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Love sense : the revolutionary new science of romantic relationships
The bestselling author of Hold Me Tight presents a revolutionary new understanding of why and how we love, based on cutting-edge research.
Book
Patient-Based Real-Time Quality Control: Review and Recommendations
For many years the concept of patient-based quality control (QC) has been discussed and implemented in hematology laboratories; however, the techniques have not been widely implemented in clinical chemistry. This is mainly because of the complexity of this form of QC, as it needs to be optimized for each population and often for each analyte. However, the clear advantages of this form of QC, together with the ongoing realization of the shortcomings of \"conventional\" QC, have driven a need to provide guidance to laboratories to assist in deploying patient-based QC. This overview describes the components of a patient-based QC system (calculation algorithm, block size, truncation limits, control limits) and the relationship of these to the analyte being controlled. We also discuss the need for patient-based QC system optimization using patient data from the individual testing laboratory to reliably detect systematic errors while ensuring that there are few false alarms. The term patient-based real-time quality control covers many activities that use data from patient samples to detect analytical errors. These activities include the monitoring of patient population parameters such as the mean or median analyte value or using single within-patient changes such as the delta check. In this report, we will restrict the discussion to population-based parameters. This overview is intended to serve as a guide for the implementation of a patient-based QC system. The report does not cover the clinical evaluation of the population.
Journal Article
Applications of MALDI Mass Spectrometry in Clinical Chemistry
MALDI-TOF mass spectrometry (MS) is set to make inroads into clinical chemistry because it offers advantages over other analytical platforms. These advantages include low acquisition and operating costs, ease of use, ruggedness, and high throughput. When coupled with innovative front-end strategies and applied to important clinical problems, it can deliver rapid, sensitive, and cost-effective assays.
This review describes the general principles of MALDI-TOF MS, highlights the unique features of the platform, and discusses some practical methods based upon it. There is substantial potential for MALDI-TOF MS to make further inroads into clinical chemistry because of the selectivity of mass detection and its ability to independently quantify proteoforms.
MALDI-TOF MS has already transformed the practice of clinical microbiology and this review illustrates how and why it is now set to play an increasingly important role in in vitro diagnostics in particular, and clinical chemistry in general.
Journal Article
Quantifying the Added Value of a Diagnostic Test or Marker
In practice, the diagnostic workup usually starts with a patient with particular symptoms or signs, who is suspected of having a particular target disease. In a sequence of steps, an array of diagnostic information is commonly documented. The diagnostic information conveyed by different results from patient history, physical examination, and subsequent testing is to varying extents overlapping and thus mutually dependent. This implies that the diagnostic potential of a test or biomarker is conditional on the information obtained from previous tests. A key question about the accuracy of a diagnostic test/biomarker is whether that test improves the diagnostic workup beyond already available diagnostic test results. This second report in a series of 4 gives an overview of several methods to quantify the added value of a new diagnostic test or biomarker, including the area under the ROC curve, net reclassification improvement, integrated discrimination improvement, predictiveness curve, and decision curve analysis. Each of these methods is illustrated with the use of empirical data. We reiterate that reporting on the relative increase in discrimination and disease classification is relevant to obtain insight into the incremental value of a diagnostic test or biomarker. We also recommend the use of decision-analytic measures to express the accuracy of an entire diagnostic workup in an informative way.
Journal Article
Gold nanoparticles for the development of clinical diagnosis methods
The impact of advances in nanotechnology is particularly relevant in biodiagnostics, where nanoparticle-based assays have been developed for specific detection of bioanalytes of clinical interest. Gold nanoparticles show easily tuned physical properties, including unique optical properties, robustness, and high surface areas, making them ideal candidates for developing biomarker platforms. Modulation of these physicochemical properties can be easily achieved by adequate synthetic strategies and give gold nanoparticles advantages over conventional detection methods currently used in clinical diagnostics. The surface of gold nanoparticles can be tailored by ligand functionalization to selectively bind biomarkers. Thiol-linking of DNA and chemical functionalization of gold nanoparticles for specific protein/antibody binding are the most common approaches. Simple and inexpensive methods based on these bio-nanoprobes were initially applied for detection of specific DNA sequences and are presently being expanded to clinical diagnosis. [graphic removed]
Journal Article
Clinical chemistry laboratory test overuse in a cardiology clinic: a single-center study
Diagnostic laboratory tests are frequently overused in healthcare entities, leading to an increased strain on laboratory resources, additional workload, and wastage of resources. Continuous monitoring of test ordering behavior is crucial to evaluate clinical necessity. This cross-sectional study aimed to estimate the necessity of ordering clinical chemistry tests in the cardiology clinic of a tertiary center in Saudi Arabia. We retrieved medical records of patients diagnosed with cardiovascular problems admitted at the cardiology clinic in 2020. The frequency and percentages of the ordered tests were calculated upon admission and follow-up, and the difference between necessary and unnecessary tests was compared for each category. Test ordering assessment included cardiac, renal, and liver functions, blood gases, thyroid and diabetic profile, iron indices, hormones, water and electrolytes, and inflammatory markers. The results showed a large number of clinical chemistry tests ordered without clinical necessity. While the number of necessary tests was significantly higher than that of unnecessary tests, 21% of the tests ordered between June-December 2021 at the center were unnecessary. Further studies are necessary to identify driving factors and develop strategies to reduce the overutilization of diagnostic laboratory tests in clinical practice. Eliminating this phenomenon will reduce the risk of unnecessary medical interventions and associated costs, improve patient outcomes, and reduce the overall burden on the healthcare system.
Journal Article
Analytical Techniques for Clinical Chemistry
Discover how analytical chemistry supports the latest clinical researchThis book details the role played by analytical chemistry in fostering clinical research. Readers will discover how a broad range of analytical techniques support all phases of clinical research, from early stages to the implementation of practical applications. Moreover, the contributing authors' careful step-by-step guidance enables readers to better understand standardized techniques and steer clear of everyday problems that can arise in the lab.Analytical Techniques for Clinical Chemistryopens with an overview of the legal and regulatory framework governing clinical lab analysis. Next, it details the latest progress in instrumentation and applications in such fields as biomonitoring, diagnostics, food quality, biomarkers, pharmaceuticals, and forensics. Comprised of twenty-five chapters divided into three sections exploring Fundamentals, Selected Applications, and Future Trends, the book covers such critical topics as:Uncertainty in clinical chemistry measurementsMetal toxicology in clinical, forensic, and chemical pathologyRole of analytical chemistry in the safety of drug therapyAtomic spectrometric techniques for the analysis of clinical samplesBiosensors for drug analysisUse of X-ray techniques in medical researchEach chapter is written by one or more leading pioneers and experts in analytical chemistry. Contributions are based on a thorough review and analysis of the current literature as well as the authors' own firsthand experiences in the lab. References at the end of each chapter serve as a gateway to the literature, enabling readers to explore individual topics in greater depth.Presenting the latest achievements and challenges in the field, Analytical Techniques for Clinical Chemistrysets the foundation for future advances in laboratory research techniques.
eBook
Machine Learning for Clinical Chemists
The current scientific scenario confirms that ML is superior when the number of facts (images) is very high and their interpretation is defined, but when the incidence is low and the interpretation is difficult, there is not evidence toward ML use only. [...]in the clinical laboratory, ML could aid in diagnosis with current parameters (high number of tests, defined thresholds, clear symptoms) and also could aid in the elaboration, release, and validation of large amounts of data (e.g., genomics, microRNA, vitamin D, which can be validated by experts currently only for small cohorts of patients) to define a possible link with symptoms or disease. Giuseppe Banfi: It is crucial to obtain a standardized output from laboratory automated instruments to store and use results that are semantically correct and significant, that is, endowed with metadata. [...]an international effort to define standardized laboratory data through, for example, Logical Observation Identifiers Names and Codes, and a link with a unique standardized source ofclinical data, for example Systematized Nomenclature of Human and Veterinary Medicine, is mandatory. [...]structured evaluation protocol and quality-control measures for these algorithms need to be developed to ensure the algorithms continue to function as intended after the initial development/implementation phase. [...]the data security and privacy of the patients must be well guarded to gain the trust of the patient and public to provide highly granular personal information that is needed to drive the algorithms for optimal outcomes.
Journal Article
Evaluation of Imprecision for Cardiac Troponin Assays at Low-Range Concentrations
The European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction (MI) has recommended that an increased cardiac troponin should be defined as a measurement above the 99th percentile value of the reference group. A total imprecision (CV) at the decision limit of
Journal Article