Contemporary Laboratory Research Articles

Impact of Internet on Cytology Information Management.

Internet technologies and services impose global information standards in the sphere of healthcare as a whole, which are then implied and applied in the domain of cytology laboratories. Web-based operations form a significant operating segment of any contemporary cytology laboratory as they enable operations by the use of technology, which is usually free of the restrictions imposed by the traditional way of business (geographic area and narrow localisation of activities). In their operations, almost all healthcare organisations currently create and use electronic data anddocuments, which can originate both inside and outside the organisation. An enormous amount of information thus used and exchanged may be processed timely and in a high-quality way only by integrated information systems, given three basic safety requirements: data confidentiality, integrity and availability. In the Republic of Croatia, integration of private and public healthcare information systems has been ongoing for several years but the private healthcare does not yet operate as an integrated system. Instead, each office operates using its own separate information system, i.e. This paper elaborates the argument that the sample private cytology laboratory possesses an IT system that meets current market and stakeholder needs of the healthcare sector in Croatia, given that private doctors' offices/polyclinics use IT technologies in their operations but make only partial use of Internet capacities in the segment of communication with their business associates and patients, implying the need to continue the research on a statistically relevant sample of EU countries.

The Thing about Replicas—Why Historic Replicas Matter

Reproduction of archaeological material was a significant and serious enterprise for antiquarians and museums in the long nineteenth century. Replicas embed many stories and embody considerable past human energy. Behind their creation, circulation, use, and after-life lies a series of specific social networks and relationships that determined why, when, and in what circumstances they were valued, or not. Summarising the context of their production, circulation, and changing fortunes, this article introduces the ways in which replicas are important, and considers the specific benefits and aspects of a biographical approach to their study. Beyond the evidential, the study of existing replicas provides a historical and contemporary laboratory in which to explore the concepts of value and authenticity, and their application in cultural heritage and collections management, offering us a richer insight into the history of ourselves as archaeologists and curators.

When does the test-study-test sequence optimize learning and retention?

In educational learning contexts, unlike typical contemporary laboratory paradigms, students have repeated opportunities to study and learn target material, thereby potentially allowing different sequences of testing and studying. We investigated learning and retention after several plausible sequences that were patterned on a classic memory paradigm. After initially reading a research methods text, 2 days later in 1 condition participants repeatedly restudied the material 3 times (SSS), in another condition they engaged in a test-restudy-test sequence (TST), and in a third condition participants repeatedly tested on the studied material (3 times: TTT). Participants received a final test 5 days later. In Experiment 1, both TST and TTT produced better final performance than did SSS; however, TST was not better than TTT. In Experiment 2 the TST condition was altered so that after the first test, correct/incorrect feedback was provided and the test and feedback were available during the study phase. With this protocol, TST produced better learning and retention than did TTT or SSS. These findings suggest possible critical aspects regarding test feedback and the availability of previous tests for helping students to optimize their restudy efforts after low- or no-stakes quizzes.

The use of force-plate posturography in the assessment of postural instability

Force-plate posturography is a simple method that is commonly used in the contemporary laboratory and clinic to assess postural control. Despite the obvious advantages and popularity of the method, universal standards for posturographic tests have not been developed thus far: most postural assessments are based on the standard spatiotemporal metrics of the center-of-foot pressure (COP) recorded during quiet stance. Unfortunately, the standard COP characteristics are strongly dependent on individual experimental design and are susceptible to distortions such as the noise of signal digitalization, which often makes the results from different laboratories incomparable and unreliable. The COP trajectories were recorded in subjects standing still, with eyes open (EO) and then, with eyes closed (EC). The 168 subjects were divided into 3 experimental groups: young adults, older adults, and patients with Parkinson's disease. Three novel output measures: the sway directional index (DI), the sway ratio (SR), and the sway vector (SV) were applied to assess the postural stability in the experimental groups. The controlled variables: age, pathology, and visual conditions, uniquely affected the output measures. The basic attributes of the SV: its reference position, magnitude, and azimuth, provided a unique set of descriptors for postural control that allowed me unambiguously to differentiate the decline in postural stability caused by natural ageing and Parkinson's disease. As shown in previous investigations, the SV attributes, when optimally filtered with a low-pass filter, were highly independent of the trial length and the sampling frequency, and were unaffected by the sampling noise. In conclusion, the SV may be recommended as the useful standard in static posturography.

Molecular identification of P2X receptors in vascular smooth muscle cells from rat anterior, posterior, and basilar arteries.

Purinergic P2X receptors in vascular smooth muscle cells (VSMCs) play an important role in physiological stimulatory responses to the extracellularly released ATP. The aim of this work was to identify molecular P2X receptor subunits in VSMCs isolated from rat anterior, posterior and basilar arteries using a number of contemporary laboratory techniques. P2X mediated ionic currents were recorded using amphotericin B perforated patch clamp method. Gene expression analysis was performed using RT-PCR in manually collected VSMCs. The expression of proteins was confirmed by fluorescent immunocytochemistry. Under voltage clamp conditions VSMCs stimulated by application of 10 μmol/l selective P2X receptor agonist αβ-meATP, the biphasic currents consisting of rapidly rising rapidly desensitizing and slowly desensitizing components were observed in freshly isolated myocytes from all three arteries. Using RT-PCR, the expression of genes encoding only P2X1 and P2X4 receptor subunits was detected in preparations from all three arteries. The expression of corresponding P2X1 and P2X4 receptor subunit proteins was confirmed in isolated VSMCs. Our work therefore identified that in major arteries of rat cerebral circulation VSMCs express only P2X1 and P2X4 receptors subunits. We can propose that these P2X receptor subunits participate in functional P2X receptor structures mediating ATP-evoked stimulatory responses in cerebral vascular myocytes in vivo.

Understanding Bland Altman analysis

In a contemporary clinical laboratory it is very common to have to assess the agreement between two quantitative methods of measurement. The correct statistical approach to assess this degree of agreement is not obvious. Correlation and regression studies are frequently proposed. However, correlation studies the relationship between one variable and another, not the differences, and it is not recommended as a method for assessing the comparability between methods. In 1983 Altman and Bland (B&A) proposed an alternative analysis, based on the quantification of the agreement between two quantitative measurements by studying the mean difference and constructing limits of agreement. The B&A plot analysis is a simple way to evaluate a bias between the mean differences, and to estimate an agreement interval, within which 95% of the differences of the second method, compared to the first one, fall. Data can be analyzed both as unit differences plot and as percentage differences plot. The B&A plot method only defines the intervals of agreements, it does not say whether those limits are acceptable or not. Acceptable limits must be defined a priori, based on clinical necessity, biological considerations or other goals. The aim of this article is to provide guidance on the use and interpretation of Bland Altman analysis in method comparison studies.

Using ATP-driven bioluminescence assay to monitor microbial safety in a contemporary human cadaver laboratory.

The objective of this study was to utilize a cost-effective method for assessing the levels of bacterial, yeast, and mold activity during a human dissection laboratory course. Nowadays, compliance with safety regulations is policed by institutions at higher standards than ever before. Fear of acquiring an unknown infection is one of the top concerns of professional healthcare students, and it provokes anti-laboratory anxiety. Human cadavers are not routinely tested for bacteria and viruses prior to embalming. Human anatomy dissecting rooms that house embalmed cadavers are normally cleaned after the dissected cadavers have been removed. There is no evidence that investigators have ever assessed bacterial and fungal activities using adenosine triphosphate (ATP)-driven bioluminescence assays. A literature search was conducted on texts, journals, and websites regarding bacterial, yeast, and mold activities in an active cadaver laboratory. Midway into a clinical anatomy course, ATP bioluminescence assays were used to swab various sites within the dissection room, including entrance and exiting door handles, water taps, cadaver tables, counter tops, imaging material, X-ray box switches, and the cadaver surfaces. The results demonstrated very low activities on cadaver tables, washing up areas, and exiting door handles. There was low activity on counter tops and X-ray boxes. There was medium activity on the entrance door handles. These findings suggest an inexpensive and accurate method for monitoring safety compliance and microbial activity. Students can feel confident and safe in the environment in which they work.

Clinical microbiology informatics.

The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future.

Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care

To consider how staffing requirements have changed with evolving and increasingly more complex assisted reproduction technology (ART) laboratory practice. Analysis by four laboratory directors from three different ART programs of the level of complexity and time requirements for contemporary ART laboratory activities to determine adequate staffing levels. University-based and private ART programs. None. None. Human resource requirements for ART procedures. Both complexity and time required for completion of a contemporary ART cycle have increased significantly compared with the same requirements for the "traditional cycle" of the past. The latter required roughly 9 personnel hours, but a contemporary cycle can require up to 20hours for completion. Consistent with this increase, a quantitative analysis shows that the number of embryologists required for safe and efficient operation of the ART laboratory has also increased. This number depends on not only the volume but also the types of procedures performed: the higher the number of complex procedures, the more personnel required. An interactive Personnel Calculator is introduced that can help determine staffing needs. The increased complexity of the contemporary ART laboratory requires a new look at the allocation of human resources. Our work provides laboratory directors with a practical, individualized tool to determine their staffing requirements with a view to increasing the safety and efficiency of operations. The work could serve as the basis for revision of the 2008 American Society for Reproductive Medicine (ASRM) staffing guidelines.

MODERN APPROACHES TO LABORATORY DIAGNOSIS OF RICKETTSIAL DISEASES

Abstract. We present a concise review of contemporary laboratory methods for diagnosis of rickettsioses with special emphasis on diseases known in Russian Federation. Classic and emerging rickettsioses are transmitted by a diverse and expanding group of arthropod vectors including ticks, fleas, lice and mites. While epidemiological and clinical clues can provide information important for initial suspicion of rickettsial infection, sensitive and specific laboratory methods are necessary for providing probable or confirmed diagnosis of the rickettsial infection. Accurate and rapid confirmation of rickettsial infection is important for ensuring proper clinical care and prompt initiation of antibiotic therapy. Correct identification of the etiology of rickettsial diseases is also important for early identification of clustered cases, novel foci of infections, and for timely initiation of public health responses to these potentially fatal infections.

Bivalirudin Use and One‐Month Outcome in the Context of Contemporary Antiplatelet Treatment: Insights from the Greek Antiplatelet Registry

Little is known about the use of bivalirudin in "real life". In the context of contemporary antiplatelet treatment, we aimed to assess bivalirudin treatment patterns and short-term (one-month) outcome. Greek Antiplatelet Registry (GRAPE) is a prospective, observational, multicenter cohort study of consecutive, moderate-to-high-risk acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI). We assessed bivalirudin treatment patterns and predictive factors for its use. Combined in-hospital and one-month major adverse cardiovascular events (MACE, including death, myocardial infarction, urgent revascularization, and stroke), and bleeding events according to Bleeding Academic Research Consortium (BARC) criteria were analyzed after propensity matching. Of 2047 registered patients, 480 (23.4%) were treated with bivalirudin. Multivariate analysis (C statistic 0.77, 0.75-0.80 95% CIs, P < 0.001) revealed as factors favoring bivalirudin use primary PCI, radial arterial access, presentation with positive biomarkers and use of novel P2Y12 inhibitor, whereas IIb/IIIa inhibitor administration did not. Regional trends also affected bivalirudin's choice. In 370 propensity-matched pairs of patients who received or not bivalirudin, MACE, BARC type 1, 2 and 3 did not differ between groups: 4.1%, 21.9%, 3.2%, 3.5% and 5.1%, 18.9%, 2.7%, 4.3%, respectively, P = nonsignificant for all. In a "real life", contemporary antiplatelet treatment registry, clinical, laboratory and logistic factors affect bivalirudin's choice, while there are no differences in one-month outcome between bivalirudin-treated and non-bivalirudin-treated patients.

Role of Uremic Compounds in Organ Injury

All substances with molecular weights up to 58 kDa retained in the blood as the results of renal dysfunction are potential uremic toxins. The search for endogenous toxic compounds seems to offer a novel approach to identifying and explaining any so far unexplored specific effects on the body organs and systems. In contemporary laboratory diagnostics there are no suitable markers for use in comprehensive evaluation of complex toxicity of uremic compounds accumulated in successive stages of developing renal dysfunction. To provide a sound basis for treatments which would effectively protect against or slow down multiple organ injury caused by uremic toxins novel parameters are needed, more specific than urea and creatinine. Identification of reliable biomarkers or their panels needs careful consideration of their concentrations in biological materials, biological activity and usefulness for effective diagnosis. Classification of uremic compounds, based on their chemical properties, role in pathophysiological processes and the organs where they are formed remains to be elucidated with meticulous observation of clearly formulated rules guiding the process.

Multimodality imaging in the cardiac catheterization laboratory: a new era in sight

Multimodality imaging in the cardiac catheterization lab continues to develop with rapid advancements in the use of intracardiac echocardiography, 3D and multidetector computed tomography with fluoroscopic overlay to produce 3D images of intracardiac structures. The improvement in these imaging tools have coincided with innovation and procedural advancement in the field of interventional cardiology, especially with regard to structural and valvular cardiac interventions. As advances in transcatheter interventions continue and the availability of these procedures become more commonplace, an understanding of the various imaging modalities used in the interventional catheterization laboratory is important for practicing clinicians. In this article, we will discuss applications of the commonly used multimodality imaging resources in the contemporary cardiac catheterization laboratory, including 3D echocardiography, intracardiac echocardiography and CT:fluoroscopy overlay.

The World's Most Popular Assay? A Review of the Ninhydrin-Based Free Amino Nitrogen Reaction (FAN Assay) Emphasizing the Development of Newer Methods and Conditions for Testing Alcoholic Beverages

This review covers what is, arguably, the world's most widely used food industry-related assay, the ninhydrin reaction, for the determination of the free amino nitrogen content of biological materials, including beverages and foods. This assay, for application to beer and wine samples, was adapted for use in a multi-well format and demonstrated the potential to scale down and run more multi-well tests in brewing quality control testing laboratories. Scaling down brewery laboratory tests reduces demands for expensive reagents, limits waste, and makes for simpler, less expensive disposal, while also giving a faster turnaround of results for many assays. In redefining the ninhydrin free amino nitrogen assay for use with modern instruments, we rediscovered the most efficient reagents and optimal conditions for application of this test in the contemporary brewing laboratory. Six critical parameters for ninhydrin reactions (buffer composition, incubation time, temperature, pH, assay volume, and reducing agent) have been reassessed with a new microwell assay combining all of them, now providing high precision and sensitivity. Finally, new reduced volume and microwell-based FAN assay formats should prove useful to many brewing, enology, distilling, and food laboratories for the routine determination of free or total useable nitrogen, and for further refinement and optimization of this important assay.

2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker: The ADAPT Trial

The purpose of this study was to determine whether a new accelerated diagnostic protocol (ADP) for possible cardiac chest pain could identify low-risk patients suitable for early discharge (with follow-up shortly after discharge). Patients presenting with possible acute coronary syndrome (ACS), who have a low short-term risk of adverse cardiac events may be suitable for early discharge and shorter hospital stays. This prospective observational study tested an ADP that included pre-test probability scoring by the Thrombolysis In Myocardial Infarction (TIMI) score, electrocardiography, and 0 + 2 h values of laboratory troponin I as the sole biomarker. Patients presenting with chest pain due to suspected ACS were included. The primary endpoint was major adverse cardiac event (MACE) within 30 days. Of 1,975 patients, 302 (15.3%) had a MACE. The ADP classified 392 patients (20%) as low risk. One (0.25%) of these patients had a MACE, giving the ADP a sensitivity of 99.7% (95% confidence interval [CI]: 98.1% to 99.9%), negative predictive value of 99.7% (95% CI: 98.6% to 100.0%), specificity of 23.4% (95% CI: 21.4% to 25.4%), and positive predictive value of 19.0% (95% CI: 17.2% to 21.0%). Many ADP negative patients had further investigations (74.1%), and therapeutic (18.3%) or procedural (2.0%) interventions during the initial hospital attendance and/or 30-day follow-up. Using the ADP, a large group of patients was successfully identified as at low short-term risk of a MACE and therefore suitable for rapid discharge from the emergency department with early follow-up. This approach could decrease the observation period required for some patients with chest pain. (An observational study of the diagnostic utility of an accelerated diagnostic protocol using contemporary central laboratory cardiac troponin in the assessment of patients presenting to two Australasian hospitals with chest pain of possible cardiac origin; ACTRN12611001069943).

Current Perspectives on Coronary Chronic Total Occlusions: The Canadian Multicenter Chronic Total Occlusions Registry

The purpose of this study was to determine the prevalence, clinical characteristics, and management of coronary chronic total occlusions (CTOs) in current practice. There is little evidence in contemporary literature concerning the prevalence, clinical characteristics, and treatment decisions regarding patients who have coronary CTOs identified during coronary angiography. Consecutive patients undergoing nonurgent coronary angiography with CTO were prospectively identified at 3 Canadian sites from April 2008 to July 2009. Patients with previous coronary artery bypass graft surgery or presenting with acute ST-segment elevation myocardial infarction were excluded. Detailed baseline clinical, angiographic, electrocardiographic, and revascularization data were collected. Chronic total occlusions were identified in 1,697 (18.4%) patients with significant coronary artery disease (>50% stenosis in ≥1 coronary artery) who were undergoing nonemergent angiography. Previous history of myocardial infarction was documented in 40% of study patients, with electrocardiographic evidence of Q waves corresponding to the CTO artery territory in only 26% of cases. Left ventricular function was normal in >50% of patients with CTO. Half the CTOs were located in the right coronary artery. Almost half the patients with CTO were treated medically, and 25% underwent coronary artery bypass graft surgery (CTO bypassed in 88%). Percutaneous coronary intervention was done in 30% of patients, although CTO lesions were attempted in only 10% (with 70% success rate). Chronic total occlusions are common in contemporary catheterization laboratory practice. Prospective studies are needed to ascertain the benefits of treatment strategies of these complex patients.

Study of elastic mechanical and physicochemical properties of refractory objects with the aim of predicting the endurance of a nonferrous metallurgy unit lining

The construction of contemporary laboratory units, procedures for studying the elastic mechanical and physicochemical properties of different composition, both original, and impregnated with molten slag-matte of copper composition are developed with the aim of determining nonferrous metallurgy unit lining endurance,. The procedures developed using new laboratory devices making it possible to predict nonferrous metallurgy unit lining endurance with sufficient accuracy. On the basis of studies using the new procedures combined highly resistant linings are created and introduced for horizontal converters and aWaelz kiln for a number of nonferrous metallurgy enterprises.

Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected children and infants in northern Tanzania.

To describe the contribution of paediatric HIV and of HIV co-infections to admissions to a hospital in Moshi, Tanzania, using contemporary laboratory methods. During 1 year, we enrolled consecutively admitted patients aged ≥2 months and <13 years with current or recent fever. All patients underwent standardized clinical history taking, a physical examination and HIV antibody testing; standard aerobic blood cultures and malaria film were also done, and hospital outcome was recorded. Early infant HIV diagnosis by HIV-1 RNA PCR was performed on those aged <18 months. HIV-infected patients also received serum cryptococcal antigen testing and had their CD4-positive T-lymphocyte count and percent determined. A total of 467 patients were enrolled whose median age was 2 years (range 2 months-13 years); Of those patients, 57.2% were female and 12.2% were HIV-infected. Admission clinical diagnosis of HIV disease was made in 10.7% and of malaria in 60.4%. Of blood cultures, 5.8% grew pathogens; of these 25.9% were Salmonella enterica (including 6 Salmonella Typhi) and 22.2%Streptococcus pneumoniae. Plasmodium falciparum was identified on blood film of 1.3%. HIV infection was associated with S. pneumoniae (odds ratio 25.7, 95% CI 2.8, 234.0) bloodstream infection (BSI), but there was no evidence of an association with Escherichia coli or P. falciparum; Salmonella Typhi BSI occurred only among HIV-uninfected participants. The sensitivity and specificity of an admission clinical diagnosis of malaria were 100% and 40.3%; and for an admission diagnosis of bloodstream infection, they were 9.1% and 86.4%, respectively. Streptococcus pneumoniae is a leading cause of bloodstream infection among paediatric admissions in Tanzania and is closely associated with HIV infection. Malaria was over-diagnosed clinically, whereas invasive bacterial disease was underestimated. HIV and HIV co-infections contribute to a substantial proportion of paediatric febrile admissions, underscoring the value of routine HIV testing.

Present at the beginning: a personal reminiscence on the history of teriparatide

The ability of parathyroid glandular extracts to stimulate bone acquisition in rodents was established in the 1920s, but interest in this action lay dormant for almost 50years until application of contemporary laboratory methods permitted the large-scale production of an amino-terminal fragment of PTH, (1-34) hPTH (teriparatide), which was capable of carrying out all known actions of the full-length (1-84) PTH molecule. In the 1970s, largely stimulated by the efforts of a British pharmacologist, Dr. John Parsons, the scientific community began to revisit these anabolic actions and showed that single daily injections of teriparatide dramatically increased bone mass in several mammalian species and restored bone in oöphorectomized rats. Shortly thereafter, human studies confirmed a striking increase in trabecular bone mass and showed also that an important part of teriparatide's action is to increase cortical bone. Eli Lilly and Company conducted a formal registration trial in postmenopausal women with osteoporosis. The unexpected occurrence of osteosarcomas in Fisher 344 rats treated long-term with teriparatide provoked an abrupt cessation of that trial, but ambiguity concerning the relevance of this rat finding to human disease, combined with significant anti-fracture efficacy, led to FDA approval of teriparatide for men and postmenopausal women with osteoporosis "at high risk for fracture" in 2002. Subsequently, teriparatide has been approved also for treatment of patients with glucocorticoid-associated osteoporosis, and papers indicating utility of this agent for dental and orthopedic applications have begun to appear.

P01-117 - Xenontherapy of withdrawal syndrom among the patients with opioid dependence

Development of safe and efficient methods of opioid withdrawal syndrome treatment is a problem of addiction psychiatry. The search for new methods is influenced by the fact that the withdrawl state is complicated by severe psycho-vegetative dysfunction, pain, consistent insomnia, absence of response to psychopharmacological treatment and frequent co-morbidity with HBV/HCV.The objective of this research was to study the effects of the inert gas - Xenon - on the psychopathological and psycho-vegetative symptoms of withdrawal and post-withdrawal states among patients with opioid dependency.The aims of the research were as follows: to develop a new medical technology in the treatment of opioid withdrawal and post-withdrawal states with an account of the severity of their course, to develop clinical-laboratory differential predictors of efficacy of the treatment. From 2001 till 2006 a complex examination and treatment of 208 patients who suffered from opioid withdrawal state were conducted. The standard treatment was complemented with the use of Xenon in the intensive care wards of the Clinic of Drug Addiction №17, Moscow. An assessment of the therapeutic efficacy was based on the dynamic use of contemporary clinical, laboratory, psychological and statistical methods.Results showed that supplementing the standard treatment with the use of Xenon led to the quickest reduction of the diver symptoms of opioid withdrawal and post-withdrawal states. It was proved that Xenon, as an antagonist of NMDA-receptors, provides a strong painkilling and neuroprotective effect and ultimatly stabilizes dysfunction of the vegetative system due to the suppression of catecholamine producing.