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1
Downes, Katharine A., and Ira A. Shulman. "Pretransfusion Testing Practices in North America, 2005–2010: An Analysis of the College of American Pathologists Interlaboratory Comparison Program J-Survey Data, 2005–2010." Archives of Pathology & Laboratory Medicine 136, no. 3 (March 1, 2012): 294–300. http://dx.doi.org/10.5858/2011-0127-cpr.1.
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Context.—Data collection and analysis of the College of American Pathologists (CAP) Interlaboratory Comparison Program (Proficiency Testing) J-Survey results provide insights into North American pretransfusion compatibility testing practices and trends. Objectives.—To assess current North American manual testing practices for ABO grouping, rhesus (Rh) typing, antibody screening, and crossmatching using CAP proficiency testing data. Design.—Analysis of the CAP Interlaboratory Comparison Program J-Survey data (2005–2010) to identify laboratory methods used for ABO grouping, Rh typing, antibody screening, and crossmatching. Data were analyzed by test method using Microsoft (Redmond, Washington) Excel software. Results.—The method used most often in ABO grouping and Rh typing was tube testing. Many laboratories also used tube testing for antibody detection and crossmatching, but during the study period, the proportion of laboratories using gel-based methodologies increased considerably. Conclusions.—Most North American CAP laboratories continue to use tube methods for ABO/Rh testing. Use of gel-based methodologies increased during the past 5 years for antibody screening and crossmatching.
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Shulman, Ira A., Lieta M. Maffei, and Katharine A. Downes. "North American Pretransfusion Testing Practices, 2001–2004: Results From the College of American Pathologists Interlaboratory Comparison Program Survey Data, 2001–2004." Archives of Pathology & Laboratory Medicine 129, no. 8 (August 1, 2005): 984–89. http://dx.doi.org/10.5858/2005-129-984-naptpr.
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Abstract Context.—Pretransfusion testing of whole blood and red blood cell recipients is regulated by the federal government under the authority of the Clinical Laboratory Improvement Amendments of 1988. Regulated tests include determination of ABO group, Rh D type, antibody detection, antibody identification, and crossmatching. A wide variety of methods and reagents are available for these regulated tests. During 2001–2004, the College of American Pathologists (CAP) Interlaboratory Comparison Program (Proficiency Testing) J-Survey collected data from more than 4000 laboratories regarding their pretransfusion testing practices. Those data are presented in this report. Objective.—To assess current testing practices for ABO grouping, Rh D typing, antibody detection, and crossmatching in North America. Design.—Data collected for the CAP Interlaboratory Comparison Program (Proficiency Testing) J-Survey were analyzed for trends in laboratory testing practice during 2001– 2004. The data were grouped for analysis by peer group (testing method used) for ABO grouping, Rh D typing, antibody detection, and crossmatching and then analyzed. Setting, Patients, or Other Participants.—Subscribers to the CAP Interlaboratory Comparison Program Transfusion Medicine J-Series. Results.—The most common testing schemes used in North America during 2001–2004 are as follows: ABO grouping (most laboratories perform tube testing: 97.6% in 2000 and 91.1% in 2004); Rh D typing (most laboratories perform tube testing: 97.7% in 2001 and 91.1% in 2004); antibody detection (most laboratories perform tube testing: 69.7% in 2001 and 55% in 2004, most frequently with the low ionic strength solution anti-human globulin [AHG] method, 48.3% in 2001 and 39.9% in 2004; as of 2004 slightly more laboratories use the gel AHG method [42%] than the low ionic strength solution AHG tube method); crossmatching for alloimmunized patients (most laboratories perform tube testing using a low ionic strength solution AHG method; 55.8% in 2001 and 47.6% in 2004); and crossmatching for nonalloimmunized patients (tube testing using an immediate spin method; 42% in 2001 and 40.4% in 2004). Conclusions.—Most North American laboratories currently favor tube methods when performing ABO grouping, Rh typing, antibody screening, and crossmatching. However, there has been a significant increase in the use of gel-based methods in recent years, especially for antibody detection and crossmatching. Data collection and data analysis of CAP Interlaboratory Comparison Program Survey results allow for assessment of laboratory proficiency and provide insights into current North American practice trends in pretransfusion compatibility testing.
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Branston, A. E., C. Y. Chen, F. A. Boudreault, and C. A. Rogers. "Testing of light-gauge steel-frame - wood structural panel shear walls." Canadian Journal of Civil Engineering 33, no. 5 (May 1, 2006): 561–72. http://dx.doi.org/10.1139/l06-014.
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At present, no Canadian document is available with which engineers can design light-gauge steel-frame – wood structural panel shear walls that are relied upon to resist lateral in-plane loading (earthquake and wind). For this reason, a research project was initiated with the overall goal of developing a shear wall design method that could be used in conjunction with the 2005 National Building Code of Canada. The initial phase of the project was to conduct an experimental study to provide information on the response of single-storey shear walls. An extensive program of tests was completed on walls composed of 1.12 mm thick 230 MPa grade steel framing sheathed with 12.5 mm Douglas-fir plywood, Canadian softwood plywood, or 11 mm oriented strand board wood structural panels. Various wall lengths and connection patterns were incorporated into the program of monotonic and reversed cyclic tests. The scope of testing was selected such that it added to the North American database of information for steel-frame – wood structural panel shear walls. Information on the test program and the general results are provided in this paper.Key words: shear wall, light-gauge steel, wood structural panel, earthquake, wind.
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Salazar, Eric, Thomas A. Long, Kristi Johnson Smock, Geoffrey D. Wool, Marian Rollins-Raval, Dong Chen, Neil Selwyn Harris, et al. "Analysis of College of American Pathologists von Willebrand Factor Proficiency Testing Program." Seminars in Thrombosis and Hemostasis 48, no. 06 (September 2022): 690–99. http://dx.doi.org/10.1055/s-0042-1758161.
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AbstractVon Willebrand factor (VWF) level and/or function is altered in von Willebrand disease (VWD), the most common heritable bleeding disorder worldwide. Laboratory assessment of VWF is continually evolving. Historically, the primary method for the assessment of VWF platelet-binding activity was the ristocetin cofactor assay (VWF:RCo). Contemporary alternative measures of VWF platelet-binding activity include VWF:GPIbR (recombinant; using ristocetin), VWF:GPIbM (recombinant; gain-of-function mutant), and monoclonal antibody. Recently, the American Society of Hematology, International Society on Thrombosis and Haemostasis, National Hemophilia Foundation, and World Federation of Hemophilia collaboration issued guidelines recommending the use of newer assays of VWF platelet-binding activity (VWF: GPIbM, VWF: GPIbR) over VWF:RCo, given known limitations of the VWF:RCo assay. Despite this recommendation, the newer VWF:GPIbM and VWF:GPIbR assays are not United States Food and Drug Administration cleared, limiting their availability in the United States. We sought to assess assay utilization trends, agreement of VWF testing methods, and imprecision of VWF testing (based on assigned sample type) from the College of American Pathologists Proficiency Testing Surveys. The analysis confirms that, while VWF antigen testing has low imprecision, the various VWF activity assays have significant interassay variability, with VWF:RCo showing greater imprecision than the newer GPIb-binding assays. The overall trends in assay utilization reflect the barriers to complete compliance with modern VWD diagnostic guidelines in North America.
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Feldman, Eva L., and Martin J. Stevens. "Clinical Testing in Diabetic Peripheral Neuropathy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 21, S4 (November 1994): S3—S7. http://dx.doi.org/10.1017/s0317167100040671.
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Abstract:Diabetic polyneuropathy is a complex disease of progressive nerve fiber loss. Initial screening and diagnosis in clinical practice usually depend on assessment of subjective complaints. A need exists for objective, simple, and reproducible assessment tools that can be readily used in clinical practice. The importance of early diagnosis is highlighted by the recent North American Diabetes Control and Complications Trial where intensive insulin therapy reduced the risk of developing diabetic neuropathy by 61%. At the University of Michigan, we have developed an outpatient neuropathy program. Patients are given a questionnaire and a brief screening examination, designated the Neuropathy Screening Instrument. Diabetic neuropathy is confirmed and staged in patients with a positive Neuropathy Screening Instrument, by a quantitative neurologic examination and nerve conduction studies, designated the Diabetic Neuropathy Score. The Michigan program has been compared with well-established instruments and has been found to be sensitive and reproducible for screening and diagnosis. We believe the program provides a valuable tool for the clinician in the practice setting and should allow diagnosis and intervention earlier in the course of diabetic neuropathy.
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Kobliha, J., and J. Stejskal. "Recent fir hybridization research in the light of Czech-American cooperation." Journal of Forest Science 55, No. 4 (March 25, 2009): 162–70. http://dx.doi.org/10.17221/114/2008-jfs.
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The project is based on control pollination of different fir species in the sense of interspecific hybridization. The aim of this procedure is a new bred material for specific needs of forestry and Christmas tree production. Concrete breeding aims are represented in this sense by resistance to limiting environmental conditions (e.g. drought) and by resistance to diseases and pests. The experiment follows a traditional hybridization program of the department focused on the genus <I>Abies</I> and recently it has been extended by the Czech-U.S. cooperation (North Carolina State University Raleigh). For hybridization mainly Mediterranean fir species are used together with Asian species (e.g. <I>Abies koreana</I>) and of course American species (above all <I>Abies fraseri</I>). Hybridizations will be followed by <I>Phytophthora cinnamomi</I> screenings that have high priority. Hybrid progenies will undergo early testing and their vegetative propagation for cloning purposes is being considered.
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Ghosh, Sumit, Jeffrey Voigt, Terrance Wynne, and Terrance Nelson. "Developing an In-House Biological Safety Cabinet Certification Program at the University of North Dakota." Applied Biosafety 24, no. 3 (July 7, 2019): 153–60. http://dx.doi.org/10.1177/1535676019859787.
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Introduction:Biological safety cabinets (BSCs) are the primary means of containment used in laboratories worldwide. To ensure the proper functioning of BSCs, they need to be certified annually, at a minimum, per National Sanitation Foundation (NSF)/American National Standards Institute Standard 49.Objectives:A common problem most organizations face is that in many instances, the technicians who certify the cabinets are not accredited by the NSF. Additionally, in states or regions that do not have local NSF accredited field certifiers, it takes weeks to get a service request completed, thereby delaying the research work of the laboratory. Moreover, in such instances, the cost associated with cabinet certification and repair can be very high.Materials and Methods:This led the Office of Safety at the University of North Dakota to do a thorough cost-benefit analysis of developing an in-house BSC certification program. After completing the training and testing requirements for the NSF’s advanced accreditation program, the BSC certification program was initiated on campus.Results:The identified benefits led to the initiation of a program in both local and regional capacity for repair, maintenance, and certification of BSCs, and the university’s experiences were shared with other universities.Conclusions:By developing an in-house BSC certification program, the University of North Dakota was able to reduce wait times associated with service repairs, reduce costs, and generate revenue for the department. Furthermore, this led to improved hands-on training programs related to BSC use in laboratories working with biohazardous agents.
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Robinson, Terence L., and William C. Johnson. "667 Apple Rootstocks for the Next Century." HortScience 34, no. 3 (June 1999): 563B—563. http://dx.doi.org/10.21273/hortsci.34.3.563b.
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Rootstock breeding programs in the United States, the United Kingdom, Germany, Russia, Poland, the Czech Republic, and Japan have all released apple rootstocks in the recent past that are potentially important to the worldwide apple industry in the next century. Several of these programs are continuing to breed new rootstocks. Each program has focused on different breeding objectives, thus giving a wide range of horticultural characteristics among this new group of rootstocks. All programs have focused on the horticulturally important traits of productivity, dwarfing and precocity but certain programs have also emphasized other characteristics such as propagability, stress tolerance, disease resistance or insect resistance. Commercialization of this new group of rootstocks is proceeding at an extremely fast pace due to the worldwide networking of fruit tree nursery companies and the use of plant patents. This presents a large job for research and extension personnel to properly test rootstocks for adaptability to different growing areas before they are planted on a large scale. The national rootstock testing project (NC-140) composed of researchers from most apple growing states and provinces in the U.S. and Canada is collecting rootstocks from around the world and conducting uniform field trials that give performance data from a wide variety of climates and soils. This information becomes the basis for local rootstock recommendations in North America. This presentation reviews the most promising rootstocks from around the world and summarize the research information from North American and worldwide trials.
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Redmon, Jennifer Hoponick, A. J. Kondash, Ed Norman, Joseph Johnson, Keith Levine, Andrea McWilliams, Melanie Napier, et al. "Lead Levels in Tap Water at Licensed North Carolina Child Care Facilities, 2020–2021." American Journal of Public Health 112, S7 (September 2022): S695—S705. http://dx.doi.org/10.2105/ajph.2022.307003.
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Objectives. To evaluate lead levels in tap water at licensed North Carolina child care facilities. Methods. Between July 2020 and October 2021, we enrolled 4005 facilities in a grant-funded, participatory science testing program. We identified risk factors associated with elevated first-draw lead levels using multiple logistic regression analysis. Results. By sample (n = 22 943), 3% of tap water sources exceeded the 10 parts per billion (ppb) North Carolina hazard level, whereas 25% of tap water sources exceeded 1 ppb, the American Academy of Pediatrics’ reference level. By facility, at least 1 tap water source exceeded 1 ppb and 10 ppb at 56% and 12% of facilities, respectively. Well water reliance was the largest risk factor, followed by participation in Head Start programs and building age. We observed large variability between tap water sources within the same facility. Conclusions. Tap water in child care facilities is a potential lead exposure source for children. Given variability among tap water sources, it is imperative to test every source used for drinking and cooking so appropriate action can be taken to protect children’s health. (Am J Public Health. 2022;112(S7):S695–S705. https://doi.org/10.2105/AJPH.2022.307003 )
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Montoro-Rodriguez, Julian, Dolores Gallagher-Thompson, Jennifer Ramsey, Ann Choryan Bilbrey, Bruno Kajiyama, Kendra Jason, and Larry W. Thompson. "CAREGIVER TLC: A VIRTUAL PSYCHOEDUCATIONAL PROGRAM FOR CAREGIVERS: BASELINE PRELIMINARY DATA." Innovation in Aging 6, Supplement_1 (November 1, 2022): 698–99. http://dx.doi.org/10.1093/geroni/igac059.2558.
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Abstract Family caregivers are at increased risk for negative impacts on their psychological and physical health compared to non-caregivers. Virtual caregiving programs are beneficial as caregivers may not have time to devote to face-to-face programs and especially important to caregivers in the context of the COVID-19 pandemic. Our team at the University of North Carolina at Charlotte is testing the efficacy of the Caregiver Thrive, Learn & Connect Virtual Program adapted from the Coping with Caregiving evidence-based multicomponent intervention (Gallagher-Thompson et al., 2003). The program offers to registered caregivers six weekly sessions over Zoom teleconferencing in small groups led by trained professionals from community partners serving socio-demographically diverse caregivers. Sessions address stress management, mood management, resilience, self-care, coping strategies, and isolation. Preliminary baseline data on 42 participants indicates that caregivers are primarily female (87%), on average 64 years old, and from diverse racial backgrounds: white (69%), African American (29%) and Asian American (2%). Participants provide care to persons with memory troubles or dementia (66%) and chronic health conditions (34%). Baseline data on initial levels of caregivers’ psychosocial outcomes indicated salient levels of mental health outcomes for burden (high = 49%; mild = 35%); anxiety (moderate = 16%; severe = 20%) and depression (mild levels = 35%; moderately and severe level of depression = 33%). Caregivers for chronic health conditions reported significantly higher anxiety compared to dementia caregivers. The Caregiver TLC program offers support to the targeted caregiver population seeking to improve their level of competence, mental health and social isolation.
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Palomaki, Glenn E., George J. Knight, Geralyn Lambert-Messerlian, Jacob A. Canick, and James E. Haddow. "Four Years' Experience With an Interlaboratory Comparison Program Involving First-Trimester Markers of Down Syndrome." Archives of Pathology & Laboratory Medicine 134, no. 11 (November 1, 2010): 1685–91. http://dx.doi.org/10.5858/2009-0670-oar.1.
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Abstract Context.—We initiated a voluntary, self-funded interlaboratory comparison program in the fall of 2005 because no proficiency testing program was available to laboratories in North America offering first-trimester, combined serum and ultrasound, Down syndrome screening. Objectives.—To evaluate the first 4 years of the interlaboratory comparison program against stated goals, to identify areas of concern, and to create new initiatives as indicated. Design.—Five serum samples are distributed 3 times a year to be tested for pregnancy-associated plasma protein A, human chorionic gonadotropin or its β subunit, and dimeric inhibin-A; participants convert these results into multiples of the median. Patient histories include nuchal translucency information that enables the calculation of the risk of Down syndrome. Also included are educational components linked to interlaboratory comparison program results. Assessment of integrated (first- and second-trimester markers) risks is accomplished by having participants combine interlaboratory comparison program results with their results from a second-trimester proficiency testing program administered by the College of American Pathologists. Results.—The precision profile for pregnancy-associated plasma protein A shows decreasing coefficients of variation with increasing pregnancy-associated plasma protein A concentrations and multiples of the median (25% to 11% and 30% to 15%, respectively). In contrast, coefficients of variation are a relatively constant 12% throughout the entire range of human chorionic gonadotropin results. On a logarithmic scale, the median coefficient of variation of the risk of Down syndrome is 9%. Conclusions.—Participants in the interlaboratory comparison program reliably measure analytes, compute multiples of the median, and calculate consistent Down syndrome risks. Assays for the measurement of pregnancy-associated plasma protein A are not standardized and are less precise than those for human chorionic gonadotropin. Participants calculate reliable median equations given sonographer-specific sets of paired crown-rump length and nuchal translucency measurements.
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Wood, F. S., and H. Whittaker. "OIL SPILL AND HAZARDOUS SUBSTANCE RESPONSE EQUIPMENT AND SYSTEMS STANDARDIZATION PROGRAM." International Oil Spill Conference Proceedings 1993, no. 1 (March 1, 1993): 591–93. http://dx.doi.org/10.7901/2169-3358-1993-1-591.
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ABSTRACT The Oil Pollution Act of 1990 (OPA 90) requires vessel and facility owners and operators to prepare oil spill response plans to remove a worst case discharge (total loss of cargo in adverse weather). It requires the Coast Guard to review response plans for approval. Plan preparers need objective standards for selecting and assigning sufficient response resources to facilitate plan approval. All parties must have common, national standards for matching oil spill response resources to anticipated response needs. The Coast Guard has solicited the assistance of the American Society for Testing and Materials (ASTM) to develop consensus technical standards for oil spill response equipment and systems. ASTM Committee F20 on Hazardous Substances and Oil Spill Response formed separate work groups to develop standards for such things as booms, skimmers, temporary storage devices, sorbents, dispersants, pumps, and bioremediants. ASTM standards take the form of test methods, guidelines, specifications, terminology, practices, classifications, and other standards pertaining to performance, durability, strength of systems, and techniques for the control and removal of oil and hazardous substances spills. The Coast Guard is working closely with Environment Canada on this process to ensure that resulting standards apply equally well across North America. This paper will discuss the Coast Guard's role and progress being made in the development of consensus standards to facilitate the enforcement of the regulations that implement OPA 90.
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Checkley, Gill E., Sandra C. Thompson, Nick Crofts, Anne M. Mijch, and Fiona K. Judd. "HIV in the Mentally Ill." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 184–94. http://dx.doi.org/10.3109/00048679609076094.
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Objective: To review the published literature in relation to prevalence of HIV infection and risk behaviours for HIV among the mentally ill to assist in the development of appropriate strategies for public health policy, surveillance and clinical management of HIV and HIV risk in these groups. Method: A search of published literature was carried out using ‘Medline’, in association with following up appropriate papers cited in the References of journals identified. Results: The North American literature shows an increased risk of HIV infection in psychiatric patients receiving treatment in both inpatient or community settings. HIV infection is associated with a number of risk behaviours, particularly male homosexual sex and injecting drug use, and being the sexual partner of a person with a history of these. Impulsivity, high levels of sexual activity during acute exacerbations of psychiatric illness, poor skills at negotiating safe sex, homelessness and drug abuse are all risk behaviours common among those affected by some mental illnesses. The mentally ill also have a comparatively poorer knowledge of HIV/AIDS. There is a dearth of published Australian data addressing the question of HIV seroprevalence or risk in the mentally ill. Although there has been development and implementation of HIV risk-reduction programs overseas, the development and evaluation of any programs in Australia has not been published. Conclusions: Arguably, Australia has developed a comprehensive program of national surveillance for HIV infection and has been relatively successful in its response to the HIV epidemic, with the high rates of infection in the early to mid-1980s substantially reduced to around 600 new diagnoses per year. However, while risk behaviours which exposed those infected with the virus are recorded, underlying conditions which predispose them to these behaviours are not. Nevertheless, there is HIV infection amongst mentally ill and intellectually disabled people in Australia. Examination of the North American experience reveals opportunities to prevent a high rate of HIV infection in those with mental illness in Australia. Such a program would require adequate risk behaviour assessment, appropriate diagnostic testing and management, and development of specific educational interventions which are properly evaluated to ensure their effectiveness.
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Cook, M. J., and J. R. Schott. "The Atmospheric Compensation Component of a Landsat Land Surface Temperature (LST) Product: Assessment of Errors Expected for a North American Test Product." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XL-1 (November 7, 2014): 73–79. http://dx.doi.org/10.5194/isprsarchives-xl-1-73-2014.
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The Landsat archive of thermal data (Landsats 4, 5 and 7) has gone through a rigorous calibration assessment and update. However, in order to be useful to most users the calibrated sensor reaching radiance must be corrected to surface temperatures by first compensating for atmospheric effects and then emissivity variations. The USGS is exploring the possibility of producing a LST product through a joint program with RIT (the atmospheric compensation component) and JPL (the emissivity compensation component). This paper addresses the atmospheric compensation component for an initial North American pilot study. In particular, the results of a comparison of retrieved water surface temperature (where emissivity is well known) and truth temperatures for over 800 sites are presented. The errors are broken down by cloud conditions with extremely good results for cloud-free conditions (errors less than 1 K). The results of the error assessment for North America by cloud class are presented along with a discussion of potential quality data for a LST product. An initial assessment of the LST errors observed for Landsat 8 bands 10 and 11 are also presented. The next steps on this effort include testing of a global atmospheric compensation approach and full integration of the atmospheric and emissivity compensation tools into an operational LST product.
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Martinez, J. Michael. "The Carter Administration and the Evolution of American Nuclear Nonproliferation Policy, 1977–1981." Journal of Policy History 14, no. 3 (July 2002): 261–92. http://dx.doi.org/10.1353/jph.2002.0019.
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In the wake of India's May 1998 decision to resume nuclear testing for the first time since 1974, as well as arch-rival Pakistan's subsequent response, the attention of the world again has focused on nuclear nonproliferation policy as a means of maintaining stability in politically troubled regions of the world. The 1990s proved to be an uncertain time for nonproliferation policy. Pakistan acquired nuclear capabilities. Iraq displayed its well-known intransigence by refusing to allow International Atomic Energy Agency (IAEA) arms inspectors access to facilities suspected of manufacturing nuclear weapons. North Korea maintained a nuclear weapons program despite opposition from many Western nations. Troubling questions about nuclear holdings persisted in Argentina, Brazil, and South Africa. New nuclear powers were created in Belarus, Kazakhstan, Russia, and Ukraine after the disintegration of the Soviet Union. Even the renewal of the Treaty on the Non-Proliferation of Nuclear Weapons in 1995 failed to assuage the concerns of Western powers fearful of aggressive measures undertaken by rogue nuclear proliferants.
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Graham, Rondell P., Amanda L. Treece, Neal I. Lindeman, Patricia Vasalos, Mu Shan,, Lawrence J. Jennings, and David L. Rimm. "Worldwide Frequency of Commonly Detected EGFR Mutations." Archives of Pathology & Laboratory Medicine 142, no. 2 (November 6, 2017): 163–67. http://dx.doi.org/10.5858/arpa.2016-0579-cp.
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Context.— Recurrent epidermal growth factor receptor (EGFR) mutations are seen in a subset of pulmonary adenocarcinomas. These mutations are targeted by EGFR inhibitors and are a biomarker for response to EGFR inhibitor therapies. Initial data have indicated an increased frequency of activating EGFR mutations in nonsmoking Asian females. However, there are very few studies of global scope that address the question of mutation distribution across the population of lung cancer. Objective.— To determine the frequency of EGFR mutations in exons 18 through 21 detected in clinical laboratories participating in the College of American Pathologists proficiency testing program for EGFR in calendar year 2013. Design.— We reviewed the surveys from 170 clinical laboratories from 20 countries that participated in the College of American Pathologists EGFR proficiency testing program. The proficiency testing includes questions regarding the total numbers of tests performed at each common mutation site, including both activating and resistance mutations, and their frequency. Countries were grouped into regional groups in order to assess frequency of mutation by type, and to indirectly assess ethnic differences in mutation frequencies. Results.— Among the treatment-sensitive activating mutations, the most common are exon 19 mutations (n = 10 802 of 136 533 cases; 7.9% of total cases tested) and the exon 21 L858R mutation (n = 10 351 of 136 533 cases; 7.6% of total cases tested) and the least common are exon 20 mutations (n = 466 of 136 533 cases; 0.3% of total cases tested). The T790M mutation in exon 20 is the more common resistance mutation (n = 1010 of 136 533 cases; 0.7% of all cases tested). The highest activating mutation frequency is seen in southern Asia (n = 4260 of 9337 cases; 46%) and the lowest activating mutation frequencies are in South and North America (n = 113 of 1439 cases and 7926 of 86 654 cases; 8% and 9%, respectively). Conclusions.— Our data confirm that activating EGFR mutations are more common in southern Asia and that the distribution of activating EGFR mutations varies significantly across the regions. Similarly, the frequency and distribution of resistance mutations also show significant variation when comparing southern Asia with other regions.
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Pfaller, Michael A., Martin Cormican, Robert K. Flamm, Rodrigo E. Mendes, and Ronald N. Jones. "Temporal and Geographic Variation in Antimicrobial Susceptibility and Resistance Patterns of Enterococci: Results From the SENTRY Antimicrobial Surveillance Program, 1997–2016." Open Forum Infectious Diseases 6, Supplement_1 (March 2019): S54—S62. http://dx.doi.org/10.1093/ofid/ofy344.
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Abstract Background The SENTRY Antimicrobial Surveillance Program was established in 1997 and presently encompasses more than 750 000 bacterial isolates from over 400 medical centers worldwide. Among these pathogens, enterococci represents a prominent cause of bloodstream (BSIs), intra-abdominal (IAIs), skin and skin structure, and urinary tract infections (UTIs). In the present study, we reviewed geographic and temporal trends in Enterococcus species and resistant phenotypes identified throughout the SENTRY Program. Methods From 1997 to 2016, a total of 49 491 clinically significant enterococci isolates (15 species) were submitted from 298 medical centers representing the Asia-Pacific (APAC), European, Latin American (LATAM), and North American (NA) regions. Bacteria were identified by standard algorithms and matrix-assisted laser desorption ionization–time of flight mass spectrometry. Susceptibility (S) testing was performed by reference broth microdilution methods and interpreted using Clinical and Laboratory Standards Institute/US Food and Drug Administration and European Committee on Antimicrobial Susceptibility Testing criteria. Results The most common Enterococcus species in all 4 regions were Enterococcus faecalis (64.7%) and E. faecium (EFM; 29.0%). Enterococci accounted for 10.7% of BSIs in NA and was most prominent as a cause of IAIs (24.0%) in APAC and of UTIs (19.8%) in LATAM. A steady decrease in the susceptibility to ampicillin and vancomycin was observed in all regions over the 20-year interval. Vancomycin-resistant enterococci (VRE) accounted for more than 8% of enterococcal isolates in all regions and was most common in NA (21.6%). Among the 7615 VRE isolates detected, 89.1% were the VanA phenotype (91.0% EFM) and 10.9% were VanB. Several newer antimicrobial agents demonstrated promising activity against VRE, including daptomycin (99.6–100.0% S), linezolid (98.0%–99.6% S), oritavancin (92.2%–98.3% S), tedizolid (99.5%–100.0% S), and tigecycline (99.4%–100.0% S). Conclusions Enterococci remained a prominent gram-positive pathogen in the SENTRY Program from 1997 through 2016. The overall frequency of VRE was 15.4% and increased over time in all monitored regions. Newly released agents with novel mechanisms of action show promising activity against VRE.
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Noufou, Ouedraogo, Davar Rezania, and Muhammad Hossain. "Measuring and exploring factors affecting students’ willingness to engage in peer mentoring." International Journal of Mentoring and Coaching in Education 3, no. 2 (June 6, 2014): 141–57. http://dx.doi.org/10.1108/ijmce-11-2012-0071.
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Purpose – The purpose of this paper is to measure students’ willingness to mentor their peers and explores key factors to student peer mentoring effectiveness. Design/methodology/approach – The paper uses a hybrid research methodology consisting of a survey and a focus group discussion. The survey was conducted with students of a bachelor of commerce (BCom) program of a North American university to analyze the impact of organizational culture and altruism on their willingness to mentor their peers. The focus group discussion was carried out with students of the same program to explore the objectives, focus, and factors contributing to their willingness to mentor and to peer mentoring effectiveness. Findings – Organizational culture and altruism significantly affect students’ emotional and intentional willingness to mentor their peers. Peer mentoring can help students prepare their transition from high school to university, guide them through university programs, and help them prepare their transition from university to workplace. Critical factors to peer mentoring effectiveness include a good fit between mentors and mentees, a reasonable ratio of mentor to protégés, and an understanding of and a willingness to address each student's specific needs. Practical implications – Business schools should embrace and promote a culture of mutual help, look for altruistic students as prospective peer mentors, and promote voluntary student peer mentoring. A mentoring program should be flexible enough to meet each student's needs. Attention should be paid to finding a good fit between mentors and protégés. Communication should focus on the benefits of student peer mentoring for mentors and protégés. Originality/value – This research brings empirical evidence on peer mentoring by testing and confirming the impact of altruism and organizational culture on students’ willingness to mentor their peers. It also provides practical insight to business schools for implementing student peer mentoring programs.
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Puttagunta, Sailaja, Steven Aronin, Michael Huband, Robert K. Flamm, and Michael Dunne. "1363. Sulopenem Activity Against Enterobacteriaceae Isolates From Patients With Urinary Tract Infection or Intra-Abdominal Infection." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S417. http://dx.doi.org/10.1093/ofid/ofy210.1194.
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Abstract Background Sulopenem is a thiopenem antibacterial with oral and parenteral formulations being developed for the treatment of urinary tract infection (UTI) or complicated intra-abdominal infection (cIAI). The activity of sulopenem aligns with the most urgent drug-resistant antimicrobial threats defined by the Centers for Disease Control (CDC), including ESBL-producing strains of Escherichia coli and Klebsiella species. We evaluated the in vitro antibacterial activity of sulopenem against clinical Enterobacteriaceae isolates from patients in North America with UTI or cIAI collected during 2016–2017. Methods Sulopenem and other antimicrobial agents were tested for in vitro activity against 1,008 recent (2016–2017) consecutive Enterobacteriaceae isolates collected through the SENTRY Antimicrobial Surveillance Program from patients in North America with UTI (906 isolates) or cIAI (102 isolates). Reference broth microdilution susceptibility testing was conducted using frozen-form panels produced by JMI Laboratories according to CLSI (M07, 2018) guidelines using cation-adjusted Mueller–Hinton broth. Quality control (QC) and interpretation of results were performed in accordance with CLSI M100 (2018) guidelines. Results Table 1. Activity of sulopenem and comparator antimicrobial agents against 1,008 Enterobacteriaceae North American isolates The sulopenem MIC50/90 values for Enterobacteriaceae were 0.03/0.25 µg/mL. For Escherichia coli, Klebsiella species and Proteus mirabilis, the MIC50/90 results were 0.03/0.03 µg/mL, 0.03/0.06 µg/mL, and 0.12/0.25 µg/mL, respectively. Conclusion Sulopenem demonstrated potent in vitro activity against organisms commonly implicated in UTI and cIAI. These data support the further clinical development of sulopenem for Gram-negative infections. Disclosures S. Puttagunta, Iterum Therapeutics: Employee and Shareholder, Salary. S. Aronin, Iterum Therapeutics: Employee and Shareholder, Salary. M. Huband, JMI Labs: Research Contractor, Grant recipient. R. K. Flamm, Allergan: Research Contractor, Research support. M. Dunne, Iterum Therapeutics: Employee and Shareholder, Salary.
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Metjian, Ara, Yvette Tanhehco, Huy Phu Pham, Nicole A. Aqui, Vijay Bhoj, Oluwatoyosi Onwuemene, Marisa Marques, and Gowthami M. Arepally. "The Thrombotic Microangiopathy Registry of North America." Blood 126, no. 23 (December 3, 2015): 5587. http://dx.doi.org/10.1182/blood.v126.23.5587.5587.
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Abstract The thrombotic microangiopathies (TMAs) are rare, life-threatening thrombotic disorders of diverse etiologies. Systematic studies of TMA have been difficult to perform due to their rare occurrence, disease heterogeneity and, lack of an organized research network in the United States. Whereas a multi-institutional approach has been used in Europe and Canada, TMA research in the US has been largely single-center based. To overcome the limitations of single institutional registries and to expand the number of TMA patients available for study, four academic centers convened during the 2013 ASFA annual meeting to establish the TMA Registry of North America (TRNA) with the following goals: (1) design and develop a registry to define "best practices" for the diagnosis, treatment, and management of TMA; (2) develop a platform for conducting observational and interventional clinical trials; (3) and, establish a national bio-repository of samples from patients with TMA to facilitate future studies. This abstract reports the first multi-institutional network in the United States designed to study TMA. Members met through bimonthly tele-conferences to develop a clinical registry using REDCap (Research Electronic Data Capture), a HIPAA-compliant, internet-based software program for data entry. To facilitate a cohesive and streamlined review of IRB applications, the TRNA utilized IRBshare, a portal for rapid approval of multi-site investigations. IRB consent included participation in a bio-repository arm for collecting blood and apheresate. Following approval through the Duke IRB in June 2014, study documents were uploaded to the IRBshare website. Since August 2015, 16 study participants with TMA have been consented, 13 of which have had their clinical information entered into the database. Preliminary data shows our population is 73% African-American and female. Average laboratory values at presentation included hemoglobin of 9.7 g/dL, platelets 53 x10^9/L, and LDH 1,150 u/L. ADAMTS13 testing was performed in 77% (10/13), of which 60% (6/10) measured at <10%. Current efforts include expansion of network sites to expand the registry and to develop clinical protocols for future studies. With its clinical and IRB infrastructure in place, the TRNA, which is the first U.S. research network designed to study TMA, is poised to perform cooperative observational and interventional trials in the near future. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.
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Johnson, Ray, Geoff Hokin, David Warner, Rod Dawney, Mike Dix, and Tim Ruble. "An emerging shale gas play in the Northern Territory." APPEA Journal 52, no. 2 (2012): 672. http://dx.doi.org/10.1071/aj11086.
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As attention to unconventional oil and gas resources increases, historical oil and gas flows in shale reservoirs across the world are being given renewed attention. Such is the case of the shaly and carbonate deposits of the McArthur and Nathan groups in the Northern Territory. The Batten Trough is a Proterozoic depocenter with potential for a shale gas play in the Barney Creek Shale and potential for conventional gas accumulations in the underlying Coxco Dolomite. This Barney Creek Shale gas play is evidenced by a number of mineral exploration drill holes that encountered live oil and gas shows within the McArthur Group. The most prominent was a mineral exploration hole drilled at the Glyde River prospect by Amoco in 1979. This well reportedly flowed gas and condensates at 140 psi for six months before it was sealed at the surface, which certainly shows permeability values greater than micro-darcies reported for many North American shale plays; thus, an exploration program of this prospective area has been planned by Armour Energy in EP 171 on several targets adjacent to the Emu Fault Zone near both Glyde and Caranbirini, along with other anticline related targets adjacent to the Abner Range. This extended abstract details how the targets were identified, the plan for data acquisition (e.g. seismic, drilling, logging and testing), and the proposed completion strategy to test this highly prospective target.
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Hooker, Gillian, Dawn C. Allain, Adam H. Buchanan, Melanie Care, Laura Conway, Alessandra Cumming, Shannan Dixon, Kristin Paulyson-Nuñez, Sara Riordan, and Janet Williams. "An analysis of growth in the genetic counseling profession 2009 to 2019." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e13526-e13526. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e13526.
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e13526 Background: Genetic counselors (GCs) are health care professionals who provide support to patients and physicians navigating the rapidly changing landscape of genetic testing and the genetic underpinnings of disease. Increased demand for genetic counseling services prompted an analysis of changes in the workforce over the last decade. Methods: To quantify the growth in the GC profession in the U.S and Canada in the last decade, we acquired data from the American Board of Genetic Counseling, National Society of Genetic Counselors, Canadian Association of Genetic Counselors, Accreditation Council for Genetic Counseling and Association of Genetic Counseling Program Directors. Results: Between 2009 and 2019, the workforce more than doubled, growing from 2,205 ABGC-certified GCs to 5,172. In Canada, the number of CAGC-certified GCs has grown from 211 in 2009 to 327 in 2019. Growth is striking in cancer genetic counseling; the proportion of GCs providing direct patient care in North America who report cancer as a primary specialty has increased from 25% in 2008 to 50% in 2019. Similar growth has been seen in training opportunities for GCs. The number of accredited graduate programs has increased from 33 in 2009 to 51 in 2019, with several more in development. Combined, these programs had 464 training slots in 2019, up from 223 in 2009. In 2019, 1569 applicants registered for the applicant match for training. Training opportunities and clinical genetic counselors are concentrated in large metropolitan areas, with over half of GCs working in 28 metro regions. GC services in rural areas are increasingly provided remotely via telemedicine, with 59% of GCs in direct patient care in 2018 reporting providing services by phone and 19% using web or video services to deliver care. In cancer genetics, about 50% of GCs nationwide reported in 2018 their 3rd next available appointment for new patients was within 14 days. Conclusions: The past decade has seen significant growth in the numbers of GCs and more patients have access to GCs than a decade ago. Reimbursement for services remains a significant barrier to access. Further research is warranted to understand additional political, administrative and logistical facilitators and barriers to providing care to all who need genetics services.
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McGrath, Jenna. "Will Updated Electricity Infrastructure Security Protect the Grid? A Case Study Modeling Electrical Substation Attacks." Infrastructures 3, no. 4 (November 20, 2018): 53. http://dx.doi.org/10.3390/infrastructures3040053.
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As targeted attacks continue to threaten electricity infrastructure, the North American Electricity Reliability Corporation (NERC) and private utilities companies are revising and updating the physical and cybersecurity standards for grid infrastructure in the United States (U.S.). Using information collected about past physical attacks, feasible physical and cyber-physical attacks are modeled against the proposed updated security standards for a U.S.-based generic electric substation. Utilizing the software program Joint Conflict and Tactical Simulation (JCATS), a series of increasingly sophisticated physical attacks are simulated on the substation, as are a set of cyber-enabled physical attacks. The purpose of this study is to determine which of the security upgrades will be most effective at mitigating damages to the electrical infrastructure from an attack. The findings indicate that some of the utility and agency-proposed security measures are more effective than others. Specifically, additional barriers around the substation and physical armored protection of transformers are most effective at mitigating damages from attacks. In contrast, increased lighting at the substation and reducing the surrounding foliage are not as effective. This case study demonstrates a modeling analysis approach to testing the efficacy of physical security measures that can assist in utility and agency decision-making for critical infrastructure security.
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Zamora, Robert J., F. Martin Ralph, Edward Clark, and Timothy Schneider. "The NOAA Hydrometeorology Testbed Soil Moisture Observing Networks: Design, Instrumentation, and Preliminary Results." Journal of Atmospheric and Oceanic Technology 28, no. 9 (September 1, 2011): 1129–40. http://dx.doi.org/10.1175/2010jtecha1465.1.
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Abstract The NOAA Hydrometeorology Testbed (HMT) program has deployed soil moisture observing networks in the watersheds of the Russian River and the North Fork (NF) of the American River in northern California, and the San Pedro River in southeastern Arizona. These networks were designed to serve the combined needs of the hydrological, meteorological, agricultural, and climatological communities for observations of soil moisture on time scales that range from minutes to decades. The networks are a major component of the HMT program that has been developed to accelerate the development and infusion of new observing technologies, modeling methods, and recent scientific research into the National Weather Service (NWS) offices and to help focus research and development efforts on key hydrological and meteorological forecast problems. These forecast problems are not only of interest to the NWS, but they also play a crucial role in providing input to water managers who work at the national, state, and local government levels to provide water for human consumption, agriculture, and other needs. The HMT soil moisture networks have been specifically designed to capture the changes in soil moisture that are associated with heavy precipitation events and runoff from snowpack during the melt season. This paper describes the strategies used to site the networks and sensors as well as the selection, testing, and calibration of the soil moisture probes. In addition, two illustrative examples of the data gathered by the networks are shown. The first example shows changes in soil moisture observed before and during a flood event on the Babocomari River tributary of the San Pedro River near Sierra Vista, Arizona, on 23 July 2008. The second example examines a 5-yr continuous time series of soil moisture gathered at Healdsburg, California. The time series illustrates the transition from a multiyear wet period to exceptionally dry conditions from a soil moisture perspective.
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Zhu, Y., K. Close, L. P. Zeldin, B. A. White, and R. G. Rozier. "Implementation of Oral Health Screening and Referral Guidelines in Primary Health Care." JDR Clinical & Translational Research 4, no. 2 (November 20, 2018): 167–77. http://dx.doi.org/10.1177/2380084418810332.
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Objectives: To determine the oral health screening and referral practices of pediatric providers, their adherence to American Academy of Pediatrics oral health guidelines, and barriers to adherence. Methods: Providers in 10 pediatric practices participating in the North Carolina Quality Improvement Initiative, funded by the Child Health Insurance Program Reauthorization Act of 2009, were asked to complete a 91-item questionnaire. Questions on risk assessment and referral practices were based on those recommended by the American Academy of Pediatrics. Adherence to oral health guidelines was assessed by practitioners’ evaluation of 4 vignettes presenting screening results for an 18-mo-old child with different levels of risk and caries status. Respondents chose referral recommendations assuming adequate and inadequate dentist workforces. Logit models determined the association between barriers specified in Cabana’s framework and adherence (count of 6 to 8 adherent vignettes vs. 0 to 5). Results: Of 72 eligible providers, 53 (74%) responded. Almost everyone (98.1%) screened for dental problems; 45.2% referred in at least half of well-child visits. Respondents were aware of oral health guidelines, expressed strong agreement with them, and reported confidence in providing preventive oral health services. Yet they underreferred by an average of 42% per vignette for the 7 clinical vignette-workforce scenarios requiring an immediate referral. Frequently cited barriers were providers’ beliefs that 1) parents are poorly motivated to seek dental care, 2) oral health counseling has a small effect on parent behaviors, 3) there is a shortage of dentists in their community who will see infants and toddlers, and 4) information systems to support referrals are insufficient. Conclusion: Pediatric clinicians’ beliefs lead to a conscious decision not to refer many patients, even when children should be referred. Knowledge Transfer Statement: Evidence suggests that the primary care–dental referral process needs improvement. This study identifies barriers to delivering recommended preventive oral health services in pediatrics. The information can be used to improve the screening and referral process and, thus, the quality of preventive oral health services provided in primary care. Results also can guide researchers on the selection of interventions that need testing and might close gaps in the referral process and improve access to dental care.
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Stanley, Steven, Marco Braaten, and Peter Silberstein. "Abstract 6746: Academic facility is associated with improved survival in patients with leiomyosarcoma: a national cancer database analysis." Cancer Research 83, no. 7_Supplement (April 4, 2023): 6746. http://dx.doi.org/10.1158/1538-7445.am2023-6746.
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Abstract Background: Leiomyosarcoma is a malignant sarcoma of smooth muscle that comprises 10-20% of all sarcomas with a predilection to the uterus and peritoneum. 1 Prior studies have shown treatment at Academic facilities is associated with improved outcomes in cancer treatment.2 The objective of this study was to investigate the effect of treatment at an Academic facility on overall survival in patients with leiomyosarcoma. Methods: The National Cancer Database (NCDB) was used to identify patients with leiomyosarcoma from 2004-2019 using the ICD-O-3 histology codes 8900 and 8901. Facility types used were assigned by the Commission on Cancer Accreditation program. Categorical Academic and Non-Academic variables were created. Data was analyzed using SPSS with a statistical significance of α = 0.05. Results: Of the 7950 patients included in this study, 3122 were treated at Academic facilities with a median survival of 77.6 months compared to 61.0 months for patients treated at a Non-Academic facility, which was statistically significant on long-rank testing (p<0.001). Compared to patients treated at Non-Academic facilities, patients at Academic facilities experienced delay in the average surgical initiation time (p<0.001), however, they were more likely to have surgery (88.1% vs. 74.1%; p<0.001), have no residual tumor margins on resection, (63.4% vs. 53.3%; p<0.001) and receive adjuvant chemotherapy (15.2% vs. 12.4%; p<0.001). Academic facility patients also had a younger mean age and were more likely to come from highest median income quartile (36.9% vs. 33.2; p<0.001). Conclusions: Patients with leiomyosarcoma treated at Academic facilities experienced improved survival compared with patients with the same disease treated at Non-Academic facilities. These patients experienced higher rates of surgery, adjuvant therapy and wider excisional margins. It is possible that treatment discrepancies and/or differences in surgical technique vary by facility type and contribute to the observed differences in survival. Citations-1. Devaud, N., et al. (2022). Leiomyosarcoma: Current Clinical Management and Future Horizons. Surgical oncology clinics of North America, 31(3), 527-546. https://doi.org/10.1016/j.soc.2022.03.0112. Gootee, J., Silberstein, P., et al. (2020). Important prognostic factors in leiomyosarcoma survival: a National Cancer Database (NCDB) analysis. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 22(6), 860-869. https://doi.org/10.1007/s12094-019-02196-7 Citation Format: Steven Stanley, Marco Braaten, Peter Silberstein. Academic facility is associated with improved survival in patients with leiomyosarcoma: a national cancer database analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6746.
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Renshaw, Andrew A., Molly K. Walsh, Barbara Blond, Ann T. Moriarty, Dina R. Mody, and Terence J. Colgan. "Robustness of Validation Criteria in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology." Archives of Pathology & Laboratory Medicine 130, no. 8 (August 1, 2006): 1119–22. http://dx.doi.org/10.5858/2006-130-1119-rovcit.
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Abstract Context.—Field validation of slides used in gynecologic cytology proficiency testing has surfaced as an important issue. Although the precision of diagnoses in peer-reviewed educational programs has been examined, the robustness of the validation criteria for specific types of interpretations used in proficiency testing has not been previously studied. Objective.—To evaluate the robustness of validation criteria for slides entering an educational slide program. Design.—We reviewed the results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology and compared the robustness of validation criteria for different reference diagnoses, using a total of 16 948 circulating slides. Results.—Validation criteria could be divided into 2 significantly different groups. The criteria for herpes, Trichomonas, squamous cell carcinoma, and adenocarcinoma were significantly more robust than the diagnoses of unsatisfactory; negative for intraepithelial lesion and malignancy, not otherwise specified; low-grade squamous intraepithelial lesion; and high-grade squamous intraepithelial lesion (P < .001). Conclusions.—The validation criteria used in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology show 2 different levels of robustness or redundancy. These results have implications for the design of fair proficiency tests. Proficiency testing can be designed with the necessary number of reviews needed for slide validation.
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Moriarty, Ann T., Barbara A. Crothers, Joel S. Bentz, Rhona J. Souers, Lisa A. Fatheree, and David C. Wilbur. "Automatic Failure in Gynecologic Cytology Proficiency Testing." Archives of Pathology & Laboratory Medicine 133, no. 11 (November 1, 2009): 1757–60. http://dx.doi.org/10.5858/133.11.1757.
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AbstractContext.—Automatic failure in gynecologic cytology proficiency testing occurs when a high-grade lesion or carcinoma (HSIL+, Category D) is misinterpreted as negative for intraepithelial lesion or malignancy (Category B).Objectives.—To document the automatic failure rate in 2006 and 2007 from the College of American Pathologists proficiency testing program (PAP PT) and compare them to projected values from 2004.Design.—Identify automatic failures from PAP PT in 2006 and 2007 and compare the rates of failure regarding participant and preparation type to validated slides in the College of American Pathologists Interlaboratory Comparison Program in 2004.Results.—There were 65 264 participant responses for HSIL+ slides included in this analysis from 2006 and 2007. Overall, 1% (666 of 65 264) of the HSIL+ responses were classified as negative, resulting in automatic failure for the participant. There were significantly fewer automatic failures in 2007 as compared with either 2006 or projected from 2004 data (P < .001). Conventional preparations had a lower automatic failure rate than liquid-based preparations but only for 2006. Both pathologists and cytotechnologists interpreting liquid-based preparations faired better than projected from 2004 data.Conclusions.—The automatic failure rate in PAP PT is lower than expected based on 2004 data from the College of American Pathologists Interlaboratory Comparison Program. Automatic failures are a relatively small component (1% or less) of proficiency testing failures. The rate of automatic failure decreased from 2006 to 2007 and may be due to loss of poor performers in the testing pool, the test-taking environment, or removal of less robust slides from the program.
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Moriarty, Ann T., Teresa M. Darragh, Lisa A. Fatheree, Rhona Souers, and David C. Wilbur. "Performance of Candida—Fungal-Induced Atypia and Proficiency Testing: Observations From the College of American Pathologists Proficiency Testing Program." Archives of Pathology & Laboratory Medicine 133, no. 8 (August 1, 2009): 1272–75. http://dx.doi.org/10.5858/133.8.1272.
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Abstract Context.—Candida may elicit cellular changes on otherwise negative screening Papanicolaou tests that may be misinterpreted as atypical squamous cells of undetermined significance. Although these changes have been correctly interpreted in the educational program of the College of American Pathologists, the Interlaboratory Comparison Program in Gynecologic Cytology, the performance of negative slides with Candida faltered when the same field validated slides were included in proficiency testing (PT). Objective.—To identify the performance differences of negative for intraepithelial lesion (NILM) Candida challenges before and after PT. Design.—We compare the performance of NILM College of American Pathologists slides with Candida as a single reference diagnosis, prior to PT (1991–2006) and after PT (2006–2007). Results.—There were 147 186 responses for slides with NILM Candida from the College of American Pathologists programs from 1991 through 2007. After PT, 79.7% of incorrect participant responses identified Candida as Category C (low-grade squamous intraepithelial lesion), whereas prior to PT only 59.5% of the incorrect diagnoses were low-grade squamous intraepithelial lesion (P < .001) in the field-validated component of the program. Validated Candida slides performed significantly more poorly in PT (97.2%) than prior to PT (98.3%) (P < .001). Candida challenges performed better in the educational component post-PT (98.3% versus 97.2%; P < .001). Cytotechnologists (97.9%) identified Candida more frequently than pathologists (97.3%) (P < .001) and ThinPrep preparations performed the best of all preparation types. Conclusions.—Proficiency testing adversely affects the performance of participants in the identification of NILM Candida. Slides with Candida are more likely to be identified as low-grade squamous intraepithelial lesion in a PT exercise. Misidentification is not due to lack of recognition but most likely an attempt of test takers to optimize their likelihood of passing the examination.
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Eversole, Galen M., Ann T. Moriarty, Mary R. Schwartz, Amy C. Clayton, Rhona Souers, Lisa A. Fatheree, Beth A. Chmara, William D. Tench, Michael R. Henry, and David C. Wilbur. "Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology, 2006." Archives of Pathology & Laboratory Medicine 134, no. 3 (March 1, 2010): 331–35. http://dx.doi.org/10.5858/134.3.331.
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Abstract Context.—Liquid-based preparations (LBPs) and human papillomavirus testing have led to changes in cervical cytology practices. The College of American Pathologists attempts to track practice patterns using a supplemental questionnaire, which allows laboratories to report diagnostic practices. Objective.—To analyze the 2006 reporting practices and to compare the results with the 2003 survey data. Design.—Questionnaire was mailed to 1621 laboratories. Participants included laboratories enrolled in the 2006 College of American Pathologists Gynecologic Proficiency Testing Program or the educational Interlaboratory Comparison Program in Gynecologic Cytology. Results.—Of the 679 responding laboratories (response rate, 42%), most (97.8%; n = 664) had implemented the Bethesda 2001 terminology. The median rate for all preparations with low-grade squamous intraepithelial lesions was 2.5% (2.9% for LBPs) compared with a 2003 median rate of 2.1%; the increase was confined to LBPs. Rates for high-grade squamous intraepithelial lesions (median, 0.5%) and atypical squamous cells have changed little. High-grade squamous intraepithelial lesions and unsatisfactory rates varied at statistically significant levels between types of LBPs. Most atypical squamous cell cases were subclassified as undetermined significance (median, 4.3%). The median ratio of atypical squamous cells to squamous intraepithelial lesions and carcinomas for all specimen types combined was 1.5, similar to the 2003 median ratio of 1.4. The median rates for findings of squamous cell abnormalities for 2006 were significantly higher for LBPs than for conventional smears. Conclusions.—Most responding laboratories have implemented the Bethesda 2001 terminology. There is an increase in LBP low-grade squamous intraepithelial lesion rates when compared with 2003 data. Liquid-based preparations have higher median squamous intraepithelial lesion and atypical squamous cell rates.
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Kreissl, J. F. "North American and European Experience with Biological Toilets." Water Science and Technology 18, no. 7-8 (July 1, 1986): 95–102. http://dx.doi.org/10.2166/wst.1986.0279.
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A history of North American and European experience with biological toilets is provided. The early use of these devices in Scandanavia was to solve a specific problem, that of providing a low-cost solution for disposing of human wastes from recreational cabins. Because of their environmental attractiveness their popularity increased rapidly and their marketing area was widened to include year-round use. These same factors resulted in closer scrutiny by both Scandanavian and American agencies in the form of controlled and field testing programs. The results of these tests have been improved designs and understanding of the viable applications of these devices, which are significantly more limited than first implied.
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Pemberton, H. Brent, Kevin Ong, Mark Windham, Jennifer Olson, and David H. Byrne. "What is Rose Rosette Disease?" HortScience 53, no. 5 (May 2018): 592–95. http://dx.doi.org/10.21273/hortsci12550-17.
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Rose rosette disease (RRD) is incited by a negative-sense RNA virus (genus Emaravirus), which is vectored by a wind-transported eriophyid mite (Phyllocoptes fructiphilus). Symptoms include witches broom/rosette-type growth, excessive prickles (thorns), discolored and distorted growth, and, unlike most other rose diseases, usually results in plant death. RRD is endemic to North America and was first described in Manitoba, Wyoming, and California in the 1940s. It has spread east with the aid of a naturalized rose species host and has become epidemic from the Great Plains to the East Coast of North America on garden roses in home and commercial landscapes where losses have been high. The disease was suggested to be incited by a virus from the beginning, but only recently has this been confirmed and the virus identified. The presence of the vector mite on roses has been associated with RRD since the first symptoms were described. However, more recently, the mite was demonstrated to be the vector of the disease and confirmed to transmit the virus itself. As a result of the RRD epidemic in North America and its effects on the national production and consumer markets for roses, a research team comprising five major universities (Texas, Florida, Tennessee, Oklahoma, and Delaware), a dozen growers and nurseries (all regions), six rose breeding programs (California, Wisconsin, Texas, and Pennsylvania), the major rose testing programs (Earth-Kind and AGRS), the major rose organization (American Rose Society), and the major trade organization AmericanHort has formed. This research project has been funded by the Specialty Crops Research Initiative through the U.S. Department of Agriculture (USDA) with the short-term objective of improving and disseminating best management practices (BMPs) and the long-term goal of identifying additional sources of resistance and developing the genetic tools to quickly transfer resistance into the elite commercial rose germplasm.
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Hantel, Andrew, Jessica Kohlschmidt, Ann-Kathrin Eisfeld, Wendy Stock, Sawyer Jacobson, Sumithra J. Mandrekar, Richard M. Stone, Daniel J. DeAngelo, John C. Byrd, and Gregory A. Abel. "Race-Ethnic Enrollment Disparities over 15 Years of Alliance/CALGB Acute Myeloid Leukemia Clinical Trials, Biobanks, and Correlative Science Protocols." Blood 138, Supplement 1 (November 5, 2021): 111. http://dx.doi.org/10.1182/blood-2021-146607.
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Abstract Introduction Race-ethnic disparities in clinical trial enrollment have the potential to bias findings, limit generalizability, misdirect drug development, and reduce equitable access to novel therapy. The degree to which such disparities exist within acute myeloid leukemia (AML) North American cooperative group trials, biobanks, and correlative studies remain unclear, as are the factors that influence biobank and correlative study participation among trial enrollees. In addition, the National Cancer Institute's (NCI) mandate for Comprehensive Cancer Centers (CCC) to designate catchment areas has not been explored as a mechanism through which AML enrollment disparities can be addressed. Methods We analyzed enrollment data from the 9 Alliance/CALGB AML treatment trials, 2 biobank protocols, and 2 correlative studies active from 1998-2013 and with published results. Trial enrollees could consent to biobank and/or correlative study participation. We compared participation rates of United States (US) enrollees for the mutually exclusive racial-ethnic groups of non-Hispanic (NH)-white, NH-Black, NH-Asian, NH-Native American, and Hispanic using X 2 testing, with NH-white as the comparator and reporting odds ratios (OR) and 95% confidence intervals (CI). Rates were adjusted by national incidence according to the Surveillance, Epidemiology, and End Results program and the US Census. Testing was repeated for the 55% of participants enrolled at 15 NCI CCCs recruiting ≥10 patients, where incidence was adjusted for catchment area size and demographics. Logistic regression models, clustered by trial, were performed to assess the following predictors for biobank and correlative study participation among trial enrollees: race-ethnicity (NH-white vs non-white), site type (CCC status), age (10-year increments), sex, neighborhood urbanity (urban vs rural) and poverty (<20% vs ≥20% below poverty line) by zip code, and distance from site (10-mile increments). Results There were 3041 trial enrollees at US sites; participant characteristics and demographics by race-ethnicity are shown in Table 1. 93.9% of patients participated in a biobanking study and 60.0% in a correlative study. National incidence adjusted enrollment odds by race-ethnicity are shown in the Figure (top); NH-Black, NH-Asian, and Hispanic persons were enrolled at significantly lower rates than NH-whites; NH-Native American enrollment was significantly higher. Enrollment odds were even lower for NH-Black, NH-Asian, and Hispanic enrollees at CCC sites when adjusted by catchment area incidence (Figure; bottom). Among trial enrollees, there were no univariable predictors of biobank participation, however, male sex (OR 1.12; 95% CI 1.01, 1.37; p=0.04) and NH-white race-ethnicity (OR 1.33; 95% CI 1.12,1.57; p<0.001) were associated with correlative study participation. Multivariable models of correlative study participation, with predictors selected based on univariable significance, are shown in Table 2 for all trial enrollees and when restricted to biobank enrollees; in both cases, NH-white race predicted participation. Conclusions Across 15 years of AML cooperative group studies, there were several enrollment disparities by race-ethnicity, which were more pronounced at CCC sites. Over 90% of trial enrollees participated in biobanking, with no race-ethnic differences seen. However, correlative study participation among trial enrollees was higher for NH-whites. Taken together, these data suggest that efforts should focus on increasing trial and correlative study participant diversity-but not biobanking-within NCI-designated CCC catchment areas. Reasonable next steps include identifying key structural, provider, and patient-based barriers to trial and correlative study participation at CCC sites and developing inclusive, multilevel interventions to address them. Figure 1 Figure 1. Disclosures Eisfeld: Karyopharm (spouse): Current Employment. Stock: Pfizer: Consultancy, Honoraria, Research Funding; amgen: Honoraria; agios: Honoraria; jazz: Honoraria; kura: Honoraria; kite: Honoraria; morphosys: Honoraria; servier: Honoraria; syndax: Consultancy, Honoraria; Pluristeem: Consultancy, Honoraria. Stone: AbbVie Inc, Actinium Pharmaceuticals Inc, Aprea Therapeutics, BerGenBio ASA, ElevateBio, Foghorn Therapeutics, GEMoaB, GlaxoSmithKline, Innate Pharma, Syndax Pharmaceuticals Inc, Syros Pharmaceuticals Inc, Takeda Oncology: Other: Advisory Committee; Agios Pharmaceuticals Inc, Novartis;: Research Funding; ACI Clinical, Syntrix Pharmaceuticals, Takeda Oncology: Other: Data Safety & Monitoring. DeAngelo: Abbvie: Research Funding; Blueprint: Research Funding; Takeda: Consultancy; Autolus: Consultancy; Forty-Seven: Consultancy; Incyte: Consultancy; Jazz: Consultancy; Novartis: Consultancy, Research Funding; Pfizer: Consultancy; Servier: Consultancy; Amgen: Consultancy; Agios: Consultancy; Glycomimetrics: Research Funding. Byrd: Newave: Membership on an entity's Board of Directors or advisory committees; Vincerx Pharmaceuticals: Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees; Novartis, Trillium, Astellas, AstraZeneca, Pharmacyclics, Syndax: Consultancy, Honoraria.
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Moriarty, Ann T., Mary R. Schwartz, Galen Eversole, Marilee Means, Amy Clayton, Rhona Souers, Lisa Fatheree, William D. Tench, Michael Henry, and David C. Wilbur. "Human Papillomavirus Testing and Reporting Rates: Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006." Archives of Pathology & Laboratory Medicine 132, no. 8 (August 1, 2008): 1290–94. http://dx.doi.org/10.5858/2008-132-1290-hptarr.
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Abstract Context.—Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. Objectives.—To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. Design.—To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. Results.—A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P < .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. Conclusions.—Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.
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Merenda, Peter F. "Measurements in the Future: Beyond the 20th Century." Psychological Reports 92, no. 1 (February 2003): 209–17. http://dx.doi.org/10.2466/pr0.2003.92.1.209.
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This article presents a brief history of psychometrics and the development in the USA shortly after the end of World War II of university graduate programs to educate and train psychometricians. Three decades later these programs in North America were on a steady decline. But, at the same time there was a surge in universities abroad in producing well-trained psychometricians, particularly in Western European countries, especially The Netherlands. Broad implications of the effect of this movement on psychological testing are suggested.
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Davey, Diane D., Margaret H. Neal, David C. Wilbur, Terence J. Colgan, Patricia E. Styer, and Dina R. Mody. "Bethesda 2001 Implementation and Reporting Rates: 2003 Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology." Archives of Pathology & Laboratory Medicine 128, no. 11 (November 1, 2004): 1224–29. http://dx.doi.org/10.5858/2004-128-1224-biarrp.
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AbstractContext.—The 2001 Bethesda System for the reporting of cervical cytology specimens and the use of new liquid-based and human papillomavirus testing technologies have led to changes in cervical cytology reporting practices.Objectives.—To analyze current laboratory reporting practices using Bethesda 2001 terminology and to compare results with previous survey data from 1996.Design.—Questionnaire survey mailed to 1751 laboratories in mid-2003.Participants.—Laboratories enrolled in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology.Results.—Of the 759 responding laboratories, most (85.5%) had implemented Bethesda 2001 terminology, and the majority had adopted major changes, such as elimination of the benign cellular changes category and the satisfactory but limited category. The median reporting rate for low-grade squamous intraepithelial lesion was 2.1%, compared to a 1996 median rate of 1.6%, but the increase was confined to liquid-based preparations. Reporting rates for high-grade squamous intraepithelial lesion (median, 0.5%) and atypical squamous cells (ASC) had changed little. Most ASC cases were subclassified as “undetermined significance” (median, 3.9%) with ASC, cannot exclude high-grade SIL accounting for a minority (median, 0.2%). The median ratio of ASC to squamous intraepithelial lesions and carcinomas (SIL+) was 1.4 and was lower than the 1996 median ratio of 2.0. Median reporting rates for squamous abnormalities for 2002 were noted to be significantly higher for liquid-based preparations than for conventional smears, while median ASC/SIL+ ratios were lower. Most laboratories offer human papillomavirus testing, but almost half (47%) of laboratories do not know the percentage of positive testing results in patients with ASC.Conclusions.—Most laboratories have implemented Bethesda 2001 terminology. New criteria and liquid-based methods have led to an increase in low-grade squamous intraepithelial lesion reporting rates and a decrease in ASC/ SIL+ ratios when compared with 1996 data. Liquid-based preparations have higher median squamous intraepithelial lesion rates and lower ASC/SIL+ ratios than conventional smears.
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Leistikow, Peter Thomas, Vidhi Patel, Christian Nouryan, and Joseph Steven Cervia. "Acceptability of HIV testing for adolescents and young adults by delivery model: a systematic review." Journal of Investigative Medicine 70, no. 3 (December 8, 2021): 829–36. http://dx.doi.org/10.1136/jim-2021-002056.
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HIV infections are prevalent among adolescents and young adults, of whom 44% remain unaware of their diagnosis. HIV screening presents numerous challenges including stigma, fear, and concerns about confidentiality, which may influence young people’s acceptance of HIV screening and linkage to care differently from individuals in other age groups. It is imperative to understand which care delivery models are most effective in facilitating these services for youth. This systematic review analyzes the rates of HIV test acceptance and linkage to care by care delivery model for adolescents and young adults. Studies were classified into emergency department (ED), primary care/inpatient setting, community-based program, or sexually transmitted infection clinic models of care. From 6395 studies initially identified, 59 met criteria for inclusion in the final analyses. Rate of test acceptance and linkage to care were stratified by model of care delivery, gender, race, age ranges (13–17, 18–24 years) as well as site (North America vs rest of the world). A significant difference in acceptance of HIV testing was found between care models, with high rates of test acceptance in the ED setting in North America and primary care/hospital setting in the rest of the world. Similarly, linkage to care differed by model of care, with EDs having high rates of linkages to HIV care in North America. Future studies are needed to test mechanisms for optimizing outcomes for each care delivery model in addressing the unique challenges faced by adolescents and young adults.
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Greene, Sarah E., Kurt Curtis, Peter U. Fischer, Christopher L. King, and Gary J. Weil. "#56: A novel test for diagnosis and surveillance of Wuchereria bancrofti infection." Journal of the Pediatric Infectious Diseases Society 10, Supplement_2 (June 1, 2021): S21. http://dx.doi.org/10.1093/jpids/piab031.051.
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Abstract Background Elephantiasis or Lymphatic filariasis (LF) is a parasitic infection that causes significant morbidity and impacts hundreds of millions of people in 73 countries. Most LF is caused by the nematode Wuchereria bancrofti, but Brugia species cause LF in some areas of Southeast Asia. The global program to eliminate LF uses mass drug administration (MDA) of antifilarial drugs in endemic areas to kill the microfilaria (MF) stage of the parasite that is required for ongoing transmission by mosquitos. Better tools are needed for assessing the success of MDA, because of limitations of available diagnostic tests. MF testing is often not feasible, because it requires collection of blood at night in most endemic areas. Existing antibody and antigen tests remain positive long after effective treatment, and their results do not correlate well with current infectivity. The Brugia Rapid test detects antibodies to BmR1, a Brugia protein that is expressed by MF. These antibodies disappear 2–3 years after effective treatment, and that makes the Brugia Rapid test a useful marker for persistent infection in the few countries with brugian filariasis. We set out to develop a novel antibody test for W. bancrofti infection based on a BmR1 homologue in W. bancrofti. Methods We cloned, expressed and purified a Wuchereria bancrofti protein (provisional name WbN1) that is a homologue of the Brugia malayi protein BmR1. Sera from patients infected with Wuchereria bancrofti as well as sera from patients infected with other closely related filarial species were tested for IgG4 antibodies to WbN1 by indirect ELISA. Results The ELISA has a sensitivity of 90.7% for infection with W. bancrofti based on the 80 bancrofti patient samples tested thus far. Specificity was 91.5% with 59 sera samples from patients infected with Onchocerca volvulus or Loa loa, which are filarial parasites that are co-endemic with W. bancrofti in Africa. Specificity was 97.9% with North American control samples. ELISA with sera from a clinical trial in Sri Lanka demonstrated that antibodies to WbN1 decreased significantly faster after treatment than antibodies to the previously described filarial antigen Bm14. Similar declines in antibody to WbN1 occurred after patients in Papua New Guinea received a single dose of triple drug treatment for LF with Ivermectin Diethylcarbamazine and Albendazole, that is effective for clearing MF from the blood without clearing filarial antigenemia. Conclusions While additional studies are needed, this ELISA for IgG4 antibody to the recombinant protein WbN1 could be a promising new surveillance tool for assessing for ongoing transmission of LF following MDA.
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Shlyk, Natalia. "HEART RATE VARIABILITY AT REST AND DURING AN ORTHOSTATIC CHALLENGE AT DIFFERENT RANGES OF MxDMn VALUES IN FEMALE SKIERS IN THE TRAINING PROCESS." SCIENCE AND SPORT: current trends 8, no. 1 (March 1, 2020): 83–96. http://dx.doi.org/10.36028/2308-8826-2020-8-1-83-96.
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The aim of the study is to analyze the heart rate variability (HRV) and to identify ranges of variability of cardiac intervals (MxDMn) at rest and during an orthostatic challenge, which result in the violation of cardioregulatory systems and decrease in the functional state of female skiers in the training process. Research methods and organization. We conducted dynamic HRV studies of 35 female skiers, including 12 young women aged 15-17 years in different periods of the training process. The analysis and physiological interpretation of HRV indicators were carried out in accordance with the recommendations of a group of Russian experts, the European Cardiology Society and the North American Society of Electrical Stimulation and Electrophysiology [1996, 2011], as well as Russian researchers [1,3,5,6]. We carried out 351 HRV studies at rest (5 minutes) and during an orthostatic challenge (6 minutes) using the "VARICARD 2.51" device and the "VARICARD MP" program in the morning before another training session. Using the "VARICARD MP" program allowed us to simultaneously register cardio intervals in four athletes. Results of the research. We paid particular attention to the variation range of cardiac intervals (MxDMn) during the individual analysis of HRV indicators in female skiers. The functional state of cardioregulatory systems at rest and during an orthostatic challenge was evaluated for different ranges of MxDMn values: <150 ms, 151-250 ms, 251-350 ms, 351-450 ms, 451-550 ms, 551-650 ms, and >650 ms. The paper contains tables with different numbers of optimal and adverse response to an orthostatic challenge in adult and young female skiers with different MxDMn values. At the same time, we paid particular attention to young female skiers who had equal training regime in the analysis of MxDMn values. The paper demonstrates the individual dynamics of MxDMn indicators at rest and during an orthostatic challenge in young female skiers during different periods of the training process. The research revealed that the smallest and largest MxDMn values cause the deregulation process at rest and the deterioration of vegetative reactivity during orthostatic testing. We revealed MxDMn values of female skiers in the range from <100 ms to >600 ms after the same training day before another training session. It indicates different activation of the sinus node control mechanisms and the body recovery processes. The paper contains the outcomes of dynamic HRV studies in different female skiers who had minimal or maximum MxDMn values at rest and adverse response to an orthostatic challenge during different periods of the training process. We demonstrated the outcomes of MxDMn values in an overtrained female skier during the transition of heart rate control mechanisms from a pronounced predominance of the autonomous regulation circuit in the preparatory period to a pronounced predominance of the central regulation circuit in the competition period. The paper contains the figures of cardiointervalograms, HRV and ECG scatergrams at rest and during an orthostatic challenge at different values of the variational range of cardiointervals (MxDMn). Conclusion. The research revealed an important role of identification of the ranges of variability of cardiac intervals (MxDMn) in the individual HRV analysis in the training process of female skiers for a more accurate assessment of the cardioregulatory system status and the sinus node functioning. The predominant type of vegetative regulation and orthostatic sampling play a great role in determination of the origin of MxDMn indicators at rest. We identified the ranges of MxDMn values at rest and during an orthostatic challenge in young female skiers, which result in deregulatory manifestations, vegetative reactivity and recovery processes disorders leading to overtraining. We identified the optimal values of the range of MxDMn values for young female skiers, which are common for the moderate prevalence of the autonomous regulation circuit.
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Valente, Juliana Y., Patricia Paiva de Oliveira Galvão, Julia Dell Sol Passos Gusmoes, and Zila M. Sanchez. "A systematic review of the effect of the school-based drug prevention program Keepin’ it REAL: translated and implemented in Brazil by PROERD." Ciência & Saúde Coletiva 27, no. 11 (November 2022): 4175–89. http://dx.doi.org/10.1590/1413-812320222711.07162022en.
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Abstract The Drug Resistance Educational Program (PROERD) is Brazil’s most widespread school-based prevention program; its current curriculum is based on the North American Keepin’ it REAL (kiR) program. There is no evidence of the effectiveness of PROERD in preventing drug use, pointing to the need for further studies to understand these findings. The aim of the study was to synthesis the evidence of the effect of the kiR curriculum (PROERD) through a systematic review. We found 17 studies that reported the effects of different versions of kiR on drug use and/or violence. Except for the Brazilian study, no studies were found that assessed the effect on drug use of the version applied by police officers (DARE-kiR), the same one implemented by PROERD. Favorable evidence of kiR in drug use prevention was found for the 7th-grade curriculum, which contradicts the PROERD’s null-effect results. No international evidence of the effect of kiR was found in the 5th-grade curriculum, in the same line as the PROERD’s study. It is suggested that PROERD’s 7th-grade curriculum should be revised to reflect international results and that the 5th-grade curriculum should be reconsidered in light of the negative international evidence.
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Davey, Diane Davis, Rhona J. Souers, Kelly Goodrich, Dina R. Mody, Sana O. Tabbara, and Christine N. Booth. "Bethesda 2014 Implementation and Human Papillomavirus Primary Screening: Practices of Laboratories Participating in the College of American Pathologists PAP Education Program." Archives of Pathology & Laboratory Medicine 143, no. 10 (April 25, 2019): 1196–202. http://dx.doi.org/10.5858/arpa.2018-0603-cp.
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Context.— Cervical cancer screening laboratory practices may evolve with new terminology and technologies. Objective.— To investigate changes in cervical cytopathology practice resulting from the 2014 Bethesda System updates and screening technologies. Design.— Questionnaires accompanied 2016 and 2017 mailings of the College of American Pathologists PAP Education program. Results.— In 2016, most laboratories surveyed had adopted or were planning to adopt 2014 Bethesda System updates, and the majority (53%; 365 of 689) used an age cutoff of 45 for reporting benign-appearing endometrial cells. However, 51.3% (354 of 690) of laboratories used the term low-grade squamous intraepithelial lesion, cannot exclude high-grade squamous intraepithelial lesion, for cases with indeterminate features, and 44.9% (298 of 664) of laboratories used a 5000-cell cutoff for minimum squamous cellularity for posthysterectomy and posttherapy specimens. Reporting rates for cervical cytology metrics changed very little from 2013 to 2016, and the median ratio of atypical squamous cells to squamous intraepithelial lesion cases was 1.9 for ThinPrep and 1.8 for SurePath preparations. Most laboratories (59.4%; 389 of 655) did not offer stand-alone primary human papillomavirus (HPV) testing in 2017, and primary HPV testing accounted for a low proportion of HPV testing volumes. The Roche Cobas method was the most common platform for HPV primary screening. Conclusions.— These questionnaire surveys provide data about the current status of cervical cytology screening, including changes related to the 2014 Bethesda System updates and the adoption of HPV primary screening techniques.
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Shortridge, Dee, Ana C. Gales, Jennifer M. Streit, Michael D. Huband, Athanasios Tsakris, and Ronald N. Jones. "Geographic and Temporal Patterns of Antimicrobial Resistance in Pseudomonas aeruginosa Over 20 Years From the SENTRY Antimicrobial Surveillance Program, 1997–2016." Open Forum Infectious Diseases 6, Supplement_1 (March 2019): S63—S68. http://dx.doi.org/10.1093/ofid/ofy343.
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Abstract Background The SENTRY Antimicrobial Surveillance Program was established in 1997 and encompasses over 750 000 bacterial isolates from ≥400 medical centers worldwide. Among the pathogens tested, Pseudomonas aeruginosa remains a common cause of multidrug-resistant (MDR) bloodstream infections and pneumonia in hospitalized patients. In the present study, we reviewed geographic and temporal trends in resistant phenotypes of P. aeruginosa over 20 years of the SENTRY Program. Methods From 1997 to 2016, 52 022 clinically significant consecutive isolates were submitted from ≥200 medical centers representing the Asia-Pacific region, Europe, Latin America, and North America. Only 1 isolate per patient per infection episode was submitted. Isolates were identified by standard algorithms and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) methods and interpreted using CLSI and European Committee on Antimicrobial Susceptibility Testing 2018 criteria at JMI Laboratories. Results The most common infection from which P. aeruginosa was isolated was pneumonia in hospitalized patients (44.6%) followed by bloodstream infection (27.9%), with pneumonia having a slightly higher rate of MDR (27.7%) than bloodstream infections (23.7%). The region with the highest percentage of MDR phenotypes was Latin America (41.1%), followed by Europe (28.4%). The MDR rates were highest in 2005–2008 and have decreased in the most recent period. Colistin was the most active drug tested (99.4% susceptible), followed by amikacin (90.5% susceptible). Conclusions Over the 20 years of SENTRY Program surveillance, the rate of MDR P. aeruginosa infections has decreased, particularly in Latin America. Whether the trend of decreasing resistance in P. aeruginosa is maintained will be documented in future SENTRY Program and other surveillance reports.
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Zhao, Chengquan, Barbara A. Crothers, Mohiedean Ghofrani, Zaibo Li, Rhona J. Souers, Mujtaba Hussain, Fang Fan, et al. "Human Papillomavirus Genotyping Testing Practice in 2014: Results of a College of American Pathologists National Survey." Archives of Pathology & Laboratory Medicine 140, no. 12 (August 4, 2016): 1364–70. http://dx.doi.org/10.5858/arpa.2016-0061-cp.
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Context.— College of American Pathologists (CAP) surveys are used to establish national benchmarks for laboratories. Objective.— To investigate human papillomavirus (HPV) genotyping testing practice patterns in laboratories in 2014. Design.— Data were analyzed from the CAP HPV Genotyping Practices Supplemental Questionnaire distributed to 749 laboratories participating in the CAP Human Papillomavirus (High Risk) for Cytology Program. Results.— Six hundred four of 749 laboratories (80.6%) responded to the survey. More laboratories offered HPV genotyping testing and performed in-house HPV genotyping testing as compared to previous surveys. The Roche cobas HPV test was the most commonly used genotyping method (37.0%; 160 of 433), followed by Hologic Aptima HPV16 18/45 (26.1%; 113 of 433) and Hologic Cervista HPV16/18 (14.3%; 62 of 433). Most laboratories (287 of 399; 71.9%) offered HPV genotyping for high-risk HPV cases regardless of Papanicolaou (Pap) test results and patient age; this pattern was more common in laboratories using cobas. The remaining laboratories specifically offered testing to women with a negative Pap test result at age 30 years and older (65.2%, 73 of 112) or all ages (37.5%, 42 of 112). The median reporting rates of HPV16 and/or HPV18 positivity were 20.6%, 25.7%, 21.1%, and 57.4% for women with positive high-risk HPV adjunctive negative Pap results, atypical squamous cells of undermined significance, low-grade squamous intraepithelial lesion, and high-grade squamous lesion, respectively. Conclusions.— Human papillomavirus genotyping testing has increased. Roche cobas and Hologic Aptima genotype methods were the most common, and laboratories using cobas usually offered genotyping regardless of Pap test result and age. The data provide a baseline and trend of HPV genotyping test practices in 2014.
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Marshall, Mazepa A., Michael Evans, Elizabeth Davis, Andrew Johnson, Ana G. Antun, Andrew M. Farland, Ryan R. Woods, et al. "Differential Effect of Rituximab on Relapse-Free Survival in De Novo and Relapsed Immune Thrombotic Thrombocytopenic Purpura in African-American and Caucasian Populations." Blood 134, Supplement_1 (November 13, 2019): 90. http://dx.doi.org/10.1182/blood-2019-129383.
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Introduction The United States Thrombotic Microangiopathy (USTMA) Consortium consists of high-volume US referral centers that are committed to collaborative research in TMAs. The USTMA Immune Thrombotic Thrombocytopenic Purpura (iTTP) registry has compiled retrospective data on demographics, treatments and outcomes in patients with iTTP to create the world's largest database of patients with this rare disease. While there is consensus on the use of therapeutic plasma exchange (TPE) for treatment of iTTP, there are no large randomized trials on which to base use of rituximab. The drug is frequently used for refractory or relapsed iTTP, but is currently being used more frequently for de novo (first episode) iTTP. We queried the USTMA iTTP registry to determine whether relapse free survival (RFS) is superior when rituximab is added to TPE and corticosteroids for treatment of iTTP. We hypothesized that the addition of rituximab would improve RFS at 5 years in both de novo and relapsing iTTP. Methods Following IRB approval at each institution, investigators independently reviewed individual patient records to confirm diagnostic criteria and entered demographic, treatment and outcomes data into the REDCap database housed at the University of North Carolina. The diagnosis of iTTP was defined as ADAMTS13 < 10% or ADAMTS13 < 20% with an inhibitor or antibody detected at any point or a clinical diagnosis of iTTP based on presenting characteristics, response to treatment and/or relapsing phenotype before ADAMTS13 testing became available (N=173). Relapse was defined as a recurrence of iTTP after at least 30 days of remission (recurrence within 30 days was considered an exacerbation, or continuation of the prior episode). To explore the effect of rituximab added to TPE and corticosteroids, we first assessed the treatment effect in de novo iTTP patients and then separately in relapse. We constructed Kaplan-Meier curves to compare RFS for patients treated with rituximab plus corticosteroids versus corticosteroids alone in both groups, and compared RFS at specific time points using the Klein method. To better understand whether other patient variables had an effect on RFS in both de novo episodes and relapses, ordinary (time-to-event) and mixed-effects (recurrent time-to-event) Cox proportional hazards models were used to examine the relationships of treatment, race/ethnicity, sex, age, treatment year, and presenting signs/symptoms with the outcome. Analyses were conducted using R version 3.5.2 (R Foundation for Statistical Computing, Vienna, Austria). Results As of July, 2019, the USTMA database contains 775 unique study patients with a confirmed diagnosis of iTTP with 1397 unique iTTP episodes. The treatment of patients' de novo iTTP episode was available for analysis in 375 patients, 188 of whom were treated with corticosteroids alone, 131 with corticosteroids plus rituximab, and 56 with other therapies. RFS was significantly higher in patients treated with corticosteroids and rituximab compared to those treated with corticosteroids alone at 1 year (0.93 vs. 0.78, p=0.0002) and 3 years (0.82 vs. 0.66, p=0.004) but not 5 years (0.60 vs. 0.56, p=0.39). In addition, the risk of relapse decreased with later treatment year for de novo iTTP (hazard ratio (HR) 0.95, 95% CI 0.92-0.99, p=0.03), consistent with rituximab use increasing over time, and was increased in African Americans compared with Caucasians (HR 1.83, 1.10-3.06, p=0.02). We then explored the treatment effect in all iTTP relapses (743 relapses in 426 patients). Here, a significant (p=0.0007) interaction between treatment and race was found. Among African Americans, we found no difference in RFS when rituximab was added (HR 1.15, 0.81-1.62, p=0.43). However, among Caucasians, RFS was significantly improved when rituximab was added (HR 0.15, 0.06-0.35, p<0.0001). Conclusions For de novo iTTP, adding rituximab to corticosteroids for immunosuppression likely delays but does not prevent relapse. Unlike in de novo disease, in patients with relapsed iTTP, we found a novel and significant interaction between race and treatment: while Caucasians had significantly improved RFS with the addition of rituximab, there was no effect on RFS in African Americans. Further investigation is warranted to determine the mechanisms of this difference in the response to rituximab in relapsed iTTP to improve outcomes in African Americans. Figure Disclosures Marshall: Sanofi: Membership on an entity's Board of Directors or advisory committees. Farland:Sanofi: Membership on an entity's Board of Directors or advisory committees. Metjian:Sanofi: Membership on an entity's Board of Directors or advisory committees. Raval:Bayer, Inc: Research Funding; Sanofi: Membership on an entity's Board of Directors or advisory committees. Liles:Imara: Other: PI on Clinical trial- Sickle cell ; Shire: Other: PI on clinical trial Sickle cell ; Novartis: Other: PI on clinical trial Sickle cell . Baumann Kreuziger:CSL Behring: Consultancy; Vaccine Injury Compensation Program: Consultancy. McCrae:Rigel Pharmaceutical: Membership on an entity's Board of Directors or advisory committees; Sanofi Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Dova Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Pfizer Pharmaceutical: Membership on an entity's Board of Directors or advisory committees. Chaturvedi:Shire/Takeda: Research Funding; Sanofi: Consultancy; Alexion: Consultancy. Zheng:Clotsolution: Other: Co-Founder; Shire/Takeda: Research Funding; Ablynx/Sanofi: Consultancy, Speakers Bureau; Alexion: Speakers Bureau. Cataland:Ablynx/Sanofi: Consultancy, Research Funding; Alexion: Consultancy, Research Funding. Off Label Disclosure: rituximab for immunosuppression in TTP.
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Castle, B., E. Vonlinsowe, B. Cook, J. Hayward, and G. Sharma. "POC Programs: A Brief Survey on Critical Value Thresholds, Instrumentation, Repeat Testing, and Training Documentation." American Journal of Clinical Pathology 156, Supplement_1 (October 1, 2021): S35—S36. http://dx.doi.org/10.1093/ajcp/aqab191.070.
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Abstract Introduction/Objective Across the United States, Point of Care (POC) programs oversee glucometer testing and are often expected to enforce thresholds for critical values, as well as provide guidance on repeat testing. Additionally, POC must track training and ongoing competency assessments of glucometer operators. Our aim was to survey POC across North America to capture the current state of variation in these POC functions, and identify opportunities for standardization. Methods/Case Report In July of 2021, an online survey was created on www.surveymonkey.com and distributed via the POC listserv of the American Association for Clinical Chemistry (AACC). The survey listed nine questions regarding instrumentation, threshold levels for critical-high and critical-low, policies on repeat testing, and practices around documentation and record retention. Results (if a Case Study enter NA) Of the 63 responses received, almost all (95.2%, n=60) indicated that their institution defines glucometer critical value thresholds. Of these, the most common threshold for critical-high was 400 mg/dL (44.4%, n=28) and for critical-low was 50 mg/dL (39.7%, n=25). A majority (55.5%, n=35) of programs require repeat testing of results that exceeded critical limits. The most popular POC result management software (50.8%, n=32) was RALS (Abbott Diagnostics, Chicago, IL) and the most popular glucometer (56%, n=23) was Roche Accu- Chek Inform II (Roche Diagnostics, Basel, Switzerland). Regarding institutions that disclosed training and competency documentation practices (93.7%, n=59), a majority (57.6%, n=34) used online-only storage, followed by hybrid online- paper storage (32.2%, n=19), and paper-only storage (10.2%, n=6). Conclusion Our brief survey has uncovered variations and insights that should raise queries on the feasibility of standardized critical value thresholds, as well as uniform recommendations for retesting critical values. We observed widespread adoption of middleware, as well as online record-keeping. We hope that our findings will trigger further discussions and follow-up studies by other researchers in the POC field.
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Susaimuthu, J., B. O. Agindotan, L. A. Miller, and K. L. Perry. "Potato aucuba mosaic virus in Potato in New York State." Plant Disease 91, no. 9 (September 2007): 1202. http://dx.doi.org/10.1094/pdis-91-9-1202a.
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Solanum tuberosum cv. Elmer's Blue is one of a number of heritage potato accessions maintained at Cornell University that exhibit virus-like symptoms of stunting and a leaf yellowing or a mottle mosaic. Testing of this cultivar by double-antibody sandwich (DAS)-ELISA revealed that it was infected with Potato virus S (PVS) but none of the other common potato viruses screened for in North American potato certification programs (3). Mechanical inoculation of sap from potato cv. Elmer's Blue onto Nicotiana debneyii, N. megalosiphon, N. occidentalis, and N. tabacum produced a range of yellowing and mosaic symptoms (symptomless on N. tabacum), indicating the presence of a transmissible agent, but all these hosts tested negative for PVS. To identify possible viruses, reverse transcription (RT)-PCR assays involving generic primers for different groups of viruses were performed on the potato and the Nicotiana spp. Degenerate primers specific to members of the genus Potexvirus (4) amplified a 600-bp region from the symptomatic potato and N. debneyii. Nucleotide sequencing of the RT-PCR amplified product from potato cv. Elmer's Blue (Genbank Accession No. EF609120) and comparisons with GenBank sequences revealed the amplified sequence as having 91% identity with the genomic sequence of Potato aucuba mosaic virus (PAMV; Accession No. S73580). The presence of this virus in potato cv. Elmer's Blue and N. debneyii was confirmed by PAMV-specific antibodies (Agdia, Inc., Elkhart, IN) in a DAS-ELISA format. PAMV is reported to occur worldwide, but uncommonly, with most descriptive work from Europe (2). While this virus has been studied in North America (1,2), these reports employed virus stocks from Europe under experimental conditions or virus in tubers obtained directly from Europe; to our knowledge, there are no unambiguous reports of PAMV in naturally infected North American potato cultivars. By contrast, the PAMV-infected cultivar in this report is a selection originally from a Canadian grower, and although not grown commercially, it is maintained in garden and field plots in New York and other states. References: (1) R. H. Bagnall. Phytopathology 50:460, 1960. (2) G. F. Kollmer and R. H. Larson. Res. Bull. Agric. Exp. Stn. Univ. Wis. 223:1, 1960. (3) S. A. Slack. Page 61 in: Potato Health Management. The American Phytopathological Society. St. Paul, MN, 1993. (4) R. A. A. van der Vlugt and M. Berendsen. Eur. J. Plant Pathol. 108:367, 2002.
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Cunningham, Mark T., John D. Olson, Wayne L. Chandler, Elizabeth M. Van Cott, Charles S. Eby, Jun Teruya, Sandra C. Hollensead, et al. "External Quality Assurance of Antithrombin, Protein C, and Protein S Assays: Results of the College of American Pathologists Proficiency Testing Program in Thrombophilia." Archives of Pathology & Laboratory Medicine 135, no. 2 (February 1, 2011): 227–32. http://dx.doi.org/10.5858/135.2.227.
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Abstract Context.—Hereditary and acquired deficiencies of antithrombin (AT), protein C (PC), and protein S (PS) are risk factors for venous thromboembolism. Proper diagnosis requires high-quality assays for these proteins. Objective.—To determine the accuracy and interlaboratory precision of AT, PC, and PS assays used by laboratories participating in the United States College of American Pathologists proficiency testing program in thrombophilia and to grade the performance of laboratories. Design.—Standardized normal plasma with assigned analyte values was sent in 2 separate challenges to participating laboratories. Participants measured AT, PC, and PS levels using local methods. Results.—When compared with the assigned values for the international standard, the order of assay accuracy from highest to lowest was AT activity, PC antigen, AT antigen, total PS antigen, PC activity, PS activity, and free PS antigen (range of assay bias, 2.6%–8.8%). The order of assay precision from highest to lowest was PC activity, AT activity, AT antigen, total PS antigen, PS activity, free PS antigen, and PC antigen (range of assay coefficient of variation, 6.1%–20.0%). Most testing events (87.8%) could be graded as pass or fail using a target range of ±3 standard deviations from the method-specific mean. The pass rate was 98.2% for all AT, PC, and PS testing events combined. Conclusions.—Accuracy and precision were higher for AT assays and lower for PC and PS assays. It was feasible to grade individual laboratory performance.
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Woodhouse, Sherry L., Janet F. Stastny, Patricia E. Styer, Mary Kennedy, Amy H. Praestgaard, and Diane D. Davey. "Interobserver Variability in Subclassification of Squamous Intraepithelial Lesions." Archives of Pathology & Laboratory Medicine 123, no. 11 (November 1, 1999): 1079–84. http://dx.doi.org/10.5858/1999-123-1079-ivisos.
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Abstract Objective.—To determine whether, on a national cytology proficiency test, a competent cytologist can consistently distinguish grades of squamous intraepithelial lesions. Design.—Results for low- and high-grade squamous intraepithelial lesion referenced slides from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology for 1996 and 1997 were analyzed including educational, nongraded vs graded validated slides. Results.—The discrepant rate between low- and high- grade lesions ranged from 9.8% to 15% for cytotechnologist, pathologist, laboratory, and all responses. There was a statistically significant difference in performance on graded, validated slides vs educational slides with better performance on validated slides. Conclusion.—This significant interobserver variability in subclassification of squamous lesions should be considered in management guidelines for abnormal Papanicolaou test results and implementation of national cytology proficiency testing.
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Wilds, Neil. "Coatings for corrosion under insulation (CUI) protection—accelerated testing methodology." APPEA Journal 53, no. 1 (2013): 127. http://dx.doi.org/10.1071/aj12010.
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Corrosion under insulation (CUI) is a serious issue in the oil and gas industry, with failures often occurring without warning and having devastating effect. When expensive redesign is not possible or practical, operators have a number of options open to them to mitigate the risk of CUI; these include the use of various protective coatings or thermally sprayed metals. Despite a number of technologies presently available, the industry is yet to establish an accepted laboratory test method for the performance benchmarking of products. This has, in the past, damaged confidence in some solutions and hampered the selection and further development of CUI coatings. As a result, the subject of accelerated laboratory testing for CUI coatings is now receiving significant attention across the industry with joint industry programs proposed in both Europe and North America. This paper will examine state-of-the-art accelerated CUI testing, evaluating the advantages and disadvantages of the existing methods available. It will then offer a detailed description of a test method that has been in use since 2004, testing more than 300 specimens and assessing a wide range of coating technologies. The reproducibility of the test program will be established by the presentation of a range of data including results obtained from a third-party test house. The third-party results will then be correlated with a seven-year case study from an end user perspective provided by Santos, a major Australian oil and gas exploration and production company, from experiences at their Port Bonython facility in SA.
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Staats, Paul N., Rhona J. Souers, Amberly Lindau Nunez, Zaibo Li, Daniel F. I. Kurtycz, Kelly Goodrich, Benjamin Lloyd Witt, Diane Davis Davey, and Christine Noga Booth. "The Differential Diagnosis of Reparative Changes and Malignancy: Performance in the College of American Pathologists Pap Education and Proficiency Testing Programs." Archives of Pathology & Laboratory Medicine 144, no. 7 (November 22, 2019): 846–52. http://dx.doi.org/10.5858/arpa.2019-0298-cp.
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Context.— Repair is a challenging diagnosis and a significant source of false-positive (FP) interpretations in cervical cytology. No large-scale study of performance of repair in the liquid-based era has been performed. Objective.— To evaluate the performance of repair in the College of American Pathologists Pap Education and Proficiency Testing (PT) programs. Design.— The FP rate for slides classified as repair was evaluated by preparation type, participant type (cytotechnologist, pathologist, or laboratory), and program. The specific misdiagnosis category and individual slide performance were also evaluated. The rate of misclassification of slides as repair by participants for other diagnostic categories in the Pap Education program was assessed. Results.— The overall FP rate was 1700 of 12 715 (13.4%). There was no significant difference by program or preparation type. Within the Education program there was no difference by participant type, but pathologists' FP rate in the PT program (47 of 514, 9.1%) was significantly better than cytotechnologists in the PT program (51 of 380, 13.4%) and pathologists in the Education program (690 of 4900, 14.1%). High-grade squamous intraepithelial lesions/cancers (HSIL+) accounted for 1380 of 1602 FP interpretations (86%) in Education, but 43 of 98 (43.9%) in PT. Most slides had a low rate of misclassification, but a small number were poor performers. False-negative diagnosis of HSIL+ as repair was less common, ranging from 0.7% to 1.8%. Conclusions.— Despite initial indications that liquid-based cytology might reduce the rate of misclassification of repair, FP interpretations remain common and are no different by preparation type. Misclassification is most commonly as HSIL or carcinoma, potentially resulting in significant patient harm.