Pneumatic Tube Research Articles

Tissue Contamination During Transportation of Formalin-Fixed, Paraffin-Embedded Blocks.

Tissue carryovers are contaminants of surgical pathology cases in which extraneous tissue is incorporated into tissue blocks. Carryovers occur most frequently at the grossing or embedding stations, but little is published about them. We sought to analyze their transmission during transit to the histology lab. Cassettes of friable donor tissue were mixed with cassettes of spongy recipient tissue in formalin-filled containers and agitated by shipment via pneumatic tube. The tissue cassettes were processed, embedded as blocks, and cut as usual. Liquid samples were prepared from the submission containers as well as from workstation submission containers and histology tissue processor waste. A high rate of contamination (14.9%) was observed under these artificial conditions. Friable donor tissue, including urothelium and colorectal adenocarcinoma, were promiscuous contaminants, as were placental villi. Fluid from submission containers showed viable tumor cells and fragments, which were also present in workstation submission containers and in tissue processor waste fluid. This study implicates liquid transport media as a possible avenue of contamination during submission and transportation of tissue cassettes for histologic processing. Attention should be given to the friability of submitted tissue and physical agitation of the cassettes in transit. Such contaminants may be present in the fluid in tissue submission bins and in tissue processor fluid.

Investigation of the effects of pneumatic tube transport system on routine biochemistry, hematology, and coagulation tests in Ankara City Hospital.

Academics are far from a consensus regarding the effects of pneumatic tube system (PTS) delivery on sample integrity and laboratory test results. As for the reasons for conflicting opinions, each PTS is uniquely designed, sample tubes and patient characteristics differ among studies. This study aims to validate the PTS utilized in Ankara City Hospital for routine chemistry, coagulation, and hematology tests by comparing samples delivered via PTS and porter. The study comprises 50 healthy volunteers. Blood samples were drawn into three biochemistry, two coagulation, and two hemogram tubes from each participant. Each of the duplicate samples was transferred to the emergency laboratory via Swiss log PTS (aka PTS-immediately) or by a porter. The last of the biochemistry tubes were delivered via the PTS, upon completion of coagulation of the blood (aka PTS-after). The results of the analysis in these groups were compared with multiple statistical analyses. The study did not reveal any correlation between the PTS and serum hemolysis index. There were statistically significant differences in several biochemistry tests. However, none of them reached the clinical significance threshold. Basophil and large unidentified cell (LUC) tests had poor correlations (r=0.47 and r=0.60; respectively) and reached clinical significance threshold (the average percentages of bias, 10.2%, and 15.4%, respectively). The remainder of the hematology and coagulation parameters did not reach clinical significance level either. The modern PTS validated in this study is safe for sample transportation for routine chemistry, coagulation, and hematology tests frequently requested in healthy individuals except for basophil and LUC.

Hemolysis and blood gas analysis: it’s time for a change!

Modern blood gas analyzers are not able to identify hemolysis, lipemia and icterus; therefore, the aim of this study was to assess the influence of hemolysis on blood gas samples. Blood gas analysis represents an essential part in the diagnosis and treatment of critically ill patients, including those affected by the pandemic coronavirus disease 2019 (COVID-19). Hemolysis, lipemia, and icterus, are causes of clinical misinterpretation of laboratory tests. A total of 1244 blood gas specimens were collected over a one-week period from different clinical wards, including the Emergency Department, and were assessed for serum indices on Cobas C6000 CE (Roche Diagnostics, Mannheim, Germany). The prevalence of hemolysis, lipemia, and icterus were 5%, 12%, and 14%, respectively. Sample storage at room temperature, delivery to central laboratory using pneumatic tube system, as well as small sample size, strongly affected blood gas parameters (p < .01). Hemolysis led to an increase in analytical bias for pH, pO2, and potassium, and a significant decrease for pCO2, HCO3 −, sodium, and Ca2+ (p <.01). Currently, hemolysis detection systems are not yet widespread, and a rapid centrifugation of samples after blood gas analysis along with the assessment of serum indices represent the only prompt approach to identify unsuitable results, avoiding pitfalls in clinical decision-making, although it cannot be applied to the Emergency Department routine. Blood gas analyzers manufacturers and suppliers should implement automated built-in serum indices detection systems.

Effect of Residential Street Speed Limit Reduction on Driving Speeds in Portland, Oregon

This study analyzed the impacts on motor vehicle observed speeds following a residential speed limit reduction from 40.23 km/hr (25 mi/hr) to 32.19 km/hr (20 mi/hr) in Portland, OR that was accompanied by a public awareness and signage campaign. The study used before and after observations of vehicle speeds collected by pneumatic tube traffic counters. Overall, the analysis suggests that the reduction of posted speed limits to 32.19 km/h (20 mi/h) has resulted in lower observed vehicle speeds and fewer vehicles traveling at higher speeds. The reduction in the percentage of vehicles traveling above 48.28 km/h (30 mi/h) (-1.7%) and 56.33 km/h (35 mi/h) (-0.5%) are larger in magnitude than other speed metrics.

Effects of Transportation of IV Bags Containing Protein Formulations Via Hospital Pneumatic Tube System: Particle Characterization by Multiple Methods

In hospitals, often drug products in intravenous (IV) bags are transported via pneumatic tube systems (PTS). The goal of this study was to evaluate the effects of such transportation of protein products on particle formation in polyvinyl chloride (PVC) and polyolefin (PO) IV bags, containing either IV saline or dextrose. We studied intravenous immunoglobulin (IVIG) and a monoclonal antibody (mAb). Particles were quantified with flow imaging, light obscuration and nanoparticle tracking analysis. PTS transportation of IVIG caused large increases in protein particle concentrations, with much greater increases observed in saline than in dextrose. The increases were greater in IV solutions in PO than those in PVC bags. With the mAb, PTS transportation in saline caused increases in protein particle levels in PO bags, but not in PVC bags. Transportation in dextrose did not result in significant increases in mAb particle concentrations in IV bags made of either material. Overall, the results document that the PTS transportation can result in large increases in protein particles and that magnitude of these increases depends the protein itself, the bag material and the IV solution. The main conclusion is that protein products in IV solutions should not be transported in hospital PTS.

Sensing technologies for traffic flow characterization: From heterogeneous traffic perspective

Importance of detailed traffic flow characterization is immense for achieving an intelligent transportation system. As such, great efforts in existing literature have gone into proposing different solutions for traffic flow characterization. Among these, first generation intrusive sensors such as pneumatic tube, inductive loop, piezoelectric and magnetic sensors were both labor intensive and expensive to install and maintain. These sensors were able to provide only vehicle count and classification under homogeneous traffic conditions. Second generation non-intrusive sensors based solutions, though a marked improvement over intrusive sensors, have the capability to only measure vehicle count, speed and classifications. Furthermore, both intrusive and non-intrusive sensor based solutions have limitations when employed under congested and heterogeneous traffic conditions. To overcome these limitations, a compute vision based solution has been proposed for traffic flow characterization under heterogeneous traffic behaviour. The proposed solution was field tested on a complex road configuration, consisting of a two-way multi-lane road with three U-turns. Unlike both intrusive and non-intrusive sensors, the proposed solution can detect pedestrians, two/ three wheelers and animal/human driven carts. Furthermore, detailed flow parameters such as vehicle count, speed, spatial/temporal densities, trajectories and heat maps were measured.

A study on multi-axis dynamic absorber with frequency tuning function using pneumatic rubber tube springs

A multi-axial dynamic vibration absorber (DVA) with adjustable natural frequency mechanism has been developed. Air-filled rubber tubes are used as the spring and damping elements of the DVA, which support each face of the iron cubic auxiliary mass. For the rubber tube, when the internal air pressure is increased, the support stiffness is increased by expansion and pressing between the acrylic plate (which constitutes the outer frame of the DVA) and the auxiliary mass. In this way, the natural frequencies of the DVA can be adjusted by manipulating the air pressure. As a first step to realize a multi-axis DVA with frequency tuning ability, this study reports the vibration characteristics of the developed DVA when the air pressure of the supporting rubber tubes is changed uniformly.

Innovation durch Technik? Rohrpostsysteme als Medientechnologien der Verwaltung im 20. Jahrhundert

Abstract This paper deals with the role of pneumatic tube systems in public administration in the twentieth century. Based on archival sources and considering examples as different as ministries in Zagreb and Bucharest, the British military administration in the 1940s, the customs and train stations on the Swiss-Italian border as well as governmental buildings in Bonn and Bern around 1970, this article shows in what ways pneumatic mail tubes were interpreted as fostering (or not) innovation in public administration and how clerks were actually dealing with this (not always effective) communication system.

Validation of blood components transport through a pneumatic tube system

IntroductionUrgent blood component transfusions may be life-saving for patients in hemorrhagic shock. Measures to reduce the time taken to provide these transfusions, such as uncrossmatched transfusion or abbreviated testing, are available. However, transport time is still an additional delay and the use of a pneumatic tube system (PTS) may be an alternative to shorten the transport time of blood components. ObjectivesTo assess pneumatic tube system transportation of blood components based on a validation protocol. Methods: Pre- and post-transport quality control laboratory parameters, visual appearance, transport time and temperature of the packed red blood cells (RBCs), thawed fresh plasma (TFP), cryoprecipitate (CR), and platelet concentrate (PC) were evaluated. Parameters were compared between transport via pneumatic tube and courier. ResultsA total of 23 units of RBCs, 50 units of TFP, 30 units of CR and ten units of PC were evaluated. No statistically significant differences were found between pre- and post-transport laboratory results. There was also no difference in laboratory parameters between transport modalities (PTS versus courier). All blood components transported matched regulatory requirements for quality criteria. The temperature during transport remained stable and the transport time via PTS was significantly shorter than the courier's transport time (p < 0.05). ConclusionThe PTS was considered a fast, safe and reliable means of transportation for blood components, also securing quality prerequisites.

Evaluation of a Pneumatic Tube System for Delivering Nivolumab Diluted Solutions

Evaluation of a Pneumatic Tube System for Delivering Nivolumab Diluted Solutions

EDTA stabilizes the concentration of platelet-derived extracellular vesicles during blood collection and handling

Citrate is the recommended anticoagulant for studies on plasma extracellular vesicles (EVs). Because citrate incompletely blocks platelet activation and the release of platelet-derived EVs, we compared EDTA and citrate in that regard. Blood from healthy individuals (n = 7) was collected and incubated with thrombin receptor-activating peptide-6 (TRAP-6) to activate platelets, subjected to pneumatic tube transportation (n = 6), a freeze-thaw cycle (n = 10), and stored before plasma preparation (n = 6). Concentrations of EVs from platelets (CD61+), activated platelets (P-selectin+), erythrocytes (CD235a+), and leukocytes (CD45+) were measured by flow cytometry. Concentrations of EVs from platelets and activated platelets increased 1.4-fold and 1.9-fold in EDTA blood upon platelet activation, and 4.2-fold and 9.6-fold in citrate blood. Platelet EV concentrations were unaffected by pneumatic tube transport in EDTA blood but increased in citrate blood, and EV concentrations of erythrocytes and leukocytes were comparable. The stability of EVs during a freeze-thaw cycle was comparable for both anticoagulants. Finally, the concentration of platelet EVs was stable during storage of EDTA blood for six hours, whereas this concentration increased 1.5-fold for citrate blood. Thus, EDTA improves the robustness of studies on plasma EVs.

Impact of centrifugation time and pneumatic tube transport on plasma concentrations of direct oral anticoagulants

Rapid results are needed when plasma concentrations of direct oral anticoagulants (DOACs) are required in acute clinical settings. We evaluated the impact of centrifugation time and pneumatic tube transport on DOAC plasma concentrations with the overall aim of reducing turnaround time. Blood samples were spiked with rivaroxaban, apixaban or dabigatran in a low and a high concentration prior to centrifugation for 25minutes (3163g) or 5minutes (3000g) (n=20 for each DOAC). Both samples spiked with DOACs (n=20 for each DOAC) and patient samples (n=25 in total) were transported manually or by pneumatic tube system samples. For samples spiked with DOAC, statistically significant differences in DOAC plasma concentrations were found between centrifugation times for rivaroxaban in low (P<.05) and high (P<.05) concentrations. Relative bias was below 9% for all DOACs. Statistically significant differences were found between modes of transportation for rivaroxaban (P<.01) and dabigatran (P<.01) in high concentrations. Relative bias was 4%-23% for all DOACs. For patient samples, no statistically significant differences were found between modes of transportation, and relative bias was below 12% for all DOACs. Minor, clinically insignificant, differences regarding centrifugation times were found in DOAC plasma concentrations. Importantly, no significant differences were found according to transportation modes for samples collected from patients. Although statistically significant differences were found depending on mode of transportation of spiked samples, relative bias was clinically acceptable. Thus, reduced centrifugation time and pneumatic tube transport should be considered to reduce turnaround time for rapid measurement of DOAC plasma concentrations.

The effects of transport by pneumatic tube system on urine analysis

The pneumatic tube transport system (PTS) is used frequently for the transport of samples in hospitals. Effects of PTS on urine components are unknown. In our study, we aim to examine the influence of PTS on the quality of routine urine microscopic parameters. Urine samples were divided into two groups: group 1 were transported to the laboratory manually and group 2 were transported to the laboratory via the PTS. Each of 187 urine samples was studied with iQ200 automated urine devices for erythrocytes, leukocytes, epithelial cells, crystal, cast and yeast cells. No statistically significant differences were detected between group 1 and group 2 for urine parameters. For erythrocytes, leukocytes, and epithelial cells, the gamma was 0.982, 0.959, and 1.0, respectively. For crystal, cast and yeast cells, the kappa values were 0.952, 0.866, and 1.0, respectively. PTS has no effect on erythrocytes, leukocytes, epithelial cells, crystal, cast, and yeast cells in urine analysis. We concluded that PTS can be used in the transport of urine samples.

Role of POC INR in the early stage of diagnosis of coagulopathy

BackgroundAcute bleeding requires fast and targeted therapy. Therefore, knowledge of the patient's potential to form a clot is crucial. Point-of-care testing (POCT) provides fast and reliable information on coagulation. Structural circumstances, such as person-bound sample transport, can prolong the reporting of the results. The aim of the present study was to investigate the diagnostic quality and accuracy between POCT INR diagnostics and standard laboratory analysis (SLA) as well as the time advantage between a pneumatic tube and a personal-based transport system. MethodsTwo groups of haemorrhagic patients (EG: emergency department; OG: delivery room; each n = 12) were examined in the context of bleeding emergencies using POCT and SLA. Samples were transported via a pneumatic tube system or by a personal transport service. ResultsINR results between POCT and SLA showed a high and significant correlation (EG: p < 0.001; OG: p < 0.001). POCT results were reported significantly more quickly (EG: 1.1 vs. 39.6 min; OG: 2.0 vs. 75.0 min; p < 0.001) and required less time for analysis (EG: 0.3 vs. 24.0 min; OG: 0.5 vs. 45.0 min; p < 0.001) compared to SLA. The time for transportation with the pneumatic tube was significantly shorter (8.0 vs. 18.5 min; p < 0.001) than with the personal-based transport system. ConclusionThe results of the present study suggest that POCT may be a suitable method for the emergency diagnosis and may be used as prognostic diagnostic elements in haemotherapy algorithms to initiate targeted haemotherapy at an early point in time.

Transportation of a commercial premixed intravenous insulin product through a pneumatic tube system.

Delivery of insulin products via pneumatic tubes is often avoided in health systems, as agitation may cause insulin proteins to destabilize, resulting in loss of function through denaturation, aggregation, or other processes. The actual loss of potency due to delivery via pneumatic tubes has not been reported for new, ready-to-use insulin products. Samples were drawn from 7 commercial intravenous (IV) bags containing a 100 units/100 mL premixed solution of regular insulin in sodium chloride injection (Myxredlin, Baxter). The bags were then exposed to 7 unique long-distance pneumatic tube routes. The posttransportation bags were visually inspected for evidence of foaming. Samples were drawn from the posttransportation bags and insulin concentrations were analyzed via an enzyme immunoassay and compared to pretransportation concentrations. All seven posttransportation insulin samples were within 10% of their respective pretransportation sample. No foaming was observed in any of the Myxredlin bags after transportation through the pneumatic tube system. Transporting 100 unit/100 mL Myxredlin i.v. bags through a pneumatic tube system does not result in a clinically significant loss of potency. Therefore, delivery of this drug product via a pneumatic tube system to patient care areas can be considered in daily practice.

Response to COVID-19 Pandemic: Managing Inpatient Pharmacy Services at King Abdulaziz Medical City - Jeddah.

Since early December 2019, the coronavirus disease 2019 (COVID-19) has been relentlessly spread worldwide and has hit the healthcare systems with terrible force. Pharmacists play a vital role in the healthcare system in providing medicines, therapeutics, vaccines, clinical services, and other pharmaceutical care services to patients. Therefore, to ensure all these services continued at King Abdulaziz Medical City - Jeddah during the COVID-19 pandemic, the Department of Pharmaceutical Care initiated a departmental crisis preparedness plan, as a part of general hospital preparedness plan. It started with adjusting medication dosing time, instituting a daily medication refill process, working remotely, expanding the use of automation, and modifying employee schedules. Other actions included the following: handling drug shortages, placing restrictions on some medications, using personal protective equipment, changing routine practices of pharmacy aides, revising the medication delivery process, starting a contingency training program, and restricting pneumatic tube operation. We took guidance from the Ministry of Health, our own institute's experience, World Health Organization recommendations, updated scientific research, and the American Society of Health-System Pharmacists regulatory updates. This article aims to describe how health services, policies, and systems were applied and adapted to address a specific problem while maintaining all pharmacy employees' safety. This article reviews the inpatient pharmacy's particular needs and responses to these needs to meet the COVID-19 pandemic challenges.

Exhaust Noise Reduction by Application of Expanded Collecting System in Pneumatic Tools and Machines

In this paper, we demonstrate how to reduce the noise level of expanded air from pneumatic tools. Instead of a muffler, we propose the expanded collecting system, where the air expands through the pneumatic tube and expansion collector. We have elaborated a mathematical model which illustrates the dynamics of the air flow, as well as the acoustic pressure at the end of the tube. The computational results were compared with experimental data to check the air dynamics and sound pressure. Moreover, the study presents the methodology of noise measurement generated in a pneumatic screwdriver in a quiet back room and on a window-fitting stand in a production hall. In addition, we have performed noise measurements for the pneumatic screwdriver and the pneumatic screwdriver on an industrial scale. These measurements prove the noise reduction of the pneumatic tools when the expanded collecting system is used. When the expanded collecting system was applied to the screwdriver, the measured Sound Pressure Level (SPL) decreased from 87 to 80 dB(A).

Effects of Pneumatic Tube Transport on Blood Gas and Supplemental Analytes.

Pneumatic tube transport of blood gas samples is a common method of delivery within a facility. The effects of pneumatic tube transport on blood gas analysis has been studied. However, other analytes that are often assessed in blood gas analysis (eg, electrolytes, metabolites, and oximetry) are not typically included in these studies. We sought to investigate the impact of pneumatic tube transport on some of these other analytes. The study was conducted at the blood gas laboratory at the University of Utah Hospital. A split sample comparison was performed. Both samples were walked to a pneumatic tube station, where one sample was sent via tube to the blood gas laboratory, while the other sample was walked back to blood gas laboratory. We examined 2 samples from each of the 27 different pneumatic tube stations in this hospital. Results were graphed with upper and lower control limits set to conform to acceptable College of American Pathologists proficiency testing evaluation criteria. Data were compared using the Student t test. Differences between walked and tubed specimens were neither clinically nor statistically significant. Pneumatic tube transport of blood gas specimens is acceptable for blood gas and supplementary analytes, as evidenced by multiple points of evaluation, including statistical analysis, clinical judgment, and concordance with regulatory guidelines.

Pneumatic tube validation: Reducing the need for donor samples by integrating a vial-embedded data logger.

The most common way to validate a pneumatic tube system is to compare pneumatic tube system-transported blood samples to blood samples carried by hand. The importance of measuring the forces inside the pneumatic tube system has also been emphasized. The aim of this study was to define a validation protocol using a mini data logger (VitalVial, Motryx Inc., Canada) to reduce the need for donor samples in pneumatic tube system validation. As an indicator of the total vibration, the blood samples are exposed to under pneumatic tube system transportation; the area under the curve was determined by a VitalVial for all hospital Tempus600 lines using a five-day validation protocol. Only the three lines with the highest area under the curves were clinically validated by analysing potassium, lactate dehydrogenase and aspartate aminotransferase. A month after pneumatic tube system commissioning, a follow-up on laboratory data was performed. Mean area under the curve of the six lines ranged between 347 and 581. The variability of the area under the curve was between 1.51 and 11.55%. In the laboratory data follow-up, an increase in lactate dehydrogenase haemolysis was seen from the three lines with the highest area under the curve and the emergency department, which was not detected in the clinical validation. When the Tempus600 system was in commission, a higher mean area under the curve was measured. A three-day validation protocol using VitalVials is enough to determine the stability of a Tempus600 system and can greatly reduce the need for donor samples. When in commission, the stability of the pneumatic tube system should be verified and lactate dehydrogenase haemolysis should be routinely checked.

Pneumatic tube transport of blood samples affects global hemostasis and platelet function assays.

Pneumatic tube systems (PTS) are frequently used for rapid and cost-effective transportation of blood samples to the clinical laboratory. The impact of PTS transport on platelet function measured by the Multiplate system and global hemostasis measured by the TEG 5000 was evaluated. Paired samples from healthy adult individuals were obtained at two study sites: Rigshospitalet (RH) and Nordsjaellands Hospital (NOH). One sample was transported by PTS and one manually (non-PTS). Platelet function was assessed by platelet aggregation (Multiplate) and global hemostasis was assessed by a variety of thrombelastography (TEG) assays. Multiplate (n=39) and TEG (n=32) analysis was performed at site RH, and Multiplate (n=28) analysis was performed at site NOH. A significant higher agonist-induced platelet aggregation was found for PTS samples compared to manual transport at site NOH (P<.02, all agonists). No significant difference was found at site RH (P>.05, all agonists). For Kaolin TEG, samples transported by PTS showed a significant lower R-time and higher Angle (P<.001). No significant differences in MA and LY30 was found (P>.05). ACT of RapidTEG was significantly reduced (P=.001) and MA of Functional Fibrinogen TEG was significantly increased (P<.001) after PTS transport. No significant impact of PTS was observed for TEG assays with heparinase (P>.05). Depending on the type of PTS, transportation by PTS affected platelet aggregation measured by Multiplate. Furthermore, PTS alters TEG parameters possibly reflecting coagulation factors. Clinical laboratories should evaluate the effect of the local PTS on Multiplate and TEG results.