Sample records for study laboratory tests

  1. [Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

    PubMed

    Ishibashi, Midori

    2015-01-01

    The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

  2. Use of proficiency test performance to determine clinical laboratory director qualifications.

    PubMed

    Howanitz, P J

    1988-04-01

    Many activities and policies influence laboratory test quality. Proficiency test results are one measure of laboratory quality, and during the past 25 years, five studies have examined the relationship of laboratory director educational requirements to proficiency test results. Data from three studies support the association between director qualifications and quality as measured by proficiency test performance, whereas no relationship was found in the other two studies. Possible reasons for conflicting results include differences in database size and demographics; in addition, proficiency test results may be inappropriate, although widely used, as the sole measure of laboratory director performance.

  3. An analysis of reference laboratory (send out) testing: an 8-year experience in a large academic medical center.

    PubMed

    MacMillan, Donna; Lewandrowski, Elizabeth; Lewandrowski, Kent

    2004-01-01

    Utilization of outside reference laboratories for selected laboratory testing is common in the United States. However, relatively little data exist in the literature describing the scope and impact of these services. In this study, we reviewed use of reference laboratory testing at the Massachusetts General Hospital, a large urban academic medical center in Boston, Massachusetts. A retrospective review of hospital and laboratory administrative records over an 8-year period from fiscal years (FY) 1995-2002. Over the 8 years studied, reference laboratory expenses increased 4.2-fold and totaled 12.4% of the total laboratory budget in FY 2002. Total reference laboratory test volume increased 4-fold to 68,328 tests in FY 2002 but represented only 1.06% of the total test volume in the hospital. The menu of reference laboratory tests comprised 946 tests (65.7% of the hospital test menu) compared to 494 (34.3%) of tests performed in house. The average unit cost of reference laboratory tests was essentially unchanged but was approximately 13 times greater than the average unit cost in the hospital laboratory. Much of the growth in reference laboratory cost can be attributed to the addition of new molecular, genetic, and microbiological assays. Four of the top 10 tests with the highest total cost in 2002 were molecular diagnostic tests that were recently added to the test menu. Reference laboratory testing comprises a major component of hospital clinical laboratory services. Although send out tests represent a small percentage of the total test volume, these services account for the majority of the hospital laboratory test menu and a disproportionate percentage of laboratory costs.

  4. 21 CFR 58.219 - Reinstatement of a disqualified testing facility.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... disqualified may be reinstated as an acceptable source of nonclinical laboratory studies to be submitted to the... laboratory studies in compliance with the good laboratory practice regulations set forth in this part and, if...

  5. 21 CFR 58.219 - Reinstatement of a disqualified testing facility.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... disqualified may be reinstated as an acceptable source of nonclinical laboratory studies to be submitted to the... laboratory studies in compliance with the good laboratory practice regulations set forth in this part and, if...

  6. 21 CFR 58.31 - Testing facility management.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Organization and Personnel § 58.31 Testing facility management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study...

  7. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

    PubMed

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-04-01

    It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

  8. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country

    PubMed Central

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-01-01

    Background It is believed that laboratory tariffs in Iran don’t reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. Objective This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. Methods This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. Results In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector’s tariffs in 2015. Conclusion This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories. PMID:28607638

  9. An inter-laboratory comparison study of the ANSI/BIFMA standard test method M7.1 for furniture

    EPA Science Inventory

    Five laboratories using five different test chambers participated in the study to quantify within- and between-laboratory variability in the measurement of emissions of volatile organic compounds (VOCs) from new commercial furniture test items following ANSI/BIFMA M7.1. Test item...

  10. 21 CFR 58.215 - Alternative or additional actions to disqualification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... against a testing facility and/or against the sponsor of a nonclinical laboratory study that has been... nonclinical laboratory study in support of an application for a research or marketing permit, if it finds that...

  11. 21 CFR 58.215 - Alternative or additional actions to disqualification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... against a testing facility and/or against the sponsor of a nonclinical laboratory study that has been... nonclinical laboratory study in support of an application for a research or marketing permit, if it finds that...

  12. Standardization of Laboratory Methods for the PERCH Study

    PubMed Central

    Karron, Ruth A.; Morpeth, Susan C.; Bhat, Niranjan; Levine, Orin S.; Baggett, Henry C.; Brooks, W. Abdullah; Feikin, Daniel R.; Hammitt, Laura L.; Howie, Stephen R. C.; Knoll, Maria Deloria; Kotloff, Karen L.; Madhi, Shabir A.; Scott, J. Anthony G.; Thea, Donald M.; Adrian, Peter V.; Ahmed, Dilruba; Alam, Muntasir; Anderson, Trevor P.; Antonio, Martin; Baillie, Vicky L.; Dione, Michel; Endtz, Hubert P.; Gitahi, Caroline; Karani, Angela; Kwenda, Geoffrey; Maiga, Abdoul Aziz; McClellan, Jessica; Mitchell, Joanne L.; Morailane, Palesa; Mugo, Daisy; Mwaba, John; Mwansa, James; Mwarumba, Salim; Nyongesa, Sammy; Panchalingam, Sandra; Rahman, Mustafizur; Sawatwong, Pongpun; Tamboura, Boubou; Toure, Aliou; Whistler, Toni; O’Brien, Katherine L.; Murdoch, David R.

    2017-01-01

    Abstract The Pneumonia Etiology Research for Child Health study was conducted across 7 diverse research sites and relied on standardized clinical and laboratory methods for the accurate and meaningful interpretation of pneumonia etiology data. Blood, respiratory specimens, and urine were collected from children aged 1–59 months hospitalized with severe or very severe pneumonia and community controls of the same age without severe pneumonia and were tested with an extensive array of laboratory diagnostic tests. A standardized testing algorithm and standard operating procedures were applied across all study sites. Site laboratories received uniform training, equipment, and reagents for core testing methods. Standardization was further assured by routine teleconferences, in-person meetings, site monitoring visits, and internal and external quality assurance testing. Targeted confirmatory testing and testing by specialized assays were done at a central reference laboratory. PMID:28575358

  13. Diagnostic and laboratory test ordering in Northern Portuguese Primary Health Care: a cross-sectional study

    PubMed Central

    Sá, Luísa; Teixeira, Andreia Sofia Costa; Tavares, Fernando; Costa-Santos, Cristina; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto Pinto; Santos, Paulo

    2017-01-01

    Objectives To characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations. Design Cross-sectional study. Setting Northern Primary Health Care, Portugal. Participants Records about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3.5 million Portuguese patients, in 2014. Outcomes To determine the 20 most ordered diagnostic and laboratory tests in the Northern Regional Health Administration; to identify the presence and extent of variations in the 20 most ordered diagnostic and laboratory tests between the Groups of Primary Care Centres and between health units; and to study factors that may explain these variations. Results The 20 most ordered diagnostic and laboratory tests almost entirely comprise laboratory tests and account for 70.9% of the total tests requested. We can trace a major pattern of test ordering for haemogram, glucose, lipid profile, creatinine and urinalysis. There was a significant difference (P<0.001) in test orders for all tests between Groups of Primary Care Centres and for all tests, except glycated haemoglobin (P=0.06), between health units. Generally, the Personalised Healthcare Units ordered more than Family Health Units. Conclusions The results from this study show that the most commonly ordered tests in Portugal are laboratory tests, that there is a tendency for overtesting and that there is a large variability in diagnostic and laboratory test ordering in different geographical and organisational Portuguese primary care practices, suggesting that there may be considerable potential for the rationalisation of test ordering. The existence of Family Health Units seems to be a strong determinant in decreasing test ordering by Portuguese family physicians. Approaches to ensuring more rational testing are needed. PMID:29146654

  14. How well do general practitioners manage laboratory test results for patients with diabetes mellitus and cardiovascular disease?: A systematic review.

    PubMed

    McCaughey, Euan J; Li, Julie; Badrick, Tony C; Westbrook, Johanna I; Georgiou, Andrew

    2017-10-01

    To evaluate how well general practitioners (GPs) manage and respond to laboratory results for patients with diabetes mellitus (DM) and cardiovascular disease (CVD). MEDLINE, CINAHL, Embase, EBM reviews, ProQuest and Scopus. Peer-reviewed journal articles published between 2000 and 2015 that assessed GPs' management of laboratory results for patients with DM or CVD. Study design and demographics, laboratory tests and key findings relating to GP management of laboratory results were extracted from studies. Thirteen articles were included, comprising seven studies which utilized surveys, four observational studies, one cohort study and one randomized controlled trial. Findings indicate that GPs often overestimate the risk of complications associated with DM and CVD based on laboratory results and have unrealistically high expectations regarding the precision of laboratory tests. Considerable variation existed in the use of repeat testing for diagnostic confirmation and in GPs' identification of the difference between two consecutive results required to indicate a change in patient condition. GPs also often failed to initiate appropriate treatment for patients with DM and CVD based on laboratory results. Feedback to GPs about their test ordering patterns and educational messages on laboratory results improved clinical outcomes. Evidence about how well GPs manage results and its impact on patient outcomes remains weak and inconclusive. This review identified a number of areas where interventions could support GPs to improve the interpretation and management of laboratory test results, including feedback to GPs and educational messages on test result reports. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  15. Quality of Liver and Kidney Function Tests among Public Medical Laboratories in Western Region of Amhara National Regional State of Ethiopia.

    PubMed

    Teka, Abaynesh; Kibatu, Girma

    2012-03-01

    Medical laboratories play essential roles in measurements of substances in body fluids for the purpose of diagnosis, treatment, prevention, and for greater understanding of the disease process. Thus, data generated from have to be reliable for which strict quality control, management and assurance are maintained. The aim of this study is to assess the accuracy and precision of clinical chemistry laboratories in western region of Amhara national regional state of Ethiopia in testing liver and kidney functions. Eight laboratories in hospitals and a Regional Health Research Laboratory Center participated in this study from February to March, 2011. Each participant was requested to measure six specimens for six chemistry tests from two control samples. Three hundred twenty four test results to be reported from all participant laboratories, if all measurements can be made, were designed to be collected and statistically evaluated. None of the study subject laboratories could deliver all the six tests for estimation of both liver and renal functions simultaneously during the study period. Only 213 values from the expected 324 values were reported and about 65 % of the 213 values reported fell outside of the allowable limits of errors for the chemistry tests of the control specimen used. This study finding showed that there were lack of accuracy and precision in chemistry measurements. A regular survey on medical laboratories should be conducted questioning the accuracy and precision of their analyses in order to sustain improvements in the quality of services provided by participating laboratories for the benefit of patients. Laboratory Quality Management Systems appreciate the need for regular quality control and quality assessment schemes in medical laboratories.

  16. Impact of Laboratory Test Use Strategies in a Turkish Hospital

    PubMed Central

    Yılmaz, Fatma Meriç; Kahveci, Rabia; Aksoy, Altan; Özer Kucuk, Emine; Akın, Tezcan; Mathew, Joseph Lazar; Meads, Catherine; Zengin, Nurullah

    2016-01-01

    Objectives Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH) and calculate potential savings in costs. Methods A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months. Results Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6–85.0%) was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars. Conclusion Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory tests. PMID:27077653

  17. Body fluid analysis: clinical utility and applicability of published studies to guide interpretation of today's laboratory testing in serous fluids.

    PubMed

    Block, Darci R; Algeciras-Schimnich, Alicia

    2013-01-01

    Requests for testing various analytes in serous fluids (e.g., pleural, peritoneal, pericardial effusions) are submitted daily to clinical laboratories. Testing of these fluids deviates from assay manufacturers' specifications, as most laboratory assays are optimized for testing blood or urine specimens. These requests add a burden to clinical laboratories, which need to validate assay performance characteristics in these fluids to exclude matrix interferences (given the different composition of body fluids) while maintaining regulatory compliance. Body fluid testing for a number of analytes has been reported in the literature; however, understanding the clinical utility of these analytes is critical because laboratories must address the analytic and clinical validation requirements, while educating clinicians on proper test utilization. In this article, we review the published data to evaluate the clinical utility of testing for numerous analytes in body fluid specimens. We also highlight the pre-analytic and analytic variables that need to be considered when reviewing published studies in body fluid testing. Finally, we provide guidance on how published studies might (or might not) guide interpretation of test results in today's clinical laboratories.

  18. Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories.

    PubMed

    Jang, Mi Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong Ho; Min, Won Ki; Lee, Ji Sung; Lee, Yong Wha; Lee, You Kyoung

    2017-05-01

    Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. © The Korean Society for Laboratory Medicine

  19. Staffing benchmarks for clinical laboratories: a College of American Pathologists Q-Probes study of laboratory staffing at 98 institutions.

    PubMed

    Jones, Bruce A; Darcy, Teresa; Souers, Rhona J; Meier, Frederick A

    2012-02-01

    Publicly available information concerning laboratory staffing benchmarks is scarce. One of the few publications on this topic summarized the findings of a Q-Probes study performed in 2004. This publication reports a similar survey with data collected in 2010. To assess the relationship between staffing levels in specified laboratory sections and test volumes in these sections and quantify management span of control. The study defined 4 laboratory sections: anatomic pathology (including cytology), chemistry/hematology/immunology, microbiology, and transfusion medicine. It divided staff into 3 categories: management, nonmanagement (operational or bench staff), and doctoral (MD, PhD) supervisory staff. People in these categories were tabulated as full-time equivalents and exclusions specified. Tests were counted in uniform formats, specified for each laboratory section, according to Medicare rules for the bundling and unbundling of tests. Ninety-eight participating institutions provided data that showed significant associations between test volumes and staffing for all 4 sections. There was wide variation in productivity based on volume. There was no relationship between testing volume per laboratory section and management span of control. Higher productivity in chemistry/hematology/immunology was associated with a higher fraction of tests coming from nonacute care patients. In both the 2004 and 2010 studies, productivity was inseparably linked to test volume. Higher test volume was associated with higher productivity ratios in chemistry/hematology/immunology and transfusion medicine sections. The impact of various testing services on productivity is section-specific.

  20. Estrogen and progesterone receptor testing in breast carcinoma: concordance of results between local and reference laboratories in Brazil.

    PubMed

    Wludarski, Sheila Cristina Lordelo; Lopes, Lisandro Ferreira; Duarte, Ivison Xavier; Carvalho, Filomena Marino; Weiss, Lawrence; Bacchi, Carlos Eduardo

    2011-01-01

    Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community) laboratories in Brazil. Retrospective study at a reference pathology laboratory. The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. There was concordance in 89.4% (447/500 cases) and 85.0% (425/500 cases) of the results from estrogen (κ = 0.744, P < 0.001) and progesterone (κ = 0.688, P < 0.001) receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7% and 14.4%, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5% and 16.0%, respectively. Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.

  1. An Experimental Study of a BSCS-Style Laboratory Approach for University General Biology.

    ERIC Educational Resources Information Center

    Leonard, William H.

    1983-01-01

    A Biological Sciences Curriculum Study (BSCS) inquiry approach for university general biology laboratory was tested against a well-established commercial program judged to be highly directive. The BSCS was found to be more effective in learning biology laboratory concepts than the commercial program as measured by a laboratory concepts test.…

  2. Integrated Data Collection Analysis (IDCA) Program - RDX Type II Class 5 Standard, Data Set 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    This document describes the results of the first reference sample material—RDX Type II Class 5—examined in the proficiency study for small-scale safety and thermal (SSST) testing of explosive materials for the Integrated Data Collection Analysis (IDCA) Program. The IDCA program is conducting proficiency testing on homemade explosives (HMEs). The reference sample materials are being studied to establish the accuracy of traditional explosives safety testing for each performing laboratory. These results will be used for comparison to results from testing HMEs. This effort, funded by the Department of Homeland Security (DHS), ultimately will put the issues of safe handling of thesemore » materials in perspective with standard military explosives. The results of the study will add SSST testing results for a broad suite of different HMEs to the literature, potentially suggest new guidelines and methods for HME testing, and possibly establish what are the needed accuracies in SSST testing to develop safe handling practices. Described here are the results for impact, friction, electrostatic discharge, and scanning calorimetry analysis of a reference sample of RDX Type II Class 5. The results from each participating testing laboratory are compared using identical test material and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. These results are then compared to historical data from various sources. The performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Air Force Research Laboratory/ RXQL (AFRL), Indian Head Division, Naval Surface Warfare Center, (IHD-NSWC), and Sandia National Laboratories (SNL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to understand how to compare results when test protocols are not identical.« less

  3. Obtaining patient test results from clinical laboratories: a survey of state law for pharmacists.

    PubMed

    Witry, Matthew J; Doucette, William R

    2009-01-01

    To identify states with laws that restrict to whom clinical laboratories may release copies of laboratory test results and to describe how these laws may affect pharmacists' ability to obtain patient laboratory test results. Researchers examined state statutes and administrative codes for all 50 states and the District of Columbia at the University of Iowa Law Library between June and July 2007. Researchers also consulted with lawyers, state Clinical Laboratory Improvement Amendments officers, and law librarians. Laws relating to the study objective were analyzed. 34 jurisdictions do not restrict the release of laboratory test results, while 17 states have laws that restrict to whom clinical laboratories can send copies of test results. In these states, pharmacists will have to use alternative sources, such as physician offices, to obtain test results. Pharmacists must consider state law before requesting copies of laboratory test results from clinical laboratories. This may be an issue that state pharmacy associations can address to increase pharmacist access to important patient information.

  4. 21 CFR 58.210 - Actions upon disqualification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

  5. 21 CFR 58.210 - Actions upon disqualification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.210... laboratory study conducted by the disqualified testing facility may be examined to determine whether such...

  6. [What's the point of cost management in clinical laboratories?].

    PubMed

    Setoyama, Tomokazu; Yamauchi, Kazuyoshi; Katsuyama, Tsutomu

    2006-11-01

    Clinical laboratories need to know and manage the costs of laboratory tests, because they need financial data (1) to estimate costs per patient, (2) to request a budget to buy equipment, and (3) to improve their work; however, less than 40% laboratories practice cost management. In 2002, Shinshu University Hospital began to assess the costs of laboratory tests, but it was difficult to evaluate the quality of our cost management because there are few data and papers about the costs of laboratory tests in Japan. In this article, we practiced cost analysis using Shinshu University Hospital's data for 3 years (2002-2004), and studied the features of laboratory test costs and the problems of laboratory cost management. As a result, we listed 7 points to check cost management in clinical laboratories. This check list was established using only one data from our hospital. So, we suggest the benchmarking laboratory test costs between laboratories of the same type of hospitals or various laboratories.

  7. Laboratory and clinical evaluation of on-site urine drug testing.

    PubMed

    Beck, Olof; Carlsson, Sten; Tusic, Marinela; Olsson, Robert; Franzen, Lisa; Hulten, Peter

    2014-11-01

    Products for on-site urine drug testing offer the possibility to perform screening for drugs of abuse directly at the point-of-care. This is a well-established routine in emergency and dependency clinics but further evaluation of performance is needed due to inherent limitations with the available products. Urine drug testing by an on-site product was compared with routine laboratory methods. First, on-site testing was performed at the laboratory in addition to the routine method. Second, the on-site testing was performed at a dependency clinic and urine samples were subsequently sent to the laboratory for additional analytical investigation. The on-site testing products did not perform with assigned cut-off levels. The subjective reading between the presence of a spot (i.e. negative test result) being present or no spot (positive result) was difficult in 3.2% of the cases, and occurred for all parameters. The tests performed more accurately in drug negative samples (specificity 96%) but less accurately for detecting positives (sensitivity 79%). Of all incorrect results by the on-site test the proportion of false negatives was 42%. The overall agreement between on-site and laboratory testing was 95% in the laboratory study and 98% in the clinical study. Although a high degree of agreement was observed between on-site and routine laboratory urine drug testing, the performance of on-site testing was not acceptable due to significant number of false negative results. The limited sensitivity of on-site testing compared to laboratory testing reduces the applicability of these tests.

  8. A system dynamics approach to analyze laboratory test errors.

    PubMed

    Guo, Shijing; Roudsari, Abdul; Garcez, Artur d'Avila

    2015-01-01

    Although many researches have been carried out to analyze laboratory test errors during the last decade, it still lacks a systemic view of study, especially to trace errors during test process and evaluate potential interventions. This study implements system dynamics modeling into laboratory errors to trace the laboratory error flows and to simulate the system behaviors while changing internal variable values. The change of the variables may reflect a change in demand or a proposed intervention. A review of literature on laboratory test errors was given and provided as the main data source for the system dynamics model. Three "what if" scenarios were selected for testing the model. System behaviors were observed and compared under different scenarios over a period of time. The results suggest system dynamics modeling has potential effectiveness of helping to understand laboratory errors, observe model behaviours, and provide a risk-free simulation experiments for possible strategies.

  9. Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories

    PubMed Central

    Jang, Mi-Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong-Ho; Min, Won-Ki; Lee, Ji Sung

    2017-01-01

    Background Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. Methods We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Results Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. Conclusions These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. PMID:28224767

  10. Changing resident test ordering behavior: a multilevel intervention to decrease laboratory utilization at an academic medical center.

    PubMed

    Vidyarthi, Arpana R; Hamill, Timothy; Green, Adrienne L; Rosenbluth, Glenn; Baron, Robert B

    2015-01-01

    Hospital laboratory test volume is increasing, and overutilization contributes to errors and costs. Efforts to reduce laboratory utilization have targeted aspects of ordering behavior, but few have utilized a multilevel collaborative approach. The study team partnered with residents to reduce unnecessary laboratory tests and associated costs through multilevel interventions across the academic medical center. The study team selected laboratory tests for intervention based on cost, volume, and ordering frequency (complete blood count [CBC] and CBC with differential, common electrolytes, blood enzymes, and liver function tests). Interventions were designed collaboratively with residents and targeted components of ordering behavior, including system changes, teaching, social marketing, academic detailing, financial incentives, and audit/feedback. Laboratory ordering was reduced by 8% cumulatively over 3 years, saving $2 019 000. By involving residents at every stage of the intervention and targeting multiple levels simultaneously, laboratory utilization was reduced and cost savings were sustained over 3 years. © 2014 by the American College of Medical Quality.

  11. An Alternative to the Physiological Psychology Laboratory: Identification of an Unknown Drug Through Behavioral Testing.

    ERIC Educational Resources Information Center

    Schumacher, Susan J.

    1982-01-01

    A laboratory project introduced physiological psychology students to research by requiring them to identify an unknown drug given to laboratory animals. Students read material about drugs and animal drug studies, designed behavioral tests, constructed the testing apparatus, conducted the tests, and wrote progress reports. (SR)

  12. Assessing student understanding of measurement and uncertainty

    NASA Astrophysics Data System (ADS)

    Jirungnimitsakul, S.; Wattanakasiwich, P.

    2017-09-01

    The objectives of this study were to develop and assess student understanding of measurement and uncertainty. A test has been adapted and translated from the Laboratory Data Analysis Instrument (LDAI) test, consists of 25 questions focused on three topics including measures of central tendency, experimental errors and uncertainties, and fitting regression lines. The test was evaluated its content validity by three physics experts in teaching physics laboratory. In the pilot study, Thai LDAI was administered to 93 freshmen enrolled in a fundamental physics laboratory course. The final draft of the test was administered to three groups—45 freshmen taking fundamental physics laboratory, 16 sophomores taking intermediated physics laboratory and 21 juniors taking advanced physics laboratory at Chiang Mai University. As results, we found that the freshmen had difficulties in experimental errors and uncertainties. Most students had problems with fitting regression lines. These results will be used to improve teaching and learning physics laboratory for physics students in the department.

  13. 40 CFR 161.32 - Format of data submission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., including identification of the substance(s) tested and the test name or data requirement addressed; (2) The author(s) of the study; (3) The date the study was completed; (4) If the study was performed in a laboratory, the name and address of the laboratory and any laboratory project numbers or other identifying...

  14. Development and validation of an immunoperoxidase antigen detection test for improved diagnosis of rabies in Indonesia.

    PubMed

    Rahmadane, Ibnu; Certoma, Andrea F; Peck, Grantley R; Fitria, Yul; Payne, Jean; Colling, Axel; Shiell, Brian J; Beddome, Gary; Wilson, Susanne; Yu, Meng; Morrissy, Chris; Michalski, Wojtek P; Bingham, John; Gardner, Ian A; Allen, John D

    2017-11-01

    Rabies continues to pose a significant threat to human and animal health in regions of Indonesia. Indonesia has an extensive network of veterinary diagnostic laboratories and the 8 National laboratories are equipped to undertake diagnostic testing for rabies using the commercially-procured direct fluorescent antibody test (FAT), which is considered the reference (gold standard) test. However, many of the Indonesian Provincial diagnostic laboratories do not have a fluorescence microscope required to undertake the FAT. Instead, certain Provincial laboratories continue to screen samples using a chemical stain-based test (Seller's stain test, SST). This test has low diagnostic sensitivity, with negative SST-tested samples being forwarded to the nearest National laboratory resulting in significant delays for completion of testing and considerable additional costs. This study sought to develop a cost-effective and diagnostically-accurate immunoperoxidase antigen detection (RIAD) test for rabies that can be readily and quickly performed by the resource-constrained Provincial laboratories. This would reduce the burden on the National laboratories and allow more rapid diagnoses and implementation of post-exposure prophylaxis. The RIAD test was evaluated using brain smears fixed with acetone or formalin and its performance was validated by comparison with established rabies diagnostic tests used in Indonesia, including the SST and FAT. A proficiency testing panel was distributed between Provincial laboratories to assess the reproducibility of the test. The performance of the RIAD test was improved by using acetone fixation of brain smears rather than formalin fixation such that it was of equivalent accuracy to that of the World Organisation for Animal Health (OIE)-recommended FAT, with both tests returning median diagnostic sensitivity and specificity values of 0.989 and 0.993, respectively. The RIAD test and FAT had higher diagnostic sensitivity than the SST (median = 0.562). Proficiency testing using a panel of 6 coded samples distributed to 16 laboratories showed that the RIAD test had good reproducibility with an overall agreement of 97%. This study describes the successful development, characterisation and use of a novel RIAD test and its fitness for purpose as a screening test for use in provincial Indonesian veterinary laboratories.

  15. Corrections of clinical chemistry test results in a laboratory information system.

    PubMed

    Wang, Sihe; Ho, Virginia

    2004-08-01

    The recently released reports by the Institute of Medicine, To Err Is Human and Patient Safety, have received national attention because of their focus on the problem of medical errors. Although a small number of studies have reported on errors in general clinical laboratories, there are, to our knowledge, no reported studies that focus on errors in pediatric clinical laboratory testing. To characterize the errors that have caused corrections to have to be made in pediatric clinical chemistry results in the laboratory information system, Misys. To provide initial data on the errors detected in pediatric clinical chemistry laboratories in order to improve patient safety in pediatric health care. All clinical chemistry staff members were informed of the study and were requested to report in writing when a correction was made in the laboratory information system, Misys. Errors were detected either by the clinicians (the results did not fit the patients' clinical conditions) or by the laboratory technologists (the results were double-checked, and the worksheets were carefully examined twice a day). No incident that was discovered before or during the final validation was included. On each Monday of the study, we generated a report from Misys that listed all of the corrections made during the previous week. We then categorized the corrections according to the types and stages of the incidents that led to the corrections. A total of 187 incidents were detected during the 10-month study, representing a 0.26% error detection rate per requisition. The distribution of the detected incidents included 31 (17%) preanalytic incidents, 46 (25%) analytic incidents, and 110 (59%) postanalytic incidents. The errors related to noninterfaced tests accounted for 50% of the total incidents and for 37% of the affected tests and orderable panels, while the noninterfaced tests and panels accounted for 17% of the total test volume in our laboratory. This pilot study provided the rate and categories of errors detected in a pediatric clinical chemistry laboratory based on the corrections of results in the laboratory information system. A direct interface of the instruments to the laboratory information system showed that it had favorable effects on reducing laboratory errors.

  16. 21 CFR 58.15 - Inspection of a testing facility.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES General Provisions § 58.15 Inspection of a testing... Administration will not consider a nonclinical laboratory study in support of an application for a research or...

  17. Current status of accreditation for drug testing in hair.

    PubMed

    Cooper, Gail; Moeller, Manfred; Kronstrand, Robert

    2008-03-21

    At the annual meeting of the Society of Hair Testing in Vadstena, Sweden in 2006, a committee was appointed to address the issue of guidelines for hair testing and to assess the current status of accreditation amongst laboratories offering drug testing in hair. A short questionnaire was circulated amongst the membership and interested parties. Fifty-two responses were received from hair testing laboratories providing details on the amount and type of hair tests they offered and the status of accreditation within their facilities. Although the vast majority of laboratories follow current guidelines (83%), only nine laboratories were accredited to ISO/IEC 17025 for hair testing. A significant number of laboratories reporting that they were in the process of developing quality systems with a view to accrediting their methods within 2-3 years. This study provides an insight into the status of accreditation in hair testing laboratories and supports the need for guidelines to encourage best practice.

  18. Reagent and labor cost optimization through automation of fluorescence in situ hybridization (FISH) with the VP 2000: an Italian case study.

    PubMed

    Zanatta, Lucia; Valori, Laura; Cappelletto, Eleonora; Pozzebon, Maria Elena; Pavan, Elisabetta; Dei Tos, Angelo Paolo; Merkle, Dennis

    2015-02-01

    In the modern molecular diagnostic laboratory, cost considerations are of paramount importance. Automation of complex molecular assays not only allows a laboratory to accommodate higher test volumes and throughput but also has a considerable impact on the cost of testing from the perspective of reagent costs, as well as hands-on time for skilled laboratory personnel. The following study tracked the cost of labor (hands-on time) and reagents for fluorescence in situ hybridization (FISH) testing in a routine, high-volume pathology and cytogenetics laboratory in Treviso, Italy, over a 2-y period (2011-2013). The laboratory automated FISH testing with the VP 2000 Processor, a deparaffinization, pretreatment, and special staining instrument produced by Abbott Molecular, and compared hands-on time and reagent costs to manual FISH testing. The results indicated significant cost and time saving when automating FISH with VP 2000 when more than six FISH tests were run per week. At 12 FISH assays per week, an approximate total cost reduction of 55% was observed. When running 46 FISH specimens per week, the cost saving increased to 89% versus manual testing. The results demonstrate that the VP 2000 processor can significantly reduce the cost of FISH testing in diagnostic laboratories. © 2014 Society for Laboratory Automation and Screening.

  19. External quality assessment of medical laboratories in Croatia: preliminary evaluation of post-analytical laboratory testing.

    PubMed

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana

    2017-02-15

    Proper standardization of laboratory testing requires assessment of performance after the tests are performed, known as the post-analytical phase. A nationwide external quality assessment (EQA) scheme implemented in Croatia in 2014 includes a questionnaire on post-analytical practices, and the present study examined laboratory responses in order to identify current post-analytical phase practices and identify areas for improvement. In four EQA exercises between September 2014 and December 2015, 145-174 medical laboratories across Croatia were surveyed using the Module 11 questionnaire on the post-analytical phase of testing. Based on their responses, the laboratories were evaluated on four quality indicators: turnaround time (TAT), critical values, interpretative comments and procedures in the event of abnormal results. Results were presented as absolute numbers and percentages. Just over half of laboratories (56.3%) monitored TAT. Laboratories varied substantially in how they dealt with critical values. Most laboratories (65-97%) issued interpretative comments with test results. One third of medical laboratories (30.6-33.3%) issued abnormal test results without confirming them in additional testing. Our results suggest that the nationwide post-analytical EQA scheme launched in 2014 in Croatia has yet to be implemented to the full. To close the gaps between existing recommendations and laboratory practice, laboratory professionals should focus on ensuring that TAT is monitored and lists of critical values are established within laboratories. Professional bodies/institutions should focus on clarify and harmonized rules to standardized practices and applied for adding interpretative comments to laboratory test results and for dealing with abnormal test results.

  20. The availability and functional status of focused antenatal care laboratory services at public health facilities in Addis Ababa, Ethiopia.

    PubMed

    Desalegn, Daniel Melese; Abay, Serebe; Taye, Bineyam

    2016-08-11

    Provision of quality laboratory services is an essential aspect of a promoting safe motherhood and better outcomes for newborn. Therefore; this study was intended to assess status of focused antenatal care (FANC) laboratory services at public health facilities in Addis Ababa, Ethiopia. Institution based, descriptive cross-sectional study was conducted from April to May 2015. The study included 13 randomly selected health facilities and 13 purposively selected laboratory service providers. The status of FANC laboratory service was assessed by using pre-tested structured questionnaire and observation checklist. The study supplemented with qualitative data through in-depth interview of laboratory service providers. The quantitative data were coded and analysed by using SPSS Version 20 software and qualitative data was transcribed, coded, categorized and thematically analysed by the principal investigator. Only 5 (38.5 %) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine microscopy and stool examination were available in all institutions. However, only 7 (53.8 %) of the health facilities reported the availability of hepatitis B virus screening test. Rapid syphilis (RPR) test was found in 10 (76.9 %) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption for more than a day within the last 1 year due to shortage of reagent and electric power disruption. Majority of the health facilities reported incomplete provision of FANC laboratory investigations. Laboratory supply shortage and electric power disruption were the facilities' major challenge to screen pregnant women for pregnancy related health conditions. Since such conditions may affect the outcome of pregnancy, therefore extensive efforts should be targeted to avoid services interruption by taking improvement measures including the fulfilment of all FANC laboratory resources.

  1. Comparison of basic laboratory test results with more sophisticated laboratory and in-situ tests methods on soils in southeastern Wisconsin : final report, March 21, 2009.

    DOT National Transportation Integrated Search

    2009-03-21

    This study investigates all of the generated soils data in an attempt to use the more 'routine' laboratory tests to determine geotechnical design parameters (such as phiangle, cohesion, wet unit weight, unconfined compression, consolidation character...

  2. Study of LTPP laboratory resilient modulus test data and response characteristics.

    DOT National Transportation Integrated Search

    2002-10-01

    The resilient modulus of every unbound structural layer of the Long Term Pavement Performance (LTPP) Specific Pavement and : General Pavement Studies Test Sections is being measured in the laboratory using LTPP test protocol P46. A total of 2,014 : r...

  3. PubMed Central

    Petithory, J. C.; Ambroise-Thomas, P.; De Loye, J.; Pelloux, H.; Goullier-Fleuret, A.; Milgram, M.; Buffard, C.; Garin, J. P.

    1996-01-01

    Reported are the results of a multicentre study involving 40 laboratories that was carried out in France to assess all the currently available methods used for the serodiagnosis of toxoplasmosis. For this purpose 10 batches of control sera were prepared with titres in the range 0-260 IU per ml. These sera were tested in nine laboratories using immunofluorescence methods; in three laboratories using dye tests; in forty laboratories using enzyme-linked immunosorbent assay; in four laboratories using direct agglutination and haemagglutination; in seven laboratories using the high-sensitivity IgG agglutination test; and in three laboratories using the latex agglutination test. In this way, 70 series of titrations were carried out using seven procedures and the results were compared with those obtained using the WHO reference serum in 15 cases, with the French national E6 serum in 16 other cases, and in 39 cases using 15 reference sera supplied by the reagent manufacturers. Rigorous comparison of the tests was not possible in all cases because one aim of the study was to ensure that the tests were carried out under the usual working conditions that prevailed in the participating laboratories. The results obtained indicate that the serological tests currently available for toxoplasmosis are acceptable for its serodiagnosis. Presentation of the titres in IU has advantages; however, caution is required since the definition of IU varies according to the test and reagents used. It is therefore essential that the conditions and limits for a positive reaction be carefully defined in each case, especially for commercially available kits. PMID:8829878

  4. [Logistics of collection and transportation of biological samples and the organization of the central laboratory in the ELSA-Brasil].

    PubMed

    Fedeli, Ligia G; Vidigal, Pedro G; Leite, Claudia Mendes; Castilhos, Cristina D; Pimentel, Robércia Anjos; Maniero, Viviane C; Mill, Jose Geraldo; Lotufo, Paulo A; Pereira, Alexandre C; Bensenor, Isabela M

    2013-06-01

    The ELSA (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health) is a multicenter cohort study which aims at the identification of risk factors associated with type 2 diabetes and cardiovascular diseases in the Brazilian population. The paper describes the strategies for the collection, processing, transportation, and quality control of blood and urine tests in the ELSA. The study decided to centralize the tests at one single laboratory. The processing of the samples was performed at the local laboratories, reducing the weight of the material to be transported, and diminishing the costs of transportation to the central laboratory at the Universidade de São Paulo Hospital. The study included tests for the evaluation of diabetes, insulin resistance, dyslipidemia, electrolyte abnormalities, thyroid hormones, uric acid, hepatic enzyme abnormalities, inflammation, and total blood cell count. In addition, leukocyte DNA, urine, plasma and serum samples were stored. The central laboratory performed approximately 375,000 tests.

  5. Trends in Testing for Mycobacterium tuberculosis Complex From US Public Health Laboratories, 2009-2013.

    PubMed

    Tyrrell, Frances; Stafford, Cortney; Yakrus, Mitchell; Youngblood, Monica; Hill, Andrew; Johnston, Stephanie

    We investigated data from US public health laboratories funded through the Centers for Disease Control and Prevention's Tuberculosis Elimination and Laboratory Cooperative Agreement to document trends and challenges in meeting national objectives in tuberculosis (TB) laboratory diagnoses. We examined data on workload and turnaround time from public health laboratories' progress reports during 2009-2013. We reviewed methodologies, laboratory roles, and progress toward rapid detection of Mycobacterium tuberculosis complex through nucleic acid amplification (NAA) testing. We compared selected data with TB surveillance reports to estimate public health laboratories' contribution to national diagnostic services. During the study period, culture and drug susceptibility tests decreased, but NAA testing increased. Public health laboratories achieved turnaround time benchmarks for drug susceptibility tests at lower levels than for acid-fast bacilli smear and identification from culture. NAA positivity in laboratories among surveillance-reported culture-positive TB cases increased from 26.6% (2355 of 8876) in 2009 to 40.0% (2948 of 7358) in 2013. Public health laboratories provided an estimated 50.9% (4285 of 8413 in 2010) to 57.2% (4210 of 7358 in 2013) of culture testing and 88.3% (6822 of 7727 in 2011) to 94.4% (6845 of 7250 in 2012) of drug susceptibility tests for all US TB cases. Public health laboratories contribute substantially to TB diagnoses in the United States. Although testing volumes mostly decreased, the increase in NAA testing indicates continued progress in rapid M tuberculosis complex detection.

  6. Integrated Data Collection Analysis (IDCA) Program - Final Review September 12, 2012 at DHS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Warner, Kirstin F.

    The Integrated Data Collection Analysis (IDCA) program conducted a final program review at the Department of Homeland Security on September 12, 2012. The review was focused on the results of the program over the complete performance period. A summary presentation delineating the accomplished tasks started the meeting, followed by technical presentations on various issues that arose during the performance period. The presentations were completed with a statistical evaluation of the testing results from all the participants in the IDCA Proficiency Test study. The meeting closed with a discussion of potential sources of funding for continuing work to resolve some ofmore » these technical issues. This effort, funded by the Department of Homeland Security (DHS), put the issues of safe handling of these materials in perspective with standard military explosives. The study added Small-Scale Safety and Thermal (SSST) testing results for a broad suite of different HMEs to the literature, and suggested new guidelines and methods to develop safe handling practices for HMEs. Each participating testing laboratory used identical test materials and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. The results were compared among the laboratories and then compared to historical data from various sources. The testing performers involved were Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Naval Surface Warfare Center, Indian Head Division (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory, Tyndall AFB (AFRL/RXQL). These tests were conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent.« less

  7. Integrated Data Collection Analysis (IDCA) Program - KClO 4/Carbon Mixture

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of a mixture of KClO 4 and activated carbon—KClO 4/C mixture. This material was selected because of the challenge of performing SSST testing of a mixture of two solids. The mixture was found to be insensitive to impact, friction, and thermal stimulus, and somewhat sensitive to spark discharge. This effort, funded by the Department of Homeland Security (DHS), ultimately will putmore » the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study has the potential to suggest new guidelines and methods and possibly establish the SSST testing accuracies needed to develop safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. The results are compared among the laboratories and then compared to historical data from various sources. The testing performers involved for the KClO 4/carbon mixture are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to understand how to compare results when these testing variables cannot be made consistent.« less

  8. 21 CFR 58.200 - Purpose.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

  9. 21 CFR 58.200 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.200 Purpose. (a) The purposes of... testing facility which has failed to comply with the requirements of the good laboratory practice...

  10. Reducing Overutilization of Testing for Clostridium difficile Infection in a Pediatric Hospital System: A Quality Improvement Initiative.

    PubMed

    Klatte, J Michael; Selvarangan, Rangaraj; Jackson, Mary Anne; Myers, Angela L

    2016-01-01

    Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing. A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A p-chart was generated to evaluate the percentage of these submitted specimens tested biweekly over a 12-month period. Cost savings for patients and the laboratory were assessed at the study period's conclusion. Run chart analysis revealed an initial shift after the interventions, suggesting a temporary decrease in testing submission; however, no sustained differences in numbers of specimens submitted biweekly were observed over time. On the p-chart, the mean percentage of specimens tested before the intervention was 100%. After the intervention, the average percentage of specimens tested dropped to 53.8%. Resultant laboratory cost savings totaled nearly $3600, and patient savings on testing charges were ∼$32 000. Automatic laboratory declination of nondiarrheal stools submitted for CDI testing resulted in a sustained decrease in the number of specimens tested, resulting in significant laboratory and patient cost savings. Despite multiple educational efforts, no sustained changes in physician ordering practices were observed. Copyright © 2016 by the American Academy of Pediatrics.

  11. Effectiveness of a computerized alert system based on re-testing intervals for limiting the inappropriateness of laboratory test requests.

    PubMed

    Lippi, Giuseppe; Brambilla, Marco; Bonelli, Patrizia; Aloe, Rosalia; Balestrino, Antonio; Nardelli, Anna; Ceda, Gian Paolo; Fabi, Massimo

    2015-11-01

    There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma. The effectiveness of the system for limiting potentially inappropriate tests was monitored for 6months. Overall, 765/3539 (22%) test requests violated the preset criteria of appropriateness and generated the appearance of electronic alert. After alert appearance, 591 requests were annulled (17% of total tests requested and 77% of tests alerted, respectively). The total number of test requests violating the preset criteria of inappropriateness constantly decreased over time (26% in the first three months of implementation versus 17% in the following period; p<0.001). The total financial saving of test withdrawn was 3387 Euros (12.8% of the total test cost) throughout the study period. The results of this study suggest that a computerized alert system may be effective to limit the inappropriateness of laboratory test requests, generating significant economic saving and educating physicians to a more efficient use of laboratory resources. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  12. Integrated Data Collection Analysis (IDCA) Program - SSST Testing Methods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the methods used for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis during the IDCA program. These methods changed throughout the Proficiency Test and the reasons for these changes are documented in this report. The most significant modifications in standard testing methods are: 1) including one specified sandpaper in impact testing among all the participants, 2) diversifying liquid test methods for selected participants, and 3) including sealed sample holders for thermal testingmore » by at least one participant. This effort, funded by the Department of Homeland Security (DHS), is putting the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study will suggest new guidelines and methods and possibly establish the SSST testing accuracies needed to develop safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods wherever possible. The testing performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent.« less

  13. EGFR T790M mutation testing within the osimertinib AURA Phase I study.

    PubMed

    Dearden, Simon; Brown, Helen; Jenkins, Suzanne; Thress, Kenneth S; Cantarini, Mireille; Cole, Rebecca; Ranson, Malcolm; Jänne, Pasi A

    2017-07-01

    Reliable epidermal growth factor receptor (EGFR) mutation testing techniques are required to identify eligible patients with EGFR mutation/T790M positive advanced non-small cell lung cancer (NSCLC), for treatment with osimertinib (AZD9291), an oral, potent, irreversible EGFR tyrosine kinase inhibitor (TKI) selective for EGFR-TKI-sensitizing and T790M resistance mutations over wild-type EGFR. There is no current consensus regarding the best method to detect EGFR T790M mutations. The aim of this study was to describe the concordance between local testing, which used a variety of methods, and central testing, using the cobas ® EGFR Mutation Test, for EGFR-sensitizing mutations and the T790M resistance mutation. Tumor samples were obtained from all patients screened for inclusion onto the osimertinib Phase I expansion component of the AURA Phase I/II study (NCT01802632). Samples underwent central laboratory testing for EGFR-sensitizing mutations and T790M resistance mutation using the cobas ® EGFR Mutation Test. Results were compared with local laboratory test results, based on other testing methodologies including Sanger sequencing, therascreen ® , PNAClamp™, and Sequenom MassARRAY ® . Central laboratory testing was successful in 99% of samples passing histopathology review and testing success rates were comparable across the three central laboratories. Concordance between central and local testing for common sensitizing mutations was high (>98%) and concordance for the T790M mutation was also high (>90%). Tumor heterogeneity, along with other technical factors may have influenced this result. Within the osimertinib AURA Phase I study, EGFR mutation testing across three centralized laboratories using the cobas ® EGFR Mutation Test was feasible and successful, with strong concordance between local and central laboratory results, including for T790M. The cobas ® EGFR Mutation Test has subsequently been approved as the companion diagnostic test for osimertinib in the USA and Japan. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil.

    PubMed

    Tobias, Alessandra Hermógenes Gomes; Amaral, Rita Goreti; Diniz, Elói Martins; Carneiro, Cláudia Martins

    2016-02-01

    The objective of this study is to assess the performance of cytopathology laboratories providing services to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) in the State of Minas Gerais, Brazil. This descriptive study uses data obtained from the Cervical Cancer Information System from January to December 2012. Three quality indicators were analyzed to assess the quality of cervical cytopathology tests: positivity index, percentage of atypical squamous cells (ASCs) in abnormal tests, and percentage of tests compatible with high-grade squamous intraepithelial lesions (HSILs). Laboratories were classified according to their production scale in tests per year ≤ 5,000; from 5,001 to 10,000; from 10,001 to 15,000; and ≥ 15,001. Based on the collection of variables and the classification of laboratories according to production scale, we created and analyzed a database using Microsoft Office Excel 97-2003. In the Brazilian state of Minas Gerais, 146 laboratories provided services to the SUS in 2012 by performing a total of 1,277,018 cervical cytopathology tests. Half of these laboratories had production scales ≤ 5,000 tests/year and accounted for 13.1% of all tests performed in the entire state; in turn, 13.7% of these laboratories presented production scales of > 15,001 tests/year and accounted for 49.2% of the total of tests performed in the entire state. The positivity indexes of most laboratories providing services to the SUS in 2012, regardless of production scale, were below or well below recommended limits. Of the 20 laboratories that performed more than 15,001 tests per year, only three presented percentages of tests compatible with HSILs above the lower limit recommended by the Brazilian Ministry of Health. The majority of laboratories providing services to the SUS in Minas Gerais presented quality indicators outside the range recommended by the Brazilian Ministry of Health. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  15. Use, location, and timeliness of clinical microbiology testing in Georgia for select infectious diseases.

    PubMed

    Brzozowski, Amanda K; Silk, Benjamin J; Berkelman, Ruth L; Loveys, Deborah A; Caliendo, Angela M

    2012-01-01

    Although clinical microbiology testing facilitates both public health surveillance of infectious diseases and patient care, research on testing patterns is scant. We surveyed hospital laboratories in Georgia to assess their diagnostic testing practices. Using e-mail, all directors of hospital laboratories in Georgia were invited to participate. The survey focused on timing and location of diagnostic testing in 2006 for 6 reportable diseases: giardiasis, legionellosis, meningococcal disease, pertussis, Rocky Mountain spotted fever, and West Nile virus disease. Of 141 laboratories, 62 (44%) responded to the survey. Hospitals varied widely in their use of diagnostic testing in 2006, with 95.1% testing for meningococcal disease, but only 66.1% and 63.3% testing for legionellosis and West Nile virus disease, respectively. Most laboratories (91%) performed gram stain/culture to diagnose meningococcal disease in-house and 23% performed ova and parasite panels for giardiasis were conducted in-house. Fewer than 11% of laboratories performed in-house testing for the remaining diseases. Laboratories affiliated with small hospitals (≤100 beds) were more likely to send specimens for outside testing compared with laboratories associated with large hospitals (>250 beds). Median turnaround time for ova and parasite panel testing for giardiasis was significantly shorter for in-house testing (1.0 days) than within-system (2.25 days) or outside laboratory (3.0 days) testing (P = .0003). No laboratories reported in-house testing for meningococcal disease, pertussis, or Rocky Mountain spotted fever using polymerase chain reaction. Many hospitals did not order diagnostic tests for important infectious diseases during 2006, even for relatively common diseases. In addition, hospital laboratories were unlikely to perform diagnostic testing in-house; sending specimens to an outside laboratory may result in substantial delays in receiving results. These unsettling findings have adverse implications for both patient care and public health surveillance; they indicate an immediate need to study nationally the use and timeliness of clinical microbiologic testing.

  16. [Serodiagnosis of toxoplasmosis: a comparative multicenter study of a standard scale through various actual tests and expression of the results in international units. Groupe de travail toxoplasmose du Contrôle national de qualité en parasotologie. Syndicat des fabricants de réactifs de laboratoire. Groupe de travail standardisation des tests sérologiques du Réseau européen de lutte contre la toxoplasmose congénitale].

    PubMed

    Petithory, J C; Ambroise-Thomas, P; De Loye, J; Pelloux, H; Goullier-Fleuret, A; Milgram, M; Buffard, C; Garin, J P

    1996-01-01

    Reported are the results of a multicentre study involving 40 laboratories that was carried out in France to assess all the currently available methods used for the serodiagnosis of toxoplasmosis. For this purpose 10 batches of control sera were prepared with titres in the range 0-260 IU per ml. These sera were tested in nine laboratories using immunofluorescence methods; in three laboratories using dye tests; in forty laboratories using enzyme-linked immunosorbent assay; in four laboratories using direct agglutination and haemagglutination; in seven laboratories using the high-sensitivity IgG agglutination test; and in three laboratories using the latex agglutination test. In this way, 70 series of titrations were carried out using seven procedures and the results were compared with those obtained using the WHO reference serum in 15 cases, with the French national E6 serum in 16 other cases, and in 39 cases using 15 reference sera supplied by the reagent manufacturers. Rigorous comparison of the tests was not possible in all cases because one aim of the study was to ensure that the tests were carried out under the usual working conditions that prevailed in the participating laboratories. The results obtained indicate that the serological tests currently available for toxoplasmosis are acceptable for its serodiagnosis. Presentation of the titres in IU has advantages; however, caution is required since the definition of IU varies according to the test and reagents used. It is therefore essential that the conditions and limits for a positive reaction be carefully defined in each case, especially for commercially available kits.

  17. Integrated Data Collection Analysis (IDCA) Program - AN and Bullseye Smokeless Powder

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of ammonium nitrate (AN) mixed with Bullseye® smokeless powder (Gunpowder). The participants found the AN/Gunpowder to: 1) have a range of sensitivity to impact, comparable to or less than RDX, 2) be fairly insensitive to friction as measured by BAM and ABL, 3) have a range for ESD, from insensitive to more sensitive than PETN, and 4) have thermal sensitivity aboutmore » the same as PETN and Gunpowder. This effort, funded by the Department of Homeland Security (DHS), is putting the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study has the potential to suggest new guidelines and methods and possibly establish the SSST testing accuracies needed when developing safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods. Note, however, the test procedures differ among the laboratories. The testing performers involved are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), Sandia National Laboratories (SNL), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to compare results when these testing variables cannot be made consistent. Keywords: Small-scale safety testing, proficiency test, impact-, friction-, spark discharge-, thermal testing, round-robin test, safety testing protocols, HME, RDX, potassium perchlorate, potassium chlorate, sodium chlorate, sugar, dodecane, PETN, carbon, ammonium nitrate, Gunpowder, Bullseye® smokeless powder.« less

  18. SEE locomotor behavior test discriminates C57BL/6J and DBA/2J mouse inbred strains across laboratories and protocol conditions.

    PubMed

    Kafkafi, Neri; Lipkind, Dina; Benjamini, Yoav; Mayo, Cheryl L; Elmer, Gregory I; Golani, Ilan

    2003-06-01

    Conventional tests of behavioral phenotyping frequently have difficulties differentiating certain genotypes and replicating these differences across laboratories and protocol conditions. This study explores the hypothesis that automated tests can be designed to quantify ethologically relevant behavior patterns that more readily characterize heritable and replicable phenotypes. It used SEE (Strategy for the Exploration of Exploration) to phenotype the locomotor behavior of the C57BL/6 and DBA/2 mouse inbred strains across 3 laboratories. The 2 genotypes differed in 15 different measures of behavior, none of which had a significant genotype-laboratory interaction. Within the same laboratory, most of these differences were replicated in additional experiments despite the test photoperiod phase being changed and saline being injected. Results suggest that well-designed tests may considerably enhance replicability across laboratories.

  19. Transferability and within- and between-laboratory reproducibilities of EpiSensA for predicting skin sensitization potential in vitro: A ring study in three laboratories.

    PubMed

    Mizumachi, Hideyuki; Sakuma, Megumi; Ikezumi, Mayu; Saito, Kazutoshi; Takeyoshi, Midori; Imai, Noriyasu; Okutomi, Hiroko; Umetsu, Asami; Motohashi, Hiroko; Watanabe, Mika; Miyazawa, Masaaki

    2018-05-03

    The epidermal sensitization assay (EpiSensA) is an in vitro skin sensitization test method based on gene expression of four markers related to the induction of skin sensitization; the assay uses commercially available reconstructed human epidermis. EpiSensA has exhibited an accuracy of 90% for 72 chemicals, including lipophilic chemicals and pre-/pro-haptens, when compared with the results of the murine local lymph node assay. In this work, a ring study was performed by one lead and two naive laboratories to evaluate the transferability, as well as within- and between-laboratory reproducibilities, of EpiSensA. Three non-coded chemicals (two lipophilic sensitizers and one non-sensitizer) were tested for the assessment of transferability and 10 coded chemicals (seven sensitizers and three non-sensitizers, including four lipophilic chemicals) were tested for the assessment of reproducibility. In the transferability phase, the non-coded chemicals (two sensitizers and one non-sensitizer) were correctly classified at the two naive laboratories, indicating that the EpiSensA protocol was transferred successfully. For the within-laboratory reproducibility, the data generated with three coded chemicals tested in three independent experiments in each laboratory gave consistent predictions within laboratories. For the between-laboratory reproducibility, 9 of the 10 coded chemicals tested once in each laboratory provided consistent predictions among the three laboratories. These results suggested that EpiSensA has good transferability, as well as within- and between-laboratory reproducibility. Copyright © 2018 John Wiley & Sons, Ltd.

  20. Impact of external haematology proficiency testing programme on quality of laboratories.

    PubMed

    Saxena, Renu; Katoch, S C; Srinivas, Upendra; Rao, Seema; Anand, Hema

    2007-11-01

    A reliable and reproducible report from a laboratory needs internal quality control within the laboratory and participation in external proficiency testing programmes (EPTP). This study conducted at the Department of Haematology, All India Institute of Medical Sciences (AIIMS), New Delhi, which has been conducting an EPTP since 1992, was undertaken to assess the efficacy of this programme in improving the performance of participating laboratories in reporting test samples sent for Hb, total leucocyte count (TLC), reticulocyte count and assessment of peripheral blood smear (PBS). The samples were prepared in our laboratory according to the International Standards Organization (ISO) guidelines. The performance of individual laboratories was assessed using robust Z score, which is an indicator of acceptability of the test result. An improvement in the overall percentage of laboratories with acceptable reports was seen during the study period. It has increased from 38,40,40 per cent in 1992 to 85, 90,94.7 per cent in 2006 for Hb, TLC, reticulocyte count, respectively. However, the results for peripheral smear assessment improved only marginally. The external haematology proficiency testing programme run by our department for Hb, TLC, reticulocyte count, and peripheral blood smear assessment, has helped in improving the reporting standards of these parameters in Indian laboratories.

  1. Development of criteria for the use of asphalt-rubber as a Stress-Absorbing Membrane Interlayer (SAMI)

    NASA Astrophysics Data System (ADS)

    Newcomb, D. E.; McKeen, R. G.

    1983-12-01

    This report documents over 2 years of research efforts to characterize asphalt-rubber mixtures to be used in Stress-Absorbing Membrane Interlayers (SAMI). The purpose of these SAMIs is to retard or prevent reflection cracking in asphalt-concrete overlays. Several laboratory experiments and one field trial were conducted to define significant test methods and parameters for incorporation into construction design and specification documents. Test methods used in this study included a modified softening point test, force-ductility, and Schweyer viscosity. Variables investigated included (1) Laboratory-mixing temperature; (2) Rubber type; (3) Laboratory storage time; (4) Laboratory storage condition; (5) Laboratory batch replication; (6) Laboratory mixing time; (7) Field mixing time; (8) Laboratory test temperature; (9) Force-Ductility elongation rates; and (10) Asphalt grade. It was found that mixing temperature, mixing time, rubber type, and asphalt grade all have significant effects upon the behavior of asphalt-rubber mixtures. Significant variability was also noticed in different laboratory batch replications. Varying laboratory test temperature and force-ductility elongation rate revealed further differences in asphalt-rubber mixtures.

  2. Practical Aspects of Designing and Conducting Validation Studies Involving Multi-study Trials.

    PubMed

    Coecke, Sandra; Bernasconi, Camilla; Bowe, Gerard; Bostroem, Ann-Charlotte; Burton, Julien; Cole, Thomas; Fortaner, Salvador; Gouliarmou, Varvara; Gray, Andrew; Griesinger, Claudius; Louhimies, Susanna; Gyves, Emilio Mendoza-de; Joossens, Elisabeth; Prinz, Maurits-Jan; Milcamps, Anne; Parissis, Nicholaos; Wilk-Zasadna, Iwona; Barroso, João; Desprez, Bertrand; Langezaal, Ingrid; Liska, Roman; Morath, Siegfried; Reina, Vittorio; Zorzoli, Chiara; Zuang, Valérie

    This chapter focuses on practical aspects of conducting prospective in vitro validation studies, and in particular, by laboratories that are members of the European Union Network of Laboratories for the Validation of Alternative Methods (EU-NETVAL) that is coordinated by the EU Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM). Prospective validation studies involving EU-NETVAL, comprising a multi-study trial involving several laboratories or "test facilities", typically consist of two main steps: (1) the design of the validation study by EURL ECVAM and (2) the execution of the multi-study trial by a number of qualified laboratories within EU-NETVAL, coordinated and supported by EURL ECVAM. The approach adopted in the conduct of these validation studies adheres to the principles described in the OECD Guidance Document on the Validation and International Acceptance of new or updated test methods for Hazard Assessment No. 34 (OECD 2005). The context and scope of conducting prospective in vitro validation studies is dealt with in Chap. 4 . Here we focus mainly on the processes followed to carry out a prospective validation of in vitro methods involving different laboratories with the ultimate aim of generating a dataset that can support a decision in relation to the possible development of an international test guideline (e.g. by the OECD) or the establishment of performance standards.

  3. Clinical microbiology laboratories do not always detect resistance of Haemophilus influenzae with disk or tablet diffusion methods. Finnish Study Group for Antimicrobial Resistance (FiRe).

    PubMed

    Manninen, R; Huovinen, P; Nissinen, A

    1998-04-01

    The performance of disk diffusion testing of Haemophilus influenzae was evaluated in 20 laboratories. Thirteen disk-medium-breakpoint-inoculum modifications were used in Finnish clinical microbiology laboratories. The performance of various methods was evaluated by testing a susceptible control strain and one with non-beta-lactamase-mediated ampicillin resistance 10 times in 16 laboratories. Gaps in millimeters were measured between these two groups of results. The strains were separated by a gap of at least 5 mm in 8/16 laboratories testing ampicillin, in 7/15 laboratories testing cefaclor, in 5/ 16 laboratories testing cefuroxime, and in 15/16 laboratories testing trimethoprim-sulfa. Detection of ampicillin resistance was better with 2.5 microg tablets than with 10 microg disks or 33 microg tablets. For MIC-determinations, 785 isolates and their disk diffusion results were collected. None of the 12 clinical isolates with non-beta-lactamase-mediated ampicillin resistance was detected as resistant in the participating laboratories. The ampicillin and cefaclor results of the isolates were no better even when a laboratory was able to separate the control strains. Cefaclor results were unreliable because of poor disk diffusion-MIC correspondence and incoherent breakpoint references. Interlaboratory variation of the zone diameters caused false intermediate results of cefuroxime-susceptible strains. When ampicillin, cefaclor and cefuroxime were tested, the discrimination of laboratories using disks and tablets was equal, whereas the laboratories using paper disks were better able to detect trimethoprim-sulfa resistance.

  4. An investigation into the effectiveness of problem-based learning in a physical chemistry laboratory course

    NASA Astrophysics Data System (ADS)

    Gürses, Ahmet; Açıkyıldız, Metin; Doğar, Çetin; Sözbilir, Mustafa

    2007-04-01

    The aim of this study was to investigate the effectiveness of a problem-based learning (PBL) approach in a physical chemistry laboratory course. The parameters investigated were students’ attitudes towards a chemistry laboratory course, scientific process skills of students and their academic achievement. The design of the study was one group pre-test post-test. Four experiments, covering the topics adsorption, viscosity, surface tension and conductivity were performed using a PBL approach in the fall semester of the 2003/04 academic year at Kazim Karabekir Education Faculty of Atatürk University. Each experiment was done over a three week period. A total of 40 students, 18 male and 22 female, participated in the study. Students took the Physical Chemistry Laboratory Concept Test (PCLCT), Attitudes towards Chemistry Laboratory (ATCL) questionnaire and Science Process Skills Test (SPST) as pre and post-tests. In addition, the effectiveness of the PBL approach was also determined through four different scales; Scales Specific to Students’ Views of PBL. A statistically significant difference between the students’ academic achievement and scientific process skills at p

  5. Laboratory testing in primary care: A systematic review of health IT impacts.

    PubMed

    Maillet, Éric; Paré, Guy; Currie, Leanne M; Raymond, Louis; Ortiz de Guinea, Ana; Trudel, Marie-Claude; Marsan, Josianne

    2018-08-01

    Laboratory testing in primary care is a fundamental process that supports patient management and care. Any breakdown in the process may alter clinical information gathering and decision-making activities and can lead to medical errors and potential adverse outcomes for patients. Various information technologies are being used in primary care with the goal to support the process, maximize patient benefits and reduce medical errors. However, the overall impact of health information technologies on laboratory testing processes has not been evaluated. To synthesize the positive and negative impacts resulting from the use of health information technology in each phase of the laboratory 'total testing process' in primary care. We conducted a systematic review. Databases including Medline, PubMed, CINAHL, Web of Science and Google Scholar were searched. Studies eligible for inclusion reported empirical data on: 1) the use of a specific IT system, 2) the impacts of the systems to support the laboratory testing process, and were conducted in 3) primary care settings (including ambulatory care and primary care offices). Our final sample consisted of 22 empirical studies which were mapped to a framework that outlines the phases of the laboratory total testing process, focusing on phases where medical errors may occur. Health information technology systems support several phases of the laboratory testing process, from ordering the test to following-up with patients. This is a growing field of research with most studies focusing on the use of information technology during the final phases of the laboratory total testing process. The findings were largely positive. Positive impacts included easier access to test results by primary care providers, reduced turnaround times, and increased prescribed tests based on best practice guidelines. Negative impacts were reported in several studies: paper-based processes employed in parallel to the electronic process increased the potential for medical errors due to clinicians' cognitive overload; systems deemed not reliable or user-friendly hampered clinicians' performance; and organizational issues arose when results tracking relied on the prescribers' memory. The potential of health information technology lies not only in the exchange of health information, but also in knowledge sharing among clinicians. This review has underscored the important role played by cognitive factors, which are critical in the clinician's decision-making, the selection of the most appropriate tests, correct interpretation of the results and efficient interventions. By providing the right information, at the right time to the right clinician, many IT solutions adequately support the laboratory testing process and help primary care clinicians make better decisions. However, several technological and organizational barriers require more attention to fully support the highly fragmented and error-prone process of laboratory testing. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Test Guideline Methods for Bed Bug Pesticide Products Now Available

    EPA Pesticide Factsheets

    EPA’s final test guidelines, 810.3900 - Laboratory Product Performance Testing Methods for Bed Bug Pesticide Products, provides recommendations for the design and execution of laboratory studies to evaluate the performance of pesticide products.

  7. The Relationship of Laboratory Performance Ratings, Information Achievement and Pencil-Paper Performance Test Scores in College-Level Electricity.

    ERIC Educational Resources Information Center

    Francis, Charles E.

    In this study, a pencil paper performance test (PPPT) was developed and administered to an experimental group of 46 students and a control group of 48 students to determine: (1) the difference between laboratory performance and the successful completion of a laboratory course in electricity, (2) the relationship between laboratory performance as…

  8. System reliability of randomly vibrating structures: Computational modeling and laboratory testing

    NASA Astrophysics Data System (ADS)

    Sundar, V. S.; Ammanagi, S.; Manohar, C. S.

    2015-09-01

    The problem of determination of system reliability of randomly vibrating structures arises in many application areas of engineering. We discuss in this paper approaches based on Monte Carlo simulations and laboratory testing to tackle problems of time variant system reliability estimation. The strategy we adopt is based on the application of Girsanov's transformation to the governing stochastic differential equations which enables estimation of probability of failure with significantly reduced number of samples than what is needed in a direct simulation study. Notably, we show that the ideas from Girsanov's transformation based Monte Carlo simulations can be extended to conduct laboratory testing to assess system reliability of engineering structures with reduced number of samples and hence with reduced testing times. Illustrative examples include computational studies on a 10-degree of freedom nonlinear system model and laboratory/computational investigations on road load response of an automotive system tested on a four-post test rig.

  9. Congenital syphilis in neonates with nonreactive nontreponemal test results.

    PubMed

    Wozniak, P S; Cantey, J B; Zeray, F; Leos, N K; Sheffield, J S; Wendel, G D; Sánchez, P J

    2017-10-01

    Infants whose mothers had syphilis during pregnancy were studied to determine how often exposed newborns with normal physical examinations and nonreactive nontreponemal serologic tests had abnormal laboratory or radiographic studies. Retrospective analysis of prospectively collected data from infants born to mothers with syphilis and had a normal examination and a nonreactive nontreponemal test. Some infants had IgM immunoblotting, PCR testing or rabbit infectivity testing (RIT) performed. From 1984 to 2002, 115 infants had a nonreactive serum Venereal Disease Research Laboratory (VDRL)/rapid plasma reagin (RPR) test and a normal physical examination at birth. Among 87 infants born to mothers who had untreated syphilis, 4 had a positive serum IgM immunoblot or PCR test, but none had spirochetes recovered by RIT. Two infants had anemia, one had an elevated serum alanine aminotransferase concentration and one with Down's syndrome had direct hyperbilirubinemia. Among 14 infants born to mothers treated <4 weeks before delivery, none had abnormal laboratory or radiographic tests, although 1 of 11 had a reactive serum IgM immunoblot. Among 14 infants born to mothers treated ⩾4 weeks before delivery, none had abnormal laboratory or radiographic tests. Newborns with normal physical examination and nonreactive nontreponemal test results are unlikely to have abnormalities detected on conventional laboratory and radiographic testing.

  10. Variability in Laboratory vs. Field Testing of Peak Power, Torque, and Time of Peak Power Production Among Elite Bicycle Motocross Cyclists.

    PubMed

    Rylands, Lee P; Roberts, Simon J; Hurst, Howard T

    2015-09-01

    The aim of this study was to ascertain the variation in elite male bicycle motocross (BMX) cyclists' peak power, torque, and time of power production during laboratory and field-based testing. Eight elite male BMX riders volunteered for the study, and each rider completed 3 maximal sprints using both a Schoberer Rad Messtechnik (SRM) ergometer in the laboratory and a portable SRM power meter on an Olympic standard indoor BMX track. The results revealed a significantly higher peak power (p ≤ 0.001, 34 ± 9%) and reduced time of power production (p ≤ 0.001, 105 ± 24%) in the field tests when compared with laboratory-derived values. Torque was also reported to be lower in the laboratory tests but not to an accepted level of significance (p = 0.182, 6 ± 8%). These results suggest that field-based testing may be a more effective and accurate measure of a BMX rider's peak power, torque, and time of power production.

  11. Comparative Laboratory-Scale Testing of Dispersant Effectiveness of 23 Crude Oils Using Four Different Testing Protocols

    EPA Science Inventory

    A controlled laboratory study was conducted to measure the dispersion effectiveness of Corexit 9500 on 20 different crude oils. This study was a part of a larger project initiated by the Bureau of Safety and Environmental Enforcement (BSEE) testing 20 oils to compare the predict...

  12. Verification of performance specifications for a US Food and Drug Administration-approved molecular microbiology test: Clostridium difficile cytotoxin B using the Becton, Dickinson and Company GeneOhm Cdiff assay.

    PubMed

    Schlaberg, Robert; Mitchell, Michael J; Taggart, Edward W; She, Rosemary C

    2012-01-01

    US Food and Drug Administration (FDA)-approved diagnostic tests based on molecular genetic technologies are becoming available for an increasing number of microbial pathogens. Advances in technology and lower costs have moved molecular diagnostic tests formerly performed for research purposes only into much wider use in clinical microbiology laboratories. To provide an example of laboratory studies performed to verify the performance of an FDA-approved assay for the detection of Clostridium difficile cytotoxin B compared with the manufacturer's performance standards. We describe the process and protocols used by a laboratory for verification of an FDA-approved assay, assess data from the verification studies, and implement the assay after verification. Performance data from the verification studies conducted by the laboratory were consistent with the manufacturer's performance standards and the assay was implemented into the laboratory's test menu. Verification studies are required for FDA-approved diagnostic assays prior to use in patient care. Laboratories should develop a standardized approach to verification studies that can be adapted and applied to different types of assays. We describe the verification of an FDA-approved real-time polymerase chain reaction assay for the detection of a toxin gene in a bacterial pathogen.

  13. Laboratory based instruction in Pakistan: Comparative evaluation of three laboratory instruction methods in biological science at higher secondary school level

    NASA Astrophysics Data System (ADS)

    Cheema, Tabinda Shahid

    This study of laboratory based instruction at higher secondary school level was an attempt to gain some insight into the effectiveness of three laboratory instruction methods: cooperative group instruction method, individualised instruction method and lecture demonstration method on biology achievement and retention. A Randomised subjects, Pre-test Post-test Comparative Methods Design was applied. Three groups of students from a year 11 class in Pakistan conducted experiments using the different laboratory instruction methods. Pre-tests, achievement tests after the experiments and retention tests one month later were administered. Results showed no significant difference between the groups on total achievement and retention, nor was there any significant difference on knowledge and comprehension test scores or skills performance. Future research investigating a similar problem is suggested.

  14. Diagnostic tests in HIV management: a review of clinical and laboratory strategies to monitor HIV-infected individuals in developing countries.

    PubMed Central

    Kimmel, April D.; Losina, Elena; Freedberg, Kenneth A.; Goldie, Sue J.

    2006-01-01

    We conducted a systematic review on the performance of diagnostic tests for clinical and laboratory monitoring of HIV-infected adults in developing countries. Diagnostic test information collected from computerized databases, bibliographies and the Internet were categorized as clinical (non-laboratory patient information), immunologic (information from immunologic laboratory tests), or virologic (information from virologic laboratory tests). Of the 51 studies selected for the review 28 assessed immunologic tests, 12 virologic tests and seven clinical and immunologic tests. Methods of performance evaluation were primarily sensitivity and specificity for the clinical category and correlation coefficients for immunologic and virologic categories. In the clinical category, the majority of test performance measures was reported as >70% sensitive and >65% specific. In the immunologic category, correlation coefficients ranged from r=0.54 to r=0.99 for different CD4 count enumeration techniques, while correlation for CD4 and total lymphocyte counts was between r=0.23 and r=0.74. In the virologic category, correlation coefficients for different human immunodeficiency virus (HIV) ribonucleic acid (RNA) quantification techniques ranged from r=0.54 to r=0.90. Future research requires consensus on designing studies, and collecting and reporting data useful for decision-makers. We recommend classifying information into clinically relevant categories, using a consistent definition of disease across studies and providing measures of both association and accuracy. PMID:16878233

  15. Validation of Dissolution Testing with Biorelevant Media: An OrBiTo Study.

    PubMed

    Mann, James; Dressman, Jennifer; Rosenblatt, Karin; Ashworth, Lee; Muenster, Uwe; Frank, Kerstin; Hutchins, Paul; Williams, James; Klumpp, Lukas; Wielockx, Kristina; Berben, Philippe; Augustijns, Patrick; Holm, Rene; Hofmann, Michael; Patel, Sanjaykumar; Beato, Stefania; Ojala, Krista; Tomaszewska, Irena; Bruel, Jean-Luc; Butler, James

    2017-12-04

    Dissolution testing with biorelevant media has become widespread in the pharmaceutical industry as a means of better understanding how drugs and formulations behave in the gastrointestinal tract. Until now, however, there have been few attempts to gauge the reproducibility of results obtained with these methods. The aim of this study was to determine the interlaboratory reproducibility of biorelevant dissolution testing, using the paddle apparatus (USP 2). Thirteen industrial and three academic laboratories participated in this study. All laboratories were provided with standard protocols for running the tests: dissolution in FaSSGF to simulate release in the stomach, dissolution in a single intestinal medium, FaSSIF, to simulate release in the small intestine, and a "transfer" (two-stage) protocol to simulate the concentration profile when conditions are changed from the gastric to the intestinal environment. The test products chosen were commercially available ibuprofen tablets and zafirlukast tablets. The biorelevant dissolution tests showed a high degree of reproducibility among the participating laboratories, even though several different batches of the commercially available medium preparation powder were used. Likewise, results were almost identicalbetween the commercial biorelevant media and those produced in-house. Comparing results to previous ring studies, including those performed with USP calibrator tablets or commercially available pharmaceutical products in a single medium, the results for the biorelevant studies were highly reproducible on an interlaboratory basis. Interlaboratory reproducibility with the two-stage test was also acceptable, although the variability was somewhat greater than with the single medium tests. Biorelevant dissolution testing is highly reproducible among laboratories and can be relied upon for cross-laboratory comparisons.

  16. Implementation of a rapid HIT immunoassay at a university hospital - Retrospective analysis of HIT laboratory orders in patients with thrombocytopenia.

    PubMed

    Black, Anne; Heimerl, Susanne; Oertli, Linnéa; Wilczek, Wolf; Greinacher, Andreas; Spannagl, Michael; Herr, Wolfgang; Hart, Christina

    2017-10-01

    Heparin-induced thrombocytopenia (HIT) is a rare cause of thrombocytopenia and a potentially life-threatening adverse drug reaction. Clinical overdiagnosis of HIT results in costly laboratory tests and anticoagulation. Criteria and algorithms for diagnosis are established, but their translation into clinical practice is still challenging. In a retrospective approach we studied all HIT related laboratory test requests within four years and evaluated data before (1st period, 24month) and after (2nd period, 24month) replacing particle gel immunoassay (PaGIA) and enzyme-linked immunosorbent assay (ELISA) by a chemiluminescent immunoassay (CLIA). HIT was confirmed by heparin-induced platelet activation (HIPA) test. Clinical pretest probability for HIT using an implemented simplified 4Ts score and platelet count were evaluated. Costs for laboratory tests and alternative anticoagulation were calculated. In 1850 patients with suspected HIT, 2327 laboratory orders were performed. In 87.2% of these orders an intermediate/high simplified 4Ts score was found. Thrombocytopenia was present in 87.1%. After replacing PaGIA and ELISA by CLIA the number of immunological and functional laboratory tests was reduced by 38.2%. The number of positive HIT immunoassays declined from 22.6% to 6.0%, while the number of positive HIPA tests among positive immunological tests increased by 19%. Altogether, acute HIT was confirmed in 59 patients. A decline in the use of alternative anticoagulants was observed in the 2nd period. Our study shows that in a university hospital setting HIT is well-known, but diagnosis requires a precise laboratory confirmation. Replacing PaGIA and ELISA by CLIA did not influence laboratory order behavior but results in reduced overall costs for laboratory diagnostics and alternative anticoagulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. 21 CFR 58.213 - Public disclosure of information regarding disqualification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing... such disclosure would further the public interest or would promote compliance with the good laboratory... Food and Drug Administration that nonclinical laboratory studies performed by the facility will not be...

  18. 21 CFR 58.217 - Suspension or termination of a testing facility by a sponsor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES... further participation in a nonclinical laboratory study that is being conducted as part of any application...

  19. 21 CFR 58.217 - Suspension or termination of a testing facility by a sponsor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES... further participation in a nonclinical laboratory study that is being conducted as part of any application...

  20. 21 CFR 58.107 - Test and control article handling.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Test and control article handling. 58.107 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.107 Test and control article handling. Procedures shall be established for a system for the handling of the test and...

  1. 21 CFR 58.107 - Test and control article handling.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Test and control article handling. 58.107 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.107 Test and control article handling. Procedures shall be established for a system for the handling of the test and...

  2. 21 CFR 58.107 - Test and control article handling.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Test and control article handling. 58.107 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.107 Test and control article handling. Procedures shall be established for a system for the handling of the test and...

  3. 21 CFR 58.107 - Test and control article handling.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Test and control article handling. 58.107 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.107 Test and control article handling. Procedures shall be established for a system for the handling of the test and...

  4. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (7th, Las Vegas, Nevada, June 3-7, 1985; 8th, Ithaca, New York, June 16-20, 1986). Volume 7/8.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.; Hauta, P. Lynn, Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceeding volume contains 12 papers: "Experimental Design and Testing: Hatching and Development in…

  5. Implications of the introduction of laboratory demand management at primary care clinics in South Africa on laboratory expenditure

    PubMed Central

    Lekalakala, Ruth; Asmall, Shaidah; Cassim, Naseem

    2016-01-01

    Background Diagnostic health laboratory services are regarded as an integral part of the national health infrastructure across all countries. Clinical laboratory tests contribute substantially to health system goals of increasing quality of care and improving patient outcomes. Objectives This study aimed to analyse current laboratory expenditures at the primary healthcare (PHC) level in South Africa as processed by the National Health Laboratory Service and to determine the potential cost savings of introducing laboratory demand management. Methods A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014 financial year across 11 pilot National Health Insurance health districts was conducted. Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests list (ELL) to determine inappropriate testing. Data were analysed using a Microsoft Access database and Excel software. Results Approximately R35 million South African Rand (10%) of the estimated R339 million in expenditures was for tests that were not listed within the ELL. Approximately 47% of expenditure was for laboratory tests that were indicated in the algorithmic management of patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included full blood count and urea, as well as electrolyte profiles usually requested to support management of patients on antiretroviral treatment. Conclusions Considerable annual savings of up to 10% in laboratory expenditure are possible at the PHC level by implementing laboratory demand management. In addition, to achieve these savings, a standardised PHC laboratory request form and some form of electronic gatekeeping system that must be supported by an educational component should be implemented. PMID:28879107

  6. Expert Assessment of Conditions for Accredited Quality Management System Functioning in Testing Laboratories

    NASA Astrophysics Data System (ADS)

    Mytych, Joanna; Ligarski, Mariusz J.

    2018-03-01

    The quality management systems compliant with the ISO 9001:2009 have been thoroughly researched and described in detail in the world literature. The accredited management systems used in the testing laboratories and compliant with the ISO/IEC 17025:2005 have been mainly described in terms of the system design and implementation. They have also been investigated from the analytical point of view. Unfortunately, a low number of studies concerned the management system functioning in the accredited testing laboratories. The aim of following study was to assess the management system functioning in the accredited testing laboratories in Poland. On 8 October 2015, 1,213 accredited testing laboratories were present in Poland. They investigated various scientific areas and substances/objects. There are more and more such laboratories that have various problems and different long-term experience when it comes to the implementation, maintenance and improvement of the management systems. The article describes the results of the conducted expert assessment (survey) carried out to examine the conditions for the functioning of a management system in an accredited laboratory. It also focuses on the characteristics of the accredited research laboratories in Poland. The authors discuss the selection of the external and internal conditions that may affect the accredited management system. They show how the experts assessing the selected conditions were chosen. The survey results are also presented.

  7. An inexpensive modification of the laboratory computer display changes emergency physicians' work habits and perceptions.

    PubMed

    Marinakis, Harry A; Zwemer, Frank L

    2003-02-01

    Little is known about how the availability of laboratory data affects emergency physicians' practice habits and satisfaction. We modified our clinical information system to display laboratory test status with continuous updates, similar to an airport arrival display. The objective of this study was to determine whether the laboratory test status display altered emergency physicians' work habits and increased satisfaction compared with the time period before implementation of laboratory test status. A retrospective analysis was performed of emergency physicians' actual use of the clinical information system before and after implementation of the laboratory test status display. Emergency physicians were retrospectively surveyed regarding the effect of laboratory test status display on their practice habits and clinical information system use. Survey responses were matched with actual use of the clinical information system. Data were analyzed by using dependent t tests and Pearson correlation coefficients. The study was conducted at a university hospital. Clinical information system use by 46 emergency physicians was analyzed. Twenty-five surveys were returned (71.4% of available emergency physicians). All emergency physicians perceived fewer clinical information system log ons per day after laboratory test status display. The actual average decrease was 19%. Emergency physicians who reported the greatest decrease in log ons per day tended to have the greatest actual decrease (r =-0.36). There was no significant correlation between actual and perceived total time logged on (r =0.08). In regard to effect on emergency physicians' practice habits, 95% reported increased efficiency, 80% reported improved satisfaction with data access, and 65% reported improved communication with patients. An inexpensive computer modification, laboratory test status display, significantly increased subjective efficiency, changed work habits, and improved satisfaction regarding data access and patient communication among emergency physicians. Knowledge of the test queue changed emergency physician behavior and improved satisfaction.

  8. 21 CFR 58.105 - Test and control article characterization.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Test and control article characterization. 58.105... GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.105 Test and control article characterization. (a) The identity, strength, purity, and composition or other...

  9. 21 CFR 58.105 - Test and control article characterization.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Test and control article characterization. 58.105... GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.105 Test and control article characterization. (a) The identity, strength, purity, and composition or other...

  10. 21 CFR 58.105 - Test and control article characterization.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Test and control article characterization. 58.105... GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.105 Test and control article characterization. (a) The identity, strength, purity, and composition or other...

  11. 21 CFR 58.105 - Test and control article characterization.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Test and control article characterization. 58.105... GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.105 Test and control article characterization. (a) The identity, strength, purity, and composition or other...

  12. 21 CFR 58.105 - Test and control article characterization.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Test and control article characterization. 58.105... GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.105 Test and control article characterization. (a) The identity, strength, purity, and composition or other...

  13. The Efficacy of the LearningRx Cognitive Training Program: Modality and Transfer Effects

    ERIC Educational Resources Information Center

    Hill, Oliver W.; Serpell, Zewelanji; Faison, M. Omar

    2016-01-01

    This article describes two studies testing the efficacy of a commercial one-on-one cognitive training program (LearningRx) and its computer-based version (Brainskills) in laboratory and school settings. Study 1 tested Brainskills in a laboratory setting with 322 middle school students. Paired "t"-tests revealed significant gains on all…

  14. Text Messaging Improves Participation in Laboratory Testing in Adolescent Liver Transplant Patients.

    PubMed

    McKenzie, Rebecca B; Berquist, William E; Foley, Megan A; Park, K T; Windsheimer, Jered E; Litt, Iris F

    In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients. AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention. Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (P<.001). This rate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM. TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.

  15. Biomagnetic Pair Therapy and Typhoid Fever: A Pilot Study.

    PubMed

    Frank, Bryan L

    2017-10-01

    Objective: This pilot study examined the laboratory responses of patients with laboratory-documented typhoid fever who were treated with Biomagnetic Pair Therapy (BPT; medical biomagnetism), a specific application of pairs of magnets for various ailments that are infectious and otherwise. Materials and Methods: This study was an assessment of patients' response to treatment with only BPT for Salmonella typhi infections (typhoid fever) using standard conventional laboratory techniques. The research was conducted in an outpatient village clinic in Kenya. There were 52 participants who were evaluated for possible systemic illness, including typhoid fever, from an open-label study. Participants who felt sick and requested testing for possible typhoid fever were tested with a standard Widal test by a certified laboratory technician. Participants who tested positive (13 patients) were then treated with BPT (a "First Aid" approach) only. These participants then returned for follow-up laboratory and clinical evaluations after 2 days. Results: Most of the participants (10 of 13) retested as negative, and all patients reported symptomatic clinical improvement. Conclusions: As a significant majority of participants demonstrated clearing of their S. typhi after BPT, this technique should be studied further in larger trials for its efficacy in treating typhoid fever.

  16. Integrated Data Collection Analysis (IDCA) program--KClO 4/Dodecane Mixture

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sandstrom, Mary M.; Brown, Geoffrey W.; Preston, Daniel N.

    The Integrated Data Collection Analysis (IDCA) program is conducting a proficiency study for Small- Scale Safety and Thermal (SSST) testing of homemade explosives (HMEs). Described here are the results for impact, friction, electrostatic discharge, and differential scanning calorimetry analysis of a mixture of KClO 4 and dodecane—KClO 4/dodecane mixture. This material was selected because of the challenge of performing SSST testing of a mixture of solid and liquid materials. The mixture was found to: 1) be less sensitive to impact than RDX, and PETN, 2) less sensitive to friction than RDX and PETN, and 3) less sensitive to spark thanmore » RDX and PETN. The thermal analysis showed little or no exothermic features suggesting that the dodecane volatilized at low temperatures. A prominent endothermic feature was observed and assigned to a phase transition of KClO 4. This effort, funded by the Department of Homeland Security (DHS), ultimately will put the issues of safe handling of these materials in perspective with standard military explosives. The study is adding SSST testing results for a broad suite of different HMEs to the literature. Ultimately the study has the potential to suggest new guidelines and methods and possibly establish the SSST testing accuracies needed to develop safe handling practices for HMEs. Each participating testing laboratory uses identical test materials and preparation methods wherever possible. Note, however, the test procedures differ among the laboratories. The results are compared among the laboratories and then compared to historical data from various sources. The testing performers involved for the KClO 4/dodecane mixture are Lawrence Livermore National Laboratory (LLNL), Los Alamos National Laboratory (LANL), Indian Head Division, Naval Surface Warfare Center, (NSWC IHD), and Air Force Research Laboratory (AFRL/RXQL). These tests are conducted as a proficiency study in order to establish some consistency in test protocols, procedures, and experiments and to understand how to compare results when these testing variables cannot be made consistent.« less

  17. Laboratory study - laboratory testing of bridge deck mixes

    DOT National Transportation Integrated Search

    2003-03-01

    The purpose of this investigation was to develop bridge deck mixes that will improve field performance and minimize cracking potential compared to MoDOT's current (B-2) bridge deck mix design. The mix designs developed in this study were tested and c...

  18. Transferability and inter-laboratory variability assessment of the in vitro bovine oocyte fertilization test.

    PubMed

    Tessaro, Irene; Modina, Silvia C; Crotti, Gabriella; Franciosi, Federica; Colleoni, Silvia; Lodde, Valentina; Galli, Cesare; Lazzari, Giovanna; Luciano, Alberto M

    2015-01-01

    The dramatic increase in the number of animals required for reproductive toxicity testing imposes the validation of alternative methods to reduce the use of laboratory animals. As we previously demonstrated for in vitro maturation test of bovine oocytes, the present study describes the transferability assessment and the inter-laboratory variability of an in vitro test able to identify chemical effects during the process of bovine oocyte fertilization. Eight chemicals with well-known toxic properties (benzo[a]pyrene, busulfan, cadmium chloride, cycloheximide, diethylstilbestrol, ketoconazole, methylacetoacetate, mifepristone/RU-486) were tested in two well-trained laboratories. The statistical analysis demonstrated no differences in the EC50 values for each chemical in within (inter-runs) and in between-laboratory variability of the proposed test. We therefore conclude that the bovine in vitro fertilization test could advance toward the validation process as alternative in vitro method and become part of an integrated testing strategy in order to predict chemical hazards on mammalian fertility. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Standardization of Terminology in Laboratory Medicine II

    PubMed Central

    Lee, Kap No; Yoon, Jong-Hyun; Min, Won Ki; Lim, Hwan Sub; Song, Junghan; Chae, Seok Lae; Jang, Seongsoo; Ki, Chang-Seok; Bae, Sook Young; Kim, Jang Su; Kwon, Jung-Ah; Lee, Chang Kyu

    2008-01-01

    Standardization of medical terminology is essential in data transmission between health care institutes and in maximizing the benefits of information technology. The purpose of this study was to standardize medical terms for laboratory observations. During the second year of the study, a standard database of concept names for laboratory terms that covered those used in tertiary health care institutes and reference laboratories was developed. The laboratory terms in the Logical Observation Identifier Names and Codes (LOINC) database were adopted and matched with the electronic data interchange (EDI) codes in Korea. A public hearing and a workshop for clinical pathologists were held to collect the opinions of experts. The Korean standard laboratory terminology database containing six axial concept names, components, property, time aspect, system (specimen), scale type, and method type, was established for 29,340 test observations. Short names and mapping tables for EDI codes and UMLS were added. Synonym tables were prepared to help match concept names to common terms used in the fields. We herein described the Korean standard laboratory terminology database for test names, result description terms, and result units encompassing most of the laboratory tests in Korea. PMID:18756062

  20. OB's high voltage laboratory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1966-01-01

    The January issue of Hi-Tension News provides a detailed description of the advanced surge test facilities and procedures in daily operation at the OB High Voltage Laboratory in Barberton, Ohio. Technical competences achieved in this laboratory contribute to the essential factors of design confirmation to basic studies of ehv insulation systems, conductor and hardware performance, and optimum tower construction. Known throughout the industry for authenticity of its full scale, all weather outdoor testing, OB's High Voltage Laboratory is a full-fledged participant in the NEMA-sponsored program to make testing facilities available on a cooperative basis.

  1. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Buchholz, Stuart A.

    This memorandum documents laboratory thermomechanical triaxial strength testing of Waste Isolation Pilot Plant (WIPP) clean salt. The limited study completed independent, adjunct laboratory tests in the United States to assist in validating similar testing results being provided by the German facilities. The testing protocol consisted of completing confined triaxial, constant strain rate strength tests of intact WIPP clean salt at temperatures of 25°C and 100°C and at multiple confining pressures. The stratigraphy at WIPP also includes salt that has been labeled “argillaceous.” The much larger test matrix conducted in Germany included both the so-called clean and argillaceous salts. When combined,more » the total database of laboratory results will be used to develop input parameters for models, assess adequacy of existing models, and predict material behavior. These laboratory studies are also consistent with the goals of the international salt repository research program. The goal of this study was to complete a subset of a test matrix on clean salt from the WIPP undertaken by German research groups. The work was performed at RESPEC in Rapid City, South Dakota. A rigorous Quality Assurance protocol was applied, such that corroboration provides the potential of qualifying all of the test data gathered by German research groups.« less

  2. Residue analysis of tetracyclines in poultry muscle: shortcomings revealed by a proficiency test.

    PubMed

    Berendsen, B J A; Van Rhijn, J A

    2006-11-01

    A proficiency test for tetracycline drug residues in poultry muscle was organized according to the guidelines of International Laboratory Accreditation Cooperation (ILAC) ILAC-G13:2000 (2000). For the proficiency test, three test materials were prepared. The homogeneity and stability of the materials during the study were demonstrated. Sixteen laboratories accepted the invitation to participate in the proficiency test; 11 laboratories reported results within the time frame of the study. Most notably, only four of the participating laboratories complied with the definition of the maximum residue limit (MRL) concerning the inclusion of 4-epimers as stated in European Commission Regulation 281/96 (1996). Most participants reported values for the decision limit (CCalpha) and detection capability (CCbeta) and hence were already in compliance with European Commission 2002/657/EC (2002) for this aspect of method validation. However, some CCalpha and CCbeta values were not in agreement with the actual within-laboratory reproducibility calculated from the results reported in this proficiency test. Although most laboratories obtained satisfactory results, it is clear that an effort is needed to include 4-epiOTC, 4-epiTC and 4-epiCTC in the analytical methods. Moreover, reconsideration of values determined for CCalpha and CCbeta with respect to their accuracy may be necessary in some cases.

  3. Comparative analytical costs of central laboratory glucose and bedside glucose testing: a College of American Pathologists Q-Probes study.

    PubMed

    Howanitz, Peter J; Jones, Bruce A

    2004-07-01

    One of the major attributes of laboratory testing is cost. Although fully automated central laboratory glucose testing and semiautomated bedside glucose testing (BGT) are performed at most institutions, rigorous determinations of interinstitutional comparative costs have not been performed. To compare interinstitutional analytical costs of central laboratory glucose testing and BGT and to provide suggestions for improvement. Participants completed a demographic form about their institutional glucose monitoring practices. They also collected information about the costs of central laboratory glucose testing, BGT at a high-volume testing site, and BGT at a low-volume testing site, including specified cost variables for labor, reagents, and instruments. A total of 445 institutions enrolled in the College of American Pathologists Q-Probes program. Median cost per glucose test at 3 testing sites. The median (10th-90th percentile range) costs per glucose test were 1.18 dollars (5.59 dollars-0.36 dollars), 1.96 dollars (9.51 dollars-0.77 dollars), and 4.66 dollars (27.54 dollars-1.02 dollars) for central laboratory, high-volume BGT sites, and low-volume BGT sites, respectively. The largest percentages of the cost per test were for labor (59.3%, 72.7%, and 85.8%), followed by supplies (27.2%, 27.3%, and 13.4%) and equipment (2.1%, 0.0%, and 0.0%) for the 3 sites, respectively. The median number of patient specimens per month at the high-volume BGT sites was 625 compared to 30 at the low-volume BGT sites. Most participants did not include labor, instrument maintenance, competency assessment, or oversight in their BGT estimated costs until required to do so for the study. Analytical costs per glucose test were lower for central laboratory glucose testing than for BGT, which, in turn, was highly variable and dependent on volume. Data that would be used for financial justification for BGT were widely aberrant and in need of improvement.

  4. An effective utilization management strategy by dual approach of influencing physician ordering and gate keeping.

    PubMed

    Elnenaei, Manal O; Campbell, Samuel G; Thoni, Andrea J; Lou, Amy; Crocker, Bryan D; Nassar, Bassam A

    2016-02-01

    There is increasing recognition of the importance of appropriate laboratory test utilization. We investigate the effect of a multifaceted educational approach that includes physician feedback on individual test ordering, in conjunction with targeted restriction, on the utilization of selected laboratory tests. Scientific evidence was compiled on the usefulness and limitations of tests suspected of being over utilized in our laboratories. A variety of approaches were used to deliver education on each of the targeted tests, with greater focus on primary care physicians (PCPs). Feedback on requesting behavior of these tests was also communicated to the latter group which included an educational component. Laboratory based restriction of testing was also exercised, including the unbundling of our electrolyte panel. PCP requesting patterns for the selected tests were found to be markedly skewed. The interventions implemented over the study period resulted in a substantial 51% reduction in overall ordering of five of the targeted tests equating to an annual marginal cost saving of $60,124. Unbundling of the electrolyte panel resulted in marginal cost savings that equated annually to $42,500 on chloride and $48,000 on total CO2. A multifaceted educational approach combined with feedback on utilization and laboratory driven gate-keeping significantly reduced the number of laboratory tests suspected of being redundant or unjustifiably requested. Laboratory professionals are well positioned to manage demand on laboratory tests by utilizing evidence base in developing specific test ordering directives and gate-keeping rules. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  5. The impact of repeat-testing of common chemistry analytes at critical concentrations.

    PubMed

    Onyenekwu, Chinelo P; Hudson, Careen L; Zemlin, Annalise E; Erasmus, Rajiv T

    2014-12-01

    Early notification of critical values by the clinical laboratory to the treating physician is a requirement for accreditation and is essential for effective patient management. Many laboratories automatically repeat a critical value before reporting it to prevent possible misdiagnosis. Given today's advanced instrumentation and quality assurance practices, we questioned the validity of this approach. We performed an audit of repeat-testing in our laboratory to assess for significant differences between initial and repeated test results, estimate the delay caused by repeat-testing and to quantify the cost of repeating these assays. A retrospective audit of repeat-tests for sodium, potassium, calcium and magnesium in the first quarter of 2013 at Tygerberg Academic Laboratory was conducted. Data on the initial and repeat-test values and the time that they were performed was extracted from our laboratory information system. The Clinical Laboratory Improvement Amendment criteria for allowable error were employed to assess for significant difference between results. A total of 2308 repeated tests were studied. There was no significant difference in 2291 (99.3%) of the samples. The average delay ranged from 35 min for magnesium to 42 min for sodium and calcium. At least 2.9% of laboratory running costs for the analytes was spent on repeating them. The practice of repeating a critical test result appears unnecessary as it yields similar results, delays notification to the treating clinician and increases laboratory running costs.

  6. Interlaboratory studies with the Chinese hamster V79 cell metabolic cooperation assay to detect tumor-promoting agents

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bohrman, J.S.; Burg, J.R.; Elmore, E.

    1988-01-01

    Three laboratories participated in an interlaboratory study to evaluate the usefulness of the Chinese hamster V79 cell metabolic cooperation assay to predict the tumor-promoting activity of selected chemical. Twenty-three chemicals of different chemical structures (phorbol esters, barbiturates, phenols, artificial sweeteners, alkanes, and peroxides) were chosen for testing based on in vivo promotion activities, as reported in the literature. Assay protocols and materials were standardized, and the chemicals were coded to facilitate unbiased evaluation. A chemical was tested only once in each laboratory, with one of the three laboratories testing only 15 out of 23 chemicals. Dunnett's test was used formore » statistical analysis. Chemicals were scored as positive (at least two concentration levels statistically different than control), equivocal (only one concentration statistically different), or negative. For 15 chemicals tested in all three laboratories, there was complete agreement among the laboratories for nine chemicals. For the 23 chemicals tested in only two laboratories, there was agreement on 16 chemicals. With the exception of the peroxides and alkanes, the metabolic cooperation data were in general agreement with in vivo data. However, an overall evaluation of the V79 cell system for predicting in vivo promotion activity was difficult because of the organ specificity of certain chemicals and/or the limited number of adequately tested nonpromoting chemicals.« less

  7. Viability testing of material derived from Mycobacterium tuberculosis prior to removal from a containment level-III laboratory as part of a Laboratory Risk Assessment Program.

    PubMed

    Blackwood, Kym S; Burdz, Tamara V; Turenne, Christine Y; Sharma, Meenu K; Kabani, Amin M; Wolfe, Joyce N

    2005-01-24

    In the field of clinical mycobacteriology, Mycobacterium tuberculosis (MTB) can be a difficult organism to manipulate due to the restrictive environment of a containment level 3 (CL3) laboratory. Tests for rapid diagnostic work involving smears and molecular methods do not require CL3 practices after the organism has been rendered non-viable. While it has been assumed that after organism deactivation these techniques can be performed outside of a CL3, no conclusive study has consistently confirmed that the organisms are noninfectious after the theoretical 'deactivation' steps. Previous studies have shown that initial steps (such as heating/chemical fixation) may not consistently kill MTB organisms. An inclusive viability study (n = 226) was undertaken to determine at which point handling of culture extraction materials does not necessitate a CL3 environment. Four different laboratory protocols tested for viability included: standard DNA extractions for IS6110 fingerprinting, crude DNA preparations for PCR by boiling and mechanical lysis, protein extractions, and smear preparations. For each protocol, laboratory staff planted a proportion of the resulting material to Bactec 12B medium that was observed for growth for 8 weeks. Of the 208 isolates initially tested, 21 samples grew within the 8-week period. Sixteen (7.7%) of these yielded positive results for MTB that included samples of: deactivated culture resuspensions exposed to 80 degrees C for 20 minutes, smear preparations and protein extractions. Test procedures were consequently modified and tested again (n = 18), resulting in 0% viability. This study demonstrates that it cannot be assumed that conventional practices (i.e. smear preparation) or extraction techniques render the organism non-viable. All methodologies, new and existing, should be examined by individual laboratories to validate the safe removal of material derived from MTB to the outside of a CL3 laboratory. This process is vital to establish in house biosafety-validated practices with the aim of protecting laboratory workers conducting these procedures.

  8. A Study on the Effects of Sympathetic Skin Response Parameters in Diagnosis of Fibromyalgia Using Artificial Neural Networks.

    PubMed

    Ozkan, Ozhan; Yildiz, Murat; Arslan, Evren; Yildiz, Sedat; Bilgin, Suleyman; Akkus, Selami; Koyuncuoglu, Hasan R; Koklukaya, Etem

    2016-03-01

    Fibromyalgia syndrome (FMS), usually observed commonly in females over age 30, is a rheumatic disease accompanied by extensive chronic pain. In the diagnosis of the disease non-objective psychological tests and physiological tests and laboratory test results are evaluated and clinical experiences stand out. However, these tests are insufficient in differentiating FMS with similar diseases that demonstrate symptoms of extensive pain. Thus, objective tests that would help the diagnosis are needed. This study analyzes the effect of sympathetic skin response (SSR) parameters on the auxiliary tests used in FMS diagnosis, the laboratory tests and physiological tests. The study was conducted in Suleyman Demirel University, Faculty of Medicine, Physical Medicine and Rehabilitation Clinic in Turkey with 60 patients diagnosed with FMS for the first time and a control group of 30 healthy individuals. In the study all participants underwent laboratory tests (blood tests), certain physiological tests (pulsation, skin temperature, respiration) and SSR measurements. The test data and SSR parameters obtained were classified using artificial neural network (ANN). Finally, in the ANN framework, where only laboratory and physiological test results were used as input, a simulation result of 96.51 % was obtained, which demonstrated diagnostic accuracy. This data, with the addition of SSR parameter values obtained increased to 97.67 %. This result including SSR parameters - meaning a higher diagnostic accuracy - demonstrated that SSR could be a new auxillary diagnostic method that could be used in the diagnosis of FMS.

  9. Clinical utility of routine laboratory testing to identify possible secondary causes in older men with osteoporosis: the Osteoporotic Fractures in Men (MrOS) Study

    PubMed Central

    Fink, Howard A.; Litwack-Harrison, Stephanie; Taylor, Brent C.; Bauer, Douglas C.; Orwoll, Eric S.; Lee, Christine G.; Barrett-Connor, Elizabeth; Schousboe, John T.; Kado, Deborah M.; Garimella, Pranav S.; Ensrud, Kristine E.

    2016-01-01

    Purpose To evaluate the utility of recommended laboratory testing to identify secondary causes in older men with osteoporosis, we examined prevalence of laboratory abnormalities in older men with and without osteoporosis. Methods 1572 men aged ≥65 years in the Osteoporotic Fractures in Men study completed bone mineral density (BMD) testing and a battery of laboratory measures, including serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), 25-OH vitamin D, total testosterone, spot urine calcium/creatinine ratio, spot urine albumin-creatinine ratio, creatinine-derived estimate glomerular filtration rate, 24-hour urine calcium, and 24-hour urine free cortisol. Using cross-sectional analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association of any and specific laboratory abnormalities with osteoporosis, and the number of men with osteoporosis needed to test to identify one additional laboratory abnormality compared to testing men without osteoporosis. Results Approximately 60% of men had ≥1 laboratory abnormality in both men with and without osteoporosis. Among individual tests, only vitamin D insufficiency (PR, 1.13; 95% CI, 1.05–1.22) and high alkaline phosphatase (PR, 3.05; 95% CI, 1.52–6.11) were more likely in men with osteoporosis. Hypercortisolism and hyperthyroidism were uncommon and not significantly more frequent in men with osteoporosis. No osteoporotic men had hypercalciuria. Conclusions Though most of these older men had ≥1 laboratory abnormality, few routinely recommended individual tests were more common in men with osteoporosis than in those without osteoporosis. Possibly excepting vitamin D and alkaline phosphatase, benefit of routine laboratory testing to identify possible secondary causes in older osteoporotic men appears low. Results may not be generalizable to younger men or to older men in whom history and exam findings raise clinical suspicion for a secondary cause of osteoporosis. PMID:26458388

  10. [An experimental proficiency test for ability to screen 104 residual pesticides in agricultural products].

    PubMed

    Tsumura, Yukari; Ishimitsu, Susumu; Otaki, Kayo; Uchimi, Hiroyuki; Matsumoto, Nobuyuki; Daba, Masaki; Tsuchiya, Tetsu; Ukyo, Masaho; Tonogai, Yasuhide

    2003-10-01

    An experimental proficiency test program for ability to screen 104 residual pesticides in agricultural products has been conducted. Eight Japanese laboratories joined the program. Items tested in the present study were limit of detection, internal proficiency test (self spike) and external proficiency test (blind spike). All 104 pesticides were well detected and recovered from agricultural foods in the internal proficiency test. However, the results of the external proficiency test did not completely agree with those of the internal proficiency tests. After 5 rounds of the blind spike test, the ratio of the number of correctly detected pesticides to that of actually contained ones (49 total) ranged from 65% to 100% among laboratories. The numbers of mistakenly detected pesticides by a laboratory were 0 to 15. Thus, there was a great difference among the laboratories in the ability to screen multiresidual pesticides.

  11. 76 FR 76736 - Agency Forms Undergoing Paperwork Reduction Act Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-08

    ... Project Survey of Rapid Influenza Diagnostic Test (RIDT) Practices in Laboratories-NEW--the Office of...). Background and Brief Description The Survey of Rapid Influenza Diagnostic Testing Practices in Laboratories is a national systematic study investigating rapid influenza diagnostic testing practices in clinical...

  12. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    PubMed

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  13. Constrained Laboratory vs. Unconstrained Steering-Induced Rollover Crash Tests.

    PubMed

    Kerrigan, Jason R; Toczyski, Jacek; Roberts, Carolyn; Zhang, Qi; Clauser, Mark

    2015-01-01

    The goal of this study was to evaluate how well an in-laboratory rollover crash test methodology that constrains vehicle motion can reproduce the dynamics of unconstrained full-scale steering-induced rollover crash tests in sand. Data from previously-published unconstrained steering-induced rollover crash tests using a full-size pickup and mid-sized sedan were analyzed to determine vehicle-to-ground impact conditions and kinematic response of the vehicles throughout the tests. Then, a pair of replicate vehicles were prepared to match the inertial properties of the steering-induced test vehicles and configured to record dynamic roof structure deformations and kinematic response. Both vehicles experienced greater increases in roll-axis angular velocities in the unconstrained tests than in the constrained tests; however, the increases that occurred during the trailing side roof interaction were nearly identical between tests for both vehicles. Both vehicles experienced linear accelerations in the constrained tests that were similar to those in the unconstrained tests, but the pickup, in particular, had accelerations that were matched in magnitude, timing, and duration very closely between the two test types. Deformations in the truck test were higher in the constrained than the unconstrained, and deformations in the sedan were greater in the unconstrained than the constrained as a result of constraints of the test fixture, and differences in impact velocity for the trailing side. The results of the current study suggest that in-laboratory rollover tests can be used to simulate the injury-causing portions of unconstrained rollover crashes. To date, such a demonstration has not yet been published in the open literature. This study did, however, show that road surface can affect vehicle response in a way that may not be able to be mimicked in the laboratory. Lastly, this study showed that configuring the in-laboratory tests to match the leading-side touchdown conditions could result in differences in the trailing side impact conditions.

  14. Between and within laboratory reliability of mouse behaviour recorded in home-cage and open-field.

    PubMed

    Robinson, Lianne; Spruijt, Berry; Riedel, Gernot

    2018-04-15

    Reproducibility of behavioural findings between laboratories is difficult due to behaviour being sensitive to environmental factors and interactions with genetics. The objective of this study was to investigate reproducibility of behavioural data between laboratories using the PhenoTyper home cage observation system and within laboratory reproducibility using different lighting regimes. The ambulatory activity of C57BL/6 and DBA/2 mice was tested in PhenoTypers in two laboratories under near identical housing and testing conditions (Exp. 1). Additionally activity and anxiety were also assessed in the open-field test. Furthermore, testing in either a normal or inverted light/dark cycle was used to determine effects of lighting regime in a within-laboratory comparison in Aberdeen (Exp. 2). Using the PhenoTyper similar circadian rhythms were observed across laboratories. Higher levels of baseline and novelty-induced activity were evident in Aberdeen compared to Utrecht although strain differences were consistent between laboratories. Open field activity was also similar across laboratories whereas strain differences in anxiety were different. Within laboratory analysis of different lighting regimes revealed that behaviour of the mice was sensitive to changes in lighting. Utilisation of a home cage observation system facilitates the reproducibility of activity but not anxiety-related behaviours across laboratories by eliminating environmental factors known to influence reproducibility in standard behavioural tests. Standardisation of housing/test conditions resulted in reproducibility of home cage and open field activity but not anxiety-related phenotypes across laboratories with some behaviours more sensitive to environmental factors. Environmental factors include lighting and time of day. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Utilization of stat test priority in the clinical laboratory: a College of American Pathologists q-probes study of 52 institutions.

    PubMed

    Volmar, Keith E; Wilkinson, David S; Wagar, Elizabeth A; Lehman, Christopher M

    2013-02-01

    Utilization of stat testing priority is a balance between safe, efficient patient management and resource expenditure. To determine the rate of stat testing, compare rates among institutions, and determine the distribution of turnaround time expectations for different turnaround time priorities. During a 7-day period, participants prospectively determined the total number of chemistry, hematology, and coagulation billable tests from inpatients and emergency department patients. Among these, the total numbers of billable tests performed stat were identified. Laboratories also reported the levels of test priority they offered and turnaround expectations for each level of test priority. Fifty institutions submitted data for the study, with 2 additional participants submitting partial results. Participants identified 639 589 chemistry, hematology, and coagulation billable tests, with 229 896 (35.9%) performed stat. The stat rate varied from 21.3% at the 10th percentile to 55.4% at the 90th percentile, with a median of 37.0% of participants' tests performed stat. Laboratories include a mean of 206 tests in chemistry, hematology, and coagulation test menus, with 67% of these tests offered stat. The fraction of the test menu offered stat varied from 29.0% at the 10th percentile to 97.8% at the 90th percentile, with a median of 73.3% of tests on the menu offered stat. The most common number of testing priorities offered by participating laboratories was 3 (44.2%). Among the 52 participating laboratories, the median stat testing rate was 37.0% and a median 73.3% of the test menu was offered stat.

  16. Using pathology-specific laboratory profiles in Clinical Pathology to reduce inappropriate test requesting: two completed audit cycles

    PubMed Central

    2012-01-01

    Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value. PMID:22759353

  17. Using pathology-specific laboratory profiles in clinical pathology to reduce inappropriate test requesting: two completed audit cycles.

    PubMed

    Baricchi, Roberto; Zini, Michele; Nibali, Maria Grazia; Vezzosi, Walter; Insegnante, Vincenzo; Manfuso, Clotilde; Polese, Alessandra; Costoli, Valmer; Spelti, Antonio; Formisano, Debora; Orlandini, Danilo; Nicolini, Fausto; Poli, Antonio

    2012-07-03

    Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs' request forms. Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p < 0.001); 2) the provisional diagnosis on the request forms was 52.8% in the trial district and 42% in the control district (P < 0.001); 3) the decrease of the number of tests on each request form was much more marked in the trial district (8.73 vs. 10.77; p < 0.001). The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value.

  18. Development and Validation of Targeted Next-Generation Sequencing Panels for Detection of Germline Variants in Inherited Diseases.

    PubMed

    Santani, Avni; Murrell, Jill; Funke, Birgit; Yu, Zhenming; Hegde, Madhuri; Mao, Rong; Ferreira-Gonzalez, Andrea; Voelkerding, Karl V; Weck, Karen E

    2017-06-01

    - The number of targeted next-generation sequencing (NGS) panels for genetic diseases offered by clinical laboratories is rapidly increasing. Before an NGS-based test is implemented in a clinical laboratory, appropriate validation studies are needed to determine the performance characteristics of the test. - To provide examples of assay design and validation of targeted NGS gene panels for the detection of germline variants associated with inherited disorders. - The approaches used by 2 clinical laboratories for the development and validation of targeted NGS gene panels are described. Important design and validation considerations are examined. - Clinical laboratories must validate performance specifications of each test prior to implementation. Test design specifications and validation data are provided, outlining important steps in validation of targeted NGS panels by clinical diagnostic laboratories.

  19. High Vacuum Creep Facility in the Materials Processing Laboratory

    NASA Image and Video Library

    1973-01-21

    Technicians at work in the Materials Processing Laboratory’s Creep Facility at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The technicians supported the engineers’ studies of refractory materials, metals, and advanced superalloys. The Materials Processing Laboratory contained laboratories and test areas equipped to prepare and develop these metals and materials. The ultra-high vacuum lab, seen in this photograph, contained creep and tensile test equipment. Creep testing is used to study a material’s ability to withstand long durations under constant pressure and temperatures. The equipment measured the strain over a long period of time. Tensile test equipment subjects the test material to strain until the material fails. The two tests were used to determine the strength and durability of different materials. The Materials Processing Laboratory also housed arc and electron beam melting furnaces, a hydraulic vertical extrusion press, compaction and forging equipment, and rolling mills and swagers. There were cryogenic and gas storage facilities and mechanical and oil diffusion vacuum pumps. The facility contained both instrumental and analytical chemistry laboratories for work on radioactive or toxic materials and the only shop to machine toxic materials in the Midwest.

  20. Laboratory-based versus non-laboratory-based method for assessment of cardiovascular disease risk: the NHANES I Follow-up Study cohort

    PubMed Central

    Gaziano, Thomas A; Young, Cynthia R; Fitzmaurice, Garrett; Atwood, Sidney; Gaziano, J Michael

    2008-01-01

    Summary Background Around 80% of all cardiovascular deaths occur in developing countries. Assessment of those patients at high risk is an important strategy for prevention. Since developing countries have limited resources for prevention strategies that require laboratory testing, we assessed if a risk prediction method that did not require any laboratory tests could be as accurate as one requiring laboratory information. Methods The National Health and Nutrition Examination Survey (NHANES) was a prospective cohort study of 14 407 US participants aged between 25–74 years at the time they were first examined (between 1971 and 1975). Our follow-up study population included participants with complete information on these surveys who did not report a history of cardiovascular disease (myocardial infarction, heart failure, stroke, angina) or cancer, yielding an analysis dataset N=6186. We compared how well either method could predict first-time fatal and non-fatal cardiovascular disease events in this cohort. For the laboratory-based model, which required blood testing, we used standard risk factors to assess risk of cardiovascular disease: age, systolic blood pressure, smoking status, total cholesterol, reported diabetes status, and current treatment for hypertension. For the non-laboratory-based model, we substituted body-mass index for cholesterol. Findings In the cohort of 6186, there were 1529 first-time cardiovascular events and 578 (38%) deaths due to cardiovascular disease over 21 years. In women, the laboratory-based model was useful for predicting events, with a c statistic of 0·829. The c statistic of the non-laboratory-based model was 0·831. In men, the results were similar (0·784 for the laboratory-based model and 0·783 for the non-laboratory-based model). Results were similar between the laboratory-based and non-laboratory-based models in both men and women when restricted to fatal events only. Interpretation A method that uses non-laboratory-based risk factors predicted cardiovascular events as accurately as one that relied on laboratory-based values. This approach could simplify risk assessment in situations where laboratory testing is inconvenient or unavailable. PMID:18342687

  1. A teaching intervention for reading laboratory experiments in college-level introductory chemistry

    NASA Astrophysics Data System (ADS)

    Kirk, Maria Kristine

    The purpose of this study was to determine the effects that a pre-laboratory guide, conceptualized as a "scientific story grammar," has on college chemistry students' learning when they read an introductory chemistry laboratory manual and perform the experiments in the chemistry laboratory. The participants (N = 56) were students enrolled in four existing general chemistry laboratory sections taught by two instructors at a women's liberal arts college. The pre-laboratory guide consisted of eight questions about the experiment, including the purpose, chemical species, variables, chemical method, procedure, and hypothesis. The effects of the intervention were compared with those of the traditional pre-laboratory assignment for the eight chemistry experiments. Measures included quizzes, tests, chemistry achievement test, science process skills test, laboratory reports, laboratory average, and semester grade. The covariates were mathematical aptitude and prior knowledge of chemistry and science processes, on which the groups differed significantly. The study captured students' perceptions of their experience in general chemistry through a survey and interviews with eight students. The only significant differences in the treatment group's performance were in some subscores on lecture items and laboratory items on the quizzes. An apparent induction period was noted, in that significant measures occurred in mid-semester. Voluntary study with the pre-laboratory guide by control students precluded significant differences on measures given later in the semester. The groups' responses to the survey were similar. Significant instructor effects on three survey items were corroborated by the interviews. The researcher's students were more positive about their pre-laboratory tasks, enjoyed the laboratory sessions more, and were more confident about doing chemistry experiments than the laboratory instructor's groups due to differences in scaffolding by the instructors.

  2. Laboratory evaluation of suspected motor neuron disease: A survey of physicians.

    PubMed

    Sanderson, Alan B; Novak, John C; Nash, Steven M; Kolb, Stephen J; Kissel, John T

    2015-07-01

    The clinical diagnosis of amyotrophic lateral sclerosis (ALS) relies on exclusion of mimic syndromes, but there are no specific guidelines regarding the extent of laboratory testing required. A survey was sent to 274 physicians listed in the Neuromuscular Section of the American Academy of Neurology. The survey asked how often they order 21 different laboratory tests in patients suspected of having ALS. Ninety-nine responses were received (36% response rate). Greater than 75% ordered serum creatine kinase, chemistry panel, and thyroid functions often or always. Fewer than 25% tested for serum complement, hexosaminidase A, spinal muscular atrophy, Kennedy disease, heavy metals, or human T-cell lymphotrophic virus often or always. Twelve other tests had intermediate responses. There is a lack of consensus among respondents regarding the laboratory evaluation of suspected ALS. Prospective studies are needed to define the diagnostic yield and cost-effectiveness of laboratory testing in this population. © 2015 Wiley Periodicals, Inc.

  3. Laboratory Safety Monitoring of Chronic Medications in Ambulatory Care Settings

    PubMed Central

    Hurley, Judith S; Roberts, Melissa; Solberg, Leif I; Gunter, Margaret J; Nelson, Winnie W; Young, Linda; Frost, Floyd J

    2005-01-01

    OBJECTIVE To evaluate laboratory safety monitoring in patients taking selected chronic prescription drugs. DESIGN Retrospective study using 1999–2001 claims data to calculate rates of missed laboratory tests (potential laboratory monitoring errors). Eleven drugs/drug groups and 64 laboratory tests were evaluated. SETTING Two staff/network model health maintenance organizations. PATIENTS Continuously enrolled health plan members age≥19 years taking ≥1 chronic medications. MEASUREMENTS AND MAIN RESULTS Among patients taking chronic medications (N=29,823 in 1999, N=32,423 in 2000, and N=36,811 in 2001), 47.1% in 1999, 45.0% in 2000, and 44.0% in 2001 did not receive ≥1 test recommended for safety monitoring. Taking into account that patients were sometimes missing more than 1 test for a given drug and that patients were frequently taking multiple drugs, the rate of all potential laboratory monitoring errors was 849/1,000 patients/year in 1999, 810/1,000 patients/year in 2000, and 797/1,000 patients/year in 2001. Rates of potential laboratory monitoring errors varied considerably across individual drugs and laboratory tests. CONCLUSIONS Lapses in laboratory monitoring of patients taking selected chronic medications were common. Further research is needed to determine whether, and to what extent, this failure to monitor patients is associated with adverse clinical outcomes. PMID:15857489

  4. Antimicrobial susceptibility testing by Australian veterinary diagnostic laboratories.

    PubMed

    Hardefeldt, L Y; Marenda, M; Crabb, H; Stevenson, M A; Gilkerson, J R; Billman-Jacobe, H; Browning, G F

    2018-04-01

    The national strategy for tackling antimicrobial resistance highlights the need for antimicrobial stewardship in veterinary practice and for surveillance of antimicrobial susceptibility in veterinary pathogens. Diagnostic laboratories have an important role in facilitating both of these processes, but it is unclear whether data from veterinary diagnostic laboratories are similar enough to allow for compilation and if there is consistent promotion of appropriate antimicrobial use embedded in the approaches of different laboratories to susceptibility testing. A cross-sectional study of antimicrobial susceptibility testing and reporting procedures by Australian veterinary diagnostic laboratories was conducted in 2017 using an online questionnaire. All 18 veterinary diagnostic laboratories in Australia completed the questionnaire. Kirby-Bauer disc diffusion was the method predominantly used for antimicrobial susceptibility testing and was used to evaluate 86% of all isolates, although two different protocols were used across the 18 laboratories (CLSI 15/18, CDS 3/18). Minimum inhibitory concentrations were never reported by 61% of laboratories. Common isolates were consistently reported on across all species, except for gram-negative isolates in pigs, for which there was some variation in the approach to reporting. There was considerable diversity in the panels of antimicrobials used for susceptibility testing on common isolates and no consistency was apparent between laboratories for any bacterial species. We recommend that nationally agreed and consistent antimicrobial panels for routine susceptibility testing should be developed and a uniform set of guidelines should be adopted by veterinary diagnostic laboratories in Australia. © 2018 Australian Veterinary Association.

  5. Inter-laboratory Comparison of Three Earplug Fit-test Systems

    PubMed Central

    Byrne, David C.; Murphy, William J.; Krieg, Edward F.; Ghent, Robert M.; Michael, Kevin L.; Stefanson, Earl W.; Ahroon, William A.

    2017-01-01

    The National Institute for Occupational Safety and Health (NIOSH) sponsored tests of three earplug fit-test systems (NIOSH HPD Well-Fit™, Michael & Associates FitCheck, and Honeywell Safety Products VeriPRO®). Each system was compared to laboratory-based real-ear attenuation at threshold (REAT) measurements in a sound field according to ANSI/ASA S12.6-2008 at the NIOSH, Honeywell Safety Products, and Michael & Associates testing laboratories. An identical study was conducted independently at the U.S. Army Aeromedical Research Laboratory (USAARL), which provided their data for inclusion in this report. The Howard Leight Airsoft premolded earplug was tested with twenty subjects at each of the four participating laboratories. The occluded fit of the earplug was maintained during testing with a soundfield-based laboratory REAT system as well as all three headphone-based fit-test systems. The Michael & Associates lab had highest average A-weighted attenuations and smallest standard deviations. The NIOSH lab had the lowest average attenuations and the largest standard deviations. Differences in octave-band attenuations between each fit-test system and the American National Standards Institute (ANSI) sound field method were calculated (Attenfit-test - AttenANSI). A-weighted attenuations measured with FitCheck and HPD Well-Fit systems demonstrated approximately ±2 dB agreement with the ANSI sound field method, but A-weighted attenuations measured with the VeriPRO system underestimated the ANSI laboratory attenuations. For each of the fit-test systems, the average A-weighted attenuation across the four laboratories was not significantly greater than the average of the ANSI sound field method. Standard deviations for residual attenuation differences were about ±2 dB for FitCheck and HPD Well-Fit compared to ±4 dB for VeriPRO. Individual labs exhibited a range of agreement from less than a dB to as much as 9.4 dB difference with ANSI and REAT estimates. Factors such as the experience of study participants and test administrators, and the fit-test psychometric tasks are suggested as possible contributors to the observed results. PMID:27786602

  6. A SIMPLE METHOD FOR EVALUATING DATA FROM AN INTERLABORATORY STUDY

    EPA Science Inventory

    Large-scale laboratory-and method-performance studies involving more than about 30 laboratories may be evaluated by calculating the HORRAT ratio for each test sample (HORRAT=[experimentally found among-laboratories relative standard deviation] divided by [relative standard deviat...

  7. A Profilometry-Based Dentifrice Abrasion Method for V8 Brushing Machines Part III: Multi-Laboratory Validation Testing of RDA-PE.

    PubMed

    Schneiderman, Eva; Colón, Ellen L; White, Donald J; Schemehorn, Bruce; Ganovsky, Tara; Haider, Amir; Garcia-Godoy, Franklin; Morrow, Brian R; Srimaneepong, Viritpon; Chumprasert, Sujin

    2017-09-01

    We have previously reported on progress toward the refinement of profilometry-based abrasivity testing of dentifrices using a V8 brushing machine and tactile or optical measurement of dentin wear. The general application of this technique may be advanced by demonstration of successful inter-laboratory confirmation of the method. The objective of this study was to explore the capability of different laboratories in the assessment of dentifrice abrasivity using a profilometry-based evaluation technique developed in our Mason laboratories. In addition, we wanted to assess the interchangeability of human and bovine specimens. Participating laboratories were instructed in methods associated with Radioactive Dentin Abrasivity-Profilometry Equivalent (RDA-PE) evaluation, including site visits to discuss critical elements of specimen preparation, masking, profilometry scanning, and procedures. Laboratories were likewise instructed on the requirement for demonstration of proportional linearity as a key condition for validation of the technique. Laboratories were provided with four test dentifrices, blinded for testing, with a broad range of abrasivity. In each laboratory, a calibration curve was developed for varying V8 brushing strokes (0, 4,000, and 10,000 strokes) with the ISO abrasive standard. Proportional linearity was determined as the ratio of standard abrasion mean depths created with 4,000 and 10,000 strokes (2.5 fold differences). Criteria for successful calibration within the method (established in our Mason laboratory) was set at proportional linearity = 2.5 ± 0.3. RDA-PE was compared to Radiotracer RDA for the four test dentifrices, with the latter obtained by averages from three independent Radiotracer RDA sites. Individual laboratories and their results were compared by 1) proportional linearity and 2) acquired RDA-PE values for test pastes. Five sites participated in the study. One site did not pass proportional linearity objectives. Data for this site are not reported at the request of the researchers. Three of the remaining four sites reported herein tested human dentin and all three met proportional linearity objectives for human dentin. Three of four sites participated in testing bovine dentin and all three met the proportional linearity objectives for bovine dentin. RDA-PE values for test dentifrices were similar between sites. All four sites that met proportional linearity requirement successfully identified the dentifrice formulated above the industry standard 250 RDA (as RDA-PE). The profilometry method showed at least as good reproducibility and differentiation as Radiotracer assessments. It was demonstrated that human and bovine specimens could be used interchangeably. The standardized RDA-PE method was reproduced in multiple laboratories in this inter-laboratory study. Evidence supports that this method is a suitable technique for ISO method 11609 Annex B.

  8. How Do Experienced Physicians Access and Evaluate Laboratory Test Results for the Chronic Patient? A Qualitative Analysis.

    PubMed

    Torsvik, Torbjørn; Lillebo, Børge; Hertzum, Morten

    2018-04-01

     Electronic health records may present laboratory test results in a variety of ways. Little is known about how the usefulness of different visualizations of laboratory test results is influenced by the complex and varied process of clinical decision making.  The purpose of this study was to investigate how clinicians access and utilize laboratory test results when caring for patients with chronic illness.  We interviewed 10 attending physicians about how they access and assess laboratory tests when following up patients with chronic illness. The interviews were audio-recorded, transcribed verbatim, and analyzed qualitatively.  Informants preferred different visualizations of laboratory test results, depending on what aspects of the data they were interested in. As chronic patients may have laboratory test results that are permanently outside standardized reference ranges, informants would often look for significant change, rather than exact values. What constituted significant change depended on contextual information (e.g., the results of other investigations, intercurrent diseases, and medical interventions) spread across multiple locations in the electronic health record. For chronic patients, the temporal relations between data could often be of special interest. Informants struggled with finding and synthesizing fragmented information into meaningful overviews.  The presentation of laboratory test results should account for the large variety of associated contextual information needed for clinical comprehension. Future research is needed to improve the integration of the different parts of the electronic health record. Schattauer GmbH Stuttgart.

  9. Automatic Vacuum Flushing Technology for Combined Sewer Solids: Laboratory Testing and Proposed Improvements (WERF Report INFR7SG09)

    EPA Science Inventory

    This research study included an extensive literature review on existing sewer sediment flushing technologies. An innovative vacuum flush system previously developed by the U.S. EPA was tested under laboratory conditions. The tests revealed a strong correlation between the strengt...

  10. 40 CFR 158.1300 - Environmental fate data requirements table.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Greenhouse Indoor Forestry Residential Outdoor Test substance Test Note No. Degradation Studies - Laboratory... Photodegradation in air CR NR CR NR CR CR TGAI or PAIRA 4 Metabolism Studies - Laboratory 835.4100 Aerobic soil R... -- Mobility Studies 835.1230835.1240 Leaching and adsorption/desorption R R R NR R R TGAI or PAIRA 6 835.1410...

  11. 40 CFR 158.1300 - Environmental fate data requirements table.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Greenhouse Indoor Forestry Residential Outdoor Test substance Test Note No. Degradation Studies - Laboratory... Photodegradation in air CR NR CR NR CR CR TGAI or PAIRA 4 Metabolism Studies - Laboratory 835.4100 Aerobic soil R... -- Mobility Studies 835.1230835.1240 Leaching and adsorption/desorption R R R NR R R TGAI or PAIRA 6 835.1410...

  12. 40 CFR 158.1300 - Environmental fate data requirements table.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Greenhouse Indoor Forestry Residential Outdoor Test substance Test Note No. Degradation Studies - Laboratory... Photodegradation in air CR NR CR NR CR CR TGAI or PAIRA 4 Metabolism Studies - Laboratory 835.4100 Aerobic soil R... -- Mobility Studies 835.1230835.1240 Leaching and adsorption/desorption R R R NR R R TGAI or PAIRA 6 835.1410...

  13. 40 CFR 158.1300 - Environmental fate data requirements table.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Greenhouse Indoor Forestry Residential Outdoor Test substance Test Note No. Degradation Studies - Laboratory... Photodegradation in air CR NR CR NR CR CR TGAI or PAIRA 4 Metabolism Studies - Laboratory 835.4100 Aerobic soil R... -- Mobility Studies 835.1230835.1240 Leaching and adsorption/desorption R R R NR R R TGAI or PAIRA 6 835.1410...

  14. 40 CFR 158.1300 - Environmental fate data requirements table.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Greenhouse Indoor Forestry Residential Outdoor Test substance Test Note No. Degradation Studies - Laboratory... Photodegradation in air CR NR CR NR CR CR TGAI or PAIRA 4 Metabolism Studies - Laboratory 835.4100 Aerobic soil R... -- Mobility Studies 835.1230835.1240 Leaching and adsorption/desorption R R R NR R R TGAI or PAIRA 6 835.1410...

  15. The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    PubMed

    Nikolac, Nora; Simundic, Ana-Maria; Kackov, Sanja; Serdar, Tihana; Dorotic, Adrijana; Fumic, Ksenija; Gudasic-Vrdoljak, Jelena; Klenkar, Kornelija; Sambunjak, Jadranka; Vidranski, Valentina

    2015-10-23

    The aim of this work was to evaluate to what extent the scope and content of information provided to patients is standardized across medical biochemistry laboratories in Croatia. Two on-line self-report surveys were sent out: Survey A regarding attitudes on importance of patient preparation and Survey B on the contents of patient preparation instructions. 13/118 laboratories (11%) do not provide written instructions to patients on how to prepare for laboratory testing, and 36 (40%) do not include information about water intake in their instructions. Only half of laboratories provide instructions for prostate-specific antigen (53.8%), female sex hormones (53.7%) and therapeutic drug monitoring (TDM) (52.5%). Inadequate information about fasting status (55.0%) and 24 hour urine collection (77.9%) were frequent errors with high severity and were associated with the greatest potential to cause patient harm. Laboratory professionals in Croatia have a positive attitude towards the importance of patient preparation for laboratory testing. However, the information for laboratory testing is not standardized and frequently lacks guidance for tests related to TDM, coagulation and endocrinology. This study highlights the need for standardized, updated and evidence-based recommendations for patient preparation in order to minimize the risk for patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Justification of parameters and selection of equipment for laboratory researches of a rammer's operating element dynamics in a soil foundation of a tank for oil and oil products storage

    NASA Astrophysics Data System (ADS)

    Gruzin, A. V.; Gruzin, V. V.; Shalay, V. V.

    2017-08-01

    The development of technology for a directional soil compaction of tank foundations for oil and oil products storage is a relevant problem which solution will enable simultaneously provide required operational characteristics of a soil foundation and reduce time and material costs to prepare the foundation. The impact dynamics of rammers' operating elements on the soil foundation is planned to specify in the course of laboratory studies. A specialized technique is developed to justify the parameters and select the equipment for laboratory researches. The usage of this technique enabled us to calculate dimensions of the models, of a test bench and specifications of the recording equipment, and a lighting system. The necessary equipment for laboratory studies was selected. Preliminary laboratory tests were carried out. The estimate of accuracy for planned laboratory studies was given.

  17. Field evaluation of an avian risk assessment model

    USGS Publications Warehouse

    Vyas, N.B.; Spann, J.W.; Hulse, C.S.; Borges, S.L.; Bennett, R.S.; Torrez, M.; Williams, B.I.; Leffel, R.

    2006-01-01

    We conducted two laboratory subacute dietary toxicity tests and one outdoor subacute dietary toxicity test to determine the effectiveness of the U.S. Environmental Protection Agency's deterministic risk assessment model for evaluating the potential of adverse effects to birds in the field. We tested technical-grade diazinon and its D Z N- 50W (50% diazinon active ingredient wettable powder) formulation on Canada goose (Branta canadensis) goslings. Brain acetylcholinesterase activity was measured, and the feathers and skin, feet. and gastrointestinal contents were analyzed for diazinon residues. The dose-response curves showed that diazinon was significantly more toxic to goslings in the outdoor test than in the laboratory tests. The deterministic risk assessment method identified the potential for risk to birds in general, but the factors associated with extrapolating from the laboratory to the field, and from the laboratory test species to other species, resulted in the underestimation of risk to the goslings. The present study indicates that laboratory-based risk quotients should be interpreted with caution.

  18. Implementation of a virtual laboratory for training on sound insulation testing and uncertainty calculations in acoustic tests.

    PubMed

    Asensio, C; Gasco, L; Ruiz, M; Recuero, M

    2015-02-01

    This paper describes a methodology and case study for the implementation of educational virtual laboratories for practice training on acoustic tests according to international standards. The objectives of this activity are (a) to help the students understand and apply the procedures described in the standards and (b) to familiarize the students with the uncertainty in measurement and its estimation in acoustics. The virtual laboratory will not focus on the handling and set-up of real acoustic equipment but rather on procedures and uncertainty. The case study focuses on the application of the virtual laboratory for facade sound insulation tests according to ISO 140-5:1998 (International Organization for Standardization, Geneva, Switzerland, 1998), and the paper describes the causal and stochastic models and the constraints applied in the virtual environment under consideration. With a simple user interface, the laboratory will provide measurement data that the students will have to process to report the insulation results that must converge with the "virtual true values" in the laboratory. The main advantage of the virtual laboratory is derived from the customization of factors in which the student will be instructed or examined (for instance, background noise correction, the detection of sporadic corrupted observations, and the effect of instrument precision).

  19. Validation of a laboratory and hospital information system in a medical laboratory accredited according to ISO 15189.

    PubMed

    Biljak, Vanja Radisic; Ozvald, Ivan; Radeljak, Andrea; Majdenic, Kresimir; Lasic, Branka; Siftar, Zoran; Lovrencic, Marijana Vucic; Flegar-Mestric, Zlata

    2012-01-01

    The aim of the study was to present a protocol for laboratory information system (LIS) and hospital information system (HIS) validation at the Institute of Clinical Chemistry and Laboratory Medicine of the Merkur University Hospital, Zagreb, Croatia. Validity of data traceability was checked by entering all test requests for virtual patient into HIS/LIS and printing corresponding barcoded labels that provided laboratory analyzers with the information on requested tests. The original printouts of the test results from laboratory analyzer(s) were compared with the data obtained from LIS and entered into the provided template. Transfer of data from LIS to HIS was examined by requesting all tests in HIS and creating real data in a finding generated in LIS. Data obtained from LIS and HIS were entered into a corresponding template. The main outcome measure was the accuracy of transfer obtained from laboratory analyzers and results transferred from LIS and HIS expressed as percentage (%). The accuracy of data transfer from laboratory analyzers to LIS was 99.5% and of that from LIS to HIS 100%. We presented our established validation protocol for laboratory information system and demonstrated that a system meets its intended purpose.

  20. The Development and Evaluation of Industrial Case Studies to Support a New Laboratory Course in Electrical Engineering.

    ERIC Educational Resources Information Center

    Bolton, B.; Adderley, K. J.

    1978-01-01

    After viewing videotaped case studies indicating the relevance of electrical laboratory work to professional engineers, student attitudes showed a positive improvement toward laboratory work. Semantic differential tests, questionnaires, and interviews were used. (Author/MH)

  1. 21 CFR 58.202 - Grounds for disqualification.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....202 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.202... adversely affected the validity of the nonclinical laboratory studies; and (c) Other lesser regulatory...

  2. 21 CFR 58.202 - Grounds for disqualification.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....202 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Disqualification of Testing Facilities § 58.202... adversely affected the validity of the nonclinical laboratory studies; and (c) Other lesser regulatory...

  3. Effects of Combined Hands-on Laboratory and Computer Modeling on Student Learning of Gas Laws: A Quasi-Experimental Study

    ERIC Educational Resources Information Center

    Liu, Xiufeng

    2006-01-01

    Based on current theories of chemistry learning, this study intends to test a hypothesis that computer modeling enhanced hands-on chemistry laboratories are more effective than hands-on laboratories or computer modeling laboratories alone in facilitating high school students' understanding of chemistry concepts. Thirty-three high school chemistry…

  4. Request of laboratory liver tests in primary care in Spain: potential savings if appropriateness indicator targets were achieved.

    PubMed

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

    2015-10-01

    Liver laboratory tests are used to screen for liver disease, suggest the underlying cause, estimate the severity, assess prognosis, and monitor the efficacy of therapy. The aim of this study was to compare the liver laboratory tests requesting patterns by GPs in Spain, according to geographic and hospital characteristics, to investigate the degree of requesting appropriateness. One hundred and forty-one clinical laboratories were invited to participate from diverse regions across Spain. They filed out the number of laboratory liver tests requested by GPs for the year 2012. Two types of appropriateness indicators were calculated: every test request per 1000 inhabitants or ratios of related tests requests. The indicator results obtained were compared between the different hospitals, according to their setting, location, and management. The savings generated, if each area would have achieved indicator targets, were calculated. We recruited 76 laboratories covering a population of 17,679,195 inhabitants. GPs requested 20,916,780 laboratory liver tests in the year 2012. No differences were obtained according to their setting. Lactate dehydrogenase and direct bilirubin per 1000 inhabitants were significantly higher in institutions with private management. Largest differences were observed between communities. Nine, 31, 0, and 13 laboratories, respectively, achieved the aspartate aminotransferase, lactate dehydrogenase, γ-glutamyl transpeptidase, and total bilirubin-related alanine aminotransferase indicator targets. Reaching ratios would have resulted in savings of €1,028,468. There was a high variability in the request of liver tests. This emphasizes the need to implement interventions to improve appropriate use of liver tests.

  5. Quantitative and Qualitative Changes in Teaching Histology by Means of Virtual Microscopy in an Introductory Course in Human Anatomy

    ERIC Educational Resources Information Center

    Husmann, Polly R.; O'Loughlin, Valerie Dean; Braun, Mark W.

    2009-01-01

    This study compares overall laboratory averages and individual test scores along with a student survey to determine the effects of using virtual microscopy in place of optical microscopes in a large undergraduate human anatomy course. T-tests revealed that the first two laboratory examinations (of four) and the overall laboratory averages were…

  6. Automated cognitive testing of monkeys in social groups yields results comparable to individual laboratory-based testing.

    PubMed

    Gazes, Regina Paxton; Brown, Emily Kathryn; Basile, Benjamin M; Hampton, Robert R

    2013-05-01

    Cognitive abilities likely evolved in response to specific environmental and social challenges and are therefore expected to be specialized for the life history of each species. Specialized cognitive abilities may be most readily engaged under conditions that approximate the natural environment of the species being studied. While naturalistic environments might therefore have advantages over laboratory settings for cognitive research, it is difficult to conduct certain types of cognitive tests in these settings. We implemented methods for automated cognitive testing of monkeys (Macaca mulatta) in large social groups (Field station) and compared the performance to that of laboratory-housed monkeys (Laboratory). The Field station animals shared access to four touch-screen computers in a large naturalistic social group. Each Field station subject had an RFID chip implanted in each arm for computerized identification and individualized assignment of cognitive tests. The Laboratory group was housed and tested in a typical laboratory setting, with individual access to testing computers in their home cages. Monkeys in both groups voluntarily participated at their own pace for food rewards. We evaluated performance in two visual psychophysics tests, a perceptual classification test, a transitive inference test, and a delayed matching-to-sample memory test. Despite the differences in housing, social environment, age, and sex, monkeys in the two groups performed similarly in all tests. Semi-free ranging monkeys living in complex social environments are therefore viable subjects for cognitive testing designed to take advantage of the unique affordances of naturalistic testing environments.

  7. Automated cognitive testing of monkeys in social groups yields results comparable to individual laboratory based testing

    PubMed Central

    Gazes, Regina Paxton; Brown, Emily Kathryn; Basile, Benjamin M.; Hampton, Robert R.

    2013-01-01

    Cognitive abilities likely evolved in response to specific environmental and social challenges and are therefore expected to be specialized for the life history of each species. Specialized cognitive abilities may be most readily engaged under conditions that approximate the natural environment of the species being studied. While naturalistic environments might therefore have advantages over laboratory settings for cognitive research, it is difficult to conduct certain types of cognitive tests in these settings. We implemented methods for automated cognitive testing of monkeys (Macaca mulatta) in large social groups (Field station) and compared the performance to that of laboratory housed monkeys (Laboratory). The Field station animals shared access to four touch screen computers in a large naturalistic social group. Each Field station subject had an RFID chip implanted in each arm for computerized identification and individualized assignment of cognitive tests. The Laboratory group was housed and tested in a typical laboratory setting, with individual access to testing computers in their home cages. Monkeys in both groups voluntarily participated at their own pace for food rewards. We evaluated performance in two visual psychophysics tests, a perceptual classification test, a transitive inference test, and a delayed matching to sample memory test. Despite differences in housing, social environment, age, and sex, monkeys in the two groups performed similarly in all tests. Semi-free ranging monkeys living in complex social environments are therefore viable subjects for cognitive testing designed to take advantage of the unique affordances of naturalistic testing environments. PMID:23263675

  8. Determination of Glucosamine in Raw Materials and Dietary Supplements Containing Glucosamine Sulfate and/or Glucosamine Hydrochloride by High-Performance Liquid Chromatography with FMOC-Su Derivatization: Collaborative Study

    PubMed Central

    Zhou, Joseph Ziqi; Waszkuc, Ted; Mohammed, Felicia

    2008-01-01

    A collaborative study was conducted for determination of glucosamine in raw materials and dietary supplements containing glucosamine sulfate and/or glucosamine hydrochloride by high-performance liquid Chromatography (HPLC) with N-(9-fluorenyl-methoxycarbonyloxy) succinimide (FMOC-Su) derivatization. Thirteen blind materials, one pair of which were duplicates, were tested by 12 collaborating laboratories. The test samples consisted of various commercial products, including tablets, capsules, drink mix, and liquids as well as raw materials, blanks, and those for spike recovery analyses. The tests with blank products and products spiked with glucosamine showed good specificity of the method. The average recoveries at spike levels of 100 and 150% of the declared amount were 99.0% with a relative standard deviation (RSD) of 2.1%, and 101% with an RSD of 2.3%, respectively. The test results between laboratories on each commercial product were reproducible with RSD values of no more than 4.0%, and the results were repeatable in the same laboratory with an average RSD of 0.7%. HorRat values ranged from 0.5 to 1.7 on both tests of spike recovery and reproducibility between laboratories on commercial products. The average determination coefficient of the calibration curves from the laboratories was 0.9995 with an RSD of 0.03%. All of the 12 collaborating laboratories succeeded in the study and none of their reported test results were outliers, partly indicating the robustness of the method. It is recommended that the method be accepted by AOAC INTERNATIONAL as Official First Action. PMID:16152919

  9. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rodriguez, J.R.; Ahrens, J.S.; Lowe, D.L.

    Throughout the years, Sandia National Laboratories (SNL) has performed various laboratory evaluations of entry control devices, including biometric identity verifiers. The reports which resulted from this testing have been very well received by the physical security community. This same community now requires equally informative field study data. To meet this need we have conducted a field study in an effort to develop the tools and methods which our customers can use to translate laboratory data into operational field performance. The field testing described in this report was based on the Recognition Systems Inc.`s (RSI) model ID3D HandKey biometric verifier. Thismore » device was selected because it is referenced in DOE documents such as the Guide for Implementation of the DOE Standard Badge and is the de facto biometric standard for the DOE. The ID3D HandKey is currently being used at several DOE sites such as Hanford, Rocky Flats, Pantex, Savannah River, and Idaho Nuclear Engineering Laboratory. The ID3D HandKey was laboratory tested at SNL. It performed very well during this test, exhibiting an equal error point of 0.2 percent. The goals of the field test were to identify operational characteristics and design guidelines to help system engineers translate laboratory data into field performance. A secondary goal was to develop tools which could be used by others to evaluate system effectiveness or improve the performance of their systems. Operational characteristics were determined by installing a working system and studying its operation over a five month period. Throughout this test we developed tools which could be used by others to similarly gauge system effectiveness.« less

  10. European Proficiency testing of national reference laboratories for the confirmation of sulfonamide residues in muscle and milk.

    PubMed

    Juhel-Gaugain, Murielle; Fourmond, Marie-Pierre; Delepine, Bernard; Laurentie, Michel; Brigitte, Roudaut; Sanders, Pascal

    2005-03-01

    Two interlaboratory studies were organized in 2002-2003 in order to check the proficiency of laboratories in confirming the presence of sulfonamide residues in muscle and milk. These studies involved 25 EU National Reference Laboratories (NRLs) from 21 different European Countries in charge of statutory monitoring of antimicrobial residues in food of animal origin at a national level. The study was conducted according to international and national guidelines by the Community Reference Laboratory (CRL) in charge of antimicrobial substances. Four different test matrices of sheep muscle and four different test matrices of bovine milk containing different sulfonamide substances were prepared and sent to the participants. Each participant was asked to use his own routine confirmatory method and to analyse each sample in triplicate within a period of about six weeks during which the stability of the materials was checked by the organizer. The sulfonamide content of each material was determined by calculating the robust means of all the results and the deviation of the results from the assigned values was assessed by calculating Z-scores. Overall, results were satisfactory, particularly considering that it was the first proficiency test dealing with sulfonamides organised by the Community Reference Laboratory.

  11. A comparison of traditional physical laboratory and computer-simulated laboratory experiences in relation to engineering undergraduate students' conceptual understandings of a communication systems topic

    NASA Astrophysics Data System (ADS)

    Javidi, Giti

    2005-07-01

    This study was designed to investigate an alternative to the use of traditional physical laboratory activities in a communication systems course. Specifically, this study examined whether as an alternative, computer simulation is as effective as physical laboratory activities in teaching college-level electronics engineering education students about the concepts of signal transmission, modulation and demodulation. Eighty undergraduate engineering students participated in the study, which was conducted at a southeastern four-year university. The students were randomly assigned to two groups. The groups were compared on understanding the concepts, remembering the concepts, completion time of the lab experiments and perception toward the laboratory experiments. The physical group's (n = 40) treatment was to conduct laboratory experiments in a physical laboratory. The students in this group used equipment in a controlled electronics laboratory. The Simulation group's (n = 40) treatment was to conduct similar experiments in a PC laboratory. The students in this group used a simulation program in a controlled PC lab. At the completion of the treatment, scores on a validated conceptual test were collected once after the treatment and again three weeks after the treatment. Attitude surveys and qualitative study were administered at the completion of the treatment. The findings revealed significant differences, in favor of the simulation group, between the two groups on both the conceptual post-test and the follow-up test. The findings also revealed significant correlation between simulation groups' attitude toward the simulation program and their post-test scores. Moreover, there was a significant difference between the two groups on their attitude toward their laboratory experience in favor of the simulation group. In addition, there was significant difference between the two groups on their lab completion time in favor of the simulation group. At the same time, the qualitative research has uncovered several issues not explored by the quantitative research. It was concluded that incorporating the recommendations acquired from the qualitative research, especially elements of incorporating hardware experience to avoid lack of hands-on skills, into the laboratory pedagogy should help improve students' experience regardless of the environment in which the laboratory is conducted.

  12. Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

    PubMed Central

    Sá, Luísa; Costa-Santos, Cristina; Teixeira, Andreia; Couto, Luciana; Costa-Pereira, Altamiro; Hespanhol, Alberto; Santos, Paulo; Martins, Carlos

    2015-01-01

    Background Physicians’ ability to make cost-effective decisions has been shown to be affected by their knowledge of health care costs. This study assessed whether Portuguese family physicians are aware of the costs of the most frequently prescribed diagnostic and laboratory tests. Methods A cross-sectional study was conducted in a representative sample of Portuguese family physicians, using computer-assisted telephone interviews for data collection. A Likert scale was used to assess physician’s level of agreement with four statements about health care costs. Family physicians were also asked to estimate the costs of diagnostic and laboratory tests. Each physician’s cost estimate was compared with the true cost and the absolute error was calculated. Results One-quarter (24%; 95% confidence interval: 23%–25%) of all cost estimates were accurate to within 25% of the true cost, with 55% (95% IC: 53–56) overestimating and 21% (95% IC: 20–22) underestimating the true actual cost. The majority (76%) of family physicians thought they did not have or were uncertain as to whether they had adequate knowledge of diagnostic and laboratory test costs, and only 7% reported receiving adequate education. The majority of the family physicians (82%) said that they had adequate access to information about the diagnostic and laboratory test costs. Thirty-three percent thought that costs did not influence their decision to order tests, while 27% were uncertain. Conclusions Portuguese family physicians have limited awareness of diagnostic and laboratory test costs, and our results demonstrate a need for improved education in this area. Further research should focus on identifying whether interventions in cost knowledge actually change ordering behavior, in identifying optimal methods to disseminate cost information, and on improving the cost-effectiveness of care. PMID:26356625

  13. Results of PBX 9501 and PBX 9502 Round-Robin Quasi-Static Tension Tests from JOWOG-9/39 Focused Exchange.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Thompson, D. G.

    2002-01-01

    A round-robin study was conducted with the participation of three laboratory facilities: Los Alamos National Laboratory (LANL), BWXT Pantex Plant (PX), and Lawrence Livermore National Laboratory (LLNL). The study involved the machining and quasi-static tension testing of two plastic-bonded high explosive (PBX) composites, PBX 9501 and PBX 9502. Nine tensile specimens for each type of PBX were to be machined at each of the three facilities; 3 of these specimens were to be sent to each of the participating materials testing facilities for tensile testing. The resultant data was analyzed to look for trends associated with specimen machining location and/ormore » trends associated with materials testing location. The analysis provides interesting insights into the variability and statistical nature of mechanical properties testing on PBX composites. Caution is warranted when results are compared/exchanged between testing facilities.« less

  14. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  15. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  16. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  17. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  18. Systematic reviews: I. The correlation between laboratory tests on marginal quality and bond strength. II. The correlation between marginal quality and clinical outcome.

    PubMed

    Heintze, Siegward D

    2007-01-01

    An accepted principle in restorative dentistry states that restorations should be placed with the best marginal quality possible to avoid postoperative sensitivity, marginal discoloration, and secondary caries. Different laboratory methods claim to predict the clinical performance of restorative materials, for example, tests of bond strength and microleakage and gap analysis. The purpose of this review was twofold: (1) find studies that correlated the results of bond strength tests with either microleakage or gap analysis for the same materials, and (2) find studies that correlated the results of microleakage and/or gaps with the clinical parameters for the same materials. Furthermore, influencing factors on the results of the laboratory tests were reviewed and assessed. For the first question, searches for studies were conducted in the MEDLINE database and IADR/AADR abtracts online with specific search and inclusion criteria. The outcome for each study was assessed on the basis of the statistical test applied in the study, and finally the number of studies with or without correlation was compiled. For the second question, results of the quantitative marginal analysis of Class V restorations published by the University of Zürich with the same test protocol and prospective clinical trials were searched that investigated the same materials for at least 2 years in Class V cavities. Pearson correlation coefficients were calculated for pooled data of materials and clinical outcome parameters such as retention loss, marginal discoloration, marginal integrity, and secondary caries. For the correlation of dye penetration and clinical outcome, studies on Class V restorations published by the same research institute were searched in MEDLINE that examined the same adhesive systems as the selected clinical trials. For the correlation bond strength/microleakage, 30 studies were included into the review, and for the correlation bond strength/gap analysis 18 studies. For both topics, about 80% of the studies revealed that there was no correlation between the two methods. For the correlation quantitative marginal analysis/clinical outcome, data were compared to the clinical outcome of 11 selected clinical studies. In only 2 out of the 11 studies (18%) did the clinical outcome match the prognosis based on the laboratory tests; the remaining studies did not show any correlation. When pooling data on 20 adhesive systems, no correlation was found between the percentage of continuous margin of restorations placed in extracted premolars and the percentage of teeth that showed no retention loss in clinical studies, no discoloured margins, acceptable margins, or absence of secondary caries. With regard to the correlation of dye penetration and clinical studies, no sufficient number of studies was found that matched the inclusion criteria. However, literature data suggest that there is no correlation between microleakage data as measured in the laboratory and clinical parameters. The results of bond strength tests did not correlate with laboratory tests that evaluated the marginal seal of restorations such as microleakage or gap analysis. The quantitative marginal analysis of Class V fillings in the laboratory was unable to predict the performance of the same materials in vivo. Therefore, microleakage tests or the quantitative marginal analysis should be abandoned and research should focus on laboratory tests that are validated with regard to their ability to satisfactorily predict the clinical performance of restorative materials.

  19. Accounting for differing exposure patterns between laboratory tests and the field in the assessment of long-term risks of pesticides to terrestrial vertebrates.

    PubMed

    Fischer, David L

    2005-11-01

    Long-term risks of pesticides to birds and mammals are currently assessed by comparing effects thresholds determined in chronic laboratory studies to exposure levels expected to occur in the field. However, there is often a mismatch between exposure patterns tested in the laboratory tests (exposure levels held constant) and those experienced by animals in the field (exposure levels varying over time). Three methods for addressing this problem are presented and discussed. Time-weighted averaging (TWA) converts a variable field exposure regime to a single value that can be compared directly to the laboratory test results. Body-burden modeling (BBM) is applied to both laboratory and field exposure regimes allowing a straightforward comparison of body residue levels expected for each situation. Temporal analysis (TA) uses expert judgment to decide if the length of time exposure exceeds a toxicity threshold is long enough to cause biologically significant effects. To reduce uncertainty in long-term assessments, the conduct of specialized laboratory tests in which test subjects are administered a time-varying exposure that mimics what occurs in the field should be considered. Such tests may also be useful testing the validity of each of these assessment methods.

  20. Lipid and lipoprotein testing in resource-limited laboratories.

    PubMed

    Myers, Gary L

    2003-01-01

    The role of total cholesterol (TC) and lipoproteins in the assessment of coronary heart disease (CHD) is firmly established from population and intervention studies. Total and low-density lipoprotein cholesterol (LDLC) levels are positively associated with CHD, and high-density lipoprotein cholesterol (HDLC) levels are negatively associated with CHD. Efforts to identify and treat people at increased risk based on cholesterol and lipoprotein levels have led to more lipid testing and the need for very reliable test results. Thus, quality laboratory services are an essential component of healthcare delivery and play a vital role in any strategy to reduce morbidity and mortality from CHD. In laboratories with limited resources, establishing laboratory capability to measure CHD risk markers may be a considerable challenge. Laboratories face problems in selecting proper techniques, difficulties in equipment availability and maintenance, and shortage of supplies, staffing, and supervision. The Centers for Disease Control and Prevention (CDC) has been providing technical assistance for more than 30 years to laboratories that measure lipids and lipoproteins and is willing to provide technical assistance as needed for other laboratories to develop this capability. CDC can provide technical assistance to establish lipid and lipoprotein testing capability to support a CHD public health program in areas with limited laboratory resources. This assistance includes: selecting a suitable testing instrument; providing training for laboratory technicians; establishing a simple quality control plan; and instructing staff on how to prepare frozen serum control materials suitable for assessing accuracy of lipid and lipoprotein testing.

  1. Performance criteria and quality indicators for the post-analytical phase.

    PubMed

    Sciacovelli, Laura; Aita, Ada; Padoan, Andrea; Pelloso, Michela; Antonelli, Giorgia; Piva, Elisa; Chiozza, Maria Laura; Plebani, Mario

    2016-07-01

    Quality indicators (QIs) used as performance measurements are an effective tool in accurately estimating quality, identifying problems that may need to be addressed, and monitoring the processes over time. In Laboratory Medicine, QIs should cover all steps of the testing process, as error studies have confirmed that most errors occur in the pre- and post-analytical phase of testing. Aim of the present study is to provide preliminary results on QIs and related performance criteria in the post-analytical phase. This work was conducted according to a previously described study design based on the voluntary participation of clinical laboratories in the project on QIs of the Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). Overall, data collected highlighted an improvement or stability in performances over time for all reported indicators thus demonstrating that the use of QIs is effective in the quality improvement strategy. Moreover, QIs data are an important source for defining the state-of-the-art concerning the error rate in the total testing process. The definition of performance specifications based on the state-of-the-art, as suggested by consensus documents, is a valuable benchmark point in evaluating the performance of each laboratory. Laboratory tests play a relevant role in the monitoring and evaluation of the efficacy of patient outcome thus assisting clinicians in decision-making. Laboratory performance evaluation is therefore crucial to providing patients with safe, effective and efficient care.

  2. Point-of-Care Hemoglobin A1c Testing: An Evidence-Based Analysis

    PubMed Central

    2014-01-01

    Background The increasing prevalence of diabetes in Ontario means that there will be growing demand for hemoglobin A1c (HbA1c) testing to monitor glycemic control for the management of this chronic disease. Testing HbA1c where patients receive their diabetes care may improve system efficiency if the results from point-of-care HbA1c testing are comparable to those from laboratory HbA1c measurements. Objectives To review the correlation between point-of-care HbA1c testing and laboratory HbA1c measurement in patients with diabetes in clinical settings. Data Sources The literature search included studies published between January 2003 and June 2013. Search terms included glycohemoglobin, hemoglobin A1c, point of care, and diabetes. Review Methods Studies were included if participants had diabetes; if they compared point-of-care HbA1c devices (licensed by Health Canada and available in Canada) with laboratory HbA1c measurement (reference method); if they performed point-of-care HbA1c testing using capillary blood samples (finger pricks) and laboratory HbA1c measurement using venous blood samples within 7 days; and if they reported a correlation coefficient between point-of-care HbA1c and laboratory HbA1c results. Results Three point-of-care HbA1c devices were reviewed in this analysis: Bayer's A1cNow+, Bio-Rad's In2it, and Siemens’ DCA Vantage. Five observational studies met the inclusion criteria. The pooled results showed a positive correlation between point-of-care HbA1c testing and laboratory HbA1c measurement (correlation coefficient, 0.967; 95% confidence interval, 0.960–0.973). Limitations Outcomes were limited to the correlation coefficient, as this was a commonly reported measure of analytical performance in the literature. Results should be interpreted with caution due to risk of bias related to selection of participants, reference standards, and the multiple steps involved in POC HbA1c testing. Conclusions Moderate quality evidence showed a positive correlation between point-of-care HbA1c testing and laboratory HbA1c measurement. Five observational studies compared 3 point-of-care HbA1c devices with laboratory HbA1c assays, and all reported strong correlation between the 2 tests. PMID:26316922

  3. A STUDY OF SOME EFFECTS OF A PROGRAMMED ORIENTATION ON LEARNING OUTCOMES OF A HUMAN RELATIONS LABORATORY. PAPER PRESENTED AT THE NATIONAL SEMINAR ON ADULT EDUCATION RESEARCH (CHICAGO, FEBRUARY 11-13, 1968).

    ERIC Educational Resources Information Center

    SEARLE, STANLEY H.; WARLOW, G.L.

    TO TEST THE EFFECTIVENESS OF ADVANCED PREPARATION IN THE HUMAN RELATIONS LABORATORY PROGRAM OF THE UNITED CHURCH OF CANADA, SEVEN DELEGATES TO A LABORATORY HELD IN JUNE 1967 RECEIVED A 27-PAGE PROGRAMED ORIENTATION TWO WEEKS PRIOR TO THE LABORATORY. ANOTHER EIGHT DELEGATES SERVED AS A CONTROL GROUP. IT WAS HYPOTHESIZED THAT THE TEST GROUP WOULD…

  4. 21 CFR 58.15 - Inspection of a testing facility.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Inspection of a testing facility. 58.15 Section 58.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES General Provisions § 58.15 Inspection of a testing...

  5. 21 CFR 58.113 - Mixtures of articles with carriers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Mixtures of articles with carriers. 58.113 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.113 Mixtures of articles with carriers. (a) For each test or control article that is mixed with a carrier, tests...

  6. 21 CFR 58.113 - Mixtures of articles with carriers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Mixtures of articles with carriers. 58.113 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.113 Mixtures of articles with carriers. (a) For each test or control article that is mixed with a carrier, tests...

  7. 21 CFR 58.113 - Mixtures of articles with carriers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Mixtures of articles with carriers. 58.113 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.113 Mixtures of articles with carriers. (a) For each test or control article that is mixed with a carrier, tests...

  8. 21 CFR 58.113 - Mixtures of articles with carriers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Mixtures of articles with carriers. 58.113 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.113 Mixtures of articles with carriers. (a) For each test or control article that is mixed with a carrier, tests...

  9. 21 CFR 58.113 - Mixtures of articles with carriers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Mixtures of articles with carriers. 58.113 Section... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Test and Control Articles § 58.113 Mixtures of articles with carriers. (a) For each test or control article that is mixed with a carrier, tests...

  10. The quality of veterinary in-clinic and reference laboratory biochemical testing.

    PubMed

    Rishniw, Mark; Pion, Paul D; Maher, Tammy

    2012-03-01

    Although evaluation of biochemical analytes in blood is common in veterinary practice, studies assessing the global quality of veterinary in-clinic and reference laboratory testing have not been reported. The aim of this study was to assess the quality of biochemical testing in veterinary laboratories using results obtained from analyses of 3 levels of assayed quality control materials over 5 days. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index to determine factors contributing to poor performance, and agreement between in-clinic and reference laboratory mean results. The suitability of in-clinic and reference laboratory instruments for statistical quality control was determined using adaptations from the computerized program, EZRules3. Reference laboratories were able to achieve desirable quality requirements more frequently than in-clinic laboratories. Across all 3 materials, > 50% of in-clinic analyzers achieved a sigma metric ≥ 6.0 for measurement of 2 analytes, whereas > 50% of reference laboratory analyzers achieved a sigma metric ≥ 6.0 for measurement of 6 analytes. Expanded uncertainty of measurement and ± total allowable error resulted in the highest mean percentages of analytes demonstrating agreement between in-clinic and reference laboratories. Owing to marked variation in bias and coefficient of variation between analyzers of the same and different types, the percentages of analytes suitable for statistical quality control varied widely. These findings reflect the current state-of-the-art with regard to in-clinic and reference laboratory analyzer performance and provide a baseline for future evaluations of the quality of veterinary laboratory testing. © 2012 American Society for Veterinary Clinical Pathology.

  11. Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States.

    PubMed

    Le, Margaret; Flores, David; May, Danica; Gourley, Eric; Nangia, Ajay K

    2016-05-01

    The evaluation and management of male hypogonadism should be based on symptoms and on serum testosterone levels. Diagnostically this relies on accurate testing and reference values. Our objective was to define the distribution of reference values and assays for free and total testosterone by clinical laboratories in the United States. Upper and lower reference values, assay methodology and source of published reference ranges were obtained from laboratories across the country. A standardized survey was reviewed with laboratory staff via telephone. Descriptive statistics were used to tabulate results. We surveyed a total of 120 laboratories in 47 states. Total testosterone was measured in house at 73% of laboratories. At the remaining laboratories studies were sent to larger centralized reference facilities. The mean ± SD lower reference value of total testosterone was 231 ± 46 ng/dl (range 160 to 300) and the mean upper limit was 850 ± 141 ng/dl (range 726 to 1,130). Only 9% of laboratories where in-house total testosterone testing was performed created a reference range unique to their region. Others validated the instrument recommended reference values in a small number of internal test samples. For free testosterone 82% of laboratories sent testing to larger centralized reference laboratories where equilibrium dialysis and/or liquid chromatography with mass spectrometry was done. The remaining laboratories used published algorithms to calculate serum free testosterone. Reference ranges for testosterone assays vary significantly among laboratories. The ranges are predominantly defined by limited population studies of men with unknown medical and reproductive histories. These poorly defined and variable reference values, especially the lower limit, affect how clinicians determine treatment. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Going GLP: Conducting Toxicology Studies in Compliance with Good Laboratory Practices.

    PubMed

    Carroll, Erica Eggers

    2016-01-01

    Good laboratory practice standards are US federal regulations enacted as part of the Federal Insecticide, Fungicide, and Rodenticide Act (40 CFR Part 160), the Toxic Substance Control Act (40 CFR Part 792), and the Good Laboratory Practice for Nonclinical Laboratory Studies (21 CFR Part 58) to support protection of public health in the areas of pesticides, chemicals, and drug investigations in response to allegations of inaccurate data acquisition. Essentially, good laboratory practices (GLPs) are a system of management controls for nonclinical research studies involving animals to ensure the uniformity, consistency, reliability, reproducibility, quality, and integrity of data collected as part of chemical (including pharmaceuticals) tests, from in vitro through acute to chronic toxicity tests. The GLPs were established in the United States in 1978 as a result of the Industrial Bio-Test Laboratory scandal which led to congressional hearings and actions to prevent fraudulent data reporting and collection. Although the establishment of infrastructure for GLPs compliance is labor-intensive and time-consuming, achievement and maintenance of GLP compliance ensures the accuracy of the data collected from each study, which is critical for defending results, advancing science, and protecting human and animal health. This article describes how and why those in the US Army Medical Department responsible for protecting the public health of US Army and other military personnel made the policy decision to have its toxicology laboratory achieve complete compliance with GLP standards, the first such among US Army laboratories. The challenges faced and how they were overcome are detailed.

  13. Challenges of Maintaining Good Clinical Laboratory Practices in Low-Resource Settings:  A Health Program Evaluation Framework Case Study From East Africa.

    PubMed

    Zhang, Helen L; Omondi, Michael W; Musyoka, Augustine M; Afwamba, Isaac A; Swai, Remigi P; Karia, Francis P; Muiruri, Charles; Reddy, Elizabeth A; Crump, John A; Rubach, Matthew P

    2016-08-01

    Using a clinical research laboratory as a case study, we sought to characterize barriers to maintaining Good Clinical Laboratory Practice (GCLP) services in a developing world setting. Using a US Centers for Disease Control and Prevention framework for program evaluation in public health, we performed an evaluation of the Kilimanjaro Christian Medical Centre-Duke University Health Collaboration clinical research laboratory sections of the Kilimanjaro Clinical Research Institute in Moshi, Tanzania. Laboratory records from November 2012 through October 2014 were reviewed for this analysis. During the 2-year period of study, seven instrument malfunctions suspended testing required for open clinical trials. A median (range) of 9 (1-55) days elapsed between instrument malfunction and biomedical engineer service. Sixteen (76.1%) of 21 suppliers of reagents, controls, and consumables were based outside Tanzania. Test throughput among laboratory sections used a median (range) of 0.6% (0.2%-2.7%) of instrument capacity. Five (55.6%) of nine laboratory technologists left their posts over 2 years. These findings demonstrate that GCLP laboratory service provision in this setting is hampered by delays in biomedical engineer support, delays and extra costs in commodity procurement, low testing throughput, and high personnel turnover. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Study of an instrument for sensing errors in a telescope wavefront

    NASA Technical Reports Server (NTRS)

    Golden, L. J.; Shack, R. V.; Slater, P. N.

    1974-01-01

    Focal plane sensors for determining the error in a telescope wavefront were investigated. The construction of three candidate test instruments and their evaluation in terms of small wavefront error aberration measurements are described. A laboratory wavefront simulator was designed and fabricated to evaluate the test instruments. The laboratory wavefront error simulator was used to evaluate three tests; a Hartmann test, a polarization shearing interferometer test, and an interferometric Zernike test.

  15. Multi-Laboratory Study of Five Methods for the Determination of Brevetoxins in Shellfish Tissue Extracts.

    PubMed

    Dickey, Robert W; Plakas, Steven M; Jester, Edward L E; El Said, Kathleen R; Johannessen, Jan N; Flewelling, Leanne J; Scott, Paula; Hammond, Dan G; Van Dolah, Frances M; Leighfield, Tod A; Bottein Dachraoui, Marie-Yasmine; Ramsdell, John S; Pierce, Richard H; Henry, Mike S; Poli, Mark A; Walker, Calvin; Kurtz, Jan; Naar, Jerome; Baden, Daniel G; Musser, Steve M; White, Kevin D; Truman, Penelope; Miller, Aaron; Hawryluk, Timothy P; Wekell, Marleen M; Stirling, David; Quilliam, Michael A; Lee, Jung K

    A thirteen-laboratory comparative study tested the performance of four methods as alternatives to mouse bioassay for the determination of brevetoxins in shellfish. The methods were N2a neuroblastoma cell assay, two variations of the sodium channel receptor binding assay, competitive ELISA, and LC/MS. Three to five laboratories independently performed each method using centrally prepared spiked and naturally incurred test samples. Competitive ELISA and receptor binding (96-well format) compared most favorably with mouse bioassay. Between-laboratory relative standard deviations (RSDR) ranged from 10 to 20% for ELISA and 14 to 31% for receptor binding. Within-laboratory (RSDr) ranged from 6 to 15% for ELISA, and 5 to 31% for receptor binding. Cell assay was extremely sensitive but data variation rendered it unsuitable for statistical treatment. LC/MS performed as well as ELISA on spiked test samples but was inordinately affected by lack of toxin-metabolite standards, uniform instrumental parameters, or both, on incurred test samples. The ELISA and receptor binding assay are good alternatives to mouse bioassay for the determination of brevetoxins in shellfish.

  16. Development, integrated investigation, laboratory and in-flight testing of Chibis-M microsatellite ADCS

    NASA Astrophysics Data System (ADS)

    Ovchinnikov, M. Yu.; Ivanov, D. S.; Ivlev, N. A.; Karpenko, S. O.; Roldugin, D. S.; Tkachev, S. S.

    2014-01-01

    Design, analytical investigation, laboratory and in-flight testing of the attitude determination and control system (ADCS) of a microsatellites are considered. The system consists of three pairs of reaction wheels, three magnetorquers, a set of Sun sensors, a three-axis magnetometer and a control unit. The ADCS is designed for a small 10-50 kg LEO satellite. System development is accomplished in several steps: satellite dynamics preliminary study using asymptotical and numerical techniques, hardware and software design, laboratory testing of each actuator and sensor and the whole ADCS. Laboratory verification is carried out on the specially designed test-bench. In-flight ADCS exploitation results onboard the Russian microsatellite "Chibis-M" are presented. The satellite was developed, designed and manufactured by the Institute of Space Research of RAS. "Chibis-M" was launched by the "Progress-13M" cargo vehicle on January 25, 2012 after undocking from the International Space Station (ISS). This paper assess both the satellite and the ADCS mock-up dynamics. Analytical, numerical and laboratory study results are in good correspondence with in-flight data.

  17. Laboratory errors and patient safety.

    PubMed

    Miligy, Dawlat A

    2015-01-01

    Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health. Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis. The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures. Original being the first data published from Arabic countries that evaluated the encountered laboratory errors and launch the great need for universal standardization and bench marking measures to control the laboratory work.

  18. Viability testing of material derived from Mycobacterium tuberculosis prior to removal from a Containment Level-III Laboratory as part of a Laboratory Risk Assessment Program

    PubMed Central

    Blackwood, Kym S; Burdz, Tamara V; Turenne, Christine Y; Sharma, Meenu K; Kabani, Amin M; Wolfe, Joyce N

    2005-01-01

    Background In the field of clinical mycobacteriology, Mycobacterium tuberculosis (MTB) can be a difficult organism to manipulate due to the restrictive environment of a containment level 3 (CL3) laboratory. Tests for rapid diagnostic work involving smears and molecular methods do not require CL3 practices after the organism has been rendered non-viable. While it has been assumed that after organism deactivation these techniques can be performed outside of a CL3, no conclusive study has consistently confirmed that the organisms are noninfectious after the theoretical 'deactivation' steps. Previous studies have shown that initial steps (such as heating /chemical fixation) may not consistently kill MTB organisms. Methods An inclusive viability study (n = 226) was undertaken to determine at which point handling of culture extraction materials does not necessitate a CL3 environment. Four different laboratory protocols tested for viability included: standard DNA extractions for IS6110 fingerprinting, crude DNA preparations for PCR by boiling and mechanical lysis, protein extractions, and smear preparations. For each protocol, laboratory staff planted a proportion of the resulting material to Bactec 12B medium that was observed for growth for 8 weeks. Results Of the 208 isolates initially tested, 21 samples grew within the 8-week period. Sixteen (7.7%) of these yielded positive results for MTB that included samples of: deactivated culture resuspensions exposed to 80°C for 20 minutes, smear preparations and protein extractions. Test procedures were consequently modified and tested again (n = 18), resulting in 0% viability. Conclusions This study demonstrates that it cannot be assumed that conventional practices (i.e. smear preparation) or extraction techniques render the organism non-viable. All methodologies, new and existing, should be examined by individual laboratories to validate the safe removal of material derived from MTB to the outside of a CL3 laboratory. This process is vital to establish in house biosafety-validated practices with the aim of protecting laboratory workers conducting these procedures. PMID:15667662

  19. Do sediment type and test durations affect results of laboratory-based, accelerated testing studies of permeable pavement clogging?

    PubMed

    Nichols, Peter W B; White, Richard; Lucke, Terry

    2015-04-01

    Previous studies have attempted to quantify the clogging processes of Permeable Interlocking Concrete Pavers (PICPs) using accelerated testing methods. However, the results have been variable. This study investigated the effects that three different sediment types (natural and silica), and different simulated rainfall intensities, and testing durations had on the observed clogging processes (and measured surface infiltration rates) of laboratory-based, accelerated PICP testing studies. Results showed that accelerated simulated laboratory testing results are highly dependent on the type, and size of sediment used in the experiments. For example, when using real stormwater sediment up to 1.18 mm in size, the results showed that neither testing duration, nor stormwater application rate had any significant effect on PICP clogging. However, the study clearly showed that shorter testing durations generally increased clogging and reduced the surface infiltration rates of the models when artificial silica sediment was used. Longer testing durations also generally increased clogging of the models when using fine sediment (<300 μm). Results from this study will help researchers and designers better anticipate when and why PICPs are susceptible to clogging, reduce maintenance and extend the useful life of these increasingly common stormwater best management practices. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Interaction Effects of Simultaneous Torsional and Compressional Cyclic Loading of Sand.

    DTIC Science & Technology

    1979-12-01

    loading 3a AftrRACT (rwo si .v1W f9111 t "Ofslr -d IderufI ST *lack ""iha)ln experimental research program based on laboratory test studies and scaled...experimental research program based on laboratory test studies and scaled slope model tests was conducted with specimens of Monterey No. 0 sand. The principal...objective of the research was to study the effects of interactive coupling during combined compression (normal) and shear loading on the response of

  1. Comparison of pneumatic tube system with manual transport for routine chemistry, hematology, coagulation and blood gas tests.

    PubMed

    Pupek, Alex; Matthewson, Beverly; Whitman, Erin; Fullarton, Rachel; Chen, Yu

    2017-08-28

    The pneumatic tube system (PTS) is commonly used in modern clinical laboratories to provide quick specimen delivery. However, its impact on sample integrity and laboratory testing results are still debatable. In addition, each PTS installation and configuration is unique to its institution. We sought to validate our Swisslog PTS by comparing routine chemistry, hematology, coagulation and blood gas test results and sample integrity indices between duplicate samples transported either manually or by PTS. Duplicate samples were delivered to the core laboratory manually by human courier or via the Swisslog PTS. Head-to-head comparisons of 48 routine chemistry, hematology, coagulation and blood gas laboratory tests, and three sample integrity indices were conducted on 41 healthy volunteers and 61 adult patients. The PTS showed no impact on sample hemolysis, lipemia, or icterus indices (all p<0.05). Although alkaline phosphatase, total bilirubin and hemoglobin reached statistical significance (p=0.009, 0.027 and 0.012, respectively), all had very low average bias which ranged from 0.01% to 2%. Potassium, total hemoglobin and percent deoxyhemoglobin were statistically significant for the neonatal capillary tube study (p=0.011, 0.033 and 0.041, respectively) but no biases greater than ±4% were identified for these parameters. All observed differences of these 48 laboratory tests were not clinically significant. The modern PTS investigated in this study is acceptable for reliable sample delivery for routine chemistry, hematology, coagulation and blood gas (in syringe and capillary tube) laboratory tests.

  2. Testing activities at the National Battery Test Laboratory

    NASA Astrophysics Data System (ADS)

    Hornstra, F.; Deluca, W. H.; Mulcahey, T. P.

    The National Battery Test Laboratory (NBTL) is an Argonne National Laboratory facility for testing, evaluating, and studying advanced electric storage batteries. The facility tests batteries developed under Department of Energy programs and from private industry. These include batteries intended for future electric vehicle (EV) propulsion, electric utility load leveling (LL), and solar energy storage. Since becoming operational, the NBTL has evaluated well over 1400 cells (generally in the form of three- to six-cell modules, but up to 140-cell batteries) of various technologies. Performance characterization assessments are conducted under a series of charge/discharge cycles with constant current, constant power, peak power, and computer simulated dynamic load profile conditions. Flexible charging algorithms are provided to accommodate the specific needs of each battery under test. Special studies are conducted to explore and optimize charge procedures, to investigate the impact of unique load demands on battery performance, and to analyze the thermal management requirements of battery systems.

  3. PIG's Speed Estimated with Pressure Transducers and Hall Effect Sensor: An Industrial Application of Sensors to Validate a Testing Laboratory.

    PubMed

    Lima, Gustavo F; Freitas, Victor C G; Araújo, Renan P; Maitelli, André L; Salazar, Andrés O

    2017-09-15

    The pipeline inspection using a device called Pipeline Inspection Gauge (PIG) is safe and reliable when the PIG is at low speeds during inspection. We built a Testing Laboratory, containing a testing loop and supervisory system to study speed control techniques for PIGs. The objective of this work is to present and validate the Testing Laboratory, which will allow development of a speed controller for PIGs and solve an existing problem in the oil industry. The experimental methodology used throughout the project is also presented. We installed pressure transducers on pipeline outer walls to detect the PIG's movement and, with data from supervisory, calculated an average speed of 0.43 m/s. At the same time, the electronic board inside the PIG received data from odometer and calculated an average speed of 0.45 m/s. We found an error of 4.44%, which is experimentally acceptable. The results showed that it is possible to successfully build a Testing Laboratory to detect the PIG's passage and estimate its speed. The validation of the Testing Laboratory using data from the odometer and its auxiliary electronic was very successful. Lastly, we hope to develop more research in the oil industry area using this Testing Laboratory.

  4. PIG’s Speed Estimated with Pressure Transducers and Hall Effect Sensor: An Industrial Application of Sensors to Validate a Testing Laboratory

    PubMed Central

    Freitas, Victor C. G.; Araújo, Renan P.; Maitelli, André L.; Salazar, Andrés O.

    2017-01-01

    The pipeline inspection using a device called Pipeline Inspection Gauge (PIG) is safe and reliable when the PIG is at low speeds during inspection. We built a Testing Laboratory, containing a testing loop and supervisory system to study speed control techniques for PIGs. The objective of this work is to present and validate the Testing Laboratory, which will allow development of a speed controller for PIGs and solve an existing problem in the oil industry. The experimental methodology used throughout the project is also presented. We installed pressure transducers on pipeline outer walls to detect the PIG’s movement and, with data from supervisory, calculated an average speed of 0.43 m/s. At the same time, the electronic board inside the PIG received data from odometer and calculated an average speed of 0.45 m/s. We found an error of 4.44%, which is experimentally acceptable. The results showed that it is possible to successfully build a Testing Laboratory to detect the PIG’s passage and estimate its speed. The validation of the Testing Laboratory using data from the odometer and its auxiliary electronic was very successful. Lastly, we hope to develop more research in the oil industry area using this Testing Laboratory. PMID:28914757

  5. Good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders.

    PubMed

    2012-04-06

    Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn screening laboratories. The recommended practices address the benefits of using a quality management system approach, factors to consider before introducing new tests, establishment and verification of test performance specifications, the total laboratory testing process (which consists of the preanalytic, analytic, and postanalytic phases), confidentiality of patient information and test results, and personnel qualifications and responsibilities for laboratory testing for inherited metabolic diseases. These recommendations are intended for laboratories that perform biochemical genetic testing to improve the quality of laboratory services and for newborn screening laboratories to ensure the quality of laboratory practices for inherited metabolic disorders. These recommendations also are intended as a resource for medical and public health professionals who evaluate laboratory practices, for users of laboratory services to facilitate their collaboration with newborn screening systems and use of biochemical genetic tests, and for standard-setting organizations and professional societies in developing future laboratory quality standards and practice recommendations. This report complements Good Laboratory Practices for Molecular Genetic Testing for Heritable Diseases and Conditions (CDC. Good laboratory practices for molecular genetic testing for heritable diseases and conditions. MMWR 2009;58 [No. RR-6]) to provide guidance for ensuring and improving the quality of genetic laboratory services and public health outcomes. Future recommendations for additional areas of genetic testing will be considered on the basis of continued monitoring and evaluation of laboratory practices, technology advancements, and the development of laboratory standards and guidelines.

  6. Laboratory Automation and Intra-Laboratory Turnaround Time: Experience at the University Hospital Campus Bio-Medico of Rome.

    PubMed

    Angeletti, Silvia; De Cesaris, Marina; Hart, Jonathan George; Urbano, Michele; Vitali, Massimiliano Andrea; Fragliasso, Fulvio; Dicuonzo, Giordano

    2015-12-01

    Intra-laboratory turnaround time (TAT) is a key indicator of laboratory performance. Improving TAT is a complex task requiring staff education, equipment acquisition, and adequate TAT monitoring. The aim of the present study was to evaluate the intra-laboratory TAT after laboratory automation implementation (June 2013-June 2014) and to compare it to that in the preautomation period (July 2012-May 2013). Intra-laboratory TAT was evaluated both as the mean TAT registered and the percentage of outlier (OP) exams. The mean TAT was 36, 38, and 34 min during the study periods, respectively. These values respected the goal TAT established at 45 min. The OP, calculated at 45 min as well as at 60 min, decreased from 26 to 21 and from 11 to 5, respectively. From a focused analysis on blood count cell, troponin I, and prothrombin (PT) test, TAT improvement was more evident for tests requiring longer preanalytical process. The follow-up of TAT from June 2013 to June 2014 revealed the reduction of the mean TAT as well as of the OP exams after automation implementation and that automation more strongly affects the test in the preanalytical phase including centrifugation of the sample, such as troponin I and PT. © 2015 Society for Laboratory Automation and Screening.

  7. Validation of a laboratory and hospital information system in a medical laboratory accredited according to ISO 15189

    PubMed Central

    Biljak, Vanja Radisic; Ozvald, Ivan; Radeljak, Andrea; Majdenic, Kresimir; Lasic, Branka; Siftar, Zoran; Lovrencic, Marijana Vucic; Flegar-Mestric, Zlata

    2012-01-01

    Introduction The aim of the study was to present a protocol for laboratory information system (LIS) and hospital information system (HIS) validation at the Institute of Clinical Chemistry and Laboratory Medicine of the Merkur University Hospital, Zagreb, Croatia. Materials and methods: Validity of data traceability was checked by entering all test requests for virtual patient into HIS/LIS and printing corresponding barcoded labels that provided laboratory analyzers with the information on requested tests. The original printouts of the test results from laboratory analyzer(s) were compared with the data obtained from LIS and entered into the provided template. Transfer of data from LIS to HIS was examined by requesting all tests in HIS and creating real data in a finding generated in LIS. Data obtained from LIS and HIS were entered into a corresponding template. The main outcome measure was the accuracy of transfer obtained from laboratory analyzers and results transferred from LIS and HIS expressed as percentage (%). Results: The accuracy of data transfer from laboratory analyzers to LIS was 99.5% and of that from LIS to HIS 100%. Conclusion: We presented our established validation protocol for laboratory information system and demonstrated that a system meets its intended purpose. PMID:22384522

  8. Cosmetics Europe multi-laboratory pre-validation of the SkinEthic™ reconstituted human corneal epithelium test method for the prediction of eye irritation.

    PubMed

    Alépée, N; Bessou-Touya, S; Cotovio, J; de Smedt, A; de Wever, B; Faller, C; Jones, P; Le Varlet, B; Marrec-Fairley, M; Pfannenbecker, U; Tailhardat, M; van Goethem, F; McNamee, P

    2013-08-01

    Cosmetics Europe, The Personal Care Association, known as Colipa before 2012, conducted a program of technology transfer and assessment of Within/Between Laboratory (WLV/BLV) reproducibility of the SkinEthic™ Reconstituted Human Corneal Epithelium (HCE) as one of two human reconstructed tissue eye irritation test methods. The SkinEthic™ HCE test method involves two exposure time treatment procedures - one for short time exposure (10 min - SE) and the other for long time exposure (60 min - LE) of tissues to test substance. This paper describes pre-validation studies of the SkinEthic™ HCE test method (SE and LE protocols) as well as the Eye Peptide Reactivity Assay (EPRA). In the SE WLV study, 30 substances were evaluated. A consistent outcome with respect to viability measurement across all runs was observed with all substances showing an SD of less than 18%. In the LE WLV study, 44 out of 45 substances were consistently classified. These data demonstrated a high level of reproducibility within laboratory for both the SE and LE treatment procedures. For the LE BLV, 19 out of 20 substances were consistently classified between the three laboratories, again demonstrating a high level of reproducibility between laboratories. The results for EPRA WLV and BLV studies demonstrated that all substances analysed were categorised similarly and that the method is reproducible. The SkinEthic™ HCE test method entered into the experimental phase of a formal ECVAM validation program in 2010. Copyright © 2013. Published by Elsevier Ltd.

  9. [Standardization of terminology in laboratory medicine I].

    PubMed

    Yoon, Soo Young; Yoon, Jong Hyun; Min, Won Ki; Lim, Hwan Sub; Song, Junghan; Chae, Seok Lae; Lee, Chang Kyu; Kwon, Jung Ah; Lee, Kap No

    2007-04-01

    Standardization of medical terminology is essential for data transmission between health-care institutions or clinical laboratories and for maximizing the benefits of information technology. Purpose of our study was to standardize the medical terms used in the clinical laboratory, such as test names, units, terms used in result descriptions, etc. During the first year of the study, we developed a standard database of concept names for laboratory terms, which covered the terms used in government health care centers, their branch offices, and primary health care units. Laboratory terms were collected from the electronic data interchange (EDI) codes from National Health Insurance Corporation (NHIC), Logical Observation Identifier Names and Codes (LOINC) database, community health centers and their branch offices, and clinical laboratories of representative university medical centers. For standard expression, we referred to the English-Korean/ Korean-English medical dictionary of Korean Medical Association and the rules for foreign language translation. Programs for mapping between LOINC DB and EDI code and for translating English to Korean were developed. A Korean standard laboratory terminology database containing six axial concept names such as components, property, time aspect, system (specimen), scale type, and method type was established for 7,508 test observations. Short names and a mapping table for EDI codes and Unified Medical Language System (UMLS) were added. Synonym tables for concept names, words used in the database, and six axial terms were prepared to make it easier to find the standard terminology with common terms used in the field of laboratory medicine. Here we report for the first time a Korean standard laboratory terminology database for test names, result description terms, result units covering most laboratory tests in primary healthcare centers.

  10. Larger differences in utilization of rarely requested tests in primary care in Spain.

    PubMed

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

    2015-01-01

    The study was performed to compare and analyze the inter-departmental variability in the request of rarely requested laboratory tests in primary care, as opposed to other more common and highly requested tests. Data from production statistics for the year 2012 from 76 Spanish laboratories was used. The number of antinuclear antibodies, antistreptolysin O, creatinine, cyclic citrullinated peptide antibodies, deaminated peptide gliadine IgA antibodies, glucose, protein electrophoresis, rheumatoid factor, transglutaminase IgA antibodies, urinalysis and uric acid tests requested was collected. The number of test requests per 1000 inhabitants was calculated. In order to explore the variability the coefficient of quartile dispersion was calculated. The smallest variation was seen for creatinine, glucose, uric acid and urinalysis; the most requested tests. The tests that were least requested showed the greatest variability. Our study shows through a very simplified approach, in a population close to twenty million inhabitants, how in primary care, the variability in the request of laboratory tests is inversely proportional to the request rate.

  11. Accelerated Leach Testing of GLASS: ALTGLASS Version 3.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Trivelpiece, Cory L.; Jantzen, Carol M.; Crawford, Charles L.

    The Accelerated Leach Testing of GLASS (ALTGLASS) database is a collection of data from short- and long-term product consistency tests (PCT, ASTM C1285 A and B) on high level waste (HLW) as well as low activity waste (LAW) glasses. The database provides both U.S. and international researchers with an archive of experimental data for the purpose of studying, modeling, or validating existing models of nuclear waste glass corrosion. The ALTGLASS database is maintained and updated by researchers at the Savannah River National Laboratory (SRNL). This newest version, ALTGLASS Version 3.0, has been updated with an additional 503 rows of datamore » representing PCT results from corrosion experiments conducted in the United States by the Savannah River National Laboratory, Pacific Northwest National Laboratory, Argonne National Laboratory, and the Vitreous State Laboratory (SRNL, PNNL, ANL, VSL, respectively) as well as the National Nuclear Laboratory (NNL) in the United Kingdom.« less

  12. A Manpower Study of Technical Personnel in Hospital Clinical Laboratories. Final Report.

    ERIC Educational Resources Information Center

    Harkness, James P., And Others

    As one of the efforts related to closing the gap between the growing demands for clinical laboratory workers and the supply of well-trained workers, the volume and quality of laboratory procedures and the general characteristics of workers in North Carolina hospitals were studied. Approaches to the study included tests on "unknowns" by…

  13. Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests.

    PubMed

    Robinson, James C; Whaley, Christopher; Brown, Timothy T

    2016-09-01

    Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting "reference pricing" policies to create incentives for patients to select lower-priced facilities. To measure the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending. We conducted an observational study of changes in laboratory pricing and selection by employees of a large national grocery firm (n = 30 415) before and after the firm implemented a reference pricing policy for laboratory services and compared the findings with changes over the same period for policy holders of a large national insurer that did not implement reference pricing (n = 181 831). The grocery firm established a maximum payment limit at the 60th percentile of the distribution of prices for each laboratory test in each region. Employees were provided with data on prices at all laboratories through a mobile digital platform. Patients selecting a laboratory that charged more than the payment limit were required to pay the full difference themselves. A total of 2.13 million claims were analyzed for 285 types of in vitro diagnostic tests between 2010 and 2013. Patient choice of laboratory, price paid per test, patient out-of-pocket costs, and employer spending. Compared with trends in prices paid by insurance policy holders not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 31.9% reduction (95% CI, 20.6%-41.6%) in average price paid per test by the third year of the program. In these 3 years, total spending on laboratory tests declined by $2.57 million (95% CI, $1.59-$3.35 million). Out-of-pocket costs by patients declined by $1.05 million (95% CI, $0.73-$1.37 million). Spending by the employer declined by $1.70 million (95% CI, $0.92-$2.48 million). When combined with access to price information, reference pricing was associated with patient choice of lower-cost laboratories and reductions in prices and payments by both employer and employees.

  14. The ACVD task force on canine atopic dermatitis (XVI): laboratory evaluation of dogs with atopic dermatitis with serum-based "allergy" tests.

    PubMed

    DeBoer, D J; Hillier, A

    2001-09-20

    Serum-based in vitro "allergy tests" are commercially available to veterinarians, and are widely used in diagnostic evaluation of a canine atopic patient. Following initial clinical diagnosis, panels of allergen-specific IgE measurements may be performed in an attempt to identify to which allergens the atopic dog is hypersensitive. Methodology for these tests varies by laboratory; few critical studies have evaluated performance of these tests, and current inter-laboratory standardization and quality control measures are inadequate. Other areas where information is critically limited include the usefulness of these tests in diagnosis of food allergy, the effect of extrinsic factors such as season of the year on results, and the influence of corticosteroid treatment on test results. Allergen-specific IgE serological tests are never completely sensitive, nor completely specific. There is only partial correlation between the serum tests and intradermal testing; however, the significance of discrepant results is unknown and unstudied. Variation in test methodologies along with the absence of universal standardization and reporting procedures have created confusion, varying study results, and an inability to compare between studies performed by different investigators.

  15. Interlaboratory comparability, bias, and precision for four laboratories measuring constituents in precipitation, November 1982-August 1983

    USGS Publications Warehouse

    Brooks, M.H.; Schroder, L.J.; Malo, B.A.

    1985-01-01

    Four laboratories were evaluated in their analysis of identical natural and simulated precipitation water samples. Interlaboratory comparability was evaluated using analysis of variance coupled with Duncan 's multiple range test, and linear-regression models describing the relations between individual laboratory analytical results for natural precipitation samples. Results of the statistical analyses indicate that certain pairs of laboratories produce different results when analyzing identical samples. Analyte bias for each laboratory was examined using analysis of variance coupled with Duncan 's multiple range test on data produced by the laboratories from the analysis of identical simulated precipitation samples. Bias for a given analyte produced by a single laboratory has been indicated when the laboratory mean for that analyte is shown to be significantly different from the mean for the most-probable analyte concentrations in the simulated precipitation samples. Ion-chromatographic methods for the determination of chloride, nitrate, and sulfate have been compared with the colorimetric methods that were also in use during the study period. Comparisons were made using analysis of variance coupled with Duncan 's multiple range test for means produced by the two methods. Analyte precision for each laboratory has been estimated by calculating a pooled variance for each analyte. Analyte estimated precisions have been compared using F-tests and differences in analyte precisions for laboratory pairs have been reported. (USGS)

  16. Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study.

    PubMed

    Valenstein, Paul N; Wang, Edward; O'Donohue, Tom

    2003-12-01

    The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P <.001). Technical staff at the median VA facility were paid more than at non-VA facilities (28.11/h dollars vs 22.60/h dollars, salaries plus benefits; P <.001), VA laboratories employed a smaller percentage of nontechnical staff (30.0% vs 41.9%; P <.001), and workers at VA laboratories worked less time per hour paid (85.5% vs 88.5%; P <.001). However, labor productivity was significantly higher at VA than at non-VA facilities (30 448 test results/total full-time equivalent (FTE)/y vs 19 260 results/total FTE; P <.001), resulting in lower labor expense per on-site test at VA sites than at non-VA sites (1.79 dollars/result vs 2.08 dollars/result; P <.001). Veterans Health Administration laboratories paid less per test for consumables (P =.003), depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

  17. Inquiry-based laboratory investigations and student performance on standardized tests in biological science

    NASA Astrophysics Data System (ADS)

    Patke, Usha

    Achievement data from the 3rd International Mathematics and Sciences Study and Program for International Student Assessment in science have indicated that Black students from economically disadvantaged families underachieve at alarming rates in comparison to White and economically advantaged peer groups. The study site was a predominately Black, urban school district experiencing underachievement. The purpose of this correlational study was to examine the relationship between students' use of inquiry-based laboratory investigations and their performance on the Biology End of Course Test, as well as to examine the relationship while partialling out the effects of student gender. Constructivist theory formed the theoretical foundation of the study. Students' perceived levels of experience with inquiry-based laboratory investigations were measured using the Laboratory Program Variable Inventory (LPVI) survey. LPVI scores of 256 students were correlated with test scores and were examined by student gender. The Pearson correlation coefficient revealed a small direct correlation between students' experience in inquiry-based laboratory investigation classes and standardized test scores on the Biology EOCT. A partial correlational analysis indicated that the correlation remained after controlling for gender. This study may prompt a change from teacher-centered to student-centered pedagogy at the local site in order to increase academic achievement for all students. The results of this study may also influence administrators and policy makers to initiate local, state, or nationwide curricular development. A change in curriculum may promote social change as students become more competent, and more able, to succeed in life beyond secondary school.

  18. Thermal comfort of aeroplane seats: influence of different seat materials and the use of laboratory test methods.

    PubMed

    Bartels, Volkmar T

    2003-07-01

    This study determined the influence of different cover and cushion materials on the thermal comfort of aeroplane seats. Different materials as well as ready made seats were investigated by the physiological laboratory test methods Skin Model and seat comfort tester. Additionally, seat trials with human test subjects were performed in a climatic chamber. Results show that a fabric cover produces a considerably higher sweat transport than leather. A three-dimensional knitted spacer fabric turns out to be the better cushion alternative in comparison to a moulded foam pad. Results from the physiological laboratory test methods nicely correspond to the seat trials with human test subjects.

  19. Update on the College of American Pathologists Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology.

    PubMed

    Ghofrani, Mohiedean; Zhao, Chengquan; Davey, Diane D; Fan, Fang; Husain, Mujtaba; Laser, Alice; Ocal, Idris T; Shen, Rulong Z; Goodrich, Kelly; Souers, Rhona J; Crothers, Barbara A

    2016-12-01

    - Since 2008, the College of American Pathologists has provided the human papillomavirus for cytology laboratories (CHPV) proficiency testing program to help laboratories meet the requirements of the Clinical Laboratory Improvement Amendments of 1988. - To provide an update on trends in proficiency testing performance in the College of American Pathologists CHPV program during the 4-year period from 2011 through 2014 and to compare those trends with the preceding first 3 years of the program. - Responses of laboratories participating in the CHPV program from 2011 through 2014 were analyzed using a nonlinear mixed model to compare different combinations of testing medium and platform. - In total, 818 laboratories participated in the CHPV program at least once during the 4 years, with participation increasing during the study period. Concordance of participant responses with the target result was more than 98% (38 280 of 38 892). Overall performance with all 3 testing media-ThinPrep (Hologic, Bedford, Massachusetts), SurePath (Becton, Dickinson and Company, Franklin Lakes, New Jersey), or Digene (Qiagen, Valencia, California)-was equivalent (P = .51), and all 4 US Food and Drug Administration (FDA)-approved platforms-Hybrid Capture 2 (Qiagen), Cervista (Hologic), Aptima (Hologic), and cobas (Roche Molecular Systems, Pleasanton, California)-outperformed laboratory-developed tests, unspecified commercial kits, and other (noncommercial) methods in ThinPrep medium (P < .001). However, certain off-label combinations of platform and medium, most notably Cervista with SurePath, demonstrated suboptimal performance (P < .001). - Laboratories demonstrated proficiency in using various combinations of testing media and platforms offered in the CHPV program, with statistically significant performance differences in certain combinations. These observations may be relevant in the current discussions about FDA oversight of laboratory-developed tests.

  20. Fuel Cell Development and Test Laboratory | Energy Systems Integration

    Science.gov Websites

    Facility | NREL Fuel Cell Development and Test Laboratory Fuel Cell Development and Test Laboratory The Energy System Integration Facility's Fuel Cell Development and Test Laboratory supports fuel a fuel cell test in the Fuel Cell Development and Test Laboratory. Capability Hubs The Fuel Cell

  1. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2013-10-01 2013-10-01 false What drugs do laboratories test for? 40.85 Section...

  2. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  3. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2014-10-01 2014-10-01 false What drugs do laboratories test for? 40.85 Section...

  4. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  5. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  6. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  7. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2011-10-01 2011-10-01 false What drugs do laboratories test for? 40.85 Section...

  8. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2012-10-01 2012-10-01 false What drugs do laboratories test for? 40.85 Section...

  9. 49 CFR 40.85 - What drugs do laboratories test for?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.85 What drugs do laboratories test for? As a laboratory, you must test for the following five drugs or classes of drugs in a DOT drug... 49 Transportation 1 2010-10-01 2010-10-01 false What drugs do laboratories test for? 40.85 Section...

  10. 49 CFR 40.81 - What laboratories may be used for DOT drug testing?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What laboratories may be used for DOT drug testing... TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.81 What laboratories may be used for DOT drug testing? (a) As a drug testing laboratory located in the U.S., you are...

  11. Indications for laboratory tests in primary care: assessment of the most frequent indications and requests with blank clinical information

    PubMed Central

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Maria; Esteban, Patricia; Ahumada, Miguel; Leiva-Salinas, Carlos

    2016-01-01

    Introduction The aim of this work is twofold. Firstly, to study the temporal evolution in the number of laboratory requests from primary care without clinical indication, and to analyse the number of such requests before and after the implementation of an automated requesting procedure. Secondly, to investigate what are the most frequent clinical indications that prompted laboratory testing. Materials and methods This is a retrospective observational study conducted from January 2009 to December 2015. We counted the requests without clinical question, calculated the number of such requests per total number of requests and listed the most frequent indications. Results The number of tests requests with a blank clinical indication was significantly higher in 2009 when compared to 2015 (80% vs. 20%; P < 0.001). For every year in this 7-year period, dyslipidemia, essential hypertension and diabetes were the most prevalent diagnoses that prompted a laboratory test in primary care, accounting for more than 20% of all indications. Conclusions The number of primary care requests without patient clinical question has decreased after the implementation of an automated requesting procedure. Disorders of lipid metabolism, essential hypertension and diabetes mellitus were the most prevalent diagnoses that prompted a laboratory test in primary care. PMID:27812310

  12. Evaluation of platelet adhesion and activation on polymers: Round-robin study to assess inter-center variability.

    PubMed

    Braune, S; Sperling, C; Maitz, M F; Steinseifer, U; Clauser, J; Hiebl, B; Krajewski, S; Wendel, H P; Jung, F

    2017-10-01

    The regulatory agencies provide recommendations rather than protocols or standard operation procedures for the hemocompatibility evaluation of novel materials e.g. for cardiovascular applications. Thus, there is a lack of specifications with regard to test setups and procedures. As a consequence, laboratories worldwide perform in vitro assays under substantially different test conditions, so that inter-laboratory and inter-study comparisons are impossible. Here, we report about a prospective, randomized and double-blind multicenter trial which demonstrates that standardization of in vitro test protocols allows a reproducible assessment of platelet adhesion and activation from fresh human platelet rich plasma as possible indicators of the thrombogenicity of cardiovascular implants. Standardization of the reported static in vitro setup resulted in a laboratory independent scoring of the following materials: poly(dimethyl siloxane) (PDMS), poly(ethylene terephthalate) (PET) and poly(tetrafluoro ethylene) (PTFE). The results of this in vitro study provide evidence that inter-laboratory and inter-study comparisons can be achieved for the evaluation of the adhesion and activation of platelets on blood-contacting biomaterials by stringent standardization of test protocols. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. A STUDY OF SMALL GROUP DYNAMICS AND PRODUCTIVITY IN THE BSCS LABORATORY BLOCK PROGRAM.

    ERIC Educational Resources Information Center

    HURD, PAUL DEHART; ROWE, MARY BUDD

    THE RELATIONSHIP BETWEEN SMALL GROUP COMPATIBILITY AND ACHIEVEMENT IN THE BIOLOGICAL SCIENCE CURRICULUM STUDY LABORATORY BLOCK PROGRAM WAS TESTED. STUDENTS IN 14 CLASSES FROM FOUR HIGH SCHOOLS WERE ASSIGNED TO FOUR-MEMBER LABORATORY GROUPS CLASSIFIED AS COMPATIBLE OR INCOMPATIBLE. GROUP CLASSIFICATION WAS VALIDATED BY OBSERVERS WHO WERE NOT AWARE…

  14. Destructive Physical Analysis of Flight- and Ground-Tested Sodium-Sulfur Cells

    NASA Technical Reports Server (NTRS)

    Wasz, Margot L.; Carter, Boyd J.; Donet, Charles M.; Baldwin, Richard S.

    1999-01-01

    Destructive physical analysis (DPA) was used to study the effects of microgravity on the sulfur electrode in sodium-sulfur cells. The cells examined in this work were provided by the Air Force Research Laboratory (AFRL) from their program on sodium-sulfur technology. The Naval Research Laboratory (NRL) provided electrical characterization of the flight-tested and ground-tested cells.

  15. Laboratories | Energy Systems Integration Facility | NREL

    Science.gov Websites

    laboratories to be safely divided into multiple test stand locations (or "capability hubs") to enable Fabrication Laboratory Energy Systems High-Pressure Test Laboratory Energy Systems Integration Laboratory Energy Systems Sensor Laboratory Fuel Cell Development and Test Laboratory High-Performance Computing

  16. Color blindness defect and medical laboratory technologists: unnoticed problems and the care for screening.

    PubMed

    Dargahi, Hossein; Einollahi, Nahid; Dashti, Nasrin

    2010-01-01

    Color-blindness is the inability to perceive differences between some color that other people can distinguish. Using a literature search, the results indicate the prevalence of color vision deficiency in the medical profession and its on medical skills. Medical laboratory technicians and technologists employees should also screen for color blindness. This research aimed to study color blindness prevalence among Hospitals' Clinical Laboratories' Employees and Students in Tehran University of Medical Sciences (TUMS). A cross-sectional descriptive and analytical study was conducted among 633 TUMS Clinical Laboratory Sciences' Students and Hospitals' Clinical Laboratories' Employees to detect color-blindness problems by Ishihara Test. The tests were first screened with certain pictures, then compared to the Ishihara criteria to be possible color defective were tested further with other plates to determine color - blindness defects. The data was saved using with SPSS software and analyzed by statistical methods. This is the first study to determine the prevalence of color - blindness in Clinical Laboratory Sciences' Students and Employees. 2.4% of TUMS Medical Laboratory Sciences Students and Hospitals' Clinical Laboratories' Employees are color-blind. There is significant correlation between color-blindness and sex and age. But the results showed that there is not significant correlation between color-blindness defect and exposure to chemical agents, type of job, trauma and surgery history, history of familial defect and race. It would be a wide range of difficulties by color blinded students and employees in their practice of laboratory diagnosis and techniques with a potentially of errors. We suggest color blindness as a medical conditions should restrict employment choices for medical laboratory technicians and technologists job in Iran.

  17. Laboratory Diagnostics Market in East Africa: A Survey of Test Types, Test Availability, and Test Prices in Kampala, Uganda.

    PubMed

    Schroeder, Lee F; Elbireer, Ali; Jackson, J Brooks; Amukele, Timothy K

    2015-01-01

    Diagnostic laboratory tests are routinely defined in terms of their sensitivity, specificity, and ease of use. But the actual clinical impact of a diagnostic test also depends on its availability and price. This is especially true in resource-limited settings such as sub-Saharan Africa. We present a first-of-its-kind report of diagnostic test types, availability, and prices in Kampala, Uganda. Test types (identity) and availability were based on menus and volumes obtained from clinical laboratories in late 2011 in Kampala using a standard questionnaire. As a measure of test availability, we used the Availability Index (AI). AI is the combined daily testing volumes of laboratories offering a given test, divided by the combined daily testing volumes of all laboratories in Kampala. Test prices were based on a sampling of prices collected in person and via telephone surveys in 2015. Test volumes and menus were obtained for 95% (907/954) of laboratories in Kampala city. These 907 laboratories offered 100 different test types. The ten most commonly offered tests in decreasing order were Malaria, HCG, HIV serology, Syphilis, Typhoid, Urinalysis, Brucellosis, Stool Analysis, Glucose, and ABO/Rh. In terms of AI, the 100 tests clustered into three groups: high (12 tests), moderate (33 tests), and minimal (55 tests) availability. 50% and 36% of overall availability was provided through private and public laboratories, respectively. Point-of-care laboratories contributed 35% to the AI of high availability tests, but only 6% to the AI of the other tests. The mean price of the most commonly offered test types was $2.62 (range $1.83-$3.46). One hundred different laboratory test types were in use in Kampala in late 2011. Both public and private laboratories were critical to test availability. The tests offered in point-of-care laboratories tended to be the most available tests. Prices of the most common tests ranged from $1.83-$3.46.

  18. Can vaccinia virus be replaced by MVA virus for testing virucidal activity of chemical disinfectants?

    PubMed

    Rabenau, Holger F; Rapp, Ingrid; Steinmann, Jochen

    2010-06-23

    Vaccinia virus strain Lister Elstree (VACV) is a test virus in the DVV/RKI guidelines as representative of the stable enveloped viruses. Since the potential risk of laboratory-acquired infections with VACV persists and since the adverse effects of vaccination with VACV are described, the replacement of VACV by the modified vaccinia Ankara strain (MVA) was studied by testing the activity of different chemical biocides in three German laboratories. The inactivating properties of different chemical biocides (peracetic acid, aldehydes and alcohols) were tested in a quantitative suspension test according to the DVV/RKI guideline. All tests were performed with a protein load of 10% fetal calf serum with both viruses in parallel using different concentrations and contact times. Residual virus was determined by endpoint dilution method. The chemical biocides exhibited similar virucidal activity against VACV and MVA. In three cases intra-laboratory differences were determined between VACV and MVA - 40% (v/v) ethanol and 30% (v/v) isopropanol are more active against MVA, whereas MVA seems more stable than VACV when testing with 0.05% glutardialdehyde. Test accuracy across the three participating laboratories was high. Remarkably inter-laboratory differences in the reduction factor were only observed in two cases. Our data provide valuable information for the replacement of VACV by MVA for testing chemical biocides and disinfectants. Because MVA does not replicate in humans this would eliminate the potential risk of inadvertent inoculation with vaccinia virus and disease in non-vaccinated laboratory workers.

  19. Comparison of estrogen receptor results from pathology reports with results from central laboratory testing.

    PubMed

    Collins, Laura C; Marotti, Jonathan D; Baer, Heather J; Tamimi, Rulla M

    2008-02-06

    We compared estrogen receptor (ER) assay results abstracted from pathology reports with ER results determined on the same specimens by a central laboratory with an immunohistochemical assay. Paraffin sections were cut from tissue microarrays containing 3093 breast cancer specimens from women enrolled in the Nurses' Health Study, 1851 of which had both pathology reports and tissue available for central laboratory testing. All sections were immunostained for ER at the same time. The original assays were biochemical for 1512 (81.7%) of the 1851 specimens, immunohistochemical for 336 (18.2%), and immunofluorescent for three (0.2%). ER results from pathology reports and repeat central laboratory testing were in agreement for 87.3% of specimens (1615 of the 1851 specimens; kappa statistic = 0.64, P < .001). When the comparison was restricted to the specimens for which the ER assays were originally performed by immunohistochemistry, the agreement rate increased to 92.3% of specimens (310 of the 336 specimens; kappa statistic = 0.78, P < .001). Thus, ER assay results from pathology reports appear to be a reasonable alternative to central laboratory ER testing for large, population-based studies of patients with breast cancer.

  20. Use of laboratory tests for immune biomarkers in environmental health studies concerned with exposure to indoor air pollutants.

    PubMed Central

    Vogt, R F

    1991-01-01

    The immune system is likely to be involved in some of the health effects caused by certain indoor air exposures, and immune biomarkers can help determine which exposures and health effects have important immune components. However, the lack of standardized laboratory tests for most human immune markers and the many confounding variables that can influence them makes interpretation of results for exposure and disease end points uncertain. This paper presents an overview of the immune system and the considerations involved in using tests for immune markers in clinical epidemiology studies, particularly those concerned with indoor air exposures. Careful study design, well-characterized laboratory methods, and rigorous documentation of exposure status are required to determine the predictive value of such tests. Clinical tests currently available for some immune markers could help identify and characterize both irritative and hypersensitivity reactions to indoor air pollutants. Newer tests developed in research settings might provide more incisive indicators of immune status that could help identify exposure, susceptibility, or preclinical disease states, but their methodologies must be refined and tested in multicenter studies before they can be used reliably in public health applications. PMID:1821385

  1. MODULAR ANALYTICS: A New Approach to Automation in the Clinical Laboratory.

    PubMed

    Horowitz, Gary L; Zaman, Zahur; Blanckaert, Norbert J C; Chan, Daniel W; Dubois, Jeffrey A; Golaz, Olivier; Mensi, Noury; Keller, Franz; Stolz, Herbert; Klingler, Karl; Marocchi, Alessandro; Prencipe, Lorenzo; McLawhon, Ronald W; Nilsen, Olaug L; Oellerich, Michael; Luthe, Hilmar; Orsonneau, Jean-Luc; Richeux, Gérard; Recio, Fernando; Roldan, Esther; Rymo, Lars; Wicktorsson, Anne-Charlotte; Welch, Shirley L; Wieland, Heinrich; Grawitz, Andrea Busse; Mitsumaki, Hiroshi; McGovern, Margaret; Ng, Katherine; Stockmann, Wolfgang

    2005-01-01

    MODULAR ANALYTICS (Roche Diagnostics) (MODULAR ANALYTICS, Elecsys and Cobas Integra are trademarks of a member of the Roche Group) represents a new approach to automation for the clinical chemistry laboratory. It consists of a control unit, a core unit with a bidirectional multitrack rack transportation system, and three distinct kinds of analytical modules: an ISE module, a P800 module (44 photometric tests, throughput of up to 800 tests/h), and a D2400 module (16 photometric tests, throughput up to 2400 tests/h). MODULAR ANALYTICS allows customised configurations for various laboratory workloads. The performance and practicability of MODULAR ANALYTICS were evaluated in an international multicentre study at 16 sites. Studies included precision, accuracy, analytical range, carry-over, and workflow assessment. More than 700 000 results were obtained during the course of the study. Median between-day CVs were typically less than 3% for clinical chemistries and less than 6% for homogeneous immunoassays. Median recoveries for nearly all standardised reference materials were within 5% of assigned values. Method comparisons versus current existing routine instrumentation were clinically acceptable in all cases. During the workflow studies, the work from three to four single workstations was transferred to MODULAR ANALYTICS, which offered over 100 possible methods, with reduction in sample splitting, handling errors, and turnaround time. Typical sample processing time on MODULAR ANALYTICS was less than 30 minutes, an improvement from the current laboratory systems. By combining multiple analytic units in flexible ways, MODULAR ANALYTICS met diverse laboratory needs and offered improvement in workflow over current laboratory situations. It increased overall efficiency while maintaining (or improving) quality.

  2. MODULAR ANALYTICS: A New Approach to Automation in the Clinical Laboratory

    PubMed Central

    Zaman, Zahur; Blanckaert, Norbert J. C.; Chan, Daniel W.; Dubois, Jeffrey A.; Golaz, Olivier; Mensi, Noury; Keller, Franz; Stolz, Herbert; Klingler, Karl; Marocchi, Alessandro; Prencipe, Lorenzo; McLawhon, Ronald W.; Nilsen, Olaug L.; Oellerich, Michael; Luthe, Hilmar; Orsonneau, Jean-Luc; Richeux, Gérard; Recio, Fernando; Roldan, Esther; Rymo, Lars; Wicktorsson, Anne-Charlotte; Welch, Shirley L.; Wieland, Heinrich; Grawitz, Andrea Busse; Mitsumaki, Hiroshi; McGovern, Margaret; Ng, Katherine; Stockmann, Wolfgang

    2005-01-01

    MODULAR ANALYTICS (Roche Diagnostics) (MODULAR ANALYTICS, Elecsys and Cobas Integra are trademarks of a member of the Roche Group) represents a new approach to automation for the clinical chemistry laboratory. It consists of a control unit, a core unit with a bidirectional multitrack rack transportation system, and three distinct kinds of analytical modules: an ISE module, a P800 module (44 photometric tests, throughput of up to 800 tests/h), and a D2400 module (16 photometric tests, throughput up to 2400 tests/h). MODULAR ANALYTICS allows customised configurations for various laboratory workloads. The performance and practicability of MODULAR ANALYTICS were evaluated in an international multicentre study at 16 sites. Studies included precision, accuracy, analytical range, carry-over, and workflow assessment. More than 700 000 results were obtained during the course of the study. Median between-day CVs were typically less than 3% for clinical chemistries and less than 6% for homogeneous immunoassays. Median recoveries for nearly all standardised reference materials were within 5% of assigned values. Method comparisons versus current existing routine instrumentation were clinically acceptable in all cases. During the workflow studies, the work from three to four single workstations was transferred to MODULAR ANALYTICS, which offered over 100 possible methods, with reduction in sample splitting, handling errors, and turnaround time. Typical sample processing time on MODULAR ANALYTICS was less than 30 minutes, an improvement from the current laboratory systems. By combining multiple analytic units in flexible ways, MODULAR ANALYTICS met diverse laboratory needs and offered improvement in workflow over current laboratory situations. It increased overall efficiency while maintaining (or improving) quality. PMID:18924721

  3. Telehealth physician oversight over direct to consumer testing: doctors working with patients towards patient empowerment.

    PubMed

    Chung, Rick

    2012-06-01

    Patient empowerment has increased the demand for direct to consumer (DTC) laboratory testing. Multiple professional societies and advocacy groups have raised concerns over how DTC laboratory testing is being offered to consumers without proper physician oversight. Physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner. Using telehealth protocols and standards established by professional health organizations and state regulators, physician telehealth oversight in DTC laboratory test ordering can be effective to increase patient access to healthcare services. With proper physician oversight in test interpretation, post-test counseling, and information collaboration, DTC laboratory testing can remain a reliable and convenient option for consumers. Working within the channel of distribution of most DTC laboratory testing, physician telehealth services can properly oversee DTC laboratory testing in a safe and medically sound manner to ensure that proper test interpretation, counseling, and information collaboration are achieved. Physician telehealth services can properly oversee DTC laboratory testing to ensure that proper test interpretation, counseling, and information collaboration are achieved.

  4. Analytical performances of food microbiology laboratories - critical analysis of 7 years of proficiency testing results.

    PubMed

    Abdel Massih, M; Planchon, V; Polet, M; Dierick, K; Mahillon, J

    2016-02-01

    Based on the results of 19 food microbiology proficiency testing (PT) schemes, this study aimed to assess the laboratory performances, to highlight the main sources of unsatisfactory analytical results and to suggest areas of improvement. The 2009-2015 results of REQUASUD and IPH PT, involving a total of 48 laboratories, were analysed. On average, the laboratories failed to detect or enumerate foodborne pathogens in 3·0% of the tests. Thanks to a close collaboration with the PT participants, the causes of outliers could be identified in 74% of the cases. The main causes of erroneous PT results were either pre-analytical (handling of the samples, timing of analysis), analytical (unsuitable methods, confusion of samples, errors in colony counting or confirmation) or postanalytical mistakes (calculation and encoding of results). PT schemes are a privileged observation post to highlight analytical problems, which would otherwise remain unnoticed. In this perspective, this comprehensive study of PT results provides insight into the sources of systematic errors encountered during the analyses. This study draws the attention of the laboratories to the main causes of analytical errors and suggests practical solutions to avoid them, in an educational purpose. The observations support the hypothesis that regular participation to PT, when followed by feed-back and appropriate corrective actions, can play a key role in quality improvement and provide more confidence in the laboratory testing results. © 2015 The Society for Applied Microbiology.

  5. Effects of mandatory screening labs in directing the disposition of the apparently healthy psychiatric patient in the emergency department.

    PubMed

    Kagel, Karyn E; Smith, Meghan; Latyshenko, Ilya V; Mitchell, Christopher; Kagel, Andrew

    2017-01-01

    To determine whether mandatory psychiatric admission laboratory tests yield results that change the disposition of a patient with primary psychiatric complaint from admission to a psychiatric service to admission to a medical service. This was a single center retrospective cohort chart review study approved by the facility Institutional Review Board in which we used a records database maintained by the emergency department's social workers to access the records of every patient that presented to our emergency department with a psychiatric chief complaint between the dates of December 1, 2011, and December 1, 2013. We focused on those that were admitted to either a psychiatric service or a medical service after a thorough evaluation by the department of social work and an emergency provider. We applied our inclusion and exclusion criteria and reviewed the results of the mandatory psychiatric laboratory tests (complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, acetaminophen, aspirin, blood alcohol level, urinalysis, urine pregnancy test, urine drug screen) required for admission. Our independent variables were the compulsory psychiatric admission laboratory tests and our dependent variable was the admission to a medical service. Of 5,606 laboratory tests that were ordered and produced results for the 682 patients enrolled in our study, 51 results were considered clinically significant abnormal results, or results requiring treatment prior to psychiatric service admission, by the 2 reviewing emergency physicians. Only one of 682 psychiatric patients received a final disposition to a medical service based upon abnormal laboratory studies. That patient presented without any medical complaints but a chief complaint of "suicidal ideation," and was found to have diabetic ketoacidosis. Based on our data, the probability that an abnormal laboratory test will result in a change in disposition is 1/682=0.1% (95% CI: 0.0% to 0.9%). Patients presenting to the emergency department with a psychiatric chief complaint and no physical complaints, abnormal vital signs, or abnormal physical exam findings have less than 1% probability that an abnormal laboratory study will change their disposition from a psychiatric admission to a medical admission.

  6. Determination of Soil Moisture Content using Laboratory Experimental and Field Electrical Resistivity Values

    NASA Astrophysics Data System (ADS)

    Hazreek, Z. A. M.; Rosli, S.; Fauziah, A.; Wijeyesekera, D. C.; Ashraf, M. I. M.; Faizal, T. B. M.; Kamarudin, A. F.; Rais, Y.; Dan, M. F. Md; Azhar, A. T. S.; Hafiz, Z. M.

    2018-04-01

    The efficiency of civil engineering structure require comprehensive geotechnical data obtained from site investigation. In the past, conventional site investigation was heavily related to drilling techniques thus suffer from several limitations such as time consuming, expensive and limited data collection. Consequently, this study presents determination of soil moisture content using laboratory experimental and field electrical resistivity values (ERV). Field and laboratory electrical resistivity (ER) test were performed using ABEM SAS4000 and Nilsson400 soil resistance meter. Soil sample used for resistivity test was tested for characterization test specifically on particle size distribution and moisture content test according to BS1377 (1990). Field ER data was processed using RES2DINV software while laboratory ER data was analyzed using SPSS and Excel software. Correlation of ERV and moisture content shows some medium relationship due to its r = 0.506. Moreover, coefficient of determination, R2 analyzed has demonstrate that the statistical correlation obtain was very good due to its R2 value of 0.9382. In order to determine soil moisture content based on statistical correlation (w = 110.68ρ-0.347), correction factor, C was established through laboratory and field ERV given as 19.27. Finally, this study has shown that soil basic geotechnical properties with particular reference to water content was applicably determined using integration of laboratory and field ERV data analysis thus able to compliment conventional approach due to its economic, fast and wider data coverage.

  7. Impact of add-on laboratory testing at an academic medical center: a five year retrospective study.

    PubMed

    Nelson, Louis S; Davis, Scott R; Humble, Robert M; Kulhavy, Jeff; Aman, Dean R; Krasowski, Matthew D

    2015-01-01

    Clinical laboratories frequently receive orders to perform additional tests on existing specimens ('add-ons'). Previous studies have examined add-on ordering patterns over short periods of time. The objective of this study was to analyze add-on ordering patterns over an extended time period. We also analyzed the impact of a robotic specimen archival/retrieval system on add-on testing procedure and manual effort. In this retrospective study at an academic medical center, electronic health records from were searched to obtain all add-on orders that were placed in the time period of May 2, 2009 to December 31, 2014. During the time period of retrospective study, 880,359 add-on tests were ordered on 96,244 different patients. Add-on testing comprised 3.3 % of total test volumes. There were 443,411 unique ordering instances, leading to an average of 1.99 add-on tests per instance. Some patients had multiple episodes of add-on test orders at different points in time, leading to an average of 9.15 add-on tests per patient. The majority of add-on orders were for chemistry tests (78.8 % of total add-ons) with the next most frequent being hematology and coagulation tests (11.2 % of total add-ons). Inpatient orders accounted for 66.8 % of total add-on orders, while the emergency department and outpatient clinics had 14.8 % and 18.4 % of total add-on orders, respectively. The majority of add-ons were placed within 8 hours (87.3 %) and nearly all by 24 hours (96.8 %). Nearly 100 % of add-on orders within the emergency department were placed within 8 hours. The introduction of a robotic specimen archival/retrieval unit saved an average of 2.75 minutes of laboratory staff manual time per unique add-on order. This translates to 24.1 hours/day less manual effort in dealing with add-on orders. Our study reflects the previous literature in showing that add-on orders significantly impact the workload of the clinical laboratory. The majority of add-on orders are clinical chemistry tests, and most add-on orders occur within 24 hours of original specimen collection. Robotic specimen archival/retrieval units can reduce manual effort in the clinical laboratory associated with add-on orders.

  8. SOFIA®RSV: prospective laboratory evaluation and implementation of a rapid diagnostic test in a pediatric emergency ward.

    PubMed

    Tran, Léa C; Tournus, Céline; Dina, Julia; Morello, Rémy; Brouard, Jacques; Vabret, Astrid

    2017-06-26

    Respiratory syncytial virus (RSV) is responsible for severe respiratory infections and higher costs in medical care. The two aims of this work were to assess the performances of SOFIA ® RSV tests in "real-life-laboratory" conditions (study 1) and implemented at point-of-care testing in a pediatric emergency department (ED, study 2), during two consecutive winter seasons. In study 1, fresh nasopharyngeal swabs from patients of all ages were sampled in 1.5 ml of Universal virological Transport Medium (UTM) and prospectively tested using SOFIA ® RSV tests. In study 2, conducted in a pediatric ED, nasopharyngeal swabs were placed in 3 ml of UTM. All SOFIA ® RSV tests were confirmed by molecular testing, considered as reference method. The epidemiological and clinical features of tested patients, as well as the care of these patients after obtaining quick results were evaluated. The sensitivities of SOFIA ® RSV in infants (aged under 24 months) performed in the laboratory and in the pediatric ED were respectively 95% (95% CI: 86.8-98.1) and 74.8% (95% CI: 68.0-80.9) compared to PCR. In study 1, the sensitivity among children (from 2 to 15 years old) and adults (above 15 years old) dropped to 45% (95% CI: 23.1-68.5) and 59% (95% CI: 32.9-81.6), respectively. In study 2, there were some differences in bed-management of SOFIA ® RSV positive compared to SOFIA ® RSV negative infants. SOFIA ® RSV tests performed in the laboratory and in the pediatric ED show high and satisfactory sensitivities among young children under 24 months, which supports its robustness and reliability. However, the impact of these tests on patient care at point-of-care cannot be clearly assessed when considering the limits of the study 2 design.

  9. Laboratory medicine handoff gaps experienced by primary care practices: A report from the shared networks of collaborative ambulatory practices and partners (SNOCAP).

    PubMed

    West, David R; James, Katherine A; Fernald, Douglas H; Zelie, Claire; Smith, Maxwell L; Raab, Stephen S

    2014-01-01

    The majority of errors in laboratory medicine testing are thought to occur in the pre- and postanalytic testing phases, and a large proportion of these errors are secondary to failed handoffs. Because most laboratory tests originate in ambulatory primary care, understanding the gaps in handoff processes within and between laboratories and practices is imperative for patient safety. Therefore, the purpose of this study was to understand, based on information from primary care practice personnel, the perceived gaps in laboratory processes as a precursor to initiating process improvement activities. A survey was used to assess perceptions of clinicians, staff, and management personnel of gaps in handoffs between primary care practices and laboratories working in 21 Colorado primary care practices. Data were analyzed to determine statistically significant associations between categorical variables. In addition, qualitative analysis of responses to open-ended survey questions was conducted. Primary care practices consistently reported challenges and a desire/need to improve their efforts to systematically track laboratory test status, confirm receipt of laboratory results, and report results to patients. Automated tracking systems existed in roughly 61% of practices, and all but one of those had electronic health record-based tracking systems in place. One fourth of these electronic health record-enabled practices expressed sufficient mistrust in these systems to warrant the concurrent operation of an article-based tracking system as backup. Practices also reported 12 different procedures used to notify patients of test results, varying by test result type. The results highlight the lack of standardization and definition of roles in handoffs in primary care laboratory practices for test ordering, monitoring, and receiving and reporting test results. Results also identify high-priority gaps in processes and the perceptions by practice personnel that practice improvement in these areas is needed. Commonalities in these areas warrant the development and support of tools for use in primary care settings. © Copyright 2014 by the American Board of Family Medicine.

  10. Regeneration of Exhausted Arsenic Adsorptive media of a Full Scale Treatment System

    EPA Science Inventory

    This presentation will describe the method and results of laboratory tests showing the feasibility of regenerating exhausted, iron-based, adsorptive media and the results of a follow up regeneration test at a full scale system in Twentynine Palms CA. The laboratory studies on se...

  11. GATE AND VACUUM FLUSHING OF SEWER SEDIMENT: LABORATORY TESTING

    EPA Science Inventory

    The objective of this study was to test the performance of a traditional gate-flushing device and a newly-designed vacuum-flushing device in removing sediment from combined sewers and CSO storage tanks. A laboratory hydraulic flume was used to simulate a reach of sewer or storag...

  12. Impact of nonintrusive clinical decision support systems on laboratory test utilization in a large academic centre.

    PubMed

    Eaton, Kevin P; Chida, Natasha; Apfel, Ariella; Feldman, Leonard; Greenbaum, Adena; Tuddenham, Susan; Kendall, Emily A; Pahwa, Amit

    2018-06-01

    The near-universal prevalence of electronic health records (EHRs) has made the utilization of clinical decision support systems (CDSS) an integral strategy for improving the value of laboratory ordering. Few studies have examined the effectiveness of nonintrusive CDSS on inpatient laboratory utilization in large academic centres. Red blood cell folate, hepatitis C virus viral loads and genotypes, and type and screens were selected for study. We incorporated the appropriate indications for these labs into text that accompanied the laboratory orders in our hospital's EHR. Providers could proceed with the order without additional clicks. An interrupted time-series analysis was performed, and the primary outcome was the rate of tests ordered on all inpatient medicine floors. The rate of folate tests ordered per monthly admissions showed no significant level change at the time of the intervention with only a slight decrease in rate of 0.0109 (P = .07). There was a 43% decrease in the rate of hepatitis C virus tests per monthly admissions immediately after the intervention with a decrease of 0.0135 tests per monthly admissions (P = .02). The rate of type and screens orders per patient days each month had a significant downward trend by 0.114 before the intervention (P = .04) but no significant level change at the time of the intervention or significant change in rate after the intervention. Our study suggests that nonintrusive CDSS should be evaluated for individual laboratory tests to ensure only effective alerts continue to be used so as to avoid increasing EHR fatigue. © 2018 John Wiley & Sons, Ltd.

  13. Testing the performance of microbiological safety cabinets used in microbiology laboratories in South Korea.

    PubMed

    Hwang, S H; Yi, T W; Cho, K H; Lee, I M; Yoon, C S

    2011-09-01

    To test a performance of the microbiological safety cabinets (MSCs) according to the type of MSCs in microbial laboratories. Tests were carried out to assess the performance of 31 MSCs in 14 different facilities, including six different biological test laboratories in six hospitals and eight different laboratories in three universities. The following tests were performed on the MSCs: the downflow test, intake velocity test, high-efficiency particulate air filter leak test and the airflow smoke pattern test. These performance tests were carried out in accordance with the standard procedures. Only 23% of Class II A1 (8), A2 (19) and unknown MSCs (4) passed these performance tests. The main reasons for the failure of MSCs were inappropriate intake velocity (65%), leakage in the HEPA filter sealing (50%), unbalanced airflow smoke pattern in the cabinets (39%) and inappropriate downflow (27%). This study showed that routine checks of MSCs are important to detect and strengthen the weak spots that frequently develop, as observed during the evaluation of the MSCs of various institutions. Routine evaluation and maintenance of MSCs are critical for optimizing performance. © 2011 The Authors. Letters in Applied Microbiology © 2011 The Society for Applied Microbiology.

  14. Research on air sprays and unique foam application methods. Phase II report. Laboratory investigation of foam systems

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1982-06-01

    The objective of this study is to assess the effectiveness of air sprays and foam systems for dust control on longwall double-drum shearer faces. Laboratory testing has been conducted using foam systems and promising results have been obtained. Upon Bureau approval, underground testing will be scheduled to assess the effectiveness of foam systems under actual operating conditions. Laboratory testing of air sprays is being conducted at present. This report presents the results of the laboratory testing of foam systems. Specifically, the results obtained on the evaluation of selected foaming agents are presented, the feasibility investigation of flushing foam through themore » shearer-drum are demonstrated, and conceptual layout of the foam system on the shearer is discussed. The laboratory investigation of the selected foaming agents reveal that the Onyx Microfoam, Onyx Maprosyl and DeTer Microfoam foaming agents have higher expansion ratios compared to the others tested. Flushing foam through the shearer drum is entirely feasible and could be a viable technique for dust suppression on longwall faces.« less

  15. A study of the impact of collaborative learning on student learning of major concepts in a microbiology laboratory exercise

    NASA Astrophysics Data System (ADS)

    Baumgarten, Kristyne A.

    This study investigated the possible relationship between collaborative learning strategies and the learning of core concepts. This study examined the differences between two groups of nursing students enrolled in an introductory microbiology laboratory course. The control group consisted of students enrolled in sections taught in the traditional method. The experimental group consisted of those students enrolled in the sections using collaborative learning strategies. The groups were assessed on their degrees of learning core concepts using a pre-test/post-test method. Scores from the groups' laboratory reports were also analyzed. There was no difference in the two group's pre-test scores. The post-test scores of the experimental group averaged 11 points higher than the scores of the control group. The lab report scores of the experimental group averaged 15 points higher than those scores of the control group. The data generated from this study demonstrated that collaborative learning strategies can be used to increase students learning of core concepts in microbiology labs.

  16. Extracting laboratory test information from biomedical text

    PubMed Central

    Kang, Yanna Shen; Kayaalp, Mehmet

    2013-01-01

    Background: No previous study reported the efficacy of current natural language processing (NLP) methods for extracting laboratory test information from narrative documents. This study investigates the pathology informatics question of how accurately such information can be extracted from text with the current tools and techniques, especially machine learning and symbolic NLP methods. The study data came from a text corpus maintained by the U.S. Food and Drug Administration, containing a rich set of information on laboratory tests and test devices. Methods: The authors developed a symbolic information extraction (SIE) system to extract device and test specific information about four types of laboratory test entities: Specimens, analytes, units of measures and detection limits. They compared the performance of SIE and three prominent machine learning based NLP systems, LingPipe, GATE and BANNER, each implementing a distinct supervised machine learning method, hidden Markov models, support vector machines and conditional random fields, respectively. Results: Machine learning systems recognized laboratory test entities with moderately high recall, but low precision rates. Their recall rates were relatively higher when the number of distinct entity values (e.g., the spectrum of specimens) was very limited or when lexical morphology of the entity was distinctive (as in units of measures), yet SIE outperformed them with statistically significant margins on extracting specimen, analyte and detection limit information in both precision and F-measure. Its high recall performance was statistically significant on analyte information extraction. Conclusions: Despite its shortcomings against machine learning methods, a well-tailored symbolic system may better discern relevancy among a pile of information of the same type and may outperform a machine learning system by tapping into lexically non-local contextual information such as the document structure. PMID:24083058

  17. Test-Enhanced Learning: The Potential for Testing to Promote Greater Learning in Undergraduate Science Courses

    PubMed Central

    Brame, Cynthia J.; Biel, Rachel

    2015-01-01

    Testing within the science classroom is commonly used for both formative and summative assessment purposes to let the student and the instructor gauge progress toward learning goals. Research within cognitive science suggests, however, that testing can also be a learning event. We present summaries of studies that suggest that repeated retrieval can enhance long-term learning in a laboratory setting; various testing formats can promote learning; feedback enhances the benefits of testing; testing can potentiate further study; and benefits of testing are not limited to rote memory. Most of these studies were performed in a laboratory environment, so we also present summaries of experiments suggesting that the benefits of testing can extend to the classroom. Finally, we suggest opportunities that these observations raise for the classroom and for further research. PMID:25999314

  18. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (5th, Clemson, South Carolina, June 13-17, 1983).

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.; And Others

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume contains eight papers: "Bacterial Transformation" (M. J. Ernest & N. J. Rosenbaum);…

  19. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (16th, Atlanta, Georgia, June 7-11, 1994). Volume 16.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume contains 17 papers on the topics of cell and molecular biology, genetics, and…

  20. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (12th, Springfield, Missouri, June 4-8, 1990). Volume 12.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume includes 13 papers: "Non-Radioactive DNA Hybridization Experiments for the…

  1. Validation of the OECD reproduction test guideline with the New Zealand mudsnail Potamopyrgus antipodarum using trenbolone and prochloraz.

    PubMed

    Geiß, Cornelia; Ruppert, Katharina; Askem, Clare; Barroso, Carlos; Faber, Daniel; Ducrot, Virginie; Holbech, Henrik; Hutchinson, Thomas H; Kajankari, Paula; Kinnberg, Karin Lund; Lagadic, Laurent; Matthiessen, Peter; Morris, Steve; Neiman, Maurine; Penttinen, Olli-Pekka; Sanchez-Marin, Paula; Teigeler, Matthias; Weltje, Lennart; Oehlmann, Jörg

    2017-04-01

    The Organisation for Economic Cooperation and Development (OECD) provides several standard test methods for the environmental hazard assessment of chemicals, mainly based on primary producers, arthropods, and fish. In April 2016, two new test guidelines with two mollusc species representing different reproductive strategies were approved by OECD member countries. One test guideline describes a 28-day reproduction test with the parthenogenetic New Zealand mudsnail Potamopyrgus antipodarum. The main endpoint of the test is reproduction, reflected by the embryo number in the brood pouch per female. The development of a new OECD test guideline involves several phases including inter-laboratory validation studies to demonstrate the robustness of the proposed test design and the reproducibility of the test results. Therefore, a ring test of the reproduction test with P. antipodarum was conducted including eight laboratories with the test substances trenbolone and prochloraz and results are presented here. Most laboratories could meet test validity criteria, thus demonstrating the robustness of the proposed test protocol. Trenbolone did not have an effect on the reproduction of the snails at the tested concentration range (nominal: 10-1000 ng/L). For prochloraz, laboratories produced similar EC 10 and NOEC values, showing the inter-laboratory reproducibility of results. The average EC 10 and NOEC values for reproduction (with coefficient of variation) were 26.2 µg/L (61.7%) and 29.7 µg/L (32.9%), respectively. This ring test shows that the mudsnail reproduction test is a well-suited tool for use in the chronic aquatic hazard and risk assessment of chemicals.

  2. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  3. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  4. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  5. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  6. 49 CFR 40.107 - Who may inspect laboratories?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.107 Who may inspect laboratories? As a...-regulated employer that contracts with the laboratory for drug testing under the DOT drug testing program...

  7. Laboratory pavement polishing device (wear machine) versus field friction test units and accumulative traffic (ADT). Phase 2. Correlation study

    NASA Astrophysics Data System (ADS)

    Godwin, H. F.; Loyed, D. B.; Miley, W. G.; Page, G. C.

    1981-04-01

    The degree to which pavement wear (vehicular traffic) could be predicted from testing samples of in-service pavements in the laboratory pavement polishing device was determined. This investigation was made on asphaltic concrete pavements, primarily friction courses used in Florida. These pavements were tested at different levels of accumulative traffic (ADT) for approximately 2 years.

  8. Laboratories | NREL

    Science.gov Websites

    | Z A Accelerated Exposure Testing Laboratory Advanced Optical Materials Laboratory Advanced Thermal Laboratory Structural Testing Laboratory Surface Analysis Laboratory Systems Performance Laboratory T Thermal Storage Materials Laboratory Thermal Storage Process and Components Laboratory Thin-Film Deposition

  9. National survey on intra-laboratory turnaround time for some most common routine and stat laboratory analyses in 479 laboratories in China.

    PubMed

    Fei, Yang; Zeng, Rong; Wang, Wei; He, Falin; Zhong, Kun; Wang, Zhiguo

    2015-01-01

    To investigate the state of the art of intra-laboratory turnaround time (intra-TAT), provide suggestions and find out whether laboratories accredited by International Organization for Standardization (ISO) 15189 or College of American Pathologists (CAP) will show better performance on intra-TAT than non-accredited ones. 479 Chinese clinical laboratories participating in the external quality assessment programs of chemistry, blood gas, and haematology tests organized by the National Centre for Clinical Laboratories in China were included in our study. General information and the median of intra-TAT of routine and stat tests in last one week were asked in the questionnaires. The response rate of clinical biochemistry, blood gas, and haematology testing were 36% (479/1307), 38% (228/598), and 36% (449/1250), respectively. More than 50% of laboratories indicated that they had set up intra-TAT median goals and almost 60% of laboratories declared they had monitored intra-TAT generally for every analyte they performed. Among all analytes we investigated, the intra-TAT of haematology analytes was shorter than biochemistry while the intra-TAT of blood gas analytes was the shortest. There were significant differences between median intra-TAT on different days of the week for routine tests. However, there were no significant differences in median intra-TAT reported by accredited laboratories and non-accredited laboratories. Many laboratories in China are aware of intra-TAT control and are making effort to reach the target. There is still space for improvement. Accredited laboratories have better status on intra-TAT monitoring and target setting than the non-accredited, but there are no significant differences in median intra-TAT reported by them.

  10. National survey on intra-laboratory turnaround time for some most common routine and stat laboratory analyses in 479 laboratories in China

    PubMed Central

    Fei, Yang; Zeng, Rong; Wang, Wei; He, Falin; Zhong, Kun

    2015-01-01

    Introduction To investigate the state of the art of intra-laboratory turnaround time (intra-TAT), provide suggestions and find out whether laboratories accredited by International Organization for Standardization (ISO) 15189 or College of American Pathologists (CAP) will show better performance on intra-TAT than non-accredited ones. Materials and methods 479 Chinese clinical laboratories participating in the external quality assessment programs of chemistry, blood gas, and haematology tests organized by the National Centre for Clinical Laboratories in China were included in our study. General information and the median of intra-TAT of routine and stat tests in last one week were asked in the questionnaires. Results The response rate of clinical biochemistry, blood gas, and haematology testing were 36% (479 / 1307), 38% (228 / 598), and 36% (449 / 1250), respectively. More than 50% of laboratories indicated that they had set up intra-TAT median goals and almost 60% of laboratories declared they had monitored intra-TAT generally for every analyte they performed. Among all analytes we investigated, the intra-TAT of haematology analytes was shorter than biochemistry while the intra-TAT of blood gas analytes was the shortest. There were significant differences between median intra-TAT on different days of the week for routine tests. However, there were no significant differences in median intra-TAT reported by accredited laboratories and non-accredited laboratories. Conclusions Many laboratories in China are aware of intra-TAT control and are making effort to reach the target. There is still space for improvement. Accredited laboratories have better status on intra-TAT monitoring and target setting than the non-accredited, but there are no significant differences in median intra-TAT reported by them. PMID:26110033

  11. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  12. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  13. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  14. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  15. 49 CFR 40.99 - How long does the laboratory retain specimens after testing?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... after testing? 40.99 Section 40.99 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.99 How long does the laboratory retain specimens after testing? (a) As a laboratory testing the primary...

  16. Pre-Service Science Teachers' Views on Laboratory Applications in Science Education: The Effect of a Two-Semester Course

    ERIC Educational Resources Information Center

    Harman, Gonca; Cokelez, Aytekin; Dal, Burckin; Alper, Umut

    2016-01-01

    The aim of this study was to examine pre-service science teachers' views about laboratory applications in science education and how their views changed through laboratory applications that were carried out for two semesters. 63 (52 females, 11 males) pre-service teachers participated in the study. The study was carried out by using pre-test and…

  17. Methodology in diagnostic laboratory test research in clinical chemistry and clinical chemistry and laboratory medicine.

    PubMed

    Lumbreras-Lacarra, Blanca; Ramos-Rincón, José Manuel; Hernández-Aguado, Ildefonso

    2004-03-01

    The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term "sensitivity and specificity" (exploded) with the text words "specificity", "false negative", and "accuracy". We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645-51) of papers published in general medical journals. Three observers evaluated each article independently. Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.

  18. 21 CFR 58.83 - Reagents and solutions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.83 Reagents and solutions. All reagents and solutions in the laboratory areas shall be labeled to indicate identity, titer...

  19. Interlaboratory ring trial to evaluate CFT proficiency of European laboratories for diagnosis of glanders in equids.

    PubMed

    Laroucau, K; Colaneri, C; Jaÿ, M; Corde, Y; Drapeau, A; Durand, B; Zientara, S; Beck, C

    2016-06-18

    To evaluate the routine complement fixation test (CFT) used to detect Burkholderia mallei antibodies in equine sera, an interlaboratory proficiency test was held with 24 European laboratories, including 22 National Reference Laboratories for glanders. The panels sent to participants were composed of sera with or without B mallei antibodies. This study confirmed the reliability of CFT and highlighted its intralaboratory reproducibility. However, the sensitivity of glanders serodiagnosis and laboratory proficiency may be improved by standardising critical reagents, including antigens, and by developing a standard B mallei serum. British Veterinary Association.

  20. Choice of experimental venue matters in ecotoxicology studies: Comparison of a laboratory-based and an outdoor mesocosm experiment.

    PubMed

    Mikó, Zsanett; Ujszegi, János; Gál, Zoltán; Imrei, Zoltán; Hettyey, Attila

    2015-10-01

    The heavy application of pesticides and its potential effects on natural communities has attracted increasing attention to inadvertent impacts of these chemicals. Toxicologists conventionally use laboratory-based tests to assess lethal concentrations of pesticides. However, these tests often do not take into account indirect, interactive and long-term effects, and tend to ignore different rates of disintegration in the laboratory and under natural conditions. Our aim was to investigate the importance of the experimental venue for ecotoxicology tests. We reared tadpoles of the agile frog (Rana dalmatina) in the laboratory and in outdoor mesocosms and exposed them to three initial concentrations of a glyphosate-based herbicide (0, 2 and 6.5 mg a.e./L glyphosate), and to the presence or absence of caged predators (dragonfly larvae). The type of experimental venue had a large effect on the outcome: The herbicide was less lethal to tadpoles reared in outdoor mesocosms than in the laboratory. Further, while the herbicide had a negative effect on development time and on body mass in the laboratory, tadpoles exposed to the herbicide in mesocosms were larger at metamorphosis and developed faster in comparison to those reared in the absence of the herbicide. The effect of the herbicide on morphological traits of tadpoles also differed between the two venues. Finally, in the presence of the herbicide, tadpoles tended to be more active and to stay closer to the bottom of laboratory containers, while tadpole behaviour shifted in the opposite direction in outdoor mesocosms. Our results demonstrate major discrepancies between results of a classic laboratory-based ecotoxicity test and outcomes of an experiment performed in outdoor mesocosms. Consequently, the use of standard laboratory tests may have to be reconsidered and their benefits carefully weighed against the difficulties of performing experiments under more natural conditions. Tests validating experimentally estimated impacts of herbicides under natural conditions and studies identifying key factors determining the applicability of experimental results are urgently needed. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains

    PubMed Central

    Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

    2017-01-01

    Background Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. Objectives We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Methods Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Results Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Conclusions Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. PMID:27193033

  2. Inter-laboratory validation of bioaccessibility testing for metals.

    PubMed

    Henderson, Rayetta G; Verougstraete, Violaine; Anderson, Kim; Arbildua, José J; Brock, Thomas O; Brouwers, Tony; Cappellini, Danielle; Delbeke, Katrien; Herting, Gunilla; Hixon, Greg; Odnevall Wallinder, Inger; Rodriguez, Patricio H; Van Assche, Frank; Wilrich, Peter; Oller, Adriana R

    2014-10-01

    Bioelution assays are fast, simple alternatives to in vivo testing. In this study, the intra- and inter-laboratory variability in bioaccessibility data generated by bioelution tests were evaluated in synthetic fluids relevant to oral, inhalation, and dermal exposure. Using one defined protocol, five laboratories measured metal release from cobalt oxide, cobalt powder, copper concentrate, Inconel alloy, leaded brass alloy, and nickel sulfate hexahydrate. Standard deviations of repeatability (sr) and reproducibility (sR) were used to evaluate the intra- and inter-laboratory variability, respectively. Examination of the sR:sr ratios demonstrated that, while gastric and lysosomal fluids had reasonably good reproducibility, other fluids did not show as good concordance between laboratories. Relative standard deviation (RSD) analysis showed more favorable reproducibility outcomes for some data sets; overall results varied more between- than within-laboratories. RSD analysis of sr showed good within-laboratory variability for all conditions except some metals in interstitial fluid. In general, these findings indicate that absolute bioaccessibility results in some biological fluids may vary between different laboratories. However, for most applications, measures of relative bioaccessibility are needed, diminishing the requirement for high inter-laboratory reproducibility in absolute metal releases. The inter-laboratory exercise suggests that the degrees of freedom within the protocol need to be addressed. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Implementation of Scientific Community Laboratories and Their Effect on Student Conceptual Learning, Attitudes, and Understanding of Uncertainty

    NASA Astrophysics Data System (ADS)

    Lark, Adam

    Scientific Community Laboratories, developed by The University of Maryland, have shown initial promise as laboratories meant to emulate the practice of doing physics. These laboratories have been re-created by incorporating their design elements with the University of Toledo course structure and resources. The laboratories have been titled the Scientific Learning Community (SLC) Laboratories. A comparative study between these SLC laboratories and the University of Toledo physics department's traditional laboratories was executed during the fall 2012 semester on first semester calculus-based physics students. Three tests were executed as pre-test and post-tests to capture the change in students' concept knowledge, attitudes, and understanding of uncertainty. The Force Concept Inventory (FCI) was used to evaluate students' conceptual changes through the semester and average normalized gains were compared between both traditional and SLC laboratories. The Colorado Learning Attitudes about Science Survey for Experimental Physics (E-CLASS) was conducted to elucidate students' change in attitudes through the course of each laboratory. Finally, interviews regarding data analysis and uncertainty were transcribed and coded to track changes in the way students understand uncertainty and data analysis in experimental physics after their participation in both laboratory type. Students in the SLC laboratories showed a notable an increase conceptual knowledge and attitudes when compared to traditional laboratories. SLC students' understanding of uncertainty showed most improvement, diverging completely from students in the traditional laboratories, who declined throughout the semester.

  4. Towards an evaluation framework for Laboratory Information Systems.

    PubMed

    Yusof, Maryati M; Arifin, Azila

    Laboratory testing and reporting are error-prone and redundant due to repeated, unnecessary requests and delayed or missed reactions to laboratory reports. Occurring errors may negatively affect the patient treatment process and clinical decision making. Evaluation on laboratory testing and Laboratory Information System (LIS) may explain the root cause to improve the testing process and enhance LIS in supporting the process. This paper discusses a new evaluation framework for LIS that encompasses the laboratory testing cycle and the socio-technical part of LIS. Literature review on discourses, dimensions and evaluation methods of laboratory testing and LIS. A critical appraisal of the Total Testing Process (TTP) and the human, organization, technology-fit factors (HOT-fit) evaluation frameworks was undertaken in order to identify error incident, its contributing factors and preventive action pertinent to laboratory testing process and LIS. A new evaluation framework for LIS using a comprehensive and socio-technical approach is outlined. Positive relationship between laboratory and clinical staff resulted in a smooth laboratory testing process, reduced errors and increased process efficiency whilst effective use of LIS streamlined the testing processes. The TTP-LIS framework could serve as an assessment as well as a problem-solving tool for the laboratory testing process and system. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  5. Research and test facilities

    NASA Technical Reports Server (NTRS)

    1993-01-01

    A description is given of each of the following Langley research and test facilities: 0.3-Meter Transonic Cryogenic Tunnel, 7-by 10-Foot High Speed Tunnel, 8-Foot Transonic Pressure Tunnel, 13-Inch Magnetic Suspension & Balance System, 14-by 22-Foot Subsonic Tunnel, 16-Foot Transonic Tunnel, 16-by 24-Inch Water Tunnel, 20-Foot Vertical Spin Tunnel, 30-by 60-Foot Wind Tunnel, Advanced Civil Transport Simulator (ACTS), Advanced Technology Research Laboratory, Aerospace Controls Research Laboratory (ACRL), Aerothermal Loads Complex, Aircraft Landing Dynamics Facility (ALDF), Avionics Integration Research Laboratory, Basic Aerodynamics Research Tunnel (BART), Compact Range Test Facility, Differential Maneuvering Simulator (DMS), Enhanced/Synthetic Vision & Spatial Displays Laboratory, Experimental Test Range (ETR) Flight Research Facility, General Aviation Simulator (GAS), High Intensity Radiated Fields Facility, Human Engineering Methods Laboratory, Hypersonic Facilities Complex, Impact Dynamics Research Facility, Jet Noise Laboratory & Anechoic Jet Facility, Light Alloy Laboratory, Low Frequency Antenna Test Facility, Low Turbulence Pressure Tunnel, Mechanics of Metals Laboratory, National Transonic Facility (NTF), NDE Research Laboratory, Polymers & Composites Laboratory, Pyrotechnic Test Facility, Quiet Flow Facility, Robotics Facilities, Scientific Visualization System, Scramjet Test Complex, Space Materials Research Laboratory, Space Simulation & Environmental Test Complex, Structural Dynamics Research Laboratory, Structural Dynamics Test Beds, Structures & Materials Research Laboratory, Supersonic Low Disturbance Pilot Tunnel, Thermal Acoustic Fatigue Apparatus (TAFA), Transonic Dynamics Tunnel (TDT), Transport Systems Research Vehicle, Unitary Plan Wind Tunnel, and the Visual Motion Simulator (VMS).

  6. Simple and inexpensive point-of-care tests improve diagnosis of vaginal infections in resource constrained settings.

    PubMed

    Madhivanan, Purnima; Krupp, Karl; Hardin, Jill; Karat, Chitra; Klausner, Jeffrey D; Reingold, Arthur L

    2009-06-01

    Bacterial vaginosis (BV) and Trichomonas vaginalis infection (TV) have been associated with adverse birth outcomes and increased risk for HIV. We compare the performance of simple inexpensive point-of-care (POC) tests to laboratory diagnosis and syndromic management of BV and TV in poor settings. Between November 2005 and March 2006, 898 sexually active women attending two reproductive health clinics in Mysore, India were recruited into a cohort study investigating the relationship between vaginal flora and HSV-2 infection. Participants were interviewed and screened for reproductive tract infections. Laboratory tests included serology for HSV-2; cultures for TV, Candida sp., and Neisseria gonorrhoeae; Gram stains; and two POC tests: vaginal pH; and Whiff test. Of the 898 participants, 411 [45.7%, 95% confidence interval (95% CI): 42.4-49.0%] had any laboratory diagnosed vaginal infection. BV was detected in 165 women (19.1%, 95%CI: 16.5-21.9%) using Nugent score. TV was detected in 76 women (8.5%, 95%CI: 6.7-10.4%) using culture. Among the entire study population, POC correctly detected 82% of laboratory diagnosed BV cases, and 83% of laboratory diagnosed TV infections. Among women with complaints of vulval itching, burning, abnormal vaginal discharge, and/or sores (445/898), POC correctly detected 83% (60 of 72 cases) of laboratory diagnosed BV cases vs. 40% (29 of 72 cases) correctly managed using the syndromic approach (P < 0.001). Similarly, POC would have detected 82% (37 of 45 cases) of TV cases vs. 51% (23 of 45 cases) correctly managed using the syndromic approach (P = 0.001). In the absence of laboratory diagnostics, POC is not only inexpensive and practical, but also significantly more sensitive than the syndromic management approach, resulting in less overtreatment. .

  7. LABORATORY SCALE STEAM INJECTION TREATABILITY STUDIES

    EPA Science Inventory

    Laboratory scale steam injection treatability studies were first developed at The University of California-Berkeley. A comparable testing facility has been developed at USEPA's Robert S. Kerr Environmental Research Center. Experience has already shown that many volatile organic...

  8. Laboratory development and testing of spacecraft diagnostics

    NASA Astrophysics Data System (ADS)

    Amatucci, William; Tejero, Erik; Blackwell, Dave; Walker, Dave; Gatling, George; Enloe, Lon; Gillman, Eric

    2017-10-01

    The Naval Research Laboratory's Space Chamber experiment is a large-scale laboratory device dedicated to the creation of large-volume plasmas with parameters scaled to realistic space plasmas. Such devices make valuable contributions to the investigation of space plasma phenomena under controlled, reproducible conditions, allowing for the validation of theoretical models being applied to space data. However, in addition to investigations such as plasma wave and instability studies, such devices can also make valuable contributions to the development and testing of space plasma diagnostics. One example is the plasma impedance probe developed at NRL. Originally developed as a laboratory diagnostic, the sensor has now been flown on a sounding rocket, is included on a CubeSat experiment, and will be included on the DoD Space Test Program's STP-H6 experiment on the International Space Station. In this talk, we will describe how the laboratory simulation of space plasmas made this development path possible. Work sponsored by the US Naval Research Laboratory Base Program.

  9. Prediction of practical performance in preclinical laboratory courses - the return of wire bending for admission of dental students in Hamburg.

    PubMed

    Kothe, Christian; Hissbach, Johanna; Hampe, Wolfgang

    2014-01-01

    Although some recent studies concluded that dexterity is not a reliable predictor of performance in preclinical laboratory courses in dentistry, they could not disprove earlier findings which confirmed the worth of manual dexterity tests in dental admission. We developed a wire bending test (HAM-Man) which was administered during dental freshmen's first week in 2008, 2009, and 2010. The purpose of our study was to evaluate if the HAM-Man is a useful selection criterion additional to the high school grade point average (GPA) in dental admission. Regression analysis revealed that GPA only accounted for a maximum of 9% of students' performance in preclinical laboratory courses, in six out of eight models the explained variance was below 2%. The HAM-Man incrementally explained up to 20.5% of preclinical practical performance over GPA. In line with findings from earlier studies the HAM-Man test of manual dexterity showed satisfactory incremental validity. While GPA has a focus on cognitive abilities, the HAM-Man reflects learning of unfamiliar psychomotor skills, spatial relationships, and dental techniques needed in preclinical laboratory courses. The wire bending test HAM-Man is a valuable additional selection instrument for applicants of dental schools.

  10. [Laboratory accreditation and proficiency testing].

    PubMed

    Kuwa, Katsuhiko

    2003-05-01

    ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

  11. Situation analysis of occupational and environmental health laboratory accreditation in Thailand.

    PubMed

    Sithisarankul, Pornchai; Santiyanont, Rachana; Wongpinairat, Chongdee; Silva, Panadda; Rojanajirapa, Pinnapa; Wangwongwatana, Supat; Srinetr, Vithet; Sriratanaban, Jiruth; Chuntutanon, Swanya

    2002-06-01

    The objective of this study was to analyze the current situation of laboratory accreditation (LA) in Thailand, especially on occupational and environmental health. The study integrated both quantitative and qualitative approaches. The response rate of the quantitative questionnaires was 54.5% (226/415). The majority of the responders was environmental laboratories located outside hospital and did not have proficiency testing. The majority used ISO 9000, ISO/IEC 17025 or ISO/ EEC Guide 25, and hospital accreditation (HA) as their quality system. However, only 30 laboratories were currently accredited by one of these systems. Qualitative research revealed that international standard for laboratory accreditation for both testing laboratory and calibration laboratory was ISO/IEC Guide 25, which has been currently revised to be ISO/IEC 17025. The National Accreditation Council (NAC) has authorized 2 organizations as Accreditation Bodies (ABs) for LA: Thai Industrial Standards Institute, Ministry of Industry, and Bureau of Laboratory Quality Standards, Department of Medical Sciences, Ministry of Public Health. Regarding LA in HA, HA considered clinical laboratory as only 1 of 31 items for accreditation. Obtaining HA might satisfy the hospital director and his management team, and hence might actually be one of the obstacles for the hospital to further improve their laboratory quality system and apply for ISO/IEC 17025 which was more technically oriented. On the other hand, HA may be viewed as a good start or even a pre-requisite for laboratories in the hospitals to further improve their quality towards ISO/IEC 17025. Interviewing the director of NAC and some key men in some large laboratories revealed several major problems of Thailand's LA. Both Thai Industrial Standards Institute and Bureau of Laboratory Quality Standards did not yet obtain Mutual Recognition Agreement (MRA) with other international ABs. Several governmental bodies had their own standards and accreditation systems, and did not accept other bodies' standards and systems. This put a burden to private laboratories because they had to apply and get accredited from several governmental bodies, but still had to apply and get accredited from international ABs especially for those dealing with exports. There were only few calibration laboratories, not enough for supporting the calibration required for the equipment in testing laboratories' LA. Purchasing proficiency testing specimens from abroad was very expensive, and often got into troubles with the customs duty procedures. The authors recommend some strategies and activities to improve laboratory accreditation in Thailand. Improvement in occupational and environmental health laboratories would essentially be beneficial to laboratory accreditation of other areas such as clinical laboratory.

  12. Laboratory performance of sweat conductivity for the screening of cystic fibrosis.

    PubMed

    Greaves, Ronda F; Jolly, Lisa; Massie, John; Scott, Sue; Wiley, Veronica C; Metz, Michael P; Mackay, Richard J

    2018-03-28

    There are several complementary English-language guidelines for the performance of the sweat chloride test. These guidelines also incorporate information for the collection of conductivity samples. However, recommendations for the measurement and reporting of sweat conductivity are less clear than for sweat chloride. The aim of the study was to develop an understanding of the testing and reporting practices of sweat conductivity in Australasian laboratories. A survey specifically directed at conductivity testing was sent to the 12 laboratories registered with the Royal College of Pathologists of Australasia Quality Assurance Programs. Nine (75%) laboratories participated in the survey, seven of whom used Wescor Macroduct® for collecting sweat and the Wescor SWEAT·CHEK™ for conductivity testing, and the remaining two used the Wescor Nanoduct®. There was considerable variation in frequency and staffing for this test. Likewise, criteria about which patients it was inappropriate to test, definitions of adequate collection sweat rate, cutoffs and actions recommended on the basis of the result showed variations between laboratories. Variations in sweat conductivity testing and reporting reflect many of the same issues that were revealed in sweat chloride test audits and have the potential to lead to uncertainty about the result and the proper action in response to the result. We recommend that sweat testing guidelines should include clearer statements about the use of sweat conductivity.

  13. OECD validation study to assess intra- and inter-laboratory reproducibility of the zebrafish embryo toxicity test for acute aquatic toxicity testing.

    PubMed

    Busquet, François; Strecker, Ruben; Rawlings, Jane M; Belanger, Scott E; Braunbeck, Thomas; Carr, Gregory J; Cenijn, Peter; Fochtman, Przemyslaw; Gourmelon, Anne; Hübler, Nicole; Kleensang, André; Knöbel, Melanie; Kussatz, Carola; Legler, Juliette; Lillicrap, Adam; Martínez-Jerónimo, Fernando; Polleichtner, Christian; Rzodeczko, Helena; Salinas, Edward; Schneider, Katharina E; Scholz, Stefan; van den Brandhof, Evert-Jan; van der Ven, Leo T M; Walter-Rohde, Susanne; Weigt, Stefan; Witters, Hilda; Halder, Marlies

    2014-08-01

    The OECD validation study of the zebrafish embryo acute toxicity test (ZFET) for acute aquatic toxicity testing evaluated the ZFET reproducibility by testing 20 chemicals at 5 different concentrations in 3 independent runs in at least 3 laboratories. Stock solutions and test concentrations were analytically confirmed for 11 chemicals. Newly fertilised zebrafish eggs (20/concentration and control) were exposed for 96h to chemicals. Four apical endpoints were recorded daily as indicators of acute lethality: coagulation of the embryo, lack of somite formation, non-detachment of the tail bud from the yolk sac and lack of heartbeat. Results (LC50 values for 48/96h exposure) show that the ZFET is a robust method with a good intra- and inter-laboratory reproducibility (CV<30%) for most chemicals and laboratories. The reproducibility was lower (CV>30%) for some very toxic or volatile chemicals, and chemicals tested close to their limit of solubility. The ZFET is now available as OECD Test Guideline 236. Considering the high predictive capacity of the ZFET demonstrated by Belanger et al. (2013) in their retrospective analysis of acute fish toxicity and fish embryo acute toxicity data, the ZFET is ready to be considered for acute fish toxicity for regulatory purposes. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Benchmarking in pathology: development of an activity-based costing model.

    PubMed

    Burnett, Leslie; Wilson, Roger; Pfeffer, Sally; Lowry, John

    2012-12-01

    Benchmarking in Pathology (BiP) allows pathology laboratories to determine the unit cost of all laboratory tests and procedures, and also provides organisational productivity indices allowing comparisons of performance with other BiP participants. We describe 14 years of progressive enhancement to a BiP program, including the implementation of 'avoidable costs' as the accounting basis for allocation of costs rather than previous approaches using 'total costs'. A hierarchical tree-structured activity-based costing model distributes 'avoidable costs' attributable to the pathology activities component of a pathology laboratory operation. The hierarchical tree model permits costs to be allocated across multiple laboratory sites and organisational structures. This has enabled benchmarking on a number of levels, including test profiles and non-testing related workload activities. The development of methods for dealing with variable cost inputs, allocation of indirect costs using imputation techniques, panels of tests, and blood-bank record keeping, have been successfully integrated into the costing model. A variety of laboratory management reports are produced, including the 'cost per test' of each pathology 'test' output. Benchmarking comparisons may be undertaken at any and all of the 'cost per test' and 'cost per Benchmarking Complexity Unit' level, 'discipline/department' (sub-specialty) level, or overall laboratory/site and organisational levels. We have completed development of a national BiP program. An activity-based costing methodology based on avoidable costs overcomes many problems of previous benchmarking studies based on total costs. The use of benchmarking complexity adjustment permits correction for varying test-mix and diagnostic complexity between laboratories. Use of iterative communication strategies with program participants can overcome many obstacles and lead to innovations.

  15. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2013-10-01 2013-10-01 false What is validity testing, and are laboratories...

  16. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2011-10-01 2011-10-01 false What is validity testing, and are laboratories...

  17. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2010-10-01 2010-10-01 false What is validity testing, and are laboratories...

  18. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2012-10-01 2012-10-01 false What is validity testing, and are laboratories...

  19. 49 CFR 40.89 - What is validity testing, and are laboratories required to conduct it?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.89 What is validity testing, and are laboratories required to conduct it? (a) Specimen validity testing is... 49 Transportation 1 2014-10-01 2014-10-01 false What is validity testing, and are laboratories...

  20. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or...

  1. 42 CFR 414.508 - Payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for a new clinical diagnostic laboratory... SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or...

  2. Assessing students' learning outcomes, self-efficacy and attitudes toward the integration of virtual science laboratory in general physics

    NASA Astrophysics Data System (ADS)

    Ghatty, Sundara L.

    Over the past decade, there has been a dramatic rise in online delivery of higher education in the United States. Recent developments in web technology and access to the internet have led to a vast increase in online courses. For people who work during the day and whose complicated lives prevent them from taking courses on campus, online courses are the only alternatives by which they may achieve their goals in education. The laboratory courses are the major requirements for college and university students who want to pursue degree and certification programs in science. It is noted that there is a lack of laboratory courses in online physics courses. The present study addressed the effectiveness of a virtual science laboratory in physics instruction in terms of learning outcomes, attitudes, and self-efficacy of students in a Historically Black University College. The study included fifty-eight students (36 male and 22 female) of different science majors who were enrolled in a general physics laboratory course. They were divided into virtual and traditional groups. Three experiments were selected from the syllabus. The traditional group performed one experiment in a traditional laboratory, while the virtual group performed the same experiment in a virtual laboratory. For the second experiment, the use of laboratories by both groups was exchanged. Learner's Assessment Test (LAT), Attitudes Toward Physics Laboratories (ATPL), and Self-Efficacy Survey (SES) instruments were used. Additionally, quantitative methods such as an independent t-test, a paired t-test, and correlation statistics were used to analyze the data. The results of the first experiment indicated the learning outcomes were higher in the Virtual Laboratory than in the traditional laboratory, whereas there was no significant difference in learning outcomes with either type of lab instruction. However, significant self-efficacy gains were observed. Students expressed positive attitudes in terms of liking as well as interests in performing experiments in virtual laboratories. No gender differences were observed in learning outcomes or self-efficacy. The results of the study indicated that virtual laboratories may be a substitute for traditional laboratories to some extent, and may play a vital role in online science courses.

  3. Rapid C-reactive protein and white cell tests decrease cost and shorten emergency visits.

    PubMed

    Kokko, Eeva; Korppi, Matti; Helminen, Merja; Hutri-Kähönen, Nina

    2014-10-01

    Elevated white blood cells (WBC) in blood and C-reactive protein (CRP) in serum are often used as non-specific markers for bacterial etiology of infection in children. The aim of the present study was to evaluate how rapid WBC and CRP testing influences patient flow and cost in the pediatric emergency room (ER). This study was a retrospective chart review. In all, 166 children who were treated during 3 months in the ER of a children's hospital, and in whom rapid tests for WBC and CRP were done, were included. The association between rapid testing and length of ER stay was evaluated, and the cost of rapid tests was compared with the corresponding cost if done in the hospital laboratory. Median ER stay was 147.5 min, if no examinations other than rapid CRP and WBC tests were done and if no emergency treatment was given, compared with 201.5 min for laboratory tests or emergency treatment given (P < 0.001). The respective figures were 142.5 min and 179.5 min in those 96 children discharged home (P = 0.003). The cost of rapid testing was only 41.5% of the corresponding laboratory cost. The simultaneous rapid testing of CRP and WBC in children with presumable infection decreased cost and shortened the length of ER stay, if no other examinations or emergency treatment were needed. The cost of rapid testing was less than half of the corresponding cost in laboratory. © 2014 Japan Pediatric Society.

  4. AFNOR validation of Premi Test, a microbiological-based screening tube-test for the detection of antimicrobial residues in animal muscle tissue.

    PubMed

    Gaudin, Valerie; Juhel-Gaugain, Murielle; Morétain, Jean-Pierre; Sanders, Pascal

    2008-12-01

    Premi Test contains viable spores of a strain of Bacillus stearothermophilus which is sensitive to antimicrobial residues, such as beta-lactams, tetracyclines, macrolides and sulphonamides. The growth of the strain is inhibited by the presence of antimicrobial residues in muscle tissue samples. Premi Test was validated according to AFNOR rules (French Association for Normalisation). The AFNOR validation was based on the comparison of reference methods (French Official method, i.e. four plate test (FPT) and the STAR protocol (five plate test)) with the alternative method (Premi Test). A preliminary study was conducted in an expert laboratory (Community Reference Laboratory, CRL) on both spiked and incurred samples (field samples). Several method performance criteria (sensitivity, specificity, relative accuracy) were estimated and are discussed, in addition to detection capabilities. Adequate agreement was found between the alternative method and the reference methods. However, Premi Test was more sensitive to beta-lactams and sulphonamides than the FPT. Subsequently, a collaborative study with 11 laboratories was organised by the CRL. Blank and spiked meat juice samples were sent to participants. The expert laboratory (CRL) statistically analysed the results. It was concluded that Premi Test could be used for the routine determination of antimicrobial residues in muscle of different animal origin with acceptable analytical performance. The detection capabilities of Premi Test for beta-lactams (amoxicillin, ceftiofur), one macrolide (tylosin) and tetracycline were at the level of the respective maximum residue limits (MRL) in muscle samples or even lower.

  5. Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering behaviour.

    PubMed

    Meidani, Z; Mousavi, G A; Kheirkhah, D; Benar, N; Maleki, M R; Sharifi, M; Farrokhian, A

    2017-12-01

    Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians' behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour.

  6. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    PubMed

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

  7. Customer Satisfaction Survey With Clinical Laboratory and Phlebotomy Services at a Tertiary Care Unit Level

    PubMed Central

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L.; Lee, Eun Yup; Son, Han Chul

    2014-01-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level. PMID:25187892

  8. 3. VIEW LOOKING NORTH, COMPONENTS TEST LABORATORY, DYNAMIC TEST FACILITY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. VIEW LOOKING NORTH, COMPONENTS TEST LABORATORY, DYNAMIC TEST FACILITY (SATURN V IN BACKGROUND). - Marshall Space Flight Center, East Test Area, Components Test Laboratory, Huntsville, Madison County, AL

  9. Protocol and standard operating procedures for common use in a worldwide multicenter study on reference values.

    PubMed

    Ozarda, Yesim; Ichihara, Kiyoshi; Barth, Julian H; Klee, George

    2013-05-01

    The reference intervals (RIs) given in laboratory reports have an important role in aiding clinicians in interpreting test results in reference to values of healthy populations. In this report, we present a proposed protocol and standard operating procedures (SOPs) for common use in conducting multicenter RI studies on a national or international scale. The protocols and consensus on their contents were refined through discussions in recent C-RIDL meetings. The protocol describes in detail (1) the scheme and organization of the study, (2) the target population, inclusion/exclusion criteria, ethnicity, and sample size, (3) health status questionnaire, (4) target analytes, (5) blood collection, (6) sample processing and storage, (7) assays, (8) cross-check testing, (9) ethics, (10) data analyses, and (11) reporting of results. In addition, the protocol proposes the common measurement of a panel of sera when no standard materials exist for harmonization of test results. It also describes the requirements of the central laboratory, including the method of cross-check testing between the central laboratory of each country and local laboratories. This protocol and the SOPs remain largely exploratory and may require a reevaluation from the practical point of view after their implementation in the ongoing worldwide study. The paper is mainly intended to be a basis for discussion in the scientific community.

  10. National Survey of Adult and Pediatric Reference Intervals in Clinical Laboratories across Canada: A Report of the CSCC Working Group on Reference Interval Harmonization.

    PubMed

    Adeli, Khosrow; Higgins, Victoria; Seccombe, David; Collier, Christine P; Balion, Cynthia M; Cembrowski, George; Venner, Allison A; Shaw, Julie

    2017-11-01

    Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group that examines variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada. Data on reference intervals currently used by 37 laboratories were collected through a national survey to examine the variation in reference intervals for seven common laboratory tests. Additionally, 40 clinical laboratories participated in a baseline assessment by measuring six analytes in a reference sample. Of the seven analytes examined, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and creatinine reference intervals were most variable. As expected, reference interval variation was more substantial in the pediatric population and varied between laboratories using the same instrumentation. Reference sample results differed between laboratories, particularly for ALT and free thyroxine (FT4). Reference interval variation was greater than test result variation for the majority of analytes. It is evident that there is a critical lack of harmonization in laboratory reference intervals, particularly for the pediatric population. Furthermore, the observed variation in reference intervals across instruments cannot be explained by the bias between the results obtained on instruments by different manufacturers. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  11. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (14th, Las Vegas, Nevada, June 2-6, 1992). Volume 14.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve undergraduate biology laboratory experiences by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume contains 11 papers: "A Practical Guide to the Use of Cellular Slime Molds for…

  12. Tested Studies for Laboratory Teaching. Proceedings. Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (11th, Fredericton, New Brunswick, Canada, June 12-16, 1989). Volume 11.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume contains 10 papers: "Investigating Fungi Which Cause Rot and Decay" (J. A Johnson);…

  13. Tested Studies for Laboratory Teaching. Proceedings of the Workshop/Conference of the Association for Biology Laboratory Education (ABLE) (15th, Toronto, Ontario, Canada, June 8-12, 1993). Volume 15.

    ERIC Educational Resources Information Center

    Goldman, Corey A., Ed.

    The focus of the Association for Biology Laboratory Education (ABLE) is to improve the undergraduate biology laboratory experience by promoting the development and dissemination of interesting, innovative, and reliable laboratory exercises. This proceedings volume contains 18 papers: "Human DNA Fingerprinting by Polymerase Chain Reaction" (M. V.…

  14. Financial incentives and the supply of laboratory tests.

    PubMed

    Carlsen, Fredrik; Grytten, Jostein; Skau, Irene

    2003-11-01

    This study examined how the number of laboratory tests taken by a sample of Norwegian contract physicians is influenced by their private economy outside of the practice and by changes in remuneration. The data are drawn from 40,000 consultations carried out by 44 contract physicians in 1991-1994. Two factors which led to changes in the level of physicians' income are considered: changes in remuneration for consultations and laboratory tests and changes in interest rates on loans and bank deposits. The effect which changes in interest rates have on physicians' disposable income was calculated using information about their financial assets and debts obtained from tax assessments. The main finding was that changes in private economy and changes in remuneration have no or only a small effect on the number of laboratory tests taken. Our results suggest that fee regulation can be an effective means of controlling physicians' income and therefore government expenditure on primary physician services.

  15. Sensor Acquisition for Water Utilities: A Survey and Technology List

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Alai, M; Glascoe, L; Love, A

    2005-03-07

    The early detection of the deliberate biological and chemical contamination of water distribution systems is a necessary capability for securing the nation's water supply. Current and emerging early-detection technology capabilities and shortcomings need to be identified and assessed to provide government agencies and water utilities with an improved methodology for assessing the value of installing these technologies. The Department of Homeland Security (DHS) has tasked a multi-laboratory team to evaluate current and future needs to protect the nation's water distribution infrastructure by supporting an objective evaluation of current and new technologies. The primary deliverables from this Operational Technology Demonstration (OTD)more » are the following: (1) establishment of an advisory board for review and approval of testing protocols, technology acquisition processes and recommendations for technology test and evaluation in laboratory and field settings; (2) development of a technology acquisition process; (3) creation of laboratory and field testing and evaluation capability; and (4) testing of candidate technologies for insertion into a water early warning system. The initial phase of this study involves the development of two separate but complementary strategies to be reviewed by the advisory board: (1) a technology acquisition strategy, and (2) a technology evaluation strategy. Lawrence Livermore National Laboratory and Sandia National Laboratories are tasked with the first strategy, while Los Alamos, Pacific Northwest, and Oak Ridge National Laboratories are tasked with the second strategy. The first goal of the acquisition strategy is the development of a technology survey process that includes a review of previous sensor surveys and current test programs and then the development of a method to solicit and select existing and emerging sensor technologies for evaluation and testing. In this paper we discuss a survey of previous efforts by governmental agencies and private companies with the aim of facilitating a water sensor technology acquisition procedure. We provide a survey of previous sensor studies with regard to the use of Early Warning Systems (EWS) including earlier surveys, testing programs, and response studies. In the project we extend this earlier work by developing a list of important sensor specifications that are then used to help assemble a sensor selection criteria. A list of sensor technologies with their specifications is appended to this document. This list will assist the second goal of the project which is a recommendation of candidate technologies for laboratory and field testing.« less

  16. The autonomic laboratory

    NASA Technical Reports Server (NTRS)

    Low, P. A.; Opfer-Gehrking, T. L.

    1999-01-01

    The autonomic nervous system can now be studied quantitatively, noninvasively, and reproducibly in a clinical autonomic laboratory. The approach at the Mayo Clinic is to study the postganglionic sympathetic nerve fibers of peripheral nerve (using the quantitative sudomotor axon reflex test [QSART]), the parasympathetic nerves to the heart (cardiovagal tests), and the regulation of blood pressure by the baroreflexes (adrenergic tests). Patient preparation is extremely important, since the state of the patient influences the results of autonomic function tests. The autonomic technologist in this evolving field needs to have a solid core of knowledge of autonomic physiology and autonomic function tests, followed by training in the performance of these tests in a standardized fashion. The range and utilization of tests of autonomic function will likely continue to evolve.

  17. A multivariate assessment of the effect of the laboratory homework component of a microcomputer-based laboratory for a college freshman physics course

    NASA Astrophysics Data System (ADS)

    Ramlo, Susan E.

    Microcomputer-based laboratories (MBLs) have been defined as software that uses an electronic probe to collect information about a physical system and then converts that information into graphical systems in real-time. Realtime Physics Laboratories (RTP) are an example of laboratories that combine the use of MBLs with collaboration and guided-inquiry. RTP Mechanics Laboratories include both laboratory activities and laboratory homework for the first semester of college freshman physics courses. Prior research has investigated the effectiveness of the RTP laboratories as a package (laboratory activities with laboratory homework). In this study, an experimental-treatment had students complete both the RTP laboratory activity and the associated laboratory homework during the same laboratory period. Observations of this treatment indicated that students primarily consulted the laboratory instructor and referred to their completed laboratory activity while completing the homework in their collaborative groups. In the control-treatment, students completed the laboratory homework outside the laboratory period. Measures of force and motion conceptual understanding included the Force and Motion Conceptual Understanding (FMCE), a 47 multiple-choice question test. Analyses of the FMCE indicated that it is both a reliable and a valid measure of force and motion conceptual understanding. A distinct, five-factor structure for the FMCE post-test answers reflected specific concepts related to force and motion. However, the three FMCE pretest factors were less distinct. Analysis of the experimental-treatment, compared to a control-treatment, included multiple regression analysis with covariates of age, prior physics-classroom experience, and the three FMCE pretest factors. Criterion variables included each of the five post-test factors, the total laboratory homework score, and a group of seven exam questions. The results were all positive, in favor of the experimental-treatment. However, the results were significant only with the criterions of the FMCE post-test factor "Concepts Regarding Newton's First and Second Laws" and the laboratory homework score. The interaction between the treatments and prior physics-classroom experience was not significant. Implications of the qualitative and quantitative findings are discussed.

  18. Baseline Assessment of 25-Hydroxyvitamin D Reference Material and Proficiency Testing/External Quality Assurance Material Commutability: A Vitamin D Standardization Program Study.

    PubMed

    Phinney, Karen W; Sempos, Christopher T; Tai, Susan S-C; Camara, Johanna E; Wise, Stephen A; Eckfeldt, John H; Hoofnagle, Andrew N; Carter, Graham D; Jones, Julia; Myers, Gary L; Durazo-Arvizu, Ramon; Miller, W Greg; Bachmann, Lorin M; Young, Ian S; Pettit, Juanita; Caldwell, Grahame; Liu, Andrew; Brooks, Stephen P J; Sarafin, Kurtis; Thamm, Michael; Mensink, Gert B M; Busch, Markus; Rabenberg, Martina; Cashman, Kevin D; Kiely, Mairead; Galvin, Karen; Zhang, Joy Y; Kinsella, Michael; Oh, Kyungwon; Lee, Sun-Wha; Jung, Chae L; Cox, Lorna; Goldberg, Gail; Guberg, Kate; Meadows, Sarah; Prentice, Ann; Tian, Lu; Brannon, Patsy M; Lucas, Robyn M; Crump, Peter M; Cavalier, Etienne; Merkel, Joyce; Betz, Joseph M

    2017-09-01

    The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25-hydroxyvitamin D [25(OH)D] in human serum, the primary indicator of vitamin D status. A set of 50 single-donor serum samples as well as 17 reference and proficiency testing/external quality assessment materials were analyzed by participating laboratories that used either immunoassay or LC-MS methods for total 25(OH)D. The commutability test materials included National Institute of Standards and Technology Standard Reference Material 972a Vitamin D Metabolites in Human Serum as well as materials from the College of American Pathologists and the Vitamin D External Quality Assessment Scheme. Study protocols and data analysis procedures were in accordance with Clinical and Laboratory Standards Institute guidelines. The majority of the test materials were found to be commutable with the methods used in this commutability study. These results provide guidance for laboratories needing to choose appropriate reference materials and select proficiency or external quality assessment programs and will serve as a foundation for additional VDSP studies.

  19. 1. VIEW EAST, COMPONENTS TEST LABORATORY SHOWING CATCH BASINS, TURBINE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW EAST, COMPONENTS TEST LABORATORY SHOWING CATCH BASINS, TURBINE TESTING AREA, AND PUMP TESTING TOWER. - Marshall Space Flight Center, East Test Area, Components Test Laboratory, Huntsville, Madison County, AL

  20. Testing high SPF sunscreens: a demonstration of the accuracy and reproducibility of the results of testing high SPF formulations by two methods and at different testing sites.

    PubMed

    Agin, Patricia Poh; Edmonds, Susan H

    2002-08-01

    The goals of this study were (i) to demonstrate that existing and widely used sun protection factor (SPF) test methodologies can produce accurate and reproducible results for high SPF formulations and (ii) to provide data on the number of test-subjects needed, the variability of the data, and the appropriate exposure increments needed for testing high SPF formulations. Three high SPF formulations were tested, according to the Food and Drug Administration's (FDA) 1993 tentative final monograph (TFM) 'very water resistant' test method and/or the 1978 proposed monograph 'waterproof' test method, within one laboratory. A fourth high SPF formulation was tested at four independent SPF testing laboratories, using the 1978 waterproof SPF test method. All laboratories utilized xenon arc solar simulators. The data illustrate that the testing conducted within one laboratory, following either the 1978 proposed or the 1993 TFM SPF test method, was able to reproducibly determine the SPFs of the formulations tested, using either the statistical analysis method in the proposed monograph or the statistical method described in the TFM. When one formulation was tested at four different laboratories, the anticipated variation in the data owing to the equipment and other operational differences was minimized through the use of the statistical method described in the 1993 monograph. The data illustrate that either the 1978 proposed monograph SPF test method or the 1993 TFM SPF test method can provide accurate and reproducible results for high SPF formulations. Further, these results can be achieved with panels of 20-25 subjects with an acceptable level of variability. Utilization of the statistical controls from the 1993 sunscreen monograph can help to minimize lab-to-lab variability for well-formulated products.

  1. [How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

    PubMed

    Kawano, Seiji

    2014-12-01

    As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).

  2. A Reference Method for Measuring Emissions of SVOCs in ...

    EPA Pesticide Factsheets

    Semivolatile organic compounds (SVOCs) are indoor air pollutants that may may have significant adverse effects on human health, and emission of SVOCs from building materials and consumer products is of growing concern. Few chamber studies have been conducted due to the challenges associated with SVOC analysis and the lack of validation procedures. Thus there is an urgent need for a reliable and accurate chamber test method to verify the performance of these measurements. A reference method employing a specially-designed chamber and experimental protocol has been developed and is undergoing extensive evaluation. A pilot interlaboratory study (ILS) has been conducted with five laboratories performing chamber tests under identical conditions. Results showed inter-laboratory variations at 25% for SVOC emission rates, with greater agreement observed between intra-laboratory measurements for most of the participating laboratories. The measured concentration profiles also compared reasonably well to the mechanistic model, demonstrating the feasibility of the proposed reference method to independently assess laboratory performance and validate SVOC emission tests. There is an urgent need for improved understanding of the measurement uncertainties associated with SVOC emissions testing. The creation of specially-designed chambers and well-characterized materials serves as a critical prerequisite for improving the procedure used to measure SVOCs emitted from indoor

  3. Does bisphenol A induce superfeminization in Marisa cornuarietis? Part I: intra- and inter-laboratory variability in test endpoints.

    PubMed

    Forbes, Valery E; Selck, Henriette; Palmqvist, Annemette; Aufderheide, John; Warbritton, Ryan; Pounds, Nadine; Thompson, Roy; van der Hoeven, Nelly; Caspers, Norbert

    2007-03-01

    It has been claimed that bisphenol A (BPA) induces superfeminization in the freshwater gastropod, Marisa cornuarietis. To explore the reproducibility of prior work, here we present results from a three-laboratory study, the objectives of which were to determine the mean and variability in test endpoints (i.e., adult fecundity, egg hatchability, and juvenile growth) under baseline conditions and to identify the sources of variability. A major source of variability for all of the measured endpoints was due to differences within and among individuals. With few exceptions, variability among laboratories and among replicate tanks within laboratories contributed little to the observed variability in endpoints. The results highlight the importance of obtaining basic knowledge of husbandry requirements and baseline information on life-history traits of potential test species prior to designing toxicity test protocols. Understanding of the levels and sources of endpoint variability is essential so that statistically robust and ecologically relevant tests of chemicals can be conducted.

  4. Capability of the Gas Analysis and Testing Laboratory at the NASA Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Broerman, Craig; Jimenez, Javier; Sweterlitsch, Jeff

    2012-01-01

    The Gas Analysis and Testing Laboratory is an integral part of the testing performed at the NASA Johnson Space Center. The Gas Analysis and Testing Laboratory is a high performance laboratory providing real time analytical instruments to support manned and unmanned testing. The lab utilizes precision gas chromatographs, gas analyzers and spectrophotometers to support the technology development programs within the NASA community. The Gas Analysis and Testing Laboratory works with a wide variety of customers and provides engineering support for user-specified applications in compressed gas, chemical analysis, general and research laboratory.

  5. Capability of the Gas Analysis and Testing Laboratory at the NASA Johnson Space Center

    NASA Technical Reports Server (NTRS)

    Broerman, Craig; Jimenez, Javier; Sweterlitsch, Jeff

    2011-01-01

    The Gas Analysis and Testing Laboratory is an integral part of the testing performed at the NASA Johnson Space Center. The Gas Analysis and Testing Laboratory is a high performance laboratory providing real time analytical instruments to support manned and unmanned testing. The lab utilizes precision gas chromatographs, gas analyzers and spectrophotometers to support the technology development programs within the NASA community. The Gas Analysis and Testing Laboratory works with a wide variety of customers and provides engineering support for user-specified applications in compressed gas, chemical analysis, general and research laboratory

  6. Poly(2,5-bis(N-Methyl-N-Hexylamino)Phenylene Vinylene) (BAM-PPV) as Pretreatment Coating for Aerospace Applications: Laboratory and Field Studies

    PubMed Central

    Zarras, Peter; Buhrmaster, Diane; Webber, Cindy; Anderson, Nicole; Stenger-Smith, John D.; Goodman, Paul A.

    2014-01-01

    In this study, an electroactive polymer (EAP), poly(2,5-bis(N-methyl-N-hexylamino)phenylene vinylene) (BAM-PPV) was investigated as a potential alternative surface pretreatment for hexavalent chromium (Cr(VI))-based aerospace coatings. BAM-PPV was tested as a pretreatment coating on an aerospace aluminum alloy (AA2024-T3) substrate in combination with a non-Cr(VI) epoxy primer and a polyurethane Advanced Performance Coating (APC) topcoat. This testing was undertaken to determine BAM-PPV’s adhesion, corrosion-inhibition, compatibility and survivability in laboratory testing and during outdoor field-testing. BAM-PPV showed excellent adhesion and acceptable corrosion performance in laboratory testing. The BAM-PPV aerospace coating system (BAM-PPV, non-Cr(VI) epoxy primer and polyurethane APC topcoat) was field tested for one year on the rear hatch door of the United States Air Force C-5 cargo plane. After one year of field testing there was no evidence of delamination or corrosion of the BAM-PPV aerospace coating system. PMID:28788292

  7. Poly(2,5-bis(N-Methyl-N-Hexylamino)Phenylene Vinylene) (BAM-PPV) as Pretreatment Coating for Aerospace Applications: Laboratory and Field Studies.

    PubMed

    Zarras, Peter; Buhrmaster, Diane; Webber, Cindy; Anderson, Nicole; Stenger-Smith, John D; Goodman, Paul A

    2014-12-17

    In this study, an electroactive polymer (EAP), poly(2,5-bis( N -methyl- N -hexylamino)phenylene vinylene) (BAM-PPV) was investigated as a potential alternative surface pretreatment for hexavalent chromium (Cr(VI))-based aerospace coatings. BAM-PPV was tested as a pretreatment coating on an aerospace aluminum alloy (AA2024-T3) substrate in combination with a non-Cr(VI) epoxy primer and a polyurethane Advanced Performance Coating (APC) topcoat. This testing was undertaken to determine BAM-PPV's adhesion, corrosion-inhibition, compatibility and survivability in laboratory testing and during outdoor field-testing. BAM-PPV showed excellent adhesion and acceptable corrosion performance in laboratory testing. The BAM-PPV aerospace coating system (BAM-PPV, non-Cr(VI) epoxy primer and polyurethane APC topcoat) was field tested for one year on the rear hatch door of the United States Air Force C-5 cargo plane. After one year of field testing there was no evidence of delamination or corrosion of the BAM-PPV aerospace coating system.

  8. The concordance of serial ANA tests in an Australian tertiary hospital pathology laboratory.

    PubMed

    Lee, Adrian Y S; Hudspeth, Andrew R; Adelstein, Stephen

    2016-10-01

    The antinuclear antibody (ANA) tests are some of the more frequently requested tests for the diagnosis of autoimmunity. Although they are used primarily as diagnostic blood tests, multiple requests on the same patient continue to be encountered in the laboratory. This retrospective analysis of serial ANA testing at one pathology laboratory in Australia is the first study that examines the statistical concordance and possible implications of this on clinical practice. High-titred ANA have quite good repeatability for titre and pattern, and low-titred ANA, which can be non-specific, have poor repeatability. Staining patterns are, in general, almost random in nature on serial tests when compared to the first-obtained ANA pattern for each patient. This study confirms that there is little benefit in serial ANA testing, and only if there is a clear change in the patient's clinical picture would repeat of an initial low-titred ANA be useful. The findings reinforce the need for pathology stewardship to minimise costs, wasted resources and unnecessary referrals. Copyright © 2016 Royal College of Pathologists of Australasia. All rights reserved.

  9. SUSCEPTIBILITY TEST FOR FUNGI: CLINICAL AND LABORATORIAL CORRELATIONS IN MEDICAL MYCOLOGY.

    PubMed

    Alastruey-Izquierdo, Ana; Melhem, Marcia S C; Bonfietti, Lucas X; Rodriguez-Tudela, Juan L

    2015-09-01

    During recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals.

  10. External quality assessment for CD4 + T-lymphocyte count test: Performance of the Brazilian public health laboratories network.

    PubMed

    Gaspar, Pâmela Cristina; Wohlke, Bruna Lovizutto Protti; Brunialti, Milena Karina Coló; Pires, Ana Flávia; Kohiyama, Igor Massaki; Salomão, Reinaldo; Alonso Neto, José Boullosa; Júnior, Orlando da Costa Ferreira; Franchini, Miriam; Bazzo, Maria Luiza; Benzaken, Adele Schwartz

    2018-05-01

    The National Network for CD4+ T-lymphocyte counting of Brazil comprises 93 laboratories. This study reports the laboratory performances achieved in external quality assessment (EQA) rounds provides by Ministry of Health to evaluate the quality of the kits used and the performance of test by the technicians.Ten EQA rounds were analyzed according the EQA criteria aimed to evaluate individual laboratory performance on the basis of the accuracy of their results compared to the general mean obtained by all participating laboratories and the reproducibility of the results obtained between 2 samples from the same donor.The percentage of approved and failed laboratories in the EQAs tends to follow a uniform pattern. Since 2011, approval has remained above 80% and the failure rate has never exceeded 15%.EQA is very important to evaluate the performance of the laboratories, to identify monitor, and to resolve errors as quickly as possible.

  11. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis.

    PubMed

    Dessau, R B; van Dam, A P; Fingerle, V; Gray, J; Hovius, J W; Hunfeld, K-P; Jaulhac, B; Kahl, O; Kristoferitsch, W; Lindgren, P-E; Markowicz, M; Mavin, S; Ornstein, K; Rupprecht, T; Stanek, G; Strle, F

    2018-02-01

    Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. The most frequent clinical manifestations are erythema migrans and Lyme neuroborreliosis. Currently, a large volume of diagnostic testing for LB is reported, whereas the incidence of clinically relevant disease manifestations is low. This indicates overuse of diagnostic testing for LB with implications for patient care and cost-effective health management. The recommendations provided in this review are intended to support both the clinical diagnosis and initiatives for a more rational use of laboratory testing in patients with clinically suspected LB. This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national and international guidelines and supplemented with specific citations. The main recommendations according to current European case definitions for LB are as follows. Typical erythema migrans should be diagnosed clinically and does not require laboratory testing. The diagnosis of Lyme neuroborreliosis requires laboratory investigation of the spinal fluid including intrathecal antibody production, and the remaining disease manifestations require testing for serum antibodies to B. burgdorferi. Testing individuals with non-specific subjective symptoms is not recommended, because of a low positive predictive value. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

  12. Pin on disk against ball on disk for the evaluation of wear improvement on cryo-treated metal cutting shears

    NASA Astrophysics Data System (ADS)

    Jimbert, P.; Iturrondobeitia, M.; Ibarretxe, J.; Fernandez-Martinez, R.

    2015-03-01

    When talking about trybology, the election of the laboratory experiment type is a common problem of discussion. Laboratory wear methods are not designed to exactly reproduce the real working conditions of the analyzed part itself but serve to engineers and researcher to extrapolate the laboratory results to the real application. In order to shed some light on this issue, two wear tests have been analyzed following an ASTM standard and using the same experimental parameters and testing pair-materials in order to be able to make a comparison: Pin-on-Disk (PoD) against Ball-on-Disk (BoD). Three different tool steel have been analyzed in this study, AISI D2, AISI A8 and AISI H13, used to produce metal cutting shears. Metal on metal dry sliding tests were designed in order to reproduce the tool working conditions. These three materials were cryogenically treated and compared against no cryogenically treated ones to measure the improvement on their wear resistance due to cryogenic treatment. Finally, the wear rates obtained with both laboratory tests were compared against some real production metal cutting tools wear data. Results revealed an improvement of the wear resistance for cryo-treated samples of around 20% with the BoD test and around 6% with the PoD test. Real production tools wear was calculated for one of the tool steels and for two different applications. The improvement was approximately the one revealed by the BoD test. So, for the studied case, the BoD laboratory test gives more realistic prediction of real tool life improvement due to the cryogenic treatment.

  13. Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

    PubMed

    Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

    2017-09-01

    Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  14. Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study

    PubMed Central

    Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

    2017-01-01

    Abstract Background Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Methods Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. Results The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other’s area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Conclusions Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other’s area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. PMID:28633405

  15. Investigation of Listeria, Salmonella, and toxigenic Escherichia coli in various pet foods.

    PubMed

    Nemser, Sarah M; Doran, Tara; Grabenstein, Michael; McConnell, Terri; McGrath, Timothy; Pamboukian, Ruiqing; Smith, Angele C; Achen, Maya; Danzeisen, Gregory; Kim, Sun; Liu, Yong; Robeson, Sharon; Rosario, Grisel; McWilliams Wilson, Karen; Reimschuessel, Renate

    2014-09-01

    The Veterinary Laboratory Investigation and Response Network (Vet-LIRN), in collaboration with the Food Emergency Response Network (FERN) and its Microbiology Cooperative Agreement Program (MCAP) laboratories, conducted a study to evaluate the prevalence of selected microbial organisms in various types of pet foods. The goal of this blinded study was to help the Center for Veterinary Medicine prioritize potential future pet food-testing efforts. The study also increased the FERN laboratories' screening capabilities for foodborne pathogens in animal feed matrices, since such pathogens may also be a significant health risk to consumers who come into contact with pet foods. Six U.S. Food and Drug Administration FERN MCAP laboratories analyzed approximately 1056 samples over 2 years. Laboratories tested for Salmonella, Listeria, Escherichia coli O157:H7 enterohemorrhagic E. coli, and Shiga toxin-producing strains of E. coli (STEC). Dry and semimoist dog and cat foods purchased from local stores were tested during Phase 1. Raw dog and cat foods, exotic animal feed, and jerky-type treats purchased through the Internet were tested in Phase 2. Of the 480 dry and semimoist samples, only 2 tested positive: 1 for Salmonella and 1 for Listeria greyii. However, of the 576 samples analyzed during Phase 2, 66 samples were positive for Listeria (32 of those were Listeria monocytogenes) and 15 samples positive for Salmonella. These pathogens were isolated from raw foods and jerky-type treats, not the exotic animal dry feeds. This study showed that raw pet foods may harbor food safety pathogens, such as Listeria monocytogenes and Salmonella. Consumers should handle these products carefully, being mindful of the potential risks to human and animal health.

  16. Investigation of Listeria, Salmonella, and Toxigenic Escherichia coli in Various Pet Foods

    PubMed Central

    Doran, Tara; Grabenstein, Michael; McConnell, Terri; McGrath, Timothy; Pamboukian, Ruiqing; Smith, Angele C.; Achen, Maya; Danzeisen, Gregory; Kim, Sun; Liu, Yong; Robeson, Sharon; Rosario, Grisel; McWilliams Wilson, Karen; Reimschuessel, Renate

    2014-01-01

    Abstract The Veterinary Laboratory Investigation and Response Network (Vet-LIRN), in collaboration with the Food Emergency Response Network (FERN) and its Microbiology Cooperative Agreement Program (MCAP) laboratories, conducted a study to evaluate the prevalence of selected microbial organisms in various types of pet foods. The goal of this blinded study was to help the Center for Veterinary Medicine prioritize potential future pet food–testing efforts. The study also increased the FERN laboratories' screening capabilities for foodborne pathogens in animal feed matrices, since such pathogens may also be a significant health risk to consumers who come into contact with pet foods. Six U.S. Food and Drug Administration FERN MCAP laboratories analyzed approximately 1056 samples over 2 years. Laboratories tested for Salmonella, Listeria, Escherichia coli O157:H7 enterohemorrhagic E. coli, and Shiga toxin–producing strains of E. coli (STEC). Dry and semimoist dog and cat foods purchased from local stores were tested during Phase 1. Raw dog and cat foods, exotic animal feed, and jerky-type treats purchased through the Internet were tested in Phase 2. Of the 480 dry and semimoist samples, only 2 tested positive: 1 for Salmonella and 1 for Listeria greyii. However, of the 576 samples analyzed during Phase 2, 66 samples were positive for Listeria (32 of those were Listeria monocytogenes) and 15 samples positive for Salmonella. These pathogens were isolated from raw foods and jerky-type treats, not the exotic animal dry feeds. This study showed that raw pet foods may harbor food safety pathogens, such as Listeria monocytogenes and Salmonella. Consumers should handle these products carefully, being mindful of the potential risks to human and animal health. PMID:24824368

  17. Microbiological community analysis of vermicompost tea and its influence on the growth of vegetables and cereals.

    PubMed

    Fritz, J I; Franke-Whittle, I H; Haindl, S; Insam, H; Braun, R

    2012-07-01

    Vermicompost, the digestion product of organic material by earthworms, has been widely reported to have a more positive effect on plant growth and plant health than conventional compost. A study was conducted to investigate the effects of different vermicompost elutriates (aerated compost teas) on soils and plant growth. The teas were analyzed by chemical, microbiological, and molecular methods accompanied by plant growth tests at laboratory and field scale. The number of microorganisms in the teas increased during the extraction process and was affected by substrate addition. The vermicompost tea found to increase plant growth best under laboratory tests was applied to cereals (wheat and barley) and vegetables (Raphanus sativus, Rucola selvatica, and Pisum sativum) in a field study. The results revealed no effects of tea application on plant yield; however, sensoric tests indicated an improvement in crop quality. The soils from laboratory and field studies were investigated to detect possible microbial or chemical changes. The results indicated that minor changes to the soil microbial community occurred following tea application by foliar spray in both the laboratory-scale and field-scale experiments.

  18. Energy Systems High-Pressure Test Laboratory | Energy Systems Integration

    Science.gov Websites

    Facility | NREL Energy Systems High-Pressure Test Laboratory Energy Systems High-Pressure Test Laboratory In the Energy Systems Integration Facility's High-Pressure Test Laboratory, researchers can safely test high-pressure hydrogen components. Photo of researchers running an experiment with a hydrogen fuel

  19. Syphilis testing in antenatal care: Policies and practices among laboratories in the Americas.

    PubMed

    Luu, Minh; Ham, Cal; Kamb, Mary L; Caffe, Sonja; Hoover, Karen W; Perez, Freddy

    2015-06-01

    To asses laboratory syphilis testing policies and practices among laboratories in the Americas. Laboratory directors or designees from PAHO member countries were invited to participate in a structured, electronically-delivered survey between March and August, 2014. Data on syphilis tests, algorithms, and quality control (QC) practices were analyzed, focusing on laboratories receiving specimens from antenatal clinics (ANCs). Surveys were completed by 69 laboratories representing 30 (86%) countries. Participating laboratories included 36 (52%) national or regional reference labs and 33 (48%) lower-level laboratories. Most (94%) were public sector facilities and 71% reported existence of a national algorithm for syphilis testing in pregnancy, usually involving both treponemal and non-treponemal testing (72%). Less than half (41%) used rapid syphilis tests (RSTs); and only seven laboratories representing five countries reported RSTs were included in the national algorithm for pregnant women. Most (83%) laboratories serving ANCs reported using some type of QC system; 68% of laboratories reported participation in external QC. Only 36% of laboratories reported data to national/local surveillance. Half of all laboratories serving ANC settings reported a stockout of one or more essential supplies during the previous year (median duration, 30days). Updating laboratory algorithms, improving testing standards, integrating data into existing surveillance, and improved procurement and distribution of commodities may be needed to ensure elimination of MTCT of syphilis in the Americas. Copyright © 2015. Published by Elsevier Ireland Ltd.

  20. Pretest expectations strongly influence interpretation of abnormal laboratory results and further management

    PubMed Central

    2010-01-01

    Background Abnormal results of diagnostic laboratory tests can be difficult to interpret when disease probability is very low. Although most physicians generally do not use Bayesian calculations to interpret abnormal results, their estimates of pretest disease probability and reasons for ordering diagnostic tests may - in a more implicit manner - influence test interpretation and further management. A better understanding of this influence may help to improve test interpretation and management. Therefore, the objective of this study was to examine the influence of physicians' pretest disease probability estimates, and their reasons for ordering diagnostic tests, on test result interpretation, posttest probability estimates and further management. Methods Prospective study among 87 primary care physicians in the Netherlands who each ordered laboratory tests for 25 patients. They recorded their reasons for ordering the tests (to exclude or confirm disease or to reassure patients) and their pretest disease probability estimates. Upon receiving the results they recorded how they interpreted the tests, their posttest probability estimates and further management. Logistic regression was used to analyse whether the pretest probability and the reasons for ordering tests influenced the interpretation, the posttest probability estimates and the decisions on further management. Results The physicians ordered tests for diagnostic purposes for 1253 patients; 742 patients had an abnormal result (64%). Physicians' pretest probability estimates and their reasons for ordering diagnostic tests influenced test interpretation, posttest probability estimates and further management. Abnormal results of tests ordered for reasons of reassurance were significantly more likely to be interpreted as normal (65.8%) compared to tests ordered to confirm a diagnosis or exclude a disease (27.7% and 50.9%, respectively). The odds for abnormal results to be interpreted as normal were much lower when the physician estimated a high pretest disease probability, compared to a low pretest probability estimate (OR = 0.18, 95% CI = 0.07-0.52, p < 0.001). Conclusions Interpretation and management of abnormal test results were strongly influenced by physicians' estimation of pretest disease probability and by the reason for ordering the test. By relating abnormal laboratory results to their pretest expectations, physicians may seek a balance between over- and under-reacting to laboratory test results. PMID:20158908

  1. Pretest expectations strongly influence interpretation of abnormal laboratory results and further management.

    PubMed

    Houben, Paul H H; van der Weijden, Trudy; Winkens, Bjorn; Winkens, Ron A G; Grol, Richard P T M

    2010-02-16

    Abnormal results of diagnostic laboratory tests can be difficult to interpret when disease probability is very low. Although most physicians generally do not use Bayesian calculations to interpret abnormal results, their estimates of pretest disease probability and reasons for ordering diagnostic tests may--in a more implicit manner--influence test interpretation and further management. A better understanding of this influence may help to improve test interpretation and management. Therefore, the objective of this study was to examine the influence of physicians' pretest disease probability estimates, and their reasons for ordering diagnostic tests, on test result interpretation, posttest probability estimates and further management. Prospective study among 87 primary care physicians in the Netherlands who each ordered laboratory tests for 25 patients. They recorded their reasons for ordering the tests (to exclude or confirm disease or to reassure patients) and their pretest disease probability estimates. Upon receiving the results they recorded how they interpreted the tests, their posttest probability estimates and further management. Logistic regression was used to analyse whether the pretest probability and the reasons for ordering tests influenced the interpretation, the posttest probability estimates and the decisions on further management. The physicians ordered tests for diagnostic purposes for 1253 patients; 742 patients had an abnormal result (64%). Physicians' pretest probability estimates and their reasons for ordering diagnostic tests influenced test interpretation, posttest probability estimates and further management. Abnormal results of tests ordered for reasons of reassurance were significantly more likely to be interpreted as normal (65.8%) compared to tests ordered to confirm a diagnosis or exclude a disease (27.7% and 50.9%, respectively). The odds for abnormal results to be interpreted as normal were much lower when the physician estimated a high pretest disease probability, compared to a low pretest probability estimate (OR = 0.18, 95% CI = 0.07-0.52, p < 0.001). Interpretation and management of abnormal test results were strongly influenced by physicians' estimation of pretest disease probability and by the reason for ordering the test. By relating abnormal laboratory results to their pretest expectations, physicians may seek a balance between over- and under-reacting to laboratory test results.

  2. Institutional practices and policies in acid-base testing: a self reported Croatian survey study on behalf of the Croatian society of medical biochemistry and laboratory medicine Working Group for acid-base balance.

    PubMed

    Dukić, Lora; Simundić, Ana-Maria

    2014-01-01

    The aim of this survey study was to assess the current practices and policies in use related to the various steps in the blood gas testing process, across hospital laboratories in Croatia. First questionnaire was sent by email to all medical biochemistry laboratories (N = 104) within general, specialized and clinical hospitals and university hospital centres to identify laboratories which perform blood gas analysis. Second questionnaire with detailed questions about sample collection, analysis and quality control procedures, was sent only to 47 laboratories identified by the first survey. Questionnaire was designed as combination of questions and statements with Likert scale. Third questionnaire was sent to all participating laboratories (N=47) for additional clarification for either indeterminate or unclear answers. Blood gas analysis is performed in 47/104 hospital laboratories in Croatia. In 25/41 (0.61) of the laboratories capillary blood gas sampling is the preferred sample type for adult patient population, whereas arterial blood sample is preferentially used in only 5/44 laboratories (0.11). Blood sampling and sample processing for capillary samples is done almost always by laboratory technicians (36/41 and 37/44, respectively), whereas arterial blood sampling is almost always done by the physician (24/29) and only rarely by a nurse (5/28). Sample acceptance criteria and sample analysis are in accordance with international recommendations for majority of laboratories. 43/44 laboratories participate in the national EQA program. POCT analyzers are installed outside of the laboratory in 20/47 (0.43) institutions. Laboratory staff is responsible for education and training of ward personnel, quality control and instrument maintenance in only 12/22, 11/20 and 9/20 institutions, respectively. Practices related to collection and analysis for blood gases in Croatia are not standardised and vary substantially between laboratories. POCT analyzers are not under the direct supervision by laboratory personnel in a large proportion of surveyed institutions. Collective efforts should be made to harmonize and improve policies and procedures related to blood gas testing in Croatian laboratories.

  3. Content of children's loss of control eating episodes assessed by self-report and laboratory test meal

    PubMed Central

    Theim, Kelly R.; Wilfley, Denise E.; Beach, Elizabeth; Tanofsky-Kraff, Marian; Goldschmidt, Andrea B.

    2014-01-01

    Pediatric loss of control (LOC) eating heightens risk for excessive weight gain and further disordered eating. Assessment of LOC typically involves self-report interview or laboratory test meal, although no study has concurrently examined data from both methods. We gathered eating episode data via interview (Child Eating Disorder Examination; ChEDE) and a laboratory test meal, among 22 overweight girls (aged 7-12 years) reporting LOC eating. Children consumed more energy during ChEDE episodes, although ChEDE and test meal episodes did not differ in macronutrient content. Episodes' correlation for amount consumed (grams) did not reach significance, p=.076. In exploratory analyses among the 7 children reporting LOC during the test meal, episodes were significantly correlated for grams consumed. Findings provide preliminary data to suggest that semi-structured interviews accurately capture children's LOC episode quantity. Episodes did not qualitatively differ, although children reported consuming more energy during self-reported episodes. Replication is warranted in larger studies. PMID:24019221

  4. A bioaccumulation bioassay for freshwater sediments

    USGS Publications Warehouse

    Mac, Michael J.; Noguchi, George E.; Hesselberg, Robert J.; Edsall, Carol C.; Shoesmith, John A.; Bowker, James D.

    1990-01-01

    A laboratory bioassay is described for determining the bioavailability of contaminants from freshwater sediments. The bioassay consists of 10-d exposures to whole sediments under flow-through conditions. After testing five species, the fathead minnow (Pimephales promelas) and the earthworm (Lubricus terrestris) were recommended for use in the test. When the availability of polychlorinated biphenyls (PCBs), Hg and Zn from Great Lakes sediments was examined in laboratory exposures, only the PCBs were accumulated. A field validation study demonstrated that the magnitude of accumulation in laboratory exposures was similar to that in organisms caged in the field. A protocol is recommended for using the test as a standardized bioaccumulation bioassay.

  5. Evaluations of Mechanisms for Pu Uptake and Retention within Spherical Resorcinol-Formaldehyde Resin Columns

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Delegard, Calvin H.; Levitskaia, Tatiana G.; Fiskum, Sandra K.

    The unexpected uptake and retention of plutonium (Pu) onto columns containing spherical resorcinol-formaldehyde (sRF) resin during ion exchange testing of Cs (Cs) removal from alkaline tank waste was observed in experiments at both the Pacific Northwest National Laboratory (PNNL) and the Savannah River National Laboratory (SRNL). These observations have raised concern regarding the criticality safety of the Cs removal unit operation within the low-activity waste pretreatment system (LAWPS). Accordingly, studies have been initiated at Washington River Protection Solutions (WRPS), who manages the operations of the Hanford Site tank farms, including the LAWPS, PNNL, and elsewhere to investigate these findings. Asmore » part of these efforts, PNNL has prepared the present report to summarize the laboratory testing observations, evaluate these phenomena in light of published and unpublished technical information, and outline future laboratory testing, as deemed appropriate based on the literature studies, with the goal to elucidate the mechanisms for the observed Pu uptake and retention.« less

  6. Comparison of Intervertebral ROM in Multi-Level Cadaveric Lumbar Spines Using Distinct Pure Moment Loading Approaches.

    PubMed

    Santoni, Brandon; Cabezas, Andres F; Cook, Daniel J; Yeager, Matthew S; Billys, James B; Whiting, Benjamin; Cheng, Boyle C

    2015-01-01

    Pure-moment loading is the test method of choice for spinal implant evaluation. However, the apparatuses and boundary conditions employed by laboratories in performing spine flexibility testing vary. The purpose of this study was to quantify the differences, if they exist, in intervertebral range of motion (ROM) resulting from different pure-moment loading apparatuses used in two laboratories. Twenty-four (laboratory A) and forty-two (laboratory B) intact L1-S1 specimens were loaded using pure moments (±7.5 Nm) in flexion-extension (FE), lateral bending (LB) and axial torsion (AT). At laboratory A, pure moments were applied using a system of cables, pulleys and suspended weights in 1.5 Nm increments. At laboratory B, specimens were loaded in a pneumatic biaxial test frame mounted with counteracting stepper-motor-driven biaxial gimbals. ROM was obtained in both labs using identical optoelectronic systems and compared. In FE, total L1-L5 ROM was similar, on average, between the two laboratories (lab A: 37.4° ± 9.1°; lab B: 35.0° ± 8.9°, p=0.289). Larger apparent differences, on average, were noted between labs in AT (lab A: 19.4° ± 7.3°; lab B: 15.7° ± 7.1°, p=0.074), and this finding was significant for combined right and left LB (lab A: 45.5° ± 11.4°; lab B: 35.3° ± 8.5°, p < 0.001). To our knowledge, this is the first study comparing ROM of multi-segment lumbar spines between laboratories utilizing different apparatuses. The results of this study show that intervertebral ROM in multi-segment lumbar spine constructs are markedly similar in FE loading. Differences in boundary conditions are likely the source of small and sometimes statistically significant differences between the two techniques in LB and AT ROM. The relative merits of each testing strategy with regard to the physiologic conditions that are to be simulated should be considered in the design of a study including LB and AT modes of loading. An understanding of these differences also serves as important information when comparing study results across different laboratories.

  7. Polygraph lie detection on real events in a laboratory setting.

    PubMed

    Bradley, M T; Cullen, M C

    1993-06-01

    This laboratory study dealt with real-life intense emotional events. Subjects generated embarrassing stories from their experience, then submitted to polygraph testing and, by lying, denied their stories and, by telling the truth, denied a randomly assigned story. Money was given as an incentive to be judged innocent on each story. An interrogator, blind to the stories, used Control Question Tests and found subjects more deceptive when lying than when truthful. Stories interacted with order such that lying on the second story was more easily detected than lying on the first. Embarrassing stories provide an alternative to the use of mock crimes to study lie detection in the laboratory.

  8. Identifying causes of laboratory turnaround time delay in the emergency department.

    PubMed

    Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

    2012-12-01

    Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

  9. Do we really need in-situ bioassays?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Salazar, M.H.; Salazar, S.M.

    1995-12-31

    In-situ bioassays are needed to validate the results from laboratory testing and to understand biological interactions. Standard laboratory protocols provide reproducible test results, and the precision of those tests can be mathematically defined. Significant correlations between toxic substances and levels of response (bioaccumulation and bioeffects) have also been demonstrated with natural field populations and suggest that the laboratory results can accurately predict field responses. An equal number of studies have shown a lack of correlation between laboratory bioassay results and responses of natural field populations. The best way to validate laboratory results is with manipulative field testing; i.e., in-situ bioassaysmore » with caged organisms. Bioaccumulation in transplanted bivalves has probably been the most frequently used form of an in-situ bioassay. The authors have refined those methods to include synoptic measurements of bioaccumulation and growth. Growth provides an easily-measured bioeffects endpoint and a means of calibrating bioaccumulation. Emphasis has been on minimizing the size range of test animals, repetitive measurements of individuals and standardization of test protocols for a variety of applications. They are now attempting to standardize criteria for accepting and interpreting data in the same way that laboratory bioassays have been standardized. Others have developed methods for in-situ bioassays using eggs, larvae, unicellular organisms, crustaceans, benthic invertebrates, bivalves, and fish. In the final analysis, the in-situ approach could be considered as an exposure system where any clinical measurements are possible. The most powerful approach would be to use the same species in laboratory and field experiments with the same endpoints.« less

  10. Computer and laboratory simulation in the teaching of neonatal nursing: innovation and impact on learning 1

    PubMed Central

    Fonseca, Luciana Mara Monti; Aredes, Natália Del' Angelo; Fernandes, Ananda Maria; Batalha, Luís Manuel da Cunha; Apóstolo, Jorge Manuel Amado; Martins, José Carlos Amado; Rodrigues, Manuel Alves

    2016-01-01

    ABSTRACT Objectives: to evaluate the cognitive learning of nursing students in neonatal clinical evaluation from a blended course with the use of computer and laboratory simulation; to compare the cognitive learning of students in a control and experimental group testing the laboratory simulation; and to assess the extracurricular blended course offered on the clinical assessment of preterm infants, according to the students. Method: a quasi-experimental study with 14 Portuguese students, containing pretest, midterm test and post-test. The technologies offered in the course were serious game e-Baby, instructional software of semiology and semiotechnique, and laboratory simulation. Data collection tools developed for this study were used for the course evaluation and characterization of the students. Nonparametric statistics were used: Mann-Whitney and Wilcoxon. Results: the use of validated digital technologies and laboratory simulation demonstrated a statistically significant difference (p = 0.001) in the learning of the participants. The course was evaluated as very satisfactory for them. The laboratory simulation alone did not represent a significant difference in the learning. Conclusions: the cognitive learning of participants increased significantly. The use of technology can be partly responsible for the course success, showing it to be an important teaching tool for innovation and motivation of learning in healthcare. PMID:27737376

  11. Human epidermal growth factor receptor 2 status of breast cancer patients in Asia: Results from a large, multicountry study.

    PubMed

    Pathmanathan, Nirmala; Geng, Jing-Shu; Li, Wencai; Nie, Xiu; Veloso, Januario; Hill, Julie; McCloud, Philip; Bilous, Michael

    2016-12-01

    Current estimates of the human epidermal growth factor receptor 2 (HER2)-positivity rate in breast cancer are largely based on studies from the United States, Europe and Australia, and might not reflect the rate among breast cancer patients in Asia. The primary aim of this study was to conduct a clinical audit of laboratories across eight countries in Asia to determine the incidence of HER2-positive breast cancer in this region. Pathology laboratories submitted data on breast cancers consecutively tested for HER2 over a two-year period. The proportion of HER2-positive, -equivocal and -negative tumors was determined for each country and overall. HER2-positivity rate by age and histological grade was also determined. HER2 results from 30 179 breast cancers were submitted by 96 laboratories. The overall HER2-positivity rate was 23.5%; the rate between countries ranged from 19.7% to 44.2%, and from 4.4% to 51.6% between laboratories. An equivocal HER2 result was recorded in 18.2% of cases. Discrepancies between laboratories suggest that testing expertise contributes to variations seen in HER2 status across laboratories, as well as the generally higher rate of HER2-positivity that was recorded. In this study, the incidence of HER2-positive breast cancer diagnosed in Asian women was higher than published studies on women from Western countries. In addition, the study found that women in Asian countries presented with breast cancer at an earlier age, with a higher histological grade. This study serves to highlight the challenges with HER2 testing and data collection in a large multicenter Asian cohort. © 2016 The Authors. Asia-Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

  12. Comparison of a New and Rapid Method: Brucella Coombs Gel Test With Other Diagnostic Tests.

    PubMed

    Kalem, Fatma; Ergün, Ayşe Gül; Durmaz, Süleyman; Doğan, Metin; Ertuğrul, Ömür; Gündem, Seval

    2016-09-01

    The aim of this study was to detect reliability of Brucella Coombs gel test (BCGT) by comparing with with ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination methods in serological diagnosis of brucellosis. Brucella Coombs gel test (BCGT), Brucella ELISA (IgG + IgM), Standard agglutination test, and Brucella immunocapture agglutination tests of 78 patients with presumptive diagnosis of brucellosis which were sent to Microbiology Laboratory of Konya Numune Hospital from various regions of Konya were studied. Of 78 patients with ELISA IgG and IgM, STA, BICA and BCGT; 26, 21, 10, 12 and 12 were positive. When compared with BICA, the sensitivity and specifity of BCGT were 100% and 100%, respectively. According to results BCGT can be used as a diagnostic test in routine laboratories after more comprehensive studies in control groups and patients. © 2016 Wiley Periodicals, Inc.

  13. The Impact of Inquiry Based Instruction on Science Process Skills and Self-Efficacy Perceptions of Pre-Service Science Teachers at a University Level Biology Laboratory

    ERIC Educational Resources Information Center

    Sen, Ceylan; Sezen Vekli, Gülsah

    2016-01-01

    The aim of this study is to determine the influence of inquiry-based teaching approach on pre-service science teachers' laboratory self-efficacy perceptions and scientific process skills. The quasi experimental model with pre-test-post-test control group design was used as an experimental design in this research. The sample of this study included…

  14. Field and Laboratory Studies for Increasing the Intrinsic Reward Value in Navy Jobs and Careers.

    DTIC Science & Technology

    1975-08-31

    Cabe, P.A. The relation be- tween embedded figures test performance and simulator behavior. Journal of Applied Psychology , 1969, 5_3, 253-254. Blood... Psychology , 1973, 99, 137-139. Moses, J.L. Selecting vigilant types: Predicting vigilance per- formance by means of a field dependence test ...Laboratory Studies for Increasing the Intrinsic Reward Value in Navy Jobs and Careers Gerald V. Barrett Faye H. Dambrot Department of Psychology

  15. Creating and Evaluating a Hypertext System of Documenting Analytical Test Methods in a Chemical Plant Quality Assurance Laboratory.

    ERIC Educational Resources Information Center

    White, Charles E., Jr.

    The purpose of this study was to develop and implement a hypertext documentation system in an industrial laboratory and to evaluate its usefulness by participative observation and a questionnaire. Existing word-processing test method documentation was converted directly into a hypertext format or "hyperdocument." The hyperdocument was designed and…

  16. A Study of the Relative Effectiveness of Content and Process Centered Biology Laboratories for College Freshmen.

    ERIC Educational Resources Information Center

    Murphy, Glenn Wayne

    The relative effectiveness of "content-centered" and "process-centered" biology laboratory courses in a freshman general biology course was investigated by administering the Nelson Biology Test, Science Attitude Scale, EPS II (a problem solving test), and an Interest Inventory at the beginning and end of the one quarter course. Course examination…

  17. Frederick National Laboratory Rallies to Meet Demand for Zika Vaccine | Frederick National Laboratory for Cancer Research

    Cancer.gov

    The Frederick National Laboratory for Cancer Research is producing another round of Zika vaccine for ongoing studies to determine the best delivery method and dosage. This will lay the groundwork for additional tests to see if the vaccine prevents i

  18. Computerised pathology test order entry reduces laboratory turnaround times and influences tests ordered by hospital clinicians: a controlled before and after study

    PubMed Central

    Westbrook, J I; Georgiou, A; Dimos, A; Germanos, T

    2006-01-01

    Objective To assess the impact of a computerised pathology order entry system on laboratory turnaround times and test ordering within a teaching hospital. Methods A controlled before and after study compared test assays ordered from 11 wards two months before (n = 97 851) and after (n = 113 762) the implementation of a computerised pathology order entry system (Cerner Millennium Powerchart). Comparisons were made of laboratory turnaround times, frequency of tests ordered and specimens taken, proportions of patients having tests, average number per patient, and percentage of gentamicin and vancomycin specimens labelled as random. Results Intervention wards experienced an average decrease in turnaround of 15.5 minutes/test assay (range 73.8 to 58.3 minutes; p<0.001). Reductions were significant for prioritised and non‐prioritised tests, and for those done within and outside business hours. There was no significant change in the average number of tests (p = 0.228), or specimens per patient (p = 0.324), and no change in turnaround time for the control ward (p = 0.218). Use of structured order screens enhanced data provided to laboratories. Removing three test assays from the liver function order set resulted in significantly fewer of these tests being done. Conclusions Computerised order entry systems are an important element in achieving faster test results. These systems can influence test ordering patterns through structured order screens, manipulation of order sets, and analysis of real time data to assess the impact of such changes, not possible with paper based systems. The extent to which improvements translate into improved patient outcomes remains to be determined. A potentially limiting factor is clinicians' capacity to respond to, and make use of, faster test results. PMID:16461564

  19. Launching a Laboratory Testing Process Quality Improvement Toolkit: From the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

    PubMed

    Fernald, Douglas; Hamer, Mika; James, Kathy; Tutt, Brandon; West, David

    2015-01-01

    Family medicine and internal medicine physicians order diagnostic laboratory tests for nearly one-third of patient encounters in an average week, yet among medical errors in primary care, an estimated 15% to 54% are attributed to laboratory testing processes. From a practice improvement perspective, we (1) describe the need for laboratory testing process quality improvements from the perspective of primary care practices, and (2) describe the approaches and resources needed to implement laboratory testing process quality improvements in practice. We applied practice observations, process mapping, and interviews with primary care practices in the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)-affiliated practice-based research networks that field-tested in 2013 a laboratory testing process improvement toolkit. From the data collected in each of the 22 participating practices, common testing quality issues included, but were not limited to, 3 main testing process steps: laboratory test preparation, test tracking, and patient notification. Three overarching qualitative themes emerged: practices readily acknowledge multiple laboratory testing process problems; practices know that they need help addressing the issues; and practices face challenges with finding patient-centered solutions compatible with practice priorities and available resources. While practices were able to get started with guidance and a toolkit to improve laboratory testing processes, most did not seem able to achieve their quality improvement aims unassisted. Providing specific guidance tools with practice facilitation or other rapid-cycle quality improvement support may be an effective approach to improve common laboratory testing issues in primary care. © Copyright 2015 by the American Board of Family Medicine.

  20. Agreement between clinical and laboratory methods assessing tonic and cross-link components of accommodation and vergence.

    PubMed

    Neveu, Pascaline; Priot, Anne-Emmanuelle; Philippe, Matthieu; Fuchs, Philippe; Roumes, Corinne

    2015-09-01

    Several tests are available to optometrists for investigating accommodation and vergence. This study sought to investigate the agreement between clinical and laboratory methods and to clarify which components are actually measured when tonic and cross-link of accommodation and vergence are assessed. Tonic vergence, tonic accommodation, accommodative vergence (AC/A) and vergence accommodation (CA/C) were measured using several tests. Clinical tests were compared to the laboratory assessment, the latter being regarded as an absolute reference. The repeatability of each test and the degree of agreement between the tests were quantified using Bland-Altman analysis. The values obtained for each test were found to be stable across repetitions; however, in most cases, significant differences were observed between tests supposed to measure the same oculomotor component. Tonic and cross-link components cannot be easily assessed because proximal and instrumental responses interfere with the assessment. Other components interfere with oculomotor assessment. Specifically, accommodative divergence interferes with tonic vergence estimation and the type of accommodation considered in the AC/A ratio affects its magnitude. Results on clinical tonic accommodation and clinical CA/C show that further investigation is needed to clarify the limitations associated with the use of difference of Gaussian as visual targets to open the accommodative loop. Although different optometric tests of accommodation and vergence rely on the same basic principles, the results of this study indicate that clinical and laboratory methods actually involve distinct components. These differences, which are induced by methodological choices, must be taken into account, when comparing studies or when selecting a test to investigate a particular oculomotor component. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

  1. 40 CFR 270.63 - Permits for land treatment demonstrations using field test or laboratory analyses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... demonstrations using field test or laboratory analyses. 270.63 Section 270.63 Protection of Environment... using field test or laboratory analyses. (a) For the purpose of allowing an owner or operator to meet... the field test or laboratory analyses, or as a two-phase facility permit covering the field tests, or...

  2. 40 CFR 270.63 - Permits for land treatment demonstrations using field test or laboratory analyses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... demonstrations using field test or laboratory analyses. 270.63 Section 270.63 Protection of Environment... using field test or laboratory analyses. (a) For the purpose of allowing an owner or operator to meet... the field test or laboratory analyses, or as a two-phase facility permit covering the field tests, or...

  3. 40 CFR 270.63 - Permits for land treatment demonstrations using field test or laboratory analyses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... demonstrations using field test or laboratory analyses. 270.63 Section 270.63 Protection of Environment... using field test or laboratory analyses. (a) For the purpose of allowing an owner or operator to meet... the field test or laboratory analyses, or as a two-phase facility permit covering the field tests, or...

  4. 40 CFR 270.63 - Permits for land treatment demonstrations using field test or laboratory analyses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... demonstrations using field test or laboratory analyses. 270.63 Section 270.63 Protection of Environment... using field test or laboratory analyses. (a) For the purpose of allowing an owner or operator to meet... the field test or laboratory analyses, or as a two-phase facility permit covering the field tests, or...

  5. 40 CFR 270.63 - Permits for land treatment demonstrations using field test or laboratory analyses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... demonstrations using field test or laboratory analyses. 270.63 Section 270.63 Protection of Environment... using field test or laboratory analyses. (a) For the purpose of allowing an owner or operator to meet... the field test or laboratory analyses, or as a two-phase facility permit covering the field tests, or...

  6. Laboratory or field tests for evaluating firefighters' work capacity?

    PubMed

    Lindberg, Ann-Sofie; Oksa, Juha; Malm, Christer

    2014-01-01

    Muscle strength is important for firefighters work capacity. Laboratory tests used for measurements of muscle strength, however, are complicated, expensive and time consuming. The aims of the present study were to investigate correlations between physical capacity within commonly occurring and physically demanding firefighting work tasks and both laboratory and field tests in full time (N = 8) and part-time (N = 10) male firefighters and civilian men (N = 8) and women (N = 12), and also to give recommendations as to which field tests might be useful for evaluating firefighters' physical work capacity. Laboratory tests of isokinetic maximal (IM) and endurance (IE) muscle power and dynamic balance, field tests including maximal and endurance muscle performance, and simulated firefighting work tasks were performed. Correlations with work capacity were analyzed with Spearman's rank correlation coefficient (rs). The highest significant (p<0.01) correlations with laboratory and field tests were for Cutting: IE trunk extension (rs = 0.72) and maximal hand grip strength (rs = 0.67), for Stairs: IE shoulder flexion (rs = -0.81) and barbell shoulder press (rs = -0.77), for Pulling: IE shoulder extension (rs = -0.82) and bench press (rs = -0.85), for Demolition: IE knee extension (rs = 0.75) and bench press (rs = 0.83), for Rescue: IE shoulder flexion (rs = -0.83) and bench press (rs = -0.82), and for the Terrain work task: IE trunk flexion (rs = -0.58) and upright barbell row (rs = -0.70). In conclusion, field tests may be used instead of laboratory tests. Maximal hand grip strength, bench press, chin ups, dips, upright barbell row, standing broad jump, and barbell shoulder press were strongly correlated (rs≥0.7) with work capacity and are therefore recommended for evaluating firefighters work capacity.

  7. [User's requests (from a practitioner's perspective)].

    PubMed

    Ohnishi, T

    1997-08-01

    As a practitioner, I have to rely on outside clinical laboratories and affiliated hospitals to perform laboratory tests. In this abstract, I describe specific problems I have encountered with third-party laboratories, and propose solutions for these problems to optimize use of laboratory tests. BLOOD TESTS: The most frequent problem in ordering blood tests is the lack of detailed information regarding sampling conditions. I often have to call laboratories to check whether the sample should be serum or plasma, what volume is needed, whether the sample should be cooled, etc. I propose that clinical laboratories should provide practitioners' manuals that describe specific sampling information. Most laboratories do not keep the data from ultrasonographic tests. The lack of these is most problematic when test results are interpreted differently by laboratories and by practitioners. Retaining the data would also help private laboratories improve the quality of the test by enabling them to compare their interpretations with others'. ANNUAL MEDICAL SCREENING: Even if an abnormal finding is detected at medical screening clinics, the final diagnosis is usually not sent back to the screening facilities. This is highly recommended to establish an official system that mediates the feedback to screening centers. MRI: Due to miscommunication between practitioners and radiologists, the test is sometimes performed inappropriately. A thorough consultation should occur before the test to clarify specific goals for each patient. PATHOLOGICAL TESTS: Interpretation of results is often inconsistent among laboratories. Independent clinical laboratories tend to report results without indicating sample problems, while pathology departments at affiliated hospitals tend to emphasize sample problems instead of diagnosis or suggesting ways to improve sample quality. Mutual communication among laboratories would help standardize the quality of pathological tests.

  8. Validating Laboratory Results in Electronic Health Records

    PubMed Central

    Perrotta, Peter L.; Karcher, Donald S.

    2017-01-01

    Context Laboratories must ensure that the test results and pathology reports they transmit to a patient’s electronic health record (EHR) are accurate, complete, and presented in a useable format. Objective To determine the accuracy, completeness, and formatting of laboratory test results and pathology reports transmitted from the laboratory to the EHR. Design Participants from 45 institutions retrospectively reviewed results from 16 different laboratory tests, including clinical and anatomic pathology results, within the EHR used by their providers to view laboratory results. Results were evaluated for accuracy, presence of required elements, and usability. Both normal and abnormal results were reviewed for tests, some of which were performed in-house and others at a reference laboratory. Results Overall accuracy for test results transmitted to the EHR was greater than 99.3% (1052 of 1059). There was lower compliance for completeness of test results, with 69.6% (732 of 1051) of the test results containing all essential reporting elements. Institutions that had fewer than half of their orders entered electronically had lower test result completeness rates. The rate of appropriate formatting of results was 90.9% (98 of 1010). Conclusions The great majority of test results are accurately transmitted from the laboratory to the EHR; however, lower percentages are transmitted completely and in a useable format. Laboratories should verify the accuracy, completeness, and format of test results at the time of test implementation, after test changes, and periodically. PMID:27575266

  9. Performance Tested Method multiple laboratory validation study of ELISA-based assays for the detection of peanuts in food.

    PubMed

    Park, Douglas L; Coates, Scott; Brewer, Vickery A; Garber, Eric A E; Abouzied, Mohamed; Johnson, Kurt; Ritter, Bruce; McKenzie, Deborah

    2005-01-01

    Performance Tested Method multiple laboratory validations for the detection of peanut protein in 4 different food matrixes were conducted under the auspices of the AOAC Research Institute. In this blind study, 3 commercially available ELISA test kits were validated: Neogen Veratox for Peanut, R-Biopharm RIDASCREEN FAST Peanut, and Tepnel BioKits for Peanut Assay. The food matrixes used were breakfast cereal, cookies, ice cream, and milk chocolate spiked at 0 and 5 ppm peanut. Analyses of the samples were conducted by laboratories representing industry and international and U.S governmental agencies. All 3 commercial test kits successfully identified spiked and peanut-free samples. The validation study required 60 analyses on test samples at the target level 5 microg peanut/g food and 60 analyses at a peanut-free level, which was designed to ensure that the lower 95% confidence limit for the sensitivity and specificity would not be <90%. The probability that a test sample contains an allergen given a prevalence rate of 5% and a positive test result using a single test kit analysis with 95% sensitivity and 95% specificity, which was demonstrated for these test kits, would be 50%. When 2 test kits are run simultaneously on all samples, the probability becomes 95%. It is therefore recommended that all field samples be analyzed with at least 2 of the validated kits.

  10. Test set readings predict clinical performance to a limited extent: preliminary findings

    NASA Astrophysics Data System (ADS)

    Soh, BaoLin P.; Lee, Warwick M.; Kench, Peter L.; Reed, Warren M.; McEntee, Mark F.; Brennan, Patrick C.

    2013-03-01

    Aim: To investigate the level of agreement between test sets and actual clinical reading Background: The performance of screen readers in detecting breast cancer is being assessed in some countries by using mammographic test sets. However, previous studies have provided little evidence that performance assessed by test sets strongly correlate to performance in clinical reading. Methods: Five clinicians from BreastScreen New South Wales participated in this study. Each clinician was asked to read 200 de-identified mammographic examinations gathered from their own case history within the BreastScreen NSW Digital Imaging Library. All test sets were designed with specific proportions of true positive, true negative, false positive and false negative examinations from the previous actual clinical reads of each reader. A prior mammogram examination for comparison (when available) was also provided for each case. Results: Preliminary analyses have shown that there is a moderate level of agreement (Kappa 0.42-0.56, p < 0.001) between laboratory test sets and actual clinical reading. In addition, a mean increase of 38% in sensitivity in the laboratory test sets as compared to their actual clinical readings was demonstrated. Specificity is similar between the laboratory test sets and actual clinical reading. Conclusion: This study demonstrated a moderate level of agreement between actual clinical reading and test set reading, which suggests that test sets have a role in reflecting clinical performance.

  11. DESIGN OF A SURFACTANT REMEDIATION FIELD DEMONSTRATION BASED ON LABORATORY AND MODELINE STUDIES

    EPA Science Inventory

    Surfactant-enhanced subsurface remediation is being evaluated as an innovative technology for expediting ground-water remediation. This paper reports on laboratory and modeling studies conducted in preparation for a pilot-scale field test of surfactant-enhanced subsurface remedia...

  12. Ultrasonic weld testing.

    DOT National Transportation Integrated Search

    1970-12-01

    The study was broken down into two phases. Phase I consisted of a laboratory investigation of test specimens to determine the reliability of the ultrasonic equipment and testing procedure. Phase II was a field study where the knowledge, skills and ab...

  13. HOMOLOGOUS MEASURES OF COGNITIVE FUNCTION IN HUMAN INFANTS AND LABORATORY ANIMALS TO IDENTIFY ENVIRONMENTAL HEALTH RISKS TO CHILDREN

    EPA Science Inventory

    The importance of including neurodevelopmental endpoints in environmental studies is clear. A validated measure of cognitive fucntion in human infants that also has a parallel test in laboratory animal studies will provide a valuable approach for largescale studies. Such a ho...

  14. 19 CFR 151.54 - Testing by Customs laboratory.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Testing by Customs laboratory. 151.54 Section 151... Other Metal-Bearing Materials § 151.54 Testing by Customs laboratory. Samples taken in accordance with § 151.52 shall be promptly forwarded to the appropriate Customs laboratory for testing in accordance...

  15. Validation of a Laboratory Method for Evaluating Dynamic Properties of Reconstructed Equine Racetrack Surfaces

    PubMed Central

    Setterbo, Jacob J.; Chau, Anh; Fyhrie, Patricia B.; Hubbard, Mont; Upadhyaya, Shrini K.; Symons, Jennifer E.; Stover, Susan M.

    2012-01-01

    Background Racetrack surface is a risk factor for racehorse injuries and fatalities. Current research indicates that race surface mechanical properties may be influenced by material composition, moisture content, temperature, and maintenance. Race surface mechanical testing in a controlled laboratory setting would allow for objective evaluation of dynamic properties of surface and factors that affect surface behavior. Objective To develop a method for reconstruction of race surfaces in the laboratory and validate the method by comparison with racetrack measurements of dynamic surface properties. Methods Track-testing device (TTD) impact tests were conducted to simulate equine hoof impact on dirt and synthetic race surfaces; tests were performed both in situ (racetrack) and using laboratory reconstructions of harvested surface materials. Clegg Hammer in situ measurements were used to guide surface reconstruction in the laboratory. Dynamic surface properties were compared between in situ and laboratory settings. Relationships between racetrack TTD and Clegg Hammer measurements were analyzed using stepwise multiple linear regression. Results Most dynamic surface property setting differences (racetrack-laboratory) were small relative to surface material type differences (dirt-synthetic). Clegg Hammer measurements were more strongly correlated with TTD measurements on the synthetic surface than the dirt surface. On the dirt surface, Clegg Hammer decelerations were negatively correlated with TTD forces. Conclusions Laboratory reconstruction of racetrack surfaces guided by Clegg Hammer measurements yielded TTD impact measurements similar to in situ values. The negative correlation between TTD and Clegg Hammer measurements confirms the importance of instrument mass when drawing conclusions from testing results. Lighter impact devices may be less appropriate for assessing dynamic surface properties compared to testing equipment designed to simulate hoof impact (TTD). Potential Relevance Dynamic impact properties of race surfaces can be evaluated in a laboratory setting, allowing for further study of factors affecting surface behavior under controlled conditions. PMID:23227183

  16. Utilization of Genetic Testing Prior to Subspecialist Referral for Cerebellar Ataxia

    PubMed Central

    Fogel, Brent L.; Vickrey, Barbara G.; Walton-Wetzel, Jenny; Lieber, Eli

    2013-01-01

    Objective: To evaluate the utilization of laboratory testing in the diagnosis of cerebellar ataxia, including the completeness of initial standard testing for acquired causes, the early use of genetic testing, and associated clinical and nonclinical factors, among a cohort referred for subspecialty consultation. Methods: Data were abstracted from records of 95 consecutive ataxia patients referred to one neurogenetics subspecialist from 2006–2010 and linked to publicly available data on characteristics of referral clinicians. Multivariable logistic and linear regression models were used to analyze unique associations of clinical and nonclinical factors with laboratory investigation of acquired causes and with early genetic testing prior to referral. Results: At referral, 27 of 95 patients lacked evidence of any of 14 laboratory studies suggested for initial work-up of an acquired cause for ataxia (average number of tests=4.5). In contrast, 92% of patients had undergone brain magnetic resonance imaging prior to referral. Overall, 41.1% (n=39) had genetic testing prior to referral; there was no association between family history of ataxia and obtaining genetic testing prior to referral (p=0.39). The level of early genetic testing was 31.6%, primarily due to genetic testing despite an incomplete laboratory evaluation for acquired causes and no family history. A positive family history was consistently associated with less extensive laboratory testing (p=0.004), and referral by a neurologist was associated with higher levels of early genetic testing. Conclusions: Among consecutive referrals to a single center, a substantial proportion of sporadic cases had genetic testing without evidence of a work-up for acquired causes. Better strategies to guide decision making and subspecialty referrals in rare neurologic disorders are needed, given the cost and consequences of genetic testing. PMID:23725007

  17. Bridging naturalistic and laboratory assessment of memory: the Baycrest mask fit test.

    PubMed

    Armson, Michael J; Abdi, Hervé; Levine, Brian

    2017-09-01

    Autobiographical memory tests provide a naturalistic counterpoint to the artificiality of laboratory research methods, yet autobiographical events are uncontrolled and, in most cases, unverifiable. In this study, we capitalised on a scripted, complex naturalistic event - the mask fit test (MFT), a standardised procedure required of hospital employees - to bridge the gap between naturalistic and laboratory memory assessment. We created a test of recognition memory for the MFT and administered it to 135 hospital employees who had undertaken the MFT at various points over the past five years. Multivariate analysis revealed two dimensions defined by accuracy and response bias. Accuracy scores showed the expected relationship to encoding-test delay, supporting the validity of this measure. Relative to younger adults, older adults' memory for this naturalistic event was better than would be predicted from the cognitive ageing literature, a result consistent with the notion that older adults' memory performance is enhanced when stimuli are naturalistic and personally relevant. These results demonstrate that testing recognition memory for a scripted event is a viable method of studying autobiographical memory.

  18. Prediction of practical performance in preclinical laboratory courses – the return of wire bending for admission of dental students in Hamburg

    PubMed Central

    Kothe, Christian; Hissbach, Johanna; Hampe, Wolfgang

    2014-01-01

    Although some recent studies concluded that dexterity is not a reliable predictor of performance in preclinical laboratory courses in dentistry, they could not disprove earlier findings which confirmed the worth of manual dexterity tests in dental admission. We developed a wire bending test (HAM-Man) which was administered during dental freshmen’s first week in 2008, 2009, and 2010. The purpose of our study was to evaluate if the HAM-Man is a useful selection criterion additional to the high school grade point average (GPA) in dental admission. Regression analysis revealed that GPA only accounted for a maximum of 9% of students’ performance in preclinical laboratory courses, in six out of eight models the explained variance was below 2%. The HAM-Man incrementally explained up to 20.5% of preclinical practical performance over GPA. In line with findings from earlier studies the HAM-Man test of manual dexterity showed satisfactory incremental validity. While GPA has a focus on cognitive abilities, the HAM-Man reflects learning of unfamiliar psychomotor skills, spatial relationships, and dental techniques needed in preclinical laboratory courses. The wire bending test HAM-Man is a valuable additional selection instrument for applicants of dental schools. PMID:24872857

  19. Serum Uric Acid Laboratory Test Request Patterns in Primary Care: How Panels May Contribute to Overutilization and Treatment of Asymptomatic Patients.

    PubMed

    Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Leiva-Salinas, Carlos

    2017-12-22

    To study the variability in the request of serum uric acid (SUA) in primary care. A cross-sectional study was designed and conducted at a main core laboratory. Spanish laboratories were invited to report their number of serum glucose (SG) and SUA tests requested from primary care during 2014. A survey was sent to every participant in November 2016 regarding the inclusion of SUA in order profiles/panels. The ratio of SUA/SG requests (SUA/SG) was calculated and compared between regions, and laboratories depending on whether SUA was included or not in a health check profile. 110 laboratories participated in the study (59.8% Spanish population). The median SUA/SG ratio was 0.82 (IQR: 0.25), and 41 laboratories had a ratio over 0.9. There was a significant regional variability (P = .008). Laboratories where SUA was not included in the "health check profile" had lower SUA/SG indicators (P = .003). There was significant regional variability in the request of SUA, and an overall over-request. Different regional customs or habits and the inclusion of SUA in the health check profile were probable causes behind the observed over-request. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Variations in biochemical values for common laboratory tests: a comparison among multi-ethnic Israeli women cohort.

    PubMed

    Birk, Ruth; Heifetz, Eliyahu M

    2018-04-28

    Biochemical laboratory values are an essential tool in medical diagnosis, treatment, and follow-up; however, they are known to vary between populations. Establishment of ethnicity-adjusted reference values is recommended by health organizations. To investigate the ethnicity element in biochemical lab values studying women of different ethnic groups. Biochemical lab values (n = 27) of 503 adult Israeli women of three ethnicities (Jewish Ashkenazi, Jewish Sephardic, and Bedouin Arab) attending a single medical center were analyzed. Biochemical data were extracted from medical center records. Ethnic differences of laboratory biochemicals were studied using ANCOVA to analyze the center of the distribution as well as quartile regression analysis to analyze the upper and lower limits, both done with an adjustment for age. Significant ethnic differences were found in almost half (n = 12) of the biochemical laboratory tests. Ashkenazi Jews exhibited significantly higher mean values compared to Bedouins in most of the biochemical tests, including albumin, alkaline phosphatase, calcium, cholesterol, cholesterol LDL and HDL, cholesterol LDL calc., folic acid, globulin, and iron saturation, while the Bedouins exhibited the highest mean values in the creatinine and triglycerides. For most of these tests, Sephardic Jews exhibited biochemical mean levels in between the two other groups. Compared to Ashkenazi Jews, Sephardic Jews had a significant shift to lower values in cholesterol LDL. Ethnic subpopulations have distinct distributions in biochemical laboratory test values, which should be taken into consideration in medical practice enabling precision medicine.

  1. Creep Laboratory manual

    NASA Astrophysics Data System (ADS)

    Osgerby, S.; Loveday, M. S.

    1992-06-01

    A manual for the NPL Creep Laboratory, a collective name given to two testing laboratories, the Uniaxial Creep Laboratory and the Advanced High Temperature Mechanical Testing Laboratory, is presented. The first laboratory is devoted to uniaxial creep testing and houses approximately 50 high sensitivity creep machines including 10 constant stress cam lever machines. The second laboratory houses a low cycle fatigue testing machine of 100 kN capacity driven by a servo-electric actuator, five machines for uniaxial tensile creep testing of engineering ceramics at temperatures up to 1600C, and an electronic creep machine. Details of the operational procedures for carrying out uniaxial creep testing are given. Calibration procedures to be followed in order to comply with the specifications laid down by British standards, and to provide traceability back to the primary standards are described.

  2. Bottom-up or top-down: unit cost estimation of tuberculosis diagnostic tests in India.

    PubMed

    Rupert, S; Vassall, A; Raizada, N; Khaparde, S D; Boehme, C; Salhotra, V S; Sachdeva, K S; Nair, S A; Hoog, A H Van't

    2017-04-01

    Of 18 sites that participated in an implementation study of the Xpert® MTB/RIF assay in India, we selected five microscopy centres and two reference laboratories. To obtain unit costs of diagnostic tests for tuberculosis (TB) and drug-resistant TB. Laboratories were purposely selected to capture regional variations and different laboratory types. Both bottom-up and the top-down methods were used to estimate unit costs. At the microscopy centres, mean bottom-up unit costs were respectively US$0.83 (range US$0.60-US$1.10) and US$12.29 (US$11.61-US$12.89) for sputum smear microscopy and Xpert. At the reference laboratories, mean unit costs were US$1.69 for the decontamination procedure, US$9.83 for a solid culture, US$11.06 for a liquid culture, US$29.88 for a drug susceptibility test, and US$18.18 for a line-probe assay. Top-down mean unit cost estimates were higher for all tests, and for sputum smear microscopy and Xpert these increased to respectively US$1.51 and US$13.58. The difference between bottom-up and top-down estimates was greatest for tests performed at the reference laboratories. These unit costs for TB diagnostics can be used to estimate resource requirements and cost-effectiveness in India, taking into account geographical location, laboratory type and capacity utilisation.

  3. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    PubMed

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  4. Reducing Missed Laboratory Results: Defining Temporal Responsibility, Generating User Interfaces for Test Process Tracking, and Retrospective Analyses to Identify Problems

    PubMed Central

    Tarkan, Sureyya; Plaisant, Catherine; Shneiderman, Ben; Hettinger, A. Zachary

    2011-01-01

    Researchers have conducted numerous case studies reporting the details on how laboratory test results of patients were missed by the ordering medical providers. Given the importance of timely test results in an outpatient setting, there is limited discussion of electronic versions of test result management tools to help clinicians and medical staff with this complex process. This paper presents three ideas to reduce missed results with a system that facilitates tracking laboratory tests from order to completion as well as during follow-up: (1) define a workflow management model that clarifies responsible agents and associated time frame, (2) generate a user interface for tracking that could eventually be integrated into current electronic health record (EHR) systems, (3) help identify common problems in past orders through retrospective analyses. PMID:22195201

  5. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds †

    PubMed Central

    Frank, Jared A.; Brill, Anthony; Kapila, Vikram

    2016-01-01

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability. PMID:27556464

  6. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds.

    PubMed

    Frank, Jared A; Brill, Anthony; Kapila, Vikram

    2016-08-20

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability.

  7. Performance testing of radiobioassay laboratories: In vivo measurements, Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacLellan, J.A.; Traub, R.J.; Olsen, P.C.

    1990-04-01

    A study of two rounds of in vivo laboratory performance testing was undertaken by Pacific Northwest Laboratory (PNL) to determine the appropriateness of the in vivo performance criteria of draft American National Standards Institute (ANSI) standard ANSI N13.3, Performance Criteria for Bioassay.'' The draft standard provides guidance to in vivo counting facilities regarding the sensitivity, precision, and accuracy of measurements for certain categories of commonly assayed radionuclides and critical regions of the body. This report concludes the testing program by presenting the results of the Round Two testing. Testing involved two types of measurements: chest counting for radionuclide detection inmore » the lung, and whole body counting for detection of uniformly distributed material. Each type of measurement was further divided into radionuclide categories as defined in the draft standard. The appropriateness of the draft standard criteria by measuring a laboratory's ability to attain them were judged by the results of both round One and Round Two testing. The testing determined that performance criteria are set at attainable levels, and the majority of in vivo monitoring facilities passed the criteria when complete results were submitted. 18 refs., 18 figs., 15 tabs.« less

  8. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

    PubMed

    Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

    2017-05-01

    Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. 4. Exterior view of Components Test Laboratory (T27), looking northeast. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Exterior view of Components Test Laboratory (T-27), looking northeast. The building wing on the left houses Test Cell 8 (oxidizer) and the oxidizer storage pit or vault, and that on the right houses Test Cell 10 (environmental). - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  10. 5. Exterior view of Components Test Laboratory (T27), looking northwest. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. Exterior view of Components Test Laboratory (T-27), looking northwest. The building wing on the left houses Test Cell 10 (environmental), and that on the right houses Test Cell 9 (fuel) and the fuel storage pit or vault. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  11. C-B3-03: Development and Pilot Testing of Guidelines to Monitor High-Risk Medications in the Ambulatory Setting

    PubMed Central

    Tjia, Jennifer; Field, Terry; Garber, Lawrence; Raebel, Marsha; Donovan, Jennifer; Kanaan, Abir; Fischer, Shira; Gagne, Shawn; Zhao, Yanfang; Fuller, Jackie; Gurwitz, Jerry

    2010-01-01

    Background: Inadequate laboratory monitoring of high-risk medications contributes to preventable adverse drug events. One barrier to appropriate monitoring is lack of standardized monitoring guidelines. The study aims were to develop guidelines to monitor high-risk medications and to assess the prevalence of laboratory testing for these medications in a multispecialty group practice. Methods: We developed guidelines for laboratory monitoring of high-risk medications as part of a patient safety intervention trial. An advisory committee of national experts and local leaders (clinicians, pharmacists, pharmacoepidemiologists, and patient safety experts) used a two-round, internet-based Delphi process to select guideline medications based on the importance of monitoring for efficacy, safety, and drug-drug interactions. Test frequency recommendations were developed by academic pharmacists based on literature review and local interdisciplinary consensus. To estimate the potential impact of the intervention, we determined the prevalence of high-risk drug dispensings and laboratory testing for guideline medications between January 1, 2008 and July 31, 2008. Results: Consensus on medications to include in the guidelines was achieved in two rounds. Final guidelines included 35 drugs/drug classes and 61 laboratory tests. The prevalence of monitoring ranged from <50% to >90%, with infrequently prescribed drugs having a lower prevalence of recommended testing. When more than one test was recommended for a selected medication, monitoring within a medication sometimes differed by > 50%. Conclusions: Even among drugs where there is general consensus that laboratory monitoring is important, prevalence of monitoring is highly variable. Further, infrequently prescribed medications are at higher risk for poor monitoring.

  12. SOLPOL: A Solar Polarimeter for Hard X-Rays and Gamma-Rays

    NASA Technical Reports Server (NTRS)

    McConnell, Michael L.

    1999-01-01

    Th goal of this project was to continue the development of a hard X-ray polarimeter for studying solar flares. In earlier work (funded by a previous SR&T grant), we had already achieved several goals, including the following: 1) development of a means of producing a polarized radiation source in the lab that could be used for prototype development; 2) demonstrated the basic Compton scatter polarimeter concept using a simple laboratory setup; 3) used the laboratory results to verify our Monte Carlo simulations; and 4) investigated various detector technologies that could be incorporated into the polarimeter design. For the current one-year program, we wanted to fabricate and test a laboratory science model based on our SOLPOL (Solar Polarimeter) design. The long-term goal of this effort is to develop and test a prototype design that could be used to study flare emissions from either a balloon- or space-borne platform. The current program has achieved its goal of fabricating and testing a science model of the SOLPOL design, although additional testing of the design (and detailed comparison with Monte Carlo simulations) is still desired. This one-year program was extended by six months (no-cost extension) to cover the summer of 1999, when undergraduate student support was available to complete some of the laboratory testing.

  13. Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico.

    PubMed

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Hernández-Tinoco, Jesús; Rico-Almochantaf, Yazmin Del Rosario; Cisneros-Camacho, Alfredo; Cisneros-Martínez, Jorge Arturo

    2017-11-18

    Background : The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods : 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii ; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results : The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti- T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti- T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by <15% of participants. Most (84.4%) participants had not performed tests for detection T. gondii infection. Conclusions : Results indicate incomplete knowledge of T. gondii infection and toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed.

  14. Field and laboratory investigation of acid effects on largemouth bass, rock bass, black crappie, and yellow perch

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Eaton, J.G.; Swenson, W.A.; McCormick, J.H.

    1992-01-01

    One-half of Little Rock Lake, a small seepage lake in north-central Wisconsin, was gradually acidified by additions of sulfuric acid between August 1983 and November 1990. The ambient pH (6.1) of the lake was reduced at successive 2-year intervals to pH 5.6, 5.1, and 4.7. Responses of largemouth bass Micropterus salmoides, rock bass Ambloplites rupestris, black crappie Pomoxis nigromaculatus, and yellow perch Perca flavescens populations to the pH reductions were recorded and compared to the responses of these species during in situ bioassays and laboratory toxicity tests on embryos and larvae. Laboratory results obtained for largemouth bass and rock bassmore » underestimated, black crappie results overestimated, and yellow perch results were similar to effects observed in field studies. In situ bioassays predicted field responses better than did laboratory toxicity tests. Laboratory results showed that monomeric Al concentrations of approximately 50 microgram/l, which were comparable to Al concentrations in the acidified half of the lake, altered low-pH toxicity. Reduced recruitment was observed in field populations at higher pH than that at which adult mortality was observed. The results indicate that laboratory toxicity tests with early life stages may not accurately predict field population responses and that results from laboratory tests should be field-validated whenever possible.« less

  15. A novel method to remotely measure food intake of free-living people in real-time

    PubMed Central

    Martin, Corby K.; Han, Hongmei; Coulon, Sandra M.; Allen, H. Raymond; Champagne, Catherine M.; Anton, Stephen D.

    2008-01-01

    The aim of this study was to report the first reliability and validity tests of the Remote Food Photography Method (RFPM), which consists of camera-enabled cell phones with data transfer capability. Participants take and transmit photographs of food selection and plate waste to researchers/clinicians for analysis. Following two pilot studies, adult participants (N=52, 20≤BMI≤35) were randomly assigned to the dine-in or take-out group. Energy intake (EI) was measured for three days. The dine-in group ate lunch and dinner in the laboratory. The take-out group ate lunch in the laboratory and dinner in free-living conditions (participants received a cooler with pre-weighed food that they returned the following morning). Energy intake was measured with the RFPM and by directly weighing foods. The RFPM was tested in laboratory and free-living conditions. Reliability was tested over three days and validity was tested by comparing directly weighed EI to EI estimated with the RFPM using Bland-Altman analysis. The RFPM produced reliable EI estimates over three days in laboratory (r=.62, p<.0001) and free-living (r=.68, p<.0001) conditions. Weighed EI correlated highly with EI estimated with the RFPM in laboratory and free-living conditions (r’s>.93, p<.0001). In two laboratory-based validity tests, the RFPM underestimated EI by -4.7% (p=.046) and -5.5% (p=.076). In free-living conditions, the RFPM underestimated EI by -6.6% (p=.017). Bias did not differ by body weight or age. The RFPM is a promising new method for accurately measuring the EI of free-living people. Error associated with the method is small compared to self-report methods. PMID:18616837

  16. A novel method to remotely measure food intake of free-living individuals in real time: the remote food photography method.

    PubMed

    Martin, Corby K; Han, Hongmei; Coulon, Sandra M; Allen, H Raymond; Champagne, Catherine M; Anton, Stephen D

    2009-02-01

    The aim of the present study was to report the first reliability and validity tests of the remote food photography method (RFPM), which consists of camera-enabled cell phones with data transfer capability. Participants take and transmit photographs of food selection and plate waste to researchers/clinicians for analysis. Following two pilot studies, adult participants (n 52; BMI 20-35 kg/m2 inclusive) were randomly assigned to the dine-in or take-out group. Energy intake (EI) was measured for 3 d. The dine-in group ate lunch and dinner in the laboratory. The take-out group ate lunch in the laboratory and dinner in free-living conditions (participants received a cooler with pre-weighed food that they returned the following morning). EI was measured with the RFPM and by directly weighing foods. The RFPM was tested in laboratory and free-living conditions. Reliability was tested over 3 d and validity was tested by comparing directly weighed EI to EI estimated with the RFPM using Bland-Altman analysis. The RFPM produced reliable EI estimates over 3 d in laboratory (r 0.62; P < 0.0001) and free-living (r 0.68; P < 0.0001) conditions. Weighed EI correlated highly with EI estimated with the RFPM in laboratory and free-living conditions (r>0.93; P < 0.0001). In two laboratory-based validity tests, the RFPM underestimated EI by - 4.7 % (P = 0.046) and - 5.5 % (P = 0.076). In free-living conditions, the RFPM underestimated EI by - 6.6 % (P = 0.017). Bias did not differ by body weight or age. The RFPM is a promising new method for accurately measuring the EI of free-living individuals. Error associated with the method is small compared with self-report methods.

  17. Comparison of a standardized procedure with current laboratory practices for the detection of lupus anticoagulant in France. Working Group on Hemostasis of the Société Française de Biologie Clinique.

    PubMed

    1993-11-15

    A multicenter study involving 13 laboratories was designed to compare a common procedure for screening lupus anticoagulants (LA) to the different practices currently in use in these laboratories. The common procedure combined 3 phospholipid-dependent assays, including mixing studies and a phospholipid neutralizing test. Due to the heterogeneity of LA expression, an abnormal result in at least one of the tests was sufficient to classify a sample as positive for LA. Consecutive samples referred for LA diagnosis were evaluated in parallel by each participant and the data found using the common procedure were analyzed independently according to mutually agreed cut-offs and criteria for sample classification. Within a period of 3 months, 535 samples were included, of which 147 were judged LA positive, 29 undetermined and 359 negative by the respective laboratories using their current practice. When using the common procedure, 149 plasmas were said to be positive, 38 undetermined and 348 negative. Absolute concordance occurred for 81% of the specimen population and absolute discordance (positive versus negative) for 7%. The level of agreement between the common procedure and the current practices, assessed by kappa indexes, indicated noticeable variations in the rates of detection from laboratory to laboratory. Among the different tests used in the common procedure, regular APTT was the least sensitive (about 50% detection) but none of the other tests alone recognized more than 73% of specimens from the LA positive population. This yield increased to about 90% with any combination of 2 sensitive tests.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Diagnostic testing for serious bacterial infections in infants aged 90 days or younger with bronchiolitis.

    PubMed

    Liebelt, E L; Qi, K; Harvey, K

    1999-05-01

    To describe the different laboratory tests that are performed on young infants aged 90 days or younger with bronchiolitis and to identify historical and clinical predictors of infants on whom laboratory tests are performed. Cross-sectional study whereby information was obtained by retrospective review of medical records from November through March 1992 to 1995 of all infants with a clinical diagnosis of bronchiolitis. Urban pediatric emergency department. Two hundred eleven consecutive infants aged 90 days or younger (median age, 54 days) with 216 episodes of bronchiolitis. Historical and clinical data on each infant in addition to laboratory data that included a white blood cell count, urinalysis, and blood, urine, and cerebrospinal fluid cultures. Two or more laboratory tests (not including chest radiographs) were obtained in 48% of all infants and 78% of febrile infants. Of the 91 infants with a history of a temperature of 38.0 degrees C or more or temperature on presentation of 38.0 degrees C or more, white blood cell counts were obtained in 77%, blood cultures in 75%, urinalyses in 53%, urine cultures in 60%, and analyses-cultures of cerebrospinal fluid in 47%. Febrile infants were 10 times more likely to get at least 2 laboratory tests than afebrile infants (P<.01). All 6 studies were done in 42 (58%) of 72 febrile infants compared with 7 (16%) of 43 afebrile infants (P<.001). Multiple logistic regression analysis identified a history of a temperature of 38.0 degrees C or more or temperature on presentation of 38.0 degrees C or more (odds ratio [OR] 10.0; 95% confidence interval [CI], 4.8%-21.0%; P<.001), oxygen saturation less than 92% on presentation (OR, 4.7; 95% CI, 1.9%-12.1%; P<.01), and history of apnea (OR, 0.1; 95% CI, 0.02-0.35; P<.001) as significant clinical predictors of whether laboratory studies were obtained. History of preterm gestation, aged younger than 28 days, previous antibiotic use, and presence of otitis media were not associated with obtainment of laboratory studies. No cases of bacteremia, urinary tract infection, or meningitis were found among all infants with bronchiolitis who had blood, urine, and/or cerebrospinal fluid cultures. There is wide variability in the diagnostic testing of infants aged 90 days or younger with bronchiolitis. The risks of bacteremia, urinary tract infection, and meningitis in infants with bronchiolitis seems to be low. History or a documented temperature of 38.0 degrees C or more; oxygen saturation of less than 92%, and history of apnea were associated with laboratory testing for bacterial infections.

  19. An Integrated Tiered Service Delivery Model (ITSDM) Based on Local CD4 Testing Demands Can Improve Turn-Around Times and Save Costs whilst Ensuring Accessible and Scalable CD4 Services across a National Programme

    PubMed Central

    Glencross, Deborah K.; Coetzee, Lindi M.; Cassim, Naseem

    2014-01-01

    Background The South African National Health Laboratory Service (NHLS) responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART), has demanded extending CD4 services to meet increasing clinical needs. The aim of this study was to review existing services and develop a service-model that integrated laboratory-based and point-of-care testing (POCT), to extend national coverage, improve local turn-around/(TAT) and contain programmatic costs. Methods NHLS Corporate Data Warehouse CD4 data, from 60–70 laboratories and 4756 referring health facilities was reviewed for referral laboratory workload, respective referring facility volumes and related TAT, from 2009–2012. Results An integrated tiered service delivery model (ITSDM) is proposed. Tier-1/POCT delivers CD4 testing at single health-clinics providing ART in hard-to-reach areas (<5 samples/day). Laboratory-based testing is extended with Tier-2/POC-Hubs (processing ≤30–40 CD4 samples/day), consolidating POCT across 8–10 health-clinics with other HIV-related testing and Tier-3/‘community’ laboratories, serving ≤40 health-clinics, processing ≤150 samples/day. Existing Tier-4/‘regional’ laboratories serve ≤100 facilities and process <350 samples/day; Tier-5 are high-volume ‘metro’/centralized laboratories (>350–1500 tests/day, serving ≥200 health-clinics). Tier-6 provides national support for standardisation, harmonization and quality across the organization. Conclusion The ITSDM offers improved local TAT by extending CD4 services into rural/remote areas with new Tier-3 or Tier-2/POC-Hub services installed in existing community laboratories, most with developed infrastructure. The advantage of lower laboratory CD4 costs and use of existing infrastructure enables subsidization of delivery of more expensive POC services, into hard-to-reach districts without reasonable access to a local CD4 laboratory. Full ITSDM implementation across 5 service tiers (as opposed to widespread implementation of POC testing to extend service) can facilitate sustainable ‘full service coverage’ across South Africa, and save>than R125 million in HIV/AIDS programmatic costs. ITSDM hierarchical parental-support also assures laboratory/POC management, equipment maintenance, quality control and on-going training between tiers. PMID:25490718

  20. Laboratory testing under managed care dominance in the USA

    PubMed Central

    Takemura, Y; Beck, J

    2001-01-01

    The uncontrolled escalation of total health care expenditure despite the government's endeavours during the past decades in the USA had led to the rapid infiltration of managed care organisations (MCOs). Traditional hospital based laboratories have been placed in a crucial situation with the advent of the managed care era. A massive reduction of in house testing urged them to develop strategies against financial difficulty. Consolidation and networking, participation in the outreach testing market, and emphasis on point of care/satellite laboratory testing in non-traditional, ambulatory settings are major strategies for the survival of hospital laboratories. Several physicians' office laboratories (POLS) have closed their doors in response both to regulatory restrictions imposed by the Clinical Laboratory Improvement Amendments of 1988 and to managed care infiltration. It seems likely that POLs and hospital laboratories will continue to reduce test volumes, whereas commercial reference laboratories will thrive through contracting with MCOs. In the current climate of managed care dominance in the USA, clinical laboratories are changing their basic operation focus and mission in response to the aggressively changing landscape. Key Words: laboratory testing • managed care organisations • survival strategies PMID:11215291

  1. Choosing the right laboratory: a review of clinical and forensic toxicology services for urine drug testing in pain management.

    PubMed

    Reisfield, Gary M; Goldberger, Bruce A; Bertholf, Roger L

    2015-01-01

    Urine drug testing (UDT) services are provided by a variety of clinical, forensic, and reference/specialty laboratories. These UDT services differ based on the principal activity of the laboratory. Clinical laboratories provide testing primarily focused on medical care (eg, emergency care, inpatients, and outpatient clinics), whereas forensic laboratories perform toxicology tests related to postmortem and criminal investigations, and drug-free workplace programs. Some laboratories now provide UDT specifically designed for monitoring patients on chronic opioid therapy. Accreditation programs for clinical laboratories have existed for nearly half a century, and a federal certification program for drug-testing laboratories was established in the 1980s. Standards of practice for forensic toxicology services other than workplace drug testing have been established in recent years. However, no accreditation program currently exists for UDT in pain management, and this review considers several aspects of laboratory accreditation and certification relevant to toxicology services, with the intention to provide guidance to clinicians in their selection of the appropriate laboratory for UDT surveillance of their patients on opioid therapy.

  2. Force instrumentation for cryogenic wind tunnels using one-piece strain-gage balances

    NASA Technical Reports Server (NTRS)

    Ferris, A. T.

    1980-01-01

    The use of cryogenic temperatures in wind tunnels to achieve high Reynolds numbers has imposed a harsh operating environment on the force balance. Laboratory tests were conducted to study the effect cryogenic temperatures have on balance materials, gages, wiring, solder, adhesives, and moisture proofing. Wind tunnel tests were conducted using a one piece three component balance to verify laboratory results. These initial studies indicate that satisfactory force data can be obtained under steady state conditions.

  3. Fecal Calprotectin Test Performed at Home: A Prospective Study of Pediatric Patients With Inflammatory Bowel Disease.

    PubMed

    Piekkala, Maija; Alfthan, Henrik; Merras-Salmio, Laura; Puustinen Wikström, Anne; Heiskanen, Kaarina; Jaakkola, Tytti; Klemetti, Paula; Md, Martti Färkkilä; Kolho, Kaija-Leena

    2018-06-01

    Measuring fecal calprotectin (FC) in a laboratory is time-consuming and that is why home tests have been developed. We studied the use of an FC home test in pediatric patients with inflammatory bowel disease (PIBD) in real-life settings. The patients were asked to perform the IBDoc FC home test monthly for 6 months and to report their clinical disease activity at testing. Clinical decision-making, however, was guided by routine FC enzyme-linked immunosorbent assay (ELISA) for patients with raised IBDoc values. Spare frozen samples were analyzed using ELISA and IBDoc in the laboratory. The participants completed a questionnaire about FC testing at the start and end of the study. Of the 52 patients, 35 (67%) ages 5 to 18 years completed the study, and 197 home tests were performed. Of these, 15% failed, mainly because of technical reasons. Just under half of the patients (47%) considered home testing comparable or superior to routine testing. In contrast, the parents were unsatisfied (61%), mostly because the IBDoc results were significantly different from ELISA and they found the phone application difficult to handle but whenever the IBDoc was performed by a laboratory professional it was comparable with ELISA, suggesting that practical issues hampered home testing. Despite their reservations, more than 80% of parents felt that home testing would improve disease management. PIBD patients and their families were interested in FC home monitoring and willing to adopt testing as a part of their disease management, but this approach requires thorough guidance.

  4. Correlation between mechanical and chemical degradation after outdoor and accelerated laboratory aging for multilayer photovoltaic backsheets

    NASA Astrophysics Data System (ADS)

    Lin, Chiao-Chi; Lyu, Yadong; Yu, Li-Chieh; Gu, Xiaohong

    2016-09-01

    Channel cracking fragmentation testing and attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy were utilized to study mechanical and chemical degradation of a multilayered backsheet after outdoor and accelerated laboratory aging. A model sample of commercial PPE backsheet, namely polyethylene terephthalate/polyethylene terephthalate/ethylene vinyl acetate (PET/PET/EVA) was investigated. Outdoor aging was performed in Gaithersburg, Maryland, USA for up to 510 days, and complementary accelerated laboratory aging was conducted on the NIST (National Institute of Standards and Technology) SPHERE (Simulated Photodegradation via High Energy Radiant Exposure). Fracture energy, mode I stress intensity factor and film strength were analyzed using an analytical model based on channel cracking fragmentation testing results. The correlation between mechanical and chemical degradation was discussed for both outdoor and accelerated laboratory aging. The results of this work provide preliminary understanding on failure mechanism of backsheets after weathering, laying the groundwork for linking outdoor and indoor accelerated laboratory testing for multilayer photovoltaic backsheets.

  5. Evaluation of FEM engineering parameters from insitu tests

    DOT National Transportation Integrated Search

    2001-12-01

    The study looked critically at insitu test methods (SPT, CPT, DMT, and PMT) as a means for developing finite element constitutive model input parameters. The first phase of the study examined insitu test derived parameters with laboratory triaxial te...

  6. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

  7. 42 CFR 414.506 - Procedures for public consultation for payment for a new clinical diagnostic laboratory test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... a new clinical diagnostic laboratory test. 414.506 Section 414.506 Public Health CENTERS FOR... FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for New Clinical Diagnostic Laboratory Tests § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test...

  8. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  9. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  10. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  11. 7 CFR 91.37 - Standard hourly fee rate for laboratory testing, analysis, and other services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Standard hourly fee rate for laboratory testing... AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Fees and Charges § 91.37 Standard hourly fee rate for laboratory testing, analysis, and other services. (a) The...

  12. Using Interorganizational Partnerships to Strengthen Public Health Laboratory Systems

    PubMed Central

    Kimsey, Paul; Buehring, Gertrude

    2013-01-01

    Due to the current economic environment, many local and state health departments are faced with budget reductions. Health department administrators and public health laboratory (PHL) directors need to assess strategies to ensure that their PHLs can provide the same level of service with decreased funds. Exploratory case studies of interorganizational partnerships among local PHLs in California were conducted to determine the impact on local PHL testing services and capacity. Our findings suggest that interorganizational forms of cooperation among local PHLs can help bolster laboratory capacity by capturing economies of scale, leveraging scarce resources, and ensuring access to affordable, timely, and quality laboratory testing services. Interorganizational partnerships will help local and state public health departments continue to maintain a strong and robust laboratory system that supports their role in communicable disease surveillance. PMID:23997305

  13. Doubling immunochemistry laboratory testing efficiency with the cobas e 801 module while maintaining consistency in analytical performance.

    PubMed

    Findeisen, P; Zahn, I; Fiedler, G M; Leichtle, A B; Wang, S; Soria, G; Johnson, P; Henzell, J; Hegel, J K; Bendavid, C; Collet, N; McGovern, M; Klopprogge, K

    2018-06-04

    The new immunochemistry cobas e 801 module (Roche Diagnostics) was developed to meet increasing demands on routine laboratories to further improve testing efficiency, while maintaining high quality and reliable data. During a non-interventional multicenter evaluation study, the overall performance, functionality and reliability of the new module was investigated under routine-like conditions. It was tested as a dedicated immunochemistry system at four sites and as a consolidator combined with clinical chemistry at three sites. We report on testing efficiency and analytical performance of the new module. Evaluation of sample workloads with site-specific routine request patterns demonstrated increased speed and almost doubled throughput (maximal 300 tests per h), thus revealing that one cobas e 801 module can replace two cobas e 602 modules while saving up to 44% floor space. Result stability was demonstrated by QC analysis per assay throughout the study. Precision testing over 21 days yielded excellent results within and between labs, and, method comparison performed versus the cobas e 602 module routine results showed high consistency of results for all assays under study. In a practicability assessment related to performance and handling, 99% of graded features met (44%) or even exceeded (55%) laboratory expectations, with enhanced reagent management and loading during operation being highlighted. By nearly doubling immunochemistry testing efficiency on the same footprint as a cobas e 602 module, the new module has a great potential to further consolidate and enhance laboratory testing while maintaining high quality analytical performance with Roche platforms. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study.

    PubMed

    Halligan, E; Edgeworth, J; Bisnauthsing, K; Bible, J; Cliff, P; Aarons, E; Klein, J; Patel, A; Goldenberg, S

    2014-08-01

    Laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. Tests are often requested sequentially and undertaken in different laboratories. This causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. A molecular multiplex test (Luminex(®) Gastrointestinal Pathogen Panel (GPP)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use of isolation facilities and user acceptability. A total of 262 (12%) patients had a pathogen detected by conventional methods compared with 483 (22.1%) by GPP. Most additional cases were detected in patients developing symptoms in the first 4 days of admission. Additional cases were detected because of presumed improved diagnostic sensitivity but also because clinicians had not requested the correct pathogen. Turnaround time (41.8 h) was faster than bacterial culture (66.5 h) and parasite investigation (66.5 h) but slower than conventional testing for Clostridium difficile (17.3 h) and viruses (27 h). The test could allow simplified requesting by clinicians and a consolidated laboratory workflow, reducing the overall number of specimens received by the laboratory. A total of 154 isolation days were saved at an estimated cost of £30 800. Consumables and labour were estimated at £150 641 compared with £63 431 for conventional testing. Multiplex molecular testing using a panel of targets allowed enhanced detection and a consolidated laboratory workflow. This is likely to be of greater benefit to cases that present within the first 4 days of hospital admission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  15. External quality assessment for CD4 + T-lymphocyte count test

    PubMed Central

    Gaspar, Pâmela Cristina; Wohlke, Bruna Lovizutto Protti; Brunialti, Milena Karina Coló; Pires, Ana Flávia; Kohiyama, Igor Massaki; Salomão, Reinaldo; Alonso Neto, José Boullosa; Júnior, Orlando da Costa Ferreira; Franchini, Miriam; Bazzo, Maria Luiza; Benzaken, Adele Schwartz

    2018-01-01

    Abstract The National Network for CD4+ T-lymphocyte counting of Brazil comprises 93 laboratories. This study reports the laboratory performances achieved in external quality assessment (EQA) rounds provides by Ministry of Health to evaluate the quality of the kits used and the performance of test by the technicians. Ten EQA rounds were analyzed according the EQA criteria aimed to evaluate individual laboratory performance on the basis of the accuracy of their results compared to the general mean obtained by all participating laboratories and the reproducibility of the results obtained between 2 samples from the same donor. The percentage of approved and failed laboratories in the EQAs tends to follow a uniform pattern. Since 2011, approval has remained above 80% and the failure rate has never exceeded 15%. EQA is very important to evaluate the performance of the laboratories, to identify monitor, and to resolve errors as quickly as possible. PMID:29794603

  16. Sensitivity, specificity, and reproducibility of four measures of laboratory turnaround time.

    PubMed

    Valenstein, P N; Emancipator, K

    1989-04-01

    The authors studied the performance of four measures of laboratory turnaround time: the mean, median, 90th percentile, and proportion of tests reported within a predetermined cut-off interval (proportion of acceptable tests [PAT]). Measures were examined with the use of turnaround time data from 11,070 stat partial thromboplastin times, 16,761 urine cultures, and 28,055 stat electrolyte panels performed by a single laboratory. For laboratories with long turnaround times, the most important quality of a turnaround time measure is high reproducibility, so that improvement in reporting speed can be distinguished from random variation resulting from sampling. The mean was found to be the most reproducible of the four measures, followed by the median. The mean achieved acceptable precision with sample sizes of 100-500 tests. For laboratories with normally rapid turnaround times, the most important quality of a measure is high sensitivity and specificity for detecting whether turnaround time has dropped below standards. The PAT was found to be the best measure of turnaround time in this setting but required sample sizes of at least 500 tests to achieve acceptable accuracy. Laboratory turnaround time may be measured for different reasons. The method of measurement should be chosen with an eye toward its intended application.

  17. 21 CFR 226.58 - Laboratory controls.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Laboratory controls. Laboratory controls shall include the establishment of adequate specifications and test... establishment of master records containing appropriate specifications and a description of the test procedures... necessary laboratory test procedures to check such specifications. (c) Assays which shall be made of...

  18. Use of laboratory testing for genital chlamydial infection in Norway.

    PubMed Central

    Aavitsland, P

    1993-01-01

    OBJECTIVE--To assess the use of laboratory tests for genital chlamydial infection in Norway. DESIGN--Questionnaire survey of general practitioners' practice in chlamydial testing, retrospective survey of laboratory records, 1986-91, and prospective study of testing in one laboratory during four weeks. SETTING--All 18 microbiological laboratories in Norway (4.2 million population), including one serving all doctors in Vestfold county (0.2 million population). SUBJECTS--302 general practitioners. MAIN MEASURES--GPs' routine practice, methods used for testing, 1986-91, and sex specific and age group specific testing in 1991. RESULTS--201(69%) GPs replied to the questionnaire: 101(51%) would test all women younger than 25 years at routine pelvic examination, 107(54%) all girls at first pelvic examination, 131(66%) all pregnant women, and 106(54%) all men whose female partner had urogenital complaints. Nationwide in 1986, 122,000 tests were performed (2.9 per 100 population); 10% were positive and 51% were cell culture tests. In 1991, 341,000 tests were performed (8.0 per 100 population); 4.5% were positive and 15% were cell culture tests. 13,184 tests were performed in Vestfold in 1991 (6.6 per 100 population). The age group specific rates (per 100 population) among women were: age 15-19 years, 22.0(95% confidence interval 18.2 to 25.8); 20-24 years, 47.2(42.1 to 52.3); 25-29 years, 42.3(37.1 to 47.5); 30-34 years, 29.8(25.4 to 34.2); and 35-39 years, 12.5(9.5 to 15.5). CONCLUSIONS--GPs use liberal indications for testing. The dramatic increase in testing, especially by enzyme immunoassays, in populations with a low prevalence of infection results in low cost effectiveness and low predictive value of positive tests, which in women over 29 years is estimated as 17-36%. IMPLICATIONS--Doctors should be educated about the limitations of enzyme immunoassays in screening low prevalence populations, and laboratories should apply a confirmatory test to specimens testing positive with such assays. PMID:10131639

  19. Cost analysis in the toxicology laboratory.

    PubMed

    Travers, E M

    1990-09-01

    The process of determining laboratory sectional and departmental costs and test costs for instrument-generated and manually generated reportable results for toxicology laboratories has been outlined in this article. It is hoped that the basic principles outlined in the preceding text will clarify and elucidate one of the most important areas needed for laboratory fiscal integrity and its survival in these difficult times for health care providers. The following general principles derived from this article are helpful aids for managers of toxicology laboratories. 1. To manage a cost-effective, efficient toxicology laboratory, several factors must be considered: the laboratory's instrument configuration, test turnaround time needs, the test menu offered, the analytic methods used, the cost of labor based on time expended and the experience and educational level of the staff, and logistics that determine specimen delivery time and costs. 2. There is a wide variation in costs for toxicologic methods, which requires that an analysis of capital (equipment) purchase and operational (test performance) costs be performed to avoid waste, purchase wisely, and determine which tests consume the majority of the laboratory's resources. 3. Toxicologic analysis is composed of many complex steps. Each step must be individually cost-accounted. Screening test results must be confirmed, and the cost for both steps must be included in the cost per reportable result. 4. Total costs will vary in the same laboratory and between laboratories based on differences in salaries paid to technical staff, differences in reagent/supply costs, the number of technical staff needed to operate the analyzer or perform the method, and the inefficient use of highly paid staff to operate the analyzer or perform the method. 5. Since direct test costs vary directly with the type and number of analyzers or methods and are dependent on the operational mode designed by the manufacturer, laboratory managers should construct an actual test-cost data base for instrument or method in use to accurately compare costs using the "bottom-up" approach. 6. Laboratory expenses can be examined from three perspectives: total laboratory, laboratory section, and subsection workstation. The objective is to track all laboratory expenses through each of these levels. 7. In the final analysis, a portion of total laboratory expenses must be allocated to each unit of laboratory output--the billable procedure or, in laboratories where tests are not billed, the tests produced.(ABSTRACT TRUNCATED AT 400 WORDS)

  20. Some new tests at the Gottingen laboratory

    NASA Technical Reports Server (NTRS)

    1921-01-01

    The tests at the Gottingen laboratory included: friction tests on a surface treated with omelette, verification tests on the M.V.A. 356 wing, and comparative tests of wing no. 36 at the Eiffel laboratory. The examination of all these experiments leads to the belief that, at large incidences, the speeds registered by the suction manometer of the testing chamber of the Eiffel laboratory wind tunnel are, owing to pressure drop, greater than the actual speeds. Therefore, the values of k(sub x) and k(sub y) measured at the Eiffel laboratory at large incidences are too low.

  1. Evaluating Laboratory Performance on Point-of-Care Glucose Testing with Six Sigma Metric for 151 Institutions in China.

    PubMed

    Fei, Yang; Wang, Wei; He, Falin; Zhong, Kun; Wang, Zhiguo

    2015-10-01

    The aim of this study was to use Six Sigma(SM) (Motorola Trademark Holdings, Libertyville, IL) techniques to analyze the quality of point-of-care (POC) glucose testing measurements quantitatively and to provide suggestions for improvement. In total, 151 laboratories in China were included in this investigation in 2014. Bias and coefficient of variation were collected from an external quality assessment and an internal quality control program, respectively, for POC glucose testing organized by the National Center for Clinical Laboratories. The σ values and the Quality Goal Index were used to evaluate the performance of POC glucose meters. There were 27, 30, 57, and 37 participants in the groups using Optium Xceed™ (Abbott Diabetes Care, Alameda, CA), Accu-Chek(®) Performa (Roche, Basel, Switzerland), One Touch Ultra(®) (Abbott), and "other" meters, respectively. The median of the absolute value of percentage difference varied among different lots and different groups. Among all the groups, the Abbott One Touch Ultra group had the smallest median of absolute value of percentage difference except for lot 201411, whereas the "other" group had the largest median in all five lots. More than 85% of participate laboratories satisfied the total allowable error (TEa) requirement in International Organization for Standardization standard 15197:2013, and 85.43% (129/151) of laboratories obtained intralaboratory coefficient of variations less than 1/3TEa. However, Six Sigma techniques suggested that 41.72% (63/151) to 65.56% (99/151) of the laboratories needed to improve their POC glucose testing performance, in either precision, trueness, or both. Laboratories should pay more attention on the practice of POC glucose testing and take actions to improve their performance. Only in this way can POC glucose testing really function well in clinical practice.

  2. Biological false-positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis - a case-control study.

    PubMed

    Zheng, S; Lin, R J; Chan, Y H; Ngan, C C L

    2018-03-01

    There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL) test from cerebrospinal fluid (CSF) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive. In this study, we compared the clinical and laboratory characteristics of true-positive VDRL-CSF cases with biological false-positive VDRL-CSF cases. We retrospectively identified cases of true and false-positive VDRL-CSF across a 3-year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false-positive VDRL-CSF is defined as a reactive VDRL-CSF with a non-reactive Treponema pallidum particle agglutination (TPPA)-CSF and/or negative Line Immuno Assay (LIA)-CSF IgG. A true-positive VDRL-CSF is a reactive VDRL-CSF with a concordant reactive TPPA-CSF and/or positive LIA-CSF IgG. During the study period, a total of 1254 specimens underwent VDRL-CSF examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL-CSF. Of the 53 patients, 42 (79.2%) were true-positive cases and 11 (20.8%) were false-positive cases. In our setting, a positive non-treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true-positive VDRL-CSF based on our laboratory definition. HIV seropositivity was an independent predictor of a true-positive VDRL-CSF. Biological false-positive VDRL-CSF is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF evaluation for neurosyphilis. © 2017 European Academy of Dermatology and Venereology.

  3. Heparin-induced thrombocytopenia: reducing misdiagnosis via collaboration between an inpatient anticoagulation pharmacy service and hospital reference laboratory.

    PubMed

    Burnett, Allison E; Bowles, Harmony; Borrego, Matthew E; Montoya, Tiffany N; Garcia, David A; Mahan, Charles

    2016-11-01

    Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of lab results. Utilizing retrospective chart review and a database for all patients with a HIT Ab ordered during the study period, we compared the incidence of HIT Ab testing before and after implementation of the pharmacy-driven 4T score intervention. Our intervention significantly reduced the number of inappropriate HIT Ab tests processed (176 vs. 63, p < 0.0001), with no increase in thrombotic or hemorrhagic events. Overall incidence of suspected and confirmed HIT was <3 and <0.005 %, respectively. Overall cost savings were $75,754 (US) or 62 % per patient exposed to heparin between the pre and post intervention groups. Collaboration between inpatient pharmacy AMS and hospital reference laboratories can result in reduction of misdiagnosis of HIT and significant cost savings with similar safety.

  4. The testing effect for mediator final test cues and related final test cues in online and laboratory experiments.

    PubMed

    Coppens, Leonora C; Verkoeijen, Peter P J L; Bouwmeester, Samantha; Rikers, Remy M J P

    2016-05-31

    The testing effect is the finding that information that is retrieved during learning is more often correctly retrieved on a final test than information that is restudied. According to the semantic mediator hypothesis the testing effect arises because retrieval practice of cue-target pairs (mother-child) activates semantically related mediators (father) more than restudying. Hence, the mediator-target (father-child) association should be stronger for retrieved than restudied pairs. Indeed, Carpenter (2011) found a larger testing effect when participants received mediators (father) than when they received target-related words (birth) as final test cues. The present study started as an attempt to test an alternative account of Carpenter's results. However, it turned into a series of conceptual (Experiment 1) and direct (Experiment 2 and 3) replications conducted with online samples. The results of these online replications were compared with those of similar existing laboratory experiments through small-scale meta-analyses. The results showed that (1) the magnitude of the raw mediator testing effect advantage is comparable for online and laboratory experiments, (2) in both online and laboratory experiments the magnitude of the raw mediator testing effect advantage is smaller than in Carpenter's original experiment, and (3) the testing effect for related cues varies considerably between online experiments. The variability in the testing effect for related cues in online experiments could point toward moderators of the related cue short-term testing effect. The raw mediator testing effect advantage is smaller than in Carpenter's original experiment.

  5. Inter-laboratory exercise on antibiotic drugs analysis in aqueous samples.

    PubMed

    Roig, B; Brogat, M; Mompelat, S; Leveque, J; Cadiere, A; Thomas, O

    2012-08-30

    An inter-laboratory exercise was organized under the PHARMAS EU project, by the Advanced School of Public Health (EHESP), in order to evaluate the performances of analytical methods for the measurement of antibiotics in waters (surface and tap). This is the first time such an exercise on antibiotics has been organized in Europe, using different kinds of analytical methods and devices. In this exercise thirteen laboratories from five countries (Canada, France, Italy, the Netherlands and Portugal) participated, and a total number of 78 samples were distributed. During the exercise, 2 testing samples (3 bottles of each) prepared from tap water and river water, respectively, spiked with antibiotics, were sent to participants and analyzed over a period of one month. A final number of 77 (98.7%) testing samples were considered. Depending on substances studied by each participant, 305 values in duplicate were collected, with the results for each sample being expressed as the target concentration. A statistical study was initiated using 611 results. The mean value, standard deviation, coefficient of variation, standard uncertainty of the mean, median, the minimum and maximum values of each series as well as the 95% confidence interval were obtained from each participant laboratory. In this exercise, 36 results (6% of accounted values) were outliers according to the distribution over the median (box plot). The outlier results were excluded. In order to establish the stability of testing samples in the course of the exercise, differences between variances obtained for every type of sample at different intervals were evaluated. The results showed no representative variations and it can be considered that all samples were stable during the exercise. The goals of this inter-laboratory study were to assess results variability when analysis is conducted by different laboratories, to evaluate the influence of different matrix samples, and to determine the rate at which participating laboratories successfully completed the tests initiated. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Laboratory compliance with the American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 testing guidelines: a 3-year comparison of validation procedures.

    PubMed

    Dyhdalo, Kathryn S; Fitzgibbons, Patrick L; Goldsmith, Jeffery D; Souers, Rhona J; Nakhleh, Raouf E

    2014-07-01

    The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) published guidelines in 2007 regarding testing accuracy, interpretation, and reporting of results for HER2 studies. A 2008 survey identified areas needing improved compliance. To reassess laboratory response to those guidelines following a full accreditation cycle for an updated snapshot of laboratory practices regarding ASCO/CAP guidelines. In 2011, a survey was distributed with the HER2 immunohistochemistry (IHC) proficiency testing program identical to the 2008 survey. Of the 1150 surveys sent, 977 (85.0%) were returned, comparable to the original survey response in 2008 (757 of 907; 83.5%). New participants submitted 124 of 977 (12.7%) surveys. The median laboratory accession rate was 14,788 cases with 211 HER2 tests performed annually. Testing was validated with fluorescence in situ hybridization in 49.1% (443 of 902) of the laboratories; 26.3% (224 of 853) of the laboratories used another IHC assay. The median number of cases to validate fluorescence in situ hybridization (n = 40) and IHC (n = 27) was similar to those in 2008. Ninety-five percent concordance with fluorescence in situ hybridization was achieved by 76.5% (254 of 332) of laboratories for IHC(-) findings and 70.4% (233 of 331) for IHC(+) cases. Ninety-five percent concordance with another IHC assay was achieved by 71.1% (118 of 168) of the laboratories for negative findings and 69.6% (112 of 161) of the laboratories for positive cases. The proportion of laboratories interpreting HER2 IHC using ASCO/CAP guidelines (86.6% [798 of 921] in 2011; 83.8% [605 of 722] in 2008) remains similar. Although fixation time improvements have been made, assay validation deficiencies still exist. The results of this survey were shared within the CAP, including the Laboratory Accreditation Program and the ASCO/CAP panel revising the HER2 guidelines published in October 2013. The Laboratory Accreditation Program checklist was changed to strengthen HER2 validation practices.

  7. How Well Does Physician Selection of Microbiologic Tests Identify Clostridium difficile and other Pathogens in Paediatric Diarrhoea? Insights Using Multiplex PCR-Based Detection

    PubMed Central

    Stockmann, Chris; Rogatcheva, Margarita; Harrel, Brian; Vaughn, Mike; Crisp, Rob; Poritz, Mark; Thatcher, Stephanie; Korgenski, Ernest K; Barney, Trenda; Daly, Judy; Pavia, Andrew T

    2014-01-01

    The objective of this study was to compare the aetiologic yield of standard of care microbiologic testing ordered by physicians with that of a multiplex PCR platform. Stool specimens obtained from children and young adults with gastrointestinal illness were evaluated by standard laboratory methods and a developmental version of the FilmArray Gastrointestinal Diagnostic System (FilmArray GI Panel), a rapid multiplex PCR platform that detects 23 bacterial, viral, and protozoal agents. Results were classified according to the microbiologic tests requested by the treating physician. A median of 3 (range 1-10) microbiologic tests were performed by the clinical laboratory during 378 unique diarrhoeal episodes. A potential aetiologic agent was identified in 46% of stool specimens by standard laboratory methods and in 65% of specimens tested using the FilmArray GI Panel (P<0.001). For those patients who only had Clostridium difficile testing requested, an alternative pathogen was identified in 29% of cases with the FilmArray GI Panel. Notably, 11 (12%) cases of norovirus were identified among children who only had testing for C. difficile ordered. Among those who had C. difficile testing ordered in combination with other tests, an additional pathogen was identified in 57% of stool specimens with the FilmArray GI Panel. For patients who had no C. difficile testing performed, the FilmArray GI Panel identified a pathogen in 63% of cases, including C. difficile in 8%. Physician-specified laboratory testing may miss important diarrhoeal pathogens. Additionally, standard laboratory testing is likely to underestimate co-infections with multiple infectious diarrhoeagenic agents. PMID:25599941

  8. Ecological Validity of the Testing Effect: The Use of Daily Quizzes in Introductory Psychology

    ERIC Educational Resources Information Center

    Batsell, W. Robert, Jr.; Perry, Jennifer L.; Hanley, Elizabeth; Hostetter, Autumn B.

    2017-01-01

    The testing effect is the enhanced retention of learned information by individuals who have studied and completed a test over the material relative to individuals who have only studied the material. Although numerous laboratory studies and simulated classroom studies have provided evidence of the testing effect, data from a natural class setting…

  9. Catch-up validation study of an in vitro skin irritation test method based on an open source reconstructed epidermis (phase II).

    PubMed

    Groeber, F; Schober, L; Schmid, F F; Traube, A; Kolbus-Hernandez, S; Daton, K; Hoffmann, S; Petersohn, D; Schäfer-Korting, M; Walles, H; Mewes, K R

    2016-10-01

    To replace the Draize skin irritation assay (OECD guideline 404) several test methods based on reconstructed human epidermis (RHE) have been developed and were adopted in the OECD test guideline 439. However, all validated test methods in the guideline are linked to RHE provided by only three companies. Thus, the availability of these test models is dependent on the commercial interest of the producer. To overcome this limitation and thus to increase the accessibility of in vitro skin irritation testing, an open source reconstructed epidermis (OS-REp) was introduced. To demonstrate the capacity of the OS-REp in regulatory risk assessment, a catch-up validation study was performed. The participating laboratories used in-house generated OS-REp to assess the set of 20 reference substances according to the performance standards amending the OECD test guideline 439. Testing was performed under blinded conditions. The within-laboratory reproducibility of 87% and the inter-laboratory reproducibility of 85% prove a high reliability of irritancy testing using the OS-REp protocol. In addition, the prediction capacity was with an accuracy of 80% comparable to previous published RHE based test protocols. Taken together the results indicate that the OS-REp test method can be used as a standalone alternative skin irritation test replacing the OECD test guideline 404. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. 21 CFR 58.31 - Testing facility management.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Testing facility management. 58.31 Section 58.31... management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...

  11. 40 CFR 160.31 - Testing facility management.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Testing facility management. 160.31... GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.31 Testing facility management. For each study, testing facility management shall: (a) Designate a study director as described in § 160.33...

  12. Toxicity and bioaccumulation of sediment-associated contaminants using freshwater invertebrates: A review of methods and applications

    USGS Publications Warehouse

    Ingersoll, C.G.; Ankley, G.T.; Benoit, D.A.; Brunson, E.L.; Burton, G.A.; Dwyer, F.J.; Hoke, R.A.; Landrum, P.F.; Norberg-King, T. J.; Winger, P.V.

    1995-01-01

    This paper reviews recent developments in methods for evaluating the toxicity and bioaccumulation of contaminants associated with freshwater sediments and summarizes example case studies demonstrating the application of these methods. Over the past decade, research has emphasized development of more specific testing procedures for conducting 10-d toxicity tests with the amphipod Hyalella azteca and the midge Chironomus tentans. Toxicity endpoints measured in these tests are survival for H. azteca and survival and growth for C. tentans. Guidance has also been developed for conducting 28-d bioaccumulation tests with the oligochaete Lumbriculus variegatus, including determination of bioaccumulation kinetics for different compound classes. These methods have been applied to a variety of sediments to address issues ranging from site assessments to bioavailability of organic and inorganic contaminants using field-collected and laboratory-spiked samples. Survival and growth of controls routinely meet or exceed test acceptability criteria. Results of laboratory bioaccumulation studies with L. variegatus have been confirmed with comparisons to residues (PCBs, PAHs, DDT) present from synoptically collected field populations of oligochaetes. Additional method development is currently underway to develop chronic toxicity tests and to provide additional data-confirming responses observed in laboratory sediment tests with natural benthic populations.

  13. Announced United States nuclear tests, July 1945 through December 1987

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1988-04-01

    This document lists chronologically and alphabetically by event name all nuclear tests conducted and announced by the United States from July 1945 through December 1987, with the exception of the GMX experiments. The 24 GMX experiments, conducted at the Nevada Test Site (NTS) between December 1954 and February 1956, were /open quotes/equation-of-state/close quotes/ physics studies that used small chemical explosives and small quantities of plutonium. Several tests conducted during Operation Dominic involved missile launches from Johnston Atoll. Several of these missle launches were aborted, resulting in the destruction of the missile and nuclear device either on the pad or inmore » the air. Data on United States tests were obtained from and verified by the Department of Energy's three weapons laboratories--Los Alamos National Laboratory, Los Alamos, New Mexico; Lawrence Livermore National Laboratory, Livermore, California; and Sandia National Laboratories, Albuquerque, New Mexico. Additionally, data were obtained from public announcements issued by the Atomic Energy Commission and its successors, the Energy Research and Development Administation and the Department of Energy, respectively.« less

  14. Multi-center evaluation of the cobas® Liat® Influenza A/B & RSV assay for rapid point of care diagnosis.

    PubMed

    Gibson, Jane; Schechter-Perkins, Elissa M; Mitchell, Patricia; Mace, Sharon; Tian, Yu; Williams, Kemi; Luo, Robert; Yen-Lieberman, Belinda

    2017-10-01

    Point of Care Testing (POCT) provides the capability for rapid laboratory test results in patient care environments where a traditional clinical laboratory is not available. POCTs have shorter turn-around times (TATs), they may be performed by non-laboratory personnel, and the need for transport time is eliminated. The Food and Drug Administration (FDA) recently granted Clinical Laboratory Improvements Amendment (CLIA) waiver status to the cobas ® Influenza A/B & RSV assay, a rapid, accurate point-of-care test for Influenza and respiratory syncytial virus (RSV) performed on the Liat ® System. The performance characteristics of this test were determined though a multi-site study consisting of different point of care testing environments. Prospectively collected Nasopharyngeal (NP) swabs from 1361 patients seen at 8 primary care clinics and 4 emergency departments (EDs) and 295 retrospectively identified specimens were tested for Influenza A/B and RSV on the cobas ® Liat ® platform. Performance characteristics were determined through comparison to ProFlu+, a laboratory-based PCR test for Influenza A/B and RSV (reference test). Discordant specimens were adjudicated following bi-directional sequencing. The cobas ® Influenza A/B and RSV assay showed sensitivities of 99.6%, 99.3%, and 96.8% for Influenza A, Influenza B, and RSV, respectively as determined from percent positive agreement (PPA) following comparison to the reference test. Sequencing confirmed cobas ® Influenza A/B and RSV results in 49.2% of reference test discordant specimens, while crossing threshold data suggest increased sensitivity compared to the reference test. The cobas ® Influenza A/B and RSV assay was found to be a rapid, sensitive POCT for the detection of these viruses, and provides laboratory-quality PCR-based diagnostic results in point of care settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. COMPARABLE MEASURES OF COGNITIVE FUNCTION IN HUMAN INFANTS AND LABORATORY ANIMALS TO IDENTIFY ENVIRONMENTAL HEALTH RISKS TO CHILDREN

    EPA Science Inventory

    The importance of including neurodevelopmental end points in environmental studies is clear. A validated measure of cognitive function in human infants that also has a homologous or parallel test in laboratory animal studies will provide a valuable approach for large-scale studie...

  16. 42 CFR 493.1425 - Standard; Testing personnel responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... laboratory's quality control policies, document all quality control activities, instrument and procedural... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Personnel for Nonwaived Testing Laboratories Performing Moderate Complexity Testing § 493.1425 Standard; Testing personnel...

  17. 11. Interior view of control room in Components Test Laboratory ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. Interior view of control room in Components Test Laboratory (T-27), looking north. Photograph shows upgraded instrumentation, piping, and technological modifications installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  18. A comparison of the MeltPro® HPV Test with the Cobas® HPV Test for detecting and genotyping 14 high-risk human papillomavirus types.

    PubMed

    Tang, Zhiteng; Xu, Ye; Song, Najie; Zou, Dongqing; Liao, Yiqun; Li, Qingge; Pan, Chao

    2018-03-01

    The clinical performance of the newly developed MeltPro ® HPV Test, based on multicolor melting curve analysis, was evaluated and compared with the commercially available Cobas ® HPV Test for detection of HPV and genotyping of HPV-16 and HPV-18. A total of 1647 cervical samples were analyzed with both tests. The agreement values were 96.2% for HPV detection, 99.6% for HPV-16 identification, and 99.7% for HPV-18 identification. All genotyping results from MeltPro ® HPV Test showed that HPV-52, HPV-58, and HPV-16 were the most common types in this study. Intra-laboratory reproducibility studies showed 97.8% agreement while inter-laboratory reproducibility studies showed 96.9% agreement for the MeltPro ® HPV Test. The MeltPro ® HPV Test and Cobas ® HPV Test are highly correlative and are useful for monitoring HPV infection.

  19. Impact of providing fee data on laboratory test ordering: a controlled clinical trial.

    PubMed

    Feldman, Leonard S; Shihab, Hasan M; Thiemann, David; Yeh, Hsin-Chieh; Ardolino, Margaret; Mandell, Steven; Brotman, Daniel J

    2013-05-27

    Inpatient care providers often order laboratory tests without any appreciation for the costs of the tests. To determine whether we could decrease the number of laboratory tests ordered by presenting providers with test fees at the time of order entry in a tertiary care hospital, without adding extra steps to the ordering process. Controlled clinical trial. Tertiary care hospital. All providers, including physicians and nonphysicians, who ordered laboratory tests through the computerized provider order entry system at The Johns Hopkins Hospital. We randomly assigned 61 diagnostic laboratory tests to an "active" arm (fee displayed) or to a control arm (fee not displayed). During a 6-month baseline period (November 10, 2008, through May 9, 2009), we did not display any fee data. During a 6-month intervention period 1 year later (November 10, 2009, through May 9, 2010), we displayed fees, based on the Medicare allowable fee, for active tests only. We examined changes in the total number of orders placed, the frequency of ordered tests (per patient-day), and total charges associated with the orders according to the time period (baseline vs intervention period) and by study group (active test vs control). For the active arm tests, rates of test ordering were reduced from 3.72 tests per patient-day in the baseline period to 3.40 tests per patient-day in the intervention period (8.59% decrease; 95% CI, -8.99% to -8.19%). For control arm tests, ordering increased from 1.15 to 1.22 tests per patient-day from the baseline period to the intervention period (5.64% increase; 95% CI, 4.90% to 6.39%) (P < .001 for difference over time between active and control tests). Presenting fee data to providers at the time of order entry resulted in a modest decrease in test ordering. Adoption of this intervention may reduce the number of inappropriately ordered diagnostic tests.

  20. B-type natriuretic peptide and its clinical utility in patients with heart failure.

    PubMed

    Wu, A H

    2001-10-01

    The implementation of entirely new clinical laboratory tests such as BNP assays is much more difficult today than it ever has been in the past. Medicare and Medicaid have been operating for many years on fixed reimbursements based on Diagnosis Related Groups (DRGs). Many third-party payers now have capitated contracts, i.e., a fixed reimbursement per member per month, regardless of the number of tests ordered and performed. Laboratories are now cost centers and not sources of revenue, thus the limited amount of income from fee-for-service reimbursements may not sufficient to cover the expenses for performing all testing. Therefore, in order to justify BNP testing, laboratory directors and hospital administrators must be able to demonstrate that implementation of BNP testing results in a savings for the hospital as a whole, even if the laboratory has a negative cost balance. If BNP testing can lead to a reduction or elimination of other tests, or if it improves the efficiency and accuracy of CHF diagnosis so that the number of inappropriate admissions is reduced, the test may be justified. Table 2 lists some specific areas where BNP might impact the other clinical areas. Outcome studies should be performed to determine if any of these changes in clinical practices can be justified.

  1. 49 CFR 199.107 - Drug testing laboratory.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Drug testing laboratory. 199.107 Section 199.107... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.107 Drug testing laboratory. (a) Each operator shall use for the drug testing required by this...

  2. 49 CFR 199.107 - Drug testing laboratory.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Drug testing laboratory. 199.107 Section 199.107... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.107 Drug testing laboratory. (a) Each operator shall use for the drug testing required by this...

  3. 49 CFR 199.107 - Drug testing laboratory.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Drug testing laboratory. 199.107 Section 199.107... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.107 Drug testing laboratory. (a) Each operator shall use for the drug testing required by this...

  4. 49 CFR 199.107 - Drug testing laboratory.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Drug testing laboratory. 199.107 Section 199.107... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.107 Drug testing laboratory. (a) Each operator shall use for the drug testing required by this...

  5. 49 CFR 199.107 - Drug testing laboratory.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Drug testing laboratory. 199.107 Section 199.107... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.107 Drug testing laboratory. (a) Each operator shall use for the drug testing required by this...

  6. Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

    PubMed

    Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

    2015-07-01

    Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

  7. A Window Into Clinical Next-Generation Sequencing-Based Oncology Testing Practices.

    PubMed

    Nagarajan, Rakesh; Bartley, Angela N; Bridge, Julia A; Jennings, Lawrence J; Kamel-Reid, Suzanne; Kim, Annette; Lazar, Alexander J; Lindeman, Neal I; Moncur, Joel; Rai, Alex J; Routbort, Mark J; Vasalos, Patricia; Merker, Jason D

    2017-12-01

    - Detection of acquired variants in cancer is a paradigm of precision medicine, yet little has been reported about clinical laboratory practices across a broad range of laboratories. - To use College of American Pathologists proficiency testing survey results to report on the results from surveys on next-generation sequencing-based oncology testing practices. - College of American Pathologists proficiency testing survey results from more than 250 laboratories currently performing molecular oncology testing were used to determine laboratory trends in next-generation sequencing-based oncology testing. - These presented data provide key information about the number of laboratories that currently offer or are planning to offer next-generation sequencing-based oncology testing. Furthermore, we present data from 60 laboratories performing next-generation sequencing-based oncology testing regarding specimen requirements and assay characteristics. The findings indicate that most laboratories are performing tumor-only targeted sequencing to detect single-nucleotide variants and small insertions and deletions, using desktop sequencers and predesigned commercial kits. Despite these trends, a diversity of approaches to testing exists. - This information should be useful to further inform a variety of topics, including national discussions involving clinical laboratory quality systems, regulation and oversight of next-generation sequencing-based oncology testing, and precision oncology efforts in a data-driven manner.

  8. Evaluation of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis.

    PubMed

    Tantisira, J G; Kowalski, R P; Gordon, Y J

    1995-07-01

    The Kodak Surecell Chlamydia test, a rapid enzyme immunoassay, has been reported to be highly sensitive (93%) and specific (96%) for detecting chlamydial lipopolysaccharide antigen in conjunctival specimens from infants, but has not been evaluated previously in adult conjunctival specimens. This study was designed to determine the efficacy of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis. Twenty Chlamydia culture-positive conjunctival specimens from adults (true-positives) and 20 true-negative specimens were tested with the Kodak Surecell Chlamydia test. The Kodak Surecell Chlamydia test was 40% (8/20) sensitive, 100% (20/20) specific, and 70% (28/40) efficient. This study indicates that the Kodak Surecell Chlamydia test, though highly specific, is less sensitive in its ability to diagnose chlamydial conjunctivitis in adults than has been reported previously in infants.

  9. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lundstrom, Blake; Chakraborty, Sudipta; Lauss, Georg

    This paper presents a concise description of state-of-the-art real-time simulation-based testing methods and demonstrates how they can be used independently and/or in combination as an integrated development and validation approach for smart grid DERs and systems. A three-part case study demonstrating the application of this integrated approach at the different stages of development and validation of a system-integrated smart photovoltaic (PV) inverter is also presented. Laboratory testing results and perspectives from two international research laboratories are included in the case study.

  10. Laboratory and field evaluation of the impact of exercise on the performance of regular and polymer-based deet repellents.

    PubMed

    Schofield, Steven; Tepper, Martin; Gadawski, Randy

    2007-11-01

    Studies were done in Manitoba, Canada, to evaluate the impact of exercise on repellent performance against mosquitoes. Two products containing the active ingredient N,N-diethyl-3-methylbenzamide (deet) were tested; one product was a polymer-based cream (3M Ultrathon Insect Repellent) and the other product was an alcohol-based pump spray formulation (Muskol Insect Repellent). Assessments were done in the laboratory using Aedes aegypti (L.) and in the field with naturally occurring populations of mosquitoes. Repellent was applied to the forearms (laboratory) or a lower leg (field) of test subjects at 1.5 g of test product per 600 cm2 surface area (0.75 or 0.83 mg deet/cm2). For a given test day, subjects exercised or did not. Exposure to mosquito attack was for 1 min at 30-min intervals in laboratory procedures, and it was continuous in field tests. Performance was measured as complete protection time (CPT). Moderate levels of physical activity resulted in a >40% decline in mean CPT, from 468 to 267 min in the laboratory experiments and from 359 to 203 min in field tests. Repellent product did not affect the magnitude of the decline. Mean biting pressure during field trials was 21.3 bites per min, and mosquito collections were made up primarily of Ochlerotatus sticticus (Meigen) and Aedes vexans (Meigen).

  11. Effect of Population Heterogenization on the Reproducibility of Mouse Behavior: A Multi-Laboratory Study

    PubMed Central

    Richter, S. Helene; Garner, Joseph P.; Zipser, Benjamin; Lewejohann, Lars; Sachser, Norbert; Touma, Chadi; Schindler, Britta; Chourbaji, Sabine; Brandwein, Christiane; Gass, Peter; van Stipdonk, Niek; van der Harst, Johanneke; Spruijt, Berry; Võikar, Vootele; Wolfer, David P.; Würbel, Hanno

    2011-01-01

    In animal experiments, animals, husbandry and test procedures are traditionally standardized to maximize test sensitivity and minimize animal use, assuming that this will also guarantee reproducibility. However, by reducing within-experiment variation, standardization may limit inference to the specific experimental conditions. Indeed, we have recently shown in mice that standardization may generate spurious results in behavioral tests, accounting for poor reproducibility, and that this can be avoided by population heterogenization through systematic variation of experimental conditions. Here, we examined whether a simple form of heterogenization effectively improves reproducibility of test results in a multi-laboratory situation. Each of six laboratories independently ordered 64 female mice of two inbred strains (C57BL/6NCrl, DBA/2NCrl) and examined them for strain differences in five commonly used behavioral tests under two different experimental designs. In the standardized design, experimental conditions were standardized as much as possible in each laboratory, while they were systematically varied with respect to the animals' test age and cage enrichment in the heterogenized design. Although heterogenization tended to improve reproducibility by increasing within-experiment variation relative to between-experiment variation, the effect was too weak to account for the large variation between laboratories. However, our findings confirm the potential of systematic heterogenization for improving reproducibility of animal experiments and highlight the need for effective and practicable heterogenization strategies. PMID:21305027

  12. Research and test facilities for development of technologies and experiments with commercial applications

    NASA Technical Reports Server (NTRS)

    1989-01-01

    One of NASA'S agency-wide goals is the commercial development of space. To further this goal NASA is implementing a policy whereby U.S. firms are encouraged to utilize NASA facilities to develop and test concepts having commercial potential. Goddard, in keeping with this policy, will make the facilities and capabilities described in this document available to private entities at a reduced cost and on a noninterference basis with internal NASA programs. Some of these facilities include: (1) the Vibration Test Facility; (2) the Battery Test Facility; (3) the Large Area Pulsed Solar Simulator Facility; (4) the High Voltage Testing Facility; (5) the Magnetic Field Component Test Facility; (6) the Spacecraft Magnetic Test Facility; (7) the High Capacity Centrifuge Facility; (8) the Acoustic Test Facility; (9) the Electromagnetic Interference Test Facility; (10) the Space Simulation Test Facility; (11) the Static/Dynamic Balance Facility; (12) the High Speed Centrifuge Facility; (13) the Optical Thin Film Deposition Facility; (14) the Gold Plating Facility; (15) the Paint Formulation and Application Laboratory; (16) the Propulsion Research Laboratory; (17) the Wallops Range Facility; (18) the Optical Instrument Assembly and Test Facility; (19) the Massively Parallel Processor Facility; (20) the X-Ray Diffraction and Scanning Auger Microscopy/Spectroscopy Laboratory; (21) the Parts Analysis Laboratory; (22) the Radiation Test Facility; (23) the Ainsworth Vacuum Balance Facility; (24) the Metallography Laboratory; (25) the Scanning Electron Microscope Laboratory; (26) the Organic Analysis Laboratory; (27) the Outgassing Test Facility; and (28) the Fatigue, Fracture Mechanics and Mechanical Testing Laboratory.

  13. Critical Value Reporting at Egyptian Laboratories.

    PubMed

    Mosallam, Rasha; Ibrahim, Samaa Zenhom

    2015-06-12

    To examine critical value reporting policies and practices and to identify critical value ranges for selected common laboratory assays at inpatient division of laboratories of Alexandria hospitals. A cross-sectional descriptive study design was used. Subjects were from inpatient division of all laboratories of Alexandria hospitals (40 laboratories). Data were collected using a questionnaire composed of 4 sections. The first section explored hospital and laboratory characteristics. The second section assessed policies and procedures of critical value reporting. The third section explored the reporting process. The fourth section explored critical value ranges for selected common laboratory assays. Written procedure for reporting of critical values was present in 77.5% of laboratories and a comprehensive list of critical values in 72.55%. For laboratories having a critical value list, the number of tests in the list ranged from 7 to 40. Three-fifths of laboratories had a policy for assessing the timeliness of reporting and 3 quarters stated that the laboratory policy requires feedback (60.0% and 75.0%, respectively). The hospital laboratory physician was responsible for critical value reporting followed by the laboratory technician (75.0% and 50.0%, respectively). The call is received mainly by nurses and physicians ordering the test (67.5% and 55.0%, respectively) and the channel of reporting is mainly the telephone or through sending test report to the ward (67.5% and 50.0%, respectively). Wireless technologies are used in reporting in only 10.0% of hospitals. The cutoff limits for reporting different assays showed considerable interlaboratory variation. Critical value policies and practices showed interinstitutional variation with deficiencies in some reporting practices. Selection of critical assays for notification and setting the limits of notification exhibited wide variation as well.

  14. 7. Exterior view of Components Test Laboratory (T27), looking south. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. Exterior view of Components Test Laboratory (T-27), looking south. The wing in the immediate foreground houses the equipment room. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  15. Integration of the CLS doctorate into the healthcare organization.

    PubMed

    Montoya, Isaac; Kimball, Olive

    2009-01-01

    A review of how the doctorally prepared CLS fits into the healthcare organization. Literature review. Numerous national studies have called for a reshaping of the health care delivery system and the need to improve patient outcomes. Because of unprecedented advances in laboratory related technology as well as the need for economic retrenchment strategies in health care, with its significant influence on patient care, the laboratory has become the subject of intensive study. It has been concluded that the traditional organizational structure of the laboratory information process and the required personnel skills both need rethinking. In order to foster change in the laboratory, an advanced degreed CLS laboratory professional is needed, one already equipped with a broad scientific base developed via a baccalaureate/masters level of education. With the addition of advanced technical expertise, basic medical skills, data interpretation skills and patient interaction abilities, and medical research experience, this laboratory professional can enhance the effective and efficient use of laboratory information and ultimately improve patient care. The clinical doctorates in CLS are educationally and experientially prepared to recommend support and enhance appropriate testing. They translate and transform complex laboratory data into an understandable product necessary for clinicians to be able to assess the validity of current and new assays to ensure better patient care. In addition, they assist in reducing questionable test usage, thereby reducing costs for both the patient and the laboratory.

  16. 5. AERIAL PHOTO OF THE COMPONENTS TEST LABORATORY DURING THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. AERIAL PHOTO OF THE COMPONENTS TEST LABORATORY DURING THE CONSTRUCTION OF THE EAST TEST AREA. 1955, FRED ORDWAY COLLECTION, U.S. SPACE AND ROCKET CENTER, HUNTSVILLE, AL. - Marshall Space Flight Center, East Test Area, Components Test Laboratory, Huntsville, Madison County, AL

  17. 40 CFR 799.4360 - Tributyl phosphate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provisions also apply: (i) Animal selection. Testing shall be performed in laboratory rats. (ii) Duration of... apply: (i) Animal selection. Testing shall be performed in laboratory rats. (ii) Duration of testing...) Animal selection. Testing shall be performed in laboratory rats. (ii) Duration of testing. Animals shall...

  18. Laboratory evaluation of the pointing stability of the ASPS Vernier System

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The annular suspension and pointing system (ASPS) is an end-mount experiment pointing system designed for use in the space shuttle. The results of the ASPS Vernier System (AVS) pointing stability tests conducted in a laboratory environment are documented. A simulated zero-G suspension was used to support the test payload in the laboratory. The AVS and the suspension were modelled and incorporated into a simulation of the laboratory test. Error sources were identified and pointing stability sensitivities were determined via simulation. Statistical predictions of laboratory test performance were derived and compared to actual laboratory test results. The predicted mean pointing stability during simulated shuttle disturbances was 1.22 arc seconds; the actual mean laboratory test pointing stability was 1.36 arc seconds. The successful prediction of laboratory test results provides increased confidence in the analytical understanding of the AVS magnetic bearing technology and allows confident prediction of in-flight performance. Computer simulations of ASPS, operating in the shuttle disturbance environment, predict in-flight pointing stability errors less than 0.01 arc seconds.

  19. Engine Propeller Research Building at the Lewis Flight Propulsion Laboratory

    NASA Image and Video Library

    1955-02-21

    The Engine Propeller Research Building, referred to as the Prop House, emits steam from its acoustic silencers at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. In 1942 the Prop House became the first completed test facility at the new NACA laboratory in Cleveland, Ohio. It contained four test cells designed to study large reciprocating engines. After World War II, the facility was modified to study turbojet engines. Two of the test cells were divided into smaller test chambers, resulting in a total of six engine stands. During this period the NACA Lewis Materials and Thermodynamics Division used four of the test cells to investigate jet engines constructed with alloys and other high temperature materials. The researchers operated the engines at higher temperatures to study stress, fatigue, rupture, and thermal shock. The Compressor and Turbine Division utilized another test cell to study a NACA-designed compressor installed on a full-scale engine. This design sought to increase engine thrust by increasing its airflow capacity. The higher stage pressure ratio resulted in a reduction of the number of required compressor stages. The last test cell was used at the time by the Engine Research Division to study the effect of high inlet densities on a jet engine. Within a couple years of this photograph the Prop House was significantly altered again. By 1960 the facility was renamed the Electric Propulsion Research Building to better describe its new role in electric propulsion.

  20. The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review.

    PubMed

    Jongen, S; Vuurman, E F P M; Ramaekers, J G; Vermeeren, A

    2016-04-01

    Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Alkali deposits found in biomass power plants: A preliminary investigation of their extent and nature. Volume 1

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Miles, T.R.; Miles, T.R. Jr.; Baxter, L.L.

    1995-04-15

    Alkali in the ash of annual crop biomass fuels creates serious fouling and slagging in conventional boilers. Even with the use of sorbents and other additives, power plants can only fire limited amounts of these fuels in combination with wood. The National Renewable Energy Laboratory (NREL), US Department of Energy, and the biomass power industry carried out eight full-scale firing tests and several laboratory experiments to study the nature and occurrence of deposits with the goal of increasing the quantities of these biofuels that can be used. This report describes the results of the laboratory and power plant tests thatmore » included: tracking and analyzing fuels and deposits by various methods; recording operating conditions; and extensive laboratory testing. The paper describes the occurrence of deposits, fuel and deposit analyses, boiler design and operation, fouling and slagging indicators, and recommendations. 37 refs., 41 figs., 17 tabs.« less

  2. Use of Web-based training for quality improvement between a field immunohistochemistry laboratory in Nigeria and its United States-based partner institution.

    PubMed

    Oluwasola, Abideen O; Malaka, David; Khramtsov, Andrey Ilyich; Ikpatt, Offiong Francis; Odetunde, Abayomi; Adeyanju, Oyinlolu Olorunsogo; Sveen, Walmy Elisabeth; Falusi, Adeyinka Gloria; Huo, Dezheng; Olopade, Olufunmilayo Ibironke

    2013-12-01

    The importance of hormone receptor status in assigning treatment and the potential use of human epidermal growth factor receptor 2 (HER2)-targeted therapy have made it beneficial for laboratories to improve detection techniques. Because interlaboratory variability in immunohistochemistry (IHC) tests may also affect studies of breast cancer subtypes in different countries, we undertook a Web-based quality improvement training and a comparative study of accuracy of immunohistochemical tests of breast cancer biomarkers between a well-established laboratory in the United States (University of Chicago) and a field laboratory in Ibadan, Nigeria. Two hundred and thirty-two breast tumor blocks were evaluated for estrogen receptors (ERs), progesterone receptors (PRs), and HER2 status at both laboratories using tissue microarray technique. Initially, concordance analysis revealed κ scores of 0.42 (moderate agreement) for ER, 0.41 (moderate agreement) for PR, and 0.39 (fair agreement) for HER2 between the 2 laboratories. Antigen retrieval techniques and scoring methods were identified as important reasons for discrepancy. Web-based conferences using Web conferencing tools such as Skype and WebEx were then held periodically to discuss IHC staining protocols and standard scoring systems and to resolve discrepant cases. After quality assurance and training, the agreement improved to 0.64 (substantial agreement) for ER, 0.60 (moderate agreement) for PR, and 0.75 (substantial agreement) for HER2. We found Web-based conferences and digital microscopy useful and cost-effective tools for quality assurance of IHC, consultation, and collaboration between distant laboratories. Quality improvement exercises in testing of tumor biomarkers will reduce misclassification in epidemiologic studies of breast cancer subtypes and provide much needed capacity building in resource-poor countries. © 2013.

  3. Lyme Disease Diagnosed by Alternative Methods: A Phenotype Similar to That of Chronic Fatigue Syndrome.

    PubMed

    Patrick, David M; Miller, Ruth R; Gardy, Jennifer L; Parker, Shoshana M; Morshed, Muhammad G; Steiner, Theodore S; Singer, Joel; Shojania, Kam; Tang, Patrick

    2015-10-01

    A subset of patients reporting a diagnosis of Lyme disease can be described as having alternatively diagnosed chronic Lyme syndrome (ADCLS), in which diagnosis is based on laboratory results from a nonreference Lyme specialty laboratory using in-house criteria. Patients with ADCLS report symptoms similar to those reported by patients with chronic fatigue syndrome (CFS). We performed a case-control study comparing patients with ADCLS and CFS to each other and to both healthy controls and controls with systemic lupus erythematosus (SLE). Subjects completed a history, physical exam, screening laboratory tests, 7 functional scales, reference serology for Lyme disease using Centers for Disease Control and Prevention criteria, reference serology for other tick-associated pathogens, and cytokine expression studies. The study enrolled 13 patients with ADCLS (12 of whom were diagnosed by 1 alternative US laboratory), 25 patients with CFS, 25 matched healthy controls, and 11 SLE controls. Baseline clinical data and functional scales indicate significant disability among ADCLS and CFS patients and many important differences between these groups and controls, but no significant differences between each other. No ADCLS patient was confirmed as having positive Lyme serology by reference laboratory testing, and there was no difference in distribution of positive serology for other tick-transmitted pathogens or cytokine expression across the groups. In British Columbia, a setting with low Lyme disease incidence, ADCLS patients have a similar phenotype to that of CFS patients. Disagreement between alternative and reference laboratory Lyme testing results in this setting is most likely explained by false-positive results from the alternative laboratory. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Quality and future of clinical laboratories: the Vico's whole cyclical theory of the recurring cycles.

    PubMed

    Plebani, Mario

    2018-05-24

    In the last few decades, laboratory medicine has undergone monumental changes, and laboratory technology, which has made enormous advances, now has new clinical applications thanks to the identification of a growing number of biomarkers and risk factors conducive to the promotion of predictive and preventive interventions that have enhanced the role of laboratory medicine in health care delivering. However, the paradigm shift in the past 50 years has led to a gap between laboratory and clinic, with an increased risk of inappropriateness in test request and interpretation, as well as the consolidation of analytical work in focused factories and megastructurers oriented only toward achieving greater volumes, decreasing cost per test and generating a vision of laboratory services as simple commodities. A careful historical revision of the changing models for delivering laboratory services in the United States leads to the prediction that there are several reasons for counteracting the vision of clinical laboratory as a commodity, and restoring the true nature of laboratory services as an integral part of the diagnosis and therapy process. The present study, which reports on internal and external drivers for change, proposes an integrated vision of quality in laboratory medicine.

  5. Evaluation of an external quality assessment program for HIV testing in Haiti, 2006-2011.

    PubMed

    Louis, Frantz Jean; Anselme, Renette; Ndongmo, Clement; Buteau, Josiane; Boncy, Jacques; Dahourou, Georges; Vertefeuille, John; Marston, Barbara; Balajee, S Arunmozhi

    2013-12-01

    To evaluate an external quality assessment (EQA) program for human immunodeficiency virus (HIV) rapid diagnostics testing by the Haitian National Public Health Laboratory (French acronym: LNSP). Acceptable performance was defined as any proficiency testing (PT) score more than 80%. The PT database was reviewed and analyzed to assess the testing performance of the participating laboratories and the impact of the program over time. A total of 242 laboratories participated in the EQA program from 2006 through 2011; participation increased from 70 laboratories in 2006 to 159 in 2011. In 2006, 49 (70%) laboratories had a PT score of 80% or above; by 2011, 145 (97.5%) laboratories were proficient (P < .05). The EQA program for HIV testing ensures quality of testing and allowed the LNSP to document improvements in the quality of HIV rapid testing over time.

  6. To Compare the Effects of Computer Based Learning and the Laboratory Based Learning on Students' Achievement Regarding Electric Circuits

    ERIC Educational Resources Information Center

    Bayrak, Bekir; Kanli, Uygar; Kandil Ingeç, Sebnem

    2007-01-01

    In this study, the research problem was: "Is the computer based physics instruction as effective as laboratory intensive physics instruction with regards to academic success on electric circuits 9th grade students?" For this research of experimental quality the design of pre-test and post-test are applied with an experiment and a control…

  7. Plasma creatinine in dogs: intra- and inter-laboratory variation in 10 European veterinary laboratories

    PubMed Central

    2011-01-01

    Background There is substantial variation in reported reference intervals for canine plasma creatinine among veterinary laboratories, thereby influencing the clinical assessment of analytical results. The aims of the study was to determine the inter- and intra-laboratory variation in plasma creatinine among 10 veterinary laboratories, and to compare results from each laboratory with the upper limit of its reference interval. Methods Samples were collected from 10 healthy dogs, 10 dogs with expected intermediate plasma creatinine concentrations, and 10 dogs with azotemia. Overlap was observed for the first two groups. The 30 samples were divided into 3 batches and shipped in random order by postal delivery for plasma creatinine determination. Statistical testing was performed in accordance with ISO standard methodology. Results Inter- and intra-laboratory variation was clinically acceptable as plasma creatinine values for most samples were usually of the same magnitude. A few extreme outliers caused three laboratories to fail statistical testing for consistency. Laboratory sample means above or below the overall sample mean, did not unequivocally reflect high or low reference intervals in that laboratory. Conclusions In spite of close analytical results, further standardization among laboratories is warranted. The discrepant reference intervals seem to largely reflect different populations used in establishing the reference intervals, rather than analytical variation due to different laboratory methods. PMID:21477356

  8. Laboratory and field measurements and evaluations of vibration at the handles of riveting hammers

    PubMed Central

    McDOWELL, THOMAS W.; WARREN, CHRISTOPHER; WELCOME, DANIEL E.; DONG, REN G.

    2015-01-01

    The use of riveting hammers can expose workers to harmful levels of hand-transmitted vibration (HTV). As a part of efforts to reduce HTV exposures through tool selection, the primary objective of this study was to evaluate the applicability of a standardized laboratory-based riveting hammer assessment protocol for screening riveting hammers. The second objective was to characterize the vibration emissions of reduced vibration riveting hammers and to make approximations of the HTV exposures of workers operating these tools in actual work tasks. Eight pneumatic riveting hammers were selected for the study. They were first assessed in a laboratory using the standardized method for measuring vibration emissions at the tool handle. The tools were then further assessed under actual working conditions during three aircraft sheet metal riveting tasks. Although the average vibration magnitudes of the riveting hammers measured in the laboratory test were considerably different from those measured in the field study, the rank orders of the tools determined via these tests were fairly consistent, especially for the lower vibration tools. This study identified four tools that consistently exhibited lower frequency-weighted and unweighted accelerations in both the laboratory and workplace evaluations. These observations suggest that the standardized riveting hammer test is acceptable for identifying tools that could be expected to exhibit lower vibrations in workplace environments. However, the large differences between the accelerations measured in the laboratory and field suggest that the standardized laboratory-based tool assessment is not suitable for estimating workplace riveting hammer HTV exposures. Based on the frequency-weighted accelerations measured at the tool handles during the three work tasks, the sheet metal mechanics assigned to these tasks at the studied workplace are unlikely to exceed the daily vibration exposure action value (2.5 m s−2) using any of the evaluated riveting hammers. PMID:22539561

  9. HYDRAULIC CHARACTERISTICS OF SEWER SEDIMENT GATE FLUSHING TANKS: LABORATORY FLUME STUDIES

    EPA Science Inventory

    The objective of this study was to test the performance of gate flushing tanks, simulated in a laboratory flume, to remove sediments from combined sewers and storage tanks. A significant amount of sediment/debris/sludge may accumulate at the bottom of a sewer during dry weather o...

  10. HYDRAULIC CHARACTERISTICS OF SEWER SEDIMENT GATE-FLUSHING TANKS: LABORATORY FLUME STUDIES

    EPA Science Inventory

    The objective of this study was to test the performance of gate-flushing tanks, simulated in a laboratory flume, to remove sediments from combined sewers and storage tanks. A significant amount of sediment/debris/sludge may accumulate at the bottom of a sewer during dry weather o...

  11. SEWER SEDIMENT GATE AND VACUUM FLUSHING TANKS: LABORATORY FLUME STUDIES

    EPA Science Inventory

    The objective of this study was to test the performance of a traditional gate-flushing device and a newly designed vacuum-flushing device in removing sediments from combined sewers and CSO storage tanks. A laboratory hydraulic flune was used to simulate a reach of sewer or storag...

  12. 2. Exterior view of Components Test Laboratory (T27), looking southeast. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. Exterior view of Components Test Laboratory (T-27), looking southeast. The building wing on the left houses the equipment room and that on the right houses Test Cell 8 (oxidizer) and the oxidizer storage pit or vault. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  13. 3. Exterior view of Components Test Laboratory (T27), looking southeast. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Exterior view of Components Test Laboratory (T-27), looking southeast. The building wing on the left houses the equipment room, and that on the right houses Test Cell 8 (oxidizer) and the oxidizer storage pit or vault. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  14. 18. Interior view of HVAC room in Components Test Laboratory ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Interior view of HVAC room in Components Test Laboratory (T-27), showing northwest corner. Photograph shows upgraded instrumentation, piping, and technological modifications for HVAC system installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  15. 19. Interior view of HVAC room in Components Test Laboratory ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. Interior view of HVAC room in Components Test Laboratory (T-27), looking toward east wall. Photograph shows upgraded instrumentation, machinery, and technological modifications for HVAC system installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  16. Laboratory-based testing to evaluate abuse-deterrent formulations and satisfy the Food and Drug Administration's recommendation for Category 1 Testing.

    PubMed

    Altomare, Christopher; Kinzler, Eric R; Buchhalter, August R; Cone, Edward J; Costantino, Anthony

    The US Food and Drug Administration (FDA) considers the development of abuse-deterrent formulations of solid oral dosage forms a public health priority and has outlined a series of premarket studies that should be performed prior to submitting an application to the Agency. Category 1 studies are performed to characterize whether the abuse-deterrent properties of a new formulation can be easily defeated. Study protocols are designed to evaluate common abuse patterns of prescription medications as well as more advanced methods that have been reported on drug abuse websites and forums. Because FDA believes Category 1 testing should fully characterize the abuse-deterrent characteristics of an investigational formulation, Category 1 testing is time consuming and requires specialized laboratory resources as well as advanced knowledge of prescription medication abuse. Recent Advisory Committee meetings at FDA have shown that Category 1 tests play a critical role in FDA's evaluation of an investigational formulation. In this article, we will provide a general overview of the methods of manipulation and routes of administration commonly utilized by prescription drug abusers, how those methods and routes are evaluated in a laboratory setting, and discuss data intake, analysis, and reporting to satisfy FDA's Category 1 testing requirements.

  17. Isotherm Sensor Calibration Program for Mars Science Laboratory Heat Shield Flight Data Analysis

    NASA Technical Reports Server (NTRS)

    Santos, Jose A.; Oishi, Tomo; Martinez, Ed R.

    2011-01-01

    Seven instrumented sensor plugs were installed on the Mars Science Laboratory heat shield in December 2008 as part of the Mars Science Laboratory Entry, Descent, and Landing Instrumentation (MEDLI) project. These sensor plugs contain four in-depth thermocouples and one Hollow aErothermal Ablation and Temperature (HEAT) sensor. The HEAT sensor follows the time progression of a 700 C isotherm through the thickness of a thermal protection system (TPS) material. The data can be used to infer char depth and, when analyzed in conjunction with the thermocouple data, the thermal gradient through the TPS material can also be determined. However, the uncertainty on the isotherm value is not well defined. To address this uncertainty, a team at NASA Ames Research Center is carrying out a HEAT sensor calibration test program. The scope of this test program is described, and initial results from experiments conducted in the laboratory to study the isotherm temperature of the HEAT sensor are presented. Data from the laboratory tests indicate an isotherm temperature of 720 C 60 C. An overview of near term arc jet testing is also given, including preliminary data from 30.48cm 30.48cm PICA panels instrumented with two MEDLI sensor plugs and tested in the NASA Ames Panel Test Facility. Forward work includes analysis of the arc jet test data, including an evaluation of the isotherm value based on the instant in time when it reaches a thermocouple depth.

  18. The Point-of-Care Laboratory in Clinical Microbiology

    PubMed Central

    Michel-Lepage, Audrey; Boyer, Sylvie; Raoult, Didier

    2016-01-01

    SUMMARY Point-of-care (POC) laboratories that deliver rapid diagnoses of infectious diseases were invented to balance the centralization of core laboratories. POC laboratories operate 24 h a day and 7 days a week to provide diagnoses within 2 h, largely based on immunochromatography and real-time PCR tests. In our experience, these tests are conveniently combined into syndrome-based kits that facilitate sampling, including self-sampling and test operations, as POC laboratories can be operated by trained operators who are not necessarily biologists. POC laboratories are a way of easily providing clinical microbiology testing for populations distant from laboratories in developing and developed countries and on ships. Modern Internet connections enable support from core laboratories. The cost-effectiveness of POC laboratories has been established for the rapid diagnosis of tuberculosis and sexually transmitted infections in both developed and developing countries. PMID:27029593

  19. Earth Resources Laboratory research and technology

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The accomplishments of the Earth Resources Laboratory's research and technology program are reported. Sensors and data systems, the AGRISTARS project, applied research and data analysis, joint research projects, test and evaluation studies, and space station support activities are addressed.

  20. Hot Corrosion Test Facility at the NASA Lewis Special Projects Laboratory

    NASA Technical Reports Server (NTRS)

    Robinson, Raymond C.; Cuy, Michael D.

    1994-01-01

    The Hot Corrosion Test Facility (HCTF) at the NASA Lewis Special Projects Laboratory (SPL) is a high-velocity, pressurized burner rig currently used to evaluate the environmental durability of advanced ceramic materials such as SiC and Si3N4. The HCTF uses laboratory service air which is preheated, mixed with jet fuel, and ignited to simulate the conditions of a gas turbine engine. Air, fuel, and water systems are computer-controlled to maintain test conditions which include maximum air flows of 250 kg/hr (550 lbm/hr), pressures of 100-600 kPa (1-6 atm), and gas temperatures exceeding 1500 C (2732 F). The HCTF provides a relatively inexpensive, yet sophisticated means for researchers to study the high-temperature oxidation of advanced materials, and the injection of a salt solution provides the added capability of conducting hot corrosion studies.

  1. Round robin investigation of methods for the recovery of poliovirus from drinking water.

    PubMed Central

    Melnick, J L; Safferman, R; Rao, V C; Goyal, S; Berg, G; Dahling, D R; Wright, B A; Akin, E; Stetler, R; Sorber, C

    1984-01-01

    Six laboratories actively involved in water virology research participated in a methods evaluation study, conducted under the auspices of the American Society for Testing and Materials Committee on Viruses in the Aquatic Environment, Task Force on Drinking Water. Each participant was asked to examine the Viradel (virus adsorption-elution) method with cartridge-type Filterite filters for virus adsorption and organic flocculation and aluminum hydroxide-hydroextraction for reconcentration. Virus was adsorbed to filter media at pH 3.5 and eluted with either glycine buffer (pH 10.5) or beef extract-glycine (pHG 9.0). Considerable variation was noted in the quantity of virus recovered from four 100-liter samples of dechlorinated tapwater seeded with low (350 to 860 PFU) and high (1,837 to 4,689 PFU) doses of poliovirus type 1. To have a more uniform standard of comparison, all the test samples were reassayed in one laboratory, where titers were also determined for the virus seed. Test results of the Viradel-organic flocculation method indicated that the average percentage of virus recovery for low-input experiments was 66%, with a range of 8 to 20% in two laboratories, 49 to 63% in three laboratories, and 198% in one laboratory. For the high-input experiments, two laboratories reported recoveries of 6 to 12%, and four laboratories reported recoveries of 26 to 46%. For the Viradel aluminum hydroxide-hydroextraction procedure, two laboratories recovered 9 to 11%, whereas four obtained 17 to 34% for low-input experiments. For the high-input tests, two laboratories reported a recovery of 3 to 5%, and four recovered 11 to 18% of the seeded virus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6320720

  2. Evaluation of a rabies ELISA as an alternative method to seroneutralisation tests in the context of international trade of domestic carnivores.

    PubMed

    Wasniewski, M; Labbe, A; Tribout, L; Rieder, J; Labadie, A; Schereffer, J L; Cliquet, F

    2014-01-01

    For several years, international movements with pets have greatly increased. Most countries have relaxed their quarantine measures and adopted a scheme combining vaccination of pets against rabies followed by a serological test to check the efficacy of vaccination. This new scheme has been strongly supported by the OIE, WHO and the European Commission to facilitate the free movement of people and pets around the world. Currently, only two reference methods are recognised and prescribed (the FAVN test and the RFFIT) to measure rabies antibody levels in serum samples for international trade. They are reliable and valuable methods of assessing the efficacy of rabies vaccination but they are time-consuming and require well-trained people and specialised laboratory facilities. A few years ago, an ELISA (Platelia™ Rabies II kit ad usum Veterinarium) was developed for domestic carnivores and wildlife. To our knowledge, this ELISA is the only one certified and prescribed by the OIE. Following its marketing, one task of the EURL for rabies serology was to evaluate the performance of laboratories using this new kit. The results revealed that 26% of the participants, which were already approved laboratories for rabies serology, failed the inter-laboratory trial. Such unsatisfactory results have never been observed during any of the previous proficiency tests organised annually since 2000 by the EURL for rabies serology using reference methods. More investigations were undertaken through internal and collaborative studies to assess the performance of this newly marketed ELISA kit. The results of the internal study revealed that even with a specificity of 100%, the sensitivity evaluated on 593 samples of domestic carnivores came to 78.2%. An issue regarding the underestimation of serum titres was also revealed during the study. The results of a collaborative study involving 23 international laboratories reinforced the preliminary conclusions regarding lack of sensitivity. Indeed, only 5 laboratories out of the 23 obtained satisfactory results. We therefore suggest adopting a threshold of 0.3 EU/mL instead of 0.5 EU/mL to increase the sensitivity of the test. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    PubMed

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.

  4. Specimen rejection in laboratory medicine: Necessary for patient safety?

    PubMed

    Dikmen, Zeliha Gunnur; Pinar, Asli; Akbiyik, Filiz

    2015-01-01

    The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.

  5. A review of the UK methodology used for monitoring cigarette smoke yields, aspects of analytical data variability and their impact on current and future regulatory compliance.

    PubMed

    Purkis, Stephen W; Drake, Linda; Meger, Michael; Mariner, Derek C

    2010-04-01

    The European Union (EU) requires that tobacco products are regulated by Directive 2001/37/EC through testing and verification of results on the basis of standards developed by the International Organization for Standardization (ISO). In 2007, the European Commission provided guidance to EU Member States by issuing criteria for competent laboratories which includes accreditation to ISO 17025:2005. Another criterion requires regular laboratory participation in collaborative studies that predict the measurement tolerance that must be observed to conclude that test results on any particular product are different. However, differences will always occur when comparing overall data across products between different laboratories. A forum for technical discussion between laboratories testing products as they are manufactured and a Government appointed verification laboratory gives transparency, ensures consistency and reduces apparent compliance issues to the benefit of all parties. More than 30years ago, such a forum was set up in the UK that continued until 2007 and will be described in this document. Anticipating further testing requirements in future product regulation as proposed by the Framework Convention on Tobacco Control, cooperation between accredited laboratories, whether for testing or verification, should be established to share know-how, to ensure a standardised level of quality and to offer competent technical dialogue in the best interest of regulators and manufacturers alike. Copyright 2009 Elsevier Inc. All rights reserved.

  6. Evaluation of Mycology Laboratory Proficiency Testing

    PubMed Central

    Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

    1999-01-01

    Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient testing. This study addresses this issue by evaluating medical mycology OPT and comparing its fungal specimen identification error rates to those obtained in a covert (blinded) proficiency testing (CPT) program. Identifications from 188 laboratories participating in the New York State mycology OPT from 1982 to 1994 were compared with the identifications of the same fungi recovered from patient specimens in 1989 and 1994 as part of the routine procedures of 88 of these laboratories. The consistency in the identification of OPT specimens was sufficient to make accurate predictions of OPT error rates. However, while the error rates in OPT and CPT were similar for Candida albicans, significantly higher error rates were found in CPT for Candida tropicalis, Candida glabrata, and other common pathogenic fungi. These differences may, in part, be due to OPT’s use of ideal organism representatives cultured under optimum growth conditions. This difference, as well as the organism-dependent error rate differences, reflects the limitations of OPT as a means of assessing the quality of routine laboratory performance in medical mycology. PMID:10364601

  7. Extrapolating non-target risk of Bt crops from laboratory to field.

    PubMed

    Duan, Jian J; Lundgren, Jonathan G; Naranjo, Steve; Marvier, Michelle

    2010-02-23

    The tiered approach to assessing ecological risk of insect-resistant transgenic crops assumes that lower tier laboratory studies, which expose surrogate non-target organisms to high doses of insecticidal proteins, can detect harmful effects that might be manifested in the field. To test this assumption, we performed meta-analyses comparing results for non-target invertebrates exposed to Bacillus thuringiensis (Bt) Cry proteins in laboratory studies with results derived from independent field studies examining effects on the abundance of non-target invertebrates. For Lepidopteran-active Cry proteins, laboratory studies correctly predicted the reduced field abundance of non-target Lepidoptera. However, laboratory studies incorporating tri-trophic interactions of Bt plants, herbivores and parasitoids were better correlated with the decreased field abundance of parasitoids than were direct-exposure assays. For predators, laboratory tri-trophic studies predicted reduced abundances that were not realized in field studies and thus overestimated ecological risk. Exposure to Coleopteran-active Cry proteins did not significantly reduce the laboratory survival or field abundance of any functional group examined. Our findings support the assumption that laboratory studies of transgenic insecticidal crops show effects that are either consistent with, or more conservative than, those found in field studies, with the important caveat that laboratory studies should explore all ecologically relevant routes of exposure.

  8. Laboratory practice at the periphery in developing countries.

    PubMed

    Lewis, S M

    2002-08-01

    An effective national health service structure requires a comprehensive programme for primary health care in peripheral and rural areas. This is especially important in under-resourced countries where facilities are sparse, the population is widely dispersed and transport is limited. Haematology has a key role in diagnosis and patient management by selecting tests for their clinical relevance and utility for the specific circumstances, and ensuring their technical reliability when used in health clinics and point-of-care testing. WHO has proposed a basic menu of tests in three categories: (a) tests such as haemoglobin screen which can be performed by nurses, midwives, health-aides or community doctors, (b) tests such as haemoglobinometry, microhaematocrit and microscopic examination of stained preparations which can be performed by a technician or laboratory assistant in a health centre, (c) tests requiring greater technical expertise of a laboratory technician or trained doctor. The peripheral health clinics and district laboratories must be familiar with the guidelines on standardized methods for collecting and storing specimens and transporting them to a regional laboratory or a reference centre. A training syllabus should be provided at the health centres and district laboratories, and this should include on-site instruction from supervisors and access to training manuals and distance-learning material. A co-ordinated programme of quality assurance and standardization of test methods should be established by a reference centre or national health authority with a network which encompasses all laboratories and health clinics undertaking any tests. Each regional laboratory should foster lower level laboratories or clinics within its neighbourhood. Of particular concern is the reliable diagnosis and management of anaemia. WHO reports indicate that 40% of the world population suffer from anaemia, especially affecting pregnant women, and a high proportion of infants and children in developing countries. The Haemoglobin Colour Scale (HCS) was recently developed for WHO as a simple, cheap and portable device which reads haemoglobin within 1 g/dl of the true value. It has been validated in a number of studies and is now manufactured commercially in accordance with WHO specifications under control of a WHO Collaborating Centre. It has an important potential role in the resource-limited environment where anaemia screening presently usually depends on unreliable clinical examination.

  9. Department of Homeland Security (DHS) Proficiency Testing on Small-Scale Safety and Thermal Testing of Improvised Explosives

    NASA Astrophysics Data System (ADS)

    Reynolds, John; Sandstrom, Mary; Brown, Geoffrey; Warner, Kirstin; Phillips, Jason; Shelley, Timothy; Reyes, Jose; Hsu, Peter

    2013-06-01

    One of the first steps in establishing safe handling procedures for explosives is small-scale safety and thermal (SSST) testing. To better understand the response of improvised materials or HMEs to SSST testing, 18 HME materials were compared to 3 standard military explosives in a proficiency-type round robin study among five laboratories--2 DoD and 3 DOE--sponsored by DHS. The testing matrix has been designed to address problems encountered with improvised materials--powder mixtures, liquid suspensions, partially wetted solids, immiscible liquids, and reactive materials. Over 30 issues have been identified that indicate standard test methods may require modification when applied to HMEs to derive accurate sensitivity assessments needed for development safe handling and storage practices. This presentation will discuss experimental difficulties encountered when testing these problematic samples, show inter-laboratory testing results, show some statistical interpretation of the results, and highlight some of the testing issues. Some of the work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. LLNL-ABS-617519 (721812).

  10. 76 FR 49491 - Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ...] Medicare Program; Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration... code under the Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration. The deadline for... interested parties of an opportunity to participate in the Treatment of Certain Complex Diagnostic Laboratory...

  11. 42 CFR 493.25 - Laboratories performing tests of high complexity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Laboratories performing tests of high complexity. 493.25 Section 493.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND....25 Laboratories performing tests of high complexity. (a) A laboratory must obtain a certificate for...

  12. 42 CFR 493.25 - Laboratories performing tests of high complexity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Laboratories performing tests of high complexity. 493.25 Section 493.25 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND....25 Laboratories performing tests of high complexity. (a) A laboratory must obtain a certificate for...

  13. A field and laboratory investigation of acid effects on largemouth bass, rock bass, black crappie, and yellow perch

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Eaton, J.G.; McCormick, J.H.; Swenson, W.A.

    1992-09-01

    One-half of Little Rock Lake, a small seepage lake in north-central Wisconsin, was gradually acidified by additions of sulfuric acid between August 1983 and November 1990. The ambient pH (6.1) of the lake was reduced at successive 2-year intervals to pH 5.6, 5.1, and 4.7. Responses of largemouth bass Micropterus salmoides, rock bass Ambloplites rupestris, black crappie Pomoxis nigromaculatus, and yellow perch Perca flavescens populations to the pH reductions were recorded and compared to the responses of these species during in situ bioassays and laboratory toxicity tests on embryos and larvae. Laboratory results obtained for largemouth bass and rock bassmore » underestimated, black crappie results overestimated, and yellow perch results were similar to effects observed in field studies. In situ bioassays predicted field responses better than did laboratory toxicity tests. Laboratory results showed that monomeric Al concentrations of approximately 50 [mu]g/L, which were comparable to Al concentrations in the acidified half of the lake, altered low-pH toxicity. Reduced recruitment was observed in field populations at higher pH than that at which adult mortality was observed. The results indicate that laboratory toxicity tests with early life stages may not accurately predict field population responses and that results from laboratory tests should be field-validated whenever possible. 42 refs., 2 figs., 7 tabs.« less

  14. 49 CFR 40.113 - Where is other information concerning laboratories found in this regulation?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.113... specimen tests (drugs). § 40.179—Role of second laboratory in split specimen tests (adulterants). § 40.181...

  15. 49 CFR 40.113 - Where is other information concerning laboratories found in this regulation?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.113... specimen tests (drugs). § 40.179—Role of second laboratory in split specimen tests (adulterants). § 40.181...

  16. 49 CFR 40.113 - Where is other information concerning laboratories found in this regulation?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.113... specimen tests (drugs). § 40.179—Role of second laboratory in split specimen tests (adulterants). § 40.181...

  17. 49 CFR 40.113 - Where is other information concerning laboratories found in this regulation?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.113... specimen tests (drugs). § 40.179—Role of second laboratory in split specimen tests (adulterants). § 40.181...

  18. 49 CFR 40.113 - Where is other information concerning laboratories found in this regulation?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Drug Testing Laboratories § 40.113... specimen tests (drugs). § 40.179—Role of second laboratory in split specimen tests (adulterants). § 40.181...

  19. Classifying performance impairment in response to sleep loss using pattern recognition algorithms on single session testing

    PubMed Central

    St. Hilaire, Melissa A.; Sullivan, Jason P.; Anderson, Clare; Cohen, Daniel A.; Barger, Laura K.; Lockley, Steven W.; Klerman, Elizabeth B.

    2012-01-01

    There is currently no “gold standard” marker of cognitive performance impairment resulting from sleep loss. We utilized pattern recognition algorithms to determine which features of data collected under controlled laboratory conditions could most reliably identify cognitive performance impairment in response to sleep loss using data from only one testing session, such as would occur in the “real world” or field conditions. A training set for testing the pattern recognition algorithms was developed using objective Psychomotor Vigilance Task (PVT) and subjective Karolinska Sleepiness Scale (KSS) data collected from laboratory studies during which subjects were sleep deprived for 26 – 52 hours. The algorithm was then tested in data from both laboratory and field experiments. The pattern recognition algorithm was able to identify performance impairment with a single testing session in individuals studied under laboratory conditions using PVT, KSS, length of time awake and time of day information with sensitivity and specificity as high as 82%. When this algorithm was tested on data collected under real-world conditions from individuals whose data were not in the training set, accuracy of predictions for individuals categorized with low performance impairment were as high as 98%. Predictions for medium and severe performance impairment were less accurate. We conclude that pattern recognition algorithms may be a promising method for identifying performance impairment in individuals using only current information about the individual’s behavior. Single testing features (e.g., number of PVT lapses) with high correlation with performance impairment in the laboratory setting may not be the best indicators of performance impairment under real-world conditions. Pattern recognition algorithms should be further tested for their ability to be used in conjunction with other assessments of sleepiness in real-world conditions to quantify performance impairment in response to sleep loss. PMID:22959616

  20. Validation of "laboratory-supported" criteria for functional (psychogenic) tremor.

    PubMed

    Schwingenschuh, Petra; Saifee, Tabish A; Katschnig-Winter, Petra; Macerollo, Antonella; Koegl-Wallner, Mariella; Culea, Valeriu; Ghadery, Christine; Hofer, Edith; Pendl, Tamara; Seiler, Stephan; Werner, Ulrike; Franthal, Sebastian; Maurits, Natasha M; Tijssen, Marina A; Schmidt, Reinhold; Rothwell, John C; Bhatia, Kailash P; Edwards, Mark J

    2016-04-01

    In a small group of patients, we have previously shown that a combination of electrophysiological tests was able to distinguish functional (psychogenic) tremor and organic tremor with excellent sensitivity and specificity. This study aims to validate an electrophysiological test battery as a tool to diagnose patients with functional tremor with a "laboratory-supported" level of certainty. For this prospective data collection study, we recruited 38 new patients with functional tremor (mean age 37.9 ± 24.5 years; mean disease duration 5.9 ± 9.0 years) and 73 new patients with organic tremor (mean age 55.4 ± 25.4 years; mean disease duration 15.8 ± 17.7 years). Tremor was recorded at rest, posture (with and without loading), action, while performing tapping tasks (1, 3, and 5 Hz), and while performing ballistic movements with the less-affected hand. Electrophysiological tests were performed by raters blinded to the clinical diagnosis. We calculated a sum score for all performed tests (maximum of 10 points) and used a previously suggested cut-off score of 3 points for a diagnosis of laboratory-supported functional tremor. We demonstrated good interrater reliability and test-retest reliability. Patients with functional tremor had a higher average score on the test battery when compared with patients with organic tremor (3.6 ± 1.4 points vs 1.0 ± 0.8 points; P < .001), and the predefined cut-off score for laboratory-supported functional tremor yielded a test sensitivity of 89.5% and a specificity of 95.9%. We now propose this test battery as the basis of laboratory-supported criteria for the diagnosis of functional tremor, and we encourage its use in clinical and research practice. © 2016 International Parkinson and Movement Disorder Society.

  1. Interlaboratory Study of Quality Control Isolates for a Broth Microdilution Method (Modified CLSI M38-A) for Testing Susceptibilities of Dermatophytes to Antifungals▿

    PubMed Central

    Ghannoum, M. A.; Arthington-Skaggs, B.; Chaturvedi, V.; Espinel-Ingroff, A.; Pfaller, M. A.; Rennie, R.; Rinaldi, M. G.; Walsh, T. J.

    2006-01-01

    The Clinical and Laboratory Standards Institute (CLSI; formerly National Committee for Clinical Laboratory Standards, or NCCLS) M38-A standard for the susceptibility testing of filamentous fungi does not specifically address the testing of dermatophytes. In 2003, a multicenter study investigated the reproducibility of the microdilution method developed at the Center for Medical Mycology, Cleveland, Ohio, for testing the susceptibility of dermatophytes. Data from that study supported the introduction of this method for testing dermatophytes in the future version of the CLSI M38-A standard. In order for the method to be accepted by CLSI, appropriate quality control isolates needed to be identified. To that end, an interlaboratory study, involving the original six laboratories plus two additional sites, was conducted to evaluate potential candidates for quality control isolates. These candidate strains included five Trichophyton rubrum strains known to have elevated MICs to terbinafine and five Trichophyton mentagrophytes strains. Antifungal agents tested included ciclopirox, fluconazole, griseofulvin, itraconazole, posaconazole, terbinafine, and voriconazole. Based on the data generated, two quality control isolates, one T. rubrum isolate and one T. mentagrophytes isolate, were identified and submitted to the American Type Culture Collection (ATCC) for inclusion as reference strains. Ranges encompassing 95.2 to 97.9% of all data points for all seven drugs were established. PMID:17050812

  2. Deep Borehole Field Test Research Activities at LBNL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dobson, Patrick; Tsang, Chin-Fu; Kneafsey, Timothy

    The goal of the U.S. Department of Energy Used Fuel Disposition’s (UFD) Deep Borehole Field Test is to drill two 5 km large-diameter boreholes: a characterization borehole with a bottom-hole diameter of 8.5 inches and a field test borehole with a bottom-hole diameter of 17 inches. These boreholes will be used to demonstrate the ability to drill such holes in crystalline rocks, effectively characterize the bedrock repository system using geophysical, geochemical, and hydrological techniques, and emplace and retrieve test waste packages. These studies will be used to test the deep borehole disposal concept, which requires a hydrologically isolated environment characterizedmore » by low permeability, stable fluid density, reducing fluid chemistry conditions, and an effective borehole seal. During FY16, Lawrence Berkeley National Laboratory scientists conducted a number of research studies to support the UFD Deep Borehole Field Test effort. This work included providing supporting data for the Los Alamos National Laboratory geologic framework model for the proposed deep borehole site, conducting an analog study using an extensive suite of geoscience data and samples from a deep (2.5 km) research borehole in Sweden, conducting laboratory experiments and coupled process modeling related to borehole seals, and developing a suite of potential techniques that could be applied to the characterization and monitoring of the deep borehole environment. The results of these studies are presented in this report.« less

  3. [Patient satisfaction in a laboratory test collection unit].

    PubMed

    de Moura, Gisela Maria Schebella Souto; Hilleshein, Eunice Fabiani; Schardosim, Juliana Machado; Delgado, Kátia Simone

    2008-06-01

    This exploratory descriptive study aimed at identifying customer satisfaction attributes in the field of laboratory tests. Data were collected in 2006, using 104 interviews in a laboratorial unit inside a teaching hospital, using the critical incident technique, and submitted to content analysis. Three attribute categories were identified: time spent in waiting for care, interpersonal contact, and technical skills. These results subsidize the assessment of the current satisfaction survey tool, and point to its reformulation. They also allow the identification of improvement needs in customer attention, and provide elements to be taken into account in personnel selection, training programs, personnel performance assessment.

  4. Utility of repeat testing of critical values: a Q-probes analysis of 86 clinical laboratories.

    PubMed

    Lehman, Christopher M; Howanitz, Peter J; Souers, Rhona; Karcher, Donald S

    2014-06-01

    A common laboratory practice is to repeat critical values before reporting the test results to the clinical care provider. This may be an unnecessary step that delays the reporting of critical test results without adding value to the accuracy of the test result. To determine the proportions of repeated chemistry and hematology critical values that differ significantly from the original value as defined by the participating laboratory, to determine the threshold differences defined by the laboratory as clinically significant, and to determine the additional time required to analyze the repeat test. Participants prospectively reviewed critical test results for 4 laboratory tests: glucose, potassium, white blood cell count, and platelet count. Participants reported the following information: initial and repeated test result; time initial and repeat results were first known to laboratory staff; critical result notification time; if the repeat result was still a critical result; if the repeat result was significantly different from the initial result, as judged by the laboratory professional or policy; significant difference threshold, as defined by the laboratory; the make and model of the instrument used for primary and repeat testing. Routine, repeat analysis of critical values is a common practice. Most laboratories did not formally define a significant difference between repeat results. Repeated results were rarely considered significantly different. Median repeated times were at least 17 to 21 minutes for 10% of laboratories. Twenty percent of laboratories reported at least 1 incident in the last calendar year of delayed result reporting that clinicians indicated had adversely affected patient care. Routine repeat analysis of automated chemistry and hematology critical values is unlikely to be clinically useful and may adversely affect patient care.

  5. Comet assay in reconstructed 3D human epidermal skin models--investigation of intra- and inter-laboratory reproducibility with coded chemicals.

    PubMed

    Reus, Astrid A; Reisinger, Kerstin; Downs, Thomas R; Carr, Gregory J; Zeller, Andreas; Corvi, Raffaella; Krul, Cyrille A M; Pfuhler, Stefan

    2013-11-01

    Reconstructed 3D human epidermal skin models are being used increasingly for safety testing of chemicals. Based on EpiDerm™ tissues, an assay was developed in which the tissues were topically exposed to test chemicals for 3h followed by cell isolation and assessment of DNA damage using the comet assay. Inter-laboratory reproducibility of the 3D skin comet assay was initially demonstrated using two model genotoxic carcinogens, methyl methane sulfonate (MMS) and 4-nitroquinoline-n-oxide, and the results showed good concordance among three different laboratories and with in vivo data. In Phase 2 of the project, intra- and inter-laboratory reproducibility was investigated with five coded compounds with different genotoxicity liability tested at three different laboratories. For the genotoxic carcinogens MMS and N-ethyl-N-nitrosourea, all laboratories reported a dose-related and statistically significant increase (P < 0.05) in DNA damage in every experiment. For the genotoxic carcinogen, 2,4-diaminotoluene, the overall result from all laboratories showed a smaller, but significant genotoxic response (P < 0.05). For cyclohexanone (CHN) (non-genotoxic in vitro and in vivo, and non-carcinogenic), an increase compared to the solvent control acetone was observed only in one laboratory. However, the response was not dose related and CHN was judged negative overall, as was p-nitrophenol (p-NP) (genotoxic in vitro but not in vivo and non-carcinogenic), which was the only compound showing clear cytotoxic effects. For p-NP, significant DNA damage generally occurred only at doses that were substantially cytotoxic (>30% cell loss), and the overall response was comparable in all laboratories despite some differences in doses tested. The results of the collaborative study for the coded compounds were generally reproducible among the laboratories involved and intra-laboratory reproducibility was also good. These data indicate that the comet assay in EpiDerm™ skin models is a promising model for the safety assessment of compounds with a dermal route of exposure.

  6. Comet assay in reconstructed 3D human epidermal skin models—investigation of intra- and inter-laboratory reproducibility with coded chemicals

    PubMed Central

    Pfuhler, Stefan

    2013-01-01

    Reconstructed 3D human epidermal skin models are being used increasingly for safety testing of chemicals. Based on EpiDerm™ tissues, an assay was developed in which the tissues were topically exposed to test chemicals for 3h followed by cell isolation and assessment of DNA damage using the comet assay. Inter-laboratory reproducibility of the 3D skin comet assay was initially demonstrated using two model genotoxic carcinogens, methyl methane sulfonate (MMS) and 4-nitroquinoline-n-oxide, and the results showed good concordance among three different laboratories and with in vivo data. In Phase 2 of the project, intra- and inter-laboratory reproducibility was investigated with five coded compounds with different genotoxicity liability tested at three different laboratories. For the genotoxic carcinogens MMS and N-ethyl-N-nitrosourea, all laboratories reported a dose-related and statistically significant increase (P < 0.05) in DNA damage in every experiment. For the genotoxic carcinogen, 2,4-diaminotoluene, the overall result from all laboratories showed a smaller, but significant genotoxic response (P < 0.05). For cyclohexanone (CHN) (non-genotoxic in vitro and in vivo, and non-carcinogenic), an increase compared to the solvent control acetone was observed only in one laboratory. However, the response was not dose related and CHN was judged negative overall, as was p-nitrophenol (p-NP) (genotoxic in vitro but not in vivo and non-carcinogenic), which was the only compound showing clear cytotoxic effects. For p-NP, significant DNA damage generally occurred only at doses that were substantially cytotoxic (>30% cell loss), and the overall response was comparable in all laboratories despite some differences in doses tested. The results of the collaborative study for the coded compounds were generally reproducible among the laboratories involved and intra-laboratory reproducibility was also good. These data indicate that the comet assay in EpiDerm™ skin models is a promising model for the safety assessment of compounds with a dermal route of exposure. PMID:24150594

  7. What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

    PubMed

    Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

    2018-02-17

    For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal risk assessment, rather than competing with economic value, enhances it.

  8. Potential over request in anemia laboratory tests in primary care in Spain.

    PubMed

    Salinas, María; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

    2015-07-01

    The aim was to study the inter-practice variability in anemia laboratory tests requested by general practitioners in Spain, to evaluate for a potential requesting inappropriateness. Laboratories from diverse Spanish regions filled out the number of cell blood count, ferritin, folate, iron, transferrin, and vitamin B12 requested by general practitioners during 2012. The number of test requests per 1000 inhabitants and ratios of related tests requests were calculated. The results obtained in hospitals from different areas (urban, rural, or urban-rural), type of management (public or private), and geographic regions were compared. There was a high variability in the number of test requests and ratios of related tests. Cell blood count was over requested in rural areas and in hospitals with private management. Andalucía was the community with the lowest number of iron requests and the lowest folate/vitamin B12 indicator value. Iron and transferrin seemed over requested in some areas; as were folate and ferritin when compared to vitamin B12 and cell blood count, respectively. The differences observed between areas indicate that other factors besides clinical reasons could be behind that variability and emphasize the need to accomplish interventions to improve the appropriate use of anemia laboratory tests.

  9. Artificial Neural Network Approach in Laboratory Test Reporting:  Learning Algorithms.

    PubMed

    Demirci, Ferhat; Akan, Pinar; Kume, Tuncay; Sisman, Ali Riza; Erbayraktar, Zubeyde; Sevinc, Suleyman

    2016-08-01

    In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently. The experimental model was built by Weka software (Weka, Waikato, New Zealand) based on the artificial neural network method. Data were received from Dokuz Eylül University Central Laboratory. "Training sets" were developed for our experimental model to teach the evaluation criteria. After training the system, "test sets" developed for different conditions were used to statistically assess the validity of the model. After developing the decision algorithm with three iterations of training, no result was verified that was refused by the laboratory specialist. The sensitivity of the model was 91% and specificity was 100%. The estimated κ score was 0.950. This is the first study based on an artificial neural network to build an experimental assessment and decision algorithm model. By integrating our trained algorithm model into a laboratory information system, it may be possible to reduce employees' workload without compromising patient safety. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. P300: Waves Identification with and without Subtraction of Traces

    PubMed Central

    Romero, Ana Carla Leite; Reis, Ana Cláudia Mirândola Barbosa; Oliveira, Anna Caroline Silva de; Oliveira Simões, Humberto de; Oliveira Junqueira, Cinthia Amorim de; Frizzo, Ana Cláudia Figueiredo

    2017-01-01

    Introduction  The P300 test requires well-defined and unique criteria, in addition to training for the examiners, for a uniform analysis of studies and to avoid variations and errors in the interpretation of measurement results. Objectives  The objective of this study is to verify whether there are differences in P300 with and without subtraction of traces of standard and nonstandard stimuli. Method  We conducted this study in collaboration with two research electrophysiology laboratories. From Laboratory 1, we selected 40 tests of subjects between 7–44 years, from Laboratory 2, we selected 83 tests of subjects between 18–44 years. We first performed the identification with the nonstandard stimuli; then, we subtracted the nonstandard stimuli from the standard stimuli. The examiners identified the waves, performing a descriptive and comparative analysis of traces with and without subtraction. Results  After a comparative analysis of the traces with and without subtraction, there was no significant difference when compared with analysis of traces in both laboratories, within the conditions, of right ears ( p  = 0.13 and 0.28 for differences between latency and amplitude measurements) and left ears ( p  = 0.15 and 0.09 for differences between latency and amplitude measurements) from Laboratory 1. As for Laboratory 2, when investigating both ears, results did not identify significant differences ( p  = 0.098 and 0.28 for differences between latency and amplitude measurements). Conclusion  There was no difference verified in traces with and without subtraction. We suggest the identification of this potential performed through nonstandard stimuli. PMID:29018497

  11. Coding and Analysing Behaviour Strategies of Instructors in University Science Laboratories to Improve Science Teachers Training

    ERIC Educational Resources Information Center

    Ajaja, Patrick Osawaru

    2013-01-01

    The intention of this study was to determine how science instructors in the university laboratories spend time on instruction. The study, was guided by three research questions and two hypotheses tested at 0.05 level of significance. The study employed a non-participant observation case study design. 48 instructors teaching lower and higher levels…

  12. Creating Best Practices for the Submission of Actionable Food and Feed Testing Data Generated in State and Local Laboratories.

    PubMed

    Wangsness, Kathryn; Salfinger, Yvonne; Randolph, Robyn; Shea, Shari; Larson, Kirsten

    2017-07-01

    Laboratory accreditation provides a level of standardization in laboratories and confidence in generated food and feed testing results. For some laboratories, ISO/IEC 17025:2005 accreditation may not be fiscally viable, or a requested test method may be out of the scope of the laboratory's accreditation. To assist laboratories for whom accreditation is not feasible, the Association of Public Health Laboratories Data Acceptance Work Group developed a white paper entitled "Best Practices for Submission of Actionable Food and Feed Testing Data Generated in State and Local Laboratories." The basic elements of a quality management system, along with other best practices that state and local food and feed testing laboratories should follow, are included in the white paper. It also covers program-specific requirements that may need to be addressed. Communication with programs and end data users is regarded as essential for establishing the reliability and accuracy of laboratory data. Following these suggested best practices can facilitate the acceptance of laboratory data, which can result in swift regulatory action and the quick removal of contaminated product from the food supply, improving public health nationally.

  13. The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system.

    PubMed

    Massambu, Charles; Mwangi, Christina

    2009-06-01

    The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process.

  14. Access to laboratory testing: the impact of managed care in the Pacific Northwest.

    PubMed

    LaBeau, K M; Simon, M; Steindel, S J

    1999-01-01

    Patient access to health-care services has become an important issue owing to the growth of managed care organizations and the number of patients enrolled. To better understand the current issues related to access to laboratory testing, with a particular focus on the impact of managed care, we gathered information from a network of clinical laboratories in the Pacific Northwest. Two questionnaires were sent to the 257 Laboratory Medicine Sentinel Monitoring Network participants in November 1995 and March 1996 to investigate trends in the availability and utilization of laboratory testing services and changes in onsite testing menus. Although laboratories reported that managed care was a factor in their decisions about laboratory practices, testing decisions were more likely made for business reasons, based on medical practice changes and marketplace influences not associated with managed care.

  15. Searching for the origins of musicality across species.

    PubMed

    Hoeschele, Marisa; Merchant, Hugo; Kikuchi, Yukiko; Hattori, Yuko; ten Cate, Carel

    2015-03-19

    In the introduction to this theme issue, Honing et al. suggest that the origins of musicality--the capacity that makes it possible for us to perceive, appreciate and produce music--can be pursued productively by searching for components of musicality in other species. Recent studies have highlighted that the behavioural relevance of stimuli to animals and the relation of experimental procedures to their natural behaviour can have a large impact on the type of results that can be obtained for a given species. Through reviewing laboratory findings on animal auditory perception and behaviour, as well as relevant findings on natural behaviour, we provide evidence that both traditional laboratory studies and studies relating to natural behaviour are needed to answer the problem of musicality. Traditional laboratory studies use synthetic stimuli that provide more control than more naturalistic studies, and are in many ways suitable to test the perceptual abilities of animals. However, naturalistic studies are essential to inform us as to what might constitute relevant stimuli and parameters to test with laboratory studies, or why we may or may not expect certain stimulus manipulations to be relevant. These two approaches are both vital in the comparative study of musicality.

  16. Searching for the origins of musicality across species

    PubMed Central

    Hoeschele, Marisa; Merchant, Hugo; Kikuchi, Yukiko; Hattori, Yuko; ten Cate, Carel

    2015-01-01

    In the introduction to this theme issue, Honing et al. suggest that the origins of musicality—the capacity that makes it possible for us to perceive, appreciate and produce music—can be pursued productively by searching for components of musicality in other species. Recent studies have highlighted that the behavioural relevance of stimuli to animals and the relation of experimental procedures to their natural behaviour can have a large impact on the type of results that can be obtained for a given species. Through reviewing laboratory findings on animal auditory perception and behaviour, as well as relevant findings on natural behaviour, we provide evidence that both traditional laboratory studies and studies relating to natural behaviour are needed to answer the problem of musicality. Traditional laboratory studies use synthetic stimuli that provide more control than more naturalistic studies, and are in many ways suitable to test the perceptual abilities of animals. However, naturalistic studies are essential to inform us as to what might constitute relevant stimuli and parameters to test with laboratory studies, or why we may or may not expect certain stimulus manipulations to be relevant. These two approaches are both vital in the comparative study of musicality. PMID:25646517

  17. Virtual laboratory learning media development to improve science literacy skills of mechanical engineering students on basic physics concept of material measurement

    NASA Astrophysics Data System (ADS)

    Jannati, E. D.; Setiawan, A.; Siahaan, P.; Rochman, C.

    2018-05-01

    This study aims to determine the description of virtual laboratory learning media development to improve science literacy skills of Mechanical Engineering students on the concept of basic Physics. Quasi experimental method was employed in this research. The participants of this research were first semester students of mechanical engineering in Majalengka University. The research instrument was readability test of instructional media. The results of virtual laboratory learning media readability test show that the average score is 78.5%. It indicates that virtual laboratory learning media development are feasible to be used in improving science literacy skill of Mechanical Engineering students in Majalengka University, specifically on basic Physics concepts of material measurement.

  18. Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico

    PubMed Central

    Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Hernández-Tinoco, Jesús; Rico-Almochantaf, Yazmin del Rosario; Cisneros-Camacho, Alfredo; Cisneros-Martínez, Jorge Arturo

    2017-01-01

    Background: The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods: 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results: The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti-T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti-T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by <15% of participants. Most (84.4%) participants had not performed tests for detection T. gondii infection. Conclusions: Results indicate incomplete knowledge of T. gondii infection and toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed. PMID:29156547

  19. Analysis of on-line clinical laboratory manuals and practical recommendations.

    PubMed

    Beckwith, Bruce; Schwartz, Robert; Pantanowitz, Liron

    2004-04-01

    On-line clinical laboratory manuals are a valuable resource for medical professionals. To our knowledge, no recommendations currently exist for their content or design. To analyze publicly accessible on-line clinical laboratory manuals and to propose guidelines for their content. We conducted an Internet search for clinical laboratory manuals written in English with individual test listings. Four individual test listings in each manual were evaluated for 16 data elements, including sample requirements, test methodology, units of measure, reference range, and critical values. Web sites were also evaluated for supplementary information and search functions. We identified 48 on-line laboratory manuals, including 24 academic or community hospital laboratories and 24 commercial or reference laboratories. All manuals had search engines and/or test indices. No single manual contained all 16 data elements evaluated. An average of 8.9 (56%) elements were present (range, 4-14). Basic sample requirements (specimen and volume needed) were the elements most commonly present (98% of manuals). The frequency of the remaining data elements varied from 10% to 90%. On-line clinical laboratory manuals originate from both hospital and commercial laboratories. While most manuals were user-friendly and contained adequate specimen-collection information, other important elements, such as reference ranges, were frequently absent. To ensure that clinical laboratory manuals are of maximal utility, we propose the following 13 data elements be included in individual test listings: test name, synonyms, test description, test methodology, sample requirements, volume requirements, collection guidelines, transport guidelines, units of measure, reference range, critical values, test availability, and date of latest revision.

  20. Non-destructive testing of concrete.

    DOT National Transportation Integrated Search

    1979-11-01

    This research project was initiated to evaluate the performance of an ultrasonic testing device device in predicting compressive strengths from tests performed on samples of fresh concrete. : The initial phase of this study involved laboratory perora...

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