Academic literature on the topic 'Laboratory Public health Laboratory Techniques and Procedures'

Context: The use of standard operating procedures (SOP) in laboratory testing is one of the most crucial factors in achieving the quality. In primary and secondary level laboratory, the scope for microbiological test is limited. Enteric fever is one of the major public health problem in the developing countries, including Bangladesh. An undiagnosed and maltreated case of enteric fever may result in serious complication and even prove fatal. Widal test is the very extensively used serological test in laboratory at all level to aid in the diagnosis of enteric fever. It is the only available practical test for demonstrating antibodies to Salmonella typhi and S. paratyphi. In this study, an attempt has been made to evaluate the present status of microbiology laboratory by comparing the test results of investigator with that of laboratory staff for widal test at primary and secondary level before and after implementation of standard operating procedure (SOP) .Methods: The present study was performed on clinically suspected cases of enteric fever attending at the primary and secondary level laboratories for widal test. A 120 blood samples were collected before implementing SOP and 50 blood samples were collected and tested after following SOP. A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratoryResults: Before standard operating procedures (SOP), significant titre of widal test was found more by the investigator than the staff at both primary and secondary level. This difference in results was statistically significant (p<0.05). After SOP difference in the results of significant titre of widal test between investigator and staff was not statistically significant (p>0.05).Conclusion: Implementing SOP for widal test and after practicing appropriate and standard techniques for dilution of serum at primary and secondary level, discrepancy in the results of widal test between investigator and staff was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 227-233

Optimal biosafety and biosecurity are major requirements of global health security. This study assessed the biorisk management in the reference veterinary laboratory of Parakou (Benin). The study was cross-sectional, descriptive, and evaluative. The non-probability sampling method with the reasoned choice was used. The Food and Agriculture Organization laboratory mapping tool-safety was used to collect information from the laboratory team. Group discussion, working environment observation, and document exploitation were the data collection techniques. The biorisk management was rated good if the average indicator of the laboratory reached at least 80%. Otherwise, the biorisk management was rated insufficient. The overall laboratory biosafety and biosecurity score was insufficient (42.4%). Per area, the scores were 26.7% for engineering, 33.3% for administration, 53.8% for personal protective equipment, and 62.3% for the operational. There was no area or category score that reached 80%. Containment, waste disposal, and personal protective equipment disposal were the best performing categories with a score above 60%. The laboratory has no biosafety and accident prevention program. Its premises require renovation. The standard operating procedures for biosafety are not yet finalized, and the training mechanism is not optimal. Therefore, strong advocacy and implementation of a biorisk management improvement plan appear as urgent corrective actions which are required to help the reference veterinary laboratory of Parakou in its task to protect the livestock and, ultimately, the people of Benin from dangerous diseases and emerging pathogens.

Laboratory medicine, as defined by the IFCC and FESCC, is the application of chemical, molecular and cellular concepts and techniques to the understanding and evaluation of human health and disease. At the core of the discipline is the provision of results of measurements and observations relevant to the cause of disease, the maintenance of health and the conversion of these data into specific and general patient- and disease- related information at the laboratory-clinician interface. The discipline is committed to deepening the understanding of health and disease through fundamental and applied research. Furthermore, there are increasing health care expectations and consequently increasing demands of health care resources. Because of the increasing health costs, governments of many European countries have cut health care expenditure, often by decreasing the funding of acute care facilities, closing hospitals, outsourcing services or privatizing health care. Medical laboratories, highly dependent on rapidly changing, expensive and sophisticate technologies, have especially been affected by these policies. Several trends in medical laboratories are developing simultaneously: ? Centralization of diagnostic medical laboratories, rationalization of services, increased emphasis on cost-benefit analysis and cost-effective total patient care, linked to improving outcomes. ? Development of highly specialized laboratories at the interface with research. ? Implementation of point of care technology. ? Development of molecular biology procedures improving diagnosis of infections and inherited diseases. ? Computerization and telecommunication, which facilitates fast communication between laboratory and clinicians. ? Automation and robotics are changing the face of classic laboratories. ? A general trend towards accreditation or certification of laboratories in order to increase and recognize quality and excellence, including consultation services, pre -and post-analytical procedures. Medical laboratory specialists, whether of medical or non-medical training background, are responsible for comprehensive laboratory services including production of analytical results, consultation with clinicians, management, quality assurance, and computer technology. When possible, they conduct research and training in laboratory medicine. There are considerable differences among countries - in particular between highly developed countries of the European Union and countries of Central/Eastern Europe - in social, economical and health system developments, which affect the practice of medicine. The ultimate goal of laboratory specialists in the Central/Eastern European countries is to catch up with all these processes and also to reduce the gap between east and west in this respect. However, sufficient governmental financial resources are lacking as well. Thus, national laboratory societies bear a higher than ever responsibility in working out and implementing successful strategies, convincing public opinion, political opinion-leaders and the media about the importance of laboratory medicine, a discipline inevitable for successful predictive, preventive and clinical curative medicine.

Subtyping systems for Listeria monocytogenes have proved to be of great use in the elucidation of the epidemiology of listeriosis. Considerations for devising strategies to subtype this organism are discussed, together with the surveillance methods, work load, and resources used by the Public Health Laboratory Service in London (England). A combination of both molecular and conventional typing methods are currently in use, and these comprise the established techniques of serotyping, phage-typing, and DNA restriction-fragment length polymorphism analysis, together with the experimental procedures of resistance to arsenite and cadmium and the detection of plasmid DNA. The efficacy of this approach is assessed using Simpson's index of diversity.

Abstract Objective.—To assess the clinical utility of the commercial nucleic acid amplification (NAA) tests (ie, Amplified Mycobacterium Tuberculosis Direct Test, Gen-Probe, Inc and AMPLICOR Mycobacterium tuberculosis Test, Roche Molecular Systems, Inc) for direct detection of Mycobacterium tuberculosis complex. Data Sources.—Review of the English-language literature. Conclusions.—The performance of both NAA tests is excellent (sensitivity, ≥95%; specificity, 100%) when testing respiratory specimens that are smear-positive for acid-fast bacilli (AFB). Only the Gen-Probe assay is approved for testing respiratory specimens regardless of the AFB smear result. Data from 3 studies showed that the sensitivity of the Mycobacterium Tuberculosis Direct Test in smear-negative patients ranged from 83% to 85%, and that the specificity was 99%. Both NAA tests have been used to test nonrespiratory specimens; in some studies, the performance was comparable to the performance obtained for respiratory specimens, whereas in others, it was lower. The NAA tests also appear to be reliable tools for rapid detection of M tuberculosis complex in positive broth cultures of all specimen types (except blood). The impact of the NAA tests on patient outcome varies based on the result of the AFB smear. In smear-positive patients, public health and hospital infection-control resources are predominantly affected. The potential for influencing patient outcome is much greater when the AFB smear is negative. In smear-negative patients, the NAA test could provide more rapid diagnosis of tuberculosis and subsequent initiation of therapy; eliminate the need for invasive diagnostic procedures, which are both costly and pose an added risk to the patient; and allow earlier discharge of hospitalized patients. Prospective studies concerning the cost-effectiveness of the NAA tests are needed.

SUMMARY This review explores the role of the cytopathology laboratory in the detection and presumptive identification of microorganisms. Sample procurement by exfoliation, abrasion, and aspiration techniques, as well as a variety of cytopreparatory and staining methods, is reviewed. Emphasis is placed on the utility of fine-needle aspiration as a rapid, safe, and cost-effective diagnositic procedure. The role of rapid interpretation and specimen triage is also discussed. Cytomorphologic features and staining characteristics are presented for a spectrum of microorganisms potentially encountered in the cytopathology laboratory. Pitfalls in diagnosis and the usefulness of special stains and ancillary techniques are also evaluated. The importance of communication, collaboration, and clinical correlation is stressed.

Context : Laboratory services have become an integral and inseparable component of modern medicine and public health. The use of standard operating procedure (SOP) in laboratory testing is one of the most crucial factor in achieving the quality. This cross sectional study was done to assess the quality of routine microscopic examination of urine of a microbiology laboratory at primary level and one microbiology laboratory at secondary level by evaluating the test results before SOP and re evaluating the test results after implementing SOP to see if there was any improvement in quality of those tests.Material and Methods: A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratory. The study was performed on clinically suspected patients of urinary tract infection (UTI) attending at the primary and secondary level laboratory for microscopic examination of urine. Clinically suspected cases of UTI who had taken any anti microbial treatment in the past 48 hours were excluded from the study. 60 urine samples were collected from each level before implementing SOP and 30 urine samples were collected from each level and tested after following SOP.Result : In routine microscopic examination of urine at primary and secondary level, before SOP, regarding significant number of Pus cells discrepancy was found in 21.67% cases at primary level and 18.33% cases at secondary level. After implementing SOP, discrepancy in the result was reduced to 10% from 21.67% at primary level and 0% from 18.33% at secondary level. This difference in results was statistically significant (p< 0.05).Conclusion: Implementing SOP and after practicing appropriate and standard techniques for collection and examination of urine at primary and secondary level, discrepancy in the results of routine microscopic examination of urine between investigator and Medical Officer (MOPathology) was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 87-93

SUMMARY Classical microbiology techniques are relatively slow in comparison to other analytical techniques, in many cases due to the need to culture the microorganisms. Furthermore, classical approaches are difficult with unculturable microorganisms. More recently, the emergence of molecular biology techniques, particularly those on antibodies and nucleic acid probes combined with amplification techniques, has provided speediness and specificity to microbiological diagnosis. Flow cytometry (FCM) allows single- or multiple-microbe detection in clinical samples in an easy, reliable, and fast way. Microbes can be identified on the basis of their peculiar cytometric parameters or by means of certain fluorochromes that can be used either independently or bound to specific antibodies or oligonucleotides. FCM has permitted the development of quantitative procedures to assess antimicrobial susceptibility and drug cytotoxicity in a rapid, accurate, and highly reproducible way. Furthermore, this technique allows the monitoring of in vitro antimicrobial activity and of antimicrobial treatments ex vivo. The most outstanding contribution of FCM is the possibility of detecting the presence of heterogeneous populations with different responses to antimicrobial treatments. Despite these advantages, the application of FCM in clinical microbiology is not yet widespread, probably due to the lack of access to flow cytometers or the lack of knowledge about the potential of this technique. One of the goals of this review is to attempt to mitigate this latter circumstance. We are convinced that in the near future, the availability of commercial kits should increase the use of this technique in the clinical microbiology laboratory.

Sickle cell disease (SCD) encompasses a group of inherited red cell disorders characterized by an abnormal hemoglobin, Hb S. The most common forms of SCD in the United States and Canada are identified through universal newborn screening (NBS) programs. Now carried out in all fifty U.S. states and 8 Canadian provinces, NBS for SCD represents one of the major public health advances in North America. The current status of NBS programs for hemoglobinopathies and the screening techniques employed in many regions worldwide reflect in large part the U.S. and Canadian experiences. Although the structure, screening algorithms and laboratory procedures, as well as reporting and follow up, vary between NBS programs, the overall workflow is similar. The current review summarized the historical background, current approaches, and methods used to screen newborns for SCD in the United States and Canada.

The recent trend in green analytical chemistry is the development of green analytical methods using environmentally friendly solvents. Therefore, three ecofriendly manipulated UV spectroscopic techniques have been validated for the concurrent quantification of newly approved remogliflozin etabonate (REM) and metformin HCl (MET) tablets using water as a solvent. The first method was established using first derivative absorption spectroscopic method by determining the peak amplitude at 233.0 nm for REM and 252.2 nm for MET, a zero crossing of one the component. The second and third methods were based on the peak amplitude difference and first-order derivative absorption of the ratio spectra developed by the manipulation of scanned UV spectra. REM and MET showed good linearity in the series of 1–20 µg ml−1 and 2.5–35 µg ml−1, respectively, by all three methods with an excellent correlation coefficient (r2 ≥ 0.998). Further, the proposed UV spectroscopic techniques were validated as per International Council for Harmonization guidelines. The methods showed good sensitivity, accuracy, and precision. Anticipated procedures were effectively utilized for the concurrent quantification of REM and MET in laboratory prepared mixtures and tablets. The high percent recovery with low standard deviation found for both analytes by all three methods confirms the accuracy and precision of the procedures. Finally, the greenness of the proposed spectroscopic methods, evaluated by semi-quantitative and quantitative methods, showed the eco-friendly nature of the methods. Furthermore, the proposed approaches were simple, accurate, sensitive, economic, and environmentally friendly and hence can be utilized for regular quality control of REM and MET formulation.

Since the Institute of Medicine highlighted the devastating impact of medical errors in their seminal report, “To Err is Human” (2000), efforts have been underway to improve patient safety. A portion of medical errors are due to medication errors, and a large portion of these can be attributed to inadequate laboratory monitoring. In this thesis, I attempt to address this small but important corner of this patient safety endeavor. Why are patients not getting their laboratory monitoring tests? Do they fail to complete them or do doctors not order the tests in the first place? Which prescribers and which patients are least likely to do what is needed for testing to happen and what interventions would be most promising? To address these questions, I conducted a systematic review of existing interventions. I then proceeded with three aims: 1) To identify reasons that patients give for missing monitoring tests; 2) To identify patient and provider factors associated with monitoring test ordering; and 3) To identify patient and provider factors associated with completion of ordered testing. To achieve these aims, I worked with patients and data at the Fallon Clinic. For aim 1, I conducted a qualitative analysis of their reasons for missing tests as well as reporting completion and ordering rates. For aims 2 and 3, I used electronic medical record data and conducted a regression with patient and provider characteristics as covariates to identify factors contributing to test ordering and completion. Interviews revealed that patients had few barriers to completion, with forgetting being the most common reason for missing a test. The quantitative studies showed that: older patients with more interactions with the health care system were more likely to have tests ordered and were more likely to complete them; providers who more frequently prescribe a drug were more likely to order testing for it; and drug-test combinations that were particularly dangerous, indicated by a black box warning, were more likely to have appropriate ordering, though for these combinations, primary care providers were less likely to order tests appropriately, and patients were less likely to complete tests. Taken together, my work can inform future interventions in laboratory monitoring and patient safety.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior<br>Os agrotÃxicos estÃo entre os mais importantes fatores de risco para a saÃde dos trabalhadores. No PiauÃ, a expansÃo agrÃcola implementada nos cerrados, por intermÃdio da intensificaÃÃo do plantio de soja, a partir da dÃcada de 1990, consistiu em um forte fator para o aumento do uso de agrotÃxicos. A utilizaÃÃo indiscriminada dos agrotÃxicos, geralmente, està associada a intoxicaÃÃes agudas e crÃnicas. A dosagem de colinesterase plasmÃtica e eritrocitÃria sÃo parÃmetros relevantes para diagnÃstico de casos cuja exposiÃÃo se deu, principalmente, de forma aguda. A genotoxicidade associada ao uso destes produtos vem sendo estudada, sendo fortes as evidÃncias que estes produtos sÃo carcinogÃnicos. No estado do PiauÃ, em setembro de 2005, no municÃpio de Ribeiro GonÃalves, ocorreram mortes cuja suspeita principal era de intoxicaÃÃo por uso dos pesticidas agrÃcolas. Este fato desencadeou uma investigaÃÃo nos municÃpios produtores de soja (UruÃuÃ, Ribeiro GonÃalves e Baixa Grande do Ribeiro). O objetivo deste trabalho foi avaliar o impacto do uso de agrotÃxicos sobre a saÃde dos trabalhadores rurais dos municÃpios de UruÃuÃ, Ribeiro GonÃalves e Baixa Grande do Ribeiro. Dividiu-se, metodologicamente, o estudo em trÃs etapas. Na primeira, aplicou-se questionÃrio sÃcio epidemiolÃgico de acordo com OrganizaÃÃo Mundial de SaÃde (OMS) e coletaram-se amostras de material biolÃgico para anÃlises bioquÃmicas, hematolÃgicas e enzimÃticas (acetil colinesterase plasmÃtica e eritrocitÃria) de 120 trabalhadores agrÃcolas da regiÃo sul do PiauÃ. Na segunda etapa, estudou-se 75 indivÃduos. Estes se submeteram a uma segunda avaliaÃÃo, tendo como ferramenta os mesmos exames anteriormente realizados. Como terceira etapa, realizou-se o teste de micronÃcleo em 31 indivÃduos que encontravam-se com os parÃmetros alterados. Fez-se coleta de cÃlulas da mucosa oral, para avaliaÃÃo do nÃvel de lesÃo de DNA atravÃs de contagem de micronÃcleos. Quanto ao questionÃrio sÃcio epidemiolÃgico os resultados encontrados indicaram que 100% da populaÃÃo estudada pertencia ao sexo masculino, com idade mÃdia de 35 anos. Ainda sobre o questionÃrio, 66% eram casados, 76,67% trabalhavam em fazendas (lavradores, operadores de mÃquinas e tÃcnicos agrÃcolas), 16,67% eram agentes de endemias ou servidores pÃblico, sendo que 21,3% tomavam medicamento sem prescriÃÃo mÃdica e que 71,67% nÃo realizaram exames mÃdicos nos Ãltimos 06 meses. A investigaÃÃo evidenciou ainda que, quanto ao estilo de vida e trabalho, 33,33% dos trabalhadores possuem o hÃbito de fumar, 55,83% de consumir bebidas alcoÃlicas, 29,9% entraram em contato direto com o agrotÃxico durante o preparo do produto, 38% atravÃs da aplicaÃÃo do produto por pulverizaÃÃo, 10% atravÃs da limpeza e manutenÃÃo dos equipamentos, 17,5% nÃo utilizavam nenhuma proteÃÃo, sendo que a grande maioria utilizavam apenas 01 tipo de EPI. Outro achado relatado refere-se que os trabalhadores utilizaram mais de 34 diferentes formulaÃÃes, sendo as classes mais utilizadas os inseticidas (45,18%), herbicidas (27,68%) e fungicidas (6,21%). Quanto ao tempo de exposiÃÃo dos trabalhadores aos pesticidas, 50,84% estavam expostos a menos de 2 anos e 10% estavam expostos a mais de 10 anos. Dentre os sintomas mais relatados, os efeitos no SNC destacaram-se com 230 queixas relatadas durante a aplicaÃÃo do questionÃrio sÃcio-epidemiolÃgico. Sobre o destino final das embalagens, 84,21% dos mesmos eram queimados, enterrados e deixados a cÃu aberto, sendo 15,79% entregues na central de recebimento. Em relaÃÃo Ãs anÃlises bioquÃmicas e hematolÃgicas dos indivÃduos submetidos à primeira coleta, os resultados indicaram que 11,67%; 4,17%; 10,83%; 0,83% ; 5,83%; 5% e 9,17% encontravam-se com nÃveis respectivamente alterados de Gama GT, Fosfatase Alcalina e TGO/ TGP, UrÃia, Creatinina componentes protÃicos, acetilcolinesterase plasmÃtica e eritrocitÃria . Na segunda etapa, os achados indicaram que os indivÃduos estavam com os nÃveis alterados de: gama GT ( 4,00%); fosfatase alcalina e TGO/TGP ( 4,00%); urÃia (4,00%); creatinina (5,33%); proteÃnas totais (17,33%); acetilcolinesterase plasmÃtica (4,00%) e acetilcolinesterase eritrocitÃria (2,67%). Com relaÃÃo à terceira etapa, dos 31 indivÃduos que realizaram teste de micronÃcleo 84,00% encontravam-se com danos citogenÃticos. Os danos citogenÃticos evidenciados nÃo apresentaram correlaÃÃes com idade, fumo, bebidas, equipamentos de proteÃÃo, medicamentos e doenÃas, confirmando a correlaÃÃo dos danos citogenÃticos evidenciados, com a exposiÃÃo aos agrotÃxicos (P<0,05)<br>The pesticides are some of the main risky factors for agricultural laborersâ health. In the state of PiauÃ, the agricultural expansion which was implemented in the cerrados through the growth of the soy crops in the 90âs was a relevant factor that increased the use of pesticides. The unbalanced usage of pesticides is often related to acute and chronic poisonings. The dosage of plasma cholinesterase and erythrocyte cholinesterase are relevant parameters to diagnose mainly cases in which an acute contact has occurred. The genotoxicity related to the use of these kinds of products has been studied and there are strong evidences that they are carcinogenic. Deaths which the main suspicion was poisoning by the misuse of agricultural pesticides happened in September of 2007 in the city of Ribeiro GonÃalves, state of PiauÃ. The fact unchained an investigation in the cities that produce soy (UruÃuÃ, Ribeiro GonÃalves and Baixa Grande do Ribeiro). The purpose of this study was evaluating the impact of the use of pesticides on agricultural laborerâs health in the cities of UruÃuÃ, Ribeiro GonÃalves and Baixa Grande do Ribeiro. The study was divided in three steps. Firstly, a social epidemiologic questionnaire Word Health Organization (WHO) was applied and samples and collected material to biochemical, hematological and enzymatic plasma acetylcholinesterase and erythrocyte acetylcholinesterase analysis of 120 agricultural laborers from the region. The second step was a study of these workers. These ones submitted salf of Piauà to a second evaluation which used, as a tool, the tests which had been previously discribed. In the third step 31 individuals with irregular parameters were submitted to a micronucleus test. Cells from the oral mucosa were collected to evaluate the level of DNA injury through micronucleus counting. The results of the social epidemiologic questionnaire pointed that 100% of the subjects who had benn studied were males with an average age of 35 years old. 66% were married, 76.67% worked in farms (farmers, machinists and agricultural technicians), 16.67% worked as endemic diseases agents or civil servants. 21.3% of them used non-prescribed medication and 71.67% had not did medical tests for the last 6 months. About life and work style the investigation showed that 33.33% of the workers is smokers, 55.83% drink alcohol, 29.9% has direct contact with the pesticide while it was being prepared to be use, 38% during the pulverization process, 10% during the equipment cleaning and maintenance, 17.5% did not take any safety protection measure, while the most used only a single kind of EPI. Another related discovery about the workers showed that they used more than 34 different formulations. Insecticides (45.18%), herbicides (27.68%) and fungicides (6.21%) were the most used products. Concerning the time of exposure the workers had to the pesticides, 50.84% were exposed to them for less than 2 years and 10% for more than 10 years. The effects on the SNC detached themselves among the most related symptoms with a 230 complaints reported during the application of the social epidemiologic questionnaire. Concerning the final destination of the containers, 84.21% were burned, buried and left outdoors while 15.79% were brought to the appropriate organ headquarter. The results from the biochemical and hematological analysis indicated that 11.67%; 4.17%; 10.83%; 0.83%; 5.83%; 5% e 9.17% of the individuals who were submitted to the first sample collection had, respectively, irregular levels of Gamma-Glutamyl Transferase (GGT); Alkaline Fosfatase and Glutamic-Oxaloacetic Transaminase/ Glutamic Pyruvic Transaminase; Urea; Creatinine; Proteic components; Plasma acetylcholinesterase and Erythrocyte acetylcholinesterase. The findings in the second step indicated that the individuals had irregular levels of: Gamma GT (4.00%); Alkaline Fosfatase and GOT/GPT (4.00%); Urea (4.00%); Creatinine (5.33%); Total Protein (17.33%); Plasma acetylcholinesterase (4.00%) and Erythrocyte acetylcholinesterase (2.67%). In the third step, 84.00% of the 31 subjects who had a micronucleus test presented cytogenetic injuries. The cytogenetic injuries which could be observed were not related to age, smoke, alcohol consumption; safety equipment, medications and diseases which confirms the co-relation between the presented cytogenetic injuries and the exposure to pesticides ( P<0.05)

Nearly five decades ago a group of volunteer scientists and citizens launched a campaign to save birds from the ravages of DDT. They went to court at the local level, then through several states and finally to Washington, DC, overcoming legal barriers and challenging unexpected new issues along the way. By the 1970s, DDT and five other pesticides had been banned. Viewed from the 21st century, these actions produced significant and permanent accomplishments: Preventing cancer—Techniques and procedures for evaluating and regulating carcinogens, which followed the DDT precedents, have been adopted by international treaty. Citizen standing in court—The DDT case broke down the standing barrier, allowing citizens to go to court to protect their environment. It fostered the development of environmental law as we know it today. Recovery of the birds—Populations of iconic bird species, including the Bald Eagle, that had been decimated by DDT, have now recovered their former abundance. Creation of the Environmental Defense Fund—EDF, spawned by the “DDT wars,” has grown into one of the nation’s largest and most influential environmental advocacy organizations. Top authorities in chemical carcinogenesis testified that DDT caused cancer in laboratory animals and that it was, therefore, a possible carcinogen in humans. The precedents set by DDT for identifying and regulating carcinogens then became the basis for banning another five dangerous chlorinated hydrocarbon pesticides: aldrin, dieldrin, heptachlor, chlordane, and mirex (see Chapter 12). EDF had established a very high standard for protection of public health against these carcinogens, as confirmed by two EPA administrators. In 2001 the Stockholm Convention on Persistent Organic Pollutants (the POPs Treaty) was signed by 151 nations to ban the “dirty dozen,” which included all of the “dirty half-dozen” singled out and banned thanks to EDF’s actions 23 years earlier. There was one exception to the total bans: DDT could be used for only malaria control. In 2009, nine additional POPs were added to the list. By 2013, 179 nations were party to the POPs Treaty, although the United States has not yet ratified it.

In the last few years internet-based technologies played an important role in reinventing various medical procedures and facilitating quick access to medical services and care, particularly in the remote areas of China. The use of artificial intelligence and cloud computing in clinical laboratory setting for slide analysis contributed to standardized cytology and pathology diagnosis but more importantly slide analysis with artificial intelligence has a huge potential to compensate for a country wide lack of pathologists and systematic quality control. While well-established automated slide scanning is already in use, we added intelligent algorithms located in a secure cloud for the better slide readings, and mobile phone microscopes to capture those regions of Hubei province where laboratory infrastructure is supported by high-speed internet and 5G networks. These technological advances allowed us to bring an important pathology expertise across the large areas of China.

What was most compelling in the case for science in medicine after 1870 were the stunning achievements in laboratory medicine by that time. During the preceding decades, the work of laboratory scientists, especially in France and Germany, had brought a far more sophisticated understanding of the physical and chemical makeup and functioning of the human body and had produced a host of new tests, instruments, and techniques that were being increasingly used to study the sick patient. The role of bacteria in fermentation and then in wound pus had been demonstrated in the years preceding 1870, and they were now claimed to be responsible for a number of specific diseases. These discoveries, in turn, stimulated a great burst of energy in surgery, eventually gave a new and more certain basis to public health work, infused new optimism into the search for pharmacological remedies, and opened up new possibilities of protection against illness through deliberate immunization. Virtually no subject in the medical curriculum was untouched by the changes in medical knowledge, as dozens of new courses were created to teach the new viewpoints in disease. The new viewpoints were deemed necessary for students to master, even though they had as yet little impact on therapy. Contrary to some later critics, medicine has always been more than the simple application of “cures” to human ailments. For thousands of years as well as in our own time, the understanding of disease, its origins and causes, its transmission, and its prevention, prognosis, and palliation have been principal reasons for consulting a physician. In the years around 1870, in particular, science made enormous gains in understanding ancient afflictions and was gaining in ways to control, alleviate, and, in a few cases, to cure them. Was science important to medicine in these years, despite the slow pace of therapeutic change? Indeed it was, even if much of ordinary medical practice, especially the healing of many illnesses, was not immediately affected by what students learned. The rapid-fire developments of these years created a vision of an experimentally based, irresistible medical science that would soon sweep all doubts before it.

This chapter describes changes in conservation practices in the twenty-first century. As public spaces were repurposed from storage to study and work space, collections were moved into dedicated spaces that could sustain tighter environmental controls than an open stack environment. Digital access relieved pressure on print collections in many libraries, while digitization projects required intervention by conservators. Rehousing replaced repair as a default preservation strategy for many materials, and improved housing materials played an increasingly important role in conservation. In this chapter, conservation for disaster recovery is examined from the perspective of short-term in situ response techniques, and longer term laboratory treatments to restore access to affected collections. Surveys have suggested that routine practices have evolved slowly since 2000. With an emphasis on novel and unique techniques in the peer-reviewed literature, many important questions about routine conservation procedures in disaster recovery have remained unanswered.

The initial investigations reported here offer some broad lessons from the analysis of a specific example. Application of the techniques and results in the Los Alamos case to other areas or cases would require modifications, and even the conclusions about plutonium in the Northern Rio Grande are more first approximations than final answers. After reviewing the lessons of the Los Alamos work, this chapter summarizes some of the natural scientific lessons, with particular reference to the changing Northern Rio Grande and some observations about the interactions between natural science for plutonium and the associated public policy and politics surrounding the issue. Because this work is a beginning rather than an ending, this chapter concludes with some speculations on the future of plutonium in the Northern Rio Grande. The lessons from the particular case of Los Alamos and the Rio Grande extend far beyond northern New Mexico. As a “test bed,” the laboratory, its plutonium releases, and the data-rich Rio Grande provide generalizations useful to researchers, monitors, regulators, decision makers, and managers of other systems and locations. This chapter reviews these lessons as two distinct groups: general guidelines and specific sediment-sampling procedures. First are several general guidelines that should direct any effort at assessing the plutonium system of a river affected by industrial-waste disposal, an accidental release during transportation, or distribution from a nuclear detonation involving surface materials or from atmospheric fallout. Second, because of the overriding importance of sediment in the transport and storage of plutonium, several specific procedures should be followed when sampling soils and sediment, to ensure accurate interpretations of the results. A refined sampling and monitoring program for plutonium in sediment should be driven by a philosophy that has the following general principles. 1. Obtain an accurate inventory of sediment-bound plutonium at the source location. If the source of contaminated sediments in a river system is a known mass, such as a well-defined waste-disposal site, a tailings accumulation, or another readily measured mass of material, a reasonable estimate of the total inventory of plutonium in the source is possible.

This talk is aimed at presenting novel solutions developed recently by the author’s group for many neurological disorders including Parkinson’s disease, Alzheimer’s disease, depression, anxiety, sleep apnea and sleep disorders using the fundamental research and developments in nanotechnologies and wireless sensor network. Point-of-care (POC) diagnostics promises to bring diagnostic testing out of the laboratory directly to patients and the general public wherever they may be. The key to POC diagnostics is capable of bringing immediate answers so that health care professionals can make rapid and accurate diagnosis of disease so as to ensure the effectiveness of therapy and early detection for preventive therapy. Selected movies illustrating the applications of both invasive and non-invasive wireless nanosensor systems to patients and surgical procedures will be shown at the talk.

Abstract Systems in service continue to degrade with passage of time. Pipelines are among the most common systems that wear away with usage. For public safety it is of utmost importance to monitor pipelines and detect new defects within the pipelines. Magnetic flux leakage (MFL) testing is a widely used nondestructive evaluation (NDE) technique for defect detections within the pipelines, particularly those composed of ferromagnetic materials. Pipeline inspection gauge (PIG) procedure based on line-scans or 2D-scans can collect accurate MFL readings for defect detection. However, in real world applications involving large pipe-sectors such extensive scanning techniques are extremely time consuming and costly. In this paper, we develop a fast and cheap methodology that does not need MFL readings at all the points used in traditional PIG procedures but conducts defect detection with similar accuracy. We consider an under-sampling based scheme that collects MFL at uniformly chosen random scan-points over large lattices instead of extensive PIG scans over all lattice points. Based on readings for the chosen random scan points, we use Kriging to reconstruct MFL readings over the entire pipe-sectors. Thereafter, we use thresholding-based segmentation on the reconstructed data for detecting defective areas. We demonstrate the applicability of our methodology on synthetic data generated using popular finite element models as well as on MFL data collected via laboratory experiments. In these experiments spanning a wide range of defect types, our proposed novel MFL based NDE methodology is witnessed to have operating characteristics within the acceptable threshold of PIG based traditional methods and thus provide an extremely cost-effective, fast procedure with competing error rates that can be successfully used for scanning massive pipeline sectors.

Carpal tunnel syndrome (CTS) is a common, costly problem in the general population and particularly in manual workers [1–3], with as many as 3 million individuals experiencing its symptoms and signs, including pain, tingling, numbness, fatigue and weakness in the hands and fingers [4]. Treatment of CTS is estimated to cost over one billion dollars a year [5]. The most prevalent theory for the pathogenesis of CTS is compression of median nerve in the carpal tunnel [6]. Although this theory is widely accepted, the cause of the compression in the carpal tunnel is not fully understood. Epidemiological research has identified several occupational risk factors associated with the development of CTS in general industry including: force, repetition, awkward/static postures, localized mechanical compression, and vibration [7]. Several studies have found greater prevalence of carpal tunnel syndrome in workers with highly repetitive manual jobs [8]. Keyboarding is a highly repetitive daily task, and its association with musculoskeletal disorders of the upper extremity has been a public health concern since the 1980s [1]. However, there are controversial results regarding the association between computer keyboarding and CTS which indicate that we have an insufficient understanding of an association between keyboarding and upper limb neuropathy. Using ultrasonographic techniques, our laboratory was able to explore acute changes in the median nerve following a one-hour keyboarding task [9].