92 ms duration and evoked fast category-selective responses in both cases. On the other hand, presentation of texture-defined objects for a short duration only evoked segmentation-related but no category-selective responses. Category-selective responses were much slower when evoked by texture-defined than by photographic objects. We suggest that in case of categorization of objects under suboptimal conditions, such as when low-level stimulus properties are not sufficient for fast object categorization, segmentation facilitates the slower categorization process.
Segmentation precedes face categorization under suboptimal conditions.

Science.gov (United States)

Van Den Boomen, Carlijn; Fahrenfort, Johannes J; Snijders, Tineke M; Kemner, Chantal

2015-01-01

Both categorization and segmentation processes play a crucial role in face perception. However, the functional relation between these subprocesses is currently unclear. The present study investigates the temporal relation between segmentation-related and category-selective responses in the brain, using electroencephalography (EEG). Surface segmentation and category content were both manipulated using texture-defined objects, including faces. This allowed us to study brain activity related to segmentation and to categorization. In the main experiment, participants viewed texture-defined objects for a duration of 800 ms. EEG results revealed that segmentation-related responses precede category-selective responses. Three additional experiments revealed that the presence and timing of categorization depends on stimulus properties and presentation duration. Photographic objects were presented for a long and short (92 ms) duration and evoked fast category-selective responses in both cases. On the other hand, presentation of texture-defined objects for a short duration only evoked segmentation-related but no category-selective responses. Category-selective responses were much slower when evoked by texture-defined than by photographic objects. We suggest that in case of categorization of objects under suboptimal conditions, such as when low-level stimulus properties are not sufficient for fast object categorization, segmentation facilitates the slower categorization process.
CORRELATIONS BETWEEN HOMOLOGUE CONCENTRATIONS OF PCDD/FS AND TOXIC EQUIVALENCY VALUES IN LABORATORY-, PACKAGE BOILER-, AND FIELD-SCALE INCINERATORS

Science.gov (United States)

The toxic equivalency (TEQ) values of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) are predicted with a model based on the homologue concentrations measured from a laboratory-scale reactor (124 data points), a package boiler (61 data points), and ...
Real-time discrete suboptimal control for systems with input and state delays: Experimental tests on a dehydration process.

Science.gov (United States)

Rodríguez-Guerrero, Liliam; Santos-Sánchez, Omar-Jacobo; Cervantes-Escorcia, Nicolás; Romero, Hugo

2017-11-01

This article presents a suboptimal control strategy with finite horizon for affine nonlinear discrete systems with both state and input delays. The Dynamic Programming Approach is used to obtain the suboptimal control sequence, but in order to avoid the computation of the Bellman functional, a numerical approximation of this function is proposed in every step. The feasibility of our proposal is demonstrated via an experimental test on a dehydration process and the obtained results show a good performance and behavior of this process. Then in order to demonstrate the benefits of using this kind of control strategy, the results are compared with a non optimal control strategy, particularly with respect to results produced by an industrial Proportional Integral Derivative (PID) Honeywell controller, which is tuned using the Ziegler-Nichols method. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.
Blood glucose measurement in patients with suspected diabetic ketoacidosis: a comparison of Abbott MediSense PCx point-of-care meter values to reference laboratory values.

Science.gov (United States)

Blank, Fidela S J; Miller, Moses; Nichols, James; Smithline, Howard; Crabb, Gillian; Pekow, Penelope

2009-04-01

The purpose of this study is to compare blood glucose levels measured by a point of care (POC) device to laboratory measurement using the same sample venous blood from patients with suspected diabetic ketoacidosis (DKA). A descriptive correlational design was used for this IRB-approved quality assurance project. The study site was the 50-bed BMC emergency department (ED) which has an annual census of over 100,000 patient visits. The convenience sample consisted of 54 blood samples from suspected DKA patients with orders for hourly blood draws for glucose measurement. Spearman correlations of the glucose POC values, reference lab values, and differences between the two, were evaluated. A chi-square test was used to evaluate the association between the acidosis status and FDA acceptability of POC values. Patient age range was 10-86 years; 63% were females; 46% had a final diagnosis of DKA. POC values underestimated glucose levels 93% of the time. There was a high correlation between the lab value and the magnitude of the difference, (lab minus POC value) indicating that the higher the true glucose value, the greater the difference between the lab and the POC value. A chi-square test showed no overall association between acidosis and FDA-acceptability. The POC values underestimated lab reported glucose levels in 50 of 54 cases even with the use of same venous sample sent to the lab, which make it highly unreliable for use in monitoring suspected DKA patients.
Determination of contamination operational value by routine monitoring in research laboratories

International Nuclear Information System (INIS)

Salomao, Edeilson; Medeiros, Regina Bitelli; Mattos, Maria Fernanda S.S.; Daros, Kellen Adriana Curci

2008-01-01

The radioisotopes have a large spectrum of applicability in many areas of science, as in medicine, agriculture and industry in general. In the biological area, the radioisotopes have brought many benefits to study physiological processes in living organisms and in vitro. The most radioisotopes used in biological research are emitters of radiation of low energy, mainly β, and are used as unsealed sources. The manipulation of these radioisotopes generates radioactive wastes and eventually can cause contamination in the areas of handling or even occasionally in areas to which access is not controlled. According to CNEN-NE-3.02 standard is necessary and mandatory the exposure and contamination levels control in the areas of handling of unsealed sources. The goal of the work is to establish how often the monitoring should be done through the survey of the contamination and exposure levels, in areas designed to manipulate 32 P and how this monitoring can contribute to the improvement the conditions of radiological protection. From the twenty eight research laboratories registered by 'Nucleo de Protecao Radiologica' (NPR) were selected four where the activities are not restrict to 32 P biological assays. The levels of contamination and exposure were evaluated using monitors GM and the layout of laboratories containing the points to be tracker defined based on the researchers' routine. At each point three values were obtained to measure the rate of contamination on the surface and exposure rate. The measures were made twice a week before and after the radioisotope manipulation. Based on these data was possible to establish the range from 0,306 to 0,678 Bq.cm -2 as operational average level to the superficial contamination. The average exposure rate measured was 5.16 n C/Kg.h. The results were important to demonstrating to researchers how they can contribute to the improvement of radiological protection conditions. (author)
Sub-optimal breastfeeding of infants during the first six months and associated factors in rural communities of Jimma Arjo Woreda, Southwest Ethiopia

Directory of Open Access Journals (Sweden)

Tamiru Dessalegn

2012-05-01

Full Text Available Abstract Background Studies have shown that sub-optimal breastfeeding is major contributor to infant and young child mortality in Ethiopia. To address this problem, infant and young child feeding guideline was developed in 2004 and interventions have been going on based on the guidelines. There is no study that assessed whether the infant and child feeding practices are according the guideline or not. This study was carried out to assess sub-optimal breastfeeding practices and associated factors among infants from birth to six months in rural communities of Jimma Arjo Woreda in the Southwest Ethiopia. Methods A cross-sectional study was carried out from December to January 2009. Quantitative data were collected from a sample of 382 respondents supplemented by qualitative data generated using in-depth interviews of 15 index mothers. Multivariable logistic regression model was used to identify predictors of timely initiation of breast feeding and non-exclusive breast feeding among mother-infant pairs. Results More than three fourth of mothers breastfeed their infants sub-optimally. Thirty-seven percent of mothers initiated breastfeeding later than one hour after delivery, which was significantly associated with not attending formal education (AOR = 1.05[95%CI: 1.03, 1.94] and painful breastfeeding experiences (AOR = 5.02[95%CI: 1.01, 10.08]. The majority (67.02% of mothers had no knowledge about exclusive breastfeeding. Non-exclusive breastfeeding was negatively associated with child’s age of 0-2 months (AOR: 0.27[95%CI: 0.16, 0.47 and 3-4 months (AOR = 0.43 [95%CI: 0.25, 0.73 and ownership of radio (AOR = 0.56[95%CI: 0.37, 0.88], but positively associated with the practice of discarding colostrums (AOR = 1.78[95%CI: 1.09, 4.94]. Conclusion The findings showed that the majority of mothers sub-optimally breastfeed their children in the study area. As most of the mothers do not have knowledge on the exclusive breast feeding. Enhancing community
Embryo transcriptome response to environmental factors: implication for its survival under suboptimal conditions.

Science.gov (United States)

Salilew-Wondim, Dessie; Tesfaye, Dawit; Hoelker, Michael; Schellander, Karl

2014-09-01

After its formation, the mammalian zygote undergoes a series of morphological, physiological and biochemical alterations prior to undergoing cell differentiation. The zygote is then transformed into a complex multicellular organism in a defined time window which may differ between species. These orderly embryonic developmental events are tightly regulated by temporal and spatial activation and/or deactivation of genes and gene products. This phenomenon may in turn be dependent on the intrinsic characteristics of the embryo itself, the physiological and biochemical composition of the maternal environment or by in vitro culture condition. In fact, when embryos are subjected to suboptimal culture condition, some of the embryos may escape the environmental stress by activating certain transcripts and some others which are unable to activate anti-stress agents may die or exhibit abnormal development. This phenomenon may partly depend on transcripts and proteins stored during oogenesis. Indeed after embryonic genome activation, the embryo destiny is governed by its own transcripts and protein synthesized over time. Therefore, this review begins by highlighting the type and quality of transcripts accumulated or degraded during oogenesis and its impact on the embryo survival. Thereafter, emphasis is given to the transcriptome response of preimplantation embryos to suboptimal culture conditions. In addition, the long term effect of preimplantation culture environment on the transcriptome response embryos/fetus during peri and post implantation has been addressed. Finally, a brief summary of the epigenetic control of culture induced genetic variation of the embryos has been highlighted. Copyright © 2014 Elsevier B.V. All rights reserved.
Suboptimal etravirine activity is common during failure of nevirapine-based combination antiretroviral therapy in a cohort infected with non-B subtype HIV-1.

Science.gov (United States)

Taiwo, Babafemi; Chaplin, Beth; Penugonda, Sudhir; Meloni, Seema; Akanmu, Sulaimon; Gashau, Wadzani; Idoko, John; Adewole, Isaac; Murphy, Robert; Kanki, Phyllis

2010-04-01

The primary objective of this study was to estimate etravirine activity in a cohort of patients infected with non-B subtype HIV-1 and failing nevirapine-based therapy. Genotypic resistance testing was performed if viral load was >OR= 1,000 copies/ml after receiving at least six months of therapy. Suboptimal response to etravirine was predicted by a score >OR= 2.5 on the Tibotec weighting schema, >OR= 4 in the Monogram schema, or classification as high to low-level resistant by a modification of the Stanford HIVdb algorithm (Version 5.1.2). Bivariate and multivariate analyses were conducted to determine the risk factors for suboptimal etravirine activity. The patients (n=91) were receiving nevirapine and lamivudine plus stavudine (57.1%) or zidovudine (42.9%). Median duration of nevirapine exposure was 53 weeks (IQR 46-101 weeks). The most common etravirine resistance associated mutations were Y181C (42.9%), G190A (25.3%), H221Y (19.8%), A98G (18.7%), K101E (16.5%), and V90I (12.1%). Suboptimal etravirine activity was predicted in 47.3 to 56.0%. There were disparities in mutations listed in Tibotec versus Monogram Schemas. Predicted suboptimal activity was not associated with nucleoside reverse transcriptase inhibitor (NRTI) used, gender, pretreatment or current CD4 cell count or viral load, subtype or NRTI mutations. Etravirine has compromised activity in approximately half of the patients failing nevirapine-based first-line treatment in this cohort, which supports guidelines that caution against using it with NRTIs alone in such patients.
Energy expenditures & physical activity in rats with chronic suboptimal nutrition

Directory of Open Access Journals (Sweden)

Lifshitz Fima

2006-01-01

Full Text Available Abstract Background Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN. In this study energy expenditure (EE; kcal/100 g body weight and physical activity (PA; oscillations in weight/min/kg body weight were assessed in rats subjected to three levels of CSN. Results Body weight gain was diminished (76.7 ± 12.0 and 61.6 ± 11.0 g in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 ± 32.3 g. The rats fed 80% gained weight similarly to controls (136.3 ± 10.5 g. Percent Fat-free body mass was reduced (143.8 ± 8.7 and 142.0 ± 7.6 g in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 ± 17.5 g as compared with controls (201.6 ± 33.4 g. Body fat (g decreased in rats fed 80% (19.7 ± 5.3, 70% (15.3 ± 3.5 and 60% (9.6 ± 2.7 of ad-libitum in comparison to controls (26.0 ± 6.7. EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 ± 0.8 and 1.7 ± 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 ± 1.4 and 7.8 ± 0.6 vs. 9.0 ± 1.2 and 9.7 ± 0.8; p Conclusion CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.
Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

NARCIS (Netherlands)

Hermanides, J.; Nørgaard, K.; Bruttomesso, D.; Mathieu, C.; Frid, A.; Dayan, C. M.; Diem, P.; Fermon, C.; Wentholt, I. M. E.; Hoekstra, J. B. L.; DeVries, J. H.

2011-01-01

To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with

Waste minimization value engineering workshop for the Los Alamos National Laboratory Omega West Reactor Decommissioning Project

International Nuclear Information System (INIS)

Hartnett, S.; Seguin, N.; Burns, M.

1995-01-01

The Los Alamos National Laboratory Pollution Prevention Program Office sponsored a Value Engineering (VE) Workshop to evaluate recycling options and other pollution prevention and waste minimization (PP/WMin) practices to incorporate into the decommissioning of the Omega West Reactor (OWR) at the laboratory. The VE process is an organized, systematic approach for evaluating a process or design to identify cost saving opportunities, or in this application, waste reduction opportunities. This VE Workshop was a facilitated process that included a team of specialists in the areas of decontamination, decommissioning, PP/WMin, cost estimating, construction, waste management, recycling, Department of Energy representatives, and others. The uniqueness of this VE Workshop was that it used an interdisciplinary approach to focus on PP/WMin practices that could be included in the OWR Decommissioning Project Plans and specifications to provide waste reduction. This report discusses the VE workshop objectives, summarizes the OWR decommissioning project, and describes the VE workshop activities, results, and lessons learned
Waste minimization value engineering workshop for the Los Alamos National Laboratory Omega West Reactor Decommissioning Project

Energy Technology Data Exchange (ETDEWEB)

Hartnett, S.; Seguin, N. [Benchmark Environmental Corp., Albuquerque, NM (United States); Burns, M. [Los Alamos National Lab., NM (United States)

1995-12-31

The Los Alamos National Laboratory Pollution Prevention Program Office sponsored a Value Engineering (VE) Workshop to evaluate recycling options and other pollution prevention and waste minimization (PP/WMin) practices to incorporate into the decommissioning of the Omega West Reactor (OWR) at the laboratory. The VE process is an organized, systematic approach for evaluating a process or design to identify cost saving opportunities, or in this application, waste reduction opportunities. This VE Workshop was a facilitated process that included a team of specialists in the areas of decontamination, decommissioning, PP/WMin, cost estimating, construction, waste management, recycling, Department of Energy representatives, and others. The uniqueness of this VE Workshop was that it used an interdisciplinary approach to focus on PP/WMin practices that could be included in the OWR Decommissioning Project Plans and specifications to provide waste reduction. This report discusses the VE workshop objectives, summarizes the OWR decommissioning project, and describes the VE workshop activities, results, and lessons learned.
ANALYSIS OF PARAMETERIZATION VALUE REDUCTION OF SOFT SETS AND ITS ALGORITHM

Directory of Open Access Journals (Sweden)

Mohammed Adam Taheir Mohammed

2016-02-01

Full Text Available In this paper, the parameterization value reduction of soft sets and its algorithm in decision making are studied and described. It is based on parameterization reduction of soft sets. The purpose of this study is to investigate the inherited disadvantages of parameterization reduction of soft sets and its algorithm. The algorithms presented in this study attempt to reduce the value of least parameters from soft set. Through the analysis, two techniques have been described. Through this study, it is found that parameterization reduction of soft sets and its algorithm has yielded a different and inconsistency in suboptimal result.
High frequency of sub-optimal semen quality in an unselected population of young men

DEFF Research Database (Denmark)

Andersen, A G; Jensen, T K; Carlsen, E

2000-01-01

for military service, this provided a unique opportunity to study the reproductive function in an unbiased population. Altogether 891 young men delivered a blood sample in which reproductive hormones were measured. From 708 of these men data were also obtained on semen quality and testis size. The median sperm...... immotile spermatozoa and follicle stimulating hormone. Possible causes for this high frequency of young men with suboptimal semen quality are obscure and need to be explored. Whether these findings apply for young male populations of comparable countries remains to be seen....
Survival of lactic acid and chlorine dioxide treated Campylobacter jejuni under suboptimal conditions of pH, temperature and modified atmosphere

DEFF Research Database (Denmark)

Smigic, Nada; Rajkovic, Andreja; Nielsen, Dennis Sandris

2010-01-01

As mild decontamination treatments are gaining more and more interest due to increased consumer demands for fresh foods, it is of great importance to establish the influence of decontamination treatments on the subsequent bacterial behaviour under suboptimal storage conditions. For this purpose...... Campylobacter jejuni cells treated with lactic acid (LA, 3% lactic acid, pH 4.0, 2 min) or chlorine dioxide (ClO(2), 20 ppm, 2 min) were inoculated in Bolton broth (pH 6.0) and incubated under 80% O(2)/20% N(2), 80% CO(2)/20% N(2), air or micro-aerophilic (10% CO(2)/85% N(2)/5% O(2)) atmosphere, at 4 degrees C...... on their pH(i) values. The pH(i) response was independent on the surrounding atmosphere since similar distribution of the subpopulations was observed for all tested atmospheres. However, the pH(i) response was dependent on the initial decontamination treatment. The investigation of intracellular parameters...
Suboptimal compliance with blood culture standards at a district

African Journals Online (AJOL)

The Clinical and Laboratory Standards. Institute (CLSI)'s ... reviewing clinical and laboratory data and by a clinician questionnaire. Results. ... the laboratory information system (LIS). ..... management of severe sepsis and septic shock: 2012.
Scoring CT/HRCT findings among asbestos-exposed workers: effects of patient's age, body mass index and common laboratory test results

Energy Technology Data Exchange (ETDEWEB)

Vehmas, T.; Huuskonen, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); Kivisaari, L. [Helsinki University Central Hospital, Department of Radiology, Helsinki (Finland); Jaakkola, M.S. [Finnish Institute of Occupational Health, Department of Radiology, Helsinki (Finland); University of Birmingham, Institute of Occupational and Environmental Medicine, Birmingham (United Kingdom)

2005-02-01

We studied the effects of age, body mass index (BMI) and some common laboratory test results on several pulmonary CT/HRCT signs. Five hundred twenty-eight construction workers (age 38-80, mean 63 years) were imaged with spiral and high resolution CT. Images were scored by three radiologists for solitary pulmonary nodules, signs indicative of fibrosis and emphysema, ground glass opacities, bronchial wall thickness and bronchiectasis. Multivariate statistical analyses were adjusted for smoking and asbestos exposure. Increasing age, blood haemoglobin value and erythrocyte sedimentation rate correlated positively with several HRCT signs. Increasing BMI was associated with a decrease in several signs, especially parenchymal bands, honeycombing, all kinds of emphysema and bronchiectasis. The latter finding might be due to the suboptimal image quality in obese individuals, which may cause suspicious findings to be overlooked. Background data, including patient's age and body constitution, should be considered when CT/HRCT images are interpreted. (orig.)
Do pigeons (Columba livia) use information about the absence of food appropriately? A further look into suboptimal choice.

Science.gov (United States)

Fortes, Inês; Machado, Armando; Vasconcelos, Marco

2017-11-01

In the natural environment, when an animal encounters a stimulus that signals the absence of food-a 'bad-news' stimulus-it will most likely redirect its search to another patch or prey. Because the animal does not pay the opportunity cost of waiting in the presence of a bad-news stimulus, the properties of the stimulus (e.g., its duration and probability) may have little impact in the evolution of the decision processes deployed in these circumstances. Hence, in the laboratory, when animals are forced to experience a bad-news stimulus they seem to ignore its duration, even though they pay the cost of waiting. Under certain circumstances, this insensitivity to the opportunity cost can lead to suboptimal preferences, such as a preference for an option yielding a low rather than a high rate of reinforcement. In 2 experiments, we tested Vasconcelos, Monteiro, and Kacelnik's (2015) assumption that, if given the opportunity, animals will escape the bad-news stimulus. To predict when an escape response should occur, we incorporated ideas from the prey choice model into Vasconcelos et al. (2015) model and made 2 novel predictions. Namely, both longer intertrial intervals and longer durations of signals predicting food or no food should lead to higher proportions of escape responses. The results of 2 experiments with pigeons supported these predictions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Laboratory Information Management Systems for Forensic Laboratories: A White Paper for Directors and Decision Makers

Energy Technology Data Exchange (ETDEWEB)

Anthony Hendrickson; Brian Mennecke; Kevin Scheibe; Anthony Townsend

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, 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.
Optimal and Suboptimal Finger Selection Algorithms for MMSE Rake Receivers in Impulse Radio Ultra-Wideband Systems

Directory of Open Access Journals (Sweden)

Chiang Mung

2006-01-01

Full Text Available The problem of choosing the optimal multipath components to be employed at a minimum mean square error (MMSE selective Rake receiver is considered for an impulse radio ultra-wideband system. First, the optimal finger selection problem is formulated as an integer programming problem with a nonconvex objective function. Then, the objective function is approximated by a convex function and the integer programming problem is solved by means of constraint relaxation techniques. The proposed algorithms are suboptimal due to the approximate objective function and the constraint relaxation steps. However, they perform better than the conventional finger selection algorithm, which is suboptimal since it ignores the correlation between multipath components, and they can get quite close to the optimal scheme that cannot be implemented in practice due to its complexity. In addition to the convex relaxation techniques, a genetic-algorithm- (GA- based approach is proposed, which does not need any approximations or integer relaxations. This iterative algorithm is based on the direct evaluation of the objective function, and can achieve near-optimal performance with a reasonable number of iterations. Simulation results are presented to compare the performance of the proposed finger selection algorithms with that of the conventional and the optimal schemes.
A Suboptimal Power-Saving Transmission Scheme in Multiple Component Carrier Networks

Science.gov (United States)

Chung, Yao-Liang; Tsai, Zsehong

Power consumption due to transmissions in base stations (BSs) has been a major contributor to communication-related CO2 emissions. A power optimization model is developed in this study with respect to radio resource allocation and activation in a multiple Component Carrier (CC) environment. We formulate and solve the power-minimization problem of the BS transceivers for multiple-CC networks with carrier aggregation, while maintaining the overall system and respective users' utilities above minimum levels. The optimized power consumption based on this model can be viewed as a lower bound of that of other algorithms employed in practice. A suboptimal scheme with low computation complexity is proposed. Numerical results show that the power consumption of our scheme is much better than that of the conventional one in which all CCs are always active, if both schemes maintain the same required utilities.
Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

Directory of Open Access Journals (Sweden)

Ndiaye M

2013-09-01

Full Text Available Maimouna Ndiaye,1,2 Peter Nyasulu,1 Hoang Nguyen,6,7 Elizabeth D Lowenthal,8,9 Robert Gross,10 Edward J Mills,3 Jean B Nachega4–6 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Central Medical Stores, Ministry of Health, Gaborone, Botswana; 3Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; 4Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 5Department of Epidemiology, Infectious Disease Epidemiology Research Program, Pittsburgh University Graduate School of Public Health, Pittsburgh, PA, USA; 6Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 7Tay Ho Clinics, Department of Medicine, Hanoi Health Services, Hanoi, Vietnam; 8Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 9Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Objective: Little is known about factors associated with suboptimal antiretroviral treatment (ART adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95% and virologic suppression
High prevalence of suboptimal vitamin B12 status in young adult women of South Asian and European ethnicity.

Science.gov (United States)

Quay, Teo A W; Schroder, Theresa H; Jeruszka-Bielak, Marta; Li, Wangyang; Devlin, Angela M; Barr, Susan I; Lamers, Yvonne

2015-12-01

Suboptimal vitamin B12 (B12) status has been associated with an increased risk of congenital anomalies, preterm birth, and childhood insulin resistance. South Asians - Canada's largest minority group - and women of reproductive age are vulnerable to B12 deficiency. This study aimed to assess the prevalence of and factors associated with B12 deficiency and suboptimal B12 status in a convenience sample of young adult women of South Asian and European descent in Metro Vancouver. We measured serum B12, holotranscobalamin, plasma methylmalonic acid, red blood cell and plasma folate, and hematologic parameters in 206 nonpregnant, healthy women aged 19-35 years. Categorization for B12 status adhered to serum B12 cutoffs for deficiency (women is higher than in the general Canadian population. In light of maternal and fetal health risks associated with B12 inadequacy in early-pregnancy, practitioners should consider monitoring B12 status before and during early pregnancy, especially in immigrants and women with low dietary B12 intakes including non-users of vitamin supplements.
Energy expenditures & physical activity in rats with chronic suboptimal nutrition.

Science.gov (United States)

Rising, Russell; Lifshitz, Fima

2006-01-31

Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN). In this study energy expenditure (EE; kcal/100 g body weight) and physical activity (PA; oscillations in weight/min/kg body weight) were assessed in rats subjected to three levels of CSN. Body weight gain was diminished (76.7 +/- 12.0 and 61.6 +/- 11.0 g) in rats fed 70 and 60% of the ad-libitum fed controls which gained more weight (148.5 +/- 32.3 g). The rats fed 80% gained weight similarly to controls (136.3 +/- 10.5 g). Percent Fat-free body mass was reduced (143.8 +/- 8.7 and 142.0 +/- 7.6 g) in rats fed 70 and 60% of ad-libitum, but not in those fed 80% (200.8 +/- 17.5 g) as compared with controls (201.6 +/- 33.4 g). Body fat (g) decreased in rats fed 80% (19.7 +/- 5.3), 70% (15.3 +/- 3.5) and 60% (9.6 +/- 2.7) of ad-libitum in comparison to controls (26.0 +/- 6.7). EE and PA were also altered by CSN. The control rats increased their EE and PA during the dark periods by 1.4 +/- 0.8 and 1.7 +/- 1.1 respectively, as compared with light the period; whereas CSN rats fed 80 and 70% of ad-libitum energy intake had reduced EE and PA during the dark periods as compared with the light period EE(7.5 +/- 1.4 and 7.8 +/- 0.6 vs. 9.0 +/- 1.2 and 9.7 +/- 0.8; p vs. 4.1 +/- 0.9 and 2.4 +/- 0.4; p vs. 0.95 +/- 0.03 and 0.91 +/- 0.05 p light (7.1 +/- 1.4) and dark period (6.2 +/- 1.0) EE and PA (3.4 +/- 0.9 and 2.5 +/- 0.5 respectively) were reduced in rats fed 60% of ad-libitum energy intake. CSN rats adapt to mild energy restriction by reducing body fat, EE and PA mainly during the dark period while growth proceeds and lean body mass is preserved. At higher levels of energy restrictions there is decreased growth, body fat and lean mass. Moreover EE and PA are also reduced during both light and dark periods.
Design of a study on suboptimal cognitive acts in the diagnostic process, the effect on patient outcomes and the influence of workload, fatigue and experience of physician

Directory of Open Access Journals (Sweden)

van der Wal Gerrit

2009-04-01

Full Text Available Abstract Background Diagnostic error is an important error type since diagnostic adverse events are regularly judged as being preventable and the consequences are considered to be severe. Existing research often focuses on either diagnostic adverse events or on the errors in diagnostic reasoning. Whether and when an incorrect diagnostic process results in adverse outcomes has not been studied extensively. The present paper describes the design of a study that aims to study the relationship between a suboptimal diagnostic process and patient outcomes. In addition, the role of personal and circumstantial factors on the quality of the diagnostic process will be examined. Methods/Design The research questions were addressed using several data sources. First, the differential diagnosis was assessed concurrently to the diagnostic process. Second, the patient records of 248 patients suffering from shortness of breath were reviewed by expert internists in order to reveal suboptimal cognitive acts and (potential consequences for the patient. The suboptimal cognitive acts were discussed with the treating physicians and classified with the taxonomy of unsafe acts. Third, workload, fatigue and work experience were measured during the physicians work. Workload and fatigue were measured during the physicians shift using the NASA tlx questionnaire on a handheld computer. Physicians participating in the study also answered questions about their work experience. Discussion The design used in this study provides insight into the relationship between suboptimal cognitive acts in the diagnostic process and possible consequences for the patient. Suboptimal cognitive acts in the diagnostic process and its causes can be revealed. Additional measurements of workload, fatigue and experience allow examining the influence of these factors on the diagnostic process. In conclusion, the present design provides a method with which insights in weaknesses of the diagnostic
Effect of stress induced by suboptimal growth factors on survival of Escherichia coli O157:H7.

Science.gov (United States)

Uyttendaele, M; Taverniers, I; Debevere, J

2001-05-21

This study investigated the growth and survival of E. coli O157:H7 exposed to a combination of suboptimal factors (22 degrees C, 7 degrees C, -18 degrees C/0.5% NaCl, 5.0% NaCl/pH 7.0, pH 5.4, pH 4.5/addition of lactic acid) in a simulation medium for red meat (beef gravy). Prolonged survival was noted as the imposed stress was more severe, and as multiple growth factors became suboptimal. At a defined temperature (7 degrees C or -18 degrees C), survival was prolonged at the more acid, more suboptimal pH (pH 4.5 > pH 5.4 > pH 7.0) while at a defined pH (pH 4.5), better survival was observed at 7 degrees C than at 22 degrees C. This suggests that application of the hurdle concept for preservation of food may inhibit outgrowth but induce prolonged survival of E. coli O157:H7 in minimal processed foods. At both 22 degrees C and 7 degrees C, the addition of lactic acid instead of HCl to reduce pH (to pH 4.5) resulted in a more rapid decrease of E. coli O157:H7. High survival was observed in beef gravy, pH 5.4 at -18 degrees C (simulation of frozen meat)-reduction of log 3.0 to log 1.9 after 43 days--and in beef gravy, pH 4.5 and 5% NaCl at 7 degrees C (simulation of a fermented dried meat product kept in refrigeration)--less than 1 log reduction in 43 days. In these circumstances, however, a high degree of sublethal damage of the bacterial cells was noted. The degree of sublethal damage can be estimated from the difference in recovery of the pathogen on the non-selective TSA medium and the selective SMAC medium.
Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression.

Directory of Open Access Journals (Sweden)

Krista J Siefried

Full Text Available Missing more than one tablet of contemporary antiretroviral therapy (ART per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings.Adults on ART with undetectable viral load (UDVL were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs. Baseline data were assessed, and suboptimal adherence was defined as self-reported missing ≥1 ART dose/month over the previous 3-months; associated factors were identified using bivariate and multivariate binary logistic regression.We assessed 522 participants (494 [94.5%] men, mean age = 50.8 years, median duration UDVL = 3.3 years [IQR = 1.2-6.8] at 17 sexual health, hospital, and general practice clinics across Australia. Seventy-eight participants (14.9% reported missing ≥1 dose/month over the previous three months, which was independently associated with: being Australian-born (AOR [adjusted odds ratio] = 2.4 [95%CI = 1.2-4.9], p = 0.014, not being in a relationship (AOR = 3.3 [95%CI = 1.5-7.3], p = 0.004, reaching the "Medicare safety net" (capping annual medical/pharmaceutical costs (AOR = 2.2 [95%CI = 1.1-4.5], p = 0.024, living in subsidised housing (AOR = 2.5 [95%CI = 1.0-6.2], p = 0.045, receiving home-care services (AOR = 4.4 [95%CI = 1.0-18.8], p = 0.046, HIV community/outreach services linkage (AOR = 2.4 [95%CI = 1.1-5.4], p = 0.033, and starting ART following self-request (AOR = 3.0 [95%CI = 1.3-7.0], p = 0.012.In this population, 15% reported recent suboptimal ART adherence at levels associated in prospective studies with subsequent virological failure, despite all having an
Evaluation of the feeding value of straw. A comparison of laboratory methods in the Nordic countries

Energy Technology Data Exchange (ETDEWEB)

Sundstoel, F; Kossila, V; Theander, O; Thomsen, K V

1978-01-01

Straw from Scandinavian countries had in vivo (sheep) organic matter digestibilities of 42 to 68%. In vitro digestibilities were 59.0 to 70.4%, and increased with enzyme-soluble organic matter contents. Acid and neutral detergent fiber contents were not correlated strongly enough with alkali treated straw to be used for prediction of nutritional value. There was a correlation between N content and digestibility in NH/sub 3/-treated straw. As long as standard measuring techniques were used, determinations of dry matter, ash, acid and neutral detergent fiber, lignin, sugars, and cellulose were correlated well among different testing laboratories.
Standardization of glycohemoglobin results and reference values in whole blood studied in 103 laboratories using 20 methods.

Science.gov (United States)

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.
Burden of laboratory-confirmed Campylobacter infections in Guatemala 2008-2012: results from a facility-based surveillance system.

Science.gov (United States)

Benoit, Stephen R; Lopez, Beatriz; Arvelo, Wences; Henao, Olga; Parsons, Michele B; Reyes, Lissette; Moir, Juan Carlos; Lindblade, Kim

2014-03-01

Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal. Published by Elsevier Ltd.

Suboptimal decision making by children with ADHD in the face of risk

DEFF Research Database (Denmark)

Sørensen, Lin; Sonuga-Barke, Edmund; Eichele, Heike

2017-01-01

Objective: Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT......-matched group of typically developing children (n = 34) performed the CGT. Results: As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive-with these 2 effects being...... correlated. Conclusions: Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively....
Robust Adaptive LCMV Beamformer Based On An Iterative Suboptimal Solution

Directory of Open Access Journals (Sweden)

Xiansheng Guo

2015-06-01

Full Text Available The main drawback of closed-form solution of linearly constrained minimum variance (CF-LCMV beamformer is the dilemma of acquiring long observation time for stable covariance matrix estimates and short observation time to track dynamic behavior of targets, leading to poor performance including low signal-noise-ratio (SNR, low jammer-to-noise ratios (JNRs and small number of snapshots. Additionally, CF-LCMV suffers from heavy computational burden which mainly comes from two matrix inverse operations for computing the optimal weight vector. In this paper, we derive a low-complexity Robust Adaptive LCMV beamformer based on an Iterative Suboptimal solution (RAIS-LCMV using conjugate gradient (CG optimization method. The merit of our proposed method is threefold. Firstly, RAIS-LCMV beamformer can reduce the complexity of CF-LCMV remarkably. Secondly, RAIS-LCMV beamformer can adjust output adaptively based on measurement and its convergence speed is comparable. Finally, RAIS-LCMV algorithm has robust performance against low SNR, JNRs, and small number of snapshots. Simulation results demonstrate the superiority of our proposed algorithms.
Prevalence of estimated GFR reporting among US clinical laboratories.

Science.gov (United States)

Accetta, Nancy A; Gladstone, Elisa H; DiSogra, Charles; Wright, Elizabeth C; Briggs, Michael; Narva, Andrew S

2008-10-01

Routine laboratory reporting of estimated glomerular filtration rate (eGFR) may help clinicians detect kidney disease. The current national prevalence of eGFR reporting in clinical laboratories is unknown; thus, the extent of the situation of laboratories not routinely reporting eGFR with serum creatinine results is not quantified. Observational analysis. National Kidney Disease Education Program survey of clinical laboratories conducted in 2006 to 2007 by mail, web, and telephone follow-up. A national random sample, 6,350 clinical laboratories, drawn from the Federal Clinical Laboratory Improvement Amendments database and stratified by 6 major laboratory types/groupings. Laboratory reports serum creatinine results. Reporting eGFR values with serum creatinine results. Percentage of laboratories reporting eGFR along with reporting serum creatinine values, reporting protocol, eGFR formula used, and style of reporting cutoff values. Of laboratories reporting serum creatinine values, 38.4% report eGFR (physician offices, 25.8%; hospitals, 43.6%; independents, 38.9%; community clinics, 47.2%; health fair/insurance/public health, 45.5%; and others, 43.2%). Physician office laboratories have a reporting prevalence lower than other laboratory types (P laboratories reporting eGFR, 66.7% do so routinely with all adult serum creatinine determinations; 71.6% use the 4-variable Modification of Diet in Renal Disease Study equation; and 45.3% use the ">60 mL/min/1.73 m(2)" reporting convention. Independent laboratories are least likely to routinely report eGFR (50.6%; P laboratories across all strata are more likely to report eGFR (P laboratories, federal database did not have names of laboratory directors/managers (intended respondents), assumed accuracy of federal database for sample purposes. Routine eGFR reporting with serum creatinine values is not yet universal, and laboratories vary in their reporting practices.
ABACC's laboratory intercomparison program

International Nuclear Information System (INIS)

Almeida, Gevaldo L. de; Esteban, Adolfo; Almeida, Silvio G. de; Araujo, Radier M. de; Rocha, Zildete

1996-01-01

A Laboratory Intercomparison Program involving Brazilian and Argentine laboratories, with the special participation of New Brunswick Laboratory - DOE and IAEA Seibersdorf Safeguards Laboratory, was implanted by ABACC having as main purpose to qualify a network to provide analytical services to this Agency on its role as administrator of the Common System of Accountability and Control of Nuclear Materials. For the first round robin of this Program, 15 laboratories were invited to perform elemental analysis on UO 2 samples, by using any desired method. Thirteen confirmed the participation and 10 reported the results. After an evaluation of the results by using a Two-Way Variance Analysis applied to a nested error model, it was found that 5 of them deviate less than 0.1% from the reference value established for the UO 2 uranium contents, being thus situated within the limits adopted for the target values, while the remaining ones reach a maximal deviation of 0.44%. The outcome of this evaluation, was sent to the laboratories, providing them with a feedback to improve their performance by applying corrective actions to the detected sources of errors or bias related to the methods techniques and procedures. (author)
Standardization of irradiation values at the Radiation Calibration Laboratory

International Nuclear Information System (INIS)

Pham Van Dung; Hoang Van Nguyen; Phan Van Toan; Phan Dinh Sinh; Tran Thi Tuyet; Do Thi Phuong

2007-01-01

The objective of the theme is to determine dose rates around radiation facilities and sources in the NRI Radiation Calibration Laboratory. By improving equipment, calibrating a main dosemeter and carrying out experiments, the theme team received the following results: 1. The controller of a X-rays generator PY(-200 was improved. It permits to increase accuracy of radiation dose calibration up to 2-4 times; 2. The FAMER DOSEMETER 2570/1B with the ionization chamber NE 2575 C of the NRI Radiation Calibration Laboratory was calibrated at SSDL (Hanoi); 3. Dose rates at 4 positions around a high activity Co-60 source were determined; 4. Dose rates at 3 positions around a low activity Co-60 source were determined; 5. Dose rates at 3 positions around a low activity Cs-137 source were determined; 6. Dose rate at 1 position of a X-rays beam (Eaverage = 48 keV) was determined; 7. Dose rate at 1 position of a X-rays beam (Eaverage = 65 keV) was determined. (author)
Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir.

Science.gov (United States)

Hong, Eun-Hye; Song, Jae-Hyoung; Shim, Aeri; Lee, Bo-Ra; Kwon, Bo-Eun; Song, Hyuk-Hwan; Kim, Yeon-Jeong; Chang, Sun-Young; Jeong, Hyeon Gun; Kim, Jong Geal; Seo, Sang-Uk; Kim, HyunPyo; Kwon, YongSoo; Ko, Hyun-Jeong

2015-01-01

Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8) virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif) ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8 infection that could be
Coadministration of Hedera helix L. Extract Enabled Mice to Overcome Insufficient Protection against Influenza A/PR/8 Virus Infection under Suboptimal Treatment with Oseltamivir.

Directory of Open Access Journals (Sweden)

Eun-Hye Hong

Full Text Available Several anti-influenza drugs that reduce disease manifestation exist, and although these drugs provide clinical benefits in infected patients, their efficacy is limited by the emergence of drug-resistant influenza viruses. In the current study, we assessed the therapeutic strategy of enhancing the antiviral efficacy of an existing neuraminidase inhibitor, oseltamivir, by coadministering with the leaf extract from Hedera helix L, commonly known as ivy. Ivy extract has anti-inflammatory, antibacterial, antifungal, and antihelminthic properties. In the present study, we investigated its potential antiviral properties against influenza A/PR/8 (PR8 virus in a mouse model with suboptimal oseltamivir that mimics a poor clinical response to antiviral drug treatment. Suboptimal oseltamivir resulted in insufficient protection against PR8 infection. Oral administration of ivy extract with suboptimal oseltamivir increased the antiviral activity of oseltamivir. Ivy extract and its compounds, particularly hedrasaponin F, significantly reduced the cytopathic effect in PR8-infected A549 cells in the presence of oseltamivir. Compared with oseltamivir treatment alone, coadministration of the fraction of ivy extract that contained the highest proportion of hedrasaponin F with oseltamivir decreased pulmonary inflammation in PR8-infected mice. Inflammatory cytokines and chemokines, including tumor necrosis factor-alpha and chemokine (C-C motif ligand 2, were reduced by treatment with oseltamivir and the fraction of ivy extract. Analysis of inflammatory cell infiltration in the bronchial alveolar of PR8-infected mice revealed that CD11b+Ly6G+ and CD11b+Ly6Cint cells were recruited after virus infection; coadministration of the ivy extract fraction with oseltamivir reduced infiltration of these inflammatory cells. In a model of suboptimal oseltamivir treatment, coadministration of ivy extract fraction that includes hedrasaponin F increased protection against PR8
[Effects of different NO3--N/NH4+-N ratios on cucumber seedlings growth, nitrogen absorption and metabolism under suboptimal temperature and light intensity].

Science.gov (United States)

Zhang, Xiao Cui; Liu, Yu Mei; Bai, Long Qiang; He, Chao Xing; Yu, Xian Chang; Li, Yan Su

2016-08-01

Cucumber (cv. Zhongnong 26) was used as material, the effects of NO 3 - -N/NH 4 + -N ratios on growth and physiological characteristics of cucumber seedlings under suboptimal temperature and light intensity (18 ℃/10 ℃,180 ± 20 μmol·m -2 ·s -1 ) were studied. Total nitrogen in the nutrient solution was equal and three NO 3 - -N/NH 4 + -N ratios, 26:2, 21:7 and 14:14, were applied as treatments. The results showed that cucumber treated by NO 3 - -N/NH 4 + -N=21:7 had the longest total root length, the biggest root volume and root surface area, and the maximum number of root tips. H + -ATPase activity and relative expression of genes encoding nitrate transporter (NRT) and ammonium transporter (AMT) in cucumber roots were increased significantly by the treatment of NO 3 - -N/NH 4 + -N=21:7. In addition, nitrate reductase (NR), glutamine synthetase (GS) and glutamate synthase (GOGAT) in cucumber leaves under the treatment of NO 3 - -N/NH 4 + -N=21:7 were higher. As a result, the nitrogen content and biomass of cucumber were significantly increased. Compared with the plants under the treatment of NO 3 - -N/NH 4 + -N=26:2 or 14:14, cucumber seedlings under the treatment of NO 3 - -N/NH 4 + -N=21:7 had the highest biomass and total dry mass (DM) which were increased by 14.0% and 19.3% respectively under suboptimal temperature and light intensity. In conclusion, under suboptimal environmental conditions, NO 3 - -N/NH 4 + -N ratio could be adjusted to increase nitrogen absorption and metabolism of cucumber and alleviate the de-trimental effects caused by suboptimal conditions and promoted the cucumber growth.
Burden of laboratory-confirmed Campylobacter infections in Guatemala 2008–2012: Results from a facility-based surveillance system

Science.gov (United States)

Benoit, Stephen R.; Lopez, Beatriz; Arvelo, Wences; Henao, Olga; Parsons, Michele B.; Reyes, Lissette; Moir, Juan Carlos; Lindblade, Kim

2015-01-01

Introduction Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. Methods Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. Results Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal. PMID:24534336
Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

Directory of Open Access Journals (Sweden)

Di Pierro F

2012-07-01

Full Text Available Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate.Methods and results: Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol® in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action.Conclusion: Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control.Keywords: berberine, silymarin, glycosylated hemoglobin, diabetes
Simula Research Laboratory

CERN Document Server

Tveito, Aslak

2010-01-01

The Simula Research Laboratory, located just outside Oslo in Norway, is rightly famed as a highly successful research facility, despite being, at only eight years old, a very young institution. This fascinating book tells the history of Simula, detailing the culture and values that have been the guiding principles of the laboratory throughout its existence. Dedicated to tackling scientific challenges of genuine social importance, the laboratory undertakes important research with long-term implications in networks, computing and software engineering, including specialist work in biomedical comp
Leveraging the real value of laboratory medicine with the value proposition

NARCIS (Netherlands)

Price, C.; John, A.S.; Christenson, R.; Scharnhorst, V.; Oellerich, M.; Jones, P.; Morris, H.A.

2016-01-01

Improving quality and patient safety, containing costs and delivering value-for-money are the key drivers of change in the delivery of healthcare and have stimulated a shift from an activity-based service to a service based on patient-outcomes. The delivery of an outcomes-based healthcare agenda
Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

OpenAIRE

Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

2016-01-01

Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sam...
Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort.

Science.gov (United States)

Ferrie, Jane E; Kivimäki, Mika; Westerlund, Hugo; Head, Jenny; Melchior, Maria; Singh-Manoux, Archana; Zins, Marie; Goldberg, Marcel; Alexanderson, Kristina; Vahtera, Jussi

2011-10-01

Although sickness absence is a strong predictor of health, whether this association varies by occupational position has rarely been examined. The aim of this study was to investigate overall and diagnosis-specific sickness absence as a predictor of future long-term sub-optimal health by occupational position. This was a prospective occupational cohort study of 15 320 employees (73% men) aged 37-51. Sickness absences (1990-1992), included in 13 diagnostic categories, were examined by occupational position in relation to self-rated health measured annually during 1993-2006. 60% of employees in higher occupational positions and 22% in lower positions had no sickness absence. Conversely, 9.5% of employees in higher positions and 40% in lower positions had over 30 sick-leave days. Repeated-measures logistic regression analyses adjusted for age, sex and chronic disease showed employees with over 30 days absence, compared to those with no absence, had approximately double the risk of sub-optimal health over the 14-year follow-up in all occupational positions. 1-30 days sick-leave was associated with greater odds of sub-optimal health in the high (OR 1.48; 95% CI 1.27 to 1.72) and intermediate (1.29; 1.15 to 1.45) but not lower occupational positions (1.06; 0.82 to 1.38). Differences by occupational position in the association between sickness absence in 13 specific diagnostic categories and sub-optimal health over the ensuing 14 years were limited to stronger associations observed with cancer and mental disorders in the higher occupational positions. The association between sickness absence of more than 30 days over 3 years and future long-term self-rated health appears to differ little by occupational position.
Critical values in hematology of 862 institutions in China.

Science.gov (United States)

Ye, Y Y; Zhao, H J; Fei, Y; Wang, W; He, F L; Zhong, K; Yuan, S; Wang, Z G

2017-10-01

A national survey on critical values in hematology of China laboratories was conducted to determine the current practice and assess the quality indicators so as to obtain a quality improvement. Laboratories participating were asked to submit the general information, the practice of critical value reporting, and the status of timeliness of critical value reporting. A total of 862 laboratories submitted the results. The majority of participants have included white blood cell count, blood platelet count, hemoglobin, prothrombin time, and activated partial thromboplastin time in their critical value lists. Many sources are used for establishing a critical value policy, and some of the laboratories consult with clinicians. The unreported critical value rate, late critical value reporting rate, and clinically unacknowledged rate in China are relatively low, and the median of critical value reporting time is 8-9 minutes. There exists a wide variety for critical value reporting in hematology in China. Laboratories should establish a policy of critical value reporting suited for their own situations and consult with clinicians to set critical value lists. Critical values are generally reported in a timely manner in China, but some measures should be taken to further improve the timeliness of critical value reporting. © 2017 John Wiley & Sons Ltd.
The effect of plant-based diet and suboptimal environmental conditions on digestive function and diet-induced enteropathy in rainbow trout (Oncorhynchus mykiss)

NARCIS (Netherlands)

Mosberian-Tanha, P.; Schrama, J.W.; Landsverk, T.; Mydland, L.T.; Øverland, M.

2018-01-01

This experiment investigated intestinal enteropathy and digestive function of rainbow trout challenged with soybean meal-based diet (SBM) at optimal or suboptimal environments created by normal or reduced water flow, respectively. Oxygen level remained above 7 mg L-1 for optimal environment and
Assessment of the Financial and Intellectual Value of a Research Library and its Application at the Idaho National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Lynn E. Melander

2012-08-01

Over the last several decades, libraries across the nation have undergone dramatic budget cuts, despite being an important resource for regional and national economic growth and innovation. Numerous studies have attempted to show that libraries increase the intellectual level of users and contribute to the economic growth of communities through surveys and customer service data. Within this study, we have attempted to develop a more analytical method for assessing library performance, using the Idaho National Laboratory Research Library as a sample subject. We have developed a mathematical model to measure the financial value of a library’s material resources as well as its intellectual value to determine if the library is a positive contributor to the wider organization and community it serves.
A low-volume polyethylene glycol solution was associated with an increased suboptimal bowel preparation rate but had similar recommendations for an early repeat colonoscopy, procedure times, and adenoma detection rates.

Directory of Open Access Journals (Sweden)

Sam C Hankins

Full Text Available Low-volume polyethylene glycol (PEG bowel preparations are better tolerated by patients than high-volume preparations and may achieve similar preparation quality. However, there is little data comparing their effects on a recommendation for an early repeat colonoscopy (because of a suboptimal preparation, procedure times, adenoma detection rate (ADR, and advanced adenoma detection rate (AADR.This is a retrospective cohort study of outpatient colonoscopies performed during a one-year period at a single academic medical center in which low-volume MoviPrep® (n = 1841 or high-volume Colyte® (n = 1337 was used. All preparations were split-dosed. Appropriate covariates were included in regression models assessing suboptimal preparation quality (fair, poor, or inadequate, procedure times, recommendation for an early repeat colonoscopy, ADR, and AADR.MoviPrep® was associated with an increase in having a suboptimal bowel preparation (OR 1.36; 95% CI: 1.06-1.76, but it was not associated with differences in insertion (p = 0.43, withdrawal (p = 0.22, or total procedure times (p = 0.10. The adjusted percentage with a suboptimal preparation was 11.7% for patients using MoviPrep® and 8.8% for patients using Colyte®. MoviPrep® was not associated with a significant difference in overall ADR (OR 0.93; 95% CI: 0.78-1.11, AADR (OR 1.18; 95% CI: 0.87-1.62, or recommendation for early repeat colonoscopy (OR 1.16; 95% CI: 0.72-1.88.MoviPrep® was associated with a small absolute increase in having a suboptimal preparation, but did not affect recommendations for an early repeat colonoscopy, procedure times, or adenoma detection rates. Mechanisms to reduce financial barriers limiting low-volume preparations should be considered because of their favorable tolerability profile.
What Is the Predictive Value of Animal Models for Vaccine Efficacy in Humans? Consideration of Strategies to Improve the Value of Animal Models.

Science.gov (United States)

Herati, Ramin Sedaghat; Wherry, E John

2018-04-02

Animal models are an essential feature of the vaccine design toolkit. Although animal models have been invaluable in delineating the mechanisms of immune function, their precision in predicting how well specific vaccines work in humans is often suboptimal. There are, of course, many obvious species differences that may limit animal models from predicting all details of how a vaccine works in humans. However, careful consideration of which animal models may have limitations should also allow more accurate interpretations of animal model data and more accurate predictions of what is to be expected in clinical trials. In this article, we examine some of the considerations that might be relevant to cross-species extrapolation of vaccine-related immune responses for the prediction of how vaccines will perform in humans. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.
[Associations between health-promoting lifestyle and suboptimal health status in Guangdong: a cross sectional study].

Science.gov (United States)

Chen, Jie-Yu; Yang, Le-Bin; Jiang, Ping-Ping; Sun, Xiao-Min; Yu, Ke-Qiang; Li, Fei; Wu, Sheng-Wei; Ji, Yan-Zhao; Zhao, Xiao-Shan; Luo, Ren

2016-04-01

To investigate associations between health-promoting lifestyle and suboptimal health status (SHS) in the population of Guangdong province. A cross-sectional survey was conducted in a clustered sample of 24 159 individuals aged 12-80 years from 2012 to 2013. Health-promoting lifestyle was assessed via the Health-Promoting Lifestyle Profile (HPLP-II), and SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24159 participants, subjects with SHS (46.0%) and disease status (35.2%) accounted for a much higher percentage than healthy subjects (18.8%). Regression analyses revealed a significant association between health status and healthy lifestyle (PUnhealthy lifestyle was an important risk factor for SHS and disease, especially the former. Compared with the participants with a healthy lifestyle (minimal exposure), after demographic adjustment, subjects with a 'poor' lifestyle (maximal exposure) were at a 43 times higher risk of developing SHS (OR: 42.825, 95% CI: 30.567-59.997), those with a general lifestyle were at a 21 times higher risk of SHS (OR: 21.072, 95%CI: 17.258-25.729), and those with a suboptimal lifestyle had a 4 times higher risk (OR: 4.085, 95%CI: 3.352-4.979). In the general population, the major risk factors for SHS included poor stress management, poor self-actualization, inactive exercise and poor interpersonal relationship. s Unhealthy lifestyles are significantly related to an increased risk of SHS. Intervention of unhealthy lifestyles, controlling the risk factors of SHS, and rigorous management of the time window of SHS are necessary to promote the heath status.

Adaptive suboptimal second-order sliding mode control for microgrids

Science.gov (United States)

Incremona, Gian Paolo; Cucuzzella, Michele; Ferrara, Antonella

2016-09-01

This paper deals with the design of adaptive suboptimal second-order sliding mode (ASSOSM) control laws for grid-connected microgrids. Due to the presence of the inverter, of unpredicted load changes, of switching among different renewable energy sources, and of electrical parameters variations, the microgrid model is usually affected by uncertain terms which are bounded, but with unknown upper bounds. To theoretically frame the control problem, the class of second-order systems in Brunovsky canonical form, characterised by the presence of matched uncertain terms with unknown bounds, is first considered. Four adaptive strategies are designed, analysed and compared to select the most effective ones to be applied to the microgrid case study. In the first two strategies, the control amplitude is continuously adjusted, so as to arrive at dominating the effect of the uncertainty on the controlled system. When a suitable control amplitude is attained, the origin of the state space of the auxiliary system becomes attractive. In the other two strategies, a suitable blend between two components, one mainly working during the reaching phase, the other being the predominant one in a vicinity of the sliding manifold, is generated, so as to reduce the control amplitude in steady state. The microgrid system in a grid-connected operation mode, controlled via the selected ASSOSM control strategies, exhibits appreciable stability properties, as proved theoretically and shown in simulation.
Effects of feeding frequency on apparent energy and nutrient digestibility/availability of channel catfish, Ictalurus punctatus, reared at optimal and suboptimal temperatures

Science.gov (United States)

This study examined the effects of feeding frequency (daily versus every other day [EOD]) on nutrient digestibility/availability of channel catfish, Ictalurus punctatus, reared at optimal (30 C) and suboptimal (24 C) temperatures. A 28% protein practical diet was used as the test diet, and chromic o...
UK laboratory intercomparison on internal dosimetry

Energy Technology Data Exchange (ETDEWEB)

Speed, J.; Birchall, A.; Bull, R.; Cockerill, R.; Jarvis, N.S.; Marsh, J.W.; Peace, M.S.; Roberts, G.; Scarlett, C.; Spencer, D.; Stewart, P

2003-07-01

A laboratory intercomparison for internal dose assessment from a variety of intake scenarios is described. This is the first UK intercomparison using the revised ICRP Human Respiratory Tract and biokinetic models. Four United Kingdom laboratories participated and six cases were assessed. Overall, the agreement in internal dose assessments between laboratories was considered satisfactory with 79% of the assessed committed effective doses, e(50), for cases within a band of {+-}40% of the median value. The range (highest/lowest) in e(50) estimated by the laboratories was smallest (1.2) for a case involving inhalation of {sup 137}Cs. The range was greatest (6.0) for a case involving a wound with, and possible inhalation of, {sup 238}Pu, {sup 239}Pu and {sup 241}Am; the variation between laboratories in assessment of intakes could not be considered to be satisfactory in this case. Judgements on the most appropriate data to use in estimating intakes, choice of parameter values for use with the ICRP models and allowing for the effects of treatment with DTPA were important sources of variability between laboratories. (author)
Suboptimal vitamin D status in a population-based study of Asian children: prevalence and relation to allergic diseases and atopy.

Directory of Open Access Journals (Sweden)

Tsung-Chieh Yao

Full Text Available BACKGROUND: New evidence shows high prevalence of vitamin D deficiency in many countries and some studies suggest a possible link between vitamin D status and allergic diseases. The objectives of this study were to determine the prevalence of suboptimal vitamin D status in a population sample of Asian children and to investigate the relationship of vitamin D status with allergic diseases and atopy. METHODS: Children aged 5-18 years (N = 1315 in the Prediction of Allergies in Taiwanese CHildren (PATCH study were evaluated using questionnaires, anthropometric measurements, and serum levels of 25-hydroxyvitamin D [25(OHD] and total and specific immunoglobulin E (IgE. RESULTS: The mean concentration of serum 25(OHD was 20.4 ng/mL (SD: 7.1 ng/mL. Vitamin D deficiency (defined as serum 25(OHD0.05. CONCLUSIONS: Low serum 25(OHD levels are remarkably common in this population sample of Asian children, suggesting that millions of children living in Taiwan may have suboptimal levels of vitamin D, which should be a matter of public health concern. Our results provides epidemiological evidence against the association of vitamin D status with various allergic diseases and atopy in Asian children.
Beyond its cost, the value of maintenance: An analytical framework for capturing its net present value

International Nuclear Information System (INIS)

Marais, Karen B.; Saleh, Joseph H.

2009-01-01

Maintenance planning and activities have grown dramatically in importance across many industries and are increasingly recognized as drivers of competitiveness if managed appropriately. Correlated with this observation is the proliferation of maintenance optimization techniques in the technical literature. But while all these models deal with the cost of maintenance (as an objective function or a constraint), only a handful addresses the notion of value of maintenance, and seldom in an analytical or quantitative way. In this paper, we propose that maintenance has intrinsic value and argue that existing cost-centric models ignore an important dimension of maintenance, namely its value, and in so doing, they can lead to sub-optimal maintenance strategies. We develop a framework for capturing and quantifying the value of maintenance activities. Our framework is based on four key components. First, we consider systems that deteriorate stochastically and exhibit multi-state failures, and model their state evolution using Markov chains and directed graphs. Second, we consider that the system provides a flow of service per unit time. This flow in turn is 'priced' and a discounted cash flow is calculated resulting in a present value (PV) for each branch of the graph-or 'value trajectory' of the system. Third as the system ages or deteriorates, it migrates towards lower PV branches of the graph, or lower value trajectories. Fourth, we conceptualize maintenance as an operator (in a mathematical sense) that raises the system to a higher PV branch in the graph. We refer to the value of maintenance as the incremental PV between the pre- and post-maintenance branches of the graphs minus the cost of maintenance. The framework presented here offers rich possibilities for future work in benchmarking existing maintenance strategies based on their value implications, and in deriving new maintenance strategies that are 'value-optimized.'
Lack of supportive leadership behavior predicts suboptimal self-rated health independent of job strain after 10 years of follow-up: findings from the population-based MONICA/KORA study.

Science.gov (United States)

Schmidt, Burkhard; Herr, Raphael M; Jarczok, Marc N; Baumert, Jens; Lukaschek, Karoline; Emeny, Rebecca T; Ladwig, Karl-Heinz

2018-04-23

Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain. The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline. Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19-3.46)] and at follow-up [OR 2.33, (95% CI 1.40-3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20-3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH. Lack of supportive leadership was associated with suboptimal SRH at 10 years' follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.
Inspiring and Challenging Laboratory Exercise in Multivariable Control Theory – The Four-rotor Helicopter

Directory of Open Access Journals (Sweden)

Dag A. H. Samuelsen

2012-12-01

Full Text Available Engineering students in a module on multivariable control theory are given a laboratory exercise for developing their skills in practical implementation of control systems. This is done in an effort to create a more complete module that gives the students experiences in the practical sides of implementing control systems, while still being theoretically challenging and inspiring. Presenting students with this kind of real-life challenges like sub-optimal models, limited processing time and large degree of uncertainty, is a challenging task, partly due to the need of adapting the level of complexity to the student or group of students doing the exercise in order to keep them engaged throughout the exercise, and in part due to the university's need to reduce expenses related to the administration, supervision, and execution of laboratory exercises. The possibility of adapting the complexity of the exercise to each student's skill level is important, both through the design of the exercise and through the students choosing between different models. The eager student might be tempted by the better performing, but more complex models, while the struggling student can find satisfaction in stabilising the aircraft using the less complex models. The laboratory setup presented uses low-cost components, giving low investment and maintenance costs.
Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

Directory of Open Access Journals (Sweden)

Feyisayo Jegede

2016-05-01

Objective: We assessed routinely-submitted LRFs to determine the degree of correctness, completeness and consistency. Methods: LRFs submitted to the Department of Haematology (DH and Blood Transfusion Services (BTS of Aminu Kano Teaching Hospital in Kano, Nigeria, between October 2014 and December 2014, were evaluated for completion of all items on the forms. Performance in four quality indicator domains, including patient identifiers, test request details, laboratory details and physician details, was derived as a composite percentage. Results: Of the 2084 LRFs evaluated, 999 were from DH and 1085 from BTS. Overall, LRF completeness was 89.5% for DH and 81.2% for BTS. Information on patient name, patient location and laboratory number were 100% complete for DH, whereas only patient name was 100% complete for BTS. Incomplete information was mostly encountered on BTS forms for physician’s signature (60.8% and signature of laboratory receiver (63.5%. None of the DH and only 9.4% of BTS LRFs met all quality indicator indices. Conclusion: The level of completion of LRFs from these two departments was suboptimal. This underscores the need to review and redesign the LRF, improve on training and communication between laboratory and clinical staff and review specimen rejection practices.
Bone marrow concentrate promotes bone regeneration with a suboptimal-dose of rhBMP-2.

Science.gov (United States)

Egashira, Kazuhiro; Sumita, Yoshinori; Zhong, Weijian; I, Takashi; Ohba, Seigo; Nagai, Kazuhiro; Asahina, Izumi

2018-01-01

Bone marrow concentrate (BMC), which is enriched in mononuclear cells (MNCs) and platelets, has recently attracted the attention of clinicians as a new optional means for bone engineering. We previously reported that the osteoinductive effect of bone morphogenetic protein-2 (BMP-2) could be enhanced synergistically by co-transplantation of peripheral blood (PB)-derived platelet-rich plasma (PRP). This study aims to investigate whether BMC can effectively promote bone formation induced by low-dose BMP-2, thereby reducing the undesirable side-effects of BMP-2, compared to PRP. Human BMC was obtained from bone marrow aspirates using an automated blood separator. The BMC was then seeded onto β-TCP granules pre-adsorbed with a suboptimal-dose (minimum concentration to induce bone formation at 2 weeks in mice) of recombinant human (rh) BMP-2. These specimens were transplanted subcutaneously to the dorsal skin of immunodeficient-mice and the induction of ectopic bone formation was assessed 2 and 4 weeks post-transplantation. Transplantations of five other groups [PB, PRP, platelet-poor plasma (PPP), bone marrow aspirate (BM), and BM-PPP] were employed as experimental controls. Then, to clarify the effects on vertical bone augmentation, specimens from the six groups were transplanted for on-lay placement on the craniums of mice. The results indicated that BMC, which contained an approximately 2.5-fold increase in the number of MNCs compared to PRP, could accelerate ectopic bone formation until 2 weeks post-transplantation. On the cranium, the BMC group promoted bone augmentation with a suboptimal-dose of rhBMP-2 compared to other groups. Particularly in the BMC specimens harvested at 4 weeks, we observed newly formed bone surrounding the TCP granules at sites far from the calvarial bone. In conclusion, the addition of BMC could reduce the amount of rhBMP-2 by one-half via its synergistic effect on early-phase osteoinduction. We propose here that BMC transplantation
[Quality use of commercial laboratory for clinical testing services - considering laboratory's role].

Science.gov (United States)

Ogawa, Shinji

2014-12-01

The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review).
Pneumoconiosis and exposures of dental laboratory technicians

International Nuclear Information System (INIS)

Rom, W.N.; Lockey, J.E.; Lee, J.S.; Kimball, A.C.; Bang, K.M.; Leaman, H.; Johns, R.E. Jr.; Perrota, D.; Gibbons, H.L.

1984-01-01

One hundred and seventy-eight dental laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean values for per cent predicted FVC and FEV1 were reduced among male nonsmoker technicians compared to male nonsmoker controls; after controlling for age, there was also a reduction in spirometry with increasing work-years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Salt Lake City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures in dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis
Value-based attentional capture influences context-dependent decision-making

Science.gov (United States)

Cha, Kexin; Rangsipat, Napat; Serences, John T.

2015-01-01

Normative theories posit that value-based decision-making is context independent. However, decisions between two high-value options can be suboptimally biased by the introduction of a third low-value option. This context-dependent modulation is consistent with the divisive normalization of the value of each stimulus by the total value of all stimuli. In addition, an independent line of research demonstrates that pairing a stimulus with a high-value outcome can lead to attentional capture that can mediate the efficiency of visual information processing. Here we tested the hypothesis that value-based attentional capture interacts with value-based normalization to influence the optimality of decision-making. We used a binary-choice paradigm in which observers selected between two targets and the color of each target indicated the magnitude of their reward potential. Observers also had to simultaneously ignore a task-irrelevant distractor rendered in a color that was previously associated with a specific reward magnitude. When the color of the task-irrelevant distractor was previously associated with a high reward, observers responded more slowly and less optimally. Moreover, as the learned value of the distractor increased, electrophysiological data revealed an attenuation of the lateralized N1 and N2Pc responses evoked by the relevant choice stimuli and an attenuation of the late positive deflection (LPD). Collectively, these behavioral and electrophysiological data suggest that value-based attentional capture and value-based normalization jointly mediate the influence of context on free-choice decision-making. PMID:25995350
Lansoprazole induces sensitivity to suboptimal doses of paclitaxel in human melanoma.

Science.gov (United States)

Azzarito, Tommaso; Venturi, Giulietta; Cesolini, Albino; Fais, Stefano

2015-01-28

Tumor acidity is now considered an important determinant of drug-resistance and tumor progression, and anti-acidic approaches, such as Proton Pump inhibitors (PPIs), have demonstrated promising antitumor and chemo-sensitizing efficacy. The main purpose of the present study was to evaluate the possible PPI-induced sensitization of human melanoma cells to Paclitaxel (PTX). Our results show that PTX and the PPI Lansoprazole (LAN) combination was extremely efficient against metastatic melanoma cells, as compared to the single treatments, both in vitro and in vivo. We also showed that acidity plays an important role on the anti-tumor activity of these drugs, being detrimental for PTX activity, while crucial for the synergistic effect of PTX following pretreatment with LAN, due to its nature of pro-drug needing protonation for a full activation. We obtained straightforward results in a human melanoma xenograft model combining well tolerated LAN doses with suboptimal and poorly toxic doses of PTX. With this study we provide a clear evidence that the PPI LAN may be included in new combined therapy of human melanoma together with low doses of PTX. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Diagnosis of early sacroiliitis in seronegative spondyloarthropathies by DWI and correlation of clinical and laboratory findings with ADC values

Energy Technology Data Exchange (ETDEWEB)

Gezmis, Esin; Donmez, Fuldem Y., E-mail: fuldemyildirim@yahoo.com; Agildere, Muhtesem

2013-12-01

Purpose: Sacroiliitis is one of the diagnostic criteria of seronegative SpA. The purpose of our study is to show the signal characteristics of the sacral and iliac surfaces by DWI which may contribute in early diagnosis of sacroiliitis and investigate the correlation between ADC values and clinical and laboratory parameters. Materials and methods: 62 patients with inflammatory low back pain, with a history or suspect of seronegative SpA are enrolled into the study. 40 age and sex-matched subjects without SpA constituted the control group. After obtaining routine T1 and T2 weighted sequences, echo planar imaging at b values of 0, 400 and 800 was performed. ADC values on both surfaces of the both sacroiliac joints were measured in all subjects. The CRP and sedimentation results and the presence of arthritis and enthesitis were also correlated with the ADC values. Results: ADC values on both surfaces of the both sacroiliac joints were found 0.23 × 10{sup −3} mm{sup 2}/sn in the control group. In the patient group, mean ADC value of 0.48 × 10{sup −3} mm{sup 2}/sn was obtained (p < 0.001), which was statistically significant, compatible with the increased diffusion due to medullary edema in early sacroiliitis. There was a slight correlation between CRP and ADC values; presumed to be showing the relation between the activity of the disease and the active inflammation on DWI. There was no correlation between arthritis and enthesitis and the ADC values (p > 0.001). Conclusion: DWI, by measuring ADC values, adds significant information in the early diagnosis of sacroiliitis and may help to evaluate the efficiency of the treatment.
Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.

Science.gov (United States)

Wang, Wei; Russell, Alyce; Yan, Yuxiang

2014-02-13

The premise of disease-related phenotypes is the definition of the counterpart normality in medical sciences. Contrary to clinical practices that can be carefully planned according to clinical needs, heterogeneity and uncontrollability is the essence of humans in carrying out health studies. Full characterization of consistent phenotypes that define the general population is the basis to individual difference normalization in personalized medicine. Self-claimed normal status may not represent health because asymptomatic subjects may carry chronic diseases at their early stage, such as cancer, diabetes mellitus and atherosclerosis. Currently, treatments for non-communicable chronic diseases (NCD) are implemented after disease onset, which is a very much delayed approach from the perspective of predictive, preventive and personalized medicine (PPPM). A NCD pandemic will develop and be accompanied by increased global economic burden for healthcare systems throughout both developed and developing countries. This paper examples the characterization of the suboptimal health status (SHS) which represents a new PPPM challenge in a population with ambiguous health complaints such as general weakness, unexplained medical syndrome (UMS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and chronic fatigue immune dysfunction syndrome (CFIDS). We applied clinical informatic approaches and developed a questionnaire-suboptimal health status questionnaire-25 (SHSQ-25) for measuring SHS. The validity and reliability of this approach were evaluated in a small pilot study and then in a cross-sectional study of 3,405 participants in China. We found a correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol among men, and a correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides
Suboptimal vitamin K status despite supplementation in children and young adults with cystic fibrosis.

Science.gov (United States)

Dougherty, Kelly A; Schall, Joan I; Stallings, Virginia A

2010-09-01

For children and adolescents with cystic fibrosis (CF) and pancreatic insufficiency, the efficacy of routine vitamin K supplementation to normalize vitamin K status remains unclear. This study examined and determined predictors of vitamin K status in subjects aged 8-25 y with CF and pancreatic insufficiency taking various vitamin K supplements. In 97 subjects, serum 25-hydroxyvitamin D [25(OH)D], dietary intake, vitamin K supplement intake, and vitamin K statusmdashdetermined on the basis of the percentage of serum undercarboxylated osteocalcin (%ucOC; sufficient: lt 20%) and plasma proteins induced by vitamin K absence-factor II (PIVKA-II; n = 60; sufficient: le 2 microg/L)mdashwere assessed. The vitamin K supplementation groups were as follows: lt 150 microg/d (low; multivitamins or no supplement), 150-999 microg/d (middle; CF-specific vitamins), and ge 1000 microg/d (high; mephyton). %ucOC values were compared with 140 healthy subjects aged 6-21 y. In subjects with CF, the median (range) %ucOC was 35% (3%, 76%) and the median (range) for PIVKA-II was 2 (0, 42) micro g/L. Subjects with CF had a higher %ucOC with low [45% (10%, 76%)] and medium [41% (3%, 66%)] supplement intakes but not with a high supplement intake [16% (4%, 72%)] compared with healthy subjects [23% (0%, 43%); both P lt 0.05]. Supplementation group for males and females and 25(OH)D and age for males were significant predictors of vitamin K status. Vitamin K status was often suboptimal despite routine supplementation. Only subjects taking high-dose vitamin K achieved a status similar to healthy subjects, and only the vitamin K supplementation dose predicted vitamin K status for males and females. These data suggest that higher doses of vitamin K are required.
Single and Combined Diagnostic Value of Clinical Features and Laboratory Tests in Acute Appendicitis

NARCIS (Netherlands)

Laméris, Wytze; van Randen, Adrienne; Go, Peter M. N. Y. H.; Bouma, Wim H.; Donkervoort, Sandra C.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

2009-01-01

Objectives: The objective was to evaluate the diagnostic accuracy of clinical features and laboratory test results in detecting acute appendicitis. Methods: Clinical features and laboratory test results were prospectively recorded in a consecutive series of 1,101 patients presenting with abdominal
[Value of history and clinical and laboratory data for the diagnosis of dehydration due to acute diarrhea in children younger than 5 years].

Science.gov (United States)

Pruvost, Isabelle; Dubos, François; Aurel, Marie; Hue, Valérie; Martinot, Alain

2008-04-01

Acute diarrhea is frequent, costly because of the number of hospital admissions required, and sometimes serious, even fatal to children in France. The clinical diagnosis of dehydration is difficult, but essential to determine management. To summarize the published data on the value of clinical history, clinical signs and laboratory results for diagnosing dehydration during acute diarrhea in young (1 month-5 years) non-malnourished children. Four databases (Medline, INIST, Ovid, and Cochrane) were searched through November 2006, with the key words "dehydration" subcategories "diagnosis, or etiology, or history", "diarrhea" subcategory "diagnosis", and age limits "infant or preschool child". We selected the articles and reviews that included as an endpoint for dehydration "weight gain > 5% after recovery" (the gold standard). Thirteen studies were selected. No single clinical history item, clinical sign or laboratory value was sufficient to discriminate between children with and without dehydration. The reproducibility of clinical signs varied substantially between studies. Persistent skin folds and signs of vasoconstriction contributed the most information, with good specificity but sensitivity dehydration. No dehydration scale has been validated. None of the studies selected had a very high level of proof (level 1 and 2); neither signs nor scores have been validated internally or externally because of the low number of subjects. The diagnosis of dehydration due to acute diarrhea in young children depends on the number of signs present, since no individual element of clinical history, clinical picture or laboratory tests distinguished dehydration. Other studies are necessary.
Positive predictive value estimates for cell-free noninvasive prenatal screening from data of a large referral genetic diagnostic laboratory.

Science.gov (United States)

Petersen, Andrea K; Cheung, Sau Wai; Smith, Janice L; Bi, Weimin; Ward, Patricia A; Peacock, Sandra; Braxton, Alicia; Van Den Veyver, Ignatia B; Breman, Amy M

2017-12-01

Since its debut in 2011, cell-free fetal DNA screening has undergone rapid expansion with respect to both utilization and coverage. However, conclusive data regarding the clinical validity and utility of this screening tool, both for the originally included common autosomal and sex-chromosomal aneuploidies as well as the more recently added chromosomal microdeletion syndromes, have lagged behind. Thus, there is a continued need to educate clinicians and patients about the current benefits and limitations of this screening tool to inform pre- and posttest counseling, pre/perinatal decision making, and medical risk assessment/management. The objective of this study was to determine the positive predictive value and false-positive rates for different chromosomal abnormalities identified by cell-free fetal DNA screening using a large data set of diagnostic testing results on invasive samples submitted to the laboratory for confirmatory studies. We tested 712 patient samples sent to our laboratory to confirm a cell-free fetal DNA screening result, indicating high risk for a chromosome abnormality. We compiled data from all cases in which the indication for confirmatory testing was a positive cell-free fetal DNA screen, including the common trisomies, sex chromosomal aneuploidies, microdeletion syndromes, and other large genome-wide copy number abnormalities. Testing modalities included fluorescence in situ hybridization, G-banded karyotype, and/or chromosomal microarray analysis performed on chorionic villus samples, amniotic fluid, or postnatally obtained blood samples. Positive predictive values and false-positive rates were calculated from tabulated data. The positive predictive values for trisomy 13, 18, and 21 were consistent with previous reports at 45%, 76%, and 84%, respectively. For the microdeletion syndrome regions, positive predictive values ranged from 0% for detection of Cri-du-Chat syndrome and Prader-Willi/Angelman syndrome to 14% for 1p36 deletion
The value of point-of-care CD4+ and laboratory viral load in tailoring antiretroviral therapy monitoring strategies to resource limitations.

Science.gov (United States)

Hyle, Emily P; Jani, Ilesh V; Rosettie, Katherine L; Wood, Robin; Osher, Benjamin; Resch, Stephen; Pei, Pamela P; Maggiore, Paolo; Freedberg, Kenneth A; Peter, Trevor; Parker, Robert A; Walensky, Rochelle P

2017-09-24

To examine the clinical and economic value of point-of-care CD4 (POC-CD4) or viral load monitoring compared with current practices in Mozambique, a country representative of the diverse resource limitations encountered by HIV treatment programs in sub-Saharan Africa. We use the Cost-Effectiveness of Preventing AIDS Complications-International model to examine the clinical impact, cost (2014 US$), and incremental cost-effectiveness ratio [$/year of life saved (YLS)] of ART monitoring strategies in Mozambique. We compare: monitoring for clinical disease progression [clinical ART monitoring strategy (CLIN)] vs. annual POC-CD4 in rural settings without laboratory services and biannual laboratory CD4 (LAB-CD4), biannual POC-CD4, and annual viral load in urban settings with laboratory services. We examine the impact of a range of values in sensitivity analyses, using Mozambique's 2014 per capita gross domestic product ($620) as a benchmark cost-effectiveness threshold. In rural settings, annual POC-CD4 compared to CLIN improves life expectancy by 2.8 years, reduces time on failed ART by 0.6 years, and yields an incremental cost-effectiveness ratio of $480/YLS. In urban settings, biannual POC-CD4 is more expensive and less effective than viral load. Compared to biannual LAB-CD4, viral load improves life expectancy by 0.6 years, reduces time on failed ART by 1.0 year, and is cost-effective ($440/YLS). In rural settings, annual POC-CD4 improves clinical outcomes and is cost-effective compared to CLIN. In urban settings, viral load has the greatest clinical benefit and is cost-effective compared to biannual POC-CD4 or LAB-CD4. Tailoring ART monitoring strategies to specific settings with different available resources can improve clinical outcomes while remaining economically efficient.

Suboptimal Weight Loss and Weight Regain after Gastric Bypass Surgery?Postoperative Status of Energy Intake, Eating Behavior, Physical Activity, and Psychometrics

OpenAIRE

Amundsen, Tina; Str?mmen, Magnus; Martins, Catia

2016-01-01

BACKGROUND: Suboptimal weight loss (SWL) and weight regain (WR) after gastric bypass surgery (GB) remains poorly understood. OBJECTIVES: This study aims to compare GB patients experiencing SWL or significant WR (SigWR) with successful controls, regarding postoperative food intake, eating behavior, physical activity (PA), and psychometrics. METHODS: Forty-nine patients with >1 year post-surgery were classified as either experiencing SWL (excess body weight loss, EWL,
Standardization of clinical enzyme analysis using frozen human serum pools with values assigned by the International Federation of Clinical Chemistry and Laboratory Medicine reference measurement procedures.

Science.gov (United States)

Tong, Qing; Chen, Baorong; Zhang, Rui; Zuo, Chang

Variation in clinical enzyme analysis, particularly across different measuring systems and laboratories, represents a critical but long-lasting problem in diagnosis. Calibrators with traceability and commutability are imminently needed to harmonize analysis in laboratory medicine. Fresh frozen human serum pools were assigned values for alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatine kinase (CK) and lactate dehydrogenase (LDH) by six laboratories with established International Federation of Clinical Chemistry and Laboratory Medicine reference measurement procedures. These serum pools were then used across 76 laboratories as a calibrator in the analysis of five enzymes. Bias and imprecision in the measurement of the five enzymes tested were significantly reduced by using the value-assigned serum in analytical systems with open and single-point calibration. The median (interquartile range) of the relative biases of ALT, AST, GGT, CK and LDH were 2.0% (0.6-3.4%), 0.8% (-0.8-2.3%), 1.0% (-0.5-2.0%), 0.2% (-0.3-1.0%) and 0.2% (-0.9-1.1%), respectively. Before calibration, the interlaboratory coefficients of variation (CVs) in the analysis of patient serum samples were 8.0-8.2%, 7.3-8.5%, 8.1-8.7%, 5.1-5.9% and 5.8-6.4% for ALT, AST, GGT, CK and LDH, respectively; after calibration, the CVs decreased to 2.7-3.3%, 3.0-3.6%, 1.6-2.1%, 1.8-1.9% and 3.3-3.5%, respectively. The results suggest that the use of fresh frozen serum pools significantly improved the comparability of test results in analytical systems with open and single-point calibration.
Inverse problems for ODEs using contraction maps and suboptimality of the 'collage method'

Science.gov (United States)

Kunze, H. E.; Hicken, J. E.; Vrscay, E. R.

2004-06-01

Broad classes of inverse problems in differential and integral equations can be cast in the following framework: the optimal approximation of a target x of a suitable metric space X by the fixed point \\bar x of a contraction map T on X. The 'collage method' attempts to solve such inverse problems by finding an operator Tc that maps the target x as close as possible to itself. In the case of ODEs, the appropriate contraction maps are integral Picard operators. In practice, the target solutions possibly arise from an interpolation of experimental data points. In this paper, we investigate the suboptimality of the collage method. A simple inequality that provides upper bounds on the improvement over collage coding is presented and some examples are studied. We conclude that, at worst, the collage method provides an excellent starting point for further optimization, in contrast to more traditional searching methods that must first select a good starting point.
Hepatopancreaticobiliary Values after Thoracoabdominal Aneurysm Repair

Science.gov (United States)

Wu, Darrell; Coselli, Joseph S.; Johnson, Michael L.; LeMaire, Scott A.

2014-01-01

Background: After thoracoabdominal aortic aneurysm (TAAA) repair, blood tests assessing hepatopancreaticobiliary (HPB) organs commonly have abnormal results. The clinical significance of such abnormalities is difficult to determine because the expected postoperative levels have not been characterized. Therefore, we sought to establish expected trends in HPB laboratory values after TAAA repair. Methods: This 5-year study comprised 155 patients undergoing elective Crawford extent II TAAA repair. In accordance with a prospective study protocol, all repairs involved left-sided heart bypass, selective visceral perfusion, and cold renal perfusion. Blood levels of aspartate transaminase (AST), alanine transaminase (ALT), γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), total bilirubin, amylase, and lipase were measured before TAAA repair and for 7 days afterward. Ratios between postoperative and baseline levels were compared for each time point with 95% confidence intervals. Results: Temporal patterns for the laboratory values varied greatly. Amylase, lipase, and AST underwent significant early increases before decreasing to preoperative levels. LDH increased immediately and remained significantly elevated, whereas ALT increased more gradually. GGT remained near baseline through postoperative day 4, and then increased to more than twice baseline. Total bilirubin never differed significantly from baseline. After adjusted analysis, the ischemic time predicted the maximum AST, lipase, GGT, and LDH values. Conclusions: Although most HPB laboratory values increase significantly after elective TAAA repair, the temporal trends for different values vary substantially. The ischemic time predicts the maximum AST, lipase, GGT, and LDH levels. These trends should be considered when laboratory values are assessed after TAAA repair. PMID:26798731
Patterns of marijuana and tobacco use associated with suboptimal self-rated health among US adult ever users of marijuana

OpenAIRE

Tsai, James; Rolle, Italia V.; Singh, Tushar; Boulet, Sheree L.; McAfee, Timothy A.; Grant, Althea M.

2017-01-01

The purpose of this study was to examine the patterns of marijuana and tobacco use and their associations with suboptimal self-rated health (SRH) among US adults who reported ?ever, even once, using marijuana or hashish.? Data came from the 2009?2012 National Health and Nutrition Examination Survey, restricting to respondents aged 20 years and older who reported using marijuana at least once in their lifetime (n?=?3,210). We assessed the age-adjusted prevalence of mutually exclusive groups of...
Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

OpenAIRE

Di Pierro, Francesco; Villanova,Nicola; Agostini,Federica; Soverini,Valentina; Marchesini,Giulio; Marzocchi,Rebecca

2012-01-01

Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which coul...
Customer satisfaction assessment at the Pacific Northwest National Laboratory; TOPICAL

International Nuclear Information System (INIS)

DN Anderson; ML Sours

2000-01-01

The Pacific Northwest National Laboratory (PNNL) is developing and implementing a customer satisfaction assessment program (CSAP) to assess the quality of research and development provided by the laboratory. This report presents the customer survey component of the PNNL CSAP. The customer survey questionnaire is composed of two major sections: Strategic Value and Project Performance. Both sections contain a set of questions that can be answered with a 5-point Likert scale response. The strategic value section consists of five questions that are designed to determine if a project directly contributes to critical future national needs. The project Performance section consists of nine questions designed to determine PNNL performance in meeting customer expectations. A statistical model for customer survey data is developed and this report discusses how to analyze the data with this model. The properties of the statistical model can be used to establish a gold standard or performance expectation for the laboratory, and then to assess progress. The gold standard is defined using laboratory management input-answers to four questions, in terms of the information obtained from the customer survey: (1) What should the average Strategic Value be for the laboratory project portfolio? (2) What Strategic Value interval should include most of the projects in the laboratory portfolio? (3) What should average Project Performance be for projects with a Strategic Value of about 2? (4) What should average Project Performance be for projects with a Strategic Value of about 4? To be able to provide meaningful answers to these questions, the PNNL customer survey will need to be fully implemented for several years, thus providing a link between management perceptions of laboratory performance and customer survey data
Policies and practices in haemostasis testing among laboratories in Croatia: a survey on behalf of a Working Group for Laboratory Coagulation of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

Science.gov (United States)

Bronić, Ana; Herak, Desiree Coen; Margetić, Sandra; Milić, Marija

2017-02-15

The objective of this survey was to assess current policies and practice in haemostasis testing among both hospital and outpatient laboratories in Republic of Croatia. A questionnaire with seventy questions divided into nine sections was created in May 2015. Participants were asked about their practice related to test request form, sample collection, prothrombin time (PT) and activated partial thromboplastin time assays, other individual haemostasis assays, point-of-care testing (POCT), reporting of coagulation tests results and quality assurance of procedures, the personnel and other laboratory resources, as well as on issues related to education and implementation of additional coagulation assays in their laboratory. The survey was administered and data were collected between June and September 2015. A total survey response rate was 104/170 (61.2%). Most respondents were faced with incomplete information on prescribed therapy and diagnosis on the test request or inappropriate samples withdrawn on distant locations, but also do not have protocols for handling samples with high haematocrit values. Reporting of PT-INR and D-dimer results was different between laboratories. Although almost all laboratories developed a critical value reporting system, reporting a value to general practitioners is still a problem. Result on coagulation POCT testing showed that not all devices were supervised by laboratories, which is not in compliance with Croatian Chamber of Medical Biochemistry acts. Obtained results highlighted areas that need improvement and different practice patterns in particular field of haemostasis testing among laboratories. A harmonization of the overall process of haemostasis testing at national level should be considered and undertaken.
Knowledge and practices of pharmaceutical laboratory workers on laboratory safety

Directory of Open Access Journals (Sweden)

Esra Emerce

2017-09-01

Full Text Available Laboratories are classified as very hazardous workplaces. Objective: The aim of this descriptive study was to determine the knowledge and practice of laboratory safety by analysts and technicians in the laboratories of the Turkish Medicine and Medical Devices Agency. Methods: 85.0% (n=93 of the workers (n=109 was reached. A pre-tested, laboratory safety oriented, self-administered questionnaire was completed under observation. Results: Participants were mostly female (66,7%, had 12.8±8.2 years of laboratory experience and worked 24.6±10.3 hours per week. 53.8% of the employees generally worked with flammable and explosive substances, 29.0% with acute toxic or carcinogenic chemicals and 30.1% with physical dangers. Of all surveyed, 14.0% had never received formal training on laboratory safety. The proportion of ‘always use’ of laboratory coats, gloves, and goggles were 84.9%, 66.7%, and 6.5% respectively. 11.9% of the participants had at least one serious injury throughout their working lives and 24.7% had at least one small injury within the last 6 months. Among these injuries, incisions, bites and tears requiring no stiches (21.0% and the inhalation of chemical vapors (16.1% took first place. The mean value for the number of correct responses to questions on basic safety knowledge was 65.4±26.5, out of a possible 100. Conclusion: Overall, the participants have failed in some safety practices and have been eager to get regular education on laboratory safety. From this point onwards, it would be appropriate for the employers to organize periodic trainings on laboratory safety.Keywords: Health personnel, laboratory personnel, occupational health, occupational safety, pharmacy
The Effect of Testosterone Topical Solution in Hypogonadal Men With Suboptimal Response to a Topical Testosterone Gel.

Science.gov (United States)

Burns, Patrick R; Kim, Edward D; Ruff, Dustin D; Seftel, Allen D

2018-05-01

This study evaluated the effect of axillary administration of a 2% testosterone solution (Axiron ® ) in hypogonadal (HGN) men who had had a suboptimal response to treatment with a commercially available topical testosterone gel. HGN men averaging 57 years old, with a mean body mass index of 31.9 kg/m 2 and median baseline testosterone level (T-level) of 185.2 ng/dL, who had failed to reach normal T-levels with a topical testosterone gel (Androgel 1.62%, Androgel, Testim, or Fortesta) were treated with a 2% testosterone solution until T-levels reached a normal range (from ≥300 to ≤1,050 ng/dL) or for up to 9 weeks. Outcomes included the cumulative percentage of men with a serum T-level in the normal range during treatment with Axiron and improvement in symptoms of low energy level and low sexual drive. During the study, 95% of HGN men (72/78) attained a T-level in the normal range. The median T-level at endpoint was 495.7 ng/dL, a threefold increase over baseline, p levels within the first 2 weeks of treatment. In a post hoc analysis, all subjects with baseline body mass indexes >35 kg/m 2 ( n = 19) achieved T-levels in the normal range. Prior to treatment, over 61% of subjects (48/78) reported impairment in either energy level or sexual drive. After treatment (or testosterone normalization), energy level improved in 75% of subjects and sexual drive improved in 70%. Topical 2% testosterone solution is a safe and effective treatment for HGN men who have had a suboptimal response to previous treatment with topical testosterone gels.
Value-based attentional capture influences context-dependent decision-making.

Science.gov (United States)

Itthipuripat, Sirawaj; Cha, Kexin; Rangsipat, Napat; Serences, John T

2015-07-01

Normative theories posit that value-based decision-making is context independent. However, decisions between two high-value options can be suboptimally biased by the introduction of a third low-value option. This context-dependent modulation is consistent with the divisive normalization of the value of each stimulus by the total value of all stimuli. In addition, an independent line of research demonstrates that pairing a stimulus with a high-value outcome can lead to attentional capture that can mediate the efficiency of visual information processing. Here we tested the hypothesis that value-based attentional capture interacts with value-based normalization to influence the optimality of decision-making. We used a binary-choice paradigm in which observers selected between two targets and the color of each target indicated the magnitude of their reward potential. Observers also had to simultaneously ignore a task-irrelevant distractor rendered in a color that was previously associated with a specific reward magnitude. When the color of the task-irrelevant distractor was previously associated with a high reward, observers responded more slowly and less optimally. Moreover, as the learned value of the distractor increased, electrophysiological data revealed an attenuation of the lateralized N1 and N2Pc responses evoked by the relevant choice stimuli and an attenuation of the late positive deflection (LPD). Collectively, these behavioral and electrophysiological data suggest that value-based attentional capture and value-based normalization jointly mediate the influence of context on free-choice decision-making. Copyright © 2015 the American Physiological Society.
Disrupted expected value signaling in youth with disruptive behavior disorders to environmental reinforcers.

Science.gov (United States)

White, Stuart F; Fowler, Katherine A; Sinclair, Stephen; Schechter, Julia C; Majestic, Catherine M; Pine, Daniel S; Blair, R James

2014-05-01

Youth with disruptive behavior disorders (DBD), including conduct disorder (CD) and oppositional defiant disorder (ODD), have difficulties in reinforcement-based decision making, the neural basis of which is poorly understood. Studies examining decision making in youth with DBD have revealed reduced reward responses within the ventromedial prefrontal cortex/orbitofrontal cortex (vmPFC/OFC), increased responses to unexpected punishment within the vmPFC and striatum, and reduced use of expected value information in the anterior insula cortex and dorsal anterior cingulate cortex during the avoidance of suboptimal choices. Previous work has used only monetary reinforcement. The current study examined whether dysfunction in youth with DBD during decision making extended to environmental reinforcers. A total of 30 youth (15 healthy youth and 15 youth with DBD) completed a novel reinforcement-learning paradigm using environmental reinforcers (physical threat images, e.g., striking snake image; contamination threat images, e.g., rotting food; appetitive images, e.g., puppies) while undergoing functional magnetic resonance imaging (fMRI). Behaviorally, healthy youth were significantly more likely to avoid physical threat, but not contamination threat, stimuli than youth with DBD. Imaging results revealed that youth with DBD showed significantly reduced use of expected value information in the bilateral caudate, thalamus, and posterior cingulate cortex during the avoidance of suboptimal responses. The current data suggest that youth with DBD show deficits to environmental reinforcers similar to the deficits seen to monetary reinforcers. Importantly, this deficit was unrelated to callous-unemotional (CU) traits, suggesting that caudate impairment may be a common deficit across youth with DBD. Published by Elsevier Inc.
Suboptimal Regulation of a Class of Bilinear Interconnected Systems with Finite-Time Sliding Planning Horizons

Directory of Open Access Journals (Sweden)

M. de la Sen

2008-01-01

Full Text Available This paper focuses on the suboptimization of a class of multivariable discrete-time bilinear systems consisting of interconnected bilinear subsystems with respect to a linear quadratic optimal regulation criterion which involves the use of state weighting terms only. Conditions which ensure the controllability of the overall system are given as a previous requirement for optimization. Three transformations of variables are made on the system equations in order to implement the scheme on an equivalent linear system. This leads to an equivalent representation of the used quadratic performance index that involves the appearance of quadratic weighting terms related to both transformed input and state variables. In this way, a Riccati-matrix sequence, allowing the synthesis of a standard feedback control law, is obtained. Finally, the proposed control scheme is tested on realistic examples.
U-value measurements on ISO round Robin window

DEFF Research Database (Denmark)

Duer, Karsten

1997-01-01

9 laboratories in 6 european and 2 north american countries have participated in a round robin U-value test of a standard facade window. The objective of the round robin test was to verify that the ISO/CEN proposals for U-value measurement standard is robust.......9 laboratories in 6 european and 2 north american countries have participated in a round robin U-value test of a standard facade window. The objective of the round robin test was to verify that the ISO/CEN proposals for U-value measurement standard is robust....
The value of the Semantic Web in the laboratory.

Science.gov (United States)

Frey, Jeremy G

2009-06-01

The Semantic Web is beginning to impact on the wider chemical and physical sciences, beyond the earlier adopted bio-informatics. While useful in large-scale data driven science with automated processing, these technologies can also help integrate the work of smaller scale laboratories producing diverse data. The semantics aid the discovery, reliable re-use of data, provide improved provenance and facilitate automated processing by increased resilience to changes in presentation and reduced ambiguity. The Semantic Web, its tools and collections are not yet competitive with well-established solutions to current problems. It is in the reduced cost of instituting solutions to new problems that the versatility of Semantic Web-enabled data and resources will make their mark once the more general-purpose tools are more available.
[How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

Science.gov (United States)

Kawano, Seiji

2014-12-01

As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).
Adaptive value of phenological traits in stressful environments: predictions based on seed production and laboratory natural selection.

Directory of Open Access Journals (Sweden)

Benjamin Brachi

Full Text Available Phenological traits often show variation within and among natural populations of annual plants. Nevertheless, the adaptive value of post-anthesis traits is seldom tested. In this study, we estimated the adaptive values of pre- and post-anthesis traits in two stressful environments (water stress and interspecific competition, using the selfing annual species Arabidopsis thaliana. By estimating seed production and by performing laboratory natural selection (LNS, we assessed the strength and nature (directional, disruptive and stabilizing of selection acting on phenological traits in A. thaliana under the two tested stress conditions, each with four intensities. Both the type of stress and its intensity affected the strength and nature of selection, as did genetic constraints among phenological traits. Under water stress, both experimental approaches demonstrated directional selection for a shorter life cycle, although bolting time imposes a genetic constraint on the length of the interval between bolting and anthesis. Under interspecific competition, results from the two experimental approaches showed discrepancies. Estimation of seed production predicted directional selection toward early pre-anthesis traits and long post-anthesis periods. In contrast, the LNS approach suggested neutrality for all phenological traits. This study opens questions on adaptation in complex natural environment where many selective pressures act simultaneously.
A Suboptimal PTS Algorithm Based on Particle Swarm Optimization Technique for PAPR Reduction in OFDM Systems

Directory of Open Access Journals (Sweden)

Ho-Lung Hung

2008-08-01

Full Text Available A suboptimal partial transmit sequence (PTS based on particle swarm optimization (PSO algorithm is presented for the low computation complexity and the reduction of the peak-to-average power ratio (PAPR of an orthogonal frequency division multiplexing (OFDM system. In general, PTS technique can improve the PAPR statistics of an OFDM system. However, it will come with an exhaustive search over all combinations of allowed phase weighting factors and the search complexity increasing exponentially with the number of subblocks. In this paper, we work around potentially computational intractability; the proposed PSO scheme exploits heuristics to search the optimal combination of phase factors with low complexity. Simulation results show that the new technique can effectively reduce the computation complexity and PAPR reduction.
A Suboptimal PTS Algorithm Based on Particle Swarm Optimization Technique for PAPR Reduction in OFDM Systems

Directory of Open Access Journals (Sweden)

Lee Shu-Hong

2008-01-01

Full Text Available Abstract A suboptimal partial transmit sequence (PTS based on particle swarm optimization (PSO algorithm is presented for the low computation complexity and the reduction of the peak-to-average power ratio (PAPR of an orthogonal frequency division multiplexing (OFDM system. In general, PTS technique can improve the PAPR statistics of an OFDM system. However, it will come with an exhaustive search over all combinations of allowed phase weighting factors and the search complexity increasing exponentially with the number of subblocks. In this paper, we work around potentially computational intractability; the proposed PSO scheme exploits heuristics to search the optimal combination of phase factors with low complexity. Simulation results show that the new technique can effectively reduce the computation complexity and PAPR reduction.
Research and Progress on Virtual Cloud Laboratory

Directory of Open Access Journals (Sweden)

Zhang Jian Wei

2016-01-01

Full Text Available In recent years, cloud computing technology has experienced continuous development and improvement, and has gradually expanded to the education sector. First, this paper will introduce the background knowledge of the current virtual cloud laboratory; by comparing the advantages and disadvantages between traditional laboratory and virtual cloud laboratory, and comparing the application, advantages and disadvantages, and development trend of OpenStack technology and VMWare technology in safety, performance, design, function, use case, and value of virtual cloud laboratory, this paper concludes that application based on OpenStack virtual cloud laboratory in universities and research institutes and other departments is essential.

AMT1;1 transgenic rice plants with enhanced NH4(+) permeability show superior growth and higher yield under optimal and suboptimal NH4(+) conditions.

Science.gov (United States)

Ranathunge, Kosala; El-Kereamy, Ashraf; Gidda, Satinder; Bi, Yong-Mei; Rothstein, Steven J

2014-03-01

The major source of nitrogen for rice (Oryza sativa L.) is ammonium (NH4(+)). The NH4(+) uptake of roots is mainly governed by membrane transporters, with OsAMT1;1 being a prominent member of the OsAMT1 gene family that is known to be involved in NH4(+) transport in rice plants. However, little is known about its involvement in NH4(+) uptake in rice roots and subsequent effects on NH4(+) assimilation. This study shows that OsAMT1;1 is a constitutively expressed, nitrogen-responsive gene, and its protein product is localized in the plasma membrane. Its expression level is under the control of circadian rhythm. Transgenic rice lines (L-2 and L-3) overexpressing the OsAMT1;1 gene had the same root structure as the wild type (WT). However, they had 2-fold greater NH4(+) permeability than the WT, whereas OsAMT1;1 gene expression was 20-fold higher than in the WT. Analogous to the expression, transgenic lines had a higher NH4(+) content in the shoots and roots than the WT. Direct NH4(+) fluxes in the xylem showed that the transgenic lines had significantly greater uptake rates than the WT. Higher NH4(+) contents also promoted higher expression levels of genes in the nitrogen assimilation pathway, resulting in greater nitrogen assimilates, chlorophyll, starch, sugars, and grain yield in transgenic lines than in the WT under suboptimal and optimal nitrogen conditions. OsAMT1;1 also enhanced overall plant growth, especially under suboptimal NH4(+) levels. These results suggest that OsAMT1;1 has the potential for improving nitrogen use efficiency, plant growth, and grain yield under both suboptimal and optimal nitrogen fertilizer conditions.
AMT1;1 transgenic rice plants with enhanced NH4 + permeability show superior growth and higher yield under optimal and suboptimal NH4 + conditions

Science.gov (United States)

Rothstein, Steven J.

2014-01-01

The major source of nitrogen for rice (Oryza sativa L.) is ammonium (NH4 +). The NH4 + uptake of roots is mainly governed by membrane transporters, with OsAMT1;1 being a prominent member of the OsAMT1 gene family that is known to be involved in NH4 + transport in rice plants. However, little is known about its involvement in NH4 + uptake in rice roots and subsequent effects on NH4 + assimilation. This study shows that OsAMT1;1 is a constitutively expressed, nitrogen-responsive gene, and its protein product is localized in the plasma membrane. Its expression level is under the control of circadian rhythm. Transgenic rice lines (L-2 and L-3) overexpressing the OsAMT1;1 gene had the same root structure as the wild type (WT). However, they had 2-fold greater NH4 + permeability than the WT, whereas OsAMT1;1 gene expression was 20-fold higher than in the WT. Analogous to the expression, transgenic lines had a higher NH4 + content in the shoots and roots than the WT. Direct NH4 + fluxes in the xylem showed that the transgenic lines had significantly greater uptake rates than the WT. Higher NH4 + contents also promoted higher expression levels of genes in the nitrogen assimilation pathway, resulting in greater nitrogen assimilates, chlorophyll, starch, sugars, and grain yield in transgenic lines than in the WT under suboptimal and optimal nitrogen conditions. OsAMT1;1 also enhanced overall plant growth, especially under suboptimal NH4 + levels. These results suggest that OsAMT1;1 has the potential for improving nitrogen use efficiency, plant growth, and grain yield under both suboptimal and optimal nitrogen fertilizer conditions. PMID:24420570
Value of innovation for hematologic malignancies.

Science.gov (United States)

Monia, Marchetti

2016-01-01

Several novel drugs are dramatically improving both lifespan and quality-of-life of patients with blood cancers. Prolonged disease duration and increased treatment costs for hematologic malignancies impose a relevant economic burden onto healthcare services, despite the low incidence of blood cancers. Therefore, an appropriate paradigm for valuing 'innovation' is urgently required in order to refine pricing and reimbursement decisions. Cost-per-QALY-gained is still the standard metric for assessing the 'incremental' value of new drugs; however, the high number of 'comparator' therapies and the huge variety of treatment sequences make plain two-treatment comparisons sub-optimal, while multiple-treatment and multiple-sequence comparisons require complex and less-transparent decision models. A repository of standard backbones for decision models might allow benchmarking and comparability among cost-effectiveness analyses; however, an international effort is required to build it up. Deontology recommends that hematologists act in optimizing healthcare resources while preserving patient-physician alliance, but clinical practice guidelines do not support doctors in balancing cost against clinical outcomes. Decision models of chronic blood cancers unexpectedly proved that cost might be an appropriate value for innovation if treatments avoided severe toxicity and further lines of treatments, despite the eventually long duration of treatment and the competing risk of death due to comorbidity and old age. The improved transparency of decision models allows sharing of relevant structural and analytic parameters (i.e., time horizon, comparator treatments, hierarchy of end-point, assumptions, source of data, sub-group analyses) by stakeholders, physicians and patients, making health economics a noble 'translator' of values for innovation.
Effects of Suboptimally Presented Erotic Pictures on Moral Judgments: A Cross-Cultural Comparison.

Directory of Open Access Journals (Sweden)

Antonio Olivera-La Rosa

Full Text Available Previous research has identified a set of core factors that influence moral judgments. The present study addresses the interplay between moral judgments and four factors: (a incidental affects, (b sociocultural context, (c type of dilemma, and (d participant's sex. We asked participants in two different countries (Colombia and Spain to judge the acceptability of actions in response to personal and impersonal moral dilemmas. Before each dilemma an affective prime (erotic, pleasant or neutral pictures was presented suboptimally. Our results show that: a relative to neutral priming, erotic primes increase the acceptance of harm for a greater good (i.e., more utilitarian judgments, b relative to Colombians, Spanish participants rated causing harm as less acceptable, c relative to impersonal dilemmas, personal dilemmas reduced the acceptance of harm, and d relative to men, women were less likely to consider harm acceptable. Our results are congruent with findings showing that sex is a crucial factor in moral cognition, and they extend previous research by showing the interaction between culture and incidental factors in the making of moral judgments.
Effects of Suboptimally Presented Erotic Pictures on Moral Judgments: A Cross-Cultural Comparison.

Science.gov (United States)

Olivera-La Rosa, Antonio; Corradi, Guido; Villacampa, Javier; Martí-Vilar, Manuel; Arango, Olber Eduardo; Rosselló, Jaume

2016-01-01

Previous research has identified a set of core factors that influence moral judgments. The present study addresses the interplay between moral judgments and four factors: (a) incidental affects, (b) sociocultural context, (c) type of dilemma, and (d) participant's sex. We asked participants in two different countries (Colombia and Spain) to judge the acceptability of actions in response to personal and impersonal moral dilemmas. Before each dilemma an affective prime (erotic, pleasant or neutral pictures) was presented suboptimally. Our results show that: a) relative to neutral priming, erotic primes increase the acceptance of harm for a greater good (i.e., more utilitarian judgments), b) relative to Colombians, Spanish participants rated causing harm as less acceptable, c) relative to impersonal dilemmas, personal dilemmas reduced the acceptance of harm, and d) relative to men, women were less likely to consider harm acceptable. Our results are congruent with findings showing that sex is a crucial factor in moral cognition, and they extend previous research by showing the interaction between culture and incidental factors in the making of moral judgments.
Plasma creatinine in dogs: intra- and inter-laboratory variation in 10 European veterinary laboratories

Directory of Open Access Journals (Sweden)

Ulleberg Thomas

2011-04-01

Full Text Available Abstract 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.
How beliefs about self-creation inflate value in the human brain.

Science.gov (United States)

Koster, Raphael; Sharot, Tali; Yuan, Rachel; De Martino, Benedetto; Norton, Michael I; Dolan, Raymond J

2015-01-01

Humans have a tendency to overvalue their own ideas and creations. Understanding how these errors in judgement emerge is important for explaining suboptimal decisions, as when individuals and groups choose self-created alternatives over superior or equal ones. We show that such overvaluation is a reconstructive process that emerges when participants believe they have created an item, regardless of whether this belief is true or false. This overvaluation is observed both when false beliefs of self-creation are elicited (Experiment 1) or implanted (Experiment 2). Using brain imaging data we highlight the brain processes mediating an interaction between value and belief of self-creation. Specifically, following the creation manipulation there is an increased functional connectivity during valuation between the right caudate nucleus, where we show BOLD activity correlated with subjective value, and the left amygdala, where we show BOLD activity is linked to subjective belief. Our study highlights psychological and neurobiological processes through which false beliefs alter human valuation and in doing so throw light on a common source of error in judgements of value.
Heterogeneity of publicly accessible online critical values for therapeutic drugs

Directory of Open Access Journals (Sweden)

Colt M McClain

2011-01-01

Full Text Available Introduction: Critical values are reported to clinicians when laboratory values are life threatening and require immediate attention. To date no definitive critical value limit recommendations have been produced regarding therapeutic drug monitoring. Some laboratories choose to publish critical value lists online. These publicly available values may be accessed and potentially utilized by laboratory staff, patient care providers, and patients. Materials and Methods: A web-based search of laboratories associated with the Accreditation Council for Graduate Medical Education pathology residency programs was initiated to determine which therapeutic drugs had critical values and to examine the degree of variation in published critical values for these institutions. Results: Of the 107 institutions with university-based pathology training programs, 36 had published critical values online for review. Thirteen therapeutic drugs were investigated and the number of institutions reporting critical value limits for the drug, as well as the median, range, standard deviation, and the coefficient of variation of critical value concentration limits for each drug were determined. A number of the online critical value limits were deemed to be erroneous, most likely due to incorrectly listed units of measurement. Conclusions: There was a large degree of heterogeneity with regard to the chosen critical value limits for therapeutic drugs. This wide variance in critical values appears to be greater than that observed in interassay proficiency testing. Institutions should reexamine the rationale for their current critical value parameters and ensure that critical value limits and associated units are accurately published online.
Online general pre-laboratory training course for facilitating first year chemical laboratory use

Directory of Open Access Journals (Sweden)

Maria Limniou

2010-03-01

Full Text Available In Chemistry, practical work is a highly demanding process in which students should be well-prepared before and alert during,laboratory sessions. Various general difficulties such as the limited laboratory time and the lack of connections between theoryand practicals often do not allow students to actively participate in the learning process. The aim of this investigation is to studyhow an online general pre-laboratory training course inspired by cognitive load theory influenced the teaching of first yearchemistry students engaged in laboratory work. Two different groups of chemistry students (experimental group (EG andcontrol group (CG from the University of Manchester participated in this investigation. The EG group participated in the onlinepre-laboratory course before entering the laboratory, while the CG group performed the experiments following the traditionalteaching procedure. The comparison of students’ responses to the same assessments of fundamental chemical and basiclaboratory knowledge showed that overall the performance of the EG group of students was higher than that of the CGstudents. Overall, the EG students valued the opportunity to have an online training course. By creating a flexible learningenvironment which included animations, simulations and self-assessments, the general laboratory difficulties were overcome.These interactive learning features gave students the opportunity to engage in independent study, by which restrictions of timeand place were overcome.
Porosity measurements of crystalline rocks by laboratory and geophysical methods

International Nuclear Information System (INIS)

Alexander, J.; Hall, D.H.; Storey, B.C.

1981-12-01

Porosity values of igneous and metamorphic crystalline rocks have been determined from core samples taken at specific depths from Altnabreac, by a combination of laboratory and geophysical techniques. Using resaturation and mercury injection methods in three laboratories within I.G.S., porosity values have been derived and the effect of variations in the measuring techniques and results obtained have been compared. Comparison of inter-laboratory porosity values illustrates that systematic errors are present, resulting in higher porosity values for samples subjected to re-testing. This is considered to be caused by the variable nature of the initial samples combined with the inability to completely dry or resaturate samples during a second testing. Geophysical techniques for determining in situ porosity using the neutron log have been carried out in borehole ALA. The neutron log has been calibrated with laboratory derived porosity values and an empirical formula derived enabling porosity values to be ascribed throughout the logged borehole ALA. Comparison of the porosity results from Altnabreac with crystalline samples elsewhere in America, Europe and the U.K. suggest that porosities at Altnabreac are lower than average. However, very few publications concerned with water movement in crystalline areas actually state the method used. (author)
Fecal bulk, energy intake, and serum cholesterol: regression response of serum cholesterol to apparent digestibility of dry matter and suboptimal energy intake in rats on fiber-fat diet.

Science.gov (United States)

Normani, M Z; Hussain, S S; Lim, J K; Albrink, M J; Gunnells, C K; Davis, G K

1981-10-01

Two experiments were conducted in the rat to determine the relationships of serum cholesterol (SC, mg/dl), apparent digestibility of dry matter (DDM, %), and digested energy intake (DE, kcal/day) at suboptimal level of energy. The energies in diet and feces were determined by calorimetry. DE as percentage of the National Research Council requirement (DE%) was suboptimal (70 to 85%). The experiments had four to five isofibrous diets, and no fiber diets, supplemented with 0.2% crystalline cholesterol (CChol). Animals in experiment 1 were fed varying amounts of feed with 18% coconut oil in the diets where as these in experiment 2 were given fixed amounts of feed with either 6 or 18% oil. The following regressions (p less than 0.001) for SC were found: experiment 1: -1157.7 -5.97 DDM +105.5 CCI -1.48 CCI2 (r2 0.35), where CCI = CChol, mg/day; -1888.4 -2.66 DE +120.97 CCI -1.62 CCI2 (r2 0.37). Experiment 2: 762.99 -6.15 DDM -0.8 fat cal % -0.87DE% (r2 0.31), where fat cal % = fat calories % of DE. Data indicate that at suboptimal energy intake, SC was inversely related to (1) DDM, (2) fat cal, and (3) total energy intake. Liver cholesterol lowering effect of the dietary fiber was also observed. The above findings help to elucidate various conflicting reports related to diet and blood cholesterol.
Maintaining turbidity and current flow in laboratory aquarium studies, a case study using Sabellaria spinulosa

DEFF Research Database (Denmark)

Davies, Andrew J.; S. Last, Kim; Attard, Karl

2009-01-01

RT) is a simple and reliable system for the resuspension of food or sediments using an enclosed airlift. The particle rain from the lift is mixed in the tank by two water inputs that provide directional current flow across the study organism(s). The vortex mixing creates a turbulent lateral water flow that allows......Many aquatic organisms rely on the suspension of particulate matter for food or for building materials, yet these conditions are difficult to replicate in laboratory mesocosms. Consequently, husbandry and experimental conditions may often be sub-optimal. The Vortex Resuspension Tank (Vo...... the distribution of particulate matter outwards from the sediment outflow. By calibrating a VoRT it is possible to control sedimentation rate by manipulating water and air flow rates. As an example application, three VoRTs were maintained under different sediment loadings to assess the sediment fraction...
Safeguards training at Pacific Northwest Laboratory

International Nuclear Information System (INIS)

Dickman, D.A.

1986-10-01

Safeguarding our country's nuclear materials against theft or diversion is extremely important due to their significantly strategic value. In addition, nuclear materials also have an extremely high monetary value. The term ''safeguards'' is defined as an integrated system of physical protection, accountability, and material control measures designed to deter, prevent, detect, and respond to unauthorized possession and use of special nuclear materials. An aggressive Safeguards program, therefore, employs both good security measures and a strong material control and accountability system. For effective internal control of nuclear materials, having people qualified in the many aspects of safeguards and accountability is essential. At Pacific Northwest Laboratory (PNL), this goal is accomplished through a Laboratory-wide Safeguards Awareness Program. All PNL staff members receive a level of Safeguards training appropriate to their particular function within the Laboratory. This paper presents an overview of the unique training opportunities this topic provides and how the training goals are accomplished through the various training courses given to the staff members
Incidence of hepatitis C infection among prisoners by routine laboratory values during a 20-year period.

Directory of Open Access Journals (Sweden)

Andrés Marco

Full Text Available To estimate the incidence of Hepatitis C virus (HCV and the predictive factors through repeated routine laboratory analyses.An observational cohort study was carried out in Quatre Camins Prison, Barcelona. The study included subjects with an initial negative HCV result and routine laboratory analyses containing HCV serology from 1992 to 2011. The incidence of infection was calculated for the study population and for sub-groups by 100 person-years of follow-up (100 py. The predictive factors were determined through Kaplan-Meier curves and a Cox regression. Hazard ratios (HR and 95% confidence intervals (CI were calculated.A total of 2,377 prisoners were included with a median follow-up time of 1,540.9 days per patient. Among the total population, 117 HCV seroconversions were detected (incidence of 1.17/100 py. The incidence was higher between 1992 and 1995 (2.57/100 py, among cases with HIV co-infection (8.34/100 py and among intravenous drug users (IDU without methadone treatment (MT during follow-up (6.66/100 py. The incidence rate of HCV seroconversion among cases with a history of IDU and current MT was 1.35/100 py, which is close to that of the total study population. The following variables had a positive predictive value for HCV infection: IDU (p<0.001; HR = 7,30; CI: 4.83-11.04, Spanish ethnicity (p = 0.009; HR = 2,03; CI: 1.93-3.44 and HIV infection (p = 0.015; HR = 1.97; CI: 1.14-3.39.The incidence of HCV infection among prisoners was higher during the first part of the study and among IDU during the entire study period. Preventative programs should be directed toward this sub-group of the prison population.
Reliability on intra-laboratory and inter-laboratory data of hair mineral analysis comparing with blood analysis.

Science.gov (United States)

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.
Module Architecture for in Situ Space Laboratories

Science.gov (United States)

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.
Representing Value as Digital Object: A Discussion of Transferability and Anonymity; Digital Library Initiatives of the Deutsche Forschungsgemeinschaft; CrossRef Turns One; Fermi National Accelerator Laboratory (Fermilab).

Science.gov (United States)

Kahn, Robert E.; Lyons, Patrice A.; Brahms, Ewald; Brand, Amy; van den Bergen, Mieke

2001-01-01

Includes four articles that discuss the use of digital objects to represent value in a network environment; digital library initiatives at the central public funding organization for academic research in Germany; an application of the Digital Object Identifier System; and the Web site of the Fermi National Accelerator Laboratory. (LRW)
Comparison of warfarin therapy clinical outcomes following implementation of an automated mobile phone-based critical laboratory value text alert system.

Science.gov (United States)

Lin, Shu-Wen; Kang, Wen-Yi; Lin, Dong-Tsamn; Lee, James; Wu, Fe-Lin; Chen, Chuen-Liang; Tseng, Yufeng J

2014-01-01

Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time
[Texture modified diet; digestibility, nutritional value, and contributions to menu of hospitals and nursing homes].

Science.gov (United States)

Irles Rocamora, Jose Antonio; García-Luna, Pedro Pablo

2014-01-21

Texture modified diet is a significant loss of the organoleptic qualities of the feed, so often associated with suboptimal intake and can increase the risk of malnutrition in people with chewing or swallowing difficulties. It is known that these diets based on traditional ground, have varying nutritional adequacy. The emergence of numerous commercial products lyophilized or ready to eat, with a wide variety of nutritional value, according to the range and recipe is concerned, represent an important step in the normalization of nutritional value and food security in people with dysphagia. This review discussed the possible advantages or disadvantages compared to traditional ground, and the possibilities of inclusion in the menu of hospitals and nursing homes. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Evaluation of Mycology Laboratory Proficiency Testing

OpenAIRE

Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

1999-01-01

Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient te...

Association of suboptimal health status with psychosocial stress, plasma cortisol and mRNA expression of glucocorticoid receptor α/β in lymphocyte.

Science.gov (United States)

Yan, Yu-Xiang; Dong, Jing; Liu, You-Qin; Zhang, Jie; Song, Man-Shu; He, Yan; Wang, Wei

2015-01-01

Suboptimal health status (SHS) has become a new public health challenge in China. This study investigated whether high SHS is associated with psychosocial stress, changes in cortisol level and/or glucocorticoid receptor (GR) isoform expression. Three-hundred eighty-six workers employed in three companies in Beijing were recruited. The SHS score was derived from data collection in the SHS questionnaire (SHSQ-25). The short standard version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to assess job-related psychosocial stress. The mean value of the five scales of COPSOQ and distribution of plasma cortisol and mRNA expression of GRα/GRβ between the high level of SHS group and the low level of SHS group were compared using a general linear model procedure. Multiple linear regression analysis was used to analyze the effect of psychosocial stress on SHS. We identified three factors that were predictive of SHS, including "demands at work", "interpersonal relations and leadership" and "insecurity at work". Significantly higher levels of plasma cortisol and GRβ/GRα mRNA ratio were observed among the high SHS group. High level of SHS is associated with decreased mRNA expression of GRα. This study confirmed the association between chronic psychosocial stress and SHS, indicating that improving the psychosocial work environment may reduce SHS and then prevent chronic diseases effectively.
Predicting Calcium Values for Gastrointestinal Bleeding Patients in Intensive Care Unit Using Clinical Variables and Fuzzy Modeling

Directory of Open Access Journals (Sweden)

G Khalili-Zadeh-Mahani

2016-07-01

Full Text Available Introduction: Reducing unnecessary laboratory tests is an essential issue in the Intensive Care Unit. One solution for this issue is to predict the value of a laboratory test to specify the necessity of ordering the tests. The aim of this paper was to propose a clinical decision support system for predicting laboratory tests values. Calcium laboratory tests of three categories of patients, including upper and lower gastrointestinal bleeding, and unspecified hemorrhage of gastrointestinal tract, have been selected as the case studies for this research. Method: In this research, the data have been collected from MIMIC-II database. For predicting calcium laboratory values, a Fuzzy Takagi-Sugeno model is used and the input variables of the model are heart rate and previous value of calcium laboratory test. Results: The results showed that the values of calcium laboratory test for the understudy patients were predictable with an acceptable accuracy. In average, the mean absolute errors of the system for the three categories of the patients are 0.27, 0.29, and 0.28, respectively. Conclusion: In this research, using fuzzy modeling and two variables of heart rate and previous calcium laboratory values, a clinical decision support system was proposed for predicting laboratory values of three categories of patients with gastrointestinal bleeding. Using these two clinical values as input variables, the obtained results were acceptable and showed the capability of the proposed system in predicting calcium laboratory values. For achieving better results, the impact of more input variables should be studied. Since, the proposed system predicts the laboratory values instead of just predicting the necessity of the laboratory tests; it was more generalized than previous studies. So, the proposed method let the specialists make the decision depending on the condition of each patient.
Laboratory administration--capital budgeting.

Science.gov (United States)

Butros, F

1997-01-01

The process of capital budgeting varies among different health-care institutions. Understanding the concept of present value of money, incremental cash flow statements, and the basic budgeting techniques will enable the laboratory manager to make the rational and logical decisions that are needed in today's competitive health-care environment.
Comparability of reference values

International Nuclear Information System (INIS)

Rossbach, M.; Stoeppler, M.

1993-01-01

Harmonization of certified values in Reference Materials (RMs) can be carried out by applying nuclear analytical techniques to RMs of various matrix types and concentration levels. Although RMs generally should not be used as primary standards the cross evaluation of concentrations in RMs leads to better compatibility of reference values and thus to a greater agreement between analytical results from different laboratories using these RMs for instrument calibration and quality assurance. (orig.)
Reference values and evaluation of the results of intercomparisons

International Nuclear Information System (INIS)

Aigner, H.; Deron, S.; Kuhn, E.

1981-01-01

The need of a reference value for the composition of materials distributed in intercomparisons is generally recognized. A single reference laboratory or a group of reference laboratories may be used to establish this reference value. The respective advantages and limitations of the two approaches are discussed. The reference measurements must be evaluated to provide the confidence limits of the reference value but also an estimate of the possible heterogeneity of the materials and its samples. The results of the intercomparison measurements should themselves be evaluated to test and discuss the significance of the biases of individual and selected groups of laboratories or techniques. The approach taken by the Analytical Quality Control Services of the International Atomic Energy Agency is illustrated by the SR-1 intercomparison on uranium assay in UO 2 powder
Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories.

Science.gov (United States)

Howanitz, Peter J; Darcy, Theresa P; Meier, Frederick A; Bashleben, Christine P

2015-09-01

The anticoagulant warfarin has been identified as the second most frequent drug responsible for serious, disabling, and fatal adverse drug events in the United States, and its effect on blood coagulation is monitored by the laboratory test called international normalized ratio (INR). To determine the presence of INR policies and procedures, INR practices, and completeness and timeliness of reporting critical INR results in participants' clinical laboratories. Participants reviewed their INR policies and procedure requirements, identified their practices by using a questionnaire, and studied completeness of documentation and timeliness of reporting critical value INR results for outpatients and emergency department patients. In 98 participating institutions, the 5 required policies and procedures were in place in 93% to 99% of clinical laboratories. Fifteen options for the allowable variations among duplicate results from different analyzers, 12 different timeliness goals for reporting critical values, and 18 unique critical value limits were used by participants. All required documentation elements were present in 94.8% of 192 reviewed INR validation reports. Critical value INR results were reported within the time frame established by the laboratory for 93.4% of 2604 results, but 1.0% of results were not reported. Although the median laboratories successfully communicated all critical results within their established time frames and had all the required validation elements based in their 2 most recent INR calculations, those participants at the lowest 10th percentile were successful in 80.0% and 85.7% of these requirements, respectively. Significant opportunities exist for adherence to INR procedural requirements and for practice patterns and timeliness goals for INR critical results' reporting.
Comparison of the analysis result between two laboratories using different methods

International Nuclear Information System (INIS)

Sri Murniasih; Agus Taftazani

2017-01-01

Comparison of the analysis result of volcano ash sample between two laboratories using different analysis methods. The research aims to improve the testing laboratory quality and cooperate with the testing laboratory from other country. Samples were tested at the Center for Accelerator of Science and Technology (CAST)-NAA laboratory using NAA, while at the University of Texas (UT) USA using ICP-MS and ENAA method. From 12 elements of target, CAST-NAA able to present 11 elements of data analysis. The comparison results shows that the analysis of the K, Mn, Ti and Fe elements from both laboratories have a very good comparison and close one to other. It is known from RSD values and correlation coefficients of the both laboratories analysis results. While observed of the results difference known that the analysis results of Al, Na, K, Fe, V, Mn, Ti, Cr and As elements from both laboratories is not significantly different. From 11 elements were reported, only Zn which have significantly different values for both laboratories. (author)
Clearance Laboratory - Capability and measurement sensitivity

Energy Technology Data Exchange (ETDEWEB)

Hedemann Jensen, P.; Lauridsen, B.; Silva, J.; Soegaard-Hansen, J.; Warming, L.

2005-08-01

A new low-level Clearance Laboratory has been built at the Risoe-site. Building materials with a low content of naturally occurring radionuclides have been used. To minimize transport of radon gas from soil into the laboratory the foundation has been supplied with a membrane. The laboratory has been equipped with two high-efficiency germanium detectors. These detectors will be used for clearance measurements on the predicted amount of 15,000 - 18,000 tonnes of non-active or nearly non-active materials, which will originate from the decommissioning of all the nuclear facilities at the Risoe-site. They will be used also for clearance measurements on buildings and land. Objects and materials to be measured for clearance are placed on a rotation table that can carry up to one tonne and can rotate once a minute to simulate some averaging of inhomogeneously distributed activity. Sensitivity and background measurements reveal that measuring times of 20 - 50 minutes would normally be sufficient to detect radionuclide concentrations of only a small fraction of the nuclide-specific clearance levels with a sufficiently low uncertainty. Probability calculations of the measurement capacity of the Clearance Laboratory indicate that the mean value of the total measuring time for all materials that potentially can be cleared would be 13 years with a 95% probability of being less than 25 years. The mean value of the annual amount of materials that can be measured in the laboratory is 600 tonnes with a 95% probability of being less than 1,200 tonnes. If needed, there is room for additional measuring systems to increase the capacity of the laboratory. (au)
Clearance Laboratory - Capability and measurement sensitivity

International Nuclear Information System (INIS)

Hedemann Jensen, P.; Lauridsen, B.; Silva, J.; Soegaard-Hansen, J.; Warming, L.

2005-09-01

A new low-level Clearance Laboratory has been built at the Risoe-site. Building materials with a low content of naturally occurring radionuclides have been used. To minimize transport of radon gas from soil into the laboratory the foundation has been supplied with a membrane. The laboratory has been equipped with two high-efficiency germanium detectors. These detectors will be used for clearance measurements on the predicted amount of 15,000 - 18,000 tonnes of non-active or nearly non-active materials, which will originate from the decommissioning of all the nuclear facilities at the Risoe-site. They will be used also for clearance measurements on buildings and land. Objects and materials to be measured for clearance are placed on a rotation table that can carry up to one tonne and can rotate once a minute to simulate some averaging of inhomogeneously distributed activity. Sensitivity and background measurements reveal that measuring times of 20 - 50 minutes would normally be sufficient to detect radionuclide concentrations of only a small fraction of the nuclide-specific clearance levels with a sufficiently low uncertainty. Probability calculations of the measurement capacity of the Clearance Laboratory indicate that the mean value of the total measuring time for all materials that potentially can be cleared would be 13 years with a 95% probability of being less than 25 years. The mean value of the annual amount of materials that can be measured in the laboratory is 600 tonnes with a 95% probability of being less than 1,200 tonnes. If needed, there is room for additional measuring systems to increase the capacity of the laboratory. (au)
An inter-laboratory comparison of arsenic analysis in Bangladesh. Draft report

International Nuclear Information System (INIS)

Aggarwal, P.K.; Dargie, M.; Groening, M.; Kulkarni, K.M.; Gibson, J.J.

2001-03-01

The International Atomic Energy Agency (IAEA) conducted an evaluation of the quality of arsenic analysis in Bangladesh through an inter-laboratory comparison of the analysis of synthetic standards and field samples. A set of 8 synthetic standards with arsenic concentrations ranging from 0 to about 500 μg/kg, traceable to an internationally recognized standard solution of arsenic, were prepared by the IAEA and provided to the participating laboratories. In addition, two samples of drinking water were collected from near Dhaka by the local office of the World Health Organization (WHO) and provided to all participating laboratories and the IAEA for analysis. Out of the 25 laboratories who received the synthetic standards and field samples, 17 laboratories submitted results to the IAEA for comparison. The reported arsenic concentrations have a wide range with values much higher or much lower than the expected value. Analysis of field samples shows a range of values from 0 to 396 μg/kg. Less than one third of the participating laboratories obtained results that were within about 20% of the expected values (about 60 μg/kg) obtained by a laboratory cooperating with the IAEA (University of Rochester). Results of this inter-laboratory comparison point to a lack of consistency in the analytical results that have been and are being obtained in Bangladesh. More importantly, drinking water wells where elevated arsenic concentrations have been found may in fact have low concentrations. Similarly, wells that have been found to be free of arsenic may in fact have substantially higher arsenic concentrations. The quality and reliability of arsenic analysis needs to be established and continually evaluated in order to identify all affected areas and to provide appropriate mitigation
Comparison of the CoaguChek XS handheld coagulation analyzer and conventional laboratory methods measuring international normalised ratio (INR) values during the time to therapeutic range after mechanical valve surgery.

Science.gov (United States)

Bardakci, Hasmet; Altıntaş, Garip; Çiçek, Omer Faruk; Kervan, Umit; Yilmaz, Sevinc; Kaplan, Sadi; Birincioglu, Cemal Levent

2013-05-01

To compare the international normalised ratio (INR) value of patients evaluated using the CoaguChek XS versus conventional laboratory methods, in the period after open-heart surgery for mechanical valve replacement until a therapeutic range is achieved using vitamin K antagonists (VKA) together with low molecular weight heparin (LMWH). One hundred and five patients undergoing open-heart surgery for mechanical valve replacement were enrolled. Blood samples were collected from patients before surgery, and on the second and fifth postoperative days, simultaneously for both the point of care device and conventional laboratory techniques. Patients were administered VKA together with LMWH at therapeutic doses (enoxaparin 100 IU/kg twice daily) subcutaneously, until an effective range was achieved on approximately the fifth day after surgery. The mean INR values using the CoaguChek XS preoperatively and on the second and fifth days postoperatively were 1.20 (SD ± 0.09), 1.82 (SD ± 0.45), and 2.55 (SD ± 0.55), respectively. Corresponding results obtained using conventional laboratory techniques were 1.18 (SD ± 0.1), 1.81 (SD ± 0.43), and 2.51 (SD ± 0.58). The correlation coefficient was r = 0.77 preoperatively, r = 0.981 on postoperative day 2, and r = 0.983 on postoperative day 5. Results using the CoaguChek XS Handheld Coagulation Analyzer correlated strongly with conventional laboratory methods, in the bridging period between open-heart surgery for mechanical valve replacement and the achievement of a therapeutic range on warfarin and LMWH. © 2013 Wiley Periodicals, Inc.
Costs of examinations performed in a hospital laboratory in Chile.

Science.gov (United States)

Andrade, Germán Lobos; Palma, Carolina Salas

2018-01-01

To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.
The laboratory workforce shortage: a managerial perspective.

Science.gov (United States)

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.
Sunk cost and work ethic effects reflect suboptimal choice between different work requirements.

Science.gov (United States)

Magalhães, Paula; White, K Geoffrey

2013-03-01

We investigated suboptimal choice between different work requirements in pigeons (Columba livia), namely the sunk cost effect, an irrational tendency to persist with an initial investment, despite the availability of a better option. Pigeons chose between two keys, one with a fixed work requirement to food of 20 pecks (left key), and the other with a work requirement to food which varied across conditions (center key). On some trials within each session, such choices were preceded by an investment of 35 pecks on the center key, whereas on others they were not. On choice trials preceded by the investment, the pigeons tended to stay and complete the schedule associated with the center key, even when the number of pecks to obtain reward was greater than for the concurrently available left key. This result indicates that pigeons, like humans, commit the sunk cost effect. With higher work requirements, this preference was extended to trials where there was no initial investment, so an overall preference for the key associated with more work was evident, consistent with the work ethic effect. We conclude that a more general work ethic effect is amplified by the effect of the prior investment, that is, the sunk cost effect. Copyright © 2013 Elsevier B.V. All rights reserved.
Establishment of Valid Laboratory Case Definition for Human Leptospirosis

NARCIS (Netherlands)

M.G.A. Goris (Marga); M.M.G. Leeflang (Mariska); K.R. Boer (Kimberly); M. Goeijenbier (Marco); E.C.M. van Gorp (Eric); J.F.P. Wagenaar (Jiri); R.A. Hartskeerl (Rudy)

2011-01-01

textabstractLaboratory case definition of leptospirosis is scarcely de ned by a solid evaluation that determines cut-off values in the tests that are applied. This study describes the process of determining optimal cut-off titers of laboratory tests for leptospirosis for a valid case definition of
A Model for Designing Adaptive Laboratory Evolution Experiments

DEFF Research Database (Denmark)

LaCroix, Ryan A.; Palsson, Bernhard O.; Feist, Adam M.

2017-01-01

in suboptimal experiments that can take multiple months to complete. With the availability of automation and computer simulations, we can now perform these experiments in an optimized fashion and can design experiments to generate greater fitness in an accelerated time frame, thereby pushing the limits of what...
Essential laboratory knowledge for the clinician

African Journals Online (AJOL)

As clinicians place huge emphasis on the numerical values obtained from the clinical ... where clinical management is based on medical decision limits that ... One area of laboratory medicine in which standardisation has been difficult to ...
Evaluation of the analytic performance of laboratories: inter-laboratorial study of the spectroscopy of atomic absorption

International Nuclear Information System (INIS)

Wong Wong, S. M.

1996-01-01

The author made an inter-laboratorial study, with the participation of 18 national laboratories, that have spectrophotometer of atomic absorption. To evaluate the methods of analysis of lead, sodium, potasium, calcium, magnesium, zinc, copper, manganese, and iron, in the ambit of mg/l. The samples, distributed in four rounds to the laboratories, were prepared from primary patterns, deionized and distilled water. The study evaluated the homogeneity and stability, and verified its concentration, using as a reference method, the spectrometry method of Inductively Coupled Plasma emission (1CP). To obtain the characteristics of analytic performance, it applied the norm ASTM E 691. To evaluated the analytic performance, it used harmonized protocol of the International Union of Pure and applied chemistry (IUPAC). The study obtained the 29% of the laboratories had a satisfactory analytic performance, 9% had a questionable performance and 62% made an unsatisfactory analytic performance, according to the IUPAC norm. The results of the values of the characteristic performance method, show that there is no intercomparability between the laboratories, which is attributed to the different methodologies of analysis. (S. Grainger)
Value of MDCT and Clinical and Laboratory Data for Predicting the Need for Surgical Intervention in Suspected Small-Bowel Obstruction.

Science.gov (United States)

Scrima, Andrew; Lubner, Meghan G; King, Scott; Pankratz, Joshua; Kennedy, Gregory; Pickhardt, Perry J

2017-04-01

The purpose of this article is to assess the value of a large panel of clinical and MDCT variables in patients with suspected small-bowel obstruction (SBO) for predicting urgent surgical intervention (data were abstracted from electronic medical record review. Univariate and multivariate analyses were performed. Among all 179 patients with suspected SBO, 56 (31.3%) underwent surgical intervention within 72 hours, 10 (5.6%) had ischemia at surgery, and nine (5.0%) required small-bowel resection. On univariate analysis, multiple CT findings were highly significant (p < 0.01) for predicting the main surgical outcomes, including degree of obstruction, 5-point radiology likelihood scores, and the presence of a transition point, closed loop, and mesenteric congestion. None of the objective clinical or laboratory variables (including serum lactate level) reached this level of significance. At multivariate analysis, forward stepwise logistic regression with 0.05 significance level cutoff included both degree of obstruction (p < 0.001) and closed loop (p < 0.01), with the presence of a transition point showing a trend toward significance (p = 0.081). A number of findings at abdominal MDCT are associated with the need for surgery and other important surgical outcomes in patients with suspected SBO. Overall radiologist impression of need for surgical intervention was a better predictor than any clinical or laboratory parameter.
Expressing analytical performance from multi-sample evaluation in laboratory EQA.

Science.gov (United States)

Thelen, Marc H M; Jansen, Rob T P; Weykamp, Cas W; Steigstra, Herman; Meijer, Ron; Cobbaert, Christa M

2017-08-28

To provide its participants with an external quality assessment system (EQAS) that can be used to check trueness, the Dutch EQAS organizer, Organization for Quality Assessment of Laboratory Diagnostics (SKML), has innovated its general chemistry scheme over the last decade by introducing fresh frozen commutable samples whose values were assigned by Joint Committee for Traceability in Laboratory Medicine (JCTLM)-listed reference laboratories using reference methods where possible. Here we present some important innovations in our feedback reports that allow participants to judge whether their trueness and imprecision meet predefined analytical performance specifications. Sigma metrics are used to calculate performance indicators named 'sigma values'. Tolerance intervals are based on both Total Error allowable (TEa) according to biological variation data and state of the art (SA) in line with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Milan consensus. The existing SKML feedback reports that express trueness as the agreement between the regression line through the results of the last 12 months and the values obtained from reference laboratories and calculate imprecision from the residuals of the regression line are now enriched with sigma values calculated from the degree to which the combination of trueness and imprecision are within tolerance limits. The information and its conclusion to a simple two-point scoring system are also graphically represented in addition to the existing difference plot. By adding sigma metrics-based performance evaluation in relation to both TEa and SA tolerance intervals to its EQAS schemes, SKML provides its participants with a powerful and actionable check on accuracy.

Suboptimal Iodine Concentration in Breastmilk and Inadequate Iodine Intake among Lactating Women in Norway.

Science.gov (United States)

Henjum, Sigrun; Lilleengen, Anne Marie; Aakre, Inger; Dudareva, Anna; Gjengedal, Elin Lovise Folven; Meltzer, Helle Margrete; Brantsæter, Anne Lise

2017-06-22

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements.
Critical phenomena in communication/computation networks with various topologies and suboptimal to optimal resource allocation

Science.gov (United States)

Cogoni, Marco; Busonera, Giovanni; Anedda, Paolo; Zanetti, Gianluigi

2015-01-01

We generalize previous studies on critical phenomena in communication networks [1,2] by adding computational capabilities to the nodes. In our model, a set of tasks with random origin, destination and computational structure is distributed on a computational network, modeled as a graph. By varying the temperature of a Metropolis Montecarlo, we explore the global latency for an optimal to suboptimal resource assignment at a given time instant. By computing the two-point correlation function for the local overload, we study the behavior of the correlation distance (both for links and nodes) while approaching the congested phase: a transition from peaked to spread g(r) is seen above a critical (Montecarlo) temperature Tc. The average latency trend of the system is predicted by averaging over several network traffic realizations while maintaining a spatially detailed information for each node: a sharp decrease of performance is found over Tc independently of the workload. The globally optimized computational resource allocation and network routing defines a baseline for a future comparison of the transition behavior with respect to existing routing strategies [3,4] for different network topologies.
A call for a value based approach to laboratory medicine funding.

Science.gov (United States)

St John, A; Edwards, G; Fisher, S; Badrick, T; Callahan, J; Crothers, J

2015-09-01

All areas of healthcare, including pathology, are being challenged by the reality that the days of ever increasing budgets are over and the key debate is about how to provide value for money. As originally described by Porter and Tiesberg, value-based healthcare is defined as maximising outcomes over cost by moving away from fee for service models to ones that reward providers on the basis of outcomes (1). While production efficiencies will continue to evolve, the opportunities for future stepwise improvements in production costs are likely to have diminished. The focus now is on delivering improved testing outcomes in a relatively cost neutral or at least cost effective way. This brings pathology into line with other health services that focus on value for money for payers, and maximising health outcomes for consumers. This would signal a break from the existing pathology funding model, which does not directly recognise or reward the contribution of pathology towards improved health outcomes, or seek to decommission tests that offer little clinical value. Pathology has a direct impact on clinical and economic outcomes that extend from testing and it is important to garner support for a new approach to funding that incentivises improvements of the overall quality and contribution of the pathology service. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Life Values as an Intrinsic Guide for Cardiopulmonary Rehabilitation Program Engagement: A QUALITATIVE ANALYSIS.

Science.gov (United States)

Ellis, Jordan M; Whited, Matthew C; Freeman, John Taylor; Corson, Ansley T; Jameson, John Paul; Greenway, Stacey; Sager, David M; Midgette, Emily P; Varju, Eliza V

2017-11-08

Participation in cardiovascular and pulmonary rehabilitation (CVPR) programs can lead to improved functional abilities and improved quality of life, but attendance and adherence to these programs remain suboptimal. Behavioral therapies have emphasized the importance of life value identification as a guide for goal setting and behavior change for both psychological and physical health conditions. Individuals who choose to engage in behaviors that align with their life values are thought to be intrinsically reinforced. The purpose of the following qualitative study was to interview patients enrolled in CVPR about their own life values and motivating factors related to healthy behavior changes. Thirty cardiac or pulmonary patients were recruited from a CVPR program and participated in a semistructured interview about their life values and motivating factors related to program engagement. The data were transcribed and analyzed thematically. Participants identified a wide range of values related to program engagement, and only half of the participants endorsed health as a value. The most frequently endorsed life values included being active, family, and independence. The interviews indicated that, although patients make lifestyle changes in the program to improve their physical health, there are often other values that primarily guide their choice to engage in and maintain lifestyle behaviors. Life values can serve as a powerful guide for individual behavior change. The present study suggests that the piloting of brief values interventions early in CVPR treatment is warranted and has the potential to improve patient outcomes.
Consumer perception and preference for suboptimal food under the emerging practice of expiration date based pricing in supermarkets

DEFF Research Database (Denmark)

Aschemann-Witzel, Jessica

2018-01-01

Consumers have been found to majorly prefer ‘optimal’ food over ‘suboptimal’ when purchasing food. To provide an incentive for consumers to select suboptimal food and thus decrease food waste in the supply chain, expiration date based pricing is suggested and increasingly applied. However......, it is unclear which contextual, individual, and product-related factors impact consumer likelihood of choice and thus acceptance of the practice in the long run. The study aimed at exploring the effect of communicating different motives for purchase, the product being organic, familiarity with the practice......, individual preferences, and product-related factors. An online survey experiment among 842 Danish consumers realistically mimicked the current market context. Findings reveal that neither communicating budget saving or food waste avoidance nor the product being organic has an influence. However...
The estimation of parameter compaction values for pavement subgrade stabilized with lime

Science.gov (United States)

Lubis, A. S.; Muis, Z. A.; Simbolon, C. A.

2018-02-01

The type of soil material, field control, maintenance and availability of funds are several factors that must be considered in compaction of the pavement subgrade. In determining the compaction parameters in laboratory desperately requires considerable materials, time and funds, and reliable laboratory operators. If the result of soil classification values can be used to estimate the compaction parameters of a subgrade material, so it would save time, energy, materials and cost on the execution of this work. This is also a clarification (cross check) of the work that has been done by technicians in the laboratory. The study aims to estimate the compaction parameter values ie. maximum dry unit weight (γdmax) and optimum water content (Wopt) of the soil subgrade that stabilized with lime. The tests that conducted in the laboratory of soil mechanics were to determine the index properties (Fines and Liquid Limit/LL) and Standard Compaction Test. Soil samples that have Plasticity Index (PI) > 10% were made with additional 3% lime for 30 samples. By using the Goswami equation, the compaction parameter values can be estimated by equation γd max # = -0,1686 Log G + 1,8434 and Wopt # = 2,9178 log G + 17,086. From the validation calculation, there was a significant positive correlation between the compaction parameter values laboratory and the compaction parameter values estimated, with a 95% confidence interval as a strong relationship.
Chemical laboratory hazardous waste management at a DOE multiprogram national laboratory

International Nuclear Information System (INIS)

Turner, P.J.

1990-03-01

Pacific Northwest Laboratory (PNL), a United States Department of Energy (DOE) Multiprogram Energy Laboratory, is establishing a program for management of diverse small-quantity laboratory waste generated on site. Although the main emphasis of this program is ''cradle-to-grave'' tracking and treatment of hazardous chemical waste and mixed waste, low-level radioactive and transuranic (TRU) waste is also being included. With the program in operation, more than 95% of all regulated waste will be treated or destroyed on site. The cost savings will return the original investment in under six years and decrease the liability to PNL and DOE -- a benefit with a potentially greater economic value. Tracking of hazardous waste will be mediated by a computer-based inventory and tracking system. The system will track all hazardous materials from receipt through final disposition, whether the material is destroyed or treated for disposal. It will allow user access to handling and hazards information as well as provide an updated inventory by location, user, and hazard type. Storage and treatment of waste will be performed by at least four facilities, made operational in three phases. 6 figs
ABACC laboratories quality assurance through Secondary Standards Exchange Program

International Nuclear Information System (INIS)

Guidicini, Olga Mafra; Thompson, Jay; Soriano, Michael

2003-01-01

In September 1999, the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC), with assistance from the New Brunswick Laboratory (NBL) of the U.S. Department of Energy, started a new cooperative activity with, among other objectives, the production and characterization of a traceable uranium secondary standard and the performance of the Third Round Robin for ABACC's laboratory network. Brazil and Argentina have fabricated UO 2 pellets for use as a secondary standard. Samples from the two batches were sent to NBL for the determination of the reference values for both uranium concentration (%U) and isotopic composition for each batch. ABACC and NBL then organized the Third ABACC Round Robin for Brazilian and Argentine laboratories that are part of the ABACC network. The laboratories comprising the network can be used to analyze real samples collected during the ABACC inspections. The Brazilian and Argentine pellets were distributed to all the laboratories together with the protocol to be followed for the uranium concentration analysis, the forms for reporting the measurement results, and natural UO 2 pellets (CETAMA OU1) to be used as reference material. For the laboratories with capability of measuring isotopics, NBL reference material CRM 125-A was provided. Several laboratories from each country provided results. As soon as the measurement results were sent to the organizers, they were statistically evaluated by NBL. During a meeting held at ABACC headquarters with the participation of NBL representatives, the ABACC technical support officer, and representatives of all the participant laboratories, the results were discussed and compared with the reference values. All the laboratories had the occasion, in an open discussion, to explain and show the difficulties and problems they faced during the exercise. ABACC had the opportunity not only to judge the quality of the measurements these laboratories performed, but also to determine
Palm-Based Standard Reference Materials for Iodine Value and Slip Melting Point

Directory of Open Access Journals (Sweden)

Azmil Haizam Ahmad Tarmizi

2008-01-01

Full Text Available This work described study protocols on the production of Palm-Based Standard Reference Materials for iodine value and slip melting point. Thirty-three laboratories collaborated in the inter-laboratory proficiency tests for characterization of iodine value, while thirty-two laboratories for characterization of slip melting point. The iodine value and slip melting point of palm oil, palm olein and palm stearin were determined in accordance to MPOB Test Methods p3.2:2004 and p4.2:2004, respectively. The consensus values and their uncertainties were based on the acceptability of statistical agreement of results obtained from collaborating laboratories. The consensus values and uncertainties for iodine values were 52.63 ± 0.14 Wijs in palm oil, 56.77 ± 0.12 Wijs in palm olein and 33.76 ± 0.18 Wijs in palm stearin. For the slip melting points, the consensus values and uncertainties were 35.6 ± 0.3 ° C in palm oil, 22.7 ± 0.4 ° C in palm olein and 53.4 ± 0.2 ° C in palm stearin. Repeatability and reproducibility relative standard deviations were found to be good and acceptable, with values much lower than that of 10%. Stability of Palm-Based Standard Reference Materials remained stable at temperatures of -20 ° C, 0 ° C, 6 ° C and 24 ° C upon storage for one year.
Palm-Based Standard Reference Materials for Iodine Value and Slip Melting Point

Directory of Open Access Journals (Sweden)

Azmil Haizam Ahmad Tarmizi

2008-01-01

Full Text Available This work described study protocols on the production of Palm-Based Standard Reference Materials for iodine value and slip melting point. Thirty-three laboratories collaborated in the inter-laboratory proficiency tests for characterization of iodine value, while thirty-two laboratories for characterization of slip melting point. The iodine value and slip melting point of palm oil, palm olein and palm stearin were determined in accordance to MPOB Test Methods p3.2:2004 and p4.2:2004, respectively. The consensus values and their uncertainties were based on the acceptability of statistical agreement of results obtained from collaborating laboratories. The consensus values and uncertainties for iodine values were 52.63 ± 0.14 Wijs in palm oil, 56.77 ± 0.12 Wijs in palm olein and 33.76 ± 0.18 Wijs in palm stearin. For the slip melting points, the consensus values and uncertainties were 35.6 ± 0.3 °C in palm oil, 22.7 ± 0.4 °C in palm olein and 53.4 ± 0.2 °C in palm stearin. Repeatability and reproducibility relative standard deviations were found to be good and acceptable, with values much lower than that of 10%. Stability of Palm-Based Standard Reference Materials remained stable at temperatures of –20 °C, 0 °C, 6 °C and 24 °C upon storage for one year.
Predictive value of clinical and laboratory variables for vesicoureteral reflux in children.

Science.gov (United States)

Soylu, Alper; Kasap, Belde; Demir, Korcan; Türkmen, Mehmet; Kavukçu, Salih

2007-06-01

We aimed to determine the predictability of clinical and laboratory variables for vesicoureteral reflux (VUR) in children with urinary tract infection (UTI). Data of children with febrile UTI who underwent voiding cystoureterography between 2002 and 2005 were evaluated retrospectively for clinical (age, gender, fever > or = 38.5 degrees C, recurrent UTI), laboratory [leukocytosis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), pyuria, serum creatinine (S(Cr))] and imaging (renal ultrasonography) variables. Children with VUR (group 1) vs. no VUR (group 2) and children with high-grade (III-V) VUR (group 3) vs. no or low-grade (I-II) VUR (group 4) were compared. Among 88 patients (24 male), 38 had VUR and 21 high-grade VUR. Fever > or = 38.5 degrees C was associated with VUR [odds ratio (OR): 7.5]. CRP level of 50 mg/l was the best cut-off level for predicting high-grade VUR (OR 15.5; discriminative ability 0.89 +/- 0.05). Performing voiding cystourethrography based on this CRP level would result in failure to notice 9% of patients with high-grade VUR, whereas 69% of children with no/low-grade VUR would be spared from this invasive test. In conclusion, fever > or = 38 degrees C and CRP > 50 mg/l seem to be potentially useful clinical predictors of VUR and high-grade VUR, respectively, in pediatric patients with UTI. Further validation of these findings could limit unnecessary voiding cystourethrography.
Burden of Disease Attributable to Suboptimal Breastfeeding in Iran during 1990-2010; Findings from the Global Burden of Disease Study 2010

Directory of Open Access Journals (Sweden)

Roya Kelishadi

2016-09-01

Full Text Available Background: This study uses data of the global burden of diseases (GBD study 2010 to report death, disability-adjusted life year (DALYs, years of life lived with disability (YLDs and years of life lost due to premature mortality (YLLs, attributed to suboptimal breastfeeding by age and gender during 1990 to 2010 in Iran. Materials and Methods:The GBD assessments were used, together with estimates of death and DALYs due to specific risk factors to calculate the attributed burden of each risk factor exposure compared with the theoretical-minimum-risk exposure. Uncertainties in the distribution of exposure, relative risks, and relevant outcomes were incorporated into estimates of mortality attributable and burden and were presented as 95 % uncertainty interval (UI. Results:In both genders, the age standardized DALYs rates and the age standardized death rate [(from 5 (95% UI: 2-8 to 1 (95% UI: 0-2 per 100,000 populations], attributed to breastfeeding, had a decreasing trends. The age standardized YLD rate increased from 7 (95% UI: 2-15 to 10 (95% UI: 3-23 per 100,000 populations in boys and, from 7(95% UI: 2-16 to 11(95% UI: 3-26 per 100,000 populations in girls. The YLD changes showed some variation according to age categories. For both genders, the age standardizes YLL rate decreased from 395 (95% UI: 185-681 per 100,000 populations to 111(95% UI: 42-213 per 100,000 populations. Conclusion: The burden attributed to suboptimal breastfeeding had a considerable reduction rate from 1990 to 2010. Additional studies on burden of exclusive breastfeeding with more accurate data are recommended for policies make decision.
Metabonomics-Based Study of Clinical Urine Samples in Suboptimal Health with Different Syndromes

Directory of Open Access Journals (Sweden)

Hai-Zhen Cui

2013-01-01

Full Text Available Objective. To explore the urinary biochemistry features of syndromes of traditional Chinese medicine (TCM such as syndrome of stagnation of liver Qi, spleen deficiency, liver Qi stagnation, and spleen deficiency (LSSDS in sub-optimal health status (SHS. Methods. 12 cases for each syndrome group in SHS were selected, 12 subjects were used as a normal control group, and 1H NMR detection was, respectively, carried out, and the data was corrected by the orthogonal signal correction (OSC and then adopted a partial least squares (PLS method for discriminate analysis. Results. The OSC-PLS (ctr analysis results of the nuclear overhauser enhancement spectroscopy (NOESY detection indicated that the syndromes in SHS could be differentiated, and there were significant differences in the levels of metabolites of the urine samples of the four groups; the biomarkers of LSSDS in SHS were found out. The contents of citric acid (2.54 and 2.66, trimethylamineoxide (3.26, and hippuric acid (3.98, 7.54, 7.58, 7.62, 7.66, 7.82, and 7.86 in the urine samples of LSSDS group were lower than that of the normal control group. Conclusion. There are differences in the 1H-NMR metabolic spectrum of the urine samples of the four groups, and the specific metabolic products of the LSSDS in SHS can be identified from metabonomics analysis.
Prostate-specific antigen density is predictive of outcome in suboptimal prostate seed brachytherapy.

Science.gov (United States)

Benzaquen, David; Delouya, Guila; Ménard, Cynthia; Barkati, Maroie; Taussky, Daniel

In prostate seed brachytherapy, a D 90 of prostate-specific antigen + 2). Univariate and multivariate analyses were performed, adjusting for known prognostic factors such as D 90 and prostate-specific antigen density (PSAD) of ≥0.15 ng/mL/cm 3 , to evaluate their ability to predict BF. Median followup for patients without BF was 72 months (interquartile range 56-96). BF-free recurrence rate at 5 years was 95% and at 8 years 88%. In univariate analysis, PSAD and cancer of the prostate risk assessment score were predictive of BF. On multivariate analysis, none of the factors remained significant. The best prognosis had patients with a low PSAD (<0.15 ng/mL/cm 3 ) and an optimal implant at 30 days after implantation (as defined by D 90 ≥ 130 Gy) compared to patients with both factors unfavorable (p = 0.006). A favorable PSAD was associate with a good prognosis, independently of the D 90 (<130 Gy vs. ≥130 Gy, p = 0.7). Patients with a PSAD of <0.15 ng/mL/cm 3 have little risk of BF, even in the case of a suboptimal implant. These results need to be validated in other patients' cohorts. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
Current use of equations for estimating glomerular filtration rate in Spanish laboratories.

Science.gov (United States)

Gràcia-Garcia, Sílvia; Montañés-Bermúdez, Rosario; Morales-García, Luis J; Díez-de Los Ríos, M José; Jiménez-García, Juan Á; Macías-Blanco, Carlos; Martínez-López, Rosalina; Ruiz-Altarejos, Joaquín; Ruiz-Martín, Guadalupe; Sanz-Hernández, Sonia; Ventura-Pedret, Salvador

2012-07-17

In 2006 the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) and the Spanish Society of Nephrology (S.E.N.) developed a consensus document in order to facilitate the diagnosis and monitoring of chronic kidney disease with the incorporation of equations for estimating glomerular filtration rate (eGFR) into laboratory reports. The current national prevalence of eGFR reporting and the degree of adherence to these recommendations among clinical laboratories is unknown. We administered a national survey in 2010-11 to Spanish clinical laboratories. The survey was through e-mail or telephone to laboratories that participated in the SEQC’s Programme for External Quality Assurance, included in the National Hospitals Catalogue 2010, including both primary care and private laboratories. A total of 281 laboratories answered to the survey. Of these, 88.2% reported on the eGFR, with 61.9% reporting on the MDRD equation and 31.6% using the MDRD-IDMS equation. A total of 42.5% of laboratories always reported serum creatinine values, and other variables only when specifically requested. Regarding the way results were presented, 46.2% of laboratories reported the exact numerical value only when the filtration rate was below 60mL/min/1.73m2, while 50.6% reported all values regardless. In 56.3% of the cases reporting eGFR, an interpretive commentary of it was enclosed. Although a high percentage of Spanish laboratories have added eGFR in their reports, this metric is not universally used. Moreover, some aspects, such as the equation used and the correct expression of eGFR results, should be improved.
Global warming uncertainties and the value of information: an analysis using CETA

International Nuclear Information System (INIS)

Peck, S.C.; Teisberg, T.J.

1993-01-01

This paper investigated the sensitivity of optimal carbon control strategies to parameters of the Carbon Emissions Trajectory Assessment (CETA) Model, and CETA is used in a simple decision tree framework to estimate the value of information about global warming uncertainties. We find that if an optimal control policy is used under uncertainty, the eventual resolution of uncertainty has high value relative to current research budgets, and resolving uncertainty about the costs of warming is nearly as important as resolving uncertainty about the extent of warming. In addition, we find that there is not a high premium on immediate resolution of uncertainty, if resolution would otherwise occur within, say, twenty years; this implies that time is available to plan and execute a carefully designed research program. On the other hand, we find that if the real world political process would result in a suboptimal control policy being chosen under uncertainty, and this choice could be prevented by early resolution of uncertainty, the benefit of early resolution may be as much as three orders of magnitude greater. 26 refs., 11 figs., 8 tabs
The changing face of clinical laboratories.

Science.gov (United States)

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.
When in doubt, seize the day? Security values, prosocial values, and proactivity under ambiguity.

Science.gov (United States)

Grant, Adam M; Rothbard, Nancy P

2013-09-01

Researchers have suggested that both ambiguity and values play important roles in shaping employees' proactive behaviors, but have not theoretically or empirically integrated these factors. Drawing on theories of situational strength and values, we propose that ambiguity constitutes a weak situation that strengthens the relationship between the content of employees' values and their proactivity. A field study of 204 employees and their direct supervisors in a water treatment plant provided support for this contingency perspective. Ambiguity moderated the relationship between employees' security and prosocial values and supervisor ratings of proactivity. Under high ambiguity, security values predicted lower proactivity, whereas prosocial values predicted higher proactivity. Under low ambiguity, values were not associated with proactivity. We replicated these findings in a laboratory experiment with 232 participants in which we measured proactivity objectively as initiative taken to correct errors: Participants with strong security values were less proactive, and participants with strong prosocial values were more proactive, but only when performance expectations were ambiguous. We discuss theoretical implications for research on proactivity, values, and ambiguity and uncertainty. PsycINFO Database Record (c) 2013 APA, all rights reserved
Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

Science.gov (United States)

Osaro, Erhabor; Chima, Njemanze

2014-06-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.
Influence of prebiotics on Lactobacillus reuteri death kinetics under sub-optimal temperatures and pH.

Science.gov (United States)

Altieri, Clelia; Iorio, Maria Clara; Bevilacqua, Antonio; Sinigaglia, Milena

2016-01-01

Eaten foodstuffs are usually fortified with prebiotic ingredients, such as inulin and oligofructose (FOS). The main goal of this study was to evaluate the combined effects of inulin and FOS with either suboptimal pH or storage temperature on the viability of Lactobacillus reuteri DSM 20016. Data were modeled through Weibull equation for the evaluation of the microbiological shelf life and the survival time. Prebiotics enhanced the microbiological shelf life and enhanced the survival time of the target bacterium. The use of the factorial ANOVA highlighted that inulin and FOS exerted a different effect as a function of pH and temperature. Inulin prolonged survival time under acidic conditions, while the effect of glucose + FOS was significant at pH 8. Finally, temperature could act by increasing or decreasing the effect of prebiotics, as they could exert a protective effect at 30 °C but not at 44 °C. As the main output of this research, we could suggest that the effect of prebiotics on L. reuteri could be significantly affected by pH and temperature, thus pinpointing that the design of a symbiotic food should also rely on these factors.

LABORATORY BIOMARKERS FOR ANKYLOSING SPONDYLITIS

Directory of Open Access Journals (Sweden)

E. N. Aleksandrova

2017-01-01

Full Text Available Ankylosing spondylitis (AS is a chronic inflammatory disease from a group of spondyloarthritis (SpA, which is characterized by lesions of the sacroiliac joints and spine with the common involvement of entheses and peripheral joints in the pathological process. Advances in modern laboratory medicine have contributed to a substantial expansion of the range of pathogenetic, diagnostic, and prognostic biomarkers of AS. As of now, there are key pathogenetic biomarkers of AS (therapeutic targets, which include tumor necrosis factor-α (TNF-α, interleukin 17 (IL-17, and IL-23. Among the laboratory diagnostic and prognostic biomarkers, HLA-B27 and C-reactive protein are of the greatest value in clinical practice; the former for the early diagnosis of the disease and the latter for the assessment of disease activity, the risk of radiographic progression and the efficiency of therapy. Anti-CD74 antibodies are a new biomarker that has high sensitivity and specificity values in diagnosing axial SpA at an early stage. A number of laboratory biomarkers, including calprotectin, matrix metalloproteinase-3 (MMP-3, vascular endothelial growth factor, Dickkopf-1 (Dkk-1, and C-terminal telopeptide of type II collagen (CTX II do not well reflect disease activity, but may predict progressive structural changes in the spine and sacroiliac joints in AS. Blood calprotectin level monitoring allows the effective prediction of a response to therapy with TNF inhibitors and anti-IL-17А monoclonal antibodies. The prospects for the laboratory diagnosis of AS are associated with the clinical validation of candidate biomarkers during large-scale prospective cohort studies and with a search for new proteomic, transcriptomic and genomic markers, by using innovative molecular and cellular technologies.
Interference by pralidoxime (PAM) salts in clinical laboratory tests.

Science.gov (United States)

Nagase, Sumika; Kohguchi, Katsunori; Tohyama, Kaoru; Watanabe, Mikio; Iwatani, Yoshinori

2013-02-01

Drugs sometimes alter the results of clinical laboratory tests. We examined the effects of pralidoxime (PAM) salts, a medicine used to treat organophosphorus poisoning, on clinical laboratory test results for the first time. The effects of PAM salts on glucose (GLU) measurements were examined using a point-of-care testing (POCT) meter, four self-monitoring of blood glucose (SMBG) meters, and two biochemical autoanalyzers. The effects of PAM salts on other clinical tests were also evaluated. The addition of PAM iodide or potassium iodide, but not of PAM chloride or potassium chloride, to blood samples increased the GLU values measured by one POCT meter and 4 SMBG meters using the enzyme electrode (hydrogen peroxidase or oxygen electrode) method. On the other hand, PAM iodide or PAM chloride, but not KI or KCl, affected the values measured at 340 nm by an autoanalyzer using absorption spectrophotometry in 8 of 14 clinical laboratory tests. The absorption spectrum of PAM changed from 294 to 338 nm due to the reaction between PAM and the alkaline buffer, a component of the measuring reagents. PAM iodide increases the GLU values measured by the enzyme electrode method, and PAM salts affected the values measured at 340 nm by absorption spectrophotometry in many other clinical test items. Copyright © 2012 Elsevier B.V. All rights reserved.
Perceptions and teaching actions in the teaching laboratory

Directory of Open Access Journals (Sweden)

Neusiane Chaves de Souza

2015-12-01

Full Text Available The Didactic laboratory, historically, has been a valued progress within the science education, as basic education as higher education. Therefore, we have discussed about the didactic laboratory in a licensure course in biological science. We have performed many semi-structured interviews with teachers from a qualitative research. The objective was the investigation of its use and the possible contribution to the formation of the teachers. The content of the interviews was analyzed through the textual-discursive analysis. There were four categories from the analysis. The first one was the relationship between the didactic laboratory, the curricular projects and the curricular reworking. The second one was the didactic laboratory as another educational formation. The third one was the planning, the developmenting and the evaluating of the laboratorial classes. The last one was the challenges of using the didactic laboratory. The didactic laboratory has intensified the relationship between the theory and the practice. Between the interaction of teacher, students, content, context. Between the execution of activities about conceptual, procedural and attitudinal contents. There is a strong potentiality in didactic laboratory because its dynamic teaching, its learning of specific contents, its didactic of biological science.
Clinical laboratory: bigger is not always better.

Science.gov (United States)

Plebani, Mario

2018-06-27

Laboratory services around the world are undergoing substantial consolidation and changes through mechanisms ranging from mergers, acquisitions and outsourcing, primarily based on expectations to improve efficiency, increasing volumes and reducing the cost per test. However, the relationship between volume and costs is not linear and numerous variables influence the end cost per test. In particular, the relationship between volumes and costs does not span the entire platter of clinical laboratories: high costs are associated with low volumes up to a threshold of 1 million test per year. Over this threshold, there is no linear association between volumes and costs, as laboratory organization rather than test volume more significantly affects the final costs. Currently, data on laboratory errors and associated diagnostic errors and risk for patient harm emphasize the need for a paradigmatic shift: from a focus on volumes and efficiency to a patient-centered vision restoring the nature of laboratory services as an integral part of the diagnostic and therapy process. Process and outcome quality indicators are effective tools to measure and improve laboratory services, by stimulating a competition based on intra- and extra-analytical performance specifications, intermediate outcomes and customer satisfaction. Rather than competing with economic value, clinical laboratories should adopt a strategy based on a set of harmonized quality indicators and performance specifications, active laboratory stewardship, and improved patient safety.
Performance of the RAD-57 pulse CO-oximeter compared with standard laboratory carboxyhemoglobin measurement.

Science.gov (United States)

Touger, Michael; Birnbaum, Adrienne; Wang, Jessica; Chou, Katherine; Pearson, Darion; Bijur, Polly

2010-10-01

We assess agreement between carboxyhemoglobin levels measured by the Rad-57 signal extraction pulse CO-oximeter (RAD), a Food and Drug Administration-approved device for noninvasive bedside measurement, and standard laboratory arterial or venous measurement in a sample of emergency department (ED) patients with suspected carbon monoxide poisoning. The study was a cross-sectional cohort design using a convenience sample of adult and pediatric ED patients in a Level I trauma, burn, and hyperbaric oxygen referral center. Measurement of RAD carboxyhemoglobin was performed simultaneously with blood sampling for laboratory determination of carboxyhemoglobin level. The difference between the measures for each patient was calculated as laboratory carboxyhemoglobin minus carboxyhemoglobin from the carbon monoxide oximeter. The limits of agreement from a Bland-Altman analysis are calculated as the mean of the differences between methods ±1.96 SDs above and below the mean. Median laboratory percentage carboxyhemoglobin level was 2.3% (interquartile range 1 to 8.5; range 0% to 38%). The mean difference between laboratory carboxyhemoglobin values and RAD values was 1.4% carboxyhemoglobin (95% confidence interval [CI] 0.2% to 2.6%). The limits of agreement of differences of measurement made with the 2 devices were -11.6% and 14.4% carboxyhemoglobin. This range exceeded the value of ±5% carboxyhemoglobin defined a priori as clinically acceptable. RAD correctly identified 11 of 23 patients with laboratory values greater than 15% carboxyhemoglobin (sensitivity 48%; 95% CI 27% to 69%). There was one case of a laboratory carboxyhemoglobin level less than 15%, in which the RAD device gave a result greater than 15% (specificity of RAD 96/97=99%; 95% CI 94% to 100%). In the range of carboxyhemoglobin values measured in this sample, the level of agreement observed suggests RAD measurement may not be used interchangeably with standard laboratory measurement. Copyright © 2010 American
Annual Report on the State of the DOE National Laboratories

Energy Technology Data Exchange (ETDEWEB)

None

2017-01-01

This first Annual Report to Congress on the State of the DOE National Laboratories provides a comprehensive overview of the Lab system, covering S&T programs, management and strategic planning. The Department committed to prepare this report in response to recommendations from the Congressionally mandated Commission to Review the Effectiveness of the National Energy Laboratories (CRENEL) that the Department should better communicate the value that the Laboratories provide to the Nation. We expect that future annual reports will be much more compact, building on the extensive description of the Laboratories and of the governance structures that are part of this first report.
Efficacy comparative of different laboratory test reagents for hepatitis C virus antibody

Directory of Open Access Journals (Sweden)

GUO Feibo

2016-09-01

Full Text Available Objective To investigate the effects of different laboratory test reagents for hepatitis C virus (HCV antibody through a comparative analysis. Methods A total of 207 samples which tested positive by four anti-HCV screening reagents commonly used in the laboratories in China (Kehua, Xinchuang, Wantai, and Abbott were included. HCV RNA nucleic acid amplification (NAT was performed, and if NAT results were negative, recombinant immunoblot assay (RIBA was performed for further confirmation. The test results of these four screening reagents were compared, and their S/CO values and true positive rates were analyzed. Results Of all the 205 samples testing positive by any one reagent, 191 (93.2% tested positive by the four reagents, and 14 (6.8% were tested inconsistently by the four reagents. The positive predictive values of Xinchuang, Kehua, Wantai, and Abbott reagents were 88.2% (180/204, 93.8% (180/192, 91.4% (180/197, and 90.0% (180/200, respectively. The S/CO thresholds with a positive predictive value of ≥95% for Xinchuang, Kehua, Wantai, and Abbott reagents were 9.0, 4.0, 5.0, and 7.0, respectively. Conclusion Xinchuang, Kehua, Wantai, and Abbott reagents have significantly different S/CO thresholds with a positive predictive value of ≥95%, which are significantly different from those in other domestic laboratories. Each laboratory should establish an applicable S/CO threshold with a positive predictive value of ≥95%, in order to reduce the sample size for confirmatory test.
Evaluation of Radiometers Deployed at the National Renewable Energy Laboratory's Solar Radiation Research Laboratory

Energy Technology Data Exchange (ETDEWEB)

Habte, Aron; Wilcox, Stephen; Stoffel, Thomas

2015-12-23

This study analyzes the performance of various commercially available radiometers used for measuring global horizontal irradiances and direct normal irradiances. These include pyranometers, pyrheliometers, rotating shadowband radiometers, and a pyranometer with fixed internal shading and are all deployed at the National Renewable Energy Laboratory's Solar Radiation Research Laboratory. Data from 32 global horizontal irradiance and 19 direct normal irradiance radiometers are presented. The radiometers in this study were deployed for one year (from April 1, 2011, through March 31, 2012) and compared to measurements from radiometers with the lowest values of estimated measurement uncertainties for producing reference global horizontal irradiances and direct normal irradiances.
Clinical and Laboratory Predictors of Articular Disorders Among HIV ...

African Journals Online (AJOL)

laboratory features of HIV‑infected patients and articular disorders. Aims: To ... The recruitment of subjects for the study took place ..... [4-8,10]. The reported range is wide and reflects prevalence from ... this study may be close to the true value because the subjects .... hence higher ESR values, indicating widespread systemic.
Entrainment in Laboratory Simulations of Cumulus Cloud Flows

Science.gov (United States)

Narasimha, R.; Diwan, S.; Subrahmanyam, D.; Sreenivas, K. R.; Bhat, G. S.

2010-12-01

A variety of cumulus cloud flows, including congestus (both shallow bubble and tall tower types), mediocris and fractus have been generated in a water tank by simulating the release of latent heat in real clouds. The simulation is achieved through ohmic heating, injected volumetrically into the flow by applying suitable voltages between diametral cross-sections of starting jets and plumes of electrically conducting fluid (acidified water). Dynamical similarity between atmospheric and laboratory cloud flows is achieved by duplicating values of an appropriate non-dimensional heat release number. Velocity measurements, made by laser instrumentation, show that the Taylor entrainment coefficient generally increases just above the level of commencement of heat injection (corresponding to condensation level in the real cloud). Subsequently the coefficient reaches a maximum before declining to the very low values that characterize tall cumulus towers. The experiments also simulate the protected core of real clouds. Cumulus Congestus : Atmospheric cloud (left), simulated laboratory cloud (right). Panels below show respectively total heat injected and vertical profile of heating in the laboratory cloud.
A novel class of laboratory middleware. Promoting information flow and improving computerized provider order entry.

Science.gov (United States)

Grisson, Ricky; Kim, Ji Yeon; Brodsky, Victor; Kamis, Irina K; Singh, Balaji; Belkziz, Sidi M; Batra, Shalini; Myers, Harold J; Demyanov, Alexander; Dighe, Anand S

2010-06-01

A central duty of the laboratory is to inform clinicians about the availability and usefulness of laboratory testing. In this report, we describe a new class of laboratory middleware that connects the traditional clinical laboratory information system with the rest of the enterprise, facilitating information flow about testing services. We demonstrate the value of this approach in efficiently supporting an inpatient order entry application. We also show that order entry monitoring and iterative middleware updates can enhance ordering efficiency and promote improved ordering practices. Furthermore, we demonstrate the value of algorithmic approaches to improve the accuracy and completeness of laboratory test searches. We conclude with a discussion of design recommendations for middleware applications and discuss the potential role of middleware as a sharable, centralized repository of laboratory test information.
Suboptimal Nutritional Characteristics in Male and Female Soldiers Compared to Sports Nutrition Guidelines.

Science.gov (United States)

Beals, Kim; Darnell, Matthew E; Lovalekar, Mita; Baker, Rachel A; Nagai, Takashi; San-Adams, Thida; Wirt, Michael D

2015-12-01

The purpose of this study was to evaluate the nutrient intake of male and female Soldiers in the 101 st Airborne Division (Air Assault) compared to sports nutrition standards for athletes, and to identify suboptimal eating characteristics that may impair physical performance and jeopardize military readiness. Male and female Soldiers from the 101 st Airborne Division (Air Assault) completed a 24-hour dietary recall and nutrition history questionnaire before anthropometric and body composition measurements were taken. Compared to sports nutrition guidelines, Soldiers of the 101 st under consume carbohydrates (males: 3.9 ± 2.0 vs. 5.0 g/kg, p < 0.001; females: 4.0 ± 2.1 vs. 5.0 g/kg, p = 0.001), male Soldiers eat too much fat (32.4% of kcal vs. <30% of kcal, p = 0.000) and saturated fat (males: 10.5 ± 3.9% of kcal vs. 10.0% of kcal, p = 0.044), and both males and females follow a meal pattern that may not optimize energy availability throughout the day. Eating too much fat and under fueling carbohydrate may negatively impact the adaptations to physical training and compromise overall health. Although Soldiers continue to participate in arduous training programs, future research should be aimed at determining the energy and macronutrient needs to fuel and recover from specific types of military training. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
Diagnostic value of imaging in infective endocarditis : a systematic review

NARCIS (Netherlands)

Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of
Suboptimal effectiveness of the 2011-2012 seasonal influenza vaccine in adult Korean populations.

Directory of Open Access Journals (Sweden)

Won Suk Choi

Full Text Available The effectiveness of the 2011-2012 seasonal influenza vaccine was evaluated in adult Korean populations with regard to how well it could prevent laboratory-confirmed influenza and influenza-related complications.A retrospective case-control and retrospective cohort study was conducted among patients who visited four selected hospitals from September 2011 to May 2012. The analysis included 1,130 laboratory-confirmed influenza patients. For each influenza case, one control patient was chosen at a ratio of 1:1. A control was defined as an age group-matched patient who visited the same hospital with influenza-like illness within 48 hours of symptom onset but for whom laboratory tests were negative for influenza. Age group and visit date were matched between the cases and controls. Vaccine effectiveness (VE was defined as [100 × (1-odds ratio for influenza in vaccinated versus non-vaccinated persons]. The patients with laboratory-confirmed influenza were followed for at least one month through reviewing the medical records and conducting a telephone interview.The VE of the 2011-2012 seasonal influenza vaccine was 3.8% [95% confidence interval (CI, -16.5% to 20.6%] for preventing laboratory-confirmed influenza, -16.1% (95% CI, -48.3 to 9.1 for influenza A and 26.2% (95% CI, -2.6 to 46.2 for influenza B. The age-specific adjusted VE was 0.3% (95% CI, -29.4 to 23.1 among participants aged 19 to 49 years, 11.9% (95% CI, -34.3 to 42.2 among those aged 50 to 64 years and -3.9% (-60.1 to 32.5 among those aged ≥65 years. The adjusted VE for preventing any influenza-related complications was -10.7% (95% CI, -41.1% to 42.2%.The 2011-2012 seasonal influenza vaccine was not effective in preventing laboratory-confirmed influenza or influenza-related complications in adult Korean populations.
COMPETITIVE ADVANTAGES IN A NANOTECHNOLOGY VALUE CHAIN

OpenAIRE

Adriana Radan UNGUREANU

2015-01-01

The value chain analysis is one of the most important methods for understanding the industrial world. The main task of the value chain that links producers and buyers consists in understanding where or how exactly the value added is generated. In the case of products incorporating nanotechnology, most of them are still in the trial phase into laboratories, but there are some examples of good practices where nanoproducts discovered their way to the market. This paper tries to present two cases...
Site characteristics of Argonne National Laboratory in Illinois

International Nuclear Information System (INIS)

Chang, Y.W.

1995-01-01

This report reviews the geology and topography of the Argonne National Laboratory, near Lemont, Illinois. It describes the thickness and stratigraphy of soils, glacial till, and bedrock in and adjacent to the laboratory and support facilities. Seismic surveys were also conducted through the area to help determine the values of seismic wave velocities in the glacial till which is important in determining the seismic hazard of the area. Borehole log descriptions are summarized along with information on area topography
Homogenization of the lipid profile values.

Science.gov (United States)

Pedro-Botet, Juan; Rodríguez-Padial, Luis; Brotons, Carlos; Esteban-Salán, Margarita; García-Lerín, Aurora; Pintó, Xavier; Lekuona, Iñaki; Ordóñez-Llanos, Jordi

Analytical reports from the clinical laboratory are essential to guide clinicians about what lipid profile values should be considered altered and, therefore, require intervention. Unfortunately, there is a great heterogeneity in the lipid values reported as "normal, desirable, recommended or referenced" by clinical laboratories. This can difficult clinical decisions and be a barrier to achieve the therapeutic goals for cardiovascular prevention. A recent international recommendation has added a new heterogeneity factor for the interpretation of lipid profile, such as the possibility of measuring it without previous fasting. All this justifies the need to develop a document that adapts the existing knowledge to the clinical practice of our health system. In this regard, professionals from different scientific societies involved in the measurement and use of lipid profile data have developed this document to establish recommendations that facilitate their homogenization. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Analysis of results from intercomparison among Spanish laboratories involved of photon energy ''137 Cs for environmental dosimetry laboratories

International Nuclear Information System (INIS)

Gonzalez, A.M.; Brosed, A.; Salas, R.

2003-01-01

Any environmental thermoluminescent dosemeter (TLD) system must be periodically calibrated at a calibration laboratory. In this frame, the Consejo de Seguridad Nuclear (CSN) has performed an intercomparison among Spanish laboratories involved in environmental monitoring, by means of TLD, in order to verify the traceability of the whole dosimeter and reader to the national standard for the protection quantities of interest for a given photon energy (''137Cs). To achieve this goal the CSN asked the Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT) to carry out the reference irradiations in the energy above mentioned at the lonising Radiations Metrology Unit headquarters. Nine laboratories have participated. All the dosemeters were irradiated with the same air kerma rate. The radiological quantity used was the ambient dose equivalent, H (10), and the values of this quantity assigned to each laboratory were between 210 and 360 μSv. All the dosemeters of the participating laboratories met the two analysis criteria used. All of them demonstrated a satisfactory fulfilment of the requirements established by so called trumpet curves and of the requirements established by the ANSI 1311. (Author) 7 refs
Factors associated with suboptimal adherence to antiretroviral therapy in Asia

Science.gov (United States)

Jiamsakul, Awachana; Kumarasamy, Nagalingeswaran; Ditangco, Rossana; Li, Patrick CK; Phanuphak, Praphan; Sirisanthana, Thira; Sungkanuparph, Somnuek; Kantipong, Pacharee; Lee, Christopher KC; Mustafa, Mahiran; Merati, Tuti; Kamarulzaman, Adeeba; Singtoroj, Thida; Law, Matthew

2014-01-01

Introduction Adherence to antiretroviral therapy (ART) plays an important role in treatment outcomes. It is crucial to identify factors influencing adherence in order to optimize treatment responses. The aim of this study was to assess the rates of, and factors associated with, suboptimal adherence (SubAdh) in the first 24 months of ART in an Asian HIV cohort. Methods As part of a prospective resistance monitoring study, the TREAT Asia Studies to Evaluate Resistance Monitoring Study (TASER-M) collected patients’ adherence based on the World Health Organization-validated Adherence Visual Analogue Scale. SubAdh was defined in two ways: (i) 14 days. Time was divided into four intervals: 0–6, 6–12, 12–18 and 18–24 months. Factors associated with SubAdh were analysed using generalized estimating equations. Results Out of 1316 patients, 32% ever reported 2 assessments per patient per year had an odds ratio (OR)=0.7 (95% confidence interval (CI) (0.55 to 0.90), p=0.006), compared to sites with ≤2 assessments per patient per year. Compared to heterosexual exposure, SubAdh was higher in injecting drug users (IDUs) (OR=1.92, 95% CI (1.23 to 3.00), p=0.004) and lower in homosexual exposure (OR=0.52, 95% CI (0.38 to 0.71), p<0.001). Patients taking a nucleoside transcriptase inhibitor and protease inhibitor (NRTI+PI) combination were less likely to report adherence <100% (OR=0.36, 95% CI (0.20 to 0.67), p=0.001) compared to patients taking an NRTI and non-nucleoside transcriptase inhibitor (NRTI+NNRTI) combination. SubAdh decreased with increasing time on ART (all p<0.001). Similar associations were found with adherence <95% as the outcome. Conclusions We found that SubAdh, defined as either <100% and <95%, was associated with mode of HIV exposure, ART regimen, time on ART and frequency of adherence measurement. The more frequently sites assessed patients, the lower the SubAdh, possibly reflecting site resourcing for patient counselling. Although social
A bayesian approach to laboratory utilization management

Directory of Open Access Journals (Sweden)

Ronald G Hauser

2015-01-01

Full Text Available Background: Laboratory utilization management describes a process designed to increase healthcare value by altering requests for laboratory services. A typical approach to monitor and prioritize interventions involves audits of laboratory orders against specific criteria, defined as rule-based laboratory utilization management. This approach has inherent limitations. First, rules are inflexible. They adapt poorly to the ambiguity of medical decision-making. Second, rules judge the context of a decision instead of the patient outcome allowing an order to simultaneously save a life and break a rule. Third, rules can threaten physician autonomy when used in a performance evaluation. Methods: We developed an alternative to rule-based laboratory utilization. The core idea comes from a formula used in epidemiology to estimate disease prevalence. The equation relates four terms: the prevalence of disease, the proportion of positive tests, test sensitivity and test specificity. When applied to a laboratory utilization audit, the formula estimates the prevalence of disease (pretest probability [PTP] in the patients tested. The comparison of PTPs among different providers, provider groups, or patient cohorts produces an objective evaluation of laboratory requests. We demonstrate the model in a review of tests for enterovirus (EV meningitis. Results: The model identified subpopulations within the cohort with a low prevalence of disease. These low prevalence groups shared demographic and seasonal factors known to protect against EV meningitis. This suggests too many orders occurred from patients at low risk for EV. Conclusion: We introduce a new method for laboratory utilization management programs to audit laboratory services.

[Normative values of kinetic tests in VNG assessment].

Science.gov (United States)

Zamysłowska-Szmytke, Ewa; Sliwińska-Kowalska, Mariola

2011-01-01

Balance assessment plays an important role in occupational medicine. The diagnosis of patients with balance disturbances is based on a number of laboratory tests, including rotational chair tests, one of the most important. The normative value of kinetic tests greatly depends on movement parameters and laboratory equipment, which vary between diagnostic centers. The aim of the presented paper was to establish normatives for our laboratory and testing methodology in a group of healthy persons. The balance examination included 45 healthy persons (21 women and 24 men) aged 20-63 years (mean 38.5 +/- 14.9). The study population underwent very thorough neuro-otological examination, static posturography and VNG tests. The caloric test result was a crucial criterion for inclusion to the group of healthy persons. Rotational tests included: one "burst" test analyzing vestibulo-ocular reflex (VOR) with and without optokinetic stimulation visual vestibular optokinetic reflex (VVOR) and cervico-ocular reflex (COR); three impulse tests and sinusoidal harmonic rotation tests of 0.04, 0.08, 0.1, 0.16, 0.32, and 0.64 Hz. The mean values were: VVOR, 0.9 +/- 0.1; VOR, 0.5 +/- 0.1; and COR, 0.2 +/- 0.1. The mean value of rotational and post-rotational nystagmus induced by sudden chair stop (impulse stimulus) was 9 +/- 7 s, the gain values were 0.4 for sinusoidal tests, in the stimulation range of 0.1-0.32 and 0.5 for 0.64 Hz stimulation. There was no significant linear relationship between age and test parameters except for the test using sinusoidal-decreasing stimulation. These normative values form the base for a closer incorporation of rotational tests in occupational medicine procedures.
Suboptimal decision making by children with ADHD in the face of risk: Poor risk adjustment and delay aversion rather than general proneness to taking risks.

Science.gov (United States)

Sørensen, Lin; Sonuga-Barke, Edmund; Eichele, Heike; van Wageningen, Heidi; Wollschlaeger, Daniel; Plessen, Kerstin Jessica

2017-02-01

Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT) to distinguish difficulties in adjusting to changing probabilities of choice outcomes (so-called risk adjustment) from general risk proneness, and to distinguish these 2 processes from delay aversion (the tendency to choose the least delayed option) and impairments in the ability to reflect on choice options. Based on previous research, we predicted that suboptimal performance on this task in children with ADHD would be primarily relate to problems with risk adjustment and delay aversion rather than general risk proneness. Drug naïve children with ADHD (n = 36), 8 to 12 years, and an age-matched group of typically developing children (n = 34) performed the CGT. As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive-with these 2 effects being correlated. Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Summary of global warming uncertainties and the value of information: An analysis using CETA

International Nuclear Information System (INIS)

Peck, S.C.

1994-01-01

The authors investigate the sensitivity of optimal carbon control strategies to parameters of the Carbon Emissions Trajectory Assessment (CETA) Model, and they use CETA in a simple decision tree framework to estimate the value of information about global warming uncertainties. They find that if an optimal control policy is used under uncertainty, the eventual resolution of uncertainty has high value relative to current research budgets, and resolving uncertainty about the costs of warming is nearly as important as resolving uncertainty about the extent of warming. In addition, the authors find that there is not a high premium on immediate resolution of uncertainty, if resolution would otherwise occur within, say, twenty years; this implies that time is available to plan and execute a carefully designed research program. On the other hand, they find that if the real-world political process would result in a suboptimal control policy being chosen under uncertainty, and this choice could be prevented by early resolution of uncertainty, the benefit of early resolution may be as much as three orders of magnitude greater
Ambient radiation levels in a microPET/CT research laboratory

Energy Technology Data Exchange (ETDEWEB)

Sarmento, D.M.; Rodrigues, D.L.; Sanches, M.P.; Carneiro, J.C.G.G., E-mail: janetegc@ipen.br [Instituto de Pesquisas Energeticas e Nucleres (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2015-07-01

This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO{sub 4}:Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)
Ambient radiation levels in a microPET/CT research laboratory

International Nuclear Information System (INIS)

Sarmento, D.M.; Rodrigues, D.L.; Sanches, M.P.; Carneiro, J.C.G.G.

2015-01-01

This study focuses on initial radiological evaluation and the exposure situation related to the worker task in a micro-positron emission tomography/computed tomography laboratory (microPET/CT). Selected and calibrated thermoluminescent dosimeters, TLD, of CaSO 4 :Dy were used to measure room radiation levels. The detectors were placed in several selected points inside the microPET/CT laboratory and adjacent rooms. In addition, the occupationally exposed workers were monthly evaluated for external and internal exposures. In none of the selected points the dose values exceeded the radiation dose limit established for supervised area, as well as the values obtained in individual monitoring. (author)
Laboratory reference intervals during pregnancy, delivery and the early postpartum period

DEFF Research Database (Denmark)

Klajnbard, Anna; Szecsi, Pal Bela; Colov, Nina P

2010-01-01

Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological ...
Laboratory reference intervals during pregnancy, delivery and the early postpartum period

DEFF Research Database (Denmark)

Klajnbard, Anna; Szecsi, Pal Bela; Colov, Nina P

2010-01-01

Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological...
Extra-analytical quality indicators and laboratory performances.

Science.gov (United States)

Sciacovelli, Laura; Aita, Ada; Plebani, Mario

2017-07-01

In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.
Seeking excellence: An evaluation of 235 international laboratories conducting water isotope analyses by isotope-ratio and laser-absorption spectrometry.

Science.gov (United States)

Wassenaar, L I; Terzer-Wassmuth, S; Douence, C; Araguas-Araguas, L; Aggarwal, P K; Coplen, T B

2018-03-15

Water stable isotope ratios (δ 2 H and δ 18 O values) are widely used tracers in environmental studies; hence, accurate and precise assays are required for providing sound scientific information. We tested the analytical performance of 235 international laboratories conducting water isotope analyses using dual-inlet and continuous-flow isotope ratio mass spectrometers and laser spectrometers through a water isotope inter-comparison test. Eight test water samples were distributed by the IAEA to international stable isotope laboratories. These consisted of a core set of five samples spanning the common δ-range of natural waters, and three optional samples (highly depleted, enriched, and saline). The fifth core sample contained unrevealed trace methanol to assess analyst vigilance to the impact of organic contamination on water isotopic measurements made by all instrument technologies. For the core and optional samples ~73 % of laboratories gave acceptable results within 0.2 ‰ and 1.5 ‰ of the reference values for δ 18 O and δ 2 H, respectively; ~27 % produced unacceptable results. Top performance for δ 18 O values was dominated by dual-inlet IRMS laboratories; top performance for δ 2 H values was led by laser spectrometer laboratories. Continuous-flow instruments yielded comparatively intermediate results. Trace methanol contamination of water resulted in extreme outlier δ-values for laser instruments, but also affected reactor-based continuous-flow IRMS systems; however, dual-inlet IRMS δ-values were unaffected. Analysis of the laboratory results and their metadata suggested inaccurate or imprecise performance stemmed mainly from skill- and knowledge-based errors including: calculation mistakes, inappropriate or compromised laboratory calibration standards, poorly performing instrumentation, lack of vigilance to contamination, or inattention to unreasonable isotopic outcomes. To counteract common errors, we recommend that laboratories include 1-2 'known
Seeking excellence: An evaluation of 235 international laboratories conducting water isotope analyses by isotope-ratio and laser-absorption spectrometry

Science.gov (United States)

Wassenaar, L. I.; Terzer-Wassmuth, S.; Douence, C.; Araguas-Araguas, L.; Aggarwal, P. K.; Coplen, Tyler B.

2018-01-01

RationaleWater stable isotope ratios (δ2H and δ18O values) are widely used tracers in environmental studies; hence, accurate and precise assays are required for providing sound scientific information. We tested the analytical performance of 235 international laboratories conducting water isotope analyses using dual-inlet and continuous-flow isotope ratio mass spectrometers and laser spectrometers through a water isotope inter-comparison test.MethodsEight test water samples were distributed by the IAEA to international stable isotope laboratories. These consisted of a core set of five samples spanning the common δ-range of natural waters, and three optional samples (highly depleted, enriched, and saline). The fifth core sample contained unrevealed trace methanol to assess analyst vigilance to the impact of organic contamination on water isotopic measurements made by all instrument technologies.ResultsFor the core and optional samples ~73 % of laboratories gave acceptable results within 0.2 ‰ and 1.5 ‰ of the reference values for δ18O and δ2H, respectively; ~27 % produced unacceptable results. Top performance for δ18O values was dominated by dual-inlet IRMS laboratories; top performance for δ2H values was led by laser spectrometer laboratories. Continuous-flow instruments yielded comparatively intermediate results. Trace methanol contamination of water resulted in extreme outlier δ-values for laser instruments, but also affected reactor-based continuous-flow IRMS systems; however, dual-inlet IRMS δ-values were unaffected.ConclusionsAnalysis of the laboratory results and their metadata suggested inaccurate or imprecise performance stemmed mainly from skill- and knowledge-based errors including: calculation mistakes, inappropriate or compromised laboratory calibration standards, poorly performing instrumentation, lack of vigilance to contamination, or inattention to unreasonable isotopic outcomes. To counteract common errors, we recommend that
Surrogate indicators of sensitivity in gynecologic cytology: Can they be used to improve the measurement of sensitivity in the laboratory?

Directory of Open Access Journals (Sweden)

Renshaw Andrew

2009-01-01

Full Text Available Background: Measuring the sensitivity of screening in gynecologic cytology in real life is problematic. However, other quality measures may correlate with sensitivity, including the atypical squamous cells (ASC/squamous intraepithelial lesion (SIL ratio. Whether these other measures can function as "surrogate indicators" for sensitivity and improve the assessment of sensitivity in the laboratory is not known. Materials and Methods: We compared multiple quality measures with true screening sensitivity in a variety of situations. Results: The abnormal rate, ASC rate, and ASC/SIL ratio were all highly correlated (r = .83 or greater with sensitivity when the overall laboratory sensitivity was low (85% but became less correlated (.64 or less or uncorrelated when the screening sensitivity was higher (88% or 95%, respectively. Sensitivity was more highly correlated with the abnormal rate than the ASC/SIL ratio at low screening sensitivity. While thresholds could be set that were highly sensitive and specific for suboptimal screening, these thresholds were often less than one standard deviation away from the mean. Conclusion: The correlation of the abnormal rate and the ASC/SIL ratio with sensitivity depends on overall sensitivity. Standards to define minimum screening sensitivity can be defined, but these standards are relatively narrow. These features may limit the utility of these quality measures as surrogates for sensitivity.
The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis.

Science.gov (United States)

Bartick, Melissa; Reinhold, Arnold

2010-05-01

A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality. Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars. If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.
Radioactive effluent monitoring at the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

Simpson, O.D.

1975-01-01

The Effluent and Radiation Measurements Laboratory at the Idaho National Engineering Laboratory (INEL) has recently upgraded capabilities in the field of monitoring and analysis of radioactive airborne and liquid effluents using the techniques of gamma-ray spectrometry. The techniques and equipment used include remotely-operated, computer-based Ge(Li) spectrometers which obtain data on a real-time basis. Permanent record files are maintained of both the effluent release values and the gamma-ray data from which the release values are calculated. Should values for release levels ever be challenged, the gamma-ray spectral information for any measurement can be recalled and analyzed as needed. Daily effluent release reports are provided to operating personnel which contributes to prompt correction of any operational problems. Monthly, quarterly, and annual reports are compiled which provide inventories of the radionuclides released. A description of the effluent monitoring, reporting and records system developed at INEL for this application will be presented
[Our experience with outside laboratory quality control].

Science.gov (United States)

Dochev, D; Arakasheva, V; Nashkov, A; Tsachev, K

1979-01-01

The results from the national outside laboratory qualitative control of the clinical diagnostic laboratory investigations for the period September 1975 -- May 1977 were described. The following interlaboratory discrepancy was found on base of a systematic analysis of the data from the last two ring-like check-ups, November 1976 and May 1977, exressed by the variation coefficient (V.C. %); total protein, sodium, potassium and chlorides -- under 10%; cholesterol, urea and total fats -- between 10 and 20%; calcium, phosphorus, iron and creatinine -- over 20%. The highest per cent of admissible results are found with total protein -- to 85%; cholesterol -- to 70.38%; glucosa -- to 73.17%, urea -- to 69.23%, potassium -- to 59.46%, chlorides -- to 57.9%. With sodium, phosphorus, calcium, iron creatinine and uric acid the "admissibility" fluctuates about or under 50 per cent. The values of the qualitative-control indices discussed are comparable with the values obtained from them in the interlaboratory comparisons of other countries.
Validation in the cytopathology laboratory: its time has come.

Science.gov (United States)

Haack, Lori A; Shalkham, John

2007-08-01

The cytology laboratory has traditionally performed a relatively small variety of tests. The testing processes employed were generally manually performed and included preparation of glass slide materials, staining of these slides, coverslipping, and microscopic evaluation of the cellular material. Instrumentation in the cytology laboratory was very limited and included a centrifuge, membrane filtration system, and possibly an automated staining machine. If instruments were added, for example, a liquid based preparation device or an automated coverslipping device; the instruments were rarely checked to assure they were operating properly before implementation into clinical practice. In addition, little documentation was maintained with regards to the instrument performance evaluation process. Increasing automation and expansion of testing options have changed how cytopathology is practiced. There are many new devices employed for the preparation of specimens, staining and coverslipping of slides, and evaluation of cellular material. The increasing use of molecular testing methods in cytopathology further adds to the changing landscape of cytopathology. New instrumentation and testing methods are routinely being introduced and the cytopathology laboratory must assure that the testing performed is accurate and consistent. Cytopathology laboratory professionals need to appreciate the value of validation of the tests we perform and the instruments we use in order to best serve the patient. Our clinical laboratory colleagues have traditionally performed validation on both instruments and test methods before using them for clinical testing. If cytopathology wants to perform the complex testing being introduced and effectively utilize new instrumentation, we need to understand the value of validation and how we apply validation to our laboratory practice. Copyright 2007 Wiley-Liss, Inc.
Simulation of General Physics laboratory exercise

International Nuclear Information System (INIS)

Aceituno, P; Hernández-Cabrera, A; Hernández-Aceituno, J

2015-01-01

Laboratory exercises are an important part of general Physics teaching, both during the last years of high school and the first year of college education. Due to the need to acquire enough laboratory equipment for all the students, and the widespread access to computers rooms in teaching, we propose the development of computer simulated laboratory exercises. A representative exercise in general Physics is the calculation of the gravity acceleration value, through the free fall motion of a metal ball. Using a model of the real exercise, we have developed an interactive system which allows students to alter the starting height of the ball to obtain different fall times. The simulation was programmed in ActionScript 3, so that it can be freely executed in any operative system; to ensure the accuracy of the calculations, all the input parameters of the simulations were modelled using digital measurement units, and to allow a statistical management of the resulting data, measurement errors are simulated through limited randomization
Laboratory automation in clinical bacteriology: what system to choose?

Science.gov (United States)

Croxatto, A; Prod'hom, G; Faverjon, F; Rochais, Y; Greub, G

2016-03-01

Automation was introduced many years ago in several diagnostic disciplines such as chemistry, haematology and molecular biology. The first laboratory automation system for clinical bacteriology was released in 2006, and it rapidly proved its value by increasing productivity, allowing a continuous increase in sample volumes despite limited budgets and personnel shortages. Today, two major manufacturers, BD Kiestra and Copan, are commercializing partial or complete laboratory automation systems for bacteriology. The laboratory automation systems are rapidly evolving to provide improved hardware and software solutions to optimize laboratory efficiency. However, the complex parameters of the laboratory and automation systems must be considered to determine the best system for each given laboratory. We address several topics on laboratory automation that may help clinical bacteriologists to understand the particularities and operative modalities of the different systems. We present (a) a comparison of the engineering and technical features of the various elements composing the two different automated systems currently available, (b) the system workflows of partial and complete laboratory automation, which define the basis for laboratory reorganization required to optimize system efficiency, (c) the concept of digital imaging and telebacteriology, (d) the connectivity of laboratory automation to the laboratory information system, (e) the general advantages and disadvantages as well as the expected impacts provided by laboratory automation and (f) the laboratory data required to conduct a workflow assessment to determine the best configuration of an automated system for the laboratory activities and specificities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Energy efficiency in California laboratory-type facilities

Energy Technology Data Exchange (ETDEWEB)

Mills, E.; Bell, G.; Sartor, D. [and others

1996-07-31

The central aim of this project is to provide knowledge and tools for increasing the energy efficiency and performance of new and existing laboratory-type facilities in California. We approach the task along three avenues: (1) identification of current energy use and savings potential, (2) development of a {ital Design guide for energy- Efficient Research Laboratories}, and (3) development of a research agenda for focused technology development and improving out understanding of the market. Laboratory-type facilities use a considerable amount of energy resources. They are also important to the local and state economy, and energy costs are a factor in the overall competitiveness of industries utilizing laboratory-type facilities. Although the potential for energy savings is considerable, improving energy efficiency in laboratory-type facilities is no easy task, and there are many formidable barriers to improving energy efficiency in these specialized facilities. Insufficient motivation for individual stake holders to invest in improving energy efficiency using existing technologies as well as conducting related R&D is indicative of the ``public goods`` nature of the opportunity to achieve energy savings in this sector. Due to demanding environmental control requirements and specialized processes, laboratory-type facilities epitomize the important intersection between energy demands in the buildings sector and the industrial sector. Moreover, given the high importance and value of the activities conducted in laboratory-type facilities, they represent one of the most powerful contexts in which energy efficiency improvements stand to yield abundant non-energy benefits if properly applied.
75 FR 27865 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

Science.gov (United States)

2010-05-18

... contributors;'' and (d) increased employee satisfaction with the Laboratory. D. Participating Employees and.... This disrupts the R&D process and reduces the Laboratory's ability to serve its customers. Under the... simply defined as the measure of the demonstrated value of what an employee did in terms of accomplishing...
Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

Science.gov (United States)

Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

2016-08-01

The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

Results of the Interlaboratory Exercise CNS/CIEMAT-2008 among Environmental Radioactivity Laboratories (Phosphogypsum)

International Nuclear Information System (INIS)

Romero, M. L.; Barrera, M.; Valino, F.

2010-01-01

The document describes the outcome of the CSN/CIEMAT-2008 interlaboratory test comparison among environmental radioactivity laboratories. The exercise was organised according to the ISO-43 and the ISO/IUPAC/AOAC. Aphosphogypsum material was used as a test sample, in an attempt to evaluate the performance of the laboratories analyzing NORM (Naturally-Occurring Radioactive Materials). The analysis required were: U-238, Th-234, U-234, Th-230, Ra-226, Pb-214, Bi-214, Pb-210, Po-210, Th-232 and U-235, and also gross alpha and gross beta activities. Reference values have been established according to the method of consensus of expert laboratories, with four international laboratories of credited experience: IAEA Seibersdorf, IAEA MEL, IRSN-Orsay and Sta.Teresa ENEA. The results of the exercise were computed for 34 answering laboratories and their analytical performance was assessed using the z-score. Robust statistics of the participants results was applied to obtain the median and standard deviation, to achieve a more complete and objective study of the laboratories performance. The exercise has shown an homogeneous behaviour of laboratories, being statistical parameters from the results close to the assigned Reference Values. Participant laboratories have demonstrated their ability to determine natural radionuclides in phosphogypsum samples (NORM material) with a satisfactory quality level. The scheme has also allowed examining the capability of laboratories to determine the activities of natural radionuclides at the equilibrium. (Author) 10 refs.
Altered Innate Immune Responses in Neutrophils from Patients with Well- and Suboptimally Controlled Asthma

Directory of Open Access Journals (Sweden)

Francesca S. M. Tang

2015-01-01

Full Text Available Background. Respiratory infections are a major cause of asthma exacerbations where neutrophilic inflammation dominates and is associated with steroid refractory asthma. Structural airway cells in asthma differ from nonasthmatics; however it is unknown if neutrophils differ. We investigated neutrophil immune responses in patients who have good (AGood and suboptimal (ASubopt asthma symptom control. Methods. Peripheral blood neutrophils from AGood (ACQ 0.75, n=7, and healthy controls (HC (n=9 were stimulated with bacterial (LPS (1 μg/mL, fMLF (100 nM, and viral (imiquimod (3 μg/mL, R848 (1.5 μg/mL, and poly I:C (10 μg/mL surrogates or live rhinovirus (RV 16 (MOI1. Cell-free supernatant was collected after 1 h for neutrophil elastase (NE and matrix metalloproteinase- (MMP- 9 measurements or after 24 h for CXCL8 release. Results. Constitutive NE was enhanced in AGood neutrophils compared to HC. fMLF stimulated neutrophils from ASubopt but not AGood produced 50% of HC levels. fMLF induced MMP-9 was impaired in ASubopt and AGood compared to HC. fMLF stimulated CXCL8 but not MMP-9 was positively correlated with FEV1 and FEV1/FVC. ASubopt and AGood responded similarly to other stimuli. Conclusions. Circulating neutrophils are different in asthma; however, this is likely to be related to airflow limitation rather than asthma control.
Economic and disease burden of breast cancer associated with suboptimal breastfeeding practices in Mexico.

Science.gov (United States)

Unar-Munguía, Mishel; Meza, Rafael; Colchero, M Arantxa; Torres-Mejía, Gabriela; de Cosío, Teresita Gonzalez

2017-12-01

Exclusive breastfeeding and longer breastfeeding reduce women's breast cancer risk but Mexico has one of the lowest breastfeeding rates worldwide. We estimated the lifetime economic and disease burden of breast cancer in Mexico if 95% of parous women breastfeed each child exclusively for 6 months and continue breastfeeding for over a year. We used a static microsimulation model with a cost-of-illness approach to simulate a cohort of Mexican women. We estimated breast cancer incidence, premature mortality, disability-adjusted life years (DALYs), medical costs, and income losses due to breast cancer and extrapolated the results to 1.116 million Mexican women of age 15 in 2012. Costs were expressed in 2015 US dollars and discounted at a 3% annual rate. We estimated that 2,186 premature deaths (95% CI 2,123-2,248), 9,936 breast cancer cases (95% CI 9,651-10,220), 45,109 DALYs (95% CI 43,000-47,217), and $245 million USD (95% CI 234-256) in medical costs and income losses owing to breast cancer could be saved over a cohort's lifetime. Medical costs account for 80% of the economic burden; income losses and opportunity costs for caregivers account for 15 and 5%, respectively. In Mexico, the burden of breast cancer due to suboptimal breastfeeding in women is high in terms of morbidity, premature mortality, and the economic costs for the health sector and society.
Laboratory system strengthening and quality improvement in Ethiopia

Directory of Open Access Journals (Sweden)

Tilahun M. Hiwotu

2014-11-01

Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories. Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels. Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.
National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

Science.gov (United States)

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.
Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times.

Science.gov (United States)

Inal, Tamer C; Goruroglu Ozturk, Ozlem; Kibar, Filiz; Cetiner, Salih; Matyar, Selcuk; Daglioglu, Gulcin; Yaman, Akgun

2018-01-01

Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems. The laboratory turnaround time for individual tests, total delay time in the sample reception area, and percentage of steps involving risks of medical errors and biological hazards in the overall process are measured. The pre-analytical process in the reception area was improved by eliminating 3 h and 22.5 min of non-value-adding work. Turnaround time also improved for stat samples from 68 to 59 min after applying Lean. Steps prone to medical errors and posing potential biological hazards to receptionists were reduced from 30% to 3%. Successful implementation of Lean Six Sigma significantly improved all of the selected performance metrics. This quality-improvement methodology has the potential to significantly improve clinical laboratories. © 2017 Wiley Periodicals, Inc.
Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.

Science.gov (United States)

Vachová, Martina; Panzner, Petr; Malkusová, Ivana; Hanzlíková, Jana; Vlas, Tomáš

2016-05-01

A diagnosis of Hymenoptera venom allergy is based on clinical history and the results of skin tests and/or laboratory methods. To analyze the utility of available laboratory tests in diagnosing Hymenoptera venom allergy. Ninety-five patients with Hymenoptera venom allergy with a history of bee (35) or wasp (60) anaphylactic sting reaction and positive skin test with bee or wasp venom were included in this analysis. Specific immunoglobulin E (to bee venom extract, wasp venom extract, available recombinant molecules, and a basophil activation test with venom extracts were assessed in all the patients. Test sensitivity and specificity were calculated by using standard threshold values; then, receiver operating characteristic curve analysis was performed to compute optimal threshold values. Also, statistical analysis of the utility of different combinations of laboratory tests was performed. The optimal threshold values were revealed to be the following: 1.0 kIU/L for bee venom extract (sensitivity, 97.14%; specificity, 100%), 0.35 kIU/L for rApi m 1 (sensitivity, 68.57%; specificity, 100%), 1.22 kIU/L for wasp venom extract (sensitivity, 88.33%; specificity, 95.45%), 0.7 kIU/L for rVes v 5 (sensitivity, 86.67%; specificity, 95.45%), 1.0 kIU/L for rVes v 1 (sensitivity, 56.67%; specificity, 95.45%), 6.5% for basophil activation test with bee venom extract (sensitivity, 80%; specificity, 95.45%), and 4.5% for basophil activation test with wasp venom extract (sensitivity, 91.53%; specificity, 95.45%). The best test combinations were found to be the following: bee venom extract plus rApi m 1 (sensitivity, 97.14%; specificity, 95.45%) in bee and either wasp venom extract plus rVes v 5, or rVes v 5 plus rVes v 1 (both sensitivity, 98.33%; specificity, 95.45%) in patients with wasp venom allergy. Our analysis confirmed that currently used laboratory tests represent effective tools in diagnosing Hymenoptera venom allergy. Moreover, our probabilistic approach offered another
Improvement of laboratory turnaround time using lean methodology.

Science.gov (United States)

Gupta, Shradha; Kapil, Sahil; Sharma, Monica

2018-05-14

Purpose The purpose of this paper is to discuss the implementation of lean methodology to reduce the turnaround time (TAT) of a clinical laboratory in a super speciality hospital. Delays in report delivery lead to delayed diagnosis increased waiting time and decreased customer satisfaction. The reduction in TAT will lead to increased patient satisfaction, quality of care, employee satisfaction and ultimately the hospital's revenue. Design/methodology/approach The generic causes resulting in increasing TAT of clinical laboratories were identified using lean tools and techniques such as value stream mapping (VSM), Gemba, Pareto Analysis and Root Cause Analysis. VSM was used as a tool to analyze the current state of the process and further VSM was used to design the future state with suggestions for process improvements. Findings This study identified 12 major non-value added factors for the hematology laboratory and 5 major non-value added factors for the biochemistry lab which were acting as bottlenecks resulting in limiting throughput. A four-month research study by the authors together with hospital quality department and laboratory staff members led to reduction of the average TAT from 180 to 95minutes in the hematology lab and from 268 to 208 minutes in the biochemistry lab. Practical implications Very few improvement initiatives in Indian healthcare are based on industrial engineering tools and techniques, which might be due to a lack of interaction between healthcare and engineering. The study provides a positive outcome in terms of improving the efficiency of services in hospitals and identifies a scope for lean in the Indian healthcare sector. Social implications Applying lean in the Indian healthcare sector gives its own potential solution to the problem caused, due to a wide gap between lean accessibility and lean implementation. Lean helped in changing the mindset of an organization toward providing the highest quality of services with faster delivery at
Clinical and laboratory profile of patients with sickle cell anemia

Directory of Open Access Journals (Sweden)

Phelipe Gabriel dos Santos Sant'Ana

Full Text Available Abstract Objective: This study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea. Methods: Clinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia. Results: Data from the medical records of 50 patients were analyzed. Most of the patients were female (56%, aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55 ± 1.33 g/dL and 25.7 ± 4.4%, respectively and increased fetal hemoglobin levels (12 ± 7%. None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value = 0.005 and p-value = 0.001, respectively. Conclusion: Sickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.
Adaptation and fixation in entrepreneurial approaches of a dental laboratory

Directory of Open Access Journals (Sweden)

Cornelia M. Ferreira

2014-08-01

Research purpose: The study described how the dental laboratory adapted its entrepreneurial approaches over time in response to critical changes that occurred and how aspects in the managerial approach became fixated and proved to be essential to success. Motivation for the study: The study provided insight into how the dental laboratory transformed into a stable and prosperous laboratory by the integration of strategic, economic, cultural and social capital through a process of business decision making. Research design, approach and method: A cohort survey research design, based upon the compilation of longitudinal data over three selected time periods, was employed. The design of the measuring instruments and the interpretation of research results were derived from an adapted entrepreneurial-in-network theoretical framework. A triangulation data compilation approach was followed. Main findings: The results revealed that cultural capital in the dental laboratory became fixated on three value principles, whilst the other critical capitals prescribed exist in sufficient volumes and improve to adapt to changing circumstances in the dental market. Practical/managerial implications: Fixated cultural values acted as a ‘parent’-actor in order to guide the righteousness of behaviour, whereas adaptation required sufficient critical capitals and the proper integration thereof. Contribution/value-added: By adopting the entrepreneurship-in-network approach, the researchers incorporated the dynamic and interactive processes of entrepreneurship. Future studies may employ the same design and use multi-varied analyses to show how a business adapt or fixate its approaches in response to crises or changes in the business environment.
External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China.

Science.gov (United States)

Wang, Lu-nan; Zhang, Rui; Shen, Zi-yu; Chen, Wen-xiang; Li, Jin-ming

2008-06-05

As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China (NCCL). The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus (HCV) RNA. Serum panels were delivered twice annually to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value (TG) designated as +/- 0.5 log. The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high. By 2007, the target value was close to the national average except for the low concentrated specimens (10(3) IU/ml). The percentage of results within the range of GM +/- 0.5 log(10) varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest (3.00 log IU/ml) as well as of the highest viral levels (6.37 log IU/ml) values, very near to the limits of the dynamic range of the assays. The comparison of these results with the previous study confirms that a regular participation in external quality assessment (EQA) assures the achievement of a high
Suboptimal Addiction Interventions for Patients Hospitalized with Injection Drug Use-Associated Infective Endocarditis.

Science.gov (United States)

Rosenthal, Elana S; Karchmer, Adolf W; Theisen-Toupal, Jesse; Castillo, Roger Araujo; Rowley, Chris F

2016-05-01

Infective endocarditis is a serious infection, often resulting from injection drug use. Inpatient treatment regularly focuses on management of infection without attention to the underlying addiction. We aimed to determine the addiction interventions done in patients hospitalized with injection drug use-associated infective endocarditis. This is a retrospective review of patients hospitalized with injection drug use-associated infective endocarditis from January, 2004 through August, 2014 at a large academic tertiary care center in Boston, Massachusetts. For the initial and subsequent admissions, data were collected regarding addiction interventions, including consultation by social work, addiction clinical nurse and psychiatry, documentation of addiction in the discharge summary plan, plan for medication-assisted treatment and naloxone provision. There were 102 patients admitted with injection drug use-associated infective endocarditis, 50 patients (49.0%) were readmitted and 28 (27.5%) patients had ongoing injection drug use at readmission. At initial admission, 86.4% of patients had social work consultation, 23.7% had addiction consultation, and 24.0% had psychiatry consultation. Addiction was mentioned in 55.9% of discharge summary plans, 7.8% of patients had a plan for medication-assisted treatment, and naloxone was never prescribed. Of 102 patients, 26 (25.5%) are deceased. The median age at death was 40.9 years (interquartile range 28.7-48.7). We found that patients hospitalized with injection drug use-associated infective endocarditis had high rates of readmission, recurrent infective endocarditis and death. Despite this, addiction interventions were suboptimal. Improved addiction interventions are imperative in the treatment of injection drug use-associated infective endocarditis. Copyright © 2016 Elsevier Inc. All rights reserved.
The medical laboratory issues about recommendation on uniform cutoff values of “normal” ALT in the ACG guidelines

Directory of Open Access Journals (Sweden)

YU Qian

2018-01-01

Full Text Available In the recent American clinical guidelines dealing with laboratory tests for evaluation of liver disease, the American College of Gastroenterology (ACG recommends ALT upper reference limits of 33 U/L for males and 25 U/L for females respectively, and that individuals with ALT above these “normal” cutoffs should be further investigated. Considering the differences between laboratory assays measuring ALT in our country, the standardization of methods and the consistency of results can not be completely ensured. The uniform “normal” range of ALT recommended by the ACG guidelines is largely based on findings from foreign studies and may not be suitable to Chinese population. On the other hand, reference upper/lower limits should not simply be equated with clinical decision thresholds. However, due to improper application of the related concepts of the above medical laboratory issues, simply recommending the uniform reference range of the ALT may lead to overdiagnosis and unnecessary follow-up examinations.
Blended learning within an undergraduate exercise physiology laboratory.

Science.gov (United States)

Elmer, Steven J; Carter, Kathryn R; Armga, Austin J; Carter, Jason R

2016-03-01

In physiological education, blended course formats (integration of face-to-face and online instruction) can facilitate increased student learning, performance, and satisfaction in classroom settings. There is limited evidence on the effectiveness of using blending course formats in laboratory settings. We evaluated the impact of blended learning on student performance and perceptions in an undergraduate exercise physiology laboratory. Using a randomized, crossover design, four laboratory topics were delivered in either a blended or traditional format. For blended laboratories, content was offloaded to self-paced video demonstrations (∼15 min). Laboratory section 1 (n = 16) completed blended laboratories for 1) neuromuscular power and 2) blood lactate, whereas section 2 (n = 17) completed blended laboratories for 1) maximal O2 consumption and 2) muscle electromyography. Both sections completed the same assignments (scored in a blinded manner using a standardized rubric) and practicum exams (evaluated by two independent investigators). Pre- and postcourse surveys were used to assess student perceptions. Most students (∼79%) watched videos for both blended laboratories. Assignment scores did not differ between blended and traditional laboratories (P = 0.62) or between sections (P = 0.91). Practicum scores did not differ between sections (both P > 0.05). At the end of the course, students' perceived value of the blended format increased (P learning key foundational content through video demonstrations before class greatly enhanced their learning of course material compared with a preassigned reading (94% vs. 78%, P Blended exercise physiology laboratories provided an alternative method for delivering content that was favorably perceived by students and did not compromise student performance. Copyright © 2016 The American Physiological Society.
Cost effectiveness of adopted quality requirements in hospital laboratories.

Science.gov (United States)

Hamza, Alneil; Ahmed-Abakur, Eltayib; Abugroun, Elsir; Bakhit, Siham; Holi, Mohamed

2013-01-01

The present study was designed in quasi-experiment to assess adoption of the essential clauses of particular clinical laboratory quality management requirements based on international organization for standardization (ISO 15189) in hospital laboratories and to evaluate the cost effectiveness of compliance to ISO 15189. The quality management intervention based on ISO 15189 was conceded through three phases; pre - intervention phase, Intervention phase and Post-intervention phase. In pre-intervention phase the compliance to ISO 15189 was 49% for study group vs. 47% for control group with P value 0.48, while the post intervention results displayed 54% vs. 79% for study group and control group respectively in compliance to ISO 15189 and statistically significant difference (P value 0.00) with effect size (Cohen's d) of (0.00) in pre-intervention phase and (0.99) in post - intervention phase. The annual average cost per-test for the study group and control group was 1.80 ± 0.25 vs. 1.97 ± 0.39, respectively with P value 0.39 whereas the post-intervention results showed that the annual average total costs per-test for study group and control group was 1.57 ± 0.23 vs 2.08 ± 0.38, P value 0.019 respectively, with cost-effectiveness ratio of (0.88) in pre -intervention phase and (0.52) in post-intervention phase. The planned adoption of quality management requirements (QMS) in clinical laboratories had great effect to increase the compliance percent with quality management system requirement, raise the average total cost effectiveness, and improve the analytical process capability of the testing procedure.
Polish Code of Ethics of a Medical Laboratory Specialist.

Science.gov (United States)

Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

2014-09-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.
Results Assessment of Intercomparison Exercise CSN/CIEMAT-2010 among Spanish National Laboratories of Environmental Radioactivity (Diet Ashes)

International Nuclear Information System (INIS)

Gasco, C.; Trinidad, J. A.; Llaurado, M.; Suarez, J. A.

2012-01-01

This report describes the results assessment of the intercomparison exercise among environmental radioactivity laboratories, organised by Spanish Regulatory Institution (CSN) and prepared and evaluated by UAB and CIEMAT respectively. The exercise has been carried out following the international standards ISO-43 and ISO/IUPAC that provide a useful guide to perform proficiency tests and inter-laboratories comparisons. The selected matrix for this year (2010) was a diet ash obtained from the ashing of a whole fresh diet (breakfast, lunch and dinner), that was enriched with artificial radionuclides (Cs-137, Co-60,Fe-55,Ni-63,Sr-90,Am-241,Pu-238,Pu-239,240 y C-14) and contained natural radionuclides (U-234, U-238, U-natural Th-230, Th-234, Ra-226, Ra-228, Pb-210, Pb-212, Pb-214, Bi-214, Ac-228, Tl-208, K-40) at environmental level of activity concentration. The z-score test was applied to determine how much the laboratories differ from the reference value. The reference value for this exercise was the median of the results from the different laboratories and their standard deviations to achieve a more complete and objective study of the laboratories performance. The participant laboratories have demonstrated a satisfactory quality level for measuring the natural and artificial radionuclides content in this matrix. The reference values obtained through the medians show a negative bias for Pb-210 and Th-234 when comparing to the given values of external qualified laboratories from ENEA and IRSN and positive one for K-40. (Author)
Evaluation of Mycology Laboratory Proficiency Testing

Science.gov (United States)

Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

1999-01-01

Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient testing. This study addresses this issue by evaluating medical mycology OPT and comparing its fungal specimen identification error rates to those obtained in a covert (blinded) proficiency testing (CPT) program. Identifications from 188 laboratories participating in the New York State mycology OPT from 1982 to 1994 were compared with the identifications of the same fungi recovered from patient specimens in 1989 and 1994 as part of the routine procedures of 88 of these laboratories. The consistency in the identification of OPT specimens was sufficient to make accurate predictions of OPT error rates. However, while the error rates in OPT and CPT were similar for Candida albicans, significantly higher error rates were found in CPT for Candida tropicalis, Candida glabrata, and other common pathogenic fungi. These differences may, in part, be due to OPT’s use of ideal organism representatives cultured under optimum growth conditions. This difference, as well as the organism-dependent error rate differences, reflects the limitations of OPT as a means of assessing the quality of routine laboratory performance in medical mycology. PMID:10364601
Ozone data assimilation with GEOS-Chem: a comparison between 3-D-Var, 4-D-Var, and suboptimal Kalman filter approaches

Science.gov (United States)

Singh, K.; Sandu, A.; Bowman, K. W.; Parrington, M.; Jones, D. B. A.; Lee, M.

2011-08-01

Chemistry transport models determine the evolving chemical state of the atmosphere by solving the fundamental equations that govern physical and chemical transformations subject to initial conditions of the atmospheric state and surface boundary conditions, e.g., surface emissions. The development of data assimilation techniques synthesize model predictions with measurements in a rigorous mathematical framework that provides observational constraints on these conditions. Two families of data assimilation methods are currently widely used: variational and Kalman filter (KF). The variational approach is based on control theory and formulates data assimilation as a minimization problem of a cost functional that measures the model-observations mismatch. The Kalman filter approach is rooted in statistical estimation theory and provides the analysis covariance together with the best state estimate. Suboptimal Kalman filters employ different approximations of the covariances in order to make the computations feasible with large models. Each family of methods has both merits and drawbacks. This paper compares several data assimilation methods used for global chemical data assimilation. Specifically, we evaluate data assimilation approaches for improving estimates of the summertime global tropospheric ozone distribution in August 2006 based on ozone observations from the NASA Tropospheric Emission Spectrometer and the GEOS-Chem chemistry transport model. The resulting analyses are compared against independent ozonesonde measurements to assess the effectiveness of each assimilation method. All assimilation methods provide notable improvements over the free model simulations, which differ from the ozonesonde measurements by about 20 % (below 200 hPa). Four dimensional variational data assimilation with window lengths between five days and two weeks is the most accurate method, with mean differences between analysis profiles and ozonesonde measurements of 1-5 %. Two sequential
A Required Rotation in Clinical Laboratory Management for Pathology Residents

OpenAIRE

Arvind Rishi MD; Syed T. Hoda MD; James M. Crawford MD, PhD

2016-01-01

Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and ins...

Designing an undergraduate laboratory course in general chemistry

Directory of Open Access Journals (Sweden)

Vianna José F.

1999-01-01

Full Text Available From an analysis of a learning model based on the theory of information processing four hypothesis were developed for improving the design of laboratory courses. Three of these hypotheses concerned specific procedures to minimise the load on students' working memories (or working spaces and the fourth hypothesis was concerned with the value of mini-projects in enhancing meaningful learning of the knowledge and skills underpinning the set experiments. A three-year study of a first year undergraduate chemistry laboratory course at a Scottish university has been carried out to test these four hypotheses. This paper reports the results of the study relevant to the three hypotheses about the burden on students' working spaces. It was predicted from the learning model that the load on students working space should be reduced by appropriate changes to the written instructions and the laboratory organisation and by the introduction of prelab-work and prelab-training in laboratory techniques. It was concluded from research conducted over the three years period that all these hypothesised changes were effective both in reducing the load on students' working spaces and in improving their attitudes to the laboratory course.
Germination of Ocotea pulchella (Nees) Mez (Lauraceae) seeds in laboratory and natural restinga environment conditions.

Science.gov (United States)

Pires, L A; Cardoso, V J M; Joly, C A; Rodrigues, R R

2009-08-01

The germination response of Ocotea pulchella (Nees) Mez seeds to light, temperature, water level and pulp presence is introduced. The laboratory assays were carried out in germination chambers and thermal-gradient apparatus, whereas the field assays were performed in environments with distinct light, temperature and soil moisture conditions within a permanent parcel of Restinga forest of the Parque Estadual da Ilha do Cardoso, Cananéia, São Paulo. The seeds do not exhibit dormancy, they are non photoblastic, and a loss of viability in dry stored seeds can be related to a decrease in water content of the seed. The presence of the pulp and the flooded substratum influenced negatively the germination of O. pulchella seeds tested in the laboratory. Otherwise, light and temperature probably are not limiting factors of the germination of O. pulchella seeds in the natural environment of Restinga. The optimum temperature range for germination of Ocotea pulchella seeds was 20 to 32 degrees C, the minimum or base temperature estimated was 11 degrees C and the maximum ranged between 33 and 42 degrees C. The isotherms exhibited a sigmoidal pattern well described by the Weibull model in the sub-optimal temperature range. The germinability of O. pulchella seeds in the understorey, both in wet and dry soil, was higher than in gaps. Germination was not affected by fluctuations in soil moisture content in the understorey environment, whereas in gaps, germination was higher in wet soils. Thus, the germination of this species involves the interaction of two or more factors and it cannot be explained by a single factor.
Radon in dwellings and laboratories from central Mexico

International Nuclear Information System (INIS)

Segovia, N.; Pena, P.; Gaso, M.I.; Ponciano, G.

2003-01-01

Average indoor radon and airborne particles concentration levels have been measured in family houses, offices and laboratories within a survey protocol related to smoking health effects. The radon measurements were performed with Honeywell A9000A devices. Airborne particle fluctuations were determined using a Personal Data Logging Real Time Aerosol Monitor. The indoor radon average value obtained in the family houses was 40 Bq m -3 . However, short term peaks higher than 150 Bq m -3 were eventually observed. At the offices and laboratories indoor radon behaviour showed several values higher than the limits, particularly for those rooms having no external windows. Airborne PM10 average particulate matter indoors at a smoker house was 0.751 ± 0.420 mg m -3 in 24 h, reaching concentrations as high as 1.6 mg m -3 , one order of magnitude higher than the maximum permissible limit of outdoor PM10 (0.150 mg m -3 ) established by the Mexican legislation. (orig.)
Radon in dwellings and laboratories from central Mexico

Energy Technology Data Exchange (ETDEWEB)

Segovia, N.; Pena, P.; Gaso, M.I. [Inst. Nacional de Investigaciones Nucleares, Mexico D. F. (Mexico); Ponciano, G. [Facultad de Medicina, UNAM, Ciudad Univ., Mexico D.F. (Mexico)

2003-07-01

Average indoor radon and airborne particles concentration levels have been measured in family houses, offices and laboratories within a survey protocol related to smoking health effects. The radon measurements were performed with Honeywell A9000A devices. Airborne particle fluctuations were determined using a Personal Data Logging Real Time Aerosol Monitor. The indoor radon average value obtained in the family houses was 40 Bq m{sup -3}. However, short term peaks higher than 150 Bq m{sup -3} were eventually observed. At the offices and laboratories indoor radon behaviour showed several values higher than the limits, particularly for those rooms having no external windows. Airborne PM10 average particulate matter indoors at a smoker house was 0.751 {+-} 0.420 mg m{sup -3} in 24 h, reaching concentrations as high as 1.6 mg m{sup -3}, one order of magnitude higher than the maximum permissible limit of outdoor PM10 (0.150 mg m{sup -3}) established by the Mexican legislation. (orig.)
Recommendations concerning classification of and discharge standards for radionuclide laboratories

International Nuclear Information System (INIS)

1985-01-01

In the report recommendations are made for the limitation of the radioactive gaseous and liquid effluents from radionuclide laboratories. The recommended values are based on a radiation exposure for members of a critical group in the population corresponding to 1% of the dose limit for individual members of the public as recommended by the ICRP. Based on these standards a classification of radionuclide laboratories is proposed. It is recommended to retain the present Dutch classification in A-, B-, C- and D-laboratories. The report contains appendices with detailed data about the transport routes of radionuclides in the environment and the subsequent irradiation of members of the public. (orig.)
Results of the Interlaboratory Exercise CNS/CIEMAT-05 among Environmental Radioactivity Laboratories (Vegetable Ash)

International Nuclear Information System (INIS)

Romero Gonzalez, M. L.; Barrera Izquierdo, M.; Valino Garcia, F.

2006-01-01

The document describes the outcome of the CSN/CIEMAT-05 interlaboratory test comparison among environmental radioactivity laboratories. The exercise was organised according to the ISO-43 and the IUPAC I nternational harmonised protocol for the proficiency testing of analytical chemistry laboratories . The exercise has been designed to evaluate the capability of national laboratories to determine environmental levels of radionuclides in vegetable ash samples. The sample has been prepared by the Environmental Radiation Laboratory, from the University of Barcelona, and it contains the following radionuclides: Sr-90, Pu-238, Am-241, Th-230, Pb-210, U-238, Ra-226, K-40, Ra-228, TI-208, Cs- 137 and Co-60. Reference values have been established TROUGH the kind collaboration of three international laboratories of recognized experience: IAEA MEL and IRSN-Orsay. The results of the exercise were computed for 35 participating laboratories and their analytical performance was assessed using the z-score approach. Robust statistics of the participant's results was applied to obtain the median and standard deviation, to achieve a more complete and objetiva study of the laboratories' performance. Some difficulties encountered to dissolve the test sample caused a lower response of analyses involving radiochemical separation, thus some laboratories couldn't apply their routine methods and no conclusions on PU-238, Am-241 and Th-230 performances have been obtained. The exercise has revealed an homogeneous behaviour of laboratories, being statistical parameters from the results close to the reference values. The study has shown that participant laboratories perform radioactive determinations in vegetable ash samples with satisfactory quality levels. (Author) 6 refs
Correlations in state space can cause sub-optimal adaptation of optimal feedback control models.

Science.gov (United States)

Aprasoff, Jonathan; Donchin, Opher

2012-04-01

Control of our movements is apparently facilitated by an adaptive internal model in the cerebellum. It was long thought that this internal model implemented an adaptive inverse model and generated motor commands, but recently many reject that idea in favor of a forward model hypothesis. In theory, the forward model predicts upcoming state during reaching movements so the motor cortex can generate appropriate motor commands. Recent computational models of this process rely on the optimal feedback control (OFC) framework of control theory. OFC is a powerful tool for describing motor control, it does not describe adaptation. Some assume that adaptation of the forward model alone could explain motor adaptation, but this is widely understood to be overly simplistic. However, an adaptive optimal controller is difficult to implement. A reasonable alternative is to allow forward model adaptation to 're-tune' the controller. Our simulations show that, as expected, forward model adaptation alone does not produce optimal trajectories during reaching movements perturbed by force fields. However, they also show that re-optimizing the controller from the forward model can be sub-optimal. This is because, in a system with state correlations or redundancies, accurate prediction requires different information than optimal control. We find that adding noise to the movements that matches noise found in human data is enough to overcome this problem. However, since the state space for control of real movements is far more complex than in our simple simulations, the effects of correlations on re-adaptation of the controller from the forward model cannot be overlooked.
Natural and laboratory TT-OSL dose response curves: Testing the lifetime of the TT-OSL signal in nature

International Nuclear Information System (INIS)

Chapot, M.S.; Roberts, H.M.; Duller, G.A.T.; Lai, Z.P.

2016-01-01

This study compares natural and laboratory generated thermally transferred optically stimulated luminescence (TT-OSL) dose response curves (DRCs) for fine-grain quartz extracts from the Luochuan loess section in central China. Both DRCs saturate at high doses relative to the quartz OSL signal; the natural TT-OSL DRC saturates at about 2200 Gy and laboratory DRCs saturate at about 2700 Gy. However, the natural and laboratory TT-OSL DRCs deviate from one another at circa 150 Gy resulting in TT-OSL equivalent dose underestimation relative to palaeodoses expected from dose rates and independent age control. The lifetime of the TT-OSL signal at 10 °C, calculated from values of trap parameters E and s, is compared against the value for lifetime of the TT-OSL signal in nature at average burial temperature as determined from the age underestimation caused by deviation of the natural and laboratory generated DRCs. These two independent assessments of TT-OSL signal lifetime at Luochuan give similar values, suggesting that laboratory measurements of thermal stability reflect natural burial lifetimes and can potentially be used to correct TT-OSL ages for the difference between natural and laboratory dose response curves. - Highlights: • Natural and laboratory TT-OSL DRCs deviate at ∼150 Gy but saturate at higher doses. • TT-OSL signal lifetime at 10 °C calculated from measured E and s values is ∼180 ka. • TT-OSL signal lifetime at Luochuan estimated from the DRCs' deviation is ∼175 ka. • Natural and laboratory TT-OSL DRC deviation may be caused by low thermal stability. • Laboratory measurements of signal lifetime may be able to correct old TT-OSL ages.
Rock stresses (Grimsel rock laboratory)

International Nuclear Information System (INIS)

Pahl, A.; Heusermann, S.; Braeuer, V.; Gloeggler, W.

1989-01-01

On the research and development project 'Rock Stress Measurements' the BGR has developed and tested several test devices and methods at GTS for use in boreholes at a depth of 200 m and has carried out rock mechanical and engineering geological investigations for the evaluation and interpretation of the stress measurements. The first time a computer for data processing was installed in the borehole together with the BGR-probe. Laboratory tests on hollow cylinders were made to study the stress-deformation behavior. To validate and to interprete the measurement results some test methods were modelled using the finite-element method. The dilatometer-tests yielded high values of Young's modulus, whereas laboratory tests showed lower values with a distinct deformation anisotropy. Stress measurements with the BGR-probe yielded horizontal stresses being higher than the theoretical overburden pressure and vertical stresses which agree well with the theoretical overburden pressure. These results are comparable to the results of the hydraulic fracturing tests, whereas stresses obtained with CSIR-triaxial cells are generally lower. The detailed geological mapping of the borehole indicated relationships between stress and geology. With regard to borehole depth different zones of rock structure joint frequency, joint orientation, and orientation of microfissures as well as stress magnitude, stress direction, and degree of deformation anisotropy could be distinguished. (orig./HP) [de
Value of improved lipid control in patients at high risk for adverse cardiac events.

Science.gov (United States)

Jena, Anupam B; Blumenthal, Daniel M; Stevens, Warren; Chou, Jacquelyn W; Ton, Thanh G N; Goldman, Dana P

2016-06-01

Lipid-lowering therapy (LLT) is suboptimally used in patients with hyperlipidemia in the 2 highest statin benefit groups (SBGs), as categorized by the American College of Cardiology and the American Heart Association. This study estimated the social value of reducing low-density lipoprotein cholesterol (LDL-C) levels by 50% for patients in SBGs 1 and 2 who have been treated with standard LLT but have not reached LDL-C goal, as well as the potential value of PCSK9 inhibitors for patients in these groups. Simulation model. We used National Health and Nutrition Examination Surveys (NHANES) and US Census data to project the population of SBGs 1 and 2 in the time period 2015 to 2035. We used insurance claims data to estimate incidence rates of major adverse cardiac events (MACEs), and NHANES with National Vital Statistics data to estimate cardiovascular disease mortality rates. Using established associations between LDL-C and MACE risk, we estimated the value of reducing LDL-C levels by 50%. We incorporated results from a meta-analysis to estimate the value of PSCK9 inhibitors. Among those treated with LLT with LDL-C > 70 mg/dL in SBGs 1 and 2, the cumulative value of reducing LDL-C levels by 50% would be $2.9 trillion from 2015 to 2035, resulting primarily from 1.6 million deaths averted. The cumulative value of PCSK9 inhibitors would range from $3.4 trillion to $5.1 trillion (1.9-2.8 million deaths averted), or $12,000 to $17,000 per patient-year of treatment. Lowering LDL-C in high-risk patients with hyperlipidemia has enormous potential social value. For patients in these high-risk groups, PCSK9 inhibitors may have considerable net value depending on the final prices payers ultimately select.
Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer

Science.gov (United States)

Grande, Michele; Milito, Giovanni; Attinà, Grazia Maria; Cadeddu, Federica; Muzi, Marco Gallinella; Nigro, Casimiro; Rulli, Francesco; Farinon, Attilio Maria

2008-01-01

Background The long-term prognosis of patients with colon cancer is dependent on many factors. To investigate the influence of a series of clinical, laboratory and morphological variables on prognosis of colon carcinoma we conducted a retrospective analysis of our data. Methods Ninety-two patients with colon cancer, who underwent surgical resection between January 1999 and December 2001, were analyzed. On survival analysis, demographics, clinical, laboratory and pathomorphological parameters were tested for their potential prognostic value. Furthermore, univariate and multivariate analysis of the above mentioned data were performed considering the depth of tumour invasion into the bowel wall as independent variable. Results On survival analysis we found that depth of tumour invasion (P anismus, hematocrit, WBC count, fibrinogen value and CT scanning were significantly related to the degree of mural invasion of the cancer. On the multivariate analysis, fibrinogen value was the most statistically significant variable (P < 0.001) with the highest F-ratio (F-ratio 5.86). Finally, in the present study, the tumour site was significantly related neither to the survival nor to the mural invasion of the tumour. Conclusion The various clinical, laboratory and patho-morphological parameters showed different prognostic value for colon carcinoma. In the future, preoperative prognostic markers will probably gain relevance in order to make a proper choice between surgery, chemotherapy and radiotherapy. Nevertheless, current data do not provide sufficient evidence for preoperative stratification of high and low risk patients. Further assessments in prospective large studies are warranted. PMID:18778464
Food adulteration analysis without laboratory prepared or determined reference food adulterant values.

Science.gov (United States)

Kalivas, John H; Georgiou, Constantinos A; Moira, Marianna; Tsafaras, Ilias; Petrakis, Eleftherios A; Mousdis, George A

2014-04-01

Quantitative analysis of food adulterants is an important health and economic issue that needs to be fast and simple. Spectroscopy has significantly reduced analysis time. However, still needed are preparations of analyte calibration samples matrix matched to prediction samples which can be laborious and costly. Reported in this paper is the application of a newly developed pure component Tikhonov regularization (PCTR) process that does not require laboratory prepared or reference analysis methods, and hence, is a greener calibration method. The PCTR method requires an analyte pure component spectrum and non-analyte spectra. As a food analysis example, synchronous fluorescence spectra of extra virgin olive oil samples adulterated with sunflower oil is used. Results are shown to be better than those obtained using ridge regression with reference calibration samples. The flexibility of PCTR allows including reference samples and is generic for use with other instrumental methods and food products. Copyright © 2013 Elsevier Ltd. All rights reserved.
Applying the Principles of Lean Production to Gastrointestinal Biopsy Handling: From the Factory Floor to the Anatomic Pathology Laboratory.

Science.gov (United States)

Sugianto, Jessica Z; Stewart, Brian; Ambruzs, Josephine M; Arista, Amanda; Park, Jason Y; Cope-Yokoyama, Sandy; Luu, Hung S

2015-01-01

To implement Lean principles to accommodate expanding volumes of gastrointestinal biopsies and to improve laboratory processes overall. Our continuous improvement (kaizen) project analyzed the current state for gastrointestinal biopsy handling using value-stream mapping for specimens obtained at a 487-bed tertiary care pediatric hospital in Dallas, Texas. We identified non-value-added time within the workflow process, from receipt of the specimen in the histology laboratory to the delivery of slides and paperwork to the pathologist. To eliminate non-value-added steps, we implemented the changes depicted in a revised-state value-stream map. Current-state value-stream mapping identified a total specimen processing time of 507 minutes, of which 358 minutes were non-value-added. This translated to a process cycle efficiency of 29%. Implementation of a revised-state value stream resulted in a total process time reduction to 238 minutes, of which 89 minutes were non-value-added, and an improved process cycle efficiency of 63%. Lean production principles of continuous improvement and waste elimination can be successfully implemented within the clinical laboratory.
Laboratory molecular spectroscopy

International Nuclear Information System (INIS)

Margolis, J.

1982-04-01

The precision required in making spectroscopic measurements is discussed. Remarks are directed specifically to vibration-rotation spectra rather than continuum absorptions. The ultimate precision that is required for line positions is related to the width of the lines which may be no narrower than the Doppler width. The spectroscopic methods considered are those which are of the most general value to the astronomers, those which acquire and can handle large volumes of spectra in digital form, or in a form which is compatible with computer analysis, and in a form which is at least internally consistent. The use of dye laser, grating instruments, and the most versatile instrument for laboratory spectroscopy, the Fourier transform spectrometer is discussed
Comparison of laboratory single species and field population-level effects of the pyrethroid insecticide lambda-cyhalothrin on freshwater invertebrates.

Science.gov (United States)

Schroer, A F W; Belgers, J D M; Brock, T C M; Matser, A M; Maund, S J; Van den Brink, P J

2004-04-01

The toxicity of the pyrethroid insecticide lambda-cyhalothrin to freshwater invertebrates has been investigated using data from short-term laboratory toxicity tests and in situ bioassays and population-level effects in field microcosms. In laboratory tests, patterns of toxicity were consistent with previous data on pyrethroids. The midge Chaoborus obscuripes was most sensitive (48- and 96-h EC50 = 2.8 ng/L). Other insect larvae (Hemiptera, Ephemeroptera) and macrocrustacea (Amphipoda, Isopoda) were also relatively sensitive, with 48- and 96-h EC50 values between 10 and 100 ng/L. Generally, microcrustacea (Cladocera, Copepoda) and larvae of certain insect groups (Odonata and Chironomidae) were less sensitive, with 48-h EC50 values higher than 100 ng/L. Mollusca and Plathelminthes were insensitive and were unaffected at concentrations at and above the water solubility (5 microg/L). Generally, the EC50 values based on initial population responses in field enclosures were similar to values derived from laboratory tests with the same taxa. Also, the corresponding fifth and tenth percentile hazard concentrations (HC5 and HC10) were similar (laboratory HC5 = 2.7 ng/L and field HC5 = 4.1 ng/L; laboratory and field HC10 = 5.1 ng/L), at least when based on the same sensitive taxonomic groups (insects and crustaceans) and when a similar concentration range was taken into account. In the three field enclosure experiments and at a treatment level of 10 ng/L, consistent effects were observed for only one population (Chaoborus obscuripes), with recovery taking place within 3 to 6 weeks. The laboratory HC5 (2.7 ng/L) and HC10 (5.1 ng/L) based on acute EC50 values of all aquatic arthropod taxa were both lower than this 10 ng/L, a concentration that might represent the "regulatory acceptable concentration." The HC5 and HC10 values in this study in The Netherlands (based on static laboratory tests with freshwater arthropods) were very similar to those derived from a previous study in
The Diagnostic Value of Pelvic Ultrasound in Girls with Central Precocious Puberty.

Science.gov (United States)

Lee, Sang Heon; Joo, Eun Young; Lee, Ji-Eun; Jun, Yong-Hoon; Kim, Mi-Young

2016-01-01

The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for differentiating central precocious puberty (CPP) from exaggerated thelarche (ET). Because of this test's limitations, previous studies have clarified the clinical and laboratory factors that predict CPP. The present study investigated the early diagnostic significance of pelvic ultrasound in girls with CPP. The GnRH stimulation test and pelvic ultrasound were performed between March 2007 and February 2015 in 192 girls (aged values in pelvic ultrasound for differentiating between CPP and ET. Pelvic ultrasound should be combined with clinical and laboratory tests to maximize its diagnostic value for CPP.
FORTRAN computer programs to process Savannah River Laboratory hydrogeochemical and stream-sediment reconnaissance data

International Nuclear Information System (INIS)

Zinkl, R.J.; Shettel, D.L. Jr.; D'Andrea, R.F. Jr.

1980-03-01

FORTRAN computer programs have been written to read, edit, and reformat the hydrogeochemical and stream-sediment reconnaissance data produced by Savannah River Laboratory for the National Uranium Resource Evaluation program. The data are presorted by Savannah River Laboratory into stream sediment, ground water, and stream water for each 1 0 x 2 0 quadrangle. Extraneous information is eliminated, and missing analyses are assigned a specific value (-99999.0). Negative analyses are below the detection limit; the absolute value of a negative analysis is assumed to be the detection limit
Different top-down approaches to estimate measurement uncertainty of whole blood tacrolimus mass concentration values.

Science.gov (United States)

Rigo-Bonnin, Raül; Blanco-Font, Aurora; Canalias, Francesca

2018-05-08

Values of mass concentration of tacrolimus in whole blood are commonly used by the clinicians for monitoring the status of a transplant patient and for checking whether the administered dose of tacrolimus is effective. So, clinical laboratories must provide results as accurately as possible. Measurement uncertainty can allow ensuring reliability of these results. The aim of this study was to estimate measurement uncertainty of whole blood mass concentration tacrolimus values obtained by UHPLC-MS/MS using two top-down approaches: the single laboratory validation approach and the proficiency testing approach. For the single laboratory validation approach, we estimated the uncertainties associated to the intermediate imprecision (using long-term internal quality control data) and the bias (utilizing a certified reference material). Next, we combined them together with the uncertainties related to the calibrators-assigned values to obtain a combined uncertainty for, finally, to calculate the expanded uncertainty. For the proficiency testing approach, the uncertainty was estimated in a similar way that the single laboratory validation approach but considering data from internal and external quality control schemes to estimate the uncertainty related to the bias. The estimated expanded uncertainty for single laboratory validation, proficiency testing using internal and external quality control schemes were 11.8%, 13.2%, and 13.0%, respectively. After performing the two top-down approaches, we observed that their uncertainty results were quite similar. This fact would confirm that either two approaches could be used to estimate the measurement uncertainty of whole blood mass concentration tacrolimus values in clinical laboratories. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Bioassay Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Bioassay Laboratory is an accredited laboratory capable of conducting standardized and innovative environmental testing in the area of aquatic ecotoxicology. The...
HYDROMECHANICS LABORATORY

Data.gov (United States)

Federal Laboratory Consortium — Naval Academy Hydromechanics LaboratoryThe Naval Academy Hydromechanics Laboratory (NAHL) began operations in Rickover Hall in September 1976. The primary purpose of...

Aespoe hard rock laboratory Sweden

International Nuclear Information System (INIS)

1992-01-01

The aim of the new Aespoe hard rock laboratory is to demonstrate state of the art of technology and evaluation methods before the start of actual construction work on the planned deep repository for spent nuclear fuel. The nine country OECD/NEA project in the Stripa mine in Sweden has been an excellent example of high quality international research co-operation. In Sweden the new Aespoe hard rock laboratory will gradually take over and finalize this work. SKB very much appreciates the continued international participation in Aespoe which is of great value for the quality efficiency, and confidence in this kind of work. We have invited a number of leading experts to this first international seminar to summarize the current state of a number of key questions. The contributions show the great progress that has taken place during the years. The results show that there is a solid scientific basis for using this knowledge on site specific preparation and work on actual repositories. (au)
Balancing Enthusiasm for Innovative Technologies with Optimizing Value: An Approach to Adopt New Laboratory Tests for Infectious Diseases Using Bloodstream Infections as Exemplar.

Science.gov (United States)

Culbreath, Karissa; Petti, Cathy A

2015-04-01

A number of exciting new technologies have emerged to detect infectious diseases with greater accuracy and provide faster times to result in hopes of improving the provision of care and patient outcomes. However, the challenge in evaluating new methods lies not in the technical performance of tests but in (1) defining the specific advantages of new methods over the present gold standards in a practicable way and (2) understanding how advanced technologies will prompt changes in medical and public health decisions. With rising costs to deliver care, enthusiasm for innovative technologies should be balanced with a comprehensive understanding of clinical and laboratory ecosystems and how such factors influence the success or failure of test implementation. Selecting bloodstream infections as an exemplar, we provide a 6-step model for test adoption that will help clinicians and laboratorians better define the value of a new technology specific to their clinical practices.
Test Cost and Test Accuracy in Clinical Laboratories in Kampala, Uganda.

Science.gov (United States)

Amukele, Timothy K; Jones, Robert; Elbireer, Ali

2018-04-25

To assess the accuracy and costs of laboratory tests in Kampala, Uganda. A random selection of 78 laboratories tested external quality assurance samples at market rates. There were 40 moderate- to high-complexity and 38 low-complexity laboratories. Four percent (3/78) of these laboratories were accredited and 94% (73/78) were private. The 40 moderate- to high-complexity laboratories performed malaria blood smear, urine human chorionic gonadotropin (hCG), human immunodeficiency virus (HIV), syphilis, glucose, and three-panel tests: CBC, liver function tests, and kidney function tests. The 38 low-complexity laboratories performed malaria blood smear, urine hCG, and syphilis testing only. Hematology, HIV, syphilis, and malarial proficiency testing samples were prepared by accredited laboratories in Kampala. All other samples were provided by the Royal College of Pathologists of Australia. 77.1% of all results were accurate (met target values). It varied widely by laboratory (50%-100%), test identity (malaria blood smear, 96%; serum urea nitrogen, 38%), and test type (quantitative: 66% [31%-89%], qualitative: 91% [68%-97%]). Test prices varied by up to 3,600%, and there was no correlation between test cost and accuracy (r2 = 0.02). There were large differences in accuracy and price across laboratories in Kampala. Price was not associated with quality.
Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

Science.gov (United States)

Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

2015-07-01

Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.
Quality control for diagnostic oral microbiology laboratories in European countries

Directory of Open Access Journals (Sweden)

Andrew J. Smith

2011-11-01

Full Text Available Participation in diagnostic microbiology internal and external quality control (QC processes is good laboratory practice and an essential component of a quality management system. However, no QC scheme for diagnostic oral microbiology existed until 2009 when the Clinical Oral Microbiology (COMB Network was created. At the European Oral Microbiology Workshop in 2008, 12 laboratories processing clinical oral microbiological samples were identified. All these were recruited to participate into the study and six laboratories from six European countries completed both the online survey and the first QC round. Three additional laboratories participated in the second round. Based on the survey, European oral microbiology laboratories process a significant (mean per laboratory 4,135 number of diagnostic samples from the oral cavity annually. A majority of the laboratories did not participate in any internal or external QC programme and nearly half of the laboratories did not have standard operating procedures for the tests they performed. In both QC rounds, there was a large variation in the results, interpretation and reporting of antibiotic susceptibility testing among the laboratories. In conclusion, the results of this study demonstrate the need for harmonisation of laboratory processing methods and interpretation of results for oral microbiology specimens. The QC rounds highlighted the value of external QC in evaluating the efficacy and safety of processes, materials and methods used in the laboratory. The use of standardised methods is also a prerequisite for multi-centre epidemiological studies that can provide important information on emerging microbes and trends in anti-microbial susceptibility for empirical prescribing in oro-facial infections.
QA experience at the University of Wisconsin accredited dosimetry calibration laboratory

Energy Technology Data Exchange (ETDEWEB)

DeWard, L.A.; Micka, J.A. [Univ. of Wisconsin, Madison, WI (United States)

1993-12-31

The University of Wisconsin Accredited Dosimetry Calibration Laboratory (UW ADCL) employs procedure manuals as part of its Quality Assurance (QA) program. One of these manuals covers the QA procedures and results for all of the UW ADCL measurement equipment. The QA procedures are divided into two main areas: QA for laboratory equipment and QA for external chambers sent for calibration. All internal laboratory equipment is checked and recalibrated on an annual basis, after establishing its consistency on a 6-month basis. QA for external instruments involves checking past calibration history as well as comparing to a range of calibration values for specific instrument models. Generally, the authors find that a chamber will have a variation of less than 0.5 % from previous Co-60 calibration factors, and falls within two standard deviations of previous calibrations. If x-ray calibrations are also performed, the energy response of the chamber is plotted and compared to previous instruments of the same model. These procedures give the authors confidence in the transfer of calibration values from National Institute of Standards and Technology (NIST).
QA experience at the University of Wisconsin accredited dosimetry calibration laboratory

International Nuclear Information System (INIS)

DeWard, L.A.; Micka, J.A.

1993-01-01

The University of Wisconsin Accredited Dosimetry Calibration Laboratory (UW ADCL) employs procedure manuals as part of its Quality Assurance (QA) program. One of these manuals covers the QA procedures and results for all of the UW ADCL measurement equipment. The QA procedures are divided into two main areas: QA for laboratory equipment and QA for external chambers sent for calibration. All internal laboratory equipment is checked and recalibrated on an annual basis, after establishing its consistency on a 6-month basis. QA for external instruments involves checking past calibration history as well as comparing to a range of calibration values for specific instrument models. Generally, the authors find that a chamber will have a variation of less than 0.5 % from previous Co-60 calibration factors, and falls within two standard deviations of previous calibrations. If x-ray calibrations are also performed, the energy response of the chamber is plotted and compared to previous instruments of the same model. These procedures give the authors confidence in the transfer of calibration values from National Institute of Standards and Technology (NIST)
Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer

Directory of Open Access Journals (Sweden)

Nigro Casimiro

2008-09-01

Full Text Available Abstract Background The long-term prognosis of patients with colon cancer is dependent on many factors. To investigate the influence of a series of clinical, laboratory and morphological variables on prognosis of colon carcinoma we conducted a retrospective analysis of our data. Methods Ninety-two patients with colon cancer, who underwent surgical resection between January 1999 and December 2001, were analyzed. On survival analysis, demographics, clinical, laboratory and pathomorphological parameters were tested for their potential prognostic value. Furthermore, univariate and multivariate analysis of the above mentioned data were performed considering the depth of tumour invasion into the bowel wall as independent variable. Results On survival analysis we found that depth of tumour invasion (P Conclusion The various clinical, laboratory and patho-morphological parameters showed different prognostic value for colon carcinoma. In the future, preoperative prognostic markers will probably gain relevance in order to make a proper choice between surgery, chemotherapy and radiotherapy. Nevertheless, current data do not provide sufficient evidence for preoperative stratification of high and low risk patients. Further assessments in prospective large studies are warranted.
Application of indices Cp and Cpk to improve quality control capability in clinical biochemistry laboratories.

Science.gov (United States)

Chen, Ming-Shu; Wu, Ming-Hsun; Lin, Chih-Ming

2014-04-30

The traditional criteria for acceptability of analytic quality may not be objective in clinical laboratories. To establish quality control procedures intended to enhance Westgard multi-rules for improving the quality of clinical biochemistry tests, we applied the Cp and Cpk quality-control indices to monitor tolerance fitting and systematic variation of clinical biochemistry test results. Daily quality-control data of a large Taiwanese hospital in 2009 were analyzed. The test items were selected based on an Olympus biochemistry machine and included serum albumin, aspartate aminotransferase, cholesterol, glucose and potassium levels. Cp and Cpk values were calculated for normal and abnormal levels, respectively. The tolerance range was estimated with data from 50 laboratories using the same instruments and reagents. The results showed a monthly trend of variation for the five items under investigation. The index values of glucose were lower than those of the other items, and their values were usually quality control, but also for revealing inter-laboratory qualitycontrol capability differences.
Guidelines for Biosafety Training Programs for Workers Assigned to BSL-3 Research Laboratories.

Science.gov (United States)

Homer, Lesley C; Alderman, T Scott; Blair, Heather Ann; Brocard, Anne-Sophie; Broussard, Elaine E; Ellis, Robert P; Frerotte, Jay; Low, Eleanor W; McCarthy, Travis R; McCormick, Jessica M; Newton, JeT'Aime M; Rogers, Francine C; Schlimgen, Ryan; Stabenow, Jennifer M; Stedman, Diann; Warfield, Cheryl; Ntiforo, Corrie A; Whetstone, Carol T; Zimmerman, Domenica; Barkley, Emmett

2013-03-01

The Guidelines for Biosafety Training Programs for Workers Assigned to BSL-3 Research Laboratories were developed by biosafety professionals who oversee training programs for the 2 national biocontainment laboratories (NBLs) and the 13 regional biocontainment laboratories (RBLs) that participate in the National Institute of Allergy and Infectious Diseases (NIAID) NBL/RBL Network. These guidelines provide a general training framework for biosafety level 3 (BSL-3) high-containment laboratories, identify key training concepts, and outline training methodologies designed to standardize base knowledge, understanding, and technical competence of laboratory personnel working in high-containment laboratories. Emphasis is placed on building a culture of risk assessment-based safety through competency training designed to enhance understanding and recognition of potential biological hazards as well as methods for controlling these hazards. These guidelines may be of value to other institutions and academic research laboratories that are developing biosafety training programs for BSL-3 research.
Suboptimal management of central nervous system infections in children: a multi-centre retrospective study

Directory of Open Access Journals (Sweden)

Kelly Christine

2012-09-01

Full Text Available Abstract Objective We aimed to audit the regional management of central nervous system (CNS infection in children. Methods The study was undertaken in five district general hospitals and one tertiary paediatric hospital in the Mersey region of the UK. Children admitted to hospital with a suspected CNS infection over a three month period were identified. Children were aged between 4 weeks and 16 years old. Details were recorded from the case notes and electronic records. We measured the appropriateness of management pathways as outlined by national and local guidelines. Results Sixty-five children were identified with a median age of 6 months (range 1 month to 15 years. Ten had a CNS infection: 4 aseptic meningitis, 3 purulent meningitis, 3 encephalitis [2 with herpes simplex virus (HSV type 1]. A lumbar puncture (LP was attempted in 50 (77% cases but only 43 had cerebrospinal fluid (CSF available for analysis. Of these 24 (57% had a complete standard set of tests performed. Fifty eight (89% received a third generation cephalosporin. Seventeen (26% also received aciclovir with no obvious indication in 9 (53%. Only 11 (65% of those receiving aciclovir had CSF herpes virus PCR. Seventeen had cranial imaging and it was the first management step in 14. Treatment lengths of both antibiotics and aciclovir were highly variable: one child with HSV encephalitis was only treated with aciclovir for 7 days. Conclusions The clinical management of children with suspected CNS infections across the Mersey region is heterogeneous and often sub-optimal, particularly for the investigation and treatment of viral encephalitis. National guidelines for the management of viral encephalitis are needed.
Common ground: An environmental ethic for Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Menlove, F.L.

1991-01-01

Three predominant philosophies have characterized American business ethical thinking over the past several decades. The first phase is the ethics of self-interest'' which argues that maximizing self-interest coincidentally maximizes the common good. The second phase is legality ethics.'' Proponents argue that what is important is knowing the rules and following them scrupulously. The third phase might be called stake-holder ethics.'' A central tenant is that everyone affected by a decision has a moral hold on the decision maker. This paper will discuss one recent initiative of the Los Alamos National Laboratory to move beyond rules and regulations toward an environmental ethic that integrates the values of stakeholder ethics'' into the Laboratory's historical culture and value systems. These Common Ground Principles are described. 11 refs.
Hepatopancreaticobiliary Values after Thoracoabdominal Aneurysm Repair

OpenAIRE

Wu, Darrell; Coselli, Joseph S.; Johnson, Michael L.; LeMaire, Scott A.

2014-01-01

Background: After thoracoabdominal aortic aneurysm (TAAA) repair, blood tests assessing hepatopancreaticobiliary (HPB) organs commonly have abnormal results. The clinical significance of such abnormalities is difficult to determine because the expected postoperative levels have not been characterized. Therefore, we sought to establish expected trends in HPB laboratory values after TAAA repair. Methods: This 5-year study comprised 155 patients undergoing elective Crawford extent II TAAA repair...
Suboptimal T-cell receptor signaling compromises protein translation, ribosome biogenesis, and proliferation of mouse CD8 T cells.

Science.gov (United States)

Tan, Thomas C J; Knight, John; Sbarrato, Thomas; Dudek, Kate; Willis, Anne E; Zamoyska, Rose

2017-07-25

Global transcriptomic and proteomic analyses of T cells have been rich sources of unbiased data for understanding T-cell activation. Lack of full concordance of these datasets has illustrated that important facets of T-cell activation are controlled at the level of translation. We undertook translatome analysis of CD8 T-cell activation, combining polysome profiling and microarray analysis. We revealed that altering T-cell receptor stimulation influenced recruitment of mRNAs to heavy polysomes and translation of subsets of genes. A major pathway that was compromised, when TCR signaling was suboptimal, was linked to ribosome biogenesis, a rate-limiting factor in both cell growth and proliferation. Defective TCR signaling affected transcription and processing of ribosomal RNA precursors, as well as the translation of specific ribosomal proteins and translation factors. Mechanistically, IL-2 production was compromised in weakly stimulated T cells, affecting the abundance of Myc protein, a known regulator of ribosome biogenesis. Consequently, weakly activated T cells showed impaired production of ribosomes and a failure to maintain proliferative capacity after stimulation. We demonstrate that primary T cells respond to various environmental cues by regulating ribosome biogenesis and mRNA translation at multiple levels to sustain proliferation and differentiation.
Laboratory quality assurance

International Nuclear Information System (INIS)

Delvin, W.L.

1977-01-01

The elements (principles) of quality assurance can be applied to the operation of the analytical chemistry laboratory to provide an effective tool for indicating the competence of the laboratory and for helping to upgrade competence if necessary. When used, those elements establish the planned and systematic actions necessary to provide adequate confidence in each analytical result reported by the laboratory (the definition of laboratory quality assurance). The elements, as used at the Hanford Engineering Development Laboratory (HEDL), are discussed and they are qualification of analysts, written methods, sample receiving and storage, quality control, audit, and documentation. To establish a laboratory quality assurance program, a laboratory QA program plan is prepared to specify how the elements are to be implemented into laboratory operation. Benefits that can be obtained from using laboratory quality assurance are given. Experience at HEDL has shown that laboratory quality assurance is not a burden, but it is a useful and valuable tool for the analytical chemistry laboratory
Interactive screen experiments-innovative virtual laboratories for distance learners

International Nuclear Information System (INIS)

Hatherly, P A; Jordan, S E; Cayless, A

2009-01-01

The desirability and value of laboratory work for physics students is a well-established principle and issues arise where students are inherently remote from their host institution, as is the case for the UK's Open University. In this paper, we present developments from the Physics Innovations Centre for Excellence in Teaching and Learning (piCETL) in the production and technology of the virtual laboratory resources, interactive screen experiments, and the benefits and drawbacks of such resources. We also explore the motivations behind current implementation of interactive screen experiments and examine evaluation strategies and outcomes through a series of case studies
log gf values for astrophysically important transitions Fe II

Science.gov (United States)

Deb, N. C.; Hibbert, A.

2014-01-01

Aims: In a recent measurement, Meléndez & Barbuy (2009, A&A, 497, 611) report accurate log gf values for 142 important astrophysical lines with wavelengths in the range 4000 Å to 8000 Å. Their results include both solar and laboratory measurements. In this paper, we describe a theoretical study of these lines. Methods: The CIV3 structure codes, combined with our "fine-tuning" extrapolation process, are used to undertake a large-scale CI calculation involving the lowest 262 fine-structure levels belonging to the 3d64s, 3d7, 3d54s2, 3d64p, and 3d54s4p configurations. Results: We find that many of the 142 transitions are very weak intercombination lines. Other transitions are weak because the dominant configurations in the two levels differ by two orbitals. Conclusions: The comparison between our log gf values and the experimental values generally shows good agreement for most of these transitions, with our theoretical values agreeing slightly more closely with the solar than with the laboratory measurements. A detailed analysis of the small number of transitions for which the agreement between theory and experiment is not as good shows that such disagreements largely arise from severe cancellation due to CI mixing.
Use of Proficiency Testing as a Tool to Improve Quality in Microbiology Laboratories.

Science.gov (United States)

Stang, Heather L; Anderson, Nancy L

2013-09-15

Proficiency testing (PT) is a valuable tool for assessing laboratory performance and verifying the accuracy and reliability of test results. Participation is required by the Clinical Laboratory Improvement Amendments (CLIA) of 1988 for each of the microbiology subspecialties (bacteriology, mycobacteriology, mycology, parasitology, and virology), and the regulations include specific PT requirements for each subspecialty. To determine the use and perceived value of PT beyond meeting CLIA requirements, the Centers for Disease Control and Prevention funded a cooperative agreement with the Association of Public Health Laboratories to convene a series of focus groups to query laboratory professionals responsible for PT. The seven focus groups were comprised of 60 laboratory professionals representing large and small clinical laboratories, microbiology subspecialties, and public health. While participants acknowledged the need to perform PT to meet regulatory requirements, many also cited benefits and challenges beyond regulatory compliance.
Germination of Ocotea pulchella (Nees Mez (Lauraceae seeds in laboratory and natural restinga environment conditions

Directory of Open Access Journals (Sweden)

LA. Pires

Full Text Available The germination response of Ocotea pulchella (Nees Mez seeds to light, temperature, water level and pulp presence is introduced. The laboratory assays were carried out in germination chambers and thermal-gradient apparatus, whereas the field assays were performed in environments with distinct light, temperature and soil moisture conditions within a permanent parcel of Restinga forest of the Parque Estadual da Ilha do Cardoso, Cananéia, São Paulo. The seeds do not exhibit dormancy, they are non photoblastic, and a loss of viability in dry stored seeds can be related to a decrease in water content of the seed. The presence of the pulp and the flooded substratum influenced negatively the germination of O. pulchella seeds tested in the laboratory. Otherwise, light and temperature probably are not limiting factors of the germination of O. pulchella seeds in the natural environment of Restinga. The optimum temperature range for germination of Ocotea pulchella seeds was 20 to 32 ºC, the minimum or base temperature estimated was 11 ºC and the maximum ranged between 33 and 42 ºC. The isotherms exhibited a sigmoidal pattern well described by the Weibull model in the sub-optimal temperature range. The germinability of O. pulchella seeds in the understorey, both in wet and dry soil, was higher than in gaps. Germination was not affected by fluctuations in soil moisture content in the understorey environment, whereas in gaps, germination was higher in wet soils. Thus, the germination of this species involves the interaction of two or more factors and it cannot be explained by a single factor.
Do children without a known bleeding tendency undergoing PICC placement require coagulation laboratory testing?

Science.gov (United States)

Woodley-Cook, Joel; Amaral, Joao; Connolly, Bairbre; Brandão, Leonardo R

2015-04-01

Obtaining basic hemostatic laboratory investigations prior to peripherally inserted central catheter (PICC) insertion remains controversial, even if the procedure is converted to a tunneled central venous line (CVL) placement. To determine the value of pre-procedural blood screening (hemoglobin level, platelet count, aPTT/INR) in hospitalized children without a known bleeding diathesis. This retrospective review included pediatric patients undergoing PICC insertion who had both laboratory screening and post-PICC hemoglobin level. Two cohorts (A: 0-3 months; B: >3 months-18 years) were analyzed for procedural major/minor bleeding. Of 1,441 consecutive children identified during a 3-year period, 832 patients (226 in cohort A, 606 in cohort B) fulfilled the inclusion criteria. Overall, 36% (300/832) of the patients had at least one abnormal laboratory result. Only 0.2% (3/1,441) of patients required conversion to a central venous line. In cohort A no major bleeding occurred; the minor bleeding frequency was 30% (68/226). Neither abnormal laboratory results nor correction of abnormal laboratory results was associated with minor bleeding complications. The positive and negative predictive values (PPV/NPV) of having abnormal laboratory screening were 0.22 and 0.68, respectively. In cohort B the major bleeding frequency was 1% (6/606) but no patient required any blood transfusion; minor bleeding occurred in 29% (174/606). Neither abnormal laboratory results nor correction of abnormal laboratory results was associated with minor bleeding complications. The PPV and NPV of abnormal laboratory screening results were 0.24 and 0.72, respectively. Pre-procedural blood screening did not predict bleeding in hospitalized children without a known bleeding diathesis undergoing PICC insertion. The rarity of major bleeding complications and need for conversion to a central venous line did not support a need for laboratory screening.

Mobile laboratory for near real-time measurements of very low-level radioactivity

International Nuclear Information System (INIS)

Sigg, R.A.

1984-01-01

The Tracking Radioactive Atmospheric Contaminants (TRAC) System is a mobile laboratory, developed by Savannah River Laboratory (SRL) to improve emergency response and environmental research capabilities at the Savannah River Plant (SRP). In the event of an atmospheric release, the TRAC laboratory can confirm the location and radionuclide composition of the downwind cloud by analyzing samples in near real-time in the field. Specialized monitoring systems were developed to analyze most radionuclides produced in SRP's diverse operations. Sensitivities are radionuclide dependent and can be below maximum permissible concentration (MPC) values by factors as large as one hundred thousand. 6 references, 6 figures
Presentation of the Nuclear Material Metrology Laboratory (LAMMAN)

International Nuclear Information System (INIS)

Arpigny, S.; Biscarrat, C.; Ruas, A.; Viallesoubranne, C.; Hanssens, A.; Roche, C.

2008-01-01

The EQRAIN Uranium or Plutonium programmes (Evaluation of the Quality of Analysis Results in the Nuclear Industry) have led to the creation of round-robins, which require reference solutions of uranyl nitrate or of plutonium nitrate to be made available. The samples are fabricated and packaged, and their benchmark values determined, by the Nuclear Material Metrology Laboratory in the Atalante facility. All the operations are carried out by highly precise weighing, including correction for air buoyancy. In order to guarantee the preservation of reference samples, a laser-sealing apparatus is used to condition the final solutions in ampoules. Random tests to check the concentration of uranium or plutonium are carried out on a certain number of ampoules after the sealing step. The analysis are performed on a photo-gravimetric analysis line (in glove box for Pu) based on the titanium potentiometric analysis method. The ampoules are then packaged and delivered to the participating laboratories. The French nuclear laboratories participating in the EQRAIN programs belong to the Cea and to the AREVA Group, with activities covering the entire fuel cycle. They have been joined by new participants from European, Japanese and South American laboratories
Presentation of the Nuclear Material Metrology Laboratory (LAMMAN)

Energy Technology Data Exchange (ETDEWEB)

Arpigny, S.; Biscarrat, C.; Ruas, A.; Viallesoubranne, C. [CEA/DEN/DRCP/SE2A/LAMM, Marcoule, BP 17171, 30207 Bagnols sur Ceze (France); Hanssens, A.; Roche, C. [CEA/DEN/DRCP/CETAMA Marcoule, BP 17171, 30207 Bagnols sur Ceze (France)

2008-07-01

The EQRAIN Uranium or Plutonium programmes (Evaluation of the Quality of Analysis Results in the Nuclear Industry) have led to the creation of round-robins, which require reference solutions of uranyl nitrate or of plutonium nitrate to be made available. The samples are fabricated and packaged, and their benchmark values determined, by the Nuclear Material Metrology Laboratory in the Atalante facility. All the operations are carried out by highly precise weighing, including correction for air buoyancy. In order to guarantee the preservation of reference samples, a laser-sealing apparatus is used to condition the final solutions in ampoules. Random tests to check the concentration of uranium or plutonium are carried out on a certain number of ampoules after the sealing step. The analysis are performed on a photo-gravimetric analysis line (in glove box for Pu) based on the titanium potentiometric analysis method. The ampoules are then packaged and delivered to the participating laboratories. The French nuclear laboratories participating in the EQRAIN programs belong to the Cea and to the AREVA Group, with activities covering the entire fuel cycle. They have been joined by new participants from European, Japanese and South American laboratories.
Medicare program; payment policies under the physician fee schedule, five-year review of work relative value units, clinical laboratory fee schedule: signature on requisition, and other revisions to part B for CY 2012. Final rule with comment period.

Science.gov (United States)

2011-11-28

This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.
Improving the measurement of longitudinal change in renal function: automated detection of changes in laboratory creatinine assay

Directory of Open Access Journals (Sweden)

Norman Poh

2015-04-01

Full Text Available IntroductionRenal function is reported using the estimates of glomerular filtration rate (eGFR. However, eGFR values are recorded without reference to the particular serum creatinine (SCr assays used to derive them, and newer assays were introduced at different time points across the laboratories in the United Kingdom. These changes may cause systematic bias in eGFR reported in routinely collected data, even though laboratory-reported eGFR values have a correction factor applied.DesignAn algorithm to detect changes in SCr that in turn affect eGFR calculation method was developed. It compares the mapping of SCr values on to eGFR values across a time series of paired eGFR and SCr measurements.SettingRoutinely collected primary care data from 20,000 people with the richest renal function data from the quality improvement in chronic kidney disease trial.ResultsThe algorithm identified a change in eGFR calculation method in 114 (90% of the 127 included practices. This change was identified in 4736 (23.7% patient time series analysed. This change in calibration method was found to cause a significant step change in the reported eGFR values, producing a systematic bias. The eGFR values could not be recalibrated by applying the Modification of Diet in Renal Disease equation to the laboratory reported SCr values.ConclusionsThis algorithm can identify laboratory changes in eGFR calculation methods and changes in SCr assay. Failure to account for these changes may misconstrue renal function changes over time. Researchers using routine eGFR data should account for these effects.
STANDARDIZATION OF GLYCOHEMOGLOBIN RESULTS AND REFERENCE VALUES IN WHOLE-BLOOD STUDIED IN 103 LABORATORIES USING 20 METHODS

NARCIS (Netherlands)

WEYKAMP, CW; PENDERS, TJ; MUSKIET, FAJ; VANDERSLIK, W

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
Results Assessment of Intercomparison Exercise CSN/CIEMAT-2011 among Spanish National Laboratories of Environmental Radioactivity (Water)

International Nuclear Information System (INIS)

Gascó, C.; Trinidad, J. A.; Llauradó, M.

2015-01-01

This report describes the results assessment of the intercomparsion exercise among environmental radioactivity laboratories, organised by Spanish Regulatory Institution (CSN) and prepared and evaluated by UAB and CIEMAT respectively. The exercise has been carried out following the international standards ISO-43 and ISO/IUPAC that provide a useful guide to perform proficiency tests and inter-laboratories comparisons. The selected matrix for this year (2011) was deionized water, simulating drinking water, that was enriched with artificial radionuclides (Cs-137, Co-60, Fe-55, Ni-63, Sr-90, Am-241 and Pu-238) and contained natural radionuclides (U-234, U-238, U-natural, Pb-210, Po-210, Th-230, Ra-226 and K-40) at environmental level of activity concentration. A second matrix of deionized water was prepared with I-129 and C-14. The z-score test was applied to determine how much the laboratories differ from the reference value. The reference value for this exercise was the median of the results from the different laboratories and their standard deviations to achieve a more complete and objective study of the laboratories performance. The participant laboratories have demonstrated a satisfactory quality level for measuring the natural and artificial radionuclides content in this matrix. The study has showed a homogeneous behaviour of the laboratories.
On valuing information in adaptive-management models.

Science.gov (United States)

Moore, Alana L; McCarthy, Michael A

2010-08-01

Active adaptive management looks at the benefit of using strategies that may be suboptimal in the near term but may provide additional information that will facilitate better management in the future. In many adaptive-management problems that have been studied, the optimal active and passive policies (accounting for learning when designing policies and designing policy on the basis of current best information, respectively) are very similar. This seems paradoxical; when faced with uncertainty about the best course of action, managers should spend very little effort on actively designing programs to learn about the system they are managing. We considered two possible reasons why active and passive adaptive solutions are often similar. First, the benefits of learning are often confined to the particular case study in the modeled scenario, whereas in reality information gained from local studies is often applied more broadly. Second, management objectives that incorporate the variance of an estimate may place greater emphasis on learning than more commonly used objectives that aim to maximize an expected value. We explored these issues in a case study of Merri Creek, Melbourne, Australia, in which the aim was to choose between two options for revegetation. We explicitly incorporated monitoring costs in the model. The value of the terminal rewards and the choice of objective both influenced the difference between active and passive adaptive solutions. Explicitly considering the cost of monitoring provided a different perspective on how the terminal reward and management objective affected learning. The states for which it was optimal to monitor did not always coincide with the states in which active and passive adaptive management differed. Our results emphasize that spending resources on monitoring is only optimal when the expected benefits of the options being considered are similar and when the pay-off for learning about their benefits is large.
Diagnostic value of imaging in infective endocarditis: a systematic review.

Science.gov (United States)

Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

2017-01-01

Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria. We searched PubMed, Embase, and Cochrane databases. 31 studies were included that presented original data on the performance of electrocardiogram (ECG)-gated multidetector CT angiography (MDCTA), ECG-gated MRI, 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT, and leucocyte scintigraphy in diagnosis of native valve endocarditis, intracardiac prosthetic material-related infection, and extracardiac foci in adults. We consistently found positive albeit weak evidence for the diagnostic benefit of 18 F-FDG PET/CT and MDCTA. We conclude that additional imaging techniques should be considered if infective endocarditis is suspected. We propose an evidence-based diagnostic work-up for infective endocarditis including these non-invasive techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.
Confirming the species-sensitivity distribution concept for endosulfan using laboratory, mesocosm, and field data

NARCIS (Netherlands)

Hose, G.C.; Brink, van den P.J.

2004-01-01

In Australia, water-quality trigger values for toxicants are derived using protective concentration values based on species-sensitivity distribution (SSD) curves. SSD curves are generally derived from laboratory data with an emphasis on using local or site-specific data. In this study, Australian
Development of the NAA Laboratory for an Accreditation Obtains

International Nuclear Information System (INIS)

Sri Wardani; Rina M, Th.; Sunarko, M.; Ratnawati, E.

2004-01-01

The evaluation of capability of the neutron activation analysis comparative method and laboratory equipment at P2TRR have been performed by analyzed a reference standard materials prepared by NIST, namely: SRM 1646a and SRM 1648 by a both of comparative and ko- NAA methods. From the analysis results used a comparative method shown that the method and laboratory equipment used at P2TRR obtained in a good precision, accuracy and high sensitivity. In this experiments a few elements could analyzed, namely: V, Ti, Mn, Cl, As, Sm, La, Na, Sc, Cr, Fe, Co, Se, Br, In, Sb, Ba, Cs, Ce, W, U, and Zn. The deviation values results compared with certificate values (NIST) obtained in a range 2 - 12.5% with confidence levels in range 68 - 98%. While, a reference standard material of SRM 1648 analyzed by k 0 -NAA method shown that the method need more research and study continued. From the qualitatively analysis results for short-lived nuclides category analysis by k 0 -NAA could identified a few elements, namely: V, Cu, Na, As and U with standard deviation values in range 1- 11% and limit detection values are 1.6 (U), 6.4 (Cu), 11.2 (V), 73.3 (As) and 199.9 (Na) μg/g for a SRM 1648. For analysis of CRM 8 the results obtained on standard deviation values in range 1 - 13 % and limit detection of 0.71 (Cu), 1.2 (As), 2.4 (V) and 375.9 (Na) μg/g. (author)
Effectiveness of the Flipped Classroom Model in Anatomy and Physiology Laboratory Courses at a Hispanic Serving Institution

Science.gov (United States)

Sanchez, Gerardo

A flipped laboratory model involves significant preparation by the students on lab material prior to entry to the laboratory. This allows laboratory time to be focused on active learning through experiments. The aim of this study was to observe changes in student performance through the transition from a traditional laboratory format, to a flipped format. The data showed that for both Anatomy and Physiology (I and II) laboratories a more normal distribution of grades was observed once labs were flipped and lecture grade averages increased. Chi square and analysis of variance tests showed grade changes to a statistically significant degree, with a p value of less than 0.05 on both analyses. Regression analyses gave decreasing numbers after the flipped labs were introduced with an r. 2 value of .485 for A&P I, and .564 for A&P II. Results indicate improved scores for the lecture part of the A&P course, decreased outlying scores above 100, and all score distributions approached a more normal distribution.
The hospital tech laboratory: quality innovation in a new era of value-conscious care.

Science.gov (United States)

Keteyian, Courtland K; Nallamothu, Brahmajee K; Ryan, Andrew M

2017-08-01

For decades, the healthcare industry has been incentivized to develop new diagnostic technologies, but this limitless progress fueled rapidly growing expenditures. With an emphasis on value, the future will favor information synthesis and processing over pure data generation, and hospitals will play a critical role in developing these systems. A Michigan Medicine, IBM, and AirStrip partnership created a robust streaming analytics platform tasked with creating predictive algorithms for critical care with the potential to support clinical decisions and deliver significant value.
Certification of biological reference materials: participation of the Neutron Activation Laboratory (LAN-IPEN/CNEN-SP)

International Nuclear Information System (INIS)

Ticianelli, Regina B.; Figueiredo, Ana Maria G.

2007-01-01

Analytical laboratories have as one of their important goals to demonstrate their competence allowing international acceptance and comparison of analytical data. The IPEN Neutron Activation Laboratory (LAN-IPEN) has implemented its Quality Assurance Program which comprises, among other activities, the participation in intercomparison runs. As a part of this Quality Assurance Program, LAN-IPEN has participated in interlaboratorial trials to analyze two biological candidate reference materials: INCT-CF-3 Corn Flour and INCT-SBF-4 Soya Bean Flour from the Institute of Nuclear Chemistry And Technology (Warszawa, Poland). The elements Br, Ca, Co, Cs, Fe, K, Na, Rb and Zn were analyzed in the candidate reference materials by instrumental neutron activation analysis (INAA). The performance of the laboratory was statistically evaluated in relation to the consensus values for these materials using the Z-Score test. This laboratory evaluation method has been accepted as a standard by ISO/IUPAC. In the present study, adequate Z-Score values (|Z|<2) were observed for all of the analyzed elements, confirming the accuracy of the nuclear methodology employed. The contribution of LAN-IPEN in the certification of the reference materials analyzed was very important, since the results provided were used in the statistical evaluation of the certified value. (author)
Predicting bioremediation of hydrocarbons: Laboratory to field scale

International Nuclear Information System (INIS)

Diplock, E.E.; Mardlin, D.P.; Killham, K.S.; Paton, G.I.

2009-01-01

There are strong drivers to increasingly adopt bioremediation as an effective technique for risk reduction of hydrocarbon impacted soils. Researchers often rely solely on chemical data to assess bioremediation efficiently, without making use of the numerous biological techniques for assessing microbial performance. Where used, laboratory experiments must be effectively extrapolated to the field scale. The aim of this research was to test laboratory derived data and move to the field scale. In this research, the remediation of over thirty hydrocarbon sites was studied in the laboratory using a range of analytical techniques. At elevated concentrations, the rate of degradation was best described by respiration and the total hydrocarbon concentration in soil. The number of bacterial degraders and heterotrophs as well as quantification of the bioavailable fraction allowed an estimation of how bioremediation would progress. The response of microbial biosensors proved a useful predictor of bioremediation in the absence of other microbial data. Field-scale trials on average took three times as long to reach the same endpoint as the laboratory trial. It is essential that practitioners justify the nature and frequency of sampling when managing remediation projects and estimations can be made using laboratory derived data. The value of bioremediation will be realised when those that practice the technology can offer transparent lines of evidence to explain their decisions. - Detailed biological, chemical and physical characterisation reduces uncertainty in predicting bioremediation.
Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study.

Directory of Open Access Journals (Sweden)

Kate Birnie

Full Text Available To compare the validity of diagnosis of urinary tract infection (UTI through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory.We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard, was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test", separately according to whether samples were obtained by clean catch or nappy (diaper pads.251 (5.2% and 88 (1.8% children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43, and better for clean catch (0.54; 0.45, 0.63 than nappy pad samples (0.20; 0.12, 0.28. In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80 than the research laboratory (0.86; 0.79, 0.92. Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively than clean catch samples.The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples could be due to contamination. Health service laboratories should consider adopting procedures used
Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

Science.gov (United States)

Birnie, Kate; Hay, Alastair D.; Wootton, Mandy; Howe, Robin; MacGowan, Alasdair; Whiting, Penny; Lawton, Michael; Delaney, Brendan; Downing, Harriet; Dudley, Jan; Hollingworth, William; Lisles, Catherine; Little, Paul; O’Brien, Kathryn; Pickles, Timothy; Rumsby, Kate; Thomas-Jones, Emma; Van der Voort, Judith; Waldron, Cherry-Ann; Harman, Kim; Hood, Kerenza; Butler, Christopher C.; Sterne, Jonathan A. C.

2017-01-01

Objectives To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. Population and methods We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the “index test”), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. Results 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. Conclusions The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service
75 FR 80011 - Good Laboratory Practice for Nonclinical Laboratory Studies

Science.gov (United States)

2010-12-21

.... FDA-2010-N-0548] Good Laboratory Practice for Nonclinical Laboratory Studies AGENCY: Food and Drug... (FDA) is seeking comment on whether to amend the regulations governing good laboratory practices (GLPs..., 1978 (43 FR 60013). As stated in its scope (Sec. 58.1), this regulation prescribes good laboratory...
Out-of-range INR values and outcomes among new warfarin patients with non-valvular atrial fibrillation.

Science.gov (United States)

Nelson, Winnie W; Wang, Li; Baser, Onur; Damaraju, Chandrasekharrao V; Schein, Jeffrey R

2015-02-01

Although efficacious in stroke prevention in non-valvular atrial fibrillation, many warfarin patients are sub-optimally managed. To evaluate the association of international normalized ratio control and clinical outcomes among new warfarin patients with non-valvular atrial fibrillation. Adult non-valvular atrial fibrillation patients (≥18 years) initiating warfarin treatment were selected from the US Veterans Health Administration dataset between 10/2007 and 9/2012. Valid international normalized ratio values were examined from the warfarin initiation date through the earlier of the first clinical outcome, end of warfarin exposure or death. Each patient contributed multiple in-range and out-of-range time periods. The relative risk ratios of clinical outcomes associated with international normalized ratio control were estimated. 34,346 patients were included for analysis. During the warfarin exposure period, the incidence of events per 100 person-years was highest when patients had international normalized ratio 3, patients had significantly increased risk of major bleeding (relative risk ratio: 1.5; 95 % confidence interval 1.2-2.0). In a Veterans Health Administration non-valvular atrial fibrillation population, exposure to out-of-range international normalized ratio values was associated with significantly increased risk of adverse clinical outcomes.
[Fundamental aspects for accrediting medical equipment calibration laboratories in Colombia].

Science.gov (United States)

Llamosa-Rincón, Luis E; López-Isaza, Giovanni A; Villarreal-Castro, Milton F

2010-02-01

Analysing the fundamental methodological aspects which should be considered when drawing up calibration procedure for electro-medical equipment, thereby permitting international standard-based accreditation of electro-medical metrology laboratories in Colombia. NTC-ISO-IEC 17025:2005 and GTC-51-based procedures for calibrating electro-medical equipment were implemented and then used as patterns. The mathematical model for determining the estimated uncertainty value when calibrating electro-medical equipment for accreditation by the Electrical Variable Metrology Laboratory's Electro-medical Equipment Calibration Area accredited in compliance with Superintendence of Industry and Commerce Resolution 25771 May 26th 2009 consists of two equations depending on the case; they are: E = (Ai + sigmaAi) - (Ar + sigmaAr + deltaAr1) and E = (Ai + sigmaAi) - (Ar + sigmaA + deltaAr1). The mathematical modelling implemented for measuring uncertainty in the Universidad Tecnológica de Pereira's Electrical Variable Metrology Laboratory (Electro-medical Equipment Calibration Area) will become a good guide for calibration initiated in other laboratories in Colombia and Latin-America.

Laboratory-acquired brucellosis

DEFF Research Database (Denmark)

Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.

2008-01-01

Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...
A FMEA clinical laboratory case study: how to make problems and improvements measurable.

Science.gov (United States)

Capunzo, Mario; Cavallo, Pierpaolo; Boccia, Giovanni; Brunetti, Luigi; Pizzuti, Sante

2004-01-01

The authors have experimented the application of the Failure Mode and Effect Analysis (FMEA) technique in a clinical laboratory. FMEA technique allows: a) to evaluate and measure the hazards of a process malfunction, b) to decide where to execute improvement actions, and c) to measure the outcome of those actions. A small sample of analytes has been studied: there have been determined the causes of the possible malfunctions of the analytical process, calculating the risk probability index (RPI), with a value between 1 and 1,000. Only for the cases of RPI > 400, improvement actions have been implemented that allowed a reduction of RPI values between 25% to 70% with a costs increment of FMEA technique can be applied to the processes of a clinical laboratory, even if of small dimensions, and offers a high potential of improvement. Nevertheless, such activity needs a thorough planning because it is complex, even if the laboratory already operates an ISO 9000 Quality Management System.
Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

Science.gov (United States)

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.
Determination of Flow Resistance Coefficient for Vegetation in Open Channel: Laboratory study

Science.gov (United States)

Aliza Ahmad, Noor; Ali, ZarinaMd; Arish, Nur Aini Mohd; Munirah Mat Daud, Azra; Fatin Amirah Alias, Nur

2018-04-01

This study focused on determination of flow resistances coefficient for grass in an open channel. Laboratory works were conducted to examine the effects of varying of roughness elements on the flume to determine flow resistance coefficient and also to determine the optimum flow resistance with five different flow rate, Q. Laboratory study with two type of vegetation which are Cow Grass and Pearl Grass were implementing to the bed of a flume. The roughness coefficient, n value is determine using Manning’s equation while Soil Conservation Services (SCS) method was used to determine the surface resistance. From the experiment, the flow resistance coefficient for Cow Grass in range 0.0008 - 0.0039 while Pearl Grass value for the flow resistance coefficient are in between 0.0013 - 0.0054. As a conclusion the vegetation roughness value in open channel are depends on density, distribution type of vegetation used and physical characteristic of the vegetation itself
Use of Proficiency Testing as a Tool to Improve Quality in Microbiology Laboratories

OpenAIRE

Stang, Heather L.; Anderson, Nancy L.

2013-01-01

Proficiency testing (PT) is a valuable tool for assessing laboratory performance and verifying the accuracy and reliability of test results. Participation is required by the Clinical Laboratory Improvement Amendments (CLIA) of 1988 for each of the microbiology subspecialties (bacteriology, mycobacteriology, mycology, parasitology, and virology), and the regulations include specific PT requirements for each subspecialty. To determine the use and perceived value of PT beyond meeting CLIA requir...
Errors in clinical laboratories or errors in laboratory medicine?

Science.gov (United States)

Plebani, Mario

2006-01-01

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

NARCIS (Netherlands)

Hollman, Peter C. H.; Katan, M.B.

1987-01-01

In order to determine the influence of laboratory procedures on nutrient values in different food tables and data banks, an interlaboratory study was set up. Nineteen laboratories participated, and received well-homogenized samples of egg powder, full-fat milk powder, whole rye and wheat meal,
Results of the Eurofood trials on between-laboratory variation in the analysis of macronutrient in foods.

NARCIS (Netherlands)

Hollman, P.C.H.; Katan, M.B.

1987-01-01

In order to determine the influence of laboratory procedures on nutrient values in different food tables and data banks, an interlaboratory study was set up. Nineteen laboratories participated, and received well-homogenized samples of egg powder, full-fat milk powder, whole rye and wheat meal,
DETERMINANTS OF SUBOPTIMAL BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: 24-HOUR AMBULATORY BLOOD PRES-SURE MONITORING

Directory of Open Access Journals (Sweden)

Mansoor Moazenzadeh

2010-12-01

Full Text Available Abstract INTRODUCTION: The study was conducted to define the determinants of suboptimal blood pressure (BP control among hypertensive patients under treatment and explore a predictive model for detecting the patients at risk for increased BP. METHODS: We enrolled 97 patients (40 males, 57 females under treatment for hypertension between June 2006 and May 2007 in Shafa hospital, Kerman, Iran. BP was measured at clinic twice within 5-minute intervals. After setting up ambulatory blood pressure monitoring (ABPM, BP was measured at 30-minute intervals during the day and 60-minute intervals during the night. The frequency of increased BP (more than 140/90 mmHg was included in a regression model as dependent variable and all the others such as age, sex, body mass index (BMI, drugs and baseline clinical measurements as the predictors. RESULTS: Increased BP was detected in 44% (95% CI: 38.79%-49.65% of all measurements during 24-hour monitoring. The frequency of increased BP had a significant relationship with BMI (b=0.35, P=0.001. Clinic's pulse pressure was a significant predicting factor for BP increase (P=0.02. CONCLUSION: BMI and pulse pressure are the best predictors for being hypertensive during lifetime. Ineffective treatment of hypertension is frequent among the hypertensive patients. Keywords: Blood pressure control, Pulse pressure, Ambulatory blood pressure monitoring (ABPM, BMI.
Suboptimal HIV Testing Uptake Among Men Who Engage in Commercial Sex Work with Men in Asia.

Science.gov (United States)

Jin, Harry; Friedman, Mackey Reuel; Lim, Sin How; Guadamuz, Thomas E; Wei, Chongyi

2016-12-01

Men who have sex with men and are sex workers (MSMSW) are disproportionately affected by the growing and emerging HIV epidemic. As sex work and same-sex behavior are heavily stigmatized and often illegal in most Asian countries, HIV research focusing on MSMSW has been limited. The goal of this analysis is to examine HIV testing practices and identify correlates of HIV testing among MSMSW in Asia. The Asia Internet MSM Sex Survey, an online cross-sectional survey of 10,861 men who have sex with men (MSM), was conducted in 2010. Data on sociodemographic characteristics, HIV testing behaviors, and sexual behaviors were collected. Five hundred and seventy-four HIV-negative/unknown respondents reported receiving payment for sex with men at least once in the past 6 months and were included in this analysis. Multivariable logistic regression was conducted to identify independent correlates of HIV testing in the past year. About half (48.6%) of the participants had been tested for HIV at least once within the past year, and 30.5% had never been tested. We also found that MSMSW participants who engaged in risky behaviors were less likely to be tested. While one might expect a high HIV testing rate among MSMSW due to the risks associated with engaging in sex work, we found that HIV testing uptake is suboptimal among MSMSW in Asia. These results suggest that targeted HIV prevention and testing promotion among MSMSW are needed.
Creatine and guanidinoacetate reference values in a French population

NARCIS (Netherlands)

Joncquel-Cheval Curt, M.; Cheillan, D.; Briand, G.; Salomons, G.S.; Mention-Mulliez, K.; Dobbelaere, D.; Cuisset, J.M.; Lion-Francois, L.; Portes, V.D.; Chabli, A.; Valayannopoulos, V.; Benoist, J.F.; Pinard, J.M.; Simard, G.; Douay, O.; Deiva, K.; Tardieu, M.; Afenjar, A.; Heron, D.; Rivier, F.; Chabrol, B.; Prieur, F.; Cartault, F.; Pitelet, G.; Goldenberg, A.; Bekri, S.; Gerard, M.; Delorme, R.; Porchet, N.; Vianey-Saban, C.; Vamecq, J.

2013-01-01

Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference
Effect of Traditional smoking Method on Nutritive Values and ...

African Journals Online (AJOL)

SH

smoking method is an important preservation method which could enhance the nutritive values of fishes and possibly reduce post-harvest losses. Keywords: ... Fishery Laboratory of College of. Agricultural Sciences, Olabisi Onabanjo .... colour helps to determine quality, degree of processing or spoilage level (Clifford et al.,.
HARNESSING VALUES TO PROMOTE MOTIVATION IN EDUCATION

Science.gov (United States)

Harackiewicz, Judith M.; Tibbetts, Yoi; Canning, Elizabeth; Hyde, Janet S.

2017-01-01

Purpose We review the interventions that promote motivation in academic contexts, with a focus on two primary questions: How can we motivate students to take more STEM courses? Once in those STEM courses, how can we keep students motivated and promote their academic achievement? Design/methodology/approach We have approached these two motivational questions from several perspectives, examining the theoretical issues with basic laboratory research, conducting longitudinal questionnaire studies in classrooms, and developing interventions implemented in different STEM contexts. Our research is grounded in three theories that we believe are complementary: expectancy-value theory (Eccles & Wigfield, 2002), interest theory (Hidi & Renninger, 2006), and self-affirmation theory (Steele, 1988). As social psychologists, we have focused on motivational theory and used experimental methods, with an emphasis on values – students’ perceptions of the value of academic tasks and students’ personal values that shape their experiences in academic contexts. Findings We review the experimental field studies in high-school science and college psychology classes, in which utility-value interventions promoted interest and performance for high-school students in science classes and for undergraduate students in psychology courses. We also review a randomized intervention in which parents received information about the utility value of math and science for their teens in high school; this intervention led students to take nearly one semester more of science and mathematics, compared with the control group. Finally, we review an experimental study of values affirmation in a college biology course and found that the intervention improved performance and retention for first-generation college students, closing the social-class achievement gap by 50%. We conclude by discussing the mechanisms through which these interventions work. Originality/value These interventions are exciting for
Applications of sub-optimality in dynamic programming to location and construction of nuclear fuel processing plant; Application de la sous-optimalite en programmation dynamique a la localisation et la cadence optimales de construction des equipements

Energy Technology Data Exchange (ETDEWEB)

Thiriet, L; Deledicq, A [Commissariat a l' Energie Atomique, 92 - Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires, section des etudes economiques generales

1968-09-01

First, the point of applying Dynamic Programming to optimization and Operational Research problems in chemical industries are recalled, as well as the conditions in which a dynamic program is illustrated by a sequential graph. A new algorithm for the determination of sub-optimal politics in a sequential graph is then developed. Finally, the applications of sub-optimality concept is shown when taking into account the indirect effects related to possible strategies, or in the case of stochastic choices and of problems of the siting of plants... application examples are given. (authors) [French] On rappelle d'abord l'interet de la Programmation Dynamique dans les problemes d'optimisation et de Recherche Operationnelle dans les industries chimiques, et les conditions de representation d'un programme dynamique par un graphe sequentiel. On expose ensuite un nouvel algorithme de determination de politiques sous-optimales dans un graphe sequentiel. On montre enfin les applications du concept de sous-optimalite a la prise en compte d'effets indirects lies aux politiques possibles, aux choix dans l'aleatoire, a des problemes de localisation optimale d'usines... et on donne des exemples d'utilisation. (auteurs)
Canon, Value, and Cultural Heritage: New Processes of Assigning Value in the Postdigital Realm

Directory of Open Access Journals (Sweden)

Nuria Rodríguez-Ortega

2018-05-01

Full Text Available The range of modes through which the new conditions of the postdigital society is leading to a redefinition of the processes of assigning value, and the values themselves, which have hitherto prevailed in the comprehension of cultural heritage, are diverse and broad. Within this framework of critical inquiry, this paper discusses the mechanisms of canon-formation in the context of the web as the new laboratory of cultural production. It is argued that the main dynamics observed can be elucidated under the form of a triad: hypercanonization, socialdecanonization, and transcanonization. These three processes operate simultaneously interlaced and unfold in dialectical tension between the rise of the new (practices, actors, values, ideas, and the maintenance of the old (those structures that already exist. This paper delves into the paths through which such interlace dynamics and tension might reshape the principles by which canonicity develops, as well as poses open questions about the challenges facing us, which should be discussed in further studies and approaches to the problem.
Closing the brain-to-brain loop in laboratory testing.

Science.gov (United States)

Plebani, Mario; Lippi, Giuseppe

2011-07-01

Abstract The delivery of laboratory services has been described 40 years ago and defined with the foremost concept of "brain-to-brain turnaround time loop". This concept consists of several processes, including the final step which is the action undertaken on the patient based on laboratory information. Unfortunately, the need for systematic feedback to improve the value of laboratory services has been poorly understood and, even more risky, poorly applied in daily laboratory practice. Currently, major problems arise from the unavailability of consensually accepted quality specifications for the extra-analytical phase of laboratory testing. This, in turn, does not allow clinical laboratories to calculate a budget for the "patient-related total error". The definition and use of the term "total error" refers only to the analytical phase, and should be better defined as "total analytical error" to avoid any confusion and misinterpretation. According to the hierarchical approach to classify strategies to set analytical quality specifications, the "assessment of the effect of analytical performance on specific clinical decision-making" is comprehensively at the top and therefore should be applied as much as possible to address analytical efforts towards effective goals. In addition, an increasing number of laboratories worldwide are adopting risk management strategies such as FMEA, FRACAS, LEAN and Six Sigma since these techniques allow the identification of the most critical steps in the total testing process, and to reduce the patient-related risk of error. As a matter of fact, an increasing number of laboratory professionals recognize the importance of understanding and monitoring any step in the total testing process, including the appropriateness of the test request as well as the appropriate interpretation and utilization of test results.
Soft Time-Suboptimal Controlling Structure for Mechanical Systems

DEFF Research Database (Denmark)

Kulczycki, Piotr; Wisniewski, Rafal; Kowalski, Piotr

2004-01-01

The paper presents conception of a soft control structure based on the time-optimal approach. Its parameters are selected in accordance with the rules of the statistical decision theory and additionally it allows to eliminate rapid changes in control values. The object is a basic mechanical system......, with uncertain (also non-stationary) mass treated as a stochastic process. The methodology proposed here is of a universal nature and may easily be applied with respect to other uncertainty elements of timeoptimal controlled mechanical systems....
Effects of mannan oligosaccharide and virginiamycin on the cecal microbial community and intestinal morphology of chickens raised under suboptimal conditions.

Science.gov (United States)

Pourabedin, Mohsen; Xu, Zhengxin; Baurhoo, Bushansingh; Chevaux, Eric; Zhao, Xin

2014-05-01

There is an increasing movement against use of antibiotic growth promoters in animal feed. Prebiotic supplementation is a potential alternative to enhance the host's natural defense through modulation of gut microbiota. In the present study, the effect of mannan oligosaccharide (MOS) and virginiamycin (VIRG) on cecal microbial ecology and intestinal morphology of broiler chickens raised under suboptimal conditions was evaluated. MOS and VIRG induced different bacterial community structures, as revealed by denaturing gradient gel electrophoresis of 16S rDNA. The antibiotic treatment reduced cecal microbial diversity while the community equitability increased. A higher bacterial diversity was observed in the cecum of MOS-supplemented birds. Quantitative polymerase chain reaction results indicated that MOS changed the cecal microbiota in favor of the Firmicutes population but not the Bacteroidetes population. No difference was observed in total bacterial counts among treatments. MOS promoted the growth of Lactobacillus spp. and Bifidobacterium spp. in the cecum and increased villus height and goblet cell numbers in the ileum and jejunum. These results provide a deeper insight into the microbial ecological changes after supplementation of MOS prebiotic in poultry diets.
Secondary standards laboratories for ionizing radiation calibrations: the national laboratory interests

International Nuclear Information System (INIS)

Roberson, P.L.; Campbell, G.W.

1984-11-01

The national laboratories are probable candidates to serve as secondary standards laboratories for the federal sector. Representatives of the major Department of Energy laboratories were polled concerning attitudes toward a secondary laboratory structure. Generally, the need for secondary laboratories was recognized and the development of such a program was encouraged. The secondary laboratories should be reviewed and inspected by the National Bureau of Standards. They should offer all of the essential, and preferably additional, calibration services in the field of radiological health protection. The selection of secondary laboratories should be based on economic and geographic criteria and/or be voluntary. 1 ref., 2 tabs
Emergency response exercise of laboratories equipped with gamma spectrometry

Energy Technology Data Exchange (ETDEWEB)

Mala, Helena; Rulik, Petr; Jezkova, Tereza; Beckova, Vera [National Radiation Protection Institute (SURO), 140 00 Praha 28 (Czech Republic)

2014-07-01

At present 7 laboratories equipped with semiconductor gamma spectrometry (HPGe detectors) are included in the Radiation Monitoring Network (RMN) in the Czech Republic. These laboratories have 31 spectrometric chains and approximately 20 'experts' and 70 'users' who would guarantee measurements during a radiological emergency (RE). The stress exercise (a load test) was carried out in 4 of them. The aim was to test their measuring capacity in existing technical facilities and staff in the event of a RE and identify problems (bottlenecks) in the whole process from receipt of samples to entering the results into the central database of RMN. Duration of the exercise was 8 to 14 hours. Due to lack of staff, work in one 12-hour shift during a RE is presumed, which the laboratories should be able to provide for 14 days. Exercise samples covered a wide range of commodities that would probably come to the laboratories during RE (aerosol filters, adsorbed gaseous forms of iodine, fallout, surface and drinking waters, food chain components and soils). Some of the samples were previously spiked with {sup 85}Sr, {sup 88}Y and {sup 40}K (these nuclides represented actual nuclides that would occur in RE); soil samples contained higher values of {sup 137}Cs activity originating from the Chernobyl accident. Almost 40 employees took part in the exercise and measurements were carried out at 18 spectrometric chains. An automatic gamma counter which allows automatic operation of two HPGe detectors including the analysis of the spectra with a storage for up to 180 sample containers was operating in one of the laboratories involved in the exercise. The procedures in individual laboratories varied slightly depending on the staff and laboratory space available. During the exercise about 700 samples were evaluated; in addition, gamma-automat measured other 80 samples in the 'night shift'. 700 samples, this means 40 samples per a spectrometric chain or, from

Comparison of point-of-care versus central laboratory measurement of hematocrit, hemoglobin, and electrolyte concentrations.

Science.gov (United States)

Gavala, Alexandra; Myrianthefs, Pavlos

We aimed to investigate the accuracy of certain laboratory examinations obtained by the ABG analyzer (ROCHE AVL OMNI S) as compared to hospital central laboratory (CL). We prospectively collected data obtained from the same arterial blood sample regarding hematocrit, hemoglobin, potassium, and sodium. ABG analyzer results were significantly lower (p < 0.0001) compared to CL values thus values between the two methods are not interchangeable. The mean bias for Hb, Na + and K + were within accepted by US Clinical Laboratory Improvement Amendment (USCLIA) differences (cut-off points) but not for Ht. In 8.0%, 17.5%, 37.5% and 56.0% of Hb, Na + , K + and Ht measurements respectively and 29.75% in sum the differences were over the USCLIA accepted limits. ABG analyzer significantly underestimate the values of Hb, Ht, Na + and K + , compared to CL and almost 30% of all examined parameters were beyond USCLIA accepted biases. ABG analyzer significantly underestimates the values of Hb, Ht, Na + and K + compared to CL and almost 30% for all examined parameters are beyond USCLIA accepted biases. These data do not support widespread or even careful use of POCT for making diagnostic and treatment decisions until technology improves and results in improved outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Performance of laboratories analysing welding fume on filter samples: results from the WASP proficiency testing scheme.

Science.gov (United States)

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 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.
Results Assessment of Intercomparison Exercise CSN/CIEMAT-2013 among Spanish National Laboratories of Environmental Radioactivity (Air)

International Nuclear Information System (INIS)

Trinidad, J. A.; Gascó, C.; Llauradó, M.

2015-01-01

This report describes the results assessment of the intercomparsion exercise among environmental radioactivity laboratories, organised by Spanish Regulatory Institution (CSN) and prepared and evaluated by UB and CIEMAT respectively. The exercise has been carried out following the international standards ISO-43 and ISO/IUPAC that provide a useful guide to perform proficiency tests and inter-laboratories comparisons. The selected matrix for this year (2013) was filters, which was enriched with artificial radionuclides (137Cs, 60Co and 57Co) and contained natural radionuclides (234U, 238U, U-natural 230Th, 226Ra, 210Pb, 234Th, 214Bi and 214Pb) at environmental level of activity concentration. Three commonly used filters (47 mm diameter, 44x44 cm2 and 20x25 cm2) were prepared. Two 47 mm diameter filter were prepared to separate 226Ra and 210Pb analysis. The z-score test was applied to determine how much the laboratories differ from the reference value. The reference value for this exercise was the median of the results from the different laboratories and their standard deviations to achieve a more complete and objective study of the laboratories performance. The participant laboratories have demonstrated a satisfactory quality level for measuring the natural and artificial radionuclides content in this matrix. The study has showed a homogeneous behaviour of the laboratories
Results Assessment of Intercomparison Exercise CSN/CIEMAT-2012 among Spanish National Laboratories of Environmental Radioactivity (Soil)

International Nuclear Information System (INIS)

Trinidad, J. A.; Gascó, C.; Llauradó, M.

2015-01-01

This report describes the results assessment of the intercomparsion exercise among environmental radioactivity laboratories, organised by Spanish Regulatory Institution (CSN) and prepared and evaluated by UB and CIEMAT respectively. The exercise has been carried out following the international standards ISO-43 and ISO/IUPAC that provide a useful guide to perform proficiency tests and inter-laboratories comparisons. The selected matrix for this year (2012) was soil, that was enriched with artificial radionuclides (137Cs, 60Co, 55Fe, 63Ni, 90Sr, 241Am, 239+240Pu and 238Pu) and contained natural radionuclides (234U, 238U, U-natural 230Th, 226Ra, 210Pb, 228Ra, 228Ac, 234Th, 214Bi, 214Pb, 212Pb, 208Tl and 40K) at environmental level of activity concentration. Two soil matrixes were prepared in order to separate 55Fe and 63Ni analysis. The z-score test was applied to determine how much the laboratories differ from the reference value. The reference value for this exercise was the median of the results from the different laboratories and their standard deviations to achieve a more complete and objective study of the laboratories performance. The participant laboratories have demonstrated a satisfactory quality level for measuring the natural and artificial radionuclides content in this matrix. The study has showed a homogeneous behaviour of the laboratories.
Informal workshop on radionuclide laboratories. Issue 1

International Nuclear Information System (INIS)

2001-01-01

The network of radionuclide stations in the International Monitoring System (IMS) of the Comprehensive Test Ban Treaty (CTBT) will be comprised of 80 monitoring stations and 16 laboratories acting in support of the monitoring stations. The 16 radionuclide laboratories have been designated but there are issues to resolve in several areas: - Fee structure and payments to the laboratories from the PTS; - Agreement on Detailed requirements for certification of the laboratories; - Duties of the laboratory To help provide technical information in these and other areas an Informal Workshop was held on January 29th - February 2nd 2001 at Atomic Weapons Establishment (AWE) United Kingdom. It was agreed that a common fee structure would make for a more efficient operation if one could be agreed. One possible fee structure for payment to the laboratories was considered to be an annual fixed fee for service (estimated at $38,000) plus a charge for each individual analysis (estimated at $1,200). These estimated values were based on the laboratory replies to a questionnaire organised by the PTS in December 2000. An average of 40 samples/year/ laboratory was considered to be the number required to maintain support to the monitoring station network and also maintain the laboratory capability. Based on this number the overall cost, payable to the laboratories, of running a network of 16 radionuclide laboratories was estimated at $1.38M per year, when all 80 radionuclide stations are operational. The first proficiency test exercise had been carried out in November 2000 and was discussed. Overall the results were highly encouraging and any minor problems found were being addressed. The technical areas requiring further consideration were uncertainty values and cascade summing corrections. The basis for an ongoing programme of such exercises was discussed and agreed by participants. One recommendation that came out of this meeting was the desirability of using a common nuclear data
Mobile spectrometric laboratory

International Nuclear Information System (INIS)

Isajenko, K.A.; Lipinski, P.

2002-01-01

The article presents the Mobile Spectrometric Laboratory used by Central Laboratory for Radiological Protection since year 2000. The equipment installed in the Mobile Laboratory and its uses is described. The results of international exercises and intercalibrations, in which the Laboratory participated are presented. (author)
Laboratory Modelling of Volcano Plumbing Systems: a review

Science.gov (United States)

Galland, Olivier; Holohan, Eoghan P.; van Wyk de Vries, Benjamin; Burchardt, Steffi

2015-04-01

Earth scientists have, since the XIX century, tried to replicate or model geological processes in controlled laboratory experiments. In particular, laboratory modelling has been used study the development of volcanic plumbing systems, which sets the stage for volcanic eruptions. Volcanic plumbing systems involve complex processes that act at length scales of microns to thousands of kilometres and at time scales from milliseconds to billions of years, and laboratory models appear very suitable to address them. This contribution reviews laboratory models dedicated to study the dynamics of volcano plumbing systems (Galland et al., Accepted). The foundation of laboratory models is the choice of relevant model materials, both for rock and magma. We outline a broad range of suitable model materials used in the literature. These materials exhibit very diverse rheological behaviours, so their careful choice is a crucial first step for the proper experiment design. The second step is model scaling, which successively calls upon: (1) the principle of dimensional analysis, and (2) the principle of similarity. The dimensional analysis aims to identify the dimensionless physical parameters that govern the underlying processes. The principle of similarity states that "a laboratory model is equivalent to his geological analogue if the dimensionless parameters identified in the dimensional analysis are identical, even if the values of the governing dimensional parameters differ greatly" (Barenblatt, 2003). The application of these two steps ensures a solid understanding and geological relevance of the laboratory models. In addition, this procedure shows that laboratory models are not designed to exactly mimic a given geological system, but to understand underlying generic processes, either individually or in combination, and to identify or demonstrate physical laws that govern these processes. From this perspective, we review the numerous applications of laboratory models to
Coalescence kinetics of dispersed crude oil in a laboratory reactor

International Nuclear Information System (INIS)

Sterling, M.C. Jr.; Ojo, T.; Autenrieth, R.L.; Bonner, J.S.; Page, C.A.; Ernst, A.N.S.

2002-01-01

A study was conducted to examine the effects of salinity and mixing energy on the resurfacing and coalescence rates of chemically dispersed crude oil droplets. This kinetic study involved the use of mean shear rates to characterize the mixing energy in a laboratory reactor. Coagulation kinetics of dispersed crude oil were determined within a range of mean shear rates of 5, 10, 15, and 20 per second, and with salinity values of 10 and 30 per cent. Observed droplet distributions were fit to a transport-reaction model to estimate collision efficiency values and their dependence on salinity and mixing energy. Dispersant efficiencies were compared with those derived from other laboratory testing methods. Experimentally determined dispersant efficiencies were found to be 10 to 50 per cent lower than predicted using a non-interacting droplet model, but dispersant efficiencies were higher than those predicted using other testing methods. 24 refs., 1 tab., 3 figs
Research programs at the Department of Energy National Laboratories. Volume 2: Laboratory matrix

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-01

For nearly fifty years, the US national laboratories, under the direction of the Department of Energy, have maintained a tradition of outstanding scientific research and innovative technological development. With the end of the Cold War, their roles have undergone profound changes. Although many of their original priorities remain--stewardship of the nation`s nuclear stockpile, for example--pressing budget constraints and new federal mandates have altered their focus. Promotion of energy efficiency, environmental restoration, human health, and technology partnerships with the goal of enhancing US economic and technological competitiveness are key new priorities. The multiprogram national laboratories offer unparalleled expertise in meeting the challenge of changing priorities. This volume aims to demonstrate each laboratory`s uniqueness in applying this expertise. It describes the laboratories` activities in eleven broad areas of research that most or all share in common. Each section of this volume is devoted to a single laboratory. Those included are: Argonne National Laboratory; Brookhaven National Laboratory; Idaho National Engineering Laboratory; Lawrence Berkeley Laboratory; Lawrence Livermore National Laboratory; Los Alamos National Laboratory; National Renewable Energy Laboratory; Oak Ridge National Laboratory; Pacific Northwest Laboratory; and Sandia National Laboratories. The information in this volume was provided by the multiprogram national laboratories and compiled at Lawrence Berkeley Laboratory.
Radiological control of a microPET/CT laboratory

International Nuclear Information System (INIS)

Sarmento, Daniele M.; Sanches, Matias P.; Carneiro, Janete C.G.G.

2015-01-01

This paper presents the radiological control of a research laboratory in order to satisfy national standards and international recommendations. The microPET/CT laboratory in IPEN uses an Albira system for research purposes in small animals. This study focuses mainly to carry out an initial radiological evaluation and the exposure situation related with the task. The assessment of workplace conditions and individual exposures constitutes as integral part of the operational monitoring programme. Initially, the radiometric survey in laboratory has been carried out using an ionization chamber Radcal 9010 (10 x 5 - 1800). In addition, nine monitoring points with potential exposure were selected, where thermoluminescent dosimeters, TLDs, of CaSO 4 :Dy, were positioned. The occupationally exposed workers were monthly evaluated for external exposures using TL dosimeters, worn on the surface of the body. For internal exposure, the evaluated period was approximately one year starting on April 2014. The average effective dose of the occupationally exposed workers did not exceed 2.4 mSv in the year of 2014, which is equal to the recording level. The workplace, microPET/CT laboratory, is classified as supervised area and the monitoring results in the evaluated period, are within the dose limits established by national standard, as well as the values obtained in individual control. (author)
THE LABORATORY WOOD DRIER - FROM THEORY TO PRACTICE

Directory of Open Access Journals (Sweden)

Daniela ŞOVA

2012-03-01

Full Text Available Based on the principle of similarity, the wood drying process can be investigated on a scale model, which is the laboratory drier, instead of the full-size industrial drier. Thus, the investigation is simplified and the drying time reduced. The laboratory drying kiln, developed by the research team, is a controlled climate air duct with closed circuit, fitted with a rectangular test section. The air flow is circulated by a centrifugal fan and the air heating is carried out by a set of electric resistances. The selection of the fan and of the heating resistances was performed according to the aerodynamic and thermal calculations, presented in the paper. For the air humidification, in accordance to the drying schedule requirements, the drier has a steam generator that prepares steam which is injected in the air. The wood sample is placed within the drier on a device conceived for both sample support and vertical motion and also, for continuous weighing. By applying the principle of similarity for both, the industrial kiln and the laboratory drier, the required air velocity for the laboratory drier is determined, for constant values of the temperature and relative humidity of air. Different invariants,characteristic to the drying schedule that was applied, have been also calculated.
Radiological control of a microPET/CT laboratory

Energy Technology Data Exchange (ETDEWEB)

Sarmento, Daniele M.; Sanches, Matias P.; Carneiro, Janete C.G.G., E-mail: dms.danica@gmail.com.br, E-mail: msanches@ipen.br, E-mail: janetgc@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2015-07-01

This paper presents the radiological control of a research laboratory in order to satisfy national standards and international recommendations. The microPET/CT laboratory in IPEN uses an Albira system for research purposes in small animals. This study focuses mainly to carry out an initial radiological evaluation and the exposure situation related with the task. The assessment of workplace conditions and individual exposures constitutes as integral part of the operational monitoring programme. Initially, the radiometric survey in laboratory has been carried out using an ionization chamber Radcal 9010 (10 x 5 - 1800). In addition, nine monitoring points with potential exposure were selected, where thermoluminescent dosimeters, TLDs, of CaSO{sub 4}:Dy, were positioned. The occupationally exposed workers were monthly evaluated for external exposures using TL dosimeters, worn on the surface of the body. For internal exposure, the evaluated period was approximately one year starting on April 2014. The average effective dose of the occupationally exposed workers did not exceed 2.4 mSv in the year of 2014, which is equal to the recording level. The workplace, microPET/CT laboratory, is classified as supervised area and the monitoring results in the evaluated period, are within the dose limits established by national standard, as well as the values obtained in individual control. (author)
The study of stiffness modulus values for AC-WC pavement

Science.gov (United States)

Lubis, AS; Muis, Z. A.; Iskandar, T. D.

2018-02-01

One of the parameters of the asphalt mixture in order for the strength and durability to be achieved as required is the stress-and-strain showing the stiffness of a material. Stiffness modulus is a very necessary factor that will affect the performance of asphalt pavements. If the stiffness modulus value decreases there will be a cause of aging asphalt pavement crack easily when receiving a heavy load. The high stiffness modulus asphalt concrete causes more stiff and resistant to bending. The stiffness modulus value of an asphalt mixture material can be obtained from the theoretical (indirect methods) and laboratory test results (direct methods). For the indirect methods used Brown & Brunton method, and Shell Bitumen method; while for the direct methods used the UMATTA tool. This study aims to determine stiffness modulus values for AC-WC pavement. The tests were conducted in laboratory that used 3 methods, i.e. Brown & Brunton Method, Shell Bitumen Method and Marshall Test as a substitute tool for the UMATTA tool. Hotmix asphalt made from type AC-WC with pen 60/70 using a mixture of optimum bitumen content was 5.84% with a standard temperature variation was 60°C and several variations of temperature that were 30, 40, 50, 70 and 80°C. The stiffness modulus value results obtained from Brown & Brunton Method, Shell Bitumen Method and Marshall Test which were 1374,93 Mpa, 235,45 Mpa dan 254,96 Mpa. The stiffness modulus value decreases with increasing temperature of the concrete asphalt. The stiffness modulus value from the Bitumen Shell method and the Marshall Test has a relatively similar value.The stiffness modulus value from the Brown & Brunton method is greater than the Bitumen Shell method and the Marshall Test, but can not measure the stiffness modulus value at temperature above 80°C.
DDInnere als Ebook-Programmpaket für Innere Medizin mit den Modulen Diagnosen, Leitsymptome und Laborwerte / DDInnere as interactive ebook package for internal medicine featuring diagnoses, symptoms and laboratory values

Directory of Open Access Journals (Sweden)

Weylandt , Karsten-H.

2008-09-01

Full Text Available DDInnere is a symptom-based compendium of internal medicine and consists of three separate ebooks for diagnoses, symptoms and laboratory values for handheld computers and smartphones. Our programs aim to provide medical knowledge at the point of care. This is also achieved by use of the well established Mobipocket Reader, which is the runtime environment not only for our programs but as well for medical ebooks from other providers (http://www.mobipocket.de. Future aims include a more detailed understanding of the role of these applications in medical care and an even better integration of our solutions into clinical processes.
Structural robustness with suboptimal responses for linear state space model

Science.gov (United States)

Keel, L. H.; Lim, Kyong B.; Juang, Jer-Nan

1989-01-01

A relationship between the closed-loop eigenvalues and the amount of perturbations in the open-loop matrix is addressed in the context of performance robustness. If the allowable perturbation ranges of elements of the open-loop matrix A and the desired tolerance of the closed-loop eigenvalues are given such that max(j) of the absolute value of Delta-lambda(j) (A+BF) should be less than some prescribed value, what is a state feedback controller F which satisfies the closed-loop eigenvalue perturbation-tolerance requirement for a class of given perturbation in A? The paper gives an algorithm to design such a controller. Numerical examples are included for illustration.
Nanotechnology Characterization Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Nanotechnology Characterization Laboratory (NCL) at the Frederick National Laboratory for Cancer Research performs preclinical characterization of nanomaterials...
Semiconductor Electrical Measurements Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Semiconductor Electrical Measurements Laboratory is a research laboratory which complements the Optical Measurements Laboratory. The laboratory provides for Hall...
The effect of distal utility value intervention for students’ learning

OpenAIRE

KERA, Masaki; NAKAYA, Motoyuki

2017-01-01

The purpose of this study was to determine whether a utility value intervention influenced students’motivation and performance. Specifically, we examined the effect of distal utility value (i.e., the recognition of content usefulness for skill development that can improve daily and future endeavors) instruction in this study.Fifty-one Japanese undergraduate students completed an experimental session in the laboratory, in which they performed a series of logical reasoning problem-solving tasks...
Laboratory Diagnosis and Characterization of Fungal Disease in Patients with Cystic Fibrosis (CF): A Survey of Current UK Practice in a Cohort of Clinical Microbiology Laboratories.

Science.gov (United States)

Boyle, Maeve; Moore, John E; Whitehouse, Joanna L; Bilton, Diana; Downey, Damian G

2018-03-02

There is much uncertainty as to how fungal disease is diagnosed and characterized in patients with cystic fibrosis (CF). A 19-question anonymous electronic questionnaire was developed and distributed to ascertain current practice in clinical microbiology laboratories providing a fungal laboratory service to CF centres in the UK. Analyses of responses identified the following: (1) current UK laboratory practice, in general, follows the current guidelines, but the scope and diversity of what is currently being delivered by laboratories far exceeds what is detailed in the guidelines; (2) there is a lack of standardization of fungal tests amongst laboratories, outside of the current guidelines; (3) both the UK CF Trust Laboratory Standards for Processing Microbiological Samples from People with Cystic Fibrosis and the US Cumulative Techniques and Procedures in Clinical Microbiology (Cumitech) Guidelines 43 Cystic Fibrosis Microbiology need to be updated to reflect both new methodological innovations, as well as better knowledge of fungal disease pathophysiology in CF; (4) there is a need for clinical medicine to decide upon a stratification strategy for the provision of new fungal assays that will add value to the physician in the optimal management of CF patients; (5) there is also a need to rationale what assays should be performed at local laboratory level and those which are best served at National Mycology Reference Laboratory level; and (6) further research is required in developing laboratory assays, which will help ascertain the clinical importance of 'old' fungal pathogens, as well as 'emerging' fungal pathogens.
CPT Profiling and Laboratory Data Correlations for Deriving of Selected Geotechnical Parameter

Directory of Open Access Journals (Sweden)

Bulko Roman

2015-12-01

Full Text Available Currently, can be seen a new trend in engineering geological survey, where laboratory analysis are replaced by in situ testing methods, which are more efficient and cost effective, and time saving too. A regular engineering geological survey cannot be provided by simple core drillings, macroscopic description (sometimes very subjective, and then geotechnical parameters are established based on indicative standardized values or archive values from previous geotechnical standards. The engineering geological survey is trustworthy if is composed of laboratory and in-situ testing supplemented by indirect methods of testing, [1]. The prevalence of rotary core drilling for obtaining laboratory soil samples from various depths (every 1 to 3 m, cannot be a more enhanced as continues evaluation of strata and properties e.g. by CPT Piezocone (every 1 cm. Core drillings survey generally uses small amounts of soil samples, but this is resulting to a lower representation of the subsoil and underestimation of parameters. Higher amounts of soil samples make laboratory testing time-consuming and results from this testing can be influenced by the storage and processing of the soil samples. Preference for geotechnical surveys with in situ testing is therefore a more suitable option. In situ testing using static and dynamic penetration tests can be used as a supplement or as a replacement for the (traditional methods of surveying.

Keeping out Trojan horses: auctions and bankruptcy in the laboratory

NARCIS (Netherlands)

Onderstal, S.; van der Veen, A.

2011-01-01

If a government auctions the right to market a good, continuity is likely to be of significant importance. In a laboratory experiment, we compare the effects of bidders' limited liability in the first-price sealed-bid auction and the English auction in a common value setting. Our data strongly
POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - GEOCHEMISTRY LABORATORY AT SANDIA NATIONAL LABORATORIES

Science.gov (United States)

These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...
HARNESSING VALUES TO PROMOTE MOTIVATION IN EDUCATION.

Science.gov (United States)

Harackiewicz, Judith M; Tibbetts, Yoi; Canning, Elizabeth; Hyde, Janet S

2014-01-01

We review the interventions that promote motivation in academic contexts, with a focus on two primary questions: How can we motivate students to take more STEM courses? Once in those STEM courses, how can we keep students motivated and promote their academic achievement? We have approached these two motivational questions from several perspectives, examining the theoretical issues with basic laboratory research, conducting longitudinal questionnaire studies in classrooms, and developing interventions implemented in different STEM contexts. Our research is grounded in three theories that we believe are complementary: expectancy-value theory (Eccles & Wigfield, 2002), interest theory (Hidi & Renninger, 2006), and self-affirmation theory (Steele, 1988). As social psychologists, we have focused on motivational theory and used experimental methods, with an emphasis on values - students' perceptions of the value of academic tasks and students' personal values that shape their experiences in academic contexts. We review the experimental field studies in high-school science and college psychology classes, in which utility-value interventions promoted interest and performance for high-school students in science classes and for undergraduate students in psychology courses. We also review a randomized intervention in which parents received information about the utility value of math and science for their teens in high school; this intervention led students to take nearly one semester more of science and mathematics, compared with the control group. Finally, we review an experimental study of values affirmation in a college biology course and found that the intervention improved performance and retention for first-generation college students, closing the social-class achievement gap by 50%. We conclude by discussing the mechanisms through which these interventions work. These interventions are exciting for their broad applicability in improving students' academic choices and
To other worlds via the laboratory (Invited)

Science.gov (United States)

Lorenz, R. D.

2009-12-01

Planetary science is fun, largely by virtue of the wide range of disciplines and techniques it embraces. Progress relies not only on spacecraft observation and models, but also on laboratory work to provide reference data with which to interpret observations and to provide quantitative constraints on model parameters. An important distinction should be drawn between two classes of investigation. The most familiar, pursued by those who make laboratory studies the focus of their careers, is the construction of well-controlled experiments, typically to determine the functional dependence of some desired physical property upon one or two controlled parameters such as temperature, pressure or concentration. Another class of experiment is more exploratory - to 'see what happens'. This exercise often reveals that models may be based on entirely false assumptions. In some cases laboratory results also have value as persuasive tools in providing graphic support for unfamiliar properties or processes - the iconic image of 'flaming ice' makes the exotic notion of methane clathrate immediately accessible. This talk will review the role of laboratory work in planetary science and especially the outer solar system. A few of the author's personal forays into laboratory measurements will be discussed in the talk; These include the physical properties of dessicated icy loess in the US Army Permafrost tunnel in Alaska (as a Mars analog), the use of a domestic microwave oven to measure radar absorptivity (in particular of ammonia-rich water ice) and the generation of waves - and ice - on the surface of a liquid by wind with fluid and air parameters appropriate to Mars and Titan rather than Earth using the MARSWIT wind tunnel at NASA Ames.
Comparison of CIE chromaticity values

CSIR Research Space (South Africa)

Van Tonder, N

1999-02-02

Full Text Available matter #1999 Elsevier Science B.V. All rights reserved. PII: S0003-2670(98)00526-1 an opal glass white standard. Furthermore, the x and y CIE chromaticity values had to be calculated under the conditions of illuminants A, C and D65 with a 28 observer. 2... to the South African national measuring standards of light by an opal glass re?ectance standard (NPL calibration number AU87) calibrated by the National Physical Laboratory, UK (NPL). Re?ectance measurements were taken at three different positions on each...
Bio Engineering Laboratory

Data.gov (United States)

Federal Laboratory Consortium — Description/History: Chemistry and biology laboratoriesThe Bio Engineering Laboratory (BeL) is theonly full spectrum biotechnology capability within the Department...
Temperature limit values for touching cold surfaces with the fingertip

NARCIS (Netherlands)

Geng, Q.; Holme, I.; Hartog, E.A. den; Havenith, G.; Jay, O.; Malchaires, J.; Piette, A.; Rintama, H.; Rissanen, S.

2006-01-01

Objectives: At the request of the European Commission and in the framework of the European Machinery Directive, research was performed in five different laboratories to develop specifications for surface temperature limit values for the short-term accidental touching of the fingertip with cold
Advanced Chemistry Laboratory

Data.gov (United States)

Federal Laboratory Consortium — Description/History: Chemistry laboratoryThe Advanced Chemistry Laboratory (ACL) is a unique facility designed for working with the most super toxic compounds known...
FOOTWEAR PERFORMANCE LABORATORY

Data.gov (United States)

Federal Laboratory Consortium — This laboratory provides biomechanical and physical analyses for both military and commercial footwear. The laboratory contains equipment that is integral to the us...
Vapor-phase biofiltration: Laboratory and field experience

International Nuclear Information System (INIS)

Evans, P.J.; Bourbonais, K.A.; Peterson, L.E.; Lee, J.H.; Laakso, G.L.

1995-01-01

Application of vapor-phase bioreactors (VPBs) to petroleum hydrocarbons is complicated by the different mass transfer characteristics of aliphatics and aromatics. Laboratory- and pilot-scale VPB studies were conducted to evaluate treatment of soil vapor extraction (SVE) off-gas. A mixture of compost, perlite, and activated carbon was the selected medium based on pressure drop, microbial colonization, and adsorption properties. Two different pilot-scale reactors were built with a difference of 70:1 in scale. The smaller VPB's maximum effective elimination capacity (EC) was determined to be 7.2 g m -3 h -1 ; the larger unit's EC was 70% to 80% of this value. Low EC values may be attributable to a combination of mass-transfer and kinetic limitations
Lincoln Laboratory Grid

Data.gov (United States)

Federal Laboratory Consortium — The Lincoln Laboratory Grid (LLGrid) is an interactive, on-demand parallel computing system that uses a large computing cluster to enable Laboratory researchers to...
Photometrics Laboratory

Data.gov (United States)

Federal Laboratory Consortium — Purpose:The Photometrics Laboratory provides the capability to measure, analyze and characterize radiometric and photometric properties of light sources and filters,...
Blackroom Laboratory

Data.gov (United States)

Federal Laboratory Consortium — FUNCTION: Enables evaluation and characterization of materials ranging from the ultraviolet to the longwave infrared (LWIR).DESCRIPTION: The Blackroom Laboratory is...
Quality of Liver and Kidney Function Tests among Public Medical Laboratories in Western Region of Amhara National Regional State of Ethiopia.

Science.gov (United States)

Teka, Abaynesh; Kibatu, Girma

2012-03-01

Medical laboratories play essential roles in measurements of substances in body fluids for the purpose of diagnosis, treatment, prevention, and for greater understanding of the disease process. Thus, data generated from have to be reliable for which strict quality control, management and assurance are maintained. The aim of this study is to assess the accuracy and precision of clinical chemistry laboratories in western region of Amhara national regional state of Ethiopia in testing liver and kidney functions. Eight laboratories in hospitals and a Regional Health Research Laboratory Center participated in this study from February to March, 2011. Each participant was requested to measure six specimens for six chemistry tests from two control samples. Three hundred twenty four test results to be reported from all participant laboratories, if all measurements can be made, were designed to be collected and statistically evaluated. None of the study subject laboratories could deliver all the six tests for estimation of both liver and renal functions simultaneously during the study period. Only 213 values from the expected 324 values were reported and about 65 % of the 213 values reported fell outside of the allowable limits of errors for the chemistry tests of the control specimen used. This study finding showed that there were lack of accuracy and precision in chemistry measurements. A regular survey on medical laboratories should be conducted questioning the accuracy and precision of their analyses in order to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients. Laboratory Quality Management Systems appreciate the need for regular quality control and quality assessment schemes in medical laboratories.
High Reproducibility of ELISPOT Counts from Nine Different Laboratories

Directory of Open Access Journals (Sweden)

Srividya Sundararaman

2015-01-01

Full Text Available The primary goal of immune monitoring with ELISPOT is to measure the number of T cells, specific for any antigen, accurately and reproducibly between different laboratories. In ELISPOT assays, antigen-specific T cells secrete cytokines, forming spots of different sizes on a membrane with variable background intensities. Due to the subjective nature of judging maximal and minimal spot sizes, different investigators come up with different numbers. This study aims to determine whether statistics-based, automated size-gating can harmonize the number of spot counts calculated between different laboratories. We plated PBMC at four different concentrations, 24 replicates each, in an IFN-γ ELISPOT assay with HCMV pp65 antigen. The ELISPOT plate, and an image file of the plate was counted in nine different laboratories using ImmunoSpot® Analyzers by (A Basic Count™ relying on subjective counting parameters set by the respective investigators and (B SmartCount™, an automated counting protocol by the ImmunoSpot® Software that uses statistics-based spot size auto-gating with spot intensity auto-thresholding. The average coefficient of variation (CV for the mean values between independent laboratories was 26.7% when counting with Basic Count™, and 6.7% when counting with SmartCount™. Our data indicates that SmartCount™ allows harmonization of counting ELISPOT results between different laboratories and investigators.
EDITORIAL: Interrelationship between plasma phenomena in the laboratory and in space

Science.gov (United States)

Koepke, Mark

2008-07-01

favor of theory-paper counterparts and, thus, the scientific support that laboratory results can provide to the development of space-relevant theoretical models is often under-recognized. It is unrealistic to expect the dimensional parameters corresponding to space plasma to be matchable in the laboratory. However, a laboratory experiment is considered well designed if the subset of parameters relevant to a specific process shares the same phenomenological regime as the subset of analogous space parameters, even if less important parameters are mismatched. Regime boundaries are assigned by normalizing a dimensional parameter to an appropriate reference or scale value to make it dimensionless and noting the values at which transitions occur in the physical behavior or approximations. An example of matching regimes for cold-plasma waves is finding a 45° diagonal line on the log--log CMA diagram along which lie both a laboratory-observed wave and a space-observed wave. In such a circumstance, a space plasma and a lab plasma will support the same kind of modes if the dimensionless parameters are scaled properly (Bellan 2006 Fundamentals of Plasma Physics (Cambridge: Cambridge University Press) p 227). The plasma source, configuration geometry, and boundary conditions associated with a specific laboratory experiment are characteristic elements that affect the plasma and plasma processes that are being investigated. Space plasma is not exempt from an analogous set of constraining factors that likewise influence the phenomena that occur. Typically, each morphologically distinct region of space has associated with it plasma that is unique by virtue of the various mechanisms responsible for the plasma's presence there, as if the plasma were produced by a unique source. Boundary effects that typically constrain the possible parameter values to lie within one or more restricted ranges are inescapable in laboratory plasma. The goal of a laboratory experiment is to examine the
Laboratory Building

Energy Technology Data Exchange (ETDEWEB)

Herrera, Joshua M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-03-01

This report is an analysis of the means of egress and life safety requirements for the laboratory building. The building is located at Sandia National Laboratories (SNL) in Albuquerque, NM. The report includes a prescriptive-based analysis as well as a performance-based analysis. Following the analysis are appendices which contain maps of the laboratory building used throughout the analysis. The top of all the maps is assumed to be north.
Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

Energy Technology Data Exchange (ETDEWEB)

Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

2004-06-01

The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC{sub 50} values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC{sub 50} obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC{sub 50}). This LC{sub 50} value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC{sub 50}. For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC{sub 50} and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC{sub 50} of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC{sub 50} values. In contrast, LC{sub 50} determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature.
Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

International Nuclear Information System (INIS)

Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

2004-01-01

The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC 50 values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC 50 obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC 50 ). This LC 50 value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC 50 . For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC 50 and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC 50 of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC 50 values. In contrast, LC 50 determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature
Determination of the acid value of instant noodles: interlaboratory study.

Science.gov (United States)

Hakoda, Akiko; Sakaida, Kenichi; Suzuki, Tadanao; Yasui, Akemi

2006-01-01

An interlaboratory study was performed to evaluate the method for determining the acid value of instant noodles, based on the Japanese Agricultural Standard (JAS), with extraction of lipid using petroleum ether at a volume of 100 mL to the test portion of 25 g. Thirteen laboratories participated and analyzed 5 test samples as blind duplicates. Statistical treatment revealed that the repeatability (RSDr) of acid value was noodles per unit weight, using the equation [acid value = percent free fatty acids (as oleic) x 1.99] and the extracted lipid contents. This method was shown to have acceptable precision by the present study.

Utility of Reference Change Values for Delta Check Limits.

Science.gov (United States)

Ko, Dae-Hyun; Park, Hae-Il; Hyun, Jungwon; Kim, Hyun Soo; Park, Min-Jeong; Shin, Dong Hoon

2017-10-01

To assess the utility of reference change values (RCVs) as delta check limits. A total of 1,650,518 paired results for 23 general chemistry test results from June 1, 2014, to October 31, 2016, were analyzed. The RCVs for each analyte were calculated from the analytical imprecision and within-subject biological variation. The percent differences between two consecutive results in one patient were categorized into one of four groups: outpatients, inpatients, emergency care, and general health care. For each, 2.5th and 97.5th percentile values were computed and compared with their RCVs. The distributions were assessed for normality using the Kolmogorov-Smirnov test. Most of the estimated limits were larger than the corresponding RCVs and, furthermore, with notable differences across the groups. Patients in the emergency care group usually demonstrated larger delta percent values than those in the other groups. None of the distributions of the percent differences passed tests of normality when subjected to Kolmogorov-Smirnov analysis. Comparison of estimated RCVs and real-world patient data revealed the pitfalls of applying RCVs in clinical laboratories. Laboratory managers should be aware of the limitations of RCVs and exercise caution when using them. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
An intercomparison of γ-spectrometry on two samples of biological origin by eight laboratories in four countries

International Nuclear Information System (INIS)

Twining, J.R.

1996-01-01

This report gives details of the first inter-laboratory comparison of γ-spectrometry to be run within SPERA, the South Pacific Environmental Radioactivity Association since its inauguration in 1991. Laboratories in Australia, Chile, French Polynesia and New Zealand participated in the exercise. Two 'unknown' samples of biological origin were analysed. The first was a sample of milk powder derived from IAEA reference material. This sample provided an assessment of overall accuracy of 134 Cs, 137 Cs and 40 K determinations. The second sample consisted of dried fish flesh including natural 40 K and spiked with a mixed nuclide solution containing 210 Pb, 109 Cd, 54 Mn, 60 Co and trace 133 Ba. Together the samples gave information on analytical precision over a range of energies and activities. When the results were compared with the recommended values and confidence intervals of the IAEA reference material, the overall accuracy of the γ-spectrometry analytical procedures was found to be good. The average mean values for combined laboratory data fell within the recommended value ranges for each isotope. Ninety percent of the individual laboratory isotope mean values were within two standard errors of the 95% confidence interval of the standard, 75% were within 1 s.e., and 33% of the analyses fell within the confidence interval. The largest sources of error were derived from reporting and calculating of results which gave a 16% gross error rate. (Author)
Neutron Standards Laboratory of the CIEMAT

International Nuclear Information System (INIS)

Guzman G, K. A.; Mendez V, R.; Vega C, H. R.

2014-08-01

By means of a calculation series with Monte Carlo methods and the code MCNPX was characterized the neutrons field produced by the existent calibration sources in the Neutron Standards Laboratory of the Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT). The laboratory has two neutron calibration sources one of 241 AmBe and other 252 Cf that are stored in a water pool. A detailed three-dimensional model of the room was built with the base of stainless steel remarking in the selector to the sources that situates them to 4 m of the floor to be irradiated on the irradiation table and the storage pool. Each one of the sources was defined on the model in its double steel encapsulated. The spectra were calculated with different cases with the purpose of to calculate the contribution of each element that impacts to the neutrons transport. The spectra of the calibration sources were calculated to different distances regarding the source from 0, 15, 35, 50 to 300 cm on the base and in a same way the values of the ambient dose equivalent using the approaches of the ICRP-74. The results show clearly that the great contribution in the modification of the spectrum is attributed to the walls, and floor of the Neutron Standards Laboratory installations. (Author)
Virtual Laboratory "vs." Traditional Laboratory: Which Is More Effective for Teaching Electrochemistry?

Science.gov (United States)

Hawkins, Ian; Phelps, Amy J.

2013-01-01

The use of virtual laboratories has become an increasing issue regarding science laboratories due to the increasing cost of hands-on laboratories, and the increase in distance education. Recent studies have looked at the use of virtual tools for laboratory to be used as supplements to the regular hands-on laboratories but many virtual tools have…
Design values of resilient modulus of stabilized and non-stabilized base.

Science.gov (United States)

2010-10-01

The primary objective of this research study is to determine design value ranges for typical base materials, as allowed by LADOTD specifications, through laboratory tests with respect to resilient modulus and other parameters used by pavement design ...
Pathology economic model tool: a novel approach to workflow and budget cost analysis in an anatomic pathology laboratory.

Science.gov (United States)

Muirhead, David; Aoun, Patricia; Powell, Michael; Juncker, Flemming; Mollerup, Jens

2010-08-01

The need for higher efficiency, maximum quality, and faster turnaround time is a continuous focus for anatomic pathology laboratories and drives changes in work scheduling, instrumentation, and management control systems. To determine the costs of generating routine, special, and immunohistochemical microscopic slides in a large, academic anatomic pathology laboratory using a top-down approach. The Pathology Economic Model Tool was used to analyze workflow processes at The Nebraska Medical Center's anatomic pathology laboratory. Data from the analysis were used to generate complete cost estimates, which included not only materials, consumables, and instrumentation but also specific labor and overhead components for each of the laboratory's subareas. The cost data generated by the Pathology Economic Model Tool were compared with the cost estimates generated using relative value units. Despite the use of automated systems for different processes, the workflow in the laboratory was found to be relatively labor intensive. The effect of labor and overhead on per-slide costs was significantly underestimated by traditional relative-value unit calculations when compared with the Pathology Economic Model Tool. Specific workflow defects with significant contributions to the cost per slide were identified. The cost of providing routine, special, and immunohistochemical slides may be significantly underestimated by traditional methods that rely on relative value units. Furthermore, a comprehensive analysis may identify specific workflow processes requiring improvement.
[Establishing biological reference intervals of alanine transaminase for clinical laboratory stored database].

Science.gov (United States)

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.
Evaluation of the laboratory mouse model for screening topical mosquito repellents.

Science.gov (United States)

Rutledge, L C; Gupta, R K; Wirtz, R A; Buescher, M D

1994-12-01

Eight commercial repellents were tested against Aedes aegypti 0 and 4 h after application in serial dilution to volunteers and laboratory mice. Results were analyzed by multiple regression of percentage of biting (probit scale) on dose (logarithmic scale) and time. Empirical correction terms for conversion of values obtained in tests on mice to values expected in tests on human volunteers were calculated from data obtained on 4 repellents and evaluated with data obtained on 4 others. Corrected values from tests on mice did not differ significantly from values obtained in tests on volunteers. Test materials used in the study were dimethyl phthalate, butopyronoxyl, butoxy polypropylene glycol, MGK Repellent 11, deet, ethyl hexanediol, Citronyl, and dibutyl phthalate.
Calgary Laboratory Services

Directory of Open Access Journals (Sweden)

James R. Wright MD, PhD

2015-12-01

Full Text Available Calgary Laboratory Services provides global hospital and community laboratory services for Calgary and surrounding areas (population 1.4 million and global academic support for the University of Calgary Cumming School of Medicine. It developed rapidly after the Alberta Provincial Government implemented an austerity program to address rising health care costs and to address Alberta’s debt and deficit in 1994. Over roughly the next year, all hospital and community laboratory test funding within the province was put into a single budget, fee codes for fee-for-service test billing were closed, roughly 40% of the provincial laboratory budget was cut, and roughly 40% of the pathologists left the province of Alberta. In Calgary, in the face of these abrupt changes in the laboratory environment, private laboratories, publicly funded hospital laboratories and the medical school department precipitously and reluctantly merged in 1996. The origin of Calgary Laboratory Services was likened to an “unhappy shotgun marriage” by all parties. Although such a structure could save money by eliminating duplicated services and excess capacity and could provide excellent city-wide clinical service by increasing standardization, it was less clear whether it could provide strong academic support for a medical school. Over the past decade, iterations of the Calgary Laboratory Services model have been implemented or are being considered in other Canadian jurisdictions. This case study analyzes the evolution of Calgary Laboratory Services, provides a metric-based review of academic performance over time, and demonstrates that this model, essentially arising as an unplanned experiment, has merit within a Canadian health care context.
Gun Dynamics Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Gun Dynamics Laboratory is a research multi-task facility, which includes two firing bays, a high bay area and a second floor laboratory space. The high bay area...
Computational Laboratory

Data.gov (United States)

Federal Laboratory Consortium — This laboratory contains a number of commercial off-the-shelf and in-house software packages allowing for both statistical analysis as well as mathematical modeling...
Laboratory hemostasis: milestones in Clinical Chemistry and Laboratory Medicine.

Science.gov (United States)

Lippi, Giuseppe; Favaloro, Emmanuel J

2013-01-01

Hemostasis is a delicate, dynamic and intricate system, in which pro- and anti-coagulant forces cooperate for either maintaining blood fluidity under normal conditions, or else will prompt blood clot generation to limit the bleeding when the integrity of blood vessels is jeopardized. Excessive prevalence of anticoagulant forces leads to hemorrhage, whereas excessive activation of procoagulant forces triggers excessive coagulation and thrombosis. The hemostasis laboratory performs a variety of first, second and third line tests, and plays a pivotal role in diagnostic and monitoring of most hemostasis disturbances. Since the leading targets of Clinical Chemistry and Laboratory Medicine include promotion of progress in fundamental and applied research, along with publication of guidelines and recommendations in laboratory diagnostics, this journal is an ideal source of information on current developments in the laboratory technology of hemostasis, and this article is aimed to celebrate some of the most important and popular articles ever published by the journal in the filed of laboratory hemostasis.
An HTS machine laboratory prototype

DEFF Research Database (Denmark)

Mijatovic, Nenad; Jensen, Bogi Bech; Træholt, Chresten

2012-01-01

This paper describes Superwind HTS machine laboratory setup which is a small scale HTS machine designed and build as a part of the efforts to identify and tackle some of the challenges the HTS machine design may face. One of the challenges of HTS machines is a Torque Transfer Element (TTE) which...... conduction compared to a shaft. The HTS machine was successfully cooled to 77K and tests have been performed. The IV curves of the HTS field winding employing 6 HTS coils indicate that two of the coils had been damaged. The maximal value of the torque during experiments of 78Nm was recorded. Loaded with 33...
The role of the autoimmunity laboratory in autoimmune diseases

Directory of Open Access Journals (Sweden)

SS Hasson

2012-04-01

Full Text Available Laboratory testing is of great value when evaluating a patient with a suspected autoimmune disease. The results can confirm a diagnosis, estimate disease severity, aid in assessing prognosis and are useful to follow disease activity. Components of the laboratory exam include complete blood count with differential, comprehensive metabolic panel, inflammatory markers, autoantibodies, and flow cytometry. Currently, autoimmunity laboratories are very vibrant owing to the constant and increasing availability of new tests, mainly due to the detection of new autoantibodies. The main characteristic that differentiates the autoimmunity laboratory from other laboratories is the use of immunoassays such as enzyme-linked immunosorbent assay (ELISA, as basic techniques which determines antibodies (autoantibodies and not antigens. For this reason, immunoassay techniques must employ antigens as reagents. However, over the last few years, a significant trend at autoimmunity laboratories has been the gradual replacement of immunofluorescence microscopy by immunoassay. Nowadays the revolution of new technology has taken place significantly, for examples; recombinant DNA technology has allowed the production of large quantities of antigens for autoantibody analysis. Flow cytometry for the analysis of microsphere-based immunoassays allows the simultaneous measurement of several autoantibodies. In the same way, autoantigen microarrays provide a practical means to analyse biological fluids in the search for a high number of autoantibodies. We are now at the beginning of an era of multiplexed analysis, with a high capacity of autoantibody specificities. The future tendency in this field will include immunoassays with greater analytical sensitivity, specificity, simultaneous multiplexed capability, the use of protein microarrays, and the use of other technologies such as microfluidics.
Laboratory facilities increased by gifts

International Nuclear Information System (INIS)

1968-01-01

As a result of gifts from two Member States facilities at the Agency's research centre at Seibersdorf, Austria, have been increased. New equipment has been provided by France and Romania. The French equipment is a coincidence counter to be operated in conjunction with a computer and is valued at $35 000. It can give automatically an exact measurement of radioactivity in a chemical solution containing radioisotopes. This means that a sample of the solution can be sent to another laboratory to be used for calibrating instruments and checking results of research work. Since 1963 nearly 8 000 radioactive solutions to be used as standards have been sent from Seibersdorf to research laboratories and hospitals in 56 countries. The demand continues to grow, and in order to meet it the equipment was developed by the Saclay Research Centre of the Commissariat a l'Energie Atomique in collaboration with Seibersdorf. From Romania have come six electronic measuring instruments worth $6 000 to assist nuclear research, surveying and prospecting. Three are electronic scalers for experimental work involving the counting of radioactive emissions, and three are survey meters for detecting the presence of radioactivity in geological samples. (author)
Geomechanics Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Geomechanics Laboratory allows its users to measure rock properties under a wide range of simulated service conditions up to very high pressures and complex load...
[REPORTING CRITICAL LAB RESULTS, A CHALLENGE FOR THE LAB AND THE PHYSICIAN - A SUMMARY OF FOUR YEARS OF EXPERIENCE IN MEIR MEDICAL CENTER LABORATORIES].

Science.gov (United States)

Rashid, Gloria; Goldman, Jacob; Weinstein, Doron; Tohami, Tali; Neumark, Eran; Weiss, Eli

2015-08-01

Critical laboratory results require prompt reporting to the attending physician, as they may indicate that a patient is in a life-threatening condition. Although this important subject has been covered in many publications, it needs more attention from our healthcare organizations, which have no official policy on the subject. Matching expectations between the doctor and the laboratory needs to be better defined. The aim of this work was to inform the community of doctors and laboratories about the multiple problems concerning the reporting of critical laboratory results, to create a platform for exchanging views and ideas, and to build an extensive infrastructure for developing a unified plan to address this important issue. We present the results of four years of experience of reporting critical laboratory values at the Meir Medical Center Laboratories. The idea leading this work was to present the relatively low rate of critical results reported by the laboratories in 2010, sharing the problems discovered while investigating the situation in depth, and presenting the solutions that enabled us to obtain the desired results within four years. Gradual implementation of these improvements resulted in critical value reporting increasing from 55% in 2010 to 95% currently. We suggest a model for improving critical laboratory values reporting based on our 4-year experience, which emphasizes: (1) The importance of selecting proper tests and values for critical results; (2) The significance of using technology and computerized measures to support the process; and (3) Developing quick procedures for monitoring and controlling the process.
Combustion and utilization of low calorific value gases (LCVG)

Energy Technology Data Exchange (ETDEWEB)

Kishore, Puneet; Ray, Anjan

2010-09-15

Combustion becomes increasingly difficult / inefficient / impossible with decrease in hydrocarbon content / calorific value of gas with available technologies. Through analysis it was postulated that Low Calorific Value Gas would be combustible with Oxygen in existing burner equipment with minor changes, and experimentally tested in the laboratory. The broad conclusion is that LCVG (with 8% or more Hydrocarbon content) could be combusted as efficiently as a normal High CV natural gas. This creates opportunity to translate significant promise and potential of LCVG from a variety of un-conventional sources globally into reliable long term energy resources.
Short-term biological variation of clinical chemical values in dumeril's monitors (Varanus dumerili)

DEFF Research Database (Denmark)

Bertelsen, Mads Frost; Kjelgaard-Hansen, Mads Jens; Howell, Jennifer R.

2007-01-01

Plasma biochemical values are routinely used in the medical management of ill reptiles, and for monitoring the health of clinically normal animals. Laboratory tests, including clinical biochemical values, are subject to biological and analytical variation, the magnitude of which determines the ut...
Evaluating the Laboratory Risk Indicator to Differentiate Cellulitis from Necrotizing Fasciitis in the Emergency Department

Directory of Open Access Journals (Sweden)

Michael M. Neeki

2017-05-01

Full Text Available Introduction: Necrotizing fasciitis (NF is an uncommon but rapidly progressive infection that results in gross morbidity and mortality if not treated in its early stages. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC score is used to distinguish NF from other soft tissue infections such as cellulitis or abscess. This study analyzed the ability of the LRINEC score to accurately rule out NF in patients who were confirmed to have cellulitis, as well as the capability to differentiate cellulitis from NF. Methods: This was a 10-year retrospective chart-review study that included emergency department (ED patients ≥18 years old with a diagnosis of cellulitis or NF. We calculated a LRINEC score ranging from 0–13 for each patient with all pertinent laboratory values. Three categories were developed per the original LRINEC score guidelines denoting NF risk stratification: high risk (LRINEC score ≥8, moderate risk (LRINEC score 6–7, and low risk (LRINEC score ≤5. All cases missing laboratory values were due to the absence of a C-reactive protein (CRP value. Since the score for a negative or positive CRP value for the LRINEC score was 0 or 4 respectively, a LRINEC score of 0 or 1 without a CRP value would have placed the patient in the “low risk” group and a LRINEC score of 8 or greater without CRP value would have placed the patient in the “high risk” group. These patients missing CRP values were added to these respective groups. Results: Among the 948 ED patients with cellulitis, more than one-tenth (10.7%, n=102 of 948 were moderate or high risk for NF based on LRINEC score. Of the 135 ED patients with a diagnosis of NF, 22 patients had valid CRP laboratory values and LRINEC scores were calculated. Among the other 113 patients without CRP values, six patients had a LRINEC score ≥ 8, and 19 patients had a LRINEC score ≤ 1. Thus, a total of 47 patients were further classified based on LRINEC score without a CRP value

Saxton Transportation Operations Laboratory

Data.gov (United States)

Federal Laboratory Consortium — The Saxton Transportation Operations Laboratory (Saxton Laboratory) is a state-of-the-art facility for conducting transportation operations research. The laboratory...
[The practice of development and implementation of quality management systems in medical laboratories. The GOST R ISO 15189-2009 "medical laboratories. The detailed requirements to quality and competence". Particular difficulties of global nature].

Science.gov (United States)

Emanuel', A V; Ivanov, G A; Fleganova, I N; Emanuel', V L

2012-12-01

The article discusses the methodological issues related to the implementation of international principles of standardization in the format of GOST R ISO 9001-2008 "Quality management systems. Requirements", GOST R ISO 15189-2009 "Medical laboratories. The detailed requirements to quality and competence" and GOST R ISO 18113.1-5 "Medical items for diagnostics in vitro. Information provided by manufacturer (marking)". This approach legibly assigns the responsibility concerning the support of metrological correctness of laboratory measurements. The lacking of both full-value public and sectorial normative documentation and coordinated positions of Rosstandard and Minzdrav of Russia on functioning of medical laboratories is noted.
Accuracy and reproducibility of virtual edentulous casts created by laboratory impression scan protocols.

Science.gov (United States)

Peng, Lingyan; Chen, Li; Harris, Bryan T; Bhandari, Bikash; Morton, Dean; Lin, Wei-Shao

2018-04-24

Although computer-aided design and computer-aided manufacturing (CAD-CAM) complete removable dental prostheses (CRDPs) have gained popularity, conventional impressions are still common for CAD-CAM CRDP treatment. These need to be digitized and converted into virtual edentulous casts with a laboratory impression scan protocol during prosthesis fabrication. How this can best be accomplished is unclear. The purpose of this in vitro study was to compare the accuracy and reproducibility of virtual edentulous casts created by a dental laboratory laser scanner and a cone-beam computed tomography (CBCT) scanner with a digitized master cast. A master cast was digitized as the virtual reference cast. Ten polyvinyl siloxane impressions were made on the master cast and scanned with the dental laboratory laser scanner and CBCT scanner. The impressions were sprayed with antiglare spray and rescanned. Four groups of virtual study casts (N=40) were created from the impression scans. All virtual study casts and the reference cast were registered with surface-matching software, and the root mean square (RMS) values (representation of overall accuracy) and percentage of measurement data points within 1 standard deviation (SD) of mean RMS values (%, representation of overall reproducibility) among the 4 study groups were measured. Additionally, 95 numeric distance differences (representation of accuracy at each region) were measured in 5 distinct regions: the apex of the denture border, 6 mm from denture border, crest of the ridge, palate, and posterior palatal seal. The repeated-measures ANOVA and post hoc test (t grouping) were used to determine statistical differences (α=.05). The laboratory scanner group had a significantly larger RMS value (4.0 ±0.3 μm, Pvirtual edentulous casts, and the antiglare spray only significantly improved the accuracy and reproducibility of virtual edentulous casts created by the dental laboratory laser scanner. The accuracy of the virtual edentulous
Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study

Science.gov (United States)

Kuo, Chang-Fu; Grainge, Matthew J; Mallen, Christian; Zhang, Weiya; Doherty, Michael

2015-01-01

Objectives To describe trends in the epidemiology of gout and patterns of urate-lowering treatment (ULT) in the UK general population from 1997 to 2012. Methods We used the Clinical Practice Research Datalink to estimate the prevalence and incidence of gout for each calendar year from 1997 to 2012. We also investigated the pattern of gout management for both prevalent and incident gout patients. Results In 2012, the prevalence of gout was 2.49% (95% CI 2.48% to 2.51%) and the incidence was 1.77 (95% CI 1.73 to 1.81) per 1000 person-years. Prevalence and incidence both were significantly higher in 2012 than in 1997, with a 63.9% increase in prevalence and 29.6% increase in incidence over this period. Regions with highest prevalence and incidence were the North East and Wales. Among prevalent gout patients in 2012, only 48.48% (95% CI 48.08% to 48.89%) were being consulted specifically for gout or treated with ULT and of these 37.63% (95% CI 37.28% to 38.99%) received ULT. In addition, only 18.6% (95% CI 17.6% to 19.6%) of incident gout patients received ULT within 6 months and 27.3% (95% CI 26.1% to 28.5%) within 12 months of diagnosis. The management of prevalent and incident gout patients remained essentially the same during the study period, although the percentage of adherent patients improved from 28.28% (95% CI 27.33% to 29.26%) in 1997 to 39.66% (95% CI 39.11% to 40.22%) in 2012. Conclusions In recent years, both the prevalence and incidence of gout have increased significantly in the UK. Suboptimal use of ULT has not changed between 1997 and 2012. Patient adherence has improved during the study period, but it remains poor. PMID:24431399
[Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

Science.gov (United States)

Yokota, Hiromitsu; Yatomi, Yutaka

2013-08-01

Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.
An Inter-Laboratory Comparison for the Urinary Acrolein Biomarker 3-Hydroxypropyl-Mercapturic Acid (3-HPMA

Directory of Open Access Journals (Sweden)

Scherer Gerhard

2017-01-01

Full Text Available An inter-laboratory comparison study on the acrolein biomarker of exposure 3-hydroxypropyl-mercapturic acid (3-HPMA with 12 laboratories from 7 globally distributed countries was performed. The laboratories received coded triplicates of 4 spiked and lyophilized urine samples (LU, 12 samples as well as 5 authentic urine pool samples (PU, 15 samples covering the 3-HPMA concentration range from background (non-smoking to heavy smoking levels for analysis by using their own (in-house analytical method. All laboratories applied liquid chromatography with tandem mass spectrometry (LC-MS/MS, with most of them (10 of 12 using solid phase extraction (SPE as sample work-up procedure. The intra-laboratory variation (indicating repeatability was determined by calculating the standard deviation (sr and the coefficient of variation (CVr of the triplicates, whereas the inter-laboratory variation (indicating reproducibility was determined by calculating the standard deviation between laboratories (sR and the corresponding coefficient of variation (CVR. After removal of outlier samples or laboratories, the mean CVr values for LU and PU test samples ranged from 2.1–3.6% (mean: 2.8% and 2.4–3.7% (mean: 3.3%, respectively, indicating good repeatability for the determination of 3-HPMA in both sample types. CVR for LU and PU test samples ranged from 9.1–31.9% (mean: 18.8% and 13.9–27.0% (mean: 18.5%, respectively, indicating limited reproducibility in 3-HPMA analysis for both sample types. Re-calculation of the PU results by applying an embedded calibration (EC, derived from the reported peak areas for the LU test samples, somewhat improved the CVR values (range: 9.6–28.8%, mean: 16.7%.
Suboptimal inhibition of protease activity in human immunodeficiency virus type 1: Effects on virion morphogenesis and RNA maturation

International Nuclear Information System (INIS)

Moore, Michael D.; Fu, William; Soheilian, Ferri; Nagashima, Kunio; Ptak, Roger G.; Pathak, Vinay K.; Hu, Wei-Shau

2008-01-01

Protease activity within nascently released human immunodeficiency virus type 1 (HIV-1) particles is responsible for the cleavage of the viral polyproteins Gag and Gag-Pol into their constituent parts, which results in the subsequent condensation of the mature conical core surrounding the viral genomic RNA. Concomitant with viral maturation is a conformational change in the packaged viral RNA from a loosely associated dimer into a more thermodynamically stable form. In this study we used suboptimal concentrations of two protease inhibitors, lopinavir and atazanavir, to study their effects on Gag polyprotein processing and on the properties of the RNA in treated virions. Analysis of the treated virions demonstrated that even with high levels of inhibition of viral infectivity (IC 90 ), most of the Gag and Gag-Pol polyproteins were processed, although slight but significant increases in processing intermediates of Gag were detected. Drug treatments also caused a significant increase in the proportion of viruses displaying either immature or aberrant mature morphologies. The aberrant mature particles were characterized by an electron-dense region at the viral periphery and an electron-lucent core structure in the viral center, possibly indicating exclusion of the genomic RNA from these viral cores. Intriguingly, drug treatments caused only a slight decrease in overall thermodynamic stability of the viral RNA dimer, suggesting that the dimeric viral RNA was able to mature in the absence of correct core condensation
Haematological and biochemical reference values for healthy adults in the middle belt of Ghana.

Directory of Open Access Journals (Sweden)

David K Dosoo

Full Text Available Reference values are very important in clinical management of patients, screening participants for enrollment into clinical trials and for monitoring the onset of adverse events during these trials. The aim of this was to establish gender-specific haematological and biochemical reference values for healthy adults in the central part of Ghana.A total of 691 adults between 18 and 59 years resident in the Kintampo North Municipality and South District in the central part of Ghana were randomly selected using the Kintampo Health and Demographic Surveillance System and enrolled in this cross-sectional survey. Out of these, 625 adults made up of 316 males and 309 females were assessed by a clinician to be healthy. Median values and nonparametric 95% reference values for 16 haematology and 22 biochemistry parameters were determined for this population based on the Clinical Laboratory and Standards Institute guidelines. Values established in this study were compared with the Caucasian values being used currently by our laboratory as reference values and also with data from other African and western countries.REFERENCE VALUES ESTABLISHED INCLUDE: haemoglobin 113-164 g/L for males and 88-144 g/L for females; total white blood cell count 3.4-9.2 × 10(9/L; platelet count 88-352 × 10(9/L for males and 89-403 × 10(9/L for females; alanine aminotransferase 8-54 U/L for males and 6-51 U/L for females; creatinine 56-119 µmol/L for males and 53-106 µmol/L for females. Using the haematological reference values based on the package inserts would have screened out up to 53% of potential trial participants and up to 25% of the population using the biochemical parameters.We have established a panel of locally relevant reference parameters for commonly used haematological and biochemical tests. This is important as it will help in the interpretation of laboratory results both for clinical management of patients and safety monitoring during a trial.
Phosphorus acquisition by barley (Hordeum vulgare L. at suboptimal soil temperature

Directory of Open Access Journals (Sweden)

Kari Ylivainio

2012-12-01

Full Text Available We studied the effects of soil temperature (8 ºC and 15 ºC on barley growth, barley phosphorus (P uptake and soil P solubility. Barley was grown in a pot experiment in two soils with different P fertilization histories for 22 years. The availability of P was estimated by using 33P-labeled fertilizer and calculating L-values. After cultivation for 22 years at ambient soil temperature without P fertilization (-P, soil L-value had decreased compared to soil that received annual P fertilization (P+. Low soil temperature further reduced the L-values, more in the -P soil than in the +P soil. Our results demonstrated that P fertilization can only partially ameliorate poor growth at low soil temperatures. Thus, applying ample fertilization to compensate for poor growth at low soil temperatures would increase the P content and solubility in the soil, but plant uptake would remain inhibited by cold.
The ATLAS project: The effects of a constructionist digital laboratory project on undergraduate laboratory performance.

Science.gov (United States)

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 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.
Value for money of changing healthcare services? Economic evaluation of quality improvement

Science.gov (United States)

Severens, J

2003-01-01

   There are many instances of perceived or real inefficiencies in health service delivery. Both healthcare providers and policy makers need to know the impact and cost of applying strategies to change the behaviour of individuals or organisations. Quality improvement or implementation research is concerned with evaluating the methods of behavioural change. Addressing inefficiencies in healthcare services raises a series of issues, beginning with how inefficiency itself should be defined. The basic concepts of cost analysis and economic evaluations are explained and a model for working through the economic issues of quality improvement is discussed. This model combines the costs and benefits of corrected inefficiency with the costs and degree of behavioural change achieved by a quality improvement method in the policy maker's locality. It shows why it may not always be cost effective for policy makers to address suboptimal behaviour. Both the interpretation of quality improvement research findings and their local application need careful consideration. The limited availability of applicable quality improvement research may make it difficult to provide robust advice on the value for money of many behavioural quality improvement strategies. PMID:14532369
Transfer and concentration factors in laboratory and environmental conditions

International Nuclear Information System (INIS)

Paschoa, A.S.; Amaral, E.C.S.

1993-01-01

Environmental transfer factors, as well as concentration and accumulation factors, have been increasingly used in environmental dosimetric models. These models are often the basis for decision-making processes concerning radiological protection. However, the uncertainties associated with measured and default values of transfer and concentration factors are usually not taken into account in the decision making processes. In addition, laboratory-based values for these factors do not necessarily agree with site-specific and species-specific transfer and concentration factors. Soil-to-plant transfer factors and water-to-aquatic-organisms concentration factors are not only time and concentration-dependent, but also species-and site-specific environment-dependent. These uncertainties and dependencies may make the decision-making process, based on models, quite a difficult exercise. The current work examines, as an example, the time-dependent variations in the accumulation of 226 Ra in zooplankton in a laboratory experiment as compared with the concentration factor measured in a natural environment. In addition, the work reviews differences in 228 Ra and 226 Ra concentration factors for several plant families measured in a highly radioactive environment. (author). 9 refs, 3 figs, 3 tabs
Worldwide Laboratory Comparison on the Determination of Trace Elements in IAEA-452 Biota Sample

International Nuclear Information System (INIS)

2012-01-01

The Marine Environmental Studies Laboratory (MESL) of the International Atomic Energy Agency's Environment Laboratories (IAEA-NAEL) has the programmatic responsibility to provide assistance to Member States' laboratories in maintaining and improving the reliability of analytical measurement results, both in trace elements and organic pollutants. This is accomplished through the provision of reference materials of marine origin, validated analytical procedures, training in the implementation of internal quality control, and through the evaluation of measurement performance by the organization of worldwide and regional interlaboratory comparison exercises. For nearly thirty years, the MESL has conducted worldwide laboratory performance studies, also known as interlaboratory comparison. The results have been used to evaluate laboratory performance with respect to a wide range of organic and inorganic pollutants, including methyl mercury. This work has been conducted in collaboration with the UNEP Regional Seas Programme. The goal of interlaboratory comparison is to demonstrate the measurement capabilities of laboratories participating in interlaboratory comparisons (ILCs) and proficiency tests (PTs). The results from ILCs or PTs are of crucial interest for laboratories as these provide clear information of its measurement capabilities. It should be pointed out that the participation is either voluntary or forced by external requirements (e.g. legal, accreditation, control bodies). NAEL's interlaboratory comparison (ILC) and proficiency test (PT) schemes involve comparison of participant's results with an assigned value, which usually is delivered as a consensus value from the overall population of test results. Those exercises are designed to monitor and demonstrate the performance and analytical capabilities of the participating laboratories, and to identify gaps and problem areas where further development is needed. Continued membership has benefits in training and
Safety in laboratories: Indian scenario.

Science.gov (United States)

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.
National laboratories

International Nuclear Information System (INIS)

Moscati, G.

1983-01-01

The foundation of a 'National Laboratory' which would support a Research center in synchrotron radiation applications is proposed. The essential features of such a laboratory differing of others centers in Brazil are presented. (L.C.) [pt
Fuel quality control: Five years of activity in laboratories

International Nuclear Information System (INIS)

Bettinelli, M.; Cimini, G.; Durello, G.; Lucchesi, P.L.

1991-01-01

A description of how ENEL (Italian National Electricity Board) carries out the activity of fuel quality control is given, and the results of the Round Robin circuit which has been operating for five years in laboratories regulary performing the control analyses of these products are reported. The laboratories taking part in the Round Robin circuit are 41 (out of which 35 are ENEL laboratories and 6 are owned by external companies) and they are situated throughout Italy; the controlled parameters are the following: heat of combustion (PCS), sulphur (S), vanadium (V) and asphaltenes (ASF); the adopted methods are the official ASTM or IP ones. The statistical analysis of the results has permitted, for every parameter, the calculation of the repeatability and the reproducibility which, in most cases, have turned out to be in keeping with the values provided for in the regulations. Among the collateral initiatives promoted in the framework of this Round Robin, the following are reported: preparation of standards of fuel oil with a known content of a sulphur and vanadium; expediting visits to all the ENEL laboratories participating in the RRT; publication of a handbook of the adopted analysis methods (in Italian); definition of guide-lines on the right selection of new automatic equipment
Quality management at Argonne National Laboratory: Status, accomplishments, and lessons learned

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

In April 1992, Argonne National Laboratory (ANL) launched the implementation of quality management (QM) as an initiative of the Laboratory Director. The goal of the program is to seek ways of improving Laboratory performance and effectiveness by drawing from the realm of experiences in the global total quality management movement. The Argonne QM initiative began with fact finding and formulating a strategy for implementation; the emphasis is that the underlying principles of QM should be an integral part of how the Laboratory is managed and operated. A primary theme that has guided the Argonne QM initiative is to consider only those practices that offer the potential for real improvement, make sense, fit the culture, and would be credible to the broad population. In October 1993, the Laboratory began to pilot a targeted set of QM activities selected to produce outcomes important to the Laboratory--strengthening the customer focus, improving work processes, enhancing employee involvement and satisfaction, and institutionalizing QM. This report describes the results of the just-concluded QM development and demonstration phase in terms of detailed strategies, accomplishments, and lessons learned. These results are offered as evidence to support the conclusion that the Argonne QM initiative has achieved value-added results and credibility and is well positioned to support future deployment across the entire Laboratory as an integrated management initiative. Recommendations for follow-on actions to implement future deployment are provided separately.
Key Performance Indicators to Measure Improvement After Implementation of Total Laboratory Automation Abbott Accelerator a3600.

Science.gov (United States)

Miler, Marijana; Nikolac Gabaj, Nora; Dukic, Lora; Simundic, Ana-Maria

2017-12-27

The aim of the study was to estimate improvement of work efficiency in the laboratory after implementation of total laboratory automation (TLA) by Abbott Accelerator a3600 in the laboratory with measuring different key performance indicators (KPIs) before and after TLA implementation. The objective was also to recommend steps for defining KPIs in other laboratories. For evaluation of improvement 10 organizational and/or technical KPIs were defined for all phases of laboratory work and measured before (November 2013) and after (from 2015 to 2017) TLA implementation. Out of 10 defined KPIs, 9 were successfully measured and significantly improved. Waiting time for registration of samples in the LIS was significantly reduced from 16 (9-28) to 9 (6-16) minutes after TLA (P performed at core biochemistry analyzers which significantly reduced walking distance for sample management (for more than 800 m per worker) and number of tube touches (for almost 50%). Analyzers downtime and engagement time for analyzers maintenance was reduced for 50 h and 28 h per month, respectively. TLA eliminated manual dilution of samples with extreme results with sigma values increment from 3.4 to >6 after TLA. Although median turnaround time TAT for potassium and troponin was higher (for approximately 20 min), number of outliers with TAT >60 min expressed as sigma values were satisfying (>3). Implementation of the TLA improved the most of the processes in our laboratory with 9 out of 10 properly defined and measured KPIs. With proper planning and defining of KPIs, every laboratory could measure changes in daily workflow.
Personalized laboratory medicine

DEFF Research Database (Denmark)

Pazzagli, M.; Malentacchi, F.; Mancini, I.

2015-01-01

diagnostic tools and expertise and commands proper state-of-the-art knowledge about Personalized Medicine and Laboratory Medicine in Europe, the joint Working Group "Personalized Laboratory Medicine" of the EFLM and ESPT societies compiled and conducted the Questionnaire "Is Laboratory Medicine ready...... in "omics"; 2. Additional training for the current personnel focused on the new methodologies; 3. Incorporation in the Laboratory of new competencies in data interpretation and counselling; 4. Improving cooperation and collaboration between professionals of different disciplines to integrate information...
Biometric identification devices -- Laboratory testing vs. real life

International Nuclear Information System (INIS)

Ahrens, J.S.

1997-01-01

For over fifteen years Sandia National Laboratories has been involved in laboratory testing of biometric identification devices. The key concept of biometric identification devices is the ability for the system to identify some unique aspect of the individual rather than some object a person may be carrying or some password they are required to know. Tests were conducted to verify manufacturer's performance claims, to determine strengths/weaknesses of devices, and to determine devices that meet the US Department of energy's needs. However, during recent field installation, significantly different performance was observed than was predicted by laboratory tests. Although most people using the device believed it operated adequately, the performance observed was over an order of magnitude worse than predicted. The search for reasons behind this gap between the predicted and the actual performance has revealed many possible contributing factors. As engineers, the most valuable lesson to be learned from this experience is the value of scientists and engineers with (1) common sense, (2) knowledge of human behavior, (3) the ability to observe the real world, and (4) the capability to realize the significant differences between controlled experiments and actual installations

Some links on this page may take you to non-federal websites. Their policies may differ from this site.