Laboratory Performance Research Articles

Field Performance of Asphalt Mixture Modified with Reactive Isocyanate Based Modifier

The reactive isocyanate-based modifier chemically reacts with asphalt components, overcoming the issues of increased viscosity and phase separation encountered with conventional modified binders. It can be used to modify binders to meet the highest performance grades currently specified by state highway agencies. This project aimed to demonstrate the constructability of an asphalt mixture modified with the reactive isocyanate-based modifier in the field and compare its performance with that of a control mixture. The project involved milling an approximately 5.0-cm (2-in) thick surface layer of two 30.5-m (100-foot) sections with similar foundation support. One section was resurfaced with a reactive isocyanate-modified mixture and the other with a conventional SBS-modified mix. The mixtures have shown no significant difference in field performance and laboratory performance test results. This study has provided insights into the field applicability of reactive isocyanate-based modifiers in asphalt mixtures, facilitating the ongoing efforts to develop durable road surfaces.

Ensuring Quality and Consistency in OPC-53 Cement Testing: A Comprehensive Proficiency Testing Evaluation

The proficiency testing (PT) program is a critical part of quality assurance in laboratories, especially within industries like construction where cement testing is essential. This study provides a comprehensive evaluation of the fifth PT scheme for Ordinary Portland Cement (OPC) grade 53, conducted by the Nodal Laboratory. The key parameters assessed in this program were standard consistency, compressive strength, and soundness using the Le-Chatelier method. Twenty-four laboratories participated, and their performance was analyzed using advanced statistical methods, adhering to ISO 17043:2010 and ISO 13528:2015 standards. The results showed that most laboratories performed satisfactorily, with only one outlier identified in the soundness test. This paper covers all aspects of the PT program, from sample preparation to the distribution of materials, as well as the homogeneity and stability tests conducted on the samples. Statistical evaluation was carried out using Z-scores, which allowed the laboratories to be ranked according to their performance in each parameter. This method highlights discrepancies and provides a clear framework for participating laboratories to improve their testing procedures. Proficiency testing is essential for maintaining high standards in laboratory performance. It helps standardize testing methods across multiple laboratories, ensuring that OPC-53 cement meets strict quality and performance specifications. The program enables laboratories to identify performance gaps and take corrective actions, ensuring the reliability and accuracy of results. Participation in PT programs is a step toward continuous improvement, keeping laboratories aligned with international standards, ultimately benefiting the broader construction industry by ensuring the structural integrity of buildings and infrastructure. This study underscores the importance of regular PT participation. It not only provides a benchmark for laboratory performance but also ensures compliance with ISO standards. This fosters the consistent quality of cement used in large-scale construction, reducing the risk of structural failures and contributing to long-term safety and durability. The findings demonstrate the positive impact of PT programs on overall testing accuracy and laboratory reliability, emphasizing their role in advancing best practices in the construction industry.

Proficiency test of SARS-CoV-2 Omicron variant detection in diagnostics samples by veterinary diagnostic laboratories

AbstractVeterinary diagnostic laboratories (VDLs) play a critical role in screening both human and animal samples for SARS-CoV-2. To evaluate the SARS-CoV-2 detection methods used by VDLs, a proficiency test was performed by the US Food and Drug Administration’s Veterinary Laboratory and Investigation and Response Network in collaboration with two other organizations. Thirty-two sets of 12 blind-coded samples were prepared by fortifying Molecular Transport Medium (MTM) or feline feces with SARS-CoV-2 Omicron variant or non-SARS-CoV-2 equine coronavirus RNA at various concentrations and shipped to 32 participants for blinded (unbiased) analysis. Results were analyzed according to the principles of International Organization for Standardization 16140-2:2016 using two approaches such as establishing the rate of detection (ROD) and the success rate by applying the analysis of binary outcome by logit approach. ROD provided the overall assessment of laboratories performance, whereas the novel logit approach provided an insight to more specific analysis based on the complexity of each sample. The ROD was 83% and 98% for MTM samples at 200 and 20000 genome copies per 100 µL, respectively. Fecal samples were classified as challenging exploratory, and results were not included in the assessment of performance but discussion purposes only. Fecal samples exhibited matrix interference impacting the performance. The ROD was 44% and 89% for fecal samples at 2000 and 20000 genome copies per 100 µL, respectively. The non-COVID coronavirus RNA, which was used to address the specificity, did not interfere with methods used. Establishing the success rate by evaluating the qualitative results (detected/not detected) applying a logit approach revealed that, out of thirty-two participants, twenty-eight had satisfactory results, one participant had unsatisfactory results, and three participants had questionable results for MTM samples. For fecal samples, three participants out of thirty-two did not meet the expectations at higher concentrations. Lower concentrations of fecal samples were excluded from this analysis. Again, the fecal samples were considered as challenge samples and the results were provided to assist participants in their continuous efforts to improve their performance and not to evaluate their performance.

The EuroFlow PIDOT external quality assurance scheme: enhancing laboratory performance evaluation in immunophenotyping of rare lymphoid immunodeficiencies.

The development of External Quality Assessment Schemes (EQAS) for clinical flow cytometry (FCM) is challenging in the context of rare (immunological) diseases. Here, we introduce a novel EQAS monitoring the primary immunodeficiency Orientation Tube (PIDOT), developed by EuroFlow, in both a 'wet' and 'dry' format. This EQAS provides feedback on the quality of individual laboratories (i.e.,accuracy, reproducibility and result interpretation), while eliminating the need for sample distribution. In the wet format, marker staining intensities (MedFIs) within landmark cell populations in PIDOT analysis performed on locally collected healthy control (HC) samples, were compared to EQAS targets. In the dry format, participants analyzed centrally distributed PIDOT flow cytometry data (n=10). We report the results of six EQAS rounds across 20 laboratories in 11 countries. The wet format (212 HC samples) demonstrated consistent technical performance among laboratories (median %rCV on MedFIs=34.5 %; average failure rate 17.3 %) and showed improvement upon repeated participation. The dry format demonstrated effective proficiency of participants in cell count enumeration (range %rCVs 3.1-7.1 % for the major lymphoid subsets), and in identifying lymphoid abnormalities (79.3 % alignment with reference). The PIDOT-EQAS allows laboratories, adhering to the standardized EuroFlow approach, to monitor interlaboratory variations without the need for sample distribution, and provides them educational support to recognize rare clinically relevant immunophenotypic patterns of primary immunodeficiencies (PID). This EQAS contributes to quality improvement of PID diagnostics and can serve as an example for future flow cytometry EQAS in the context of rare diseases.

Laboratory performances during proficiency tests for the analysis of active substances in pesticide formulations during 2021–2023

During the period 2021–2023, the Italian National Institute of Health (ISS) organised, in collaboration with the Italian Health Ministry, proficiency testing (PTs) for about 22 Italian and other EU laboratories involved in the monitoring programmes for Plant Protection Products (PPPs). The aim of the PTs was to determine the amount of active ingredient in various formulations of PPPs. Overall, the type of formulations to be analysed were soluble concentrate (SL), suspension concentrate (SC), capsule suspension (CS), emulsion water oil (EW), soluble water granule (SG), dustable powder (DP), water dispersible granule (WDG) and emulsion concentrate (EC). In 2021, the ISS organised PTs for the determination of Imazamox, Fenhexamid and Trinexapac-ethyl in three different PPPs as soluble concentrate (SL), suspension concentrate (SC), and capsule suspension (CS), respectively. In 2022, PTs for the determination of Bentazone, Spinosad and Tau-Fluvalinate were organised. For this PTs, commercial PPPs were obtained from the Italian market as SC, emulsion oil water (EW) and soluble water granule (SG). In 2023, the PT was organised to determine the active ingredient Trifloxystrobin, Deltamethrin and Cyprodinil in the commercial product as water dispersible granule (WDG), dustable powder (DP) and emulsion concentrate (EC), respectively. Homogeneity and stability, performed for all PT samples, fulfilled the acceptability criteria. The Jarque–Bera test was used to verify the hypothesis of normality of the data distributions before to calculate the z-score values. Laboratory performances, expressed in terms of z-scores, were satisfactory for almost all participants for all substances.

Identifying and Addressing Errors in Anatomical Pathology: A Survey Analysis

Abstract Introduction/Objective To get an update on potential sources of pre-analytical, analytical, post-analytical and other sources of errors in anatomic pathology and strategies to mitigate such errors. Methods/Case Report The authors designed a 5-question survey in Google software and shared it widely on social media platforms. Results (if a Case Study enter NA) The survey, which garnered 43 responses from staff across various areas of the anatomic pathology laboratory, revealed significant insights. Labeling and fixation/preservation errors emerged as the most prevalent pre-analytical errors, while discrepancies between gross and microscopic examinations were common analytical errors. Specimen handling, inadequate clinical information, and transportation were the most frequently perceived other potential sources of errors. The implications of these findings are clear: robust protocols with multiple identifiers, staff training, and barcode labeling can significantly reduce patient identification errors. Similarly, standardized collection instructions, pre-labeled containers, and meticulous verification processes can effectively minimize such errors. Validated tests, standardized scoring systems, and proper investigation of quality control discrepancies are key to reducing analytical errors. Documented procedures, staff training, regular equipment calibration, and reagent testing are also crucial. Conclusion This study contributes to the literature on the current state of potential sources of errors in anatomic pathology. The study findings and recommendations on strategies to address such errors would improve the performance of the anatomic pathology laboratory and eventually improve patient care.

Multi-scale mechanical and acoustic characterization of low noise pavements

Using data on in situ performance of low noise pavements, three well performing mixtures were selected: SDA 4, SDA 6, and SDA 8. These mixtures and the corresponding mastic (filler + bitumen + additive) were tested for their mechanical and acoustic performance in non-aged and aged states using a multi-scale approach (mm to km). Thereafter, an optimization protocol was applied to these mastics (mm-scale) and promising combinations were implemented at the mixture scale (cm-scale). As a result, the best performing mixture parameters were implemented in the m-scale slabs where the mechanical and acoustic performance were determined. The proposed work could uniquely combine knowledge from in situ long term and laboratory performance of low noise pavements. Using a traffic simulator and measurements before and after trafficking, the acoustic modeling showed that the modified mixtures’ noise levels were maintained after loading. This indicates that the modification assured acoustical integrity of the mixture after loading.

Effects of Perceptual-Cognitive Training on Anticipation and Decision-Making Skills in Team Sports: A Systematic Review and Meta-Analysis.

Team sports require athletes' exceptional perceptual-cognitive skills, such as anticipation and decision-making. Perceptual-cognitive training in laboratories aims to enhance these abilities. However, its effectiveness in real-game performance remains controversial, necessitating a systematic review and meta-analysis to determine optimal training methods. Following the PRISMA guidelines, we searched databases (e.g., PubMed, WOS, Scopus, and EBSCO) for relevant studies published before November 2023, assessed study quality, extracted important characteristics, and conducted a meta-analysis using Stata 15.1. This study was registered in PROSPERO (CRD42023494324). A total of 22 quantitative studies involving 45 effect sizes were included. Perceptual-cognitive training positively influenced elite athletes' anticipation and decision-making. However, its transfer effect on real-game performance improvement (ES = 0.65) was inferior to laboratory performance improvement (ES = 1.51). Sub-group analyses indicated that the effects of training interventions varied based on stimulus presentation and intervention duration. Based on our findings, we concluded that while perceptual-cognitive training improved on-court performance, its transfer effects were limited. To maximize effectiveness, future interventions should use virtual reality to present training stimuli and incorporate participants' sport-specific responses to reflect real-game scenarios.

Virtual assessment of phone booths' acoustic performance in laboratory and office environments

The irrelevant speech noise is one of the significant issues affecting workers' productivity and comfort. Acoustic furniture is the most common solution addressing this problem: mobile phone booths and partially closed workstations are two examples. The acoustic performance of such devices is defined with laboratory tests according to ISO 23351-1:2020. The sound power level measured in reverberation rooms with and without the product determines the reduction of speech A-weighted sound power level (DS,A). However, predicting acoustic performance in real-world scenarios is still challenging. The present work explores the discrepancies between DS,A, and apparent speech reduction (D'S,A) through numerical models. The study assesses the performance difference between a calibrated virtual reverberation room and virtual open-plan offices maintaining the same acoustic properties, i.e., sound transmission and sound absorption, of a typical two-person phone booth. Moreover, the study investigates the fluctuation on D'S,A changing main room acoustic criteria, e.g., the reverberation time (T) and the total absorption area (A). Results help define ray-based simulations' reliability in predicting furniture ensembles' acoustic performance.

Impact sound insulation performance of floor coverings in a heavyweight reference floor with a floating floor

This study investigates the impact sound reduction performance of floor coverings used on the heavyweight standard floor of a floating floor structure in comparison with bare slab testbeds through on-site experiments. The laboratory performance evaluation of floor coverings designates only a bare slab between 100 mm and 160 mm as the heavyweight reference floor according to Annex C in ISO 10140-5. However, the recent expansion of over-floor heating systems has led to an increased need for understanding the impact sound reduction performance of floor coverings on floating floors, to enhance occupants' thermal comfort. In this study, it was measured the heavyweight and lightweight floor impact sound reduction levels of various floor covering test specimens in testbeds with different thicknesses of bare slabs and actual apartment houses with floating floors applied. The reduction rate for each frequency band was determined before and after installing floor coverings including single number quantity in accordance with ISO 717-2. Additionally, the impact of heavyweight reference floor conditions on quantifying the sound performance of floor coverings was discussed.

B-031 A new Ready to use Bio-Rad Quality Control to Streamline Daily Workflow

Abstract Background A comprehensive Quality Management System starts with performing a daily Quality Control (Q.C.) process. The daily Q.C. process monitors the Instrument’s optimal performance and detects shifts and trends. However, the existing traditional daily Q.C. process is not only prone to manual errors, but also time consuming, costly and labor intensive. We evaluated a Bio-Rad InteliQTM Load and go Quality Control that comes in a barcoded tube ready to be loaded. We monitored the workflow efficiency gained in comparison to the traditional quality control material that comes in glass vials. Methods We evaluated the new quality control material ready to load on the instrument. This new Q.C. (Bio-Rad InteliQ Assayed Multiqual Control - 3 levels) were processed in parallel with our routine Q.C. (Bio-Rad Assayed Chemistry Lyphocheck vials - 2 levels). We performed the evaluation on Abbott Architect c8000 Chemistry analyzers in our central Laboratory (NGHA-Jeddah). The Q.C. was stored frozen. Before testing it was thawed at room temperature as per the insert instruction. Over a 5 days period, in parallel with our routine quality control, we run the new Q.C. Two times per day for 33 analytes. We monitored the processing time difference between the new and current approaches. We monitored the stability of all the analytes in the tube after Two days and again after Five days. We also monitored the cost effectiveness, labor intensiveness, probability of operator error and the overall improvement in workflow and Turn Around Time. Results Over the evaluation period, we observed the following: - Saving 40 minutes in average per week only for chemistry Q.C (time spent in reconstituting, mixing and aliquoting old Q.C) - 100% reduction in waste of plastic consumables such as pipette and plastic tubes. - Save an average of 1.0 ml dead volume in every 5.0 ml old Q.C. vial (20% of the volume, hence saving 20% of the total Q.C. cost). The dead volume wasted due to aliquoting step using the old Q.C. - 100% Eliminated delays caused by operator error such as wrong reconstitution, inadequate mixing and wrong Q.C. aliquoting. Not needed for the InteliQ. - High score of staff satisfaction. - Stability of the 32 analytes was excellent except that of Co2, which deteriorated by 14% after Two days as indicated in the insert package. Co2 day five result deteriorated by 34%. Conclusions Bio-Rad InteliQ is easy to use. It saves time and cost. When combined with Unity Q.C. data management solution it can streamline Q.C. workflow, eliminate operator errors, reduce T.A.T. and increase the overall laboratory performance. It may also work optimally with Instruments that have on-board fridge for Q.C.

A-135 Assessment of Inter-Laboratory Variation in Biochemistry Parameters in Mongolian Clinical Laboratories: A Twelve-Year Analysis

Abstract Background External quality assessment (EQA) is essential for evaluating the performance of clinical laboratories and improving the quality of their analytical procedures. The Mongolian External Quality Assessment Scheme (MEQAS) has been established by organizations under the Ministry of Health to fulfill this purpose. The aim of this study is to provide a comprehensive summary of the inter-laboratory variation in biochemistry parameters among laboratories in Mongolia over a twelve-year period. Methods Three types of control materials were utilized: QAP-Trol Normal and Pathological levels, manufactured by Sysmex, and Pooled serum, prepared by combining leftover serum of patients. Samples were distributed semi-annually to laboratories, with participants measuring them promptly within three days. Results for 23 biochemistry parameters were submitted within a week via the “SmartEqas” software, enabling for analysis based on method and analyzer, and calculating standard deviation index (SDI), coefficient of variation (CV), and bias percentage (Bias%). Results In comparing the initial and most recent surveys, the number of participants has increased by nearly four times, rising from 55 to 217. Notably, the proportion of fully automatic users surged from 23.6% to 86.6%, a trend attributed to the establishment of numerous new laboratories and a growing recognition of the importance of EQA. Changes in the inter-laboratory coefficient of variation (CV) for each parameter were assessed from the initial to the recent period by calculating the mean of changes. In the recent assessments, CVs decreased to less than 10% for 14 parameters, including AST, ALT, UN, CRE, GLU, and others. Certain parameters, such as K, GLU, and Urea, exhibited markedly reduced variation from 16.3%, 12.1%, and 22.2% to 2.9%, 7.4%, and 9.3%, respectively. Conversely, some parameters, including LD (L-P), GGT, AMY (1), ALP (2), UA, TBIL, DBIL, FE, and MG, displayed gradual reductions in CVs to 10-20% compared to the initial period. In contrast, the coefficient of variation (CV) for four parameters: LD (P-L), AMY (2), ALP (3), and ALP (4), has not shown significant decreases and remains high, exceeding 20%. Conclusions Despite participation not being mandatory, laboratories in Mongolia exhibit a strong willingness to engage in the assessment process. The implementation of MEQAS has yielded tangible benefits, a reduction in inter-laboratory variation for most biochemistry parameters, with some achieving international level. While this improvement can be attributed to the streamlining of measurement methods, similar to outcomes observed in other countries, it is important to acknowledge the persistence of random and systematic errors. However, it is worth noting that certain parameters still exhibit higher CVs compared to similar studies. This discrepancy may be attributed to the inherent variation in enzymes among different methods and manufacturers. Hence, there is a clear need for continuous improvement measures and knowledge-sharing initiatives with other nations to address these challenges. Evaluating and implementing such measures at the national level will further enhance the quality of medical care in Mongolia.

A-344 Delivering better and timely diagnosis for critical patients: POC clinical performance versus Central Laboratory assays in key cardiac markers

Abstract Background Cardiac markers are often used in critical settings, such as emergency department and coronary units. Clinica Redsalud Santiago implemented a reference Cardiovascular center to improve patient length of stay and clinical output, supported by diverse procedures and opportune diagnosis. Our aim was to implement POC devices for measuring key Cardiac Markers. Here we validated clinically and analytically the performance of POC devices versus Central Laboratory results for Troponin I, hs Troponin I, BNP and NT-proBNP markers. Methods Forty-nine patients admitted at emergency department were included in the study. Forty samples were obtained from male patients (69.7±9.8 years) and 9 from female patients (67.8±3.9 years). Samples were drawn and processed in parallel using Triage SOB panel, hsTroponin I and NT-proBNP tests, and the other samples were analyzed in a VITROS system, using Troponin I ES, hs Troponin I and NT-proBNP. Results Clinical agreement was assessed for different methodologies, using kappa values. Almost perfect agreement was achieved for Troponin I and NT-proBNP between Triage and VITROS systems (Figure 1). For harmonization results reporting purposes, regression fits and Bland-Altman plots were analyzed for both assays (data not shown). Hs Troponin methods did not show a good linear correlation fit, but it improves significantly on quadratic regression. For NT-proBNP methods, a good linear correlation was achieved. In both comparisons, major differences were observed for high values, while those values near to cut-off or low-to-mid in pathological range were comparable. Conclusions Timely decisions are important but is difficult to find perfect solutions for end-to-end needs. We identified two key cardiac biomarkers used routinely in emergency department and coronary care that can be harmonized for clinicians, in terms of quality and traceability. Based upon results, we can expect value discrepancies between different methodologies, hence the need for creating proper guidance for supporting key decisions for clinicians.

A-207 Enhancing Healthcare Delivery Network Laboratories: The Role of Third-Party Consultants in Benchmarking and Reviewing RFP Results

Abstract Background Healthcare delivery networks, particularly laboratory services, play a critical role in patient care and diagnosis. However, ensuring the quality and efficiency of these services can be challenging due to the complex and dynamic nature of healthcare systems. Third-party consultants offer valuable expertise in benchmarking and reviewing Request for Proposal (RFP) results, which can improve the quality and cost-effectiveness of laboratory services within healthcare networks. Methods To evaluate the role of third-party consultants in enhancing healthcare delivery network laboratories, the author conducted surveys to 50 laboratory leaders with a 50% response rate and analyzed the following aspects: Benchmarking: Comparing laboratory performance metrics with industry best practices and peer institutions to identify areas for improvement. RFP Review: Utilizing subject matter experts to assess the technical and financial proposals submitted by vendors to ensure compliance with RFP requirements and to identify the most suitable vendor for the network. Emotional Procurement: Minimizing the influence of emotional factors, such as personal relationships or brand loyalty, during the RFP process. Results Improved Quality: 65% said they can save >50 hours of labor utilizing a 3rd party for RFP, thus able to focus on patient results and quality. Cost Savings: 76% of respondents said consultants can help networks reduce expenses and improve their financial performance by 10-20% above and beyond incumbent negotiations. Emotional Procurement Mitigation: While the specific statistics supporting the influence of consultants on mitigating emotional factors in procurement decisions are not readily available, the broader impact of emotions on decision-making is well-documented. Therefore, while direct statistics may be limited, the influence of emotions on procurement decisions is a recognized factor in the field of decision science and consumer behavior. Turn around time: 70% of respondents said utilizing a 3rd party can reduce the turnaround time of a sourcing event from >3 months to < 1months. Conclusions Third-party consultants can provide valuable insights and expertise in benchmarking and reviewing RFP results, leading to several benefits. They can play a crucial role in enhancing healthcare delivery network laboratories by providing valuable expertise in benchmarking, reviewing RFP results, communication and reducing turnaround time. By improving quality, reducing costs, mitigating emotional procurement based on brand loyalty, and enhancing collaboration, consultants can help networks deliver high-quality services to patients and improve their overall performance. Consultants can facilitate more focused communication and partnership development between laboratories, vendors, and other stakeholders, ensuring a seamless transition and optimal performance without scope creep. As healthcare networks continue to evolve and face new challenges, the role of third-party consultants will become increasingly important in ensuring the quality and efficiency of laboratory services, potentially resulting in $100’s of millions in cost takeout across the country.

A-280 The Good, the Bad, and the Downright Inappropriate reporting of Gram Positive Resistance Genes in a Proficiency Testing Program

Abstract Background Molecular technologies can rapidly identify the pathogen, allowing for the correct antimicrobial agent to be used for initial treatment. Many laboratories have implemented molecular technologies to identify the causative agents of infections from various bodily sources. Screening for potential resistance genes to common antimicrobial agents provides high value to clinicians to help guide optimal antimicrobial therapy selection. CLIA ‘88 required proficiency testing for physician office laboratories in 1994. This was in addition to the requirement for hospital and reference laboratories instituted under CLIA ‘67. This study compares the accuracy of laboratory performance for molecular multiplex platforms in the detection of Gram positive resistance genes from gold standard qualified samples in a novel proficiency program. Methods American Proficiency Institute, an independent proficiency testing provider, reviewed the reporting of various molecular multiplex systems against simulated patient samples in proficiency samples offered in 2023. Participants were instructed to only report resistance genes their systems were capable of testing for, and ensure they were appropriate for the organism recovered. Failure rates for participants were evaluated against an 80% participant consensus standard for detection of resistance genes. Results During the 2023 proficiency year, Gram positive targets were included 14 times in 4 different multiplex programs. Accuracy for correct reporting of resistance genes appropriate for the organism recovered ranged between 71.0%- 100%. Conversely, the number of laboratories reporting resistance genes that were inappropriate for the organism recovered ranged between 2.0% - 67.0%. Conclusions Based on the results reported by participants in API’s proficiency event, Molecular Multiplex platforms are accurately identifying Gram positive resistance genes. However, many participants using both FDA approved and LDT systems reported results for resistance genes that were not applicable for the organism recovered. This inaccurate reporting could potentially lead to inappropriate antimicrobial therapies being prescribed.

Identification methods as a factor affecting the performance of clinical microbiology laboratories participating in an external quality assessment program: a cross-sectional, retrospective analysis.

Introduction. Laboratory participation in external quality assessment (EQA) programmes including proficiency testing (PT) is a requirement of clinical laboratory conformance to ISO 15189:2022 Medical laboratories - Requirements for quality and competence. PT is one EQA method whereby laboratories are sent blinded samples for characterization by routine laboratory diagnostic methods. Importantly, PT enables a laboratory's performance to be evaluated in comparison to the standard reference methods and to the performance of other peer laboratories using similar diagnostic methods.Gap statement. The desired outcome of participating in PT is to help laboratories identify possible sources of error in each step of the total testing process and particularly in their test methods during the analytical phase.Aim. This cross-sectional study investigated the impact of using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) compared to conventional phenotypic biochemical testing on laboratory performance in a clinical bacteriology PT scheme.Methodology. During a 6-year period from 2017-2022, the Canadian Microbiology Proficiency Testing implemented 112 PT challenges comprising 22 different sample types and included 61 different bacterial species. This was translated into 5883 graded test events for analysis. Multiple logistic regression techniques were employed to explore the association between the test method employed and laboratory performance. The sample type and aerobic classification of challenge organisms were included as confounding variables.Results. Laboratories using MALDI-TOF MS performed significantly better in characterizing microorganisms than laboratories using phenotypic biochemical testing alone [odds ratio OR = 5.68, confidence interval (CI): 3.92, 8.22] regardless of the sample type and aerobic classification. Notably, our analysis identified a significant association between anaerobic organisms and laboratory performance (OR: 0.24, CI: 0.17-0.35), suggesting that culturing and identifying fastidious organisms remains a significant obstacle for many clinical microbiology laboratories.Conclusions. Although no method is infallible and its performance will depend on the validation and quality assurance procedures, this finding may help the management in the decision for implementing MALDI-TOF MS in the microbiology laboratory. This study highlights the important role PT providers play in the objective assessment of laboratory performance and how it can provide evidence for quality improvement.

The 2023 National Proficiency Test for molecular detection of shrimp infectious myonecrosis virus (IMNV) in China

Infectious myonecrosis virus (IMNV), an emerging virus that can cause severe viral disease in penaeid shrimp, was first confirmed to have spread to China in 2020. In order to standardize diagnostic procedures and reliable detection capability, and to evaluate the performances of aquatic clinical diagnostic laboratories, the competent authority has launched a proficiency test (PT) scheme for the molecular detection of IMNV in China from the year of 2023. In the ring test of IMNV-PT 2023, five tissue samples containing different concentrations of IMNV were provided as a panel of test samples. A total of 68 laboratories participated in the PT test of qualitative and quantitative analysis of the five samples using standard molecular assays. The results showed that 92.65 % (63/68) of the participants correctly reported all samples in the panel using Real-time reverse transcription PCR and 62 participants achieved satisfactory results, one participant using conventional PCR and four participants had not completed the test. Out of the 62 participants in the z-scores analysis, 88.71 % (55/62) achieved acceptable ZB-scores, with two outlier laboratories and five laboratories being questionable. Additionally, 98.39 % (61/62) achieved ZW-scores, with only one laboratory being questionable. Furthermore, the national PT conducted in the present study proved to be an effective tool for evaluating laboratory performance in IMNV molecular testing. This assessment can aid in improving the capabilities of IMNV molecular testing of the participating laboratories, and also provided technical supporting to enhance the national response to IMN outbreaks.

Performance of natural asphalt as a paving material: A laboratory and field evaluation

The ever-growing need to build roads to meet the necessary transportation demands is challenging, especially for developing countries. Low-volume roads (LVRs) are usually the backbone of catalyzing economic growth in these countries. With impediments surrounding Petroleum bitumen (price fluctuations) and environmental concerns, scientists are putting their effort into finding an alternative. The presented research is an attempt to check if Natural asphalt can be used as a full or partial replacement of the Petroleum bitumen. To the best of the authors' knowledge, only limited studies have focused on characterizing and understanding the engineering properties of Natural asphalt. The available techniques do not provide reliable information to the road authorities and hence they are discouraged from using it in practice. Particularly for countries, where the Natural asphalt source is available, the overall dependence on importing the Bitumen could be substantially reduced. Empirical and experience-based design criteria may not be sufficient as the standards were never developed for such materials, hence, a scientific approach is required before bringing it into practice. In this research, Natural asphalt sourced from different locations in Nigeria was assessed. Before performing the mixture level tests using Marshall and Cantabro design methods, the rheological and fatigue properties of the extracted Natural bitumen were examined in the laboratory. In the design of the experiment, various percentages of Natural asphalt were added between 0 % and 20 % by total mix weight; implying that the remaining required fraction of binder was fulfilled by the addition of petroleum bitumen. By using a ranking system (supported by statistics), an optimal design of mixture was obtained which was used in the field (exposed to normal traffic) at 30 different sections. Overall, results showed a good correlation between laboratory and field performance as compared to the petroleum-based mixture which was used as a reference mixture

Establishment of Preanalytical Quality Indicators and Current Status of Preanalytical Phase Laboratory Performance Monitoring in the Clinical Laboratories in Korea

Establishment of Preanalytical Quality Indicators and Current Status of Preanalytical Phase Laboratory Performance Monitoring in the Clinical Laboratories in Korea

Proficiency testing within Eurotransplant.

Eurotransplant is responsible for the international allocation of organs between eight countries in Europe. All HLA laboratories affiliated to Eurotransplant must be EFI or ASHI-accredited and must participate in the Eurotransplant external proficiency testing (EPT) program, organized by the Eurotransplant Reference Laboratory (ETRL). EPT within Eurotransplant has a long tradition, starting in 1978. The current EPT program consists of the following schemes: HLA typing including serology, CDC crossmatching, HLA-specific antibody detection, and identification. Participants enter the results of laboratory tests using a web-based application. Assessed results are visible on the website. An additional component called "patient-based cases" runs since 2016. Results are summarized and published on the EPT website. Furthermore, these results are discussed during the annual extramural tissue typers meeting, which is organized by the ETRL. Thanks to this EPT program, the performance of all HLA laboratories affiliated to Eurotransplant can be monitored and corrected, if necessary. Because all affiliated laboratories are assessed in the same EPT program, where these laboratories show to be consistent in most of their results, Eurotransplant EPT has proven to be an efficient tool to create a more uniform level of quality of histocompatibility testing within Eurotransplant.