Does routine repeat testing of critical laboratory values improve their accuracy?

Background: Routine repeat testing of critical laboratory values is very common these days to increase their accuracy and to avoid reporting false or infeasible results. We figure that repeat testing of critical laboratory values has any benefits or not. Methods: We examined 2233 repeated critical laboratory values in 13 different hematology and chemistry tests including: hemoglobin, white blood cell, platelet, international normalized ratio, partial thromboplastin time, glucose, potassium, sodium, phosphorus, magnesium, calcium, total bilirubin and direct bilirubin. The absolute difference and the percentage of change between the two tests for each critical value were calculated and then compared with the College of American Pathologists/Clinical Laboratory Improvement Amendments allowable error. Results: Repeat testing yielded results that were within the allowable error on 2213 of 2233 specimens (99.1). There was only one outlier (0.2) in the white blood cell test category, 9 (2.9) in the platelet test category, 5 (4) in the partial thromboplastin time test category, 5 (4.8) in the international normalized ratio test category and none in other test categories. Conclusion: Routine, repeat testing of critical hemoglobin, white blood cell, platelet, international normalized ratio, partial thromboplastin time, glucose, potassium, sodium, phosphorus, magnesium, calcium, total bilirubin and direct bilirubin results does not have any benefits to increase their accuracy

Altered hip mechanics and patellofemoral pain. A review of literature

Patellofemoral pain (PFP) is a common knee disorder in orthopedic clinics. In the last decade, several investigations have considered the role of proximal factors in addition to local and distal factors in development of PFP. There is a hypothesis which suggests that impaired neuromuscular control and altered hip joint kinematic affect tibiofemoral and patellofemoral biomechanics. Hence, PFP may develop as a result. This article reviews studies assessing the relationship between altered hip mechanics and PFP. The Medline and PubMed databases were searched between January 2004 and October 2014. Two authors independently selected related articles using the same search strategy and key words. Among 149 articles, 16 met the review inclusion criteria. The study results were described in three sections: 1) kinematic studies, 2) muscle activity studies, and 3) postural stability studies. Increased hip adduction and internal rotation, gluteal muscle weakness, and neuromuscular impairment were common findings in patients with patellofemoral pain. Precise assessment of hip mechanics, including hip kinematic, muscle performance and postural stability, should be considered in the examination of patients with patellofemoral pain. © MEDSPORTPRESS

Diagnostic accuracy of fine needle aspiration cytology versus concurrent core needle biopsy in evaluation of intrathoracic lesions: A retrospective comparative study

Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. Materials and Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H&E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. Results: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5) malignant lesions and 32 (30.5) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3 (CI: 79.3-90.7) and 93.2 (CI: 87.3-96.0) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8 of cases by FNA and 80.6 by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3 compared with 50 for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3 and 6.3 for CNB and FNA, respectively. Conclusions: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role

Impact of Pollution Location on Time and Frequency Characteristics of Leakage Current of Porcelain Insulator String under Different Humidity and Contamination Severity

One of the important factors influencing outdoor insulators performance is pollution phenomenon. The pollution, especially during humidity condition, reduces superficial resistance of insulator and lead to a flow of Leakage Currents (LC) on the insulator surface, which may result in total flashover. The LC characteristics are affected by parameters such as nature and severity of pollution. Location of pollution is another parameter that can be effective. This paper presents the analysis of LC waveforms of insulator strings under different pollution location and Equivalent Salt Deposit Density (ESDD). The tests was performed on the HV porcelain suspension insulator string in which three adjacent discs of insulator string were contaminated and location of them changes along the insulator string. Besides, the effect of humidity and operating voltage on LC waveforms were investigated. Experimental data were analyzed in both time and frequency domain. Obtained results indicate that there is strong correlation between the location of pollution and LC parameters such as peak value ( ), harmonic components and Total Harmonic Distortion (THD). Also, the ratio of fifth to third harmonic component ( ) is presented as an important index that has strong relationship to the pollution location

Effect of alveolar ridge preservation with PDFDBA on orthodontic tooth movement rate, formation of gingival invagination and root resorption: A randomized, controlled pilot study

Tooth extraction results in resorptive remodeling of the alveolar bone, but alveolar ridge preservation procedure maintains the original shape of the extraction socket. This may be beneficial for space closure by orthodontic tooth movement (OTM). In the current pilot study for randomized controlled clinical trial the effect of alveolar ridge preservation with partial demineralized freezedried bone allograft (PDFDBA) on OTM rate, formation of gingival invagination and root resorption was evaluated. Both mandibular first premolars of 6 patients were extracted due to orthodontic treatment. In a split-mouth study design, alveolar ridge preservation was performed on one side, while the other side served as a control and the extraction socket healed naturally. After 6 weeks of healing period, the canines were moved to the extraction site to close the extraction space. Eight weeks later, the amount of OTM was measured. After space closure, the extraction sites were examined for the presence of gingival invagination. Root resorption was evaluated on digital panoramic radiographs. Photographs were taken for documentation. There was no significant difference in OTM rate between the ridge preserved areas and naturally healed sockets. Gingival invagination formed in 5 of 6 naturally healed sockets; none of the ridge preserved areas showed formation of gingival invagination. No root resorption was observed in any of the teeth adjacent to the extraction sites. Alveolar ridge preservation with PDFDBA has no effect on the rate of OTM and root resorption but prevents formation of gingival invagination during orthodontic space closure

COVID-19 spread in a classroom equipped with partition – A CFD approach

In this study, the motion and distribution of droplets containing coronaviruses emitted by coughing of an infected person in front of a classroom (e.g., a teacher) were investigated using CFD. A 3D turbulence model was used to simulate the airflow in the classroom, and a Lagrangian particle trajectory analysis method was used to track the droplets. The numerical model was validated and was used to study the effects of ventilation airflow speeds of 3, 5, and 7 m/s on the dispersion of droplets of different sizes. In particular, the effect of installing transparent barriers in front of the seats on reducing the average droplet concentration was examined. The results showed that using the seat partitions for individuals can prevent the infection to a certain extent. An increase in the ventilation air velocity increased the droplets’ velocities in the airflow direction, simultaneously reducing the trapping time of the droplets by solid barriers. As expected, in the absence of partitions, the closest seats to the infected person had the highest average droplet concentration (3.80 × 10−8 kg/m3 for the case of 3 m/s)

Green Synthesis of Silver Nanoparticles Using the Extract of Lonicera Nummulariifolia and Investigating Its Antioxidant, Antimicrobial and Anticancer Effects Against Lung Cancer Cell Line A549

BACKGROUND AND OBJECTIVE: Due to the increasing incidence of cancer-related deaths and the deficiencies of chemotherapy and radiotherapy in advanced forms of cancer, new approaches are needed to control cancer, and one of these techniques is the use of nanoparticles, especially silver nanoparticles. Nowadays, the use of plants for the synthesis of silver nanoparticles has attracted the attention of researchers due to their low cost. Therefore, the aim of this study was to investigate the green synthesis of silver nanoparticles using the extract of lonicera nummulariifolia and to study its antioxidant, antimicrobial and anticancer effects against lung cancer cell line A549. METHODS: In this experimental study, silver nanoparticles were synthesized using the extract of lonicera nummulariifolia as a regenerative agent. The antioxidant effects of synthesized silver nanoparticles were evaluated by DPPH assay and finally its antimicrobial and anticancer activity were respectively evaluated by Broth Microdilution and MTT assays at concentrations of 3.125, 6.25, 12.5, 25, 50, 100 μg/ml on lung cancer cell line within 24 h. FINDINGS: The results of DPPH assay showed that the synthesized silver nanoparticles at 100 µg/ml had an antioxidant effect of 33.77±0.83. Antimicrobial test results showed that the antimicrobial effects of silver nanoparticles were greater on gram negative bacteria. MTT results also showed that cell viability was 70.33±0.21 (p>0.05), 51.66±0.24 (p<0.05) 35.75±0.35 (p<0.01), 20.66±0.28 (p<0.001), 13.5±0.31 (p<0.001), and 7.6±0.37 (p<0.001), respectively. Results of DPPH assay showed that silver nanoparticles has significant antioxidant effects (p<0.05). CONCLUSION: Considering the antimicrobial and anticancer effects of synthesized silver nanoparticles, it can be used as a drug candidate

Clinical outcomes and cost effectiveness of two aftercare models provided by general physicians and nurses to patients with severe mental illness

Background: Implementing community-based psychiatric services is one of the priorities of the WHO/EMRO mental health programs. This study presents an aftercare service, as a community based-service, for patients with severe mental illness (SMIs). Methods: In this randomized controlled clinical trial design, 176 patients, who attended selective hospitals with SMI, were allocated into three groups: clinical case managers provided by general practitioners, nurses and the control group (usual treatment). The clients and their caregivers received monthly home visits (education and treatment supervision). The effectiveness of the intervention was measured by indicators of psychopathology such as scores of YOUNG, caregivers' knowledge and satisfaction with the services. Health-related quality of life (SF-36) was considered as the primary outcome variable. Data were collected at baseline and at 12 months follow-up. Direct and indirect medical costs were obtained through a periodic completion of questionnaires and interviews by care-givers. Cost effectiveness ratio was estimated as cost per QALY gained in each group. SPSS 16.0 was used in this survey and statistical methods were chi-square, ANOVA, Scheffe as post-Hoc test and paired sample t-test with 95 confidence interval and 0.05 significance level. Results: The results of our study revealed that the score of YOUNG, caregivers' knowledge and satisfaction with service were improved in both intervention groups after 12 months. Improvement in health-related quality of life was observed in the general practitioner and nurse group. The incremental cost effectiveness ratio was 5740807 IRR and 5048459 IRR per QALYs gained in the general practitioner and nurse groups, respectively. Conclusion: The model of aftercare services provided by trained nurses is the most cost- effective and feasible model for Iran's socio-economic conditions with low resource allocations

Effects of the main cereal and type of fat of the diet on productive performance and egg quality of brown egg laying hens from twenty two to fifty four weeks of age

The influence of the main cereal and supplemental fat of the diet on productive performance and egg quality was studied in 756 brown-egg laying hens from 22 to 54 weeks of age. The experiment was conducted as a completely randomized design with 9 treatments arranged factorially with 3 cereals (dented corn, soft wheat, and barley) and 3 types of fat [soy oil (SBO), acidulated soapstocks (AOS), and lard]