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SAC - Specimen Container Detail Segment

The container detail segment is the data necessary to maintain the containers that are being used throughout the Laboratory Automation System.

The specimens in many laboratories are transported and processed in containers (e.g., sample tubes). When SPM and SAC are used in the same message, then the conceptually duplicate attributes will be valued only in the SPM. This applies to SAC-6 Specimen Source, SAC-27 Additives, and SAC-43 Special Handling Considerations.

HL7 Attribute Table - SAC - Specimen Container Detail Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
SAC
1 01329 External Accession Identifier [0..1] EI
2 01330 Accession Identifier [0..1] EI
3

01331 Container Identifier MAY
True:
False:
C
[1..1]
[0..1]
EI
4

01332 Primary MAY
True:
False:
C
[1..1]
[0..1]
EI
5 01333 Equipment Container Identifier [0..1] EI
6 00249 Specimen Source SHALL NOT W [0..0]
7 01334 Registration Date/Time [0..1] DTM
8 01335 Container Status [0..1] CWE
9 01336 Carrier Type [0..1] CWE
10 01337 Carrier Identifier [0..1] EI
11 01338 Position in Carrier [0..1] NA
12 01339 Tray Type – SAC [0..1] CWE
13 01340 Tray Identifier [0..1] EI
14 01341 Position in Tray [0..1] NA
15 01342 Location [0..*] CWE
16 01343 Container Height # [0..1] 10 NM
17 01344 Container Diameter # [0..1] 10 NM
18 01345 Barrier Delta # [0..1] 10 NM
19 01346 Bottom Delta # [0..1] 10 NM
20 01347 Container Height/Diameter/Delta Units [0..1] CWE
21 00644 Container Volume [0..1] NM
22 01349 Available Specimen Volume # [0..1] 10 NM
23 01350 Initial Specimen Volume # [0..1] 10 NM
24 01351 Volume Units [0..1] CWE
25 01352 Separator Type [0..1] CWE
26 01353 Cap Type [0..1] CWE
27 00647 Additive [0..*] CWE
28 01355 Specimen Component [0..1] CWE
29 01356 Dilution Factor [0..1] SN
30 01357 Treatment [0..1] CWE
31 01358 Temperature [0..1] SN
32 01359 Hemolysis Index # [0..1] 10 NM
33 01360 Hemolysis Index Units [0..1] CWE
34 01361 Lipemia Index # [0..1] 10 NM
35 01362 Lipemia Index Units [0..1] CWE
36 01363 Icterus Index # [0..1] 10 NM
37 01364 Icterus Index Units [0..1] CWE
38 01365 Fibrin Index # [0..1] 10 NM
39 01366 Fibrin Index Units [0..1] CWE
40 01367 System Induced Contaminants [0..*] CWE
41 01368 Drug Interference [0..*] CWE
42 01369 Artificial Blood [0..1] CWE
43 01370 Special Handling Code [0..*] CWE
44 01371 Other Environmental Factors [0..*] CWE
45 02496 Container Length [0..1] CQ
46 02497 Container Width [0..1] CQ
47 02498 Container Form [0..1] CWE
48 02499 Container Material [0..1] CWE
49 02500 Container Common Name [0..1] CWE

SAC-1: External Accession Identifier (EI) 01329

Definition: This field identifies the laboratory accession (see section Glossary). This identifier is assigned by the external laboratory information system.

Example: If laboratory A sends a specimen to laboratory B, then within laboratory B this field contains accession identifier of lab A.

SAC-2: Accession Identifier (EI) 01330

(Definition from IPC.1 in Ch. 4)

Definition: A workflow-management IDIS generated number that identifies the Filler Order for an Imaging Service (Imaging Service Request). This identifier corresponds one-to-one to the Order Filler number but is used in internal tracking of the work by the IDIS and in communication between IDIS within the department. It also has specific requirements to assure its compatibility with DICOM. It is a case of the Entity Identifier data type (section 2.A.28). Its first component is a string that identifies the Imaging Service Request. A limit of sixteen (16) characters is required to allow compatibility with DICOM. See DICOM Standard Part 3 for further details on DICOM Attribute (0008,0050) that conveys information identical to the component one of this field.

An IDIS that performs functions of the workflow management for a department may accept a single Placer Order that gives rise to one or more Filler Orders-Imaging Service Requests. For example, an IDIS may receive an order for an X-ray examination of the patient daily at 8 am for the next three days. For the purposes of fulfilling the Placer Order, it will identify each of the daily exams either as a separate Filler Order or parts of a single Filler Order. Correspondingly, it will assign one or more Filler Order numbers associated with the order. For each of the Filler Order numbers, it will assign a unique Accession Number.

Each of the Imaging Service Requests may contain one or more Requested Procedures that it will identify with the Requested Procedure ID. The Requested Procedure is the most granular unit of work that may lead to the creation of the procedure report. Each procedure report contributes to the results for the order. In the example mentioned above, each of the daily examinations will require a separate diagnostic report, hence each of them will be treated as a separate Requested Procedure. Depending on the treatment of the order by the IDIS, it will either link all Requested Procedures to a single Filler Order-Imaging Service Request, or link each Requested Procedure to its own Imaging Service Request. Exact type of requested procedure is conveyed by the coded values in OBR-44 Procedure Code and OBR-45 Procedure Code modifier for each procedure. Note that in case of multiple Requested Procedures corresponding to one order, each procedure may have different code.

To support communication with the instances of equipment in a department (acquisition modalities), IDIS will also generate the Study Instance UID, a globally unique identifier for each Requested Procedure. This identifier will be used by acquisition modalities to identify all generated images and other DICOM objects related to this Requested Procedure. Note that, unlike the Study Instance UID, the Requested Procedure ID must only be unique within the scope of the encompassing Imaging Service Request identified by an Accession Number.

Each of the Requested Procedures may be further broken down by the IDIS into the Scheduled Procedure Steps based on the timing and equipment requirements. Each step is identified with the Scheduled Procedure Step ID. A single Procedure Step may only be performed on a single type and instance of the equipment. Thus, while the Requested Procedure may identify multi-modality examination (such as ones common in Nuclear Medicine), a single Procedure Step shall correspond to the operations performed on a single modality.

The example of the hierarchy of Imaging Service Request, Requested Procedure and Scheduled Procedure Step is depicted in a figure 4-6. Identifiers of the entities are represented by the field names stated in square brackets.

Figure 4-6. Hierarchy of Imaging Service Request, Requested Procedure and Scheduled Procedure Step

The full hierarchy constitutes the context that will be shared between all IDIS within a department in a course of order fulfillment.

Each OMI message shall convey information about Requested Procedure(s) pertaining to one order. A pair of Segments ORC/OBR shall correspond to each requested procedure. If the Requested Procedure is comprised of multiple Procedure Steps, multiple IPC segments shall be included for each ORC/OBR pair in the message. Value of the IPC-1 field shall be identical in all IPC segments.

Considering the preceding example of X-ray examinations on subsequent days with two different steps identified for the last Requested Procedure and examinations to be performed at the site, "RADIOLOGY", the communication of the information using OMI message may look like the following:

MSH|...<cr>

PID|...<cr>

ORC|NW|...<cr>

OBR|1|X1234^HIS|R578^RIS|56782^X-Ray Chest|...|XPA^X-Ray Chest PA|...<cr>

IPC|A345^RIS|P1234^RIS|1.2.840.1234567890.3456786.1^RIS|SPS1^RIS|CR|SXPA^Chest PA||RADIOLOGY|<cr>

ORC|NW|...<cr>

OBR|2|X1234^HIS|R578^RIS|56782^X-Ray Chest|...|XPA^X-Ray Chest PA|...<cr>

IPC|A345^RIS|P1235^RIS|1.2.840.1234567890.3456786.2^RIS|SPS1^RIS|CR|SXPA^Chest PA||RADIOLOGY|<cr>

ORC|NW|...<cr>

OBR|3|X1234^HIS|R578^RIS|56782^X-Ray Chest|...|XPALAT^X-Ray Chest PA and Lateral|...<cr>

IPC|A345^RIS|P1236^RIS|1.2.840.1234567890.3456786.3^RIS|SPS1^RIS|CR|SXPA^Chest PA||RADIOLOGY|<cr>

IPC|A345^RIS|P1236^RIS|1.2.840.1234567890.3456786.3^RIS|SPS2^RIS|CR|SXLAT^Chest Lat||RADIOLOGY|<cr>

(Definition from SAC.2 in Ch. 13)

Definition: This field identifies the laboratory accession (see section 13.2.3, "Glossary"). This identifier is assigned by the information system of the laboratory performing the tests.

An accession identifier can refer to more than one container. A Container Identifier (see below) is a Unique Identifier for that container.

SAC-3: Container Identifier (EI) 01331

Definition: This field identifies the container. This field is the container's unique identifier assigned by the corresponding equipment. A container may contain the primary (original) specimen or an aliquot (secondary sample) of that specimen. For primary sample this field contains Primary Container ID; for bar-coded aliquot samples this field contains Aliquot Container ID; for non-bar-coded aliquot samples (e.g., microtiter plate) this field is empty.9

The NCCLS standard requires a unique identifier for each container introduced into the Laboratory Automation System. The combination of the fields: Primary Container ID, Container ID, Carrier ID / Position, Tray ID / Position must identify the container uniquely within the LAS. The naturally best solution is unique machine-readable ID attached to the container (which of course is sufficient to ensure the uniqueness of the fields' combination). A bar code that symbolizes this ID should meet the proposed standard NCCLS AUTO2 (Laboratory Automation: Bar Codes for Specimen Container Identification).

SAC-4: Primary (EI) 01332

Definition: If this field is filled in, it identifies the primary container from which this specimen came. For primary samples this field is empty; for aliquot samples this field should contain the identifier of primary container.

SAC-5: Equipment Container Identifier (EI) 01333

Definition: This field identifies the container in a particular device (e.g., one container in a carousel or rack of containers within an analyzer, analyzer specific bar code mapping, etc.).

SAC-6: Specimen Source

(Definition from OBR.15 in Ch. 4)

Attention: The OBR-15 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. See SPM in Chapter 7.

(Definition from OBR.15 in Ch. 7)

Attention: The OBR-15 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. See SPM in Chapter 7.

(Definition from SAC.6 in Ch. 13)

Attention: This field was deprecated and retained for backward compatibilityonly as of v2.5 and withdrawn and removed as of v2.7.

(Definition from TCC.3 in Ch. 13)

Attention: As of version 2.5 this field was deprecated and retained for backward compatibility only and withdrawn as of v2.7.

SAC-7: Registration Date/Time (DTM) 01334

Definition: This field is the date/time that the container was last registered with the "automated system," e.g., reading of a container bar code by a device.

SAC-8: Container Status (CWE) 01335

Definition: This field identifies the status of the unique container in which the specimen resides at the time that the transaction was initiated. Refer to HL7 Table 0370 - Container Status in Chapter 2C, Code Tables, for valid values. The equipment specific container status should be sent as <alternate identifier> as needed.

The container states are relevant for the exchange of information among devices (within the LAS). Not all of them are relevant for information transfer between the LAS and the LIS.

SAC-9: Carrier Type (CWE) 01336

Definition: This field identifies the type of the carrier (see section 13.2.3, "Glossary"). Refer to User-defined Table 0378 – Carrier Type in Chapter 2C, Code Tables, for suggested values. Because the geometry can be different, the carrier type should, if possible, express the number of positions in the carrier.

The definition assumes hierarchical nesting using the following phrases: container is located in a carrier; carrier is located in a tray.

SAC-10: Carrier Identifier (EI) 01337

Definition: This field identifies the carrier. It is the ID (e.g., number or bar code) of the carrier where the container (e.g., tube) is located.

Example: A carrier could be a rack with single or multiple specimen containers. A carrier is usually used for automated specimen transport. Multiple carriers can be stacked in a tray, which is then used for manual or automatic transport.

SAC-11: Position in Carrier (NA) 01338

Definition: This field identifies the position of the container in the carrier (e.g., 1...3...). The sub-components allow, if necessary, to transfer multiple axis information, e.g., 2-dimensional carrier (X^Y).

SAC-12: Tray Type – SAC (CWE) 01339

Definition: This field identifies the type of the tray (see section 13.2.3, "Glossary"). Refer to User-defined Table 0379 – Tray Type in chapter 2C for suggested values. Because the geometry can be different, the tray type should if possible express the number of positions in the tray.

The definition assumes hierarchical nesting using the following phrases: container is located in a carrier, carrier is located in a tray.

SAC-13: Tray Identifier (EI) 01340

Definition: This field identifies the tray identifier (e.g., a number of a tray or a bar code on the tray) where the container carrier is located.

SAC-14: Position in Tray (NA) 01341

Definition: This field identifies the position of the carrier in the tray. The sub-components allow, if necessary, to transfer multiple axis information, e.g., 2-dimensional tray (X^Y).

SAC-15: Location (CWE) 01342

Definition: This field is the physical location that the specimen was at the time that the transaction was initiated. The location description can vary with the LAS. For example, it can be an X,Y,Z coordinate in a storage system; a refrigerator number and drawer number where the container-carrier-tray is located; or it can be the name of the institution and the laboratory which owns the container currently. The repeating of this field allows for hierarchical representation of location (lowest level first), e.g., shelf number, refrigerator storage id, lab name, institution name, etc. Refer to Table 0774 - Location in Chapter 2C for valid values.

SAC-16: Container Height (NM) 01343

Definition: This field identifies the height of the container in units specified below.

Note:     If the container type is categorized (FBT (false-bottom-tube), Cup, etc.), the specific codes should be transferred in the SPM-27 field “Container Type”. If the container is characterized by dimensions and other characteristics this information should be transferred as specific values in the SAC segment (fields: SAC-16 through SAC-21, or SAC-45 to SAC-48).


SAC-17: Container Diameter (NM) 01344

Definition: This field identifies the outside diameter of the container in units specified below. For non-cylindrical containers SAC-45 Container Length and SAC-46 Container Width may be used instead of SAC-17 Container Diameter.

SAC-18: Barrier Delta (NM) 01345

Definition: This field identifies the distance from the Point of Reference to the separator material (barrier) within the container in units specified below. This distance may be provided by the LAS to the instrument and/or specimen processing/handling device to facilitate the insertion of a sampling probe into the specimen without touching the separator. Refer to Point Of Reference definition in section Glossary or in NCCLS standard AUTO5 Laboratory Automation: Electromechanical Interfaces.

SAC-19: Bottom Delta (NM) 01346

Definition: This field identifies the distance from the Point of Reference to the outside bottom of the container in units specified below. Refer to Point Of Reference definition in section 13.2.3, "Glossary," or in NCCLS standard AUTO5 Laboratory Automation: Electromechanical Interfaces.

SAC-20: Container Height/Diameter/Delta Units (CWE) 01347

Definition: This field is the unit identifier that is being used to describe the diameter, height and deltas of the container. If the units are ISO+ units, they should be recorded as single case abbreviations. If the units are ANS+ or L (local), the units and the source code table must be recorded, except that in this case, component delimiters should be replaced by subcomponent delimiters. The default unit is millimeters (mm), which should be assumed if no units are reported. Refer to Table 0775 - Container Height/Diameter/Delta Units in Chapter 2C for valid values.

SAC-21: Container Volume (NM) 00644

(Definition from OM4.4 in Ch. 8)

Definition: This field indicates the capacity of the container. This field repeats to accommodate all the possible specimen that will be allowed. If a container is preferred, only that container should be messaged here with the alternate containers messaged in a repeat OM4 segment

(Definition from SAC.21 in Ch. 13)

Definition: This field indicates the capacity of the container in the units specified below.

SAC-22: Available Specimen Volume (NM) 01349

Definition: This field identifies the current specimen volume available for use in this container in the units specified below.

SAC-23: Initial Specimen Volume (NM) 01350

Definition: This field identifies the volume of the specimen initially filled in this container in the units specified below.

SAC-24: Volume Units (CWE) 01351

Definition: This field is the unit identifier that is being used to describe the volume of the container. If the units are ISO+ units, they should be recorded as single case abbreviations. The default unit is milliliters (ml), which should be assumed if no units are reported. Refer to Table 0777 - Volume Units in Chapter 2C for valid values.

SAC-25: Separator Type (CWE) 01352

Definition: This field identifies the type of the separator that is being used (e.g., gel separator in the container – not to be confused with the communication separators). Refer to User-defined Table 0380 – SeparatorType in Chapter 2C, Code Tables, for suggested values. It is recommended that the first table entry be "NO" meaning "No Separator."

SAC-26: Cap Type (CWE) 01353

Definition: This field indicates the type of cap that is to be used with this container for decapping, piercing or other mechanisms. Refer to User-defined Table 0381 – Cap Type in Chapter 2C, Code Tables, for suggested values.

SAC-27: Additive (CWE) 00647

(Definition from OM4.7 in Ch. 8)

Definition: This field contains the codes that should be those provided by NCCLS3. Refer to HL7 Table 0371 - Additive/Preservative in Chapter 2C, Code Tables, for valid values. The table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

This table was not specified in previous versions and thus sites may choose to use other site-specific tables.

(Definition from SAC.27 in Ch. 13)

Definition: This field identifies any additives introduced to the specimen before or at the time of collection. These additives may be introduced in order to preserve, maintain or enhance the particular nature or component of the specimen. It is a repetitive field. Refer to HL7 Table 0371 – Additive/Preservative for valid values. 'The value set can be extended with user specific values.

When the SPM (Specimen) segment is sent together with the SAC segment the additive attribute value from the SPM segment can be included in this field of the SAC.

SAC-28: Specimen Component (CWE) 01355

Definition: This field identifies the specimen component, e.g., supernatant, sediment, etc. Refer to User-defined Table 0372 – Specimen Component in Chapter 2C, Code Tables, for valid values. This table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

SAC-29: Dilution Factor (SN) 01356

(Definition from SAC.29 in Ch. 13)

Definition: This field identifies the factor of dilution already performed on the specimen. The equipment entity that changes the dilution is responsible for sending this information to other equipment. If the endogenous content of the test (analyte) in the diluent is required for the calculation of the test (analyte) concentration, then the test (analyte) specific values should be exchanged between the systems via Master Files or other means.

Examples of use:

|^1^:^5|    - means dilution 1 to 5, i.e., 1 part sample, 4 parts diluent

|^1^+|    - sample is diluted, but the factor is unknown

|^1^:^1|    - not diluted sample

||    - dilution not changed

(Definition from SCD.35 in Ch. 17)

Definition: The dilution ratio of peracetic acid to water.

SAC-30: Treatment (CWE) 01357

Definition: This field identifies the specimen treatment performed during lab processing. Refer to User-defined Table 0373 – Treatment in chapter 2C for valid values. This table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

SAC-31: Temperature (SN) 01358

Definition: This field identifies the specimen temperature in degrees Celsius [°C] at the time of the transaction specified in the EQU segment.

SAC-32: Hemolysis Index (NM) 01359

Definition: This field is the index identifier that is being used to describe the Hemolysis Index of the specimen.

SAC-33: Hemolysis Index Units (CWE) 01360

Definition: This field is the unit's identifier that is being used to describe the Hemolysis Index of the specimen. It is recommended to use g/L. (The transmission of the index values is added here instead of the original use of the OBX segments, because the frequency of the transfer of the specimen details justifies use of more efficient mechanism.) Refer to Table 0779 - Hemolysis Index Units in Chapter 2C for valid values.

If this field is null, the recommended value is assumed.

SAC-34: Lipemia Index (NM) 01361

Definition: This field is the index identifier that is being used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).

SAC-35: Lipemia Index Units (CWE) 01362

Definition: This field is the unit's identifier that is being used to describe the Lipemia Index of the specimen. Refer to Table 0780 - Lipemia Index Units in Chapter 2C for valid values.

If this field is null, the recommended value is assumed.

SAC-36: Icterus Index (NM) 01363

Definition: This field is the index identifier that is being used to describe the Icterus Index of the specimen.

SAC-37: Icterus Index Units (CWE) 01364

Definition: This field is the unit's identifier that is being used to describe the Icterus Index of the specimen. It is recommended to use mMol/L of bilirubin. Refer to Table 0781 - Icterus Index Units in Chapter 2C for valid values.

If this field is null, the recommended value is assumed.

SAC-38: Fibrin Index (NM) 01365

Definition: This field is the index identifier that is being used to describe the Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, we recommend using 0 and 1 respectively and send the field Fibrin Index Units null.

SAC-39: Fibrin Index Units (CWE) 01366

Definition: This field is the unit's identifier that is being used to describe the Fibrin Index of the specimen. Refer to Table 0782 - Fibrin Index Units in Chapter 2C for valid values.

SAC-40: System Induced Contaminants (CWE) 01367

Definition: This field describes the specimen contaminant identifier that is associated with the specimen in this container. Refer to User-defined Table 0374 – System Induced Contaminants in Chapter 2C, Code Tables, for valid values. This table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

SAC-41: Drug Interference (CWE) 01368

Definition: This field describes the drug interference identifier that is associated with the specimen. Refer to User-defined Table 0382 – Drug Interference in Chapter 2C, Code Tables, for suggested values.

SAC-42: Artificial Blood (CWE) 01369

Definition: This field describes the artificial blood identifier that is associated with the specimen. Refer to User-defined Table 0375 – Artificial Blood in Chapter 2C, Code Tables, for valid values. This table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

SAC-43: Special Handling Code (CWE) 01370

(Definition from SAC.43 in Ch. 13)

Definition: This field describes any special handling considerations that are associated with the specimen in the specific container (e.g., centrifugation). This describes how the specimen needs to be stored during collection, in transit, and upon receipt. Refer to User-defined Table 0376 – Special Handling Code in Chapter 2C, Code Tables, for valid values. 'The value set can be extended with user specific values.

(Definition from ITM.29 in Ch. 17)

Definition: This field contains a special handling code to describe special handling considerations for this item. Refer to User-defined Table 0376 – Special Handling Code in Chapter 2C, Code Tables, for suggested values. The value set can be extended with user specific values.

SAC-44: Other Environmental Factors (CWE) 01371

Definition: This field describes other environmental factors that are associated with the specimen in a specific container, e.g., atmospheric exposure. Refer to User-defined Table 0377 – Other Environmental Factors in Chapter 2C, Code Tables, for valid values. This table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

SAC-45: Container Length (CQ) 02496

Definition: This field describes the longest horizontal measurement of the container, for non-cylindrical containers. For cylindrical containers SAC-17 Container Diameter may be used instead of SAC-45 Container Length and SAC-46 Container Width.

SAC-46: Container Width (CQ) 02497

Definition: This field desrcibes the distance from side to side, measuring across the object at right angles to the length, for non-cylindrical containers. For cylindrical containers SAC-17 Container Diameter may be used instead of SAC-45 Container Length and SAC-46 Container Width.

SAC-47: Container Form (CWE) 02498

Definition: This field is the coded representation of the format or type of the container (e.g. tube/vial, jar, bag, block, slide, etc.). Refer to User-Defined Table 0967 for suggested values.

SAC-48: Container Material (CWE) 02499

Definition: This field is the coded representation of the material composition (i.e. physical substance) of the container and may be considered to modify for further describe SAC-47 (Container Form). It may also indicate a virtual container in the cases of digitized specimens (e.g. scans obtained by whole slide imaging techniques, etc.). Refer to User-Defined Table 0968 for suggested values.

SAC-49: Container Common Name (CWE) 02500

Definition: This field is a coded representation of the way the container type is commonly referenced in an organization, in order to aid in ensuring the appropriate container is used. Examples include “Red Top” (for tubes/vials), “Wet Mount” (for slides), etc. Frequently these values will be locally defined and meaning may vary by supplier. Refer to User-Defined Table 0969 for suggested values.

In many cases this is a shorthand way to express a combination of other container attributes, for example the combination of SAC-47 (Container Form) of “Tube/vial” + SAC-48 (Container Material) of “Glass” + SAC-27 (Additive) of “EDTA” may be referenced commonly in an organization as a “Lavender Top”.