WorldWideScience

Sample records for technology clinical laboratory

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

    Science.gov (United States)

    Alphus D. Wilson

    2012-01-01

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

  2. Advanced methods for teaching electronic-nose technologies to diagnosticians and clinical laboratory technicians

    Science.gov (United States)

    Alphus D. Wilson

    2012-01-01

    Electronic-detection technologies and instruments increasingly are being utilized in the biomedical field to perform a wide variety of clinical operations and laboratory analyses to facilitate the delivery of health care to patients. The introduction of improved electronic instruments for diagnosing diseases and for administering treatments has required new training of...

  3. Bringing the laboratory and clinic to the community: mobile technologies for health promotion and disease prevention.

    Science.gov (United States)

    Kaplan, Robert M; Stone, Arthur A

    2013-01-01

    Health-related information collected in psychological laboratories may not be representative of people's everyday health. For at least 70 years, there has been a call for methods that sample experiences from everyday environments and circumstances. New technologies, including cell phones, sensors, and monitors, now make it possible to collect information outside of the laboratory in environments representative of everyday life. We review the role of mobile technologies in the assessment of health-related behaviors, physiological responses, and self-reports. Ecological momentary assessment offers a wide range of new opportunities for ambulatory assessment and evaluation. The value of mobile technologies for interventions to improve health is less well established. Among 21 randomized clinical trials evaluating interventions that used mobile technologies, more than half failed to document significant improvements on health outcomes or health risk factors. Theoretical and practical issues for future research are discussed.

  4. Distributed Energy Technology Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Distributed Energy Technologies Laboratory (DETL) is an extension of the power electronics testing capabilities of the Photovoltaic System Evaluation Laboratory...

  5. Acoustic Technology Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — This laboratory contains an electro-magnetic worldwide data collection and field measurement capability in the area of acoustic technology. Outfitted by NASA Langley...

  6. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  7. Informatics and the clinical laboratory.

    Science.gov (United States)

    Jones, Richard G; Johnson, Owen A; Batstone, Gifford

    2014-08-01

    The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a

  8. 78 FR 6330 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2013-01-30

    ... related to improvement in clinical laboratory quality and laboratory medicine practice and specific... laboratory services; revisions to the standards under which clinical laboratories are regulated; the impact... clinical laboratory test results; and assuring the quality of new DNA sequencing technologies in the...

  9. COMMERCIALLY ORIENTED CLINICAL LABORATORIES

    Science.gov (United States)

    Chapman, W. Max

    1964-01-01

    Out-of-state flat-rate mail order contract laboratories operating from states which have little or no legal control over them can do business in California without obedience to regulations that govern laboratories located within the state. The flat-rate contract principle under which some out-of-state laboratories operate is illegal in California. The use of such laboratories increases physician liability. Legislation for the control of these laboratories is difficult to construct, and laws which might result would be awkward to administer. The best remedy is for California physicians not to use an out-of-state laboratory offering contracts or conditions that it could not legally offer if it were located in California. PMID:14165875

  10. 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

  11. Miniaturization and globalization of clinical laboratory activities.

    Science.gov (United States)

    Melo, Murilo R; Clark, Samantha; Barrio, Daniel

    2011-04-01

    Clinical laboratories provide an invaluable service to millions of people around the world in the form of quality diagnostic care. Within the clinical laboratory industry the impetus for change has come from technological development (miniaturization, nanotechnology, and their collective effect on point-of-care testing; POCT) and the increasingly global nature of laboratory services. Potential technological gains in POCT include: the development of bio-sensors, microarrays, genetics and proteomics testing, and enhanced web connectivity. In globalization, prospective opportunities lie in: medical tourism, the migration of healthcare workers, cross-border delivery of testing, and the establishment of accredited laboratories in previously unexplored markets. Accompanying these impressive opportunities are equally imposing challenges. Difficulty transitioning from research to clinical use, poor infrastructure in developing countries, cultural differences and national barriers to global trade are only a few examples. Dealing with the issues presented by globalization and the impact of developing technology on POCT, and on the clinical laboratory services industry in general, will be a daunting task. Despite such concerns, with appropriate countermeasures it will be possible to address the challenges posed. Future laboratory success will be largely dependent on one's ability to adapt in this perpetually shifting landscape.

  12. Service quality framework for clinical laboratories.

    Science.gov (United States)

    Ramessur, Vinaysing; Hurreeram, Dinesh Kumar; Maistry, Kaylasson

    2015-01-01

    The purpose of this paper is to illustrate a service quality framework that enhances service delivery in clinical laboratories by gauging medical practitioner satisfaction and by providing avenues for continuous improvement. The case study method has been used for conducting the exploratory study, with focus on the Mauritian public clinical laboratory. A structured questionnaire based on the SERVQUAL service quality model was used for data collection, analysis and for the development of the service quality framework. The study confirms the pertinence of the following service quality dimensions within the context of clinical laboratories: tangibility, reliability, responsiveness, turnaround time, technology, test reports, communication and laboratory staff attitude and behaviour. The service quality framework developed, termed LabSERV, is vital for clinical laboratories in the search for improving service delivery to medical practitioners. This is a pioneering work carried out in the clinical laboratory sector in Mauritius. Medical practitioner expectations and perceptions have been simultaneously considered to generate a novel service quality framework for clinical laboratories.

  13. Arctic Energy Technology Development Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sukumar Bandopadhyay; Charles Chamberlin; Robert Chaney; Gang Chen; Godwin Chukwu; James Clough; Steve Colt; Anthony Covescek; Robert Crosby; Abhijit Dandekar; Paul Decker; Brandon Galloway; Rajive Ganguli; Catherine Hanks; Rich Haut; Kristie Hilton; Larry Hinzman; Gwen Holdman; Kristie Holland; Robert Hunter; Ron Johnson; Thomas Johnson; Doug Kame; Mikhail Kaneveskly; Tristan Kenny; Santanu Khataniar; Abhijeet Kulkami; Peter Lehman; Mary Beth Leigh; Jenn-Tai Liang; Michael Lilly; Chuen-Sen Lin; Paul Martin; Pete McGrail; Dan Miller; Debasmita Misra; Nagendra Nagabhushana; David Ogbe; Amanda Osborne; Antoinette Owen; Sharish Patil; Rocky Reifenstuhl; Doug Reynolds; Eric Robertson; Todd Schaef; Jack Schmid; Yuri Shur; Arion Tussing; Jack Walker; Katey Walter; Shannon Watson; Daniel White; Gregory White; Mark White; Richard Wies; Tom Williams; Dennis Witmer; Craig Wollard; Tao Zhu

    2008-12-31

    The Arctic Energy Technology Development Laboratory was created by the University of Alaska Fairbanks in response to a congressionally mandated funding opportunity through the U.S. Department of Energy (DOE), specifically to encourage research partnerships between the university, the Alaskan energy industry, and the DOE. The enabling legislation permitted research in a broad variety of topics particularly of interest to Alaska, including providing more efficient and economical electrical power generation in rural villages, as well as research in coal, oil, and gas. The contract was managed as a cooperative research agreement, with active project monitoring and management from the DOE. In the eight years of this partnership, approximately 30 projects were funded and completed. These projects, which were selected using an industry panel of Alaskan energy industry engineers and managers, cover a wide range of topics, such as diesel engine efficiency, fuel cells, coal combustion, methane gas hydrates, heavy oil recovery, and water issues associated with ice road construction in the oil fields of the North Slope. Each project was managed as a separate DOE contract, and the final technical report for each completed project is included with this final report. The intent of this process was to address the energy research needs of Alaska and to develop research capability at the university. As such, the intent from the beginning of this process was to encourage development of partnerships and skills that would permit a transition to direct competitive funding opportunities managed from funding sources. This project has succeeded at both the individual project level and at the institutional development level, as many of the researchers at the university are currently submitting proposals to funding agencies, with some success.

  14. Integration of technology into clinical practice.

    Science.gov (United States)

    Doern, Christopher D

    2013-09-01

    It is an exciting time in clinical microbiology. New advances in technology are revolutionizing every aspect of the microbiology laboratory, from processing of specimens to bacterial identification; as a result, the microbiology laboratory is rapidly changing. With this change comes the challenge of selecting and implementing the technology that is most appropriate for each laboratory and clinical setting. This review focuses on issues surrounding implementation of new technology such that the improvements to clinical care are maximized. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Outsourcing of Academic Clinical Laboratories

    Science.gov (United States)

    Mrak, Robert E.; Parslow, Tristram G.; Tomaszewski, John E.

    2018-01-01

    American hospitals are increasingly turning to service outsourcing to reduce costs, including laboratory services. Studies of this practice have largely focused on nonacademic medical centers. In contrast, academic medical centers have unique practice environments and unique mission considerations. We sought to elucidate and analyze clinical laboratory outsourcing experiences in US academic medical centers. Seventeen chairs of pathology with relevant experience were willing to participate in in-depth interviews about their experiences. Anticipated financial benefits from joint venture arrangements often eroded after the initial years of the agreement, due to increased test pricing, management fees, duplication of services in support of inpatients, and lack of incentive for utilization control on the part of the for-profit partner. Outsourcing can preclude development of lucrative outreach programs; such programs were successfully launched in several cases after joint ventures were either avoided or terminated. Common complaints included poor test turnaround time and problems with test quality (especially in molecular pathology, microbiology, and flow cytometry), leading to clinician dissatisfaction. Joint ventures adversely affected retention of academically oriented clinical pathology faculty, with adverse effects on research and education, which further exacerbated clinician dissatisfaction due to lack of available consultative expertise. Resident education in pathology and in other disciplines (especially infectious disease) suffered both from lack of on-site laboratory capabilities and from lack of teaching faculty. Most joint ventures were initiated with little or no input from pathology leadership, and input from pathology leadership was seen to have been critical in those cases where such arrangements were declined or terminated. PMID:29637086

  16. Clinical laboratory test reference (CLTR).

    Science.gov (United States)

    Grams, R R

    1993-04-01

    As the healthcare system undergoes a transformation in scope and funding, there remain many unfinished projects which will be essential for the next generation of automated medical support services. The most demanding and labor intensive tasks for this new frontier deal with the accumulation of knowledge which can be used as a clinical database to support supervisory functions in a physician operated interactive care delivery environment. These databases will contain the worlds accumulated knowledge in specialized areas. They will be organized by topic or clinical service, and have significant impact on the quality of care as well as medical malpractice exposure. This article will describe a clinical pathology database that has been adapted for medical practice. The database contains information about laboratory tests and their interpretation. The data is structured for rapid reading and has references where indicated. The database can be used in a stand alone program or integrated into an information system within an application program. The files are reviewed on a continuing basis and quarterly updates are made available to subscribers.

  17. Variation in interoperability across clinical laboratories nationwide.

    Science.gov (United States)

    Patel, Vaishali; McNamara, Lauren; Dullabh, Prashila; Sawchuk, Megan E; Swain, Matthew

    2017-12-01

    To characterize nationwide variation and factors associated with clinical laboratories': (1) capabilities to send structured test results electronically to ordering practitioners' EHR systems; and (2) their levels of exchange activity, as measured by whether they sent more than three-quarters of their test results as structured data to ordering practitioners' EHR systems. A national survey of all independent and hospital laboratories was conducted in 2013. Using an analytic weighted sample of 9382 clinical laboratories, a series of logistic regression analyses were conducted to identify organizational and area characteristics associated with clinical laboratories' exchange capability and activity. Hospital-based clinical laboratories (71%) and larger clinical laboratories (80%) had significantly higher levels of capability compared to independent (58%) and smaller laboratories (48%), respectively; though all had similar levels of exchange activity, with 30% of clinical laboratories sending 75% or more of their test results electronically. In multivariate analyses, hospital and the largest laboratories had 1.87 and 4.40 higher odds, respectively, of possessing the capability to send results electronically compared to independent laboratories (pLaboratories located in areas with a higher share of potential exchange partners had a small but significantly greater capability to send results electronically and higher levels of exchange activity(pClinical laboratories' capability to exchange varied by size and type; however, all clinical laboratories had relatively low levels of exchange activity. The role of exchange partners potentially played a small but significant role in driving exchange capability and activity. Published by Elsevier B.V.

  18. A Laboratory Course in Technological Chemistry.

    Science.gov (United States)

    Wiseman, P.

    1986-01-01

    Describes a laboratory course taught at the University of Manchester Institute of Science and Technology (United Kingdom) which focuses on the preparation, properties, and applications of end-use products of the chemical industry. Outlines laboratory experiments on dyes, fibers, herbicides, performance testing, antioxidants, and surface active…

  19. High Technology Mass Spectrometry Laboratory

    Science.gov (United States)

    2010-08-01

    distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Preparedness for acts of chemical terrorism and warfare require detecti testing will allow...chemical terrorism and warfare require detection and response to such attacks. Appropriate chemical testing will allow for the proper diagnosis and...acrylonitrile and acrolein in human blood, and potentially to devise rapid, high throughput screening technology to enable examination of large groups of

  20. [Why medical consultation is needed in the clinical laboratory].

    Science.gov (United States)

    Kawai, T

    1998-10-01

    During the 20th century, at least until the 1980s, clinical laboratory practice had been rapidly expanded, mainly because of a significant advancement in medicine as a whole and also in laboratory technology. However, recent economic changes in health care environment worldwide have been influencing greatly future trends in clinical laboratory practice. Four major macroeconomic forces drive change in clinical laboratory practice as follows; (1) Increasing cost of health care, (2) Implications of an aging population, (3) Social change in the patient population, and (4) Explosion of new technologies. Obviously, the increasing cost of health care is the primary driver. Considering a rapid change in the health care environment, clearly there are two separate pathways to be considered with regard to future modes of delivering patient care services through the clinical laboratory: commercial independent laboratories and hospital laboratories. In most hospital laboratories, in addition to high-quality, accurate and precise laboratory data being delivered through automated informatics in a timely fashion, laboratory physicians and other laboratorians should be available 24 hours a day and 7 days a week. The primary purpose of this approach is to develop a system in which the physician can order the most efficient number of tests, which will provide the maximum amount of clinically relevant informations most rapidly and most accurately at the least cost to the patient. Laboratory physicians must play a key role particularly in hospital laboratories. Their most important roles include those of a professional supplier of laboratory results being useful for health care and clinically relevant, and that of a consultative role for primary care physicians and other co-medical staffs to make important medical decision, based on laboratory results obtained. Therefore, the Japan Society of Clinical Pathology started in 1990 in publishing a series of proposed guidelines for adequate

  1. Proceedings of symposium on technology in laboratories

    International Nuclear Information System (INIS)

    2008-03-01

    The Symposium on Technology in Laboratories was held on both 10th and 11th March 2008 at Ceratopia Toki in Toki city, Gifu Prefecture, Japan, which hosted by the National Institute for Fusion Science (NIFS). 287 people participated and 97 papers were presented from many universities, national laboratories, technical colleges, and some industries in Japan. Technical experience and new techniques were reported and discussed in four fields: technology of fabrication and cryogenics', 'device technology', 'diagnostic and control system', and 'computer and processing'. The 37 of the presented papers are indexed individually. (J.P.N.)

  2. Automation in the clinical microbiology laboratory.

    Science.gov (United States)

    Novak, Susan M; Marlowe, Elizabeth M

    2013-09-01

    Imagine a clinical microbiology laboratory where a patient's specimens are placed on a conveyor belt and sent on an automation line for processing and plating. Technologists need only log onto a computer to visualize the images of a culture and send to a mass spectrometer for identification. Once a pathogen is identified, the system knows to send the colony for susceptibility testing. This is the future of the clinical microbiology laboratory. This article outlines the operational and staffing challenges facing clinical microbiology laboratories and the evolution of automation that is shaping the way laboratory medicine will be practiced in the future. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Cab technology integration laboratory demonstration with moving map technology

    Science.gov (United States)

    2013-03-31

    A human performance study was conducted at the John A. Volpe National Transportation Systems Center (Volpe Center) using a locomotive research simulatorthe Cab Technology Integration Laboratory (CTIL)that was acquired by the Federal Railroad Ad...

  4. Technology transfer in the national laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Yonas, G.

    1991-08-01

    The title of this paper might unfairly provoke readers if it conjures up visions of vast stores of high-tech gadgets in several hundred technology warehouses'' (also known as federal laboratories) around the country, open for browsing by those in search of a bargain. That vision, unfortunately, is a mirage. The term technology transfer'' is not really as accurate as is the term technology team-work,'' a process of sharing ideas and knowledge rather than widgets. In addition, instead of discussing the efforts of more than 700 federal labs in the US, I mean to address only those nine government-owned, contractor-operated multiprogram labs run by the Department of Energy. Nevertheless, the topic of technology team-work opportunities with DOE multiprogram national lab is of significance to those concerned with increasing economic competitiveness and finding technological solutions to a host of national problems. A significant fraction of US R D capabilities rests in the nine DOE multiprogram national laboratories -- and these labs have only just begun to join the other federal laboratories in these efforts due to the passage and recent implementation of the National Competitiveness Technology Transfer Act of 1989.

  5. Oak Ridge National Laboratory Technology Logic Diagram

    International Nuclear Information System (INIS)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D ampersand D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram and Vol. 3, Technology EvaLuation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D ampersand D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TM, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A. B. and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A. B, and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D ampersand D, RA and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2

  6. 76 FR 82299 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-12-30

    ... under which clinical laboratories are regulated; the impact on medical and laboratory practice of... the Clinical Laboratory Workforce; laboratory communication and electronic health records, integration... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical...

  7. Technology transfer from Canadian nuclear laboratories

    International Nuclear Information System (INIS)

    MacDonald, R.D.; Evans, W.; MacEwan, J.R.; Melvin, J.G.

    1985-09-01

    Canada has developed a unique nuclear power system, the CANDU reactor. AECL - Research Company (AECL-RC) has played a key role in the CANDU program by supplying its technology to the reactor's designers, constructors and operators. This technology was transferred from our laboratories to our sister AECL companies and to domestic industries and utilities. As CANDUs were built overseas, AECL-RC made its technology available to foreign utilities and agencies. Recently the company has embarked on a new transfer program, commercial R and D for nuclear and non-nuclear customers. During the years of CANDU development, AECL-RC has acquired the skills and technology that are especially valuable to other countries embarking on their own nuclear programs. This report describes AECL-RC's thirty years' experience with the transfer of technology

  8. Oak Ridge National Laboratory Technology Logic Diagram

    International Nuclear Information System (INIS)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision-support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration, testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D ampersand D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1 (Technology Evaluation), Vol. 2 (Technology Logic Diagram), and Vol. 3 (Technology Evaluation Data Sheets). Part A of Vols. 1 and 2 focuses on D ampersand D. Part B of Vols. 1 and 2 focuses on RA of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TLD, an explanation of the program-specific responsibilities, a review of identified technologies, and the ranking os remedial technologies. Volume 2 (Pts. A, B, and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A, B, and C) contains the TLD data sheets. The focus of Vol. 1, Pt. B, is RA, and it has been divided into six chapters. The first chapter is an introduction, which defines problems specific to the ER Program for ORNL. Chapter 2 provides a general overview of the TLD. Chapters 3 through 5 are organized into necessary subelement categories: RA, characterization, and robotics and automation. The final chapter contains regulatory compliance information concerning RA

  9. Technology integration project: Environmental Restoration Technologies Department Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Williams, C.V.; Burford, T.D. [Sandia National Labs., Albuquerque, NM (United States). Environmental Restoration Technologies; Allen, C.A. [Tech Reps, Inc., Albuquerque, NM (United States)

    1996-08-01

    Sandia National Laboratories Environmental Restoration Technologies Department is developing environmental restoration technologies through funding form the US Department of Energy`s (DOE`s) Office of Science and Technology. Initially, this technology development has been through the Mixed Waste Landfill Integrated Demonstration (MWLID). It is currently being developed through the Contaminant Plume containment and Remediation Focus Area, the Landfill Stabilization Focus Area, and the Characterization, Monitoring, and Sensor Cross-Cutting Program. This Technology Integration Project (TIP) was responsible for transferring MWLID-developed technologies for routine use by environmental restoration groups throughout the DOE complex and commercializing these technologies to the private sector. The MWLID`s technology transfer/commercialization successes were achieved by involving private industry in development, demonstration, and technology transfer/commercialization activities; gathering and disseminating information about MWLID activities and technologies; and promoting stakeholder and regulatory involvement. From FY91 through FY95, 30 Technical Task Plans (TTPs) were funded. From these TTPs, the MWLID can claim 15 technology transfer/commercialization successes. Another seven technology transfer/commercialization successes are expected. With the changeover to the focus areas, the TIP continued the technology transfer/commercialization efforts begun under the MWLID.

  10. Technology integration project: Environmental Restoration Technologies Department Sandia National Laboratories

    International Nuclear Information System (INIS)

    Williams, C.V.; Burford, T.D.

    1996-08-01

    Sandia National Laboratories Environmental Restoration Technologies Department is developing environmental restoration technologies through funding form the US Department of Energy's (DOE's) Office of Science and Technology. Initially, this technology development has been through the Mixed Waste Landfill Integrated Demonstration (MWLID). It is currently being developed through the Contaminant Plume containment and Remediation Focus Area, the Landfill Stabilization Focus Area, and the Characterization, Monitoring, and Sensor Cross-Cutting Program. This Technology Integration Project (TIP) was responsible for transferring MWLID-developed technologies for routine use by environmental restoration groups throughout the DOE complex and commercializing these technologies to the private sector. The MWLID's technology transfer/commercialization successes were achieved by involving private industry in development, demonstration, and technology transfer/commercialization activities; gathering and disseminating information about MWLID activities and technologies; and promoting stakeholder and regulatory involvement. From FY91 through FY95, 30 Technical Task Plans (TTPs) were funded. From these TTPs, the MWLID can claim 15 technology transfer/commercialization successes. Another seven technology transfer/commercialization successes are expected. With the changeover to the focus areas, the TIP continued the technology transfer/commercialization efforts begun under the MWLID

  11. [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.

  12. [Guidelines for blood transfusion teaching to medical laboratory technology students].

    Science.gov (United States)

    Moncharmont, P; Tourlourat, M; Fourcade, C; Julien, E; Peyrard, T; Cabaud, J-J

    2012-02-01

    The new French law about clinical laboratory medicine, the requirements of the ISO/CEI 15189 standard, the numerous abilities expected from the medical laboratory technologists and their involvement in blood bank management has led the working group "Recherche et démarche qualité" of the French Society of Blood Transfusion to initiate an inventory of blood transfusion teaching syllabus for medical laboratory technology students and to propose transfusion medicine teaching guidelines. Seven worksheets have been established for that purpose including red blood cell antigen typing and antibody screening, blood sampling in immunohaematology, automation, clinical practices, blood products, blood delivery and haemovigilance. These guidelines aim at contributing to the harmonization of transfusion medicine teaching and at providing objective elements to the medical laboratory managers regarding the practical and theoretical skills of theirs collaborators. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  13. Error tracking in a clinical biochemistry laboratory

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Ødum, Lars

    2009-01-01

    BACKGROUND: We report our results for the systematic recording of all errors in a standard clinical laboratory over a 1-year period. METHODS: Recording was performed using a commercial database program. All individuals in the laboratory were allowed to report errors. The testing processes were......-technicians collected blood samples. CONCLUSIONS: Each clinical laboratory should record errors in a structured manner. A relation database is a useful tool for the recording and extraction of data, as the database can be structured to reflect the workflow at each individual laboratory....... classified according to function, and errors were classified as pre-analytical, analytical, post-analytical, or service-related, and then further divided into descriptive subgroups. Samples were taken from hospital wards (38.6%), outpatient clinics (25.7%), general practitioners (29.4%), and other hospitals...

  14. Three-dimensional printing physiology laboratory technology.

    Science.gov (United States)

    Sulkin, Matthew S; Widder, Emily; Shao, Connie; Holzem, Katherine M; Gloschat, Christopher; Gutbrod, Sarah R; Efimov, Igor R

    2013-12-01

    Since its inception in 19th-century Germany, the physiology laboratory has been a complex and expensive research enterprise involving experts in various fields of science and engineering. Physiology research has been critically dependent on cutting-edge technological support of mechanical, electrical, optical, and more recently computer engineers. Evolution of modern experimental equipment is constrained by lack of direct communication between the physiological community and industry producing this equipment. Fortunately, recent advances in open source technologies, including three-dimensional printing, open source hardware and software, present an exciting opportunity to bring the design and development of research instrumentation to the end user, i.e., life scientists. Here we provide an overview on how to develop customized, cost-effective experimental equipment for physiology laboratories.

  15. Computer technology forecasting at the National Laboratories

    International Nuclear Information System (INIS)

    Peskin, A.M.

    1980-01-01

    The DOE Office of ADP Management organized a group of scientists and computer professionals, mostly from their own national laboratories, to prepare an annually updated technology forecast to accompany the Department's five-year ADP Plan. The activities of the task force were originally reported in an informal presentation made at the ACM Conference in 1978. This presentation represents an update of that report. It also deals with the process of applying the results obtained at a particular computing center, Brookhaven National Laboratory. Computer technology forecasting is a difficult and hazardous endeavor, but it can reap considerable advantage. The forecast performed on an industry-wide basis can be applied to the particular needs of a given installation, and thus give installation managers considerable guidance in planning. A beneficial side effect of this process is that it forces installation managers, who might otherwise tend to preoccupy themselves with immediate problems, to focus on longer term goals and means to their ends

  16. Clinical laboratory waste management in Shiraz, Iran.

    Science.gov (United States)

    Askarian, Mehrdad; Motazedian, Nasrin; Palenik, Charles John

    2012-06-01

    Clinical laboratories are significant generators of infectious waste, including microbiological materials, contaminated sharps, and pathologic wastes such as blood specimens and blood products. Most waste produced in laboratories can be disposed of in the general solid waste stream. However, improper management of infectious waste, including mixing general wastes with infectious wastes and improper handling or storage, could lead to disease transmission. The aim of this study was to assess waste management processes used at clinical laboratories in Shiraz, Iran. One hundred and nine clinical laboratories participated In this cross sectional study, Data collection was by questionnaire and direct observation. Of the total amount of waste generated, 52% (by weight) was noninfectious domestic waste, 43% was non-sharps infectious waste and 5% consisted of sharps. There was no significant relationship between laboratory staff or manager education and the score for quality of waste collection and disposal at clinical laboratories. Improvements in infectious waste management processes should involve clearer, more uniformly accepted definitions of infectious waste and increased staff training.

  17. Document control practices in 120 clinical laboratories.

    Science.gov (United States)

    Valenstein, Paul N; Stankovic, Ana K; Souers, Rhona J; Schneider, Frank; Wagar, Elizabeth A

    2009-06-01

    A variety of document control practices are required of clinical laboratories by US regulation, laboratory accreditors, and standard-setting organizations. To determine how faithfully document control is being implemented in practice and whether particular approaches to document control result in better levels of compliance. Contemporaneous, structured audit of 8814 documents used in 120 laboratories for conformance with 6 generally accepted document control requirements: available, authorized, current, reviewed by management, reviewed by staff, and archived. Of the 8814 documents, 3113 (35%) fulfilled all 6 document control requirements. The requirement fulfilled most frequently was availability of the document at all shifts and locations (8564 documents; 97%). Only 4407 (50%) of documents fulfilled Clinical Laboratory Improvement Amendment requirements for being properly archived after updating or discontinuation. Policies and procedures were more likely to fulfill document control requirements than forms and work aids. Documents tended to be better controlled in some laboratory sections (eg, transfusion service) than in others (eg, microbiology and client services). We could not identify document control practices significantly associated with higher compliance rates. Most laboratories are not meeting regulatory and accreditation requirements related to control of documents. It is not clear whether control failures have any impact on the quality of laboratory results or patient outcomes.

  18. Decreasing mislabeled laboratory specimens using barcode technology and bedside printers.

    Science.gov (United States)

    Brown, Judy E; Smith, Nancy; Sherfy, Beth R

    2011-01-01

    Mislabeling of laboratory samples has been found to be a high-risk issue in acute care hospitals. The goal of this study was to decrease mislabeled blood specimens. In the first year after the implementation of a positive patient identification system using barcoding and computer technology, the number of labeling errors decreased from 103 to 8 per year. The outcome was clinically and statistically significant (P < .001).

  19. Measure of clinical information technology adoption.

    Science.gov (United States)

    Lee, Jinhyung; Park, Young-Taek

    2013-03-01

    The objective of this study was to create a new measure for clinical information technology (IT) adoption as a proxy variable of clinical IT use. Healthcare Information and Management Systems Society (HIMSS) data for 2004 were used. The 18 clinical IT applications were analyzed across 3,637 acute care hospitals in the United States. After factor analysis was conducted, the clinical IT adoption score was created and evaluated. Basic clinical IT systems, such as laboratory, order communication/results, pharmacy, radiology, and surgery information systems had different adoption patterns from advanced IT systems, such as cardiology, radio picture archiving, and communication, as well as computerized practitioner order-entry. This clinical IT score varied across hospital characteristics. Different IT applications have different adoption patterns. In creating a measure of IT use among various IT components in hospitals, the characteristics of each type of system should be reflected. Aggregated IT adoption should be used to explain technology acquisition and utilization in hospitals.

  20. Mobile technology in clinical teaching.

    Science.gov (United States)

    Mackay, B J; Anderson, J; Harding, T

    2017-01-01

    Technology is having a profound effect on education in the 21st century and nurse educators are being challenged to integrate technological innovation to assist students in their learning. This paper reports a study on the introduction of smart mobile technology to support student learning in the clinical environment. In a climate of collaborative inquiry, clinical lecturers and two researchers from the same department carried out a project in three phases: formation, implementation and analysis. Following the formation phase, six clinical lecturers adopted iPads to support their clinical teaching (implementation phase). At this time they also kept reflective journals. In the analysis phase a thematic analysis of the data from the journals and from a focus group found both enabling and constraining factors influenced the use of iPads by clinical lecturers. The themes categorised as enablers were: resources and technology; and, management and technology support. Those identified as barriers or constraining factors were: clinical staff engagement; and lecturer experience with technology. Student engagement and learning, and connectivity were both enabling and constraining factors. This paper concludes that the use of a mobile device such as an iPad can enhance teaching in clinical settings but that in order for such devices to be successfully integrated into clinical teaching consideration needs to be given to professional development needs, adequate resourcing and technology support. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. What Clinical and Laboratory Parameters Distinguish Between ...

    African Journals Online (AJOL)

    Introduction: In developing countries, a large number of patients presenting acutely in renal failure are indeed cases of advanced chronic renal failure. In this study, we compared clinical and laboratory parameters between patients with acute renal failure (ARF) and chronic renal failure (CRF), to identify discriminatory ...

  2. Clinical laboratory reference intervals in pediatrics: the CALIPER initiative.

    Science.gov (United States)

    Jung, Benjamin; Adeli, Khosrow

    2009-11-01

    Reference intervals provided on laboratory reports are essential for appropriate interpretation of test results, and can significantly impact clinical decision-making and the quality of patient care. Careful determination and/or validation of reference intervals by the laboratory for use in the patient population it serves are therefore important to ensure their proper utility. Unfortunately, critical gaps currently exist in accurate and up-to-date pediatric reference intervals for accurate interpretation of laboratory tests performed in children and adolescents. These critical gaps in the available pediatric laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases of childhood and adolescence. Most of the available "normal" ranges for laboratory tests were determined over 2 decades ago on older instruments and technologies, and are no longer relevant considering the current testing technology used by clinical laboratories. It is thus critical and of utmost urgency that a more acceptable and comprehensive database be established. In the present review, we discuss the considerations and challenges faced when generating and validating reference intervals in accordance to the current guidelines published by the Clinical Laboratory Standards Institute (CLSI). We raise particular attention to the present-day deficiencies in available pediatric reference intervals, and highlight the special issues and unique difficulties that are additionally faced when establishing reference intervals in children. Finally, we highlight a recent Canadian initiative, the CALIPER project, whose mandate is to establish and maintain a database of comprehensive and up-to-date pediatric reference intervals to be eventually made available to all clinical laboratories worldwide.

  3. Guidelines on good clinical laboratory practice: bridging operations between research and clinical research laboratories.

    Science.gov (United States)

    Ezzelle, J; Rodriguez-Chavez, I R; Darden, J M; Stirewalt, M; Kunwar, N; Hitchcock, R; Walter, T; D'Souza, M P

    2008-01-07

    A set of Good Clinical Laboratory Practice (GCLP) standards that embraces both the research and clinical aspects of GLP were developed utilizing a variety of collected regulatory and guidance material. We describe eleven core elements that constitute the GCLP standards with the objective of filling a gap for laboratory guidance, based on IND sponsor requirements, for conducting laboratory testing using specimens from human clinical trials. These GCLP standards provide guidance on implementing GLP requirements that are critical for laboratory operations, such as performance of protocol-mandated safety assays, peripheral blood mononuclear cell processing and immunological or endpoint assays from biological interventions on IND-registered clinical trials. The expectation is that compliance with the GCLP standards, monitored annually by external audits, will allow research and development laboratories to maintain data integrity and to provide immunogenicity, safety, and product efficacy data that is repeatable, reliable, auditable and that can be easily reconstructed in a research setting.

  4. 42 CFR 414.510 - Laboratory date of service for clinical laboratory and pathology specimens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Laboratory date of service for clinical laboratory... AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.510 Laboratory date of service for clinical laboratory and pathology specimens. The date of service for either a...

  5. Push technology at Argonne National Laboratory.

    Energy Technology Data Exchange (ETDEWEB)

    Noel, R. E.; Woell, Y. N.

    1999-04-06

    Selective dissemination of information (SDI) services, also referred to as current awareness searches, are usually provided by periodically running computer programs (personal profiles) against a cumulative database or databases. This concept of pushing relevant content to users has long been integral to librarianship. Librarians traditionally turned to information companies to implement these searches for their users in business, academia, and the science community. This paper describes how a push technology was implemented on a large scale for scientists and engineers at Argonne National Laboratory, explains some of the challenges to designers/maintainers, and identifies the positive effects that SDI seems to be having on users. Argonne purchases the Institute for Scientific Information (ISI) Current Contents data (all subject areas except Humanities), and scientists no longer need to turn to outside companies for reliable SDI service. Argonne's database and its customized services are known as ACCESS (Argonne-University of Chicago Current Contents Electronic Search Service).

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

    Science.gov (United States)

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

    2004-03-01

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

  7. Research in clinical laboratory science: professionals' involvement.

    Science.gov (United States)

    Laudicina, Rebecca; Fenn, JoAnn P; Freeman, Vickie; McCoy, Carol; McLane, Mary Ann; Mundt, Lillian; Polancic, Joan; Randolph, Tim; Shanahan, Kristy

    2011-01-01

    To describe current qualitative and quantitative aspects of research engagement and other scholarly activities conducted by clinical laboratory science (CLS) professionals across a range of employment settings. A link to a 3-part online survey was sent by electronic mail to 7,572 members of the American Society for Clinical Laboratory Science and 500 program directors. email message, on-line survey all ASCLS members and all directors of accredited clinical laboratory educational programs Quantitative and qualitative measures of professionals' engagement in research and other scholarly activities 556 of 7572 (7.3%) persons completed the survey. Thirty-two percent of survey respondents reported spending between 1 to > 40 work hours per week conducting research with 68% of respondents not participating in research activities. Conducting research is an employment requirement for 18% of survey participants. Twenty-nine percent of respondents have published at least one research article, and 47% of respondents who conduct research have published studies in the journal Clinical Laboratory Science. More than 57% of respondents participate in non-research scholarly activities as part of their employment. CLS professionals who conduct research are more likely to do applied, clinical, or educational research than other types of research. Fifty-seven percent of respondents who conduct research lack external funding for their work. Ninety-three percent of total research dollars is obtained by respondents who hold the Ph.D. degree. The perception of the importance of conducting research varies by employment position. Barriers to participation in research include lack of inclusion of research in the job description, time constraints, inadequate research funding, limited opportunity, and lack of space and equipment. CLS professionals participate in research in limited numbers, and are more likely to engage in non-research types of scholarly activities. Numerous barriers are

  8. Guidance, Navigation and Control Digital Emulation Technology Laboratory. Volume 1. Part 2. Task 1: Digital Emulation Technology Laboratory

    Science.gov (United States)

    1991-09-27

    Engineering Research Laboratory " Autnor: Stephen R. Wachtel extern int level; I extern char "list( vic. ca.. staterent ( identifier, opion...ENGINEERING RESEARCH LABORATORY Georgia Institute of Technology Atlanta, Georgia 30332 - 0540 Contract Data Requirements List Item A005 Period Covered: FY 91...COMPUTER ENGINEERING RESEARCH LABORATORY Georgia Institute of Technology Atlanta, Georgia 30332 - 0540 Eugene L. Sanders Cecil 0. Alford USASDC Georgia

  9. Clinical and laboratory evaluation of adrenal dysfunction

    International Nuclear Information System (INIS)

    Ashkar, F.S.; Fishman, L.M.

    1983-01-01

    Because of their special physical and chemical properties, the adrenal secretory products were among the first hormonal substances to be measured by methods other than bioassay. Over the past several years, the development of sensitive and specific methods of hormone assay dependent on the use of radionuclides has revolutionized investigative and clinical endocrinology. While the capacity of defining most abnormalities of adrenal function antedates hormone measurement and adrenal imaging utilizing radioisotopes, the availability of such methods has greatly facilitated and made more precise the diagnostic approach to patients with suspected adrenal dysfunction. As an example of how clinical and laboratory considerations can be integrated into a rational approach to the diagnosis of adrenal disease, the problem of suspected adrenal hyperfunction is analyzed in light of current understanding of its pathophysiology. Reflection demonstrates that suspected primary aldosteronism and adrenal insufficiency are equally amenable to such an approach

  10. Hidden sources of mercury in clinical laboratories.

    Science.gov (United States)

    Alvarez-Chavez, C R; Federico-Perez, R A; Gomez-Alvarez, A; Velazquez-Contreras, L E; Perez-Rios, R

    2014-09-01

    The healthcare sector is an important contributor to mercury (Hg) pollution because of the potential presence of mercury in thermometers, blood pressure cuffs, amalgams, etc. There are also other potential sources of mercury in this sector which are used frequently and in high volumes where the presence of the metal is not obvious and which might be collectively contributing to pollution. For instance, some chemicals used for the clinical diagnosis of illness may contain mercury. The goal of this study was to investigate potential sources of mercury pollution, which originate from clinical laboratory discharges, using an exploratory approach. The focus was on the residue generated during automatic analysis of patients' bodily fluids at a medical center in Hermosillo, Sonora, Mexico. This study shows an overview of what might be happening in the region or the country related to non-obvious sources of mercury in the healthcare sector. The results showed measurable levels of mercury in the residues coming from urine sediment analysis. These amounts do not exceed the maximum allowed by Mexican environmental regulations; nevertheless, the frequency and cumulative volume of residues generated, combined with the potential for persistence and the bioaccumulation of mercury in the environment, warrant attention. The work carried out in this study is being taken as a model for future studies for pollution prevention in the healthcare sector with the goal of measuring mercury emissions to the environment from clinical laboratory wastewater, including identifying sources which--while not obvious--could be important given the frequency and volume of their use in the clinical diagnosis.

  11. Simulation-based medical education in clinical skills laboratory.

    Science.gov (United States)

    Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

    2012-01-01

    Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens' participation and cooperation in medical education.

  12. MIT Lincoln Laboratory: Technology in Support of National Security

    Science.gov (United States)

    2011-01-01

    Carter, Cathy Ho, Ngaire Underhill, Sara James, Jessica Olszta, Jessica Brooks, Melissa May, and Rodolfo Cuevas. Because Lincoln Laboratory is at the...Corporation Applicon Arcon Corporation Ascension Technology Atlantic Aerospace Electronics Axsun Technologies Broadcloud Communications Carl Blake

  13. Laboratory research at the clinical trials of Veterinary medicinal Products

    OpenAIRE

    ZHYLA M.I.

    2011-01-01

    The article analyses the importance of laboratory test methods, namely pathomorfological at conduct of clinical trials. The article focuses on complex laboratory diagnostics at determination of clinical condition of animals, safety and efficacy of tested medicinal product.

  14. Clinical laboratory analytics: Challenges and promise for an emerging discipline

    Directory of Open Access Journals (Sweden)

    Brian H Shirts

    2015-01-01

    Full Text Available The clinical laboratory is a major source of health care data. Increasingly these data are being integrated with other data to inform health system-wide actions meant to improve diagnostic test utilization, service efficiency, and "meaningful use." The Academy of Clinical Laboratory Physicians and Scientists hosted a satellite meeting on clinical laboratory analytics in conjunction with their annual meeting on May 29, 2014 in San Francisco. There were 80 registrants for the clinical laboratory analytics meeting. The meeting featured short presentations on current trends in clinical laboratory analytics and several panel discussions on data science in laboratory medicine, laboratory data and its role in the larger healthcare system, integrating laboratory analytics, and data sharing for collaborative analytics. One main goal of meeting was to have an open forum of leaders that work with the "big data" clinical laboratories produce. This article summarizes the proceedings of the meeting and content discussed.

  15. Clinical laboratory analytics: Challenges and promise for an emerging discipline

    Science.gov (United States)

    Shirts, Brian H.; Jackson, Brian R.; Baird, Geoffrey S.; Baron, Jason M.; Clements, Bryan; Grisson, Ricky; Hauser, Ronald George; Taylor, Julie R.; Terrazas, Enrique; Brimhall, Brad

    2015-01-01

    The clinical laboratory is a major source of health care data. Increasingly these data are being integrated with other data to inform health system-wide actions meant to improve diagnostic test utilization, service efficiency, and “meaningful use.” The Academy of Clinical Laboratory Physicians and Scientists hosted a satellite meeting on clinical laboratory analytics in conjunction with their annual meeting on May 29, 2014 in San Francisco. There were 80 registrants for the clinical laboratory analytics meeting. The meeting featured short presentations on current trends in clinical laboratory analytics and several panel discussions on data science in laboratory medicine, laboratory data and its role in the larger healthcare system, integrating laboratory analytics, and data sharing for collaborative analytics. One main goal of meeting was to have an open forum of leaders that work with the “big data” clinical laboratories produce. This article summarizes the proceedings of the meeting and content discussed. PMID:25774320

  16. Mystery patient insight into clinical laboratory service.

    Science.gov (United States)

    O'Malley, John

    2003-01-01

    Gone are the days when most patients tolerated impersonal service from their physicians and health-care providers in general. Every day, customer and patient satisfaction becomes more critical to a health-care provider's success and survival. Open communications, Internet-informed patients, and aggressive watch groups reveal those health-care providers who consistently deliver poor service. Most health-care providers employ patient satisfaction surveys to monitor their level of service; however, written and telephone surveys seldom provide the surveyor the insight necessary to provide differentiating service because of a large illiteracy rate and fear of reprisal. Toward this end, a well-trained mystery patients offers the health-care provider greater insight into how service is dispensed to its customers and patients. This article offers an aggregate of mystery patient insights into delivering clinical laboratory services both in hospital and medical practice environments, supported with insightful information into creating winning service strategies.

  17. Near-drowning and clinical laboratory changes.

    Science.gov (United States)

    Oehmichen, Manfred; Hennig, Renate; Meissner, Christoph

    2008-01-01

    Opposite to clinical laboratory findings in experimental drowning of animals (erythrocytic lysis, hyperkalemia, and final cardial fibrillation) are the observations in drowned humans (increase of pCO2, hypoxic encephalopathy), which leads to a different pathophysiological interpretation of the drowning process. This process, however, is recently discussed again, therefore an additional study seemed to be recommended. In a retrospective study, 31 cases of near-drowning (23 cases: fresh water; 8 cases: brackish water) clinical laboratory data were analysed. While 21 of the cases were fatal with a delay of up to 180 days, 10 individuals survived the accident, four cases with severe neurological deficits. Data of pH, potassium, sodium, chloride, hemoglobin and total protein were collected during the very early post-drowning period. Nearly all cases (96%) revealed a reduction of pH due to hypoxic acidosis, and only two cases (6.5%) exhibited a slight hyperkalemia. The hemoglobin level was normal in most of the cases (83%) and slightly reduced in the others (17%) while the protein level was slightly reduced in most of the fatalities (80%). As a result of our investigation we have to state the lack of hyperkalemia as well as of an increase of the hemoglobin level indicate that there is no distinct intravascular red cell lysis due to influx of water into the vascular compartment. Therefore the death by drowning in humans in most cases is the result of a hypoxic cerebral process. A comparison with animal experiments obviously is not helpful because the drowning process in humans leads to an aspiration of only 2-4 ml water/kg, while in animal experiments more than 10 ml water/kg will be artificially aspirated leading to red cell lysis as well as to electrolyte disturbances and cardial fibrillation.

  18. Radiation and Health Technology Laboratory Capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Goles, Ronald W.; Johnson, Michelle Lynn; Piper, Roman K.; Peters, Jerry D.; Murphy, Mark K.; Mercado, Mike S.; Bihl, Donald E.; Lynch, Timothy P.

    2003-07-15

    The Radiological Standards and Calibrations Laboratory, a part of Pacific Northwest National Laboratory (PNNL)(a) performs calibrations and upholds reference standards necessary to maintain traceability to national standards. The facility supports U.S. Department of Energy (DOE) programs at the Hanford Site, programs sponsored by DOE Headquarters and other federal agencies, radiological protection programs at other DOE and commercial nuclear sites and research and characterization programs sponsored through the commercial sector. The laboratory is located in the 318 Building of the Hanford Site's 300 Area. The facility contains five major exposure rooms and several laboratories used for exposure work preparation, low-activity instrument calibrations, instrument performance evaluations, instrument maintenance, instrument design and fabrication work, thermoluminescent and radiochromic Dosimetry, and calibration of measurement and test equipment (M&TE). The major exposure facilities are a low-scatter room used for neutron and photon exposures, a source well room used for high-volume instrument calibration work, an x-ray facility used for energy response studies, a high-exposure facility used for high-rate photon calibration work, a beta standards laboratory used for beta energy response studies and beta reference calibrations and M&TE laboratories. Calibrations are routinely performed for personnel dosimeters, health physics instrumentation, photon and neutron transfer standards alpha, beta, and gamma field sources used throughout the Hanford Site, and a wide variety of M&TE. This report describes the standards and calibrations laboratory.

  19. Radiation and Health Technology Laboratory Capabilities

    International Nuclear Information System (INIS)

    Goles, Ronald W.; Johnson, Michelle Lynn; Piper, Roman K.; Peters, Jerry D.; Murphy, Mark K.; Mercado, Mike S.; Bihl, Donald E.; Lynch, Timothy P.

    2003-01-01

    The Radiological Standards and Calibrations Laboratory, a part of Pacific Northwest National Laboratory (PNNL)(a) performs calibrations and upholds reference standards necessary to maintain traceability to national standards. The facility supports U.S. Department of Energy (DOE) programs at the Hanford Site, programs sponsored by DOE Headquarters and other federal agencies, radiological protection programs at other DOE and commercial nuclear sites and research and characterization programs sponsored through the commercial sector. The laboratory is located in the 318 Building of the Hanford Site's 300 Area. The facility contains five major exposure rooms and several laboratories used for exposure work preparation, low-activity instrument calibrations, instrument performance evaluations, instrument maintenance, instrument design and fabrication work, thermoluminescent and radiochromic Dosimetry, and calibration of measurement and test equipment (M and TE). The major exposure facilities are a low-scatter room used for neutron and photon exposures, a source well room used for high-volume instrument calibration work, an x-ray facility used for energy response studies, a high-exposure facility used for high-rate photon calibration work, a beta standards laboratory used for beta energy response studies and beta reference calibrations and M and TE laboratories. Calibrations are routinely performed for personnel dosimeters, health physics instrumentation, photon and neutron transfer standards alpha, beta, and gamma field sources used throughout the Hanford Site, and a wide variety of M and TE. This report describes the standards and calibrations laboratory.

  20. [Perspective technologies and researches in the areaof medical laboratory diagnostics].

    Science.gov (United States)

    Ivanov, A M; Zhdanov, K V; Krivoruchko, A A; Ivoĭlov, O O

    2013-06-01

    The main principles of organisation of medical laboratory diagnostics are efficiency of analysis, mobility of laboratory services and quality of researches. These goals can be achieved by the use of portative laboratory analizers, by automation and computerization of the laboratorial service, by development and adoption of new laboratory technologies, integrating different methods and types of research. It is necessary to pay attention to the problem of NPT and indication of pathogenic germs. Priority areas of medical laboratory diagnostics development are: development and use of portative laboratory analyzers; development of chemical, that help to speed up and cheapen researches, improve effectiveness of laboratory diagnostics of infections and indications of pathogenic and other germ; development of new, more sensitive, specific, but simple methods of laboratory analysis; development of complex methods and types of researches, further implementation of methods and researches with different principles of action; development and implementation of new methods of NPT results recording; automation and computerization of the laboratorial diagnostics.

  1. Bringing ayahuasca to the clinical research laboratory.

    Science.gov (United States)

    Riba, Jordi; Barbanoj, Manel J

    2005-06-01

    Since the winter of 1999, the authors and their research team have been conducting clinical studies involving the administration of ayahuasca to healthy volunteers. The rationale for conducting this kind of research is twofold. First, the growing interest of many individuals for traditional indigenous practices involving the ingestion of natural psychotropic drugs such as ayahuasca demands the systematic study of their pharmacological profiles in the target species, i.e., human beings. The complex nature of ayahuasca brews combining a large number of pharmacologically active compounds requires that research be carried out to establish the safety and overall pharmacological profile of these products. Second, the authors believe that the study of psychedelics in general calls for renewed attention. Although the molecular and electrophysiological level effects of these drugs are relatively well characterized, current knowledge of the mechanisms by which these compounds modify the higher order cognitive processes in the way they do is still incomplete, to say the least. The present article describes the development of the research effort carried out at the Autonomous University of Barcelona, commenting on several methodological aspects and reviewing the basic clinical findings. It also describes the research currently underway in our laboratory, and briefly comments on two new studies we plan to undertake in order to further our knowledge of the pharmacology of ayahuasca.

  2. Nontyphoidal Salmonella: An Occupational Hazard for Clinical Laboratory Workers

    OpenAIRE

    Barker, Anna; Duster, Megan; Van Hoof, Sarah; Safdar, Nasia

    2015-01-01

    Laboratory-acquired infections due to nontyphoidal Salmonella are rare. Yet, recent outbreaks in microbiology teaching laboratories show that these species are still an appreciable occupational hazard for laboratory employees. This article presents two cases of nontyphoidal Salmonella that occurred at the authors' institution—an infected patient and a clinical laboratory worker who acquired the infection by handling this patient's specimens.

  3. Delivery of laboratory data with World Wide Web technology.

    Science.gov (United States)

    Hahn, A W; Leon, M A; Klein-Leon, S; Allen, G K; Boon, G D; Patrick, T B; Klimczak, J C

    1997-01-01

    We have developed an experimental World Wide Web (WWW) based system to deliver laboratory results to clinicians in our Veterinary Medical Teaching Hospital. Laboratory results are generated by the clinical pathology section of our Veterinary Medical Diagnostic Laboratory and stored in a legacy information system. This system does not interface directly to the hospital information system, and it cannot be accessed directly by clinicians. Our "meta" system first parses routine print reports and then instantiates the data into a modern, open-architecture relational database using a data model constructed with currently accepted international standards for data representation and communication. The system does not affect either of the existing legacy systems. Location-independent delivery of patient data is via a secure WWW based system which maximizes usability and allows "value-added" graphic representations. The data can be viewed with any web browser. Future extensibility and intra- and inter-institutional compatibility served as key design criteria. The system is in the process of being evaluated using accepted methods of assessment of information technologies.

  4. 75 FR 1063 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2010-01-08

    ... under which clinical laboratories are regulated; the impact on medical and laboratory practice of... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory Committee (CLIAC) In accordance with section 10(a)(2) of the Federal Advisory...

  5. The mass spectrometry technology MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time- Of-Flight for a more rapid and economic workflow in the clinical microbiology laboratory

    Directory of Open Access Journals (Sweden)

    Simona Barnini

    2012-12-01

    Full Text Available Introduction: In order to improve the outcome of patients, reduce length of stay, costs and resources engaged in diagnostics, more rapid reports are requested to the clinical microbiologists.The purpose of this study is to assess the impact on workflow of MALDI-TOF technology, recently made available for use in routine diagnostics. Methods:The work list by the management information system is sent to the instrument MALDI-TOF, where are held at least three successive analytic sessions: the first includes bacteria isolated from CSF, blood cultures, and cases already reported as serious/urgent, the second includes all other germs isolated, the third, microorganisms that require extraction with trifluoroacetic acid (TFA or formic acid (FA for identification.The results of each session direct to the execution of different types of susceptibility testing. Results:The times of microbial identifications are reduced by 24 or 48 hours and made available to the clinician for the rational empirical therapy.The reagent costs are reduced by 40%.The subcultures were reduced by 80%, and microscopic examinations by 50%.The antibiotic susceptibility tests were immediately performed with the most appropriate method, based on the knowledge of local epidemiology and microbial species. Conclusion:The bacteriology is the less automated discipline among the clinical laboratory activities and results of diagnostic tests are poorly well-timed. The new interpretative algorithms of MALDI-TOF spectra, now available, allow the correct identification of bacteria in near real time, completely eliminating the wait is necessary for biochemical identification and guiding the operator in selecting the most appropriate antibiotic susceptibility tests. This technology makes work more rapid, economic and efficient, eliminating errors and, together with effective computerization of data, transforms the information content of the microbiological report, making it much more effective

  6. SSPM based radiation sensing: Preliminary laboratory and clinical results

    International Nuclear Information System (INIS)

    Konnoff, Daniel C.; Plant, Thomas K.; Shiner, Elizabeth

    2011-01-01

    Recent Solid State Photomultiplier (SSPM) technology has matured, reaching a performance level that is suitable for replacement of the ubiquitous photomultiplier tube in selected applications for environmental radiation monitoring, clinical dosimetry, and medical imaging purposes. The objective of this work is low signal level laboratory and high signal level clinical testing of the Hamamatsu MPPC (S10362-11-050C), Photonique SSPM (0810G1), and Voxtel SiPM (SQBF-EKAA/SQBF-EIOA) SSPMs coupled to different inorganic scintillator crystals (Prelude 420, BGO), inorganic doped glass scintillator material SiO 2 :Cu 2+ and organic BCF-12 plastic scintillating fibers, used as detector elements. Plastic Optical Fibers (POFs) and Glass Optical Fibers (GOFs) are used as signal conduits for laboratory and clinical testing. Further, reduction of electron-beam-generated Cerenkov light in optical fibers is facilitated by the inclusion of metalized air-core capillary tubing between the BCF-12 plastic scintillating fiber and the POF. In a clinical setting dose linearity, percent depth dose, and angular measurements for 6 MV/18 MV photon beams and 9 MeV electron beams are compared with and without the use of the air-core capillary tubing for BCF-12 plastic scintillating fiber. These same measurements are repeated for SiO 2 :Cu 2+ scintillator material without air-core capillary tubing.

  7. Materials technology at Argonne National Laboratory

    International Nuclear Information System (INIS)

    Betten, P.

    1989-01-01

    Argonne is actively involved in the research and development of new materials research and development (R ampersand D). Five new materials technologies have been identified for commercial potential and are presented in this paper as follows: (1) nanophase materials, (2) nuclear magnetic resonance (NMR) imaging of ceramics, (3) superconductivity developments and technology transfer mechanisms, and (4) COMMIX computer code modeling for metal castings, and (5) tribology using ion-assisted deposition (IAB). 4 refs., 7 figs., 1 tab

  8. Brookhaven National Laboratory technology transfer report, fiscal year 1986

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    An increase in the activities of the Office of Research and Technology Applications (ORTA) is reported. Most of the additional effort has been directed to the regional electric utility initiative, but intensive efforts have been applied to the commercialization of a compact synchrotron storage ring for x-ray lithography applications. At least six laboratory technologies are reported as having been transferred or being in the process of transfer. Laboratory accelerator technology is being applied to study radiation effects, and reactor technology is being applied for designing space reactors. Technologies being transferred and emerging technologies are described. The role of the ORTA and the technology transfer process are briefly described, and application assessment records are given for a number of technologies. A mini-incubator facility is also described. (LEW)

  9. Brookhaven National Laboratory technology transfer report, fiscal year 1986

    International Nuclear Information System (INIS)

    1986-01-01

    An increase in the activities of the Office of Research and Technology Applications (ORTA) is reported. Most of the additional effort has been directed to the regional electric utility initiative, but intensive efforts have been applied to the commercialization of a compact synchrotron storage ring for x-ray lithography applications. At least six laboratory technologies are reported as having been transferred or being in the process of transfer. Laboratory accelerator technology is being applied to study radiation effects, and reactor technology is being applied for designing space reactors. Technologies being transferred and emerging technologies are described. The role of the ORTA and the technology transfer process are briefly described, and application assessment records are given for a number of technologies. A mini-incubator facility is also described

  10. Basic laboratory procedures in clinical bacteriology

    National Research Council Canada - National Science Library

    Vandepitte, J

    2003-01-01

    ... of laboratory resources Collection and transport of stool specimens Visual examination of stool specimens Enrichment and inoculation of stool specimens Media for enteric pathogens Primary isolation Prelimin...

  11. 76 FR 5379 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-01-31

    ... for, and the nature of, revisions to the standards under which clinical laboratories are regulated... Coordinating Council on the Clinical Laboratory Workforce; the National Institutes of Health Genetic Test... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical...

  12. Medical Service Clinical Laboratory Procedure--Hematology.

    Science.gov (United States)

    Department of the Army, Washington, DC.

    Presented are laboratory studies focusing on blood cells and the complete scheme of blood coagulation. Formed is the basis for the following types of laboratory operations: (1) distinguishing the morphology of normal and abnormal blood cells; (2) measuring the concentrations or number of blood cells; (3) measuring concentration and detecting…

  13. Atomic spectrometry and trends in clinical laboratory medicine

    International Nuclear Information System (INIS)

    Parsons, Patrick J.; Barbosa, Fernando

    2007-01-01

    Increasing numbers of clinical laboratories are transitioning away from flame and electrothermal AAS methods to those based on ICP-MS. Still, for many laboratories, the choice of instrumentation is based upon (a) the element(s) to be determined, (b) the matrix/matrices to be analyzed, and (c) the expected concentration(s) of the analytes in the matrix. Most clinical laboratories specialize in measuring Se, Zn, Cu, and Al in serum, and/or Pb, Cd, Hg, As, and Cr in blood and/or urine, while other trace elements (e.g., Pt, Au etc.) are measured for therapeutic purposes. Quantitative measurement of elemental species is becoming more widely accepted for nutritional and/or toxicological screening purposes, and ICP-MS interfaced with separation techniques, such as liquid chromatography or capillary electrophoresis, offers the advantage of on-line species determination coupled with very low detection limits. Polyatomic interferences for some key elements such as Se, As, and Cr require instrumentation equipped with dynamic reaction cell or collision cell technologies, or might even necessitate the use of sector field ICP-MS, to assure accurate results. Nonetheless, whatever analytical method is selected for the task, careful consideration must be given both to specimen collection procedures and to the control of pre-analytical variables. Finally, all methods benefit from access to reliable certified reference materials (CRMs). While a variety of reference materials (RMs) are available for trace element measurements in clinical matrices, not all can be classified as CRMs. The major metrological organizations (e.g., NIST, IRMM, NIES) provide a limited number of clinical CRMs, however, secondary reference materials are readily available from commercial organizations and organizers of external quality assessment schemes

  14. 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.

  15. HyTech - The Hydrogen Technology Laboratory at Savannah River

    International Nuclear Information System (INIS)

    Motyka, T.; Knight, J.R.; Heung, L.K.; Lee, M.W.

    1995-01-01

    SRS recently announced the formation of the Hydrogen Technology Laboratory (HyTech) to work with industry and government in developing technologies based on the site's four decades of experience with tritium and other forms of H. HyTech will continue to sustain the site's ongoing role in H technology applications for defense programs. In addition, the laboratory will work with the chemical, transportation, power, medical, and other industries to develop and test related technologies. HyTech, which is located in the Savannah River Technology Center, will make use of its facilities and staff, as well as the infrastructure within the site's Tritium Facilities. More than 80 SRS scientists, engineers, and technical professionals with backgrounds in chemistry, engineering, materials science, metallurgy, physics, and computer science will work with the laboratory. This paper describes some of HyTech's current initiatives in the area of H storage, transportation, and energy applications

  16. Clinical and laboratory features of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Andrés Cárdenas

    2007-02-01

    Full Text Available

    The clinical presentation of hepatocellular carcinoma (HCC differs between patients in developing countries (African and Chinese populations from those in industrialized countries. In industrialized countries, HCC co-exists with symptomatic cirrhosis in 80% of cases and clinical manifestations are usually related to those of the underlying disease. On the other hand, patients from developing countries have HCC and cirrhosis in approximately 40% of cases. Underlying cirrhosis in many cases is not advanced and does not produce any symptoms or associated symptoms are masked by those of the tumor (right upper quadrant pain, mass in the upper abdomen, weight loss and weakness. In a subset of patients, there are no clinical manifestations as HCC may occur in the context of hepatitis B infection without cirrhosis.

    Clinical Manifestations

    In Western countries, nearly 35% percent of patients with HCC are asymptomatic. Some of the most common clinical manifestations include: abdominal pain (53-58% of patients, especially in epigastrium or right upper quadrant, abdominal mass (30%, weight loss, malaise, anorexia, cachexia, jaundice or fever.

    Physical Exam

    Physical findings vary with the stage of disease. The patient may exhibit slight or moderate wasting when first seen. In patients with cirrhosis, typical stigmata of chronic liver disease may be present. In advanced stages of HCC the liver may be enlarged and there is significant tenderness. An arterial bruit may be heard over the liver

  17. [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).

  18. Measurement of errors in clinical laboratories.

    Science.gov (United States)

    Agarwal, Rachna

    2013-07-01

    Laboratories have a major impact on patient safety as 80-90 % of all the diagnosis are made on the basis of laboratory tests. Laboratory errors have a reported frequency of 0.012-0.6 % of all test results. Patient safety is a managerial issue which can be enhanced by implementing active system to identify and monitor quality failures. This can be facilitated by reactive method which includes incident reporting followed by root cause analysis. This leads to identification and correction of weaknesses in policies and procedures in the system. Another way is proactive method like Failure Mode and Effect Analysis. In this focus is on entire examination process, anticipating major adverse events and pre-emptively prevent them from occurring. It is used for prospective risk analysis of high-risk processes to reduce the chance of errors in the laboratory and other patient care areas.

  19. Duplicate Type and Screen Testing: Waste in the Clinical Laboratory.

    Science.gov (United States)

    Compton, Margaret L; Szklarski, Penny C; Booth, Garrett S

    2018-03-01

    - In the United States, approximately $65 billion dollars is spent per year on clinical laboratory testing, of which 20% to 30% of all testing is deemed inappropriate. There have been multiple studies in the field of transfusion medicine regarding evidence-based transfusion practices, but limited data exist regarding inappropriate pretransfusion testing and its financial and clinical implications. - To assess duplicative testing practices in the transfusion medicine service. - A 24-month retrospective review was performed at a 1025-bed tertiary care center, identifying all duplicate type and screen (TS) tests performed within 72 hours of the previous TS. Duplicative testing was classified as appropriate or inappropriate by predetermined criteria. The level of underordering was analyzed through a query of the electronic event reporting system. A cost analysis was performed to determine the financial impact of inappropriate duplicative TS. - The mean rate of inappropriate, duplicative TS orders was 4.13% (standard deviation ± 4.09%). Rates of inappropriate ordering ranged from 0.01% to 15.5% depending on the clinical service and did not correlate with volume of tests ordered. There were 8 reported cases of delayed blood delivery due to lack of a valid TS during the study period, demonstrating that underordering is also a harmful practice. The laboratory cost of inappropriate testing for the study period was $80,434, and phlebotomy costs were $45,469. - Our study demonstrates that inappropriate TS ordering is costly, both financially and clinically. By evaluating the percentage of inappropriate TS tests by clinical services, we have identified services that may benefit from additional education and technologic intervention.

  20. A smart model for clinical laboratory personnel development.

    Science.gov (United States)

    Sirisali, Kulnaree; Manochiopinij, Sudarat; Leelahakul, Pairoj; Vattanaviboon, Phantip; Wonglumsom, Wijit; Sirisali, Sophon

    2010-11-01

    To become a quality clinical laboratory, personnel development is the most important factor. In order to achieve this goal, it should emphasize that clinical laboratory is not only a testing laboratory; it must be a knowledge-based service laboratory. A smart model for clinical laboratory personnel development under the Human Asset Development (HAD) program had been launched since 2003. To strengthen the competency of clinical laboratory personnel, an appropriate model was developed and apply to the clinical laboratory personnel. Medical technologist who currently worked in clinical laboratory participated in this study. The proposed model consisted of 3 phases. 1) The knowledge providing via update and refresher courses. 2) Application of learned knowledge to practice under close supervision. 3) Training on special topic and self oriented research activity. The outcome of 5 years project was evaluated. After the first phase, they were able to identify and solve their own troublesome under ours close supervision. There were 25 projects presented within 3 years. The last phase, they were very constructive. Nine projects of self created had been presented. Those projects contained clear objectives and were able to implement. The smart model for clinical laboratory personnel development leaded to many self created projects in a few years. Thus, this implies its important role in human resource development that should be continued. The keys index of success were ours strong intention, with providing motivation and periodically encouragement to the participants, and keep going on consistently.

  1. 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.

  2. [Clinical governance and patient safety culture in clinical laboratories in the Spanish National Health System].

    Science.gov (United States)

    Giménez-Marín, Á; Rivas-Ruiz, F

    To conduct a situational analysis of patient safety culture in public laboratories in the Spanish National Health System and to determine the clinical governance variables that most strongly influence patient safety. A descriptive cross-sectional study was carried out, in which a Survey of Patient Safety in Clinical Laboratories was addressed to workers in 26 participating laboratories. In this survey, which consisted of 45 items grouped into 6 areas, scores were assigned on a scale from 0 to 100 (where 0 is the lowest perception of patient safety). Laboratory managers were asked specific questions about quality management systems and technology. The mean scores for the 26 participating hospitals were evaluated, and the following results observed: in 4of the 6areas, the mean score was higher than 70 points. In the third area (equipment and resources) and the fourth area (working conditions), the scores were lower than 60 points. Every hospital had a digital medical record system. This 100% level of provision was followed by that of an electronic request management system, which was implemented in 82.6% of the hospitals. The results obtained show that the culture of security is homogeneous and of high quality in health service laboratories, probably due to the steady improvement observed. However, in terms of clinical governance, there is still some way to go, as shown by the presence of weaknesses in crucial dimensions of safety culture, together with variable levels of implementation of fail-safe technologies and quality management systems. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Figure 1. Associations between pre-ART clinical and laboratory ...

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Figure 1. Associations between pre-ART clinical and laboratory characteristics with subsequent TB-IRIS events. Figure 1. Associations between pre-ART clinical and laboratory characteristics with subsequent TB-IRIS events.

  4. 76 FR 39879 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-07-07

    ... the nature of, revisions to the standards under which clinical laboratories are regulated; the impact... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory Committee (CLIAC) In accordance with section 10(a)(2) of the Federal Advisory...

  5. 75 FR 39028 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2010-07-07

    ... to the standards under which clinical laboratories are regulated; the impact on medical and... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory Committee (CLIAC) In accordance with section 10(a)(2) of the Federal Advisory...

  6. [Knowledge management system for laboratory work and clinical decision support].

    Science.gov (United States)

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  7. Oak Ridge National Laboratory Technology Logic Diagram. Indexes

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Decontamination and Decommissioning (D&D) Index provides a comprehensive list of site problems, problem area/constituents, remedial technologies, and regulatory terms discussed in the D&D sections of the Oak Ridge National Laboratory Technology Logic Diagram. All entries provide specific page numbers, or cross-reference entries that provide specific page numbers, in the D&D volumes (Vol. 1, Pt. A; Vol. 2, Pt. A; and appropriate parts of Vol. 3). The Oak Ridge National Laboratory Technology (TLD) was developed to provide a decision-support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration, testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA) and WM activities. It is essential that follow-on engineering studies be conducted to build on the output of this project. These studies will begin by selecting the most promising technologies identified in the TLD and finding an optimum mix of technologies that will provide a socially acceptable balance between cost and risk.

  8. Prisons: Logical, Innovative Clinical Nursing Laboratories.

    Science.gov (United States)

    Fontes, Honore Culleton

    1991-01-01

    The nursing faculty at Mercy College (New York) affiliated with several prison facilities to provide clinical experiences for senior nursing students. An ideal setting for the clinical group leadership course, the prison affiliations also helped students develop social awareness and advocacy strategies for this at-risk population. (SK)

  9. Reducing the Environmental Impact of Clinical Laboratories.

    Science.gov (United States)

    Lopez, Joseph B; Jackson, David; Gammie, Alistair; Badrick, Tony

    2017-02-01

    Healthcare is a significant contributor to environmental impact but this has received little attention. The typical laboratory uses far more energy and water per unit area than the typical office building. There is a need to sensitise laboratories to the importance of adopting good environmental practices. Since this comes at an initial cost, it is vital to obtain senior management support. Convincing management of the various tangible and intangible benefits that can accrue in the long run should help achieve this support. Many good environmental practices do not have a cost but will require a change in the culture and mind-set of the organisation. Continuing education and training are important keys to successful implementation of good practices. There is a need to undertake a rigorous cost-benefit analysis of every change that is introduced in going green. The adoption of good practices can eventually lead to ISO certification if this is desired. This paper provides suggestions that will allow a laboratory to start going green. It will allow the industry to enhance its corporate citizenship whilst improving its competitive advantage for long-term.

  10. Washington Clinical Laboratory Initiative: a vision for collaboration and strategic planning for an integrated laboratory system.

    Science.gov (United States)

    Counts, J M

    2001-01-01

    This article addresses the importance of public health, hospital, and clinical laboratories in the role of patient care, disease prevention, and surveillance. It also focuses on the coordination and planning that needs to take place between these institutions in order to develop a more cost-effective and responsive laboratory delivery system. The Washington Clinical Laboratory Initiative is an innovative state initiative illustrating that coordinated and integrated strategic planning of public and private sector laboratories can be accomplished within a state. It also has increased interaction, collaboration, and communication between health practitioners, health plans, hospitals, laboratories, government agencies, and academicians. This accomplishment has enabled the establishment of public policy concerning laboratory reimbursement and development of standards of laboratory practice.

  11. [ISO 15189 accreditation in clinical microbiology laboratory: general concepts and the status in our laboratory].

    Science.gov (United States)

    Akyar, Işin

    2009-10-01

    One important trend in the laboratory profession and quality management is the global convergence of laboratory operations. The goal of an accredited medical laboratory is to continue "offering useful laboratory service for diagnosis and treatment of the patients and also aid to the health of the nation". An accredited clinical laboratory is managed by a quality control system, it is competent technically and the laboratory service meets the needs of all its patients and physicians by taking the responsibility of all the medical tests and therapies. For this purpose, ISO 15189 international standard has been prepared by 2003. ISO 15189 standard is originated from the arrangement of ISO 17025 and ISO 9001:2000 standards. Many countries such as England, Germany, France, Canada and Australia have preferred ISO 15189 as their own laboratory accreditation programme, meeting all the requirements of their medical laboratories. The accreditation performance of a clinical microbiology laboratory is mainly based on five essential points; preanalytical, analytical, postanalytical, quality control programmes (internal, external, interlaboratory) and audits (internal, external). In this review article, general concepts on ISO 15189 accreditation standards for the clinical microbiology laboratories have been summarized and the status of a private laboratory (Acibadem LabMed, Istanbul) in Turkey has been discussed.

  12. Dental laboratory technology education in China: current situation and challenges.

    Science.gov (United States)

    Zheng, Liwei; Yue, Li; Zhou, Min; Yu, Haiyang

    2013-03-01

    Modern dentistry and dental education in China were first introduced from abroad by Dr. Lindsay in 1907. However, advancements in the field of dental laboratory technology did not occur to the same degree in specialties such as prosthodontics and orthodontics. Since the 1990s, orders from abroad demanding dental appliances surged as the image of China as the "world's factory" strengthened. The assembly line model, in which technicians work like simple procedure workers, was rapidly applied to denture production, while the traditional education system and apprenticeship systems demonstrated little progress in these years. The lack of advancement in dental laboratory technology education caused insufficient development in China's dental technology industry. In order to alter the situation, a four-year dental laboratory technology undergraduate educational program was established in 2005 by West China School of Stomatology, Sichuan University (WCSS, SCU). This program was based on SCU's undergraduate education and WCSS's junior college education systems. The program introduced scientific methods in relevant subjects into laboratory technicians' training and made many improvements in the availability of trained faculty, textbooks, laboratory facilities, and curriculum.

  13. Quality control of parasitology stool examination in Tabriz clinical laboratories

    Directory of Open Access Journals (Sweden)

    shahram Khademvatan

    2011-06-01

    Full Text Available The purpose of quality control program was to make doctors and laboratory personnel trust in laboratory results and consequently increasing confidence in laboratory achievements. The quality assurance means raising the level of quality in all tests that lead to raising the level of work efficiency and laboratories including minimum expense for society and minimum time for lab personnel. This study aimed to assess and determine the accuracy and precision of results in Tabriz medical diagnostic laboratories. Materials and Methods: In this retrospective study, 790 stool samples were selected randomly and tested by standard methods.Student t- test, SPSS software and sensitivity and accuracy formulas were used for data analysis. Results: The sensitivity was 62%, 22% and 8% with 95% confidence intervals for worm's eggs, protozoan cysts and trophozoite detection respectively. Conclusion: To elevate quality assurance in clinical diagnostic laboratory, monitoring and check of the laboratories by standard methods continually should be done.

  14. Important clinical and laboratory correlates of glomerular filtration ...

    African Journals Online (AJOL)

    2015-02-03

    Feb 3, 2015 ... associated with laboratory indicators of hemolysis in this group of patients.[6] Progression of sickle nephropathy can. Important clinical and laboratory correlates of glomerular filtration rate in sickle cell anemia. AJ Madu, A Ubesie1, S Ocheni, J Chinawa1, KA Madu2, OG Ibegbulam, C Nlemadim3, A Eze3.

  15. Promoting Rapid Learning in the Histology Laboratory by Integrating Technology

    Science.gov (United States)

    Shields, Vonnie

    2008-01-01

    This paper describes the results of incorporating technology in the histology laboratory by using high-resolution video-imaging equipment (VIE). The study sought to determine if (1) the VIE would allow students to more easily and rapidly find histological structures over more conventional methods, and (2) if they could find the structures with the…

  16. Sensitivity and Specificity of Clinical and Laboratory Otolith Function Tests.

    Science.gov (United States)

    Kumar, Lokesh; Thakar, Alok; Thakur, Bhaskar; Sikka, Kapil

    2017-10-01

    To evaluate clinic based and laboratory tests of otolith function for their sensitivity and specificity in demarcating unilateral compensated complete vestibular deficit from normal. Prospective cross-sectional study. Tertiary care hospital vestibular physiology laboratory. Control group-30 healthy adults, 20-45 years age; Case group-15 subjects post vestibular shwannoma excision or post-labyrinthectomy with compensated unilateral complete audio-vestibular loss. Otolith function evaluation by precise clinical testing (head tilt test-HTT; subjective visual vertical-SVV) and laboratory testing (headroll-eye counterroll-HR-ECR; vesibular evoked myogenic potentials-cVEMP). Sensitivity and specificity of clinical and laboratory tests in differentiating case and control subjects. Measurable test results were universally obtained with clinical otolith tests (SVV; HTT) but not with laboratory tests. The HR-ECR test did not indicate any definitive wave forms in 10% controls and 26% cases. cVEMP responses were absent in 10% controls.HTT test with normative cutoff at 2 degrees deviations from vertical noted as 93.33% sensitive and 100% specific. SVV test with normative cutoff at 1.3 degrees noted as 100% sensitive and 100% specific. Laboratory tests demonstrated poorer specificities owing primarily to significant unresponsiveness in normal controls. Clinical otolith function tests, if conducted with precision, demonstrate greater ability than laboratory testing in discriminating normal controls from cases with unilateral complete compensated vestibular dysfunction.

  17. Clinical laboratory test prices in Zimbabwe: A case of profiteering?

    Science.gov (United States)

    Musarurwa, C; Nyamayaro, T; Mujaji, W B; Matarira, H T; Gomo, Z A R

    2012-01-01

    To compare the prices charged for clinical laboratory tests in Zimbabwean institutions with those of similar institutions abroad. An online analytical cross sectional study was conducted. An online survey. We did an online survey of clinical laboratories that published prices of the tests offered on their websites. We also extracted price information from documents published by fees regulatory authorities. Laboratory test prices for independent institutions, Laboratory test prices for State institutions. Overally for all countries, laboratory test prices were lower in state laboratories compared to the independent laboratories. In Zimbabwe, state laboratories generally charged about 50% of the independent laboratory tariff for most tests. However prices from both Zimbabwean institutions were generally much higher than those of the comparison countries (United Kingdom, South Africa, India, United States of America and New Zealand). Prices of laboratory tests are indeed higher in Zimbabwean institutions compared to other centres abroad. These higher prices could be attributed to challenges in consumable procurement logistics. We also present measures that could be put in place to reduce the costs and therefore prices.

  18. [Clinical microbiology laboratory and imported parasitic diseases].

    Science.gov (United States)

    Martín-Rabadán, Pablo; Martínez-Ruiz, Rocío; Cuadros, Juan; Cañavate, Carmen

    2010-12-01

    Imported parasitosis represents an increasingly frequent diagnostic challenge for microbiology laboratories. A surge in immigration and international travel has led to a rise in the number of imported cases of parasitosis, and this trend is expected to continue in the future. The present article addresses this challenge by reviewing recommended diagnostic approaches and tests. Currently, microscopy is always recommended when analysing blood samples for parasites. If malaria is suspected, rapid antigen testing (including at least HRP2 antigen) should also be performed. The work-up for suspected leishmaniasis should include serology, culture, and in selected cases detection of antigen in urine. In suspected Chagas disease, two different serological tests should be performed. PCR for blood protozoa is highly sensitive, although it cannot be used to rule out Chagas disease, since this condition may be present without parasitemia. Accurate diagnosis of intestinal amebiasis usually requires PCR or antigen detection tests. In helminthiasis, traditional microscopy may need to be complemented with other tests, such as agar plate culture for strongyloidiasis, Og4C3 antigen detection for bancroftian filariasis, and antibody detection test for filariasis and schistosomiasis. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  19. The advance of technology as a prelude to the laboratory of the twenty-first century.

    Science.gov (United States)

    Woo, J; Henry, J B

    1994-09-01

    Technological changes in the clinical laboratory are usually driven by the goal of patient care optimization. In the last decade, the trend appeared to be directed at clinical laboratory decentralization. A new generation of analytical instruments, the biosensors, is redirecting laboratory testing closer to the patient, at the bedside, in the physician's office, and by the patient at home. These miniaturized biosensors are easy to operate, require small specimen size, and provide reliable results with rapid TAT. Thus far, bedside testing using biosensor technology appears to offer unique opportunities for earlier availability of clinical laboratory data, decision making, and more specific diagnosis, and faster and more frequent monitoring; these may translate into improved patient care and reduced hospital costs. It is likely that this trend will continue into the twenty-first century. Electrochemical sensors (e.g., for electrolytes, glucose, urea, and hematocrit) and pulse oximetry, having gained clinical acceptance, will probably be the leading instrumentation for bedside testing. Continuous monitoring either by near-infrared sensing technology or with an implantable sensor is valuable in the care of the critically ill patient. Acceptance for clinical use will depend on complete data integration and a favorable cost-benefit ratio.

  20. Plasma Levels of Uric Acid, Urea and Creatinine in Diabetics Who Visit the Clinical Analysis Laboratory (CAn-Lab) at Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

    Science.gov (United States)

    Amartey, N A A; Nsiah, K; Mensah, F O

    2015-02-01

    Diabetes mellitus is one of the most common metabolic diseases worldwide. This metabolic disorder contributes greatly to the significant proportion of the burden of renal damage and dysfunction. The aim of the study was to investigate the renal function of the diabetic patients who visit the Clinical Analysis Laboratory (CAn-Lab) at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Demographic data as well as medical history were obtained through the administration of a questionnaire. Anthro-pometric measurements were taken and blood samples were analysed for glucose, uric acid, urea and creatinine. Data collected were analysed using SPSS version 16.0. A total of 34 diabetic patients, aged from 40-77 y were recruited, 22 (64.7%) of them were males with mean age of 57.40 ± 11.8 y (±SD), while 12 (35.3%) were females with mean age of 58.17 ± 7.47 y. There was a statistically significant difference between the mean duration of the disease, as the females had longer duration, 12.50 ± 6.95 y, as compared to 7.32 ± 4.48 y in males (p=0.033). The mean plasma creatinine level in the females was 84.17 ± 54.73 μmol/l. In the diabetic population, there was a positive correlation between age and plasma creatinine level, (r=0.375, p=0.029). In the female diabetics, there was a positive correlation between fasting blood sugar (FBS) and the measured metabolic end products (r>0.5, p<0.05), a positive correlation between body mass index (BMI) and uric acid (r=0.576, p=0.005) and a positive correlation between BMI and FBS (r= 0.625, p= 0.030). Our results on the parameters measured; show that the diabetic population was experiencing mild kidney dysfunction, compared to non-diabetic controls.

  1. Laboratory Technology Research: Abstracts of FY 1996 projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    The Laboratory Technology Research (LTR) program supports high-risk, multidisciplinary research partnerships to investigate challenging scientific problems whose solutions have promising commercial potential. These partnerships capitalize on two great strengths of this country: the world-class basic research capability of the DOE Energy Research (ER) multi-program national laboratories and the unparalleled entrepreneurial spirit of American industry. Projects supported by the LTR program are conducted by the five ER multi-program laboratories: Argonne, Brookhaven, Lawrence Berkeley, Oak Ridge, and Pacific Northwest National Laboratories. These projects explore the applications of basic research advances relevant to Department of Energy`s (DOE) mission over a full range of scientific disciplines. The program presently emphasizes three critical areas of mission-related research: advanced materials, intelligent processing/manufacturing research, and sustainable environments.

  2. Developmental hemostasis: laboratory and clinical implications.

    Science.gov (United States)

    Toulon, P

    2016-05-01

    The pediatric hemostatic balance, which is different from that in adults, is an evolving process as the hemostatic system changes and matures throughout the time from fetal to adult life, particularly in the first months of life. The concept of developmental hemostasis was confirmed by several studies evaluating different patients' population in various technical conditions. All these studies demonstrated that, at birth, the plasma levels of most coagulation factors were around half that found in adults, the preterm newborns having lower levels than full-term newborns. Adult values were usually reached between a few months of age and up to above 16 years for specific parameters. If the global trends are consistent across the studies, differences in absolute values could be demonstrated that are likely due to differences in the reagents and/or the instruments used. Accordingly, it is recommended by the Perinatal and Pediatric Haemostasis Subcommittee of the Scientific and Standardization Committee of the ISTH for each laboratory to define the age-dependent reference ranges using its own technical condition. The understanding of that concept of developmental hemostasis, which is now universally accepted, is critical to ensure optimal prevention, diagnosis, and treatment of thrombotic and hemorrhagic diseases in children. Actually, developmental hemostasis could affect the interaction between anticoagulant drugs and the coagulation system and so explain in part the discrepancy between anticoagulation in adults and in children. Finally, developmental hemostasis could probably provide a protective mechanism for neonates and children, contributing to the decreased risk of thrombosis and/or bleeding in these age-groups. © 2016 John Wiley & Sons Ltd.

  3. Laboratory 3.0: Manufacturing Technologies Laboratory Virtualization with a Student-Centred Methodology

    Science.gov (United States)

    Fabregat-Sanjuan, Albert; Pàmies-Vilà, Rosa; Ferrando Piera, Francesc; De la Flor López, Silvia

    2017-01-01

    This paper presents a blended-learning strategy for improving the teaching method applied in the laboratory subject Manufacturing Technologies. The teaching method has been changed from a predominantly teacher-centred to an active learning system with a student-centred focus and e-learning activities. In face-to-face classes, a game-based learning…

  4. College of American Pathologists' laboratory standards for next-generation sequencing clinical tests.

    Science.gov (United States)

    Aziz, Nazneen; Zhao, Qin; Bry, Lynn; Driscoll, Denise K; Funke, Birgit; Gibson, Jane S; Grody, Wayne W; Hegde, Madhuri R; Hoeltge, Gerald A; Leonard, Debra G B; Merker, Jason D; Nagarajan, Rakesh; Palicki, Linda A; Robetorye, Ryan S; Schrijver, Iris; Weck, Karen E; Voelkerding, Karl V

    2015-04-01

    The higher throughput and lower per-base cost of next-generation sequencing (NGS) as compared to Sanger sequencing has led to its rapid adoption in clinical testing. The number of laboratories offering NGS-based tests has also grown considerably in the past few years, despite the fact that specific Clinical Laboratory Improvement Amendments of 1988/College of American Pathologists (CAP) laboratory standards had not yet been developed to regulate this technology. To develop a checklist for clinical testing using NGS technology that sets standards for the analytic wet bench process and for bioinformatics or "dry bench" analyses. As NGS-based clinical tests are new to diagnostic testing and are of much greater complexity than traditional Sanger sequencing-based tests, there is an urgent need to develop new regulatory standards for laboratories offering these tests. To develop the necessary regulatory framework for NGS and to facilitate appropriate adoption of this technology for clinical testing, CAP formed a committee in 2011, the NGS Work Group, to deliberate upon the contents to be included in the checklist. Results . -A total of 18 laboratory accreditation checklist requirements for the analytic wet bench process and bioinformatics analysis processes have been included within CAP's molecular pathology checklist (MOL). This report describes the important issues considered by the CAP committee during the development of the new checklist requirements, which address documentation, validation, quality assurance, confirmatory testing, exception logs, monitoring of upgrades, variant interpretation and reporting, incidental findings, data storage, version traceability, and data transfer confidentiality.

  5. Antiphospholipid antibody: laboratory, pathogenesis and clinical manifestations

    Directory of Open Access Journals (Sweden)

    T. Ziglioli

    2011-06-01

    Full Text Available Antiphospholipid antibodies (aPL represent a heterogeneous group of antibodies that recognize various antigenic targets including beta2 glycoprotein I (β2GPI, prothrombin (PT, activated protein C, tissue plasminogen activator, plasmin and annexin A2. The most commonly used tests to detect aPL are: lupus anticoagulant (LAC, a functional coagulation assay, anticardiolipin antibody (aCL and anti-β2GPI antibody (anti-β2GPI, which are enzyme-linked immunoassay (ELISA. Clinically aPL are associated with thrombosis and/or with pregnancy morbidity. Apparently aPL alone are unable to induce thrombotic manifestations, but they increase the risk of vascular events that can occur in the presence of another thrombophilic condition; on the other hand obstetrical manifestations were shown to be associated not only to thrombosis but mainly to a direct antibody effect on the trophoblast.

  6. Nomenclature and basic concepts in automation in the clinical laboratory setting: a practical glossary.

    Science.gov (United States)

    Evangelopoulos, Angelos A; Dalamaga, Maria; Panoutsopoulos, Konstantinos; Dima, Kleanthi

    2013-01-01

    In the early 80s, the word automation was used in the clinical laboratory setting referring only to analyzers. But in late 80s and afterwards, automation found its way into all aspects of the diagnostic process, embracing not only the analytical but also the pre- and post-analytical phase. While laboratories in the eastern world, mainly Japan, paved the way for laboratory automation, US and European laboratories soon realized the benefits and were quick to follow. Clearly, automation and robotics will be a key survival tool in a very competitive and cost-concious healthcare market. What sets automation technology apart from so many other efficiency solutions are the dramatic savings that it brings to the clinical laboratory. Further standardization will assure the success of this revolutionary new technology. One of the main difficulties laboratory managers and personnel must deal with when studying solutions to reengineer a laboratory is familiarizing themselves with the multidisciplinary and technical terminology of this new and exciting field. The present review/glossary aims at giving an overview of the most frequently used terms within the scope of laboratory automation and to put laboratory automation on a sounder linguistic basis.

  7. Laboratory technology research - abstracts of FY 1997 projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-11-01

    The Laboratory Technology Research (LTR) program supports high-risk, multidisciplinary research partnerships to investigate challenging scientific problems whose solutions have promising commercial potential. These partnerships capitalize on two great strengths of this country: the world-class basic research capability of the DOE Energy Research (ER) multi-program national laboratories and the unparalleled entrepreneurial spirit of American industry. A distinguishing feature of the ER multi-program national laboratories is their ability to integrate broad areas of science and engineering in support of national research and development goals. The LTR program leverages this strength for the Nation`s benefit by fostering partnerships with US industry. The partners jointly bring technology research to a point where industry or the Department`s technology development programs can pursue final development and commercialization. Projects supported by the LTR program are conducted by the five ER multi-program laboratories. These projects explore the applications of basic research advances relevant to DOE`s mission over a full range of scientific disciplines. The program presently emphasizes three critical areas of mission-related research: advanced materials; intelligent processing/manufacturing research; and sustainable environments.

  8. Picture of Norwegian clinical learning laboratories for undergraduate nursing students.

    Science.gov (United States)

    Wellard, Sally J; Solvoll, Betty-Ann; Heggen, Kristin M

    2009-07-01

    Clinical preparation for practice is a vital part of undergraduate education in nursing. This study explored contemporary constructions of clinical skills laboratories in two nursing undergraduate programs in Norway using qualitative collective case study methods. Data were gathered using individual and group interviews and observation during site visits. The data revealed slightly different ways of organizing teaching and experimenting with use of pedagogical methods to facilitate learning of technical skills as well as encouraging students to activate relevant theoretical knowledge. While there was a lively and striking enthusiasm among staff about the way learning was managed within the laboratories, the pedagogical underpinnings for their particular approaches were less certain amongst participants. The paper concludes with the necessity to provide evidence for the outcome of laboratories learning and investigate suitable pedagogical methods for effective teaching and learning of practice skills. Hence, a need for research on transfer of knowledge and skills between the different sites (academy, clinical settings, and laboratories) is identified.

  9. SANDIA NATIONAL LABORATORIES IN SITU ELECTROKINETIC EXTRACTION TECHNOLOGY; INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As a part of the Superfund Innovative Technology Evaluation (SITE) Program, the U.S. Environmental Protection Agency evaluated the In-Situ Electrokinetic Extraction (ISEE) system at Sandia National Laboratories, Albuquerque, New Mexico.The SITE demonstration results show ...

  10. [View of a Laboratory Physician on the Present and Future of Clinical Laboratories].

    Science.gov (United States)

    Matsuo, Shuji

    2014-10-01

    It is meaningful to discuss the "present and future of laboratories" for the development of laboratories and education of medical technologists. Laboratory staff must be able to perform urgent high-quality tests and take part in so-called team-based medicine and should be proud of devising systems that efficiently provide laboratory data for all medical staff. On the other hand, there may be staff with a poor sense of professionalism who work no more than is expected and too readily ask firms and commercial laboratories to solve problems. Overwork caused by providing team-based medicine and a decrease in numbers of clinical chemists are concerns. The following are hoped for in the future. Firstly, laboratory staff will become conscious of their own high-level abilities and expand their areas of work, for example, bioscience, proteomics, and reproductive medicine. Secondly, a consultation system for medical staff and patients will be established. Thirdly, clinical research will be advanced, such as investigating unknown pathophysiologies using laboratory data and samples, and developing new methods of measurement. Lastly, it is of overriding importance that staff of laboratory and educational facilities will cooperate with each other to train the next generation. In conclusion, each laboratory should be appreciated, attractive, positive regarding its contribution to society, and show individuality.

  11. Clinical laboratory as an economic model for business performance analysis

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovečki, Mladen

    2011-01-01

    Aim To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Methods Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. Conclusion The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by

  12. Clinical laboratory as an economic model for business performance analysis.

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovecki, Mladen

    2011-08-15

    To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal

  13. Mass Spectrometry in Clinical Laboratory: Applications in Therapeutic Drug Monitoring and Toxicology.

    Science.gov (United States)

    Garg, Uttam; Zhang, Yan Victoria

    2016-01-01

    Mass spectrometry (MS) has been used in research and specialized clinical laboratories for decades as a very powerful technology to identify and quantify compounds. In recent years, application of MS in routine clinical laboratories has increased significantly. This is mainly due to the ability of MS to provide very specific identification, high sensitivity, and simultaneous analysis of multiple analytes (>100). The coupling of tandem mass spectrometry with gas chromatography (GC) or liquid chromatography (LC) has enabled the rapid expansion of this technology. While applications of MS are used in many clinical areas, therapeutic drug monitoring, drugs of abuse, and clinical toxicology are still the primary focuses of the field. It is not uncommon to see mass spectrometry being used in routine clinical practices for those applications.

  14. Important clinical and laboratory correlates of glomerular filtration ...

    African Journals Online (AJOL)

    Background: Renal impairment is routinely assessed using the estimated glomerular filtration rate (eGFR) and it may be helpful to obtain certain clinical or laboratory markers, which show relationship with glomerular filtration rate (GFR) in sickle cell disease (SCD). Aim: To assess the relationship between important clinical ...

  15. Clinical correlates of laboratory abnormalities in patients with severe ...

    African Journals Online (AJOL)

    Clinical correlates of laboratory abnormalities in patients with severe preeclampsia at the University of Benin Teaching Hospital. ... Journal of Medicine and Biomedical Research ... We aimed to detect the frequency of these abnormalities in severe preeclamptics in Benin City, and to determine their clinical correlates.

  16. Clinical and laboratory features of Pertussis in hospitalized infants ...

    African Journals Online (AJOL)

    Subjects and Methods: The study population consisted of infants ≤12 months of age with clinical diagnosis of pertussis that fulfilled the World Health Organization definition for pertussis or those diagnosed by physicians. Clinico‑laboratory findings were compared between two groups of patients (confirmed vs. clinical ...

  17. The intelligent clinical laboratory as a tool to increase cancer care management productivity.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza

    2014-01-01

    Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity.

  18. [Problems in the management of clinical laboratories in Japan].

    Science.gov (United States)

    Kayaba, Hiroyuki

    2012-08-01

    In Japan, laboratory automation has spread over the last two decades. Laboratory automation has saved time and labor for routine sample tests in clinical laboratories, and contributed to the downsizing of the division. This "contribution" resulted in re-arrangement of the work-force, namely, shrinkage of the blood chemistry division and expansion of the physiological tests and diagnostic imaging division. Some may call this re-arrangement as an adaptation for survival. However, I am concerned that extreme adaptation may cause irreversible shrinkage of clinical laboratories and laboratory medicine itself. In fact, outsourcing of sample tests including microbiological tests has become very popular over the last decade. Since the cost for microbiological tests is suppressed by the national health insurance policy, it is becoming difficult to keep microbiological laboratories in small-scale hospitals. The presence of a microbiological laboratory in a hospital is crucial for prompt and appropriate therapies for infectious diseases, and is essential for advanced infection control activities. The government is pushing forward fixed-term employment in national universities and hospitals, threatening long-term career planning for medical technologists. We have to keep in mind that nurturing medical personnel with special skills and extensive knowledge is mandatory to university hospitals, and laboratory medicine is crucial to the progress of modern medicine.

  19. [Strategy Development for International Cooperation in the Clinical Laboratory Field].

    Science.gov (United States)

    Kudo, Yoshiko; Osawa, Susumu

    2015-10-01

    The strategy of international cooperation in the clinical laboratory field was analyzed to improve the quality of intervention by reviewing documents from international organizations and the Japanese government. Based on the world development agenda, the target of action for health has shifted from communicable diseases to non-communicable diseases (NCD). This emphasizes the importance of comprehensive clinical laboratories instead of disease-specific examinations in developing countries. To achieve this goal, the World Health Organization (WHO) has disseminated to the African and Asian regions the Laboratory Quality Management System (LQMS), which is based on the same principles of the International Organization of Standardization (ISO) 15189. To execute this strategy, international experts must have competence in project management, analyze information regarding the target country, and develop a strategy for management of the LQMS with an understanding of the technical aspects of laboratory work. However, there is no appropriate pre- and post-educational system of international health for Japanese international workers. Universities and academic organizations should cooperate with the government to establish a system of education for international workers. Objectives of this education system must include: (1) training for the organization and understanding of global health issues, (2) education of the principles regarding comprehensive management of clinical laboratories, and (3) understanding the LQMS which was employed based on WHO's initiative. Achievement of these objectives will help improve the quality of international cooperation in the clinical laboratory field.

  20. Advances in Measurement Technology at NIST's Physical Measurement Laboratory

    Science.gov (United States)

    Dehmer, Joseph

    2014-03-01

    The NIST mission is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology. The Physical Measurement Laboratory (PML) has responsibility for maintaining national standards for two dozen physical quantities needed for international trade; and, importantly, it carries out advanced research at the frontiers of measurement science to enable extending innovation into new realms and new markets. This talk will highlight advances being made across several sectors of technology; and it will describe how PML interacts with its many collaborators and clients in industry, government, and academe.

  1. The principles of Health Technology Assessment in laboratory medicine.

    Science.gov (United States)

    Liguori, Giorgio; Belfiore, Patrizia; D'Amora, Maurizio; Liguori, Renato; Plebani, Mario

    2017-01-01

    The Health Technology Assessment (HTA) is a multi-professional and multidisciplinary evaluation approach designed to assess health technology in the broadest sense of the term, from its instruments to the rearranging of its organizational structures. It is by now an established methodology at national and international levels that involves several medical disciplines thanks to its versatility. Laboratory medicine is one of these disciplines. Such specialization was subjected, in recent years, to deep changes even from an organizational standpoint, in order to meet the health needs of the population, making them as effective and cost-effective as possible. In this regard, HTA was the tool used to assess implications in different areas.

  2. 42 CFR 493.2001 - Establishment and function of the Clinical Laboratory Improvement Advisory Committee.

    Science.gov (United States)

    2010-10-01

    ...) Applicability to the standards of new technology; and (7) Other issues relevant to part 493, if requested by HHS... 42 Public Health 5 2010-10-01 2010-10-01 false Establishment and function of the Clinical Laboratory Improvement Advisory Committee. 493.2001 Section 493.2001 Public Health CENTERS FOR MEDICARE...

  3. Hyperthermia: from the clinic to the laboratory and back again

    International Nuclear Information System (INIS)

    Maher, E.J.

    1989-01-01

    Murine tumours have been used extensively to investigate the effects of heat and radiation, but there are significant differences between controlled laboratory studies and relatively uncontrolled clinical experience. From 1983 to 1986 a simple clinical system was developed in order to investigate biological questions in the clinic. This involved identifying a suitable patient population, reliable heating and thermometry, and methods of evaluating response of human tumours and their vasculature. (author)

  4. [Medical support on human resources and clinical laboratory in Myanmar].

    Science.gov (United States)

    Koide, Norio

    2012-03-01

    I have been involved in medical cooperation programs between Myanmar and Japan for over 10 years. The purpose of the first visit to Myanmar was the investigation of hepatitis C spreading among thalassemia patients. I learned that the medical system was underdeveloped in this country, and have initiated several cooperation programs together with Professor Shigeru Okada, such as the "Protection against hepatitis C in Myanmar", "Scientist exchange between the Ministry of Health, Myanmar and Okayama University", and "Various activities sponsored by a Non-Profit Organization". As for clinical laboratories, the laboratory system itself is pre-constructed and the benefit of a clinical laboratory in modern medicine is not given to patients in Myanmar. The donation of drugs and reagents for laboratory tests is helpful, but it will be more helpful to assist the future leaders to learn modern medicine and develop their own various systems to support modern medicine. Our activity in the cooperation program is described.

  5. Establishing a stem cell culture laboratory for clinical trials

    Science.gov (United States)

    Sekiya, Elíseo Joji; Forte, Andresa; Kühn, Telma Ingrid Borges de Bellis; Janz, Felipe; Bydlowski, Sérgio Paulo; Alves, Adelson

    2012-01-01

    Adult stem/progenitor cells are found in different human tissues. An in vitro cell culture is needed for their isolation or for their expansion when they are not available in a sufficient quantity to regenerate damaged organs and tissues. The level of complexity of these new technologies requires adequate facilities, qualified personnel with experience in cell culture techniques, assessment of quality and clear protocols for cell production. The rules for the implementation of cell therapy centers involve national and international standards of good manufacturing practices. However, such standards are not uniform, reflecting the diversity of technical and scientific development. Here standards from the United States, the European Union and Brazil are analyzed. Moreover, practical solutions encountered for the implementation of a cell therapy center appropriate for the preparation and supply of cultured cells for clinical studies are described. Development stages involved the planning and preparation of the project, the construction of the facility, standardization of laboratory procedures and development of systems to prevent cross contamination. Combining the theoretical knowledge of research centers involved in the study of cells with the practical experience of blood therapy services that manage structures for cell transplantation is presented as the best potential for synergy to meet the demands to implement cell therapy centers. PMID:23049427

  6. 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...

  7. Assessment of Thyroid Function: Towards an Integrated Laboratory - Clinical Approach

    OpenAIRE

    Stockigt, Jim

    2003-01-01

    Laboratory assessment of thyroid function is now often initiated with a low pre-test probability, by clinicians who may not have a detailed knowledge of current methodology or testing strategies. Skilled laboratory staff can significantly enhance the choice of appropriate tests and the accuracy of clinical response; such involvement requires both appropriate training and relevant information from the clinician. Measurement of the serum thyroid stimulating hormone (TSH) concentration with an a...

  8. Pharmacology Portal: An Open Database for Clinical Pharmacologic Laboratory Services.

    Science.gov (United States)

    Karlsen Bjånes, Tormod; Mjåset Hjertø, Espen; Lønne, Lars; Aronsen, Lena; Andsnes Berg, Jon; Bergan, Stein; Otto Berg-Hansen, Grim; Bernard, Jean-Paul; Larsen Burns, Margrete; Toralf Fosen, Jan; Frost, Joachim; Hilberg, Thor; Krabseth, Hege-Merete; Kvan, Elena; Narum, Sigrid; Austgulen Westin, Andreas

    2016-01-01

    More than 50 Norwegian public and private laboratories provide one or more analyses for therapeutic drug monitoring or testing for drugs of abuse. Practices differ among laboratories, and analytical repertoires can change rapidly as new substances become available for analysis. The Pharmacology Portal was developed to provide an overview of these activities and to standardize the practices and terminology among laboratories. The Pharmacology Portal is a modern dynamic web database comprising all available analyses within therapeutic drug monitoring and testing for drugs of abuse in Norway. Content can be retrieved by using the search engine or by scrolling through substance lists. The core content is a substance registry updated by a national editorial board of experts within the field of clinical pharmacology. This ensures quality and consistency regarding substance terminologies and classification. All laboratories publish their own repertoires in a user-friendly workflow, adding laboratory-specific details to the core information in the substance registry. The user management system ensures that laboratories are restricted from editing content in the database core or in repertoires within other laboratory subpages. The portal is for nonprofit use, and has been fully funded by the Norwegian Medical Association, the Norwegian Society of Clinical Pharmacology, and the 8 largest pharmacologic institutions in Norway. The database server runs an open-source content management system that ensures flexibility with respect to further development projects, including the potential expansion of the Pharmacology Portal to other countries. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  9. Rules for the certification of good practices in clinical laboratories. No regulation. 3-2009. Good Laboratory Practice

    International Nuclear Information System (INIS)

    2015-01-01

    Regulation for Certification of Good Practices in clinical laboratories, hereinafter Regulation establishes the methodology and procedures for clinical laboratories to demonstrate their state of compliance with good practices, according to Regulation 3-2009, and that the CECMED can verify.

  10. Potential for new technologies in clinical practice.

    Science.gov (United States)

    Burridge, Jane H; Hughes, Ann-Marie

    2010-12-01

    Cost-effective neurorehabilitation is essential owing to financial constraints on healthcare resources. Technologies have the potential to contribute but without strong clinical evidence are unlikely to be widely reimbursed. This review presents evidence of new technologies since 2008 and identifies barriers to translation of technologies into clinical practice. Technology has not been shown to be superior to intensively matched existing therapies. Research has been undertaken into the development and preliminary clinical testing of novel technologies including robotics, electrical stimulation, constraint-induced movement therapy, assistive orthoses, noninvasive brain stimulation, virtual reality and gaming devices. Translation of the research into clinical practice has been impeded by a lack of robust evidence of clinical effectiveness and usability. Underlying mechanisms associated with recovery are beginning to be explored, which may lead to more targeted interventions. Improvements in function have been demonstrated beyond the normal recovery period, but few trials demonstrate lasting effects. Technologies, alone or combined, may offer a cost-effective way to deliver intensive neurorehabilitation therapy in clinical and community environments, and have the potential to empower patients to take more responsibility for their rehabilitation and continue with long-term exercise.

  11. Load Disaggregation Technologies: Real World and Laboratory Performance

    Energy Technology Data Exchange (ETDEWEB)

    Mayhorn, Ebony T.; Sullivan, Greg P.; Petersen, Joseph M.; Butner, Ryan S.; Johnson, Erica M.

    2016-09-28

    Low cost interval metering and communication technology improvements over the past ten years have enabled the maturity of load disaggregation (or non-intrusive load monitoring) technologies to better estimate and report energy consumption of individual end-use loads. With the appropriate performance characteristics, these technologies have the potential to enable many utility and customer facing applications such as billing transparency, itemized demand and energy consumption, appliance diagnostics, commissioning, energy efficiency savings verification, load shape research, and demand response measurement. However, there has been much skepticism concerning the ability of load disaggregation products to accurately identify and estimate energy consumption of end-uses; which has hindered wide-spread market adoption. A contributing factor is that common test methods and metrics are not available to evaluate performance without having to perform large scale field demonstrations and pilots, which can be costly when developing such products. Without common and cost-effective methods of evaluation, more developed disaggregation technologies will continue to be slow to market and potential users will remain uncertain about their capabilities. This paper reviews recent field studies and laboratory tests of disaggregation technologies. Several factors are identified that are important to consider in test protocols, so that the results reflect real world performance. Potential metrics are examined to highlight their effectiveness in quantifying disaggregation performance. This analysis is then used to suggest performance metrics that are meaningful and of value to potential users and that will enable researchers/developers to identify beneficial ways to improve their technologies.

  12. Autoimmune diagnostics: the technology, the strategy and the clinical governance.

    Science.gov (United States)

    Bizzaro, Nicola; Tozzoli, Renato; Villalta, Danilo

    2015-02-01

    In recent years, there has been a profound change in autoimmune diagnostics. From long, tiring and inaccurate manual methods, the art of diagnostics has turned to modern, rapid and automated technology. New antibody tests have been developed, and almost all autoimmune diseases now have some specific diagnostic markers. The current need to make the most of available economic and human resources has led to the production of diagnostic algorithms and guidelines designated for optimal strategic use of the tests and to increase the diagnostic appropriateness. An important role in this scenario was assumed by the laboratory autoimmunologist, whose task is not only to govern the analytical phase, but also to help clinicians in correctly choosing the most suitable test for each clinical situation and provide consultancy support. In this review, we summarize recent advances in technology, describe the diagnostic strategies and highlight the current role of the laboratory autoimmunologist in the clinical governance of autoimmune diagnostics.

  13. Attrition in a clinical laboratory technician associate degree program.

    Science.gov (United States)

    Blume, W M; Krefetz, R G

    1997-01-01

    To determine the reasons for attrition in a clinical laboratory technician-associate degree program, a retrospective study was done on classes entering from 1987 to 1992. Suggestions are made to increase retention. The medical laboratory department at the Community College of Philadelphia in Pennsylvania. There were 43,987 students enrolled for the 1993 to 1994 academic year; 17,846 full time equivalents at the college. Clinical laboratory technician students averaged 26.2 years and were 26% male and 74% female, which closely paralleled the college. The ethnic make-up of the clinical laboratory technician classes was 54% White, 32% African American, 11% Asian, and 3% Latin American, compared to 48% African American, 36% White, 10% Asian, and 6% Latin American students in the college. A retrospective study was performed to evaluate attrition rates for the classes entering the clinical laboratory technician program at the Community College of Philadelphia from 1987 to 1992. Reasons for this attrition were tabulated and evaluated. One hundred twenty-nine students entered the program and 75 graduated, producing an attrition rate of 42%. There were 6 categories of reasons given for not completing the program: academic difficulties, dislike of the laboratory science field, family problems, financial problems, substance abuse, and other problems not specified. Because 80% of the attrition was due to poor academic performance and a dislike of the field, several changes are being made in the Community College of Philadelphia's retention program. An enhanced orientation will be given to all students, and students will be required to visit a hospital laboratory. Early faculty intervention and peer counseling for students with poor academic performance will be instituted.

  14. Remote participation technologies in the EFDA Laboratories - status and prospects

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, V. [Associazione EURATOM-ENEA sulla Fusione, Consorzio RFX, Padova (Italy); How, J.A. [Association Euratom-CEA Cadarache, 13 - Saint-Paul-lez-Durance (France). Dept. de Recherches sur la Fusion Controlee

    2003-07-01

    More than 25 laboratories of the European Fusion Development Agreement (EFDA) have been increasingly using remote participation (RP) technologies for collaborative work on several experiments. We present an overview of the technologies that are employed to provide remote data access, remote computer access, and tele-conference. We also deal with computer network requirements, and support and documentation needs. The biggest application of these tools has been the joint scientific exploitation of the JET Facilities. Increasingly other experiments are operated as shared facilities, and the RP tools are being used in this context. For remote data access there is a clear trend towards MDSplus as common data access layer for multi-experiment data access. Secure Remote Computer access is converging on two different solutions. Video-conference is also converging on two partially inter-operable solutions, whereas the sharing of presentation material is converging on one solution. Remote Control Room participation is being used in two laboratories. Network monitoring has been developed and is now in routine use. The RP work is being done at many laboratories and is co-ordinated by EFDA. A number of items in several fields need still to be tackled and an overview of these is presented. (authors)

  15. Remote participation technologies in the EFDA Laboratories - status and prospects

    International Nuclear Information System (INIS)

    Schmidt, V.; How, J.A.

    2003-01-01

    More than 25 laboratories of the European Fusion Development Agreement (EFDA) have been increasingly using remote participation (RP) technologies for collaborative work on several experiments. We present an overview of the technologies that are employed to provide remote data access, remote computer access, and tele-conference. We also deal with computer network requirements, and support and documentation needs. The biggest application of these tools has been the joint scientific exploitation of the JET Facilities. Increasingly other experiments are operated as shared facilities, and the RP tools are being used in this context. For remote data access there is a clear trend towards MDSplus as common data access layer for multi-experiment data access. Secure Remote Computer access is converging on two different solutions. Video-conference is also converging on two partially inter-operable solutions, whereas the sharing of presentation material is converging on one solution. Remote Control Room participation is being used in two laboratories. Network monitoring has been developed and is now in routine use. The RP work is being done at many laboratories and is co-ordinated by EFDA. A number of items in several fields need still to be tackled and an overview of these is presented. (authors)

  16. Effective use of technology in clinical supervision

    Directory of Open Access Journals (Sweden)

    Priya Martin

    2017-06-01

    Full Text Available Clinical supervision is integral to continuing professional development of health professionals. With advances in technology, clinical supervision too can be undertaken using mediums such as videoconference, email and teleconference. This mode of clinical supervision is termed as telesupervision. While telesupervision could be useful in any context, its value is amplified for health professionals working in rural and remote areas where access to supervisors within the local work environment is often diminished. While telesupervision offers innovative means to undertake clinical supervision, there remain gaps in the literature in terms of its parameters of use in clinical practice. This article outlines ten evidence-informed, practical tips stemming from a review of the literature that will enable health care stakeholders to use technology effectively and efficiently while undertaking clinical supervision. By highlighting the “how to” aspect, telesupervision can be delivered in the right way, to the right health professional, at the right time.

  17. CHRONIC MYELOID LEUKEMIA EXPECTED RELAPSE'S CLINICAL-LABORATORY INDEXES.

    Science.gov (United States)

    Kirtava, T; Ghirdaladze, D; Vatsadze, T

    2017-06-01

    Today Chronic Myeloid Leukemia (CML) relapse's final assessment and monitoring in the whole world is implemented by BCR-ABL gene quantitative detection - during the polymerase chain reaction (by PSR means). Implementation of this monitoring materially and technically is not often available and remission during years is being assessed using monthly clinical-laboratory data. Proceeding from this, the goal of our work was to find the clinical-laboratory features, indicating the expected relapse and require the urgent molecular research carry out. In order to find the clinical-hematologic indicators of the Chronic Myeloid Leukemia expected relapse, BCR-ABL gene quantitative determination using the PSR method after the Imatinib treatment was done in 64 patients with CML who had remission (duration 0,5-14 years). The retrospective analyses of clinical-laboratory data was also held before the research. According to the molecular research results, we have set the risk groups of the patients - low, moderate and high risk groups. In the groups we have found the clinical-laboratory changes, existed before the research. We have held the comparative analyses of the molecular research in groups and the clinical-laboratory changes in them. As a result, we have established, that moderate anemia (expressed often during the whole remission period among the patients of all three risk groups) does not indicate the expected relapse and that in the Chronic Myeloid Leukemia remission period the expected relapse indicator could be the patient's Imatinib irregular intakes, non-systemic treatment and high, inexplicable progressive thrombocytosis in peripheral blood. These factors indicate the necessity to hold the urgent molecular research in order to define the post-treatment tactics.

  18. Comparison of semen quality between university-based and private assisted reproductive technology laboratories

    DEFF Research Database (Denmark)

    Jensen, Christian Fuglesang S; Khan, Omar; Sønksen, Jens

    2018-01-01

    .9%). No significant differences were found in volume, concentration and total motile sperm count although the Bland-Altman plot bias for concentration was clinically significant (15.9 × 106/ml). CONCLUSIONS: In this small series, motility was significantly higher at private laboratories compared to a university......OBJECTIVE: Obtaining a semen analysis (SA) is an essential step in evaluating infertile men. Despite using standardized procedures for analysis semen quality in the same individual often varies on repeated tests. The objective of this study was to investigate inter-laboratory variation in semen...... quality between private- and university-based assisted reproductive technology (ART) laboratories. MATERIALS AND METHODS: IRB approval was obtained to retrospectively evaluate men with a SA at both the private- and university-based ART laboratories. When more than one SA was available from either...

  19. Laboratory technology research: Abstracts of FY 1998 projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    The Laboratory Technology Research (LTR) program supports high-risk, multidisciplinary research partnerships to investigate challenging scientific problems whose solutions have promising commercial potential. These partnerships capitalize on two great strengths of the country: the world-class basic research capability of the DOE Office of Science (SC) national laboratories and the unparalleled entrepreneurial spirit of American industry. Projects supported by the LTR program in FY 1998 explore the applications of basic research advances relevant to DOE`s mission over a full range of scientific disciplines. The program presently emphasizes three critical areas of mission-related research: advanced materials, intelligent processing and manufacturing research, and environmental and biomedical research. Abstracts for 85 projects are contained in this report.

  20. Environmental assessment for the Processing and Environmental Technology Laboratory (PETL)

    International Nuclear Information System (INIS)

    1995-09-01

    The U.S. Department of Energy (DOE) has prepared an environmental assessment (EA) on the proposed Processing and Environmental Technology Laboratory (PETC) at Sandia National Laboratories/New Mexico (SNL/NM). This facility is needed to integrate, consolidate, and enhance the materials science and materials process research and development (R ampersand D) currently in progress at SNL/NM. Based on the analyses in the EA, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, an environmental impact statement is not required, and DOE is issuing this Finding of No Significant Impact (FONSI)

  1. Environmental assessment for the Processing and Environmental Technology Laboratory (PETL)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The U.S. Department of Energy (DOE) has prepared an environmental assessment (EA) on the proposed Processing and Environmental Technology Laboratory (PETC) at Sandia National Laboratories/New Mexico (SNL/NM). This facility is needed to integrate, consolidate, and enhance the materials science and materials process research and development (R&D) currently in progress at SNL/NM. Based on the analyses in the EA, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, an environmental impact statement is not required, and DOE is issuing this Finding of No Significant Impact (FONSI).

  2. Bioterrorism and the Role of the Clinical Microbiology Laboratory.

    Science.gov (United States)

    Wagar, Elizabeth

    2016-01-01

    Regular review of the management of bioterrorism is essential for maintaining readiness for these sporadically occurring events. This review provides an overview of the history of biological disasters and bioterrorism. I also discuss the recent recategorization of tier 1 agents by the U.S. Department of Health and Human Services, the Laboratory Response Network (LRN), and specific training and readiness processes and programs, such as the College of American Pathologists (CAP) Laboratory Preparedness Exercise (LPX). LPX examined the management of cultivable bacterial vaccine and attenuated strains of tier 1 agents or close mimics. In the LPX program, participating laboratories showed improvement in the level of diagnosis required and referral of isolates to an appropriate reference laboratory. Agents which proved difficult to manage in sentinel laboratories included the more fastidious Gram-negative organisms, especially Francisella tularensis and Burkholderia spp. The recent Ebola hemorrhagic fever epidemic provided a check on LRN safety processes. Specific guidelines and recommendations for laboratory safety and risk assessment in the clinical microbiology are explored so that sentinel laboratories can better prepare for the next biological disaster. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Multiple myeloma in Nigeria: An insight to the clinical, laboratory ...

    African Journals Online (AJOL)

    Aim: In developing African nations, late presentation and occurrence of complications adversely affects survival. This study aims at identifying initial clinical and basic laboratory features of multiple myeloma (MM), which will aid the physician to entertain a high index of suspicion and therefore target his investigations in order ...

  4. A Computerized Clinical Support System and Psychological Laboratory.

    Science.gov (United States)

    Cassel, Russell N.

    1978-01-01

    Advocating "holistic" medicine, this article details the benefits to be derived from using a computerized clinical support system in a psychological laboratory focusing on internal healing where the client/patient becomes a committed partner utilizing biofeedback equipment, gaming, and simulation to achieve self-understanding and…

  5. Correlation of laboratory result and clinical diagnosis of ...

    African Journals Online (AJOL)

    Malaria remains a major cause of morbidity and mortality especially among children. While early diagnosis and prompt treatment are crucial to its control, anecdotal evidence has shown that there is increasing overdiagnosis of the illness. This study therefore aims to compare the outcome of laboratory and clinical diagnosis ...

  6. 76 FR 9578 - Clinical Laboratory Improvement Advisory Committee

    Science.gov (United States)

    2011-02-18

    ... committee management activities, for the Centers for Disease Control and Prevention and the Agency for Toxic... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory..., Number 20, page 5379. The location of the meeting has changed as follows: ] Place: DoubleTree Hotel...

  7. Thirty-day stroke mortality and associated clinical and laboratory ...

    African Journals Online (AJOL)

    Although stroke mortality in developing countries is more than 85%, the case fatality in Uganda is not known. Objective We determined 30 day case fatality, associated clinical and laboratory presentations among adult stroke patients admitted to Mulago Hospital. Design Prospective descriptive study. Setting Mulago national ...

  8. Clinical and Laboratory Predictors of Articular Disorders Among HIV ...

    African Journals Online (AJOL)

    Background: HIV infection may be associated with different arthropathies that are often underdiagnosed. There is also paucity of reported studies of relationship between clinical and laboratory features of HIV‑infected patients and articular disorders. Aims: To determine the predictors of articular disorders among ...

  9. Clinical laboratory assessment of congenital and acquired disorders ...

    African Journals Online (AJOL)

    ... various methods of assessing platelet function in the clinical laboratory have been derived; however with the advent of automation, more research is still on to further unveil specific defects in the structure and functions of platelets. Methods are however being specific for investigating certain stages of haemostasis process.

  10. Clinical and Laboratory Predictors of Articular Disorders Among HIV ...

    African Journals Online (AJOL)

    radiologist for features of avascular necrosis (AVN) and sacroiliitis, respectively. Synovial fluid was obtained, for analysis and microscopy, culture/sensitivity testing and acid fast bacilli detection in those with demonstrable joint effusion. The clinically evident articular features, laboratory, and radiographic findings were used ...

  11. Clinical and laboratory experience of chorionic villous sampling in ...

    African Journals Online (AJOL)

    Background: Chorionic villous sampling is a first trimester invasive diagnosis procedure that was introduced in Nigeria <2 decades ago. Objective: The objective of the following study is to review experience with chorionic villous sampling in relation to clinical and laboratory procedures, including general characteristics of ...

  12. Symptomatic HIV infection in infancy - clinical and laboratory ...

    African Journals Online (AJOL)

    in infancy - clinical and laboratory markers of infection. M P Meyer, Z Latief, C Haworlh, 5 Salie,. A van Dyk. Objective. To investigate the usefulness of immunological tests in the diagnosis of HIV infection in young symptomatic children « 15 months of age). Design. Tests were evaluated in HIV-infected (HIV antibody- and ...

  13. An Analysis of Medical Laboratory Technology Journals' Instructions for Authors.

    Science.gov (United States)

    Horvat, Martina; Mlinaric, Ana; Omazic, Jelena; Supak-Smolcic, Vesna

    2016-08-01

    Instructions for authors (IFA) need to be informative and regularly updated. We hypothesized that journals with a higher impact factor (IF) have more comprehensive IFA. The aim of the study was to examine whether IFA of journals indexed in the Journal Citation Reports 2013, "Medical Laboratory Technology" category, are written in accordance with the latest recommendations and whether the quality of instructions correlates with the journals' IF. 6 out of 31 journals indexed in "Medical Laboratory Technology" category were excluded (unsuitable or unavailable instructions). The remaining 25 journals were scored based on a set of 41 yes/no questions (score 1/0) and divided into four groups (editorial policy, research ethics, research integrity, manuscript preparation) by three authors independently (max score = 41). We tested the correlation between IF and total score and the difference between scores in separate question groups. The median total score was 26 (21-30) [portion of positive answers 0.63 (0.51-0.73)]. There was no statistically significant correlation between a journal's IF and the total score (rho = 0.291, P = 0.159). IFA included recommendations concerning research ethics and manuscript preparation more extensively than recommendations concerning editorial policy and research integrity (Ht = 15.91, P = 0.003). Some policies were poorly described (portion of positive answers), for example: procedure for author's appeal (0.04), editorial submissions (0.08), appointed body for research integrity issues (0.08). The IF of the "Medical Laboratory Technology" journals does not reflect a journals' compliance to uniform standards. There is a need for improving editorial policies and the policies on research integrity.

  14. 78 FR 32637 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

    Science.gov (United States)

    2013-05-31

    ..., Science and Technology Reinvention Laboratory Personnel Management Demonstration Project, Department of... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Personnel Management Demonstration Project, Department of the Army, Army Research, Development and...

  15. 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.

  16. Laboratory 3.0: Manufacturing technologies laboratory virtualization with a student-centred methodology

    Directory of Open Access Journals (Sweden)

    Albert Fabregat-Sanjuan

    2017-06-01

    Full Text Available This paper presents a blended-learning strategy for improving the teaching method applied in the laboratory subject Manufacturing Technologies. The teaching method has been changed from a predominantly teacher-centred to an active learning system with a student-centred focus and e-learning activities. In face-to-face classes, a game-based learning platform has been used. This methodology ensured engaging classes at the same time that provided a useful live feedback for students and teachers. The virtualization of the laboratory was achieved by two different e-learning activities, self-assessment tasks and video clips. These e-learning tools have been used not only to improve the students’ learning but also to enhance their motivation. The results from academic outputs show a significant improvement after the new blended learning method is applied. Moreover, a student satisfaction survey shows the positive impact of the methodology on the students’ engagement and motivation.

  17. Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Annesley, Thomas M.; Cooks, Robert G.; Herold, David A.; Hoofnagle, Andrew N.

    2016-01-04

    Each year the journal Clinical Chemistry publishes a January special issue on a topic that is relevant to the laboratory medicine community. In January 2016 the topic is mass spectrometry, and the issue is entitled “Clinical Mass Spectrometry: Achieving Prominence in Laboratory Medicine”. One popular feature in our issues is a Q&A on a topic, clearly in this case mass spectrometry. The journal is assembling a panel of 5-6 experts from various areas of mass spectrometry ranging from instrument manufacturing to practicing clinical chemists. Dick Smith is one of the scientist requested to participate in this special issue Q&A on Mass Spectrometry. The Q&A Transcript is attached

  18. CANMET Materials Technology Laboratory technical review 2003-2004

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This technical review described research activities of the CANMET Materials Technology Laboratory, whose mandate is to develop and deploy technologies that improve aspects of producing and using products derived from minerals and metals. During the reporting period, 126 reports for clients were published and the lab participated in 15 national and international consortia. The Advanced Concrete Technology Program was reviewed. The Advanced Materials Technologies Program was discussed, and recent advances in the hydroforming of tubes and corrosion protection techniques for magnesium used in automobiles were presented. A review of the Sustainable Casting Program was presented. New materials for the mining industry were discussed, as well as issues concerning lost-foam casting. Details of the Efficient Metal Production Program were provided and new galvanized TRIP steel and metal inert gas welding processes were outlined. New additions to the Infrastructure Reliability Program included intelligent systems for pipeline infrastructure reliability; software for corrosion control; and risk management of pipelines. Additions to the Certifying Agency for Non-Destructive Testing included a new certification of X-Ray Fluorescence operators and revisions to the non-destructive testing qualification and certification of personnel. New patents developed by the laboratory included a hydrogen sensor using a solid hydrogen ion conducting electrolyte; reinforcement preform for the production of magnesium composite and other metal matrix composite materials; a rechargeable battery electrode testing device; a sulfide biosensor; and a bio-corrosion probe. During the 2 year review period, staff received 13 national and international awards. An outline of major facilities and equipment was presented, as well as details of new materials for use by the transportation sector. Advances in concrete and other construction materials were outlined, as well as metallurgical process improvements. A

  19. Quality documentation challenges for veterinary clinical pathology laboratories.

    Science.gov (United States)

    Sacchini, Federico; Freeman, Kathleen P

    2008-05-01

    An increasing number of veterinary laboratories worldwide have obtained or are seeking certification based on international standards, such as the International Organization for Standardization/International Electrotechnical Commission 17025. Compliance with any certification standard or quality management system requires quality documentation, an activity that may present several unique challenges in the case of veterinary laboratories. Research specifically addressing quality documentation is conspicuously absent in the veterinary literature. This article provides an overview of the quality system documentation needed to comply with a quality management system with an emphasis on preparing written standard operating procedures specific for veterinary laboratories. In addition, the quality documentation challenges that are unique to veterinary clinical pathology laboratories are critically evaluated against the existing quality standards and discussed with respect to possible solutions and/or recommended courses of action. Documentation challenges include the establishment of quality requirements for veterinary tests, the use or modification of human analytic methods for animal samples, the limited availability of quality control materials satisfactory for veterinary clinical pathology laboratories, the limited availability of veterinary proficiency programs, and the complications in establishing species-specific reference intervals.

  20. A Review of Research on Technology-Assisted School Science Laboratories

    Science.gov (United States)

    Wang, Chia-Yu; Wu, Hsin-Ka; Lee, Silvia Wen-Yu; Hwang, Fu-Kwun; Chang, Hsin-Yi; Wu, Ying-Tien; Chiou, Guo-Li; Chen, Sufen; Liang, Jyh-Chong; Lin, Jing-Wen; Lo, Hao-Chang; Tsai, Chin-Chung

    2014-01-01

    Studies that incorporate technologies into school science laboratories have proliferated in the recent two decades. A total of 42 studies published from 1990 to 2011 that incorporated technologies to support school science laboratories are reviewed here. Simulations, microcomputer-based laboratories (MBLs), and virtual laboratories are commonly…

  1. Preventing PCR amplification carryover contamination in a clinical laboratory.

    Science.gov (United States)

    Aslanzadeh, Jaber

    2004-01-01

    During the past two decades PCR and several other DNA/RNA amplification techniques have become important diagnostic tools in clinical laboratories. Amplification products contamination has been the main impediment to using these techniques routinely in diagnostic laboratories. Over the years, several creative pre- and post-amplification methods have been developed that prevent amplicon carryover contamination. These procedures, coupled with automated systems that employ real-time amplification and simultaneous detection in a closed system, have substantially reduced the possibility of false positive results due to amplification products carryover contamination.

  2. On Masculinities, Technologies and Pain: The Testing of Male Contraceptives Technologies in the Clinic and the Media

    NARCIS (Netherlands)

    Oudshoorn, Nelly E.J.

    1999-01-01

    In the last fifteen years, testing has attracted much attention in science and technology studies. Most researchers have focused almost exclusively on testing in the laboratory, specifically designed test locations, and, for medical technologies, the clinic. What counts as testing has largely been

  3. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or...

  4. 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.

  5. The American Society for Clinical Pathology's 2015 Wage Survey of Medical Laboratories in the United States.

    Science.gov (United States)

    Garcia, Edna; Fisher, Patrick B

    2017-05-01

    To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois. Electronic survey invitations were sent to individuals who are currently practicing in the field. Data reveal increased salaries since 2013 for all staff-level laboratory professionals surveyed except phlebotomists and pathologists' assistants. Laboratory assistants and phlebotomists, regardless of level, continue to have lower salaries while pathologists' assistants and administration personnel have higher salaries than the rest of the laboratory professions surveyed. Survey results put emphasis on strategic recruitment and retention by laboratory training programs and institutions that hire laboratory professionals. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  6. The American Society for Clinical Pathology's 2014 vacancy survey of medical laboratories in the United States.

    Science.gov (United States)

    Garcia, Edna; Ali, Asma M; Soles, Ryan M; Lewis, D Grace

    2015-09-01

    To determine the extent and distribution of workforce shortages within the nation's medical laboratories. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2014 Vacancy Survey was conducted through collaboration between American Society for Clinical Pathology's Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, Illinois. Data were collected via an Internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Data reveal increased overall vacancy rates since 2012 for all departments surveyed except cytology and cytogenetics. Also, results show higher anticipated retirement rates for both staff and supervisors. Overall certification rates are highest among laboratory personnel in cytogenetics, hematology/coagulation, and flow cytometry departments and lowest among phlebotomy, specimen processing, and anatomic pathology. Factors such as retirement and the improving economy are driving the need for more laboratory professionals. Recruitment of qualified laboratory professionals in the workforce and students in laboratory programs will be the key in fulfilling the higher vacancies revealed from the survey results in 2014. Copyright© by the American Society for Clinical Pathology.

  7. The present status of the clinical laboratory medicine in Cambodia.

    Science.gov (United States)

    Kudo, Yoshiko

    2002-01-01

    The educational system and the introduction of legislation of clinical medicine are both still in developing stage in Cambodia where only 10 years have passed since the establishment of a new government. In order to maintain good health of all Cambodian citizens and to improve the quality of care in health services, it should be necessary to implement an appropriate educational system for both laboratory technologists and technicians. To conduct refreshment training course for laboratory workers with provision of the instruments, material and reagents is another way to make improvement of it in public hospitals. It should be also required to overcome economic problems how to absorb medical expense and to understand the importance for doctors to diagnose with scientific data of clinical examinations. Maturation of the total medical system in this country should be necessary and suggestions from neighboring countries with views toward the world standard would be expected.

  8. Technological capability at the Brazilian official pharmaceutical laboratories

    Directory of Open Access Journals (Sweden)

    José Vitor Bomtempo Martins

    2008-10-01

    Full Text Available This paper studies the technological capability in the Brazilian Official Pharmaceutical Laboratories [OPL]. The technological capability analysis could contribute to organization strategies and governmental actions in order to improve OPL basic tasks as well to incorporate new ones, particularly concerning the innovation management. Inspired in Figueiredo (2000, 2003a, 2003b and Figueiredo and Ariffin (2003, a framework was drawn and adapted to pharmaceutical industry characteristics and current sanitary and health legislation. The framework allows to map different dimensions of the technological capability (installations, processes, products, equipments, organizational capability and knowledge management and the level attained by OPL (ordinary or innovating capability. OPL show a good development of ordinary capabilities, particularly in Product and Processes. Concerning the other dimensions, OPL are quite diverse. In general, innovating capabilities are not much developed. In the short term, it was identified a dispersion in the capacitating efforts. Considering their present level and the absorption efforts, good perspectives can be found in Installations, Processes and Organizational Capability. A lower level of efforts in Products and Knowledge Management could undermine these capabilities in the future.

  9. Monsanto Mound Laboratory tritium waste control technology development program

    International Nuclear Information System (INIS)

    Bixel, J.C.; Kershner, C.J.; Rhinehammer, T.B.

    1975-01-01

    Over the past four years, implementation of tritium waste control programs has resulted in a 30-fold reduction in the gaseous tritium effluents from Mound Laboratory. However, to reduce tritium waste levels to the ''as low as practicable'' guideline poses problems that are beyond ready solution with state-of-the-art tritium control technology. To meet this advanced technology need, a tritium waste control technology program was initiated. Although the initial thrust of the work under this program was oriented toward development of gaseous effluent treatment systems, its natural evolution has been toward the liquid waste problem. It is thought that, of all the possible approaches to disposal of tritiated liquid wastes, recovery offers the greatest advantages. End products of the recovery processes would be water detritiated to a level below the Radioactivity Concentration Guide (RCG) or detritiated to a level that would permit safe recycle in a closed loop operation and enriched tritium. The detritiated water effluent could be either recycled in a closed loop operation such as in a fuel reprocessing plant or safely released to the biosphere, and the recovered tritium could be recycled for use in fusion reactor studies or other applications

  10. Monsanto/Mound Laboratory tritium waste control technology development program

    International Nuclear Information System (INIS)

    Bixel, J.C.; Kershner, C.J.; Rhinehammer, T.B.

    1975-01-01

    Over the past four years, implementation of tritium waste control programs has resulted in a 30-fold reduction in the gaseous tritium effluents from Mound Laboratory. However, to reduce tritium waste levels to the ''as low as practicable'' guideline poses problems that are beyond ready solution with state-of-the-art tritium control technology. To meet this advanced technology need, a tritium waste control technology program was initiated. Although the initial thrust of the work under this program was oriented toward development of gaseous effluent treatment systems, its natural evolution has been toward the liquid waste problem. We contend that, of all the possible approaches to disposal of tritiated liquid wastes, recovery offers the greatest advantages. End products of the recovery processes would be: (1) water detritiated to a level below the Radioactivity Concentration Guide or detritiated to a level that would permit safe recycle in a closed loop operation and, (2) enriched tritium. The detritiated water effluent could be either recycled in a closed loop operation such as in a fuel reprocessing plant or safely released to the biosphere, and the recovered tritium could be recycled for use in fusion reactor studies or other applications

  11. Clinical Laboratory Stressors Used to Study Alcohol?Stress Relationships

    OpenAIRE

    Thomas, Suzanne; Bacon, Amy K.; Sinha, Rajita; Uhart, Magdalena; Adinoff, Bryon

    2012-01-01

    Understanding the biologic systems that underlie the relationship between stress and alcohol consumption may lead to better prevention efforts and more effective treatments for alcoholism. Clinical laboratory studies offer a unique opportunity to examine these relationships by using a controlled environment to study how an acute stressor affects alcohol drinking and alcohol craving, how individuals in recovery or those at risk for alcoholism may respond differently to stressors relative to co...

  12. Blockchain technology for improving clinical research quality.

    Science.gov (United States)

    Benchoufi, Mehdi; Ravaud, Philippe

    2017-07-19

    Reproducibility, data sharing, personal data privacy concerns and patient enrolment in clinical trials are huge medical challenges for contemporary clinical research. A new technology, Blockchain, may be a key to addressing these challenges and should draw the attention of the whole clinical research community.Blockchain brings the Internet to its definitive decentralisation goal. The core principle of Blockchain is that any service relying on trusted third parties can be built in a transparent, decentralised, secure "trustless" manner at the top of the Blockchain (in fact, there is trust, but it is hardcoded in the Blockchain protocol via a complex cryptographic algorithm). Therefore, users have a high degree of control over and autonomy and trust of the data and its integrity. Blockchain allows for reaching a substantial level of historicity and inviolability of data for the whole document flow in a clinical trial. Hence, it ensures traceability, prevents a posteriori reconstruction and allows for securely automating the clinical trial through what are called Smart Contracts. At the same time, the technology ensures fine-grained control of the data, its security and its shareable parameters, for a single patient or group of patients or clinical trial stakeholders.In this commentary article, we explore the core functionalities of Blockchain applied to clinical trials and we illustrate concretely its general principle in the context of consent to a trial protocol. Trying to figure out the potential impact of Blockchain implementations in the setting of clinical trials will shed new light on how modern clinical trial methods could evolve and benefit from Blockchain technologies in order to tackle the aforementioned challenges.

  13. Clinical and laboratory surface finishing procedures for zirconia on opposing human enamel wear: A laboratory study.

    Science.gov (United States)

    Chong, Bevan J; Thangavel, Arun K; Rolton, Shane B; Guazzato, Massimiliano; Klineberg, Iven J

    2015-10-01

    To investigate the effect of laboratory and clinical finishing procedures for zirconia on antagonistic enamel wear. Forty-eight yttria-tetragonal partially stabilised zirconia (Y-TZP) specimens were prepared and divided into four groups according to their surface preparation: laboratory polished (LP); laboratory polished and glazed (G); clinically adjusted (CA); and clinically adjusted and repolished (CAR). Enamel opposing enamel was used as a control. Pre-testing surface roughness for each group was determined using contact profilometry. Two-body wear resistance tests were conducted using a masticatory simulator. Enamel specimens were subjected to 120,000 cycles in distilled water (frequency 1.6 Hz, loading force of 49 N). Volumetric and vertical enamel losses were measured by superimposition of pre- and post-testing images using a three-dimensional laser scanner and software analysis. Scanning electron microscopy was used for qualitative surface analysis of pre- and post-testing zirconia and enamel surfaces. One-way ANOVA and multiple comparisons with Bonferroni corrections were used for statistical analysis at a significance level of α=0.05. There was no statistical difference in volumetric and vertical enamel loss between CAR, G and LP. CAR produced statistically significantly less volumetric enamel loss compared with CA and control, and statistically significantly less vertical enamel loss compared with CA. Volumetric and vertical enamel loss were highly correlated in all groups. Enamel wear by clinically ground zirconia is comparable to that of opposing enamel surfaces and greater than clinically repolished zirconia. Repolishing of zirconia restorations following clinical adjustment with diamond burs is effective in reducing antagonistic enamel wear. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Modern clinical and laboratory features of influenza in adults

    Directory of Open Access Journals (Sweden)

    О.К. Duda

    2017-10-01

    Full Text Available We examined and treated 472 patients with influenza, 72 of them had radiologically confirmed pneumonia, and 69 were hospitalized in the intensive care unit of Kyiv Municipal Clinical Hospital N 4. We analyzed clinical and laboratory pattern of flu in adults caused by influenza A virus (H1N1. Pneumonia is one of the most frequent complications of influenza, which significantly affects the prognosis. It was shown that unfavorable prognostic criteria are: late medical help (day 5–6 of the disease, the development of acute respiratory distress syndrome, increased white blood cell count and the presence of severe comorbidity.

  15. Assuring the Quality of Next-Generation Sequencing in Clinical Microbiology and Public Health Laboratories.

    Science.gov (United States)

    Gargis, Amy S; Kalman, Lisa; Lubin, Ira M

    2016-12-01

    Clinical microbiology and public health laboratories are beginning to utilize next-generation sequencing (NGS) for a range of applications. This technology has the potential to transform the field by providing approaches that will complement, or even replace, many conventional laboratory tests. While the benefits of NGS are significant, the complexities of these assays require an evolving set of standards to ensure testing quality. Regulatory and accreditation requirements, professional guidelines, and best practices that help ensure the quality of NGS-based tests are emerging. This review highlights currently available standards and guidelines for the implementation of NGS in the clinical and public health laboratory setting, and it includes considerations for NGS test validation, quality control procedures, proficiency testing, and reference materials. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  16. Avanços tecnológicos em hematologia laboratorial Technological advances in laboratorial haematology

    Directory of Open Access Journals (Sweden)

    Paulo C. Naoum

    2001-08-01

    Full Text Available O recente avanço científico e tecnológico direcionado à identificação imuno-hematológica de produtos celulares (ex.: citocinas, interleucinas, interferons, entre outros sintetizados por determinadas células sanguíneas, bem como na identificação de antígenos de membrana de leucócitos e células progenitoras hematopoiéticas, promoveram excepcional desenvolvimento no diagnóstico laboratorial de diversas doenças hematológicas. Somam-se a esse fato as aplicações das técnicas de biologia molecular que se tornam cada vez mais instrumentos laboratoriais de grande definição no diagnóstico e na prevenção de doenças hematológicas, notadamente aquelas de origem hereditária. O presente artigo teve o objetivo de expor as principais aplicações de novas tecnologias que deverão ser adotadas rapidamente pela moderna hematologia laboratorial, bem como a de sensibilizar os profissionais hematologistas, clínicos e laboratoriais, para a necessidade de se atualizarem numa nova ciência, a dos produtos celulares.Recent progress towards the identification of products synthesised by some blood cells (ex.: cytokines, interleukins, interferons, etc as well as the identification of white blood cell and stem cell membrane antigens, has aided the exceptional development of laboratory diagnostics of several haematological diseases. In addition to this there has been a great development in the use of molecular biology techniques which have become instrumentals of high definition in the diagnosis and prevention of haematological diseases, specifically those of hereditary origin. This article has the aim of disclosing the main applications of the new technologies that will soon be used widely in laboratory haematology.

  17. Smart Technology in Lung Disease Clinical Trials.

    Science.gov (United States)

    Geller, Nancy L; Kim, Dong-Yun; Tian, Xin

    2016-01-01

    This article describes the use of smart technology by investigators and patients to facilitate lung disease clinical trials and make them less costly and more efficient. By "smart technology" we include various electronic media, such as computer databases, the Internet, and mobile devices. We first describe the use of electronic health records for identifying potential subjects and then discuss electronic informed consent. We give several examples of using the Internet and mobile technology in clinical trials. Interventions have been delivered via the World Wide Web or via mobile devices, and both have been used to collect outcome data. We discuss examples of new electronic devices that recently have been introduced to collect health data. While use of smart technology in clinical trials is an exciting development, comparison with similar interventions applied in a conventional manner is still in its infancy. We discuss advantages and disadvantages of using this omnipresent, powerful tool in clinical trials, as well as directions for future research. Published by Elsevier Inc.

  18. Clinical and Laboratory Diagnosis of Dengue Virus Infection.

    Science.gov (United States)

    Muller, David A; Depelsenaire, Alexandra C I; Young, Paul R

    2017-03-01

    Infection with any of the 4 dengue virus serotypes results in a diverse range of symptoms, from mild undifferentiated fever to life-threatening hemorrhagic fever and shock. Given that dengue virus infection elicits such a broad range of clinical symptoms, early and accurate laboratory diagnosis is essential for appropriate patient management. Virus detection and serological conversion have been the main targets of diagnostic assessment for many years, however cross-reactivity of antibody responses among the flaviviruses has been a confounding issue in providing a differential diagnosis. Furthermore, there is no single, definitive diagnostic biomarker that is present across the entire period of patient presentation, particularly in those experiencing a secondary dengue infection. Nevertheless, the development and commercialization of point-of-care combination tests capable of detecting markers of infection present during different stages of infection (viral nonstructural protein 1 and immunoglobulin M) has greatly simplified laboratory-based dengue diagnosis. Despite these advances, significant challenges remain in the clinical management of dengue-infected patients, especially in the absence of reliable biomarkers that provide an effective prognostic indicator of severe disease progression. This review briefly summarizes some of the complexities and issues surrounding clinical dengue diagnosis and the laboratory diagnostic options currently available. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  19. Oak Ridge National Laboratory Technology Logic Diagram. Volume 1, Technology Evaluation: Part B, Remedial Action

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision-support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration, testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1 (Technology Evaluation), Vol. 2 (Technology Logic Diagram), and Vol. 3 (Technology Evaluation Data Sheets). Part A of Vols. 1 and 2 focuses on D&D. Part B of Vols. 1 and 2 focuses on RA of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TLD, an explanation of the program-specific responsibilities, a review of identified technologies, and the ranking os remedial technologies. Volume 2 (Pts. A, B, and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A, B, and C) contains the TLD data sheets. The focus of Vol. 1, Pt. B, is RA, and it has been divided into six chapters. The first chapter is an introduction, which defines problems specific to the ER Program for ORNL. Chapter 2 provides a general overview of the TLD. Chapters 3 through 5 are organized into necessary subelement categories: RA, characterization, and robotics and automation. The final chapter contains regulatory compliance information concerning RA.

  20. Simulation Technology Laboratory Building 970 hazards assessment document

    International Nuclear Information System (INIS)

    Wood, C.L.; Starr, M.D.

    1994-11-01

    The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Simulation Technology Laboratory, Building 970. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distances at which a postulated facility event will produce consequences exceeding the ERPG-2 and Early Severe Health Effects thresholds are 78 and 46 meters, respectively. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 100 meters

  1. Clinical Simulation: A Protocol for Evaluation of Mobile Technology.

    Science.gov (United States)

    Mather, Carey; Jensen, Sanne; Cummings, Elizabeth

    2017-01-01

    For mobile technology to be accepted at point of care in healthcare environments there is a need to demonstrate benefits whilst ameliorating the risks and challenges. To provide a standardised approach to evaluation of mobile technology a simulation protocol was developed to provide guidance for its use in healthcare environments. Simulated conditions provide the opportunity to assess intended and unintended consequences and identify potential workarounds when using technology. The protocol can also be used to demonstrate the importance of the development of digital professionalism by end-users prior to students entering the clinical practice setting. The mobile technology protocol was adapted from a health information systems protocol developed and used at the ITX Lab, Denmark for use in other simulation laboratories. Use case scenarios were developed to enable evaluation of mobile technology for mobile learning of nurses, nurse supervisors, students and patients. The scenarios can be used in a range of simulated environments including hospital bedside, outpatient clinic or community settings. A case study exemplar of a nurse and patient is included to demonstrate how the mobile technology protocol can be applied.

  2. Student perceptions of the clinical laboratory science profession.

    Science.gov (United States)

    McClure, Karen

    2009-01-01

    The purpose of this paper is to describe the attitudes and perceptions among college biology and CLS/CLT students. These students were on selected college campuses at Texas universities in Houston, Dallas and the Austin/San Antonio areas for the Spring 2007 semester. Specifically, students were questioned on factors that influence their choice of field of study, career expectations, legislative measures which might be used to attract individuals to the career, and factors that will be required to keep them in the field of practice. This study was part of a larger qualitative study which included exploratory discovery and inductive logic regarding the attitudes of four focus groups in Texas. Focus groups took place on college campuses or in hotel conference rooms. (1) junior/senior-level college biology students and (2) junior/senior-level students currently enrolled in CLS/CLT programs. Focus group discussions using a standard set of questions; group sessions lasted about 45 minutes. This study was a qualitative study which included exploratory discovery and inductive logic regarding the attitudes of two groups in Texas. College biology and CLS/CLT students find the clinical laboratory science profession to be interesting and exciting as a career prospect, however, many do not see themselves remaining in the profession and perceive it does not have good prospects for career advancement. The majority of students must work to support themselves through their college education and would welcome additional grants, scholarships and loan forgiveness programs as incentives to study the clinical laboratory sciences. Students believe that additional recruitment on high school and college campuses is needed to increase the visibility of the field as career choice. The majority of students who are entering the clinical laboratory science profession do not see the profession as their final career choice, but rather a stepping stone to another career field in healthcare or a

  3. Introducing clinical laboratory science: CLS students help shape the future.

    Science.gov (United States)

    Sawyer, Barbara G; Hubbard, Joel; Rice-Spearman, Lori

    2006-01-01

    The profession of clinical laboratory science (CLS) is in dire need of increased exposure to young people. By introducing the clinical laboratory sciences to students at a critical point in their science education and by making it relevant to their lives, more choices are made available to them when considering future career options. With this in mind, the CLS faculty at Texas Tech University Health Sciences Center (TTUHSC) redesigned a recruitment program and developed it into one making use of CLS student knowledge, enthusiasm, and professionalism. CLS students were given the assignment of designing an entire curriculum for a ten day presentation of clinical laboratory science topics to middle and secondary school students. Following the presentations, participants in the program were asked to provide feedback regarding CLS student performance and overall opinion of their interest in clinical laboratory science. The objectives of this study were twofold: 1) to determine if educational methodologies could be appropriately applied by CLS students to present CLS disciplines to middle and high school students; and 2) to determine if the student presentation was successful in initiating interest in the CLS profession based on outcome measures. As a component of the CLS laboratory management course, CLS students were instructed in education methodologies including objective writing, teaching-unit preparation, and evaluation tool design. In the following semester, these students were divided into groups and assigned a specific CLS discipline that would then be presented to middle and secondary school students in a two week, 30 hour educational program. This program was offered by the TTUHSC CLS program in cooperation with the Institute for the Development and Enrichment of Advanced Learners (IDEAL) at Texas Tech University. The curriculum prepared by the CLS students (with faculty supervision) provided the framework for the present study. Didactic instruction of the CLS

  4. Development of excavation technologies at the Canadian underground research laboratory

    International Nuclear Information System (INIS)

    Kuzyk, Gregory W.; Martino, Jason B.

    2008-01-01

    Several countries, Canada being among them, are developing concepts for disposal of used fuel from power generating nuclear reactors. As in underground mining operations, the disposal facilities will require excavation of many kilometres of shafts and tunnels through the host rock mass. The need to maintain the stability of excavations and safety of workers will be of paramount importance. Also, excavations required for many radioactive waste repositories will ultimately need to be backfilled and sealed to maintain stability and minimize any potential for migration of radionuclides, should they escape their disposal containers. The method used to excavate the tunnels and shafts, and the rock damage that occurs due to excavation, will greatly affect the performance characteristics of repository sealing systems. The underground rock mechanics and geotechnical engineering work performed at the Canadian Underground Research Laboratory (URL) has led to the development of excavation technologies that reduce rock damage in subsurface excavations. This paper discusses the excavation methods used to construct the URL and their application in planning for the construction of similar underground laboratories and repositories for radioactive wastes. (author)

  5. Liposomal drug delivery system from laboratory to clinic

    Directory of Open Access Journals (Sweden)

    Kshirsagar N

    2005-01-01

    Full Text Available The main objective of drug delivery systems is to deliver a drug effectively, specifically to the site of action and to achieve greater efficacy and minimise the toxic effects compared to conventional drugs. Amongst various carrier systems, liposomes have generated a great interest because of their versatility. Liposomes are vesicular concentric bilayered structures, which are biocompatible, biodegradable and nonimmumnogenic. They can control the delivery of drugs by targeting the drug to the site of action or by site avoidance drug delivery or by prolonged circulation of drugs. Amphotericin B (Amp B remains the drug of choice in most systemic mycoses and also as a second line treatment for Kala azar. However, its toxic effects often limit its use. Although the liposome delivery system has been tried for several drugs, only a few have been used in patients due to the slow development of necessary large-scale pharmaceutical procedures. This paper reviews the development of the technique for liposomal Amphotericin B (L-Amp-LRC-1, FungisomeTM drug delivery system in our laboratory in collaboration with the department of Biochemistry, Delhi University in India and proving the safety and efficacy of this preparation in clinical practice. It also attempts to compare the efficacy and benefits of our product for Indian patients with those of similar products and it includes facts from the publications that flowed from our work. As compared to conventional Amp B, Fungisome is infused over a much shorter period requiring a smaller volume and no premedication. It was found to be safe in patients who had developed serious unacceptable toxicity with conventional Amp B. In renal transplant patients, Fungisome did not produce any nephrotoxicity. Fungisome is effective in fungal infections resistant to fluconazole, conventional Amp B and in virgin and resistant cases of visceral leishmaniasis. The cost of any drug is of great significance, especially in India

  6. Clinical, laboratorial and radiographic predictors of Bordetella pertussis infection

    Directory of Open Access Journals (Sweden)

    Camila Vieira Bellettini

    2014-12-01

    Full Text Available OBJECTIVE: To identify clinical, laboratorial and radiographic predictors for Bordetella pertussis infection.METHODS: This was a retrospective study, which analyzed medical records of all patients submitted to a molecular dignosis (qPCR for B. pertussis from September 2011 to January 2013. Clinical and laboratorial data were reviewed, including information about age, sex, signs/symptoms, length of hospitalization, blood cell counts, imaging findings, coinfection with other respiratory pathogens and clinical outcome.RESULTS: 222 cases were revised. Of these, 72.5% had proven pertussis, and 60.9% were under 1 year old. In patients aging up to six months, independent predictors for B. pertussisinfection were (OR 8.0, CI 95% 1.8-36.3; p=0.007 and lymphocyte count >104/µL (OR 10.0, CI 95% 1.8-54.5; p=0.008. No independent predictors of B. pertussisinfection could be determined for patients older than six months. Co-infection was found in 21.4% of patients, of which 72.7% were up to six months of age. Adenovirus was the most common agent (40.9%. In these patients, we were not able to identify any clinical features to detect patients presenting with a respiratory co-infection, even though longer hospital stay was observed in patients with co-infections (12 vs. 6 days; p=0.009.CONCLUSIONS: Cyanosis and lymphocytosis are independent predictors for pertussis in children up to 6 months old.

  7. Measurement uncertainty for clinical laboratories - a revision of the concept.

    Science.gov (United States)

    Dallas Jones, Graham Ross

    2016-08-01

    The uncertainty of a measurement result is a fundamental concept in metrology indicating the range within the "true" value of a measurement should lie. Although not commonly reported with results, the calculation of measurement uncertainty (MU) has become common in routine clinical laboratories. Interpretation of numerical pathology results is made by comparison with data from other measurements. As MU is aimed at assisting with result interpretation, it should be related to the specific comparison being made. There are three basic type of comparators: a previous result from the same patient, a population reference interval, or a clinical decision point. For each comparison, the "true" value is that which would have been obtained from the instrument used to make the comparator measurements if it was measured without uncertainty. The MU is the range of likely deviations from this true value due to the method used to produce the result under interpretation. For patient monitoring, if the two measurements were made on the same analyzer, the uncertainty is the imprecision of the assay over the relevant time frame. In comparing with a manufacturer-specific reference interval, the MU is deviation from the manufacturer's master calibrator. For clinical decision points produced with the assays traceable to international references, the MU is related to deviation from that reference standard. For optimal use of MU in the clinical laboratory, it may be necessary to consider the use of the test result and the concept of a single MU for each result may need to be revised.

  8. Histoplasmosis in a Brazilian center: clinical forms and laboratory tests.

    Science.gov (United States)

    Leimann, Beatriz Consuelo Quinet; Pizzini, Cláudia Vera; Muniz, Mauro Medeiros; Albuquerque, Priscila Carvalho; Monteiro, Paulo Cezar Fialho; Reis, Rosani Santos; Almeida-Paes, Rodrigo; Lazera, Márcia Santos; Wanke, Bodo; Pérez, Maurício Andrade; Zancopé-Oliveira, Rosely Maria

    2005-09-01

    Histoplasmosis, caused by the dimorphic fungus Histoplasma capsulatum, is endemic in many regions of the Americas, Asia and Africa. It has a wide spectrum of clinical manifestations, from asymptomatic infection to severe disseminated disease. A retrospective study was carried out to describe the clinical forms and assess the clinical significance of the laboratory diagnostic tests of patients with histoplasmosis during the period of July 1987 to December 2003 at Instituto de Pesquisa Clínica Evandro Chagas/ FIOCRUZ, RJ, Brazil. Seventy-four patients were included. Forty-nine percent of the cases (n = 36) occurred in HIV positive patients who presented with disseminated disease. The remaining 38 cases were classified in different clinical forms. Histoplasma capsulatum was isolated from 69.5% of the clinical specimens sent to culture. Immunodiffusion and immunoblot were positive in 72.6% and 100% of the performed tests, respectively. Histopathologic findings suggestive of H. capsulatum were found in 63.2% of the performed exams. Serology had a lower proportion of positivity amongst AIDS patients, when compared with HIV negative patients (X2 = 6.65; p lower than 0.008). Statistical differences between AIDS and non-AIDS patients were not observed with culture and histopathology. The specific role of each test varies according to the clinical form. Physicians need to know the value and limitations of the available diagnostic tests, but before that, they have to think about histoplasmosis and consider this clinical entity in their differential diagnosis.

  9. Incubator management in an assisted reproductive technology laboratory.

    Science.gov (United States)

    Higdon, H Lee; Blackhurst, Dawn W; Boone, William R

    2008-03-01

    To study the effect of incubator management on assisted reproductive technology (ART) outcomes. Series of retrospective and controlled, randomized studies. Tertiary care infertility practice. Mammalian gametes/embryos. Evaluation of human and bovine oocytes/embryos cultured in various environmental conditions. Fertilization and embryo development rate as well as clinical pregnancy rate (PR). Here we review the general topic of incubator management as it pertains to ART. Discussed within the context of this article will be our experiences as they relate to incubator management. Details as they apply to incubator environment also will include gamete/embryo positions within incubator, air quality, and quality control.

  10. Successful Implementation of Clinical Information Technology

    Science.gov (United States)

    Hill, V.; Bruner, K.; Maciaz, G.; Saucedo, L.; Catzoela, L.; Ramirez, R.; Jacobs, W.J.; Nguyen, P.; Patel, L.; Webster, S.L.

    2015-01-01

    Summary Objectives To identify and describe the most critical strategic and operational contributors to the successful implementation of clinical information technologies, as deployed within a moderate sized system of U.S. community hospitals. Background and Setting CHRISTUS Health is a multi-state system comprised of more than 350 services and 60 hospitals with over 9 000 physicians. The Santa Rosa region of CHRISTUS Health, located in greater San Antonio, Texas is comprised of three adult community hospital facilities and one Children’s hospital each with bed capacities of 142–180. Computerized Patient Order Entry (CPOE) was first implemented in 2012 within a complex market environment. The Santa Rosa region has 2 417 credentialed physicians and 263 mid-level allied health professionals. Methods This report focuses on the seven most valuable strategies deployed by the Health Informatics team in a large four hospital CHRISTUS region to achieve strong CPOE adoption and critical success lessons learned. The findings are placed within the context of the literature describing best practices in health information technology implementation. Results While the elements described involved discrete de novo process generation to support implementation and operations, collectively they represent the creation of a new customer-centric service culture in our Health Informatics team, which has served as a foundation for ensuring strong clinical information technology adoption beyond CPOE. Conclusion The seven success factors described are not limited in their value to and impact on CPOE adoption, but generalize to – and can advance success in – varied other clinical information technology implementations across diverse hospitals. A number of these factors are supported by reports in the literature of other institutions’ successful implementations of CPOE and other clinical information technologies, and while not prescriptive to other settings, may be adapted to yield

  11. Kikuchi-Fujimoto disease: Clinical and laboratory characteristics and outcome

    Directory of Open Access Journals (Sweden)

    P S Rakesh

    2014-01-01

    Full Text Available Introduction: Kikuchi-Fujimoto disease is an uncommon disorder with worldwide distribution, characterized by fever and benign enlargement of the lymph nodes, primarily affecting young adults. Awareness about this disorder may help prevent misdiagnosis and inappropriate investigations and treatment. The objective of the study was to evaluate the clinical and laboratory characteristics of histopathologically confirmed cases of Kikuchi′s disease from a tertiary care center in southern India. Materials and Methods: Retrospective analysis of all adult patients with histopathologically confirmed Kikuchi′s disease from January 2007 to December 2011 in a 2700-bed teaching hospital in South India was done. The clinical and laboratory characteristics and outcome were analyzed. Results: There were 22 histopathologically confirmed cases of Kikuchi′s disease over the 5-year period of this study. The mean age of the subjects′ was 29.7 years (SD 8.11 and majority were women (Male: female- 1:3.4. Apart from enlarged cervical lymph nodes, prolonged fever was the most common presenting complaint (77.3%. The major laboratory features included anemia (54.5%, increased erythrocyte sedimentation rate (31.8%, elevated alanine aminotransferase (27.2% and elevated lactate dehydrogenase (LDH (31.8%. Conclusion: Even though rare, Kikuchi′s disease should be considered in the differential diagnosis of young individuals, especially women, presenting with lymphadenopathy and prolonged fever. Establishing the diagnosis histopathologically is essential to avoid inappropriate investigations and therapy.

  12. Uses of internet technology in clinical practice

    International Nuclear Information System (INIS)

    Mansoor, I.

    2001-01-01

    The practice of medicine has extended itself to vast areas and requires active clinicians to systematize and organize their workload through the use of the most up-to-date digital and computer communication technologies. Computerization and worldwide accessibility of information has especially provided great assistance in this regard. The explosive growth of medical information increases the need for the use of these new methods of organizing and accessing data. This article briefly summarizes a few of the vital tools that internet technology has provided clinical practice, with the aid of basic concepts of internet, database systems, hospital systems and data security and reliability. (author)

  13. Laboratory hematology in the history of Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Hoffmann, Johannes J M L

    2013-01-01

    For the occasion of the 50th anniversary of the journal Clinical Chemistry and Laboratory Medicine (CCLM), an historic overview of papers that the journal has published in the field of laboratory hematology (LH) is presented. All past volumes of CCLM were screened for papers on LH and these were categorized. Bibliographic data of these papers were also analyzed. CCLM published in total 387 LH papers. The absolute number of LH papers published annually showed a significant increase over the years since 1985. Also the share of LH papers demonstrated a steady increase (overall mean 5%, but mean 8% over the past 4 years). The most frequent category was coagulation and fibrinolysis (23.5%). Authors from Germany contributed the most LH papers to the journal (22.7%), followed by the Netherlands and Italy (16.3 and 13.2%, respectively). Recent citation data indicated that other publications cited LH review papers much more frequently than other types of papers. The history of the journal reflects the emergence and development of laboratory hematology as a separate discipline of laboratory medicine.

  14. Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

    Science.gov (United States)

    Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

    2014-12-01

    The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

  15. Advanced robotic technologies for transfer at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, P.C.

    1994-10-01

    Hazardous operations which have in the past been completed by technicians are under increased scrutiny due to high costs and low productivity associated with providing protective clothing and environments. As a result, remote systems are needed to accomplish many hazardous materials handling tasks such as the clean-up of waste sites in which the exposure of personnel to radiation, chemical, explosive and other hazardous constituents is unacceptable. Computer models augmented by sensing, and structured, modular computing environments are proving effective in automating many unstructured hazardous tasks. Work at Sandia National Laboratories (SNL) has focused on applying flexible automation (robotics) to meet the needs of the U.S. Department of Energy (USDOE). Dismantling facilities, environmental remediation, and materials handling in changing, hazardous environments lead to many technical challenges. Computer planning, monitoring and operator assistance shorten training cycles, reduce errors, and speed execution of operations. Robotic systems that re-use well-understood generic technologies can be much better characterized than robotic systems developed for a particular application, leading to a more reliable and safer systems. Further safety in robotic operations results from use of environmental sensors and knowledge of the task and environment. Collision detection and avoidance is achieved from such sensor integration and model-based control. This paper discusses selected technologies developed at SNL for use within the USDOE complex that have been or are ready for transfer to government and industrial suppliers. These technologies include sensors, sub-systems, and the design philosophy applied to quickly integrate them into a working robotic system. This paper represents the work of many people at the Intelligent Systems and Robotics Center at SNL, to whom the credit belongs.

  16. Advanced robotic technologies for transfer at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Bennett, P.C.

    1994-01-01

    Hazardous operations which have in the past been completed by technicians are under increased scrutiny due to high costs and low productivity associated with providing protective clothing and environments. As a result, remote systems are needed to accomplish many hazardous materials handling tasks such as the clean-up of waste sites in which the exposure of personnel to radiation, chemical, explosive and other hazardous constituents is unacceptable. Computer models augmented by sensing, and structured, modular computing environments are proving effective in automating many unstructured hazardous tasks. Work at Sandia National Laboratories (SNL) has focused on applying flexible automation (robotics) to meet the needs of the U.S. Department of Energy (USDOE). Dismantling facilities, environmental remediation, and materials handling in changing, hazardous environments lead to many technical challenges. Computer planning, monitoring and operator assistance shorten training cycles, reduce errors, and speed execution of operations. Robotic systems that re-use well-understood generic technologies can be much better characterized than robotic systems developed for a particular application, leading to a more reliable and safer systems. Further safety in robotic operations results from use of environmental sensors and knowledge of the task and environment. Collision detection and avoidance is achieved from such sensor integration and model-based control. This paper discusses selected technologies developed at SNL for use within the USDOE complex that have been or are ready for transfer to government and industrial suppliers. These technologies include sensors, sub-systems, and the design philosophy applied to quickly integrate them into a working robotic system. This paper represents the work of many people at the Intelligent Systems and Robotics Center at SNL, to whom the credit belongs

  17. Environmental Audit at Santa Barbara Operations, Special Technologies Laboratory, Remote Sensing Laboratory, North Las Vegas Facilities

    International Nuclear Information System (INIS)

    1991-03-01

    This report documents the results of the Environmental Audit of selected facilities under the jurisdiction of the DOE Nevada Operations Office (NV) that are operated by EG and G Energy Measurements, Incorporated (EG and G/EM). The facilities included in this Audit are those of Santa Barbara Operation (SBO) at Goleta, California; the Special Technologies Laboratory (STL) at Santa Barbara, California; and Las Vegas Area Operations (LVAO) including the Remote Sensing Laboratory (RSL) at Nellis Air Force Base in Nevada, and the North Las Vegas Facilities (NLVF) at North Las Vegas, Nevada. The Environmental Audit was conducted by the US Department of Energy's (DOE) Office of Environmental Audit, commencing on January 28, 1991 and ending on February 15, 1991. The scope of the Audit was comprehensive, addressing environmental activities in the technical areas of air, surface water/drinking water, groundwater, waste management, toxic and chemical materials, quality assurance, radiation, inactive waste sites, and environmental management. Also assessed was compliance with applicable Federal, state, and local regulations and requirements; internal operating requirements; DOE Orders; and best management practices. 8 tabs

  18. On the improvement of blood sample collection at clinical laboratories.

    Science.gov (United States)

    Grasas, Alex; Ramalhinho, Helena; Pessoa, Luciana S; Resende, Mauricio G C; Caballé, Imma; Barba, Nuria

    2014-01-09

    Blood samples are usually collected daily from different collection points, such hospitals and health centers, and transported to a core laboratory for testing. This paper presents a project to improve the collection routes of two of the largest clinical laboratories in Spain. These routes must be designed in a cost-efficient manner while satisfying two important constraints: (i) two-hour time windows between collection and delivery, and (ii) vehicle capacity. A heuristic method based on a genetic algorithm has been designed to solve the problem of blood sample collection. The user enters the following information for each collection point: postal address, average collecting time, and average demand (in thermal containers). After implementing the algorithm using C programming, this is run and, in few seconds, it obtains optimal (or near-optimal) collection routes that specify the collection sequence for each vehicle. Different scenarios using various types of vehicles have been considered. Unless new collection points are added or problem parameters are changed substantially, routes need to be designed only once. The two laboratories in this study previously planned routes manually for 43 and 74 collection points, respectively. These routes were covered by an external carrier company. With the implementation of this algorithm, the number of routes could be reduced from ten to seven in one laboratory and from twelve to nine in the other, which represents significant annual savings in transportation costs. The algorithm presented can be easily implemented in other laboratories that face this type of problem, and it is particularly interesting and useful as the number of collection points increases. The method designs blood collection routes with reduced costs that meet the time and capacity constraints of the problem.

  19. Detection of intestinal protozoa in the clinical laboratory.

    Science.gov (United States)

    McHardy, Ian H; Wu, Max; Shimizu-Cohen, Robyn; Couturier, Marc Roger; Humphries, Romney M

    2014-03-01

    Despite recent advances in diagnostic technology, microscopic examination of stool specimens remains central to the diagnosis of most pathogenic intestinal protozoa. Microscopy is, however, labor-intensive and requires a skilled technologist. New, highly sensitive diagnostic methods have been developed for protozoa endemic to developed countries, including Giardia lamblia (syn. G. intestinalis/G. duodenalis) and Cryptosporidium spp., using technologies that, if expanded, could effectively complement or even replace microscopic approaches. To date, the scope of such novel technologies is limited and may not include common protozoa such as Dientamoeba fragilis, Entamoeba histolytica, or Cyclospora cayetanensis. This minireview describes canonical approaches for the detection of pathogenic intestinal protozoa, while highlighting recent developments and FDA-approved tools for clinical diagnosis of common intestinal protozoa.

  20. Quality Management Systems in the Clinical Laboratories in Latin America

    Science.gov (United States)

    2015-01-01

    The implementation of management systems in accordance with standards like ISO 9001:2008 (1,2) in the clinical laboratories has conferred and added value of reliability and therefore a very significant input to patient safety. As we know the ISO 9001:2008 (1) a certification standard, and ISO 15189:2012 (2) an accreditation standard, both, at the time have generated institutional memory where they have been implemented, the transformation of culture focused on correct execution, control and following, evidence needed and the importance of register. PMID:27683495

  1. Clinical and Laboratory Characteristics of Leishmaniasis in Armenia

    Directory of Open Access Journals (Sweden)

    A.L. Kazinian

    2014-11-01

    Full Text Available This work presents the clinical and laboratory characteristics of visceral leishmaniasis according to the data from Clinical hospital of infectious diseases «Nork» in Yerevan for 2013. It is shown that Armenia is a country endemic for visceral leishmaniasis. Most patients (81 % were males. About half of the patients were young children (up to 2 years. It was found that the majority of patients had acute onset of the disease with fever up to 40 °C, severe symptoms of intoxication and single hemorrhages on the skin. Enlargement of the liver and spleen was noted in all patients. The enlargement of the spleen was more pronounced, and it reached the level of the pelvis. One of the cardinal symptoms of visceral leishmaniasis — anemia — developed in all patients admitted to the hospital, and a significant change in the hemogram was observed in young children.

  2. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Science.gov (United States)

    Hoda, Syed T.; Crawford, James M.

    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 institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates. PMID:28725766

  3. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Directory of Open Access Journals (Sweden)

    Arvind Rishi MD

    2016-05-01

    Full Text Available 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 institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9 felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

  4. [Laboratory unification: advantages and disadvantages for clinical microbiology].

    Science.gov (United States)

    Andreu, Antonia; Matas, Lurdes

    2010-10-01

    This article aims to reflect on which areas or tasks of microbiology laboratories could be unified with those of clinical biochemistry, hematology, immunology or pathology laboratories to benefit patients and the health system, as well as the areas that should remain independent since their amalgamation would not only fail to provide a benefit but could even jeopardize the quality of microbiological diagnosis, and consequently patient care. To do this, the distinct analytic phases of diagnosis are analyzed, and the advantages and disadvantages of amalgamation are evaluated in each phase. The pros and cons of the unification of certain areas such as the computer system, occupational risk units, customer service, purchasing logistics, and materials storage, etc, are also discussed. Lastly, the effect of unification on urgent microbiology diagnosis is analyzed. Microbiological diagnosis should be unique. The microbiologist should perform an overall evaluation of the distinct techniques used for a particular patient, both those that involve direct diagnosis (staining, culture, antigen detection techniques or molecular techniques) and indirect diagnosis (antibody detection). Moreover, the microbiology laboratory should be independent, with highly trained technicians and specialists in microbiology that provide added value as experts in infection and as key figures in the process of establishing a correct etiological diagnosis. Copyright © 2010 Elsevier España S.L. All rights reserved.

  5. Applications of mid-infrared spectroscopy in the clinical laboratory setting.

    Science.gov (United States)

    De Bruyne, Sander; Speeckaert, Marijn M; Delanghe, Joris R

    2018-01-01

    Fourier transform mid-infrared (MIR-FTIR) spectroscopy is a nondestructive, label-free, highly sensitive and specific technique that provides complete information on the chemical composition of biological samples. The technique both can offer fundamental structural information and serve as a quantitative analysis tool. Therefore, it has many potential applications in different fields of clinical laboratory science. Although considerable technological progress has been made to promote biomedical applications of this powerful analytical technique, most clinical laboratory analyses are based on spectroscopic measurements in the visible or ultraviolet (UV) spectrum and the potential role of FTIR spectroscopy still remains unexplored. In this review, we present some general principles of FTIR spectroscopy as a useful method to study molecules in specimens by MIR radiation together with a short overview of methods to interpret spectral data. We aim at illustrating the wide range of potential applications of the proposed technique in the clinical laboratory setting with a focus on its advantages and limitations and discussing the future directions. The reviewed applications of MIR spectroscopy include (1) quantification of clinical parameters in body fluids, (2) diagnosis and monitoring of cancer and other diseases by analysis of body fluids, cells, and tissues, (3) classification of clinically relevant microorganisms, and (4) analysis of kidney stones, nails, and faecal fat.

  6. Client/Server computing: is this the future direction for the clinical laboratory?

    Science.gov (United States)

    Wells, I G; Farnan, L P; Rayment, M W

    1996-04-15

    One of the major trends in computing for the 1990s is the move towards distributed systems based on Client/Server architecture. Although a recent survey has suggested that some 41% of the major companies in the UK are either using or planning to adopt this new technology, there is little evidence at present of similar progress in the field of clinical laboratory computing. The Pathology Laboratories at St. Luke's Hospital have been developing in-house computer systems using object-oriented software tools since 1988, but these were initially based on conventional file sharing and suffered from poor performance under load. The conversion to Client/Server took place in March 1993 and the results have either met or exceeded all expectations. Our experience suggests that this approach may well be the way forward for the high performance but user-friendly laboratory systems of the future.

  7. Nanotechnology Laboratory Continues Partnership with FDA and National Institute of Standards and Technology | Poster

    Science.gov (United States)

    The NCI-funded Nanotechnology Characterization Laboratory (NCL)—a leader in evaluating promising nanomedicines to fight cancer—recently renewed its collaboration with the U.S. Food and Drug Administration (FDA) and the National Institute of Standards and Technology (NIST) to continue its groundbreaking work on characterizing nanomedicines and moving them toward the clinic. In partnership with NIST and the FDA, NCL has laid a solid, scientific foundation for using the power of nanotechnology to increase the potency and target the delivery

  8. Multidimensional Dyspnea Profile: an instrument for clinical and laboratory research.

    Science.gov (United States)

    Banzett, Robert B; O'Donnell, Carl R; Guilfoyle, Tegan E; Parshall, Mark B; Schwartzstein, Richard M; Meek, Paula M; Gracely, Richard H; Lansing, Robert W

    2015-06-01

    There is growing awareness that dyspnoea, like pain, is a multidimensional experience, but measurement instruments have not kept pace. The Multidimensional Dyspnea Profile (MDP) assesses overall breathing discomfort, sensory qualities, and emotional responses in laboratory and clinical settings. Here we provide the MDP, review published evidence regarding its measurement properties and discuss its use and interpretation. The MDP assesses dyspnoea during a specific time or a particular activity (focus period) and is designed to examine individual items that are theoretically aligned with separate mechanisms. In contrast, other multidimensional dyspnoea scales assess recalled recent dyspnoea over a period of days using aggregate scores. Previous psychophysical and psychometric studies using the MDP show that: 1) subjects exposed to different laboratory stimuli could discriminate between air hunger and work/effort sensation, and found air hunger more unpleasant; 2) the MDP immediate unpleasantness scale (A1) was convergent with common dyspnoea scales; 3) in emergency department patients, two domains were distinguished (immediate perception, emotional response); 4) test-retest reliability over hours was high; 5) the instrument responded to opioid treatment of experimental dyspnoea and to clinical improvement; 6) convergent validity with common instruments was good; and 7) items responded differently from one another as predicted for multiple dimensions. Copyright ©ERS 2015.

  9. Transmission of hepatitis B virus in clinical laboratory areas.

    Science.gov (United States)

    Lauer, J L; VanDrunen, N A; Washburn, J W; Balfour, H H

    1979-10-01

    The transmission of hepatitis B virus (HBV) in clinical laboratory areas was delineated by the use of hepatitis B surface antigen (HBsAg) as presumptive evidence for the presence of the infective agent. Twenty-six (34%) of 76 environmental surfaces sampled were positive for HBsAg. The outer surfaces of blood- and serum-specimen containers had HBsAg contamination rates of 55% (six of 11) and 44% (four of nine), respectively. Subsequent handling of pipetting aids, marking devices, and other items led to their contamination and further dissemination of HBsAg. An assay instrument for complete determinations of blood cell counts was observed to splatter and drip blood during its operation. The contamination rate for environmental surfaces associated with this instrument was 15%. The data indicate that transmission of HBV in the clinical laboratory is subtle and mainly via hand contact with contaminated items during the various steps of blood processing. These data support the concept that the portal of entry of HBV is through inapparent breaks in skin and mucous membranes.

  10. Using cooperative learning in clinical laboratory science education.

    Science.gov (United States)

    Bose, Mary J; Jarreau, Patsy C; Lawrence, Louann W; Snyder, Patricia

    2004-01-01

    To compare performance of students instructed by cooperative learning (CL) activities with those taught by lecture. A secondary objective was to assess students' perceptions about their ability to work in teams before and after their exposure to these instructional approaches. CL was incorporated into the immunology/serology course of a university-based clinical laboratory science (CLS) program. Twenty-two students participated in a 4-week study and were randomly assigned to one of two study groups. One group received the course material by CL activities, and the other group was exposed to the material through lecture. Mean examination scores for CL and lecture groups were compared using an independent samples t-test. Teamwork knowledge, skills, and attitude (KSA) assessment rated students' perceptions of their ability to work in a team environment pre and post tests were compared using a 2 x 2 repeated measures ANOVA. No significant difference was found between mean examination scores of students who acquired their knowledge by CL activities (85.09%) and those taught by lecture (82.18%). Teamwork KSA means scores pre and post tests (22.5, 22.6 CL; 22.7, 21.6 lecture) were not significantly different. Results suggest that the incorporation of CL activities did not reduce the students' academic performance or self-perceptions of their ability to work in teams. The use of CL in the classroom, student laboratory, or clinical setting may help prepare students for the role they will be expected to perform as laboratory professionals.

  11. Clinical and Laboratory Findings in Various Reasons of Thrombocytopenia

    Directory of Open Access Journals (Sweden)

    Serkan Akin

    2017-12-01

    Full Text Available Background: Thrombocytopenia is an important cause of bleeding. Different clinical conditions associated with thrombocytopenia and their reflections to the hemostatic table will be examined in this study. Methods: A total of 100 patients with thrombocytopenia who were treated in Hacettepe University between 1993 and 2013, 29 with thrombotic thrombocytopenic purpura (TTP, 36 with immune thrombocytopenic purpura (ITP, and 35 with aplastic anemia (AA, were included in the study. Clinical features and laboratory values were reviewed. Results: Thrombosis, fever, and sepsis were more frequently seen in TTP. The most common bleeding type was subcutaneous bleeding in all patient groups. Among patients with TTP, twenty-five patients (86, 2% had fever, 26 patients (89, 7% had a neurologic disorder, and 16 patients (55, 1% had renal dysfunction. Regarding the diagnostic criteria of TTP, 13 patients (44, 8% met five, 12 (41, 4% patients met four and 4 (13, 8% patients met three criteria. The median session of plasmapheresis was 17 (range; 2-127. There was no relation between session count and remission (p=0.28. Conclusion: The severity of clinical presentation and underlying disorders are the most important points with which to approach patients with thrombocytopenia. Clinical reflections may help to identify the cause of thrombocytopenia but not sufficiently demonstrative for diagnosis. [J Contemp Med 2017; 7(4.000: 316-322

  12. Integration of tablet technologies in the e-laboratory of cytology: a health technology assessment.

    Science.gov (United States)

    Giansanti, Daniele; Pochini, Marco; Giovagnoli, Maria Rosaria

    2014-10-01

    Although tablet systems are becoming a powerful technology, particularly useful in every application of medical imaging, to date no one has investigated the acceptance and performance of this technology in digital cytology. The specific aims of the work were (1) to design a health technology assessment (HTA) tool to assess, in terms of performance and acceptance, the introduction of tablet technologies (wearable, portable, and non portable) in the e-laboratories of cytology and (2) to test the tool in a first significant application of digital cytology. An HTA tool was proposed operating on a domain of five dimensions of investigation comprising the basic information of the product of digital cytology, the perceived subjective quality of images, the assessment of the virtual navigation on the e-slide, the assessment of the information and communication technologies features, and the diagnostic power. Six e-slides regarding studies of cervicovaginal cytology digitalized by means of an Aperio ( www.aperio.com ) scanner and uploaded onto the www.digitalslide.it Web site were used for testing the methodology on three different network connections. Three experts of cytology successfully tested the methodology on seven tablets found suitable for the study in their own standard configuration. Specific indexes furnished by the tool indicated both a high degree of performance and subjective acceptance of the investigated technology. The HTA tool thus could be useful to investigate new tablet technologies in digital cytology and furnish stakeholders with useful information that may help them make decisions involving the healthcare system. From a global point of view the study demonstrates the feasibility of using the tablet technology in digital cytology.

  13. Innovative technology summary report: Road Transportable Analytical Laboratory (RTAL)

    International Nuclear Information System (INIS)

    1998-10-01

    The Road Transportable Analytical Laboratory (RTAL) has been used in support of US Department of Energy (DOE) site and waste characterization and remediation planning at Fernald Environmental Management Project (FEMP) and is being considered for implementation at other DOE sites, including the Paducah Gaseous Diffusion Plant. The RTAL laboratory system consists of a set of individual laboratory modules deployable independently or as an interconnected group to meet each DOE site's specific analysis needs. The prototype RTAL, deployed at FEMP Operable Unit 1 Waste Pits, has been designed to be synergistic with existing analytical laboratory capabilities, thereby reducing the occurrence of unplanned rush samples that are disruptive to efficient laboratory operations

  14. MODERN CLINICAL AND LABORATORY FEATURES OF ENTEROVIRAL MENINGITIS

    Directory of Open Access Journals (Sweden)

    O. V. Usacheva

    2014-04-01

    Full Text Available Among numerous viral meningitises from 80% to 90% of cases are accounted for meningitis of enteroviral etiology according to the international data. Despite the favorable disease course, there are forms which are characterized by severe damage of CNS. In order to improve diagnostics of enteroviral meningitis in this article we have made a comparative analysis of clinical and laboratory parameters in 23 patients with enteroviral meningitis and 18 patients with serous meningitis of non-enteroviral etiology. Anamnesis data and the major clinical manifestations of the disease dynamics were analyzed. Particular attention is paid to the comparison of diagnoses, by which patients were sent to infectious hospital, the symptoms that occurred during patients’ admission into hospitals and their severity. The presence and severity of meningeal symptoms and the indices of cerebrospinal fluid in the patients of the comparison group were analyzed in detail. It is shown that enteroviruses are the important factor in the development of meningitis in the children of younger age. The clinical picture of enteroviral meningitis often develops gradually for 2-3 days and includes the typical syndromes: intoxication and meningeal ones. Every third patient with enterovirus infection has diarrhea and catarrhal symptoms, that’s why it is difficult to diagnose meningitis in its early stages, but it allows to assume enteroviral etiology of the disease. The meningitis of enteroviral etiology is characterized by multiple meningeal signs, while the non-enteroviral meningitis is characterized by dissociation with the prevalence of the of Kernig’s and Brudzinski’s symptoms. The analysis of the laboratory data showed that the enteroviral meningitis is characterized by low (over 50-100 cells "mixed" pleocytosis (the ratio of lymphocytes and neutrophils is about 1:1. These data can be used for differential diagnosis between enteroviral meningitis and serous meningitis of

  15. Lean-Agile Adaptations in Clinical Laboratory Accredited ISO 15189

    Directory of Open Access Journals (Sweden)

    Carlos Vilaplana Pérez

    2015-12-01

    Full Text Available It’s introduced Lean techniques in a Clinical Laboratory to improve the operability and the efficiency in continuous processes of analysis, failsafe systems, analysis of areas of value pursuit of zero defects and reduction of waste, and it promote continuous improvement in presented difficulties in adapting to the changing needs of the healthcare environment. Whereas it is necessary to incorporate certification and accreditation, note that the adaptability of the clinical laboratory to the changing needs of physicians in obtaining analytical information is reduced. The application of an agile methodology on analytical systems can provide a line of work that allows the incorporation of planning short work cycles on equips quickly with operational autonomy on the basis of demand and respecting the accreditation requirements and flexibility to ensure adequate performance as the intercomparison of results from the different units analytics, analytical quality and turnaround times. Between 2012 and 2014, a process of analysis and improvement was applied to circuits, a 5 s system, transportation of samples, inventory of reactive and samples, motion of personal and samples, reductions of waiting and delays, overproduction, over processing, and defects of results and reports. At last it seems necessary to apply the Agile methodology to adapt to the evolving necessities in time and the different origins of the samples. It’s have used modular systems where the modules of this study are programmed with immunoassay techniques and it has reduced the operative modules depending on the required activity, ensuring the goals of turnaround times, analytic quality, service, health care continuity, and keeping up with the ISO 15189 accreditation requirements. The results of applying the concept of Lean-Agile to a modular system allows us to reduce the associated costs to the seasonal variation of the health care demand and to adapt the system to the changes on

  16. Oak Ridge National Laboratory Technology Logic Diagram. Volume 1, Technology Evaluation: Part A, Decontamination and Decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Strategic Roadmap for the Oak Ridge Reservation is a generalized planning document that identifies broad categories of issues that keep ORNL outside full compliance with the law and other legally binding agreements. Possible generic paths to compliance, issues, and the schedule for resolution of the issues one identified. The role of the Oak Ridge National Laboratory Technology Logic Diagram (TLD) is then to identify specific site issues (problems), identify specific technologies that can be brought to bear on the issues, and assess the current status and readiness of these remediation technologies within the constraints of the schedule commitment. Regulatory requirements and commitments contained in the Strategic Roadmap for the Oak Ridge Reservation are also included in the TLD as constraints to the application of immature technological solutions. Some otherwise attractive technological solutions may not be employed because they may not be deployable on the schedule enumerated in the regulatory agreements. The roadmap for ORNL includes a list of 46 comprehensive logic diagrams for WM of low-level, radioactive-mixed, hazardous, sanitary and industrial. and TRU waste. The roadmapping process gives comparisons of the installation as it exists to the way the installation should exist under full compliance. The identification of the issues is the goal of roadmapping. This allows accurate and timely formulation of activities.

  17. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

    OpenAIRE

    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

    2013-01-01

    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bac...

  18. TECHNOLOGY TRANSFER: Several Factors Have Led to a Decline in Partnerships at DOE's Laboratories

    National Research Council Canada - National Science Library

    2002-01-01

    Since 1980, the Congress has enacted several laws designed to make federally funded technology available to the public by facilitating the transfer of technology from federal laboratories to U.S. businesses...

  19. Review of clinical and laboratory features of human Brucellosis

    Directory of Open Access Journals (Sweden)

    Mantur B

    2007-01-01

    Full Text Available Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on

  20. Review of clinical and laboratory features of human brucellosis.

    Science.gov (United States)

    Mantur, B G; Amarnath, S K; Shinde, R S

    2007-07-01

    Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on experience gained > 30

  1. Ion beam therapy fundamentals, technology, clinical applications

    CERN Document Server

    2012-01-01

    The book provides a detailed, up-to-date account of the basics, the technology, and the clinical use of ion beams for radiation therapy. Theoretical background, technical components, and patient treatment schemes are delineated by the leading experts that helped to develop this field from a research niche to its current highly sophisticated and powerful clinical treatment level used to the benefit of cancer patients worldwide. Rather than being a side-by-side collection of articles, this book consists of related chapters. It is a common achievement by 76 experts from around the world. Their expertise reflects the diversity of the field with radiation therapy, medical and accelerator physics, radiobiology, computer science, engineering, and health economics. The book addresses a similarly broad audience ranging from professionals that need to know more about this novel treatment modality or consider to enter the field of ion beam therapy as a researcher. However, it is also written for the interested public an...

  2. Autoimmune thyroiditis goitrogenic. Aspects of clinical and laboratorial diagnostic

    International Nuclear Information System (INIS)

    Costa, H.F.Z. da.

    1986-01-01

    To asses the accuracy achieved by the A.C.A.T. and other clinical and laboratorial criterion in the diagnoses of T.A.I.B. we investigated twenty patients with goiter and antimicrossomal antibodies titres of 1/1.600 or more. Analysing the parameters useful in the diagnosis, we found a significant correlation between the antimicrossomal antibodies titres and the basal TSH concentration, an elevated basal TSH and an exaggerated response to TRH independent of the patient clinical status reflecting in the majority of the cases a state of subclinical hypotyroidism; an irregular appearance of the radioisotope thyroid scan and a positive response to a perchlorate discharge test. We conclude that from the parameters useful in the T.A.I.B. diagnosis, the A.C.A.T. detection mainly the antimicrossomal antibodies, is an excellent tool to detect patients with a clinical suspect of thyroid auto-immune disease and when we found high tires in a patient with goiter and an elevated basal TSH concentration we can suggest T.A.I.B. diagnosis. (author)

  3. Glycogen storage disease type I: clinical and laboratory profile

    Directory of Open Access Journals (Sweden)

    Berenice L. Santos

    2014-12-01

    Full Text Available OBJECTIVES: To characterize the clinical, laboratory, and anthropometric profile of a sample of Brazilian patients with glycogen storage disease type I managed at an outpatient referral clinic for inborn errors of metabolism. METHODS: This was a cross-sectional outpatient study based on a convenience sampling strategy. Data on diagnosis, management, anthropometric parameters, and follow-up were assessed. RESULTS: Twenty-one patients were included (median age 10 years, range 1-25 years, all using uncooked cornstarch therapy. Median age at diagnosis was 7 months (range, 1-132 months, and 19 patients underwent liver biopsy for diagnostic confirmation. Overweight, short stature, hepatomegaly, and liver nodules were present in 16 of 21, four of 21, nine of 14, and three of 14 patients, respectively. A correlation was found between height-for-age and BMI-for-age Z-scores (r = 0.561; p = 0.008. CONCLUSIONS: Diagnosis of glycogen storage disease type I is delayed in Brazil. Most patients undergo liver biopsy for diagnostic confirmation, even though the combination of a characteristic clinical presentation and molecular methods can provide a definitive diagnosis in a less invasive manner. Obesity is a side effect of cornstarch therapy, and appears to be associated with growth in these patients.

  4. Glycogen storage disease type I: clinical and laboratory profile.

    Science.gov (United States)

    Santos, Berenice L; Souza, Carolina F M de; Schuler-Faccini, Lavinia; Refosco, Lilia; Epifanio, Matias; Nalin, Tatiele; Vieira, Sandra M G; Schwartz, Ida V D

    2014-01-01

    To characterize the clinical, laboratory, and anthropometric profile of a sample of Brazilian patients with glycogen storage disease type I managed at an outpatient referral clinic for inborn errors of metabolism. This was a cross-sectional outpatient study based on a convenience sampling strategy. Data on diagnosis, management, anthropometric parameters, and follow-up were assessed. Twenty-one patients were included (median age 10 years, range 1-25 years), all using uncooked cornstarch therapy. Median age at diagnosis was 7 months (range, 1-132 months), and 19 patients underwent liver biopsy for diagnostic confirmation. Overweight, short stature, hepatomegaly, and liver nodules were present in 16 of 21, four of 21, nine of 14, and three of 14 patients, respectively. A correlation was found between height-for-age and BMI-for-age Z-scores (r=0.561; p=0.008). Diagnosis of glycogen storage disease type I is delayed in Brazil. Most patients undergo liver biopsy for diagnostic confirmation, even though the combination of a characteristic clinical presentation and molecular methods can provide a definitive diagnosis in a less invasive manner. Obesity is a side effect of cornstarch therapy, and appears to be associated with growth in these patients. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Abnormalities of laboratory coagulation tests versus clinically evident coagulopathic bleeding

    DEFF Research Database (Denmark)

    Chang, Ronald; Fox, Erin E; Greene, Thomas J

    2018-01-01

    BACKGROUND: Laboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described. METHODS: Prospective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma...... centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-. We used a mixed-effects, Poisson regression with robust error variance to test the hypothesis...... that abnormalities on rapid thrombelastography (r-TEG) and international normalized ratio (INR) were independently associated with CC+. RESULTS: Of 1,019 highest-risk patients, CC+ (n=41, 4%) were more severely injured (median ISS 32 vs 17), had evidence of LC on r-TEG and INR, received more transfused blood...

  6. Biocarbon urinary conduit: laboratory experience and clinical applications.

    Science.gov (United States)

    Kobashi, L I; Raible, D A

    1980-07-01

    A new urinary conduit utilizing pure vitreous carbon has been used successfully in dogs. Pure carbon appears to be inert with respect to urine and urothelium. Lack of urinary salt encrustation on the exposed surface provides a well-functioning urinary conduit for vesical drainage. Twenty-one vesicostomies were performed in dogs. Careful follow-up and histologic studies of removed specimens were done to establish the biocompatibility of pure carbon. All vesicostomies functioned well. A description of the device, protocol, and results of laboratory experimentation are outlined. The surgical procedure is explained in detail. Results encourage the clinical trial of these devices in humans. Indications include patients with neurogenic vesicla dysfunction and those with total urinary incontinence, both of which require permanent indwelling catheters.

  7. Clinical and laboratory factors associated with mortality in dengue.

    Science.gov (United States)

    Saroch, Atul; Arya, Vivek; Sinha, Nitin; Taneja, R S; Sahai, Pooja; Mahajan, R K

    2017-04-01

    Dengue is endemic in more than 100 countries, giving rise to an increased number of deaths in the last five years in the South-East Asian region. We report our findings from a retrospective study of adults admitted with confirmed dengue at our institution. We studied the clinical and laboratory parameters associated with mortality in these patients. Of the 172 hospitalised patients studied, 156 (90.69 %) recovered while 16 (9.3%) died. Univariate analysis showed altered sensorium on presentation, lower haemoglobin and haematocrit levels, higher serum creatinine, higher serum transaminase and lower serum albumin levels to be significantly associated with mortality in dengue. Further, using stepwise multivariate logistic regression, altered sensorium ( P = 0.006) and hypoalbuminemia ( P = 0.013) were identified as independent predictors of mortality in dengue. Identification of these parameters early in the course of disease should prompt intensification of treatment in dengue cases.

  8. Use of the National Committee for Clinical Laboratory Standards Guidelines for Disk Diffusion Susceptibility Testing in New York State Laboratories

    Science.gov (United States)

    Kiehlbauch, Julia A.; Hannett, George E.; Salfinger, Max; Archinal, Wendy; Monserrat, Catherine; Carlyn, Cynthia

    2000-01-01

    Accurate antimicrobial susceptibility testing is vital for patient care and surveillance of emerging antimicrobial resistance. The National Committee for Clinical Laboratory Standards (NCCLS) outlines generally agreed upon guidelines for reliable and reproducible results. In January 1997 we surveyed 320 laboratories participating in the New York State Clinical Evaluation Program for General Bacteriology proficiency testing. Our survey addressed compliance with NCCLS susceptibility testing guidelines for bacterial species designated a problem (Staphylococcus aureus and Enterococcus species) or fastidious (Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae) organism. Specifically, we assessed compliance with guidelines for inoculum preparation, medium choice, number of disks per plate, and incubation conditions for disk diffusion tests. We also included length of incubation for S. aureus and Enterococcus species. We found overall compliance with the five characteristics listed above in 80 of 153 responding laboratories (50.6%) for S. aureus and 72 of 151 (47.7%) laboratories for Enterococcus species. The most common problem was an incubation time shortened to less than 24 h. Overall compliance with the first four characteristics was reported by 92 of 221 (41.6%) laboratories for S. pneumoniae, 49 of 163 (30.1%) laboratories for H. influenzae, and 11 of 77 (14.3%) laboratories for N. gonorrhoeae. Laboratories varied from NCCLS guidelines by placing an excess number of disks per plate. Laboratories also reported using alternative media for Enterococcus species, N. gonorrhoeae, and H. influenzae. This study demonstrates a need for education among clinical laboratories to increase compliance with NCCLS guidelines. PMID:10970381

  9. The History of Industrial Research Laboratories as a Resource for Teaching about Science-Technology Relationships.

    Science.gov (United States)

    de Vries, Marc

    2001-01-01

    Studies the complex relationship between science and technology. Derives three different interaction patterns from the history of industrial research laboratories: (1) science as enabler for technology; (2) science as a forerunner of technology; and (3) science as a knowledge resource for technology. (Contains 21 references.) (DDR)

  10. Review and Identification of DOE Laboratory Technologies for Countermine/Unexploded Ordnance Detection

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C.M.

    2002-04-03

    Several Department of Energy (DOE) laboratories have worked and/or are working on technologies that are applicable to the detection of landmines and/or unexploded ordnance. This report is a compilation of technical summaries for many of these technologies. For additional information on any technology, appropriate points of contact are provided for each technology.

  11. Instructional Efficiency of Tutoring in an Outreach Gene Technology Laboratory

    Science.gov (United States)

    Scharfenberg, Franz-Josef; Bogner, Franz X.

    2013-01-01

    Our research objective focused on examining the instructional efficiency of tutoring as a form of instructional change as opposed to a non-tutoring approach in an outreach laboratory. We designed our laboratory based on cognitive load (CL) theory. Altogether, 269 twelfth-graders participated in our day-long module "Genetic Fingerprinting." In a…

  12. THE EMPLOYMENT OF COMPUTER TECHNOLOGIES IN LABORATORY COURSE ON PHYSICS

    Directory of Open Access Journals (Sweden)

    Liudmyla M. Nakonechna

    2010-08-01

    Full Text Available Present paper considers the questions on development of conceptually new virtual physical laboratory, the employment of which into secondary education schools will allow to check the theoretical knowledge of students before laboratory work and to acquire the modern methods and skills of experiment.

  13. THE EMPLOYMENT OF COMPUTER TECHNOLOGIES IN LABORATORY COURSE ON PHYSICS

    OpenAIRE

    Liudmyla M. Nakonechna

    2010-01-01

    Present paper considers the questions on development of conceptually new virtual physical laboratory, the employment of which into secondary education schools will allow to check the theoretical knowledge of students before laboratory work and to acquire the modern methods and skills of experiment.

  14. Practical aspects of the use of FMEA tool in clinical laboratory risk management

    Directory of Open Access Journals (Sweden)

    Maria Elizabete Mendes

    2013-06-01

    Full Text Available INTRODUCTION: This paper presents the failure modes and effects analysis (FMEA tool in a clinical laboratory through the introduction of new technology for blood gas and serum ionized calcium in multi-parameter analyzers such as Point of Care Testing (POCT. OBJECTIVE: To present FMEA as a tool for risk managing and improvement with the introduction of new technologies in a public laboratory. METHODS: The change of multiparameter gas analyzer type POCT was defined and described as a process. Subsequently, the criteria were presented to the risk assessment and its quantification. We studied the failure modes that might occur in this process. We established three action plans involving improvements to be made in the technological change. FMEA was applied in two stages: at the beginning of the project and after the implementation of the proposed measures. RESULTS: The first plan involved administrative measures related to the bidding process; the second preventive action involved the possibility of which supplier would win the bid by studying the efficiency of the analyzer and its impact on productivity; the third set of actions was directed to improvements in the relationship with the clinical staff in order to minimize occasional complaints. The last actions referred to employing new employees to meet the growing demand. CONCLUSION: FMEA proved to be a reliable tool for performance improvement, which proactively identifies, prioritizes and mitigates patient risks.

  15. [Evaluation of clinical laboratories--assurance of their quality and competence].

    Science.gov (United States)

    Kawai, Tadashi

    2007-01-01

    Since ISO 15189:2003 was published, the accreditation program of clinical laboratories based on ISO 15189 has been introduced in many countries, except for those in USA where all clinical laboratories must be required to follow the federal law, CLIA'88. It will certainly help the accredited clinical laboratories improve their quality and competence. In relation to the activity of JCTLM, reference measurement laboratories will be accredited, based on ISO 15195 which is now under its review and amendment by ISO/TC212/WG2. In Japan, JCCLS (Japanese Committee for Clinical Laboratory Standards) and JAB (Japan Accreditation Board for Conformity Assessment) cojointly started the accreditation program for clinical laboratories, based on ISO 15189:2003, and a total of 15 laboratories including university hospitals, community hospitals and independent clinical laboratories have been accredited up until the end of 2006.

  16. Secondary calibration laboratory for ionizing radiation laboratory accreitation program National Institute of Standards and Technology National Voluntary Laboratory Accreditation Program

    International Nuclear Information System (INIS)

    Martin, P.R.

    1993-01-01

    This paper presents an overview of the procedures and requirements for accreditation under the Secondary Calibration Laboratory for Ionizing Radiation Program (SCLIR LAP). The requirements for a quality system, proficiency testing and the onsite assessment are discussed. The purpose of the accreditation program is to establish a network of secondary calibration laboratories that can provide calibrations traceable to the primary national standards

  17. 77 FR 68752 - Notice of Intent To Grant Exclusive License Between National Energy Technology Laboratory and...

    Science.gov (United States)

    2012-11-16

    ... Eugene, Oregon. The inventions are owned by the United States of America as represented by the Department... person setting forth reasons why it would not be in the best interest of the United States to grant the... Technology Laboratory and Corrosion Solutions AGENCY: National Energy Technology Laboratory, Department of...

  18. Energy and Technology Review, July 1984: state of the Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-01

    Each year, Director Roger Batzel addresses the LLNL staff on the state of the Laboratory and the achievements of the past year. On May 17, 1984, Dr. Batzel reported on the estimated budget for fiscal year 1985, which includes an 8.5% increase in operating funds, and on recent progress in our major programs. In this issue, we summarize Dr. Batzel's address and present a sampling of Laboratory achievements.

  19. Energy and Technology Review, July 1984: state of the Laboratory

    International Nuclear Information System (INIS)

    1984-01-01

    Each year, Director Roger Batzel addresses the LLNL staff on the state of the Laboratory and the achievements of the past year. On May 17, 1984, Dr. Batzel reported on the estimated budget for fiscal year 1985, which includes an 8.5% increase in operating funds, and on recent progress in our major programs. In this issue, we summarize Dr. Batzel's address and present a sampling of Laboratory achievements

  20. Science teachers' perceptions of the effectiveness of technology in the laboratories: Implications for science education leadership

    Science.gov (United States)

    Yaseen, Niveen K.

    2011-12-01

    The purpose of this study was to identify science teachers' perceptions concerning the use of technology in science laboratories and identify teachers' concerns and recommendations for improving students' learning. Survey methodology with electronic delivery was used to gather data from 164 science teachers representing Texas public schools. The data confirmed that weaknesses identified in the 1990s still exist. Lack of equipment, classroom space, and technology access, as well as large numbers of students, were reported as major barriers to the implementation of technology in science laboratories. Significant differences were found based on gender, grade level, certification type, years of experience, and technology proficiency. Females, elementary teachers, traditionally trained teachers, and less experienced teachers revealed a more positive attitude toward the use of technology in science laboratories. Participants in this study preferred using science software simulations to support rather than replace traditional science laboratories. Teachers in this study recommended professional development programs that focused on strategies for a technology integrated classroom.

  1. MALDI-TOF mass spectrometry in the clinical mycology laboratory: identification of fungi and beyond.

    Science.gov (United States)

    Posteraro, Brunella; De Carolis, Elena; Vella, Antonietta; Sanguinetti, Maurizio

    2013-04-01

    MALDI-TOF mass spectrometry (MS) is becoming essential in most clinical microbiology laboratories throughout the world. Its successful use is mainly attributable to the low operational costs, the universality and flexibility of detection, as well as the specificity and speed of analysis. Based on characteristic protein spectra obtained from intact cells - by means of simple, rapid and reproducible preanalytical and analytical protocols - MALDI-TOF MS allows a highly discriminatory identification of yeasts and filamentous fungi starting from colonies. Whenever used early, direct identification of yeasts from positive blood cultures has the potential to greatly shorten turnaround times and to improve laboratory diagnosis of fungemia. More recently, but still at an infancy stage, MALDI-TOF MS is used to perform strain typing and to determine antifungal drug susceptibility. In this article, the authors discuss how the MALDI-TOF MS technology is destined to become a powerful tool for routine mycological diagnostics.

  2. Idaho National Engineering Laboratory waste area groups 1--7 and 10 Technology Logic Diagram

    International Nuclear Information System (INIS)

    O'Brien, M.C.; Meservey, R.H.; Little, M.; Ferguson, J.S.; Gilmore, M.C.

    1993-09-01

    The Technology Logic Diagram was developed to provide technical alternatives for environmental restoration projects at the Idaho National Engineering Laboratory. The diagram (three volumes) documents suggested solutions to the characterization, retrieval, and treatment phases of cleanup activities at contaminated sites within 8 of the laboratory's 10 waste area groups. Contaminated sites at the laboratory's Naval Reactor Facility and Argonne National Laboratory-West are not included in this diagram

  3. 42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

    Science.gov (United States)

    2010-10-01

    ... Condition: Laboratories performing high complexity testing; clinical consultant. The laboratory must have a... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing high complexity testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID...

  4. 42 CFR 493.1415 - Condition: Laboratories performing moderate complexity testing; clinical consultant.

    Science.gov (United States)

    2010-10-01

    ... § 493.1415 Condition: Laboratories performing moderate complexity testing; clinical consultant. The laboratory must have a clinical consultant who meets the qualification requirements of § 493.1417 of this... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing moderate...

  5. Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories.

    Science.gov (United States)

    Magnette, A; Chatelain, M; Chatelain, B; Ten Cate, H; Mullier, F

    2016-01-01

    Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results. Pre-analytical errors may occur throughout the testing process and arise from unsuitable, inappropriate or wrongly handled procedures. Problems may arise during the collection of blood specimens such as misidentification of the sample, use of inadequate devices or needles, incorrect order of draw, prolonged tourniquet placing, unsuccessful attempts to locate the vein, incorrect use of additive tubes, collection of unsuitable samples for quality or quantity, inappropriate mixing of a sample, etc. Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage. Laboratory errors can often have serious adverse consequences. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can also have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as "diagnostic". Controlling pre-analytical variables is critical since this has a direct influence on the quality of results and on their clinical reliability. The accurate standardization of the pre-analytical phase is of pivotal importance for achieving reliable results of coagulation tests and should reduce the side effects of the influence

  6. Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Gunja, Ateka; Pandey, Yagya [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States); Xie, Hui [Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL (United States); Faculty of Health Sciences, Simon Fraser University, Burnaby, BC (Canada); Wolska, Beata M. [Department of Physiology and Biophysics, Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL (United States); Shroff, Adhir R.; Ardati, Amer K. [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States); Vidovich, Mladen I., E-mail: miv@uic.edu [Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL (United States); Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL (United States)

    2017-04-15

    Background: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. Methods and results: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N = 200) and a new image noise reduction fluoroscopy system (N = 200). The primary endpoint was radiation dose (mGy cm{sup 2}). Secondary endpoints were contrast dose, fluoroscopy times, number of cineangiograms, and radiation dose by operator between the two study periods. Radiation was reduced by 44.7% between the old and new cardiac catheterization laboratory (75.8 mGy cm{sup 2} ± 74.0 vs. 41.9 mGy cm{sup 2} ± 40.7, p < 0.0001). Radiation was reduced for both diagnostic procedures (45.9%, p < 0.0001) and interventional procedures (37.7%, p < 0.0001). There was no statistically significant difference in radiation dose between individual operators (p = 0.84). In multivariate analysis, radiation dose remained significantly decreased with the use of the new system (p < 0.0001) and was associated with weight (p < 0.0001), previous coronary artery bypass grafting (p < 0.0007) and greater than 3 stents used (p < 0.0004). TRA was used in 90% of all cases in both periods. Compared with a transfemoral approach (TFA), TRA was not associated with higher radiation doses (p = 0.20). Conclusions: Image noise reduction technology significantly reduces radiation dose in a contemporary radial-first cardiac catheterization clinical practice. - Highlights: • Radial arterial access has been associated with higher doses compared to femoral access. • In a radial-first cardiac catheterization laboratory (90% radial) we examined radiation doses reduction with a contemporary image

  7. Third Annual Clinical Diabetes Technology Meeting

    National Research Council Canada - National Science Library

    Klonoff, David D

    2007-01-01

    .... The attendance was 378 healthcare providers and scientists. The first day of the meeting covered Technologies for Diabetes Monitoring and the second day covered Technologies for Diabetes Therapy...

  8. Oak Ridge National Laboratory Technology Logic Diagram. Executive Summary

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-30

    This executive summary contains a description of the logic diagram format; some examples from the diagram (Vol. 2) and associated technology evaluation data sheets (Vol. 3); a complete (albeit condensed) listing of the RA, D&D, and WM problems at ORNL; and a complete listing of the technology rankings for all the areas covered by the diagram.

  9. MendeLIMS: a web-based laboratory information management system for clinical genome sequencing.

    Science.gov (United States)

    Grimes, Susan M; Ji, Hanlee P

    2014-08-27

    Large clinical genomics studies using next generation DNA sequencing require the ability to select and track samples from a large population of patients through many experimental steps. With the number of clinical genome sequencing studies increasing, it is critical to maintain adequate laboratory information management systems to manage the thousands of patient samples that are subject to this type of genetic analysis. To meet the needs of clinical population studies using genome sequencing, we developed a web-based laboratory information management system (LIMS) with a flexible configuration that is adaptable to continuously evolving experimental protocols of next generation DNA sequencing technologies. Our system is referred to as MendeLIMS, is easily implemented with open source tools and is also highly configurable and extensible. MendeLIMS has been invaluable in the management of our clinical genome sequencing studies. We maintain a publicly available demonstration version of the application for evaluation purposes at http://mendelims.stanford.edu. MendeLIMS is programmed in Ruby on Rails (RoR) and accesses data stored in SQL-compliant relational databases. Software is freely available for non-commercial use at http://dna-discovery.stanford.edu/software/mendelims/.

  10. Treatment of Laboratory Wastewater by Sequence Batch reactor technology

    International Nuclear Information System (INIS)

    Imtiaz, N.; Butt, M.; Khan, R.A.; Saeed, M.T.; Irfan, M.

    2012-01-01

    These studies were conducted on the characterization and treatment of sewage mixed with waste -water of research and testing laboratory (PCSIR Laboratories Lahore). In this study all the parameters COD, BOD and TSS etc of influent (untreated waste-water) and effluent (treated waste-water) were characterized using the standard methods of examination for water and waste-water. All the results of the analyzed waste-water parameters were above the National Environmental Quality Standards (NEQS) set at National level. Treatment of waste-water was carried out by conventional sequencing batch reactor technique (SBR) using aeration and settling technique in the same treatment reactor at laboratory scale. The results of COD after treatment were reduced from (90-95 %), BOD (95-97 %) and TSS (96-99 %) and the reclaimed effluent quality was suitable for gardening purposes. (author)

  11. Inter-laboratory agreement on embryo classification and clinical decision: Conventional morphological assessment vs. time lapse.

    Science.gov (United States)

    Martínez-Granados, Luis; Serrano, María; González-Utor, Antonio; Ortíz, Nereyda; Badajoz, Vicente; Olaya, Enrique; Prados, Nicolás; Boada, Montse; Castilla, Jose A

    2017-01-01

    -perfect inter-laboratory agreement among conventional morphological assessment (CMA), EmbryoScope™ and Primo Vision™, except for false divisions, vacuoles and asymmetry (users of all methods) and multinucleation (users of Primo Vision™), where the degree of agreement was lower. The inter-laboratory agreement on embryo classification according to the ASEBIR criteria was moderate-substantial (Gwet 0.41-0.80) for the laboratories using CMA and EmbryoScope™, and fair-moderate (Gwet 0.21-0.60) for those using Primo Vision™. The inter-laboratory agreement for clinical decision was moderate (Gwet 0.41-0.60) on day 5 for CMA users and almost perfect (Gwet 0.81-1) for time-lapse users. In conclusion, time-lapse technology does not improve inter-laboratory agreement on embryo classification or the analysis of each morphological variable. Moreover, depending on the time-lapse platform used, inter-laboratory agreement may be lower than that obtained by CMA. However, inter-laboratory agreement on clinical decisions is improved with the use of time lapse, regardless of the platform used.

  12. DOE weapons laboratories' contributions to the nation's defense technology base

    Energy Technology Data Exchange (ETDEWEB)

    Hecker, S.S.

    1988-04-01

    The question of how the Department of Energy (DOE) weapons laboratories can contribute to a stronger defense technology base is addressed in testimony before the Subcommittee on Defense Industry and Technology of the Senate Armed Services Committee. The importance of the defense technology base is described, the DOE technology base is also described, and some technology base management and institutional issues are discussed. Suggestions are given for promoting a more stable, long-term relationship between the DOE weapons laboratories and the Department of Defense. 12 refs., 2 figs.

  13. Commercialization of Los Alamos National Laboratory technologies via small businesses. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brice, R.; Carton, D.; Rhyne, T. [and others

    1997-06-01

    Appendices are presented from a study performed on a concept model system for the commercialization of Los Alamos National Laboratory technologies via small businesses. Topics include a summary of information from the joint MCC/Los Alamos technology conference; a comparison of New Mexico infrastructure to other areas; a typical licensing agreement; technology screening guides; summaries of specific DOE/UC/Los Alamos documents; a bibliography; the Oak Ridge National Laboratory TCRD; The Ames Center for Advanced Technology Development; Los Alamos licensing procedures; presentation of slides from monthly MCC/Los Alamos review meetings; generalized entrepreneurship model; and a discussion on receiving equity for technology.

  14. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    Science.gov (United States)

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  15. An evaluation of clinical laboratory services in sub-Saharan Africa. Ex africa semper aliquid novi?

    Science.gov (United States)

    Gray, I P; Carter, J Y

    1997-11-06

    Pathology services represent the rational, scientific basis of the practice of clinical care. It does not represent deus ex machina, an implausible solution to a complex plot, but rather the way in which clinical care can be audited, controlled, guided and kept appropriate to the funds and the skills available. Arguments are presented to support this statement as well as to analyse what is wrong with health care, from the point of view of laboratory medicine, in sub-Saharan Africa. In most African countries 'first world' technology has to be imported by economies barely able to sustain the basic requirements of human life. Badly needed foreign exchange is obtained by growing export crops at the cost of traditional lifestyle, disenfranchising communities, urbanisation, and even at the cost not being able to grow food. War, corruption, lack of accountability even in the Western sense of being able to go to the polls every so often, lack of empowerment, low literacy rate etc all debase the communities, with minimal exceptions, of Africa. Health care is under the same capricious rule as all other public services: investment in laboratories is poor and most have no access to a professional laboratory at all. More investment, not less; expansion of pathology services not restricting them, is needed throughout the continent.

  16. Laboratory technology for hydrogen purification in liquefying installations

    International Nuclear Information System (INIS)

    Avram, I.; David, E.; Dordea, M.; Peculea, M.; Pop, F.; Stanciu, V.; Varzaru, O.; Panu, E.; Curuia, M.; Fron, P.; Balint, I.; Culcer, M.; Roman, T.; Smeureanu, N.

    1995-01-01

    This paper presents the development of a laboratory installation for purification of the hydrogen to be liquefied. The purification is achieved by the procedure of physical adsorption at low temperature. This procedure implies the use of materials with extensive active surfaces such as activated carbon, molecular sieves and silica gels. The main stages of the purification process are described

  17. 76 FR 66367 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and...

    Science.gov (United States)

    2011-10-26

    ... DEPARTMENT OF VETERANS AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical... the panels of the Joint Biomedical Laboratory Research and Development and Clinical Science Research....... The Sheraton Crystal City. Oncology December 8-9, 2011.. The Sheraton Crystal City. Clinical Research...

  18. Meeting report: present state of molecular genetics in clinical laboratories. Report on the VII European Symposium on Clinical Laboratory and In Vitro Diagnostic Industry in Barcelona.

    Science.gov (United States)

    Padró-Miquel, Ariadna; Candás-Estébanez, Beatriz

    2015-02-01

    The VII European Symposium of the Clinical Laboratory and In Vitro Diagnostic Industry, co-organized between the Catalan Association for Clinical Laboratory Sciences (ACCLC) and the Catalan Society of Biology, was held on May 28th-29th, 2013 in Barcelona (Catalonia, Spain) under the IFCC auspices and the IUPAC sponsorship. The subject of the present Symposium was "Molecular Genetics in the Clinical Laboratory" and began with an opening conference that was a stroll through the history of molecular genetics in the context of the clinical laboratory. The scientific program was structured in several 2-h length roundtables that dealt with the following topics: recent advances in molecular genetics for clinical microbiology, latest evidences and real applicability of pharmacogenetics in the clinical practice, quality assurance of a molecular genetics laboratory, and latest trends in prenatal genetic diagnosis. The aim of the Symposium was the discussion of the transformation that molecular genetics has generated on clinical laboratories in terms of organization, specialization, interpretation of results and fast technical and knowledge evolution. High-qualified professionals from several countries together with in-country experts formed the roundtables. Attendants participated actively in the debates, increasing the overall interest.

  19. Implications of the introduction of laboratory demand management at primary care clinics in South Africa on laboratory expenditure.

    Science.gov (United States)

    Mahomed, Ozayr H; Lekalakala, Ruth; Asmall, Shaidah; Cassim, Naseem

    2016-01-01

    Diagnostic health laboratory services are regarded as an integral part of the national health infrastructure across all countries. Clinical laboratory tests contribute substantially to health system goals of increasing quality of care and improving patient outcomes. This study aimed to analyse current laboratory expenditures at the primary healthcare (PHC) level in South Africa as processed by the National Health Laboratory Service and to determine the potential cost savings of introducing laboratory demand management. A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014 financial year across 11 pilot National Health Insurance health districts was conducted. Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests list (ELL) to determine inappropriate testing. Data were analysed using a Microsoft Access database and Excel software. Approximately R35 million South African Rand (10%) of the estimated R339 million in expenditures was for tests that were not listed within the ELL. Approximately 47% of expenditure was for laboratory tests that were indicated in the algorithmic management of patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included full blood count and urea, as well as electrolyte profiles usually requested to support management of patients on antiretroviral treatment. Considerable annual savings of up to 10% in laboratory expenditure are possible at the PHC level by implementing laboratory demand management. In addition, to achieve these savings, a standardised PHC laboratory request form and some form of electronic gatekeeping system that must be supported by an educational component should be implemented.

  20. Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concepts. Final report FY-96

    Energy Technology Data Exchange (ETDEWEB)

    Barrie, S.L.; Carpenter, G.S.; Crockett, A.B. [and others

    1997-04-01

    The Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concept Project was initiated for the expedited development of new or conceptual technologies in support of groundwater fate, transport, and remediation; buried waste characterization, retrieval, and treatment; waste minimization/pollution prevention; and spent fuel handling and storage. In Fiscal Year 1996, The Idaho National Engineering and Environmental Laboratory proposed 40 development projects and the Department of Energy funded 15. The projects proved the concepts of the various technologies, and all the technologies contribute to successful environmental management.

  1. Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concepts. Final report FY-96

    International Nuclear Information System (INIS)

    Barrie, S.L.; Carpenter, G.S.; Crockett, A.B.

    1997-04-01

    The Idaho National Engineering and Environmental Laboratory Environmental Technologies Proof-of-Concept Project was initiated for the expedited development of new or conceptual technologies in support of groundwater fate, transport, and remediation; buried waste characterization, retrieval, and treatment; waste minimization/pollution prevention; and spent fuel handling and storage. In Fiscal Year 1996, The Idaho National Engineering and Environmental Laboratory proposed 40 development projects and the Department of Energy funded 15. The projects proved the concepts of the various technologies, and all the technologies contribute to successful environmental management

  2. 76 FR 56406 - Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army...

    Science.gov (United States)

    2011-09-13

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army Research, Development and Engineering Command; Tank... Berry, U. S. Army Tank Automotive Research, Development and Engineering Center (TARDEC), 6501 East 11...

  3. 78 FR 64204 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

    Science.gov (United States)

    2013-10-28

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Personnel Management Demonstration Project, Department of Navy, Office of Naval Research (ONR); Amendment... ONR Personnel Management Demonstration Project (75 FR 77380-77447, December 10, 2010). SUMMARY: On...

  4. Professionalising the asphalt construction process: aligning information technologies, operators' knowledge and laboratory practices

    NARCIS (Netherlands)

    Bijleveld, Frank

    2015-01-01

    This research addresses the need to professionalise the asphalt construction process. A distinctive action research strategy is designed and carried out to progressively improve operational strategies of asphalt teams from technological, human (operator) and laboratory perspectives. Using

  5. Federal Laboratory Consortium Recognizes Unituxin Collaborators with Excellence in Technology Transfer Awards | Poster

    Science.gov (United States)

    The Federal Laboratory Consortium (FLC) presented an Excellence in Technology Transfer award to the group that collaborated to bring Unituxin (dinutuximab, also known as ch14.18), an immunotherapy for neuroblastoma, to licensure.

  6. The elephant in the room (and how to lead it out): In-clinic laboratory quality challenges.

    Science.gov (United States)

    Flatland, Bente; Weiser, Glade

    2014-01-01

    Over 30 yr of technological evolution have resulted in sophisticated instrumentation for in-clinic laboratories, yet there is no regulatory oversight of diagnostic testing quality. Long overdue, the veterinary profession must address quality assurance (QA) of diagnostic testing. Each practice must weigh the responsibility for laboratory instrumentation test results that are often a combination of in-clinic and send-out testing. Challenges faced by clinic staff maintaining in-clinic laboratories include lack of training in QA and quality control (QC), lack of emphasis placed on QA/QC by instrument suppliers, QC financial and time costs, and a general lack of laboratory QA/QC support resources in the veterinary community. Possible solutions include increased continuing education opportunities and the provision of guidelines and other resources by national veterinary organizations; specialty certification of veterinary technicians; an increasing role of veterinary clinical pathologists as QA/QC consultants; and development of external quality assessment programs aimed at veterinary practices. The potential exists for animal health companies to lead in this effort by innovating instrument design, providing QC services, and exploiting instrument connectivity to monitor performance. Veterinary laboratory QA/QC is a neglected aspect of the profession. In coming years, veterinarians will hopefully find increased support for this core practice component.

  7. Pacific Northwest Laboratory environmental technologies available for deployment

    International Nuclear Information System (INIS)

    Slate, S.C.

    1994-07-01

    The Department of Energy created the Office of Environmental Management (EM) to conduct a 30-year plus, multi-billion dollar program to manage the wastes and cleanup the legacy from over fifty years of nuclear material production. Across the DOE System there are thousands of sites containing millions of metric tons of buried wastes and contaminated soils and groundwater. Additionally, there are nearly 400,000 m 3 of highly radioactive wastes in underground storage tanks, over 1,400 different mixed-waste streams, and thousands of contaminated surplus facilities, some exceeding 200,000 m 2 in size. Costs to remediate all these problems have been estimated to be as much as several hundred billion dollars. The tremendous technical challenges with some of the problems and the high costs of using existing technologies has led the Department to create the Office of Technology Development (TD) to lead an aggressive, integrated national program to develop and deploy the needed advanced, cost-effective technologies. This program is developing technologies for all major cleanup steps: assessment, characterization, retrieval, treatment, final stabilization, and disposal. Work is focused on the Department's five major problem areas: High-Level Waste Tank Remediation; Contaminant Plume Containment and Remediation; Mixed Waste Characterization, Treatment, and Disposal; Contaminated Soils and Buried Wastes Facility Transitioning, Decommissioning, and Final Disposal

  8. Hypermedia Laboratory, Defense Applied Information Technology Center; Review for 1988

    Science.gov (United States)

    1988-12-01

    technology and the CCL system to produce an Artificial Inteligence driven Hypermedia environment to access heterogenous database systems. The development...8, December 1988 a minicomputer * HYPERTEXT * multiuser dgis artificial inteligence hypermedi Hypermedia for ASCII Hyperext on the VAX is an ASCII...CODES 18. SUBJECT TERMS (Continue on reverse if necessary and identify by block number) FIELD GROUP SUB-GROUP Hypermedia, Artificial Intelligence

  9. Report on the International Society for Laboratory Hematology Survey on guidelines to support clinical hematology laboratory practice.

    Science.gov (United States)

    Hayward, C P M; Moffat, K A; George, T I; Proytcheva, M; Iorio, A

    2016-05-01

    Given the importance of evidence-based guidelines in health care, we surveyed the laboratory hematology community to determine their opinions on guideline development and their experience and interest in developing clinical hematology laboratory practice guidelines. The study was conducted using an online survey, distributed to members of the International Society for Laboratory Hematology (ISLH) in 2015, with analysis of collected, anonymized responses. A total of 245 individuals participated. Most worked in clinical and/or research laboratories (83%) or industry (11%). 42% felt there were gaps in current guidelines. The majority (58%) recommended that ISLH engages its membership in guideline development. Participants differed in their familiarity with, and use of, different organizations' guidelines. Participants felt it was important to follow best practice recommendations on guideline development, including engagement of experts, statement about conflict of interests and how they were managed, systematic review and grading evidence for recommendations, identifying recommendations lacking evidence or consensus, and public input and peer review of the guideline. Moreover, it was considered important to provide guidelines free of charge. Industry involvement in guidelines was considered less important. The clinical laboratory hematology community has high expectations of laboratory practice guidelines that are consistent with recent recommendations on evidence-based guideline development. © 2016 John Wiley & Sons Ltd.

  10. Energy and technology review, January--February 1995. State of the laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Bookless, W.A.; Stull, S.; Cassady, C.; Kaiper, G.; Ledbetter, G.; McElroy, L.; Parker, A. [eds.

    1995-02-01

    This issue of Energy and Technology Review highlights the Laboratory`s 1994 accomplishments in their mission areas and core programs--economic competitiveness, national security, lasers, energy, the environment, biology and biotechnology, engineering, physics and space science, chemistry and materials science, computations, and science and math education. LLNL is a major national resource of science and technology expertise, and they are committed to applying this expertise to meet vital national needs.

  11. 77 FR 69601 - Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration Projects

    Science.gov (United States)

    2012-11-20

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration Projects AGENCY: Office of the Deputy Assistant Secretary of Defense... Assistant for Laboratory Management, AMRDEC, 5400 Fowler Road, Redstone Arsenal, AL 35898-5000; Engineer...

  12. 78 FR 29335 - Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration Projects

    Science.gov (United States)

    2013-05-20

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration Projects AGENCY: Office of the Deputy Assistant Secretary of Defense...: Special Assistant for Laboratory Management, AMRDEC, 5400 Fowler Road, Redstone Arsenal, AL 35898-5000...

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

    Science.gov (United States)

    Jagodzinski, Piotr; Wolski, Robert

    2015-01-01

    Natural User Interfaces (NUI) are now widely used in electronic devices such as smartphones, tablets and gaming consoles. We have tried to apply this technology in the teaching of chemistry in middle school and high school. A virtual chemical laboratory was developed in which students can simulate the performance of laboratory activities similar…

  14. Developments of Spent Nuclear Fuel Pyroprocessing Technology at Idaho National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Michael F. Simpson

    2012-03-01

    This paper summarizes research in used fuel pyroprocessing that has been published by Idaho National Laboratory over the last decade. It includes work done both on treatment of Experimental Breeder Reactor-II and development of advanced technology for potential scale-up and commercialization. Collaborations with universities and other laboratories is included in the cited work.

  15. The National Market for Medicare Clinical Laboratory Testing

    Data.gov (United States)

    U.S. Department of Health & Human Services — Current Medicare payment policy for outpatient laboratory services is outdated. Future reforms, such as competitive bidding, should consider the characteristics of...

  16. Infections in British clinical laboratories, 1986-87.

    OpenAIRE

    Grist, N R; Emslie, J A

    1989-01-01

    During 1986-87 this continuing survey showed 15 specific infections in the staff of 235 laboratories, representing 28,524 person years of exposure. The community was the probable source of four of the five cases of tuberculosis and one of the five cases of salmonellosis. Occupational exposure was the probable cause of four infections by Shigella flexneri, three by Salmonella typhimurium, and one by S typhi, all affecting medical laboratory scientific officers (MLSOs) in microbiology. Occupati...

  17. Energy technologies at Sandia National Laboratories: Past, Present, Future

    Energy Technology Data Exchange (ETDEWEB)

    1989-08-01

    We at Sandia first became involved with developing energy technology when the nation initiated its push toward energy independence in the early 1970s. That involvement continues to be strong. In shaping Sandia's energy programs for the 1990s, we will build on our track record from the 70s and 80s, a record outlined in this publication. It contains reprints of three issues of Sandia's Lab News that were devoted to our non-nuclear energy programs. Together, they summarize the history, current activities, and future of Sandia's diverse energy concerns; hence my desire to see them in one volume. Written in the fall of 1988, the articles cover Sandia's extremely broad range of energy technologies -- coal, oil and gas, geothermal, solar thermal, photovoltaics, wind, rechargeable batteries, and combustion.

  18. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening.

    Science.gov (United States)

    Raftery, Philomena; Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64-100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can be

  19. Establishing Ebola Virus Disease (EVD) diagnostics using GeneXpert technology at a mobile laboratory in Liberia: Impact on outbreak response, case management and laboratory systems strengthening

    Science.gov (United States)

    Condell, Orla; Wasunna, Christine; Kpaka, Jonathan; Zwizwai, Ruth; Nuha, Mahmood; Fallah, Mosoka; Freeman, Maxwell; Harris, Victoria; Miller, Mark; Baller, April; Massaquoi, Moses; Katawera, Victoria; Saindon, John; Bemah, Philip; Hamblion, Esther; Castle, Evelyn; Williams, Desmond; Gasasira, Alex; Nyenswah, Tolbert

    2018-01-01

    The 2014–16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening. During the period of operation, site coordination, management and operational capacity was supported through a successful collaboration between Ministry of Health (MoH), World Health Organization (WHO) and international partners. A team of Liberian laboratory technicians were trained to conduct EVD diagnostics and the laboratory had capacity to test 64–100 blood specimens per day. Establishment of the laboratory significantly increased the daily testing capacity for EVD in Liberia, from 180 to 250 specimens at a time when the effectiveness of the surveillance system was threatened by insufficient diagnostic capacity. During the 18 months of operation, the laboratory tested a total of 9,063 blood specimens, including 21 EVD positives from six confirmed cases during two outbreaks. Following clearance of the significant backlog of untested EVD specimens in November 2015, a new cluster of EVD cases was detected at the laboratory. Collaboration between surveillance and laboratory coordination teams during this and a later outbreak in March 2016, facilitated timely and targeted response interventions. Specimens taken from cases during both outbreaks were analysed at the laboratory with results informing clinical management of patients and discharge decisions. The GeneXpert platform is easy to use, has relatively low running costs and can

  20. Point of care technology or standard laboratory service in an emergency department: is there a difference in time to action? A randomised trial

    DEFF Research Database (Denmark)

    Backer Mogensen, Christian; Borch, Anders; Brandslund, Ivan

    2011-01-01

    services. However, the question is if the time to clinical action is also reduced if a decisive laboratory answer is available during the first contact between the patient and doctor. The present study addresses this question: Does a laboratory answer, provided by POCT to the doctor who first attends...... the patient on admission, change the time to clinical decision in commonly occurring diseases in an ED compared with the traditional service from a central laboratory?......Emergency Departments (ED) have a high flow of patients and time is often crucial. New technologies for laboratory analysis have been developed, including Point of Care Technologies (POCT), which can reduce the transport time and time of analysis significantly compared with central laboratory...

  1. Technology for enhancing chest auscultation in clinical simulation.

    Science.gov (United States)

    Ward, Jeffrey J; Wattier, Bryan A

    2011-06-01

    The ability to use an acoustic stethoscope to detect lung and/or heart sounds, and then to then communicate one's interpretation of those sounds is an essential skill for many medical professionals. Interpretation of lung and heart sounds, in the context of history and other examination findings, often aids the differential diagnosis. Bedside assessment of changing auscultation findings may also guide treatment. Learning lung and heart auscultation skills typically involves listening to pre-recorded normal and adventitious sounds, often followed by laboratory instruction to guide stethoscope placement, and finally correlating the sounds with the associated pathophysiology and pathology. Recently, medical simulation has become an important tool for teaching prior to clinical practice, and for evaluating bedside auscultation skills. When simulating cardiovascular or pulmonary problems, high-quality lung and heart sounds should be able to accurately corroborate other findings such as vital signs, arterial blood gas values, or imaging. Digital audio technology, the Internet, and high-fidelity simulators have increased opportunities for educators and learners. We review the application of these technologies and describe options for reproducing lung and heart sounds, as well as their advantages and potential limitations.

  2. Oak Ridge National Laboratory Technology Logic Diagram. Volume 3, Technology evaluation data sheets: Part A, Characterization, Decontamination

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram; and Vol. 3, Technology Evaluation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D&D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TLD, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A, B, and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A, B,and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D&D, RA, and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2. The data sheets are arranged alphanumerically by the TEDS code number in the upper right comer of each sheet.

  3. Communication and computing technology in biocontainment laboratories using the NEIDL as a model.

    Science.gov (United States)

    McCall, John; Hardcastle, Kath

    2014-07-01

    The National Emerging Infectious Diseases Laboratories (NEIDL), Boston University, is a globally unique biocontainment research facility housing biosafety level 2 (BSL-2), BSL-3, and BSL-4 laboratories. Located in the BioSquare area at the University's Medical Campus, it is part of a national network of secure facilities constructed to study infectious diseases of major public health concern. The NEIDL allows for basic, translational, and clinical phases of research to be carried out in a single facility with the overall goal of accelerating understanding, treatment, and prevention of infectious diseases. The NEIDL will also act as a center of excellence providing training and education in all aspects of biocontainment research. Within every detail of NEIDL operations is a primary emphasis on safety and security. The ultramodern NEIDL has required a new approach to communications technology solutions in order to ensure safety and security and meet the needs of investigators working in this complex building. This article discusses the implementation of secure wireless networks and private cloud computing to promote operational efficiency, biosecurity, and biosafety with additional energy-saving advantages. The utilization of a dedicated data center, virtualized servers, virtualized desktop integration, multichannel secure wireless networks, and a NEIDL-dedicated Voice over Internet Protocol (VoIP) network are all discussed. © 2014 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

  4. [Historic Development of Clinical Biology Laboratories in Luxembourg].

    Science.gov (United States)

    Wennig R; Humbel R-L

    2014-01-01

    After a short overview on the development of diagnostic tools in clinical biology at an international level from Antiquity towards today, a history of the clinical biology including public and private institutions in Luxembourg will be outlined.

  5. comparison of clinical and laboratory profile of haart adherent and ...

    African Journals Online (AJOL)

    Global Journal

    HAART. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) with optimal adherence set at ≥95%. Clinical stage, anthropometry, CD4, total lymphocyte and haemoglobin were used to monitor clinical, immunological and haematological outcome of adherence. Result: The mean (SD) age of ...

  6. Use of artificial intelligence in analytical systems for the clinical laboratory.

    Science.gov (United States)

    Place, J F; Truchaud, A; Ozawa, K; Pardue, H; Schnipelsky, P

    1995-01-01

    The incorporation of information-processing technology into analytical systems in the form of standard computing software has recently been advanced by the introduction of artificial intelligence (AI), both as expert systems and as neural networks.This paper considers the role of software in system operation, control and automation, and attempts to define intelligence. AI is characterized by its ability to deal with incomplete and imprecise information and to accumulate knowledge. Expert systems, building on standard computing techniques, depend heavily on the domain experts and knowledge engineers that have programmed them to represent the real world. Neural networks are intended to emulate the pattern-recognition and parallel processing capabilities of the human brain and are taught rather than programmed. The future may lie in a combination of the recognition ability of the neural network and the rationalization capability of the expert system.In the second part of the paper, examples are given of applications of AI in stand-alone systems for knowledge engineering and medical diagnosis and in embedded systems for failure detection, image analysis, user interfacing, natural language processing, robotics and machine learning, as related to clinical laboratories.It is concluded that AI constitutes a collective form of intellectual propery, and that there is a need for better documentation, evaluation and regulation of the systems already being used in clinical laboratories.

  7. Environmental Technology (Laboratory Analysis and Environmental Sampling) Curriculum Development Project. Final Report.

    Science.gov (United States)

    Hinojosa, Oscar V.; Guillen, Alfonso

    A project assessed the need and developed a curriculum for environmental technology (laboratory analysis and environmental sampling) in the emerging high technology centered around environmental safety and health in Texas. Initial data were collected through interviews by telephone and in person and through onsite visits. Additional data was…

  8. Science and Technology Teachers' Views about the Causes of Laboratory Accidents

    Science.gov (United States)

    Aydogdu, Cemil

    2015-01-01

    The aim of this study was to determine science and technology teachers' views about the causes of the problems encountered in laboratories. In this research, phenomenology, a qualitative research design, was used. 21 science and technology teachers who were working in elementary schools in Eskisehir during the 2010-2011 spring semester were the…

  9. 76 FR 79273 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and...

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF VETERANS AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical... Committee Act) that the Panel for Eligibility of the Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development Services Scientific Merit Review Board will meet on...

  10. 76 FR 1212 - Joint Biomedical Laboratory Research and Development and Clinical Science Research and...

    Science.gov (United States)

    2011-01-07

    ... DEPARTMENT OF VETERANS AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical... Committee Act) that the Panel for Eligibility of the Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development Services Scientific Merit Review Board will meet on...

  11. Practicing Handoffs Early: Applying a Clinical Framework in the Anatomy Laboratory

    Science.gov (United States)

    Lazarus, Michelle D.; Dos Santos, Jason A.; Haidet, Paul M.; Whitcomb, Tiffany L.

    2016-01-01

    The anatomy laboratory provides an ideal environment for the integration of clinical contexts as the willed-donor is often regarded as a student's "first patient." This study evaluated an innovative approach to peer teaching in the anatomy laboratory using a clinical handoff context. The authors introduced the "Situation,…

  12. EXPERIENCE OF THE ORGANIZATION OF VIRTUAL LABORATORIES ON THE BASIS OF TECHNOLOGIES OF CLOUD COMPUTING

    Directory of Open Access Journals (Sweden)

    V. Oleksyuk

    2014-06-01

    Full Text Available The article investigated the concept of «virtual laboratory». This paper describes models of deploying of cloud technologies in IT infrastructure. The hybrid model is most recent for higher educational institution. The author suggests private cloud platforms to deploying the virtual laboratory. This paper describes the experience of the deployment enterprise cloud in IT infrastructure of Department of Physics and Mathematics of Ternopil V. Hnatyuk National Pedagogical University. The object of the research are virtual laboratories as components of IT infrastructure of higher education. The subject of the research are clouds as base of deployment of the virtual laboratories. Conclusions. The use of cloud technologies in the development virtual laboratories of the is an actual and need of the development. The hybrid model is the most appropriate in the deployment of cloud infrastructure of higher educational institution. It is reasonable to use the private (Cloudstack, Eucalyptus, OpenStack cloud platform in the universities.

  13. Proceedings of symposium on technology in laboratories by department of engineering and technical services

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-06-01

    The Symposium on Technology in Laboratories was held on March 14 and 15 at Ceratopia Toki in Toki City, Gifu Prefecture, Japan. This symposium was hosted by National Institute for Fusion Science (NIFS). There were 407 participants from many Japanese universities, national laboratories, technical colleges and from some Japanese Industrial world. One hundred and thirty one papers were presented in the symposium. Technical experience and new techniques were reported and discussed being divided into five sessions; technology of fabrication, device technology, diagnostic and control system, cryogenics, computer and data processing. (author)

  14. The national laboratory business role in energy technology research and development. Panel Discussion

    International Nuclear Information System (INIS)

    Sackett, John; Sullivan, Charles J.; Aumeier, Steve; Sanders, Tom; Johnson, Shane; Bennett, Ralph

    2001-01-01

    Full text of publication follows: Energy issues will play a pivotal role in the economic and political future of the United States. For reasons of both available supply and environmental concerns, development and deployment of new energy technologies is critical. Nuclear technology is important, but economic, political, and technical challenges must be overcome if it is to play a significant role. This session will address business opportunities for national laboratories to contribute to the development and implementation of a national energy strategy, concentrating on the role of nuclear technology. Panelists have been selected from the national laboratories, the U.S. Department of Energy, and state regulators. (authors)

  15. Clinical and Laboratory Features of the Nocardia spp. Based on Current Molecular Taxonomy

    Science.gov (United States)

    Brown-Elliott, Barbara A.; Brown, June M.; Conville, Patricia S.; Wallace, Richard J.

    2006-01-01

    The recent explosion of newly described species of Nocardia results from the impact in the last decade of newer molecular technology, including PCR restriction enzyme analysis and 16S rRNA sequencing. These molecular techniques have revolutionized the identification of the nocardiae by providing rapid and accurate identification of recognized nocardiae and, at the same time, revealing new species and a number of yet-to-be-described species. There are currently more than 30 species of nocardiae of human clinical significance, with the majority of isolates being N. nova complex, N. abscessus, N. transvalensis complex, N. farcinica, N. asteroides type VI (N. cyriacigeorgica), and N. brasiliensis. These species cause a wide variety of diseases and have variable drug susceptibilities. Accurate identification often requires referral to a reference laboratory with molecular capabilities, as many newer species are genetically distinct from established species yet have few or no distinguishing phenotypic characteristics. Correct identification is important in deciding the clinical relevance of a species and in the clinical management and treatment of patients with nocardial disease. This review characterizes the currently known pathogenic species of Nocardia, including clinical disease, drug susceptibility, and methods of identification. PMID:16614249

  16. Audit of clinical-laboratory practices in haematology and blood ...

    African Journals Online (AJOL)

    In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive ...

  17. Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters

    Directory of Open Access Journals (Sweden)

    Anet Papazovska Cherepnalkovski

    2015-12-01

    CONCLUSIONS: The laboratory profile in ABO/Rh isoimmunisation cases depicts hemolytic mechanism of jaundice. These cases carry a significant risk for early and severe hyperbilirubinemia and are eligible for neurodevelopmental follow-up. Hematological parameters and blood grouping are simple diagnostic methods that assist the etiological diagnosis of neonatal hyperbilirubinemia.

  18. National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for use of tumor markers in clinical practice

    DEFF Research Database (Denmark)

    Sturgeon, Catharine M; Hoffman, Barry R; Chan, Daniel W

    2008-01-01

    BACKGROUND: This report presents updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines summarizing quality requirements for the use of tumor markers. METHODS: One subcommittee developed guidelines for analytical quality relevant to serum and tissue-based tumor...... questions to ensure selection of the appropriate test, adherence to good clinical and laboratory practices (e.g., minimization of the risk of incorrect patient and/or specimen identification, tube type, or timing), use of internationally standardized and well-characterized methods, careful adherence...... and laboratory users, and regulatory agencies. CONCLUSIONS: Implementation of these recommendations, adapted to local practice, should encourage optimization of the clinical use of tumor markers....

  19. TECHNOLOGICAL COMPETENCE OF FUTURE ENGINEER: FORMATION AND DEVELOPMENT IN COMPUTER INTEGRATED LABORATORY WORKSHOP ON PHYSICS

    Directory of Open Access Journals (Sweden)

    Ihor S. Chernetskyi

    2013-12-01

    Full Text Available The article examines the category «technological competence» and the definition of its components according to the educational process. A structural and functional model of technological competence of future engineers through forms, means, methods and technologies of computer oriented laboratory work. Selected blocks and elements of the model in the course of a typical student laboratory work on the course of general physics. We consider the possibility of using some type of digital labs «Phywe», «Fourier» and modern electronic media (flash books to optimize laboratory work at the Technical University. The analysis of the future research of structural elements model of technological competence.

  20. Virtual Cultural Landscape Laboratory Based on Internet GIS Technology

    Science.gov (United States)

    Bill, R.

    2012-07-01

    In recent years the transfer of old documents (books, paintings, maps etc.) from analogue to digital form has gained enormous importance. Numerous interventions are concentrated in the digitalisation of library collections, but also commercial companies like Microsoft or Google try to convert large analogue stocks such as books, paintings, etc. in digital form. Data in digital form can be much easier made accessible to a large user community, especially to the interested scientific community. The aim of the described research project is to set up a virtual research environment for interdisciplinary research focusing on the landscape of the historical Mecklenburg in the north-east of Germany. Georeferenced old maps from 1786 and 1890 covering complete Mecklenburg should be combined with current geo-information, satellite and aerial imagery to support spatio-temporal research aspects in different scales in space (regional 1:200,000 to local 1:25.000) and time (nearly 250 years in three time steps, the last 30 years also in three time slices). The Virtual Laboratory for Cultural Landscape Research (VKLandLab) is designed and developed by the Chair of Geodesy and Geoinformatics, hosted at the Computing Centre (ITMZ) and linked to the Digital Library (UB) at Rostock University. VKLandLab includes new developments such as wikis, blogs, data tagging, etc. and proven components already integrated in various data-related infrastructures such as InternetGIS, data repositories and authentication structures. The focus is to build a data-related infrastructure and a work platform that supports students as well as researchers from different disciplines in their research in space and time.

  1. VIRTUAL CULTURAL LANDSCAPE LABORATORY BASED ON INTERNET GIS TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    R. Bill

    2012-07-01

    Full Text Available In recent years the transfer of old documents (books, paintings, maps etc. from analogue to digital form has gained enormous importance. Numerous interventions are concentrated in the digitalisation of library collections, but also commercial companies like Microsoft or Google try to convert large analogue stocks such as books, paintings, etc. in digital form. Data in digital form can be much easier made accessible to a large user community, especially to the interested scientific community. The aim of the described research project is to set up a virtual research environment for interdisciplinary research focusing on the landscape of the historical Mecklenburg in the north-east of Germany. Georeferenced old maps from 1786 and 1890 covering complete Mecklenburg should be combined with current geo-information, satellite and aerial imagery to support spatio-temporal research aspects in different scales in space (regional 1:200,000 to local 1:25.000 and time (nearly 250 years in three time steps, the last 30 years also in three time slices. The Virtual Laboratory for Cultural Landscape Research (VKLandLab is designed and developed by the Chair of Geodesy and Geoinformatics, hosted at the Computing Centre (ITMZ and linked to the Digital Library (UB at Rostock University. VKLandLab includes new developments such as wikis, blogs, data tagging, etc. and proven components already integrated in various data-related infrastructures such as InternetGIS, data repositories and authentication structures. The focus is to build a data-related infrastructure and a work platform that supports students as well as researchers from different disciplines in their research in space and time.

  2. Laboratory Focus on Improving the Culture of Biosafety: Statewide Risk Assessment of Clinical Laboratories That Process Specimens for Microbiologic Analysis.

    Science.gov (United States)

    Munson, Erik; Bowles, Erin J; Dern, Richard; Beck, Eric; Podzorski, Raymond P; Bateman, Allen C; Block, Timothy K; Kropp, Joshua L; Radke, Tyler; Siebers, Karen; Simmons, Brian; Smith, Mary A; Spray-Larson, Frances; Warshauer, David M

    2018-01-01

    The Wisconsin State Laboratory of Hygiene challenged Wisconsin laboratories to examine their biosafety practices and improve their culture of biosafety. One hundred three clinical and public health laboratories completed a questionnaire-based, microbiology-focused biosafety risk assessment. Greater than 96% of the respondents performed activities related to specimen processing, direct microscopic examination, and rapid nonmolecular testing, while approximately 60% performed culture interpretation. Although they are important to the assessment of risk, data specific to patient occupation, symptoms, and travel history were often unavailable to the laboratory and, therefore, less contributory to a microbiology-focused biosafety risk assessment than information on the specimen source and test requisition. Over 88% of the respondents complied with more than three-quarters of the mitigation control measures listed in the survey. Facility assessment revealed that subsets of laboratories that claim biosafety level 1, 2, or 3 status did not possess all of the biosafety elements considered minimally standard for their respective classifications. Many laboratories reported being able to quickly correct the minor deficiencies identified. Task assessment identified deficiencies that trended higher within the general (not microbiology-specific) laboratory for core activities, such as packaging and shipping, direct microscopic examination, and culture modalities solely involving screens for organism growth. For traditional microbiology departments, opportunities for improvement in the cultivation and management of highly infectious agents, such as acid-fast bacilli and systemic fungi, were revealed. These results derived from a survey of a large cohort of small- and large-scale laboratories suggest the necessity for continued microbiology-based understanding of biosafety practices, vigilance toward biosafety, and enforcement of biosafety practices throughout the laboratory

  3. Clinical characteristics of biopsy-proven allergic bronchopulmonary mycosis: variety in causative fungi and laboratory findings.

    Science.gov (United States)

    Ishiguro, Takashi; Takayanagi, Noboru; Kagiyama, Naho; Shimizu, Yoshihiko; Yanagisawa, Tsutomu; Sugita, Yutaka

    2014-01-01

    The diagnosis of allergic bronchopulmonary mycosis (ABPM) has traditionally relied widely on Rosenberg's criteria, which emphasize immunologic responses while overlooking the investigation of mucous plugs as a primary criterion. Therefore, the characteristics of biopsy-proven ABPM require further elucidation. The aim of this study was to analyze the clinical characteristics of biopsy-proven ABPM and address whether full compliance with clinical criteria, such as the presence of asthma, and certain laboratory findings is necessary to establish a diagnosis of ABPM. We retrospectively analyzed 17 patients with biopsy-proven ABPM focusing on causative fungi and laboratory findings. Causative fungi included Aspergillus sp. in seven patients, Schizophyllum commune in four patients, Penicillium sp. in two patients and unknown in five patients. Bronchial asthma was observed in 10 patients, eosinophilia was observed in 10 patients and an increased serum immunoglobulin (Ig) E level was observed in 14 of the 17 patients. IgG for Aspergillus sp. was positive in six of the seven patients with ABPM due to Aspergillus and turned positive in the remaining patient during follow-up. Technological limitations prevented the measurement of specific IgE for S. commune and IgG for S. commune and Penicillium sp. in most patients. Computed tomography revealed central bronchiectasis, pulmonary infiltration and mucous plugs in all patients. Causative fungi other than Aspergillus sp. are not uncommon, and immunological tests for other fungi should be popularized. Asthma and characteristic laboratory findings, such as peripheral blood eosinophilia, increased serum IgE and precipitating antibodies, may not always be required to diagnose ABPM. The importance of typical pathologic findings of mucous plugs for diagnosing ABPM requires reevaluation. Further studies are needed to establish more elaborate diagnostic criteria for ABPM.

  4. Clinical, Laboratory Diagnosis and Treatment of Ehrlichial Infections ...

    African Journals Online (AJOL)

    Clinically the disease can take the acute or chronic form with a wide range of clinical presentations that include fever, depression, lethargy, dyspnea, anorexia, weight loss, lymphadenopathy, hemorrhage, epistaxis, increased hair loss, vomiting, blindness, edema, ataxia and polyarthritis. Superinfection with other organisms ...

  5. Contributions of Analytical Chemistry to the Clinical Laboratory.

    Science.gov (United States)

    Skogerboe, Kristen J.

    1988-01-01

    Highlights several analytical techniques that are being used in state-of-the-art clinical labs. Illustrates how other advances in instrumentation may contribute to clinical chemistry in the future. Topics include: biosensors, polarization spectroscopy, chemiluminescence, fluorescence, photothermal deflection, and chromatography in clinical…

  6. HEPATIC MALIGNANCIES - CLINICAL-FEATURES AND LABORATORY TESTS

    NARCIS (Netherlands)

    Beuers, U.

    1991-01-01

    While both primary and secondary hepatic malignancies grow continuously, clinically they remain silent and usually are detected late in their course. Common clinical symptoms include a triad of abdominal pain, weight loss, and malaise. The prominent physical finding is hepatomegaly. Standard

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

    Science.gov (United States)

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

    2015-01-01

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

  8. [Software for illustrating a cost-quality balance carried out by clinical laboratory practice].

    Science.gov (United States)

    Nishibori, Masahiro; Asayama, Hitoshi; Kimura, Satoshi; Takagi, Yasushi; Hagihara, Michio; Fujiwara, Mutsunori; Yoneyama, Akiko; Watanabe, Takashi

    2010-09-01

    We have no proper reference indicating the quality of clinical laboratory practice, which should clearly illustrates that better medical tests require more expenses. Japanese Society of Laboratory Medicine was concerned about recent difficult medical economy and issued a committee report proposing a guideline to evaluate the good laboratory practice. According to the guideline, we developed software that illustrate a cost-quality balance carried out by clinical laboratory practice. We encountered a number of controversial problems, for example, how to measure and weight each quality-related factor, how to calculate costs of a laboratory test and how to consider characteristics of a clinical laboratory. Consequently we finished only prototype software within the given period and the budget. In this paper, software implementation of the guideline and the above-mentioned problems are summarized. Aiming to stimulate these discussions, the operative software will be put on the Society's homepage for trial

  9. Pre-analytical phase in clinical chemistry laboratory

    OpenAIRE

    Neogi SS; Mehndiratta M; Gupta S; Puri D

    2016-01-01

    The laboratory testing process is divided into the pre-analytical, analytical and post-analytical phases. For obtaining reliable test results, the prevention and detection of errors at all steps is required. While analytical standards have been developed by recognized quality control criteria, there is a scarcity in the development of standards for the preanalytical phase. This phase is most prone to errors as the steps involved are directly dependent on humans and are out of dire...

  10. Oak Ridge National Laboratory Technology Logic Diagram. Volume 3, Technology evaluation data sheets: Part C, Robotics/automation, Waste management

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram and Vol. 3, Technology EvaLuation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D&D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TM, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A. B. and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A. B, and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D&D, RA and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2.

  11. Oak Ridge National Laboratory Technology Logic Diagram. Volume 3, Technology evaluation data sheets: Part B, Dismantlement, Remedial action

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Oak Ridge National Laboratory Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates environmental restoration (ER) and waste management (WM) problems at Oak Ridge National Laboratory (ORNL) to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to decontamination and decommissioning (D&D), remedial action (RA), and WM activities. The TLD consists of three fundamentally separate volumes: Vol. 1, Technology Evaluation; Vol. 2, Technology Logic Diagram and Vol. 3, Technology EvaLuation Data Sheets. Part A of Vols. 1 and 2 focuses on RA. Part B of Vols. 1 and 2 focuses on the D&D of contaminated facilities. Part C of Vols. 1 and 2 focuses on WM. Each part of Vol. 1 contains an overview of the TM, an explanation of the problems facing the volume-specific program, a review of identified technologies, and rankings of technologies applicable to the site. Volume 2 (Pts. A. B. and C) contains the logic linkages among EM goals, environmental problems, and the various technologies that have the potential to solve these problems. Volume 3 (Pts. A. B, and C) contains the TLD data sheets. This volume provides the technology evaluation data sheets (TEDS) for ER/WM activities (D&D, RA and WM) that are referenced by a TEDS code number in Vol. 2 of the TLD. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than is given for the technologies in Vol. 2.

  12. Clinical laboratory detection of carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.

    Science.gov (United States)

    Miller, Shelley; Humphries, Romney M

    2016-08-01

    Carbapenemases, enzymes that hydrolyze carbapenem-class antimicrobials, pose serious clinical and diagnostic challenges, including their recent rapid spread among members of the Enterobacteriaceae, a family with no inherent carbapenem resistance. Currently there is no one-size-fits-all method for detecting carbapenem-resistant Enterobacteriaceae (CRE) in the laboratory, nor how to differentiate carbapenemase-producers (CP) from isolates that are carbapenem-resistant via other or combined mechanisms. This article reviews definitions for CRE and CP-CRE, and discusses current phenotypic and molecular methods available to the clinical laboratory for the detection of both CP and non-CP CRE. Expert commentary: Routine evaluation of carbapenem resistance mechanism by the routine clinical laboratory are not necessary for patient care, as clinical breakpoints best predict response. However, evaluation for carbapenemase is integral to infection control efforts, and laboratories should have the capacity to do such testing, either in house or by submitting isolates to a reference laboratory.

  13. Laboratory-based surveillance in the molecular era: The typened model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    H.G.M. Niesters (Bert); J.W. Rossen (John); H.G.A.M. van der Avoort (Harrie); D. Baas; K. Benschop (Kimberley); E.C.J. Claas (Eric); A. Kroneman; N.M. van Maarseveen (Noortje); S.D. Pas (Suzan); W. van Pelt (Wilfred); J. Rahamat-Langendoen (Janette); R. Schuurman (Rob); H. Vennema (Harry); L. Verhoef; K.C. Wolthers (Katja); M.P.G. Koopmans D.V.M. (Marion)

    2013-01-01

    textabstractLaboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories

  14. Laboratory-based surveillance in the molecular era : the TYPENED model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    Niesters, H G; Rossen, J W; van der Avoort, H; Baas, D; Benschop, K; Claas, E C; Kroneman, A; van Maarseveen, N; Pas, S; van Pelt, W; Rahamat-Langendoen, J C; Schuurman, R; Vennema, H; Verhoef, L; Wolthers, K; Koopmans, Marion

    2013-01-01

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for

  15. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories

    NARCIS (Netherlands)

    Niesters, H. G.; Rossen, J. W.; van der Avoort, H.; Baas, D.; Benschop, K.; Claas, E. C.; Kroneman, A.; van Maarseveen, N.; Pas, S.; van Pelt, W.; Rahamat-Langendoen, J. C.; Schuurman, R.; Vennema, H.; Verhoef, L.; Wolthers, K.; Koopmans, M.

    2013-01-01

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for

  16. Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics*

    Science.gov (United States)

    Orofino-Costa, Rosane; de Macedo, Priscila Marques; Rodrigues, Anderson Messias; Bernardes-Engemann, Andréa Reis

    2017-01-01

    In the late 90's there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developed; nevertheless, more clinical trials are required to confirm its efficacy. PMID:29166494

  17. [Impact of digital technology on clinical practices: perspectives from surgery].

    Science.gov (United States)

    Zhang, Y; Liu, X J

    2016-04-09

    Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Being integrated into clinical practice, digital techniques facilitate surgical care by improving outcomes and reducing risks. Digital techniques are becoming increasingly popular in trauma surgery, orthopedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes.

  18. The evolution of Interior Intrusion Detection Technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-07-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the US Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). We also discuss new sensors and unique sensor combinations developed when commercial sensors were unavailable and the future application of expert systems

  19. The evolution of interior intrusion detection technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-07-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the US Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). We also discuss new sensors and unique sensor combination developed when commercial sensors were unavailable and the future application of expert systems. 5 refs

  20. The evolution of interior intrusion detection technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-01-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the U.S. Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). The authors also discuss new sensors and unique sensor combinations developed when commercial sensors were unavailable and the future application of expert systems

  1. Implementation of a companion diagnostic in the clinical laboratory

    DEFF Research Database (Denmark)

    Mancini, Irene; Pinzani, Pamela; Simi, Lisa

    2015-01-01

    A companion diagnostic test provides information that is essential for the safe and effective use of a corresponding therapeutic product as indicated in the drug instructions. The implementation of a companion diagnostic follows the rules of a molecular test for somatic mutations in a routine......, as an example, the BRAF genotype analysis in tumor tissue samples for identification of melanoma patients that can benefit treatment with BRAF inhibitors. The manuscript is focused on the following aspects: i) medical rationale, ii) methodologies of analysis, iii) laboratory performance evaluation and iv...

  2. ESWT for tendinopathy: technology and clinical implications.

    Science.gov (United States)

    van der Worp, Henk; van den Akker-Scheek, Inge; van Schie, Hans; Zwerver, Johannes

    2013-06-01

    The general consensus that tendinopathy, at least in the chronic stage, is mainly a degenerative condition and inflammation plays a minor role has led to a shift from treatments that target inflammation towards treatment options that promote regeneration. One of these treatments is extracorporeal shockwave therapy (ESWT), a physical therapy modality that uses pressure waves to treat tendinopathy. This review was undertaken to give an overview of the literature concerning this treatment, and special attention is given to the differences between focused and radial ESWT. A narrative description of wave characteristics, generation methods and in vitro effects of ESWT is given. The literature on ESWT as a treatment for one common tendinopathy, patellar tendinopathy, was systematically reviewed. Waves that are generated for focused and radial ESWT have very different physical characteristics. It is unclear how these characteristics are related to clinical effectiveness. Studies into the biological effects of ESWT have mainly used focused shockwave therapy, showing a number of effects of shockwaves on biological tissue. The systematic review of studies into the clinical effects of ESWT for patellar tendinopathy showed conflicting evidence for its effectiveness. Physical characteristics of focused and radial waves differ substantially, but effect on clinical effectiveness is unclear. Whereas in vitro studies often show the effects of ESWT on tendon tissue, results of clinical studies are inconsistent. Based on the review of the literature, suggestions are given for the use of ESWT in clinical practice regarding timing and treatment parameters.

  3. Computerized Laboratory in Science and Technology Teaching: Course in Machine Elements

    OpenAIRE

    Ivan KOLAROV

    2005-01-01

    The computer registration of physical and mechanical quantities gives a lot of possibilities for machine elements and mechanisms research. The advantages of well-organized computer laboratory both technical and methodological are namely: registration and on-line observation of a number of processes with random speed; replacement of high-cost specialized laboratory equipment; mathematical data processing; solving educational problems by modern technologies. The purpose of this paper is to ...

  4. Clinical operations generation next… The age of technology and outsourcing.

    Science.gov (United States)

    Temkar, Priya

    2015-01-01

    Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.

  5. Clinical operations generation next… The age of technology and outsourcing

    Directory of Open Access Journals (Sweden)

    Priya Temkar

    2015-01-01

    Full Text Available Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations.

  6. Clinical operations generation next… The age of technology and outsourcing

    Science.gov (United States)

    Temkar, Priya

    2015-01-01

    Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. PMID:26623386

  7. Incidence of ricket clinical symptoms and relation between clinical and laboratory findings in infants

    Directory of Open Access Journals (Sweden)

    Čukalović M.

    2014-01-01

    Full Text Available Rickets presents osteomalacia which is developed due to negative balance of calcium and / or phosphorus during growth and development. Therefore it appears only in children. The most common reason of insufficient mineralization is deficiency of vitamin D, which is necessary for inclusion of calcium in cartilage and bones. As result, proliferation of cartilage and bone tissue appears, creating calluses on typical places. Bones become soft and curve, resulting in deformities. Our present study included 86 infants, in whom, besides other diseases, clinical and laboratory signs of rickets were identified. In our study, rickets is most common (82.5% in infants older than 6 months. By clinical picture, craniotabes is present in 46.5% of cases, Harisson groove in 26.7%, rachitic bracelets in 17.4%, rachitic rosary in 17.4% and carpopedal spasms in 2.3% of cases. Leading biochemical signs of vitamin D deficient rickets is hypophosphatemia (in 87.3% of cases, normal calcemia (in 75.6% of cases and increased values of alkaline phosphatase (in 93% of cases. It has been shown that rickets in infant age may later affect higher incidence of juvenile diabetes, infection of lower respiratory tract, osteoporosis, and so on.

  8. Cost comparison of laboratory methods and four field screening technologies for uranium-contaminated soil

    International Nuclear Information System (INIS)

    Douthat, D.M.; Armstrong, A.Q.

    1994-01-01

    To address the problem of characterizing uranium-contaminated surface soil at federal facilities, the Department of Energy has the development of four uranium field screening technologies, under the direction of the Uranium-in-Soils Integrated Demonstration (USID) Program. These four technologies include: a long-range alpha detector a beta scintillation detector, an in situ gamma detector, and a mobile laser ablation-inductively coupled plasma/atomic emission spectrometry (LA-ICP/AES) laboratory. As part of the performance assessment for these field screening technologies, cost estimates for the development and operation of each technology were created. A cost study was conducted to compare three of the USID field screening technologies to the use of traditional field surveying equipment to adequately characterize surface soils of a one-acre site. The results indicate that the use of traditional equipment costs more than the in situ gamma detector, but less than the beta scintillation detector and LRAD. The use of traditional field surveying equipment results in cost savings of 4% and 34% over the use of the beta scintillation and LRAD technologies, respectively. A study of single-point surface soil sampling and laboratory analysis costs was also conducted. Operational costs of the mobile LA-ICP/AES laboratory were compared with operational costs of traditional sampling and analysis, which consists of collecting soil samples and conducting analysis in a radiochemical laboratory. The cost study indicates that the use of the mobile LA-ICP/AES laboratory results in cost savings of 23% and 40% over traditional field sampling and laboratory analysis conducted by characterization groups at two DOE facilities

  9. Oak Ridge National Laboratory Technology Logic Diagram. Volume 1, Technology Evaluation: Part C, Waste Management

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    This report documents activities at ORNL including waste management and remedial action at the site; also waste processing and disposal; robotics and automation of the laboratory; and regulatory compliance

  10. Proceedings of symposium on technology in laboratories by department of engineering and technical services

    International Nuclear Information System (INIS)

    1994-07-01

    The Symposium on Technology in Laboratories was held on March 23 and 24 at Ceratopia Toki, and Toki Chamber of Commerce and Industry in Toki city, Gifu Prefecture, Japan. This symposium was hosted by National Institute for Fusion Science (NIFS). There were 273 participants from many Japanese universities and laboratories, from some Japanese industrial world. Seventy eight papers were presented in the symposium. Technical experience and new techniques were reported and discussed being divided into five sessions; technologies of fabrication, cryogenics, diagnostic and control system, computer and experimental apparatus. (author)

  11. Solid oxide cell R&D at Riso National Laboratory-and its transfer to technology

    DEFF Research Database (Denmark)

    Linderoth, Søren

    2009-01-01

    Risø National Laboratory has conducted R&D on solid oxide cells for almost 20 years—all the time together with industries with interest in deploying the technology when mature. Risø National Laboratory (Risø) and Topsoe Fuel Cell A/S (TOFC) have for several years jointly carried out a development...... by the consortium, e.g. a metal-supported cell. TOFC has an extended program to develop the SOFC technology all the way to a marketable product....

  12. Implementation of Good Clinical Laboratory Practice (GCLP) guidelines within the External Quality Assurance Program Oversight Laboratory (EQAPOL).

    Science.gov (United States)

    Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella

    2014-07-01

    The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.

  13. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    Science.gov (United States)

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

  14. The Martin Marietta Energy Systems Associated Laboratories for Excellence in Radiation Technology (ALERT)

    International Nuclear Information System (INIS)

    Bogard, J.S.; Casson, W.H. Sr.; Bauer, M.L.; Gregory, D.C.

    1993-01-01

    The excellence and uniqueness of radiation technology expertise at Oak Ridge National Laboratory (ORNL) was recognized during a review by the DOE Oak Ridge Field Office prior to a 1990 Tiger Team review, and the Laboratory was encouraged at that time to explore ways of sharing this expertise with other DOE facilities. The subsequent evolution of DOE Laboratory Accreditation Programs, with their challenging performance requirements, and of program guidance such as that contained in the DOE Radiation Control Manual, which requires improved radiological instrument services and encourages standardization, reemphasizes the importance of sharing ORNL's extensive capabilities for supporting improved radiological safety and health programs

  15. Quality assurance consideration for cement-based grout technology programs at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    McDaniel, E.W.; Tallent, O.K.; Sams, T.L.; Delzer, D.B.

    1987-01-01

    Oak Ridge National Laboratory has developed and is continuing to refine a method of immobilizing low-level radioactive liquid wastes by mixing them with cementitious dry-solid blends. A quality assurance program is vital to the project because Nuclear Regulatory Commission (NRC), Environmental Protection Agency (EPA) and state environmental regulations must be demonstrably met (the work must be defensible in a court of law). The end result of quality assurance (QA) is, by definition, a product of demonstrable quality. In the laboratory, this entails traceability, repeatability, and credibility. This paper describes the application of QA in grout technology development at Oak Ridge National Laboratory

  16. Epidemiologic, clinical and laboratory aspects of hepatitis E

    Indian Academy of Sciences (India)

    HEV infection: Clinical features · Hepatitis virus superinfection · HEV and cirrhosis: methods · HEV superinfection in cirrhosis · Hepatitis E: host cell damage · Intracellular cytokine expression · Slide 34 · Cytokine-expressing CD4 cells (ORF2) · Cytokine-expressing CD8 cells (ORF2) · Cytokine-expressing CD4 cells (ORF3).

  17. Glycogen storage disease type I: clinical and laboratory profile

    Directory of Open Access Journals (Sweden)

    Berenice L. Santos

    2014-11-01

    Conclusions: Diagnosis of glycogen storage disease type I is delayed in Brazil. Most patients undergo liver biopsy for diagnostic confirmation, even though the combination of a characteristic clinical presentation and molecular methods can provide a definitive diagnosis in a less invasive manner. Obesity is a side effect of cornstarch therapy, and appears to be associated with growth in these patients.

  18. The medical laboratory scientist in the clinical chemistry service ...

    African Journals Online (AJOL)

    The recent opening of an official register for medicallaboratory scientists in South Africa has prompted an examination of the professional role, training and qualification of one particular group of scientists, namely clinical chemists working in hospital pathology departments. Lack of recognition of the potential contribution of ...

  19. Clinical and laboratory findings in mad honey poisoning: A single ...

    African Journals Online (AJOL)

    Objective: This study is aimed at analyzing the demographic and clinical characteristics, as well as the hematological.biochemical parameters of patients who admitted to the hospital with the diagnosis of mad honey poisoning. Materials and Methods: A total of 16 patients who were admitted with mad honey intoxication ...

  20. Professional behaviors, sense of belonging, and professional socialization of early career clinical laboratory scientists

    Science.gov (United States)

    Schill, Janna Marie

    Professional socialization is a process that individuals experience as members of a profession and consists of the knowledge, attitudes, and experiences that influence and shape their professional identity. The process of professional socialization has not been studied in the clinical laboratory science profession. Clinical laboratory science is an allied health profession that is faced by a workforce shortage that has been caused by a decrease in new graduates, decreased retention of qualified professionals, and increased retirements. Other allied health professions such as nursing, athletic training, and pharmacy have studied professional socialization as a way to identify factors that may influence the retention of early career professionals. This mixed method study, which quantitatively used Hall's Professionalism Scale (1968) in addition to qualitative focus group interviews, sought to identify the professional attitudes and behaviors, sense of belonging, and professional socialization of early career clinical laboratory scientists. Early career clinical laboratory scientists were divided into two groups based upon the amount of work experience they had; new clinical laboratory science graduates have had less than one year of work experience and novice clinical laboratory scientists had between one and three years of work experience. This study found that early career clinical laboratory scientists have established professional identities and view themselves as members of the clinical laboratory science field within four proposed stages of professional socialization consisting of pre-arrival, encounter, adaptation, and commitment. New CLS graduates and novice clinical laboratory scientists were found to be at different stages of the professional stage process. New CLS graduates, who had less than one year of work experience, were found to be in the encounter stage. Novice clinical laboratory scientists, with one to three years of work experience, were found to

  1. Rome Laboratory speech and audio processing technologies with applicability to law enforcement

    Science.gov (United States)

    Walter, Sharon M.; Ratley, Roy J.; Cupples, Edward J.

    1997-02-01

    Rome Laboratory, one of the United States Air Force's four Super Laboratories, has been designated by the National Institute of Justice (NIJ) to be its National Law Enforcement and Corrections Technology Center for the Northeast (NLECTC-NE). A Department of Defense leader in research and development (R&D) in speech and audio processing for over 25 years, Rome Laboratory's main thrust in these R&D areas has focused on developing technology to improve the collection, handling, identification and intelligibility of communication signals. Rome Laboratory speech and audio technology is unique and particularly appropriate for application to law enforcement requirements because it addresses the military need for time critical decisions and actions, operating within noisy environments, and use by uncooperative speakers in tactical, real-time applications. Speech enhancement and speaker recognition are the primary technologies discussed in this paper. Automatic language and dialect identification, automatic gisting, spoken language translation, co-channel speaker separation and audio manipulation technologies are briefly discussed.

  2. Laboratory challenges conducting international clinical research in resource-limited settings.

    Science.gov (United States)

    Fitzgibbon, Joseph E; Wallis, Carole L

    2014-01-01

    There are many challenges to performing clinical research in resource-limited settings. Here, we discuss several of the most common laboratory issues that must be addressed. These include issues relating to organization and personnel, laboratory facilities and equipment, standard operating procedures, external quality assurance, shipping, laboratory capacity, and data management. Although much progress has been made, innovative ways of addressing some of these issues are still very much needed.

  3. The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine

    DEFF Research Database (Denmark)

    Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob

    2012-01-01

    Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring...... and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations...

  4. The changing landscape of genetic testing and its impact on clinical and laboratory services and research in Europe.

    Science.gov (United States)

    Hastings, Ros; de Wert, Guido; Fowler, Brian; Krawczak, Michael; Vermeulen, Eric; Bakker, Egbert; Borry, Pascal; Dondorp, Wybo; Nijsingh, Niels; Barton, David; Schmidtke, Jörg; van El, Carla G; Vermeesch, Joris; Stol, Yrrah; Carmen Howard, Heidi; Cornel, Martina C

    2012-09-01

    The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the 'Changing landscape of genetic testing', co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research.

  5. Zirconia as a sliding material: histologic, laboratory, and clinical data.

    Science.gov (United States)

    Cales, B

    2000-10-01

    Zirconia ceramics have been introduced in orthopaedic surgery as prosthetic femoral heads to solve the critical issue of femoral head fractures sometimes observed with alumina ceramics. In addition to outstanding mechanical properties, zirconia ceramics have, similar to other surgical grade ceramics, a high biocompatibility and a high resistance to scratching. The radioactivity of zirconia ceramic, which has been the subject of contradictory data, now is well understood and managed with appropriate standards. The long-term stability of zirconia ceramics recently has been studied extensively and precise models allow a good prediction of their long-term behavior. In vitro wear tests against polyethylene and clinical data confirm the low wear rate associated with the use of ceramic femoral heads. The use of zirconia femoral heads in ceramic-on-ceramic total hip prostheses also has been investigated and now is clinically effective.

  6. Experimental Psychopathology: From laboratory studies to clinical practice

    Directory of Open Access Journals (Sweden)

    Pierre Philippot

    2006-03-01

    Full Text Available Recently, David Barlow (2004, a pioneer in the field of anxiety disorders, has proposed that psychologists should abandon the concept of psychotherapy and rather use the one of “psychological treatment”. The provoking idea behind this proposal is that the concept of psychotherapy, relying on the notion of “therapeutic school” should be discarded by professional psychologists because it relies too much on conceptions based on pre-scientific models. Barlow (2004 insists that, today, psychology as an empirical science has gathered sufficient knowledge and know-how to found clinical practice. It is no longer necessary to rely on pre-scientific theories. Further, Barlow’s perspective opens clinical practice to the entire field of psychology, i.e. to the advances accomplished by research on emotion, cognition, learning, development, etc.

  7. [Systemic lupus erythematosus in the aged: clinical and laboratory characteristics].

    Science.gov (United States)

    Takayasu, V; Bonfá, E; Levy Neto, M; Kumeda, C; Daud, R M; Cossermelli, W

    1992-01-01

    The clinical and serologic characteristics of 199 systemic lupus erythematosus patients with early and late onset of disease were compared to determine if the disease in the older age group defines a specific subset of SLE. This study demonstrated that SLE in the elderly patients exhibits peculiar clinical features with a high frequency of muscular involvement (p manifestations (p manifestation was muscular pain and stiffness, arthritis and weight loss (over 10 kg). This condition is often hard to distinguish from polymyalgia rheumatica or underlying malignancy. The frequency of autoantibodies was similar in both groups. The absence of anti-La was surprising, however it was confirmed by "Western blotting". The symptoms of late onset SLE are not very prominent however the diagnosis should be considered in order to avoid delays in treatment.

  8. Research and development of superconductivity for energy technology in electrotechnical laboratory

    International Nuclear Information System (INIS)

    Koyama, K.

    1984-01-01

    Superconductivity is a physical effect wherein the electrical resistivity disappears at cryogenic temperatures. Superconductivity has the advantage of following large current densities and high magnetic fields, which are stable and homogeneous. There are many applications of superconductivity which take advantage of these merits. It is of special importance to apply superconductors to alternative energy and energy saving technology. This paper presents briefly some of the research and development efforts to apply superconductivity to energy technology in the Electrotechnical Laboratory

  9. BETA-THALASSEMIA SYNDROMES, CLINICAL AND LABORATORY APPROACH

    OpenAIRE

    Türkkan, Emine; Berrak, Su Gülsün; Canpolat, Cengiz

    2016-01-01

    The Beta ((3) thalassemia syndromes are a heterogeneous group of genetic disorders. The frequency of thalassemia is dependent on the ethnic origins of the patient population. Turkey is located in a geographic area of the world where thalassemia syndromes are common. The incidence rate of (3-thalassemia carriers was stated to be 2 per cent in Turkey. Clinical manifestations are diverse and range from asymptomatic hypochromia and microcytosis to profound anemia leading to death in early childho...

  10. Genetic, Clinical, and Laboratory Markers for DOCK8 Immunodeficiency Syndrome

    Directory of Open Access Journals (Sweden)

    Jeremiah C. Davis

    2010-01-01

    Full Text Available DOCK8 immunodeficiency syndrome (DIDS is a combined immunodeficiency characterized by recurrent viral infections, severe atopy, and early onset malignancy. Genetic studies revealed large, unique deletions in patients from different families and ethnic backgrounds. Clinical markers of DIDS include atopic dermatitis, allergies, cutaneous viral infections, recurrent respiratory tract infections, and malignancy. Immune assessments showed T cell lymphopenia, hyper-IgE, hypo-IgM, and eosinophilia. The impaired lymphocyte functions in DIDS patients appear central for disease pathogenesis.

  11. A Clinical and Laboratory Comparison of Alginate Impression Techniques,

    Science.gov (United States)

    1981-09-04

    impression would be inaccurate, and if these casts were to be used for the fabrication of a partial denture framework, the framework would be clinically...partially edentulous arches (referred tu --s standards) were made using a combination of metal and acrylic . Landmarks (machined indentations) in the second...with the alginate material, custom acrylic trays were made and polysulfide rubber was used to prepare 20 impressions of the maxillary and mandibular

  12. Clinical and Laboratory Findings of Patients with Breath Holding Spells

    OpenAIRE

    Özlem Özdemir; Serpil Çalışkan Can; Evren Semizel; Mehmet S. Okan

    2009-01-01

    Aim: The aim of this prospective study was to evaluate the clinical characteristics; physical findings, cardiological, hematological and neurological problems; treatment approaches; and the prognosis of children with breath holding spells.Materials and Method: Seventhy patients were included in this study. All patients were evaluated with detailed history and physical examination. Complete blood count, serum iron and iron binding capacity were studied; cardiological (telecardiography, electro...

  13. Clinical and laboratory findings in 220 children with recurrent abdominal pain

    NARCIS (Netherlands)

    Gijsbers, C. F. M.; Benninga, M. A.; Büller, H. A.

    2011-01-01

    Aim: To investigate the clinical and laboratory findings in children with recurrent abdominal pain (RAP). Methods: Consecutive patients with RAP (Apley criteria), age 4-16 years, referred to a secondary medical centre were evaluated by a standardized history, physical examination and laboratory

  14. CLINICAL AND LABORATORY PROFILE OF PATIENTS WITH IDIOPATHIC CD4 LYMPHOCYTOPENIA- A RARE CLINICAL ENTITY

    Directory of Open Access Journals (Sweden)

    Vijayashree Thyagaraj

    2017-01-01

    Full Text Available BACKGROUND Since 1989, several investigators have reported unusual cases of severe opportunistic infections associated with CD4 lymphocytopenia in the absence of human immunodeficiency virus infection. The cause of this condition is unknown. The Centres for Disease Control and Prevention (CDC defines Idiopathic CD4 T Lymphocytopenia (ICL as a clinical condition in which patients with depressed numbers of circulating CD4+ T-cell lymphocytes (<300 cells/μL or <20% of total T cells at a minimum of two separate time points at least 6 weeks apart, have no laboratory evidence of infection with human HIV-1 or HIV-2, or any defined immunodeficiency or therapy associated with depressed levels of CD4 T cells. The aim of the study is to analyse the clinical profile, opportunistic infections, laboratory parameters and outcome in terms of survival of patients diagnosed with ICL. MATERIALS AND METHODS Eight HIV negative patients who presented with opportunistic infections and who were diagnosed with ICL from 2007 to 2015 were included in the study. A detailed history was taken; physical examination was performed and the nature of illness with which they presented was documented. Then, CD4 and CD8 counts were done and CD4 count was repeated after a 6-week interval. The patients were followed up until discharge or death. RESULTS The mean age was 37.50±9.55 years. There were six males (75% and two females (25%. Fever was a presenting symptom among six (75% of them. Two were diagnosed to have cutaneous cryptococcosis (25%, two with invasive aspergillosis (25% and four with tuberculosis (50%. Absolute lymphocyte count was less than 1200 in seven patients (87.5%, which roughly correlates with a CD4 count of less than 200 cells/μL, among PLWHIV. The mean CD4 count was 183.63±63.74 cells/μL during the first measurement and 214.43±103.98 cells/μL during the second one. Two patients died (37.5%. None of the patients were recorded to have any form of malignancy

  15. [Technologies for Complex Intelligent Clinical Data Analysis].

    Science.gov (United States)

    Baranov, A A; Namazova-Baranova, L S; Smirnov, I V; Devyatkin, D A; Shelmanov, A O; Vishneva, E A; Antonova, E V; Smirnov, V I

    2016-01-01

    The paper presents the system for intelligent analysis of clinical information. Authors describe methods implemented in the system for clinical information retrieval, intelligent diagnostics of chronic diseases, patient's features importance and for detection of hidden dependencies between features. Results of the experimental evaluation of these methods are also presented. Healthcare facilities generate a large flow of both structured and unstructured data which contain important information about patients. Test results are usually retained as structured data but some data is retained in the form of natural language texts (medical history, the results of physical examination, and the results of other examinations, such as ultrasound, ECG or X-ray studies). Many tasks arising in clinical practice can be automated applying methods for intelligent analysis of accumulated structured array and unstructured data that leads to improvement of the healthcare quality. the creation of the complex system for intelligent data analysis in the multi-disciplinary pediatric center. Authors propose methods for information extraction from clinical texts in Russian. The methods are carried out on the basis of deep linguistic analysis. They retrieve terms of diseases, symptoms, areas of the body and drugs. The methods can recognize additional attributes such as "negation" (indicates that the disease is absent), "no patient" (indicates that the disease refers to the patient's family member, but not to the patient), "severity of illness", disease course", "body region to which the disease refers". Authors use a set of hand-drawn templates and various techniques based on machine learning to retrieve information using a medical thesaurus. The extracted information is used to solve the problem of automatic diagnosis of chronic diseases. A machine learning method for classification of patients with similar nosology and the methodfor determining the most informative patients'features are

  16. Annual Technology Baseline (Including Supporting Data); NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Blair, Nate; Cory, Karlynn; Hand, Maureen; Parkhill, Linda; Speer, Bethany; Stehly, Tyler; Feldman, David; Lantz, Eric; Augusting, Chad; Turchi, Craig; O' Connor, Patrick

    2015-07-08

    Consistent cost and performance data for various electricity generation technologies can be difficult to find and may change frequently for certain technologies. With the Annual Technology Baseline (ATB), National Renewable Energy Laboratory provides an organized and centralized dataset that was reviewed by internal and external experts. It uses the best information from the Department of Energy laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information. The ATB includes both a presentation with notes (PDF) and an associated Excel Workbook. The ATB includes the following electricity generation technologies: land-based wind; offshore wind; utility-scale solar PV; concentrating solar power; geothermal power; hydropower plants (upgrades to existing facilities, powering non-powered dams, and new stream-reach development); conventional coal; coal with carbon capture and sequestration; integrated gasification combined cycle coal; natural gas combustion turbines; natural gas combined cycle; conventional biopower. Nuclear laboratory's renewable energy analysts and Energy Information Administration information for conventional technologies. The ATB will be updated annually in order to provide an up-to-date repository of current and future cost and performance data. Going forward, we plan to revise and refine the values using best available information.

  17. Research with radioisotopes in clinical and laboratory medicine: a bibliographic review

    International Nuclear Information System (INIS)

    Metz, J.; Van der Walt, L.A.; Malan, J.M.

    1985-01-01

    This bibliography is restricted mainly to AEC-supported projects which are considered to amply reflect the widespread use of radioisotopes in clinical and laboratory medicine in South Africa and which describe research with radioisotopes of some direct relevance to diagnostic-clinical or laboratory medicine, or both, but excluding therapy with isotopes. General information is given in this review on oncology, endocrinology, metabolism and nutrition, haematology, neurology, angiocardiology, pulmonology, gastroenterology, gynaecology and obstetrics, nephrology, immunology and transplantation, microbiology and parasitology

  18. Excellence in clinical laboratories: the standard ISO 15189:2007

    Directory of Open Access Journals (Sweden)

    Antonio Scipioni

    2010-06-01

    Full Text Available I laboratori clinici operano in stretto contatto con i pazienti e collaborano direttamente alla loro cura, in modo corresponsabile con i medici e i reparti ospedalieri. L’importanza della loro attività per la salute pubblica rende obbligatoria l’esplicitazione di alcuni punti finora spesso considerati ovvii. Ai pazienti dev’essere infatti garantito che: - i metodi di analisi utilizzati siano stati preliminarmente valutati, per confermare la loro rispondenza agli obiettivi dell’analisi stessa, verificati, per controllarne l’effettiva efficacia e, se necessario, validati per garantire che siano appropriati allo scopo; - il personale che esegue le analisi sia stato adeguatamente formato e quindi tecnicamente competente; - il laboratorio assicuri un’adeguata consulenza allo staff clinico che richiede le analisi, allo scopo di ottenere una sinergia tra il laboratorio e il clinico che ha in cura il paziente, sia nella fase di prelievo di materiale biologico, sia nella fase di interpretazione dei risultati. Tutto ciò è necessario per dimostrare ai pazienti

  19. Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

    Directory of Open Access Journals (Sweden)

    Marilda Mazzali

    1999-03-01

    Full Text Available CONTEXT: Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years.1 Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. OBJECTIVES: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. DESIGN: Accuracy study, retrospective analysis. SETTING: A university terciary referral center. SAMPLE: 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. MAIN MEASUREMENTS: Laboratory evaluation and hystological analysis (light microscopy, imunofluorescent eletronic microscopy. RESULTS: Most of the biopsies (58.9% were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. CONCLUSIONS: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.

  20. Meet the best Award-winning technologies from Pacific Northwest Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    The Battelle Memorial Institute has managed the Pacific Northwest Laboratory (PNL) for the US Department of Energy for 25 years. During this time, numerous new technologies have been discovered and developed at PNL as a result of our research programs. This document will introduce you to some of the more significant discoveries and newly commercialized technologies. Each of the technologies described has received an award from Research Development magazine or the Federal Laboratory Consortium--sometimes both Each technology is available to you through PNL's technology transfer program or one of our licensees. Similarly, our award-winning scientists and engineers are available to assist you as you search for innovative technologies to solve your technical problems. These researchers are familiar with current problems confronting industry, government agencies, and the academic community. They are happy to apply their skills and PNL's resources to your problems. PNL encourages its researchers to work with government agencies, universities, and US industries. PNL technology transfer programs address the nation's drive toward increased competitiveness by being flexible and aggressive, and are designed to tailor results to fit your needs and those of your clients. If you are in search of a new technology or increased competitiveness, consider collaborative efforts with our award-winning staff, whose accomplishments are synopsized in this booklet.

  1. Sesame seed allergy: Clinical manifestations and laboratory investigations

    Directory of Open Access Journals (Sweden)

    Fazlollahi MR.

    2007-10-01

    Full Text Available Background: Plant-origin foods are among the most important sources of food allergic reactions. An increase in the incidence of sesame seed allergy among children and adults has been reported in recent years. The aim of this preliminary study was to investigate the prevalence, importance and clinical manifestations of sesame allergy among Iranian patients.Methods: In a cross-sectional survey, 250 patients with suspected IgE-mediated food allergies completed a questionnaire and underwent skin prick tests with sesame extract as well as cross-reacting foods (walnut, soya and peanut. Total IgE and sesame-specific IgE levels were measured. Patients with positive skin test reactions and/or IgE specific for sesame without clinical symptoms were considered sensitive to sesame. The patients who also had clinical symptoms with sesame consumption were diagnosed as allergic to sesame.Results: Of the 250 patients enrolled in this study, 129 were male and 121 female, with a mean age of 11.7 years. The most common food allergens were cow's milk, egg, curry, tomato and sesame. Sesame sensitivity was found in 35 patients (14.1%. Only five patients (2% had sesame allergy. Sesame-sensitive patients had a significantly higher frequency of positive prick test to cross-reacting foods when compared to non-sensitized patients (p=0.00. The type of symptom was independent of gender and age of the patients, but urticaria and dermatitis-eczema were significantly more frequent in sensitized patients (p=0.008.Conclusions: This is the first study addressing the prevalence of sesame seed allergy in Iranian population. We found sesame to be a common and important cause of food allergy. The panel of foods recommended for use in diagnostic allergy tests should be adjusted.

  2. 'Net Generation' medical students: technological experiences of pre-clinical and clinical students.

    Science.gov (United States)

    Kennedy, Gregor; Gray, Kathleen; Tse, Justin

    2008-02-01

    While institutions have been keen to integrate information and communication technologies into medical education, little is known about the technological experiences of the current cohort of so-called 'Net Generation' students. This study investigated the technological experiences of medical students and determined whether there were differences between pre-clinical and clinical students. In 2006, 207 pre-clinical and 161 clinical students studying medicine at a major Australian university were surveyed. The questionnaire asked students about their access to, use of and skills with an array of technologies and technology-based tools. The results show that access to mobile phones, memory sticks, desktop computers, and broadband Internet connections was high while technologies such as PDAs were used in very low numbers. A factor analysis of students' use of 39 technology-based tools revealed nine clear activity types, including the 'standard' use of computers and mobile-phones, and the use of the Internet as a pastime activity, for podcasting and for accessing services. A comparison of pre-clinical and clinical students revealed a number of significant differences in terms of the frequency and skill with which these students use distinct technology-based tools. The findings inform current technology-based teaching and learning activities and shed light on potential areas of educational technology development.

  3. Exploratory analyses of the association of MRI with clinical, laboratory and radiographic findings in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Emery, Paul; van der Heijde, Désirée; Østergaard, Mikkel

    2011-01-01

    Evaluate relationships between MRI and clinical/laboratory/radiographic findings in rheumatoid arthritis (RA).......Evaluate relationships between MRI and clinical/laboratory/radiographic findings in rheumatoid arthritis (RA)....

  4. 78 FR 34655 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Project...

    Science.gov (United States)

    2013-06-10

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Personnel Management Demonstration Project, Department of Navy, Office of Naval Research (ONR); Proposed..., 2010 (75 FR 77380-77447), DoD published a notice of approval of a personnel management demonstration...

  5. 76 FR 67154 - Science and Technology Reinvention Laboratory Personnel Management Demonstration Program

    Science.gov (United States)

    2011-10-31

    ... to eight legacy Science and Technology Reinvention Laboratory (STRL) Personnel Management Demonstration (demo) Project Plans resulting from section 1107(c) of the National Defense Authorization Act... flexibilities, modifying demo project plans, or executing Federal Register Notices has identified some areas for...

  6. Vertical and Horizontal Integration of Laboratory Curricula and Course Projects across the Electronic Engineering Technology Program

    Science.gov (United States)

    Zhan, Wei; Goulart, Ana; Morgan, Joseph A.; Porter, Jay R.

    2011-01-01

    This paper discusses the details of the curricular development effort with a focus on the vertical and horizontal integration of laboratory curricula and course projects within the Electronic Engineering Technology (EET) program at Texas A&M University. Both software and hardware aspects are addressed. A common set of software tools are…

  7. Application of virtual reality technology in clinical medicine.

    Science.gov (United States)

    Li, Lan; Yu, Fei; Shi, Dongquan; Shi, Jianping; Tian, Zongjun; Yang, Jiquan; Wang, Xingsong; Jiang, Qing

    2017-01-01

    The present review discusses the application of virtual reality (VR) technology in clinical medicine, especially in surgical training, pain management and therapeutic treatment of mental illness. We introduce the common types of VR simulators and their operational principles in aforementioned fields. The clinical effects are also discussed. In almost every study that dealt with VR simulators, researchers have arrived at the same conclusion that both doctors and patients could benefit from this novel technology. Moreover, advantages and disadvantages of the utilization of VR technology in each field were discussed, and the future research directions were proposed.

  8. Outbreak of chikungunya in Johor Bahru, Malaysia: clinical and laboratory features of hospitalized patients.

    Science.gov (United States)

    Chew, L P; Chua, H H

    2009-09-01

    In 2008, an outbreak of chikungunya infection occurred in Johor. We performed a retrospective review of all laboratory confirmed adult chikungunya cases admitted to Hospital Sultanah Aminah, Johor Bahru from April to August 2008, looking into clinical and laboratory features. A total of 18 laboratory confirmed cases of chikungunya were identified with patients presenting with fever, joint pain, rash and vomiting. Haemorrhagic signs were not seen. Lymphopenia, neutropenia, thrombocytopenia, raised liver enzymes and deranged coagulation profile were the prominent laboratory findings. We hope this study can help guide physician making a diagnosis of chikungunya against other arborviruses infection.

  9. Technology breakthrough and clinic application of gemstone CT

    International Nuclear Information System (INIS)

    Wang Jian

    2009-01-01

    Gemstone CT breaks through the conventional CT development model of expending detector's width over the past decade. By gemstone detector and spectral imaging technology, it could provide higher diagnostic accuracy, quicker diagnosis speed and higher definition of imaging, and better meet comprehensive clinical needs than conventional CT. To summarize technical breakthrough and clinical application of Gemstone CT. (authors)

  10. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

    Science.gov (United States)

    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

    2013-01-01

    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bacteria, viruses. protozoa and fungi was positive in 425 (49.76%) cases. From this number the test on bacteria was positive in 248 (58.62%) cases, on viruses it was positive in 165 (39.0%), on protozoa in 9 (2.12%) cases and on fungi only one case. Rotavirus was the most frequent one in viral test, it was isolated in 142 (86.06%) cases, adenoviruses were found in 9 (5.45%) cases and noroviruses in only one case. The same feces sample that contained rotavirus and adenoviruses were isolated in five cases, whereas rotavirus with bacteria was isolated in the same feces sample in five cases. The biggest number of cases 62 (43.66%) were of the age 6-12 months, whereas the smallest number 10 (7.04%) cases were of the age 37-60 months. There were 76 (53.52%) of cases of male gender, from rural areas there were 81 (57.04%) cases and there were 58 (40.80%) cases during the summer period. Among the clinical symptoms the most prominent were diarrhea, vomiting, high temperature, whereas the different degree of dehydration were present in all cases (the most common one was moderate dehydration). The most frequent one was isonatremic dehydration in 91 (64.08%) cases, less frequent one was hypernatremic dehydration in 14 (9.85%) cases. The majority of cases (97.89%) had lower blood pH values, whereas 67 (47.17%) cases had pH values that varied from 7.16 -7.20 (curve peak), normal values were registered in only 3 (2.11%) cases. Urea values were increased in 45 (31.07%) cases (the maximum value

  11. Dentistry proteomics: from laboratory development to clinical practice.

    Science.gov (United States)

    Rezende, Taia M B; Lima, Stella M F; Petriz, Bernardo A; Silva, Osmar N; Freire, Mirna S; Franco, Octávio L

    2013-12-01

    Despite all the dental information acquired over centuries and the importance of proteome research, the cross-link between these two areas only emerged around mid-nineties. Proteomic tools can help dentistry in the identification of risk factors, early diagnosis, prevention, and systematic control that will promote the evolution of treatment in all dentistry specialties. This review mainly focuses on the evolution of dentistry in different specialties based on proteomic research and how these tools can improve knowledge in dentistry. The subjects covered are an overview of proteomics in dentistry, specific information on different fields in dentistry (dental structure, restorative dentistry, endodontics, periodontics, oral pathology, oral surgery, and orthodontics) and future directions. There are many new proteomic technologies that have never been used in dentistry studies and some dentistry areas that have never been explored by proteomic tools. It is expected that a greater integration of these areas will help to understand what is still unknown in oral health and disease. Copyright © 2013 Wiley Periodicals, Inc.

  12. 10 CFR 32.71 - Manufacture and distribution of byproduct material for certain in vitro clinical or laboratory...

    Science.gov (United States)

    2010-01-01

    ... certain in vitro clinical or laboratory testing under general license. 32.71 Section 32.71 Energy NUCLEAR... certain in vitro clinical or laboratory testing under general license. An application for a specific... only by physicians, veterinarians in the practice of veterinary medicine, clinical laboratories or...

  13. 42 CFR 414.509 - Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... for a new clinical diagnostic laboratory test. 414.509 Section 414.509 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.509 Reconsideration of basis for and amount of payment for a new clinical diagnostic laboratory...

  14. 75 FR 30041 - Medicare Program; Public Meeting in Calendar Year 2010 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2010-05-28

    ... clinical diagnostic laboratory tests under Part B of title XVIII of the Social Security Act (the Act) that... tests are any clinical diagnostic laboratory tests with respect to which a new or substantially revised... Year 2010 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  15. 76 FR 10600 - Medicare Program; Public Meeting in Calendar Year 2011 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2011-02-25

    ... payment determinations for new clinical diagnostic laboratory tests under Part B of title XVIII of the... amount of, payment for any clinical diagnostic laboratory tests with respect to which a new or... Year 2011 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  16. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

    Science.gov (United States)

    2013-05-24

    ... for coding and payment determinations for new clinical diagnostic laboratory tests under Part B of..., and amount of, payment for any clinical diagnostic laboratory test with respect to which a new or... [CMS-1451-N] Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test...

  17. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Science.gov (United States)

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

  18. Clinical alarm hazards: a "top ten" health technology safety concern.

    Science.gov (United States)

    Keller, James P

    2012-01-01

    For the past several years ECRI Institute has published a list of Top Ten Health Technology Hazards. This list is based on ECRI's extensive research in health technology safety and on data provided to its problemreporting systems. For every year that the Top Ten list has been published, Alarm Hazards have been at or near the top of the list. Improving alarm safety requires a systematic review of a hospital's alarm-based technologies and analysis of alarm management policies like alarm escalation strategies and staffing patterns. It also requires careful selection of alarm setting criteria for each clinical care area. This article will overview the clinical alarm problems that have been identified through ECRI Institute's research and analysis of various problem reporting databases, including those operated by ECRI Institute. It will also highlight suggestions for improvement, particularly from a technology design and technology management perspective. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. 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.

  20. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course.

  1. Neurobrucellosis: Clinical and laboratory findings in 22 patients

    Directory of Open Access Journals (Sweden)

    Rasoolinejad M

    1999-09-01

    Full Text Available Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160; eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.

  2. Exploring a Laboratory Model of Pharmacogenetics as Applied to Clinical Decision Making

    Directory of Open Access Journals (Sweden)

    David F. Kisor

    2013-01-01

    Full Text Available Objective: To evaluate a pilot of a laboratory model for relating pharmacogenetics to clinical decision making. Case Study: This pilot was undertaken and evaluated to help determine if a pharmacogenetics laboratory should be included in the core Doctor of Pharmacy curriculum. The placement of the laboratory exercise in the curriculum was determined by identifying the point in the curriculum where the students had been introduced to the chemistry of deoxyribonucleic acid (DNA as well as instructed on the chemistry of genetic variation. The laboratory included cytochrome P450 2C19 genotyping relative to the *2 variant. Twenty-four students served as the pilot group. Students provided buccal swabs as the source of DNA. Students stabilized the samples and were then provided instructions related to sample preparation, polymerase chain reaction, and gel electrophoresis. The results were reported as images of gels. Students used a reference gel image to compare their results to. Students then applied a dosing algorithm to make a "clinical decision" relative to clopidogrel use. Students were offered a post laboratory survey regarding attitudes toward the laboratory. Twenty-four students completed the laboratory with genotyping results being provided for 22 students (91.7%. Sixteen students were wild-type (*1/*1, while six students were heterozygous (*1/*2. Twenty-three students (96% completed the post laboratory survey. All 23 agreed (6, 26.1% or strongly agreed (17, 73.9% that the laboratory "had relevance and value in the pharmacy curriculum" Conclusion: The post pilot study survey exploring a laboratory model for pharmacogenetics related to clinical decision making indicated that such a laboratory would be viewed positively by students. This model may be adopted by colleges to expand pharmacogenetics education.   Type: Case Study

  3. 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.

  4. Bridging the transfer gap: laboratory exercise combines clinical exposure and anatomy review.

    Science.gov (United States)

    Wilson, Adam B; Ross, Christopher; Petty, Michael; Williams, James M; Thorp, Laura E

    2009-08-01

    One of the goals of medical education is to bridge the gap between basic science and clinical practice. Students acquire basic science knowledge during their pre-clinical years, yet have limited opportunities to apply this knowledge clinically. This hands-on laboratory exercise was designed to facilitate a review of anatomy in the context of select clinical procedures, highlighting the application of anatomical concepts in clinical practice. In 2008, Year 2 medical students participated in a clinical procedures laboratory taught by senior residents and attending physicians. Before participating, all students completed anatomy and clinical pre-tests and received syllabi detailing the select procedures and the anatomy pertinent to each. Students were organised into experimental (EG, n = 48) and control (CG, n = 17) groups. The EG observed and practised five procedures on cadavers and the CG participated in a traditional anatomy review laboratory with no procedural demonstrations or practice. Anatomy and clinical post-tests were administered to both groups following the 3-hour interventions. Surveys and focus sessions were used to assess student opinions. Scores on the anatomy pre- and post-tests were compared and were found to have significantly increased (P anatomy coupled with the teaching of clinical procedures results in an anatomical review superior to that of traditional methods, enhances knowledge of clinical procedures, and heightens students' awareness of the relationships between basic science and clinical practice.

  5. PNH revisited: Clinical profile, laboratory diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Gupta P

    2009-01-01

    Full Text Available Background: Paroxysmal nocturnal hemoglobinuria (PNH is characterized by intravascular hemolysis, marrow failure, nocturnal hemoglobinuria and thrombophila. This acquired disease caused by a deficiency of glycosylphosphatidylinositol (GPI anchored proteins on the hematopoietic cells is uncommon in the Indian population. Materials and Methods: Data of patients diagnosed with PNH in the past 1 year were collected. Clinical data (age, gender, various presenting symptoms, treatment information and follow-up data were collected from medical records. Results of relevant diagnostic tests were documented i.e., urine analysis, Ham′s test, sucrose lysis test and sephacryl gel card test (GCT for CD55 and CD59. Results: A total of 5 patients were diagnosed with PNH in the past 1 year. Presenting symptoms were hemolytic anemia (n=4 and bone marrow failure (n=1. A GCT detected CD59 deficiency in all erythrocytes in 4 patients and CD55 deficiency in 2 patients. A weak positive PNH test for CD59 was seen in 1 patient and a weak positive PNH test for CD55 was seen in 3 patients. All patients were negative by sucrose lysis test. Ham′s test was positive in two cases. Patients were treated with prednisolone and/or androgen and 1 patient with aplastic anemia was also given antithymocyte globulin. A total of 4 patients responded with a partial recovery of hematopoiesis and 1 patient showed no recovery. None of the patients received a bone marrow transplant. Conclusion: The study highlights the diagnostic methods and treatment protocols undertaken to evaluate the PNH clone in a developing country where advanced methods like flowcytometry immunophenotyping (FCMI and bone marrow transplants are not routinely available.

  6. Practices for Identifying and Rejecting Hemolyzed Specimens Are Highly Variable in Clinical Laboratories.

    Science.gov (United States)

    Howanitz, Peter J; Lehman, Christopher M; Jones, Bruce A; Meier, Frederick A; Horowitz, Gary L

    2015-08-01

    Hemolysis is an important clinical laboratory quality attribute that influences result reliability. To determine hemolysis identification and rejection practices occurring in clinical laboratories. We used the College of American Pathologists Survey program to distribute a Q-Probes-type questionnaire about hemolysis practices to Chemistry Survey participants. Of 3495 participants sent the questionnaire, 846 (24%) responded. In 71% of 772 laboratories, the hemolysis rate was less than 3.0%, whereas in 5%, it was 6.0% or greater. A visual scale, an instrument scale, and combination of visual and instrument scales were used to identify hemolysis in 48%, 11%, and 41% of laboratories, respectively. A picture of the hemolysis level was used as an aid to technologists' visual interpretation of hemolysis levels in 40% of laboratories. In 7.0% of laboratories, all hemolyzed specimens were rejected; in 4% of laboratories, no hemolyzed specimens were rejected; and in 88% of laboratories, some specimens were rejected depending on hemolysis levels. Participants used 69 different terms to describe hemolysis scales, with 21 terms used in more than 10 laboratories. Slight and moderate were the terms used most commonly. Of 16 different cutoffs used to reject hemolyzed specimens, moderate was the most common, occurring in 30% of laboratories. For whole blood electrolyte measurements performed in 86 laboratories, 57% did not evaluate the presence of hemolysis, but for those that did, the most common practice in 21 laboratories (24%) was centrifuging and visually determining the presence of hemolysis in all specimens. Hemolysis practices vary widely. Standard assessment and consistent reporting are the first steps in reducing interlaboratory variability among results.

  7. CLINIC-LABORATORY DESIGN BASED ON FUNCTION AND PHILOSOPHY AT PURDUE UNIVERSITY.

    Science.gov (United States)

    HANLEY, T.D.; STEER, M.D.

    THIS REPORT DESCRIBES THE DESIGN OF A NEW CLINIC AND LABORATORY FOR SPEECH AND HEARING TO ACCOMMODATE THE THREE BASIC PROGRAMS OF--(1) CLINICAL TRAINING OF UNDERGRADUATE AND GRADUATE STUDENT MAJORS, (2) SERVICES MADE AVAILABLE TO THE SPEECH AND HEARING HANDICAPPED, AND (3) RESEARCH IN SPEECH PATHOLOGY, AUDIOLOGY, PSYCHO-ACOUSTICS, AND…

  8. An Enzymatic Clinical Chemistry Laboratory Experiment Incorporating an Introduction to Mathematical Method Comparison Techniques

    Science.gov (United States)

    Duxbury, Mark

    2004-01-01

    An enzymatic laboratory experiment based on the analysis of serum is described that is suitable for students of clinical chemistry. The experiment incorporates an introduction to mathematical method-comparison techniques in which three different clinical glucose analysis methods are compared using linear regression and Bland-Altman difference…

  9. 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

  10. In vitro fertilization (IVF): a review of 3 decades of clinical innovation and technological advancement.

    Science.gov (United States)

    Wang, Jeff; Sauer, Mark V

    2006-12-01

    In vitro fertilization, popularly referred to as IVF, has captured the attention of the public since its sensational introduction in 1978. Today assisted reproductive technology is available throughout most of the civilized world, and the practice is largely different from that used during the early days. Refinements in laboratory technology and clinical practice have allowed IVF to evolve into a medical procedure that is efficient, safe, readily accessible, and relatively affordable. More than 2 million IVF children have been born to date, and it is likely that continued enhancements will widen its appeal and applicability.

  11. Clinical and laboratory characteristics of occult hepatitis B

    Directory of Open Access Journals (Sweden)

    E. V. Esaulenko

    2016-01-01

    Full Text Available HBsAg earlier was always considered as the required serological marker of the current HBV-infection, and the presence of НВsAb was considered as evidence of the previous infection with the elimination of virus and the recovery. Exceptions of this rule were discovered more than two decades ago, after which it appeared the concept «occult» hepatitis В.Aim: to characterize clinical course of chronic HBV-infection HBsAg-negative (occult depending on HBsAb levels in serum.Materials and methods: were examined 198 patients with HBsAg-negative chronic HBV-infection, with the confirmation mono-infection in the absence of factors of liver injury noninfectious etiology.Results: most of the patient was in 45–74 years old. In 53 patients (27,8% were identified HBcAb and HBsAb titer greater than 10 IU/l: positive HBcAb and HBsAb titre from 10 to 100 IU/l in 21,2% of cases; positive HBcAb and HBsAb titer more than 100 IU/l – 5,5%. DNA HBV was determined in 7,1% of cases. Cirrhotic stage of disease diagnosed in 30,2% of patients with low levels of HBsAb and 13,2% of patients with a high level of HBsAb. Evaluation of the degree of liver cirrhosis were revealed a class C in 86,9% of cases. Patients with decompensated cirrhosis are twice as likely HBsAb in low titre than high.Conclusion: chronic HBV-infection with the serological profile of «past infection» independently of the level HBsAb can estimate as disease with the latent flow and may progression of pathologic process up to cirrhosis of the liver. These patients are subject to regular medical check once a year in a day hospital of a specialized center.

  12. Technology study of Gunite tank sludge mobilization at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    DeVore, J.R.; Herrick, T.J.; Lott, K.E.

    1994-12-01

    The Oak Ridge National Laboratory (ORNL) Gunite Tank Sludge Mobilization Technology Study was initiated to support the Gunite Tank Treatability Study effort. The technology study surveyed the methods and technologies available for tank cleaning and sludge mobilization in a radioactive environment. Technologies were identified and considered for applicability to the Gunite and Associated Tanks (GAAT) problems. These were then either accepted for further study or rejected as not applicable. Technologies deemed applicable to the GAAT sludge removal project were grouped for evaluation according to (1) deployment method, (2) types of remotely operated end effector equipment applicable to removal of sludge, (3) methods for removing wastes from the tanks, and (4) methods for concrete removal. There were three major groups of deployment technologies: ''past practice'' technologies, mechanical arm-based technologies, and vehicle-based technologies. The different technologies were then combined into logical sequences of deployment platform, problem, end effector, conveyance, post-removal treatment required (if any), and disposition of the waste. Many waste removal options are available, but the best technology in one set of circumstances at one site might not be the best type to use at a different site. No single technology is capable of treating the entire spectrum of wastes that will be encountered in GAAT. None of the systems used in other industries appears to be suitable, primarily because of the nature of the sludges in the GAAT Operable Unit (OU), their radiation levels, and tank geometries. Other commercial technologies were investigated but rejected because the authors did not believe them to be applicable

  13. Technology study of Gunite tank sludge mobilization at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    DeVore, J.R.; Herrick, T.J.; Lott, K.E.

    1994-12-01

    The Oak Ridge National Laboratory (ORNL) Gunite Tank Sludge Mobilization Technology Study was initiated to support the Gunite Tank Treatability Study effort. The technology study surveyed the methods and technologies available for tank cleaning and sludge mobilization in a radioactive environment. Technologies were identified and considered for applicability to the Gunite and Associated Tanks (GAAT) problems. These were then either accepted for further study or rejected as not applicable. Technologies deemed applicable to the GAAT sludge removal project were grouped for evaluation according to (1) deployment method, (2) types of remotely operated end effector equipment applicable to removal of sludge, (3) methods for removing wastes from the tanks, and (4) methods for concrete removal. There were three major groups of deployment technologies: ``past practice`` technologies, mechanical arm-based technologies, and vehicle-based technologies. The different technologies were then combined into logical sequences of deployment platform, problem, end effector, conveyance, post-removal treatment required (if any), and disposition of the waste. Many waste removal options are available, but the best technology in one set of circumstances at one site might not be the best type to use at a different site. No single technology is capable of treating the entire spectrum of wastes that will be encountered in GAAT. None of the systems used in other industries appears to be suitable, primarily because of the nature of the sludges in the GAAT Operable Unit (OU), their radiation levels, and tank geometries. Other commercial technologies were investigated but rejected because the authors did not believe them to be applicable.

  14. Incorporating spectroscopy and measurement technology into the high school chemistry laboratory

    Science.gov (United States)

    Harbert, Emily Ann

    Science and technology are becoming increasingly important in maintaining a healthy economy at home and a competitive edge on the world stage, though that is just one facet affected by inadequate science education in the United States. Engaging students in the pursuit of knowledge and giving them the skills to think critically are paramount. One small way to assist in achieving these goals is to increase the quality and variety of technology-rich activities conducted in high school classrooms. Incorporating more laboratory measurement technology into high schools may incite more student interest in the processes and practices of science and may allow students to learn to think more critically about their data and what it represents. The first objective of the work described herein was to determine what measurement technology is being used in schools and to what extent, as well as to determine other teacher needs and preferences. Second, the objective was to develop a new program to provide incoming freshmen (or rising seniors) with measurement technology training they did not receive in high school, and expose them to new research and career opportunities in science. The final objective was to create a technology-rich classroom laboratory activity for use in high schools.

  15. Quality of Control of Clinical-Biochemical Laboratories – Serbian Case

    Directory of Open Access Journals (Sweden)

    Vinko Peric

    2014-06-01

    Full Text Available In the last 20 years in medical laboratories, numerous activities regarding quality and accreditation system were taken. Approach to this problem in European countries is different, so the task of the Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 to help the efforts to harmonize this issue. External quality control in clinical-chemical laboratories imposed the need for the implementation of quality management system. »Good laboratory practice« and its principles were adopted by nominated bodies, both international and national. In the beginning, the standard ISO 9001 was applied for certification and for accreditation EN 45001 and ISO Guide 25, which are prepared for testing and calibration laboratories. Standard ISO 17025 is the successor of the previous documents and for now it is a reference for mentioned laboratories. Accreditation Work Group of the Confederation of European societies for clinical chemistry (EC 4 made an amendment of the requirements for medical laboratories, which this standard describes. Standard draft ISO 15189 was adopted on February 2003 as a final version with requirements for medical laboratories.

  16. U.S. High-Level Isolation Unit Clinical Laboratory Capabilities Update.

    Science.gov (United States)

    Herstein, Jocelyn J; Iwen, Peter C; Jelden, Katelyn C; Biddinger, Paul D; Gibbs, Shawn G; Le, Aurora B; Hewlett, Angela L; Lowe, John J

    2018-02-01

    In late 2014, 56 hospitals in the United States were designated by state and federal public health authorities as specially designed high-level isolation units (HLIUs) equipped with advanced infrastructure, laboratory capabilities, and trained staff to care for patients with highly hazardous communicable diseases (HHCDs), such as Ebola virus disease. This survey describes the clinical laboratory support capabilities of U.S. HLIUs, including the specific test menus that HLIUs have identified to safely manage HHCD patients and the locations where such testing would be performed. In spring 2016, a survey was electronically distributed, as a fillable pdf file, to the 56 U.S. HLIUs. Site representatives completed the surveys, and data were coded and analyzed in an electronic spreadsheet, using descriptive statistics. Thirty-six HLIUs (64%) responded, and 33 completed the laboratory capabilities section. Thirty-one HLIUs (94%) had performed risk analyses for all laboratory procedures and equipment. Twenty-nine (88%) had decontamination procedures specified for all laboratory equipment used for patients with suspected or confirmed HHCDs. On-site laboratories in 27 HLIUs (81%) had the capacity to inventory and to securely store HHCD patient specimens. Ten HLIUs (31%) had at least one test they would conduct within the patient isolation room. The high-risk nature of HHCDs and the occupational exposures that may occur in clinical laboratories demand advanced preparation and risk assessment of work practices, laboratory equipment, and instrumentation by HLIU laboratories. Although risk analyses of clinical laboratory testing and equipment that HLIUs have conducted have likely focused on those for Ebola virus, HLIUs must be prepared to revise their current procedures for other HHCDs. Copyright © 2018 American Society for Microbiology.

  17. 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.

  18. Accelerator laboratories: development centers for experimental physics and technology in Mexico

    International Nuclear Information System (INIS)

    Mazari, M.

    1989-01-01

    Three years ago in this Nuclear Center the author and Professor Graef expounded the inception and development of experimental physics and new techniques centered about laboratories and equipped in our country with positive ion accelerators. Extracted here is the information on the laboratories that have allowed professional training as well as the furtherance of scientific productivity in each group. An additional proposal as to how the technical groups knowledgeable in advanced technology might contribute significantly to adequate preparation of youth at the intermediate level able to generate innocuous micro industries in their own neighbourhood. (Author). 5 refs, 2 figs, 2 tabs

  19. [The issues and basic principles of training of physicians of clinical laboratory diagnostics].

    Science.gov (United States)

    Morozova, V T; Naumova, E V

    2012-07-01

    The article considers the main positions concerning the clinical laboratory diagnostics as an independent clinical specialty and the principles of professional training and improvement of specialists. The basic issues complicating the training and improvement of personnel to be kept in line with actual needs of laboratory service of public health system are discussed. Among them are the availability of laboratory academic sub disciplines demanding a profound special theoretical education and technical skills; the need to account in the process of professional training the variety of forms, sizes and types of laboratory structures in different medical institutions; the need of special training programs for numerous specialists with non-medical basic education. The combination of the present system of postgraduate training of specialists on chairs of state educational organizations with initiative involvement of specialists in various public forms of permanent professional improvement (professional scientific societies meetings, research conferences, internet seminars, etc.) is supported Along with a positive appraisal of the existing system of training in the state educational institutions and corresponding regulation documents, a critique is expressed regarding certain actual documents which improperly limit the administrative functions of physicians of clinical laboratory diagnostics and complicate training of bacteriologists for clinical laboratories.

  20. Commercialization of Los Alamos National Laboratory technologies via small businesses. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brice, R.; Cartron, D.; Rhyne, T.; Schulze, M.; Welty, L.

    1997-06-01

    Over the past decade, numerous companies have been formed to commercialize research results from leading U.S. academic and research institutions. Emerging small businesses in areas such as Silicon Valley, Boston`s Route 128 corridor, and North Carolina`s Research Triangle have been especially effective in moving promising technologies from the laboratory bench to the commercial marketplace--creating new jobs and economic expansion in the process. Unfortunately, many of the U.S. national laboratories have not been major participants in this technology/commercialization activity, a result of a wide variety of factors which, until recently, acted against successful commercialization. This {open_quotes}commercialization gap{close_quotes} exists partly due to a lack, within Los Alamos in particular and the DOE in general, of in-depth expertise and experience in such business areas as new business development, securities regulation, market research and the determination of commercial potential, the identification of entrepreneurial management, marketing and distribution, and venture capital sources. The immediate consequence of these factors is the disappointingly small number of start-up companies based on technologies from Los Alamos National Laboratory that have been attempted, the modest financial return Los Alamos has received from these start-ups, and the lack of significant national recognition that Los Alamos has received for creating and commercializing these technologies.

  1. The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010

    DEFF Research Database (Denmark)

    McMurray, Janet; Zérah, Simone; Hallworth, Michael

    2010-01-01

    In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more...... than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous...

  2. [The paper summarizes data on laboratory and clinical assessment of Corega dent Laboratory and clinical analysis of Corega denture adhesive cream mechanical properties].

    Science.gov (United States)

    Kalivradzhiyan, E S; Podoprigora, A V; Kaverina, E Yu; Bobeshko, M N

    The paper summarizes data on laboratory and clinical assessment of Corega denture adhesive cream adhesive properties: adhesion strength and time of adhesive material fixing. Clinical assessment was based on Ulitovsky-Leontyev denture fixation index evaluated in 18 edentulous patients with full removable dentures 1 and 12 months after denture manufacturing. After one year of evaluation denture fixation in patients using Corega denture adhesive cream was 8-15% better (depending on alveolar bed anatomy) than in controls proving that Corega improves full denture adaptation to physiological atrophy of alveolar bone.

  3. Critical values comparison: a College of American Pathologists Q-Probes survey of 163 clinical laboratories.

    Science.gov (United States)

    Wagar, Elizabeth A; Friedberg, Richard C; Souers, Rhona; Stankovic, Ana K

    2007-12-01

    Critical laboratory values are values that may be indicative of life-threatening conditions requiring rapid clinical intervention. Designation of critical values by clinical laboratories is required by the Clinical Laboratory Improvement Amendments and regulatory agencies. The development of critical values often involves consultation with clinical services. Also, questions are frequently asked about how critical values compare between institutions. To examine and compare critical value ranges for selected common critical value analytes. Additional specific questions addressed the source of these values, the inclusion of specific items on a critical values list, and the procedures for establishing such lists. A total of 163 clinical laboratories provided critical values for potassium, calcium, magnesium, thyroid-stimulating hormone, hemoglobin, platelet count, and activated partial thromboplastin time. Collected data were subjected to analysis for statistical variation. A questionnaire regarding demographic characteristics, institutional practices, and critical values management was also completed by participants. There was slight variation in pediatric and adult critical values used by the central 80% of study laboratories. Three areas of interest were noted: (1) 27% of laboratories allowed nonpractitioners to accept inpatient critical value reports, (2) there was nonconsensus regarding the handling of outpatient critical values during weekday versus evening/weekend hours, and (3) only 56% of respondents had a written critical values policy or procedure. Pediatric and adult critical values for the selected analytes were consistent in a comparison between the 163 clinical laboratories. Several weaknesses in current critical values management were identified. A consensus critical values list that may be of value to other institutions was assembled.

  4. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine').

    Science.gov (United States)

    Orth, Matthias; Averina, Maria; Chatzipanagiotou, Stylianos; Faure, Gilbert; Haushofer, Alexander; Kusec, Vesna; Machado, Augusto; Misbah, Siraj A; Oosterhuis, Wytze; Pulkki, Kari; Twomey, Patrick J; Wieland, Eberhard

    2017-12-22

    The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts-exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Idaho National Engineering Laboratory Waste Area Groups 1-7 and 10 Technology Logic Diagram

    International Nuclear Information System (INIS)

    O'Brien, M.C.; Meservey, R.H.; Little, M.; Ferguson, J.S.; Gilmore, M.C.

    1993-09-01

    The Idaho National Engineering Laboratory (INEL) Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates Environmental Restoration (ER) and Waste Management (WM) problems at the INEL to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration, testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to an environmental restoration need. It is essential that follow-on engineering and system studies be conducted to build on the output of this project. These studies will begin by selecting the most promising technologies identified in this TLD and finding an optimum mix of technologies that will provide a socially acceptable balance between cost and risk to meet the site windows of opportunity. The TLD consists of three separate volumes: Volume I includes the purpose and scope of the TLD, a brief history of the INEL Waste Area Groups, and environmental problems they represent. A description of the TLD, definitions of terms, a description of the technology evaluation process, and a summary of each subelement, is presented. Volume II (this volume) describes the overall layout and development of the TLD in logic diagram format. This section addresses the environmental restoration of contaminated INEL sites. Specific INEL problem areas/contaminants are identified along with technology solutions, the status of the technologies, precise science and technology needs, and implementation requirements. Volume III provides the Technology Evaluation Data Sheets (TEDS) for Environmental Restoration and Waste Management (EM) activities that are referenced by a TEDS codenumber in Volume II. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than provided for technologies in Volume II

  6. Clinical laboratories collaborate to resolve differences in variant interpretations submitted to ClinVar.

    Science.gov (United States)

    Harrison, Steven M; Dolinsky, Jill S; Knight Johnson, Amy E; Pesaran, Tina; Azzariti, Danielle R; Bale, Sherri; Chao, Elizabeth C; Das, Soma; Vincent, Lisa; Rehm, Heidi L

    2017-10-01

    Data sharing through ClinVar offers a unique opportunity to identify interpretation differences between laboratories. As part of a ClinGen initiative, four clinical laboratories (Ambry, GeneDx, Partners Healthcare Laboratory for Molecular Medicine, and University of Chicago Genetic Services Laboratory) collaborated to identify the basis of interpretation differences and to investigate if data sharing and reassessment resolve interpretation differences by analyzing a subset of variants. ClinVar variants with submissions from at least two of the four participating laboratories were compared. For a subset of identified differences, laboratories documented the basis for discordance, shared internal data, independently reassessed with the American College of Medical Genetics and Genomics-Association for Molecular Pathology (ACMG-AMP) guidelines, and then compared interpretations. At least two of the participating laboratories interpreted 6,169 variants in ClinVar, of which 88.3% were initially concordant. Laboratories reassessed 242/724 initially discordant variants, of which 87.2% (211) were resolved by reassessment with current criteria and/or internal data sharing; 12.8% (31) of reassessed variants remained discordant owing to differences in the application of the ACMG-AMP guidelines. Participating laboratories increased their overall concordance from 88.3 to 91.7%, indicating that sharing variant interpretations in ClinVar-thereby allowing identification of differences and motivation to resolve those differences-is critical to moving toward more consistent variant interpretations.Genet Med advance online publication 09 March 2017.

  7. [Akita University Graduate School of Medicine: status of clinical laboratory medicine education].

    Science.gov (United States)

    Ito, Wataru; Chihara, Junichi

    2010-03-01

    Education in laboratory medicine is important. However, many medical students and doctors cannot understand this importance. This problem may be caused by the unclear character of laboratory medicine in research as well as hospital work, resulting in a lack of staff in the Department of Laboratory Medicine. One of the characters of laboratory medicine is its all-inclusive actions unrestrained by medical specialty. Thus, we tell medical students that the staff of laboratory medicine are suitable members of the infection control team (ICT) and nutrition support team (NST) in lectures. Moreover, we also teach allergy, immunology, infection, and sex-specific medicine, which are some subjects the topics of research. Many students in Akita University recognize that the staff of the Department of Laboratory Medicine are specialists of infection and allergy. On the other hand, young doctors can also receive postgraduate clinical training and conduct research not restricted to allergy and infection. We have a policy whereby the Department of Laboratory Medicine always opens its door widely to everyone including students and doctors. Nine staff joined the Department of Laboratory Medicine of Akita University about ten years, and now, can fully provide students with medical education. To solve some problems regarding education in laboratory medicine, we should promote our roles in medical education as well as in hospitals, and increase the number of staff.

  8. Outsourcing of Academic Clinical Laboratories: Experiences and Lessons From the Association of Pathology Chairs Laboratory Outsourcing Survey.

    Science.gov (United States)

    Mrak, Robert E; Parslow, Tristram G; Tomaszewski, John E

    2018-01-01

    American hospitals are increasingly turning to service outsourcing to reduce costs, including laboratory services. Studies of this practice have largely focused on nonacademic medical centers. In contrast, academic medical centers have unique practice environments and unique mission considerations. We sought to elucidate and analyze clinical laboratory outsourcing experiences in US academic medical centers. Seventeen chairs of pathology with relevant experience were willing to participate in in-depth interviews about their experiences. Anticipated financial benefits from joint venture arrangements often eroded after the initial years of the agreement, due to increased test pricing, management fees, duplication of services in support of inpatients, and lack of incentive for utilization control on the part of the for-profit partner. Outsourcing can preclude development of lucrative outreach programs; such programs were successfully launched in several cases after joint ventures were either avoided or terminated. Common complaints included poor test turnaround time and problems with test quality (especially in molecular pathology, microbiology, and flow cytometry), leading to clinician dissatisfaction. Joint ventures adversely affected retention of academically oriented clinical pathology faculty, with adverse effects on research and education, which further exacerbated clinician dissatisfaction due to lack of available consultative expertise. Resident education in pathology and in other disciplines (especially infectious disease) suffered both from lack of on-site laboratory capabilities and from lack of teaching faculty. Most joint ventures were initiated with little or no input from pathology leadership, and input from pathology leadership was seen to have been critical in those cases where such arrangements were declined or terminated.

  9. Computer-Aided Generation of Result Text for Clinical Laboratory Texts

    OpenAIRE

    Kuzmak, Peter M.; Miller, R. E.

    1983-01-01

    Efficient processing of non-numeric textual data is a frequent requirement with medical computer applications such as clinical laboratory result reporting. In such instances, it is often desirable that the computer control the generation of the text to ensure that the intended meaning is conveyed. This paper describes a technique for interactively selecting predefined text segments to form complex textual reports for laboratory tests. The approach, which uses algorithms based on augmented tra...

  10. The Chemical Technology Division at Argonne National Laboratory: Applying chemical innovation to environmental problems

    International Nuclear Information System (INIS)

    1995-01-01

    The Chemical Technology Division is one of the largest technical divisions at Argonne National Laboratory, a leading center for research and development related to energy and environmental issues. Since its inception in 1948, the Division has pioneered in developing separations processes for the nuclear industry. The current scope of activities includes R ampersand D on methods for disposing of radioactive and hazardous wastes and on energy conversion processes with improved efficiencies, lower costs, and reduced environmental impact. Many of the technologies developed by CMT can be applied to solve manufacturing as well as environmental problems of industry

  11. [The balanced scorecard used as a management tool in a clinical laboratory: internal business processes indicators].

    Science.gov (United States)

    Salinas La Casta, Maria; Flores Pardo, Emilio; Uris Selles, Joaquín

    2009-01-01

    to propose a set of indicators as a management tool for a clinical laboratory, by using the balanced scorecard internal business processes perspective. indicators proposed are obtained from different sources; external proficiency testing of the Valencia Community Government, by means of internal surveys and laboratory information system registers. One year testing process proportion indicators results are showed. internal management indicators are proposed (process, appropriateness and proficiency testing). The process indicators results show gradual improvement since its establishment. after one years of using a conceptually solid Balanced Scorecard Internal business processes perspective indicators, the obtained results validate the usefulness as a laboratory management tool.

  12. Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

    Science.gov (United States)

    Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

    2017-09-01

    Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  13. Establishment of an Environmental Control Technology Laboratory with a Circulating Fluidized-Bed Combustion System

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Pan; Yan Cao; John Smith

    2008-05-31

    On February 14, 2002, President Bush announced the Clear Skies Initiative, a legislative proposal to control the emissions of nitrogen oxides (NO{sub x}), sulfur dioxide (SO{sub 2}), and mercury from power plants. In response to this initiative, the National Energy Technology Laboratory organized a Combustion Technology University Alliance and hosted a Solid Fuel Combustion Technology Alliance Workshop. The workshop identified multi-pollutant control; improved sorbents and catalysts; mercury monitoring and capture; and improved understanding of the underlying reaction chemistry occurring during combustion as the most pressing research needs related to controlling environmental emissions from fossil-fueled power plants. The Environmental Control Technology Laboratory will help meet these challenges and offer solutions for problems associated with emissions from fossil-fueled power plants. The goal of this project was to develop the capability and technology database needed to support municipal, regional, and national electric power generating facilities to improve the efficiency of operation and solve operational and environmental problems. In order to effectively provide the scientific data and the methodologies required to address these issues, the project included the following aspects: (1) Establishing an Environmental Control Technology Laboratory using a laboratory-scale, simulated fluidized-bed combustion (FBC) system; (2) Designing, constructing, and operating a bench-scale (0.6 MW{sub th}), circulating fluidized-bed combustion (CFBC) system as the main component of the Environmental Control Technology Laboratory; (3) Developing a combustion technology for co-firing municipal solid waste (MSW), agricultural waste, and refuse-derived fuel (RDF) with high sulfur coals; (4) Developing a control strategy for gaseous emissions, including NO{sub x}, SO{sub 2}, organic compounds, and heavy metals; and (5) Developing new mercury capturing sorbents and new

  14. Laboratory open-quotes proof of principleclose quotes investigation for the acoustically enhanced remediation technology

    International Nuclear Information System (INIS)

    Iovenitti, J.L.; Spencer, J.W.; Hill, D.G.

    1995-01-01

    This document describes a three phase program of Weiss Associates which investigates the systematics of using acoustic excitation fields (AEFs) to enhance the in-situ remediation of contaminated soil and ground water under both saturated and unsaturated conditions. The focus in this particular paper is a laboratory proof of principle investigation. The field deployment and engineering viability of acoustically enhanced remediation technology is also examined

  15. Argonne National Laboratory contributions to the International Symposium on Fusion Nuclear Technology (ISFNT)

    Energy Technology Data Exchange (ETDEWEB)

    1988-10-01

    A total of sixteen papers with authors from Argonne National Laboratory were presented at the First International Symposium on Fusion Nuclear Technology (ISFNT), held in Tokyo, Japan, in April 1988. The papers cover the results of recent investigations in blanket design and analysis, fusion neutronics, materials experiments in liquid metal corrosion and solid breeders, tritium recovery analysis, experiments and analysis for liquid metal MHD, reactor safety and economic analysis, and transient electromagnetic analysis.

  16. Argonne National Laboratory contributions to the International Symposium on Fusion Nuclear Technology (ISFNT)

    International Nuclear Information System (INIS)

    1988-10-01

    A total of sixteen papers with authors from Argonne National Laboratory were presented at the First International Symposium on Fusion Nuclear Technology (ISFNT), held in Tokyo, Japan, in April 1988. The papers cover the results of recent investigations in blanket design and analysis, fusion neutronics, materials experiments in liquid metal corrosion and solid breeders, tritium recovery analysis, experiments and analysis for liquid metal MHD, reactor safety and economic analysis, and transient electromagnetic analysis

  17. Laboratory Performance Testing of Warm-Mix Asphalt Technologies for Airfield Pavements

    Science.gov (United States)

    2013-12-01

    moisture damage and low-temperature cracking , durability, and workability. The use of high reclaimed asphalt pavement (RAP) contents was also evaluated...ER D C/ G SL T R -1 3 -4 1 Laboratory Performance Testing of Warm-Mix Asphalt Technologies for Airfield Pavements G eo te ch n ic al a... Pavements Jesse D. Doyle, John F. Rushing, Mariely Mejías-Santiago, Timothy J. McCaffrey, Lance C. Warnock, and M. Kevin Taylor Geotechnical and

  18. National survey on internal quality control for tumour markers in clinical laboratories in China.

    Science.gov (United States)

    Wang, Wei; Zhong, Kun; Yuan, Shuai; He, Falin; Du, Yuxuan; Hu, Zhehui; Wang, Zhiguo

    2018-06-15

    This survey was initiated to obtain knowledge on the current situation of internal quality control (IQC) practice for tumour markers (TMs) in China. Additionally, we tried to acquire the most appropriate quality specifications. This survey was a current status survey. The IQC information had been collected via online questionnaires. All of 1821 clinical laboratories which participated in the 2016 TMs external quality assessment (EQA) programme had been enrolled. The imprecision evaluation criteria were the minimal, desirable, and optimal allowable imprecisions based on biological variations, and 1/3 total allowable error (TEa) and 1/4 TEa. A total of 1628 laboratories answered the questionnaires (89%). The coefficients of variation (CVs) of the IQC of participant laboratories varied greatly from 1% (5 th percentile) to 13% (95 th percentile). More than 82% (82 - 91%) of participant laboratories two types of CVs met 1/3 TEa except for CA 19-9. The percentiles of current CVs were smaller than cumulative CVs. A number of 1240 laboratories (76%) reported their principles and systems used. The electrochemiluminescence was the most used principle (45%) and had the smallest CVs. The performance of laboratories for TMs IQC has yet to be improved. On the basis of the obtained results, 1/3 TEa would be realistic and attainable quality specification for TMs IQC for clinical laboratories in China.

  19. Designing a clinical skills training laboratory with focus on video for better learning

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein; Toftgård, Rie Castella; Nørgaard, Cita

    resources of varying quality on the internet if this is not made available during teaching. The objective of this project was to design a new clinical skills laboratory with IT and video facilities to support learning processes. Methods Teaching principles were described before decisions on the design...... with IT-companies resulted in novel ideas about laboratory design consisting of “skills training islands” utilizing iPads, AppleTVs, big screens and a secure multimedia server. Conclusion We successfully designed and implemented IT and video into a novel ‘easy-to-use’ clinical skills laboratory based......Objective The principles of apprenticeship in clinical skills training are increasingly being challenged. First, most students are proficient in learning from visual multimedia and will expect this to be part of a modern university education. Second, students will often find visual teaching...

  20. Embryology training for Reproductive Endocrine fellows in the clinical human embryology laboratory.

    Science.gov (United States)

    Scott, Richard T; Hong, Kathleen H; Werner, Marie D; Forman, Eric J; Ruiz, Andrew; Cheng, Michael C; Zhao, Tian; Upham, Kathleen M

    2014-04-01

    To determine if comprehensive embryology training for clinical Reproductive Endocrinology fellows could be completed to a level of proficiency equivalent to that of experienced embryologists. Clinical fellows were integrated into the clinical embryology team and were trained to perform all the various procedures utilized in clinical embryology. The fellows were trained to the same standards as the clinical embryology staff and underwent the same certification and sign off procedures. To determine if inclusion of clinical fellows on the embryology team impacted outcomes, outcomes for individual oocytes/embryos and the clinical cases where the fellows perform embryology procedures were compared to the outcomes of those oocytes/embryos and cases performed by the full time embryology staff. Clinical procedures performed by the fellows included isolation and processing of oocytes following retrieval, loading catheters for embryo transfer, and vitrification (N = 823 cases). Micromanipulation procedures compared included ICSI and assisted hatching (N = 650 cases). For each procedure, the outcomes in those cases performed by the RE fellows were equivalent to those done by the fully trained clinical embryology staff. When fellows are trained to perform embryology procedures as an integral part of their fellowship curricula, laboratory efficiencies and clinical outcomes are fully maintained. This experience provides valuable insight into the ART process critical to this subspecialty. It also empowers fellows to fully participate in research relating to the viability of gamete and embryos and optimization of the clinical ART laboratory.

  1. The answer of the Bacteriology Laboratory to new clinical needs. Rapid sepsis diagnotics at the Novara hospital

    Directory of Open Access Journals (Sweden)

    Vesselina Kroumova

    2012-06-01

    Full Text Available Faster microbiological responses are increasingly necessary in modern medicine and the Laboratory of Microbiology must be equipped in this sense. New instrumentation and, above all, a new approach by the Clinical Microbiologist that puts a focus on the real needs of the patient before the microbiological may allow for significantly improving the TAT of these diagnostics. The use of both new methodologies, new tools and revisited old technologies may mean less these days as it was obtained at the Laboratory of Microbiology and Virology of Novara, where the combined use of molecular biology techniques, and mass spectrometry techniques rapid growth have allowed for more than 36 hours to shorten the response time by positivization of blood cultures. Such an approach allows an important support to the clinician with obvious benefits for the patient.

  2. Emerging technologies in education and training: applications for the laboratory animal science community.

    Science.gov (United States)

    Ketelhut, Diane Jass; Niemi, Steven M

    2007-01-01

    This article examines several new and exciting communication technologies. Many of the technologies were developed by the entertainment industry; however, other industries are adopting and modifying them for their own needs. These new technologies allow people to collaborate across distance and time and to learn in simulated work contexts. The article explores the potential utility of these technologies for advancing laboratory animal care and use through better education and training. Descriptions include emerging technologies such as augmented reality and multi-user virtual environments, which offer new approaches with different capabilities. Augmented reality interfaces, characterized by the use of handheld computers to infuse the virtual world into the real one, result in deeply immersive simulations. In these simulations, users can access virtual resources and communicate with real and virtual participants. Multi-user virtual environments enable multiple participants to simultaneously access computer-based three-dimensional virtual spaces, called "worlds," and to interact with digital tools. They allow for authentic experiences that promote collaboration, mentoring, and communication. Because individuals may learn or train differently, it is advantageous to combine the capabilities of these technologies and applications with more traditional methods to increase the number of students who are served by using current methods alone. The use of these technologies in animal care and use programs can create detailed training and education environments that allow students to learn the procedures more effectively, teachers to assess their progress more objectively, and researchers to gain insights into animal care.

  3. Developing linear-alpha-Olefins technology. From laboratory to a commercial plant

    Energy Technology Data Exchange (ETDEWEB)

    Meiswinkel, Andreas; Woehl, Anina; Mueller, Wolfgang; Boelt, Heinz V. [Linde AG, Pullach (Germany). Engineering Div.; Mosa, Fuad M.; Al-Hazmi, Mohammed H. [Saudi Basic Industries Corporation, Riyadh (Saudi Arabia)

    2012-06-15

    Linear {alpha}-Olefins (LAOs) are used in several applications in chemical industry. Together with SABIC (Saudi Basic Industries Corporation) Linde jointly developed the {alpha}-SABLIN {sup registered} technology for a full range LAO plant as well as a 1-Hexene selective On Purpose technology (LAO OP) to cover the rapidly increasing demand for this specific comonomer. The {alpha}-SABLIN {sup registered} as well as the LAO OP technology are both homogenously catalyzed systems. This is raising special challenges concerning process and reactor design compared to much more established heterogeneous systems in chemical industry. E.g., the reactor concept is a bubble-column which allows efficient mixing as well as cooling of the reaction mixture. The development of the process was based on laboratory experiments which - based on an initial conceptual design for a large scale technical process - were first transformed into a pilot device before the commercial plant was designed, engineered and successfully started up and declared as commercialized. Today the {alpha}-SABLIN {sup registered} technology is the only LAO technology with a commercial reference which is free for licensing. A lot of experience and knowledge from the {alpha}-SABLIN development and commercial operation was gained. Although newly developed LAO OP technology is based on a different catalytic system, this experience is now utilized and transformed within the commercialization of this new technological development. (orig.)

  4. Developing linear-alpha-olefins technology. From laboratory to a commercial plant

    Energy Technology Data Exchange (ETDEWEB)

    Meiswinkel, A.; Woehl, A.; Mueller, W.; Boelt, H. [Linde AG, Pullach (Germany)

    2011-07-01

    Linear {alpha}-Olefins (LAOs) are used in several applications in chemical industry. Together with SABIC (Saudi Basic Industries Corporation) Linde jointly developed the {alpha}-SABLIN technology for a full range LAO plant as well as a 1-Hexene selective ''On Purpose'' technology (LAO OP) to cover the rapidly increasing demand for this specific comonomer. The {alpha}-SABLIN as well as the OP technology are both homogenously catalyzed systems. This is raising special challenges concerning process and reactor design compared to much more established heterogeneous systems in chemical industry. E.g., the reactor concept is a bubble-column which allows efficient mixing as well as cooling of the reaction mixture. The development of the process was based on laboratory experiments which - based on an initial conceptual design for a large scale technical process - were first transformed into a pilot device before the commercial plant was designed, engineered and successfully started up and declared as commercialized. Today the {alpha}-SABLIN technology is the only LAO technology with a commercial reference which is free for licensing. A lot of experience and knowledge from the {alpha}-SABLIN development and commercial operation was gained. Although newly developed OP technology is based on a different catalytic system, this experience is now utilized and transformed within the commercialization of this new technological development. (orig.)

  5. Performance of direct immunofluorescence assay for the detection of human metapneumovirus under clinical laboratory settings.

    Science.gov (United States)

    Wolf, Jonas Michel; Gregianini, Tatiana Schäffer; Seadi, Claudete Maria Farina; Tumioto, Gabriela Luchiari; Dambrós, Bibiana Paula; Lehmann, Fernanda Kieling Moreira; Carli, Silvia De; Ikuta, Nilo; Lunge, Vagner Ricardo

    2015-01-01

    Human metapneumovirus (hMPV) is an emergent human respiratory pathogen. This study aimed to evaluate the performance of direct immunofluorescence (DIF) to detect hMPV in a clinical laboratory setting. Nasopharyngeal aspirate samples (448) of children and adults with respiratory illness were used to detect hMPV by using DIF and real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assays. In all, 36 (8%) samples were positive by DIF and 94 (21%) were positive by qRT-PCR. Direct immunofluorescence specificity was 99% and sensitivity was 38%. DIF is not very sensitive under clinical laboratory settings.

  6. Definition of an XML markup language for clinical laboratory procedures and comparison with generic XML markup.

    Science.gov (United States)

    Saadawi, Gilan M; Harrison, James H

    2006-10-01

    Clinical laboratory procedure manuals are typically maintained as word processor files and are inefficient to store and search, require substantial effort for review and updating, and integrate poorly with other laboratory information. Electronic document management systems could improve procedure management and utility. As a first step toward building such systems, we have developed a prototype electronic format for laboratory procedures using Extensible Markup Language (XML). Representative laboratory procedures were analyzed to identify document structure and data elements. This information was used to create a markup vocabulary, CLP-ML, expressed as an XML Document Type Definition (DTD). To determine whether this markup provided advantages over generic markup, we compared procedures structured with CLP-ML or with the vocabulary of the Health Level Seven, Inc. (HL7) Clinical Document Architecture (CDA) narrative block. CLP-ML includes 124 XML tags and supports a variety of procedure types across different laboratory sections. When compared with a general-purpose markup vocabulary (CDA narrative block), CLP-ML documents were easier to edit and read, less complex structurally, and simpler to traverse for searching and retrieval. In combination with appropriate software, CLP-ML is designed to support electronic authoring, reviewing, distributing, and searching of clinical laboratory procedures from a central repository, decreasing procedure maintenance effort and increasing the utility of procedure information. A standard electronic procedure format could also allow laboratories and vendors to share procedures and procedure layouts, minimizing duplicative word processor editing. Our results suggest that laboratory-specific markup such as CLP-ML will provide greater benefit for such systems than generic markup.

  7. Integration of new technology into clinical practice after FDA approval.

    Science.gov (United States)

    Govil, Ashul; Hao, Steven C

    2016-10-01

    Development of new medical technology is a crucial part of the advancement of medicine and our ability to better treat patients and their diseases. This process of development is long and arduous and requires a significant investment of human, financial and material capital. However, technology development can be rewarded richly by its impact on patient outcomes and successful sale of the product. One of the major regulatory hurdles to technology development is the Food and Drug Administration (FDA) approval process, which is necessary before a technology can be marketed and sold in the USA. Many businesses, medical providers and consumers believe that the FDA approval process is the only hurdle prior to use of the technology in day-to-day care. In order for the technology to be adopted into clinical use, reimbursement for both the device as well as the associated work performed by physicians and medical staff must be in place. Work and coverage decisions require Current Procedural Terminology (CPT) code development and Relative Value Scale Update Committee (RUC) valuation determination. Understanding these processes is crucial to the timely availability of new technology to patients and providers. Continued and better partnerships between physicians, industry, regulatory bodies and payers will facilitate bringing technology to market sooner and ensure appropriate utilization.

  8. After the clinic? Researching sexual health technology in context.

    Science.gov (United States)

    Davis, Mark

    2015-01-01

    There is great interest in what testing, pharmaceutical, information and social media technology can do for sexual health. Much programmatic and research activity is focused on assessing how these technologies can be used to best effect. Less obvious are analyses that place technology into historical, political and real-world settings. Developing an 'in-context' analysis of sexual health technology, this paper draws on interviews with leading community advocates, researchers and clinicians in Australia, Canada and the UK and looks across examples, including social media, rapid HIV testing, pre-Exposure Prophylaxis for HIV and polymerase chain reaction Chlamydia testing. The analysis is framed by studies of techno-society and the dialectics of sex-affirmative advocacy with biomedical authority and attends to: the rationalistic and affective dimensions of the imaginary associated with technology; the role of technology in the re-spatialisation and re-temporalisation of the sexual health clinic; and the re-invention of technology in its real-world contexts. This in-context approach is important for: the effective implementation of new technology; strengthening the social science contribution to the field; and enriching social theory in general on life in techno-societies.

  9. [Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

    Science.gov (United States)

    Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

    2015-05-26

    The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for

  10. Report of the results of the International Clinical Cytometry Society and American Society for Clinical Pathology workload survey of clinical flow cytometry laboratories.

    Science.gov (United States)

    Wolniak, Kristy; Goolsby, Charles; Choi, Sarah; Ali, Asma; Serdy, Nina; Stetler-Stevenson, Maryalice

    2017-11-01

    Thorough review of current workload, staffing, and testing practices in clinical laboratories allows for optimization of laboratory efficiency and quality. This information is largely missing with regard to clinical flow cytometry laboratories. The purpose of this survey is to provide comprehensive, current, and accurate data on testing practices and laboratory staffing in clinical laboratories performing flow cytometric studies. Survey data was collected from flow cytometry laboratories through the ASCP website. Data was collected on the workload during a 1-year time period of full-time and part-time technical and professional (M.D./D.O./Ph.D. or equivalent) flow cytometry employees. Workload was examined as number of specimens and tubes per full time equivalent (FTE) technical and professional staff. Test complexity, test result interpretation, and reporting practices were also evaluated. There were 205 respondent laboratories affiliated predominantly with academic and health system institutions. Overall, 1,132 FTE employees were reported with 29% professional FTE employees and 71% technical. Fifty-one percent of the testing performed was considered high complexity and 49% was low complexity. The average number of tubes per FTE technologist was 1,194 per year and the average number of specimens per FTE professional was 1,659 per year. The flow cytometry reports were predominantly written by pathologists (57%) and were typically written as a separate report (58%). This survey evaluates the overall status of the current practice of clinical flow cytometry and provides a comprehensive dataset as a framework to help laboratory departments, directors, and managers make appropriate, cost-effective staffing decisions. © 2016 International Clinical Cytometry Society. © 2016 International Clinical Cytometry Society.

  11. Clinical Chemistry Laboratory Automation in the 21st Century - Amat Victoria curam (Victory loves careful preparation)

    Science.gov (United States)

    Armbruster, David A; Overcash, David R; Reyes, Jaime

    2014-01-01

    The era of automation arrived with the introduction of the AutoAnalyzer using continuous flow analysis and the Robot Chemist that automated the traditional manual analytical steps. Successive generations of stand-alone analysers increased analytical speed, offered the ability to test high volumes of patient specimens, and provided large assay menus. A dichotomy developed, with a group of analysers devoted to performing routine clinical chemistry tests and another group dedicated to performing immunoassays using a variety of methodologies. Development of integrated systems greatly improved the analytical phase of clinical laboratory testing and further automation was developed for pre-analytical procedures, such as sample identification, sorting, and centrifugation, and post-analytical procedures, such as specimen storage and archiving. All phases of testing were ultimately combined in total laboratory automation (TLA) through which all modules involved are physically linked by some kind of track system, moving samples through the process from beginning-to-end. A newer and very powerful, analytical methodology is liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). LC-MS/MS has been automated but a future automation challenge will be to incorporate LC-MS/MS into TLA configurations. Another important facet of automation is informatics, including middleware, which interfaces the analyser software to a laboratory information systems (LIS) and/or hospital information systems (HIS). This software includes control of the overall operation of a TLA configuration and combines analytical results with patient demographic information to provide additional clinically useful information. This review describes automation relevant to clinical chemistry, but it must be recognised that automation applies to other specialties in the laboratory, e.g. haematology, urinalysis, microbiology. It is a given that automation will continue to evolve in the clinical laboratory

  12. Clinical Chemistry Laboratory Automation in the 21st Century - Amat Victoria curam (Victory loves careful preparation).

    Science.gov (United States)

    Armbruster, David A; Overcash, David R; Reyes, Jaime

    2014-08-01

    The era of automation arrived with the introduction of the AutoAnalyzer using continuous flow analysis and the Robot Chemist that automated the traditional manual analytical steps. Successive generations of stand-alone analysers increased analytical speed, offered the ability to test high volumes of patient specimens, and provided large assay menus. A dichotomy developed, with a group of analysers devoted to performing routine clinical chemistry tests and another group dedicated to performing immunoassays using a variety of methodologies. Development of integrated systems greatly improved the analytical phase of clinical laboratory testing and further automation was developed for pre-analytical procedures, such as sample identification, sorting, and centrifugation, and post-analytical procedures, such as specimen storage and archiving. All phases of testing were ultimately combined in total laboratory automation (TLA) through which all modules involved are physically linked by some kind of track system, moving samples through the process from beginning-to-end. A newer and very powerful, analytical methodology is liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). LC-MS/MS has been automated but a future automation challenge will be to incorporate LC-MS/MS into TLA configurations. Another important facet of automation is informatics, including middleware, which interfaces the analyser software to a laboratory information systems (LIS) and/or hospital information systems (HIS). This software includes control of the overall operation of a TLA configuration and combines analytical results with patient demographic information to provide additional clinically useful information. This review describes automation relevant to clinical chemistry, but it must be recognised that automation applies to other specialties in the laboratory, e.g. haematology, urinalysis, microbiology. It is a given that automation will continue to evolve in the clinical laboratory

  13. Liquid Chromatography-Tandem Mass Spectrometry: An Emerging Technology in the Toxicology Laboratory.

    Science.gov (United States)

    Zhang, Yan Victoria; Wei, Bin; Zhu, Yu; Zhang, Yanhua; Bluth, Martin H

    2016-12-01

    In the last decade, liquid chromatography-tandem mass spectrometry (LC-MS/MS) has seen enormous growth in routine toxicology laboratories. LC-MS/MS offers significant advantages over other traditional testing, such as immunoassay and gas chromatography-mass spectrometry methodologies. Major strengths of LC-MS/MS include improvement in specificity, flexibility, and sample throughput when compared with other technologies. Here, the basic principles of LC-MS/MS technology are reviewed, followed by advantages and disadvantages of this technology compared with other traditional techniques. In addition, toxicology applications of LC-MS/MS for simultaneous detection of large panels of analytes are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 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.

  15. Idaho National Engineering Laboratory Waste Area Groups 1-7 and 10 Technology Logic Diagram

    International Nuclear Information System (INIS)

    O'Brien, M.C.; Meservey, R.H.; Little, M.; Ferguson, J.S.; Gilmore, M.C.

    1993-09-01

    The Idaho National Engineering Laboratory (INEL) Technology Logic Diagram (TLD) was developed to provide a decision support tool that relates Environmental Restoration (ER) and Waste Management (WM) problems at the INEL to potential technologies that can remediate these problems. The TLD identifies the research, development, demonstration, testing, and evaluation needed to develop these technologies to a state that allows technology transfer and application to an environmental restoration need. It is essential that follow-on engineering and system studies be conducted to build on the output of this project. These studies will begin by selecting the most promising technologies identified in this TLD and finding an optimum mix of technologies that will provide a socially acceptable balance between cost and risk to meet the site windows of opportunity. The TLD consists of three separate volumes: Volume I includes the purpose and scope of the TLD, a brief history of the INEL Waste Area Groups, and environmental problems they represent. A description of the TLD, definitions of terms, a description of the technology evaluation process, and a summary of each subelement, is presented. Volume II describes the overall layout and development of the TLD in logic diagram format. This section addresses the environmental restoration of contaminated INEL sites. Volume III (this volume) provides the Technology Evaluation Data Sheets (TEDS) for Environmental Restoration and Waste Management (EM) activities that are reference by a TEDS code number in Volume II. Each of these sheets represents a single logic trace across the TLD. These sheets contain more detail than provided for technologies in Volume II. Data sheets are arranged alphanumerically by the TEDS code number in the upper right corner of each sheet

  16. Clinical and laboratory signs associated to serious dengue disease in hospitalized children

    Directory of Open Access Journals (Sweden)

    Sheila Moura Pone

    2016-09-01

    Conclusions: Lethargy, abdominal distension, pleural effusion, and hypoalbuminemia were the best clinical and laboratorial markers of serious dengue disease in hospitalized children, while bleeding, severe hemorrhage, hemoconcentration and thrombocytopenia did not reach adequate diagnostic accuracy. In pediatric referral hospitals, the absence of hemoconcentration does not imply absence of plasma leakage, particularly in children with previous fluid replacement. These findings may contribute to the clinical management of dengue in children at referral hospitals.

  17. Nursing students' perceptions of factors influencing their learning environment in a clinical skills laboratory: A qualitative study.

    Science.gov (United States)

    Haraldseid, Cecilie; Friberg, Febe; Aase, Karina

    2015-09-01

    The mastery of clinical skills learning is required to become a trained nurse. Due to limited opportunities for clinical skills training in clinical practice, undergraduate training at clinical skills laboratories (CSLs) is an essential part of nursing education. In a sociocultural learning perspective learning is situated in an environment. Growing student cohorts, rapid introduction of technology-based teaching methods and a shift from a teaching- to a learning-centered education all influence the environment of the students. These changes also affect CSLs and therefore compel nursing faculties to adapt to the changing learning environment. This study aimed to explore students' perceptions of their learning environment in a clinical skills laboratory, and to increase the knowledge base for improving CSL learning conditions identifying the most important environmental factors according to the students. An exploratory qualitative methodology was used. Nineteen second-year students enrolled in an undergraduate nursing program in Norway participated in the study. They took the same clinical skills course. Eight were part-time students (group A) and 11 were full-time students (group B). Focus group interviews and content analysis were conducted to capture the students' perception of the CSL learning environment. The study documents students' experience of the physical (facilities, material equipment, learning tools, standard procedures), psychosocial (expectations, feedback, relations) and organizational (faculty resources, course structure) factors that affect the CSL learning environment. Creating an authentic environment, facilitating motivation, and providing resources for multiple methods and repetitions within clinical skills training are all important for improving CSL learning environments from the student perspective. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Transferring Exome Sequencing Data from Clinical Laboratories to Healthcare Providers: Lessons Learned at a Pediatric Hospital

    Directory of Open Access Journals (Sweden)

    Rajeswari Swaminathan

    2018-02-01

    Full Text Available The adoption rate of genome sequencing for clinical diagnostics has been steadily increasing leading to the possibility of improvement in diagnostic yields. Although laboratories generate a summary clinical report, sharing raw genomic data with healthcare providers is equally important, both for secondary research studies as well as for a deeper analysis of the data itself, as seen by the efforts from organizations such as American College of Medical Genetics and Genomics and Global Alliance for Genomics and Health. Here, we aim to describe the existing protocol of genomic data sharing between a certified clinical laboratory and a healthcare provider and highlight some of the lessons learned. This study tracked and subsequently evaluated the data transfer workflow for 19 patients, all of whom consented to be part of this research study and visited the genetics clinic at a tertiary pediatric hospital between April 2016 to December 2016. Two of the most noticeable elements observed through this study are the manual validation steps and the discrepancies in patient identifiers used by a clinical lab vs. healthcare provider. Both of these add complexity to the transfer process as well as make it more susceptible to errors. The results from this study highlight some of the critical changes that need to be made in order to improve genomic data sharing workflows between healthcare providers and clinical sequencing laboratories.

  19. The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine

    DEFF Research Database (Denmark)

    Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob

    2012-01-01

    Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring...... and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations...... in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing...

  20. Automated Flow Cytometry: An Alternative to Urine Culture in a Routine Clinical Microbiology Laboratory?

    Directory of Open Access Journals (Sweden)

    Patricia Mejuto

    2017-01-01

    Full Text Available The urine culture is the “gold standard” for the diagnosis of urinary tract infections (UTI but constitutes a significant workload in the routine clinical laboratory. Due to the high percentage of negative results, there is a need for an efficient screening method, with a high negative predictive value (NPV that could reduce the number of unnecessary culture tests. With the purpose of improving the efficiency of laboratory work, several methods for screening out the culture-negative samples have been developed, but none of them has shown adequate sensitivity (SE and high NPV. Many authors show data about the efficacy of flow cytometry in the routine clinical laboratory. The aim of this article is to review and discuss the current literature on the feasibility of urine flow cytometry (UFC and its utility as an alternative analytical technique in urinalysis.

  1. Clinical significance of laboratory errors in patients with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    N.G. Klyukvina

    2014-01-01

    Full Text Available Laboratory examination is an integral part of managing patients with systemic lupus erythematosus (SLE. A number of laboratory tests need to be conducted to verify the diagnosis; some indicators attest to the development of a concomitant pathology (development of comorbid conditions and therapeutic aggravation. The monitoring of individual laboratory tests makes it possible to assess the effectiveness of therapy or indicates that it needs to be enhanced in some cases. Furthermore, some parameters are considered to be prognostic factors of treatment outcome. The article reports on the range and frequency of laboratory errors in SLE patients. The role of laboratory tests in diagnosis and assessment of disease prognosis is discussed. The relationship between clinical and laboratory manifestations and the mechanisms for preventing laboratory errors are studied. The international guidelines for monitoring SLE patients are presented. Proper range of examination of SLE patients and interpretation of the results ensures timely diagnosis (sometimes at the early stage and allows one to avoid a hyperdiagnosis, to timely prescribe adequate therapy, and prevent its complications. 

  2. External quality assurance performance of clinical research laboratories in sub-saharan Africa.

    Science.gov (United States)

    Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

    2012-11-01

    Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

  3. Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

    Directory of Open Access Journals (Sweden)

    Rodrigo Andrade Alves

    Full Text Available CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1 determine the prevalence of anemia among patients with inflammatory bowel disease; 2 investigate whether routine laboratory markers are useful for diagnosing anemia; and 3 evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6% and ulcerative colitis (76.7%. Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

  4. The Clinical and Laboratory Features of Plasma Cell NeoplasiaIn ...

    African Journals Online (AJOL)

    OBJECTIVE: To analyze the clinical and laboratory features of Multiple Myeloma at presentation in a tertiary centre in Port Harcourt, Southern Nigeria. METHODS: The medical records of all patients diagnosed for plasma cell neoplasia within a 10 year period at the University of Port Harcourt Teaching Hospital were ...

  5. Bridging the gap between clinical failure and laboratory fracture strength tests using a fractographic approach

    NARCIS (Netherlands)

    Aboushelib, M.N.; Feilzer, A.J.; Kleverlaan, C.J.

    2009-01-01

    Objective: The aim of this study was to analyze and to compare the fracture type and the stress at failure of clinically fractured zirconia-based all ceramic restorations with that of morphologically similar replicas tested in a laboratory setup. Methods: Replicas of the same shape and dimensions

  6. Computer-aided diagnosis: how to move from the laboratory to the clinic

    NARCIS (Netherlands)

    van Ginneken, Bram; Schaefer-Prokop, Cornelia M.; Prokop, Mathias

    2011-01-01

    Computer-aided diagnosis (CAD), encompassing computer-aided detection and quantification, is an established and rapidly growing field of research. In daily practice, however, most radiologists do not yet use CAD routinely. This article discusses how to move CAD from the laboratory to the clinic. The

  7. Computer-aided Diagnosis: How to Move from the Laboratory to the Clinic.

    NARCIS (Netherlands)

    Ginneken, B. van; Schaefer-Prokop, C.M.; Prokop, M.

    2011-01-01

    Computer-aided diagnosis (CAD), encompassing computer-aided detection and quantification, is an established and rapidly growing field of research. In daily practice, however, most radiologists do not yet use CAD routinely. This article discusses how to move CAD from the laboratory to the clinic. The

  8. The value of clinical and laboratory diagnostics for chest pain patients at the emergency department

    NARCIS (Netherlands)

    Jellema, Laurens-Jan C.; Backus, Barbra E.; Six, A. Jacob; Braam, Richard; Groenemeijer, Bjorn; van der Zaag-Loonen, Hester J.; Tio, Rene; van Suijlen, Jeroen D. E.

    Background: The focus during the diagnostic process for patients with acute chest pain is to discriminate patients who can be safely discharged from those who are at risk for an acute coronary syndrome (ACS). In this study the diagnostic value of the clinical examination is compared with laboratory

  9. Impacts and Trends in Health Care Research for the Clinical Laboratory

    OpenAIRE

    Maturi, Vincent F.

    1981-01-01

    This paper reviews some of the Federal Government support of health care research on computer applications in the clinical laboratory. The significant innovations and features of this program are reviewed in detail and an analysis is made to determine trends and impacts.

  10. Clinical characteristics and laboratory findings in Danish children hospitalized with primary Epstein-Barr virus infection

    DEFF Research Database (Denmark)

    Topp, Sofie Kathrine; Rosenfeldt, Vibeke; Vestergaard, Hanne

    2015-01-01

    . METHODS: All immunocompetent children hospitalized at Hvidovre University Hospital, Copenhagen between 2002 and 2013, who presented with clinical features that prompted a laboratory test for EBV, and who tested positive by presence of EBV-specific antibodies, heterophile antibodies or a positive EBV PCR...

  11. Critical value reporting: A survey of 36 clinical laboratories in South ...

    African Journals Online (AJOL)

    Objective. 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. Methods.

  12. Correlation of 111In-labeled leukocyte scintigraphy with clinical and laboratory findings

    International Nuclear Information System (INIS)

    Uchida, Yoshitaka; Kitakata, Yuusuke; Uno, Kimiichi; Minoshima, Satoshi; Arimizu, Noboru.

    1993-01-01

    This study evaluated the relationship between 111 In-labeled leukocyte scintigraphy and clinical information and laboratory findings in 24 patients with bone infection and 35 patients with abdominal infection. Fifty-nine scintigrams were retrospectively reviewed and classified into positive or negative results. As the laboratory findings, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR) at 60 minutes, and peripheral blood leukocyte counts (WBCC) were evaluated. Clinical information such as presence of fever and administration of antibiotics was also compared. No significant relationship between the scintigraphic results and clinical as well as laboratory findings was observed in bone infection patients. CRP levels in positive scintigraphic patients were significantly higher than those in negative scintigraphic patients in the abdominal infection group, otherwise the other indices were not correlated with the scintigraphic results. A few patients with slightly increased CRP (mostly chronic cases) did not show positive scintigrams, suggesting an increased false negative rate of leukocyte scintigraphy in such circumstances. These results suggest that it is inappropriate to determine the application of leukocyte scintigraphy depending on clinical as well as laboratory findings, and leukocyte scintigraphy would yield additional information different from other indices when evaluating inflammatory foci. (author)

  13. Application of failure mode and effect analysis in an assisted reproduction technology laboratory.

    Science.gov (United States)

    Intra, Giulia; Alteri, Alessandra; Corti, Laura; Rabellotti, Elisa; Papaleo, Enrico; Restelli, Liliana; Biondo, Stefania; Garancini, Maria Paola; Candiani, Massimo; Viganò, Paola

    2016-08-01

    Assisted reproduction technology laboratories have a very high degree of complexity. Mismatches of gametes or embryos can occur, with catastrophic consequences for patients. To minimize the risk of error, a multi-institutional working group applied failure mode and effects analysis (FMEA) to each critical activity/step as a method of risk assessment. This analysis led to the identification of the potential failure modes, together with their causes and effects, using the risk priority number (RPN) scoring system. In total, 11 individual steps and 68 different potential failure modes were identified. The highest ranked failure modes, with an RPN score of 25, encompassed 17 failures and pertained to "patient mismatch" and "biological sample mismatch". The maximum reduction in risk, with RPN reduced from 25 to 5, was mostly related to the introduction of witnessing. The critical failure modes in sample processing were improved by 50% in the RPN by focusing on staff training. Three indicators of FMEA success, based on technical skill, competence and traceability, have been evaluated after FMEA implementation. Witnessing by a second human operator should be introduced in the laboratory to avoid sample mix-ups. These findings confirm that FMEA can effectively reduce errors in assisted reproduction technology laboratories. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-03-01

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

  15. Clinical features and dynamic ordinary laboratory tests differentiating dengue fever from other febrile illnesses in children.

    Science.gov (United States)

    Chen, Chih-Ho; Huang, Yi-Chuan; Kuo, Kuang-Che; Li, Chung-Chen

    2017-06-30

    Dengue fever is not easily to be diagnosed before presentation of the classic symptoms. The study aimed to investigate the clinical features and dynamic laboratory tests in pediatric patients to facilitate dengue diagnosis. This retrospective study examined the medical records of all pediatric patients who were clinically suspected to have dengue from June to December 2014. Laboratory-positive dengue cases were confirmed by detecting non-structural protein NS1, reverse transcription-polymerase chain reaction of dengue virus, and dengue-specific IgM seroconversion. Of the 317 pediatric cases clinically suspected of dengue, 205 were laboratory-positive and 112 were laboratory-negative. In laboratory-positive cases, the most common clinical manifestation was skin rash in 156 (76.1%). Leukopenia occurred on days 1-5; thrombocytopenia, on days 2-7; prolonged activated partial thromboplastin time (aPTT), on days 1-4; and elevated transaminase levels, on days 3-11; and low CRP, on days 0-14. The specificity and positive predictive value (PPV) of combining of rash, itching and petechiae increased up to 100%. The PPV of combining of leukopenia, thrombocytopenia, and elevated transaminase levels reached 100% on day 2 as well as days 6-8. Leukopenia, thrombocytopenia, elevated aPTT, elevated transaminase levels, and low CRP could be used to differentiate dengue fever from other febrile illnesses. During dengue epidemics, combinations of the symptoms and laboratory findings are helpful to physicians for accurate diagnosis of dengue fever. Copyright © 2017. Published by Elsevier B.V.

  16. 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.

  17. Clinical pharmacology quality assurance program: models for longitudinal analysis of antiretroviral proficiency testing for international laboratories.

    Science.gov (United States)

    DiFrancesco, Robin; Rosenkranz, Susan L; Taylor, Charlene R; Pande, Poonam G; Siminski, Suzanne M; Jenny, Richard W; Morse, Gene D

    2013-10-01

    Among National Institutes of Health HIV Research Networks conducting multicenter trials, samples from protocols that span several years are analyzed at multiple clinical pharmacology laboratories (CPLs) for multiple antiretrovirals. Drug assay data are, in turn, entered into study-specific data sets that are used for pharmacokinetic analyses, merged to conduct cross-protocol pharmacokinetic analysis, and integrated with pharmacogenomics research to investigate pharmacokinetic-pharmacogenetic associations. The CPLs participate in a semiannual proficiency testing (PT) program implemented by the Clinical Pharmacology Quality Assurance program. Using results from multiple PT rounds, longitudinal analyses of recovery are reflective of accuracy and precision within/across laboratories. The objectives of this longitudinal analysis of PT across multiple CPLs were to develop and test statistical models that longitudinally: (1) assess the precision and accuracy of concentrations reported by individual CPLs and (2) determine factors associated with round-specific and long-term assay accuracy, precision, and bias using a new regression model. A measure of absolute recovery is explored as a simultaneous measure of accuracy and precision. Overall, the analysis outcomes assured 97% accuracy (±20% of the final target concentration of all (21) drug concentration results reported for clinical trial samples by multiple CPLs). Using the Clinical Laboratory Improvement Act acceptance of meeting criteria for ≥2/3 consecutive rounds, all 10 laboratories that participated in 3 or more rounds per analyte maintained Clinical Laboratory Improvement Act proficiency. Significant associations were present between magnitude of error and CPL (Kruskal-Wallis P < 0.001) and antiretroviral (Kruskal-Wallis P < 0.001).

  18. Amdinocillin (Mecillinam) Resistance Mutations in Clinical Isolates and Laboratory-Selected Mutants of Escherichia coli

    Science.gov (United States)

    Thulin, Elisabeth; Sundqvist, Martin

    2015-01-01

    Amdinocillin (mecillinam) is a β-lactam antibiotic that is used mainly for the treatment of uncomplicated urinary tract infections. The objectives of this study were to identify mutations that confer amdinocillin resistance on laboratory-isolated mutants and clinical isolates of Escherichia coli and to determine why amdinocillin resistance remains rare clinically even though resistance is easily selected in the laboratory. Under laboratory selection, frequencies of mutation to amdinocillin resistance varied from 8 × 10−8 to 2 × 10−5 per cell, depending on the concentration of amdinocillin used during selection. Several genes have been demonstrated to give amdinocillin resistance, but here eight novel genes previously unknown to be involved in amdinocillin resistance were identified. These genes encode functions involved in the respiratory chain, the ribosome, cysteine biosynthesis, tRNA synthesis, and pyrophosphate metabolism. The clinical isolates exhibited significantly greater fitness than the laboratory-isolated mutants and a different mutation spectrum. The cysB gene was mutated (inactivated) in all of the clinical isolates, in contrast to the laboratory-isolated mutants, where mainly other types of more costly mutations were found. Our results suggest that the frequency of mutation to amdinocillin resistance is high because of the large mutational target (at least 38 genes). However, the majority of these resistant mutants have a low growth rate, reducing the probability that they are stably maintained in the bladder. Inactivation of the cysB gene and a resulting loss of cysteine biosynthesis are the major mechanism of amdinocillin resistance in clinical isolates of E. coli. PMID:25583718

  19. [The clinical application of three dimention printing technology].

    Science.gov (United States)

    Zhong, S Z; Fang, C H

    2016-09-01

    In recent years, the three-dimentional(3D)printing technology is gradually applied in medicine.Now, the 3D printing has already play an important role in medical education, surgical device development, prosthesis implantation and so on.There are still many challenges and difficulties in the clinical overall application of 3D printing for some time, but it also contains a huge application prospect.Once with appropriate applications of this technology, it will be a major breakthrough in iatrical history once more.

  20. Technology roadmap for development of SiC sensors at plasma processes laboratory

    Directory of Open Access Journals (Sweden)

    Mariana Amorim Fraga

    2010-08-01

    Full Text Available Recognizing the need to consolidate the research and development (R&D activities in microelectronics fields in a strategic manner, the Plasma Processes Laboratory of the Technological Institute of Aeronautics (LPP-ITA has established a technology roadmap to serve as a guide for activities related to development of sensors based on silicon carbide (SiC thin films. These sensors have also potential interest to the aerospace field due to their ability to operate in harsh environment such as high temperatures and intense radiation. In the present paper, this roadmap is described and presented in four main sections: i introduction, ii what we have already done in the past, iii what we are doing in this moment, and iv our targets up to 2015. The critical technological issues were evaluated for different categories: SiC deposition techniques, SiC processing techniques for sensors fabrication and sensors characterization. This roadmap also presents a shared vision of how R&D activities in microelectronics should develop over the next five years in our laboratory.

  1. An Experimental Study of Laboratory Hybrid Power System with the Hydrogen Technologies

    Directory of Open Access Journals (Sweden)

    Daniel Minarik

    2014-01-01

    Full Text Available This paper presents very small laboratory hybrid photovoltaic-hydrogen power system. The system was primarily assembled to verify the operability of the control algorithms and practical deployment of available commercial hydrogen technologies that are directly usable for storage of electricity produced from renewable energy sources in a small island system. This energetic system was installed and tested in Laboratory of fuel cells that is located in the university campus of VSB-Technical University of Ostrava. The energetic system consists of several basic components: a photovoltaic field, accumulators bank, water commercial electrolyzer and compact fuel cell system. The weather conditions recorded in two different weeks as model weather and solar conditions are used as case studies to test the energetic system and the results for two different cases are compared each other. The results show and illustrate selected behaviour curves of the power system and also average energy storage efficiency for accumulation subsystem based on hydrogen technologies or at the energetic system embedded components. On the basis of real measurement and its evaluation the ideal parameters of the photovoltaic field were calculated as well as the hydrogen technologies for supposed purpose and the power requirements.

  2. From Usability Testing to Clinical Simulations: Bringing Context into the Design and Evaluation of Usable and Safe Health Information Technologies

    DEFF Research Database (Denmark)

    Kushniruk, Andre; Nøhr, Christian; Jensen, Sanne

    2013-01-01

    Objectives: The objective of this paper is to explore human factors approaches to understanding the use of health information technology (HIT) by extending usability engineering approaches to include analysis of the impact of clinical context through use of clinical simulations. Methods: Methods...... discussed are considered on a continuum from traditional laboratory-based usability testing to clinical simulations. Clinical simulations can be conducted in a simulation laboratory and they can also be conducted in real-world settings. The clinical simulation approach attempts to bring the dimension...... such evaluation can be used to improve both the usability and safety of HIT. In addition, recent work has shown that clinical simulations, in particular those conducted in-situ, can lead to considerable benefits when compared to the costs of running such studies. Conclusion: In order to bring context of use...

  3. ESTABLISHMENT OF AN ENVIRONMENTAL CONTROL TECHNOLOGY LABORATORY WITH A CIRCULATING FLUIDIZED-BED COMBUSTION SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Pan; Andy Wu; John T. Riley

    2004-10-30

    This report is to present the progress made on the project ''Establishment of an Environmental Control Technology Laboratory (ECTL) with a Circulating Fluidized-Bed Combustion (CFBC) System'' during the period July 1, 2004 through September 30, 2004. The following tasks have been completed. First, renovation of the new Combustion Laboratory and the construction of the Circulating Fluidized-Bed (CFB) Combustor Building have started. Second, the design if the component parts of the CFBC system have been reviewed and finalized so that the drawings may be released to the manufacturers during the next quarter. Third, the experiments for solid waste (chicken litter) incineration have been conducted using a Thermogravimetric Analyzer (TGA). This is in preparation for testing in the simulated fluidized-bed combustor. The experimental results from this study are presented in this report. Finally, the proposed work for the next quarter has been outlined in this report.

  4. National Research Council Research Associateships Program with Methane Hydrates Fellowships Program/National Energy Technology Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Basques, Eric O. [National Academy of Sciences, Washington, DC (United States)

    2014-03-20

    This report summarizes work carried out over the period from July 5, 2005-January 31, 2014. The work was carried out by the National Research Council Research Associateships Program of the National Academies, under the US Department of Energy's National Energy Technology Laboratory (NETL) program. This Technical Report consists of a description of activity from 2005 through 2014, broken out within yearly timeframes, for NRC/NETL Associateships researchers at NETL laboratories which includes individual tenure reports from Associates over this time period. The report also includes individual tenure reports from associates over this time period. The report also includes descriptions of program promotion efforts, a breakdown of the review competitions, awards offered, and Associate's activities during their tenure.

  5. FEATURES OF TECHNOLOGIES CREATE INTERACTIVE ELECTRONIC DOCUMENT FOR SUPPORT OF LABORATORY PRACTICAL PHYSICS

    Directory of Open Access Journals (Sweden)

    Mykola A. Meleshko

    2014-02-01

    Full Text Available The article discusses the content of the «flash-book» construct, defining its properties and possible components. There are presented some examples of components programming steps of “authoring flash – book”, considered the possibility of using such an electronic document to optimize the learning process at the Technical University in the performance of laboratory training on general physics. The technique of its using to provide individualized approach to learning and the use of various experimental base from classical to digital equipment laboratories is proposed. It was carried out the analysis of ways to improve such interactive electronic document for the development of information technology competence of engineering students.

  6. Using the Technology: Introducing Point of View Video Glasses Into the Simulated Clinical Learning Environment.

    Science.gov (United States)

    Metcalfe, Helene; Jonas-Dwyer, Diana; Saunders, Rosemary; Dugmore, Helen

    2015-10-01

    The introduction of learning technologies into educational settings continues to grow alongside the emergence of innovative technologies into the healthcare arena. The challenge for health professionals such as medical, nursing, and allied health practitioners is to develop an improved understanding of these technologies and how they may influence practice and contribute to healthcare. For nurse educators to remain contemporary, there is a need to not only embrace current technologies in teaching and learning but to also ensure that students are able to adapt to this changing pedagogy. One recent technological innovation is the use of wearable computing technology, consisting of video recording with the capability of playback analysis. The authors of this article discuss the introduction of the use of wearable Point of View video glasses by a cohort of nursing students in a simulated clinical learning laboratory. Of particular interest was the ease of use of the glasses, also termed the usability of this technology, which is central to its success. Students' reflections were analyzed together with suggestions for future use.

  7. Designing healthcare information technology to catalyse change in clinical care

    Directory of Open Access Journals (Sweden)

    William Lester

    2008-05-01

    Full Text Available The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge_performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environmentwhere disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their realworld effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT tools for translating clinical information into clinical action.

  8. Clinical and Laboratory Characteristics of a Tinea Capitis Outbreak Among Novice Buddhist Monks.

    Science.gov (United States)

    Bunyaratavej, Sumanas; Leeyaphan, Charussri; Rujitharanawong, Chuda; Muanprasat, Chanai; Matthapan, Lalita

    2017-05-01

    Sixty novice Buddhist monks with tinea capitis confirmed according to clinical presentation and mycological laboratory finding were included in this study. Mixed-type clinical presentation was observed in approximately half of all cases, together with scarring alopecia (95%) and superficial fungal skin infection at locations other than the scalp (43.3%). The major isolated organism was Trichophyton violaceum, and mixed-organism infection was found in 27 cases (45%). Slow-onset presentation and an extensive area of infection were significantly associated with mixed-type clinical presentation. © 2017 Wiley Periodicals, Inc.

  9. Health technology assessment in Australia: a role for clinical registries?

    Science.gov (United States)

    Scott, Anna Mae

    2017-03-01

    Objective Health technology assessment (HTA) is a process of assessing evidence to inform policy decisions about public subsidy of new drugs and medical procedures. Where evidence is uncertain but the technology itself is promising, funders may recommend funding on an interim basis. It is unknown whether evidence from clinical registries is used to resolve uncertainties identified in interim-funded decisions made by Australian HTA bodies. Therefore, the present study evaluated the role of evidence from clinical registries in resolving evidence uncertainties identified by the Medical Services Advisory Committee (MSAC). Methods All HTAs considered by MSAC between 1998 and 2015 were reviewed and assessments that recommended interim funding were identified. The MSAC website was searched to identify reassessments of these recommendations and sources of evidence used to resolve the uncertainties were identified. Results Of 173 HTA reports considered by MSAC, 17 (10%) contained an interim funding recommendation. Eight recommendations cited uncertainty around safety, 15 cited uncertainty around clinical effectiveness and 13 cited uncertainty around economics (cost-effectiveness and/or budget impact). Of the 17 interim funding recommendations, 11 (65%) have been reassessed. Only two reassessments relied on clinical registry evidence to resolve evidence gaps identified at the time of the interim funding recommendation. Conclusions Clinical registries are underused as a source of evidence for resolving uncertainties around promising new health technologies in Australia. An open dialogue between stakeholders on the role of registries in this context is needed. What is known about the topic? HTA is a process of assessing the evidence to inform policy decisions about public subsidy of new health technologies (e.g. pharmaceuticals, diagnostic tests, medical procedures). Where evidence is uncertain but the technology under evaluation is promising, funders may recommend the funding

  10. New technology of functional infrared imaging and its clinical applications

    Science.gov (United States)

    Yang, Hongqin; Xie, Shusen; Lu, Zukang; Liu, Zhongqi

    2006-01-01

    With improvements in infrared camera technology, the promise of reduced costs and noninvasive character, infrared thermal imaging resurges in medicine. The paper introduces a new technology of functional infrared imaging, thermal texture maps (TTM), which is not only an apparatus for thermal radiation imaging but also a new method for revealing the relationship between the temperature distribution of the skin surface and the emission field inside body. The skin temperature distribution of a healthy human body exhibits a contralateral symmetry. Any disease in the body is associated with an alteration of the thermal distribution of human body. Infrared thermography is noninvasive, so it is the best choice for studying the physiology of thermoregulation and the thermal dysfunction associated with diseases. Reading and extracting information from the thermograms is a complex and subjective task that can be greatly facilitated by computerized techniques. Through image processing and measurement technology, surface or internal radiation sources can be non-invasively distinguished through extrapolation. We discuss the principle, the evaluation procedure and the effectiveness of TTM technology in the clinical detection and diagnosis of cancers, especially in their early stages and other diseases by comparing with other imaging technologies, such as ultrasound. Several study cases are given to show the effectiveness of this method. At last, we point out the applications of TTM technology in the research field of traditional medicine.

  11. [Development of a Web-based laboratory data browser integrated with heterogeneous clinical information].

    Science.gov (United States)

    Fujikawa, Jun

    2009-02-01

    To demonstrate the feasibility of a Web-based laboratory data browser integrated with heterogeneous clinical information in a hospital setting. A Java-based web application was developed in-house, using free open-source software. The server side manages queries to heterogeneous hospital databases containing patient data. Order entry information including laboratory test results, drug prescriptions, injection orders, physiological test orders and, imaging test orders, was retrieved from a replication database, and integrated with nursing data from a nursing system database. The result was visualized in a time-series table format, and accessed by web browsers on computers connected to the hospital intranet. The laboratory data browser system achieved practical response times over huge databases (> 90 million records). The medical personnel accepted the system well, and applied the system to various clinical situations. Integrating heterogeneous data from hospital databases in a Web-based laboratory data browser is a practical approach. Presenting relevant medical information simultaneously added value to the laboratory data, and may promote better medical management.

  12. 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.

  13. [Effectiveness assessment of public clinical laboratories: the case of Belo Horizonte, Minas Gerais State].

    Science.gov (United States)

    Sancho, Leyla Gomes; Vargens, José Muniz da Costa; Sancho, Rafael Gomes

    2011-01-01

    The organization of public clinical laboratories is experiencing changes without, however, an organizational assessment of its effectiveness. The study aimed to determine a parameter of effectiveness for public clinical laboratories of Belo Horizonte, Minas Gerais State, and set cut-off points for the sections of these laboratories. In order to do so, the total production and number of hours worked during a period of 7 months in the year 2008 were consolidated. Due to the entrance of the workers in the mode of production in the laboratories network, it could be observed a variability regarding the performance of these workers. The effectiveness parameter of the network was established in 29.90 tests per hour. As a consequence of this first analysis, the cut-off points are: 15.50 for the hematology section; 67.29 for chemistry; 6.45 for parasitology; 11.35 for urinalysis; 4.94 for microbiology and 19.03 for immunology. From these results, it was concluded that the working process in laboratories can generate a decrease in effectiveness.

  14. A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard.

    Science.gov (United States)

    Azadmanjir, Zahra; Torabi, Mashallah; Safdari, Reza; Bayat, Maryam; Golmahi, Fatemeh

    2015-08-01

    management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard. the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified. the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers. the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.

  15. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K [Mayo Clinic, Rochester, MN (United States)

    2014-06-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  16. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    International Nuclear Information System (INIS)

    Fetterly, K

    2014-01-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care

  17. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    Science.gov (United States)

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  18. [Security Management in Clinical Laboratory Departments and Facilities: Current Status and Issues].

    Science.gov (United States)

    Ishida, Haku; Nakamura, Junji; Yoshida, Hiroshi; Koike, Masaru; Inoue, Yuji

    2014-11-01

    We conducted a questionnaire survey regarding the current activities for protecting patients' privacy and the security of information systems (IS) related to the clinical laboratory departments of university hospitals, certified training facilities for clinical laboratories, and general hospitals in Yamaguchi Prefecture. The response rate was 47% from 215 medical institutions, including three commercial clinical laboratory centers. The results showed that there were some differences in management activities among facilities with respect to continuing education, the documentation or regulation of operational management for paper records, electronic information, remaining samples, genetic testing, and laboratory information for secondary use. They were suggested to be caused by differences in functions between university and general hospitals, differences in the scale of hospitals, or whether or not hospitals have received accreditation or ISO 15189. Regarding the IS, although the majority of facilities had sufficiently employed the access control to IS, there was some room for improvement in the management of special cases such as VIPs and patients with HIV infection. Furthermore, there were issues regarding the login method for computers shared by multiple staff, the showing of the names of personnel in charge of reports, and the risks associated with direct connections to systems and the Internet and the use of portable media such as USB memory sticks. These results indicated that further efforts are necessary for each facility to continue self-assessment and make improvements.

  19. Reference ranges for the clinical laboratory derived from a rural population in Kericho, Kenya.

    Directory of Open Access Journals (Sweden)

    Rukia S Kibaya

    Full Text Available The conduct of Phase I/II HIV vaccine trials internationally necessitates the development of region-specific clinical reference ranges for trial enrollment and participant monitoring. A population based cohort of adults in Kericho, Kenya, a potential vaccine trial site, allowed development of clinical laboratory reference ranges. Lymphocyte immunophenotyping was performed on 1293 HIV seronegative study participants. Hematology and clinical chemistry were performed on up to 1541 cohort enrollees. The ratio of males to females was 1.9:1. Means, medians and 95% reference ranges were calculated and compared with those from other nations. The median CD4+ T cell count for the group was 810 cells/microl. There were significant gender differences for both red and white blood cell parameters. Kenyan subjects had lower median hemoglobin concentrations (9.5 g/dL; range 6.7-11.1 and neutrophil counts (1850 cells/microl; range 914-4715 compared to North Americans. Kenyan clinical chemistry reference ranges were comparable to those from the USA, with the exception of the upper limits for bilirubin and blood urea nitrogen, which were 2.3-fold higher and 1.5-fold lower, respectively. This study is the first to assess clinical reference ranges for a highland community in Kenya and highlights the need to define clinical laboratory ranges from the national community not only for clinical research but also care and treatment.

  20. Advances in liquid biopsy on-chip for cancer management: Technologies, biomarkers, and clinical analysis.

    Science.gov (United States)

    Tadimety, Amogha; Closson, Andrew; Li, Cathy; Yi, Song; Shen, Ting; Zhang, John X J

    2018-02-01

    Liquid biopsy, as a minimally invasive method of gleaning insight into the dynamics of diseases through a patient fluid sample, has been growing in popularity for cancer diagnosis, prognosis, and monitoring. While many technologies have been developed and validated in research laboratories, there has also been a push to expand these technologies into other clinical settings and as point of care devices. In this article, we discuss and evaluate microchip-based technologies for circulating tumor cell (CTC), exosome, and circulating tumor nucleic acid (ctNA) capture, detection, and analysis. Such integrated systems streamline otherwise multiple-step, manual operations to get a sample-to-answer quantitation. In addition, analysis of disease biomarkers is suited to point of care settings because of ease of use, low consumption of sample and reagents, and high throughput. We also cover the basics of biomarkers and their detection in biological fluid samples suitable for liquid biopsy on-chip. We focus on emerging technologies that process a small patient sample with high spatial-temporal resolution and derive clinically meaningful results through on-chip biomarker sensing and downstream molecular analysis in a simple workflow. This critical review is meant as a resource for those interested in developing technologies for capture, detection, and analysis platforms for liquid biopsy in a variety of settings.

  1. Stool-specimen testing practices adopted by clinical microbiology laboratories in the Veneto Region, Italy

    Directory of Open Access Journals (Sweden)

    Paolo Spolaore

    2008-03-01

    Full Text Available In order to correctly analyze data of laboratory diagnoses of infectious gastroenteritis for epidemiological purposes, a survey on analytical methods applied by hospital-based clinical microbiology laboratories has been conducted in the Veneto Region (Italy. The survey has been carried out in 2005 through a questionnaire collecting data on laboratory protocols and materials used for faecal specimens analysis. Laboratories from all the Local Health Units and University Hospitals of the Region returned the questionnaire. Almost all the laboratories routinely tested for the main foodborne pathogens: 23/23 for Salmonella, 22/23 for Shigella and 19/23 for Campylobacter jejuni. A great variety of analytical methods was applied for pathogen isolation; among these is worth of notice the inappropriate use of selenite broth for Shigella enrichment.Among noncultural methods, immunoassays were largely adopted. The survey allowed to appraise stool-specimen testing practices among laboratories of the Veneto Region; overall the compliance with guidelines proposed by the main national and international scientific societies resulted rather good.

  2. Clinical Variant Classification: A Comparison of Public Databases and a Commercial Testing Laboratory.

    Science.gov (United States)

    Gradishar, William; Johnson, KariAnne; Brown, Krystal; Mundt, Erin; Manley, Susan

    2017-07-01

    There is a growing move to consult public databases following receipt of a genetic test result from a clinical laboratory; however, the well-documented limitations of these databases call into question how often clinicians will encounter discordant variant classifications that may introduce uncertainty into patient management. Here, we evaluate discordance in BRCA1 and BRCA2 variant classifications between a single commercial testing laboratory and a public database commonly consulted in clinical practice. BRCA1 and BRCA2 variant classifications were obtained from ClinVar and compared with the classifications from a reference laboratory. Full concordance and discordance were determined for variants whose ClinVar entries were of the same pathogenicity (pathogenic, benign, or uncertain). Variants with conflicting ClinVar classifications were considered partially concordant if ≥1 of the listed classifications agreed with the reference laboratory classification. Four thousand two hundred and fifty unique BRCA1 and BRCA2 variants were available for analysis. Overall, 73.2% of classifications were fully concordant and 12.3% were partially concordant. The remaining 14.5% of variants had discordant classifications, most of which had a definitive classification (pathogenic or benign) from the reference laboratory compared with an uncertain classification in ClinVar (14.0%). Here, we show that discrepant classifications between a public database and single reference laboratory potentially account for 26.7% of variants in BRCA1 and BRCA2 . The time and expertise required of clinicians to research these discordant classifications call into question the practicality of checking all test results against a database and suggest that discordant classifications should be interpreted with these limitations in mind. With the increasing use of clinical genetic testing for hereditary cancer risk, accurate variant classification is vital to ensuring appropriate medical management

  3. [The challenges of standardization in clinical diagnostic laboratories of medical organizations].

    Science.gov (United States)

    Men'shikov, V V

    2013-04-01

    The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

  4. Application of failure mode and effects analysis in a clinical chemistry laboratory.

    Science.gov (United States)

    Jiang, Yuanyuan; Jiang, Hongmin; Ding, Siyi; Liu, Qin

    2015-08-25

    Timely delivery of correct results has long been considered as the goal of quality management in clinical laboratory. With increasing workload as well as complexities of laboratory testing and patient care, the traditional technical adopted like internal quality control (IQC) and external quality assessment (EQA) may not enough to cope with quality management problems for clinical laboratories. We applied failure mode and effects analysis (FMEA), a proactive tool, to reduce errors associated with the process beginning with sample collection and ending with a test report in a clinical chemistry laboratory. Our main objection was to investigate the feasibility of FMEA in a real-world situation, namely the working environment of hospital. A team of 8 people (3 laboratory workers, 2 couriers, 2 nurses, and 1 physician) from different departments who were involved in the testing process were recruited and trained. Their main responsibility was to analyze and score all possible clinical chemistry laboratory failures based on three aspects: the severity of the outcome (S), the likeliness of occurrence (O), and the probability of being detected (D). These three parameters were multiplied to calculate risk priority numbers (RPNs), which were used to prioritize remedial measures. Failure modes with RPN≥200 were deemed as high risk, meaning that they needed immediate corrective action. After modifications that were put, we compared the resulting RPN with the previous one. A total of 33 failure modes were identified. Many of the failure modes, including the one with the highest RPN (specimen hemolysis) appeared in the pre-analytic phase, whereas no high-risk failure modes (RPN≥200) were found during the analytic phase. High-priority risks were "sample hemolysis" (RPN, 336), "sample delivery delay" (RPN, 225), "sample volume error" (RPN, 210), "failure to release results in a timely manner" (RPN, 210), and "failure to identify or report critical results" (RPN, 200). The

  5. The Los Alamos, Sandia, and Livermore Laboratories: Integration and collaboration solving science and technology problems for the nation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-12-01

    More than 40 years ago, three laboratories were established to take on scientific responsibility for the nation`s nuclear weapons - Los Alamos, Sandia, and Livermore. This triad of laboratories has provided the state-of-the-art science and technology to create America`s nuclear deterrent and to ensure that the weapons are safe, secure, and to ensure that the weapons are safe, secure, and reliable. These national security laboratories carried out their responsibilities through intense efforts involving almost every field of science, engineering, and technology. Today, they are recognized as three of the world`s premier research and development laboratories. This report sketches the history of the laboratories and their evolution to an integrated three-laboratory system. The characteristics that make them unique are described and some of the major contributions they have made over the years are highlighted.

  6. State of malaria diagnostic testing at clinical laboratories in the United States, 2010: a nationwide survey.

    Science.gov (United States)

    Abanyie, Francisca A; Arguin, Paul M; Gutman, Julie

    2011-11-10

    The diagnosis of malaria can be difficult in non-endemic areas, such as the United States, and delays in diagnosis and errors in treatment occur too often. A nationwide survey of laboratories in the United States and its nine dependent territories was conducted in 2010 to determine factors that may contribute to shortcomings in the diagnosis of malaria. This survey explored the availability of malaria diagnostic tests, techniques used, and reporting practices. The survey was completed by 201 participants. Ninety percent reported that their laboratories had at least one type of malaria diagnostic test available on-site. Nearly all of the respondents' laboratories performed thick and thin smears on-site; approximately 50% had access to molecular testing; and only 17% had access to rapid diagnostic tests on-site. Seventy-three percent reported fewer than five confirmed cases of malaria in their laboratory during the 12-month period preceding the survey. Twenty-eight percent stated that results of species identification took more than 24 hours to report. Only five of 149 respondents that performed testing 24 hours a day, 7 days a week complied with all of the Clinical and Laboratory Standards Institute (CLSI) guidelines for analysis and reporting of results. Although malaria diagnostic testing services were available to a majority of U.S. laboratories surveyed, very few were in complete compliance with all of the CLSI guidelines for analysis and reporting of results, and most respondents reported very few cases of malaria annually. Laboratories' difficulty in adhering to the rigorous CLSI guidelines and their personnel's lack of practice and proficiency may account for delays and errors in diagnosis. It is recommended that laboratories that infrequently process samples for malaria seek opportunities for practice and proficiency training annually and take advantage of available resources to assist in species identification. © 2011 Abanyie et al; licensee BioMed Central

  7. Clinical utility of RapidArc™ radiotherapy technology

    International Nuclear Information System (INIS)

    Infusino, Erminia

    2015-01-01

    RapidArc™ is a radiation technique that delivers highly conformal dose distributions through the complete rotation (360°) and speed variation of the linear accelerator gantry. This technique, called volumetric modulated arc therapy (VMAT), compared with conventional radiotherapy techniques, can achieve high-target volume coverage and sparing damage to normal tissues. RapidArc delivers precise dose distribution and conformity similar to or greater than intensity-modulated radiation therapy in a short time, generally a few minutes, to which image-guided radiation therapy is added. RapidArc has become a currently used technology in many centers, which use RapidArc technology to treat a large number of patients. Large and small hospitals use it to treat the most challenging cases, but more and more frequently for the most common cancers. The clinical use of RapidArc and VMAT technology is constantly growing. At present, a limited number of clinical data are published, mostly concerning planning and feasibility studies. Clinical outcome data are increasing for a few tumor sites, even if only a little. The purpose of this work is to discuss the current status of VMAT techniques in clinical use through a review of the published data of planning systems and clinical outcomes in several tumor sites. The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, BioMed Central, and Scopus databases by searching for the keywords “RapidArc”, “Volumetric modulated arc radiotherapy”, and “Intensity-modulated radiotherapy”

  8. Autoverification in a core clinical chemistry laboratory at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2014-01-01

    Full Text Available Background: Autoverification is a process of using computer-based rules to verify clinical laboratory test results without manual intervention. To date, there is little published data on the use of autoverification over the course of years in a clinical laboratory. We describe the evolution and application of autoverification in an academic medical center clinical chemistry core laboratory. Subjects and Methods: At the institution of the study, autoverification developed from rudimentary rules in the laboratory information system (LIS to extensive and sophisticated rules mostly in middleware software. Rules incorporated decisions based on instrument error flags, interference indices, analytical measurement ranges (AMRs, delta checks, dilution protocols, results suggestive of compromised or contaminated specimens, and ′absurd′ (physiologically improbable values. Results: The autoverification rate for tests performed in the core clinical chemistry laboratory has increased over the course of 13 years from 40% to the current overall rate of 99.5%. A high percentage of critical values now autoverify. The highest rates of autoverification occurred with the most frequently ordered tests such as the basic metabolic panel (sodium, potassium, chloride, carbon dioxide, creatinine, blood urea nitrogen, calcium, glucose; 99.6%, albumin (99.8%, and alanine aminotransferase (99.7%. The lowest rates of autoverification occurred with some therapeutic drug levels (gentamicin, lithium, and methotrexate and with serum free light chains (kappa/lambda, mostly due to need for offline dilution and manual filing of results. Rules also caught very rare occurrences such as plasma albumin exceeding total protein (usually indicative of an error such as short sample or bubble that evaded detection and marked discrepancy between total bilirubin and the spectrophotometric icteric index (usually due to interference of the bilirubin assay by immunoglobulin (Ig M monoclonal

  9. HLA genotyping in the clinical laboratory: comparison of next-generation sequencing methods.

    Science.gov (United States)

    Profaizer, T; Lázár-Molnár, E; Close, D W; Delgado, J C; Kumánovics, A

    2016-07-01

    Implementation of human leukocyte antigen (HLA) genotyping by next-generation sequencing (NGS) in the clinical lab brings new challenges to the laboratories performing this testing. With the advent of commercially available HLA-NGS typing kits, labs must make numerous decisions concerning capital equipment and address labor considerations. Therefore, careful and unbiased evaluation of available methods is imperative. In this report, we compared our in-house developed HLA NGS typing with two commercially available kits from Illumina and Omixon using 10 International Histocompatibility Working Group (IHWG) and 36 clinical samples. Although all three methods employ long range polymerase chain reaction (PCR) and have been developed on the Illumina MiSeq platform, the methodologies for library preparation show significant variations. There was 100% typing concordance between all three methods at the first field when a HLA type could be assigned. Overall, HLA typing by NGS using in-house or commercially available methods is now feasible in clinical laboratories. However, technical variables such as hands-on time and indexing strategies are sufficiently different among these approaches to impact the workflow of the clinical laboratory. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Taking a new biomarker into routine use – A perspective from the routine clinical biochemistry laboratory

    Science.gov (United States)

    Sturgeon, Catharine; Hill, Robert; Hortin, Glen L; Thompson, Douglas

    2010-01-01

    There is increasing pressure to provide cost-effective healthcare based on “best practice.” Consequently, new biomarkers are only likely to be introduced into routine clinical biochemistry departments if they are supported by a strong evidence base and if the results will improve patient management and outcome. This requires convincing evidence of the benefits of introducing the new test, ideally reflected in fewer hospital admissions, fewer additional investigations and/or fewer clinic visits. Carefully designed audit and cost-benefit studies in relevant patient groups must demonstrate that introducing the biomarker delivers an improved and more effective clinical pathway. From the laboratory perspective, pre-analytical requirements must be thoroughly investigated at an early stage. Good stability of the biomarker in relevant physiological matrices is essential to avoid the need for special processing. Absence of specific timing requirements for sampling and knowledge of the effect of medications that might be used to treat the patients in whom the biomarker will be measured is also highly desirable. Analytically, automation is essential in modern high-throughput clinical laboratories. Assays must therefore be robust, fulfilling standard requirements for linearity on dilution, precision and reproducibility, both within- and between-run. Provision of measurements by a limited number of specialized reference laboratories may be most appropriate, especially when a new biomarker is first introduced into routine practice. PMID:21137030

  11. Current practices and challenges in the standardization and harmonization of clinical laboratory tests123

    Science.gov (United States)

    Vesper, Hubert W; Myers, Gary L; Miller, W Greg

    2016-01-01

    Effective patient care, clinical research, and public health efforts require comparability of laboratory results independent of time, place, and measurement procedure. Comparability is achieved by establishing metrological traceability, which ensures that measurement procedures measure the same quantity and that the calibration of measurement procedures is traceable to a common reference system consisting of reference methods and materials. Whereas standardization ensures traceability to the International System of Units, harmonization ensures traceability to a reference system agreed on by convention. This article provides an overview of standardization and harmonization with an emphasis on commutability as an important variable that affects testing accuracy. Commutability of reference materials is required to ensure that traceability is established appropriately and that laboratory results are comparable. The use of noncommutable reference materials leads to inaccurate results. Whereas procedures and protocols for standardizing measurements are established and have been successfully applied in efforts such as the Hormones Standardization Program of the CDC, harmonization activities require new, more complex procedures and approaches. The American Association for Clinical Chemistry, together with its domestic and international partners, formed the International Consortium for Harmonization of Clinical Laboratory Results to coordinate harmonization efforts. Reference systems, as well as procedures and protocols to establish traceability of clinical laboratory tests, have been established and continue to be developed by national and international groups and organizations. Serum tests of thyroid function, including those for the thyroid hormones thyroxine and triiodothyronine, are among the clinical procedures for which standardization efforts are well under way. Approaches to the harmonization of measurement procedures for serum concentrations of thyroid

  12. Energy Saving Separations Technologies for the Petroleum Industry: An Industry-University-National Laboratory Research Partnership

    Energy Technology Data Exchange (ETDEWEB)

    Dorgan, John R.; Stewart, Frederick F.; Way, J. Douglas

    2003-03-28

    This project works to develop technologies capable of replacing traditional energy-intensive distillations so that a 20% improvement in energy efficiency can be realized. Consistent with the DOE sponsored report, Technology Roadmap for the Petroleum Industry, the approach undertaken is to develop and implement entirely new technology to replace existing energy intensive practices. The project directly addresses the top priority issue of developing membranes for hydrocarbon separations. The project is organized to rapidly and effectively advance the state-of-the-art in membranes for hydrocarbon separations. The project team includes ChevronTexaco and BP, major industrial petroleum refiners, who will lead the effort by providing matching resources and real world management perspective. Academic expertise in separation sciences and polymer materials found in the Chemical Engineering and Petroleum Refining Department of the Colorado School of Mines is used to invent, develop, and test new membrane materials. Additional expertise and special facilities available at the Idaho National Engineering and Environmental Laboratory (INEEL) are also exploited in order to effectively meet the goals of the project. The proposed project is truly unique in terms of the strength of the team it brings to bear on the development and commercialization of the proposed technologies.

  13. Simple Clinical and Laboratory Predictors of Chikungunya versus Dengue Infections in Adults

    Science.gov (United States)

    Lee, Vernon J.; Chow, Angela; Zheng, Xiaohui; Carrasco, Luis R.; Cook, Alex R.; Lye, David C.; Ng, Lee-Ching; Leo, Yee-Sin

    2012-01-01

    Background Dengue and chikungunya are co-circulating vector-borne diseases with substantial overlap in clinical presentations. It is important to differentiate between them during first presentation as their management, especially for dengue hemorrhagic fever (DHF), is different. This study compares their clinical presentation in Singapore adults to derive predictors to assist doctors in diagnostic decision-making. Methods We compared 117 patients with chikungunya infection diagnosed with reverse transcription-polymerase chain reaction (RT-PCR) with 917 dengue RT-PCR-positive adult patients (including 55 with DHF). We compared dengue fever (DF), DHF, and chikungunya infections by evaluating clinical characteristics of dengue and chikungunya; developing classification tools via multivariate logistic regression models and classification trees of disease etiology using clinical and laboratory factors; and assessing the time course of several clinical variables. Findings At first presentation to hospital, significantly more chikungunya patients had myalgia or arthralgia, and fewer had a sore throat, cough (for DF), nausea, vomiting, diarrhea, abdominal pain, anorexia or tachycardia than DF or DHF patients. From the decision trees, platelets chikungunya with an overall correct classification of 89%. For DHF versus chikungunya using platelets chikungunya infections, but simple clinical and laboratory variables can predict these infections at presentation for appropriate management. PMID:23029573

  14. Development of an internal dynamic web site to promote quality assurance in a clinical laboratory.

    Science.gov (United States)

    Pernet, Pascal; Mario, Nathalie; Vaubourdolle, Michel

    2004-01-01

    In clinical laboratories, one challenging quality assurance objective is to maintain standardized practices. Meeting this objective entails ensuring information flow, which is necessary to smooth running of the laboratory. To facilitate information flow, we developed an internal quality Web site on our local network. The dynamic generated pages of the site were constructed with EasyPHP v.1.6, a complete freeware package providing PHP dynamic language and databases. The site comprises various sections: general news, specific laboratory units news, documents (quality manual, guidelines, emergency processes), schedules, National Quality Control results, forum, etc. Five to 10 pages are updated each week. This work was facilitated by the use of PHP-written pages and data tables, which enable us to record in real time the operation of our assurance quality project and to improve traceability. This approach could be extended to other aspects of quality management and could help meet the future IS015189 standard requirements.

  15. Collection, transport and general processing of clinical specimens in Microbiology laboratory.

    Science.gov (United States)

    Sánchez-Romero, M Isabel; García-Lechuz Moya, Juan Manuel; González López, Juan José; Orta Mira, Nieves

    2018-02-06

    The interpretation and the accuracy of the microbiological results still depend to a great extent on the quality of the samples and their processing within the Microbiology laboratory. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples. Nowadays, the laboratory automation and the availability of rapid techniques allow the precision and turn-around time necessary to help the clinicians in the decision making. In order to be efficient, it is very important to obtain clinical information to use the best diagnostic tools. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  16. 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

  17. ESTABLISHMENT OF AN ENVIRONMENTAL CONTROL TECHNOLOGY LABORATORY WITH A CIRCULATING FLUIDIZED-BED COMBUSTION SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Pan; Andy Wu; John T. Riley

    2005-04-30

    This report is to present the progress made on the project ''Establishment of an Environmental Control Technology Laboratory (ECTL) with a Circulating Fluidized-Bed Combustion (CFBC) System'' during the period January 1, 2005 through March 31, 2005. The following tasks have been completed. First, the renovation of the new Combustion Laboratory is nearly complete, and the construction of the Circulating Fluidized-Bed (CFB) Combustor Building is in the final stages. Second, the fabrication and manufacture of the CFBC Facility is being discussed with a potential contractor. Discussions with potential contactor regarding the availability of materials and current machining capabilities have resulted in the modification of the original designs. The selection of the fabrication contractor for the CFBC Facility is expected during the next quarter. Third, co-firing experiments conducted with coal and chicken waste have been initiated in the laboratory-scale simulated fluidized-bed facility. The experimental results from this study are presented in this report. Finally, the proposed work for the next quarter is described in this report.

  18. ESTABLISHMENT OF AN ENVIRONMENTAL CONTROL TECHNOLOGY LABORATORY WITH A CIRCULATING FLUIDIZED-BED COMBUSTION SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Pan; Andy Wu; John T. Riley

    2005-07-30

    This purpose of this report is to present the progress made on the project ''Establishment of an Environmental Control Technology Laboratory (ECTL) with a Circulating Fluidized-Bed Combustion (CFBC) System'' during the period April 1, 2005 through June 30, 2005. The following tasks have been completed. First, the new Combustion Laboratory was occupied on June 15, 2005, and the construction of the Circulating Fluidized-Bed (CFB) Combustor Building is in the final painting stage. Second, the fabrication and manufacturing contract for the CFBC Facility was awarded to Sterling Boiler & Mechanical, Inc. of Evansville, Indiana. Sterling is manufacturing the assembly and component parts of the CFBC system. The erection of the CFBC system is expected to start September 1, 2005. Third, mercury emissions from the cofiring of coal and chicken waste was studied experimentally in the laboratory-scale simulated fluidized-bed combustion facility. The experimental results from this study are presented in this report. Finally, the proposed work for the next quarter is described.

  19. Reducing cognitive load in the chemistry laboratory by using technology-driven guided inquiry experiments

    Science.gov (United States)

    Hubacz, Frank, Jr.

    The chemistry laboratory is an integral component of the learning experience for students enrolled in college-level general chemistry courses. Science education research has shown that guided inquiry investigations provide students with an optimum learning environment within the laboratory. These investigations reflect the basic tenets of constructivism by engaging students in a learning environment that allows them to experience what they learn and to then construct, in their own minds, a meaningful understanding of the ideas and concepts investigated. However, educational research also indicates that the physical plant of the laboratory environment combined with the procedural requirements of the investigation itself often produces a great demand upon a student's working memory. This demand, which is often superfluous to the chemical concept under investigation, creates a sensory overload or extraneous cognitive load within the working memory and becomes a significant obstacle to student learning. Extraneous cognitive load inhibits necessary schema formation within the learner's working memory thereby impeding the transfer of ideas to the learner's long-term memory. Cognitive Load Theory suggests that instructional material developed to reduce extraneous cognitive load leads to an improved learning environment for the student which better allows for schema formation. This study first compared the cognitive load demand, as measured by mental effort, experienced by 33 participants enrolled in a first-year general chemistry course in which the treatment group, using technology based investigations, and the non-treatment group, using traditional labware, investigated identical chemical concepts on five different exercises. Mental effort was measured via a mental effort survey, a statistical comparison of individual survey results to a procedural step count, and an analysis of fourteen post-treatment interviews. Next, a statistical analysis of achievement was

  20. Assisted reproductive technologies: professional and legal restrictions in Australian clinics.

    Science.gov (United States)

    Petersen, Kerry; Baker, H W G; Pitts, Marian; Thorpe, Rachel

    2005-02-01

    The professional and legal regulation of assisted reproductive technologies (ART) in Australia is a vast maze of intersecting laws and guidelines which place restrictions on the provision of services such as infertility treatment, surrogacy, sex selection for social reasons, donor insemination, pre-implantation diagnosis and human embryo research. This study investigated the application of these restrictions on clinical practice in New South Wales, a relatively unregulated State, and Victoria, a relatively highly regulated State. The results of the survey indicate that the range of ART services in Victorian clinics was far more limited than in New South Wales clinics. The Victorian clinics uniformly restricted access of single and lesbian women and did not offer social sex selection procedures. The New South Wales clinics adopted different polices regarding these services. It was found that restrictive laws governing "social" issues have a significant impact on the availability of ART services and some respondents seemed unclear about the nature of restrictions and laws relevant to their work. It was also found that "reproductive tourism" is prevalent and restrictions were circumnavigated by patients with assistance from clinics. It was concluded that more evidence is required to evaluate regulation in this field of medicine.