Effects of Dynamic Temperature and Humidity Stresses on Point-of-Care Glucose Testing for Disaster Care

2012 ◽  
Vol 6 (3) ◽  
pp. 232-240 ◽  
Author(s):  
Richard F. Louie ◽  
William J. Ferguson ◽  
Stephanie L. Sumner ◽  
Jimmy N. Yu ◽  
Corbin M. Curtis ◽  
...  
Keyword(s):  
Hurricane Katrina ◽  
Point Of Care ◽  
Glucose Dehydrogenase ◽  
Test Strips ◽  
Dynamic Temperature ◽  
Glucose Testing ◽  
Temperature And Humidity ◽  
Level 3 ◽  
Glucose Test ◽  
Level 1

ABSTRACTObjective: To characterize the performance of glucose meter test strips using simulated dynamic temperature and humidity disaster conditions.Methods: Glucose oxidase- and glucose dehydrogenase-based test strips were dynamically stressed for up to 680 hours using an environmental chamber to simulate conditions during Hurricane Katrina. Paired measurements vs control were obtained using 3 aqueous reagent levels for GMS1 and 2 for GMS2.Results: Stress affected the performance of GMS1 at level 1 (P <. 01); and GMS2 at both levels (P <. 001), lowering GMS1 results but elevating GMS2 results. Glucose median-paired differences were elevated at both levels on GMS2 after 72 hours. Median-paired differences (stress minus control) were as much as −10 mg/dL (range, −65 to 33) at level 3 with GMS1, with errors as large as 21.9%. Glucose median-paired differences were as high as 5 mg/dL (range, −1 to 10) for level 1 on GMS2, with absolute errors up to 24.4%.Conclusions: The duration of dynamic stress affected the performance of both GMS1 and GMS2 glucose test strips. Therefore, proper monitoring, handling, and storage of point-of-care (POC) reagents are needed to ensure their integrity and quality of actionable results, thereby minimizing treatment errors in emergency and disaster settings.(Disaster Med Public Health Preparedness. 2012;6:232–240)

scholarly journals Thermal Stress and Point-of-Care Testing Performance: Suitability of Glucose Test Strips and Blood Gas Cartridges for Disaster Response

2009 ◽  
Vol 3 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Richard F. Louie ◽  
Stephanie L. Sumner ◽  
Shaunyé Belcher ◽  
Ron Mathew ◽  
Nam K. Tran ◽  
...  
Keyword(s):  
Thermal Stresses ◽  
Point Of Care ◽  
Blood Gas ◽  
Point Of Care Testing ◽  
Medical Assistance ◽  
Test Strips ◽  
Glucose Test ◽  
Glucose Meter ◽  
Glucose Test Strips ◽  
Blood Gas Analyzer

ABSTRACTObjective: Point-of-care testing (POCT) devices are deployed in the field for emergency on-site testing under a wide range of environmental conditions. Our objective was to evaluate the performance of glucose meter test strips and handheld blood gas analyzer cartridges following thermal stresses that simulate field conditions.Methods: We evaluated electrochemical and spectrophotometric glucose meter systems and a handheld blood gas analyzer. Glucose test strips were cold-stressed (–21°C) and heat-stressed (40°C) for up to 4 weeks. Blood gas cartridges were stressed at –21°C, 2°C, and 40°C for up to 72 hours. Test strip and cartridge performance was evaluated using aqueous quality control solutions. Results were compared with those obtained with unstressed POCT strips and cartridges.Results: Heated glucose test strips and blood gas cartridges yielded elevated results. Frozen test strips and cooled cartridges yielded depressed glucose and blood gas results, respectively. Frozen cartridges failed.Conclusions: The performance of glucose test strips and blood gas cartridges was affected adversely by thermal stresses. Heating generated elevated results, and cooling depressed results. Disaster medical assistance teams and emergency medical responders should be aware of these risks. Field POCT devices must be robust to withstand adverse conditions. We recommend that industry produce POCT devices and reagents suitable for disaster medical assistance teams. (Disaster Med Public Health Preparedness. 2009;3:13–17)

Oxygen effects on glucose meter measurements with glucose dehydrogenase- and oxidase-based test strips for point-of-care testing

2001 ◽  
Vol 29 (5) ◽  
pp. 1062-1070 ◽  
Author(s):  
Zuping Tang ◽  
Richard F. Louie ◽  
Judith H. Lee ◽  
Debra M. Lee ◽  
Earl E. Miller ◽  
...  
Keyword(s):  
Point Of Care ◽  
Glucose Dehydrogenase ◽  
Point Of Care Testing ◽  
Test Strips ◽  
Oxygen Effects ◽  
Glucose Meter

scholarly journals EVALUASI ANALITIK POCT METODE GLUCOSE DEHYDROGENASE PARAMETER GLUKOSA PADA SPESEIMEN SERUM DAN PLASMA EDTA

2021 ◽  
Vol 9 (1) ◽  
pp. 26-36
Author(s):  
Suryanata Kesuma ◽  
Didi Irwadi ◽  
Nia Ardelia
Keyword(s):  
Health Care ◽  
Whole Blood ◽  
Communicable Disease ◽  
Point Of Care ◽  
Glucose Dehydrogenase ◽  
Serum Glucose ◽  
Glucose Measurement ◽  
Glucose Testing ◽  
Analytic Evaluation ◽  
Health Care Institutions

Diabetes is a non-communicable disease that can be prevented and detected as early as possible by routine glucose checks. Point Of Care Testing (POCT) as a diabetes test screening tool is widely used by health care institutions and is even used independently by the wider community. Blood glucose can be measured by serum, plasma, and whole blood specimens. The standard specimen for glucose measurement using POCT is whole blood. Based on the author's survey, the use of the POCT tool in several health care institutions was not following the insert of the tool kit, one of which was the type of specimen used. Many laboratories use EDTA serum and plasma specimens for glucose testing using the POCT device. There are many methods used in the POCT tool, one of these methods is the glucose dehydrogenase method. Therefore analytic evaluation is necessary to ensure the accuracy and accuracy of laboratory examination results in glucose examination. This type of research is the analytical method with a comparative design. The data was collected using the total sampling method. The data is reported using Microsoft Excel and SPSS applications. The number of samples for analytic evaluation was 40 samples. Based on the results of tests performed in duplicate, there were clinical differences in glucose values using serum and plasma EDTA samples so that the use of these samples was not suitable for use for diagnostic purposes using the POCT glucose dehydrogenase method. There was a statistical difference in serum glucose and plasma EDTA against whole blood that was examined using the POCT glucose dehydrogenase method with a correlation value (R) of 0.9722 and 0.9695.

Effects of Humidity on Foil and Vial Packaging to Preserve Glucose and Lactate Test Strips for Disaster Readiness

2014 ◽  
Vol 8 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Anh-Thu Truong ◽  
Richard F. Louie ◽  
John H. Vy ◽  
Corbin M. Curtis ◽  
William J. Ferguson ◽  
...  
Keyword(s):  
Disaster Response ◽  
Point Of Care ◽  
Test Strip ◽  
Rank Test ◽  
Test Strips ◽  
Signed Rank ◽  
Test Concentration ◽  
Signed Rank Test ◽  
Glucose Test ◽  
Experimental Trials

AbstractObjectiveEfficient emergency and disaster response is challenged by environmental conditions exceeding test reagent storage and operating specifications. We assessed the effectiveness of vial and foil packaging in preserving point-of-care (POC) glucose and lactate test strip performance in humid conditions.MethodsGlucose and lactate test strips in both packaging were exposed to mean relative humidity of 97.0 ± 1.1% in an environmental chamber for up to 168 hours. At defined time points, stressed strips were removed and tested in pairs with unstressed strips using whole blood samples spiked to glucose concentrations of 60, 100, and 250 mg/dL (n = 20 paired measurements per level). A Wilcoxon signed rank test was used to compare stressed and unstressed test strip measurements.ResultsStressed glucose and lactate test strip measurements differed significantly from unstressed strips, and were inconsistent between experimental trials. Median glucose paired difference was as high as 12.5 mg/dL at the high glucose test concentration. Median lactate bias was −0.2 mmol/L. Stressed strips from vial (3) and foil (7) packaging failed to produce results.ConclusionsBoth packaging designs appeared to protect glucose and lactate test strips for at least 1 week of high humidity stress. Documented strip failures revealed the need for improved manufacturing process. (Disaster Med Public Health Preparedness. 2014;0:1–7)

Anwendung des 10-Gruppenklassifikationssystems nach Robson für den Vergleich eines Perinatalzentrums Level 1 mit einem Level-3-Zentrum

2020 ◽  
Author(s):  
C Pulvermacher ◽  
P van de Vondel ◽  
L Gerzen ◽  
U Gembruch ◽  
W Merz
Keyword(s):  
Level 3 ◽  
Level 1

EVALUASI PELATIHAN DI PT. PUPUK KUJANG CIKAMPEK

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Lania Muharsih ◽  
Ratih Saraswati
Keyword(s):  
Training Evaluation ◽  
Work Productivity ◽  
Learning Behavior ◽  
Level 3 ◽  
Level 1 ◽  
Four Levels ◽  
A Company ◽  
Level 2 ◽  
Evaluation Sheet ◽  
Assessment Factor

This study aims to determine the training evaluation at PT. Kujang Fertilizer. PT. Pupuk Kujang is a company engaged in the field of petrochemicals. Evaluation sheet of PT. Fertilizer Kujang is made based on Kirkpatrick's theory which consists of four levels of evaluation, namely reaction, learning, behavior, and results. At level 1, namely reaction, in the evaluation sheet is in accordance with the theory of Kirkpatrick, at level 2 that is learning should be held pretest and posttest but only made scale. At level 3, behavior, according to theory, but on assessment factor number 3, quantity and work productivity should not need to be included because they are included in level 4. At level 4, that is the result, here is still lacking to get a picture of the results of the training that has been carried out because only based on answers from superiors without evidence of any documents.   Keywords: Training Evaluation, Kirkpatrick Theory.    Penelitian ini bertujuan mengetahui evaluasi training di PT. Pupuk Kujang. PT. Pupuk Kujang merupakan perusahaan yang bergerak di bidang petrokimia. Lembar evaluasi PT. Pupuk Kujang dibuat berdasarkan teori Kirkpatrick yang terdiri dari empat level evaluasi, yaitu reaksi, learning, behavior, dan hasil. Pada level 1 yaitu reaksi, di lembar evaluasi tersebut sudah sesuai dengan teori dari Kirkpatrick, pada level 2 yaitu learning seharusnya diadakan pretest dan posttest namun hanya dibuatkan skala. Pada level 3 yaitu behavior, sudah sesuai teori namun pada faktor penilaian nomor 3 kuantitas dan produktivitas kerja semestinya tidak perlu dimasukkan karena sudah termasuk ke dalam level 4. Pada level 4 yaitu hasil, disini masih sangat kurang untuk mendapatkan gambaran hasil dari pelatihan yang sudah dilaksanakan karena hanya berdasarkan dari jawaban atasan tanpa bukti dokumen apapun.   Kata kunci: Evaluasi Pelatihan, Teori Kirkpatrick.

scholarly journals 905 How to prioritise patients and safely resume elective surgery during the Covid-19 pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Subbiah Ponniah ◽  
M Ahmed ◽  
T Edwards ◽  
J Cobb ◽  
E Dean ◽  
...  
Keyword(s):  
Patient Safety ◽  
High Risk ◽  
Orthopaedic Surgery ◽  
Elective Surgery ◽  
Paediatric Patients ◽  
Level 3 ◽  
Level 1 ◽  
Surgical Unit

Abstract Introduction There are now over 2.5 million NHS patients awaiting elective surgery, with the most in orthopaedics. We present an algorithm and results for safely and equitably restarting surgery at COVID-light sites. Method An MDT applied the COVID-19 Algorithm for Resuming Elective Surgery (CARES) on 1169 patients awaiting elective orthopaedic surgery. It assessed safety, procedural efficacy, and biopsychosocial factors, to prioritise patients. They were assigned to five categories and underwent surgery at one of three COVID-light sites (1. access to HDU/ITU/Paediatrics/specialist equipment, 2. an NHS elective surgical unit and 3. a private elective surgical unit). Results 21 ‘Urgent’ patients received expedited care; 118 were Level 1/2; 222 were Level 3; 808 were Level 4. In 6 weeks, 355 surgeries were performed, with Urgent and Level 1/2 cases performed soonest (mean 18 days, p &lt; 0.001). 33 high-risk/complex/paediatric patients had surgery at Site 1 and the rest at Sites 2 and 3. No patients contracted COVID-19 within 2 weeks of surgery. Conclusions We validated a widely generalisable model to facilitate resumption of elective surgery in COVID-light sites. It enabled surgery for patients in most suffering, undergoing the most efficacious procedures and/or at highest risk of deterioration, without compromising patient-safety.

scholarly journals An Atmospheric Visibility Grading Method Based on Ensemble Learning and Stochastic Weight Average

Atmosphere ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 869
Author(s):  
Xiuguo Zou ◽  
Jiahong Wu ◽  
Zhibin Cao ◽  
Yan Qian ◽  
Shixiu Zhang ◽  
...  
Keyword(s):  
Ensemble Learning ◽  
Traffic Accidents ◽  
Feature Sets ◽  
Atmospheric Visibility ◽  
Average Accuracy ◽  
Level 3 ◽  
Visual Characteristics ◽  
Level 1 ◽  
Grading Model ◽  
Level 2

In order to adequately characterize the visual characteristics of atmospheric visibility and overcome the disadvantages of the traditional atmospheric visibility measurement method with significant dependence on preset reference objects, high cost, and complicated steps, this paper proposed an ensemble learning method for atmospheric visibility grading based on deep neural network and stochastic weight averaging. An experiment was conducted using the scene of an expressway, and three visibility levels were set, i.e., Level 1, Level 2, and Level 3. Firstly, the EfficientNet was transferred to extract the abstract features of the images. Then, training and grading were performed on the feature sets through the SoftMax regression model. Subsequently, the feature sets were ensembled using the method of stochastic weight averaging to obtain the atmospheric visibility grading model. The obtained datasets were input into the grading model and tested. The grading model classified the results into three categories, with the grading accuracy being 95.00%, 89.45%, and 90.91%, respectively, and the average accuracy of 91.79%. The results obtained by the proposed method were compared with those obtained by the existing methods, and the proposed method showed better performance than those of other methods. This method can be used to classify the atmospheric visibility of traffic and reduce the incidence of traffic accidents caused by atmospheric visibility.

scholarly journals Comparison of four commercial, automated antigen tests to detect SARS-CoV-2 variants of concern

2021 ◽  
Author(s):  
Andreas Osterman ◽  
Maximilian Iglhaut ◽  
Andreas Lehner ◽  
Patricia Späth ◽  
Marcel Stern ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Point Of Care ◽  
Study Cohort ◽  
Operating Characteristics ◽  
Testing Strategies ◽  
Level 3 ◽  
Amino Acid Mutations ◽  
Antigen Tests ◽  
Roche Diagnostics ◽  
Analytical Sensitivities

AbstractA versatile portfolio of diagnostic tests is essential for the containment of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. Besides nucleic acid-based test systems and point-of-care (POCT) antigen (Ag) tests, quantitative, laboratory-based nucleocapsid Ag tests for SARS-CoV-2 have recently been launched. Here, we evaluated four commercial Ag tests on automated platforms and one POCT to detect SARS-CoV-2. We evaluated PCR-positive (n = 107) and PCR-negative (n = 303) respiratory swabs from asymptomatic and symptomatic patients at the end of the second pandemic wave in Germany (February–March 2021) as well as clinical isolates EU1 (B.1.117), variant of concern (VOC) Alpha (B.1.1.7) or Beta (B.1.351), which had been expanded in a biosafety level 3 laboratory. The specificities of automated SARS-CoV-2 Ag tests ranged between 97.0 and 99.7% (Lumipulse G SARS-CoV-2 Ag (Fujirebio): 97.03%, Elecsys SARS-CoV-2 Ag (Roche Diagnostics): 97.69%; LIAISON® SARS-CoV-2 Ag (Diasorin) and SARS-CoV-2 Ag ELISA (Euroimmun): 99.67%). In this study cohort of hospitalized patients, the clinical sensitivities of tests were low, ranging from 17.76 to 52.34%, and analytical sensitivities ranged from 420,000 to 25,000,000 Geq/ml. In comparison, the detection limit of the Roche Rapid Ag Test (RAT) was 9,300,000 Geq/ml, detecting 23.58% of respiratory samples. Receiver-operating-characteristics (ROCs) and Youden’s index analyses were performed to further characterize the assays’ overall performance and determine optimal assay cutoffs for sensitivity and specificity. VOCs carrying up to four amino acid mutations in nucleocapsid were detected by all five assays with characteristics comparable to non-VOCs. In summary, automated, quantitative SARS-CoV-2 Ag tests show variable performance and are not necessarily superior to a standard POCT. The efficacy of any alternative testing strategies to complement nucleic acid-based assays must be carefully evaluated by independent laboratories prior to widespread implementation.

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