An approach for estimating measurement uncertainty in medical laboratories using data from long-term quality control and external quality assessment schemes

The present study was prompted by the ISO 15189 requirements that medical laboratories should estimate measurement uncertainty (MU)

Spatially Adaptive Regularization in Image Segmentation

We modify the total-variation-regularized image segmentation model proposed by Chan, Esedoglu and Nikolova [SIAM Journal on Applied Mathematics 66, 2006] by introducing local regularization that takes into account spatial image information. We propose some techniques for defining local regularization parameters, based on the cartoon-texture decomposition of the given image, on the mean and median filters, and on a thresholding technique, with the aim of preventing excessive regularization in piecewise-constant or smooth regions and preserving spatial features in nonsmooth regions. We solve the modified model by using split Bregman iterations. Numerical experiments show the effectiveness of our approach

A distributed combustion solver for engine simulations on grids

AbstractMulti-dimensional models for predictive simulations of modern engines are an example of multi-physics and multi-scale mathematical models, since lots of thermofluiddynamic processes in complex geometrical configurations have to be considered. Typical models involve different submodels, including turbulence, spray and combustion models, with different characteristic time scales. The predictive capability of the complete models depends on the accuracy of the submodels as well as on the reliability of the numerical solution algorithms. In this work we propose a multi-solver approach for reliable and efficient solution of the stiff Ordinary Differential Equation (ODE) systems arising from detailed chemical reaction mechanisms for combustion modeling. Main aim was to obtain high-performance parallel solution of combustion submodels in the overall procedure for simulation of engines on distributed heterogeneous computing platforms. To this aim we interfaced our solver with the CHEMKIN-II package and the KIVA3V-II code and carried out multi-computer simulations of realistic engines. Numerical experiments devoted to test reliability of the simulation results and efficiency of the distributed combustion solver are presented and discussed

Verification of examination procedures in clinical laboratory for imprecision, trueness and diagnostic accuracy according to ISO 15189:2012: a pragmatic approach

Background The International Standard ISO 15189 is recognized as a valuable guide in ensuring high quality clinical laboratory services and promoting the harmonization of accreditation programmes in laboratory medicine. Examination procedures must be verified in order to guarantee that their performance characteristics are congruent with the intended scope of the test. The aim of the present study was to propose a practice model for implementing procedures employed for the verification of validated examination procedures already used for at least 2 years in our laboratory, in agreement with the ISO 15189 requirement at the Section 5.5.1.2. Methods In order to identify the operative procedure to be used, approved documents were identified, together with the definition of performance characteristics to be evaluated for the different methods; the examination procedures used in laboratory were analyzed and checked for performance specifications reported by manufacturers. Then, operative flow charts were identified to compare the laboratory performance characteristics with those declared by manufacturers. Results The choice of performance characteristics for verification was based on approved documents used as guidance, and the specific purpose tests undertaken, a consideration being made of: imprecision and trueness for quantitative methods; diagnostic accuracy for qualitative methods; imprecision together with diagnostic accuracy for semi-quantitative methods. Conclusions The described approach, balancing technological possibilities, risks and costs and assuring the compliance of the fundamental component of result accuracy, appears promising as an easily applicable and flexible procedure helping laboratories to comply with the ISO 15189 requirements

Advanced numerical treatment of an accurate SPH method

The summation of Gaussian kernel functions is an expensive operation frequently encountered in scientific simulation algorithms and several methods have been already proposed to reduce its computational cost. In this work, the Improved Fast Gauss Transform (IFGT) [1] is properly applied to the Smoothed Particle Hydrodynamics (SPH) method [2] in order to speed up its efficiency. A modified version of the SPH method is considered in order to overcome the loss of accuracy of the standard formulation [3]. A suitable use of the IFGT allows us to reduce the computational effort while tuning the desired accuracy into the SPH framework. This technique, coupled with an algorithmic design for exploiting the performance of Graphics Processing Units (GPUs), makes the procedure promising as shown by preliminary numerical simulations

Bronchiolitis. Analysis of 10 consecutive epidemic seasons

Bronchiolitis is the leading cause of hospitalization in infants under 12 months. Our aims were to analyze epidemiological characteristics of infants with bronchiolitis over 10 consecutive seasons and to evaluate whether there are any clinical differences between infants hospitalized for bronchiolitis during epidemic peak months and infants in non-peak months. We enrolled consecutive enrolled 723 previously healthy term infants hospitalized at the Paediatric Emergency Department, "Sapienza" University of Rome over the period 2004-2014. Fourteen respiratory viruses were detected from nasopharyngeal aspirates by molecular methods. Clinical and demographic data were extracted from clinical charts. Viruses were detected in 351 infants (48.5%): RSV in 234 (32.4%), RV in 44 (6.1%), hBoV in 11 (1.5%), hMPV in 12 (1.6%), co-infections in 39 (5.4%), and other viruses in 11 (1.5%). Analyzing the 10 epidemic seasons, we found higher incidence for bronchiolitis every 4 years with a peak during the months December-January. Infants hospitalized during peak months had lower family history for asthma (P = 0.003), more smoking mothers during pregnancy (P = 0.036), were slightly higher breastfed (0.056), had lower number of blood eosinophils (P = 0.015) and had a higher clinical severity score (P = 0.017). RSV was detected mostly during peak months, while RV was equally distributed during the seasons. We found some variations in bronchiolitis incidence during epidemics, and discriminative characteristics in infants hospitalized for bronchiolitis during peak months and in non-peak months, that might reflect two different populations of children. Pediatr Pulmonol. 2016; 9999:XX-XX. © 2016 Wiley Periodicals, Inc

Performance criteria and quality indicators for the post-analytical phase

Background: Quality indicators (QIs) used as performance measurements are an effective tool in accurately estimating quality, identifying problems that may need to be addressed, and monitoring the processes over time. In Laboratory Medicine, QIs should cover all steps of the testing process, as error studies have confirmed that most errors occur in the pre- and post-analytical phase of testing. Aim of the present study is to provide preliminary results on QIs and related performance criteria in the post-analytical phase. Methods: This work was conducted according to a previously described study design based on the voluntary -participation of clinical laboratories in the project on QIs of the Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). Results: Overall, data collected highlighted an improvement or stability in performances over time for all reported indicators thus demonstrating that the use of QIs is-effective in the quality improvement strategy. Moreover, QIs data are an important source for defining the state-of- the-art concerning the error rate in the total testing process. The definition of performance specifications based on the state-of-the-art, as suggested by consensus documents, is a valuable benchmark point in evaluating the performance of each laboratory. Conclusions: Laboratory tests play a relevant role in the monitoring and evaluation of the efficacy of patient outcome thus assisting clinicians in decision-making. Laboratory performance evaluation is therefore crucial to providing patients with safe, effective and efficient care