Best Practices for LOINC@ Mapping and Maintenance

The purpose of this action research project was to assess the current clinical laboratory industry perception of Logical Observation Identifiers Names and Codes (LOINC) and if best practices exist for the mapping and maintenance of them. A literature review was conducted, beginning with the creation of the LOINC nomenclature in 1994 through the current studies detailing recommended best practices and standards that are necessary to ensure success of clinical laboratory result interoperability. An original, qualitative survey was created emailed to 7,303 Iaboratorians, of whom 206 responded. The results of the survey reinforce the researcher\u27s perception of the implementation and maintenance of LOINC within the clinical laboratory and strongly depict the need for industry guidance regarding LOINC implernentation and maintenance. Recommendations and best practices for initial LOINC mappings and twice-yearly maintenance are documented, inclusive of suggestions regarding the organization[sJ that should hold primary responsibility for each proposition

Assess program: Interactive data management systems for airborne research

Two data systems were developed for use in airborne research. Both have distributed intelligence and are programmed for interactive support among computers and with human operators. The C-141 system (ADAMS) performs flight planning and telescope control functions in addition to its primary role of data acquisition; the CV-990 system (ADDAS) performs data management functions in support of many research experiments operating concurrently. Each system is arranged for maximum reliability in the first priority function, precision data acquisition

Modelling and filtering almost periodic signals by time-varying fourier series with application to near-infrared spectroscopy

We propose a new approach to modelling almost periodic signals and to model-based estimation of such signals from noisy observations. The signal model is based on Fourier series where both the coefficients and the fundamental frequency can continuously change over time. This signal model can be represented by a factor graph which we use to derive message passing algorithms to estimate the time-dependent model parameters from the observed samples

Dielectric behavior of Copper Tantalum Oxide

A thorough investigation of the dielectric properties of Cu2Ta4O12, a material crystallizing in a pseudo-cubic, perovskite-derived structure is presented. We measured the dielectric constant and conductivity of single crystals in an exceptionally broad frequency range up to GHz frequencies and at temperatures from 25 - 500 K. The detected dielectric constant is unusually high (reaching values up to 105) and almost constant in a broad frequency and temperature range. Cu2Ta4O12 possesses a crystal structure similar to CaCu3Ti4O12, the compound for which such an unusually high dielectric constant was first observed. An analysis of the results using a simple equivalent circuit and measurements with different types of contact revealed that extrinsic interfacial polarization effects, derived from surface barrier capacitors are the origin of the observed giant dielectric constants. The intrinsic properties of Cu2Ta4O12 are characterized by a (still relatively high) dielectric constant in the order of 100 and by charge transport via hopping conduction of Anderson-localized charge carriers.Comment: 18 pages, 6 figures, submitted to Jouranl of Physical Chemestr

Improving the spiritual dimension of whole person care: Reaching national and international consensus

Two conferences, Creating More Compassionate Systems of Care (November 2012) and On Improving the Spiritual Dimension of Whole Person Care: The Transformational Role of Compassion, Love and Forgiveness in Health Care (January 2013), were convened with the goals of reaching consensus on approaches to the integration of spirituality into health care structures at all levels and development of strategies to create more compassionate systems of care. The conferences built on the work of a 2009 consensus conference, Improving the Quality of Spiritual Care as a Dimension of Palliative Care. Conference organizers in 2012 and 2013 aimed to identify consensus-derived care standards and recommendations for implementing them by building and expanding on the 2009 conference model of interprofessional spiritual care and its recommendations for palliative care. The 2013 conference built on the 2012 conference to produce a set of standards and recommended strategies for integrating spiritual care across the entire health care continuum, not just palliative care. Deliberations were based on evidence that spiritual care is a fundamental component of high-quality compassionate health care and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers

Accuracy of Plasma B-Type Natriuretic Peptide to Diagnose Significant Cardiovascular Disease in Children The Better Not Pout Children! Study

ObjectivesThe purpose of this study was to assess the ability of plasma B-type natriuretic peptide (BNP) to diagnose significant cardiovascular disease (CVD) in the pediatric population.BackgroundBNP has been shown to be reliable in detecting ventricular dysfunction and heart failure in adults. Timely and accurate identification of significant pediatric heart disease is important but challenging. A simple blood test could aid the front-line physician in this task.MethodsSubjects without a history of heart disease with findings possibly attributable to significant CVD in the acute care setting requiring a cardiology consult were enrolled. Clinicians were blinded to the BNP result, and confirmation of disease was made by cardiology consultation.ResultsSubjects were divided into a neonatal (n = 42, 0 to 7 days) and older age group (n = 58, >7 days to 19 years). CVD was present in 74% of neonates and 53% of the older age group. In neonates with disease, median BNP was 526 pg/ml versus 96 pg/ml (p < 0.001) for those without disease. In older children with disease, median BNP was 122 pg/ml versus 22 pg/ml in those without disease (p < 0.001). Subjects with disease from an anatomic defect, a longer hospital stay, or who died had higher BNP. A BNP of 170 pg/ml yielded a sensitivity of 94% and specificity of 73% in the neonatal group and 87% and 70% in the older age group, respectively, using a BNP of 41 pg/ml.ConclusionsBNP is a reliable test to diagnose significant structural or functional CVD in children. Optimal cutoff values are different from adult values

Laboratory Diagnosis of Mycobacterial Infections: New Tools and Lessons Learned

Even in the 21st century, tuberculosis continues to be a problem. Although the number of cases continues gradually to decrease in the United States, cases get more difficult to treat, specifically those that are multiple-drug resistant. Infection of one-third of the world's population ensures that tuberculosis will not disappear in the near future. In light of this, it will be useful to know the goals for the health care system and how these goals may be accomplished. Laboratory testing in the mycobacteriology field is experiencing more changes today than ever before. Determining what assays will be most useful to the clinician is a challenge, and acceptance of the new technology by the medical community an even greater one. Clinicians must use the best available resources to determine the most appropriate care for their patients and work together with the laboratory to ensure that the communication channels are open. This review focuses on current state-of-the-art resources useful for accurate and rapid laboratory diagnosis of mycobacterial infection

Diagnostic methods to determine microbiology of postpartum endometritis in South Asia: laboratory methods protocol used in the Postpartum Sepsis Study: A prospective cohort study

Background: The South Asian region has the second highest risk of maternal death in the world. To prevent maternal deaths due to sepsis and to decrease the maternal mortality ratio as per the World Health Organization Millenium Development Goals, a better understanding of the etiology of endometritis and related sepsis is required. We describe microbiological laboratory methods used in the maternal Postpartum Sepsis Study, which was conducted in Bangladesh and Pakistan, two populous countries in South Asia.Methods/Design: Postpartum maternal fever in the community was evaluated by a physician and blood and urine were collected for routine analysis and culture. If endometritis was suspected, an endometrial brush sample was collected in the hospital for aerobic and anaerobic culture and molecular detection of bacterial etiologic agents (previously identified and/or plausible).Discussion: The results emanating from this study will provide microbiologic evidence of the etiology and susceptibility pattern of agents recovered from patients with postpartum fever in South Asia, data critical for the development of evidence-based algorithms for management of postpartum fever in the region

Unsuspected Dengue as a Cause of Acute Febrile Illness in Children and Adults in Western Nicaragua

Dengue is an emerging infectious disease of global significance. Suspected dengue, especially in children in Nicaragua’s heavily-urbanized capital of Managua, has been well documented, but unsuspected dengue among children and adults with undifferentitated fever has not