scholarly journals Novel method to determine diagnosis-defining refraction points

2019 ◽  
Author(s):  
Tsuneto Yamauchi ◽  
Mitsuhiro Ohshima ◽  
Yoko Yamaguchi ◽  
Kazunori Konishi ◽  
Kai Kappert ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Diabetic Patients ◽  
Reference Ranges ◽  
Test Results ◽  
Mathematical Methods ◽  
Distribution Of Values ◽  
Clinical Diagnoses ◽  
Novel Method ◽  
The Mean ◽  
Data Sorting

AbstractDiagnosis of a certain disease generally relies on definitions established by professional medical societies and comprise the patient’s history, physical examination, and test results. These include physical compositions such as body mass index (BMI), and laboratory tests such as serum creatinine and albumin in urine samples. In general, laboratory tests are based on mathematical methods,e.g.defining critical values from the mean ± kσ of a population, where k is a natural number and the standard deviation is σ (“mean ± kσ-method”). In most cases k is defined as 2, leading to reference ranges defining 95% of test results as normal. However, this method mostly depends on a normal distribution of values.Here we applied a novel method (“SoFR-method”) based on data sorting to define refraction points, which carry informative value as diagnostic criteria. Applying the SoFR-method, standard measures such as critical BMI-values are categorized by equal robustness as by the mean ± kσ-method. However, the SoFR-method showed higher validity when analyzing non-normalized values such as creatinine and albumin, as well as hepatocyte growth factor (HGF) and hemoglobin in a novel Perioscreen assay in saliva of diabetic and non-diabetic patients.Taken together, we defined a novel method based on data sorting of test results from patients to effectively define refraction points which might guide more accurately clinical diagnoses and define relevant thresholds.

scholarly journals LO26: The mean abnormal response rates of laboratory tests ordered in the emergency department: shooting percentage insights from a multicentre study

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S16-S16
Author(s):  
E. Enwere ◽  
D. Wang ◽  
M. Guo ◽  
C. Naugler ◽  
E. Lang
Keyword(s):  
Administrative Data ◽  
Laboratory Tests ◽  
Population Data ◽  
Primary Objective ◽  
High Yield ◽  
Test Results ◽  
Abnormal Result ◽  
Component Test ◽  
Abnormal Response ◽  
The Mean

Introduction: There is ongoing concern about the burden placed on healthcare systems by lab tests. Although these concerns are widespread, it is difficult to quantify the extent of the problem. One approach involves use of a metric known as the Mean Abnormal Response Rate (MARR), which is the proportion of tests ordered that return an abnormal result; a higher MARR value indicates higher yield. The primary objective of this study was to calculate MARRs for tests ordered between April 2014 and March 2019 at the four adult emergency departments (EDs) covering a metropolitan population of 1.3 million. Secondary objectives included identifying tests with highest and lowest MARRs; comparison of MARRs for nurse- and physician-initiated orders; correlation of the number of tests per order requisition to MARR; and correlation of physician experience to MARR. Methods: In total, 40 laboratory tests met inclusion criteria for this study. Administrative data on these tests as ordered at the four EDs were obtained and analyzed. Multi-component test results, such as from CBC, were consolidated such that an abnormal result for any component was coded as an abnormal result for the entire test. Repeat tests ordered within a single patient visit were excluded. Physician experience was quantified for 209 ED physicians as number of years since licensure. Analyses were descriptive where appropriate for whole-population data. Risk of bias was attenuated by the focus on administrative data. Results: The population dataset comprised 33,757,004 test results on 415,665 unique patients. Of these results, 30.3% were the outcomes of nurse-initiated orders. The 5-year MARRs for the four hospitals were 38.3%, 40.0%, 40.7% and 40.9%. The highest per-test MARRs were for BNP (80.5%) and CBC (62.6%), while the lowest were for glucose (7.9%) and sodium (11.6%). MARRs were higher for nurse-initiated orders than for physician-initiated orders (44.7% vs. 38.1%), likely due to the greater order frequency of high-yield CBC in nurse-initiated orders (38.6% vs. 18.1%). The number of tests per order requisition was inversely associated with MARR (r = -0.90, p < 0.001). Finally, the number of years since licensure was modestly but significantly associated with MARR (r = 0.28, p < 0.001). Conclusion: This is the first and largest study to apply the MARR in an ED setting. As a metric, MARR effectively identifies differences in test ordering practices on per-test and per-hospital bases, which could be useful for data-informed practice optimization.

The Usefulness of Laboratory Tests in Health-Screening Programs

1973 ◽  
Vol 19 (4) ◽  
pp. 366-372 ◽  
Author(s):  
David L Sackett
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Health Screening ◽  
Test Results ◽  
Screening Programs ◽  
Laboratory Screening ◽  
Rare Exception ◽  
Laboratory Test Results ◽  
The Mean ◽  
Regression Toward The Mean

Abstract I discuss pitfalls in laboratory-screening programs: regression toward the mean on repeated biochemical determinations; the problem of defining normalcy in the interpretation of laboratory test results; and a remarkable professional myopia in which clinical chemists have, with rare exception, failed to accept responsibility for evaluating whether the programs in which they are engaged are of benefit to patients.

scholarly journals Working on Health Optimization: A Major Goal for Health Maintenance

2020 ◽  
Vol 3 (1) ◽  
pp. 87-89
Author(s):  
David IMB
Keyword(s):  
General Practice ◽  
21St Century ◽  
Preventive Care ◽  
Laboratory Tests ◽  
Reference Ranges ◽  
Test Results ◽  
Major Goal ◽  
Optimal Test ◽  
Health Maintenance ◽  
The One

Some years ago – let’s say, for sure, some decades ago – a “good physician” was considered the one who would request a few laboratory tests to some patient and they would come out all altered. – Yes – one would say – he got it right to the point, disease concerning. However, in the 21st century, when we have moved the focus of preventive care from prevention of diseases to health maintenance, we believe that the “good physician” may be considered the one that aims at keeping all the test results basically normal. Actually, more than that: optimal. In fact, keeping the eyes on optimal test results is a major goal for Age Management practitioners. For that, even if we still have the established reference ranges, we’ve got to have our own interpretation of the tests we are used to from a different, more detailed standpoint than in the general practice. Some normal results must be seen as subnormal, which are, indeed, still different from abnormal. Some results may also be considered critical – that is, those ones which demand some urgent and immediate action.

scholarly journals A novel method to test for lead contamination in soil around US schools

2020 ◽  
Vol 10 (1) ◽  
pp. 94-96
Author(s):  
H Garcia ◽  
R Palacio
Keyword(s):  
Plant Growth ◽  
Root Length ◽  
Laboratory Tests ◽  
Lead Contamination ◽  
Surrounding Area ◽  
The Us ◽  
Uncontaminated Soil ◽  
Novel Method ◽  
The Mean ◽  
Multiple Species

It has been rumored that soils around schools in the US are contaminated with lead, which is known to be harmful to children, and is known to inhibit plant growth. The purpose of this study is to investigate the growth of plants in soil sampled from US schools to see if decreased plant growth can indicate lead contamination before testing is done. After comparing the time until germination, height, and root length of radishes grown in soil from the surrounding area of the school to that of those grown in uncontaminated soil, we found that radishes grown in soil from schools germinated at a rate 38% slower than radishes grown in uncontaminated soil (HR = 0.62, 95% CI 0.33-1.2, Ptrend = 0.13). The mean radish heights between the two groups were also found to be significantly different (p = 0.12). Decreased plant growth may serve as an indicator for soil contamination before other laboratory tests are done. It is recommended that further testing for lead and other toxins should be conducted on the soil of the surrounding area, and larger studies with multiple species of plants should be conducted to see if these trends could be applied to the general plant population around schools. Int. J. Agril. Res. Innov. Tech. 10(1): 94-96, June 2020

Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics

1991 ◽  
Vol 30 (05) ◽  
pp. 183-188
Author(s):  
A. Aydrner ◽  
A. Oto ◽  
E. Oram ◽  
O. Gedik ◽  
C. F. Bekdik ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Filling Fraction ◽  
Time To Peak ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.

Platelet Suruival and Function in Rats with Enhanced Thrombotic Tendency

1985 ◽  
Vol 54 (04) ◽  
pp. 739-743 ◽  
Author(s):  
Federica Delaini ◽  
Elisabetta Dejana ◽  
Ine Reyers ◽  
Elisa Vicenzi ◽  
Germana De Bellis Vitti ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Nephrotic Syndrome ◽  
Platelet Function ◽  
Laboratory Tests ◽  
Thrombus Formation ◽  
The Other ◽  
Mean Survival Time ◽  
The Mean ◽  
And Function ◽  
Thrombotic Tendency

SummaryWe have investigated the relevance of some laboratory tests of platelet function in predicting conditions of thrombotic tendency. For this purpose, we studied platelet survival, platelet aggregation in response to different stimuli, TxB2 and 6-keto-PGFlα production in serum of rats bearing a nephrotic syndrome induced by adriamycin. These animals show a heavy predisposition to the development of both arterial and venous thrombosis. The mean survival time was normal in nephrotic rats in comparison to controls. As to aggregation tests, a lower aggregating response was found in ADR-treated rats using ADP or collagen as stimulating agents. With arachidonic acid (AA) we observed similar aggregating responses at lower A A concentrations, whereas at higher AA concentrations a significantly lower response was found in nephrotic rats, despite their higher TxB2 production. Also TxB2 and 6-keto-PGFlα levels in serum of nephrotic rats were significantly higher than in controls. No consistent differences were found in PGI2-activity generated by vessels of control or nephrotic rats.These data show that platelet function may appear normal or even impaired in rats with a markedly increased thrombotic tendency. On the other hand, the significance of high TxB2 levels in connection with mechanisms leading to thrombus formation remains a controversial issue.

Assessment of nutritional status of students of medical institute according to the blood biochemical parameters

2020 ◽  
pp. 55-63
Author(s):  
Rofail Rakhmanov ◽  
Elena Bogomolova ◽  
Mariya Shaposhnikova ◽  
Mariya Sapozhnikova
Keyword(s):  
Nutritional Status ◽  
Lower Boundary ◽  
Density Lipoprotein ◽  
Blood Parameters ◽  
Medical Institute ◽  
Specific Situation ◽  
Mathematical Methods ◽  
Normal Range ◽  
Mean Values ◽  
The Mean

The biochemical blood parameters characterizing the students ’nutritional status were evaluated: protein, lipid, carbohydrate metabolism, a number of minerals. The mean values, errors of the mean, median (Me), boundary (Q) and the range of 25–75 percentiles were determined. In 9.1 % of students and 28.6 % of students, the total protein was increased. Creatinine in men was in the upper normal range, in women — at the upper limit of normal, of which 46.2 % was higher than normal. The interval Q25–75 of uric acid in students is determined in the lower normal zone. In 40.0 % of men, decreased high-density lipoprotein cholesterol (Q25–75 corresponded to 1.15–1.79), in women — below normal, Q25–75 5 was 1.3–1.5, decreased in 73.3 %. Me and Q25–75 iron were in the lower normal range; 14.1 % of men and 13.2 % of women are below normal. Me sodium and potassium at the level of the lower boundary of the norm, Q25–75 in the lower zone of the norm: in 16.0 % and 15.4 % of students the levels are reduced. Calcium is slightly above the lower limit of the norm, Q25–75–2.1–2.24, indicating an insufficient intake in the whole group; 25.0 % are below normal. The border of the 25th percentile of magnesium is at the level of the lower border of the norm, in 19.2 % it is reduced. 7.2 % lack of chlorine. Phosphorus is normal, but Q25–75 is in the upper zone; 17.9 % increased. Biochemical markers can identify individuals with metabolic disorders of nutrients. Statistical indicators — the median, the boundaries of 25–75 quartiles and their scope characterize the metabolism of macronutrients and minerals in the group and subgroups of students. Laboratory and mathematical methods can provide a basis for identifying the specific causes of these changes. For this, you can use the questionnaire method of studying the nutrition of students, possibly using the developed questionnaires for a specific situation.

The Relationship of Metabolic and Endocrine Parameters with Associated Diseases in Diabetes Mellitus

2018 ◽  
Vol 69 (5) ◽  
pp. 1288-1291 ◽  
Author(s):  
Mariana Cornelia Tilinca ◽  
Sandor Pal ◽  
Zoltan Preg ◽  
Eniko Barabas Hajdu ◽  
Raluca Tilinca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Scoring System ◽  
Laboratory Tests ◽  
Treatment Plan ◽  
Individual Treatment ◽  
Diabetic Patients ◽  
Thyroid Disorders ◽  
Associated Diseases ◽  
Investigation Methods ◽  
Predictive Role

The most common comorbidities in patients with diabetes mellitus are cardiovascular diseases, obesity, dyslipidemia, thyroid disorders but other associated diseases may frequently occur. Laboratory tests are useful investigation methods that may reveal the subclinical manifestations of the disease but they are also essential for patient monitoring. The aim of the study was to assess laboratory parameters and associated diseases in diabetic subjects and to implement a scoring system with a predictive role in the evolution of the cases. Material and methods: The study group consisted of 195 subjects with documented type 1 or type 2 diabetes. About half of the cases were collected from the Procardia outpatient unit, and the rest were patients admitted to the Diabetology Clinic in T�rgu Mure�. The study was performed between January - June 2017. The results of the laboratory tests, as well as the information regarding comorbidities and treatment, was collected and patients� body mass index was calculated. Based on the clinical data, a scoring system, called Diabetes Complication Severity Index (DCSI) with a predictive role, was implemented. The diabetic outpatients presented significantly better carbohydrate metabolic balance compared to the hospitalized subjects. No significant differences could be observed regarding kidney function, hepatic status and lipid profile of the two subgroups of diabetic subjects. The most important comorbidity observed in both patient groups was arterial hypertension. The hospitalized diabetic subjects had significantly higher incidence of ischemic heart disease and significantly lower incidence of thyroid disorders compared to the outpatients. The DCSI scoring system revealed that comorbidities are more frequently present in the hospitalized patients compared to the ambulant diabetic subjects. Evaluation of clinical status and laboratory results in diabetic patients followed by implementation of a scoring system based on the data obtained regarding comorbidities could help clinicians to set up an individual treatment plan for these patients, focusing on preventing other complications.

scholarly journals Ex vivo evaluation of a multilayered sealant patch for watertight dural closure: cranial and spinal models

2021 ◽  
Vol 32 (8) ◽  
Author(s):  
A. Kinaci ◽  
S. van Thoor ◽  
S. Redegeld ◽  
M. Tooren ◽  
T. P. C. van Doormaal
Keyword(s):  
Ex Vivo ◽  
Resistance Test ◽  
Burst Pressure ◽  
Cerebrospinal Fluid Leakage ◽  
Computer Assisted ◽  
Dural Defect ◽  
Test Results ◽  
Physiological Conditions ◽  
Dural Attachment ◽  
The Mean

AbstractCerebrospinal fluid leakage is a frequent complication after cranial and spinal surgery. To prevent this complication and seal the dura watertight, we developed Liqoseal, a dural sealant patch comprising a watertight polyesterurethane layer and an adhesive layer consisting of poly(DL-lactide-co-ε-caprolactone) copolymer and multiarmed N-hydroxylsuccinimide functionalized polyethylene glycol. We compared acute burst pressure and resistance to physiological conditions for 72 h of Liqoseal, Adherus, Duraseal, Tachosil, and Tisseel using computer-assisted models and fresh porcine dura. The mean acute burst pressure of Liqoseal in the cranial model (145 ± 39 mmHg) was higher than that of Adherus (87 ± 47 mmHg), Duraseal (51 ± 42 mmHg) and Tachosil (71 ± 16 mmHg). Under physiological conditions, cranial model resistance test results showed that 2 of 3 Liqoseal sealants maintained dural attachment during 72 hours as opposed to 3 of 3 for Adherus and Duraseal and 0 of 3 for Tachosil. The mean burst pressure of Liqoseal in the spinal model (233 ± 81 mmHg) was higher than that of Tachosil (123 ± 63 mmHg) and Tisseel (23 ± 16 mmHg). Under physiological conditions, spinal model resistance test results showed that 2 of 3 Liqoseal sealants maintained dural attachment for 72 hours as opposed to 3 of 3 for Adherus and 0 of 3 for Duraseal and Tachosil. This novel study showed that Liqoseal is capable of achieving a strong watertight seal over a dural defect in ex vivo models.

scholarly journals LiDAR-Based Glass Detection for Improved Occupancy Grid Mapping

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2263
Author(s):  
Haileleol Tibebu ◽  
Jamie Roche ◽  
Varuna De Silva ◽  
Ahmet Kondoz
Keyword(s):  
Laser Scanner ◽  
Point Clouds ◽  
Light Detection And Ranging ◽  
Test Results ◽  
New Approach ◽  
Occupancy Grid ◽  
Laser Scanners ◽  
Novel Method ◽  
Occupancy Grid Mapping ◽  
Cartesian Coordinate

Creating an accurate awareness of the environment using laser scanners is a major challenge in robotics and auto industries. LiDAR (light detection and ranging) is a powerful laser scanner that provides a detailed map of the environment. However, efficient and accurate mapping of the environment is yet to be obtained, as most modern environments contain glass, which is invisible to LiDAR. In this paper, a method to effectively detect and localise glass using LiDAR sensors is proposed. This new approach is based on the variation of range measurements between neighbouring point clouds, using a two-step filter. The first filter examines the change in the standard deviation of neighbouring clouds. The second filter uses a change in distance and intensity between neighbouring pules to refine the results from the first filter and estimate the glass profile width before updating the cartesian coordinate and range measurement by the instrument. Test results demonstrate the detection and localisation of glass and the elimination of errors caused by glass in occupancy grid maps. This novel method detects frameless glass from a long range and does not depend on intensity peak with an accuracy of 96.2%.

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