BACKGROUND: Digital pathology practice is rapidly gaining popularity among practicing anatomic pathologists. Acceptance is higher among the newer generation of pathologists who are willing to adapt to this new diagnostic method due to the advantages offered by whole slide imaging (WSI) compared to traditional light microscopy (TLM). We performed this validation study because we plan to implement the WSI system for diagnostic services. OBJECTIVES: Determine the feasibility of using digital pathology for diagnostic services by assessing the equivalency of WSI and TLM. DESIGN: A laboratory-based cross-sectional study. SETTING: Central laboratory at a tertiary health care center. MATERIALS AND METHODS: Four practicing surgical pathologists participated in this study. Each pathologist blindly reviewed 60 surgical neuropathology cases with a minimum 8-week washout-period between the two diagnostic modalities (WSI vs. TLM). Intraobserver concordance rates between WSI and TLM diagnoses as compared to the original diagnosis were calculated. MAIN OUTCOME MEASURES: Overall intraobserver concordance rates between each diagnostic method (WSI and TLM) and original diagnosis. SAMPLE SIZE: 60 in-house surgical neuropathology cases. RESULTS: The overall intraobserver concordance rate between TLM and original diagnosis was 86.3% (range 76.7%-91.7%) versus 80.8% for WSI (range 68.3%-88.3%). These findings are suggestive of the superiority of TLM, but the Fleiss' Kappa statistic indicated that the two methods are equivalent, despite the low level of the K value. CONCLUSION: WSI is not inferior to the light microscopy and is feasible for primary diagnosis in surgical neuropathology. However, to ensure the best results, only formally trained neuropathologists should handle the digital neuropathology service. LIMITATIONS: Only one diagnostic slide per case rather than the whole set of slides, sample size was relatively small, and there was an insufficient number of participating neuropathologists. CONFLICT OF INTEREST: None.
Countries need to ensure that national LTBI policies and a standardised monitoring and evaluation system are in place to promote the programmatic management of LTBI.
Hyperglyceridemia induced pancreatitis in pregnancy accounts for 4% of all cases of acute pancreatitis. Though rare, hypertriglyceridemia induced pancreatitis may lead to fatal maternal and fetal complications, even maternal death. Its management during pregnancy remains a challenge for many physicians. Management options are limited in pregnancy. In the refractory cases, management options and timing of delivery is debatable. Here we report a case of hyperglyceridemia induced pancreatitis and the challenges faced in the management.
Given the global commitment and potential availability of resources towards controlling AMR, collaboration between the two programs is discussed towards a more efficient use of resources in the region.
This paper is predominately for people to realize the potential promising outcomes of the innovative contracting strategy model of which it can provide a minimum of 10% cost reduction while still offering flexibility to accommodate upside scope with faster oil acceleration through efficiency in execution.
Continuous improvement through optimization and cost reduction has always been top priority in the BN area, that has been the focus for current and future development. Approximately eleven fields in the BN area are contributing to the success today. The fields in the area offer lots of opportunities and many upside scopes. A cross-functional team was deployed to ensure the preferred contracting strategy model is properly explored and fit for the project value drivers.
Clear value drivers and scope optimisation was determined upfront and different in-house contracting models were compared and ranked using SWOT analysis (Strength-Weakness-Opportunity-Threats). Innovative contracting model was introduced, a Hybrid model that can deliver the project value drivers and provide the management the optimum long-term results.
Value drivers of the project have been revisited prior to the contracting strategy workshop in order to reflect the latest view of the project. Apart from CAPEX saving, flexibility has become crucial to the project success due to nature of subsurface uncertainty in the area.
Pre-workshop preparation involved many stakeholders’ engagement in order to take learnings from existing/current on going contracts in the company. SWOT analysis for each contracting type has been built with support from all the contract holdership team who has an experience in each contract type. The SWOT analysis has been combined and ranked against the value drivers of the assessed project.
Contracting strategy assessment workshop has been conducted successfully and the Hybrid Model was ranked as the preferred option. Hybrid model concept looks-into two different contracting models (Insourcing and Integrated Service Management (ISM)) of which each Model has its own characteristics and benefits. Hence, Well Services Review is vital to identify and detail the project Hybrid Scope of Work (SOW) such as interference, enablers, etc.
Minimum 10% saving of well cost through standardization and efficiency in project management is a target set; however, the ongoing Gap to Potential, external benchmarking, and full integrated project economics will entail further cost savings. In addition, Hybrid Model commercialisation is being studied for potential project attractiveness, cost savings, and efficiency i.e., rental fee analysis.
The approach involves a true understanding of the project value drivers and uncertainties. Integrated team from subsurface, surface, contract and procurement are the heart of the success which allow the project to be analyzed in detail through out. Creative, innovative with commercial mind-set thinking has actually proven to deliver continuous improvement and contracting effectiveness.
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