Essential steps to providing reliable results using the Analytical Quality Assurance Cycle

Considering how demand for quality assurance (QA) has grown in analytical laboratories, we show the trends in analytical science, illustrated through international standard ISO/IEC 17025, validation, measurements of uncertainty, and quality-control (QC) measures. A detailed review of the history of analytical chemistry indicates that these concepts are consistently used in laboratories to demonstrate their traceabilities and competences to provide reliable results. We propose a new approach for laboratory QA, which also develops a diagram to support routine laboratories (which generally apply a quality system, such as ISO/IEC 17025) or research laboratories (that have some difficult applying this international standard). This approach, called the Analytical Quality Assurance Cycle (AQAC), presents the major QA concepts and the relationships between these concepts in order to provide traceability and reliable results. The AQAC is a practical tool to support the trend towards QA in analytical laboratories. (C) 2012 Elsevier Ltd. All rights reserved.

The Brazilian Network for HIV-1 Genotyping External Quality Control Assurance Programme

The Brazilian network for genotyping is composed of 21 laboratories that perform and analyze genotyping tests for all HIV-infected patients within the public system, performing approximately 25,000 tests per year. We assessed the interlaboratory and intralaboratory reproducibility of genotyping systems by creating and implementing a local external quality control evaluation. Plasma samples from HIV-1-infected individuals (with low and intermediate viral loads) or RNA viral constructs with specific mutations were used. This evaluation included analyses of sensitivity and specificity of the tests based on qualitative and quantitative criteria, which scored laboratory performance on a 100-point system. Five evaluations were performed from 2003 to 2008, with 64% of laboratories scoring over 80 points in 2003, 81% doing so in 2005, 56% in 2006, 91% in 2007, and 90% in 2008 (Kruskal-Wallis, p = 0.003). Increased performance was aided by retraining laboratories that had specific deficiencies. The results emphasize the importance of investing in laboratory training and interpretation of DNA sequencing results, especially in developing countries where public (or scarce) resources are used to manage the AIDS epidemic.

Tools and methods for the quality assurance of force platforms in human movement analysis

The human movement analysis (HMA) aims to measure the abilities of a subject to stand or to walk. In the field of HMA, tests are daily performed in research laboratories, hospitals and clinics, aiming to diagnose a disease, distinguish between disease entities, monitor the progress of a treatment and predict the outcome of an intervention [Brand and Crowninshield, 1981; Brand, 1987; Baker, 2006]. To achieve these purposes, clinicians and researchers use measurement devices, like force platforms, stereophotogrammetric systems, accelerometers, baropodometric insoles, etc. This thesis focus on the force platform (FP) and in particular on the quality assessment of the FP data. The principal objective of our work was the design and the experimental validation of a portable system for the in situ calibration of FPs. The thesis is structured as follows: Chapter 1. Description of the physical principles used for the functioning of a FP: how these principles are used to create force transducers, such as strain gauges and piezoelectrics transducers. Then, description of the two category of FPs, three- and six-component, the signals acquisition (hardware structure), and the signals calibration. Finally, a brief description of the use of FPs in HMA, for balance or gait analysis. Chapter 2. Description of the inverse dynamics, the most common method used in the field of HMA. This method uses the signals measured by a FP to estimate kinetic quantities, such as joint forces and moments. The measures of these variables can not be taken directly, unless very invasive techniques; consequently these variables can only be estimated using indirect techniques, as the inverse dynamics. Finally, a brief description of the sources of error, present in the gait analysis. Chapter 3. State of the art in the FP calibration. The selected literature is divided in sections, each section describes: systems for the periodic control of the FP accuracy; systems for the error reduction in the FP signals; systems and procedures for the construction of a FP. In particular is detailed described a calibration system designed by our group, based on the theoretical method proposed by ?. This system was the “starting point” for the new system presented in this thesis. Chapter 4. Description of the new system, divided in its parts: 1) the algorithm; 2) the device; and 3) the calibration procedure, for the correct performing of the calibration process. The algorithm characteristics were optimized by a simulation approach, the results are here presented. In addiction, the different versions of the device are described. Chapter 5. Experimental validation of the new system, achieved by testing it on 4 commercial FPs. The effectiveness of the calibration was verified by measuring, before and after calibration, the accuracy of the FPs in measuring the center of pressure of an applied force. The new system can estimate local and global calibration matrices; by local and global calibration matrices, the non–linearity of the FPs was quantified and locally compensated. Further, a non–linear calibration is proposed. This calibration compensates the non– linear effect in the FP functioning, due to the bending of its upper plate. The experimental results are presented. Chapter 6. Influence of the FP calibration on the estimation of kinetic quantities, with the inverse dynamics approach. Chapter 7. The conclusions of this thesis are presented: need of a calibration of FPs and consequential enhancement in the kinetic data quality. Appendix: Calibration of the LC used in the presented system. Different calibration set–up of a 3D force transducer are presented, and is proposed the optimal set–up, with particular attention to the compensation of non–linearities. The optimal set–up is verified by experimental results.

Technological trajectories and environmental policy: the transformation of the automobile

This thesis aims to fill the gap in the literature by examining the relationship between technological trajectories and environmental policy in the automotive industry, focusing on the role of environmental policies in unlocking the industry from fossil fuel path-dependence. It first explores the inducement mechanism that underpins the interaction between environmental policy and green technological advances, investigating under what conditions the European environmental transport policy portfolio and the intrinsic characteristics of assignees' knowledge boost worldwide green patent production. Subsequently, the thesis empirically analyses the dynamics of technological knowledge involved in technological trajectories assessing evolution patterns such as variation, selection and retention, in order to study the impact of policy implementation on technological knowledge related to electric and hybrid vehicle technologies. Finally, the thesis sheds light on the drivers that encourage a shift from incumbent internal combustion engine technologies towards low-emission vehicle technologies. This analysis tests whether tax-inclusive fuel prices and technological proximity between technological fields induce a shift from non-environmental inventions to environmentally friendly inventive activities and if they impact the competition between alternative vehicle technologies. The findings provide insights into the effectiveness of environmental policy in triggering inventive activities related to the development of alternative vehicle technologies. In addition, there is evidence that environmental policy redirects technological efforts towards a sustainable path and impacts the competition between low-emission vehicles.

Studio di Flow-Assurance e sensitivity analysis in sistemi di distribuzione di petrolio e gas naturale

Argomento del lavoro è stato lo studio di problemi legati alla Flow-Asurance. In particolare, si focalizza su due aspetti: i) una valutazione comparativa delle diverse equazioni di stato implementate nel simulatore multifase OLGA, per valutare quella che porta a risultati più conservativi; ii) l’analisi della formazione di idrati, all’interno di sistemi caratterizzati dalla presenza di gas ed acqua. Il primo argomento di studio nasce dal fatto che per garantire continuità del flusso è necessario conoscere il comportamento volumetrico del fluido all’interno delle pipelines. Per effettuare tali studi, la Flow-Assurance si basa sulle Equazioni di Stato cubiche. In particolare, sono state confrontate: -L’equazione di Soave-Redlich-Kwong; -L’equazione di Peng-Robinson; -L’equazione di Peng-Robinson modificata da Peneloux. Sono stati analizzati 4 fluidi idrocarburici (2 multifase, un olio e un gas) con diverse composizioni e diverse condizioni di fase. Le variabili considerate sono state pressione, temperatura, densità e viscosità; sono state poi valutate le perdite di carico, parametro fondamentale nello studio del trasporto di un fluido, valutando che l'equazione di Peng-Robinson è quella più adatta per caratterizzare termodinamicamente il fluido durante una fase di design, in quanto fornisce l'andamento più conservativo. Dopo aver accertato la presenza di idrati nei fluidi multifase, l’obiettivo del lavoro è stato analizzare come il sistema rispondesse all’aggiunta di inibitori chimici per uscire dalla regione termodinamica di stabilità dell’idrato. Gli inibitori utilizzati sono stati metanolo e mono-etilen-glicole in soluzione acquosa. L’analisi è stata effettuata confrontando due metodi: -Metodo analitico di Hammerschmidt; -Metodo iterativo con PVTSim. I risultati ottenuti hanno dimostrato che entrambi gli inibitori utilizzati risolvono il problema della formazione di idrato spostando la curva di stabilità al di fuori delle pressioni e temperature che si incontrano nella pipeline. Valutando le quantità da iniettare, il metodo di Hammerschmidt risulta quello più conservativo, indicando portate maggiori rispetto al PVTsim, soprattutto aggiungendo metanolo.

Formula Zero: Traduzione trilingue inglese-italiano-spagnolo di un policy statement sulla sicurezza stradale della Federazione Internazionale dell'Automobile (FIA)

The aim of this dissertation is to provide a trilingual translation from English into Italian and from Italian into Spanish of a policy statement from the Fédération Internationale de l’Automobile (FIA) regarding road safety. The document, named “Formula Zero: a strategy for reducing fatalities and injuries on track and road”, was published in June 2000 and involves an approach about road safety inspired by another approach introduced in Sweden called ‘Vision Zero’. This work consists of six sections. The first chapter introduces the main purposes and activities of the Federation, as well as the institutions related to it and Vision Zero. The second chapter presents the main lexical, morphosyntactic and stylistic features of the institutional texts and special languages. In particular, the text contains technical nomenclature of transports and elements of sport language, especially regarding motor sport and Formula One. In the third chapter, the methodology is explained, with all the resources used during the preliminary phase and the translation, including corpora, glossaries, expert consultancy and specialised sites. The fourth chapter focuses on the morphosyntactic and terminology features contained in the text, while the fifth chapter presents the source text and the target texts. The final chapter deals with all the translation strategies that are applied, alongside with all the challenging elements detected. Therefore, the dissertation concludes with some theoretical and practical considerations about the role of inverse translation and English as Lingua Franca (ELF), by comparing the text translated into Spanish to the original in English, using Italian as a lingua franca.

Enabling the evolution of J2EE applications through reverse engineering and quality assurance

Enterprise Applications are complex software systems that manipulate much persistent data and interact with the user through a vast and complex user interface. In particular applications written for the Java 2 Platform, Enterprise Edition (J2EE) are composed using various technologies such as Enterprise Java Beans (EJB) or Java Server Pages (JSP) that in turn rely on languages other than Java, such as XML or SQL. In this heterogeneous context applying existing reverse engineering and quality assurance techniques developed for object-oriented systems is not enough. Because those techniques have been created to measure quality or provide information about one aspect of J2EE applications, they cannot properly measure the quality of the entire system. We intend to devise techniques and metrics to measure quality in J2EE applications considering all their aspects and to aid their evolution. Using software visualization we also intend to inspect to structure of J2EE applications and all other aspects that can be investigate through this technique. In order to do that we also need to create a unified meta-model including all elements composing a J2EE application.

Use of EORTC Target Definition Guidelines for Dose-Intensified Salvage Radiation Therapy for Recurrent Prostate Cancer: Results of the Quality Assurance Program of the Randomized Trial SAKK 09/10

PURPOSE Different international target volume delineation guidelines exist and different treatment techniques are available for salvage radiation therapy (RT) for recurrent prostate cancer, but less is known regarding their respective applicability in clinical practice. METHODS AND MATERIALS A randomized phase III trial testing 64 Gy vs 70 Gy salvage RT was accompanied by an intense quality assurance program including a site-specific and study-specific questionnaire and a dummy run (DR). Target volume delineation was performed according to the European Organisation for the Research and Treatment of Cancer guidelines, and a DR-based treatment plan was established for 70 Gy. Major and minor protocol deviations were noted, interobserver agreement of delineated target contours was assessed, and dose-volume histogram (DVH) parameters of different treatment techniques were compared. RESULTS Thirty European centers participated, 43% of which were using 3-dimensional conformal RT (3D-CRT), with the remaining centers using intensity modulated RT (IMRT) or volumetric modulated arc technique (VMAT). The first submitted version of the DR contained major deviations in 21 of 30 (70%) centers, mostly caused by inappropriately defined or lack of prostate bed (PB). All but 5 centers completed the DR successfully with their second submitted version. The interobserver agreement of the PB was moderate and was improved by the DR review, as indicated by an increased κ value (0.59 vs 0.55), mean sensitivity (0.64 vs 0.58), volume of total agreement (3.9 vs 3.3 cm(3)), and decrease in the union volume (79.3 vs 84.2 cm(3)). Rectal and bladder wall DVH parameters of IMRT and VMAT vs 3D-CRT plans were not significantly different. CONCLUSIONS The interobserver agreement of PB delineation was moderate but was improved by the DR. Major deviations could be identified for the majority of centers. The DR has improved the acquaintance of the participating centers with the trial protocol.

Online privacy concerns and legal assurance: a user perspective

Since the emergence of the Internet and Social Media, privacy concerns and need for regulation in this area have been a frequent subject on the agenda of numerous stakeholders and policy-makers worldwide. Contributing to this debate, this paper builds on the responses of 553 Internet users to uncover users’ current privacy concerns and their attitudes towards legal assurances in this context. Our findings suggest that users have a complex attitude towards these issues. While they express strong concerns about privacy when asked directly, they often have difficulties formulating the exact nature of these concerns. In the Facebook context, Facebook itself is often mentioned as the primary source of threat, closely followed by marketing organizations. Users feel ill-protected by existing legal framework, especially when using Social Networking Sites. Reasons include common beliefs that the law is unable to address complexities of the Internet; local character of laws; possibilities to disregard the law, particularly since enforcement is difficult. Overall, positive changes in legal framework are desirable, with many respondents willing to pay more in taxes to ensure progress in this area.

BENCHMARKING AND IMPLEMENTATION OF A NEW INDEPENDENT MONTE CARLO DOSE CALCULATION QUALITY ASSURANCE AUDIT TOOL FOR CLINICAL TRIALS

Introduction Commercial treatment planning systems employ a variety of dose calculation algorithms to plan and predict the dose distributions a patient receives during external beam radiation therapy. Traditionally, the Radiological Physics Center has relied on measurements to assure that institutions participating in the National Cancer Institute sponsored clinical trials administer radiation in doses that are clinically comparable to those of other participating institutions. To complement the effort of the RPC, an independent dose calculation tool needs to be developed that will enable a generic method to determine patient dose distributions in three dimensions and to perform retrospective analysis of radiation delivered to patients who enrolled in past clinical trials. Methods A multi-source model representing output for Varian 6 MV and 10 MV photon beams was developed and evaluated. The Monte Carlo algorithm, know as the Dose Planning Method (DPM), was used to perform the dose calculations. The dose calculations were compared to measurements made in a water phantom and in anthropomorphic phantoms. Intensity modulated radiation therapy and stereotactic body radiation therapy techniques were used with the anthropomorphic phantoms. Finally, past patient treatment plans were selected and recalculated using DPM and contrasted against a commercial dose calculation algorithm. Results The multi-source model was validated for the Varian 6 MV and 10 MV photon beams. The benchmark evaluations demonstrated the ability of the model to accurately calculate dose for the Varian 6 MV and the Varian 10 MV source models. The patient calculations proved that the model was reproducible in determining dose under similar conditions described by the benchmark tests. Conclusions The dose calculation tool that relied on a multi-source model approach and used the DPM code to calculate dose was developed, validated, and benchmarked for the Varian 6 MV and 10 MV photon beams. Several patient dose distributions were contrasted against a commercial algorithm to provide a proof of principal to use as an application in monitoring clinical trial activity.

Benefits and challenges in practice-oriented psychotherapy research in Germany: The TK and the QS-PSY-BAY projects of quality assurance in outpatient psychotherapy

Objective: Two patient-focused long-term research projects performed in the German outpatient psychotherapy system are focused on in this article. The TK (Techniker Krankenkasse) project is the first study to evaluate a quality assurance and feedback system with regard to its practical feasibility in German routine care. The other study (“Quality Assurance in Outpatient Psychotherapy in Bavaria”; QS-PSY-BAY) was designed to test a new approach for quality assurance in outpatient psychotherapy using electronic documentation of patient characteristics and outcome parameters. In addition this project provides the opportunity to analyze data on health-related costs for the patients undergoing outpatient psychotherapy. Method: Both projects and their results indicating high effect sizes are briefly described. Results: From the perspectives of the research teams, advisory boards and other stakeholders, the experiences with these projects are discussed focusing on obstacles, challenges, difficulties, and benefits in developing and implementing the studies. The triangle collaboration of therapists, researchers, and health insurance companies/health service institutions turned out to be fruitful in both studies. Conclusions: Despite some controversies between the partners the experiences indicate the importance of practiced-research collaborations to provide relevant information about the delivery of outpatient psychotherapy in the health system