Evaluation of chemotherapy preparation processes: Volumetric method reliability and gravimetric method utility within 5 US hospitals

2021 ◽  
Author(s):  
Adam Moss ◽  
Stephanie Kang ◽  
Kathryn Morbitzer ◽  
Lam Nguyen ◽  
Moe Shwin ◽  
...  
Keyword(s):  
Gravimetric Method ◽  
The United States ◽  
Volumetric Method ◽  
Preparation Process ◽  
Accuracy And Precision ◽  
Data Collection Process ◽  
Accurate Dose ◽  
Actual Volume ◽  
Drug Expenditures ◽  
Transfer Device

Abstract Disclaimer In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The primary aim of this study was to investigate the accuracy of the volumetric method for intravenous (IV) preparations and explore the utility of gravimetric methods in the medication preparation process within multiple institutions. Secondary outcomes of this study were syringe size percent variations and impact on drug expenditures. Methods A prospective, noninterventional, multisite study was conducted between March 2015 and December 2016 to generate baseline estimates of accuracy and precision in the volumetric medication preparation process. Five hospitals in the United States were recruited for study participation. During the data collection process, technicians were required to measure the syringe at 3 different points: when the new empty syringe was connected to a closed-system transfer device (CSTD), when the filled syringe containing the prepared dose of medication was connected to a CSTD, and when the used syringe with residual medication was connected to a CSTD. The actual dose of drug dispensed (in mg) was divided by the specific gravity of the medication to determine the actual volume of medication dispensed. Results A total of 4,443 compounded sterile products representing 60 medications across 5 hospitals were eligible for the study. Of the evaluated preparations, 91.92% were within 5% of the prescribed dose and 96.56% were within 10% of the prescribed dose. The outliers ranged from –144.10% to 233.72%. Conclusion The potential for significant over- and undertreatment of an individual patient receiving IV chemotherapy exists, indicating the need for an additional measurement method, such as real-time gravimetric verification, to ensure an accurate dose is administered to every patient.

scholarly journals Human body burdens of chemicals used in plastic manufacture

2009 ◽  
Vol 364 (1526) ◽  
pp. 2063-2078 ◽  
Author(s):  
Holger M. Koch ◽  
Antonia M. Calafat
Keyword(s):  
Analytical Chemistry ◽  
Bisphenol A ◽  
The United States ◽  
Environmental Chemicals ◽  
Biological Matrices ◽  
Relevant Research ◽  
Biomarkers Of Exposure ◽  
Accuracy And Precision ◽  
High Degree ◽  
Selection Of

In the last decades, the availability of sophisticated analytical chemistry techniques has facilitated measuring trace levels of multiple environmental chemicals in human biological matrices (i.e. biomonitoring) with a high degree of accuracy and precision. As biomonitoring data have become readily available, interest in their interpretation has increased. We present an overview on the use of biomonitoring in exposure and risk assessment using phthalates and bisphenol A as examples of chemicals used in the manufacture of plastic goods. We present and review the most relevant research on biomarkers of exposure for phthalates and bisphenol A, including novel and most comprehensive biomonitoring data from Germany and the United States. We discuss several factors relevant for interpreting and understanding biomonitoring data, including selection of both biomarkers of exposure and human matrices, and toxicokinetic information.

Mathematische Methoden zur Sicherung der Vertraulichkeit und Anonymität von Forschungsdaten / Mathematical Methods to Assure Confidentiality and Anonymity of Research Data

1973 ◽  
Vol 2 (3) ◽  
Author(s):  
Robert F. Boruch ◽  
Günter Endruweit
Keyword(s):  
Social Research ◽  
Legal Protection ◽  
The United States ◽  
Research Data ◽  
Research Subjects ◽  
Mathematical Methods ◽  
Private Lives ◽  
Accuracy And Precision ◽  
The Social ◽  
Response Method

AbstractThe need to develop methods for assuring confidentiality of social research data stems from two related problems. First, research subjects who are emabarassed or threatened by an inquiry about their private lives may refuse to respond or may distort their response, thereby assuring for themselves the confidentiality of particular information; as a consequence, the accuracy and precision of estimates of parameters in social research may be critically undermined. Second, the social researcher in Germany as in the United States, has no legal protection against judicial appropriation of the data for non-research purposes; if obtained from the researcher, the research subjects’ responses may lead to legal or social sanctions against him.The mathematical methods described in this article have been developed to alleviate these problems and, more specifically, to increase the strength of the researcher’s promise that “confidentiality” will be maintained. The randomized response method, the unrelated question method, and the newly developed contamination method permit one to aquire information without needlessly jeopardizing or embarrassing the research subject. The methods, based on simple laws of probability, are summarized and compared in the following remarks.

scholarly journals A Qualitative Exploratory Observational Study: An Entrepreneurship Managers’ Emotional Intelligence and Impact on the Financial Organization’s Success in the United States

2021 ◽  
Vol 5 (2) ◽  
pp. 14-33
Author(s):  
Amala Luncheon ◽  
Karina Kasztelnik
Keyword(s):  
Emotional Intelligence ◽  
Organizational Performance ◽  
Employee Engagement ◽  
The United States ◽  
Organizational Leaders ◽  
Scientific Discussion ◽  
Data Collection Process ◽  
The Caribbean ◽  
Emotional Intelligence Training ◽  
Emotionally Intelligent

This paper summarizes the arguments and counterarguments within the scientific discussion on emotional intelligence. Emotional intelligence is an essential trait for managers to possess to be effective and successful in organizations. Soft skills are becoming as crucial as making quotas. Scholarly literature lacks research on emotional intelligence and employee engagement in retail in St. Lucia. Engaged employees could stay motivated during adversity and help maintain an organization’s culture. This exploratory observational study’s primary purpose was to examine how retail store managers in St. Lucia perceived their emotional intelligence influences employee engagement. The conceptual framework that grounded the study was emotional intelligence and employee engagement from an organizational performance perspective. The data collection process included reviewing archival data. The paper presents empirical analysis results; several patterns and themes emerged from the data analysis, including emotional intelligence, controlling emotions, coaching, legacy, training, hiring well, communication, and personalized relationships. Increased emotional intelligence training emerged as useful in the St. Lucian business landscape and the Caribbean by extension. The research empirically confirms and theoretically proves that researching other sectors at varying levels may give a broader understanding of how emotional intelligence is perceived. This study’s findings may be useful to stakeholders and organizational leaders to allow developing strategies to build more emotionally intelligent and engaged organizations and positively affect social change.

Automated Method for Determining Direct Available P2O5 in Fertilizers

1974 ◽  
Vol 57 (4) ◽  
pp. 785-790
Author(s):  
Larry L Wall ◽  
Charles W Gehrke
Keyword(s):  
Sampling Rate ◽  
Gravimetric Method ◽  
Ammonium Citrate ◽  
Slight Effect ◽  
Flow Rates ◽  
Automated Method ◽  
Accuracy And Precision ◽  
Analytical System ◽  
Hydrolysis Of ◽  
Heating Bath

Abstract In the automated method for the analysis of direct available and total P205 in fertilizers, a heating bath is used to destroy ammonium citrate and colored material and for hydrolysis of non-orthophosphates. The heating bath was maintained at 98°C and contained a 40' time delay coil, providing 15 min digestion. Improvements on the method for the automated digestion of citrate extracts of fertilizer included decreasing the reagent and sample flow rates by factors of 2 to 5. All of the citrate in those samples containing the highest levels of citrate was not destroyed; however, the slight effect of the remaining citrate could be eliminated by changing the concentration of the molybdovanadate reagent. No difficulty was encountered with the hydrolysis of non-orthophosphates. With this analytical system, steady state conditions were reached at a sampling rate of 40 samples/hr and with a 4 : 1 sample-to-wash ratio. Repeated analyses were made on 9 samples, and the accuracy and precision of results obtained by the automated method compared very well with data by the official AOAC gravimetric method.

scholarly journals Commentary: Race and Ethnicity in Biomedical Research – Classifications, Challenges, and Future Directions

2018 ◽  
Vol 28 (4) ◽  
pp. 561-564 ◽  
Author(s):  
Dame Idossa ◽  
Narjust Duma ◽  
Katerina Chekhovskiy ◽  
Ronald Go ◽  
Sikander Ailawadhi
Keyword(s):  
Biomedical Research ◽  
Race And Ethnicity ◽  
The United States ◽  
Future Research ◽  
Future Directions ◽  
Data Collection Process ◽  
Large Databases ◽  
Future Research Directions ◽  
Racial Ethnic

The use of race and ethnicity in biomedical research has been a subject of debate for the past three decades. Initially the two ma­jor race categories were: White and Black, leaving other minorities uncounted or inap­propriately misclassified. As the science of health disparities evolves, more sophisticat­ed and detailed information has been add­ed to large databases. Despite the addition of new racial classifications, including multi-racial denominations, the quality of the data is limited to the data collection process and other social misconceptions. Although race is viewed as an imposed or ascribed status, ethnicity is an achieved status, making it a more challenging variable to include in biomedical research. Ambiguity between race and ethnicity often exists, ultimately affecting the value of both variables. To bet­ter understand specific health outcomes or disparities of groups, it is necessary to col­lect subgroup-specific data. Cultural percep­tions and practices, health experiences, and susceptibility to disease vary greatly among broad racial-ethnic groups and requires the collection of nuanced data to understand. Here, we provide an overview of the clas­sification of race and ethnicity in the United States over time, the existing challenges in using race and ethnicity in biomedical re­search and future research directions. Ethn Dis. 2018;28(4):561-564; doi:10.18865/ed.28.4.561.

scholarly journals Determinations of Labile Nutrients (Methylcobalamin, 5-Methyltetrahydrofolate, and Trans Menaquinone-7) in Oil- and Beadlet-Filled, Gastric-Resistant Capsule

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1183-1183
Author(s):  
Hong You ◽  
Yuhao Yin ◽  
Kangzi Ren ◽  
Zhiyan Liu ◽  
Jeffrey Whaley ◽  
...  
Keyword(s):  
Dietary Supplements ◽  
Analytical Methods ◽  
The United States ◽  
Nutrient Delivery ◽  
Funding Sources ◽  
Rp Hplc ◽  
Accuracy And Precision ◽  
Relative Standard ◽  
On Line ◽  
Superficially Porous Particles

Abstract Objectives The dietary supplement industry has grown substantially, and advances in technology have played important roles in the development of new forms of dietary supplements and delivery systems. While it is recommended to use compendia methods for testing dietary supplements, the analytical methods in place are often developed for single ingredients or simple matrices and are not always fit to be used for solving modern matrix challenges. Oil- and beadlet-filled, gastric acid-resistant capsule (OBGRC) is designed to improve nutrient delivery and absorption. However, it is challenging to accurately analyze labile nutrients in OBGRCs because nutrients within different physical locations are difficult to separate, and lengthy sample preparations lead to nutrient degradation. We developed and validated analytical methods to determine methylcobalamin (MeB12), 5-methyltetrahydrofolate (5-MTHF), and trans menaquinone-7 (MK-7) in OBGRCs. Methods MeB12 and 5-MTHF were extracted by completely dissolving the OBGRC shells using aqueous buffers and then applying hexane-facilitated liquid-liquid extraction to remove the oil phase and determined by RP-HPLC using superficially porous particles columns. For MK-7 analysis, the whole OBGRC was cut to open and the oil phase was collected to dissolve in a mixture of dimethyl sulfoxide/tetrahydrofuran/ethanol before analyzed by RP-HPLC with fluorescence detection after on-line, post-column zinc reduction. The methods were subjected to single-laboratory validations according to the United States Pharmacopeia (USP) guidelines for linearity, suitability, detection limits, specificity, accuracy, and precision. Results The methods achieved chromatographic resolution of target analytes without the expensive requirement of ultra-high pressure liquid chromatography and/or mass spectrometry. The methods have wide analytical ranges (from at least 50% to 250% of the input concentrations), high precision (repeatability relative standard deviations ranging from 1.04% to 4.90%), and high accuracy (spike recovery rate ranging from 89.2% to 108%). Conclusions All three methods passed USP method validation criteria and have the potential to be widely adopted to analyze MeB12, 5-MTHF, and MK-7 in similar matrices for quality control purposes. Funding Sources The research funding was provided by Ritual and Eurofins.

Sustaining the gains in cancer care from the oncology care model.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6632-6632
Author(s):  
Valerie P Csik ◽  
Jared Minetola ◽  
Andrew E. Chapman ◽  
Neal Flomenberg
Keyword(s):  
Cancer Care ◽  
Clinical Pathways ◽  
The United States ◽  
Demonstration Project ◽  
Cancer Center ◽  
Care Model ◽  
Drug Expenditures ◽  
Oncology Care ◽  
Ed Visits ◽  
Feedback Data

6632 Background: The Oncology Care Model (OCM) is a 5-year demonstration project led by the Centers for Medicare and Medicaid Services (CMS) to create a framework for the future of oncology care in the United States. More than half way through the project, our large, urban NCI-designated cancer center chose to focus on and invest in resources and personnel for patient navigation and the development of clinical pathways. Although navigation has shown to reduce emergency department (ED) visits by as much as 6% per quarter compared to non-navigated patients, sustaining it is a challenge because it is a nonbillable service. Clinical pathways are a tool to reduce care variation by addressing drug expenditures, and represent an opportunity to reduce outpatient costs by as much as 35% when patients are treated on pathway.3 Many OCM practices made similar investments and all are facing the question: How will the infrastructure and efforts developed during OCM be sustainable after the demonstration project ends? Methods: An analysis of average ED cost and utilization as well as drug expenditures was conducted using OCM feedback data (Q1-Q8). Total utilization of ED visits and ED admits were used to determine a projected annualized cost which was compared to a budgeted navigation team. Similarly, projected annualized drug expenditures were compared to the annual cost of the pathways tool. Results: We found that ED visits and ED admits would need to be reduced by 11% to cover navigation costs. Similarly, a 0.7% reduction in total drug expenditures would cover the cost of clinical pathways. The OCM data represents a timeframe prior to implementation of these programs and an average increase of 1.6% per quarter for ED admits, a 0.6% decrease in ED visits and 2.7% increase in drug expenditures. This will serve as a baseline to measure progress towards our sustainability targets. Conclusions: Long term sustainability of the infrastructure developed during OCM to support cancer care transformation will be dependent on reducing high cost and highly utilized services. Aligning impact areas with resources/tools to ensure sustainability is an approach that can help define targets for OCM practices.

scholarly journals New standards for reducing gravity data: The North American gravity database

Geophysics ◽  
2005 ◽  
Vol 70 (4) ◽  
pp. J25-J32 ◽  
Author(s):  
William J. Hinze ◽  
Carlos Aiken ◽  
John Brozena ◽  
Bernard Coakley ◽  
David Dater ◽  
...  
Keyword(s):  
North American ◽  
Gravity Data ◽  
Gravity Anomalies ◽  
The United States ◽  
Web Based ◽  
The North ◽  
Accuracy And Precision ◽  
Height Datum ◽  
Gravity Database ◽  
National Databases

The North American gravity database as well as data-bases from Canada, Mexico, and the United States are being revised to improve their coverage, versatility, and accuracy. An important part of this effort is revising procedures for calculating gravity anomalies, taking into account our enhanced computational power, improved terrain databases and datums, and increased interest in more accurately defining long-wavelength anomaly components. Users of the databases may note minor differences between previous and revised database values as a result of these procedures. Generally, the differences do not impact the interpretation of local anomalies but do improve regional anomaly studies. The most striking revision is the use of the internationally accepted terrestrial ellipsoid for the height datum of gravity stations rather than the conventionally used geoid or sea level. Principal facts of gravity observations and anomalies based on both revised and previous procedures together with germane metadata will be available on an interactive Web-based data system as well as from national agencies and data centers. The use of the revised procedures is encouraged for gravity data reduction because of the widespread use of the global positioning system in gravity fieldwork and the need for increased accuracy and precision of anomalies and consistency with North American and national databases. Anomalies based on the revised standards should be preceded by the adjective “ellipsoidal” to differentiate anomalies calculated using heights with respect to the ellipsoid from those based on conventional elevations referenced to the geoid.

Collaborative Study of the Photometric Molyb do vanadate Method for Phosphorus

1965 ◽  
Vol 48 (3) ◽  
pp. 654-657
Author(s):  
Mary Heckman
Keyword(s):  
Collaborative Study ◽  
Gravimetric Method ◽  
Volumetric Method ◽  
Photometric Method ◽  
Coefficients Of Variation ◽  
Standard Deviations ◽  
Official Status ◽  
Feed Samples ◽  
Phosphorus Levels ◽  
Good Agreement

Abstract Sixteen laboratories analyzed five feed samples, with phosphorus levels ranging from about 0.60 to 5.50% by the photometric molybdovanadate method studied in 1963 (This Journal, 46, 836 (1963)), and by either the volumetric method, 22.061, or the gravimetric quinoline molybdate method (ibid., 47, 170 (1964)), both of which have some official status. Eight sets of results based on the volumetric method and eight based on the gravimetric method were available. Means for all methods were in good agreement. Standard deviations and coefficients of variation were satisfactory for all methods, indicating superiority of both volumetric and gravimetric methods over the photometric method. Calculation of standard deviations for the entire range tested, however, showed the photometric method to be superior to the volumetric method and inferior to the gravimetric. The molybdovanadate method was adopted as official, first action.

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