Non-linearity and gaps in results distribution over successive Roche Lipase method applications: improvement but persistence

Abstract

Non-linearity within the primary measurement range of a lipase assay (<300?U/L) has been shown on Cobas^® Roche analyzers, causing gaps in results distribution between 300 and 400?U/L. Since, new lipase method applications (LMAs) have been used. The purpose is to retrospectively evaluate their impact on relative frequencies of lipase results (RFLs).

Plasma lipase results from two hospital laboratories, assayed over 7.2?years, were collected. Over this period, three successive LMAs, characterized by automated repeat-on-dilution (1/11, 1/2, or 1/10), were applied for lipase results >300?U/L: LMA1 and LMA2 on the Modular^®P800, Cobas^®c501 and Cobas^®C701 analyzers, and LMA3 on the Cobas^®C701. RFLs were determined, linearity tests were performed, and inter-agreements between lipase results corrected and uncorrected for nonlinear biases were assessed, using 180?U/L as a decisional cut-off for acute pancreatitis.

Overall, RFL gaps narrowed from LMA1 (300 to ～380?U/L) to LMA3 (300 to ～330?U/L). For a lipase activity fixed at 300?U/L, non-linearity biases were determined at ?11.2% on the Modular^®P800 (LMA1), ?20.8% on the Cobas^®c501 (LMA1), and ?3.5% (LMA2) and ?2.2% (LM3) on the Cobas^®C701. Diagnostically, a maximum of 0.48% lipase results were misclassified as negative (LMA1 on the Cobas^®c501), and a minimum of 0.01% misclassified as negative (LMA3 on the Cobas^®C701). In conclusion, successive Roche lipase method applications improved linearity within the primary measurement range. While persisting, gaps in lipase results distribution narrowed with the evolution of the methods, with a minor impact in terms of diagnostic of acute pancreatitis.     

Fate of abstracts presented at the annual meetings of the American association of clinical anatomists

A recent study examined the rate of full‐length research paper publication following abstract presentation at the British association of clinical anatomists (BACA) annual meetings. The accepted standard for research dissemination is peer‐reviewed publication following presentation at a national or international meeting. The study objectives were quantitative assessment of the abstracts presented at the American Association of Clinical Anatomists' (AACA) annual meetings with regards to the rate of subsequent full‐length publication and comparison to BACA publication rates. All abstracts presented at the AACA annual meetings between 2003 and 2010 were analysed. MEDLINE was searched to identify peer‐reviewed publications arising from each presented abstract. In total, 1,120 abstracts were presented with 22.9% (n = 257) subsequently published as full‐length research papers. The mean number of abstracts presented each year was 140.0 ± 35.9. The median time to publication was 16 months. Chi‐squared analysis showed the publication rate of abstracts presented at AACA (22.9%) was not statistically significantly different to BACA (20.4%) (P = 0.09). A total of 11.3% (n = 29) of the articles were published as full‐length research articles before presentation as an abstract at an AACA meeting compared to 5.4% of abstracts presented at a BACA meeting. These rates are lower but comparable to those of surgical specialty meetings. Further work should try to identify any concerning reasons for the reduced rate of abstract publication in anatomical research. Clin. Anat. 30:140–144, 2017. © 2017 Wiley Periodicals, Inc.     

乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察

目的乳牙预成冠及树脂修复治疗乳磨牙大面积龋的临床效果观察。方法 2013年7月至2015年12月于本院就医的乳磨牙龋的患儿78例,所有患儿均通过入院前确诊,满足乳磨牙龋诊断标准,然后按照随机数字表法分为观察组与对照组,各组均为39例,其中观察组采用预成冠方法进行修复,而对照组以复合树脂进行修复,两组患儿均为同一位医生完成治疗,统计各组的总体治疗成功率。结果本研究半年内两组患儿随访临床治疗评估(每月1次)显示,观察组患儿在治疗后3个月、6个月的总有效率分别为97.43%、94.87%,均高于对照组的89.74%、84.61%,以上组间差异显著,具有统计学意义(P0.05);对于乳牙功能的行使保存,预成冠成功率要远远高于树脂修复成功率,预成冠保存乳牙继续行使咀嚼功能疗效较树脂修复显著,以上两组的组间数据对比存在明显差异,具有统计学意义(P0.05)。结论对于乳磨牙龋修复而言,运用预成冠修复方法无论在成功率、咀嚼功能疗效均高于树脂修复效果,具有临床推广意义。     

Instrument validation: hospital nurse perceptions of their Behavioral Health Care Competency

Aim. To report the development and psychometric testing of the Behavioral Health Care Competency survey, designed to measure hospital nurse perceptions of behavioral healthcare competency. Background. Hospital nurses working in general or other non‐psychiatric units may lack behavioral healthcare competency to manage disruptive behaviours associated with mental illnesses. Design. Instrument development. Method. A nurse study team including clinical experts and nurse researchers from three community hospitals in southern California (USA) reviewed content validity of each item and the 31‐item instrument and created a behavioral health care competency conceptual model based on the nursing process. Separate institutional review board permissions were obtained from each hospital. The study team collaborated in the timing of survey administration (November 2010), analysis of the results and survey validation. Results. A total of 844 nurses completed the survey, representing approximately 23–41% of eligible nurses from each hospital. Using principal component analysis with varimax rotation, 23 items led to a factor structure with four components. Four subscales with adequate alpha coefficients were formed: Resource Adequacy, Patient Assessment, Practice/Intervention Competency, and Psychotropic Recommendation. Conclusion. The 23‐item hospital nurse Behavioral Health Care Competency survey is an adequate and valid newly developed instrument. Further testing with diverse samples is needed to strengthen generalizability and address unique and specialized nursing care needs.     

The effectiveness of simulation activities on the cognitive abilities of undergraduate third‐year nursing students: a randomised control trial

Aims and objectives. To provide evidence on the effectiveness of simulation activities on the clinical decision‐making abilities of undergraduate nursing students. Based on previous research, it was hypothesised that the higher the cognitive score, the greater the ability a nursing student would have to make informed valid decisions in their clinical practice. Background. Globally, simulation is being espoused as an education method that increases the competence of health professionals. At present, there is very little evidence to support current investment in time and resources. Methods. Following ethical approval, fifty‐eight third‐year undergraduate nursing students were randomised in a pretest–post‐test group‐parallel controlled trial. The learning environment preferences (LEP) inventory was used to test cognitive abilities in order to refute the null hypothesis that activities in computer‐based simulated learning environments have a negative effect on cognitive abilities when compared with activities in skills laboratory simulated learning environments. Results. There was no significant difference in cognitive development following two cycles of simulation activities. Therefore, it is reasonable to assume that two simulation tasks, either computer‐based or laboratory‐based, have no effect on an undergraduate student’s ability to make clinical decisions in practice. However, there was a significant finding for non‐English first‐language students, which requires further investigation. Conclusions. More longitudinal studies that quantify the education effects of simulation on the cognitive, affective and psychomotor attributes of health science students and professionals from both English‐speaking and non‐English‐speaking backgrounds are urgently required. It is also recommended that to achieve increased participant numbers and prevent non‐participation owing to absenteeism, further studies need to be imbedded directly into curricula. Relevance to clinical practice. This investigation confirms the effect of simulation activities on real‐life clinical practice, and the comparative learning benefits with traditional clinical practice and university education remain unknown.