Stability of coagulation assays performed in plasma from citrated whole blood transported at ambient temperature

Many preanalytical variables affect the results of coagulation assays. A possible way to control some of them would be to accept blood specimens shipped in the original collection tube. The aim of our study was to investigate the stability of coagulation assays in citrated whole blood transported at ambient temperature for up to two days after specimen collection. Blood samples from 59 patients who attended our haematology outpatient ward for thrombophilia screening were transported at ambient temperature (outdoor during the day, indoor overnight) for following periods of time: <1 hour, 4-6, 8-12, 24-28 and 48-52 hours prior to centrifugation and plasma-freezing. The following coagulation tests were performed: PT, aPTT, fibrinogen, FII:C, FV:C, FVII:C, FVIII:C, FIX:C, FX:C, FXI:C, VWF:RCo, VWF:Ag, AT, PC activity, total and free PS antigen, modified APC-sensitivity-ratio, thrombin-antithrombin-complex and D-dimer. Clinically significant changes, defined as a percentage change of more than 10% from the initial value, were observed for FV:C, FVIII:C and total PS antigen starting at 24-28 hours, and for PT, aPTT and FVII:C at 48-52 hours. No statistically significant differences were seen for fibrinogen, antithrombin, or thrombin-antithrombin complexes (Friedman repeated measures analysis of variance). The present data suggest that the use of whole blood samples transported at ambient temperature may be an acceptable means of delivering specimens for coagulation analysis. With the exception of factor V and VIII coagulant activity, and total PS antigen all investigated parameters can be measured 24-28 hours after specimen collection without observing clinically relevant changes.

Variation in carbon content of tropical tree species from Ghana

Most research on carbon content of trees has focused on temperate tree species with little information existing on the carbon content of tropical tree species. This study investigated the variation in carbon content of selected tropical tree species and compared carbon content of Khaya spp from two ecozones in Ghana. Allometric equations developed for mixed-plantation stands for wet evergreen forest verified the expected strong relationship between tree volumes and dbh (r2>0.93) and volume and dbh2×height (r2>0.97). Carbon concentration, wood density and carbon content differed significantly among species. Volume at age 12 ranged from 0.01 to 1.04 m3 per tree, and wood density was highly variable among species, ranging from 0.27 to 0.76 g cm-3. This suggests that species specific density data is critical for accurate conversion of volumes derived from allometric relationships into carbon contents. Significant differences in density of Khaya spp existed between the wet and moist semi-deciduous ecozones. The baseline species-level information from this study will be useful for carbon accounting and development of carbon sequestration strategies in Ghana and other tropical African countries.

Towards greater accuracy in individual-tree mortality regression

Background mortality is an essential component of any forest growth and yield model. Forecasts of mortality contribute largely to the variability and accuracy of model predictions at the tree, stand and forest level. In the present study, I implement and evaluate state-of-the-art techniques to increase the accuracy of individual tree mortality models, similar to those used in many of the current variants of the Forest Vegetation Simulator, using data from North Idaho and Montana. The first technique addresses methods to correct for bias induced by measurement error typically present in competition variables. The second implements survival regression and evaluates its performance against the traditional logistic regression approach. I selected the regression calibration (RC) algorithm as a good candidate for addressing the measurement error problem. Two logistic regression models for each species were fitted, one ignoring the measurement error, which is the “naïve” approach, and the other applying RC. The models fitted with RC outperformed the naïve models in terms of discrimination when the competition variable was found to be statistically significant. The effect of RC was more obvious where measurement error variance was large and for more shade-intolerant species. The process of model fitting and variable selection revealed that past emphasis on DBH as a predictor variable for mortality, while producing models with strong metrics of fit, may make models less generalizable. The evaluation of the error variance estimator developed by Stage and Wykoff (1998), and core to the implementation of RC, in different spatial patterns and diameter distributions, revealed that the Stage and Wykoff estimate notably overestimated the true variance in all simulated stands, but those that are clustered. Results show a systematic bias even when all the assumptions made by the authors are guaranteed. I argue that this is the result of the Poisson-based estimate ignoring the overlapping area of potential plots around a tree. Effects, especially in the application phase, of the variance estimate justify suggested future efforts of improving the accuracy of the variance estimate. The second technique implemented and evaluated is a survival regression model that accounts for the time dependent nature of variables, such as diameter and competition variables, and the interval-censored nature of data collected from remeasured plots. The performance of the model is compared with the traditional logistic regression model as a tool to predict individual tree mortality. Validation of both approaches shows that the survival regression approach discriminates better between dead and alive trees for all species. In conclusion, I showed that the proposed techniques do increase the accuracy of individual tree mortality models, and are a promising first step towards the next generation of background mortality models. I have also identified the next steps to undertake in order to advance mortality models further.

Infrared Thermography Enhancements for Concrete Bridge Evaluation

Infrared thermography is a well-recognized non-destructive testing technique for evaluating concrete bridge elements such as bridge decks and piers. However, overcoming some obstacles and limitations are necessary to be able to add this invaluable technique to the bridge inspector's tool box. Infrared thermography is based on collecting radiant temperature and presenting the results as a thermal infrared image. Two methods considered in conducting an infrared thermography test include passive and active. The source of heat is the main difference between these two approaches of infrared thermography testing. Solar energy and ambient temperature change are the main heat sources in conducting a passive infrared thermography test, while active infrared thermography involves generating a temperature gradient using an external source of heat other than sun. Passive infrared thermography testing was conducted on three concrete bridge decks in Michigan. Ground truth information was gathered through coring several locations on each bridge deck to validate the results obtained from the passive infrared thermography test. Challenges associated with data collection and processing using passive infrared thermography are discussed and provide additional evidence to confirm that passive infrared thermography is a promising remote sensing tool for bridge inspections. To improve the capabilities of the infrared thermography technique for evaluation of the underside of bridge decks and bridge girders, an active infrared thermography technique using the surface heating method was developed in the laboratory on five concrete slabs with simulated delaminations. Results from this study demonstrated that active infrared thermography not only eliminates some limitations associated with passive infrared thermography, but also provides information regarding the depth of the delaminations. Active infrared thermography was conducted on a segment of an out-of-service prestressed box beam and cores were extracted from several locations on the beam to validate the results. This study confirms the feasibility of the application of active infrared thermography on concrete bridges and of estimating the size and depth of delaminations. From the results gathered in this dissertation, it was established that applying both passive and active thermography can provide transportation agencies with qualitative and quantitative measures for efficient maintenance and repair decision-making.

Evaluation of factors affecting speed perception in a driving simulator

The present study was conducted to determine the effects of different variables on the perception of vehicle speeds in a driving simulator. The motivations of the study include validation of the Michigan Technological University Human Factors and Systems Lab driving simulator, obtaining a better understanding of what influences speed perception in a virtual environment, and how to improve speed perception in future simulations involving driver performance measures. Using a fixed base driving simulator, two experiments were conducted, the first to evaluate the effects of subject gender, roadway orientation, field of view, barriers along the roadway, opposing traffic speed, and subject speed judgment strategies on speed estimation, and the second to evaluate all of these variables as well as feedback training through use of the speedometer during a practice run. A mixed procedure model (mixed model ANOVA) in SAS® 9.2 was used to determine the significance of these variables in relation to subject speed estimates, as there were both between and within subject variables analyzed. It was found that subject gender, roadway orientation, feedback training, and the type of judgment strategy all significantly affect speed perception. By using curved roadways, feedback training, and speed judgment strategies including road lines, speed limit experience, and feedback training, speed perception in a driving simulator was found to be significantly improved.

A Report of the Geology of the Golden Sunlight Mining District

This paper is a report of a geological survey made of an area of approximately fifty square miles lying Northeast of Whitehall, Montana, in the region of the Golden Sun­light Mine. The survey was made by a field party consisting of twenty-three members of the senior class of the Montana School of Mines.

Mineralogy and Genesis of the Vermiculite Deposits at Libby, Montana

The problem considered in this report is one of the mineralogy and mode of formation of the extremely pure, large bodies of vermiculite. Mineralogically the ultrabasic intrusive, with which the economic mineral is associated, presents an array of rather unusual minerals. The determination of these minerals, their associations, and the sequence of alteration that lead to the formation of the vermiculite bodies, constitutes the problem.

The Amplifier - v. 9, no. 5

In this issue...Newman Club, Christmas Formal, Mining Congress, Magma, Orediggers, YMCA, Sylvia White, Intramural sports, Big Sky Country

Lack of extended venous thromboembolism prophylaxis in high-risk patients undergoing major orthopaedic or major cancer surgery. Electronic Assessment of VTE Prophylaxis in High-Risk Surgical Patients at Discharge from Swiss Hospitals (ESSENTIAL)

Extended pharmacological venous thromboembolism (VTE) prophylaxis beyond discharge is recommended for patients undergoing high-risk surgery. We prospectively investigated prophylaxis in 1,046 consecutive patients undergoing major orthopaedic (70%) or major cancer surgery (30%) in 14 Swiss hospitals. Appropriate in-hospital prophylaxis was used in 1,003 (96%) patients. At discharge, 638 (61%) patients received prescription for extended pharmacological prophylaxis: 564 (77%) after orthopaedic surgery, and 74 (23%) after cancer surgery (p < 0.001). Patients with knee replacement (94%), hip replacement (81%), major trauma (80%), and curative arthroscopy (73%) had the highest prescription rates for extended VTE prophylaxis; the lowest rates were found in patients undergoing major surgery for thoracic (7%), gastrointestinal (19%), and hepatobiliary (33%) cancer. The median duration of prescribed extended prophylaxis was longer in patients with orthopaedic surgery (32 days, interquartile range 14-40 days) than in patients with cancer surgery (23 days, interquartile range 11-30 days; p<0.001). Among the 278 patients with an extended prophylaxis order after hip replacement, knee replacement, or hip fracture surgery, 120 (43%) received a prescription for at least 35 days, and among the 74 patients with an extended prophylaxis order after major cancer surgery, 20 (27%) received a prescription for at least 28 days. In conclusion, approximately one quarter of the patients with major orthopaedic surgery and more than three quarters of the patients with major cancer surgery did not receive prescription for extended VTE prophylaxis. Future effort should focus on the improvement of extended VTE prophylaxis, particularly in patients undergoing major cancer surgery.

The Bison: 1991

This digital object was funded in part through a grant from the Andrew W. Mellon Foundation. The digitalization of this object was part of a collaborative effort with the Washington Research Library Consortium and George Washington University.

The Bison: 1955

This digital object was funded in part through a grant from the Andrew W. Mellon Foundation. The digitalization of this object was part of a collaborative effort with the Washington Research Library Consortium and George Washington University.

Association of fatigue and psychological distress with quality of life in patients with a previous venous thromboembolic event

Health-related quality of life (QoL) has been associated with several social and medical conditions in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). To the best of our knowledge, there is no study investigating the relationship of QoL with psychological variables in this patient population. We assumed as a hypothesis an association between heightened levels of fatigue and psychological distress, as well as decreased QoL in patients with an objectively diagnosed venous thromboembolic event. Study participants were 205 consecutively enrolled out-patients (47.4 years, 54.6% men) with DVT and/or PE. Approximately 10 days before blood collection for thrombophilia work-up, QoL, fatigue, and psychological distress were assessed using the Short Form Health Survey (SF-12), the Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) as well as the Hospitality Anxiety and Depression scale (HADS). After controlling for demographic and medical factors, fatigue (p < 0.01) but not psychological distress (p>0.05) was negatively associated with physical QoL, explaining 11.0% of the variance. Fatigue (p < 0.001) and psychological distress (p < 0.001) were significant predictors of mental QoL, explaining an additional 36.2% and 3.6% of the variance. Further analyses revealed that all subscales of the HADS (e.g. anxiety and depression) and of the MFSI-SF (e.g. general fatigue, physical fatigue, emotional fatigue, mental fatigue and vigor) were significant predictors of mental QoL. MFSI-SF subscales also predicted physical QoL. The findings suggest that fatigue and psychological distress substantially predict QoL in patients with a previous venous thromboembolic event above and beyond demographic factors.

Is perioperative point-of-care prothrombin time testing accurate compared to the standard laboratory test?

There is no accepted way of measuring prothrombin time without time loss for patients undergoing major surgery who are at risk of intraoperative dilution and consumption coagulopathy due to bleeding and volume replacement with crystalloids or colloids. Decisions to transfuse fresh frozen plasma and procoagulatory drugs have to rely on clinical judgment in these situations. Point-of-care devices are considerably faster than the standard laboratory methods. In this study we assessed the accuracy of a Point-of-care (PoC) device measuring prothrombin time compared to the standard laboratory method. Patients undergoing major surgery and intensive care unit patients were included. PoC prothrombin time was measured by CoaguChek XS Plus (Roche Diagnostics, Switzerland). PoC and reference tests were performed independently and interpreted under blinded conditions. Using a cut-off prothrombin time of 50%, we calculated diagnostic accuracy measures, plotted a receiver operating characteristic (ROC) curve and tested for equivalence between the two methods. PoC sensitivity and specificity were 95% (95% CI 77%, 100%) and 95% (95% CI 91%, 98%) respectively. The negative likelihood ratio was 0.05 (95% CI 0.01, 0.32). The positive likelihood ratio was 19.57 (95% CI 10.62, 36.06). The area under the ROC curve was 0.988. Equivalence between the two methods was confirmed. CoaguChek XS Plus is a rapid and highly accurate test compared with the reference test. These findings suggest that PoC testing will be useful for monitoring intraoperative prothrombin time when coagulopathy is suspected. It could lead to a more rational use of expensive and limited blood bank resources.