Quality control in mutation analysis: the European Molecular Genetics Quality Network (EMQN).

PubMed

Müller, C R

2001-08-01

The demand for clinical molecular genetics testing has steadily grown since its introduction in the 1980s. In order to reach and maintain the agreed quality standards of laboratory medicine, the same internal and external quality assurance (IQA/EQA) criteria have to be applied as for "conventional" clinical chemistry or pathology. In 1996 the European Molecular Genetics Quality Network (EMQN) was established in order to spread QA standards across Europe and to harmonise the existing national activities. EMQN is operated by a central co-ordinator and 17 national partners from 15 EU countries; since 1998 it is being funded by the EU commission for a 3-year period. EMQN promotes QA by two tools: by providing disease-specific best practice meetings (BPM) and EQA schemes. A typical BPM is focussed on one disease or group of related disorders. International experts report on the latest news of gene characterisation and function and the state-of-the-art techniques for mutation detection. Disease-specific EQA schemes are provided by experts in the field. DNA samples are sent out together with mock clinical referrals and a diagnostic question is asked. Written reports must be returned which are marked for genotyping and interpretation. So far, three BPMs have been held and six EQA schemes are in operation at various stages. Although mutation types and diagnostic techniques varied considerably between schemes, the overall technical performance showed a high diagnostic standard. Nevertheless, serious genotyping errors have been occurred in some schemes which underline the necessity of quality assurance efforts. The European Molecular Genetics Quality Network provides a necessary platform for the internal and external quality assurance of molecular genetic testing.

42 CFR 438.352 - External quality review protocols.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false External quality review protocols. 438.352 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.352 External quality review protocols. Each protocol must specify— (a) The data to be gathered; (b) The sources of the...

Bilateral tibial lengthening over the nail: our experience of 143 cases.

PubMed

Motallebi Zadeh, Nader; Mortazavi, Seyedeh Hamideh; Khaki, Siavash; Heidari, Kazem; Karbasi, Ashraf; Ostad Rahimi, Sedigheh

2014-09-01

Using lengthening over an intramedullary nail as a technique for cosmetic purposes improves the individuals' quality of life and provides more satisfactory results due to less external fixator period. This study reports a case series of 143 individuals who underwent bilateral tibial lengthening over an intramedullary nail for cosmetic purposes together with the review of parameters related to the surgery and complications. Level of satisfaction was measured with the standard visual analog scale at least 1 year after removal of external fixator. In this study, mean (SD) age of patients was 26.6 (7.26) years. 85 (59.4%) participants were male and 58 (40.6%) were female. Mean end lengthening of all individuals was 6.65 cm. The mean external fixator period was 93.7 days. Complication rate was 0.74 per segment but it decreased to 0.45 when pin-tract infection was excluded. Complications were categorized based on Paley et al.'s classification as 129 problems, 85 obstacles and no sequelae. Interestingly, 44 (30.8%) individuals had no problem and obstacle. Lengthening over an intramedullary nail provides bone formation in equal quality to that obtained by the conventional Ilizarov method, along with lower rate of complications. The large number of individuals involved in our study is a remarkable benefit which could be used as an appropriate sample to compare results for outcomes and complications.

An In-Depth Study on the Impact of External Quality Assurance

ERIC Educational Resources Information Center

Stensaker, Bjorn; Langfeldt, Liv; Harvey, Lee; Huisman, Jeroen; Westerheijden, Don

2011-01-01

After more than two decades of external quality assurance, there is an increasing interest in questions concerning the impact and effects of this activity. Following an external evaluation of NOKUT--the Norwegian quality assurance agency, this article studies the impact of external quality assurance in detail by analysing quantitative and…

77 FR 21086 - Patents External Quality Survey (formerly Customer Panel Quality Survey)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office Patents External Quality Survey (formerly Customer Panel Quality Survey) ACTION: Proposed collection; comment request. SUMMARY: The United...: [email protected] . Include ``0651- 0057 Patents External Quality Survey comment'' in the...

Root resorption during orthodontic treatment with self-ligating or conventional brackets: a systematic review and meta-analysis.

PubMed

Yi, Jianru; Li, Meile; Li, Yu; Li, Xiaobing; Zhao, Zhihe

2016-11-21

The aim of this study was to compare the external apical root resorption (EARR) in patients receiving fixed orthodontic treatment with self-ligating or conventional brackets. Studies comparing the EARR between orthodontic patients using self-ligating or conventional brackets were identified through electronic search in databases including CENTRAL, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and SIGLE, and manual search in relevant journals and reference lists of the included studies until Apr 2016. The extraction of data and risk of bias evaluation were conducted by two investigators independently. The original outcome underwent statistical pooling by using Review Manager 5. Seven studies were included in the systematic review, out of which, five studies were statistically pooled in meta-analysis. The value of EARR of maxillary central incisors in the self-ligating bracket group was significantly lower than that in the conventional bracket group (SMD -0.31; 95% CI: -0.60--0.01). No significant differences in other incisors were observed between self-ligating and conventional brackets. Current evidences suggest self-ligating brackets do not outperform conventional brackets in reducing the EARR in maxillary lateral incisors, mandible central incisors and mandible lateral incisors. However, self-ligating brackets appear to have an advantage in protecting maxillary central incisor from EARR, which still needs to be confirmed by more high-quality studies.

[THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

PubMed

Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

2015-08-01

The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality.

PubMed

Denis, Dan; Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O'Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi; Gregory, Alice M

2017-08-01

Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18-27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18-66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

Externalizing Behaviors and Callous-Unemotional Traits: Different Associations With Sleep Quality

PubMed Central

Akhtar, Reece; Holding, Benjamin C; Murray, Christina; Panatti, Jennifer; Claridge, Gordon; Sadeh, Avi; Barclay, Nicola L; O’Leary, Rachael; Maughan, Barbara; McAdams, Tom A; Rowe, Richard; Eley, Thalia C; Viding, Essi

2017-01-01

Abstract Study Objectives Sleep quality is associated with different aspects of psychopathology, but relatively little research has examined links between sleep quality and externalizing behaviors or callous-unemotional traits. We examined: (1) whether an association exists between sleep quality and externalizing behaviors; (2) whether anxiety mediates this association; (3) whether callous-unemotional traits are associated with sleep quality. Methods Data from two studies were used. Study 1 involved 1556 participants of the G1219 study aged 18–27 years (62% female). Questionnaire measures assessed sleep quality, anxiety, externalizing behaviors, and callous-unemotional traits. Study 2 involved 338 participants aged 18–66 years (65% female). Questionnaires measured sleep quality, externalizing behaviors, and callous-unemotional traits. In order to assess objective sleep quality, actigraphic data were also recorded for a week from a subsample of study 2 participants (n = 43). Results In study 1, poorer sleep quality was associated with greater externalizing behaviors. This association was partially mediated by anxiety and moderated by levels of callous-unemotional traits. There was no significant relationship between sleep quality and callous-unemotional traits. In study 2, poorer sleep quality, as assessed via self-reported but not objective measures, was associated with higher levels of externalizing behaviors. Furthermore, in study 2, better sleep quality (indicated in both questionnaires and actigraphy measures: lower mean activity, and greater sleep efficiency) was associated with higher levels of callous-unemotional traits. Conclusions Self-reports of poorer sleep quality are associated with externalizing behaviors, and this association is partially mediated by anxiety. Callous-unemotional traits are not associated with poor sleep and may even be related to better sleep quality. This is an exceptional finding given that poor sleep quality appears to be a characteristic of most psychopathology. PMID:28575510

Comparing near-infrared conventional diffuse reflectance spectroscopy and hyperspectral imaging for determination of the bulk properties of solid samples by multivariate regression: determination of Mooney viscosity and plasticity indices of natural rubber.

PubMed

Juliano da Silva, Carlos; Pasquini, Celio

2015-01-21

Conventional reflectance spectroscopy (NIRS) and hyperspectral imaging (HI) in the near-infrared region (1000-2500 nm) are evaluated and compared, using, as the case study, the determination of relevant properties related to the quality of natural rubber. Mooney viscosity (MV) and plasticity indices (PI) (PI0 - original plasticity, PI30 - plasticity after accelerated aging, and PRI - the plasticity retention index after accelerated aging) of rubber were determined using multivariate regression models. Two hundred and eighty six samples of rubber were measured using conventional and hyperspectral near-infrared imaging reflectance instruments in the range of 1000-2500 nm. The sample set was split into regression (n = 191) and external validation (n = 95) sub-sets. Three instruments were employed for data acquisition: a line scanning hyperspectral camera and two conventional FT-NIR spectrometers. Sample heterogeneity was evaluated using hyperspectral images obtained with a resolution of 150 × 150 μm and principal component analysis. The probed sample area (5 cm(2); 24,000 pixels) to achieve representativeness was found to be equivalent to the average of 6 spectra for a 1 cm diameter probing circular window of one FT-NIR instrument. The other spectrophotometer can probe the whole sample in only one measurement. The results show that the rubber properties can be determined with very similar accuracy and precision by Partial Least Square (PLS) regression models regardless of whether HI-NIR or conventional FT-NIR produce the spectral datasets. The best Root Mean Square Errors of Prediction (RMSEPs) of external validation for MV, PI0, PI30, and PRI were 4.3, 1.8, 3.4, and 5.3%, respectively. Though the quantitative results provided by the three instruments can be considered equivalent, the hyperspectral imaging instrument presents a number of advantages, being about 6 times faster than conventional bulk spectrometers, producing robust spectral data by ensuring sample representativeness, and minimizing the effect of the presence of contaminants.

Evaluation of the performance of a micromethod for measuring urinary iodine by using six sigma quality metrics.

PubMed

Hussain, Husniza; Khalid, Norhayati Mustafa; Selamat, Rusidah; Wan Nazaimoon, Wan Mohamud

2013-09-01

The urinary iodine micromethod (UIMM) is a modification of the conventional method and its performance needs evaluation. UIMM performance was evaluated using the method validation and 2008 Iodine Deficiency Disorders survey data obtained from four urinary iodine (UI) laboratories. Method acceptability tests and Sigma quality metrics were determined using total allowable errors (TEas) set by two external quality assurance (EQA) providers. UIMM obeyed various method acceptability test criteria with some discrepancies at low concentrations. Method validation data calculated against the UI Quality Program (TUIQP) TEas showed that the Sigma metrics were at 2.75, 1.80, and 3.80 for 51±15.50 µg/L, 108±32.40 µg/L, and 149±38.60 µg/L UI, respectively. External quality control (EQC) data showed that the performance of the laboratories was within Sigma metrics of 0.85-1.12, 1.57-4.36, and 1.46-4.98 at 46.91±7.05 µg/L, 135.14±13.53 µg/L, and 238.58±17.90 µg/L, respectively. No laboratory showed a calculated total error (TEcalc)

Non-Destructive and rapid evaluation of staple foods quality by using spectroscopic techniques: A review.

PubMed

Su, Wen-Hao; He, Hong-Ju; Sun, Da-Wen

2017-03-24

Staple foods, including cereals, legumes, and root/tuber crops, dominate the daily diet of humans by providing valuable proteins, starch, oils, minerals, and vitamins. Quality evaluation of staple foods is primarily carried out on sensory (e.g. external defect, color), adulteration (e.g. species, origin), chemical (e.g. starch, proteins), mycotoxin (e.g. Fusarium toxin, aflatoxin), parasitic infection (e.g. weevil, beetle), and internal physiological (e.g. hollow heart, black heart) aspects. Conventional methods for the quality assessment of staple foods are always laborious, destructive, and time-consuming. Requirements for online monitoring of staple foods have been proposed to encourage the development of rapid, reagentless, and noninvasive techniques. Spectroscopic techniques, such as visible-infrared spectroscopy, Raman spectroscopy, nuclear magnetic resonance spectroscopy, and spectral imaging, have been introduced as promising analytical tools and applied for the quality evaluation of staple foods. This review summarizes the recent applications and progress of such spectroscopic techniques in determining various qualities of staple foods. Besides, challenges and future trends of these spectroscopic techniques are also presented.

Ambient Air Quality Data Inventory

EPA Pesticide Factsheets

The Office of Air and Radiation's (OAR) Ambient Air Quality Data (Current) contains ambient air pollution data collected by EPA, other federal agencies, as well as state, local, and tribal air pollution control agencies. Its component data sets have been collected over the years from approximately 10,000 monitoring sites, of which approximately 5,000 are currently active. OAR's Office of Air Quality Planning and Standards (OAQPS) and other internal and external users, rely on this data to assess air quality, assist in Attainment/Non-Attainment designations, evaluate State Implementation Plans for Non-Attainment Areas, perform modeling for permit review analysis, and other air quality management functions. Air quality information is also used to prepare reports for Congress as mandated by the Clean Air Act. This data covers air quality data collected after 1980, when the Clean Air Act requirements for monitoring were significantly modified. Air quality data from the Agency's early years (1970s) remains available (see OAR PRIMARY DATA ASSET: Ambient Air Quality Data -- Historical), but because of technical and definitional differences the two data assets are not directly comparable. The Clean Air Act of 1970 provided initial authority for monitoring air quality for Conventional Air Pollutants (CAPs) for which EPA has promulgated National Ambient Air Quality Standards (NAAQS). Requirements for monitoring visibility-related parameters were added in 1977. Requiremen

Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

ERIC Educational Resources Information Center

Shah, Mahsood

2012-01-01

External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

Semiconductor ring lasers subject to both on-chip filtered optical feedback and external conventional optical feedback

NASA Astrophysics Data System (ADS)

Khoder, Mulham; Van der Sande, Guy; Danckaert, Jan; Verschaffelt, Guy

2016-05-01

It is well known that the performance of semiconductor lasers is very sensitive to external optical feedback. This feedback can lead to changes in lasing characteristics and a variety of dynamical effects including chaos and coherence collapse. One way to avoid this external feedback is by using optical isolation, but these isolators and their packaging will increase the cost of the total system. Semiconductor ring lasers nowadays are promising sources in photonic integrated circuits because they do not require cleaved facets or mirrors to form a laser cavity. Recently, some of us proposed to combine semiconductor ring lasers with on chip filtered optical feedback to achieve tunable lasers. The feedback is realized by employing two arrayed waveguide gratings to split/recombine light into different wavelength channels. Semiconductor optical amplifier gates are used to control the feedback strength. In this work, we investigate how such lasers with filtered feedback are influenced by an external conventional optical feedback. The experimental results show intensity fluctuations in the time traces in both the clockwise and counterclockwise directions due to the conventional feedback. We quantify the strength of the conventional feedback induced dynamics be extracting the standard deviation of the intensity fluctuations in the time traces. By using filtered feedback, we can shift the onset of the conventional feedback induced dynamics to larger values of the feedback rate [ Khoder et al, IEEE Photon. Technol. Lett. DOI: 10.1109/LPT.2016.2522184]. The on-chip filtered optical feedback thus makes the semiconductor ring laser less senstive to the effect of (long) conventional optical feedback. We think these conclusions can be extended to other types of lasers.

[Standardization in laboratory hematology by participating in external quality assurance programs].

PubMed

Nazor, Aida; Siftar, Zoran; Flegar-Mestrić, Zlata

2011-09-01

Since 1985, Department of Clinical Chemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, has been participating in the International External Quality Assessment Scheme for Hematology (IEQAS-H) organized by the World Health Organization (WHO). Owing to very good results, in 1987 the Department received a certificate of participation in this control scheme. Department has been cooperating in the external quality assessment program in laboratory hematology which has been continuously performed in Croatia since 1986 by the Committee for External Quality Assessment Schemes under the auspices of the Croatian Society of Medical Biochemists and School of Pharmacy and Biochemistry, University of Zagreb. Nowadays, 186 medical biochemical laboratories are included in the National External Quality Assessment program, which is performed three times per year. Our Department has participated in the international projects of the European Committee for External Quality Assurance Programs in Laboratory Medicine (EQALM).

3D-printed external light trap for solar cells.

PubMed

van Dijk, Lourens; Paetzold, Ulrich W; Blab, Gerhard A; Schropp, Ruud E I; di Vece, Marcel

2016-05-01

We present a universally applicable 3D-printed external light trap for enhanced absorption in solar cells. The macroscopic external light trap is placed at the sun-facing surface of the solar cell and retro-reflects the light that would otherwise escape. The light trap consists of a reflective parabolic concentrator placed on top of a reflective cage. Upon placement of the light trap, an improvement of 15% of both the photocurrent and the power conversion efficiency in a thin-film nanocrystalline silicon (nc-Si:H) solar cell is measured. The trapped light traverses the solar cell several times within the reflective cage thereby increasing the total absorption in the cell. Consequently, the trap reduces optical losses and enhances the absorption over the entire spectrum. The components of the light trap are 3D printed and made of smoothened, silver-coated thermoplastic. In contrast to conventional light trapping methods, external light trapping leaves the material quality and the electrical properties of the solar cell unaffected. To explain the theoretical operation of the external light trap, we introduce a model that predicts the absorption enhancement in the solar cell by the external light trap. The corresponding calculated path length enhancement shows good agreement with the empirically derived value from the opto-electrical data of the solar cell. Moreover, we analyze the influence of the angle of incidence on the parasitic absorptance to obtain full understanding of the trap performance. © 2015 The Authors. Progress in Photovoltaics: Research and Applications published by John Wiley & Sons, Ltd.

Still Balancing Improvement and Accountability? Developments in External Quality Assurance in the Nordic Countries 1996-2006

ERIC Educational Resources Information Center

Dano, Trine; Stensaker, Bjorn

2007-01-01

The role and function of external quality assurance is of great importance for the development of an internal quality culture in higher education. Research has shown that external quality assurance can stimulate but also create obstacles for institutional improvement. To strike a balance between improvement and accountability is, therefore, a key…

External Quality Arrangements for Scotland's Colleges

ERIC Educational Resources Information Center

Her Majesty's Inspectorate of Education, 2008

2008-01-01

This document represents an innovative and radical landmark in the development of external quality arrangements for Scotland's colleges. The quality framework and arrangements for annual engagement, subject-based aspect reports, and external review reflect new thinking nationally, within HMIE, in the Scottish Further and Higher Education Funding…

Importance-performance analysis as a guide for hospitals in improving their provision of services.

PubMed

Whynes, D K; Reed, G

1995-11-01

As a result of the 1990 National Health Services Act, hospitals now compete with one another to win service contracts. A high level of service quality represents an important ingredient of a successful competitive strategy, yet, in general, hospitals have little external information on which to base quality decisions. Specifically, in their efforts to win contracts from fundholding general practitioners, hospitals require information on that which these purchasers deem important with respect to quality, and on how these purchasers assess the quality of their current service performance. The problem is complicated by the fact that hospital service quality, in itself, is multi-dimensional. In other areas of economic activity, the information problem has been resolved by importance-performance analysis and this paper reports the findings of such an analysis conducted for hosptials in the Trent region. The importance and performance service quality ratings of fundholders were obtained from a questionnaire survey and used in a particular variant of importance-performance analysis, which possesses certain advantages over more conventional approaches. In addition to providing empirical data on the determinants of service quality, as perceived by the purchasers of hospital services, this paper demonstrates how such information can be successfully employed in a quality enhancement strategy.

42 CFR 438.362 - Exemption from external quality review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Exemption from external quality review. 438.362 Section 438.362 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.362 Exemption...

42 CFR 438.362 - Exemption from external quality review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Exemption from external quality review. 438.362 Section 438.362 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.362 Exemption...

[The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

PubMed

Men'shikov, V V

2013-08-01

The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

Current external beam radiation therapy quality assurance guidance: does it meet the challenges of emerging image-guided technologies?

PubMed

Palta, Jatinder R; Liu, Chihray; Li, Jonathan G

2008-01-01

The traditional prescriptive quality assurance (QA) programs that attempt to ensure the safety and reliability of traditional external beam radiation therapy are limited in their applicability to such advanced radiation therapy techniques as three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, inverse treatment planning, stereotactic radiosurgery/radiotherapy, and image-guided radiation therapy. The conventional QA paradigm, illustrated by the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 40 (TG-40) report, consists of developing a consensus menu of tests and device performance specifications from a generic process model that is assumed to apply to all clinical applications of the device. The complexity, variation in practice patterns, and level of automation of high-technology radiotherapy renders this "one-size-fits-all" prescriptive QA paradigm ineffective or cost prohibitive if the high-probability error pathways of all possible clinical applications of the device are to be covered. The current approaches to developing comprehensive prescriptive QA protocols can be prohibitively time consuming and cost ineffective and may sometimes fail to adequately safeguard patients. It therefore is important to evaluate more formal error mitigation and process analysis methods of industrial engineering to more optimally focus available QA resources on process components that have a significant likelihood of compromising patient safety or treatment outcomes.

Infancy parenting and externalizing psychopathology from childhood through adulthood: developmental trends.

PubMed

Lorber, Michael F; Egeland, Byron

2009-07-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy parenting was associated with externalizing problems at kindergarten and first grade (mother report) as well as at 23 and 26 years (self report). Infancy parenting was not significantly associated with either mothers' or youths' reports of externalizing problems at 16 years. These findings are consistent with the notion that poor-quality infancy parenting is a risk factor for externalizing problems in developmental periods for which externalizing behavior is most deviant.

Modeling in conventional and supra electroporation for model cell with organelles

NASA Astrophysics Data System (ADS)

Sulaeman, Muhammad Yangki; Widita, Rena

2015-09-01

Electroporation is a formation of pores in the membrane cell due to the external electric field applied to the cell. There are two types of electroporation, conventional and supra-electroporation. The purpose of creating pores in the cell using conventional electroporation are to increase the effectiveness of chemotherapy (electrochemotherapy) and to kill cancer tissue using irreversible electroporation. Supra-electroporation shows that it can induce electroporation in the organell inside the cell, so it can kill the cell by apoptosis mechanism. Modeling of electroporation phenomenon on a model cell had been done by using software COMSOL Multiphysics 4.3b with the applied external electric field used are 1.1 kV/cm for conventional electroporation and 60 kV/cm for supra-electroporation to find the difference between transmembrane voltage and pore density for both electroporation. It can be concluded from the results that there is a big difference between transmembrane voltage and pores density on conventional and supra electroporation on model cell.

Effect of a Bluetooth-implemented hearing aid on speech recognition performance: subjective and objective measurement.

PubMed

Kim, Min-Beom; Chung, Won-Ho; Choi, Jeesun; Hong, Sung Hwa; Cho, Yang-Sun; Park, Gyuseok; Lee, Sangmin

2014-06-01

The object was to evaluate speech perception improvement through Bluetooth-implemented hearing aids in hearing-impaired adults. Thirty subjects with bilateral symmetric moderate sensorineural hearing loss participated in this study. A Bluetooth-implemented hearing aid was fitted unilaterally in all study subjects. Objective speech recognition score and subjective satisfaction were measured with a Bluetooth-implemented hearing aid to replace the acoustic connection from either a cellular phone or a loudspeaker system. In each system, participants were assigned to 4 conditions: wireless speech signal transmission into hearing aid (wireless mode) in quiet or noisy environment and conventional speech signal transmission using external microphone of hearing aid (conventional mode) in quiet or noisy environment. Also, participants completed questionnaires to investigate subjective satisfaction. Both cellular phone and loudspeaker system situation, participants showed improvements in sentence and word recognition scores with wireless mode compared to conventional mode in both quiet and noise conditions (P < .001). Participants also reported subjective improvements, including better sound quality, less noise interference, and better accuracy naturalness, when using the wireless mode (P < .001). Bluetooth-implemented hearing aids helped to improve subjective and objective speech recognition performances in quiet and noisy environments during the use of electronic audio devices.

Endorsing good quality assurance practices in molecular pathology: risks and recommendations for diagnostic laboratories and external quality assessment providers.

PubMed

Tembuyser, Lien; Dequeker, Elisabeth M C

2016-01-01

Quality assurance is an indispensable element in a molecular diagnostic laboratory. The ultimate goal is to warrant patient safety. Several risks that can compromise high quality procedures are at stake, from sample collection to the test performed by the laboratory, the reporting of test results to clinicians, and the organization of effective external quality assessment schemes. Quality assurance should therefore be safeguarded at each level and should imply a holistic multidisciplinary approach. This review aims to provide an overview of good quality assurance practices and discusses certain risks and recommendations to promote and improve quality assurance for both diagnostic laboratories and for external quality assessment providers. The number of molecular targets is continuously rising, and new technologies are evolving. As this poses challenges for clinical implementation and increases the demand for external quality assessment, the formation of an international association for improving quality assurance in molecular pathology is called for.

Development of an integrated electrochemical system for in vitro yeast viability testing.

PubMed

Adami, Andrea; Ress, Cristina; Collini, Cristian; Pedrotti, Severino; Lorenzelli, Leandro

2013-02-15

This work describes the development and testing of a microfabricated sensor for rapid cell growth monitoring, especially focused on yeast quality assessment for wine applications. The device consists of a NMOS ISFET sensor with Si(3)N(4) gate, able to indirectly monitor extracellular metabolism through pH variation of the medium, and a solid-state reference electrode implemented with PVC membranes doped with lipophilic salts (tetrabutylammonium-tetrabutylborate (TBA-TBB) and Potassium tetrakis(4-chlorphenyl)borate (KTClpB)). The use of a solid state reference electrode enables the implementation of a large number of cell assays in parallel, without the need of external conventional reference electrodes. Microbial growth testing has been performed both in standard culture conditions and on chip at different concentrations of ethanol in order to carry out a commonly used screening of wine yeast strains. Cell growth tests can be performed in few hours, providing a fast, sensitive and low cost analysis with respect to the conventional procedures. Copyright © 2012 Elsevier B.V. All rights reserved.

Dual mode fuel injector with one piece needle valve member

DOEpatents

Lawrence, Keith E.; Hinrichsen, Michael H.; Buckman, Colby

2005-01-18

A fuel injector includes a homogenous charge nozzle outlet set and a conventional nozzle outlet set controlled respectively by inner and outer needle value members. The homogenous charged nozzle outlet set is defined by an outer needle value member that is moveably positioned in an injector body, which defines the conventional nozzle outlet set. The inner needle valve member is positioned in the outer needle valve member. The outer needle valve member is a piece component that includes at least one external guide surface, an external value surface and an internal valve seat.

Associations of Perceived Sibling and Parent-Child Relationship Quality with Internalizing and Externalizing Problems: Comparing Indian and Dutch Early Adolescents

ERIC Educational Resources Information Center

Buist, Kirsten L.; Verhoeven, Marjolein; Hoksbergen, René; ter Laak, Jan; Watve, Sujala; Paranjpe, Analpa

2017-01-01

The aims of the present study were (a) to examine whether Dutch and Indian early adolescents differ concerning sibling and parent-child relationship quality and externalizing and internalizing problems, and (b) to compare the associations between sibling and parent-child relationship quality and externalizing and internalizing problems for Indian…

The Influence of Strategy and External Quality Audit on University Performance: An Australian Perspective

ERIC Educational Resources Information Center

Shah, Mahsood; Nair, Sid

2011-01-01

External quality audits have been introduced in many parts of the world including Asia Pacific, Asia, Africa, Europe, and the Middle East. While external quality audits have been introduced for more than a decade in some countries like New Zealand, the United Kingdom (UK), Denmark, and Sweden, there is limited research on the extent to which such…

Technological Advancements and Error Rates in Radiation Therapy Delivery

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

Margalit, Danielle N., E-mail: dmargalit@partners.org; Harvard Cancer Consortium and Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA; Chen, Yu-Hui

2011-11-15

Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)-conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system atmore » Brigham and Women's Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher's exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01-0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08-0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique. There was a lower error rate with IMRT compared with 3D/conventional RT, highlighting the need for sustained vigilance against errors common to more traditional treatment techniques.« less

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

PubMed Central

Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2015-01-01

Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

PubMed

Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2016-04-01

Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

Effect of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury

PubMed Central

El-Shamy, Shamekh; Alsharif, Rabab

2017-01-01

Objectives: The objective was to evaluate the effects of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. Methods: Forty children with Erb’s palsy were selected for this randomized controlled study. They were assigned randomly to either group A (conventional physiotherapy program) or group B (virtual reality program using Armeo® spring for 45 min three times/week for 12 successive weeks). Mallet system scores for shoulder function and shoulder abduction, and external rotation range of motion (ROM) were obtained; shoulder abductor, and external rotators isometric strength were evaluated pre-and post-treatment using Mallet scoring system, standard universal goniometer, and handheld dynamometer. Results: The results of this study indicate that the children in both groups showed improvement in shoulder functions post-treatment with greater improvements in group B. The abduction muscle strength after treatment was 8.53 and 11.3 Nm for group A and group B, respectively. The external rotation muscle strength after treatment was 5.88 and 7.45 Nm for group A and group B, respectively. Conclusions: The virtual reality program is a significantly more effective than conventional physiotherapy program in improving the upper extremity functions in children with obstetric brachial plexus injury. PMID:29199193

Target analyte quantification by isotope dilution LC-MS/MS directly referring to internal standard concentrations--validation for serum cortisol measurement.

PubMed

Maier, Barbara; Vogeser, Michael

2013-04-01

Isotope dilution LC-MS/MS methods used in the clinical laboratory typically involve multi-point external calibration in each analytical series. Our aim was to test the hypothesis that determination of target analyte concentrations directly derived from the relation of the target analyte peak area to the peak area of a corresponding stable isotope labelled internal standard compound [direct isotope dilution analysis (DIDA)] may be not inferior to conventional external calibration with respect to accuracy and reproducibility. Quality control samples and human serum pools were analysed in a comparative validation protocol for cortisol as an exemplary analyte by LC-MS/MS. Accuracy and reproducibility were compared between quantification either involving a six-point external calibration function, or a result calculation merely based on peak area ratios of unlabelled and labelled analyte. Both quantification approaches resulted in similar accuracy and reproducibility. For specified analytes, reliable analyte quantification directly derived from the ratio of peak areas of labelled and unlabelled analyte without the need for a time consuming multi-point calibration series is possible. This DIDA approach is of considerable practical importance for the application of LC-MS/MS in the clinical laboratory where short turnaround times often have high priority.

Systems Perspectives on External Quality Assurance: Implications for Micro-States

ERIC Educational Resources Information Center

Houston, Don; Maniku, Ahmed Ali

2005-01-01

Quality assurance in higher education is a mess: the "problem" of quality is embedded in complex sets of interacting issues that are of concern to many and varied stakeholders. Developing higher education systems that have responded to issues of quality through a "best practice" model of external quality assurance has produced…

Modelling in conventional electroporation for model cell with organelles using COMSOL Multiphysics

NASA Astrophysics Data System (ADS)

Sulaeman, M. Y.; Widita, R.

2016-03-01

Conventional electroporation is a formation of pores in the membrane cell due to the external electric field applied to the cell. The purpose of creating pores in the cell using conventional electroporation are to increase the effectiveness of chemotherapy (electrochemotherapy) and to kill cancer tissue using irreversible electroporation. Modeling of electroporation phenomenon on a model cell had been done by using software COMSOL Multiphysics 4.3b with the applied external electric field with intensity at 1.1 kV/cm to find transmembrane voltage and pore density. It can be concluded from the results of potential distribution and transmembrane voltage, it show that pores formation only occurs in the membrane cells and it could not penetrate into inside the model cell so there is not pores formation in its organells.

A systematic review of the quality of homeopathic clinical trials

PubMed Central

Jonas, Wayne B; Anderson, Rachel L; Crawford, Cindy C; Lyons, John S

2001-01-01

Background While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature. Methods In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945–1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95. Results 59 studies met the inclusion criteria. Of these, 79% were from peer-reviewed journals, 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. The main validity problems were in measurement where 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. 17% of subjects dropped out in studies where this was reported. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies in homeopathy was worse and only slightly improved in more recent years. Conclusions Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. Many of these problems are correctable even within a "holistic" paradigm given sufficient research expertise, support and methods. PMID:11801202

75 FR 16459 - Draft Document Related to the Review of the National Ambient Air Quality Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-01

... Review of the National Ambient Air Quality Standards for Particulate Matter AGENCY: Environmental... Review of the Particulate Matter National Ambient Air Quality Standards--First External Review Draft (75... Particulate Matter National Ambient Air Quality Standards--First External Review Draft (March 2010), please...

Thoughts on Internal and External Quality Assurance

ERIC Educational Resources Information Center

Zhang, Jianxin

2012-01-01

Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

Infancy Parenting and Externalizing Psychopathology from Childhood through Adulthood: Developmental Trends

ERIC Educational Resources Information Center

Lorber, Michael F.; Egeland, Byron

2009-01-01

Developmental models and previous findings suggest that early parenting is more strongly associated with externalizing problems in early childhood than it is in adolescence. In this article, the authors address whether the association of poor-quality infancy parenting and externalizing problems "rebounds" in adulthood. Poor-quality infancy…

External quality mechanisms for health care: summary of the ExPeRT project on visitatie, accreditation, EFQM and ISO assessment in European Union countries. External Peer Review Techniques. European Foundation for Quality Management. International Organization for Standardization.

PubMed

Shaw, C D

2000-06-01

This paper is a summary of the operation, findings and conclusions of a European Union project on external peer review techniques, termed 'ExPeRT', to research the scope, mechanisms and use of external quality mechanisms in the improvement of health care. Many of the themes outlined are described in detail in other papers that have been prepared specifically for this issue of The International Journal for Quality in Health Care. Although the emphasis of this project and of this issue of the Journal is on Europe, the conclusions are more widely relevant.

GaN-Based Light-Emitting Diodes Grown on Nanoscale Patterned Sapphire Substrates with Void-Embedded Cortex-Like Nanostructures

NASA Astrophysics Data System (ADS)

Lin, Yu-Sheng; Yeh, J. Andrew

2011-09-01

High-efficiency GaN-based light-emitting diodes (LEDs) with an emitting wavelength of 438 nm were demonstrated utilizing nanoscale patterned sapphire substrates with void-embedded cortex-like nanostructures (NPSS-VECN). Unlike the previous nanopatterned sapphire substrates, the presented substrate has a new morphology that can not only improve the crystalline quality of GaN epilayers but also generate a void-embedded nanostructural layer to enhance light extraction. Under a driving current of 20 mA, the external quantum efficiency of an LED with NPSS-VECN is enhanced by 2.4-fold compared with that of the conventional LED. Moreover, the output powers of two devices respectively are 33.1 and 13.9 mW.

Stretchable Dual-Capacitor Multi-Sensor for Touch-Curvature-Pressure-Strain Sensing.

PubMed

Jin, Hanbyul; Jung, Sungchul; Kim, Junhyung; Heo, Sanghyun; Lim, Jaeik; Park, Wonsang; Chu, Hye Yong; Bien, Franklin; Park, Kibog

2017-09-07

We introduce a new type of multi-functional capacitive sensor that can sense several different external stimuli. It is fabricated only with polydimethylsiloxane (PDMS) films and silver nanowire electrodes by using selective oxygen plasma treatment method without photolithography and etching processes. Differently from the conventional single-capacitor multi-functional sensors, our new multi-functional sensor is composed of two vertically-stacked capacitors (dual-capacitor). The unique dual-capacitor structure can detect the type and strength of external stimuli including curvature, pressure, strain, and touch with clear distinction, and it can also detect the surface-normal directionality of curvature, pressure, and touch. Meanwhile, the conventional single-capacitor sensor has ambiguity in distinguishing curvature and pressure and it can detect only the strength of external stimulus. The type, directionality, and strength of external stimulus can be determined based on the relative capacitance changes of the two stacked capacitors. Additionally, the logical flow reflected on a tree structure with its branches reaching the direction and strength of the corresponding external stimulus unambiguously is devised. This logical flow can be readily implemented in the sensor driving circuit if the dual-capacitor sensor is commercialized actually in the future.

What is limiting more flexible fire management—public or agency pressure?

Treesearch

Toddi A. Steelman; Sarah M. McCaffrey

2011-01-01

Conventional wisdom within American federal fire management agencies suggests that external influence such as community or political pressure for aggressive suppression are key factors circumscribing the ability to execute less aggressive fire management strategies. Thus, a better understanding of external constraints on fire management options is essential. This...

The Effectiveness of the Higher Education Quality Assessment System: Problems and Countermeasures in China

ERIC Educational Resources Information Center

Guangli, Zhou

2016-01-01

The effectiveness of the higher education quality assessment system is essentially a matter of policy evaluation. On the macro level, such a system refers to external quality assessment, which includes government evaluation, quality certification, and university rankings. Depending on the degree of government intervention, the external quality…

Friendship Quality, Peer Group Affiliation, and Peer Antisocial Behavior as Moderators of the Link Between Negative Parenting and Adolescent Externalizing Behavior

PubMed Central

Lansford, Jennifer E.; Criss, Michael M.; Pettit, Gregory S.; Dodge, Kenneth A.; Bates, John E.

2009-01-01

Quality of peer relationships and perceived peer antisocial behavior were examined as moderators of the link between negative parenting and externalizing behavior problems in school from middle childhood to early adolescence. Data on negative parenting (i.e., unilateral parental decision making, low supervision and awareness, and harsh discipline) were collected from 362 parents in the summer preceding the adolescents’ entry into Grade 6. Adolescent reports of positive peer relationships and peer antisocial behavior were assessed in the winter of Grade 7. The outcome measure was teacher report of adolescent externalizing behavior in the spring of Grade 7, controlling for externalizing behavior in Grade 5. High levels of friendship quality and peer group affiliation attenuated the association between unilateral parental decision making and adolescent externalizing behavior in school; this was particularly true when adolescents associated with peers perceived to be low in antisocial behavior. In addition, having low-quality peer relationships and having peers perceived to be highly antisocial further amplified the association between unilateral parental decision making and adolescent externalizing behavior problems. Finally, high levels of friend and peer group antisocial behavior exacerbated the predictiveness of harsh discipline for adolescents’ externalizing behavior. PMID:20209019

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2014-02-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to external quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2013-09-01

Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

Quality of natural product clinical trials: a comparison of those published in alternative medicine versus conventional medicine journals.

PubMed

Cochrane, Zara Risoldi; Gregory, Philip; Wilson, Amy

2011-06-01

To compare the quality of natural product clinical trials published in alternative medicine journals versus those published in conventional medicine journals. Systematic search and review of the literature. Randomized controlled trials of natural products were included if they were published in English between 2003 and 2008. Articles were categorized by their journal of publication (alternative medicine versus conventional medicine). Two independent reviewers evaluated study quality using guidelines from the Cochrane Collaboration. The results with respect to the primary outcome (positive or negative) were also assessed. Thirty articles were evaluated, 15 published in alternative medicine journals and 15 in conventional medicine journals. Of articles published in alternative medicine journals, 33.33% (n = 5) were considered low quality, and none were considered high quality. Of articles published in conventional medicine journals, 26.67% (n = 4) were considered low quality and 6.67% (n = 1) were considered high quality. Two thirds of all trials reviewed were of unclear quality, due to inadequate reporting of information relating to the study's methodology. Similar proportions of positive and negative primary outcomes were found in alternative and conventional medicine journals, and low-quality articles were not more likely to report a positive primary outcome (Fisher's exact test, two-tailed p = .287). The quality of natural product randomized controlled trials was similar among alternative and conventional medicine journals. Efforts should be made to improve the reporting of natural product clinical trials for accurate determinations of study quality to be possible.

Testing the role of external debt in environmental degradation: empirical evidence from Turkey.

PubMed

Katircioglu, Salih; Celebi, Aysem

2018-03-01

This study investigates the role of external debt stock in Turkey, which has suffered from heavy (external and domestic) debt stock for many years. Annual data from 1960 to 2013 was analyzed using time series analysis in order to study this. The results confirm the validity of the conventional environmental Kuznets curve (EKC) in the case of Turkey. However, this study also found that Turkey's external debt stock did not influence the Turkish economy's long-term EKC behavior. Fortunately, the results suggest that there are important interactions among external debt stock, CO 2 emissions, energy consumption, and real income; that is, changes in external debt volume precede changes in these aggregates' volumes.

[Clinical experience with various techniques integrated treat the wounded with gunshot fractures of limbs].

PubMed

Kozlov, V K; Akhmedov, B G; Chililov, A M

To increase an efficiency of complex treatment of patients with diaphyseal gunshot fractures of long bones by introduction of modern minimally invasive surgical techniques of internal osteosynthesis into clinical practice of civil health care and to improve the outcomes in victims. Prospective comparative clinical trial included 104 victims from the Republic of Yemen with gunshot wounds of limbs of various severity for the period 2009-2011. There were diaphyseal fractures of long bones of limbs associated with soft tissue injuries. Men were predominant (80.7%). Age ranged from 15 to 80 years (mean 38,5 ± 5,7 years). Various surgical techniques of simultaneous and staged treatment were used for gunshot fractures of long bones of limbs. Additional immune therapy was prescribed to prevent infectious complications in the most severe cases. Victims were comprehensively treated according to different staged treatment: conventional surgical treatment with external fixation devices or early primary minimally invasive functionally stable osteosynthesis with LCP/BIOS plates were applied for low-energy fractures; in case of high-energy fractures the first stage included external fixation devices deployment followed by their subsequent replacement during delayed minimally invasive osteosynthesis. The essence of improvement is pursuit to simultaneous minimally invasive surgery by using of current plates for osteosynthesis and preventive immunotherapy of immune dysfunction to eliminate infectious complications. As a result, we obtained 2-fold decrease of surgical invasiveness (r≤0,01) and hospital-stay (r≤0,01). Repeated osteosynthesis was not made. Also 4-fold and 40-fold reduction of infectious and noninfectious complications was observed. This management was accompanied by reduced rehabilitation tine and significantly improved quality of life. Improved technique and algorithm of complex treatment of diaphyseal gunshot fractures of long bones of limbs were described. Early minimally invasive functionally stable osteosynthesis with modern implants and non-specific immune prevention of infectious complications are more effective and economically justified compared with conventional treatment including external fixation devices without immunoactive therapy.

External Quality Assessment for Rubella Virus RNA Detection Using Armored RNA in China.

PubMed

Zhang, D; Lin, G; Yi, L; Hao, M; Fan, G; Yang, X; Peng, R; Ding, J; Zhang, K; Zhang, R; Li, J

2017-02-01

Although tremendous efforts have been made to reduce rubella incidence, there are still 300 new cases of congenital rubella syndrome daily; thus, rubella infections remain one of the leading causes of preventable congenital birth defects. An effective surveillance system, which could be achieved and maintained by using an external quality assessment program, is critical for prevention and control of this disease. Armored RNAs, which are noninfectious and RNase-resistant, were used for encapsulation of the E1 gene of rubella virus and for preparation of a 10-specimen panel for external quality assessment. Thirty-two laboratories across mainland China that used nucleic acid tests for rubella virus RNA detection were included in the external quality assessment program organized by the National Center for Clinical Laboratories of China. Different kinds of commercial kits were used by the laboratories for nucleic acid extraction and TaqMan real-time reverse-transcription PCR for rubella virus RNA detection; 99.2% sensitivity and 100% specificity were achieved in this external quality assessment program. Most of the participating laboratories obtained accurate results for rubella nucleic acid tests, thereby achieving the quality required for regional rubella and congenital rubella syndrome elimination.

75 FR 47595 - Science Advisory Board Staff Office; Notification of a Public Teleconference of the Clean Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... Air Quality Standards--Second External Review Draft (June 2010). DATES: The teleconference will be... Standards--Second External Review Draft (June 2010). Background information on previous meetings and... Quality Standards--Second External Review Draft (June 2010) should be directed to Ms. Beth Hassett-Sipple...

75 FR 9206 - Science Advisory Board Staff Office; Notification of a Clean Air Scientific Advisory Committee...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-01

...: Second External Review Draft and EPA's Policy Assessment for the Review of the Carbon Monoxide National Ambient Air Quality Standards: External Review Draft. The chartered CASAC will subsequently hold a public... National Ambient Air Quality Standards: Second External Review Draft and the Policy Assessment for the...

Longitudinal effects of sibling relationship quality on adolescent problem behavior: a cross-ethnic comparison.

PubMed

Buist, Kirsten L; Paalman, Carmen H; Branje, Susan J T; Deković, Maja; Reitz, Ellen; Verhoeven, Marjolein; Meeus, Wim H J; Koot, Hans M; Hale, William W

2014-04-01

The aim of the present study was to examine whether adolescents of Moroccan and Dutch origin differ concerning sibling relationship quality and to examine whether the associations between quality of the sibling relationship and level and change in externalizing and internalizing problem behavior are comparable for Moroccan and Dutch adolescents. Five annual waves of questionnaire data on sibling support and conflict as well as externalizing problems, anxiety and depression were collected from 159 ethnic Moroccan adolescents (Mage = 13.3 years) and from 159 ethnic Dutch adolescents (Mage = 13.0 years). Our findings demonstrated significant mean level differences between the Moroccan and Dutch sample in sibling relationship quality, externalizing problems, and depression, with Moroccan adolescents reporting higher sibling relationship quality and less problem behavior. However, effects of sibling relationship quality on externalizing problems, anxiety, and depression were similar for the Moroccan and Dutch samples. Sibling support was not related to level of externalizing problems, nor to changes in externalizing problems, anxiety, and depression. Additionally, more sibling conflict was related to a higher starting level of and faster decreases in problem behaviors. Our results support the ethnic equivalence model, which holds that the influence of family relationships is similar for different ethnic groups. Moreover, sibling support and conflict affect both the level and the fluctuations in problem behavior over time in specific ethnic groups similarly. Implications for future studies and interventions are subsequently discussed.

[Coronary artery bypass surgery: methods of performance monitoring and quality control].

PubMed

Albert, A; Sergeant, P; Ennker, J

2009-10-01

The strength of coronary bypass operations depends on the preservation of their benefits regarding freedom of symptoms, quality of life and survival, over decades. Significant variability of the results of an operative intervention according to the hospital or the operating surgeon is considered a weakness in the procedure. The external quality insurance tries to reach a transparent service providing market through hospital ranking comparability. Widely available information and competition will promote the improvement of the whole quality. The structured dialog acts as a control instrument for the BQS (Federal Quality Insurance). It is launched in case of deviations from the standard references or statistically significant differences between the results of the operations in any hospital and the average notational results. In comparison to the external control the hospital internal control has greater ability to reach a medically useful statement regarding the results of the treatment and to correct the mistakes in time. An online information portal based on a departmental databank (DataWarehouse, DataMart) is an attractive solution for the physician in order to get transparently and timely informed about the variability in the performance.The individual surgeon significantly influences the short- and long-term treatment results. Accordingly, selection, targeted training and performance measurements are necessary.Strict risk management and failure analysis of individual cases are included in the methods of internal quality control aiming to identify and correct the inadequacies in the system and the course of treatment. According to the international as well as our own experience, at least 30% of the mortalities after bypass operations are avoidable. A functioning quality control is especially important in minimally invasive interventions because they are often technically more demanding in comparison to the conventional procedures. In the field of OPCAB surgery, the special advantages of the procedure can be utilised to reach a nearly complete avoidance of postoperative stroke through combining the procedure with aorta no-touch technique. The long-term success of the bypass operation depends on the type of bypass material in additions to many other factors. Both internal mammary arteries are considered the most durable.Using an operation preparation check contributes to the operative success.

Modern Aspects of Liquid Metal Engineering

NASA Astrophysics Data System (ADS)

Czerwinski, Frank

2017-02-01

Liquid metal engineering (LME) refers to a variety of physical and/or chemical treatments of molten metals aimed at influencing their solidification characteristics. Although the fundamentals have been known for decades, only recent progress in understanding solidification mechanisms has renewed an interest in opportunities this technique creates for an improvement of castings. This review covers conventional and novel concepts of LME with their application to modern manufacturing techniques based not only on liquid but also on semisolid routes. The role of external forces applied to the melt combined with grain nucleation control is explained along with laboratory- and commercial-scale equipment designed for implementation of various concepts exploring mechanical, electromagnetic, and ultrasound principles. An influence of melt treatments on quality of the final product is considered through distinguishing between internal integrity of net shape components and the alloy microstructure. Recent global developments indicate that exploring the synergy of melt chemistry and physical treatments achieved through LME allows creating the optimum conditions for nucleation and growth during solidification, positively affecting quality of castings.

Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

ERIC Educational Resources Information Center

Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

2015-01-01

The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

A Three-Dimensional Hydrodynamic Focusing Method for Polyplex Synthesis

PubMed Central

Lu, Mengqian; Ho, Yi-Ping; Grigsby, Christopher L.; Nawaz, Ahmad Ahsan; Leong, Kam W.; Huang, Tony Jun

2014-01-01

Successful intracellular delivery of nucleic acid therapeutics relies on multi-aspect optimization, one of which is formulation. While there has been ample innovation on chemical design of polymeric gene carriers, the same cannot be said for physical processing of polymer-DNA nanocomplexes (polyplexes). Conventional synthesis of polyplexes by bulk mixing depends on the operators’ experience. The poorly controlled bulk-mixing process may also lead to batch-to-batch variation and consequent irreproducibility. Here, we synthesize polyplexes by using a three-dimensional hydrodynamic focusing (3D-HF) technique in a single-layered, planar microfluidic device. Without any additional chemical treatment or post processing, the polyplexes prepared by the 3D-HF method show smaller size, slower aggregation rate, and higher transfection efficiency, while exhibiting reduced cytotoxicity compared to the ones synthesized by conventional bulk mixing. In addition, by introducing external acoustic perturbation, mixing can be further enhanced, leading to even smaller nanocomplexes. The 3D-HF method provides a simple and reproducible process for synthesizing high-quality polyplexes, addressing a critical barrier in the eventual translation of nucleic acid therapeutics. PMID:24341632

High performance terahertz metasurface quantum-cascade VECSEL with an intra-cryostat cavity

DOE PAGES

Xu, Luyao; Curwen, Christopher A.; Reno, John L.; ...

2017-09-04

A terahertz quantum-cascade (QC) vertical-external-cavity surface-emitting-laser (VECSEL) is demonstrated with over 5 mW power in continuous-wave and single-mode operation above 77 K, in combination with a near-Gaussian beam pattern with full-width half-max divergence as narrow as ~5° × 5°, with no evidence of thermal lensing. This is realized by creating an intra-cryostat VECSEL cavity to reduce the cavity loss and designing an active focusing metasurface reflector with low power dissipation for efficient heat removal. Compared with a conventional quantumcascade laser based on a metal-metal waveguide, the intra-cryostat QC-VECSEL exhibits significant improvements in both output power level and beam pattern. Also,more » the intra-cryostat configuration newly allows evaluation of QC-VECSEL operation vs. temperature, showing a maximum pulsed mode operating temperature of 129 K. While the threshold current density in the QC-VECSEL is worse in comparison to a conventional edge-emitting metal-metal waveguide QClaser, the beam quality, slope efficiency, maximum power, and thermal resistance are all significantly improved.« less

The Effectiveness of External Quality Audits: A Study of Australian Universities

ERIC Educational Resources Information Center

Shah, Mahsood

2013-01-01

External quality audits have been introduced in many countries as part of higher education reforms. This article is based on research on 30 Australian universities to assess the extent to which audits by the Australian Universities Quality Agency (AUQA) have improved quality assurance in the core and support areas of the universities. The article…

Academic Staff Views on External Quality Audit: Post Audit Evaluation in a Private Higher Education College

ERIC Educational Resources Information Center

Shah, Mahsood; Nair, Chenicheri Sid; Stanford, Sue-Ann

2011-01-01

Governments in many countries have funded independent agencies to undertake quality audits of higher education institutions. Such agencies ensure that universities and other higher education providers have effective systems and processes to assure quality assurance in core and support areas. While external quality audits have been in place for a…

Investigation of Thrust and Drag Characteristics of a Plug-type Exhaust Nozzle

NASA Technical Reports Server (NTRS)

Hearth, Donald P; Gorton, Gerald C

1954-01-01

An investigation was conducted in the 8- by 6-foot supersonic wind tunnel on the external and internal characteristics of a plug-type exhaust nozzle. Two positions of the center plug, one simulating a convergent nozzle and the other a convergent-divergent nozzle, were investigated. Data were obtained at free-stream Mach numbers of 0.1, 0.6, 1.6, and 2.0 over a pressure-ratio range of 1 to 20 and angles of attack of zero and 8 degrees. Results of this investigation indicated that the plug nozzle had thrust-minus-drag performance over the entire pressure-ratio range comparable with equivalent conventional nozzles. The effect of the exhaust jet on the external aerodynamics was similar to results observed for conventional nozzles. In addition, the thrust characteristics were generally insensitive to external flow and good agreement was noted with data obtained on comparable plug nozzles in quiescent air.

Metabolomic fingerprinting employing DART-TOFMS for authentication of tomatoes and peppers from organic and conventional farming.

PubMed

Novotná, H; Kmiecik, O; Gałązka, M; Krtková, V; Hurajová, A; Schulzová, V; Hallmann, E; Rembiałkowska, E; Hajšlová, J

2012-01-01

The rapidly growing demand for organic food requires the availability of analytical tools enabling their authentication. Recently, metabolomic fingerprinting/profiling has been demonstrated as a challenging option for a comprehensive characterisation of small molecules occurring in plants, since their pattern may reflect the impact of various external factors. In a two-year pilot study, concerned with the classification of organic versus conventional crops, ambient mass spectrometry consisting of a direct analysis in real time (DART) ion source and a time-of-flight mass spectrometer (TOFMS) was employed. This novel methodology was tested on 40 tomato and 24 pepper samples grown under specified conditions. To calculate statistical models, the obtained data (mass spectra) were processed by the principal component analysis (PCA) followed by linear discriminant analysis (LDA). The results from the positive ionisation mode enabled better differentiation between organic and conventional samples than the results from the negative mode. In this case, the recognition ability obtained by LDA was 97.5% for tomato and 100% for pepper samples and the prediction abilities were above 80% for both sample sets. The results suggest that the year of production had stronger influence on the metabolomic fingerprints compared with the type of farming (organic versus conventional). In any case, DART-TOFMS is a promising tool for rapid screening of samples. Establishing comprehensive (multi-sample) long-term databases may further help to improve the quality of statistical classification models.

Higher Education Quality Assessment in China: An Impact Study

ERIC Educational Resources Information Center

Liu, Shuiyun

2015-01-01

This research analyses an external higher education quality assessment scheme in China, namely, the Quality Assessment of Undergraduate Education (QAUE) scheme. Case studies were conducted in three Chinese universities with different statuses. Analysis shows that the evaluated institutions responded to the external requirements of the QAUE…

Large-scale affordable PanLeucogated CD4+ testing with proactive internal and external quality assessment: in support of the South African national comprehensive care, treatment and management programme for HIV and AIDS.

PubMed

Glencross, Deborah K; Janossy, George; Coetzee, Lindi M; Lawrie, Denise; Aggett, Hazel M; Scott, Lesley E; Sanne, Ian; McIntyre, James A; Stevens, Wendy

2008-01-01

In order to expand the treatment of human immunodeficiency virus-1 (HIV) infected patients in Africa, millions will require cost-effective CD4 counts. Supporting laboratories therefore, need to move away from crisis management and haphazard practices to organized pathology services. The authors reviewed the performance of the simplified single platform (SP) PanLeucogated (PLG) CD4 methodology, introduced into 52 laboratories across the South African National Health Laboratory Service (SA-NHLS), with a proactive approach to training, internal quality control (IQC), and external quality assessment (EQA). Two-color flow cytometry for SP PLG (CD4/CD45) was combined with the sample-by-sample bead-count-rate (BCR) IQC for bead pipetting. PLG + BCR was validated versus conventional predicate SP and dual-platform (DP) 4-color flow cytometric methods used in the first world-on 1181 samples from 250 HIV+ patients followed longitudinally on anti-retroviral therapy (ART). EQA (accuracy) was performed through the United Kingdom National External Quality Assessment Scheme (UK-NEQAS). Further EQA was performed across the 52 SA-NHLS SP-PLG laboratories participating on the CD4 African Regional External Quality Assessment Scheme (AFREQAS), to assess both accuracy and/precision between NHLS PLG laboratories. There was virtually no bias noted between SP PLG and SP predicate methods. On DP, bias and variability increased but the errors introduced were minor without affecting CD4-related clinical decisions. The simpler 2-color PLG was less expensive with additional advantages: CD4+ T-cells were discriminated from monocytes without a need for CD3-staining, and the training was faster and easier for the trainees and trainers alike. The accuracy of SP-PLG was satisfactory: all PLG results submitted to the UK NEQAS were within +/-1 Trimmed Standard Deviation (SD) of the UK NEQAS CD4 Pool Trimmed Mean. Further, on the CD4 AFREQAS, the SA-NHLS laboratories using SP-PLG + BCR showed better precision (mean %CV = 7.2%) than the CD4 methods employed in other laboratories in Africa (mean %CV = 10.7%) or on other continents (mean %CV = 12.9%). PLG + BCR accommodated high workloads, exceeding 3,000 tests/laboratory/month, with capacity for further growth around 10% per month across the SA-NHLS. The superior performance of PLG + BCR over other methods has been demonstrated. In resource-conscious countries, where large-scale ART is being introduced, flow-cytometry using PLG + BCR can make a significant impact-due to simpler operation, easier training, stricter quality assurance, and better cost-efficiency. These cost-effective flow methods can legitimately replace the more cumbersome predicate technology of the first world for ART monitoring whilst accommodating an ever-expanding national ART program and consequent extremely high workloads reached country-wide. Copyright 2008 Clinical Cytometry Society.

Interrater Reliability in Large-Scale Assessments--Can Teachers Score National Tests Reliably without External Controls?

ERIC Educational Resources Information Center

Pantzare, Anna Lind

2015-01-01

In most large-scale assessment systems a set of rather expensive external quality controls are implemented in order to guarantee the quality of interrater reliability. This study empirically examines if teachers' ratings of national tests in mathematics can be reliable without using monitoring, training, or other methods of external quality…

Quality Assurance Reconsidered: A Case Study

ERIC Educational Resources Information Center

Gynnild, Vidar

2007-01-01

This article examines an external evaluation of the quality assurance system at the Norwegian University of Science and Technology (NTNU) conducted by The Norwegian Agency for Quality Assurance in Higher Education (NOKUT). The external audit report along with internal reports provided by the seven faculties of the university served as the major…

42 CFR 438.364 - External quality review results.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false External quality review results. 438.364 Section 438.364 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... quality review results. (a) Information that must be produced. The State must ensure that the EQR produces...

42 CFR 438.364 - External quality review results.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false External quality review results. 438.364 Section 438.364 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... quality review results. (a) Information that must be produced. The State must ensure that the EQR produces...

42 CFR 438.364 - External quality review results.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false External quality review results. 438.364 Section 438.364 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... quality review results. (a) Information that must be produced. The State must ensure that the EQR produces...

42 CFR 438.364 - External quality review results.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false External quality review results. 438.364 Section 438.364 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... quality review results. (a) Information that must be produced. The State must ensure that the EQR produces...

42 CFR 438.364 - External quality review results.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false External quality review results. 438.364 Section 438.364 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... quality review results. (a) Information that must be produced. The State must ensure that the EQR produces...

Parenting and Friendship Quality as Predictors of Internalizing and Externalizing Symptoms in Early Adolescence

ERIC Educational Resources Information Center

Gaertner, Alden E.; Fite, Paula J.; Colder, Craig R.

2010-01-01

Research indicates both parents and peers influence child and adolescent adjustment outcomes. Moreover, friendship quality has been found to buffer the influence of parenting on adolescent adjustment, particularly externalizing symptoms. Little to no research, however, has longitudinally examined whether friendship quality moderates the relation…

The Introduction of External Quality Assurance in South African Higher Education: An Analysis of Stakeholder Response

ERIC Educational Resources Information Center

Luckett, Kathy

2007-01-01

This paper analyses the take-up of proposals for a national quality assurance system in South Africa using different approaches to quality assurance to classify stakeholder responses to survey and interview questions. The context of the study was the introduction of an external quality assurance system for South African higher education by an…

We Can't Go Home Again: Insights from a Quarter Century of Experiments in External Academic Quality Assurance

ERIC Educational Resources Information Center

Dill, David D.

2010-01-01

What have we learned from 25 years of experience with external academic quality assurance that can help design more effective framework conditions for assuring academic standards? The key elements appear to be the structure and means of evaluating national academic quality assurance agencies, the nature of academic quality information mandated by…

75 FR 65480 - Science Advisory Board Staff Office; Notification of Two Public Teleconferences of the Clean Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... Quality Standards for NOX and SOX: Second External Review Draft (September 2010) and a teleconference for... the Secondary National Ambient Air Quality Standards for NO X and SO X : Second External Review Draft... External Review Draft (September 2010) should be directed to Dr. Byran Hubbell, OAR, at (919) 541-0621 or...

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

PubMed

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

2017-09-01

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

Optimization of Fat-Reduced Puff Pastry Using Response Surface Methodology.

PubMed

Silow, Christoph; Zannini, Emanuele; Axel, Claudia; Belz, Markus C E; Arendt, Elke K

2017-02-22

Puff pastry is a high-fat bakery product with fat playing a key role, both during the production process and in the final pastry. In this study, response surface methodology (RSM) was successfully used to evaluate puff pastry quality for the development of a fat-reduced version. The technological parameters modified included the level of roll-in fat, the number of fat layers (50-200) and the final thickness (1.0-3.5 mm) of the laminated dough. Quality characteristics of puff pastry were measured using the Texture Analyzer with an attached Extended Craft Knife (ECK) and Multiple Puncture Probe (MPP), the VolScan and the C-Cell imaging system. The number of fat layers and final dough thickness, in combination with the amount of roll-in fat, had a significant impact on the internal and external structural quality parameters. With technological changes alone, a fat-reduced (≥30%) puff pastry was developed. The qualities of fat-reduced puff pastries were comparable to conventional full-fat (33 wt %) products. A sensory acceptance test revealed no significant differences in taste of fatness or 'liking of mouthfeel'. Additionally, the fat-reduced puff pastry resulted in a significant ( p < 0.05) positive correlation to 'liking of flavor' and overall acceptance by the assessors.

Optimization of Fat-Reduced Puff Pastry Using Response Surface Methodology

PubMed Central

Silow, Christoph; Zannini, Emanuele; Axel, Claudia; Belz, Markus C. E.; Arendt, Elke K.

2017-01-01

Puff pastry is a high-fat bakery product with fat playing a key role, both during the production process and in the final pastry. In this study, response surface methodology (RSM) was successfully used to evaluate puff pastry quality for the development of a fat-reduced version. The technological parameters modified included the level of roll-in fat, the number of fat layers (50–200) and the final thickness (1.0–3.5 mm) of the laminated dough. Quality characteristics of puff pastry were measured using the Texture Analyzer with an attached Extended Craft Knife (ECK) and Multiple Puncture Probe (MPP), the VolScan and the C-Cell imaging system. The number of fat layers and final dough thickness, in combination with the amount of roll-in fat, had a significant impact on the internal and external structural quality parameters. With technological changes alone, a fat-reduced (≥30%) puff pastry was developed. The qualities of fat-reduced puff pastries were comparable to conventional full-fat (33 wt %) products. A sensory acceptance test revealed no significant differences in taste of fatness or ‘liking of mouthfeel’. Additionally, the fat-reduced puff pastry resulted in a significant (p < 0.05) positive correlation to ‘liking of flavor’ and overall acceptance by the assessors. PMID:28231095

External Quality Assessment for Zika Virus Molecular Diagnostic Testing, Brazil.

PubMed

Fischer, Carlo; Pedroso, Celia; Mendrone, Alfredo; Bispo de Filippis, Ana Maria; Vallinoto, Antonio Carlos Rosário; Ribeiro, Bergmann Morais; Durigon, Edison Luiz; Marques, Ernesto T A; Campos, Gubio S; Viana, Isabelle F T; Levi, José Eduardo; Scarpelli, Luciano Cesar; Nogueira, Mauricio Lacerda; Bastos, Michele de Souza; Souza, Nathalia C Santiago; Khouri, Ricardo; Lira, Sanny; Komninakis, Shirley Vasconcelos; Baronti, Cécile; Charrel, Rémi N; Kümmerer, Beate M; Drosten, Christian; Brites, Carlos; de Lamballerie, Xavier; Niedrig, Matthias; Netto, Eduardo Martins; Drexler, Jan Felix

2018-05-01

We conducted an external quality assessment of Zika virus molecular diagnostic tests in Brazil using a new Zika virus standard. Of 15 laboratories, 73% showed limited sensitivity and specificity. Viral load estimates varied significantly. Continuous quality assurance is needed to adequately estimate risk for Zika virus-associated disease and determine patient care.

Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices.

PubMed

Bleszynski, Peter A; Luc, Jessica G Y; Schade, Peter; PhilLips, Steven J; Tchantchaleishvili, Vakhtang

There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.

Helical CT scan with 2D and 3D reconstructions and virtual endoscopy versus conventional endoscopy in the assessment of airway disease in neonates, infants and children.

PubMed

Yunus, Mahira

2012-11-01

To study the use of helical computed tomography 2-D and 3-D images, and virtual endoscopy in the evaluation of airway disease in neonates, infants and children and its value in lesion detection, characterisation and extension. Conducted at Al-Noor Hospital, Makkah, Saudi Arabia, from January 1 to June 30, 2006, the study comprised of 40 patients with strider, having various causes of airway obstruction. They were examined by helical CT scan with 2-D and 3-D reconstructions and virtual endoscopy. The level and characterisation of lesions were carried out and results were compared with actual endoscopic findings. Conventional endoscopy was chosen as the gold standard, and the evaluation of endoscopy was done in terms of sensitivity and specificity of the procedure. For statistical purposes, SPSS version 10 was used. All CT methods detected airway stenosis or obstruction. Accuracy was 98% (n=40) for virtual endoscopy, 96% (n=48) for 3-D external rendering, 90% (n=45) for multiplanar reconstructions and 86% (n=43) for axial images. Comparing the results of 3-D internal and external volume rendering images with conventional endoscopy for detection and grading of stenosis were closer than with 2-D minimum intensity multiplanar reconstruction and axial CT slices. Even high-grade stenosis could be evaluated with virtual endoscope through which conventional endoscope cannot be passed. A case of 4-year-old patient with tracheomalacia could not be diagnosed by helical CT scan and virtual bronchoscopy which was diagriosed on conventional endoscopy and needed CT scan in inspiration and expiration. Virtual endoscopy [VE] enabled better assessment of stenosis compared to the reading of 3-D external rendering, 2-D multiplanar reconstruction [MPR] or axial slices. It can replace conventional endoscopy in the assessment of airway disease without any additional risk.

Category 1 external quality assessment program for serum creatinine.

PubMed

González-Lao, Elisabet; Díaz-Garzón, Jorge; Corte, Zoraida; Ricós, Carmen; Perich, Carmen; Álvarez, Virtudes; Simón, Margarita; Minchinela, Joana; García-Lario, José Vicente; Boned, Beatriz; Biosca, Carmen; Cava, Fernando; Fernández-Fernández, Pilar; Fernández-Calle, Pilar

2017-03-01

The Commission of Analytical Quality and the Committee of External Quality Programs of Spanish Society of Laboratory Medicine (SEQC) in collaboration with the Dutch Foundation for the Quality organized the first national category 1 External Quality Assessment Programs (EQAP) pilot study. The aim is to evaluate the standardization of serum creatinine measurements in the Spanish laboratories through a category 1 external quality assurance program with commutable material and reference method assigned values. A total of 87 Spanish laboratories were involved in this program in 2015. Each day a sample control was measured by duplicate during 6 consecutive days. Percentage deviations and coefficients of variation obtained were compared with quality specifications derived from biological variation. A total of 1044 creatinine results were obtained. Laboratories were coded in 11 different method-traceability combinations. Only enzymatic methods get all results within the acceptability limits. To participate in a category 1 EQAP is a valuable tool to assess the standardization degree in our country; a big effort should be made to promote laboratories to change their procedures and to use enzymatic creatinine methods, in order to achieve a satisfactory standardization degree for this important analyte.

Automatic online and real-time tumour motion monitoring during stereotactic liver treatments on a conventional linac by combined optical and sparse monoscopic imaging with kilovoltage x-rays (COSMIK)

NASA Astrophysics Data System (ADS)

Bertholet, Jenny; Toftegaard, Jakob; Hansen, Rune; Worm, Esben S.; Wan, Hanlin; Parikh, Parag J.; Weber, Britta; Høyer, Morten; Poulsen, Per R.

2018-03-01

The purpose of this study was to develop, validate and clinically demonstrate fully automatic tumour motion monitoring on a conventional linear accelerator by combined optical and sparse monoscopic imaging with kilovoltage x-rays (COSMIK). COSMIK combines auto-segmentation of implanted fiducial markers in cone-beam computed tomography (CBCT) projections and intra-treatment kV images with simultaneous streaming of an external motion signal. A pre-treatment CBCT is acquired with simultaneous recording of the motion of an external marker block on the abdomen. The 3-dimensional (3D) marker motion during the CBCT is estimated from the auto-segmented positions in the projections and used to optimize an external correlation model (ECM) of internal motion as a function of external motion. During treatment, the ECM estimates the internal motion from the external motion at 20 Hz. KV images are acquired every 3 s, auto-segmented, and used to update the ECM for baseline shifts between internal and external motion. The COSMIK method was validated using Calypso-recorded internal tumour motion with simultaneous camera-recorded external motion for 15 liver stereotactic body radiotherapy (SBRT) patients. The validation included phantom experiments and simulations hereof for 12 fractions and further simulations for 42 fractions. The simulations compared the accuracy of COSMIK with ECM-based monitoring without model updates and with model updates based on stereoscopic imaging as well as continuous kilovoltage intrafraction monitoring (KIM) at 10 Hz without an external signal. Clinical real-time tumour motion monitoring with COSMIK was performed offline for 14 liver SBRT patients (41 fractions) and online for one patient (two fractions). The mean 3D root-mean-square error for the four monitoring methods was 1.61 mm (COSMIK), 2.31 mm (ECM without updates), 1.49 mm (ECM with stereoscopic updates) and 0.75 mm (KIM). COSMIK is the first combined kV/optical real-time motion monitoring method used clinically online on a conventional accelerator. COSMIK gives less imaging dose than KIM and is in addition applicable when the kV imager cannot be deployed such as during non-coplanar fields.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2013].

PubMed

de Gopegui Bordes, Enrique Ruiz; Orta Mira, Nieves; Del Remedio Guna Serrano, M; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

2015-07-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology and HIV-1, HCV and HBV viral loads. This manuscript presents the analysis of results obtained of the participants from the 2013 SEIMC External Quality Control Programme, except viral loads controls, that they are summarized in a manuscript abroad. As a whole, the results obtained in 2013 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Influence of physical activity, sedentary behavior, and diet quality in childhood on the incidence of internalizing and externalizing disorders during adolescence: a population-based cohort study.

PubMed

Wu, XiuYun; Bastian, Kerry; Ohinmaa, Arto; Veugelers, Paul

2018-02-01

Studies among youth suggest that physical inactivity, sedentary behaviors, and poor diet quality are associated with poor mental health. Few population-based studies have investigated these relationships longitudinally. We examined the association between physical activity, sedentary behaviors, and diet quality in childhood and the incidence of internalizing and externalizing disorders throughout adolescence. We linked health behavior survey data from 2003 among 10- to 11-year-old children across Nova Scotia, Canada, with administrative health care data from 2003 to 2011. Students' diet quality was assessed using the Harvard Food Frequency Questionnaire. Physical activity and sedentary behaviors were self-reported, and internalizing and externalizing disorders were diagnosed by a physician. We applied Cox regression to examine the associations of the health behaviors with the incidence of internalizing and externalizing disorders between 2003 and 2011. Of the 4861 participating students, 23.7% and 9.4% had a diagnosis of internalizing and externalizing disorders, respectively. The incidences of internalizing and externalizing disorders were higher among students who were less physically active and spent more time using computers and video games. These findings suggest that promoting an active lifestyle in childhood may contribute to the prevention of both internalizing and externalizing disorders during adolescence. Copyright © 2017 Elsevier Inc. All rights reserved.

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems.

PubMed

Jensen, Todd M; Lippold, Melissa A; Mills-Koonce, Roger; Fosco, Gregory M

2017-03-07

The stepfamily literature is replete with between-group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well-being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent-child, parent-child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent-child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent-child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice. © 2017 Family Process Institute.

Determinants of Quality Perception in Educational Administration: Potential Conflict between the Requirements of Internal and External Customers.

ERIC Educational Resources Information Center

Galloway, R. L.; Wearn, Katrina

1998-01-01

Attempts to measure perceived quality, based on customers' views within the context of a (British) university faculty office, using a modified SERVQUAL instrument. Internal customers demonstrated that perceived quality is driven by task-focused issues, stressing clarity, accuracy, and reliability. External customers, whose usage is more casual,…

When Somebody's Watching: Researching the Workplace Impact of Academic Audit. AIR 2002 Forum Paper.

ERIC Educational Resources Information Center

Palermo, Josephine

The proposed quality assurance framework for higher education in Australia will, for the first time since the early 1990s, introduce a process of external quality monitoring through the auspices of the Australian Universities Quality Agency. There is little research that evaluates the impact of external monitoring on the experiences of staff,…

Proof of concept for a new energy-positive wastewater treatment scheme.

PubMed

Remy, C; Boulestreau, M; Lesjean, B

2014-01-01

For improved exploitation of the energy content present in the organic matter of raw sewage, an innovative concept for treatment of municipal wastewater is tested in pilot trials and assessed in energy balance and operational costs. The concept is based on a maximum extraction of organic matter into the sludge via coagulation, flocculation and microsieving (100 μm mesh size) to increase the energy recovery in anaerobic sludge digestion and decrease aeration demand for carbon mineralisation. Pilot trials with real wastewater yield an extraction of 70-80% of total chemical oxygen demand into the sludge while dosing 15-20 mg/L Al and 5-7 mg/L polymer with stable operation of the microsieve and effluent limits below 2-3 mg/L total phosphorus. Anaerobic digestion of the microsieve sludge results in high biogas yields of 600 NL/kg organic dry matter input (oDMin) compared to 430 NL/kg oDMin for mixed sludge from a conventional activated sludge process. The overall energy balance for a 100,000 population equivalent (PE) treatment plant (including biofilter for post-treatment with full nitrification and denitrification with external carbon source) shows that the new concept is an energy-positive treatment process with comparable effluent quality than conventional processes, even when including energy demand for chemicals production. Estimated operating costs for electricity and chemicals are in the same range for conventional activated sludge processes and the new concept.

The psychosocial adjustment of African American youth from single mother homes: the relative contribution of parents and peers.

PubMed

Chester, Charlene; Jones, Deborah J; Zalot, Alecia; Sterrett, Emma

2007-01-01

This study examined the relative roles of parents and peers in the psychosocial adjustment of African American youth (7-15 years old) from single mother homes (N = 242). Main effects of both positive parenting and peer relationship quality were found for youth depressive symptoms. In addition, a main effect of peer relationship quality and an interaction of Positive Parenting x Peer Relationship Quality emerged for youth externalizing symptoms. When mothers engaged in higher levels of positive parenting behavior, peer relationship quality was not associated with youth externalizing symptomatology. When mothers engaged in lower levels of positive parenting behavior, however, higher peer relationship quality was associated with greater youth externalizing symptomatology. Clinical implications and future research directions are discussed.

Development of Handling Qualities Criteria for Rotorcraft with Externally Slung Loads

NASA Technical Reports Server (NTRS)

Hoh, Roger H.; Heffley, Robert K.; Mitchell, David G.

2006-01-01

Piloted simulations were performed on the NASA-Ames Vertical Motion Simulator (VMS) to explore handling qualities issues for large cargo helicopters, particularly focusing on external slung load operations. The purpose of this work was based upon the need to include handling qualities criteria for cargo helicopters in an upgrade to the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard-33 (ADS-33E-PRF). From the VMS results, handling qualities criteria were developed fro cargo helicopters carrying external slung loads in the degraded visual environment (DVE). If satisfied, these criteria provide assurance that the handling quality rating (HQR) will be 4 or better for operations in the DVE, and with a load mass ratio of 0.33 or less. For lighter loads, flying qualities were found to be less dependent on the load geometry and therefore the significance of the criteria is less. For heavier loads, meeting the criteria ensures the best possible handling qualities, albeit Level 2 for load mass ratios greater than 0.33.

Does external evaluation of laboratories improve patient safety?

PubMed

Noble, Michael A

2007-01-01

Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

Effect of training and level of external auditory feedback on the singing voice: volume and quality

PubMed Central

Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J.

2015-01-01

Background Previous research suggests that classically trained professional singers rely not only on external auditory feedback but also on proprioceptive feedback associated with internal voice sensitivities. Objectives The Lombard Effect in singers and the relationship between Sound Pressure Level (SPL) and external auditory feedback was evaluated for professional and non-professional singers. Additionally, the relationship between voice quality, evaluated in terms of Singing Power Ratio (SPR), and external auditory feedback, level of accompaniment, voice register and singer gender was analyzed. Methods The subjects were 10 amateur or beginner singers, and 10 classically-trained professional or semi-professional singers (10 males and 10 females). Subjects sang an excerpt from the Star-spangled Banner with three different levels of the accompaniment, 70, 80 and 90 dBA, and with three different levels of external auditory feedback. SPL and the SPR were analyzed. Results The Lombard Effect was stronger for non-professional singers than professional singers. Higher levels of external auditory feedback were associated with a reduction in SPL. As predicted, the mean SPR was higher for professional than non-professional singers. Better voice quality was detected in the presence of higher levels of external auditory feedback. Conclusions With an increase in training, the singer’s reliance on external auditory feedback decreases. PMID:26186810

Effect of Training and Level of External Auditory Feedback on the Singing Voice: Volume and Quality.

PubMed

Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J

2016-07-01

Previous research suggests that classically trained professional singers rely not only on external auditory feedback but also on proprioceptive feedback associated with internal voice sensitivities. The Lombard effect and the relationship between sound pressure level (SPL) and external auditory feedback were evaluated for professional and nonprofessional singers. Additionally, the relationship between voice quality, evaluated in terms of singing power ratio (SPR), and external auditory feedback, level of accompaniment, voice register, and singer gender was analyzed. The subjects were 10 amateur or beginner singers and 10 classically trained professional or semiprofessional singers (10 men and 10 women). Subjects sang an excerpt from the Star-Spangled Banner with three different levels of the accompaniment, 70, 80, and 90 dBA and with three different levels of external auditory feedback. SPL and SPR were analyzed. The Lombard effect was stronger for nonprofessional singers than professional singers. Higher levels of external auditory feedback were associated with a reduction in SPL. As predicted, the mean SPR was higher for professional singers than nonprofessional singers. Better voice quality was detected in the presence of higher levels of external auditory feedback. With an increase in training, the singer's reliance on external auditory feedback decreases. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Quality of life and satisfaction with information after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy: a long-term follow-up study.

PubMed

Nicolaisen, Marianne; Müller, Stig; Patel, Hitendra R H; Hanssen, Tove Aminda

2014-12-01

To assess patients' symptoms, quality of life and satisfaction with information three to four years after radical prostatectomy, radical external beam radiotherapy and postoperative radiotherapy and to analyse differences between treatment groups and the relationship between disease-specific, health-related and overall quality of life and satisfaction with information. Radical prostate cancer treatments are associated with changes in quality of life. Differences between patients undergoing different treatments in symptoms and quality of life have been reported, but there are limited long-term data comparing radical prostatectomy with radical external beam radiotherapy and postoperative radiotherapy. A cross-sectional survey design was used. The study sample included 143 men treated with radical prostatectomy and/or radical external beam radiotherapy. Quality of life was measured using the 12-item Short Form Health Survey and the 50-item Expanded Prostate Cancer Index Composite Instrument. Questions assessing overall Quality of life and satisfaction with information were included. Descriptive statistics and interference statistical methods were applied to analyse the data. Radical external beam radiotherapy was associated with less urinary incontinence and better urinary function. There were no differences between the groups for disease-specific quality of life sum scores. Sexual quality of life was reported very low in all groups. Disease-specific quality of life and health-related quality of life were associated with overall quality of life. Patients having undergone surgery were more satisfied with information, and there was a positive correlation between quality of life and patient satisfaction. Pretreatment information and patient education lead to better quality of life and satisfaction. This study indicates a need for structured, pretreatment information and follow-up for all men going through radical prostate cancer treatment. Long-term quality of life effects should be considered when planning follow-up and information for men after radical prostate cancer treatment. Structured and organised information/education may increase preparedness for symptoms and bother after the treatment, improve symptom management strategies and result in improved quality of life. © 2014 John Wiley & Sons Ltd.

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

Shedlock, Daniel; Dugan, Edward T.; Jacobs, Alan M.

X-ray backscatter radiography by selective detection (RSD) is a field tested and innovative approach to non-destructive evaluation (NDE). RSD is an enhanced single-side x-ray Compton backscatter imaging (CBI) technique which selectively detects scatter components to improve image contrast and quality. Scatter component selection is accomplished through a set of specially designed detectors with fixed and movable collimators. Experimental results have shown that this NDE technique can be used to detect boric acid deposition on a metallic plate through steel foil reflective insulation commonly covering reactor pressure vessels. The current system is capable of detecting boric acid deposits with sub-millimeter resolution,more » through such insulating materials. Industrial systems have been built for Lockheed Martin Space Co. and NASA. Currently the x-ray backscatter RSD scanning systems developed by the University of Florida are being used to inspect the spray-on foam insulation (SOFI) used on the external tank of the space shuttle. RSD inspection techniques have found subsurface cracking in the SOFI thought to be responsible for the foam debris which separated from the external tank during the last shuttle launch. These industrial scanning systems can be customized for many applications, and a smaller, lighter, more compact unit design is being developed. The smaller design is approximately four inches wide, three inches high, and about 12 inches in length. This smaller RSD system can be used for NDE of areas that cannot be reached with larger equipment. X-ray backscatter RSD is a proven technology that has been tested on a wide variety of materials and applications. Currently the system has been used to inspect materials such as aluminum, plastics, honeycomb laminates, reinforced carbon composites, steel, and titanium. The focus of RSD is for one-sided detection for applications where conventional non-destructive examination methods either will not work or give poor results. Acquired images have clearly shown, for a variety of conditions, that proper selection of x-ray field scatter components leads to a significant improvement in image quality and contrast. Improvements are significant enough in some cases that objects not visible to conventional CBI or transmission radiography become readily discernable with RSD. (authors)« less

Heat regenerative external combustion engine

NASA Astrophysics Data System (ADS)

Duva, Anthony W.

1993-03-01

It is an object of the invention to provide an external combustion expander-type engine having improved efficiency. It is another object of the invention to provide an external combustion engine in which afterburning in the exhaust channel is substantially prevented. Yet another object of the invention is to provide an external combustion engine which is less noisy than an external combustion engine of conventional design. These and other objects of the invention will become more apparent from the following description. The above objects of the invention are realized by providing a heat regenerative external combustion engine. The heat regenerative external combustion engine of the invention comprises a combustion chamber for combusting a monopropellant fuel in order to form an energized gas. The energized gas is then passed through a rotary valve to a cylinder having a reciprocating piston disposed therein. The gas is spent in moving the piston, thereby driving a drive shaft.

Guidelines for External Reviews of Quality Assurance Agencies in the European Higher Education Area. ENQA Occasional Papers 19

ERIC Educational Resources Information Center

ENQA (European Association for Quality Assurance in Higher Education), 2012

2012-01-01

In accordance with the ENQA (European Association for Quality Assurance in Higher Education) membership criteria laid down in the Statutes of ENQA, member agencies are required to undergo external reviews against the membership criteria, and thereby the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) as…

First External Evaluations of Quality Assurance Agencies--Lessons Learned. ENQA Workshop Report 10

ERIC Educational Resources Information Center

Costes, Nathalie; Curvale, Bruno; Kraft, Michael G.; Llavori, Rafael; Malan, Thierry; Szanto, Tibor

2010-01-01

This report is a product of an ENQA (European Association for Quality Assurance in Higher Education) seminar on the first external evaluations of quality assurance agencies, held in Paris in July 2008. The seminar took stock of the achieved reviews of agencies to learn lessons from these first outcomes and, hence, provided a platform for…

Child Diurnal Cortisol Rhythms, Parenting Quality, and Externalizing Behaviors in Preadolescence

PubMed Central

Martin, Christina Gamache; Kim, Hyoun K.; Bruce, Jacqueline; Fisher, Philip A.

2014-01-01

This study examined a neurobiologically–informed model of the emergence of child externalizing behaviors in an ethnically diverse community sample of 232 9–12 year old children. Replicating extensive prior research, our analyses revealed that parents’ inconsistent discipline and poor quality monitoring were predictive of child externalizing behavior. In addition, poor parental monitoring, but not inconsistent discipline, was associated with children having a significantly flatter morning–to–evening cortisol slope, which was in turn, related to higher levels of externalizing behaviors. An indirect effect of parental monitoring on externalizing behaviors, through child diurnal cortisol rhythms, was also supported. These findings highlight the role of the hypothalamic–pituitary–adrenal (HPA) axis and its hormonal end product, cortisol, in the relationship between the caregiving environment and the development of externalizing behaviors. PMID:24485489

Egg shell quality in Japanese quail: characteristics, heritabilities and genetic and phenotypic relationships.

PubMed

Narinc, D; Aygun, A; Karaman, E; Aksoy, T

2015-07-01

The objective of the present study was to estimate heritabilities as well as genetic and phenotypic correlations for egg weight, specific gravity, shape index, shell ratio, egg shell strength, egg length, egg width and shell weight in Japanese quail eggs. External egg quality traits were measured on 5864 eggs of 934 female quails from a dam line selected for two generations. Within the Bayesian framework, using Gibbs Sampling algorithm, a multivariate animal model was applied to estimate heritabilities and genetic correlations for external egg quality traits. The heritability estimates for external egg quality traits were moderate to high and ranged from 0.29 to 0.81. The heritability estimates for egg and shell weight of 0.81 and 0.76 were fairly high. The genetic and phenotypic correlations between egg shell strength with specific gravity, shell ratio and shell weight ranging from 0.55 to 0.79 were relatively high. It can be concluded that it is possible to determine egg shell quality using the egg specific gravity values utilizing its high heritability and fairly high positive correlation with most of the egg shell quality traits. As a result, egg specific gravity may be the choice of selection criterion rather than other external egg traits for genetic improvement of egg shell quality in Japanese quails.

Laboratory evaluation of compressor blades considered for use in CIP/CUP compressors. [GAT2, 214X, X224, and D-15Al alloys

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

Ritchie, K.L.

1976-04-30

Four die-casting alloys, the external-pressure-pin and conventional casting methods, an accelerated aging heat treatment, and an airfoil fillet modification were evaluated for 33F-S1 compressor blades considered for use in axial flow compressors installed during the Cascade Improvement and Uprating Programs at the three gaseous diffusion plants. Based on castability, resonant frequency, resistance to fatigue cracking, and shank breaking load, the ranking of the four alloys from highest to lowest is GAT2, 214X, X224, and D-15. The GAT2 alloy ranked highest in all categories except impact value; the impact values of both X224 and 214X alloys exceeded that of the GAT2more » alloy, thus indicating the latter is relatively more brittle. However, in view of its other excellent properties, including fatigue cracking resistance, GAT2 alloy is worthy of consideration for use in blades for CIP/CUP or Add-on Plant compressors, particularly if castability becomes a problem with the presently used 214X alloy. Use of the external-pressure-pin casting method is not recommended because the resulting casting difficulties cannot be justified by the small increases in shank breaking loads. The airfoil fillet modification, which is a change from the conventional circular fillet to an elliptical fillet, resulted in increases (1.5 to 4.0 percent) in the average resonant frequency and in resistance to fatigue cracking (15 to 100 percent). The results of giving the blades an accelerated aging heat treatment, designed to simulate in excess of 10,000 hours of cascade exposure, showed that overaging had no significant effect on average resonant frequency but that overaging improved blade quality by reducing residual casting stress. (auth)« less

Clinical governance: bridging the gap between managerial and clinical approaches to quality of care

PubMed Central

Buetow, S. A.; Roland, M.

1999-01-01

Clinical governance has been introduced as a new approach to quality improvement in the UK national health service. This article maps clinical governance against a discussion of the four main approaches to measuring and improving quality of care: quality assessment, quality assurance, clinical audit, and quality improvement (including continuous quality improvement). Quality assessment underpins each approach. Whereas clinical audit has, in general, been professionally led, managers have driven quality improvement initiatives. Quality assurance approaches have been perceived to be externally driven by managers or to involve professional inspection. It is discussed how clinical governance seeks to bridge these approaches. Clinical governance allows clinicians in the UK to lead a comprehensive strategy to improve quality within provider organisations, although with an expectation of greatly increased external accountability. Clinical governance aims to bring together managerial, organisational, and clinical approaches to improving quality of care. If successful, it will define a new type of professionalism for the next century. Failure by the professions to seize the opportunity is likely to result in increasingly detailed external control of clinical activity in the UK, as has occurred in some other countries. PMID:10847876

Improvement of coagulation laboratory practice in Thailand: the first-year experience of the national external quality assessment scheme for blood coagulation.

PubMed

Tientadakul, Panutsaya; Opartkiattikul, Nisarat; Wongtiraporn, Wanida

2009-01-01

In Thailand until 2005 there had been no external quality assessment scheme at the national level for blood coagulation tests. Only a few laboratories had an external quality assessment for these tests. In the year 2005, the Thailand National External Quality Assessment Scheme for Blood Coagulation was founded. To describe the establishment of the Thailand National External Quality Assessment Scheme for Blood Coagulation (including problems encountered and solutions), its progression and expansion, and the improvement of coagulation laboratory practice in Thailand during 2 trial surveys and 4 formal surveys conducted in the first 1 1/2 years. Between 2005 and 2006, the external quality assessment samples for prothrombin time/international normalized ratio and activated partial thromboplastin time were distributed to the participants as well as the instructions and suggestions for the improvement of laboratory practice. From the data collected, the all-method coefficient of variation of the international normalized ratio and activated partial thromboplastin time was calculated for each survey. The number of participants increased during the first 1 1/2 years that the surveys were conducted, from 109 to 127. Survey data demonstrate an improvement in response rate and an increase in the number of laboratories that determine their own reference ranges and repeat this for every change of reagent lot, using the appropriate anticoagulant. The increased precision of tests is indicated by the decrease of the all-method coefficient of variation of the international normalized ratio and activated partial thromboplastin time. Examples of individual laboratory improvement through feedback are also described. The improvement of coagulation laboratory practice both through the instructions provided and liaison with participants was observed during the course of this scheme.

Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

PubMed

Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

2011-03-01

We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality. PsycINFO Database Record (c) 2011 APA, all rights reserved.

The application of a low-cost 3D depth camera for patient set-up and respiratory motion management in radiotherapy

NASA Astrophysics Data System (ADS)

Tahavori, Fatemeh

Respiratory motion induces uncertainty in External Beam Radiotherapy (EBRT), which can result in sub-optimal dose delivery to the target tissue and unwanted dose to normal tissue. The conventional approach to managing patient respiratory motion for EBRT within the area of abdominal-thoracic cancer is through the use of internal radiological imaging methods (e.g. Megavoltage imaging or Cone-Beam Computed Tomography) or via surrogate estimates of tumour position using external markers placed on the patient chest. This latter method uses tracking with video-based techniques, and relies on an assumed correlation or mathematical model, between the external surrogate signal and the internal target position. The marker's trajectory can be used in both respiratory gating techniques and real-time tracking methods. Internal radiological imaging methods bring with them limited temporal resolution, and additional radiation burden, which can be addressed by external marker-based methods that carry no such issues. Moreover, by including multiple external markers and placing them closer to the internal target organs, the effciency of correlation algorithms can be increased. However, the quality of such external monitoring methods is underpinned by the performance of the associated correlation model. Therefore, several new approaches to correlation modelling have been developed as part of this thesis and compared using publicly-available datasets. Highly competitive results have been obtained when compared against state-of-the-art methods. Marker-based methods also have the disadvantages of requiring manual set-up time for marker placement and patient positioning and potential issues with reproducibility of marker placement. This motivates the investigation of non-contact marker-free methods for use in EBRT, which is the main topic of this thesis. The Microsoft Kinect is used as an example of a low-cost consumer grade 3D depth camera for capturing and analysing external respiratory motion. This thesis makes the first presentation of detailed studies of external respiratory motion captured using such low-cost technology and demonstrates its potential in a healthcare environment. Firstly, the fundamental performance of a range of Microsoft Kinect sensors is assessed for use in radiotherapy (and potentially other healthcare applications), in terms of static and dynamic performance using both phantoms and volunteers. Then external respiratory motion is captured using the above technology from a group of 32 healthy volunteers and Principal Component Analysis (PCA) is applied to a region of interest encompassing the complete anterior surface to demonstrate breathing style. This work demonstrates that this surface motion can be compactly described by the first two PCA eigenvectors. The reproducibility of subject-specific EBRT set-up using conventional laser-based alignment and marker-based Deep Inspiration Breath Hold (DIBH) methods are also studied using the Microsoft Kinect sensor. A cohort of five healthy female volunteers is repeatedly set-up for left-sided breast cancer EBRT and multiple DIBH episodes captured over five separate sessions representing multiple fractionated radiotherapy treatment sessions, but without dose delivery. This provided an independent assessment that subjects were set-up and generally achieved variations within currently accepted margins of clinical practice. Moreover, this work demonstrated the potential role of consumer-grade 3D depth camera technology as a possible replacement for marker based set-up and DIBH management procedures. This brings with it the additional benefits of low cost, and potential through-put benefits, as patient set-up could ultimately be fully automated with this technology, and DIBH could be independently monitored without requiring preparatory manual intervention.

Quasi-radial wall jets as a new concept in boundary layer flow control

NASA Astrophysics Data System (ADS)

Javadi, Khodayar; Hajipour, Majid

2018-01-01

This work aims to introduce a novel concept of wall jets wherein the flow is radially injected into a medium through a sector of a cylinder, called quasi-radial (QR) wall jets. The results revealed that fluid dynamics of the QR wall jet flow differs from that of conventional wall jets. Indeed, lateral and normal propagations of a conventional three-dimensional wall jet are via shear stresses. While, lateral propagation of a QR wall jet is due to mean lateral component of the velocity field. Moreover, discharged Arrays of conventional three-dimensional wall jets in quiescent air lead to formation of a combined wall jet at large distant from the nozzles, while QR wall jet immediately spread in lateral direction, meet each other and merge together very quickly in a short distance downstream of the jet nozzles. Furthermore, in discharging the conventional jets into an external flow, there is no strong interaction between them as they are moving parallel. While, in QR wall jets the lateral components of the velocity field strongly interact with boundary layer of the external flow and create strong helical vortices acting as vortex generators.

Computationally inexpensive approach for pitch control of offshore wind turbine on barge floating platform.

PubMed

Zuo, Shan; Song, Y D; Wang, Lei; Song, Qing-wang

2013-01-01

Offshore floating wind turbine (OFWT) has gained increasing attention during the past decade because of the offshore high-quality wind power and complex load environment. The control system is a tradeoff between power tracking and fatigue load reduction in the above-rated wind speed area. In allusion to the external disturbances and uncertain system parameters of OFWT due to the proximity to load centers and strong wave coupling, this paper proposes a computationally inexpensive robust adaptive control approach with memory-based compensation for blade pitch control. The method is tested and compared with a baseline controller and a conventional individual blade pitch controller with the "NREL offshore 5 MW baseline wind turbine" being mounted on a barge platform run on FAST and Matlab/Simulink, operating in the above-rated condition. It is shown that the advanced control approach is not only robust to complex wind and wave disturbances but adaptive to varying and uncertain system parameters as well. The simulation results demonstrate that the proposed method performs better in reducing power fluctuations, fatigue loads and platform vibration as compared to the conventional individual blade pitch control.

Computationally Inexpensive Approach for Pitch Control of Offshore Wind Turbine on Barge Floating Platform

PubMed Central

Zuo, Shan; Song, Y. D.; Wang, Lei; Song, Qing-wang

2013-01-01

Offshore floating wind turbine (OFWT) has gained increasing attention during the past decade because of the offshore high-quality wind power and complex load environment. The control system is a tradeoff between power tracking and fatigue load reduction in the above-rated wind speed area. In allusion to the external disturbances and uncertain system parameters of OFWT due to the proximity to load centers and strong wave coupling, this paper proposes a computationally inexpensive robust adaptive control approach with memory-based compensation for blade pitch control. The method is tested and compared with a baseline controller and a conventional individual blade pitch controller with the “NREL offshore 5 MW baseline wind turbine” being mounted on a barge platform run on FAST and Matlab/Simulink, operating in the above-rated condition. It is shown that the advanced control approach is not only robust to complex wind and wave disturbances but adaptive to varying and uncertain system parameters as well. The simulation results demonstrate that the proposed method performs better in reducing power fluctuations, fatigue loads and platform vibration as compared to the conventional individual blade pitch control. PMID:24453834

Alternate space shuttle concepts study. Part 2: Technical summary. Volume 2: Orbiter definition

NASA Technical Reports Server (NTRS)

1971-01-01

A study was conducted of a three-engined external hydrogen tank orbiter/heat sink booster utilizing 415 K sea level thrust engines. The results of the study, pertaining to the orbiter portion of the configuration, are presented. A complete summary of characteristics is given for the external tank configuration along with some comparative data for a conventional internal tank configuration.

CMOS compatible fabrication process of MEMS resonator for timing reference and sensing application

NASA Astrophysics Data System (ADS)

Huynh, Duc H.; Nguyen, Phuong D.; Nguyen, Thanh C.; Skafidas, Stan; Evans, Robin

2015-12-01

Frequency reference and timing control devices are ubiquitous in electronic applications. There is at least one resonator required for each of this device. Currently electromechanical resonators such as crystal resonator, ceramic resonator are the ultimate choices. This tendency will probably keep going for many more years. However, current market demands for small size, low power consumption, cheap and reliable products, has divulged many limitations of this type of resonators. They cannot be integrated into standard CMOS (Complement metaloxide- semiconductor) IC (Integrated Circuit) due to material and fabrication process incompatibility. Currently, these devices are off-chip and they require external circuitries to interface with the ICs. This configuration significantly increases the overall size and cost of the entire electronic system. In addition, extra external connection, especially at high frequency, will potentially create negative impacts on the performance of the entire system due to signal degradation and parasitic effects. Furthermore, due to off-chip packaging nature, these devices are quite expensive, particularly for high frequency and high quality factor devices. To address these issues, researchers have been intensively studying on an alternative for type of resonator by utilizing the new emerging MEMS (Micro-electro-mechanical systems) technology. Recent progress in this field has demonstrated a MEMS resonator with resonant frequency of 2.97 GHz and quality factor (measured in vacuum) of 42900. Despite this great achievement, this prototype is still far from being fully integrated into CMOS system due to incompatibility in fabrication process and its high series motional impedance. On the other hand, fully integrated MEMS resonator had been demonstrated but at lower frequency and quality factor. We propose a design and fabrication process for a low cost, high frequency and a high quality MEMS resonator, which can be integrated into a standard CMOS IC. This device is expected to operate in hundreds of Mhz frequency range; quality factor surpasses 10000 and series motional impedance low enough that could be matching into conventional system without enormous effort. This MEMS resonator can be used in the design of many blocks in wireless and RF (Radio Frequency) systems such as low phase noise oscillator, band pass filter, power amplifier and in many sensing application.

Design, fabrication and evaluation of chalcogenide glass Luneburg lenses for LiNbO3 integrated optical devices

NASA Technical Reports Server (NTRS)

Wood, V. E.; Busch, J. R.; Verber, C. M.

1982-01-01

Optical waveguide Luneburg lenses of arsenic trisulfide glass are described. The lenses are formed by thermal evaporation of As2S3 through suitably placed masks onto the surface of LiNbO3:Ti indiffused waveguides. The lenses are designed for input apertures up to 1 cm and for speeds of f/5 or better. They are designed to focus the TM sub 0 guided mode of a beam of wavelength, external to the guide, of 633 nm. The refractive index of the As2S3 films and the changes induced in the refractive index by exposure to short wavelength light were measured. Some correlation between film thickness and optical properties was noted. The short wavelength photosensitivity was used to shorten the lens focal length from the as deposited value. Lenses of rectangular shape, as viewed from above the guide, as well as conventional circular Luneburg lenses, were made. Measurements made on the lenses include thickness profile, general optical quality, focal length, quality of focal spot, and effect of ultraviolet irradiation on optical properties.

A low cost short wave near infrared spectrophotometer: application for determination of quality parameters of diesel fuel.

PubMed

Gonzaga, Fabiano Barbieri; Pasquini, Celio

2010-06-18

A low cost absorption spectrophotometer for the short wave near infrared spectral region (850-1050 nm) is described. The spectrophotometer is basically composed of a conventional dichroic lamp, a long-pass filter, a sample cell and a Czerny-Turner type polychromator coupled to a 1024 pixel non-cooled photodiode array. A preliminary evaluation of the spectrophotometer showed good repeatability of the first derivative of the spectra at a constant room temperature and the possibility of assigning some spectral regions to different C-H stretching third overtones. Finally, the spectrophotometer was successfully applied for the analysis of diesel samples and the determination of some of their quality parameters using partial least squares calibration models. The values found for the root mean square error of prediction using external validation were 0.5 for the cetane index and from 2.5 to 5.0 degrees C for the temperatures achieved during distillation when obtaining 10, 50, 85, and 90% (v/v) of the distilled sample, respectively. 2010 Elsevier B.V. All rights reserved.

New patient-controlled abdominal compression method in radiography: radiation dose and image quality.

PubMed

Piippo-Huotari, Oili; Norrman, Eva; Anderzén-Carlsson, Agneta; Geijer, Håkan

2018-05-01

The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position . To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography. An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images. There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality. Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.

Optimized design of total energy systems: The RETE project

NASA Astrophysics Data System (ADS)

Alia, P.; Dallavalle, F.; Denard, C.; Sanson, F.; Veneziani, S.; Spagni, G.

1980-05-01

The RETE (Reggio Emilia Total Energy) project is discussed. The total energy system (TES) was developed to achieve the maximum quality matching on the thermal energy side between plant and user and perform an open scheme on the electrical energy side by connection with the Italian electrical network. The most significant qualitative considerations at the basis of the plant economic energy optimization and the selection of the operating criterion most fitting the user consumption characteristics and the external system constraints are reported. The design methodology described results in a TES that: in energy terms achieves a total efficiency evaluated on a yearly basis to be equal to about 78 percent and a fuel saving of about 28 percent and in economic terms allows a recovery of the investment required as to conventional solutions, in about seven years.

Child diurnal cortisol rhythms, parenting quality, and externalizing behaviors in preadolescence.

PubMed

Martin, Christina Gamache; Kim, Hyoun K; Bruce, Jacqueline; Fisher, Philip A

2014-02-01

This study examined a neurobiologically informed model of the emergence of child externalizing behaviors in an ethnically diverse community sample of 232 9-12 year old children. Replicating extensive prior research, our analyses revealed that parents' inconsistent discipline and poor quality monitoring were predictive of child externalizing behavior. In addition, poor parental monitoring, but not inconsistent discipline, was associated with children having a significantly flatter morning-to-evening cortisol slope, which was in turn, related to higher levels of externalizing behaviors. An indirect effect of parental monitoring on externalizing behaviors, through child diurnal cortisol rhythms, was also supported. These findings highlight the role of the hypothalamic-pituitary-adrenal (HPA) axis and its hormonal end product, cortisol, in the relationship between the caregiving environment and the development of externalizing behaviors. Copyright © 2013 Elsevier Ltd. All rights reserved.

Teacher-Child Relationships and Children's Externalizing Behaviors in Head Start

ERIC Educational Resources Information Center

Whittaker, Jessica E. Vick; Jones Harden, Brenda

2010-01-01

This study explored the association between teacher-child relationship quality and Head Start children's externalizing behaviors. We also investigated the associations among teacher, student, and classroom characteristics and teacher-child relationship quality. Data were gathered from 100 Head Start children and their teachers. Teacher-child…

Piezoelectric-Induced Triboelectric Hybrid Nanogenerators Based on the ZnO Nanowire Layer Decorated on the Au/polydimethylsiloxane-Al Structure for Enhanced Triboelectric Performance.

PubMed

Jirayupat, Chaiyanut; Wongwiriyapan, Winadda; Kasamechonchung, Panita; Wutikhun, Tuksadon; Tantisantisom, Kittipong; Rayanasukha, Yossawat; Jiemsakul, Thanakorn; Tansarawiput, Chookiat; Liangruksa, Monrudee; Khanchaitit, Paisan; Horprathum, Mati; Porntheeraphat, Supanit; Klamchuen, Annop

2018-02-21

Here, we demonstrate a novel device structure design to enhance the electrical conversion output of a triboelectric device through the piezoelectric effect called as the piezo-induced triboelectric (PIT) device. By utilizing the piezopotential of ZnO nanowires embedded into the polydimethylsiloxane (PDMS) layer attached on the top electrode of the conventional triboelectric device (Au/PDMS-Al), the PIT device exhibits an output power density of 50 μW/cm 2 , which is larger than that of the conventional triboelectric device by up to 100 folds under the external applied force of 8.5 N. We found that the effect of the external piezopotential on the top Au electrode of the triboelectric device not only enhances the electron transfer from the Al electrode to PDMS but also boosts the internal built-in potential of the triboelectric device through an external electric field of the piezoelectric layer. Furthermore, 100 light-emitting diodes (LEDs) could be lighted up via the PIT device, whereas the conventional device could illuminate less than 20 LED bulbs. Thus, our results highlight that the enhancement of the triboelectric output can be achieved by using a PIT device structure, which enables us to develop hybrid nanogenerators for various self-power electronics such as wearable and mobile devices.

External quality assessment for enterovirus 71 and coxsackievirus A16 detection by reverse transcription-PCR using armored RNA as a virus surrogate.

PubMed

Song, Liqiong; Sun, Shipeng; Li, Bo; Pan, Yang; Li, Wenli; Zhang, Kuo; Li, Jinming

2011-10-01

Three armored RNAs (virus-like particles [VLPs]) containing target sequences from enterovirus 71 (EV71) and coxsackievirus A16 (CA16) and a pan-enterovirus (pan-EV) sequence were constructed and used in an external quality assessment (EQA) to determine the performance of laboratories in the detection of EV71 and CA16. The EQA panel, which consisted of 20 samples, including 14 positive samples with different concentrations of EV and either EV71 or CA16 armored RNAs, 2 samples with all 3 armored RNAs, and 4 negative-control samples (NaN(3)-preserved minimal essential medium [MEM] without VLPs), was distributed to 54 laboratories that perform molecular diagnosis of hand, foot, and mouth disease (HFMD) virus infections. A total of 41 data sets from 41 participants were returned; 5 (12.2%) were generated using conventional in-house reverse transcription-PCR (RT-PCR) assays, and 36 (87.8%) were generated using commercial real-time RT-PCR assays. Performance assessments of laboratories differed; 12 (29.3%) showed a need for improvement. Surprisingly, 4 laboratories were unable to detect EV71 RNA in any samples, even those containing the highest concentration of 10(7) IU/ml. Furthermore, the detection sensitivity for EV71 among all laboratories (82.1%) was substantially lower than that for EV (97.4%) or CA16 (95.1%). Overall, the results of the present study indicate that EQA should be performed periodically to help laboratories monitor their ability to detect HFMD viruses and to improve the comparability of results from different laboratories.

External Quality Assessment for Enterovirus 71 and Coxsackievirus A16 Detection by Reverse Transcription-PCR Using Armored RNA as a Virus Surrogate▿†

PubMed Central

Song, Liqiong; Sun, Shipeng; Li, Bo; Pan, Yang; Li, Wenli; Zhang, Kuo; Li, Jinming

2011-01-01

Three armored RNAs (virus-like particles [VLPs]) containing target sequences from enterovirus 71 (EV71) and coxsackievirus A16 (CA16) and a pan-enterovirus (pan-EV) sequence were constructed and used in an external quality assessment (EQA) to determine the performance of laboratories in the detection of EV71 and CA16. The EQA panel, which consisted of 20 samples, including 14 positive samples with different concentrations of EV and either EV71 or CA16 armored RNAs, 2 samples with all 3 armored RNAs, and 4 negative-control samples (NaN3-preserved minimal essential medium [MEM] without VLPs), was distributed to 54 laboratories that perform molecular diagnosis of hand, foot, and mouth disease (HFMD) virus infections. A total of 41 data sets from 41 participants were returned; 5 (12.2%) were generated using conventional in-house reverse transcription-PCR (RT-PCR) assays, and 36 (87.8%) were generated using commercial real-time RT-PCR assays. Performance assessments of laboratories differed; 12 (29.3%) showed a need for improvement. Surprisingly, 4 laboratories were unable to detect EV71 RNA in any samples, even those containing the highest concentration of 107 IU/ml. Furthermore, the detection sensitivity for EV71 among all laboratories (82.1%) was substantially lower than that for EV (97.4%) or CA16 (95.1%). Overall, the results of the present study indicate that EQA should be performed periodically to help laboratories monitor their ability to detect HFMD viruses and to improve the comparability of results from different laboratories. PMID:21865426

Air Quality Criteria for Ozone and Related Photochemical Oxidants (First External Review Draft)

EPA Science Inventory

This first external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants (Ozone Criteria Document) is being released in January 2005 for public comment and for review by EPA's Clean A...

Air Quality Criteria for Ozone and Related Photochemical Oxidants (Second External Review Draft)

EPA Science Inventory

This second external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants, Volumes I-III (Ozone Criteria Document) is being released for public comment and for review by EPA's Clean Air Scientific Advisory Committee (CASAC) r...

Child Reactivity Moderates the Over-Time Association between Mother-Child Conflict Quality and Externalizing Problems

ERIC Educational Resources Information Center

Nelson, Jackie A.

2015-01-01

Constructive parent-child conflict interactions that teach children to problem-solve and negotiate can enhance children's social adjustment. This paper identifies constructive and destructive qualities of mother-child conflict and explores whether child temperament moderated associations with changes in externalizing problems over time. One…

Higher Education Quality: Perception Differences among Internal and External Stakeholders

ERIC Educational Resources Information Center

Abidin, Munirul

2015-01-01

Conceptually, education quality of higher education can be determined by evaluation of their stakeholders's satisfaction level. The purpose of this study is to describe how students as external stakeholder and lecturers as internal stakeholder, perceived their satisfaction of learning experience in the university. This study was conducted in…

AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III, (EXTERNAL REVIEW DRAFT, 1995)

EPA Science Inventory

There is no abstract available for these documents.

If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed above.

• Air Quality Criteria for Particulate Matter, Volume I, Extern...

• Relating Child Care during Infancy to Externalizing and Internalizing Behaviors in Toddlerhood: How Specific Features of Child Care Quality Matter Depending on a Child's Gender and Temperament

  ERIC Educational Resources Information Center

  Lemay, Lise; Bigras, Nathalie; Bouchard, Caroline

  2014-01-01

  This study explored whether the relationships between specific features of child care quality and externalizing and internalizing behaviors in 24-month-old children are moderated by gender and temperament. Questionnaires were used to record children's gender and measure their temperament. Child care quality was observed with the "Échelles…

• KSC-02pd0974

  NASA Image and Video Library

  2002-06-13

  KENNEDY SPACE CENTER, FLA. -- The 2002 Florida Press Association and Florida Society of Newspaper Editors Convention offers a panel on space. At the podium is Bob Stover, managing editor, Florida Today. Panel participants enjoying a laugh are (left to right) Craig Covault, senior editor, Aviation Week; Howard Benedict, retired AP reporter; JoAnn Morgan, director, External Relations and Business Development, Kennedy Space Center; Marcia Dunn, AP reporter. The convention was held at the Debus Center, KSC Visitors Complex. Also speaking at the convention were Center Director Roy Bridges and NASA Associate Deputy Administrator Dr. Daniel Mulville

• Parent beliefs and children's social-behavioral functioning: the mediating role of parent-teacher relationships.

  PubMed

  Kim, Elizabeth Moorman; Sheridan, Susan M; Kwon, Kyongboon; Koziol, Natalie

  2013-04-01

  This research investigated whether parent-teacher relationship quality mediated the relation between parents' motivational beliefs and children's adaptive functioning and externalizing behaviors. The sample consisted of kindergarten through third-grade children with behavioral concerns (N=206). Parents reported on their motivational beliefs (i.e., role construction and efficacy), and teachers reported on the quality of their relationships with parents and children's adaptive functioning (i.e., social and adaptive skills) and externalizing behaviors. Results indicated that parents' motivational beliefs were related significantly and positively to children's adaptive functioning and negatively to children's externalizing behaviors. Parents' motivational beliefs were also significantly associated with enhanced parent-teacher relationship quality. There was a significant medium-sized indirect effect of parents' motivational beliefs on children's adaptive functioning through parent-teacher relationship quality (k(2)=.12) and a small indirect effect of parents' motivational beliefs on children's externalizing behaviors (k(2)=.05). This research suggests that parent-teacher relationship quality may be one mechanism by which the benefits of parents' motivational beliefs are transmitted to children. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

• Feasibility of certified quality management in a comprehensive stroke care network using telemedicine: STENO project.

  PubMed

  Handschu, René; Scibor, Mateusz; Wacker, Angela; Stark, David R; Köhrmann, Martin; Erbguth, Frank; Oschmann, Patrick; Schwab, Stefan; Marquardt, Lars

  2014-12-01

  Stroke care networks with and without telemedicine have been established in several countries over the last decade to provide specialized stroke expertise to patients in rural areas. Acute consultation is a first step in the management of stroke, but not the only one. Methods of standardization of care and treatment are much needed. So far, quality management systems have only been used for single stroke units. To the best of our knowledge, we are the first stroke network worldwide to aim for certification of a network-wide quality management system. The Stroke Network Using Telemedicine in Northern Bavaria (STENO), currently with 20 associated medical institutions, is one of the world's largest stroke networks, caring for over 5000 stroke patients each year. In 2010, we initiated the implementation of a network-wide 'total' quality management system according to ISO standard 9001:2008 in cooperation with the German Stroke Society and a third-party certification organization (LGA InterCert). Certification according to ISO 9001:2008 was awarded in March 2011 and maintained over a complete certification cycle of 3 years without major deviation from the norm in three external third-party audits. Thrombolysis rate significantly increased from 8·2% (2009) to 12·8% (2012). Certified quality management within a large stroke network using telemedicine is possible and might improve stroke care procedures and thrombolysis rates. Outcome studies comparing conventional stroke care and telestroke care are inevitable. © 2014 World Stroke Organization.

• Machine Vision-Based Measurement Systems for Fruit and Vegetable Quality Control in Postharvest.

  PubMed

  Blasco, José; Munera, Sandra; Aleixos, Nuria; Cubero, Sergio; Molto, Enrique

  Individual items of any agricultural commodity are different from each other in terms of colour, shape or size. Furthermore, as they are living thing, they change their quality attributes over time, thereby making the development of accurate automatic inspection machines a challenging task. Machine vision-based systems and new optical technologies make it feasible to create non-destructive control and monitoring tools for quality assessment to ensure adequate accomplishment of food standards. Such systems are much faster than any manual non-destructive examination of fruit and vegetable quality, thus allowing the whole production to be inspected with objective and repeatable criteria. Moreover, current technology makes it possible to inspect the fruit in spectral ranges beyond the sensibility of the human eye, for instance in the ultraviolet and near-infrared regions. Machine vision-based applications require the use of multiple technologies and knowledge, ranging from those related to image acquisition (illumination, cameras, etc.) to the development of algorithms for spectral image analysis. Machine vision-based systems for inspecting fruit and vegetables are targeted towards different purposes, from in-line sorting into commercial categories to the detection of contaminants or the distribution of specific chemical compounds on the product's surface. This chapter summarises the current state of the art in these techniques, starting with systems based on colour images for the inspection of conventional colour, shape or external defects and then goes on to consider recent developments in spectral image analysis for internal quality assessment or contaminant detection.

• Some engineering aspects of insulin delivery systems.

  PubMed

  Spencer, W J; Bair, R E; Carlson, G A; Love, J T; Urenda, R S; Eaton, R P; Schade, D S

  1980-01-01

  The characteristics of electronically controlled insulin delivery systems are presented. Early experiments with an external system have shown promise in providing improved glycemic control over conventional methods of single or multiple subcutaneous insulin injections. The encouraging results with external insulin delivery systems have led to the development and early testing in dogs of an implantable system with remote controls to permit variable insulin flow rates. A number of questions remain to be answered before widespread experimentation with external and implanted insulin delivery systems is possible. There appears to be no major development problems with the engineering aspects of such systems.

• [Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].

  PubMed

  Neuderth, S; Lukasczik, M; Musekamp, G; Gerlich, C; Saupe-Heide, M; Löbmann, R; Vogel, H

  2013-02-01

  There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions. On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels. The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions. For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments. © Georg Thieme Verlag KG Stuttgart · New York.

• Three Rounds of External Quality Assessment in France to Evaluate the Performance of 28 Platforms for Multiparametric Molecular Testing in Metastatic Colorectal and Non-Small Cell Lung Cancer.

  PubMed

  Dequeker, Elisabeth M C; Keppens, Cleo; Egele, Caroline; Delen, Sofie; Lamy, Aude; Lemoine, Antoinette; Sabourin, Jean-Christophe; Andrieu, Catherine; Ligtenberg, Marjolijn; Fetique, Dominique; Tops, Bastiaan; Descarpentries, Clotilde; Blons, Hélène; Denoux, Yves; Aube, Cécile; Penault-Llorca, Frederique; Hofman, Paul; Leroy, Karen; Le Marechal, Cédric; Doucet, Laurent; Duranton-Tanneur, Valérie; Pedeutour, Florence; Soubeyran, Isabelle; Côté, Jean-François; Emile, Jean-François; Vignaud, Jean-Michel; Monhoven, Nathalie; Haddad, Véronique; Laurent-Puig, Pierre; van Krieken, Han; Nowak, Frederique; Lonchamp, Etienne; Bellocq, Jean-Pierre; Rouleau, Etienne

  2016-03-01

  Personalized medicine has gained increasing importance in clinical oncology, and several clinically important biomarkers are implemented in routine practice. In an effort to guarantee high quality of molecular testing in France, three subsequent external quality assessment rounds were organized at the initiative of the National Cancer Institute between 2012 and 2014. The schemes included clinically relevant biomarkers for metastatic colorectal (KRAS, NRAS, BRAF, PIK3CA, microsatellite instability) and non-small cell lung cancer (EGFR, KRAS, BRAF, PIK3CA, ERBB2), and they represent the first multigene/multicancer studies throughout Europe. In total, 56 laboratories coordinated by 28 regional molecular centers participated in the schemes. Laboratories received formalin-fixed, paraffin-embedded samples and were asked to use routine methods for molecular testing to predict patient response to targeted therapies. They were encouraged to return results within 14 calendar days after sample receipt. Both genotyping and reporting were evaluated separately. During the three external quality assessment rounds, mean genotype scores were all above the preset standard of 90% for all biomarkers. Participants were mainly challenged in case of rare insertions or deletions. Assessment of the written reports showed substantial progress between the external quality assessment schemes on multiple criteria. Several essential elements such as the clinical interpretation of test results and the reason for testing still require improvement by continued external quality assessment education. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

• Dry-grind processing using amylase corn and superior yeast to reduce the exogenous enzyme requirements in bioethanol production.

  PubMed

  Kumar, Deepak; Singh, Vijay

  2016-01-01

  Conventional corn dry-grind ethanol production process requires exogenous alpha and glucoamylases enzymes to breakdown starch into glucose, which is fermented to ethanol by yeast. This study evaluates the potential use of new genetically engineered corn and yeast, which can eliminate or minimize the use of these external enzymes, improve the economics and process efficiencies, and simplify the process. An approach of in situ ethanol removal during fermentation was also investigated for its potential to improve the efficiency of high-solid fermentation, which can significantly reduce the downstream ethanol and co-product recovery cost. The fermentation of amylase corn (producing endogenous α-amylase) using conventional yeast and no addition of exogenous α-amylase resulted in ethanol concentration of 4.1 % higher compared to control treatment (conventional corn using exogenous α-amylase). Conventional corn processed with exogenous α-amylase and superior yeast (producing glucoamylase or GA) with no exogenous glucoamylase addition resulted in ethanol concentration similar to control treatment (conventional yeast with exogenous glucoamylase addition). Combination of amylase corn and superior yeast required only 25 % of recommended glucoamylase dose to complete fermentation and achieve ethanol concentration and yield similar to control treatment (conventional corn with exogenous α-amylase, conventional yeast with exogenous glucoamylase). Use of superior yeast with 50 % GA addition resulted in similar increases in yield for conventional or amylase corn of approximately 7 % compared to that of control treatment. Combination of amylase corn, superior yeast, and in situ ethanol removal resulted in a process that allowed complete fermentation of 40 % slurry solids with only 50 % of exogenous GA enzyme requirements and 64.6 % higher ethanol yield compared to that of conventional process. Use of amylase corn and superior yeast in the dry-grind processing industry can reduce the total external enzyme usage by more than 80 %, and combining their use with in situ removal of ethanol during fermentation allows efficient high-solid fermentation.

• [External stability of the elbow after surgical treatment of epicondylitis. Presentation of a case].

  PubMed

  Llop-Corbacho, A; Romero-Ruiz, J; Denia-Alarcón, N

  2014-01-01

  Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Externalizing symptoms, effortful control, and intrusive parenting: A test of bidirectional longitudinal relations during early childhood.

PubMed

Eisenberg, Nancy; Taylor, Zoe E; Widaman, Keith F; Spinrad, Tracy L

2015-11-01

At approximately 30, 42, and 54 months of age (N = 231), the relations among children's externalizing symptoms, intrusive maternal parenting, and children's effortful control (EC) were examined. Both intrusive parenting and low EC have been related to psychopathology, but children's externalizing problems and low EC might affect the quality of parenting and one another. Mothers' intrusive behavior with their children was assessed with observations, children's EC was measured with mothers' and caregivers' reports, and children's externalizing symptoms were assessed with mothers', fathers', and caregivers' reports. In a structural equation panel model, bidirectional relations between intrusive parenting and EC were found: EC at 30 and 42 months predicted low levels of intrusive parenting a year later, controlling for prior levels of parenting and vice versa. Moreover, high levels of children's externalizing problems at both 30 and 42 months negatively predicted EC a year later, controlling for prior levels of EC. Although externalizing problems positively predicted high EC over time, this appeared to be a suppression effect because these variables had a strong negative pattern in the zero-order correlations. Moreover, when controlling for the stability of intrusive parenting, EC, and externalizing (all exhibited significant stability across time) and the aforementioned cross-lagged predictive paths, EC and externalizing problems were still negatively related within the 54-month assessment. The findings are consistent with the view that children's externalizing behavior undermines their EC and contributes to intrusive mothering and that relations between intrusive parenting and EC are bidirectional across time. Thus, interventions that focus on modifying children's externalizing problems (as well as the quality of parenting) might affect the quality of parenting they receive and, hence, subsequent problems with adjustment.

Is It Possible? Investigating the Influence of External Quality Audit on University Performance

ERIC Educational Resources Information Center

Carr, Sarah; Hamilton, Emma; Meade, Phil

2005-01-01

This paper explores whether it is possible to isolate independent effects of external quality audit (EQA) and concludes that effectiveness evaluations have a stronger foundation when the combined effects of university governance and management initiatives and government initiatives are examined together with EQA. The issue of how successful these…

UK PhD Assessment in Accounting and Finance: Social Capital in Action

ERIC Educational Resources Information Center

Smith, Sarah Jane; Urquhart, Vivien

2018-01-01

Assessment lies at the centre of PhD degree quality standards, with quality assurance relying on independent external examiners. This study investigates the role of the viva and the selection of external examiners from within the accounting and finance discipline across UK institutions. A questionnaire survey and follow-up interviews with…

42 CFR 438.362 - Exemption from external quality review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Exemption from external quality review. 438.362 Section 438.362 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Medicaid contract has been in effect for at least 2 consecutive years before the effective date of the...

[Clinicofunctional condition and quality of life in patients with chronic obstructive pulmonary disease before and after outpatient treatment with fenspiride].

PubMed

Butorov, S I; Butorov, I V; Bodrug, N I; Krushka, S I; Tofan, E F

2008-01-01

To study effects of long-term administration of fenspiride in combination with broncholytic drugs on dynamics of clinical symptoms, external respiration function and quality of life in patients with chronic obstructive pulmonary disease (COPD). A comparative randomized trial of fenspiride used for 6 months in combination with broncholytic drugs enrolled 68 COPD patients. A clinical status, external respiration function were examined. Quality of life was evaluated with WHO questionnaire WHOQOL-100. Addition of fenspiride to combined treatment of COPD attenuates COPD symptoms, normalizes blood biochemistry, improves external respiration function, raises exercise tolerance. Quality of life improved by physical and mental state scales. Fenspiride addition to COPD treatment improves efficacy of the standard treatment and is recommended for treatment of COPD of stage I and II in combination with broncholytic drugs.

Fear of abandonment as a mediator of the relations between divorce stressors and mother-child relationship quality and children's adjustment problems.

PubMed

Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Doyle, Kathryn W

2002-08-01

This study examines whether fear of abandonment mediates the prospective relations between divorce stressors and mother-child relationship quality and adjustment problems of children of divorce. Participants were 216 children, ages 8-12, and their primary residential mothers. Children reported on divorce stressors and fear of abandonment; mothers and children reported on mother-child relationship quality and internalizing and externalizing problems. Structural equation models indicated that Time 1 fear of abandonment mediated the relation between Time 1 divorce stressors and Time 2 internalizing and externalizing problems. Time 1 fear of abandonment also mediated the relation between Time 1 mother-child relationship quality and Time 2 internalizing and externalizing problems. Implications of these results for understanding variability in children's postdivorce adjustment problems and interventions for divorced families are discussed.

Environmental And Quality Management System In The Context Of Sustainable Development

NASA Astrophysics Data System (ADS)

Rusko, Miroslav

2015-06-01

Growing load and deterioration of the environment can be interpreted as a result of some external effects interventions. While the positive externalities influence the positive productional and utilizational functions of other subjects, the negative externalities influence the negative ones. Both types of external effects can act as parcial or global externalities. Linking of environmental issues to economy and finance is an important sphere.

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review

PubMed Central

Al-Thomali, Yousef; Mohamed, Roshan-Noor; Basha, Sakeenabi

2017-01-01

Background To evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets. Material and Methods Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). Results In total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets. Conclusions Conventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets. Key words:Systematic review, self ligation, torque expression, conventional ligation. PMID:28149476

Torque expression in self-ligating orthodontic brackets and conventionally ligated brackets: A systematic review.

PubMed

Al-Thomali, Yousef; Mohamed, Roshan-Noor; Basha, Sakeenabi

2017-01-01

To evaluate the torque expression of self ligating (SL) orthodontic brackets and conventionally ligated brackets and the torque expression in active and passive SL brackets. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus, and key journals and review articles; the date of the last search was April 4th 2016. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). In total, 87 studies were identified for screening, and 9 studies were eligible. The quality assessment rated one of the study as being of strong quality, 7 (77.78%) of these studies as being of moderate quality. Three out of 7 studies which compared SL and conventionally ligated brackets showed, conventionally ligated brackets with highest torque expression compared to SL brackets. Badawi showed active SL brackets with highest torque expression compared to passive SL brackets. Major and Brauchli showed no significant differences in torque expression of active and passive SL brackets. Conventionally ligated brackets presented with highest torque expression compared to SL brackets. Minor difference was recorded in a torque expression of active and passive SL brackets. Key words: Systematic review, self ligation, torque expression, conventional ligation.

[In-house team seminars: working together as a team--from data and statistics to quality development].

PubMed

Berlage, Silvia; Wenzlaff, Paul; Damm, Gabriele; Sens, Brigitte

2010-01-01

The concept of the "ZQ In-house Seminars" provided by external trainers/experts pursues the specific aim to enable all healthcare staff members of hospital departments to analyse statistical data--especially from external quality measurements--and to initiate in-hospital measures of quality improvement based on structured team work. The results of an evaluation in Lower Saxony for the period between 2004 and 2008 demonstrate a sustainable increase in outcome quality of care and a strengthening of team and process orientation in clinical care.

Association Between Echocardiography Laboratory Accreditation and the Quality of Imaging and Reporting for Valvular Heart Disease.

PubMed

Thaden, Jeremy J; Tsang, Michael Y; Ayoub, Chadi; Padang, Ratnasari; Nkomo, Vuyisile T; Tucker, Stephen F; Cassidy, Cynthia S; Bremer, Merri; Kane, Garvan C; Pellikka, Patricia A

2017-08-01

It is presumed that echocardiographic laboratory accreditation leads to improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited versus nonaccredited laboratories for the evaluation of valvular heart disease. We enrolled 335 consecutive valvular heart disease subjects who underwent echocardiography at our institution and an external accredited or nonaccredited institution within 6 months. Completeness and quality of echocardiographic reports and images were assessed by investigators blinded to the external laboratory accreditation status and echocardiographic results. Compared with nonaccredited laboratories, accredited sites more frequently reported patient sex (94% versus 78%; P <0.001), height and weight (96% versus 63%; P <0.001), blood pressure (86% versus 39%; P <0.001), left ventricular size (96% versus 83%; P <0.001), right ventricular size (94% versus 80%; P =0.001), and right ventricular function (87% versus 73%; P =0.006). Accredited laboratories had higher rates of complete and diagnostic color (58% versus 35%; P =0.002) and spectral Doppler imaging (45% versus 21%; P <0.0001). Concordance between external and internal grading of external studies was improved when diagnostic quantification was performed (85% versus 69%; P =0.003), and in patients with mitral regurgitation, reproducibility was improved with higher quality color Doppler imaging. Accredited echocardiographic laboratories had more complete reporting and better image quality, while echocardiographic quantification and color Doppler image quality were associated with improved concordance in grading valvular heart disease. Future quality improvement initiatives should highlight the importance of high-quality color Doppler imaging and echocardiographic quantification to improve the accuracy, reproducibility, and quality of echocardiographic studies for valvular heart disease. © 2017 American Heart Association, Inc.

The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

PubMed

Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

2016-01-01

External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance.

The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes

PubMed Central

Yahaya, Ali A.; Gumede-Moeletsi, Hieronyma N.

2016-01-01

External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance. PMID:28879135

10 CFR Appendix I to Subpart B of... - Uniform Test Method for Measuring the Energy Consumption of Conventional Ranges, Conventional...

Code of Federal Regulations, 2014 CFR

2014-01-01

..., set the clock time to 3:23 and use the average power approach described in Section 5, Paragraph 5.3.2... circulates air internally or externally to the cooking product for a finite period of time after the end of... persist for an indefinite time. An indicator that only shows the user that the product is in the off...

Engineering Strategies and Methods for Avoiding Air-Quality Externalities: Dispersion Modeling, Home Energy Conservation, and Scenario Planning

NASA Astrophysics Data System (ADS)

Knox, Andrew James

Energy conservation can improve air quality by reducing emissions from fuel combustion. The human health value retained through better air quality can then offset the cost of energy conservation. Through this thesis' innovative yet widely-accessible combination of air pollution dispersion modeling and atmospheric chemistry, it is estimated that the health value retained by avoiding emissions from Ontario's former coal-fired generating stations is 5.74/MWh (using an upper-bound value of 265,000 per year of life lost). This value is combined with energy modeling of homes in the first-ever assessment of the air-quality health benefits of low-energy buildings. It is shown that avoided health damages can equal 7% of additional construction costs of energy efficient buildings in Ontario. At 7%, health savings are a significant item in the cost analysis of efficient buildings. Looking to energy efficiency in the context of likely future low-resource natural gas scenarios, building efficient buildings today is shown to be more economically efficient than any building retrofit option. Considering future natural gas scarcity in the context of Ontario's Long-Term Energy Plan reveals that Ontario may be forced to return to coal-fired electricity. Projected coal use would result in externalities greater than $600 million/year; 80% more than air-quality externalities from Ontario's electricity in 1985. Radically aggressive investment in electricity conservation (75% reduction per capita by 2075) is one promising path forward that keeps air-quality externalities below 1985 levels. Non-health externalities are an additional concern, the quantification, and ultimately monetization, of which could be practical using emerging air pollution monitoring technologies. Energy, conservation, energy planning, and energy's externalities form a complex situation in which today's decisions are critical to a successful future. It is clear that reducing the demand for energy is essential and that there are economically efficient conservation opportunities, particularly in the building sector, being missed.

The case for regime-based water quality standards

Treesearch

G.C. Poole; J.B. Dunham; D.M. Keenan; S.T. Sauter; D.A. McCullough; C. Mebane; J.C. Lockwood; D.A. Essig; M.P. Hicks; D.J. Sturdevant; E.J. Materna; S.A. Spalding; J. Risley; M. Deppman

2004-01-01

Conventional water quality standards have been successful in reducing the concentration of toxic substances in US waters. However, conventional standards are based on simple thresholds and are therefore poorly structured to address human-caused imbalances in dynamic, natural water quality parameters, such as nutrients, sediment, and temperature. A more applicable type...

REACTOR HAVING NaK-UO$sub 2$ SLURRY HELICALLY POSITIONED IN A GRAPHITE MODERATOR

DOEpatents

Rodin, M.B.; Carter, J.C.

1962-05-15

A reactor utilizing 20% enriched uranium consists of a central graphite island in cylindrical form, with a spiral coil of tubing fitting against the central island. An external graphite moderator is placed around the central island and coil. A slurry of uranium dioxide dispersed in alkali metal passes through the coil to transfer heat externally to the reactor. There are also conventional controls for regulating the nuclear reaction. (AEC)

Real-time in vivo Cherenkoscopy imaging during external beam radiation therapy.

PubMed

Zhang, Rongxiao; Gladstone, David J; Jarvis, Lesley A; Strawbridge, Rendall R; Jack Hoopes, P; Friedman, Oscar D; Glaser, Adam K; Pogue, Brian W

2013-11-01

Cherenkov radiation is induced when charged particles travel through dielectric media (such as biological tissue) faster than the speed of light through that medium. Detection of this radiation or excited luminescence during megavoltage external beam radiotherapy (EBRT) can allow emergence of a new approach to superficial dose estimation, functional imaging, and quality assurance for radiation therapy dosimetry. In this letter, the first in vivo Cherenkov images of a real-time Cherenkoscopy during EBRT are presented. The imaging system consisted of a time-gated intensified charge coupled device (ICCD) coupled with a commercial lens. The ICCD was synchronized to the linear accelerator to detect Cherenkov photons only during the 3.25-μs radiation bursts. Images of a tissue phantom under irradiation show that the intensity of Cherenkov emission is directly proportional to radiation dose, and images can be acquired at 4.7 frames/s with SNR>30. Cherenkoscopy was obtained from the superficial regions of a canine oral tumor during planned, Institutional Animal Care and Use Committee approved, conventional (therapeutically appropriate) EBRT irradiation. Coregistration between photography and Cherenkoscopy validated that Cherenkov photons were detected from the planned treatment region. Real-time images correctly monitored the beam field changes corresponding to the planned dynamic wedge movement, with accurate extent of overall beam field, and expected cold and hot regions.

Space Shuttle - Bringing cryohydrogen technology down to earth. [details of LH2 and LO2 technology and External Tank design

NASA Technical Reports Server (NTRS)

Odom, J. B.

1978-01-01

The External Tank must provide a safe storage container for both LH2 and LO2, a means of maintaining propellant quality in order to meet the engine pump net positive suction pressure requirements, and a structural strong-back for the Space Shuttle system, all at the minimum recurring cost and weight, while maintaining quality and reliability. The present paper summarizes External Tank design features and discusses the advantages of using LH2 and LO2 for the Space Shuttle system.

Environment construction and bottleneck breakthrough in the improvement of wisdom exhibition

NASA Astrophysics Data System (ADS)

Zhang, Jiankang

2017-08-01

Wisdom exhibition is an inexorable trend in convention and exhibition industry in China. Information technology must be utilized by exhibition industry to achieve intelligent application and wisdom management, breaking the limitation of time as well as space, which raise the quality of exhibition service and level of operation to a totally new standard. Accordingly, exhibition industry should optimize mobile internet, a fundamental technology platform, during the advancing process of wisdom exhibition and consummate the combination among three plates including wisdom connection of information, wisdom exhibition environment and wisdom application of technology. Besides, the industry should realize the wisdom of external environment including wisdom of exhibition city, exhibition place, exhibition resource deal etc and break through bottle-neck in construction of wisdom exhibition industry, which includes construction of big data center, development of Mobile Internet application platform, promotion of information construction, innovative design of application scenarios.

An integrated content and metadata based retrieval system for art.

PubMed

Lewis, Paul H; Martinez, Kirk; Abas, Fazly Salleh; Fauzi, Mohammad Faizal Ahmad; Chan, Stephen C Y; Addis, Matthew J; Boniface, Mike J; Grimwood, Paul; Stevenson, Alison; Lahanier, Christian; Stevenson, James

2004-03-01

A new approach to image retrieval is presented in the domain of museum and gallery image collections. Specialist algorithms, developed to address specific retrieval tasks, are combined with more conventional content and metadata retrieval approaches, and implemented within a distributed architecture to provide cross-collection searching and navigation in a seamless way. External systems can access the different collections using interoperability protocols and open standards, which were extended to accommodate content based as well as text based retrieval paradigms. After a brief overview of the complete system, we describe the novel design and evaluation of some of the specialist image analysis algorithms including a method for image retrieval based on sub-image queries, retrievals based on very low quality images and retrieval using canvas crack patterns. We show how effective retrieval results can be achieved by real end-users consisting of major museums and galleries, accessing the distributed but integrated digital collections.

Colour-crafted phosphor-free white light emitters via in-situ nanostructure engineering.

PubMed

Min, Daehong; Park, Donghwy; Lee, Kyuseung; Nam, Okhyun

2017-03-08

Colour-temperature (T c ) is a crucial specification of white light-emitting diodes (WLEDs) used in a variety of smart-lighting applications. Commonly, T c is controlled by distributing various phosphors on top of the blue or ultra violet LED chip in conventional phosphor-conversion WLEDs (PC-WLEDs). Unfortunately, the high cost of phosphors, additional packaging processes required, and phosphor degradation by internal thermal damage must be resolved to obtain higher-quality PC-WLEDs. Here, we suggest a practical in-situ nanostructure engineering strategy for fabricating T c -controlled phosphor-free white light-emitting diodes (PF-WLEDs) using metal-organic chemical vapour deposition. The dimension controls of in-situ nanofacets on gallium nitride nanostructures, and the growth temperature of quantum wells on these materials, were key factors for T c control. Warm, true, and cold white emissions were successfully demonstrated in this study without any external processing.

Colour-crafted phosphor-free white light emitters via in-situ nanostructure engineering

PubMed Central

Min, Daehong; Park, Donghwy; Lee, Kyuseung; Nam, Okhyun

2017-01-01

Colour-temperature (Tc) is a crucial specification of white light-emitting diodes (WLEDs) used in a variety of smart-lighting applications. Commonly, Tc is controlled by distributing various phosphors on top of the blue or ultra violet LED chip in conventional phosphor-conversion WLEDs (PC-WLEDs). Unfortunately, the high cost of phosphors, additional packaging processes required, and phosphor degradation by internal thermal damage must be resolved to obtain higher-quality PC-WLEDs. Here, we suggest a practical in-situ nanostructure engineering strategy for fabricating Tc-controlled phosphor-free white light-emitting diodes (PF-WLEDs) using metal-organic chemical vapour deposition. The dimension controls of in-situ nanofacets on gallium nitride nanostructures, and the growth temperature of quantum wells on these materials, were key factors for Tc control. Warm, true, and cold white emissions were successfully demonstrated in this study without any external processing. PMID:28272455

Movement quality of conventional prostheses and the DEKA Arm during everyday tasks

PubMed Central

Cowley, Jeffrey; Resnik, Linda; Wilken, Jason; Walters, Lisa Smurr; Gates, Deanna

2017-01-01

Background Conventional prosthetic devices fail to restore the function and characteristic movement quality of the upper limb. The DEKA Arm is a new, advanced prosthesis featuring a compound, powered wrist and multiple grip configurations. Objectives The purpose of this study was to determine if the DEKA Arm improved the movement quality of upper limb prosthesis users compared to conventional prostheses. Study design Case series. Methods Three people with transradial amputation completed tasks of daily life with their conventional prosthesis and with the DEKA Arm. A total of 10 healthy controls completed the same tasks. The trajectory of the wrist joint center was analyzed to determine how different prostheses affected movement duration, speed, smoothness, and curvature compared to patients’ own intact limbs and controls. Results Movement quality decreased with the DEKA Arm for two participants, and increased for the third. Prosthesis users made slower, less smooth, more curved movements with the prosthetic limb compared to the intact limb and controls, particularly when grasping and manipulating objects. Conclusion The effects of one month of training with the DEKA Arm on movement quality varied with participants’ skill and experience with conventional prostheses. Future studies should examine changes in movement quality after long-term use of advanced prostheses. PMID:26932980

Can a combination of average of normals and "real time" External Quality Assurance replace Internal Quality Control?

PubMed

Badrick, Tony; Graham, Peter

2018-03-28

Internal Quality Control and External Quality Assurance are separate but related processes that have developed independently in laboratory medicine over many years. They have different sample frequencies, statistical interpretations and immediacy. Both processes have evolved absorbing new understandings of the concept of laboratory error, sample material matrix and assay capability. However, we do not believe at the coalface that either process has led to much improvement in patient outcomes recently. It is the increasing reliability and automation of analytical platforms along with improved stability of reagents that has reduced systematic and random error, which in turn has minimised the risk of running less frequent IQC. We suggest that it is time to rethink the role of both these processes and unite them into a single approach using an Average of Normals model supported by more frequent External Quality Assurance samples. This new paradigm may lead to less confusion for laboratory staff and quicker responses to and identification of out of control situations.

7 CFR 14.6 - Criteria for determining the primary purpose of payments with respect to potential exclusion from...

Code of Federal Regulations, 2013 CFR

2013-01-01

... quality of the natural external or extrinsic conditions directly or indirectly affecting people. (2... their lives. (d) Restoring the environment. (1) Payments shall be considered to be made primarily for... practices undertaken to reestablish, return, or enhance the quantity or quality of the natural external or...

The Impact of Identifying a Specific Purpose and External Audience for Writing on Second Graders' Writing Quality

ERIC Educational Resources Information Center

Block, Meghan K.

2013-01-01

The Common Core State Standards for English Language Arts and Literacy in History/Social Studies, Science, and Technical Subjects (CCSS) emphasize the importance of writing and specify that students should write for external, and, at times, unfamiliar audiences. Given the relationship between audience specification and quality writing in older…

External Quality Assessments for Microbiologic Diagnosis of Diphtheria in Europe

PubMed Central

Both, Leonard; Neal, Shona; De Zoysa, Aruni; Mann, Ginder; Czumbel, Ida

2014-01-01

The European Diphtheria Surveillance Network (EDSN) ensures the reliable epidemiological and microbiologic assessment of disease prevalence in the European Union. Here, we describe a survey of current diagnostic techniques for diphtheria surveillance conducted across the European Union and report the results from three external quality assessment (EQA) schemes performed between 2010 and 2014. PMID:25297336

The Impact of External Quality Assessment on Universities: The Estonian Experience

ERIC Educational Resources Information Center

Vilgats, Birgit; Heidmets, Mati

2011-01-01

This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

External Quality Arrangements for the Review of Modern Apprenticeship Off-the-Job Training

ERIC Educational Resources Information Center

Education Scotland, 2015

2015-01-01

This publication provides a quality framework to provide a structure for external review of Modern Apprenticeship off-the-job training.? The indicators in this framework are arranged under three key principles, addressing five questions which Education Scotland is adopting for evaluation purposes. These are underpinned by a wider principle on the…

Design concept for improved photo-scan tube

NASA Technical Reports Server (NTRS)

Malling, L. R.

1967-01-01

Conceptual photo-scan tube avoids complexity of internal beam scanning and beam-current adjustment by optical scan readout. It differs from a conventional image orthicon in its use of an external oscilloscope tube.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2012].

PubMed

de Gopegui Bordes, Enrique Ruiz; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

2014-02-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2012 controls. As a whole, the results obtained in 2012 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2014 Elsevier España, S.L. All rights reserved.

[Analysis of the results of the 2010 External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Ruiz de Gopegui Bordes, Enrique; Serrano, M del Remedio Guna; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Cardona, Concepción Gimeno

2011-12-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most important conclusions and lessons of the 2010 controls. As a whole, the results obtained in 2010 confirm the excellent skill and good technical standards found in previous years. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls to ensure maximal quality of microbiological tests(1). Copyright © 2011 Elsevier España S.L. All rights reserved.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2014].

PubMed

Gopegui Bordes, Enrique Ruiz de; Guna Serrano, M Del Remedio; Orta Mira, Nieves; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

2016-07-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2014 controls. As a whole, the results obtained in 2014 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of the SEIMC program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

High-frequency chaotic dynamics enabled by optical phase-conjugation

PubMed Central

Mercier, Émeric; Wolfersberger, Delphine; Sciamanna, Marc

2016-01-01

Wideband chaos is of interest for applications such as random number generation or encrypted communications, which typically use optical feedback in a semiconductor laser. Here, we show that replacing conventional optical feedback with phase-conjugate feedback improves the chaos bandwidth. In the range of achievable phase-conjugate mirror reflectivities, the bandwidth increase reaches 27% when compared with feedback from a conventional mirror. Experimental measurements of the time-resolved frequency dynamics on nanosecond time-scales show that the bandwidth enhancement is related to the onset of self-pulsing solutions at harmonics of the external-cavity frequency. In the observed regime, the system follows a chaotic itinerancy among these destabilized high-frequency external-cavity modes. The recorded features are unique to phase-conjugate feedback and distinguish it from the long-standing problem of time-delayed feedback dynamics. PMID:26739806

Features of a Self-Mixing Laser Diode Operating Near Relaxation Oscillation.

PubMed

Liu, Bin; Yu, Yanguang; Xi, Jiangtao; Fan, Yuanlong; Guo, Qinghua; Tong, Jun; Lewis, Roger A

2016-09-21

When a fraction of the light reflected by an external cavity re-enters the laser cavity, both the amplitude and the frequency of the lasing field can be modulated. This phenomenon is called the self-mixing effect (SME). A self-mixing laser diode (SM-LD) is a sensor using the SME. Usually, such LDs operate below the stability boundary where no relaxation oscillation happens. The boundary is determined by the operation condition including the injection current, optical feedback strength and external cavity length. This paper discovers the features of an SM-LD where the LD operates beyond the stability boundary, that is, near the relaxation oscillation (RO) status. We call the signals from such a SM-LD as RO-SM signals to differentiate them from the conventional SM signals reported in the literature. Firstly, simulations are made based on the well-known Lang and Kobayashi (L-K) equations. Then the experiments are conducted on different LDs to verify the simulation results. It shows that a RO-SM signal exhibits high frequency oscillation with its amplitude modulated by a slow time varying envelop which corresponds to the movement of the external target. The envelope has same fringe structure (half-wavelength displacement resolution) with the conventional SM signals. However, the amplitudes of the RO-SM signals are much higher compared to conventional SM signals. The results presented reveal that an SM-LD operating near the RO has potential for achieving sensing with improved sensitivity.

Features of a Self-Mixing Laser Diode Operating Near Relaxation Oscillation

PubMed Central

Liu, Bin; Yu, Yanguang; Xi, Jiangtao; Fan, Yuanlong; Guo, Qinghua; Tong, Jun; Lewis, Roger A.

2016-01-01

When a fraction of the light reflected by an external cavity re-enters the laser cavity, both the amplitude and the frequency of the lasing field can be modulated. This phenomenon is called the self-mixing effect (SME). A self-mixing laser diode (SM-LD) is a sensor using the SME. Usually, such LDs operate below the stability boundary where no relaxation oscillation happens. The boundary is determined by the operation condition including the injection current, optical feedback strength and external cavity length. This paper discovers the features of an SM-LD where the LD operates beyond the stability boundary, that is, near the relaxation oscillation (RO) status. We call the signals from such a SM-LD as RO-SM signals to differentiate them from the conventional SM signals reported in the literature. Firstly, simulations are made based on the well-known Lang and Kobayashi (L-K) equations. Then the experiments are conducted on different LDs to verify the simulation results. It shows that a RO-SM signal exhibits high frequency oscillation with its amplitude modulated by a slow time varying envelop which corresponds to the movement of the external target. The envelope has same fringe structure (half-wavelength displacement resolution) with the conventional SM signals. However, the amplitudes of the RO-SM signals are much higher compared to conventional SM signals. The results presented reveal that an SM-LD operating near the RO has potential for achieving sensing with improved sensitivity. PMID:27657077

Dosimetric quality endpoints for low-dose-rate prostate brachytherapy using biological effective dose (bed) vs. conventional dose

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

Singh, Rachana; Al-Hallaq, Hania; Pelizzari, Charles A.

2003-12-31

The purpose of this study was to compare conventional low-dose-rate prostate brachytherapy dosimetric quality parameters with their biological effective dose (BED) counterparts. To validate a model for transformation from conventional dose to BED, the postimplant plans of 31 prostate brachytherapy patients were evaluated using conventional dose-volume histogram (DVH) quality endpoints and analogous BED-DVH endpoints. Based on CT scans obtained 4 weeks after implantation, DVHs were computed and standard dosimetric endpoints V100 (volume receiving 100% of the prescribed dose), V150, V200, HI (1-[V150/V100]), and D90 (dose that 90% of the target volume received) were obtained for quality analysis. Using known andmore » reported transformations, dose grids were transformed to BED-early ({alpha}/{beta} = 10 Gy) and BED-late ({alpha}/{beta} = 3 Gy) grids, and the same dosimetric endpoints were analyzed. For conventional, BED-early and BED-late DVHs, no differences in V100 were seen (0.896, 0.893, and 0.894, respectively). However, V150 and V200 were significantly higher for both BED-early (0.582 and 0.316) and BED-late (0.595 and 0.337), compared with the conventional (0.539 and 0.255) DVHs. D90 was significantly lower for the BED-early (103.1 Gy) and BED-late transformations (106.9 Gy) as compared with the conventional (119.5 Gy) DVHs. The conventional prescription parameter V100 is the same for the corresponding BED-early and BED-late transformed DVHs. The toxicity parameters V150 and V200 are slightly higher using the BED transformations, suggesting that the BED doses are somewhat higher than predicted using conventional DVHs. The prescription/quality parameter D90 is slightly lower, implying that target coverage is lower than predicted using conventional DVHs. This methodology can be applied to analyze BED dosimetric endpoints to improve clinical outcome and reduce complications of prostate brachytherapy.« less

[Simultaneous quantitative analysis of five alkaloids in Sophora flavescens by multi-components assay by single marker].

PubMed

Chen, Jing; Wang, Shu-Mei; Meng, Jiang; Sun, Fei; Liang, Sheng-Wang

2013-05-01

To establish a new method for quality evaluation and validate its feasibilities by simultaneous quantitative assay of five alkaloids in Sophora flavescens. The new quality evaluation method, quantitative analysis of multi-components by single marker (QAMS), was established and validated with S. flavescens. Five main alkaloids, oxymatrine, sophocarpine, matrine, oxysophocarpine and sophoridine, were selected as analytes to evaluate the quality of rhizome of S. flavescens, and the relative correction factor has good repeatibility. Their contents in 21 batches of samples, collected from different areas, were determined by both external standard method and QAMS. The method was evaluated by comparison of the quantitative results between external standard method and QAMS. No significant differences were found in the quantitative results of five alkaloids in 21 batches of S. flavescens determined by external standard method and QAMS. It is feasible and suitable to evaluate the quality of rhizome of S. flavescens by QAMS.

Multicentre validation of IMRT pre-treatment verification: comparison of in-house and external audit.

PubMed

Jornet, Núria; Carrasco, Pablo; Beltrán, Mercè; Calvo, Juan Francisco; Escudé, Lluís; Hernández, Victor; Quera, Jaume; Sáez, Jordi

2014-09-01

We performed a multicentre intercomparison of IMRT optimisation and dose planning and IMRT pre-treatment verification methods and results. The aims were to check consistency between dose plans and to validate whether in-house pre-treatment verification results agreed with those of an external audit. Participating centres used two mock cases (prostate and head and neck) for the intercomparison and audit. Compliance to dosimetric goals and total number of MU per plan were collected. A simple quality index to compare the different plans was proposed. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit. While for the prostate case, all centres fulfilled the dosimetric goals and plan quality was homogeneous, that was not the case for the head and neck case. The number of MU did not correlate with the plan quality index. Pre-treatment verifications results of the external audit did not agree with those of the in-house measurements for two centres: being within tolerance for in-house measurements and unacceptable for the audit or the other way round. Although all plans fulfilled dosimetric constraints, plan quality is highly dependent on the planner expertise. External audits are an excellent tool to detect errors in IMRT implementation and cannot be replaced by intercomparison using results obtained by centres. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study.

PubMed

Sommer, Jordana L; Mota, Natalie; Edmondson, Donald; El-Gabalawy, Renée

2018-05-10

The current study compared physical and mental health characteristics and quality of life of illness-induced posttraumatic stress disorder (PTSD) versus those with PTSD due to external traumatic events in a population-based sample. PTSD was assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) using DSM-5 criteria in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Participants with past-year PTSD (n = 1779) were categorized into two groups: illness-induced (6.5%) and other trauma-induced PTSD (92.9%) based on index trauma. Group differences in physical health, mental health, and quality of life were estimated using multiple logistic and linear regressions with adjustment for demographics and medical morbidity. Compared to PTSD due to external events, illness-induced PTSD had higher rates of life-threatening illness in the past year. Illness-induced PTSD compared to PTSD due to external events was associated with reduced odds of depressive/bipolar disorders and antisocial personality disorder, but increased odds of cannabis use disorder. The groups did not differ on quality of life after accounting for medical morbidity. Illness-induced PTSD is common among American adults and has a similar impact on quality of life as PTSD due to external events, but may have distinct mental health correlates. Copyright © 2018 Elsevier Inc. All rights reserved.

The effects of internal and external control factors on college students' marijuana use and cessation of use.

PubMed

Lo, C C; Globetti, G

1995-01-01

The purpose of this study was to examine how selected internal and external control variables influence lifetime use, frequency of use, and cessation of use of marijuana. The internal control factor, comprising the variables 1) perceived risk of marijuana use and 2) attitudes toward prohibition of marijuana use, refers to a built-in personal tendency toward conventionality. The external control factor refers to social-environmental forces which discourage marijuana use. External control is indicated by factors including the number of extra-curricular activities in which an individual is involved; place of residence; the availability of marijuana; peer attitudes toward marijuana use; the number of an individual's friends who use marijuana; and the number of occasions on which an individual has observed others using marijuana. The study's results show that both internal and external control factors are significant predictors of the frequency of marijuana use. The external control factor, however, plays a more important role in explaining lifetime marijuana use and cessation of marijuana use.

Coding conventions and principles for a National Land-Change Modeling Framework

USGS Publications Warehouse

Donato, David I.

2017-07-14

This report establishes specific rules for writing computer source code for use with the National Land-Change Modeling Framework (NLCMF). These specific rules consist of conventions and principles for writing code primarily in the C and C++ programming languages. Collectively, these coding conventions and coding principles create an NLCMF programming style. In addition to detailed naming conventions, this report provides general coding conventions and principles intended to facilitate the development of high-performance software implemented with code that is extensible, flexible, and interoperable. Conventions for developing modular code are explained in general terms and also enabled and demonstrated through the appended templates for C++ base source-code and header files. The NLCMF limited-extern approach to module structure, code inclusion, and cross-module access to data is both explained in the text and then illustrated through the module templates. Advice on the use of global variables is provided.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232

Determining polarizable force fields with electrostatic potentials from quantum mechanical linear response theory

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

Wang, Hao; Yang, Weitao, E-mail: weitao.yang@duke.edu; Department of Physics, Duke University, Durham, North Carolina 27708

We developed a new method to calculate the atomic polarizabilities by fitting to the electrostatic potentials (ESPs) obtained from quantum mechanical (QM) calculations within the linear response theory. This parallels the conventional approach of fitting atomic charges based on electrostatic potentials from the electron density. Our ESP fitting is combined with the induced dipole model under the perturbation of uniform external electric fields of all orientations. QM calculations for the linear response to the external electric fields are used as input, fully consistent with the induced dipole model, which itself is a linear response model. The orientation of the uniformmore » external electric fields is integrated in all directions. The integration of orientation and QM linear response calculations together makes the fitting results independent of the orientations and magnitudes of the uniform external electric fields applied. Another advantage of our method is that QM calculation is only needed once, in contrast to the conventional approach, where many QM calculations are needed for many different applied electric fields. The molecular polarizabilities obtained from our method show comparable accuracy with those from fitting directly to the experimental or theoretical molecular polarizabilities. Since ESP is directly fitted, atomic polarizabilities obtained from our method are expected to reproduce the electrostatic interactions better. Our method was used to calculate both transferable atomic polarizabilities for polarizable molecular mechanics’ force fields and nontransferable molecule-specific atomic polarizabilities.« less

Hybrid computing using a neural network with dynamic external memory.

PubMed

Graves, Alex; Wayne, Greg; Reynolds, Malcolm; Harley, Tim; Danihelka, Ivo; Grabska-Barwińska, Agnieszka; Colmenarejo, Sergio Gómez; Grefenstette, Edward; Ramalho, Tiago; Agapiou, John; Badia, Adrià Puigdomènech; Hermann, Karl Moritz; Zwols, Yori; Ostrovski, Georg; Cain, Adam; King, Helen; Summerfield, Christopher; Blunsom, Phil; Kavukcuoglu, Koray; Hassabis, Demis

2016-10-27

Artificial neural networks are remarkably adept at sensory processing, sequence learning and reinforcement learning, but are limited in their ability to represent variables and data structures and to store data over long timescales, owing to the lack of an external memory. Here we introduce a machine learning model called a differentiable neural computer (DNC), which consists of a neural network that can read from and write to an external memory matrix, analogous to the random-access memory in a conventional computer. Like a conventional computer, it can use its memory to represent and manipulate complex data structures, but, like a neural network, it can learn to do so from data. When trained with supervised learning, we demonstrate that a DNC can successfully answer synthetic questions designed to emulate reasoning and inference problems in natural language. We show that it can learn tasks such as finding the shortest path between specified points and inferring the missing links in randomly generated graphs, and then generalize these tasks to specific graphs such as transport networks and family trees. When trained with reinforcement learning, a DNC can complete a moving blocks puzzle in which changing goals are specified by sequences of symbols. Taken together, our results demonstrate that DNCs have the capacity to solve complex, structured tasks that are inaccessible to neural networks without external read-write memory.

Friends' knowledge of youth internalizing and externalizing adjustment: accuracy, bias, and the influences of gender, grade, positive friendship quality, and self-disclosure.

PubMed

Swenson, Lance P; Rose, Amanda J

2009-08-01

Some evidence suggests that close friends may be knowledgeable of youth's psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends' reports of youth adjustment are accurate (i.e., predicted by youths' actual adjustment) versus biased (i.e., predicted by the friend reporters' own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths' internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts.

Evaluation of the quality of life of patients with diabetes mellitus treated with conventional or analogue insulins.

PubMed

Machado-Alba, Jorge Enrique; Medina-Morales, Diego Alejandro; Echeverri-Cataño, Luis Felipe

2016-06-01

The results of two scales that measure quality of life of patients with diabetes mellitus treated with conventional or analogue insulin were evaluated and compared. Descriptive, observational, cross-sectional study, conducted in the cities of Pereira and Manizales, Colombia, in a care facility between 1 August 2013 and 30 March 2014. A total of 238 patients diagnosed with diabetes mellitus type 1 or type 2 who had been undergoing treatment with conventional or analogue insulin for at least 6months. Comparison of the results of the Diabetes 39 (specific) and European Quality of Life-5 Dimensions (EQ-5D) (generic) tools it was performed. Comparisons between the results of the two instruments were performed. Tests for parametric and non-parametric distribution (Pearson's correlation coefficient, Mann-Whitney U test, Student's t-test and Wilcoxon test) were used. The mean age was 57.7±16.6years. Conventional insulin was prescribed to 69.6% of patients, and analogue insulin was prescribed to 30.4% of patients. Diabetes-39 (D-39) showed 24.7% of subjects with a high quality of life. No statistically significant differences were found when comparing patients prescribed conventional or analogue insulin (p=0.35; 95% confidence interval [CI]: 0.375-1.419). In the EQ-5D survey, 45.7% claimed to have a high quality of life, without statistically significant differences between groups (p=0.56; 95%CI: 0.676-2.047). No differences between patients receiving conventional insulin versus analogue insulin were detected in terms of quality of life. The group aged over 60years requires special attention to improve their quality of life, and programs should focus on those individuals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. Copyright © 2013. Published by Elsevier GmbH.

Assessment of Reference Height Models on Quality of Tandem-X dem

NASA Astrophysics Data System (ADS)

Mirzaee, S.; Motagh, M.; Arefi, H.

2015-12-01

The aim of this study is to investigate the effect of various Global Digital Elevation Models (GDEMs) in producing high-resolution topography model using TanDEM-X (TDX) Coregistered Single Look Slant Range Complex (CoSSC) images. We selected an image acquired on Jun 12th, 2012 over Doroud region in Lorestan, west of Iran and used 4 external digital elevation models in our processing including DLR/ASI X-SAR DEM (SRTM-X, 30m resolution), ASTER GDEM Version 2 (ASTER-GDEMV2, 30m resolution), NASA SRTM Version 4 (SRTM-V4, 90m resolution), and a local photogrammetry-based DEM prepared by National Cartographic Center (NCC DEM, 10m resolution) of Iran. InSAR procedure for DEM generation was repeated four times with each of the four external height references. The quality of each external DEM was initially assessed using ICESat filtered points. Then, the quality of, each TDX-based DEM was assessed using the more precise external DEM selected in the previous step. Results showed that both local (NCC) DEM and SRTM X-band performed the best (RMSE< 9m) for TDX-DEM generation. In contrast, ASTER GDEM v2 and SRTM C-band v4 showed poorer quality.

The development and role of megavoltage cone beam computerized tomography in radiation oncology

NASA Astrophysics Data System (ADS)

Morin, Olivier

External beam radiation therapy has now the ability to deliver doses that conform tightly to a tumor volume. The steep dose gradients planned in these treatments make it increasingly important to reproduce the patient position and anatomy at each treatment fraction. For this reason, considerable research now focuses on in-room three-dimensional imaging. This thesis describes the first clinical megavoltage cone beam computed tomography (MVCBCT) system, which utilizes a conventional linear accelerator equipped with an amorphous silicon flat panel detector. The document covers the system development and investigation of its clinical applications over the last 4-5 years. The physical performance of the system was evaluated and optimized for soft-tissue contrast resolution leading to recommendations of imaging protocols to use for specific clinical applications and body sites. MVCBCT images can resolve differences of 5% in electron density for a mean dose of 9 cGy. Hence, the image quality of this system is sufficient to differentiate some soft-tissue structures. The absolute positioning accuracy with MVCBCT is better than 1 mm. The accuracy of isodose lines calculated using MVCBCT images of head and neck patients is within 3% and 3 mm. The system shows excellent stability in image quality, CT# calibration, radiation exposure and absolute positioning over a period of 8 months. A procedure for MVCBCT quality assurance was developed. In our clinic, MVCBCT has been used to detect non rigid spinal cord distortions, to position a patient with a paraspinous tumor close to metallic hardware, to position prostate cancer patients using gold markers or soft-tissue landmarks, to monitor head and neck anatomical changes and their dosimetric consequences, and to complement the convention CT for treatment planning in presence of metallic implants. MVCBCT imaging is changing the clinical practice of our department by increasingly revealing patient-specific errors. New verification protocols are being developed to minimize those errors thus moving the practice of radiation therapy one step closer to personalized medicine.

How does context affect intimate relationships? linking external stress and cognitive processes within marriage.

PubMed

Neff, Lisa A; Karney, Benjamin R

2004-02-01

Stressors external to the marriage frequently affect the way spouses evaluate their marital quality. To date, however, understanding of the interplay between external stress and internal relationship processes has been limited in two ways. First, research has generally examined only the short-term consequences of stress. Second, the mechanisms through which external stressors influence relationship outcomes are unclear. This study addressed both limitations by examining relationship cognitions that may mediate the effects of external stress throughout 4 years of marriage. Analyses confirmed that stressful experiences were associated with the trajectory of marital quality overtime. Furthermore, both the content and the organization of spouses' specific relationship cognitions mediated this effect. That is, stress negatively influenced the nature of spouses' marital perceptions as well as the way spouses interpreted and processed those perceptions. These findings draw attention to ways that the context of relationships shapes and constrains relationship processes.

A rapid communication from the AAPM Task Group 201: recommendations for the QA of external beam radiotherapy data transfer. AAPM TG 201: quality assurance of external beam radiotherapy data transfer.

PubMed

Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Santanam, Lakshmi; Blodgett, Kurt; Curran, Bruce H; Engelsman, Martijn; Feng, Wenzheng; Mechalakos, Jim; Pavord, Dan; Simon, Tom; Sutlieff, Steven; Zhu, X Ronald

2010-12-04

The transfer of radiation therapy data among the various subsystems required for external beam treatments is subject to error. Hence, the establishment and management of a data transfer quality assurance program is strongly recommended. It should cover the QA of data transfers of patient specific treatments, imaging data, manually handled data and historical treatment records. QA of the database state (logical consistency and information integrity) is also addressed to ensure that accurate data are transferred.

Improved detection rates and treatment planning of head and neck cancer using dual-layer spectral CT.

PubMed

Lohöfer, Fabian K; Kaissis, Georgios A; Köster, Frances L; Ziegelmayer, Sebastian; Einspieler, Ingo; Gerngross, Carlos; Rasper, Michael; Noel, Peter B; Koerdt, Steffen; Fichter, Andreas; Rummeny, Ernst J; Braren, Rickmer F

2018-05-28

The aim of this study was to evaluate the advantages of dual-layer spectral CT (DLSCT) in detection and staging of head and neck cancer (HNC) as well as the imaging of tumour margins and infiltration depth compared to conventional contrast enhanced CT (CECT). Thirty-nine patients with a proven diagnosis of HNC were examined with a DLSCT scanner and retrospectively analysed. An age-matched healthy control group of the same size was used. Images were acquired in the venous phase. Virtual monoenergetic 40keV-equivalent (MonoE40) images were compared to CECT-images. Diagnostic confidence for tumour identification and margin detection was rated independently by four experienced observers. The steepness of the Hounsfield unit (HU)-increase at the tumour margin was analysed. External carotid artery branch image reconstructions were performed and their contrast compared to conventional arterial phase imaging. Means were compared using a Student's t-test. ANOVA was used for multiple comparisons. MonoE40 images were superior to CECT-images in tumour detection and margin delineation. MonoE40 showed significantly higher attenuation differences between tumour and healthy tissue compared to CECT-images (p < 0.001). The HU-increase at the boundary of the tumour was significantly steeper in MonoE40 images compared to CECT-images (p < 0.001). Iodine uptake in the tumour was significantly higher compared to healthy tissue (p < 0.001). MonoE40 compared to conventional images allowed visualisation of external carotid artery branches from the venous phase in a higher number of cases (87% vs. 67%). DLSCT enables improved detection of primary and recurrent head and neck cancer and quantification of tumour iodine uptake. Improved contrast of MonoE40 compared to conventional reconstructions enables higher diagnostic confidence concerning tumour margin detection and vessel identification. • Sensitivity concerning tumour detection are higher using dual-layer spectral-CT than conventional CT. • Lesion to background contrast in DLSCT is significantly higher than in CECT. • DLSCT provides sufficient contrast for evaluation of external carotid artery branches.

Disturbance observer-based fuzzy control for flexible spacecraft combined attitude & sun tracking system

NASA Astrophysics Data System (ADS)

Chak, Yew-Chung; Varatharajoo, Renuganth; Razoumny, Yury

2017-04-01

This paper investigates the combined attitude and sun-tracking control problem in the presence of external disturbances and internal disturbances, caused by flexible appendages. A new method based on Pythagorean trigonometric identity is proposed to drive the solar arrays. Using the control input and attitude output, a disturbance observer is developed to estimate the lumped disturbances consisting of the external and internal disturbances, and then compensated by the disturbance observer-based controller via a feed-forward control. The stability analysis demonstrates that the desired attitude trajectories are followed even in the presence of external disturbance and internal flexible modes. The main features of the proposed control scheme are that it can be designed separately and incorporated into the baseline controller to form the observer-based control system, and the combined attitude and sun-tracking control is achieved without the conventional attitude actuators. The attitude and sun-tracking performance using the proposed strategy is evaluated and validated through numerical simulations. The proposed control solution can serve as a fail-safe measure in case of failure of the conventional attitude actuator, which triggered by automatic reconfiguration of the attitude control components.

Removal of copper by oxygenated pyrolytic tire char: kinetics and mechanistic insights.

PubMed

Quek, Augustine; Balasubramanian, Rajashekhar

2011-04-01

The kinetics of copper ion (Cu(II)) removal from aqueous solution by pyrolytic tire char was modeled using five different conventional models. A modification to these models was also developed through a modified equation that accounts for precipitation. Conventional first- and second-order reaction models did not fit the copper sorption kinetics well, indicating a lack of simple rate-order dependency on solute concentration. Instead, a reversible first-order rate reaction showed the best fit to the data, indicating a dependence on surface functional groups. Due to the varying solution pH during the sorption process, modified external and internal mass transfer models were employed. Results showed that the sorption of copper onto oxygenated chars was limited by external mass transfer and internal resistance with and without the modification. However, the modification of the sorption process produced very different results for unoxygenated chars, which showed neither internal nor external limitation to sorption. Instead, its slow sorption rate indicates a lack of surface functional groups. The sorption of Cu(II) by oxygenated and unoxygenated chars was also found to occur via three and two distinct stages, respectively. Copyright © 2010 Elsevier Inc. All rights reserved.

Preliminary thermodynamic study for an efficient turbo-blower external combustion Rankine cycle

NASA Astrophysics Data System (ADS)

Romero Gómez, Manuel; Romero Gómez, Javier; Ferreiro Garcia, Ramón; Baaliña Insua, Álvaro

2014-08-01

This research paper presents a preliminary thermodynamic study of an innovative power plant operating under a Rankine cycle fed by an external combustion system with turbo-blower (TB). The power plant comprises an external combustion system for natural gas, where the combustion gases yield their thermal energy, through a heat exchanger, to a carbon dioxide Rankine cycle operating under supercritical conditions and with quasi-critical condensation. The TB exploits the energy from the pressurised exhaust gases for compressing the combustion air. The study is focused on the comparison of the combustion system's conventional technology with that of the proposed. An energy analysis is carried out and the effect of the flue gas pressure on the efficiency and on the heat transfer in the heat exchanger is studied. The coupling of the TB results in an increase in efficiency and of the convection coefficient of the flue gas with pressure, favouring a reduced volume of the heat exchanger. The proposed innovative system achieves increases in efficiency of around 12 % as well as a decrease in the heat exchanger volume of 3/5 compared with the conventional technology without TB.

75 FR 19971 - Science Advisory Board Staff Office; Notification of a Public Teleconference of the Clean Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Quality Standards--First External Review Draft (March 2010). DATES: The teleconference will be held on May... assessment documents titled Particulate Matter Urban-Focused Visibility Assessment: Second External Review Draft (January 2010) and Quantitative Health Risk Assessment for Particulate Matter: Second External...

[Indicators of water microbial pollution: problems and perspectives].

PubMed

Nusca, A; D'Alessandro, D; Funari, E

2008-01-01

Conventional indicators of fecal contamination provide a precious contribution in evaluating water microbiological quality. In recent years some important issues have sprung up which have risen doubts about their reliability and have suggested a revision of their function. In developed countries, where the law regarding water quality is very strict, there have been several outbreaks, even though conventional indicators of fecal pollution pointed an appropriate microbiological quality. These outbreaks have been imputed to new pathogenic microorganisms which are often characterized by a great resistance to disinfection treatments than conventional indicators. In order to obtain an appropriate microbiological quality of waters, various approaches have been started such as the Water Safety Plans by World Health Organization the revision of the functions of suitable indicators (of the water quality), the setting up of specific methods either for pathogen microorganisms and for a quick surveying of an inadequate microbiological water quality.

Nanoscale theranostics for physical stimulus-responsive cancer therapies.

PubMed

Chen, Qian; Ke, Hengte; Dai, Zhifei; Liu, Zhuang

2015-12-01

Physical stimulus-responsive therapies often employing multifunctional theranostic agents responsive to external physical stimuli such as light, magnetic field, ultra-sound, radiofrequency, X-ray, etc., have been widely explored as novel cancer therapy strategies, showing encouraging results in many pre-clinical animal experiments. Unlike conventional cancer chemotherapy which often accompanies with severe toxic side effects, physical stimulus-responsive agents usually are non-toxic by themselves and would destruct cancer cells only under specific external stimuli, and thus could offer greatly reduced toxicity and enhanced treatment specificity. In addition, physical stimulus-responsive therapies can also be combined with other traditional therapeutics to achieve synergistic anti-tumor effects via a variety of mechanisms. In this review, we will summarize the latest progress in the development of physical stimulus-responsive therapies, and discuss the important roles of nanoscale theranostic agents involved in those non-conventional therapeutic strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reshaping Light-Emitting Diodes To Increase External Efficiency

NASA Technical Reports Server (NTRS)

Rogowski, Robert; Egalon, Claudio

1995-01-01

Light-emitting diodes (LEDs) reshaped, according to proposal, increasing amount of light emitted by decreasing fraction of light trapped via total internal reflection. Results in greater luminous output power for same electrical input power; greater external efficiency. Furthermore, light emitted by reshaped LEDs more nearly collimated (less diffuse). Concept potentially advantageous for conventional red-emitting LEDs. More advantageous for new "blue" LEDs, because luminous outputs and efficiencies of these devices very low. Another advantage, proposed conical shapes achieved relatively easily by chemical etching of semiconductor surfaces.

Bilateral Deep Peroneal Nerve Paralysis Following Kerosene Self-Injection into External Hemorrhoids

PubMed Central

Rostami, Khalil; Farzaneh, Esmaeil; Abolhassani, Hassan

2010-01-01

Along with conventional therapies, some abrogated traditional treatment had been used for hemorrhoids like local Kerosene injection especially for extremely irritated external hemorrhoids. We report a rare case of Kerosene self-injection into the hemorrhoid. Despite antibiotics therapy, extent debridement, and colostomy, the patient died after 24 hours because of heart attack. Moreover, we discuss here the case with contact or injection of hydrocarbon materials and early care action to decrease the extensions of injury and side effects. PMID:20936130

The Indirect Effect of Family Cohesion on Children's Weight Status through Maternal Quality of Life and Children's Internalizing and Externalizing Symptoms

ERIC Educational Resources Information Center

Frontini, Roberta; Haycraft, Emma; Canavarro, Maria Cristina; Moreira, Helena

2017-01-01

Background: Obesity has serious psychosocial consequences for youth and family members and has reached epidemic levels in Portugal. Objective: This study had two goals: (1) to investigate differences in family cohesion, mothers' quality of life (QoL), and externalizing/internalizing symptoms between children/adolescents with healthy-weight and…

Assessing the Organisational Impact of External Quality Assurance: Hypothesising Key Dimensions and Mechanisms

ERIC Educational Resources Information Center

Stensaker, Bjørn; Leiber, Theodor

2015-01-01

The aim of the article is to provide a framework in which the organisational impact of external quality assurance (EQA) can be assessed. Based on existing studies of the impact of EQA in universities and colleges it is suggested that greater systematisation of how impact is measured is needed for a better understanding of how EQA can be used as a…

Longitudinal Associations between Externalizing Problems and Student-Teacher Relationship Quality for Young Children with ASD

ERIC Educational Resources Information Center

Eisenhower, Abbey S.; Blacher, Jan; Bush Hurst, Hillary

2015-01-01

The associations between student-teacher relationship (STR) quality and externalizing behavior problems in school were examined among 166 children with ASD (82% boys, ages 4-7 years) across three assessments over a 1.5-year period; IQs in the sample range from 50 to 139 (M = 88.7). Unlike other non-ASD populations, the association between STR…

Implementation of the External Quality Assessment Program in Brazil.

PubMed

Fleury, Marcos Kneip; Menezes, Maria Elizabeth; Correa, José Abol

2017-02-15

The External Quality Assessment (EQA) in Brazil is performed by the National Health Ministry for diseases that are under supervision of Public Health Department. In addition to the government program, the Brazilian Society of Clinical Analysis and the Brazilian Society of Medical Pathology are allowed to provide their programs under the Supervision of National Agency for Sanitary Surveillance (ANVISA) that regulates laboratories to perform EQA programs.

Repeatability and Reproducibility of Virtual Subjective Refraction.

PubMed

Perches, Sara; Collados, M Victoria; Ares, Jorge

2016-10-01

To establish the repeatability and reproducibility of a virtual refraction process using simulated retinal images. With simulation software, aberrated images corresponding with each step of the refraction process were calculated following the typical protocol of conventional subjective refraction. Fifty external examiners judged simulated retinal images until the best sphero-cylindrical refraction and the best visual acuity were achieved starting from the aberrometry data of three patients. Data analyses were performed to assess repeatability and reproducibility of the virtual refraction as a function of pupil size and aberrometric profile of different patients. SD values achieved in three components of refraction (M, J0, and J45) are lower than 0.25D in repeatability analysis. Regarding reproducibility, we found SD values lower than 0.25D in the most cases. When the results of virtual refraction with different pupil diameters (4 and 6 mm) were compared, the mean of differences (MoD) obtained were not clinically significant (less than 0.25D). Only one of the aberrometry profiles with high uncorrected astigmatism shows poor results for the M component in reproducibility and pupil size dependence analysis. In all cases, vision achieved was better than 0 logMAR. A comparison between the compensation obtained with virtual and conventional subjective refraction was made as an example of this application, showing good quality retinal images in both processes. The present study shows that virtual refraction has similar levels of precision as conventional subjective refraction. Moreover, virtual refraction has also shown that when high low order astigmatism is present, the refraction result is less precise and highly dependent on pupil size.

An overview of the European Organization for External Quality Assurance Providers in Laboratory Medicine (EQALM)

PubMed Central

Stavelin, Anne; Albe, Xavier; Meijer, Piet; Sarkany, Erika; MacKenzie, Finlay

2017-01-01

The European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) was founded in 1996 and currently has members from 29 European countries and 6 countries from outside Europe. EQALM provides a forum for co-operation and exchange of knowledge on quality-related matters in laboratory medicine, especially with regard to external quality assessment (EQA) programs in Europe. In addition, EQALM represent the EQA providers in laboratory medicine at European level vis-ŕ-vis political, professional, scientific and other bodies, including patients’ organisations. To this end EQALM promotes activities such as organizing meetings with scientific and practical themes for members and other interested parties, issuing scientific publications, developing EQA projects and representing laboratory medicine EQA activities within other organisations and networks. EQALM is active in scientific and educational activity in different fields such as survey frequency, haematology, haemostasis, microbiology, nomenclature, virtual microscopy, traceability, accreditation, and quality assurance of the total testing process. The aim of this paper is to give an overview of the EQALM organisation. PMID:28392724

Analytical performance evaluation of a high-volume hematology laboratory utilizing sigma metrics as standard of excellence.

PubMed

Shaikh, M S; Moiz, B

2016-04-01

Around two-thirds of important clinical decisions about the management of patients are based on laboratory test results. Clinical laboratories are required to adopt quality control (QC) measures to ensure provision of accurate and precise results. Six sigma is a statistical tool, which provides opportunity to assess performance at the highest level of excellence. The purpose of this study was to assess performance of our hematological parameters on sigma scale in order to identify gaps and hence areas of improvement in patient care. Twelve analytes included in the study were hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), mean corpuscular volume (MCV), red cell distribution width (RDW), total leukocyte count (TLC) with percentages of neutrophils (Neutr%) and lymphocytes (Lymph %), platelet count (Plt), mean platelet volume (MPV), prothrombin time (PT), and fibrinogen (Fbg). Internal quality control data and external quality assurance survey results were utilized for the calculation of sigma metrics for each analyte. Acceptable sigma value of ≥3 was obtained for the majority of the analytes included in the analysis. MCV, Plt, and Fbg achieved value of <3 for level 1 (low abnormal) control. PT performed poorly on both level 1 and 2 controls with sigma value of <3. Despite acceptable conventional QC tools, application of sigma metrics can identify analytical deficits and hence prospects for the improvement in clinical laboratories. © 2016 John Wiley & Sons Ltd.

Computer vision for automatic inspection of agricultural produce

NASA Astrophysics Data System (ADS)

Molto, Enrique; Blasco, Jose; Benlloch, Jose V.

1999-01-01

Fruit and vegetables suffer different manipulations from the field to the final consumer. These are basically oriented towards the cleaning and selection of the product in homogeneous categories. For this reason, several research projects, aimed at fast, adequate produce sorting and quality control are currently under development around the world. Moreover, it is possible to find manual and semi- automatic commercial system capable of reasonably performing these tasks.However, in many cases, their accuracy is incompatible with current European market demands, which are constantly increasing. IVIA, the Valencian Research Institute of Agriculture, located in Spain, has been involved in several European projects related with machine vision for real-time inspection of various agricultural produces. This paper will focus on the work related with two products that have different requirements: fruit and olives. In the case of fruit, the Institute has developed a vision system capable of providing assessment of the external quality of single fruit to a robot that also receives information from other senors. The system use four different views of each fruit and has been tested on peaches, apples and citrus. Processing time of each image is under 500 ms using a conventional PC. The system provides information about primary and secondary color, blemishes and their extension, and stem presence and position, which allows further automatic orientation of the fruit in the final box using a robotic manipulator. Work carried out in olives was devoted to fast sorting of olives for consumption at table. A prototype has been developed to demonstrate the feasibility of a machine vision system capable of automatically sorting 2500 kg/h olives using low-cost conventional hardware.

A special ionisation chamber for quality control of diagnostic and mammography X ray equipment.

PubMed

Costa, A M; Caldas, L V E

2003-01-01

A quality control program for X ray equipment used for conventional radiography and mammography requires the constancy check of the beam qualities in terms of the half-value layers. In this work, a special double-faced parallel-plate ionisation chamber was developed with inner electrodes of different materials, in a tandem system. Its application will be in quality control programs of diagnostic and mammography X ray equipment for confirmation of half-value layers previously determined by the conventional method. Moreover, the chamber also may be utilised for measurements of air kerma values (and air kerma rates) in X radiation fields used for conventional radiography and mammography. The chamber was studied in relation to the characteristics of saturation, ion collection efficiency, polarity effects, leakage current, and short-term stability. The energy dependence in response of each of the two faces of the chamber was determined over the conventional radiography and mammography X ray ranges (unattenuated beams). The different energy response of the two faces of the chamber allowed the formation of a tandem system useful for the constancy check of beam qualities.

Brachytherapy for Buccal Cancer: From Conventional Low Dose Rate (LDR) or Mold Technique to High Dose Rate Interstitial Brachytherapy (HDR-ISBT).

PubMed

Kotsuma, Tadayuki; Yamazaki, Hideya; Masui, Koji; Yoshida, Ken; Shimizutani, Kimishige; Akiyama, Hironori; Murakami, Shumei; Isohashi, Fumiaki; Yoshioka, Yasuo; Ogawa, Kazuhiko; Tanaka, Eiichi

2017-12-01

To examine the effectiveness of newly-installed high-dose-rate interstitial brachytherapy (HDR-ISBT) for buccal cancer. We retrospectively reviewed 36 patients (25 men and 11 women) with buccal cancer treated with curative brachytherapy with or without external radiotherapy with a median follow-up of 99 months. A total of 15 HDR-ISBT (median 48 Gy/ 8 fractions, range=24-60 Gy) patients were compared to conventional 15 cases LDR-ISBT (70 Gy, range=42.8-110 Gy) and 7 molds techniques (15 Gy, range=9-74 Gy). A total of 31 patients also underwent external radiotherapy (30 Gy, range=24-48 Gy). They comprised of 3T1, 23 T2, 8 T3, 3 T4 including 11 node positive cases. HDR-ISBT provided 82% of local control rate at 5 years, whereas conventional brachytherapy showed 72% [p=0.44; LDR-ISBT (65%), mold therapy (85.7%)]. Patients with early lesions (T1-2 or stage I-II) showed better local control rates than those with advanced lesions (T3-4 or stage III-IV). Severe late grade 3 complications developed in two patients treated with LDR-ISBT and EBRT. There is no significant difference in toxicity grade ≤2 between conventional brachytherapy (5/15=33%) and HDR-ISBT (7/32=32%, p=0.92). HDR-ISBT achieved good and comparable local control rates to conventional brachytherapy without elevating the toxicity. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

External root resorption with the self-ligating Damon system-a retrospective study.

PubMed

Handem, Roberta Heiffig; Janson, Guilherme; Matias, Murilo; de Freitas, Karina Maria Salvatore; de Lima, Darwin Vaz; Garib, Daniela Gamba; de Freitas, Marcos Roberto

2016-12-01

The aim of this study was to compare the degree of external apical root resorption (EARR) in patients treated with self-ligating Damon appliances and with conventional preadjusted appliances. The sample comprised 52 patients, divided into two groups. Group 1 consisted of 25 patients treated with self-ligating Damon appliances, with an initial age of 16.04 years, final age of 18.06 years, and treatment time of 2.02 years. Group 2 consisted of 27 patients, treated with conventional preadjusted appliances, with an initial age of 16.77 years, final age of 18.47 years and treatment time of 1.70 years. The groups were matched regarding the initial and final ages, treatment time, type of malocclusion, and treatment protocol without extractions. Root resorption was evaluated on periapical radiographs of the maxillary and mandibular incisors at the end of orthodontic treatment with the scores of Levander and Malmgren. Intergroup comparisons of root resorption were performed with Mann-Whitney tests. No significant difference in the degree of root resorption between the two groups was found. Similar degrees of resorption can be expected after non-extraction treatment with Damon self-ligating or conventional preadjusted appliances.

Authentication of organic feed by near-infrared spectroscopy combined with chemometrics: a feasibility study.

PubMed

Tres, A; van der Veer, G; Perez-Marin, M D; van Ruth, S M; Garrido-Varo, A

2012-08-22

Organic products tend to retail at a higher price than their conventional counterparts, which makes them susceptible to fraud. In this study we evaluate the application of near-infrared spectroscopy (NIRS) as a rapid, cost-effective method to verify the organic identity of feed for laying hens. For this purpose a total of 36 organic and 60 conventional feed samples from The Netherlands were measured by NIRS. A binary classification model (organic vs conventional feed) was developed using partial least squares discriminant analysis. Models were developed using five different data preprocessing techniques, which were externally validated by a stratified random resampling strategy using 1000 realizations. Spectral regions related to the protein and fat content were among the most important ones for the classification model. The models based on data preprocessed using direct orthogonal signal correction (DOSC), standard normal variate (SNV), and first and second derivatives provided the most successful results in terms of median sensitivity (0.91 in external validation) and median specificity (1.00 for external validation of SNV models and 0.94 for DOSC and first and second derivative models). A previously developed model, which was based on fatty acid fingerprinting of the same set of feed samples, provided a higher sensitivity (1.00). This shows that the NIRS-based approach provides a rapid and low-cost screening tool, whereas the fatty acid fingerprinting model can be used for further confirmation of the organic identity of feed samples for laying hens. These methods provide additional assurance to the administrative controls currently conducted in the organic feed sector.

External Quality Monitoring of the Cervical Cytopathological Exams in the Rio de Janeiro City.

PubMed

Rocha, Vânia Stiepanowez de Oliveira; Malfacini, Solange da Silva; Gomes, Alex Moreira; Rocha, Cláudia Ramos Marques da

2018-06-20

 To discuss the implementation and contributions of the External Quality Monitoring in the city of Rio de Janeiro and to analyze the performance of the main providers of cervical cytopathology in this city from September 2013 to March 2017, here referred to as "Alpha laboratory" and "Beta laboratory."  Observational, cross-sectional, retrospective study using information from the Cervical Cancer Control Information System (SISCOLO, in the Portuguese acronym), municipal coordination module, External Quality Monitoring report. The proportions of false positives, false negatives, unsatisfactory samples and rejected samples were estimated. The agreement among the observers was analyzed through the Kappa index and the reduction of disagreements in the period for each laboratory studied, comparing the results of each cycle.  A total of 19,158 examinations were selected, of which 19,130 (99.85%) were monitored, 16.649 (87, 03%) were reviewed by the External Quality Monitoring Unit, 2,481 (12,97%) were rejected and 441 (2,65%) were considered unsatisfactory. The "Beta laboratory" presented excellent concordance in all cycles; the "Alpha laboratory" had good concordance in the first two cycles (K = 0.76 and 0.79), becoming excellent in the following four cycles. The average Kappa index was 0.85, with median of 0.86. The percentage of diagnostic disagreement was 6.63% of the reviewed exams, of which 5.38% required a change of conduct CONCLUSION:  External Quality Monitoring is an exercise in diagnostic improvement, and its implementation was fundamental to ensure the reliability of the cytopathological exams in the city of Rio de Janeiro. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries

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

Smolders, R., E-mail: roel.smolders@vito.be; Den Hond, E.; Koppen, G.

In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother–child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality andmore » lifestyle. In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making. - Highlights: • External data was collected to interpret HBM data from DEMOCOPHES. • Hg in hair could be related to fish consumption across different countries. • Urinary cotinine was related to strictness of anti-smoking legislation. • Urinary Cd was borderline significantly related to air and food quality. • Lack of comparable data among countries hampered the analysis.« less

Quality management, a directive approach to patient safety.

PubMed

Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan

Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

[Quality management in pathology--an executive function and political implications].

PubMed

Turzynski, A

2013-09-01

Quality management (QM) is primarily an in-house executive function. It conduces to ensure a high quality service and has the external object to satisfy customer expectations. In Germany the implementation of quality management systems (QMS) is made compulsory for all medical facilities by law. However, details are not regulated and there is no need to certify the in-house QMS. Within the last 10 years many pathology institutions have become certified or accredited and have implemented voluntary measures of external quality assurance, such as quality circles and round robin trials. For non-certified institutions it might be helpful to be guided by established QM standards like the ISO 9001:2008. The fundamental concepts of QM, some pathology-specific aspects and some implications for the professional associations are discussed in this article.

Quality and Safety in Health Care, Part XIV: The External Environment and Research for Diagnostic Processes.

PubMed

Harolds, Jay A

2016-09-01

The work system in which diagnosis takes place is affected by the external environment, which includes requirements such as certification, accreditation, and regulations. How errors are reported, malpractice, and the system for payment are some other aspects of the external environment. Improving the external environment is expected to decrease errors in diagnosis. More research on improving the diagnostic process is needed.

External built residential environment characteristics that affect mental health of adults.

PubMed

Ochodo, Charles; Ndetei, D M; Moturi, W N; Otieno, J O

2014-10-01

External built residential environment characteristics include aspects of building design such as types of walls, doors and windows, green spaces, density of houses per unit area, and waste disposal facilities. Neighborhoods that are characterized by poor quality external built environment can contribute to psychosocial stress and increase the likelihood of mental health disorders. This study investigated the relationship between characteristics of external built residential environment and mental health disorders in selected residences of Nakuru Municipality, Kenya. External built residential environment characteristics were investigated for 544 residents living in different residential areas that were categorized by their socioeconomic status. Medically validated interview schedules were used to determine mental health of residents in the respective neighborhoods. The relationship between characteristics of the external built residential environment and mental health of residents was determined by multivariable logistic regression analyses and chi-square tests. The results show that walling materials used on buildings, density of dwelling units, state of street lighting, types of doors, states of roofs, and states of windows are some built external residential environment characteristics that affect mental health of adult males and females. Urban residential areas that are characterized by poor quality external built environment substantially expose the population to daily stressors and inconveniences that increase the likelihood of developing mental health disorders.

Quality of herbal medicines: challenges and solutions.

PubMed

Zhang, Junhua; Wider, Barbara; Shang, Hongcai; Li, Xuemei; Ernst, Edzard

2012-01-01

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of herbal medicines can be classified into two categories: external and internal. In this review, external issues including contamination (e.g. toxic metals, pesticides residues and microbes), adulteration and misidentification are detailed. Complexity and non-uniformity of the ingredients in herbal medicines are the internal issues affecting the quality of herbal medicines. Solutions to the raised problems are discussed. The rigorous implementation of Good Agricultural and Collection Practices (GACP) and Good Manufacturing Practices (GMP) would undoubtedly reduce the risk of external issues. Through the use of modern analytical methods and pharmaceutical techniques, previously unsolved internal issues have become solvable. Standard herbal products can be manufactured from the standard herbal extracts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effect of a commercial housing system on egg quality during extended storage.

PubMed

Jones, D R; Karcher, D M; Abdo, Z

2014-05-01

Egg producers in the United States are utilizing a variety of commercial egg production systems to provide consumer choice and meet legislative requirements. Consumer egg grades in the United States were developed for conventional cage production, and it is unclear what effect alternative production systems might have on egg quality during retail and consumer home storage. The current study was undertaken to determine what changes in egg quality characteristics occur during extended cold storage for commercially produced conventional cage, enriched colony cage, and cage-free aviary eggs. During 12 wk of cold storage, egg weight, albumen height, Haugh unit, static compression shell strength, vitelline membrane strength and deformation, yolk index, shell dynamic stiffness, and whole egg total solids were monitored. Overall, aviary and enriched eggs were significantly (P < 0.05) heavier than conventional cage. Albumen height and Haugh unit (P < 0.05) were significantly greater for conventional cage than enriched eggs. Static compression shell strength was greatest (P < 0.05) for enriched eggs compared with aviary. No overall housing system effects for yolk measurements, shell dynamic stiffness, or whole egg total solids were observed. Albumen height, Haugh unit, and yolk quality measurements were all greatest at 0 and lowest at 12 wk of storage (P < 0.05). The rate of quality change among the housing systems for each measured attribute at 4, 6, and 12 wk was determined. Other than differences in the change of egg weight at 4 wk, no significant differences in the rate of quality decline were found among the housing systems. The results of the current study indicate that current US egg quality standards should effectively define quality for commercially produced conventional cage, enriched colony cage, and cage-free aviary eggs.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2011].

PubMed

Ruiz de Gopegui Bordes, Enrique; Guna Serrano, M del Remedio; Orta Mira, Nieves; Ovies, María Rosario; Poveda, Marta; Gimeno Cardona, Concepción

2013-02-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. This article presents the most relevant conclusions and lessons from the 2011 controls. Overall, the results obtained in 2011 confirm the excellent skill and good technical standards found in previous years. Nevertheless, erroneous results can be obtained in any laboratory and in clinically relevant determinations. The results of this program highlight the need to implement both internal and external controls, such as those offered by the SEIMC program, in order to ensure maximal quality of microbiological tests. Copyright © 2013 Elsevier España, S.L. All rights reserved.

[Quality management in a public health agency].

PubMed

Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

2012-01-01

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Examining the Assessment Literacy of External Examiners

ERIC Educational Resources Information Center

Medland, Emma

2015-01-01

External scrutiny of higher education courses is evident globally, but the use of an external examiner from another institution for the purposes of quality assurance has been a distinguishing feature of UK higher education since the 1830s. However, the changing higher education context has led to mounting criticism of the system and the…

78 FR 14538 - Notification of a Public Teleconference of the Clean Air Scientific Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... Assessment for Lead (Third External Review Draft--November 2012) and EPA's Policy Assessment for the Review of the Lead National Ambient Air Quality Standards (First External Review Draft--January 2013). DATES... CASAC will hold a public teleconference review its draft letters on EPA's third external review draft of...

External pH changes affect NMDA-evoked and spontaneous release of cholecystokinin, somatostatin and noradrenaline from rat cerebrocortical nerve endings.

PubMed

Gemignani, Anita; Paudice, Paolo; Longordo, Fabio; Raiteri, Maurizio

2004-10-01

It was previously reported that the K+-evoked release of somatostatin-like immunoreactivity (SRIF-LI) and of cholecystokinin-like immunoreactivity (CCK-LI) from superfused rat cerebrocortical synaptosomes can be enhanced by NMDA or D-serine alone. We here studied the effects of extraterminal pH changes on SRIF-LI and CCK-LI release. Lowering pH from 7.4 to 6.9 or 6.4 abolished the effects of NMDA or D-serine on the K+-evoked peptide release. Identical results were obtained when external pH was raised to 8 or 8.7. Sudden alkalinization of the superfusion medium, in absence of K+-depolarization, induced SRIF-LI or CCK-LI release which was insensitive to NMDA. Based on experiments in Ca2+-free medium and with voltage-sensitive Ca2+ channel (VSCC) blockers, the pH 8.7-induced release of SRIF-LI and CCK-LI was only in part (30-50%) dependent on external Ca2+ and Ca2+ channel activation. In contrast, the alkalinization-evoked release of [3H]noradrenaline was highly sensitive to external Ca2+ removal and to blockade of Ca2+ channels with omega-conotoxins. The pH 8.7-evoked SRIF-LI and CCK-LI was about halved in synaptosomes intoxicated with botulinum toxin C1. The results suggest that the pH-sensitive NMDA receptors mediating somatostatin and cholecystokinin release contain NR1 subunits lacking the exon-5 cassette. Alkalinization represents a novel releasing stimulus which elicits neuropeptide release in part by conventional exocytosis and largely by an external Ca2+-independent mechanism. Differently, the release of noradrenaline provoked by alkalinization occurs entirely by conventional exocytosis.

Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

PubMed

Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

2014-09-01

To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

PubMed Central

Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Atua, Benjamin; Sheshe, Nicole; Kanza, Albert; Mayunda, Jean Bosco; Mongita, Briston; Senga, Raphaël; Ngoyi, John; Muyembe, Jean-Jacques; Jacobs, Jan

2013-01-01

Abstract Objective To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. Methods A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113 530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Findings Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. Conclusion The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern. PMID:24052681

[Comparison of root resorption between self-ligating and conventional brackets using cone-beam CT].

PubMed

Liu, Yun; Guo, Hong-ming

2016-04-01

To analyze the differences of root resorption between passive self-ligating and conventional brackets, and to determine the relationship between passive self-ligating brackets and root resorption. Fifty patients were randomly divided into 2 groups using passive self-ligating brackets or conventional straight wire brackets (0.022 system), respectively. Cone-beam CT was taken before and after treatment. The amount of external apical root resorption of maxillary incisors was measured on CBCT images. Student's t test was performed to analyze the differences of root apical resorption between the 2 groups with SPSS17.0 software package. No significant difference(P> 0.05) in root resorption of maxillary incisors was found between passive self-ligating brackets and conventional brackets. Passive self-ligating brackets and conventional brackets can cause root resorption, but the difference was not significant. Passive self-ligating brackets do not induce more root resorption.

Nearly 100% triplet harvesting in conventional fluorescent dopant-based organic light-emitting devices through energy transfer from exciplex.

PubMed

Liu, Xiao-Ke; Chen, Zhan; Zheng, Cai-Jun; Chen, Miao; Liu, Wei; Zhang, Xiao-Hong; Lee, Chun-Sing

2015-03-25

Nearly 100% triplet harvesting in conventional fluorophor-based organic light-emitting devices is realized through energy transfer from exciplex. The best C545T-doped device using the exciplex host exhibits a maximum current efficiency of 44.0 cd A(-1) , a maximum power efficiency of 46.1 lm W(-1) , and a maximum external quantum efficiency of 14.5%. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

External jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies.

PubMed

Abdullah, Mohamed Hussein; Soliman, Hossam El Deen; Morad, Wessam Saber

2011-12-01

Many centers have adopted central vein cannulation both for central venous pressure monitoring and fluid administration for right hepatectomy in living-liver donors. However, use of central venous catheters is associated with adverse events that are hazardous to patients and expensive to treat. This study sought to examine the use of external jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies Forty ASA grade I adult living liver-donors without a known history of significant cardiac or pulmonary diseases were enrolled in this prospective observational study. Paired measurement of venous pressures (external jugular venous pressure and internal jugular venous pressure) were taken at the following times: after induction of anesthesia, 30 minutes after skin incision, during right lobe mobilization (every 15 minutes), during hepatic transaction (every 15 minutes), after right lobe resection (every 15 minutes), and after abdominal closure. Paired measurements were equal in 47.5%, 53.5%, 61.5%, 46.3%, and 52.5% for after induction, after skin incision, right lobe mobilization, right lobe transection, after resection, and before abdominal closure periods. However, all measurements were within acceptable limits of bias measurements (± 2 mm Hg). Central venous pressure catheter placement can be avoided and replaced by a less-invasive method such as external jugular venous pressure (which gave an acceptable estimate of central venous pressure in all phases of right lobe resection) in living-donor liver transplant and allowed equivalent monitor even during fluid restriction phases.

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange

PubMed Central

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-01-01

Objectives The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. Setting NHS commissioning organisations and private and not-for-profit providers. Design Mixed methods case study of eight cases. Data collection 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Analysis Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. Results In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. Conclusions NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital component of commissioning and should be embedded in external provider contracts. PMID:25716174

The Relevance of External Quality Assessment for Molecular Testing for ALK Positive Non-Small Cell Lung Cancer: Results from Two Pilot Rounds Show Room for Optimization

PubMed Central

Tembuyser, Lien; Tack, Véronique; Zwaenepoel, Karen; Pauwels, Patrick; Miller, Keith; Bubendorf, Lukas; Kerr, Keith; Schuuring, Ed; Thunnissen, Erik; Dequeker, Elisabeth M. C.

2014-01-01

Background and Purpose Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012–2013. Materials and Methods Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images. Results Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images. Conclusion There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing. PMID:25386659

The relevance of external quality assessment for molecular testing for ALK positive non-small cell lung cancer: results from two pilot rounds show room for optimization.

PubMed

Tembuyser, Lien; Tack, Véronique; Zwaenepoel, Karen; Pauwels, Patrick; Miller, Keith; Bubendorf, Lukas; Kerr, Keith; Schuuring, Ed; Thunnissen, Erik; Dequeker, Elisabeth M C

2014-01-01

Molecular profiling should be performed on all advanced non-small cell lung cancer with non-squamous histology to allow treatment selection. Currently, this should include EGFR mutation testing and testing for ALK rearrangements. ROS1 is another emerging target. ALK rearrangement status is a critical biomarker to predict response to tyrosine kinase inhibitors such as crizotinib. To promote high quality testing in non-small cell lung cancer, the European Society of Pathology has introduced an external quality assessment scheme. This article summarizes the results of the first two pilot rounds organized in 2012-2013. Tissue microarray slides consisting of cell-lines and resection specimens were distributed with the request for routine ALK testing using IHC or FISH. Participation in ALK FISH testing included the interpretation of four digital FISH images. Data from 173 different laboratories was obtained. Results demonstrate decreased error rates in the second round for both ALK FISH and ALK IHC, although the error rates were still high and the need for external quality assessment in laboratories performing ALK testing is evident. Error rates obtained by FISH were lower than by IHC. The lowest error rates were observed for the interpretation of digital FISH images. There was a large variety in FISH enumeration practices. Based on the results from this study, recommendations for the methodology, analysis, interpretation and result reporting were issued. External quality assessment is a crucial element to improve the quality of molecular testing.

Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.

PubMed

Shang, Aijing; Huwiler-Müntener, Karin; Nartey, Linda; Jüni, Peter; Dörig, Stephan; Sterne, Jonathan A C; Pewsner, Daniel; Egger, Matthias

Homoeopathy is widely used, but specific effects of homoeopathic remedies seem implausible. Bias in the conduct and reporting of trials is a possible explanation for positive findings of trials of both homoeopathy and conventional medicine. We analysed trials of homoeopathy and conventional medicine and estimated treatment effects in trials least likely to be affected by bias. Placebo-controlled trials of homoeopathy were identified by a comprehensive literature search, which covered 19 electronic databases, reference lists of relevant papers, and contacts with experts. Trials in conventional medicine matched to homoeopathy trials for disorder and type of outcome were randomly selected from the Cochrane Controlled Trials Register (issue 1, 2003). Data were extracted in duplicate and outcomes coded so that odds ratios below 1 indicated benefit. Trials described as double-blind, with adequate randomisation, were assumed to be of higher methodological quality. Bias effects were examined in funnel plots and meta-regression models. 110 homoeopathy trials and 110 matched conventional-medicine trials were analysed. The median study size was 65 participants (range ten to 1573). 21 homoeopathy trials (19%) and nine (8%) conventional-medicine trials were of higher quality. In both groups, smaller trials and those of lower quality showed more beneficial treatment effects than larger and higher-quality trials. When the analysis was restricted to large trials of higher quality, the odds ratio was 0.88 (95% CI 0.65-1.19) for homoeopathy (eight trials) and 0.58 (0.39-0.85) for conventional medicine (six trials). Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.

42 CFR 460.140 - Additional quality assessment activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Additional quality assessment activities. 460.140... FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality assessment activities. A PACE organization must meet external quality assessment and reporting requirements...

Enhancing DInSAR capabilities for landslide monitoring by applying GIS-based multicriteria filtering analysis

NASA Astrophysics Data System (ADS)

Beyene, F.; Knospe, S.; Busch, W.

2015-04-01

Landslide detection and monitoring remain difficult with conventional differential radar interferometry (DInSAR) because most pixels of radar interferograms around landslides are affected by different error sources. These are mainly related to the nature of high radar viewing angles and related spatial distortions (such as overlays and shadows), temporal decorrelations owing to vegetation cover, and speed and direction of target sliding masses. On the other hand, GIS can be used to integrate spatial datasets obtained from many sources (including radar and non-radar sources). In this paper, a GRID data model is proposed to integrate deformation data derived from DInSAR processing with other radar origin data (coherence, layover and shadow, slope and aspect, local incidence angle) and external datasets collected from field study of landslide sites and other sources (geology, geomorphology, hydrology). After coordinate transformation and merging of data, candidate landslide representing pixels of high quality radar signals were filtered out by applying a GIS based multicriteria filtering analysis (GIS-MCFA), which excludes grid points in areas of shadow and overlay, low coherence, non-detectable and non-landslide deformations, and other possible sources of errors from the DInSAR data processing. At the end, the results obtained from GIS-MCFA have been verified by using the external datasets (existing landslide sites collected from fieldworks, geological and geomorphologic maps, rainfall data etc.).

Effect of using reporting guidelines during peer review on quality of final manuscripts submitted to a biomedical journal: masked randomised trial

PubMed Central

Cortés, J; Ribera, J M; Cardellach, F; Selva-O’Callaghan, A; Kostov, B; García, L; Cirugeda, L; Altman, D G; González, J A; Sànchez, J A; Miras, F; Urrutia, A; Fonollosa, V; Rey-Joly, C; Vilardell, M

2011-01-01

Objective To investigate the effect of an additional review based on reporting guidelines such as STROBE and CONSORT on quality of manuscripts. Design Masked randomised trial. Population Original research manuscripts submitted to the Medicina Clínica journal from May 2008 to April 2009 and considered suitable for publication. Intervention Control group: conventional peer reviews alone. Intervention group: conventional review plus an additional review looking for missing items from reporting guidelines. Outcomes Manuscript quality, assessed with a 5 point Likert scale (primary: overall quality; secondary: average quality of specific items in paper). Main analysis compared groups as allocated, after adjustment for baseline factors (analysis of covariance); sensitivity analysis compared groups as reviewed. Adherence to reviewer suggestions assessed with Likert scale. Results Of 126 consecutive papers receiving conventional review, 34 were not suitable for publication. The remaining 92 papers were allocated to receive conventional reviews alone (n=41) or additional reviews (n=51). Four papers assigned to the conventional review group deviated from protocol; they received an additional review based on reporting guidelines. We saw an improvement in manuscript quality in favour of the additional review group (comparison as allocated, 0.25, 95% confidence interval –0.05 to 0.54; as reviewed, 0.33, 0.03 to 0.63). More papers with additional reviews than with conventional reviews alone improved from baseline (22 (43%) v eight (20%), difference 23.6% (3.2% to 44.0%), number needed to treat 4.2 (from 2.3 to 31.2), relative risk 2.21 (1.10 to 4.44)). Authors in the additional review group adhered more to suggestions from conventional reviews than to those from additional reviews (average increase 0.43 Likert points (0.19 to 0.67)). Conclusions Additional reviews based on reporting guidelines improve manuscript quality, although the observed effect was smaller than hypothesised and not definitively demonstrated. Authors adhere more to suggestions from conventional reviews than to those from additional reviews, showing difficulties in adhering to high methodological standards at the latest research phases. To boost paper quality and impact, authors should be aware of future requirements of reporting guidelines at the very beginning of their study. Trial registration and protocol Although registries do not include trials of peer review, the protocol design was submitted to sponsored research projects (Instituto de Salud Carlos III, PI081903). PMID:22108262

The 2005 meta-analysis of homeopathy: the importance of post-publication data.

PubMed

Rutten, A L B; Stolper, C F

2008-10-01

There is a discrepancy between the outcome of a meta-analysis published in 1997 of 89 trials of homeopathy by Linde et al and an analysis of 110 trials by Shang et al published in 2005, these reached opposite conclusions. Important data were not mentioned in Shang et al's paper, but only provided subsequently. What was the outcome of Shang et al's predefined hypotheses? Were the homeopathic and conventional trials comparable? Was subgroup selection justified? The possible role of ineffective treatments. Was the conclusion about effect justified? Were essential data missing in the original article? Analysis of post-publication data. Re-extraction and analysis of 21 higher quality trials selected by Shang et al with sensitivity analysis for the influence of single indications. Analysis of comparability. Sensitivity analysis of influence of subjective choices, like quality of single indications and of cut-off values for 'larger samples'. The quality of trials of homeopathy was better than of conventional trials. Regarding smaller trials, homeopathy accounted for 14 out of 83 and conventional medicine 2 out of 78 good quality trials with n<100. There was selective inclusion of unpublished trials only for homeopathy. Quality was assessed differently from previous analyses. Selecting subgroups on sample size and quality caused incomplete matching of homeopathy and conventional trials. Cut-off values for larger trials differed between homeopathy and conventional medicine without plausible reason. Sensitivity analyses for the influence of heterogeneity and the cut-off value for 'larger higher quality studies' were missing. Homeopathy is not effective for muscle soreness after long distance running, OR=1.30 (95% CI 0.96-1.76). The subset of homeopathy trials on which the conclusion was based was heterogeneous, comprising 8 trials on 8 different indications, and was not matched on indication with those of conventional medicine. Essential data were missing in the original paper. Re-analysis of Shang's post-publication data did not support the conclusion that homeopathy is a placebo effect. The conclusion that homeopathy is and that conventional is not a placebo effect was not based on comparative analysis and not justified because of heterogeneity and lack of sensitivity analysis. If we confine ourselves to the predefined hypotheses and the part of the analysis that is indeed comparative, the conclusion should be that quality of homeopathic trials is better than of conventional trials, for all trials (p=0.03) as well as for smaller trials (p=0.003).

Computed lateral rate and acceleration power spectral response of conventional and STOL airplanes to atmospheric turbulence

NASA Technical Reports Server (NTRS)

Lichtenstein, J. H.

1975-01-01

Power-spectral-density calculations were made of the lateral responses to atmospheric turbulence for several conventional and short take-off and landing (STOL) airplanes. The turbulence was modeled as three orthogonal velocity components, which were uncorrelated, and each was represented with a one-dimensional power spectrum. Power spectral densities were computed for displacements, rates, and accelerations in roll, yaw, and sideslip. In addition, the power spectral density of the transverse acceleration was computed. Evaluation of ride quality based on a specific ride quality criterion was also made. The results show that the STOL airplanes generally had larger values for the rate and acceleration power spectra (and, consequently, larger corresponding root-mean-square values) than the conventional airplanes. The ride quality criterion gave poorer ratings to the STOL airplanes than to the conventional airplanes.

[Quality management and consumer orientation: survey of referring pediatricians of a Berlin pediatric clinic].

PubMed

Lüthy, A; Lotze, I; Leiske, M; Rossi, R

2000-01-01

Quality management in hospitals not only includes performance according to international medical standards but also the optimization of processes regarding internal staff as well as external customers. Total Quality Management (TQM) and the Business Excellence Model of the European Foundation of Quality Management (EFQM) require continuous evaluation of customer satisfaction. Specialists and family physician as external customers influence the patient's choice of a hospital. The aim of the present study is to evaluate the satisfaction of admitting physicians of a children's hospital with the help of a questionnaire. The results describe their needs and their level of satisfaction regarding service, information, cooperation and communication within the hospital.

Development and Evaluation of a Computer-Based Program for Assessing Quality of Family Medicine Teams Based on Accreditation Standards

PubMed Central

Valjevac, Salih; Ridjanovic, Zoran; Masic, Izet

2009-01-01

CONFLICT OF INTEREST: NONE DECLARED SUMMARY Introduction Agency for healthcare quality and accreditation in Federation of Bosnia and Herzegovina (AKAZ) is authorized body in the field of healthcare quality and safety improvement and accreditation of healthcare institutions. Beside accreditation standards for hospitals and primary health care centers, AKAZ has also developed accreditation standards for family medicine teams. Methods Software development was primarily based on Accreditation Standards for Family Medicine Teams. Seven chapters / topics: (1. Physical factors; 2. Equipment; 3. Organization and Management; 4. Health promotion and illness prevention; 5. Clinical services; 6. Patient survey; and 7. Patient’s rights and obligations) contain 35 standards describing expected level of family medicine team’s quality. Based on accreditation standards structure and needs of different potential users, it was concluded that software backbone should be a database containing all accreditation standards, self assessment and external assessment details. In this article we will present the development of standardized software for self and external evaluation of quality of service in family medicine, as well as plans for the future development of this software package. Conclusion Electronic data gathering and storing enhances the management, access and overall use of information. During this project we came to conclusion that software for self assessment and external assessment is ideal for accreditation standards distribution, their overview by the family medicine team members, their self assessment and external assessment. PMID:24109157

[eLearning-radiology.com--sustainability for quality assurance].

PubMed

Ketelsen, D; Talanow, R; Uder, M; Grunewald, M

2009-04-01

The aim of the study was to analyze the availability of published radiological e-learning tools and to establish a solution for quality assurance. Substantial pubmed research was performed to identify radiological e-learning tools. 181 e-learning programs were selected. As examples two databases expanding their programs with external links, Compare (n = 435 external links) and TNT-Radiology (n = 1078 external links), were evaluated. A concept for quality assurance was developed by an international taskforce. At the time of assessment, 56.4 % (102 / 181) of the investigated e-learning tools were accessible at their original URL. A subgroup analysis of programs published 5 to 8 years ago showed significantly inferior availability to programs published 3 to 5 years ago (p < 0.01). The analysis of external links showed 49.2 % and 61.0 % accessible links for the programs Compare (published 2003) and TNT-Radiology (published 2006), respectively. As a consequence, the domain www.eLearning-radiology.com was developed by the taskforce and published online. This tool allows authors to present their programs and users to evaluate the e-learning tools depending on several criteria in order to remove inoperable links and to obtain information about the complexity and quality of the e-learning tools. More than 50 % of investigated radiological e-learning tools on the Internet were not accessible after a period of 5 to 8 years. As a consequence, an independent, international tool for quality assurance was designed and published online under www.eLearning-radiology.com .

External Accountability of Collaborative Arrangements; A Case Study of a Multi Academy Trust in England

ERIC Educational Resources Information Center

Ehren, Melanie C. M.; Godfrey, David

2017-01-01

This paper explores the impact of external accountability on four mechanisms of network-internal quality control and the properties of (mandated) inter-organizational networks. An explorative case study approach examines the external accountability of a newly established educational network (MAT) and how schools and the Trust are held accountable…

Trajectories of Classroom Externalizing Behavior: Contributions of Child Characteristics, Family Characteristics, and the Teacher-Child Relationship during the School Transition

ERIC Educational Resources Information Center

Silver, R.B.; Measelle, J.R.; Armstrong, J.M.; Essex, M.J.

2005-01-01

The unique and interactive contributions of past externalizing behavior, negative parenting, and teacher-child relationship quality to externalizing behavior trajectories after the transition to school were examined. In a sample of 283 children, random regression analyses indicated that conflict in the teacher-child relationship during the school…

Pulp Chip Quality from In-woods Chippers Coupled with Chain Flail Delimbers-Debarkers: Does it Match Conventional Woodyard Quality?

Treesearch

W.F. Watson; A.A. Twaddle; B.J. Stokes

1991-01-01

Chain flail delimber-debarkers have gained a degree of acceptance in the Southern USA, especially for processing thinnings from pine plantations. TIzis Technical Release compares the quality of chips produced by in-woods chippers teamed with chain flail delimber-debarkers, with chips produced in conventional large-scale woodyards, to be a guideline as to what may occur...

External quality assessment of clinical laboratories in the United Kingdom

PubMed Central

Whitehead, TP; Woodford, FP

1981-01-01

A review is given of the National External Quality Assessment Schemes (NEQASs) in various pathology disciplines in the United Kingdom, with a discussion of the relative roles of the DHSS, individual laboratory scientists, and the relevant professional bodies. Principles of operation and scientific problems in the design of NEQASs in different disciplines are described and contrasted, and some comparisons with the experience in other European countries and the USA are drawn. PMID:7024326

Design and implementation of an external quality assessment program for HIV viral load measurements using dried blood spots.

PubMed

Prach, Lisa M; Puren, Adrian; Lippman, Sheri A; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott; Liegler, Teri

2015-03-01

An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Parents' work-family experiences and children's problem behaviors: The mediating role of the parent-child relationship.

PubMed

Vieira, Joana M; Matias, Marisa; Ferreira, Tiago; Lopez, Frederick G; Matos, Paula Mena

2016-06-01

Studies on the impact of work-family dynamics on both parenting and children's outcomes are scarce. The present study addressed this gap by exploring how parents' negative (conflicting) and positive (enriching) experiencing of work and family roles related to children's internalizing and externalizing problem behaviors through its association with the quality of parent-child relationships. A sample of 317 dual-earner couples with preschool children was used to conduct a dyadic analysis of both within- and cross-dyad influences of parents' work-family experiences on child problem behaviors. Our results indicated that the way parents balance work and family is associated with their parent-child relationships, which in turn is differentially linked with their children's behaviors. We found that mothers' work-family conflict (WFC) contributed to children's externalization difficulties through its detrimental associations with their own and with their partners' parent-child relationship quality. By contrast, mothers' work-family enrichment (WFE) was negatively linked to children's externalization difficulties through its positive link with the mother-child relationship. Fathers' experience of WFC was associated with both children's internalization and externalization difficulties through its negative association with their own father-child relationship quality. In addition, fathers' experience of WFE also linked to children's externalization difficulties, but only indirectly, via its positive association with the quality of their relationship with the child. Further implications of these findings for advancing understanding of the impact of work-family dynamics on intrafamily relationships, as well as for individual and organizational interventions, are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Validity of self-assessment in a quality improvement collaborative in Ecuador.

PubMed

Hermida, Jorge; Broughton, Edward I; Miller Franco, Lynne

2011-12-01

Health care quality improvement (QI) efforts commonly use self-assessment to measure compliance with quality standards. This study investigates the validity of self-assessment of quality indicators. Cross sectional. A maternal and newborn care improvement collaborative intervention conducted in health facilities in Ecuador in 2005. Four external evaluators were trained in abstracting medical records to calculate six indicators reflecting compliance with treatment standards. About 30 medical records per month were examined at 12 participating health facilities for a total of 1875 records. The same records had already been reviewed by QI teams at these facilities (self-assessment). Overall compliance, agreement (using the Kappa statistic), sensitivity and specificity were analyzed. We also examined patterns of disagreement and the effect of facility characteristics on levels of agreement. External evaluators reported compliance of 69-90%, while self-assessors reported 71-92%, with raw agreement of 71-95% and Kappa statistics ranging from fair to almost perfect agreement. Considering external evaluators as the gold standard, sensitivity of self-assessment ranged from 90 to 99% and specificity from 48 to 86%. Simpler indicators had fewer disagreements. When disagreements occurred between self-assessment and external valuators, the former tended to report more positive findings in five of six indicators, but this tendency was not of a magnitude to change program actions. Team leadership, understanding of the tools and facility size had no overall impact on the level of agreement. When compared with external evaluation (gold standard), self-assessment was found to be sufficiently valid for tracking QI team performance. Sensitivity was generally higher than specificity. Simplifying indicators may improve validity.

Neutron star dynamics under time-dependent external torques

NASA Astrophysics Data System (ADS)

Gügercinoǧlu, Erbil; Alpar, M. Ali

2017-11-01

The two-component model describes neutron star dynamics incorporating the response of the superfluid interior. Conventional solutions and applications involve constant external torques, as appropriate for radio pulsars on dynamical time-scales. We present the general solution of two-component dynamics under arbitrary time-dependent external torques, with internal torques that are linear in the rotation rates, or with the extremely non-linear internal torques due to vortex creep. The two-component model incorporating the response of linear or non-linear internal torques can now be applied not only to radio pulsars but also to magnetars and to neutron stars in binary systems, with strong observed variability and noise in the spin-down or spin-up rates. Our results allow the extraction of the time-dependent external torques from the observed spin-down (or spin-up) time series, \\dot{Ω }(t). Applications are discussed.

External Quality Assurance Programs Managed by the U.S. Geological Survey in Support of the National Atmospheric Deposition Program/Mercury Deposition Network

USGS Publications Warehouse

Latysh, Natalie E.; Wetherbee, Gregory A.

2007-01-01

The U.S. Geological Survey (USGS) Branch of Quality Systems operates external quality assurance programs for the National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Beginning in 2004, three programs have been implemented: the system blank program, the interlaboratory comparison program, and the blind audit program. Each program was designed to measure error contributed by specific components in the data-collection process. The system blank program assesses contamination that may result from sampling equipment, field exposure, and routine handling and processing of the wet-deposition samples. The interlaboratory comparison program evaluates bias and precision of analytical results produced by the Mercury Analytical Laboratory (HAL) for the NADP/MDN, operated by Frontier GeoSciences, Inc. The HAL's performance is compared with the performance of five other laboratories. The blind audit program assesses bias and variability of MDN data produced by the HAL using solutions disguised as environmental samples to ascertain true laboratory performance. This report documents the implementation of quality assurance procedures for the NADP/MDN and the operating procedures for each of the external quality assurance programs conducted by the USGS. The USGS quality assurance information provides a measure of confidence to NADP/MDN data users that measurement variability is distinguished from environmental signals.

Quality Assurance in Post-Secondary Education: Some Common Approaches

ERIC Educational Resources Information Center

Law, Dennis Chung Sea

2010-01-01

Purpose: The common approaches to quality assurance (QA), as practiced by most post-secondary education institutions for internal quality monitoring and most QA authorities for external quality monitoring (EQM), have been considered by many researchers as having largely failed to address the essence of educational quality. The purpose of this…

ASVCP guidelines: quality assurance for point-of-care testing in veterinary medicine.

PubMed

Flatland, Bente; Freeman, Kathleen P; Vap, Linda M; Harr, Kendal E

2013-12-01

Point-of-care testing (POCT) refers to any laboratory testing performed outside the conventional reference laboratory and implies close proximity to patients. Instrumental POCT systems consist of small, handheld or benchtop analyzers. These have potential utility in many veterinary settings, including private clinics, academic veterinary medical centers, the community (eg, remote area veterinary medical teams), and for research applications in academia, government, and industry. Concern about the quality of veterinary in-clinic testing has been expressed in published veterinary literature; however, little guidance focusing on POCT is available. Recognizing this void, the ASVCP formed a subcommittee in 2009 charged with developing quality assurance (QA) guidelines for veterinary POCT. Guidelines were developed through literature review and a consensus process. Major recommendations include (1) taking a formalized approach to POCT within the facility, (2) use of written policies, standard operating procedures, forms, and logs, (3) operator training, including periodic assessment of skills, (4) assessment of instrument analytical performance and use of both statistical quality control and external quality assessment programs, (5) use of properly established or validated reference intervals, (6) and ensuring accurate patient results reporting. Where possible, given instrument analytical performance, use of a validated 13s control rule for interpretation of control data is recommended. These guidelines are aimed at veterinarians and veterinary technicians seeking to improve management of POCT in their clinical or research setting, and address QA of small chemistry and hematology instruments. These guidelines are not intended to be all-inclusive; rather, they provide a minimum standard for maintenance of POCT instruments in the veterinary setting. © 2013 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

A randomized control trial evaluating fluorescent ink versus dark ink tattoos for breast radiotherapy

PubMed Central

Kirby, Anna M; Lee, Steven F; Bartlett, Freddie; Titmarsh, Kumud; Donovan, Ellen; Griffin, Clare L; Gothard, Lone; Locke, Imogen; McNair, Helen A

2016-01-01

Objective: The purpose of this UK study was to evaluate interfraction reproducibility and body image score when using ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare with conventional dark ink. Methods: In this non-blinded, single-centre, parallel group, randomized control trial, patients were allocated to receive either conventional dark ink or UV ink tattoos using computer-generated random blocks. Participant assignment was not masked. Systematic (∑) and random (σ) setup errors were determined using electronic portal images. Body image questionnaires were completed at pre-treatment, 1 month and 6 months to determine the impact of tattoo type on body image. The primary end point was to determine that UV tattoo random error (σsetup) was no less accurate than with conventional dark ink tattoos, i.e. <2.8 mm. Results: 46 patients were randomized to receive conventional dark or UV ink tattoos. 45 patients completed treatment (UV: n = 23, dark: n = 22). σsetup for the UV tattoo group was <2.8 mm in the u and v directions (p = 0.001 and p = 0.009, respectively). A larger proportion of patients reported improvement in body image score in the UV tattoo group compared with the dark ink group at 1 month [56% (13/23) vs 14% (3/22), respectively] and 6 months [52% (11/21) vs 38% (8/21), respectively]. Conclusion: UV tattoos were associated with interfraction setup reproducibility comparable with conventional dark ink. Patients reported a more favourable change in body image score up to 6 months following treatment. Advances in knowledge: This study is the first to evaluate UV tattoo external references in a randomized control trial. PMID:27710100

A randomized control trial evaluating fluorescent ink versus dark ink tattoos for breast radiotherapy.

PubMed

Landeg, Steven J; Kirby, Anna M; Lee, Steven F; Bartlett, Freddie; Titmarsh, Kumud; Donovan, Ellen; Griffin, Clare L; Gothard, Lone; Locke, Imogen; McNair, Helen A

2016-12-01

The purpose of this UK study was to evaluate interfraction reproducibility and body image score when using ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare with conventional dark ink. In this non-blinded, single-centre, parallel group, randomized control trial, patients were allocated to receive either conventional dark ink or UV ink tattoos using computer-generated random blocks. Participant assignment was not masked. Systematic (∑) and random (σ) setup errors were determined using electronic portal images. Body image questionnaires were completed at pre-treatment, 1 month and 6 months to determine the impact of tattoo type on body image. The primary end point was to determine that UV tattoo random error (σ setup ) was no less accurate than with conventional dark ink tattoos, i.e. <2.8 mm. 46 patients were randomized to receive conventional dark or UV ink tattoos. 45 patients completed treatment (UV: n = 23, dark: n = 22). σ setup for the UV tattoo group was <2.8 mm in the u and v directions (p = 0.001 and p = 0.009, respectively). A larger proportion of patients reported improvement in body image score in the UV tattoo group compared with the dark ink group at 1 month [56% (13/23) vs 14% (3/22), respectively] and 6 months [52% (11/21) vs 38% (8/21), respectively]. UV tattoos were associated with interfraction setup reproducibility comparable with conventional dark ink. Patients reported a more favourable change in body image score up to 6 months following treatment. Advances in knowledge: This study is the first to evaluate UV tattoo external references in a randomized control trial.

Nonpoint sources as external threats to coastal water quality: lessons from Park Service experience

USGS Publications Warehouse

Burroughs, R.H.

1993-01-01

Program design for nonpoint source control was considered through an analogous problem, external threats to national parks. Nonpoint sources are diffuse land activities that degrade water quality, and recent federal legislation seeks to limit them in coastal areas. External threats occur outside a park boundary but affect the purposes for, or resources within, a park. They have been subject to federal management for many decades. Nonpoint sources are a class of external threat. Therefore, programs to limit them should consider techniques used in part protection. These park techniques include 'hard approaches', which rely on power, usually through legal devices, and 'soft approaches', which utilize shared values and objectives. A linked approach, as exemplified at the Cape Cod National Seashore, appears most promising. In a linked approach, if a soft approach fails, the manager of the protected unit is empowered to take an alternative hard action to protect the resource.

Time-lapse systems for embryo incubation and assessment in assisted reproduction.

PubMed

Armstrong, Sarah; Bhide, Priya; Jordan, Vanessa; Pacey, Allan; Farquhar, Cindy

2018-05-25

Embryo incubation and assessment is a vital step in assisted reproductive technology (ART). Traditionally, embryo assessment has been achieved by removing embryos from a conventional incubator daily for quality assessment by an embryologist, under a light microscope. Over recent years time-lapse systems have been developed which can take digital images of embryos at frequent time intervals. This allows embryologists, with or without the assistance of embryo selection software, to assess the quality of the embryos without physically removing them from the incubator.The potential advantages of a time-lapse system (TLS) include the ability to maintain a stable culture environment, therefore limiting the exposure of embryos to changes in gas composition, temperature and movement. A TLS has the potential advantage of improving embryo selection for ART treatment by utilising additional information gained through continuously monitoring embryo development. Use of a TLS often adds significant extra cost onto an in vitro fertilisation (IVF) cycle. To determine the effect of a TLS compared to conventional embryo incubation and assessment on clinical outcomes in couples undergoing ART. We used standard methodology recommended by Cochrane. We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, CINAHL and two trials registers on 2 August 2017. We included randomised controlled trials (RCTs) in the following comparisons: comparing a TLS, with or without embryo selection software, versus conventional incubation with morphological assessment; and TLS with embryo selection software versus TLS without embryo selection software among couples undergoing ART. We used standard methodological procedures recommended by Cochrane. The primary review outcomes were live birth, miscarriage and stillbirth. Secondary outcomes were clinical pregnancy and cumulative clinical pregnancy. We reported quality of the evidence for important outcomes using GRADE methodology. We made the following comparisons.TLS with conventional morphological assessment of still TLS images versus conventional incubation and assessmentTLS utilising embryo selection software versus TLS with conventional morphological assessment of still TLS images TLS utilising embryo selection software versus conventional incubation and assessment MAIN RESULTS: We included eight RCTs (N = 2303 women). The quality of the evidence ranged from very low to moderate. The main limitations were imprecision and risk of bias associated with lack of blinding of participants and researchers, and indirectness secondary to significant heterogeneity between interventions in some studies. There were no data on cumulative clinical pregnancy.TLS with conventional morphological assessment of still TLS images versus conventional incubation and assessmentThere is no evidence of a difference between the interventions in terms of live birth rates (odds ratio (OR) 0.73, 95% CI 0.47 to 1.13, 2 RCTs, N = 440, I 2 = 11% , moderate-quality evidence) and may also be no evidence of difference in miscarriage rates (OR 2.25, 95% CI 0.84 to 6.02, 2 RCTs, N = 440, I 2 = 44%, low-quality evidence). The evidence suggests that if the live birth rate associated with conventional incubation and assessment is 33%, the rate with use of TLS with conventional morphological assessment of still TLS images is between 19% and 36%; and that if the miscarriage rate with conventional incubation is 3%, the rate associated with conventional morphological assessment of still TLS images would be between 3% and 18%. There is no evidence of a difference between the interventions in the stillbirth rate (OR 1.00, 95% CI 0.13 to 7.49, 1 RCT, N = 76, low-quality evidence). There is no evidence of a difference between the interventions in clinical pregnancy rates (OR 0.88, 95% CI 0.58 to 1.33, 3 RCTs, N = 489, I 2 = 0%, moderate-quality evidence).TLS utilising embryo selection software versus TLS with conventional morphological assessment of still TLS imagesNo data were available on live birth or stillbirth. We are uncertain whether TLS utilising embryo selection software influences miscarriage rates (OR 1.39, 95% CI 0.64 to 3.01, 2 RCTs, N = 463, I 2 = 0%, very low-quality evidence) and there may be no difference in clinical pregnancy rates (OR 0.97, 95% CI 0.67 to 1.42, 2 RCTs, N = 463, I 2 = 0%, low-quality evidence). The evidence suggests that if the miscarriage rate associated with assessment of still TLS images is 5%, the rate with embryo selection software would be between 3% and 14%.TLS utilising embryo selection software versus conventional incubation and assessmentThere is no evidence of a difference between TLS utilising embryo selection software and conventional incubation improving live birth rates (OR 1.21, 95% CI 0.96 to 1.54, 2 RCTs, N = 1017, I 2 = 0%, very low-quality evidence). We are uncertain whether TLS influences miscarriage rates (OR 0.73, 95% CI 0.49 to 1.08, 3 RCTs, N = 1351, I 2 = 0%, very low-quality evidence). The evidence suggests that if the live birth rate associated with no TLS is 38%, the rate with use of conventional incubation would be between 36% and 58%, and that if miscarriage rate with conventional incubation is 9%, the rate associated with TLS would be between 4% and 10%. No data on stillbirths were available. It was uncertain whether the intervention influenced clinical pregnancy rates (OR 1.17, 95% CI 0.94 to 1.45, 3 RCTs, N = 1351, I 2 = 42%, very low-quality evidence). There is insufficient evidence of differences in live birth, miscarriage, stillbirth or clinical pregnancy to choose between TLS, with or without embryo selection software, and conventional incubation. The studies were at high risk of bias for randomisation and allocation concealment, the result should be interpreted with extreme caution.

Using a Template to Facilitate External Peer Preview of Curriculum: A Variation on the PRoT Theme

ERIC Educational Resources Information Center

Sealey, Rebecca

2013-01-01

Peer reviewing of teaching and curriculum in Higher Education is a common practice aimed at both quality assurance and professional development. External review of curriculum prior to implementation appears less common. The aim of this project was to develop, implement and evaluate a user-friendly process for external peer preview of teaching…

Love numbers for the long-period tides estimated by VLBI

NASA Astrophysics Data System (ADS)

Krásná, Hana; Böhm, Johannes; Haas, Rüdiger; Schuh, Harald

2013-04-01

Love and Shida numbers are proportionality factors characterizing the deformation of the anelastic Earth which arises as a response to external forces from the Moon and Sun. The increasing precision and quality of the Very Long Baseline Interferometry (VLBI) measurements allow determining those parameters. In particular, the long history of the VLBI data enables the estimation of Love and Shida numbers at the low frequencies of the tidal waves including the periods from 14 days to 18.6 years. In this study we analyse 27 years of VLBI measurements (1984.0 - 2011.0) following the recent IERS Conventions 2010. In several global solutions, we estimate the complex Love and Shida numbers of the solid Earth tides for the main long-period tidal waves. Furthermore, we determine the Love and Shida numbers of the rotational deformation due to polar motion, the so-called pole tide. We also focus on station displacement where still some deficiencies in the long-period signal modelling can be seen.

Road Lane Detection Robust to Shadows Based on a Fuzzy System Using a Visible Light Camera Sensor.

PubMed

Hoang, Toan Minh; Baek, Na Rae; Cho, Se Woon; Kim, Ki Wan; Park, Kang Ryoung

2017-10-28

Recently, autonomous vehicles, particularly self-driving cars, have received significant attention owing to rapid advancements in sensor and computation technologies. In addition to traffic sign recognition, road lane detection is one of the most important factors used in lane departure warning systems and autonomous vehicles for maintaining the safety of semi-autonomous and fully autonomous systems. Unlike traffic signs, road lanes are easily damaged by both internal and external factors such as road quality, occlusion (traffic on the road), weather conditions, and illumination (shadows from objects such as cars, trees, and buildings). Obtaining clear road lane markings for recognition processing is a difficult challenge. Therefore, we propose a method to overcome various illumination problems, particularly severe shadows, by using fuzzy system and line segment detector algorithms to obtain better results for detecting road lanes by a visible light camera sensor. Experimental results from three open databases, Caltech dataset, Santiago Lanes dataset (SLD), and Road Marking dataset, showed that our method outperformed conventional lane detection methods.

A New Thermal Treatment Process of Low Value Volcanic Glass towards the Production of Expanded Material and its Use on CNTs’ Synthesis as Substrate Material

NASA Astrophysics Data System (ADS)

Angelopoulos, Panagiotis M.; Samouhos, Michail; Taxiarchou, Maria; Tsakiridis, P.; Haggman, John; Joyce, Paul

2018-05-01

Pitchstone is a naturally occurring volcanic glass that contains considerable amount of chemically bound water (> 6 % wt). Due to its high water content, its direct thermal processing in conventional expansion furnaces towards the production of lightweight material, similar to expanded perlite, is practically impossible. In the current research paper a sophisticated 2 stage process is presented that consists of a partial dehydration and an expansion stage towards the production of high quality expanded material. After proper treatment, low-value volcanic glass is transformed to frothy, lightweight material of closed external surface and apparent density of 52 kg·m-3 that can be used in various branches of the industry. The material produced is used as substrate for the development of multiwall CNTs through CVD method. Dense multiwall CNT clusters were identified on expanded pitchstone surface, thus rendering the material suitable for such application.

Device characterization for design optimization of 4 junction inverted metamorphic concentrator solar cells

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

Geisz, John F.; France, Ryan M.; Steiner, Myles A.

Quantitative electroluminescence (EL) and luminescent coupling (LC) analysis, along with more conventional characterization techniques, are combined to completely characterize the subcell JV curves within a fourjunction (4J) inverted metamorphic solar cell (IMM). The 4J performance under arbitrary spectral conditions can be predicted from these subcell JV curves. The internal radiative efficiency (IRE) of each junction has been determined as a function of current density from the external radiative efficiency using optical modeling, but this required the accurate determination of the individual junction current densities during the EL measurement as affected by LC. These measurement and analysis techniques can be appliedmore » to any multijunction solar cell. The 4J IMM solar cell used to illustrate these techniques showed excellent junction quality as exhibited by high IRE and a one-sun AM1.5D efficiency of 36.3%. This device operates up to 1000 suns without limitations due to any of the three tunnel junctions.« less

Globally linearized control on diabatic continuous stirred tank reactor: a case study.

PubMed

Jana, Amiya Kumar; Samanta, Amar Nath; Ganguly, Saibal

2005-07-01

This paper focuses on the promise of globally linearized control (GLC) structure in the realm of strongly nonlinear reactor system control. The proposed nonlinear control strategy is comprised of: (i) an input-output linearizing state feedback law (transformer), (ii) a state observer, and (iii) an external linear controller. The synthesis of discrete-time GLC controller for single-input single-output diabatic continuous stirred tank reactor (DCSTR) has been studied first, followed by the synthesis of feedforward/feedback controller for the same reactor having dead time in process as well as in disturbance. Subsequently, the multivariable GLC structure has been designed and then applied on multi-input multi-output DCSTR system. The simulation study shows high quality performance of the derived nonlinear controllers. The better-performed GLC in conjunction with reduced-order observer has been compared with the conventional proportional integral controller on the example reactor and superior performance has been achieved by the proposed GLC control scheme.

Respiratory Sinus Arrhythmia Moderates the Relation between Parent-Adolescent Relationship Quality and Adolescents' Social Adjustment.

PubMed

Van der Graaff, Jolien; Meeus, Wim; de Wied, Minet; van Boxtel, Anton; van Lier, Pol; Branje, Susan

2016-02-01

This 2-wave longitudinal study aimed (1) to investigate whether high resting RSA predicted adolescents' lower externalizing behavior and higher empathic concern, and (2) to address the potential moderating role of resting RSA in the association between parent-adolescent relationship quality and adolescents' externalizing behavior and empathic concern. In a sample of 379 adolescents (212 boys, 167 girls), resting RSA was assessed during a laboratory session, and adolescents reported on parental support, negative interaction with parents, empathic concern and externalizing behavior during a home visit. We found no support for high resting RSA predicting low externalizing behavior or high empathic concern. However, in line with our hypotheses, we did find several instances of RSA functioning as a moderator, although the interaction patterns varied. First, negative interaction with parents was a negative predictor of externalizing behavior for girls low in resting RSA, whereas the association was non-significant for girls with high RSA. Second, higher negative interaction with parents predicted lower empathic concern for boys high in resting RSA, whereas the association was reversed for boys with low resting RSA. Third, parental support was a positive predictor of empathic concern for girls high in resting RSA, whereas the association was non-significant for girls low in resting RSA. The findings suggest that adolescents with different levels of resting RSA respond differentially to relationship quality with parents.

Effect-Based Screening Methods for Water Quality Characterization Will Augment Conventional Analyte-by-Analyte Chemical Methods in Research As Well As Regulatory Monitoring

EPA Science Inventory

Conventional approaches to water quality characterization can provide data on individual chemical components of each water sample. This analyte-by-analyte approach currently serves many useful research and compliance monitoring needs. However these approaches, which require a ...

Comparisons of nanoindentation, 3-point bending, and tension tests for orthodontic wires.

PubMed

Iijima, Masahiro; Muguruma, Takeshi; Brantley, William A; Mizoguchi, Itaru

2011-07-01

The purposes of this study were to obtain information about mechanical properties with the nanoindentation test for representative wire alloys and compare the results with conventional mechanical tests. Archwires having 0.016 × 0.022-in cross sections were obtained of 1 stainless steel, 1 cobalt-chromium-nickel, 1 beta-titanium alloy, and 2 nickel-titanium products. Specimens of as-received wires were subjected to nanoindentation testing along the external surfaces and over polished cross sections to obtain values of hardness and elastic modulus. Other specimens of as-received wires were subjected to Vickers hardness, 3-point bending, and tension tests. All testing was performed at 25°C. Differences were found in hardness and elastic modulus obtained with the nanoindentation test at the external and cross-sectioned surfaces and with the conventional mechanical-property tests. Mechanical properties obtained with the nanoindentation test generally varied with indentation depth. The 3 testing methods did not yield identical values of hardness and elastic modulus, although the order among the 5 wire products was the same. Variations in results for the nanoindentation and conventional mechanical property tests can be attributed to the different material volumes sampled, different work-hardening levels, and an oxide layer on the wire surface. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Two-stage removal of an impacted foreign body with an epoxied anchor.

PubMed

Isaacson, Glenn

2003-09-01

A stone impacted in a child's external auditory canal had defied all conventional means of removal. It was extracted successfully after attachment of a specially formed metal anchor with epoxy glue. The technique of and rationale for this approach are discussed.

Make or Buy? That's Really Not the Question

ERIC Educational Resources Information Center

Peurach, Donald J.; Glazer, Joshua L.; Lenhoff, Sarah Winchell

2012-01-01

Conventional thinking holds that districts and schools face a strategic decision between two fundamentally different alternatives: make or buy? The former refers to planning, designing, and enacting school-specific improvement initiatives. The latter refers to contracting with external providers of schoolwide improvement programs. However, there…

Greenhouse gas emissions in an agroforestry system in the southeastern U.S.

USDA-ARS?s Scientific Manuscript database

Agroforestry systems can provide diverse ecosystem services and economic benefits that conventional farming practices cannot. Importantly, these systems have the potential to mitigate greenhouse gas emissions by reducing the need for external inputs, enhancing nutrient cycling and promoting C seques...

Entropic stochastic resonance without external force in oscillatory confined space.

PubMed

Ding, Huai; Jiang, Huijun; Hou, Zhonghuai

2015-05-21

We have studied the dynamics of Brownian particles in a confined geometry of dumbbell-shape with periodically oscillating walls. Entropic stochastic resonance (ESR) behavior, characterizing by a maximum value of the coherent factor Q at some optimal level of noise, is observed even without external periodic force in the horizontal direction, which is necessary for conventional ESR where the wall is static and the particle is subjected to the force. Interestingly, the ESR can be remarkably enhanced by the particle gravity G, in contrast to the conventional case. In addition, Q decreases (increases) with G in the small (large) noise limit, respectively, while it non-monotonically changes with G for moderate noise levels. We have applied an effective 1D coarsening description to illustrate such a nontrivial dependence on G, by investigating the property of the 1D effective potential of entropic nature and paying special attention to the excess part resulting from the boundary oscillation. Dependences of the ESR strength with other related parameters are also discussed.

Conventional and conformal technique of external beam radiotherapy in locally advanced cervical cancer: Dose distribution, tumor response, and side effects

NASA Astrophysics Data System (ADS)

Mutrikah, N.; Winarno, H.; Amalia, T.; Djakaria, M.

2017-08-01

The objective of this study was to compare conventional and conformal techniques of external beam radiotherapy (EBRT) in terms of the dose distribution, tumor response, and side effects in the treatment of locally advanced cervical cancer patients. A retrospective cohort study was conducted on cervical cancer patients who underwent EBRT before brachytherapy in the Radiotherapy Department of Cipto Mangunkusumo Hospital. The prescribed dose distribution, tumor response, and acute side effects of EBRT using conventional and conformal techniques were investigated. In total, 51 patients who underwent EBRT using conventional techniques (25 cases using Cobalt-60 and 26 cases using a linear accelerator (LINAC)) and 29 patients who underwent EBRT using conformal techniques were included in the study. The distribution of the prescribed dose in the target had an impact on the patient’s final response to EBRT. The complete response rate of patients to conformal techniques was significantly greater (58%) than that of patients to conventional techniques (42%). No severe acute local side effects were seen in any of the patients (Radiation Therapy Oncology Group (RTOG) grades 3-4). The distribution of the dose and volume to the gastrointestinal tract affected the proportion of mild acute side effects (RTOG grades 1-2). The urinary bladder was significantly greater using conventional techniques (Cobalt-60/LINAC) than using conformal techniques at 72% and 78% compared to 28% and 22%, respectively. The use of conformal techniques in pelvic radiation therapy is suggested in radiotherapy centers with CT simulators and 3D Radiotherapy Treatment Planning Systems (RTPSs) to decrease some uncertainties in radiotherapy planning. The use of AP/PA pelvic radiation techniques with Cobalt-60 should be limited in body thicknesses equal to or less than 18 cm. When using conformal techniques, delineation should be applied in the small bowel, as it is considered a critical organ according to RTOG consensus guidelines.

Toward development of a comprehensive external quality assurance program for polyfunctional intracellular cytokine staining assays

PubMed Central

Staats, Janet S.; Enzor, Jennifer H.; Sanchez, Ana M.; Rountree, Wes; Chan, Cliburn; Jaimes, Maria; Chan, Ray Chun-Fai; Gaur, Amitabh; Denny, Thomas N.; Weinhold, Kent J.

2014-01-01

The External Quality Assurance Program Oversight Laboratory (EQAPOL) Flow Cytometry Program assesses the proficiency of NIH/NIAID/DAIDS-supported and potentially other interested research laboratories in performing Intracellular Cytokine Staining (ICS) assays. The goal of the EQAPOL Flow Cytometry External Quality Assurance Program (EQAP) is to provide proficiency testing and remediation for participating sites. The program is not punitive; rather, EQAPOL aims to help sites identify areas for improvement. EQAPOL utilizes a highly standardized ICS assay to minimize variability and readily identify those sites experiencing technical difficulties with their assays. Here, we report the results of External Proficiency 3 (EP3) where participating sites performed a 7-color ICS assay. On average, sites perform well in the Flow Cytometry EQAP (median score is “Good”). The most common technical issues identified by the program involve protocol adherence and data analysis; these areas have been the focus of site remediation. The EQAPOL Flow Cytometry team is now in the process of expanding the program to 8-color ICS assays. Evaluating polyfunctional ICS responses would align the program with assays currently being performed in support of HIV immune monitoring assays. PMID:24968072

WE-AB-209-07: Explicit and Convex Optimization of Plan Quality Metrics in Intensity-Modulated Radiation Therapy Treatment Planning

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

Engberg, L; KTH Royal Institute of Technology, Stockholm; Eriksson, K

Purpose: To formulate objective functions of a multicriteria fluence map optimization model that correlate well with plan quality metrics, and to solve this multicriteria model by convex approximation. Methods: In this study, objectives of a multicriteria model are formulated to explicitly either minimize or maximize a dose-at-volume measure. Given the widespread agreement that dose-at-volume levels play important roles in plan quality assessment, these objectives correlate well with plan quality metrics. This is in contrast to the conventional objectives, which are to maximize clinical goal achievement by relating to deviations from given dose-at-volume thresholds: while balancing the new objectives means explicitlymore » balancing dose-at-volume levels, balancing the conventional objectives effectively means balancing deviations. Constituted by the inherently non-convex dose-at-volume measure, the new objectives are approximated by the convex mean-tail-dose measure (CVaR measure), yielding a convex approximation of the multicriteria model. Results: Advantages of using the convex approximation are investigated through juxtaposition with the conventional objectives in a computational study of two patient cases. Clinical goals of each case respectively point out three ROI dose-at-volume measures to be considered for plan quality assessment. This is translated in the convex approximation into minimizing three mean-tail-dose measures. Evaluations of the three ROI dose-at-volume measures on Pareto optimal plans are used to represent plan quality of the Pareto sets. Besides providing increased accuracy in terms of feasibility of solutions, the convex approximation generates Pareto sets with overall improved plan quality. In one case, the Pareto set generated by the convex approximation entirely dominates that generated with the conventional objectives. Conclusion: The initial computational study indicates that the convex approximation outperforms the conventional objectives in aspects of accuracy and plan quality.« less

van der Waals epitaxial two-dimensional CdSxSe(1-x) semiconductor alloys with tunable-composition and application to flexible optoelectronics.

PubMed

Xia, Jing; Zhao, Yun-Xuan; Wang, Lei; Li, Xuan-Ze; Gu, Yi-Yi; Cheng, Hua-Qiu; Meng, Xiang-Min

2017-09-21

Despite the substantial progress in the development of two-dimensional (2D) materials from conventional layered crystals, it still remains particularly challenging to produce high-quality 2D non-layered semiconductor alloys which may bring in some unique properties and new functions. In this work, the synthesis of well-oriented 2D non-layered CdS x Se (1-x) semiconductor alloy flakes with tunable compositions and optical properties is established. Structural analysis reveals that the 2D non-layered alloys follow an incommensurate van der Waals epitaxial growth pattern. Photoluminescence measurements show that the 2D alloys have composition-dependent direct bandgaps with the emission peak varying from 1.8 eV to 2.3 eV, coinciding well with the density functional theory calculations. Furthermore, photodetectors based on the CdS x Se (1-x) flakes exhibit a high photoresponsivity of 703 A W -1 with an external quantum efficiency of 1.94 × 10 3 and a response time of 39 ms. Flexible devices fabricated on a thin mica substrate display good mechanical stability upon repeated bending. This work suggests a facile and general method to produce high-quality 2D non-layered semiconductor alloys for next-generation optoelectronic devices.

Application of Super-Resolution Convolutional Neural Network for Enhancing Image Resolution in Chest CT.

PubMed

Umehara, Kensuke; Ota, Junko; Ishida, Takayuki

2017-10-18

In this study, the super-resolution convolutional neural network (SRCNN) scheme, which is the emerging deep-learning-based super-resolution method for enhancing image resolution in chest CT images, was applied and evaluated using the post-processing approach. For evaluation, 89 chest CT cases were sampled from The Cancer Imaging Archive. The 89 CT cases were divided randomly into 45 training cases and 44 external test cases. The SRCNN was trained using the training dataset. With the trained SRCNN, a high-resolution image was reconstructed from a low-resolution image, which was down-sampled from an original test image. For quantitative evaluation, two image quality metrics were measured and compared to those of the conventional linear interpolation methods. The image restoration quality of the SRCNN scheme was significantly higher than that of the linear interpolation methods (p < 0.001 or p < 0.05). The high-resolution image reconstructed by the SRCNN scheme was highly restored and comparable to the original reference image, in particular, for a ×2 magnification. These results indicate that the SRCNN scheme significantly outperforms the linear interpolation methods for enhancing image resolution in chest CT images. The results also suggest that SRCNN may become a potential solution for generating high-resolution CT images from standard CT images.

The Era of the Large Databases: Outcomes After Gastroesophageal Surgery According to NSQIP, NIS, and NCDB Databases. Systematic Literature Review.

PubMed

Batista Rodríguez, Gabriela; Balla, Andrea; Fernández-Ananín, Sonia; Balagué, Carmen; Targarona, Eduard M

2018-05-01

The term big data refers to databases that include large amounts of information used in various areas of knowledge. Currently, there are large databases that allow the evaluation of postoperative evolution, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), and the National Cancer Database (NCDB). The aim of this review was to evaluate the clinical impact of information obtained from these registries regarding gastroesophageal surgery. A systematic review using the Meta-analysis of Observational Studies in Epidemiology guidelines was performed. The research was carried out using the PubMed database identifying 251 articles. All outcomes related to gastroesophageal surgery were analyzed. A total of 34 articles published between January 2007 and July 2017 were included, for a total of 345 697 patients. Studies were analyzed and divided according to the type of surgery and main theme in (1) esophageal surgery and (2) gastric surgery. The information provided by these databases is an effective way to obtain levels of evidence not obtainable by conventional methods. Furthermore, this information is useful for the external validation of previous studies, to establish benchmarks that allow comparisons between centers and have a positive impact on the quality of care.

A Pilot Study Evaluating "Dojo," a Videogame Intervention for Youths with Externalizing and Anxiety Problems.

PubMed

Schuurmans, Angela A T; Nijhof, Karin S; Vermaes, Ignace P R; Engels, Rutger C M E; Granic, Isabela

2015-10-01

Externalizing problems, which are the main reason for youth referrals to mental health agencies, are highly persistent and predict a range of negative outcomes. Youths with externalizing problems are also frequently comorbid with anxiety. Among the most widely recognized evidence-based treatments is cognitive behavioral therapy (CBT). Although CBT principles seem to be sound, effect sizes remain moderate, suggesting improvements could be made to this conventional treatment approach. The main premise of the current pilot study is to investigate the feasibility of implementing a videogame intervention ("Dojo" [Gamedesk, Los Angeles, CA]) that incorporates CBT principles and aims to address the limitations of conventional CBT delivery models, with the ultimate goal of improving outcomes for this difficult-to-treat population. "Dojo" is an emotion management game that helps youths to recognize and control their physiological and emotional arousal. We explored the implementation and user experience of "Dojo" in a sample of eight adolescents in residential treatment for both externalizing and anxiety problems. Participants attended all sessions without complaints. They evaluated "Dojo" very positively and exhibited high compliance during the training sessions. We encountered some problems with session scheduling and obtaining mentor reports. Quantitative data show the predicted decrease in three out of four measurements. The smooth implementation, high user satisfaction, high self-reported compliance during training sessions, and initial outcome results all indicate the high potential "Dojo" holds as an innovative intervention. If additional rigorously designed randomized controlled trials prove to be successful, "Dojo" can be a cost-effective way to engage high-risk youths in effective intervention.

Shoulder isokinetic profile of male handball players of the Brazilian National Team

PubMed Central

Andrade, Marília S.; Vancini, Rodrigo L.; de Lira, Claudio A. B.; Mascarin, Naryana C.; Fachina, Rafael J. F. G.; da Silva, Antonio C.

2013-01-01

Background Data obtained on an isokinetic dynamometer are useful to characterize muscle status and have been reported in muscle imbalance studies in different types of sport. However, few studies have assessed elite handball players to establish reference values. Objective The purpose of this study was to compare, for the dominant (D) and non-dominant (ND) side, the isokinetic profile of shoulder rotator muscle strength between male handball players (H) and asymptomatic non-athletes (NA). Method Isokinetic concentric and eccentric strength tests for D upper limbs were performed by the H group (n=20) and the NA group (n=12). Internal and external rotator muscle peak torque in concentric action was assessed at 60°/s and 300°/s and in eccentric action at 300°/s. We also calculated conventional balance (the ratio of external rotator peak torque to internal rotator peak torque in concentric action) and functional balance (the ratio of external rotator peak torque in eccentric action to internal rotator peak torque in concentric action). Results In the H group, dominant limbs were stronger in concentric action for external rotation at 60 and 300°/s. The conventional balance ratio for the D side was significantly lower at 60 and 300°/s for H compared to NA. The functional ratio for the D side was significantly lower at 300º/s for H compared to NA. Conclusions Compared to asymptomatic non-athletes, handball players presented significant muscular imbalance resulting from daily sports practice, a known risk factor for shoulder injuries. PMID:24271090

Standards and Quality in Higher Education. Higher Education Policy Series 37.

ERIC Educational Resources Information Center

Brennan, John, Ed.; de Vries, Peter, Ed.; Williams, Ruth, Ed.

The papers in this book reflect current debates on academic standards and quality assurance, and speak from the perspective of institutional leaders and national quality bodies and higher education researchers. Included are reports on the progress of several international quality initiatives and studies on the impact of external quality assurance…

Using Quality Schemes in Adult and Community Learning: A Guide for Managers.

ERIC Educational Resources Information Center

Ewens, David; Watters, Kate

This document examines adult and community learning (ACL) and quality programs across England. The difficulties faced by local education agencies' ACL services in delivering quality are noted, along with ways quality improvement has been supported. Quality programs--whether internal or external, based on awards, or used as diagnostic tools--are…

A Study on Students' Satisfaction Based on Quality Standards of Accreditation in Higher Education

ERIC Educational Resources Information Center

Neelaveni, C.; Manimaran S.

2015-01-01

Quality standards are evaluated by the Higher Educational Institutions by self evaluation at different levels and are also assessed by external agencies. Application of quality standards in administrative practices have been associated with the quality of higher education. To improve the quality of administrative practices, evaluation scales are…

Development of an evidence-based approach to external quality assurance for breast cancer hormone receptor immunohistochemistry: comparison of reference values.

PubMed

Makretsov, Nikita; Gilks, C Blake; Alaghehbandan, Reza; Garratt, John; Quenneville, Louise; Mercer, Joel; Palavdzic, Dragana; Torlakovic, Emina E

2011-07-01

External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs. To explore reference values for estrogen receptor and progesterone receptor immunohistochemistry in order to develop an evidence-based analytic platform for external quality assurance. There were 31 participating laboratories, 4 of which were previously designated as "expert" laboratories. Each participant tested a tissue microarray slide with 44 breast carcinomas for estrogen receptor and progesterone receptor and submitted it to the Canadian Immunohistochemistry Quality Control Program for analysis. Nuclear staining in 1% or more of the tumor cells was a positive score. Five methods for determining reference values were compared. All reference values showed 100% agreement for estrogen receptor and progesterone receptor scores, when indeterminate results were excluded. Individual laboratory performance (agreement rates, test sensitivity, test specificity, positive predictive value, negative predictive value, and κ value) was very similar for all reference values. Identification of suboptimal performance by all methods was identical for 30 of 31 laboratories. Estrogen receptor assessment of 1 laboratory was discordant: agreement was less than 90% for 3 of 5 reference values and greater than 90% with the use of 2 other reference values. Various reference values provide equivalent laboratory rating. In addition to descriptive feedback, our approach allows calculation of technical test sensitivity and specificity, positive and negative predictive values, agreement rates, and κ values to guide corrective actions.

The case for regime-based water quality standards

USGS Publications Warehouse

Poole, Geoffrey C.; Dunham, J.B.; Keenan, D.M.; Sauter, S.T.; McCullough, D.A.; Mebane, Christopher; Lockwood, Jeffrey C.; Essig, Don A.; Hicks, Mark P.; Sturdevant, Debra J.; Materna, E.J.; Spalding, M.; Risley, John; Deppman, Marianne

2004-01-01

Conventional water quality standards have been successful in reducing the concentration of toxic substances in US waters. However, conventional standards are based on simple thresholds and are therefore poorly structured to address human-caused imbalances in dynamic, natural water quality parameters, such as nutrients, sediment, and temperature. A more applicable type of water quality standarda??a a??regime standarda??a??would describe desirable distributions of conditions over space and time within a stream network. By mandating the protection and restoration of the aquatic ecosystem dynamics that are required to support beneficial uses in streams, well-designed regime standards would facilitate more effective strategies for management of natural water quality parameters.

Resistance to abrasion of extrinsic porcelain esthetic characterization techniques.

PubMed

Chi, Woo J; Browning, William; Looney, Stephen; Mackert, J Rodway; Windhorn, Richard J; Rueggeberg, Frederick

2017-01-01

A novel esthetic porcelain characterization technique involves mixing an appropriate amount of ceramic colorants with clear, low-fusing porcelain (LFP), applying the mixture on the external surfaces, and firing the combined components onto the surface of restorations in a porcelain oven. This method may provide better esthetic qualities and toothbrush abrasion resistance compared to the conventional techniques of applying color-corrective porcelain colorants alone, or applying a clear glaze layer over the colorants. However, there is no scientific literature to support this claim. This research evaluated toothbrush abrasion resistance of a novel porcelain esthetic characterization technique by subjecting specimens to various durations of simulated toothbrush abrasion. The results were compared to those obtained using the conventional characterization techniques of colorant application only or colorant followed by placement of a clear over-glaze. Four experimental groups, all of which were a leucite reinforced ceramic of E TC1 (Vita A1) shade, were prepared and fired in a porcelain oven according to the manufacturer's instructions. Group S (stain only) was characterized by application of surface colorants to provide a definitive shade of Vita A3.5. Group GS (glaze over stain) was characterized by application of a layer of glaze over the existing colorant layer as used for Group S. Group SL (stain+LFP) was characterized by application of a mixture of colorants and clear low-fusing add-on porcelain to provide a definitive shade of Vita A3.5. Group C (Control) was used as a control without any surface characterization. The 4 groups were subjected to mechanical toothbrushing using a 1:1 water-to-toothpaste solution for a simulated duration of 32 years of clinical use. The amount of wear was measured at time intervals simulating every 4 years of toothbrushing. These parameters were evaluated longitudinally for all groups as well as compared at similar time points among groups. In this study, the novel external characterization technique (stain+LFP: Group SL) did not significantly enhance the wear resistance against toothbrush abrasion. Instead, the average wear of the applied extrinsic porcelain was 2 to 3 times more than Group S (stain only) and Group GS (glaze over stain). Application of a glaze layer over the colorants (Group GS) showed a significant improvement on wear resistance. Despite its superior physical properties, the leucite reinforced ceramic core (Group C) showed 2 to 4 times more wear when compared with other test groups. A conventional external esthetic characterization technique of applying a glaze layer over the colorants (Group GS) significantly enhanced the surface wear resistance to toothbrush abrasion when compared with other techniques involving application of colorants only (Group S) or mixture of colorant and LFP (Group SL). The underlying core ceramic had significantly less wear resistance compared with all externally characterized specimens. The novel esthetic characterization technique showed more wear and less color stability, and is thus not advocated as the "best" method for surface characterization. Application of a glaze layer provides a more wear-resistant surface from toothbrush abrasion when adjusting or extrinsically characterizing leucite reinforced ceramic restorations. Without the glaze layer, the restoration is subjected to a 2 to 4 times faster rate and amount of wear leading to possible shade mismatch.

Transportation management and security during the 2004 Democratic National Convention

DOT National Transportation Integrated Search

2005-01-05

The transportation operations plan for the 2004 Democratic National Convention (DNC) in Boston, Massachusetts, was not a typical transportation plan driven by goals such as mobility and air quality. The DNC was the first national political convention...

Quality characteristics of battered and fried chicken: comparison of pressure frying and conventional frying.

PubMed

Das, Rashmi; Pawar, Deepthi P; Modi, Vinod Kumar

2013-04-01

The marinated and battered chicken leg meat and breast meat were pressure fried and their physico-chemical qualities were compared to the conventional fried product (open pan deep fat frying). Shrinkage due to frying process was significantly lesser in case of pressure fried leg meat (PLM) and breast meat (PBM) as compared to products prepared by conventional frying leg meat (CLM) and breast meat (CBM). Also, juiciness of pressure fried chicken products was superior (p ≤ 0.05) than fried products obtained by the conventional method. PLM and PBM had lower fat content (p ≤ 0.05) compared to conventionally fried CLM and CBM. Lipid oxidation was higher (p ≤ 0.05) in conventional frying as compared to pressure frying. Irrespective of the type of chicken meat, conventionally fried meat required higher shear force as compared to pressure fried products. Salmonella, Staphylococcus aureus, Shigella and E. coli were not detected. The study indicates the usefulness and superiority of pressure frying in comparison to conventional deep fat frying.

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange.

PubMed

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-02-25

The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. NHS commissioning organisations and private and not-for-profit providers. Mixed methods case study of eight cases. 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital component of commissioning and should be embedded in external provider contracts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ultrafast Brain MRI: Clinical Deployment and Comparison to Conventional Brain MRI at 3T.

PubMed

Prakkamakul, Supada; Witzel, Thomas; Huang, Susie; Boulter, Daniel; Borja, Maria J; Schaefer, Pamela; Rosen, Bruce; Heberlein, Keith; Ratai, Eva; Gonzalez, Gilberto; Rapalino, Otto

2016-09-01

To compare an ultrafast brain magnetic resonance imaging (MRI) protocol to the conventional protocol in motion-prone inpatient clinical settings. This retrospective study was HIPAA compliant and approved by the Institutional Review Board with waived inform consent. Fifty-nine inpatients (30 males, 29 females; mean age 55.1, range 23-93 years)who underwent 3-Tesla brain MRI using ultrafast and conventional protocols, both including five sequences, were included in the study. The total scan time for five ultrafast sequences was 4 minutes 59 seconds. The ideal conventional acquisition time was 10 minutes 32 seconds but the actual acquisition took 15-20 minutes. The average scan times for ultrafast localizers, T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted, T2*-weighted sequences were 14, 41, 62, 96, 80, 6 seconds, respectively. Two blinded neuroradiologists independently assessed three aspects: (1) image quality, (2) gray-white matter (GM-WM) differentiation, and (3) diagnostic concordance for the detection of six clinically relevant imaging findings. Wilcoxon signed-rank test was used to compare image quality and GM-WM scores. Interobserver reproducibility was calculated. The ultrafast T1-weighted sequence demonstrated significantly better image quality (P = .005) and GM-WM differentiation (P < .001) compared to the conventional sequence. There was high agreement (>85%) between both protocols for the detection of mass-like lesion, hemorrhage, diffusion restriction, WM FLAIR hyperintensities, subarachnoid FLAIR hyperintensities, and hydrocephalus. The ultrafast protocol achieved at least comparable image quality and high diagnostic concordance compared to the conventional protocol. This fast protocol can be a viable option to replace the conventional protocol in motion-prone inpatient clinical settings. Copyright © 2016 by the American Society of Neuroimaging.

Follow-Up of External Quality Controls for PCR-Based Diagnosis of Whooping Cough in a Hospital Laboratory Network (Renacoq) and in Other Hospital and Private Laboratories in France.

PubMed

Guillot, Sophie; Guiso, Nicole

2016-08-01

The French National Reference Centre (NRC) for Whooping Cough carried out an external quality control (QC) analysis in 2010 for the PCR diagnosis of whooping cough. The main objective of the study was to assess the impact of this QC in the participating laboratories through a repeat analysis in 2012. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Intraoral distalizer effects with conventional and skeletal anchorage: a meta-analysis.

PubMed

Grec, Roberto Henrique da Costa; Janson, Guilherme; Branco, Nuria Castello; Moura-Grec, Patrícia Garcia; Patel, Mayara Paim; Castanha Henriques, José Fernando

2013-05-01

The aims of this meta-analysis were to quantify and to compare the amounts of distalization and anchorage loss of conventional and skeletal anchorage methods in the correction of Class II malocclusion with intraoral distalizers. The literature was searched through 5 electronic databases, and inclusion criteria were applied. Articles that presented pretreatment and posttreatment cephalometric values were preferred. Quality assessments of the studies were performed. The averages and standard deviations of molar and premolar effects were extracted from the studies to perform a meta-analysis. After applying the inclusion and exclusion criteria, 40 studies were included in the systematic review. After the quality analysis, 2 articles were classified as high quality, 27 as medium quality, and 11 as low quality. For the meta-analysis, 6 studies were included, and they showed average molar distalization amounts of 3.34 mm with conventional anchorage and 5.10 mm with skeletal anchorage. The meta-analysis of premolar movement showed estimates of combined effects of 2.30 mm (mesialization) in studies with conventional anchorage and -4.01 mm (distalization) in studies with skeletal anchorage. There was scientific evidence that both anchorage systems are effective for distalization; however, with skeletal anchorage, there was no anchorage loss when direct anchorage was used. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The "New" Economics of Education: Towards a "Unified" Macro/Micro-Educational Planning Policy.

ERIC Educational Resources Information Center

Kraft, Richard H.; Nakib, Yasser

1991-01-01

Takes issue with conventional human capital theory, questioning assumptions regarding external benefits, internal efficiency, educational purposes, and returns-to-education and manpower needs approaches. Reviews new theoretical directions regarding supply and demand, socialization, labor market segmentation, and overeducation and undereducation,…

Dynamic volume vs respiratory correlated 4DCT for motion assessment in radiation therapy simulation.

PubMed

Coolens, Catherine; Bracken, John; Driscoll, Brandon; Hope, Andrew; Jaffray, David

2012-05-01

Conventional (i.e., respiratory-correlated) 4DCT exploits the repetitive nature of breathing to provide an estimate of motion; however, it has limitations due to binning artifacts and irregular breathing in actual patient breathing patterns. The aim of this work was to evaluate the accuracy and image quality of a dynamic volume, CT approach (4D(vol)) using a 320-slice CT scanner to minimize these limitations, wherein entire image volumes are acquired dynamically without couch movement. This will be compared to the conventional respiratory-correlated 4DCT approach (RCCT). 4D(vol) CT was performed and characterized on an in-house, programmable respiratory motion phantom containing multiple geometric and morphological "tumor" objects over a range of regular and irregular patient breathing traces obtained from 3D fluoroscopy and compared to RCCT. The accuracy of volumetric capture and breathing displacement were evaluated and compared with the ground truth values and with the results reported using RCCT. A motion model was investigated to validate the number of motion samples needed to obtain accurate motion probability density functions (PDF). The impact of 4D image quality on this accuracy was then investigated. Dose measurements using volumetric and conventional scan techniques were also performed and compared. Both conventional and dynamic volume 4DCT methods were capable of estimating the programmed displacement of sinusoidal motion, but patient breathing is known to not be regular, and obvious differences were seen for realistic, irregular motion. The mean RCCT amplitude error averaged at 4 mm (max. 7.8 mm) whereas the 4D(vol) CT error stayed below 0.5 mm. Similarly, the average absolute volume error was lower with 4D(vol) CT. Under irregular breathing, the 4D(vol) CT method provides a close description of the motion PDF (cross-correlation 0.99) and is able to track each object, whereas the RCCT method results in a significantly different PDF from the ground truth, especially for smaller tumors (cross-correlation ranging between 0.04 and 0.69). For the protocols studied, the dose measurements were higher in the 4D(vol) CT method (40%), but it was shown that significant mAs reductions can be achieved by a factor of 4-5 while maintaining image quality and accuracy. 4D(vol) CT using a scanner with a large cone-angle is a promising alternative for improving the accuracy with which respiration-induced motion can be characterized, particularly for patients with irregular breathing motion. This approach also generates 4DCT image data with a reduced total scan time compared to a RCCT scan, without the need for image binning or external respiration signals within the 16 cm scan length. Scan dose can be made comparable to RCCT by optimization of the scan parameters. In addition, it provides the possibility of measuring breathing motion for more than one breathing cycle to assess stability and obtain a more accurate motion PDF, which is currently not feasible with the conventional RCCT approach.

Higher-order spin-noise spectroscopy of atomic spins in fluctuating external fields

DOE PAGES

Li, Fuxiang; Crooker, S. A.; Sinitsyn, N. A.

2016-03-09

Here, we discuss the effect of external noisy magnetic fields on mesoscopic spin fluctuations that can be probed in semiconductors and atomic vapors by means of optical spin-noise spectroscopy. We also show that conventional arguments of the law of large numbers do not apply to spin correlations induced by external fields, namely, the magnitude of the 4th-order spin cumulant grows as ~N 2 with the number N of observed spins, i.e., it is not suppressed in comparison to the 2nd-order cumulant. Moreover, this allows us to design a simple experiment to measure the 4th-order cumulant of spin fluctuations in anmore » atomic system near thermodynamic equilibrium and develop a quantitative theory that explains all observations.« less

Arterial chemoradiotherapy for carcinomas of the external auditory canal and middle ear.

PubMed

Fujiwara, Masayuki; Yamamoto, Satoshi; Doi, Hiroshi; Takada, Yasuhiro; Odawara, Soichi; Niwa, Yasue; Ishikura, Reiichi; Kamikonya, Norihiko; Terada, Tomonori; Uwa, Nobuhiro; Sagawa, Kosuke; Hirota, Shozo

2015-03-01

The purpose of this study was to estimate the efficacy of superselective arterial chemoradiotherapy for locally advanced carcinomas of the external auditory canal and middle ear. A retrospective study of clinical data for consecutive patients with locally advanced carcinomas of the external auditory canal and middle ear. Thirteen patients with locally advanced carcinomas of the external auditory canal and middle ear (T3: one patient, T4: 12 patients) were reviewed. The median follow-up duration in the living patients was 33 months. The total dose of radiation therapy was 60 Gy using conventional fractionation. Four, five, or six courses of a superselective arterial infusion (cisplatin 50 mg) were given weekly. The overall survival and progression-free survival rates at 2 years, calculated by the Kaplan-Meier method, were 58.7% and 53.8%, respectively. No late-phase adverse effects due to chemoradiation and no adverse effects due to catheterization were observed. These results suggest that superselective arterial chemoradiation can be a treatment option for locally advanced carcinomas of the external auditory canal and middle ear. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Locus of control, quality of life, anxiety, and depression among Malaysian breast cancer patients: The mediating role of uncertainty.

PubMed

Pahlevan Sharif, Saeed

2017-04-01

The main objective of this study was to investigate the mediating role of uncertainty in the relationship between locus of control with quality of life, anxiety, and depression. A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS). The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant). The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life. Copyright © 2017 Elsevier Ltd. All rights reserved.

Technology usage, quality management system, and service quality in Thailand.

PubMed

Sivabrovornvatana, Nilubon; Siengthai, Sununta; Krairit, Donyaprueth; Paul, Himangshu

2005-01-01

This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.

MBA Quality Signals.

ERIC Educational Resources Information Center

Chapman, Randall S.

1998-01-01

A study identified quality signals for master's programs in business administration (MBAs). Traditional scholarly oriented academic signals are apparently not valued as such by external customer groups. MBA academic quality appears to be a multidimensional construct, with subdimensions of real-worldness; placement; student satisfaction; and…

External Validation of the Acoustic Voice Quality Index Version 03.01 With Extended Representativity.

PubMed

Barsties, Ben; Maryn, Youri

2016-07-01

The Acoustic Voice Quality Index (AVQI) is an objective method to quantify the severity of overall voice quality in concatenated continuous speech and sustained phonation segments. Recently, AVQI was successfully modified to be more representative and ecologically valid because the internal consistency of AVQI was balanced out through equal proportion of the 2 speech types. The present investigation aims to explore its external validation in a large data set. An expert panel of 12 speech-language therapists rated the voice quality of 1058 concatenated voice samples varying from normophonia to severe dysphonia. The Spearman rank-order correlation coefficients (r) were used to measure concurrent validity. The AVQI's diagnostic accuracy was evaluated with several estimates of its receiver operating characteristics (ROC). Finally, 8 of the 12 experts were chosen because of reliability criteria. A strong correlation was identified between AVQI and auditoryperceptual rating (r = 0.815, P = .000). It indicated that 66.4% of the auditory-perceptual rating's variation was explained by AVQI. Additionally, the ROC results showed again the best diagnostic outcome at a threshold of AVQI = 2.43. This study highlights external validation and diagnostic precision of the AVQI version 03.01 as a robust and ecologically valid measurement to objectify voice quality. © The Author(s) 2016.

External bone marrow cytological examination quality assurance (EQAhem)--summary after 6 years in Poland.

PubMed

Lewandowski, Krzysztof; Kurpierz, Katarzyna; Sledzinska, Anna

2015-10-01

Bone marrow macroscopic examination remains one of the most difficult and subjective laboratory assessments in hematology. Only a few external quality assurance programs in the field are present worldwide. We have developed an external quality assurance program EQAhem that allows assessment of the whole process of bone marrow examination. The program participants assess blood and bone marrow smears from the patient, identify selected cells from photographs provided to them, and interpret the microscopic results. In this article, the results of the EQAhem program in Poland from 6 years are summarized. During this time, 62 labs were assessed in total, and positive results were achieved by 89.25 % labs, taking into account all tests. Correct responses with respect to the percentage of cell count were provided by ca. 77.5 % labs. Slightly worse results were obtained when megakaryocyte count and cell identification from photographs were tested. The worst results were obtained in case of dysplasia assessment and clinical interpretation of microscopic examination (54.1 and 58.6 % correct responses, respectively). EQAhem delivers precise information about the quality of bone marrow examinations performed in Poland and has a substantial educational value. We believe that after 6 years, EQAhem has significantly improved the quality of bone marrow microscopic examinations performed in Poland.

External quality assessment on detection of hepatitis C virus RNA in clinical laboratories of China.

PubMed

Wang, Lu-nan; Zhang, Rui; Shen, Zi-yu; Chen, Wen-xiang; Li, Jin-ming

2008-06-05

As with many studies carried out in European countries, a quality assurance program has been established by the National Center for Clinical Laboratories in China (NCCL). The results showed that the external quality assessment significantly improves laboratory performance for quantitative evaluation of hepatitis C virus (HCV) RNA. Serum panels were delivered twice annually to the clinical laboratories which performed HCV RNA detection in China. Each panel made up of 5 coded samples. All laboratories were requested to carry out the detection within the required time period and report on testing results which contained qualitative and/or quantitative test findings, reagents used and relevant information about apparatus. All the positive samples were calibrated against the first International Standard for HCV RNA in a collaborative study and the range of comparison target value (TG) designated as +/- 0.5 log. The numbers of laboratories reporting on qualitative testing results for the first and second time external quality assessment were 168 and 167 in the year of 2003 and increased to 209 and 233 in 2007; the numbers of laboratories reporting on quantitative testing results were 134 and 147 in 2003 and rose to 340 and 339 in 2007. Deviation between the mean value for quantitative results at home in 2003 and the target value was above 0.5 log, which was comparatively high. By 2007, the target value was close to the national average except for the low concentrated specimens (10(3) IU/ml). The percentage of results within the range of GM +/- 0.5 log(10) varied from 8.2% to 93.5%. Some laboratories had some difficulties in the exact quantification of the lowest (3.00 log IU/ml) as well as of the highest viral levels (6.37 log IU/ml) values, very near to the limits of the dynamic range of the assays. The comparison of these results with the previous study confirms that a regular participation in external quality assessment (EQA) assures the achievement of a high proficiency level in the diagnosis of HCV infection. During the 5-year external quality assessment, sensitivity and accuracy of detection in most of the clinical laboratories have been evidently improved and the quality of kits has also been substantially improved.

Assessing the Quality of PhD Dissertations. A Survey of External Committee Members

ERIC Educational Resources Information Center

Kyvik, Svein; Thune, Taran

2015-01-01

This article reports on a study of the quality assessment of doctoral dissertations, and asks whether examiner characteristics influence assessment of research quality in PhD dissertations. Utilising a multi-dimensional concept of quality of PhD dissertations, we look at differences in assessment of research quality, and particularly test whether…

Pinpointing Chinese Early Childhood Teachers' Professional Development Needs through Self-Evaluation and External Observation of Classroom Quality

ERIC Educational Resources Information Center

Hu, Bi Ying; Zhou, Yisu; Li, Kejian

2014-01-01

This study compared Chinese kindergarten teachers' values and perceptions of program quality with trained raters' assessments of quality in order to gain insights into effective professional development for improving teacher quality. A total of 284 Chinese kindergarten teachers self-assessed the quality of their classroom teaching and rated their…

Quality Assurance of Quality Assurance Agencies from an Asian Perspective: Regulation, Autonomy and Accountability

ERIC Educational Resources Information Center

Hou, Angela Yung-Chi; Ince, Martin; Tsai, Sandy; Chiang, Chung Lin

2015-01-01

As quality guardians of higher education, quality assurance agencies are required to guarantee the credibility of the review process and to ensure the objectivity and transparency of their decisions and recommendations. These agencies are therefore expected to use a range of internal and external approaches to prove the quality of their review…

[Quality of data on deaths from external causes in a medium-sized city in Minas Gerais State, Brazil].

PubMed

Melo, Cristiane Magalhães de; Bevilacqua, Paula Dias; Barletto, Marisa; França, Elisabeth Barboza

2014-09-01

This study aimed to assess the quality of data on deaths from external causes in Viçosa, Minas Gerais State, Brazil, from 2000 to 2009, and the completeness of the Mortality Information System (SIM). The data were obtained from the SIM of the Municipal Health Department, municipal police enquiries, and local newspaper articles, resulting in a databank with 495 deaths from external causes. The results showed a high proportion of deaths with indeterminate intent (21%) in the SIM, suggesting problems with quality of information. Comparison of data from the SIM and police department detected problems with coverage in the SIM (21%) and thus in the official statistics on mortality from accidents and violence. The results emphasize the importance of searches in other data sources to upgrade the SIM and expand its coverage, and especially the need for studies to identify and analyze problems faced by small and medium-sized cities in the production of mortality data.

[Guideline compliance in hip fracture: results of an external quality-assurance program in North Rhine Westphalia: 2003-2005].

PubMed

Schulze Raestrup, U; Grams, A; Smektala, R

2008-02-01

Whereas the Scottish guidelines are audited annually, nobody evaluates guideline compliance in Germany. Thus, can external quality assurance data pursuant to section 137 of the German Social Code Book V be suitable for auditing guideline compliance? From North Rhine Westphalia, a total of 48,831 cases of femoral fractures near the hip joint were evaluated. Compliance with the guidelines was determined based on preoperative hospital stay, thrombosis, and antibiotic prophylaxis. Guideline rationale was reviewed in terms of mortality and thromboembolism rate. Sixty-four percent of the interventions were performed in a timely manner. Thrombosis prophylaxis was given in 99% of cases. Antibiotics were given as a single shot. There was no connection between mortality and thromboembolism rates or time to surgery. Guideline compliance is similar in German and Scotland. The external quality assurance data are suitable for evaluating guideline compliance. The literature recommends a short time to surgery. Given the short observation period, it was not possible to demonstrate any improvement in outcomes.

Optical sampling by laser cavity tuning.

PubMed

Hochrein, Thomas; Wilk, Rafal; Mei, Michael; Holzwarth, Ronald; Krumbholz, Norman; Koch, Martin

2010-01-18

Most time-resolved optical experiments rely either on external mechanical delay lines or on two synchronized femtosecond lasers to achieve a defined temporal delay between two optical pulses. Here, we present a new method which does not require any external delay lines and uses only a single femtosecond laser. It is based on the cross-correlation of an optical pulse with a subsequent pulse from the same laser. Temporal delay between these two pulses is achieved by varying the repetition rate of the laser. We validate the new scheme by a comparison with a cross-correlation measurement carried out with a conventional mechanical delay line.

US policy and the Iranian threat. Final report

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

Kerstanski, P.

1995-02-01

Topics include `dual containment` as it affects Iran, international community thoughts; external pressures being applied on Clinton administration; conventional arms buildup from threat it poses to GCC. Israel and U.S.; external threat poised against a weakened Iran; dangers Iran`s unconventional weapons program pose to GCC, Israel. Iraq and West; why Iran believes such a program is essential to its existence; capability of Iran to export its terrorist and revolutionary zeal. Iran overcoming odds on its domestic front; U.S. - GCC relationship and GCC - Iranian relationship and questioned policy of excluding Iran from regional security agreements.

Emergence of resonant mode-locking via delayed feedback in quantum dot semiconductor lasers.

PubMed

Tykalewicz, B; Goulding, D; Hegarty, S P; Huyet, G; Erneux, T; Kelleher, B; Viktorov, E A

2016-02-22

With conventional semiconductor lasers undergoing external optical feedback, a chaotic output is typically observed even for moderate levels of the feedback strength. In this paper we examine single mode quantum dot lasers under strong optical feedback conditions and show that an entirely new dynamical regime is found consisting of spontaneous mode-locking via a resonance between the relaxation oscillation frequency and the external cavity repetition rate. Experimental observations are supported by detailed numerical simulations of rate equations appropriate for this laser type. The phenomenon constitutes an entirely new mode-locking mechanism in semiconductor lasers.

Rotational fluxons of Bose-Einstein condensates in coplanar double-ring traps

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

Brand, J.; Institute of Natural Sciences, Massey University; Haigh, T. J.

Rotational analogs to magnetic fluxons in conventional Josephson junctions are predicted to emerge in the ground state of rotating tunnel-coupled annular Bose-Einstein condensates (BECs). Such topological condensate-phase structures can be manipulated by external potentials. We determine conditions for observing macroscopic quantum tunneling of a fluxon. Rotational fluxons in double-ring BECs can be created, manipulated, and controlled by external potentials in different ways than is possible in the solid-state system, thus rendering them a promising candidate system for studying and utilizing quantum properties of collective many-particle degrees of freedom.

Self-cleaning of superhydrophobic surfaces by spontaneously jumping condensate drops

NASA Astrophysics Data System (ADS)

Wisdom, Katrina; Watson, Jolanta; Watson, Gregory; Chen, Chuan-Hua

2012-11-01

The self-cleaning function of superhydrophobic surfaces is conventionally attributed to the removal of contaminating particles by impacting or rolling water droplets, which implies the action of external forces such as gravity. Here, we demonstrate a new self-cleaning mechanism, whereby condensate drops spontaneously jump upon coalescence on a superhydrophobic surface, and the merged drop self-propels away from the surface along with the contaminants. The jumping-condensate mechanism is shown to autonomously clean superhydrophobic cicada wings, where the contaminating particles cannot be removed by external wind flow. Our findings offer new insights for the development of self-cleaning materials.

Trace element fingerprinting of jewellery rubies by external beam PIXE

NASA Astrophysics Data System (ADS)

Calligaro, T.; Poirot, J.-P.; Querré, G.

1999-04-01

External beam PIXE analysis allows the non-destructive in situ characterisation of gemstones mounted on jewellery pieces. This technique was used for the determination of the geographical origin of 64 rubies set on a high-valued necklace. The trace element content of these gemstones was measured and compared to that of a set of rubies of known sources. Multivariate statistical processing of the results allowed us to infer the provenance of rubies : one comes from Thailand/Cambodia deposit while the remaining are attributed to Burma. This highlights the complementary capabilities of PIXE and conventional gemological observations.

Nonlinear mechanism for the generation of electromagnetic fields in a magnetized plasma by the beatings of waves

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

Aburjania, G. D.; Machabeli, G. Z.; Kharshiladze, O. A.

2006-07-15

The modulational instability in a plasma in a strong constant external magnetic field is considered. The plasmon condensate is modulated not by conventional low-frequency ion sound but by the beatings of two high-frequency transverse electromagnetic waves propagating along the magnetic field. The instability reduces the spatial scales of Langmuir turbulence along the external magnetic field and generates electromagnetic fields. It is shown that, for a pump wave with a sufficiently large amplitude, the effect described in the present paper can be a dominant nonlinear process.

7 CFR 51.1561 - Serious damage.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... any combination of defects, which seriously detracts from the edible or marketing quality, or the internal or external appearance of the potato, or any external defect which cannot be removed without a...

The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance.

PubMed

Jenks, Michelle; Craig, Joyce; Higgins, Joanne; Willits, Iain; Barata, Teresa; Wood, Hannah; Kimpton, Christine; Sims, Andrew

2014-12-01

Scoliosis-structural lateral curvature of the spine-affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18).

Is meat quality of forage-fed steers comparable to the meat quality of conventional beef from concentrate-fed bulls?

PubMed

Blanco, Mireia; Casasús, Isabel; Ripoll, Guillermo; Albertí, Pere; Panea, Begoña; Joy, Margalida

2017-11-01

Replacing concentrates with forages in the diet of finishing cattle to satisfy societal demands and for economic reasons is a target for beef farmers, but this change may affect meat acceptance. In the Mediterranean area, young bulls are usually finished on concentrates (Conventional beef). Alternatively, steers can be finished on grass with supplements (G-supp); however, if carcasses are too lean, meat quality may be negatively affected. To increase fat deposition, grazing steers were finished on a total mixed ration composed of alfalfa hay and corn (TMR). Thus the objective of the study was to compare the quality of Longissimus muscle of the three systems. Conventional beef had low yellowness and similar lightness and redness values compared with the beef from the forage-based systems, which differed slightly. The meat of the G-supp and TMR steers had higher conjugated linoleic acid (CLA) and total n-3 polyunsaturated fatty acid (PUFA) contents and lower n-6/n-3 PUFA ratio (more appropriate from a human health point of view) but was tougher than the Conventional beef. The Conventional beef was better accepted by consumers than the beef from both forage-based systems because it was the most tender. Thus tenderness of meat from forage-fed steers should be improved to ensure consumer acceptance. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Prediction of bovine milk technological traits from mid-infrared spectroscopy analysis in dairy cows.

PubMed

Visentin, G; McDermott, A; McParland, S; Berry, D P; Kenny, O A; Brodkorb, A; Fenelon, M A; De Marchi, M

2015-09-01

Rapid, cost-effective monitoring of milk technological traits is a significant challenge for dairy industries specialized in cheese manufacturing. The objective of the present study was to investigate the ability of mid-infrared spectroscopy to predict rennet coagulation time, curd-firming time, curd firmness at 30 and 60min after rennet addition, heat coagulation time, casein micelle size, and pH in cow milk samples, and to quantify associations between these milk technological traits and conventional milk quality traits. Samples (n=713) were collected from 605 cows from multiple herds; the samples represented multiple breeds, stages of lactation, parities, and milking times. Reference analyses were undertaken in accordance with standardized methods, and mid-infrared spectra in the range of 900 to 5,000cm(-1) were available for all samples. Prediction models were developed using partial least squares regression, and prediction accuracy was based on both cross and external validation. The proportion of variance explained by the prediction models in external validation was greatest for pH (71%), followed by rennet coagulation time (55%) and milk heat coagulation time (46%). Models to predict curd firmness 60min from rennet addition and casein micelle size, however, were poor, explaining only 25 and 13%, respectively, of the total variance in each trait within external validation. On average, all prediction models tended to be unbiased. The linear regression coefficient of the reference value on the predicted value varied from 0.17 (casein micelle size regression model) to 0.83 (pH regression model) but all differed from 1. The ratio performance deviation of 1.07 (casein micelle size prediction model) to 1.79 (pH prediction model) for all prediction models in the external validation was <2, suggesting that none of the prediction models could be used for analytical purposes. With the exception of casein micelle size and curd firmness at 60min after rennet addition, the developed prediction models may be useful as a screening method, because the concordance correlation coefficient ranged from 0.63 (heat coagulation time prediction model) to 0.84 (pH prediction model) in the external validation. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Design of a Cognitive Tool to Enhance Problemsolving Performance

ERIC Educational Resources Information Center

Lee, Youngmin; Nelson, David

2005-01-01

The design of a cognitive tool to support problem-solving performance for external representation of knowledge is described. The limitations of conventional knowledge maps are analyzed in proposing the tool. The design principles and specifications are described. This tool is expected to enhance learners problem-solving performance by allowing…

75 FR 27614 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... of vital shipping lanes. --External relations: --Report on the status of the Convention and.... Additional information regarding this and other IMO SHC public meetings may be found at: http://www.uscg.mil.... The Department of State finds that there is an exceptional circumstance in that this advisory...

Multi-centre audit of VMAT planning and pre-treatment verification.

PubMed

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

PubMed

Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

2015-08-01

To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

Quantifying the accuracy of the tumor motion and area as a function of acceleration factor for the simulation of the dynamic keyhole magnetic resonance imaging method.

PubMed

Lee, Danny; Greer, Peter B; Pollock, Sean; Kim, Taeho; Keall, Paul

2016-05-01

The dynamic keyhole is a new MR image reconstruction method for thoracic and abdominal MR imaging. To date, this method has not been investigated with cancer patient magnetic resonance imaging (MRI) data. The goal of this study was to assess the dynamic keyhole method for the task of lung tumor localization using cine-MR images reconstructed in the presence of respiratory motion. The dynamic keyhole method utilizes a previously acquired a library of peripheral k-space datasets at similar displacement and phase (where phase is simply used to determine whether the breathing is inhale to exhale or exhale to inhale) respiratory bins in conjunction with central k-space datasets (keyhole) acquired. External respiratory signals drive the process of sorting, matching, and combining the two k-space streams for each respiratory bin, thereby achieving faster image acquisition without substantial motion artifacts. This study was the first that investigates the impact of k-space undersampling on lung tumor motion and area assessment across clinically available techniques (zero-filling and conventional keyhole). In this study, the dynamic keyhole, conventional keyhole and zero-filling methods were compared to full k-space dataset acquisition by quantifying (1) the keyhole size required for central k-space datasets for constant image quality across sixty four cine-MRI datasets from nine lung cancer patients, (2) the intensity difference between the original and reconstructed images in a constant keyhole size, and (3) the accuracy of tumor motion and area directly measured by tumor autocontouring. For constant image quality, the dynamic keyhole method, conventional keyhole, and zero-filling methods required 22%, 34%, and 49% of the keyhole size (P < 0.0001), respectively, compared to the full k-space image acquisition method. Compared to the conventional keyhole and zero-filling reconstructed images with the keyhole size utilized in the dynamic keyhole method, an average intensity difference of the dynamic keyhole reconstructed images (P < 0.0001) was minimal, and resulted in the accuracy of tumor motion within 99.6% (P < 0.0001) and the accuracy of tumor area within 98.0% (P < 0.0001) for lung tumor monitoring applications. This study demonstrates that the dynamic keyhole method is a promising technique for clinical applications such as image-guided radiation therapy requiring the MR monitoring of thoracic tumors. Based on the results from this study, the dynamic keyhole method could increase the imaging frequency by up to a factor of five compared with full k-space methods for real-time lung tumor MRI.

Competition, Speculative Risks, and IT Security Outsourcing

NASA Astrophysics Data System (ADS)

Cezar, Asunur; Cavusoglu, Huseyin; Raghunathan, Srinivasan

Information security management is becoming a more critical and, simultaneously, a challenging function for many firms. Even though many security managers are skeptical about outsourcing of IT security, others have cited reasons that are used for outsourcing of traditional IT functions for why security outsourcing is likely to increase. Our research offers a novel explanation, based on competitive externalities associated with IT security, for firms' decisions to outsource IT security. We show that if competitive externalities are ignored, then a firm will outsource security if and only if the MSSP offers a quality (or a cost) advantage over in-house operations, which is consistent with the traditional explanation for security outsourcing. However, a higher quality is neither a prerequisite nor a guarantee for a firm to outsource security. The competitive risk environment and the nature of the security function outsourced, in addition to quality, determine firms' outsourcing decisions. If the reward from the competitor's breach is higher than the loss from own breach, then even if the likelihood of a breach is higher under the MSSP the expected benefit from the competitive demand externality may offset the loss from the higher likelihood of breaches, resulting in one or both firms outsourcing security. The incentive to outsource security monitoring is higher than that of infrastructure management because the MSSP can reduce the likelihood of breach on both firms and thus enhance the demand externality effect. The incentive to outsource security monitoring (infrastructure management) is higher (lower) if either the likelihood of breach on both firms is lower (higher) when security is outsourced or the benefit (relative to loss) from the externality is higher (lower). The benefit from the demand externality arising out of a security breach is higher when more of the customers that leave the breached firm switch to the non-breached firm.

AIR QUALITY CRITERIA CARBON MONOXIDE, EXTERNAL REVIEW DRAFT

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in criteria documents. The last air quality criteria document for carbon monoxide (CO) was completed by EPA in 1991. This...

Farmers' Visions on Soils: A Case Study among Agroecological and Conventional Smallholders in Minas Gerais, Brazil

ERIC Educational Resources Information Center

Klingen, Klarien Elisabeth; De Graaff, Jan; Botelho, Maria Izabel Vieira; Kessler, Aad

2012-01-01

Purpose: Why do farmers not take better care of their soils? This article aims to give insight into how farmers look at soil quality management. Design/methodology/approach: It analyses diverse land management practices and visions on soils and soil quality of ten agroecological and 14 conventional smallholder farmers in Araponga, Minas Gerais,…

Current Flow in the Bubble and Stripe Phases

NASA Astrophysics Data System (ADS)

Friess, B.; Umansky, V.; von Klitzing, K.; Smet, J. H.

2018-03-01

The spontaneous ordering of spins and charges in geometric patterns is currently under scrutiny in a number of different material systems. A topic of particular interest is the interaction of such ordered phases with itinerant electrons driven by an externally imposed current. It not only provides important information on the charge ordering itself but potentially also allows manipulating the shape and symmetry of the underlying pattern if current flow is strong enough. Unfortunately, conventional transport methods probing the macroscopic resistance suffer from the fact that the voltage drop along the sample edges provides only indirect information on the bulk properties because a complex current distribution is elicited by the inhomogeneous ground state. Here, we promote the use of surface acoustic waves to study these broken-symmetry phases and specifically address the bubble and stripe phases emerging in high-quality two-dimensional electron systems in GaAs /AlGaAs heterostructures as prototypical examples. When driving a unidirectional current, we find a surprising discrepancy between the sound propagation probing the bulk of the sample and the voltage drop along the sample edges. Our results prove that the current-induced modifications observed in resistive transport measurements are in fact a local phenomenon only, leaving the majority of the sample unaltered. More generally, our findings shed new light on the extent to which these ordered electron phases are impacted by an external current and underline the intrinsic advantages of acoustic measurements for the study of such inhomogeneous phases.

Impact of antipsychotic treatments on the motivation to eat: preliminary results in 153 schizophrenic patients.

PubMed

Sentissi, Othman; Viala, Annie; Bourdel, Marie C; Kaminski, Flaminia; Bellisle, France; Olié, Jean P; Poirier, Marie F

2009-09-01

Many aspects of the motivation to eat are involved in the impairment of adequate food intake and body weight control. The aim of this study was to evaluate, by adopting widely used eating questionnaires, the Three Factors Eating Behaviour Questionnaire (TFEQ) and the Dutch Eating Behavior Questionnaire (DEBQ), the associations of different antipsychotic medications with the food attitudes of 153 schizophrenic patients: we compared 93 individuals treated with atypical antipsychotics, 27 treated with conventional neuroleptics and 33 untreated patients. We did not find any difference according to sex, but the mean body mass index varied significantly among the three groups of patients. The DEBQ external eating factor was higher in patients treated with atypical antipsychotics than in patients who received conventional neuroleptics (P=0.035). The TFEQ disinhibition and DEBQ emotional eating scores tended to change among the three types of treatment. Patients with metabolic syndrome (19%) had lower DEBQ external eating scores (P=0.044) and a tendency of higher TFEQ disinhibition scores. The TFEQ disinhibition and hunger scores increased according to the body mass index (P=0.003; P=0.017). The main outcome of this study is that the patients treated with atypical antipsychotics were more reactive to external eating cues, which could partly explain the higher weight gain often reported in these patients.

Quality Assurance in Higher Education: Proposals for Consultation.

ERIC Educational Resources Information Center

Higher Education Funding Council for England, Bristol.

This document sets out for consultation proposals for a revised method for quality assurance of teaching and learning in higher education. The proposals cover: (1) the objectives and principles of quality assurance; (2) an approach to quality assurance based on external audit principles; (3) the collection and publication of information; (4)…

Towards a Culture of Quality. Perspectives on Distance Education

ERIC Educational Resources Information Center

Koul, Badri N., Ed.; Kanwar, Asha, Ed.

2006-01-01

This third publication on the theme of quality in the Commonwealth of Learning Perspectives on Distance Education series widens the discussion beyond external quality assurance processes to a more generic focus on a "culture of quality." It is an extension of the earlier two publications, which came out in 1994 and 1997 and drew…

RAS screening in colorectal cancer: a comprehensive analysis of the results from the UK NEQAS colorectal cancer external quality assurance schemes (2009-2016).

PubMed

Richman, Susan D; Fairley, Jennifer; Butler, Rachel; Deans, Zandra C

2017-12-01

Evidence strongly indicates that extended RAS testing should be undertaken in mCRC patients, prior to prescribing anti-EGFR therapies. With more laboratories implementing testing, the requirement for External Quality Assurance schemes increases, thus ensuring high standards of molecular analysis. Data was analysed from 15 United Kingdom National External Quality Assessment Service (UK NEQAS) for Molecular Genetics Colorectal cancer external quality assurance (EQA) schemes, delivered between 2009 and 2016. Laboratories were provided annually with nine colorectal tumour samples for genotyping. Information on methodology and extent of testing coverage was requested, and scores given for genotyping, interpretation and clerical accuracy. There has been a sixfold increase in laboratory participation (18 in 2009 to 108 in 2016). For RAS genotyping, fewer laboratories now use Roche cobas®, pyrosequencing and Sanger sequencing, with more moving to next generation sequencing (NGS). NGS is the most commonly employed technology for BRAF and PIK3CA mutation screening. KRAS genotyping errors were seen in ≤10% laboratories, until the 2014-2015 scheme, when there was an increase to 16.7%, corresponding to a large increase in scheme participants. NRAS genotyping errors peaked at 25.6% in the first 2015-2016 scheme but subsequently dropped to below 5%. Interpretation and clerical accuracy scores have been consistently good throughout. Within this EQA scheme, we have observed that the quality of molecular analysis for colorectal cancer has continued to improve, despite changes in the required targets, the volume of testing and the technologies employed. It is reassuring to know that laboratories clearly recognise the importance of participating in EQA schemes.

Engineering Quality Software: 10 Recommendations for Improved Software Quality Management

DTIC Science & Technology

2010-04-27

lack of user involvement • Inadequate Software Process Management & Control By Contractors • No “Team” of Vendors and users; little SME participation...1990 Quality Perspectives • Process Quality ( CMMI ) • Product Quality (ISO/IEC 2500x) – Internal Quality Attributes – External Quality Attributes... CMMI /ISO 9000 Assessments – Capture organizational knowledge • Identify best practices, lessons learned Know where you are, and where you need to be

Comparison of nutritional quality between conventional and organic dairy products: a meta-analysis.

PubMed

Palupi, Eny; Jayanegara, Anuraga; Ploeger, Angelika; Kahl, Johannes

2012-11-01

As a contribution to the debate on the comparison of nutritional quality between conventional versus organic products, the present study would like to provide new results on this issue specifically on dairy products by integrating the last 3 years' studies using a meta-analysis approach with Hedges' d effect size method. The current meta-analysis shows that organic dairy products contain significantly higher protein, ALA, total omega-3 fatty acid, cis-9,trans-11 conjugated linoleic acid, trans-11 vaccenic acid, eicosapentanoic acid, and docosapentanoic acid than those of conventional types, with cumulative effect size ( ± 95% confidence interval) of 0.56 ± 0.24, 1.74 ± 0.16, 0.84 ± 0.14, 0.68 ± 0.13, 0.51 ± 0.16, 0.42 ± 0.23, and 0.71 ± 0.3, respectively. It is also observed that organic dairy products have significantly (P < 0.001) higher omega-3 to -6 ratio (0.42 vs. 0.23) and Δ9-desaturase index (0.28 vs. 0.27) than the conventional types. The current regulation on organic farming indeed drives organic farms to production of organic dairy products with different nutritional qualities from conventional ones. The differences in feeding regime between conventional and organic dairy production is suspected as the reason behind this evidence. Further identical meta-analysis may be best applicable for summarizing a comparison between conventional and organic foodstuffs for other aspects and food categories. Copyright © 2012 Society of Chemical Industry.

International Accreditations as Drivers of Business School Quality Improvement

ERIC Educational Resources Information Center

Bryant, Michael

2013-01-01

Business schools are under pressure to implement continuous improvement and quality assurance processes to remain competitive in a globalized higher education market. Drivers for quality improvement include external, environmental pressures, regulatory bodies such as governments, and, increasingly, voluntary accreditation agencies such as AACSB…

External quality assurance for HIV point-of-care testing in Africa: A collaborative country-partner approach to strengthen diagnostic services

PubMed Central

2016-01-01

It is important to consider the role of diagnostics and the critical need for quality diagnostics services in resource-limited settings. Accurate diagnostic tests play a key role in patient management and the prevention and control of most infectious diseases. As countries plan for implementation of HIV early infant diagnosis and viral load point-of-care testing, the London School of Hygiene & Tropical Medicine has worked with countries and partners with an interest in external quality assurance to support quality point-of-care testing on the continent. Through a series of collaborative consultations and workshops, the London School of Hygiene & Tropical Medicine has gathered lessons learned, tools, and resources and developed quality assurance models that will support point-of-care testing. The London School of Hygiene & Tropical Medicine is committed to the continued advancement of laboratory diagnostics in Africa and quality laboratory services and point-of-care testing. PMID:28879132

Speech perception benefits of internet versus conventional telephony for hearing-impaired individuals.

PubMed

Mantokoudis, Georgios; Dubach, Patrick; Pfiffner, Flurin; Kompis, Martin; Caversaccio, Marco; Senn, Pascal

2012-07-16

Telephone communication is a challenge for many hearing-impaired individuals. One important technical reason for this difficulty is the restricted frequency range (0.3-3.4 kHz) of conventional landline telephones. Internet telephony (voice over Internet protocol [VoIP]) is transmitted with a larger frequency range (0.1-8 kHz) and therefore includes more frequencies relevant to speech perception. According to a recently published, laboratory-based study, the theoretical advantage of ideal VoIP conditions over conventional telephone quality has translated into improved speech perception by hearing-impaired individuals. However, the speech perception benefits of nonideal VoIP network conditions, which may occur in daily life, have not been explored. VoIP use cannot be recommended to hearing-impaired individuals before its potential under more realistic conditions has been examined. To compare realistic VoIP network conditions, under which digital data packets may be lost, with ideal conventional telephone quality with respect to their impact on speech perception by hearing-impaired individuals. We assessed speech perception using standardized test material presented under simulated VoIP conditions with increasing digital data packet loss (from 0% to 20%) and compared with simulated ideal conventional telephone quality. We monaurally tested 10 adult users of cochlear implants, 10 adult users of hearing aids, and 10 normal-hearing adults in the free sound field, both in quiet and with background noise. Across all participant groups, mean speech perception scores using VoIP with 0%, 5%, and 10% packet loss were 15.2% (range 0%-53%), 10.6% (4%-46%), and 8.8% (7%-33%) higher, respectively, than with ideal conventional telephone quality. Speech perception did not differ between VoIP with 20% packet loss and conventional telephone quality. The maximum benefits were observed under ideal VoIP conditions without packet loss and were 36% (P = .001) for cochlear implant users, 18% (P = .002) for hearing aid users, and 53% (P = .001) for normal-hearing adults. With a packet loss of 10%, the maximum benefits were 30% (P = .002) for cochlear implant users, 6% (P = .38) for hearing aid users, and 33% (P = .002) for normal-hearing adults. VoIP offers a speech perception benefit over conventional telephone quality, even when mild or moderate packet loss scenarios are created in the laboratory. VoIP, therefore, has the potential to significantly improve telecommunication abilities for the large community of hearing-impaired individuals.

Speech Perception Benefits of Internet Versus Conventional Telephony for Hearing-Impaired Individuals

PubMed Central

Dubach, Patrick; Pfiffner, Flurin; Kompis, Martin; Caversaccio, Marco

2012-01-01

Background Telephone communication is a challenge for many hearing-impaired individuals. One important technical reason for this difficulty is the restricted frequency range (0.3–3.4 kHz) of conventional landline telephones. Internet telephony (voice over Internet protocol [VoIP]) is transmitted with a larger frequency range (0.1–8 kHz) and therefore includes more frequencies relevant to speech perception. According to a recently published, laboratory-based study, the theoretical advantage of ideal VoIP conditions over conventional telephone quality has translated into improved speech perception by hearing-impaired individuals. However, the speech perception benefits of nonideal VoIP network conditions, which may occur in daily life, have not been explored. VoIP use cannot be recommended to hearing-impaired individuals before its potential under more realistic conditions has been examined. Objective To compare realistic VoIP network conditions, under which digital data packets may be lost, with ideal conventional telephone quality with respect to their impact on speech perception by hearing-impaired individuals. Methods We assessed speech perception using standardized test material presented under simulated VoIP conditions with increasing digital data packet loss (from 0% to 20%) and compared with simulated ideal conventional telephone quality. We monaurally tested 10 adult users of cochlear implants, 10 adult users of hearing aids, and 10 normal-hearing adults in the free sound field, both in quiet and with background noise. Results Across all participant groups, mean speech perception scores using VoIP with 0%, 5%, and 10% packet loss were 15.2% (range 0%–53%), 10.6% (4%–46%), and 8.8% (7%–33%) higher, respectively, than with ideal conventional telephone quality. Speech perception did not differ between VoIP with 20% packet loss and conventional telephone quality. The maximum benefits were observed under ideal VoIP conditions without packet loss and were 36% (P = .001) for cochlear implant users, 18% (P = .002) for hearing aid users, and 53% (P = .001) for normal-hearing adults. With a packet loss of 10%, the maximum benefits were 30% (P = .002) for cochlear implant users, 6% (P = .38) for hearing aid users, and 33% (P = .002) for normal-hearing adults. Conclusions VoIP offers a speech perception benefit over conventional telephone quality, even when mild or moderate packet loss scenarios are created in the laboratory. VoIP, therefore, has the potential to significantly improve telecommunication abilities for the large community of hearing-impaired individuals. PMID:22805169

Internal quality assurance in diagnostic microbiology: A simple approach for insightful data

PubMed Central

Scherz, Valentin; Durussel, Christian

2017-01-01

Given the importance of microbiology results on patient care, high quality standards are expected. Internal quality assurance (IQA) could mitigate the limitations of internal quality control, competency assessment and external quality assurance, adding a longitudinal insight, including pre- and post-analytical steps. Here, we implemented an IQA program in our clinical microbiology facilities with blind resubmission of routine samples during 22 months. One-hundred-and-twenty-one out of 123 (98.4%) serological analyses and 112 out of 122 (91.8%) molecular analyses were concordant. Among the discordances in molecular biology analyses, 6 results were low positive samples that turned out negative, likely due to stochastic repartition of nucleic acids. Moreover, one identified retranscription error led us to implement automated results transmission from the Applied Biosystems instruments to the laboratory information system (LIS). Regarding Gram stain microscopy, 560 out of 745 (75.2%) of compared parameters were concordant. As many as 67 out of 84 (79.8%) pairs of culture results were similar, including 16 sterile pairs, 27 having identical identification or description and semi-quantification and 24 only showing variations in semi-quantification with identical description or identification of colonies. Seventeen pairs had diverging identification or description of colonies. Culture was twice only done for one member of the pairs. Regarding antibiotic susceptibility testing, a major discrepancy was observed in 5 out of 48 results (10.4%). In conclusion, serological tests were highly reproducible. Molecular diagnosis also revealed to be robust except when the amounts of nucleic acids present in the sample were close to the limits of detection. Conventional microbiology was less robust with major discrepancies reaching 39.5% of the samples for microscopy. Similarly, culture and antibiotic susceptibility testing were prone to discrepancies. This work was ground for reconsidering multiples aspects of our practices and demonstrates the importance of IQA to complete the other quality management procedures. PMID:29135992

Internal quality assurance in diagnostic microbiology: A simple approach for insightful data.

PubMed

Scherz, Valentin; Durussel, Christian; Greub, Gilbert

2017-01-01

Given the importance of microbiology results on patient care, high quality standards are expected. Internal quality assurance (IQA) could mitigate the limitations of internal quality control, competency assessment and external quality assurance, adding a longitudinal insight, including pre- and post-analytical steps. Here, we implemented an IQA program in our clinical microbiology facilities with blind resubmission of routine samples during 22 months. One-hundred-and-twenty-one out of 123 (98.4%) serological analyses and 112 out of 122 (91.8%) molecular analyses were concordant. Among the discordances in molecular biology analyses, 6 results were low positive samples that turned out negative, likely due to stochastic repartition of nucleic acids. Moreover, one identified retranscription error led us to implement automated results transmission from the Applied Biosystems instruments to the laboratory information system (LIS). Regarding Gram stain microscopy, 560 out of 745 (75.2%) of compared parameters were concordant. As many as 67 out of 84 (79.8%) pairs of culture results were similar, including 16 sterile pairs, 27 having identical identification or description and semi-quantification and 24 only showing variations in semi-quantification with identical description or identification of colonies. Seventeen pairs had diverging identification or description of colonies. Culture was twice only done for one member of the pairs. Regarding antibiotic susceptibility testing, a major discrepancy was observed in 5 out of 48 results (10.4%). In conclusion, serological tests were highly reproducible. Molecular diagnosis also revealed to be robust except when the amounts of nucleic acids present in the sample were close to the limits of detection. Conventional microbiology was less robust with major discrepancies reaching 39.5% of the samples for microscopy. Similarly, culture and antibiotic susceptibility testing were prone to discrepancies. This work was ground for reconsidering multiples aspects of our practices and demonstrates the importance of IQA to complete the other quality management procedures.

Feedstock and Conversion Supply System Design and Analysis

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

Jacobson, J.; Mohammad, R.; Cafferty, K.

The success of the earlier logistic pathway designs (Biochemical and Thermochemical) from a feedstock perspective was that it demonstrated that through proper equipment selection and best management practices, conventional supply systems (referred to in this report as “conventional designs,” or specifically the 2012 Conventional Design) can be successfully implemented to address dry matter loss, quality issues, and enable feedstock cost reductions that help to reduce feedstock risk of variable supply and quality and enable industry to commercialize biomass feedstock supply chains. The caveat of this success is that conventional designs depend on high density, low-cost biomass with no disruption frommore » incremental weather. In this respect, the success of conventional designs is tied to specific, highly productive regions such as the southeastern U.S. which has traditionally supported numerous pulp and paper industries or the Midwest U.S for corn stover.« less

Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

PubMed

Yoon, Jihyung; Xie, Yibo; Zhang, Rui

2018-03-01

The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

L-Boronophenylalanine-Mediated Boron Neutron Capture Therapy for Malignant Glioma Progressing After External Beam Radiation Therapy: A Phase I Study

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

Kankaanranta, Leena; Seppaelae, Tiina; Koivunoro, Hanna

Purpose: To investigate the safety of boronophenylalanine-mediated boron neutron capture therapy (BNCT) in the treatment of malignant gliomas that progress after surgery and conventional external beam radiation therapy. Methods and Materials: Adult patients who had histologically confirmed malignant glioma that had progressed after surgery and external beam radiotherapy were eligible for this Phase I study, provided that >6 months had elapsed from the last date of radiation therapy. The first 10 patients received a fixed dose, 290 mg/kg, of L-boronophenylalanine-fructose (L-BPA-F) as a 2-hour infusion before neutron irradiation, and the remaining patients were treated with escalating doses of L-BPA-F, eithermore » 350 mg/kg, 400 mg/kg, or 450 mg/kg, using 3 patients on each dose level. Adverse effects were assessed using National Cancer Institute Common Toxicity Criteria version 2.0. Results: Twenty-two patients entered the study. Twenty subjects had glioblastoma, and 2 patients had anaplastic astrocytoma, and the median cumulative dose of prior external beam radiotherapy was 59.4 Gy. The maximally tolerated L-BPA-F dose was reached at the 450 mg/kg level, where 4 of 6 patients treated had a grade 3 adverse event. Patients who were given >290 mg/kg of L-BPA-F received a higher estimated average planning target volume dose than those who received 290 mg/kg (median, 36 vs. 31 Gy [W, i.e., a weighted dose]; p = 0.018). The median survival time following BNCT was 7 months. Conclusions: BNCT administered with an L-BPA-F dose of up to 400 mg/kg as a 2-hour infusion is feasible in the treatment of malignant gliomas that recur after conventional radiation therapy.« less

System Study for Axial Vane Engine Technology

NASA Technical Reports Server (NTRS)

Badley, Patrick R.; Smith, Michael R.; Gould, Cedric O.

2008-01-01

The purpose of this engine feasibility study was to determine the benefits that can be achieved by incorporating positive displacement axial vane compression and expansion stages into high bypass turbofan engines. These positive-displacement stages would replace some or all of the conventional compressor and turbine stages in the turbine engine, but not the fan. The study considered combustion occurring internal to an axial vane component (i.e., Diesel engine replacing the standard turbine engine combustor, burner, and turbine); and external continuous flow combustion with an axial vane compressor and an axial vane turbine replacing conventional compressor and turbine systems.

A new algorithm for modeling friction in dynamic mechanical systems

NASA Technical Reports Server (NTRS)

Hill, R. E.

1988-01-01

A method of modeling friction forces that impede the motion of parts of dynamic mechanical systems is described. Conventional methods in which the friction effect is assumed a constant force, or torque, in a direction opposite to the relative motion, are applicable only to those cases where applied forces are large in comparison to the friction, and where there is little interest in system behavior close to the times of transitions through zero velocity. An algorithm is described that provides accurate determination of friction forces over a wide range of applied force and velocity conditions. The method avoids the simulation errors resulting from a finite integration interval used in connection with a conventional friction model, as is the case in many digital computer-based simulations. The algorithm incorporates a predictive calculation based on initial conditions of motion, externally applied forces, inertia, and integration step size. The predictive calculation in connection with an external integration process provides an accurate determination of both static and Coulomb friction forces and resulting motions in dynamic simulations. Accuracy of the results is improved over that obtained with conventional methods and a relatively large integration step size is permitted. A function block for incorporation in a specific simulation program is described. The general form of the algorithm facilitates implementation with various programming languages such as FORTRAN or C, as well as with other simulation programs.

The Value of Data and Metadata Standardization for Interoperability in Giovanni

NASA Astrophysics Data System (ADS)

Smit, C.; Hegde, M.; Strub, R. F.; Bryant, K.; Li, A.; Petrenko, M.

2017-12-01

Giovanni (https://giovanni.gsfc.nasa.gov/giovanni/) is a data exploration and visualization tool at the NASA Goddard Earth Sciences Data Information Services Center (GES DISC). It has been around in one form or another for more than 15 years. Giovanni calculates simple statistics and produces 22 different visualizations for more than 1600 geophysical parameters from more than 90 satellite and model products. Giovanni relies on external data format standards to ensure interoperability, including the NetCDF CF Metadata Conventions. Unfortunately, these standards were insufficient to make Giovanni's internal data representation truly simple to use. Finding and working with dimensions can be convoluted with the CF Conventions. Furthermore, the CF Conventions are silent on machine-friendly descriptive metadata such as the parameter's source product and product version. In order to simplify analyzing disparate earth science data parameters in a unified way, we developed Giovanni's internal standard. First, the format standardizes parameter dimensions and variables so they can be easily found. Second, the format adds all the machine-friendly metadata Giovanni needs to present our parameters to users in a consistent and clear manner. At a glance, users can grasp all the pertinent information about parameters both during parameter selection and after visualization. This poster gives examples of how our metadata and data standards, both external and internal, have both simplified our code base and improved our users' experiences.

Use of in Vitro HTS-Derived Concentration-Response Data as ...

EPA Pesticide Factsheets

Background: Quantitative high-throughput screening (qHTS) assays are increasingly being employed to inform chemical hazard identification. Hundreds of chemicals have been tested in dozens of cell lines across extensive concentration ranges by the National Toxicology Program in collaboration with the NIH Chemical Genomics Center. Objectives: To test a hypothesis that dose-response data points of the qHTS assays can serve as biological descriptors of assayed chemicals and, when combined with conventional chemical descriptors, may improve the accuracy of Quantitative Structure-Activity Relationship (QSAR) models applied to prediction of in vivo toxicity endpoints. Methods and Results: The cell viability qHTS concentration-response data for 1,408 substances assayed in 13 cell lines were obtained from PubChem; for a subset of these compounds rodent acute toxicity LD50 data were also available. The classification k Nearest Neighbor and Random Forest QSAR methods were employed for modeling LD50 data using either chemical descriptors alone (conventional models) or in combination with biological descriptors derived from the concentration-response qHTS data (hybrid models). Critical to our approach was the use of a novel noise-filtering algorithm to treat qHTS data. We show that both the external classification accuracy and coverage (i.e., fraction of compounds in the external set that fall within the applicability domain) of the hybrid QSAR models was superior to convent

Direct Signal-to-Noise Quality Comparison between an Electronic and Conventional Stethoscope aboard the International Space Station

NASA Technical Reports Server (NTRS)

Marshburn, Thomas; Cole, Richard; Ebert, Doug; Bauer, Pete

2014-01-01

Introduction: Evaluation of heart, lung, and bowel sounds is routinely performed with the use of a stethoscope to help detect a broad range of medical conditions. Stethoscope acquired information is even more valuable in a resource limited environments such as the International Space Station (ISS) where additional testing is not available. The high ambient noise level aboard the ISS poses a specific challenge to auscultation by stethoscope. An electronic stethoscope's ambient noise-reduction, greater sound amplification, recording capabilities, and sound visualization software may be an advantage to a conventional stethoscope in this environment. Methods: A single operator rated signal-to-noise quality from a conventional stethoscope (Littman 2218BE) and an electronic stethoscope (Litmann 3200). Borborygmi, pulmonic, and cardiac sound quality was ranked with both stethoscopes. Signal-to-noise rankings were preformed on a 1 to 10 subjective scale with 1 being inaudible, 6 the expected quality in an emergency department, 8 the expected quality in a clinic, and 10 the clearest possible quality. Testing took place in the Japanese Pressurized Module (JPM), Unity (Node 2), Destiny (US Lab), Tranquility (Node 3), and the Cupola of the International Space Station. All examinations were conducted at a single point in time. Results: The electronic stethoscope's performance ranked higher than the conventional stethoscope for each body sound in all modules tested. The electronic stethoscope's sound quality was rated between 7 and 10 in all modules tested. In comparison, the traditional stethoscope's sound quality was rated between 4 and 7. The signal to noise ratio of borborygmi showed the biggest difference between stethoscopes. In the modules tested, the auscultation of borborygmi was rated between 5 and 7 by the conventional stethoscope and consistently 10 by the electronic stethoscope. Discussion: This stethoscope comparison was limited to a single operator. However, we believe the results are noteworthy. The electronic stethoscope out preformed the traditional stethoscope in each direct comparison. Consideration should be made to incorporate an electronic stethoscope into current and future space vehicle medical kits.

Evaluation of an external quality assessment program for HIV testing in Haiti, 2006-2011.

PubMed

Louis, Frantz Jean; Anselme, Renette; Ndongmo, Clement; Buteau, Josiane; Boncy, Jacques; Dahourou, Georges; Vertefeuille, John; Marston, Barbara; Balajee, S Arunmozhi

2013-12-01

To evaluate an external quality assessment (EQA) program for human immunodeficiency virus (HIV) rapid diagnostics testing by the Haitian National Public Health Laboratory (French acronym: LNSP). Acceptable performance was defined as any proficiency testing (PT) score more than 80%. The PT database was reviewed and analyzed to assess the testing performance of the participating laboratories and the impact of the program over time. A total of 242 laboratories participated in the EQA program from 2006 through 2011; participation increased from 70 laboratories in 2006 to 159 in 2011. In 2006, 49 (70%) laboratories had a PT score of 80% or above; by 2011, 145 (97.5%) laboratories were proficient (P < .05). The EQA program for HIV testing ensures quality of testing and allowed the LNSP to document improvements in the quality of HIV rapid testing over time.

The association of academic burnout with self-efficacy and quality of learning experience among Iranian students.

PubMed

Charkhabi, Morteza; Azizi Abarghuei, Mohsen; Hayati, Davood

2013-01-01

The present study examines the relationship between academic burnout and quality of learning experience and self-efficacy among undergraduate students. The sample consisted of 233 undergraduate students (106 men and 127 women) who were selected by stratified random sampling method. The participants completed the Quality of Learning Experience Scale, Academic Burnout scale, and General Self-Efficacy scale. This study is particularly interesting in the context of Iran, known for its equality-striving and high-quality educational system. Iranian youth, compared with youth in many other countries, have a lower level of well-being. The antecedents of academic burnout are divided into two categories: internal and external variables. In most studies regarding to the issue, one category is used to predict the dependent variable. However, in this study we utilized both ones; self-efficacy was considered as internal and quality of learning experience was used as an external predictor. Correlation coefficients indicated that all relationships between academic burnout and its components with self-efficacy were statistically significant. Furthermore, academic burnout and all of its components had significant correlations with quality of learning experience. Also, the relationship between resources with emotional exhaustion and professor-student relationship with academic inefficacy were not significant. On the basis of the results, through our research, we will expand academic burnout literature by focusing on its external and internal antecedents. In addition, we conclude with theoretical and practical implications and propose a clear horizon for future researches.

Infrared machine vision system for the automatic detection of olive fruit quality.

PubMed

Guzmán, Elena; Baeten, Vincent; Pierna, Juan Antonio Fernández; García-Mesa, José A

2013-11-15

External quality is an important factor in the extraction of olive oil and the marketing of olive fruits. The appearance and presence of external damage are factors that influence the quality of the oil extracted and the perception of consumers, determining the level of acceptance prior to purchase in the case of table olives. The aim of this paper is to report on artificial vision techniques developed for the online estimation of olive quality and to assess the effectiveness of these techniques in evaluating quality based on detecting external defects. This method of classifying olives according to the presence of defects is based on an infrared (IR) vision system. Images of defects were acquired using a digital monochrome camera with band-pass filters on near-infrared (NIR). The original images were processed using segmentation algorithms, edge detection and pixel value intensity to classify the whole fruit. The detection of the defect involved a pixel classification procedure based on nonparametric models of the healthy and defective areas of olives. Classification tests were performed on olives to assess the effectiveness of the proposed method. This research showed that the IR vision system is a useful technology for the automatic assessment of olives that has the potential for use in offline inspection and for online sorting for defects and the presence of surface damage, easily distinguishing those that do not meet minimum quality requirements. Crown Copyright © 2013 Published by Elsevier B.V. All rights reserved.

Higher quality of molecular testing, an unfulfilled priority: Results from external quality assessment for KRAS mutation testing in colorectal cancer.

PubMed

Tembuyser, Lien; Ligtenberg, Marjolijn J L; Normanno, Nicola; Delen, Sofie; van Krieken, J Han; Dequeker, Elisabeth M C

2014-05-01

Precision medicine is now a key element in clinical oncology. RAS mutational status is a crucial predictor of responsiveness to anti-epidermal growth factor receptor agents in metastatic colorectal cancer. In an effort to guarantee high-quality testing services in molecular pathology, the European Society of Pathology has been organizing an annual KRAS external quality assessment program since 2009. In 2012, 10 formalin-fixed, paraffin-embedded samples, of which 8 from invasive metastatic colorectal cancer tissue and 2 artificial samples of cell line material, were sent to more than 100 laboratories from 26 countries with a request for routine KRAS testing. Both genotyping and clinical reports were assessed independently. Twenty-seven percent of the participants genotyped at least 1 of 10 samples incorrectly. In total, less than 5% of the distributed specimens were genotyped incorrectly. Genotyping errors consisted of false negatives, false positives, and incorrectly genotyped mutations. Twenty percent of the laboratories reported a technical error for one or more samples. A review of the written reports showed that several essential elements were missing, most notably a clinical interpretation of the test result, the method sensitivity, and the use of a reference sequence. External quality assessment serves as a valuable educational tool in assessing and improving molecular testing quality and is an important asset for monitoring quality assurance upon incorporation of new biomarkers in diagnostic services. Copyright © 2014 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

Guide to the measurement of tree characteristics important to the quality classification for young hardwood trees

Treesearch

David L. Sonderman

1979-01-01

A procedure is shown for measuring external tree characteristics that are important in determining the current and future quality of young hardwood trees. This guide supplements a precious study which describes the quality classification system for young hardwood trees

Comparison of the microbiological quality of environmentally friendly and conventionally grown vegetables sold at retail markets in Korea.

PubMed

Ryu, Jee-Hoon; Kim, Minju; Kim, Eun-Gyeong; Beuchat, Larry R; Kim, Hoikyung

2014-09-01

Fresh produce is usually eaten raw without cooking or heating, which may increase the probability of foodborne infection. The microbiological quality of 11 types of fresh, raw vegetables (romaine lettuce, sesame leaves, crown daisy, garlic chives, iceberg lettuce, cabbage, broccoli, leek, chili pepper, capsicum, and zucchini) purchased at retail markets in Iksan, Korea as affected by cultivation method (environmentally friendly vegetables [organic, pesticide-free, and low-pesticide vegetables] and conventionally grown vegetables) and harvest season was determined. Escherichia coli O157:H7 and Salmonella were not detected in all samples of vegetables tested. Aerobic mesophiles (>6 log cfu/g) were detected in environmentally friendly romaine lettuce and crown daisy and environmentally friendly and conventionally grown garlic chives, which also contained coliforms (>3 log cfu/g). Sesame leaf and crown daisy (regardless of cultivation method), as well as conventionally grown romaine lettuce and leek, contained >1 log cfu/g of E. coli. The overall microbiological quality of environmentally friendly and conventionally grown vegetables was not significantly different (P > 0.05). However, there were seasonal effects on populations of coliforms and generic E. coli on vegetables. The greatest numbers of microorganisms were isolated from environmentally friendly or conventionally grown vegetables purchased in winter. The vegetables, regardless of cultivation method or season, should be subjected to appropriate antimicrobial treatment to enhance their microbial safety. © 2014 Institute of Food Technologists®

External front instabilities induced by a shocked particle ring.

PubMed

Rodriguez, V; Saurel, R; Jourdan, G; Houas, L

2014-10-01

The dispersion of a cylindrical particle ring by a blast or shock wave induces the formation of coherent structures which take the form of particle jets. A blast wave, issuing from the discharge of a planar shock wave at the exit of a conventional shock tube, is generated in the center of a granular medium ring initially confined inside a Hele-Shaw cell. With the present experimental setup, under impulsive acceleration, a solid particle-jet formation is observed in a quasi-two-dimensional configuration. The aim of the present investigation is to observe in detail the formation of very thin perturbations created around the external surface of the dispersed particle layer. By means of fast flow visualization with an appropriate recording window, we focus solely on the first instants during which the external particle ring becomes unstable. We find that the critical area of the destabilization of the external ring surface is constant regardless of the acceleration of the initial layer. Moreover, we observe in detail the external front perturbation wavelength, rendered dimensionless by the initial ring perimeter, and follow its evolution with the initial particle layer acceleration. We report this quantity to be constant regardless of the evolution of the initial particle layer acceleration. Finally, we can reasonably assert that external front perturbations depend solely on the material of the particles.

[Quality assurance in interventional cardiology].

PubMed

Gülker, H

2009-10-01

Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

The Logic of the Thai Higher Education Sector on Quality Assessment Policy

ERIC Educational Resources Information Center

Sae-Lao, Rattana

2013-01-01

Although the concept of quality has been an essential part of the higher education sector, the global quest for Quality Assessment (QA hereafter) has raised attention to quality to a new level. Van Vught and Westerheijden (1994) argue that the common charateristics of QA policy include: meta-level organization to conduct external evaluation,…

Institutional Quality of a Higher Education Institution from the Perspective of Employers

ERIC Educational Resources Information Center

Rodman, Karmen; Biloslavo, Roberto; Bratoz, Silva

2013-01-01

The present paper proposes a theoretical model of institutional quality of a higher education institution (HEI) which, in addition to the internal dimensions of quality, incorporates also the external dimension, i.e. the outcomes dimension. This dimension has been neglected by the quality standards and models examined in our paper. Furthermore,…

Lecturer Quality, Quantity and Gender in Colleges of Education in Nigeria

ERIC Educational Resources Information Center

Arubayi, D. O.

2009-01-01

The quality and quantity of lecturers in Tertiary institutions to a great extent determines the quality of graduates. To ensure quality and quantity the Colleges of Education in Nigeria have established internal and external mechanisms. Quantity is determined by the number of students to a given lecturer. Despite the mechanism put forward to…

Laying the groundwork for NEON's continental-scale ecological research

NASA Astrophysics Data System (ADS)

Dethloff, G.; Denslow, M.

2013-12-01

The National Ecological Observatory Network (NEON) is designed to examine a suite of ecological issues. Field-collected data from 96 terrestrial and aquatic sites across the U.S. will be combined with remotely sensed data and existing continental-scale data sets. Field collections will include a range of physical and biological types, including soil, sediment, surface water, groundwater, precipitation, plants, animals, insects, and microbes as well as biological sub-samples such as leaf material, blood and tissue samples, and DNA extracts. Initial data analyses and identifications of approximately 175,000 samples per year will occur at numerous external laboratories when all sites are fully staffed in 2017. Additionally, NEON will archive biotic and abiotic specimens at collections facilities where they will be curated and available for additional analyses by the scientific community. The number of archived specimens is currently estimated to exceed 130,000 per year by 2017. We will detail how NEON is addressing the complexities and challenges around this set of analyses and specimens and how the resulting high-quality data can impact ecological understanding. The raw data returned from external laboratories that is quality checked and served by NEON will be the foundation for many NEON data products. For example, sequence-quality nucleic acids extracted from surface waters, benthic biofilms, and soil samples will be building blocks for data products on microbial diversity. The raw sequence data will also be available for uses such as evolutionary investigations, and the extracts will be archived so others can acquire them for additional research. Currently, NEON is establishing contracts for the analysis and archiving of field-collected samples through 2017. During this period, NEON will gather information on the progress and success of this large-scale effort in order to determine the most effective course to pursue with external facilities. Two areas that NEON already knows to evaluate are the need for geographic expertise in taxonomic identifications and the capacity necessary to handle the volume of samples. NEON is also addressing challenges associated with external entities and the logistics of sample movement, data formatting, data ingestion, and reporting. For example, NEON is considering tools, such as web APIs, which could allow efficient transfer of data from external facilities. Having a standard format in place for that data will be critical to transfer success and quality assessment. NEON is also working on the implementation of quality control measures for diverse analytical and taxonomic processes across laboratories, and is developing an external audit process. Additionally, given NEON's open access approach, the Network is focused on selecting a sample identification protocol that aids in tracking samples with more involved analytical needs and also allows maximum utility for the scientific community. Given the complex nature and breadth of the project, NEON will be developing novel sample management systems as well as metadata schemas. These efforts insure integrity and quality from field to external facility to archive for each sample taken, providing high-quality data now and confidence in future research stemming from raw data generated by NEON and its collection specimens.

Introduction to a Special Issue of the Journal of Immunological Methods: Building global resource programs to support HIV/AIDS clinical trial studies.

PubMed

Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice

2014-07-01

This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of virologic and immunologic testing. Copyright © 2014 Elsevier B.V. All rights reserved.

Deepening our understanding of quality improvement in Europe (DUQuE): overview of a study of hospital quality management in seven countries.

PubMed

Secanell, Mariona; Groene, Oliver; Arah, Onyebuchi A; Lopez, Maria Andrée; Kutryba, Basia; Pfaff, Holger; Klazinga, Niek; Wagner, Cordula; Kristensen, Solvejg; Bartels, Paul Daniel; Garel, Pascal; Bruneau, Charles; Escoval, Ana; França, Margarida; Mora, Nuria; Suñol, Rosa

2014-04-01

This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods applied, highlighting the novel features of this study. DUQuE was designed as a multi-level cross-sectional study with data collection at hospital, pathway, professional and patient level in eight countries. We aimed to collect data for the assessment of hospital-wide constructs from up to 30 randomly selected hospitals in each country, and additional data at pathway and patient level in 12 of these 30. A comprehensive conceptual framework was developed to account for the multiple levels that influence hospital performance and patient outcomes. We assessed hospital-specific constructs (organizational culture and professional involvement), clinical pathway constructs (the organization of care processes for acute myocardial infarction, stroke, hip fracture and deliveries), patient-specific processes and outcomes (clinical effectiveness, patient safety and patient experience) and external constructs that could modify hospital quality (external assessment and perceived external pressure). Data was gathered from 188 hospitals in 7 participating countries. The overall participation and response rate were between 75% and 100% for the assessed measures. This is the first study assessing relation between quality management and patient outcomes at EU level. The study involved a large number of respondents and achieved high response rates. This work will serve to develop guidance in how to assess quality management and makes recommendations on the best ways to improve quality in healthcare for hospital stakeholders, payers, researchers, and policy makers throughout the EU.

Conventional vs. reduced field of view diffusion weighted imaging of the prostate: Comparison of image quality, correlation with histology, and inter-reader agreement.

PubMed

Warndahl, Brent A; Borisch, Eric A; Kawashima, Akira; Riederer, Stephen J; Froemming, Adam T

2018-04-01

To evaluate if Field of view Optimized and Constrained Undistorted Single shot (FOCUS) (GE Healthcare, Waukesha, WI) diffusion weighted images (DWI) provide more reliable imaging than conventional DWI, with non-inferior quantitative apparent diffusion coefficient (ADC) results. IRB approval was obtained for this study of 43 patients (44 exams, one patient with two visits) that underwent multiparametric prostate MRI with two DWI sequences and subsequent radical prostatectomy with histology as the gold standard. Randomized DWI sequence images were graded independently by two blinded experienced prostate MRI radiologists with a period of memory extinction between the two separate reading sessions. Blinded images were also reviewed head to head in a later session for direct comparison. Multiple parameters were measured from a region of interest in a dominant lesion as well as two control areas. Patient characteristics were collected by chart review. There was good correlation between the mean ADC value for lesions obtained by conventional and FOCUS DWI (ρ=0.85), with no trend toward any systematic difference, and equivalent correlation between ADC measurements and Gleason score. Agreement between the two readers was significantly higher for lesion ROI analysis with the FOCUS DWI derived ADC values (CCC 0.839) compared with the conventional ADC values (CCC 0.618; difference 0.221, 95% CI 0.01-0.46). FOCUS showed significantly better image quality scores (separate review: mean 2.17±0.6, p<0.001) compared to the conventional sequence (mean 2.65±0.6, p<0.001). In 13 cases the image quality was improved from grade of 3+ with conventional DWI to <3 with FOCUS DWI, a clinically meaningful improvement. Head-to-head blinded review found 61 ratings showed strong to slight preference for FOCUS, 13 no preference, and 14 slight preference for the conventional sequence. There was also a strong and equivalent correlation between both sequences and PIRADS version 2 grading (ρ=-0.56 and -0.58 for FOCUS and conventional, respectively, p<0.001 for both). FOCUS DWI of the prostate shows significant improvement in inter-reader agreement and image quality. As opposed to previous conflicting smaller studies, we found equivalent ADC metrics compared with the conventional DWI sequence, and preserved correlation with Gleason score. In 52% of patients the improved image quality with FOCUS had the potential to salvage exams with otherwise limited to non-diagnostic DWI. Copyright © 2017 Elsevier Inc. All rights reserved.

Prospective randomized controlled trial of conventional laparoscopic versus laparoendoscopic single-site radical nephrectomy for localized renal cell carcinoma: a preliminary report regarding quality of life.

PubMed

Park, Yong Hyun; Kim, Kwang Taek; Ko, Kyungtae; Kim, Hyeon Hoe

2015-03-01

The safety and efficacy of laparoendoscopic single-site surgery (LESS) for renal cell carcinoma (RCC) have not been clearly demonstrated. We aimed to present preliminary data from a prospective randomized controlled trial of LESS versus conventional laparoscopic radical nephrectomy for localized RCC. Patients with cT1-2 RCC were randomized to LESS (n = 17) or conventional laparoscopy (n = 18) group. The short-term outcome measures assessed were perioperative morbidity, postoperative pain, and quality of recovery as determined using QoR-40. No significant differences were observed between the LESS and conventional laparoscopy groups with respect to operative time (143.5 vs. 126.1 min, p = 0.218), blood loss (143.6 vs. 118.2 ml, p = 0.121), hospital stay (3.8 vs. 3.1 day s, p = 0.170), analgesic requirements (63.2 vs. 60.0 mg, p = 0.956), and complication rates (26.7 vs. 22.2 %, p = 0.767). However, postoperative quality of recovery was better in the LESS group (176.4 vs. 152.6, p = 0.005). Furthermore, quality of recovery, as measured using the QoR-40 dimensions of emotional state (39.9 vs. 34.0, p = 0.003), physical comfort (51.9 vs. 46.7, p = 0.034), psychological support (32.2 vs. 25.8, p = 0.003), and physical independence (20.7 vs. 17.5, p = 0.047), but not pain (31.8 vs. 29.6, p = 0.259), was significantly better in the LESS group. The preliminary results from this prospective trial suggest that LESS could be a safe and effective treatment option for localized RCC with equivalent surgical outcomes and improved postoperative quality of recovery compared with conventional laparoscopic surgery.

Image quality assessment of silent T2 PROPELLER sequence for brain imaging in infants.

PubMed

Kim, Hyun Gi; Choi, Jin Wook; Yoon, Soo Han; Lee, Sieun

2018-02-01

Infants are vulnerable to high acoustic noise. Acoustic noise generated by MR scanning can be reduced by a silent sequence. The purpose of this study is to compare the image quality of the conventional and silent T2 PROPELLER sequences for brain imaging in infants. A total of 36 scans were acquired from 24 infants using a 3 T MR scanner. Each patient underwent both conventional and silent T2 PROPELLER sequences. Acoustic noise level was measured. Quantitative and qualitative assessments were performed with the images taken with each sequence. The sound pressure level of the conventional T2 PROPELLER imaging sequence was 92.1 dB and that of the silent T2 PROPELLER imaging sequence was 73.3 dB (reduction of 20%). On quantitative assessment, the two sequences (conventional vs silent T2 PROPELLER) did not show significant difference in relative contrast (0.069 vs 0.068, p value = 0.536) and signal-to-noise ratio (75.4 vs 114.8, p value = 0.098). Qualitative assessment of overall image quality (p value = 0.572), grey-white differentiation (p value = 0.986), shunt-related artefact (p value > 0.999), motion artefact (p value = 0.801) and myelination degree in different brain regions (p values ≥ 0.092) did not show significant difference between the two sequences. The silent T2 PROPELLER sequence reduces acoustic noise and generated comparable image quality to that of the conventional sequence. Advances in knowledge: This is the first report to compare silent T2 PROPELLER images with that of conventional T2 PROPELLER images in children.

Integral bypass diodes in an amorphous silicon alloy photovoltaic module

NASA Technical Reports Server (NTRS)

Hanak, J. J.; Flaisher, H.

1991-01-01

Thin-film, tandem-junction, amorphous silicon (a-Si) photovoltaic modules were constructed in which a part of the a-Si alloy cell material is used to form bypass protection diodes. This integral design circumvents the need for incorporating external, conventional diodes, thus simplifying the manufacturing process and reducing module weight.

Some Background Considerations to the Establishment of an External Studies Programme.

ERIC Educational Resources Information Center

Gordon, Hopeton L. A.

A study was made of how conventional, face-to-face teaching methods might be used in conjunction with correspondence study (CS), programed instruction (PI), educational television (ETV) and radio broadcasts, and other approaches to make higher education more widely available throughout the region served by the University of the West Indies. These…

Observations of Representational Practices by Indian-Descent Children in a US Preschool Classroom: Connections among People, Spaces and Artifacts

ERIC Educational Resources Information Center

Braswell, Gregory S.

2015-01-01

This exploratory study examined children's experiences with producing and comprehending external representations in a preschool classroom. Data collection and analyses focused on how artifacts, spaces, adult-guided routines, and social conventions shape young children's representational development. Participants included 4- and…

Assistance and Accountability in Externally Managed Schools: The Case of Edison Schools, Inc.

ERIC Educational Resources Information Center

Marsh, Julie; Hamilton, Laura; Gill, Brian

2008-01-01

Edison Schools, Inc., is the largest and most visible among a growing number of Education Management Organizations that have entered into contracts to manage public schools, including both conventional and charter schools. Edison's approach to managing schools is comprehensive, and it distinguishes itself from most other school improvement…

Unconstrained tripolar hip implants: effect on hip stability.

PubMed

Guyen, Olivier; Chen, Qing Shan; Bejui-Hugues, Jacques; Berry, Daniel J; An, Kai-Nan

2007-02-01

Tripolar implants were developed to treat unstable total hip arthroplasties. However, there is limited confirmation that they achieve this purpose despite their increasing use. Because they have a larger effective head size, these implants are expected to increase range of motion to impingement and improve stability in situations at risk for impingement compared with conventional implants. We assessed the range of motion to impingement using a tripolar implant mounted to an automated hip simulator using 22.2-mm and 28-mm femoral head sizes. The 22 and 28-mm tripolar implants provided increases of 30.5 degrees in flexion, 15.4 degrees in adduction, and 22.4 degrees in external rotation compared with the conventional 22.2-mm femoral head diameter implant. At the critical position of 90 degrees hip flexion, there was an increase of 45.2 degrees in internal rotation. At 0 degrees and 30 degrees external rotation, extension increases were 18.8 degrees and 7.8 degrees, respectively. Bony impingement was the limiting factor. Tripolar implants increased the arc of motion before impingement in positions at risk for dislocation and are expected to provide greater stability.

Development of adolescents' peer crowd identification in relation to changes in problem behaviors.

PubMed

Doornwaard, Suzan M; Branje, Susan; Meeus, Wim H J; ter Bogt, Tom F M

2012-09-01

This 5-wave longitudinal study, which included 1,313 Dutch adolescents, examined the development of peer crowd identification in relation to changes in problem behaviors. Adolescents from 2 age cohorts annually reported their identification with 7 peer crowds and their levels of internalizing and externalizing problem behaviors. Univariate latent growth curve analyses revealed declines (i.e., "Hip Hoppers" and "Metal Heads") or declines followed by stabilization (i.e., "Nonconformists") in identification with nonconventional crowds and increases (i.e., "Elites" and "Brains") or declines followed by stabilization (i.e., "Normals" and "Jocks") in identification with conventional crowds. Multivariate latent growth curve analyses indicated that stronger and more persistent identifications with nonconventional crowds were generally associated with more problem behaviors throughout adolescence. In contrast, stronger and more persistent identifications with conventional crowds were generally associated with fewer problem behaviors throughout adolescence with the notable exception of Brains, who showed a mixed pattern. Though characterized by fewer externalizing problems, this group did report more anxiety problems. These findings and their implications are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

78 FR 67140 - Office of Environmental Information; Pause the Development of the Draft Quality Standard for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9902-70-OEI] Office of Environmental Information; Pause the... (External) Organizations and Two Associated QA Handbooks AGENCY: Environmental Protection Agency (EPA... Environmental Data Collection, Production, and Use by Non-EPA (External) Organizations and two associated QA...

Departmental Publication Productivity and Reputational Quality: Disciplinary Differences

ERIC Educational Resources Information Center

Baird, Leonard

2009-01-01

Using US national data, this study examines the levels and interactions between reputational rankings, average publications, citations, and external research support across 30 disciplines. The analyses show great variation among the disciplines in average and range of publications, citations, and external research support. They also show that the…

Effect of high pressure-high temperature process on meat product quality

NASA Astrophysics Data System (ADS)

Duranton, Frédérique; Marée, Elvire; Simonin, Hélène; Chéret, Romuald; de Lamballerie, Marie

2011-03-01

High pressure/high temperature (HPHT) processing is an innovative way to sterilize food and has been proposed as an alternative to conventional retorting. By using elevated temperatures and adiabatic compression, it allows the inactivation of vegetative microorganisms and pathogen spores. Even though the microbial inactivation has been widely studied, the effect of such process on sensorial attributes of food products, especially meat products, remains rare. The aim of this study was to investigate the potential of using HPHT process (500 MPa/115 °C) instead of conventional retorting to stabilize Toulouse sausages while retaining high organoleptic quality. The measurements of texture, color, water-holding capacity and microbial stability were investigated. It was possible to manufacture stable products at 500 MPa/115 °C/30 min. However, in these conditions, no improvement of the quality was found compared with conventional retorting.

Identification of Technological Parameters of Ni-Alloys When Machining by Monolithic Ceramic Milling Tool

NASA Astrophysics Data System (ADS)

Czán, Andrej; Kubala, Ondrej; Danis, Igor; Czánová, Tatiana; Holubják, Jozef; Mikloš, Matej

2017-12-01

The ever-increasing production and the usage of hard-to-machine progressive materials are the main cause of continual finding of new ways and methods of machining. One of these ways is the ceramic milling tool, which combines the pros of conventional ceramic cutting materials and pros of conventional coating steel-based insert. These properties allow to improve cutting conditions and so increase the productivity with preserved quality known from conventional tools usage. In this paper, there is made the identification of properties and possibilities of this tool when machining of hard-to-machine materials such as nickel alloys using in airplanes engines. This article is focused on the analysis and evaluation ordinary technological parameters and surface quality, mainly roughness of surface and quality of machined surface and tool wearing.

SIDS-toADF File Mapping Manual

NASA Technical Reports Server (NTRS)

McCarthy, Douglas; Smith, Matthew; Poirier, Diane; Smith, Charles A. (Technical Monitor)

2002-01-01

The "CFD General Notation System" (CGNS) consists of a collection of conventions, and conforming software, for the storage and retrieval of Computational Fluid Dynamics (CFD) data. It facilitates the exchange of data between sites and applications, and helps stabilize the archiving of aerodynamic data. This effort was initiated in order to streamline the procedures in exchanging data and software between NASA and its customers, but the goal is to develop CGNS into a National Standard for the exchange of aerodynamic data. The CGNS development team is comprised of members from Boeing Commercial Airplane Group, NASA-Ames, NASA-Langley, NASA-Lewis, McDonnell-Douglas Corporation (now Boeing-St. Louis), Air Force-Wright Lab., and ICEM-CFD Engineering. The elements of CGNS address all activities associated with the storage of data on external media and its movement to and from application programs. These elements include: 1) The Advanced Data Format (ADF) Database manager, consisting of both a file format specification and its I/O software, which handles the actual reading and writing of data from and to external storage media; 2) The Standard Interface Data Structures (SIDS), which specify the intellectual content of CFD data and the conventions governing naming and terminology; 3) The SIDS-to-ADF File Mapping conventions, which specify the exact location where the CFD data defined by the SIDS is to be stored within the ADF file(s); and 4) The CGNS Mid-level Library, which provides CFD-knowledgeable routines suitable for direct installation into application codes. The SIDS-toADF File Mapping Manual specifies the exact manner in which, under CGNS conventions, CFD data structures (the SIDS) are to be stored in (i.e., mapped onto) the file structure provided by the database manager (ADF). The result is a conforming CGNS database. Adherence to the mapping conventions guarantees uniform meaning and location of CFD data within ADF files, and thereby allows the construction of universal software to read and write the data.

2D XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration

PubMed Central

Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon

2017-01-01

Object Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMR). We evaluated whether a free-breathing (FB) radial imaging CCMR sequence with compressed sensing reconstruction (eXtra-Dimension (e.g. cardiac and respiratory phases) Golden-angle RAdial Sparse Parallel, or XD-GRASP) could provide better image quality than a conventional Cartesian breath-held (BH) sequence, in an unselected population of patients undergoing clinical CCMR. Material and Methods 101 patients who underwent BH and FB imaging in a mid-ventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a 5-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastole (ED) and end-systole (ES) left-ventricular areas were also measured and compared for both BH and FB images. Results Image quality was generally better with the BH cines (overall quality grade BH vs FB: 4 vs 2.9, p<0.001; noise 0.06 vs 0.08 p< 0.001; SNR grade: 4.1 vs 3, p<0.001), except for sharpness (p=0.48). There were no significant differences between BH and FB images regarding ED or ES areas (p=0.35 and 0.12). 18 of the 101 patients had impaired BH image quality (grades 1 or 2). In this subgroup, image quality of the FB images was better (p=0.0032), as was the SNR grade (p=0.003), but there were no significant differences regarding noise and sharpness (p=0.45, p=0.47). Conclusion Although FB XD-GRASP CCMR was visually inferior to conventional BH cardiac cine in general, it provided improved image quality in the subgroup of patients presenting respiratory motion-induced artifacts on breath-held images. PMID:29067539

Two-dimensional XD-GRASP provides better image quality than conventional 2D cardiac cine MRI for patients who cannot suspend respiration.

PubMed

Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Latson, Larry A; Bhatla, Puneet; Feng, Li; Axel, Leon

2018-02-01

Residual respiratory motion degrades image quality in conventional cardiac cine MRI (CCMRI). We evaluated whether a free-breathing (FB) radial imaging CCMRI sequence with compressed sensing reconstruction [extradimensional (e.g. cardiac and respiratory phases) golden-angle radial sparse parallel, or XD-GRASP] could provide better image quality than a conventional Cartesian breath-held (BH) sequence in an unselected population of patients undergoing clinical CCMRI. One hundred one patients who underwent BH and FB imaging in a midventricular short-axis plane at a matching location were included. Visual and quantitative image analysis was performed by two blinded experienced readers, using a five-point qualitative scale to score overall image quality and visual signal-to-noise ratio (SNR) grade, with measures of noise and sharpness. End-diastolic and end-systolic left ventricular areas were also measured and compared for both BH and FB images. Image quality was generally better with the BH cines (overall quality grade for BH vs FB images 4 vs 2.9, p < 0.001; noise 0.06 vs 0.08 p < 0.001; SNR grade 4.1 vs 3, p < 0.001), except for sharpness (p = 0.48). There were no significant differences between BH and FB images regarding end-diastolic or end-systolic areas (p = 0.35 and p = 0.12). Eighteen of the 101 patients had poor BH image quality (grade 1 or 2). In this subgroup, the quality of the FB images was better (p = 0.0032), as was the SNR grade (p = 0.003), but there were no significant differences regarding noise and sharpness (p = 0.45 and p = 0.47). Although FB XD-GRASP CCMRI was visually inferior to conventional BH CCMRI in general, it provided improved image quality in the subgroup of patients with respiratory-motion-induced artifacts on BH images.

Technical proficiency in cytopathology: assessment through external quality assurance.

PubMed

Cummings, M C; Greaves, J; Shukor, R A; Perkins, G; Ross, J

2017-04-01

To assess both the feasibility and value of conducting an external quality assurance programme concerning technical aspects of cytopathology laboratory practice, and the interest by laboratories in enrolling in such a programme. Six technical surveys, comprising staining exercises and questionnaires relating to laboratory practice, were distributed over a 4-year period to the approximately 220 laboratories enrolled in the RCPAQAP Cytopathology slide survey modules. Staining exercises using the Papanicolaou and Romanowsky techniques, the preparation of urine and body fluid specimens and immunocytochemistry on the cell block material were assessed. Accompanying relevant questionnaires were included, and one survey comprised a questionnaire alone concerning the collection of urinary tract and body fluid samples. Provision of an external cytopathology technical module was feasible for the RCPAQAP and participation rates (maximum of 87% per survey; average 68% for stained slides and 66% for questionnaires) were commendable, particularly considering these were optional undertakings with some exercises not applicable to all laboratories. The great majority of submitted slides were scored as satisfactory, and there was an especially high standard for the immunocytochemical staining exercise with 95% considered satisfactory, including 50.6% with a perfect score. Reasons for suboptimal scores were provided for potential quality improvement for interested laboratories. A wealth of information relating to laboratory practice was provided to the RCPAQAP which was collated and summarised for laboratory use. The provision of a technical module in cytopathology is both a feasible and valuable undertaking of interest to laboratories which should become standard practice for cytopathology external quality assurance providers. © 2016 John Wiley & Sons Ltd.

Internal versus External Quality Management

ERIC Educational Resources Information Center

Hofman, Roelande H.; Dijkstra, Nynke J.; Hofman, W. H. Adriaan

2008-01-01

This article presents the findings of research into quality management in Dutch elementary schools using theories of school accountability and school improvement as fundamentals. The study is based on data gathered from almost 1000 school leaders. It attempts to determine whether different types of quality management exist in primary schools.…

Improving Quality Higher Education in Nigeria: The Roles of Stakeholders

ERIC Educational Resources Information Center

Asiyai, Romina Ifeoma

2015-01-01

This paper discusses the roles of stakeholders in improving quality of university education in Nigeria. Internal and external stakeholders are identified and the various roles they could play in improving the quality of university education are discussed. The paper contends that continuous and holistic improvement in university education system…

External Quality Control Review of the Defense Information Systems Agency Audit Organization

DTIC Science & Technology

2012-08-07

We are providing this report for your information and use. We have reviewed the system of quality control for the audit organization of the Defense...audit organization encompasses the audit organization’s leadership, emphasis on performing high quality work, and policies and procedures established

Theoretical princi les of constructing the equations of motion for a spin color-charged particle in gauge and fermion fields

NASA Astrophysics Data System (ADS)

Markov, Yu. A.; Shishmarev, A. A.

2010-11-01

Based on the most general principles of materiality, gauge, and re-parameterized invariance, the problem of constructing an action describing the dynamics of a classical color-charged particle moving in external non-Abelian gauge and fermion fields is considered. The case of a linear Lagrangian dependence on the external fermion fields is discussed. Within the framework of the description of the color degree of freedom of the particle with half-integer spin by the Grassmann color charges, a new concept of the Grassmann color source of the particle being a fermion analog of the conventional color current is introduced.

Comparison of Factorization-Based Filtering for Landing Navigation

NASA Technical Reports Server (NTRS)

McCabe, James S.; Brown, Aaron J.; DeMars, Kyle J.; Carson, John M., III

2017-01-01

This paper develops and analyzes methods for fusing inertial navigation data with external data, such as data obtained from an altimeter and a star camera. The particular filtering techniques are based upon factorized forms of the Kalman filter, specifically the UDU and Cholesky factorizations. The factorized Kalman filters are utilized to ensure numerical stability of the navigation solution. Simulations are carried out to compare the performance of the different approaches along a lunar descent trajectory using inertial and external data sources. It is found that the factorized forms improve upon conventional filtering techniques in terms of ensuring numerical stability for the investigated landing navigation scenario.

A microscale turbine driven by diffusive mass flux.

PubMed

Yang, Mingcheng; Liu, Rui; Ripoll, Marisol; Chen, Ke

2015-10-07

An external diffusive mass flux is shown to be able to generate a mechanical torque on a microscale object based on anisotropic diffusiophoresis. In light of this finding, we propose a theoretical prototype micro-turbine driven purely by diffusive mass flux, which is in strong contrast to conventional turbines driven by convective mass flows. The rotational velocity of the proposed turbine is determined by the external concentration gradient, the geometry and the diffusiophoretic properties of the turbine. This scenario is validated by performing computer simulations. Our finding thus provides a new type of chemo-mechanical response which could be used to exploit existing chemical energies at small scales.

Outcomes of Pituitary Radiation for Cushing's Disease.

PubMed

Ironside, Natasha; Chen, Ching-Jen; Lee, Cheng-Chia; Trifiletti, Daniel M; Vance, Mary Lee; Sheehan, Jason P

2018-06-01

Achievement of biochemical remission with preservation of normal pituitary function is the goal of treatment for Cushing's disease. For patients with persistent or recurrent Cushing's disease after transsphenoidal resection, radiation therapy may be a safe and effective treatment. Stereotactic radiosurgery is favored over conventional fractionated external beam radiation. Hormonal recurrence rates range from 0% to 36% at 8 years after treatment. Tumor control rates are high. New pituitary hormone deficiency is the most common adverse effect after stereotactic radiosurgery and external beam radiation. The effects of radiation planning optimization and use of adjuvant medication on endocrine remission rates warrant investigation. Copyright © 2018 Elsevier Inc. All rights reserved.

High-accuracy self-mixing interferometer based on multiple reflections using a simple external reflecting mirror

NASA Astrophysics Data System (ADS)

Wang, Xiu-lin; Wei, Zheng; Wang, Rui; Huang, Wen-cai

2018-05-01

A self-mixing interferometer (SMI) with resolution twenty times higher than that of a conventional interferometer is developed by multiple reflections. Only by employing a simple external reflecting mirror, the multiple-pass optical configuration can be constructed. The advantage of the configuration is simple and easy to make the light re-injected back into the laser cavity. Theoretical analysis shows that the resolution of measurement is scalable by adjusting the number of reflections. The experiment shows that the proposed method has the optical resolution of approximate λ/40. The influence of displacement sensitivity gain ( G) is further analyzed and discussed in practical experiments.

Annular Internal-External-Expansion Rocket Nozzles for Large Booster Applications

NASA Technical Reports Server (NTRS)

Connors, James F.; Cubbison, Robert W.; Mitchell, Glenn A.

1961-01-01

For large-thrust booster applications, annular rocket nozzles employing both internal and external expansion are investigated. In these nozzles, free-stream air flows through the center as well as around the outside of the exiting jet. Flaps for deflecting the rocket exhaust are incorporated on the external-expansion surface for thrust-vector control. In order to define nozzle off-design performance, thrust vectoring effectiveness, and external stream effects, an experimental investigation was conducted on two annular nozzles with area ratios of 15 and 25 at Mach 0, 2, and 3 in the Lewis 10- by 10-foot wind tunnel. Air, pressurized to 600 pounds per square inch absolute, was used to simulate the exhaust flow. For a nozzle-pressure-ratio range of 40 to 1000, the ratio of actual to ideal thrust was essentially constant at 0.98 for both nozzles. Compared with conventional convergent-divergent configurations on hypothetical boost missions, the performance gains of the annular nozzle could yield significant orbital payload increases (possibly 8 to 17 percent). A single flap on the external-expansion surface of the area-ratio-25 annular nozzle produced a side force equal to 4 percent of the axial force with no measurable loss in axial thrust.

Chest compression quality management and return of spontaneous circulation: a matched-pair registry study.

PubMed

Lukas, Roman-Patrik; Gräsner, Jan Thorsten; Seewald, Stephan; Lefering, Rolf; Weber, Thomas Peter; Van Aken, Hugo; Fischer, Matthias; Bohn, Andreas

2012-10-01

Investigating the effects of any intervention during cardiac arrest remains difficult. The ROSC after cardiac arrest score was introduced to facilitate comparison of rates of return of spontaneous circulation (ROSC) between different ambulance services. To study the influence of chest compression quality management (including training, real-time feedback devices, and debriefing) in comparison with conventional cardiopulmonary resuscitation (CPR), a matched-pair analysis was conducted using data from the German Resuscitation Registry, with the calculated ROSC after cardiac arrest score as the baseline. Matching for independent ROSC after cardiac arrest score variables yielded 319 matched cases from the study period (January 2007-March 2011). The score predicted a 45% ROSC rate for the matched pairs. The observed ROSC increased significantly with chest compression quality management, to 52% (P=0.013; 95% CI, 46-57%). No significant differences were seen in the conventional CPR group (47%; 95% CI, 42-53%). The difference between the observed ROSC rates was not statistically significant. Chest compression quality management leads to significantly higher ROSC rates than those predicted by the prognostic score (ROSC after cardiac arrest score). Matched-pair analysis shows that with conventional CPR, the observed ROSC rate was not significantly different from the predicted rate. Analysis shows a trend toward a higher ROSC rate for chest compression quality management in comparison with conventional CPR. It is unclear whether a single aspect of chest compression quality management or the combination of training, real-time feedback, and debriefing contributed to this result. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Impact of rearing conditions on the microbiological quality of raw retail poultry meat.

PubMed

Hardy, Bridgshe; Crilly, Nate; Pendleton, Sean; Andino, Ana; Wallis, Audra; Zhang, Nan; Hanning, Irene

2013-08-01

There is a gap in knowledge of microbiological quality in raw chicken products produced by nonconventional methods and no studies have reported the microbiological quality of turkeys produced under different rearing environments. Thus, the aim of this study was to compare the microbiological quality of conventionally and organically reared whole chicken and turkey carcasses purchased from 3 retail outlets in Knoxville, Tenn., U.S.A. A total of 100 raw broiler chickens organically (n = 50) and 50 raw turkey carcasses consisting of 3 brands reared either conventionally (n = 25) or organically (n = 25) were evaluated. The FDA BAM protocol for rinsing poultry carcasses was used to enumerate of aerobic bacteria, Campylobacter, and Staphylococcus spp., and for qualitative analysis of Salmonella. Organic chickens from one brand had the highest average counts of aerobic bacteria, Staphylococcus spp. and Campylobacter (4.8, 4.8, and 4.7 Log10 CFU/mL rinsate, respectively) while the other organic brand had the lowest average counts (3.4, 3.3, and 3.1, respectively) of all 4 brands evaluated. The organic turkeys had the highest average counts of these same bacteria (4, 3.9, and 3.8, respectively) compared to the 2 brands of conventional turkeys evaluated. Salmonella (5% prevalence) was isolated only from organic chickens and turkeys. From these data, it appears that the microbiological quality of the raw product was not dependent on rearing conditions and, thus, it cannot be assumed that organic raw poultry is safer than conventionally raised poultry in terms of microbiological quality. © 2013 Institute of Food Technologists®

Presence and Quality of Kindergarten Children’s Friendships: Concurrent and Longitudinal Associations with Child Adjustment in the Early School Years

PubMed Central

Engle, Jennifer M.; McElwain, Nancy L.

2010-01-01

The presence and quality of friendships are posited to have developmental significance, yet little is known about the extent to which children without friends versus low-quality friendships compare on socioemotional adjustment. The current study utilized data from a subsample of 567 children (289 boys) participating in the NICHD Study of Early Child Care and Youth Development. Based on maternal reports at kindergarten, four friendship groups were formed: no friends, low quality, average quality, and high quality, and these groups were used to predict teacher-reported behavior problems and social skills concurrently (in kindergarten) and longitudinally (in first and third grade). Concurrently, low-quality friendships were associated with greater externalizing behavior, whereas high-quality friendships were associated with greater social skills. Longitudinally, having no friends in kindergarten was associated with higher levels of externalizing behavior for boys, but lower levels for girls. Children without friends also showed more internalizing problems at first grade. Lastly, having a high-quality friendship in kindergarten was associated with greater social skills in first and third grades, but only for boys. Results underscore high-quality friendship as a context for the development of social skills and indicate different trajectories of problem behavior for kindergarten children with no friends versus low-quality friendships. PMID:21822401

An investigation of the internal and external aerodynamics of cattle trucks

NASA Technical Reports Server (NTRS)

Muirhead, V. U.

1983-01-01

Wind tunnel tests were conducted on a one-tenth scale model of a conventional tractor trailer livestock hauler to determine the air flow through the trailer and the drag of the vehicle. These tests were conducted with the trailer empty and with a full load of simulated cattle. Additionally, the drag was determined for six configurations, of which details for three are documented herein. These are: (1) conventional livestock trailer empty, (2) conventional trailer with smooth sides (i.e., without ventilation openings), and (3) a stream line tractor with modified livestock trailer (cab streamlining and gap fairing). The internal flow of the streamlined modification with simulated cattle was determined with two different ducting systems: a ram air inlet over the cab and NACA submerged inlets between the cab and trailer. The air flow within the conventional trailer was random and variable. The streamline vehicle with ram air inlet provided a nearly uniform air flow which could be controlled. The streamline vehicle with NACA submerged inlets provided better flow conditions than the conventional livestock trailer but not as uniform or controllable as the ram inlet configuration.

Use of in Vitro HTS-Derived Concentration–Response Data as Biological Descriptors Improves the Accuracy of QSAR Models of in Vivo Toxicity

PubMed Central

Sedykh, Alexander; Zhu, Hao; Tang, Hao; Zhang, Liying; Richard, Ann; Rusyn, Ivan; Tropsha, Alexander

2011-01-01

Background Quantitative high-throughput screening (qHTS) assays are increasingly being used to inform chemical hazard identification. Hundreds of chemicals have been tested in dozens of cell lines across extensive concentration ranges by the National Toxicology Program in collaboration with the National Institutes of Health Chemical Genomics Center. Objectives Our goal was to test a hypothesis that dose–response data points of the qHTS assays can serve as biological descriptors of assayed chemicals and, when combined with conventional chemical descriptors, improve the accuracy of quantitative structure–activity relationship (QSAR) models applied to prediction of in vivo toxicity end points. Methods We obtained cell viability qHTS concentration–response data for 1,408 substances assayed in 13 cell lines from PubChem; for a subset of these compounds, rodent acute toxicity half-maximal lethal dose (LD50) data were also available. We used the k nearest neighbor classification and random forest QSAR methods to model LD50 data using chemical descriptors either alone (conventional models) or combined with biological descriptors derived from the concentration–response qHTS data (hybrid models). Critical to our approach was the use of a novel noise-filtering algorithm to treat qHTS data. Results Both the external classification accuracy and coverage (i.e., fraction of compounds in the external set that fall within the applicability domain) of the hybrid QSAR models were superior to conventional models. Conclusions Concentration–response qHTS data may serve as informative biological descriptors of molecules that, when combined with conventional chemical descriptors, may considerably improve the accuracy and utility of computational approaches for predicting in vivo animal toxicity end points. PMID:20980217

External Hand Forces Exerted by Long-Term Care Staff to Push Floor-Based Lifts: Effects of Flooring System and Resident Weight.

PubMed

Lachance, Chantelle C; Korall, Alexandra M B; Russell, Colin M; Feldman, Fabio; Robinovitch, Stephen N; Mackey, Dawn C

2016-09-01

The aim of this study was to investigate the effects of flooring type and resident weight on external hand forces required to push floor-based lifts in long-term care (LTC). Novel compliant flooring is designed to reduce fall-related injuries among LTC residents but may increase forces required for staff to perform pushing tasks. A motorized lift may offset the effect of flooring on push forces. Fourteen female LTC staff performed straight-line pushes with two floor-based lifts (conventional, motor driven) loaded with passengers of average and 90th-percentile resident weights over four flooring systems (concrete+vinyl, compliant+vinyl, concrete+carpet, compliant+carpet). Initial and sustained push forces were measured by a handlebar-mounted triaxial load cell and compared to participant-specific tolerance limits. Participants rated pushing difficulty. Novel compliant flooring increased initial and sustained push forces and subjective ratings compared to concrete flooring. Compared to the conventional lift, the motor-driven lift substantially reduced initial and sustained push forces and perceived difficulty of pushing for all four floors and both resident weights. Participants exerted forces above published tolerance limits only when using the conventional lift on the carpet conditions (concrete+carpet, compliant+carpet). With the motor-driven lift only, resident weight did not affect push forces. Novel compliant flooring increased linear push forces generated by LTC staff using floor-based lifts, but forces did not exceed tolerance limits when pushing over compliant+vinyl. The motor-driven lift substantially reduced push forces compared to the conventional lift. Results may help to address risk of work-related musculoskeletal injury, especially in locations with novel compliant flooring. © 2016, Human Factors and Ergonomics Society.

Self-powered electrospinning apparatus based on a hand-operated Wimshurst generator

NASA Astrophysics Data System (ADS)

Han, Wen-Peng; Huang, Yuan-Yuan; Yu, Miao; Zhang, Jun-Cheng; Yan, Xu; Yu, Gui-Feng; Zhang, Hong-Di; Yan, Shi-Ying; Long, Yun-Ze

2015-03-01

A conventional electrospinning setup cannot work without a plug (electricity supply). In this article, we report a self-powered electrospinning setup based on a hand-operated Wimshurst generator. The new device has better applicability and portability than a typical conventional electrospinning setup because it is lightweight and can work without an external power supply. Experimental parameters of the apparatus such as the minimum number of handle turns to generate enough energy to spin, rotation speed of the handle and electrospinning distance were investigated. Different polymers such as polystyrene (PS), poly(vinylidene fluoride) (PVDF), polycaprolactone (PCL) and polylactic acid (PLA) were electrospun into ultrathin fibers successfully by this apparatus. The stability, reliability, and repeatability of the new apparatus demonstrate that it can be used as not only a demonstrator for an electrospinning process, but also a beneficial complement to conventional electrospinning especially where or when without a power supply, and may be used in wound healing and rapid hemostasis, etc.A conventional electrospinning setup cannot work without a plug (electricity supply). In this article, we report a self-powered electrospinning setup based on a hand-operated Wimshurst generator. The new device has better applicability and portability than a typical conventional electrospinning setup because it is lightweight and can work without an external power supply. Experimental parameters of the apparatus such as the minimum number of handle turns to generate enough energy to spin, rotation speed of the handle and electrospinning distance were investigated. Different polymers such as polystyrene (PS), poly(vinylidene fluoride) (PVDF), polycaprolactone (PCL) and polylactic acid (PLA) were electrospun into ultrathin fibers successfully by this apparatus. The stability, reliability, and repeatability of the new apparatus demonstrate that it can be used as not only a demonstrator for an electrospinning process, but also a beneficial complement to conventional electrospinning especially where or when without a power supply, and may be used in wound healing and rapid hemostasis, etc. Electronic supplementary information (ESI) available: The video of the electrospinning process by this new self-powered electrospinning apparatus and the vivid details were recorded by a high-speed digital video camera. See DOI: 10.1039/c5nr00387c

Comparison between Conventional MR Arthrograhphy and Abduction and External Rotation MR Arthrography in Revealing Tears of the Antero-Inferior Glenoid Labrum

PubMed Central

Choi, Jung-Ah; Suh, Sang-il; Kim, Baek Hyun; Cha, Sang Hoon; Lee, Ki Yeol; Lee, Chang Hee

2001-01-01

Objective To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful. PMID:11754329

Molecular genetics external quality assessment pilot scheme for KRAS analysis in metastatic colorectal cancer.

PubMed

Deans, Zandra C; Tull, Justyna; Beighton, Gemma; Abbs, Stephen; Robinson, David O; Butler, Rachel

2011-11-01

Laboratories are increasingly required to perform molecular tests for the detection of mutations in the KRAS gene in metastatic colorectal cancers to allow better clinical management and more effective treatment for these patients. KRAS mutation status predicts a patient's likely response to the monoclonal antibody cetuximab. To provide a high standard of service, these laboratories require external quality assessment (EQA) to monitor the level of laboratory output and measure the performance of the laboratory against other service providers. National External Quality Assurance Services for Molecular Genetics provided a pilot EQA scheme for KRAS molecular analysis in metastatic colorectal cancers during 2009. Very few genotyping errors were reported by participating laboratories; however, the reporting nomenclature of the genotyping results varied considerably between laboratories. The pilot EQA scheme highlighted the need for continuing EQA in this field which will assess the laboratories' ability not only to obtain accurate, reliable results but also to interpret them safely and correctly ensuring that the referring clinician has the correct information to make the best clinical therapeutic decision for their patient.

Self-cleaning skin-like prosthetic polymer surfaces

DOEpatents

Simpson, John T [Clinton, TN; Ivanov, Ilia N [Knoxville, TN; Shibata, Jason [Manhattan Beach, CA

2012-03-27

An external covering and method of making an external covering for hiding the internal endoskeleton of a mechanical (e.g., prosthetic) device that exhibits skin-like qualities is provided. The external covering generally comprises an internal bulk layer in contact with the endoskeleton of the prosthetic device and an external skin layer disposed about the internal bulk layer. The external skin layer is comprised of a polymer composite with carbon nanotubes embedded therein. The outer surface of the skin layer has multiple cone-shaped projections that provide the external skin layer with superhydrophobicity. The carbon nanotubes are preferably vertically aligned between the inner surface and outer surface of the external skin layer in order to provide the skin layer with the ability to transmit heat. Superhydrophobic powders may optionally be used as part of the polymer composite or applied as a coating to the surface of the skin layer to enhance superhydrophobicity.

Method of making self-cleaning skin-like prosthetic polymer surfaces

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

Simpson, John T.; Ivanov, Ilia N.; Shibata, Jason

An external covering and method of making an external covering for hiding the internal endoskeleton of a mechanical (e.g., prosthetic) device that exhibits skin-like qualities is provided. The external covering generally comprises an internal bulk layer in contact with the endoskeleton of the prosthetic device and an external skin layer disposed about the internal bulk layer. The external skin layer is comprised of a polymer composite with carbon nanotubes embedded therein. The outer surface of the skin layer has multiple cone-shaped projections that provide the external skin layer with superhydrophobicity. The carbon nanotubes are preferably vertically aligned between the innermore » surface and outer surface of the external skin layer in order to provide the skin layer with the ability to transmit heat. Superhydrophobic powders may optionally be used as part of the polymer composite or applied as a coating to the surface of the skin layer to enhance superhydrophobicity.« less

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

Simpson, John T.; Ivanov, Ilia N.; Shibata, Jason

An external covering and method of making an external covering for hiding the internal endoskeleton of a mechanical (e.g., prosthetic) device that exhibits skin-like qualities is provided. The external covering generally comprises an internal bulk layer in contact with the endoskeleton of the prosthetic device and an external skin layer disposed about the internal bulk layer. The external skin layer is comprised of a polymer composite with carbon nanotubes embedded therein. The outer surface of the skin layer has multiple cone-shaped projections that provide the external skin layer with superhydrophobicity. The carbon nanotubes are preferably vertically aligned between the innermore » surface and outer surface of the external skin layer in order to provide the skin layer with the ability to transmit heat. Superhydrophobic powders may optionally be used as part of the polymer composite or applied as a coating to the surface of the skin layer to enhance superhydrophobicity.« less

Unidirectional growth of benzil crystal from solution by Sankaranarayanan-Ramasamy method and its characterization

NASA Astrophysics Data System (ADS)

Rajalakshmi, M.; Shyju, T. S.; Indirajith, R.; Gopalakrishnan, R.

2012-02-01

Good quality <1 0 0> benzil single crystal with a diameter 18 mm and length 75 mm was successfully grown from solution by the unidirectional growth method of Sankaranarayanan-Ramasamy (SR) for the first time in the literature. The seed crystals have been harvested from conventional solution growth technique and subsequently used for unidirectional growth. The grown crystal was subjected to various characterization studies. The results of UV-vis spectral analysis, photoluminescence, etching and microhardness studies were compared with conventional solution grown crystal to that of SR method grown crystal. The quality of SR method grown benzil crystal is better than conventional solution grown crystal.

A comparison of the nutritional quality of organic and conventional ready-to-eat breakfast cereals based on NuVal scores.

PubMed

Woodbury, Nancy J; George, Valerie A

2014-07-01

To identify whether there were differences in nutritional quality between organic and conventional ready-to-eat breakfast cereals of similar types, based on NuVal scores. The current descriptive study analysed NuVal scores for 829 ready-to-eat breakfast cereals and eighteen different cereal types. ANOVA was used to compare the mean NuVal scores of 723 conventional cereals with those of 106 organic cereals. Ready-to-eat breakfast cereals (n 829) with NuVal scores. Not applicable. There was no significant difference in NuVal scores between conventional (mean 28·4 (sd 13·4)) and organic (mean 30·6 (sd 13·2)) cereal types. Consumers who choose the organic version of a ready-to-eat breakfast cereal believing that nutritional quality is superior may not be making a valid assumption. Public health nutrition educators must help consumers understand that organic cereals are not necessarily more nutritious and their consumption could result in excessive intake of undesirable nutrients, such as fat, sugar and sodium.

Measurement of Quality of Nursing Practice in Congenital Cardiac Care.

PubMed

Connor, Jean Anne; Mott, Sandra; Green, Angela; Larson, Carol; Hickey, Patricia

2016-03-01

The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States. A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis. Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data. External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks. ©2016 American Association of Critical-Care Nurses.

Impact of pre-imputation SNP-filtering on genotype imputation results

PubMed Central

2014-01-01

Background Imputation of partially missing or unobserved genotypes is an indispensable tool for SNP data analyses. However, research and understanding of the impact of initial SNP-data quality control on imputation results is still limited. In this paper, we aim to evaluate the effect of different strategies of pre-imputation quality filtering on the performance of the widely used imputation algorithms MaCH and IMPUTE. Results We considered three scenarios: imputation of partially missing genotypes with usage of an external reference panel, without usage of an external reference panel, as well as imputation of completely un-typed SNPs using an external reference panel. We first created various datasets applying different SNP quality filters and masking certain percentages of randomly selected high-quality SNPs. We imputed these SNPs and compared the results between the different filtering scenarios by using established and newly proposed measures of imputation quality. While the established measures assess certainty of imputation results, our newly proposed measures focus on the agreement with true genotypes. These measures showed that pre-imputation SNP-filtering might be detrimental regarding imputation quality. Moreover, the strongest drivers of imputation quality were in general the burden of missingness and the number of SNPs used for imputation. We also found that using a reference panel always improves imputation quality of partially missing genotypes. MaCH performed slightly better than IMPUTE2 in most of our scenarios. Again, these results were more pronounced when using our newly defined measures of imputation quality. Conclusion Even a moderate filtering has a detrimental effect on the imputation quality. Therefore little or no SNP filtering prior to imputation appears to be the best strategy for imputing small to moderately sized datasets. Our results also showed that for these datasets, MaCH performs slightly better than IMPUTE2 in most scenarios at the cost of increased computing time. PMID:25112433

The Genetics of Non-conventional Wine Yeasts: Current Knowledge and Future Challenges.

PubMed

Masneuf-Pomarede, Isabelle; Bely, Marina; Marullo, Philippe; Albertin, Warren

2015-01-01

Saccharomyces cerevisiae is by far the most widely used yeast in oenology. However, during the last decade, several other yeasts species has been purposed for winemaking as they could positively impact wine quality. Some of these non-conventional yeasts (Torulaspora delbrueckii, Metschnikowia pulcherrima, Pichia kluyveri, Lachancea thermotolerans, etc.) are now proposed as starters culture for winemakers in mixed fermentation with S. cerevisiae, and several others are the subject of various studies (Hanseniaspora uvarum, Starmerella bacillaris, etc.). Along with their biotechnological use, the knowledge of these non-conventional yeasts greatly increased these last 10 years. The aim of this review is to describe the last updates and the current state-of-art of the genetics of non-conventional yeasts (including S. uvarum, T. delbrueckii, S. bacillaris, etc.). We describe how genomics and genetics tools provide new data into the population structure and biodiversity of non-conventional yeasts in winemaking environments. Future challenges will lie on the development of selection programs and/or genetic improvement of these non-conventional species. We discuss how genetics, genomics and the advances in next-generation sequencing will help the wine industry to develop the biotechnological use of non-conventional yeasts to improve the quality and differentiation of wines.

Atraumatic restorative treatment (ART): a three-year clinical study in Malawi--comparison of conventional amalgam and ART restorations.

PubMed

Kalf-Scholte, Sonja M; van Amerongen, Willem E; Smith, Albert J E; van Haastrecht, Harry J A

2003-01-01

This study compares the quality of class I restorations made with the atraumatic restorative treatment (ART) technique and conventional class I amalgam restorations. The study was carried out among secondary school students in Mzuzu, Malawi. First-year students in 1987 who needed at least two class I restorations were selected. Based on a split-mouth design, each participant received both ART and conventional restorations. The 89 pairs of class I cavities were divided randomly into two groups, since two different cermet ionomer cement (CIC) filling materials were used. Impressions of the restorations and subsequent models were made shortly after restoration, after six months, one year, two years, and three years. The quality of the restorations was determined on the models following the US Public Health Service criteria. Bulk fracture, contour, marginal integrity, and surface texture of the restorations were recorded and evaluated separately. Survival rates were determined by the resultant score of all criteria. Though conventional amalgam restorations performed better on all criteria, this difference was significant only for the contour criterion. The survival rates of ART restorations after three years (81.0%) were lower than those of amalgam restorations (90.4%) (P=.067). The quality of ART class I restorations is competitive with that of conventional amalgam restorations.

Chinese Classical Formula Sijunzi Decoction and Chronic Atrophic Gastritis: Evidence for Treatment Approach?

PubMed Central

Xu, Aili; Du, Hongbo

2017-01-01

Objective This aim is to evaluate the effect of Sijunzi decoction (SJZD) treating chronic atrophic gastritis (CAG). Methods We performed searches in seven databases. The randomized controlled trials (RCTs) comparing SJZD with standard medical care or inactive intervention for CAG were enrolled. Combined therapy of SJZD plus conventional therapies compared with conventional therapies alone was also retrieved. The primary outcome included the incidence of gastric cancer and the improvement of atrophy, intestinal metaplasia, and dysplasia based on the gastroscopy and pathology. The secondary outcomes were Helicobacter pylori clearance rate, quality of life, and adverse event/adverse drug reaction. Results Six RCTs met the inclusion criteria. The research quality was low in the trials. For the overall effect rate, pooled analysis from 4 trials showed that modified SJZD plus conventional medications exhibited a significant improvement (OR = 4.86; 95% CI: 2.80 to 8.44; P < 0.00001) and without significant heterogeneity compared with the conventional medications alone. None reported the adverse effect. Conclusions Modified SJZD combined with conventional western medicines appears to have benefits for CAG. Due to the limited number and methodological flaw, the beneficial and harmful effects of SJZD for CAG could not be identified. More high-quality clinical trials are needed to confirm the results. PMID:29138645

Regeneration of Stevia Plant Through Callus Culture

PubMed Central

Patel, R. M.; Shah, R. R.

2009-01-01

Stevia rebaudiana Bertoni that conventionally propagated by seed or by cuttings or clump division which has a limitation of quality and quantity seed material. In present study, callus culture technique was tried to achieve rapid plant multiplication for quality seed material. Callus induction and multiplication medium was standardized from nodal as well as leaf sagments. It is possible to maintain callus on Murashige and Skoog medium supplemented with 6-benzyl amino purine and naphthalene acetic acid. Maximum callus induction was obtained on Murashige and Skoog medium incorporated with 6-benzyl amino purine (2.0-3.0 mg/l) and naphthalene acetic acid (2.0 mg/l) treatments. However, Murashige and Skoog medium containing 2.0 mg/l 6-benzyl amino purine+2.0 mg/l naphthalene acetic acid was found to be the best for callus induction. Higher regeneration frequency was noticed with Murashige and Skoog medium supplemented with 2.0 mg/l 6-benzyl amino purine+0.2 mg/l naphthalene acetic acid. Regenerated plants were rooted better on ¼ Murashige and Skoog strength supplemented with 0.1 mg/l indole-3-butyric acid. The rooted plantlets were hardened successfully in tera care medium with 63 per cent survival rate. The developed protocol can be utilized for mass production of true to type planting material on large scale independent of season, i.e. external environmental conditions. PMID:20177455

Effect of Auxiliary Preheating of the Filler Wire on Quality of Gas Metal Arc Stainless Steel Claddings

NASA Astrophysics Data System (ADS)

Shahi, Amandeep S.; Pandey, Sunil

2008-02-01

Weld cladding is a process for producing surfaces with good corrosion resistant properties by means of depositing/laying of stainless steels on low-carbon steel components with an objective of achieving maximum economy and enhanced life. The aim of the work presented here was to investigate the effect of auxiliary preheating of the solid filler wire in mechanized gas metal arc welding (GMAW) process (by using a specially designed torch to preheat the filler wire independently, before its emergence from the torch) on the quality of the as-welded single layer stainless steel overlays. External preheating of the filler wire resulted in greater contribution of arc energy by resistive heating due to which significant drop in the main welding current values and hence low dilution levels were observed. Metallurgical aspects of the as welded overlays such as chemistry, ferrite content, and modes of solidification were studied to evaluate their suitability for service and it was found that claddings obtained through the preheating arrangement, besides higher ferrite content, possessed higher content of chromium, nickel, and molybdenum and lower content of carbon as compared to conventional GMAW claddings, thereby giving overlays with superior mechanical and corrosion resistance properties. The findings of this study not only establish the technical superiority of the new process, but also, owing to its productivity-enhanced features, justify its use for low-cost surfacing applications.

Impact of low-trans fat compositions on the quality of conventional and fat-reduced puff pastry.

PubMed

Silow, Christoph; Zannini, Emanuele; Arendt, Elke K

2016-04-01

Four vegetable fat blends (FBs) with low trans-fatty acid (TFA ≤ 0.6 %) content with various ratios of palm stearin (PS) and rapeseed oil (RO) were characterised and examined for their application in puff pastry production. The amount of PS decreased from FB1 to FB4 and simultaneously the RO content increased. A range of analytical methods were used to characterise the FBs, including solid fat content (SFC), differential scanning calorimetry (DSC), cone penetrometry and rheological measurements. The internal and external structural quality parameters of baked puff pastry were investigated using texture analyser equipped with an Extended Craft Knife (ECK), VolScan and C-Cell image system. Puff pastry containing FB1 and FB2 achieved excellent baking results for full fat and fat-reduced puff pastry; hence these FBs contained adequate shortening properties. A fat reduction by 40 % using FB2 and a reduction of saturated fatty acids (SAFA) by 49 %, compared to the control, did not lead to adverse effects in lift and specific volume. The higher amount of RO and the lower SAFA content compared to FB1 coupled with the satisfying baking results makes FB2 the fat of choice in this study. FB3 and FB4 were found to be unsuitable for puff pastry production because of their melting behaviour.

External quality assessment programs in the context of ISO 15189 accreditation.

PubMed

Sciacovelli, Laura; Secchiero, Sandra; Padoan, Andrea; Plebani, Mario

2018-05-23

Effective management of clinical laboratories participating in external quality assessment schemes (EQAS) is of fundamental importance in ensuring reliable analytical results. The International Standard ISO 15189:2012 requires participation in interlaboratory comparison [e.g. external quality assessment (EQA)] for all tests provided by an individual laboratory. If EQAS is not commercially available, alternative approaches should be identified, although clinical laboratories may find it challenging to choose the EQAS that comply with the international standards and approved guidelines. Great competence is therefore required, as well as knowledge of the characteristics and key elements affecting the reliability of an EQAS, and the analytical quality specifications stated in approved documents. Another skill of fundamental importance is the ability to identify an alternative approach when the available EQAS are inadequate or missing. Yet the choice of the right EQA program alone does not guarantee its effectiveness. In fact, the fundamental steps of analysis of the information provided in EQA reports and the ability to identify improvement actions to be undertaken call for the involvement of all laboratory staff playing a role in the specific activity. The aim of this paper was to describe the critical aspects that EQA providers and laboratory professionals should control in order to guarantee effective EQAS management and compliance with ISO 15189 accreditation requirements.

Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

PubMed

Seretis, Charalampos; Mankotia, Rajnish; Goonetilleke, Kolitha; Rawstorne, Edward

2014-01-01

The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool. An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases. Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases. The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

Night Eating is Associated with Emotional and External Eating in College Students

PubMed Central

Nolan, Laurence J.; Geliebter, Allan

2012-01-01

The night eating syndrome (NES) consists of evening hyperphagia and/or nocturnal eating and has been associated with depressed mood, that worsens in the evening. However, it is not consistently related to elevated BMI. The present study was conducted to examine whether a relationship exists between NES and emotional, external, and restrained eating. BMI and sleep quality were also obtained. A sample of 246 students completed the Night Eating Diagnostic Questionnaire (NEDQ), Night Eating Syndrome History and Inventory (NESHI), Sleep Quality Index (SQI), and Dutch Eating Behavior Questionnaire (DEBQ), containing subscales for emotional, external, and restrained eating. They also provided demographic information, including height and weight. Participants were grouped by severity of NES features using the NEDQ and NESHI: normal, mild night eater, moderate night eater, and full night eater syndrome. MANOVA was used to compare DEBQ subscores for the groups; those in the full syndrome category had significantly higher emotional eating scores and external eating scores than those in the normal and mild categories. There was no difference in restrained eating between the normal and full syndrome groups. Those with moderate and full syndrome NES symptoms also reported significantly lower sleep quality. No significant relationship was found between NES and BMI. The results show that NES is associated with more eating in response to negative mood and in response to food cues. PMID:22664397

Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

PubMed

Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

2008-03-01

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories.

Treatment Options for Extrahepatic Bile Duct Cancer

MedlinePlus

... caused by a blocked bile duct and improve quality of life : Biliary bypass : If cancer is blocking the bile ... as palliative treatment to relieve symptoms and improve quality of life . External or internal radiation therapy as palliative treatment ...

Stages of Extrahepatic Bile Duct Cancer

MedlinePlus

... caused by a blocked bile duct and improve quality of life : Biliary bypass : If cancer is blocking the bile ... as palliative treatment to relieve symptoms and improve quality of life . External or internal radiation therapy as palliative treatment ...

Treatment Option Overview (Extrahepatic Bile Duct Cancer)

MedlinePlus

... caused by a blocked bile duct and improve quality of life : Biliary bypass : If cancer is blocking the bile ... as palliative treatment to relieve symptoms and improve quality of life . External or internal radiation therapy as palliative treatment ...

Clinical governance and external audit.

PubMed

Glazebrook, S G; Buchanan, J G

2001-01-01

This paper describes a model of clinical governance that was developed at South Auckland Health during the period 1995 to 2000. Clinical quality and safety are core objectives. A multidisciplinary Clinical Board is responsible for the development and publicising of sound clinical policies together with monitoring the effects of their implementation on quality and safety. The Clinical Board has several committees, including an organization-wide Continuous Quality Improvement Committee to enhance the explicit nature of the quality system in terms of structure, staff awareness and involvement, and to develop the internal audit system. The second stream stems from the Chief Medical Officer and clinical directors in a clinical management sense. The Audit Committee of the Board of Directors covers both clinical and financial audit. The reporting lines back to that committee are described and the role of the external auditor of clinical standards is explained. The aim has been to create a supportive culture where quality initiatives and innovation can flourish, and where the emphasis is not on censure but improvement.

External quality assurance performance of clinical research laboratories in sub-saharan Africa.

PubMed

Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

2012-11-01

Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

Human tooth and root canal morphology reconstruction using magnetic resonance imaging.

PubMed

Drăgan, Oana Carmen; Fărcăşanu, Alexandru Ştefan; Câmpian, Radu Septimiu; Turcu, Romulus Valeriu Flaviu

2016-01-01

Visualization of the internal and external root canal morphology is very important for a successful endodontic treatment; however, it seems to be difficult considering the small size of the tooth and the complexity of the root canal system. Film-based or digital conventional radiographic techniques as well as cone beam computed tomography provide limited information on the dental pulp anatomy or have harmful effects. A new non-invasive diagnosis tool is magnetic resonance imaging, due to its ability of imaging both hard and soft tissues. The aim of this study was to demonstrate magnetic resonance imaging to be a useful tool for imaging the anatomic conditions of the external and internal root canal morphology for endodontic purposes. The endodontic system of one freshly extracted wisdom tooth, chosen for its well-known anatomical variations, was mechanically shaped using a hybrid technique. After its preparation, the tooth was immersed into a recipient with saline solution and magnetic resonance imaged immediately. A Bruker Biospec magnetic resonance imaging scanner operated at 7.04 Tesla and based on Avance III radio frequency technology was used. InVesalius software was employed for the 3D reconstruction of the tooth scanned volume. The current ex-vivo experiment shows the accurate 3D volume rendered reconstruction of the internal and external morphology of a human extracted and endodontically treated tooth using a dataset of images acquired by magnetic resonance imaging. The external lingual and vestibular views of the tooth as well as the occlusal view of the pulp chamber, the access cavity, the distal canal opening on the pulp chamber floor, the coronal third of the root canals, the degree of root separation and the apical fusion of the two mesial roots, details of the apical region, root canal curvatures, furcal region and interradicular root grooves could be clearly bordered. Magnetic resonance imaging offers 3D image datasets with more information than the conventional radiographic techniques. Due to its ability of imaging both hard and soft dental tissues, magnetic resonance imaging can be successfully used as a 3D diagnostic imaging technique in dentistry. When choosing the imaging method, dental clinicians should weight the benefit-risk ratio, taking into account the costs associated to magnetic resonance imaging and the harmful effects of ionizing radiations when cone beam computed tomography or conventional x-ray are used.

Study of Reactive Melt Processing Behavior of Externally Plasticized Cellulose Acetate in Presence of Isocyanate

PubMed Central

Erdmann, Rafael; Kabasci, Stephan; Kurek, Joanna; Zepnik, Stefan

2014-01-01

Two types of externally plasticized cellulose acetate (CA) were chemically modified using 4,4'-methylene diphenyl diisocyanate (MDI) as crosslinking agent. Crosslinking was performed in the molten state by means of melt mixing in an internal mixer. The viscoelastic properties of the non-crosslinked, externally plasticized CA show typical temperature dependence, similar to conventional thermoplastics. A strong increase in storage modulus is observed with increasing crosslink density indicating that the crosslinked compounds exhibit predominately elastic response. The complex viscosity also increases considerably with increasing crosslink density and does not reach the typical Newtonian plateau at low radial frequencies any more. The viscoelastic properties correlate well with the data recorded online during reactive melt processing in the internal mixer. In comparison to the non-crosslinked CA, the crosslinked compounds show higher glass transition temperature, higher VICAT softening temperatures, improved thermal stability and lower plasticizer evaporation at evaluated temperatures. PMID:28788273

Study of Reactive Melt Processing Behavior of Externally Plasticized Cellulose Acetate in Presence of Isocyanate.

PubMed

Erdmann, Rafael; Kabasci, Stephan; Kurek, Joanna; Zepnik, Stefan

2014-12-04

Two types of externally plasticized cellulose acetate (CA) were chemically modified using 4,4'-methylene diphenyl diisocyanate (MDI) as crosslinking agent. Crosslinking was performed in the molten state by means of melt mixing in an internal mixer. The viscoelastic properties of the non-crosslinked, externally plasticized CA show typical temperature dependence, similar to conventional thermoplastics. A strong increase in storage modulus is observed with increasing crosslink density indicating that the crosslinked compounds exhibit predominately elastic response. The complex viscosity also increases considerably with increasing crosslink density and does not reach the typical Newtonian plateau at low radial frequencies any more. The viscoelastic properties correlate well with the data recorded online during reactive melt processing in the internal mixer. In comparison to the non-crosslinked CA, the crosslinked compounds show higher glass transition temperature, higher VICAT softening temperatures, improved thermal stability and lower plasticizer evaporation at evaluated temperatures.

Copper mediated polymerization without external deoxygenation or oxygen scavengers.

PubMed

Liarou, Evelina; Whitfield, Richard; Anastasaki, Athina; Engelis, Nikolaos G; Jones, Glen R; Velonia, Kelly; Haddleton, David

2018-05-14

Overcoming the challenge of rigorous deoxygenation in copper mediated controlled radical polymerization processes (e.g. ATRP), we report a simple Cu(0)-RDRP system in the absence of external additives (e.g. reducing agents, enzymes etc.). By simply adjusting the headspace of the reaction vessel, a wide range of monomers, namely acrylates, methacrylates, acrylamides and styrene, can be polymerized in a controlled manner yielding polymers with low dispersities, near-quantitative conversions and high end group fidelity. Significantly, this approach is scalable (~ 125 g), tolerant to elevated temperatures, compatible with both organic and aqueous media and does not rely on external stimuli which may limit the monomer pool. The robustness and versatility of this methodology is further demonstrated by the applicability to a number of other copper mediated techniques including conventional ATRP and light-mediated approaches. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Adiabatic photo-steering theory in topological insulators.

PubMed

Inoue, Jun-Ichi

2014-12-01

Feasible external control of material properties is a crucial issue in condensed matter physics. A new approach to achieving this aim, named adiabatic photo-steering, is reviewed. The core principle of this scheme is that several material constants are effectively turned into externally tunable variables by irradiation of monochromatic laser light. Two-dimensional topological insulators are selected as the optimal systems that exhibit a prominent change in their properties following the application of this method. Two specific examples of photo-steered quantum phenomena, which reflect topological aspects of the electronic systems at hand, are presented. One is the integer quantum Hall effect described by the Haldane model, and the other is the quantum spin Hall effect described by the Kane-Mele model. The topological quantities associated with these phenomena are the conventional Chern number and spin Chern number, respectively. A recent interesting idea, time-reversal symmetry breaking via a temporary periodic external stimulation, is also discussed.

Adiabatic photo-steering theory in topological insulators

NASA Astrophysics Data System (ADS)

Inoue, Jun-ichi

2014-12-01

Feasible external control of material properties is a crucial issue in condensed matter physics. A new approach to achieving this aim, named adiabatic photo-steering, is reviewed. The core principle of this scheme is that several material constants are effectively turned into externally tunable variables by irradiation of monochromatic laser light. Two-dimensional topological insulators are selected as the optimal systems that exhibit a prominent change in their properties following the application of this method. Two specific examples of photo-steered quantum phenomena, which reflect topological aspects of the electronic systems at hand, are presented. One is the integer quantum Hall effect described by the Haldane model, and the other is the quantum spin Hall effect described by the Kane-Mele model. The topological quantities associated with these phenomena are the conventional Chern number and spin Chern number, respectively. A recent interesting idea, time-reversal symmetry breaking via a temporary periodic external stimulation, is also discussed.

Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis.

PubMed

Pinquart, Martin

2017-05-01

The present meta-analysis integrates research from 1,435 studies on associations of parenting dimensions and styles with externalizing symptoms in children and adolescents. Parental warmth, behavioral control, autonomy granting, and an authoritative parenting style showed very small to small negative concurrent and longitudinal associations with externalizing problems. In contrast, harsh control, psychological control, authoritarian, permissive, and neglectful parenting were associated with higher levels of externalizing problems. The strongest associations were observed for harsh control and psychological control. Parental warmth, behavioral control, harsh control, psychological control, autonomy granting, authoritative, and permissive parenting predicted change in externalizing problems over time, with associations of externalizing problems with warmth, behavioral control, harsh control, psychological control, and authoritative parenting being bidirectional. Moderating effects of sampling, child's age, form of externalizing problems, rater of parenting and externalizing problems, quality of measures, and publication status were identified. Implications for future research and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Exploring How School Intra-Organizational Mechanisms Mediate the Effects of External Interventions on Improving Teaching and Learning

ERIC Educational Resources Information Center

Sun, Min

2011-01-01

This dissertation collects three independent but interrelated studies exploring how school intra-organizational mechanism may mediate the impact of external interventions on improving teaching and learning. This first study examines how high-quality professional development (PD) can promote the diffusion of effective teaching strategies among…

Research by External Agencies or Individuals in AISD, 1990-91.

ERIC Educational Resources Information Center

Dietzen, Sandra

Abstracts of research projects conducted within the Austin (Texas) Independent School District (AISD) by external agencies or individuals are presented. Each of these researchers went through a screening process in which AISD staff members reviewed their proposals to ensure protection of AISD students and staff and quality research that fits the…

Structural Model of the Effects of Poverty on Externalizing and Internalizing Behaviors of Four- to Five-Year-Old Children.

ERIC Educational Resources Information Center

Eamon, Mary Keegan

2000-01-01

Identifies the parenting practices that mediate relations between persistent, recent, and transitional poverty and the externalizing and internalizing behaviors of children four to five years old. Results reveal that lower-quality physical environment, maternal emotional unresponsiveness, and fewer stimulating experiences contribute significantly…

A Closer Look at Co-Rumination: Gender, Coping, Peer Functioning and Internalizing/Externalizing Problems

ERIC Educational Resources Information Center

Tompkins, Tanya L.; Hockett, Ashlee R.; Abraibesh, Nadia; Witt, Jody L.

2011-01-01

Co-rumination, defined as repetitive, problem-focused talk explains higher levels of friendship quality in youth (Rose, 2002) and increased levels of anxiety/depression in females. Middle adolescents (N = 146) participated in a study of co-rumination, individual coping, externalizing/internalizing problems, and peer functioning. Consistent with…

Supporting Curriculum Assessment and Development: Implications for the Faculty Role and Institutional Support

ERIC Educational Resources Information Center

Hughes, Julia Christensen

2007-01-01

It has been suggested that growing interest in curriculum assessment and development in higher education is the result of a number of external and internal factors. External factors include increasing government interest in quality assurance, accessibility, and degree completion rates; growing recognition of the important role university graduates…

Social Ontology Documentation for Knowledge Externalization

NASA Astrophysics Data System (ADS)

Aranda-Corral, Gonzalo A.; Borrego-Díaz, Joaquín; Jiménez-Mavillard, Antonio

Knowledge externalization and organization is a major challenge that companies must face. Also, they have to ask whether is possible to enhance its management. Mechanical processing of information represents a chance to carry out these tasks, as well as to turn intangible knowledge assets into real assets. Machine-readable knowledge provides a basis to enhance knowledge management. A promising approach is the empowering of Knowledge Externalization by the community (users, employees). In this paper, a social semantic tool (called OntoxicWiki) for enhancing the quality of knowledge is presented.

Magnetic hyperthermia study in water based magnetic fluids containing TMAOH coated Fe3O4 using infrared thermography

NASA Astrophysics Data System (ADS)

Lahiri, B. B.; Ranoo, Surojit; Philip, John

2017-01-01

We study the alternating magnetic field induced heating of a water based ferrofluid containing tetramethyl ammonium hydroxide coated iron oxide nanoparticles using infrared thermography and compare the results obtained from the conventional fiber optic temperature sensor. Experiments are performed on ferrofluid samples of five different concentrations and under four different external field amplitudes at a fixed frequency. The temperature rise curves measured using both the infrared thermography and fiber optic sensor are found to be very similar up to a certain time interval, above which deviations are observed, which are attributed to the internal and external convection phenomena. A correction methodology is developed to account for the convection losses. The convection corrected specific absorption rate is found to be in good agreement with the values obtained from the conventional fiber optic temperature sensor, within a maximum error of ±3.4%. The highest specific absorption rate obtained in the present study is 135.98 (±4.6) W/gFe for a sample concentration of 3 wt.%, at an external field amplitude and a frequency of 63.0 kA m-1 and 126 kHz, respectively. The specific absorption rate is found to decrease with increasing sample concentration, due to the enhancement of dipolar interaction with increasing sample concentration due to agglomeration. This study validates the efficacy and universal applicability of IRT as an alternate, real time, non-contact and wide area temperature measurement methodology for magnetic fluid hyperthermia experiments without any sample contamination.

Interactive effects of the affect quality and directional focus of mental imagery on pain analgesia.

PubMed

Alden, A L; Dale, J A; DeGood, D E

2001-06-01

College students (25 men and 25 women) were randomly assigned (within sex) to each of the 4 factorial groups, based on manipulation of affect quality (positive vs. negative) and directional focus (internal vs. external) of mental imagery, and to a control group receiving no manipulation. Both imagery variables had a significant impact on pain tolerance and ratings during a cold-pressor test with positive affect and external imagery producing greater analgesia than their counterpart conditions. Positive affect imagery combined with external imagery resulted in the lowest reported pain amongst the groups. However, self-reported mood descriptors did not consistently parallel the pain tolerance and rating data. Likewise, although heart rate and skin potential responses increased during the cold pressor for the group as a whole, the only significant difference amongst the experimental groups was the relatively higher skin potential reactivity of the positive affect-external imagery group--possibly reflecting greater task engagement for this group. Seemingly, imagery in this situation operates primarily via cognitive, rather than via physiological mediators of the pain experience.

Dose reduction of up to 89% while maintaining image quality in cardiovascular CT achieved with prospective ECG gating

NASA Astrophysics Data System (ADS)

Londt, John H.; Shreter, Uri; Vass, Melissa; Hsieh, Jiang; Ge, Zhanyu; Adda, Olivier; Dowe, David A.; Sabllayrolles, Jean-Louis

2007-03-01

We present the results of dose and image quality performance evaluation of a novel, prospective ECG-gated Coronary CT Angiography acquisition mode (SnapShot Pulse, LightSpeed VCT-XT scanner, GE Healthcare, Waukesha, WI), and compare it to conventional retrospective ECG gated helical acquisition in clinical and phantom studies. Image quality phantoms were used to measure noise, slice sensitivity profile, in-plane resolution, low contrast detectability and dose, using the two acquisition modes. Clinical image quality and diagnostic confidence were evaluated in a study of 31 patients scanned with the two acquisition modes. Radiation dose reduction in clinical practice was evaluated by tracking 120 consecutive patients scanned with the prospectively gated scan mode. In the phantom measurements, the prospectively gated mode resulted in equivalent or better image quality measures at dose reductions of up to 89% compared to non-ECG modulated conventional helical scans. In the clinical study, image quality was rated excellent by expert radiologist reviewing the cases, with pathology being identical using the two acquisition modes. The average dose to patients in the clinical practice study was 5.6 mSv, representing 50% reduction compared to a similar patient population scanned with the conventional helical mode.

A series of strategies for solving the shortage of reference standards for multi-components determination of traditional Chinese medicine, Mahoniae Caulis as a case.

PubMed

Wang, Wenguang; Ma, Xiaoli; Guo, Xiaoyu; Zhao, Mingbo; Tu, Pengfei; Jiang, Yong

2015-09-18

In order to solve the bottleneck of reference standards shortage for comprehensive quality control of traditional Chinese medicines (TCMs), a series of strategies, including one single reference standard to determine multi-compounds (SSDMC), quantitative analysis by standardized reference extract (QASRE), and quantitative nuclear magnetic resonance spectroscopy (qNMR) were proposed, and Mahoniae Caulis was selected as an example to develop and validate these methods for simultaneous determination of four alkaloids, columbamine, jatrorrhizine, palmatine, and berberine. Comprehensive comparisons among these methods and with the conventional external standard method (ESM) were carried out. The relative expanded uncertainty of measurement was firstly used to compare their credibility. The results showed that all these three new developed methods can accurately accomplish the quantification by using only one purified reference standard, but each of them has its own advantages and disadvantages as well as the specific application scope, which were also discussed in detail in this paper. Copyright © 2015 Elsevier B.V. All rights reserved.

Road Lane Detection Robust to Shadows Based on a Fuzzy System Using a Visible Light Camera Sensor

PubMed Central

Hoang, Toan Minh; Baek, Na Rae; Cho, Se Woon; Kim, Ki Wan; Park, Kang Ryoung

2017-01-01

Recently, autonomous vehicles, particularly self-driving cars, have received significant attention owing to rapid advancements in sensor and computation technologies. In addition to traffic sign recognition, road lane detection is one of the most important factors used in lane departure warning systems and autonomous vehicles for maintaining the safety of semi-autonomous and fully autonomous systems. Unlike traffic signs, road lanes are easily damaged by both internal and external factors such as road quality, occlusion (traffic on the road), weather conditions, and illumination (shadows from objects such as cars, trees, and buildings). Obtaining clear road lane markings for recognition processing is a difficult challenge. Therefore, we propose a method to overcome various illumination problems, particularly severe shadows, by using fuzzy system and line segment detector algorithms to obtain better results for detecting road lanes by a visible light camera sensor. Experimental results from three open databases, Caltech dataset, Santiago Lanes dataset (SLD), and Road Marking dataset, showed that our method outperformed conventional lane detection methods. PMID:29143764

Enhancing climate Adaptation Capacity for Drinking Water ...

EPA Pesticide Factsheets

Journal article This paper considers the adaptation capacity of conventional water treatment systems. A modeling framework is used to illustrate climate adaptation mechanisms that could enable conventional treatment systems to accommodate water quality impairments.

Microwave processing of gustatory tissues for immunohistochemistry

PubMed Central

Bond, Amanda; Kinnamon, John C.

2013-01-01

We use immunohistochemistry to study taste cell structure and function as a means to elucidate how taste receptor cells communicate with nerve fibers and adjacent taste cells. This conventional method, however, is time consuming. In the present study we used taste buds from rat circumvallate papillae to compare conventional immunohistochemical tissue processing with microwave processing for the colocalization of several biochemical pathway markers (PLCβ2, syntaxin-1, IP3R3, α-gustducin) and the nuclear stain, Sytox. The results of our study indicate that in microwave versus conventional immunocytochemistry: (1) fixation quality is improved; (2) the amount of time necessary for processing tissue is decreased; (3) antigen retrieval is no longer needed; (4) image quality is superior. In sum, microwave tissue processing of gustatory tissues is faster and superior to conventional immunohistochemical tissue processing for many applications. PMID:23473796

The effect of mandibular 2-implant overdentures on oral health-related quality of life: an international multicentre study.

PubMed

Awad, Manal A; Rashid, Faahim; Feine, Jocelyne S

2014-01-01

To determine the difference in oral health-related quality of life (OHRQoL) in patients who received mandibular 2-implant overdentures and conventional dentures in a pragmatic international study. In this prospective study, data were gathered from 203 edentulous patients (mean age, 68.8; SD: 10.4 years) at eight centres in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by 2 implants and ball attachments and opposed by conventional dentures. At baseline and at 6 months post-treatment, patients rated their oral health-related quality of life using the OHIP-20. A significantly higher proportion of the participants in the implant group in North America reported improvement in both the psychological and the handicap domains, compared to those who received conventional dentures (93% vs. 52%; P < 0.05). In South America, 100% of participants who received implant overdentures reported improvement in physical pain, compared to 66% in the conventional group (P < 0.05). Differences in mean change scores among those who expressed improvement were not significantly different between sites or treatments. Mandibular 2-implant overdentures are more likely than conventional dentures to improve OHRQL for edentulous patients. Cultural differences were also observed in the impact of implant overdentures on the different domains of the OHIP-20. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

PubMed Central

Zerbini, Talita; da Silva, Luiz Fernando Ferraz; Ferro, Antonio Carlos Gonçalves; Kay, Fernando Uliana; Junior, Edson Amaro; Pasqualucci, Carlos Augusto Gonçalves; do Nascimento Saldiva, Paulo Hilario

2014-01-01

OBJECTIVE: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. METHOD: Comparison between the findings of different methods: autopsy and postmortem computed tomography. RESULTS: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography. CONCLUSIONS: Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations. PMID:25518020

On the establishment and maintenance of a modern conventional terrestrial reference system

NASA Technical Reports Server (NTRS)

Bock, Y.; Zhu, S. Y.

1982-01-01

The frame of the Conventional Terrestrial Reference System (CTS) is defined by an adopted set of coordinates, at a fundamental epoxh, of a global network of stations which contribute the vertices of a fundamental polyhedron. A method to estimate this set of coordinates using a combination of modern three dimensional geodetic systems is presented. Once established, the function of the CTS is twofold. The first is to monitor the external (or global) motions of the polyhedron with respect to the frame of a Conventional Inertial Reference System, i.e., those motions common to all stations. The second is to monitor the internal motions (or deformations) of the polyhedron, i.e., those motions that are not common to all stations. Two possible estimators for use in earth deformation analysis are given and their statistical and physical properties are described.

A Network Approach to Curriculum Quality Assessment

ERIC Educational Resources Information Center

Jordens, J. Zoe; Zepke, Nick

2009-01-01

This paper argues for an alternative approach to quality assurance in New Zealand universities that locates evaluation not with external auditors but with members of the teaching team. In the process, aspects of network theories are introduced as the basis for an approach to quality assurance. From this, the concept of networks is extended to…

Regulatory Intermediation and Quality Assurance in Higher Education: The Case of the Auditors

ERIC Educational Resources Information Center

King, Roger; Griffiths, Paul; Williams, Ruth

2007-01-01

The paper takes the external quality assurance of English universities and colleges as an example of regulation in higher education as undertaken by the Quality Assurance Agency (QAA). Regulatory scholarship generally has been largely disinterested in higher education and the paper applies a "regulatory lens" to higher education quality…

A Guide to Pathways through the Pre-Five Quality Process.

ERIC Educational Resources Information Center

Strathclyde Regional Council, Glasgow (Scotland).

This guide describes a quality process for external and internal evaluation of the elementary school education department. The term "pathway" is used to define routes through the quality process that describe any school administrative activity in terms of the indicators and examples of good practice. There are five pathways: process…

The Representation of Library Value in Extra-Institutional Evaluations of University Quality

ERIC Educational Resources Information Center

Jackson, Brian

2017-01-01

The ways in which university quality assessments are developed reveal a great deal about value constructs surrounding higher education. Measures developed and consumed by external stakeholders, in particular, indicate which elements of academia are broadly perceived to be most reflective of quality. This paper examines the historical context of…

Effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour or patient outcomes

PubMed Central

Flodgren, Gerd; Pomey, Marie-Pascale; Taber, Sarah A; Eccles, Martin P

2014-01-01

Background Inspection systems are used in health care to promote quality improvements, i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes. These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of health care. However, the benefits of external inspection in terms of organisational, provider and patient level outcomes are not clear. Objectives To evaluate the effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour and patient outcomes. Search methods We searched the following electronic databases for studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, Scopus, HMIC, Index to Theses and Intute from their inception dates up to May 2011. There was no language restriction and studies were included regardless of publication status. We searched the reference lists of included studies and contacted authors of relevant papers, accreditation bodies and the International Organization for Standardisation (ISO), regarding any further published or unpublished work. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time-series (ITSs) and controlled before and after studies (CBAs) evaluating the effect of external inspection against external standards on healthcare organisation change, healthcare professional behaviour or patient outcomes in hospitals, primary healthcare organisations and other community-based healthcare organisations. Data collection and analysis Two review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study. Since meta-analysis was not possible, we produced a narrative results summary. Main results We identified one cluster-RCT involving 20 South African public hospitals (Salmon 2003) and one ITS involving all acute trusts in England (OPM 2009) for inclusion in this review. Salmon and colleagues (Salmon 2003) showed mixed effects of a hospital accreditation system on the compliance with COHSASA (the Council for Health Services Accreditation for South Africa) accreditation standards and eight indicators of hospital quality. Significantly improved total mean compliance score with COHSASA accreditation standards was found for 21/28 service elements: mean intervention effect (95% confidence interval (CI)) was 30% (23% to 57%) (P < 0.001). The score increased from 48% to 78% in intervention hospitals, while remaining the same in control hospitals (43%). A sub-analysis of 424 a priori identified critical criteria (19 service elements) showed significantly improved compliance with the critical standards (P < 0.001). The score increased from 41% (21% to 46%) to 75% (55% to 96%) in intervention hospitals, but was unchanged in control hospitals (37%). Only one of the nine intervention hospitals gained full accreditation status at the end of the study period, with two others reached pre-accreditation status.The median intervention effect (range) for the indicators of hospital quality of care was 2.4 (−1.9 to +11.8) and only one of the eight indicators: ‘nurses perception of clinical quality, participation and teamwork’ was significantly improved (mean intervention effect 5.7, P = 0.03). Re-analysis of the MRSA (methicillin-resistant Staphylococcus aureus) data showed statistically non-significant effects of the Healthcare Commissions Infection Inspection programme. Authors’ conclusions We only identified two studies for inclusion in this review, which highlights the paucity of high-quality controlled evaluations of the effectiveness of external inspection systems. No firm conclusions could therefore be drawn about the effectiveness of external inspection on compliance with standards. PMID:22071861

When attention wanders: Pupillometric signatures of fluctuations in external attention.

PubMed

Konishi, Mahiko; Brown, Kevin; Battaglini, Luca; Smallwood, Jonathan

2017-11-01

Attention is not always directed to events in the external environment. On occasion our thoughts wander to people and places distant from the here and now. Sometimes, this lack of external attention can compromise ongoing task performance. In the current study we set out to understand the extent to which states of internal and external attention can be determined using pupillometry as an index of ongoing cognition. In two experiments we found that periods of slow responding were associated with elevations in the baseline pupil signal over three and a half seconds prior to a behavioural response. In the second experiment we found that unlike behavioural lapses, states of off-task thought, particularly those associated with a focus on the past and with an intrusive quality, were associated with reductions in the size of the pupil over the same window prior to the probe. These data show that both states of large and small baseline pupil size are linked to states when attention is not effectively focused on the external environment, although these states have different qualities. More generally, these findings illustrate that subjective and objective markers of task performance may not be equivalent and underscore the importance of developing objective indicators that can allow these different states to be understood. Copyright © 2017 Elsevier B.V. All rights reserved.

Development of a Browser-Based Mobile Audience Response System for Large Classrooms

ERIC Educational Resources Information Center

Andergassen, Monika; Guerra, Victor; Ledermüller, Karl; Neumann, Gustaf

2013-01-01

Didactical advantages of audience response systems (ARS) have been discussed extensively ever since they have been used in classes. However, conventional ARS bear some drawbacks, such as requiring specific hardware, generating costs (text messaging based and web service fees) and creating a dependency on external hosts. In this paper we present a…

The liquid droplet radiator: Status of development

NASA Astrophysics Data System (ADS)

Persson, J.

1991-12-01

The ever greater amounts of power to be dissipated onboard future spacecraft, together with their limited external dimensions, will make it increasingly difficult to use conventional radiator technology without imposing a severe mass penalty. Hunting for lightweight alternatives to current heat rejection systems has become a matter of growing urgency, which explains the great interest that the Liquid Droplet Radiator (LDR) has attracted. Tradeoff analyses indicate that an LDR may be as much as an order of magnitude lighter than a comparable conventional radiator. A literature study examining the progress of the LDR research and some of its possible applications is reviewed. An investigation of the LDR heat rejection capability is presented.

A review of the impacts of tobacco heating system on indoor air quality versus conventional pollution sources.

PubMed

Kaunelienė, Violeta; Meišutovič-Akhtarieva, Marija; Martuzevičius, Dainius

2018-05-08

With the introduction of novel and potentially less polluting nicotine containing products to the market, the impacts of their usage to indoor air quality as opposed to conventional pollution sources must be reviewed and considered. This review study aimed to comparatively analyse changes in indoor air quality as the consequence of tobacco heating system (THS) generated pollution against general indoor air quality in various micro-environments, especially with combustion-based pollution sources present. Indoor concentrations of formaldehyde, acetaldehyde, benzene, toluene, nicotine and PM 2.5 were reviewed and compared; concentrations of other harmful and potentially harmful substances (HPHCs) were discussed. Generally, the usage of THS has been associated with lower or comparable indoor air pollutant concentrations compared against other conventional indoor sources or environments, in most cases distinguishable above background, thus potentially being associated with health effects at prolonged exposures as any other artificial air pollution source. In the controlled environment the use of THS (as well as an electronic cigarette) resulted in the lowest concentrations of formaldehyde, benzene, toluene, PM 2.5, among majority researched pollution sources (conventional cigarettes, waterpipe, incense, mosquito coils). The exposure to significantly higher pollution levels of benzene, toluene, and formaldehyde occurred in public environments, especially transport micro-environments. Such low levels of conventionally-assessed indoor pollutants resulting from the use of new nicotine containing products raise challenges for epidemiological studies of second-hand exposure to THS aerosol in real-life environments. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer: a prospective, randomized, controlled study.

PubMed

Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S; Morita, Satoshi; Yoshikawa, Takaki

2015-02-01

Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue-assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy.

A Methylene Blue–assisted Technique for Harvesting Lymph Nodes After Radical Surgery for Gastric Cancer

PubMed Central

Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S.; Morita, Satoshi

2015-01-01

Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue–assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy. PMID:25356528

Quality of life after robotic thyroidectomy by a gasless unilateral axillary approach.

PubMed

Song, Chang Myeon; Ji, Yong Bae; Bang, Hyang Sook; Park, Chul Won; Kim, Dong Sun; Tae, Kyung

2014-12-01

Robotic thyroidectomies have been safely performed with early surgical outcomes comparable to conventional cervical thyroidectomies. However, health-related quality of life (HRQOL) after robotic thyroidectomy has not yet been evaluated. The aim of this study was to compare HRQOL of patients who underwent robotic thyroidectomy with that of those who received conventional thyroidectomy. We conducted a cross-sectional study in 111 patients who underwent either robotic thyroidectomy (44 patients) via a gasless unilateral axillary approach, or conventional cervical thyroidectomy (67 patients), for papillary thyroid carcinoma (PTC). HRQOL of patients was assessed using two questionnaires, the University of Washington Quality of Life (UW-QOL) questionnaire for patients with head and neck cancer, and the Quality of Life-Thyroid Version (QOL-TV), which was specifically designed for thyroid cancer patients. The survey using the questionnaires was performed 1 year after surgery at a routine outpatient clinic follow-up. There was no difference in UW-QOL scores between the two groups for any factor other than neck appearance and physical composite score, which were higher in the robotic group. Humor (mood) and anxiety, emotional measures of UW-QOL, were selected by patients in both groups as being their most significant issue during the preceding 7 days. There was no between-group difference in the four QOL-TV domains (physical, psychological, social, and spiritual well-being). Patients who underwent robotic thyroidectomy reported a higher score for satisfaction with neck appearance compared to patients receiving conventional cervical thyroidectomy. However, the overall HRQOL of patients in the robotic and conventional groups was similar.

Development of fuzzy air quality index using soft computing approach.

PubMed

Mandal, T; Gorai, A K; Pathak, G

2012-10-01

Proper assessment of air quality status in an atmosphere based on limited observations is an essential task for meeting the goals of environmental management. A number of classification methods are available for estimating the changing status of air quality. However, a discrepancy frequently arises from the quality criteria of air employed and vagueness or fuzziness embedded in the decision making output values. Owing to inherent imprecision, difficulties always exist in some conventional methodologies like air quality index when describing integrated air quality conditions with respect to various pollutants parameters and time of exposure. In recent years, the fuzzy logic-based methods have demonstrated to be appropriated to address uncertainty and subjectivity in environmental issues. In the present study, a methodology based on fuzzy inference systems (FIS) to assess air quality is proposed. This paper presents a comparative study to assess status of air quality using fuzzy logic technique and that of conventional technique. The findings clearly indicate that the FIS may successfully harmonize inherent discrepancies and interpret complex conditions.

Application of meteorology-based methods to determine local and external contributions to particulate matter pollution: A case study in Venice (Italy)

NASA Astrophysics Data System (ADS)

Squizzato, Stefania; Masiol, Mauro

2015-10-01

The air quality is influenced by the potential effects of meteorology at meso- and synoptic scales. While local weather and mixing layer dynamics mainly drive the dispersion of sources at small scales, long-range transports affect the movements of air masses over regional, transboundary and even continental scales. Long-range transport may advect polluted air masses from hot-spots by increasing the levels of pollution at nearby or remote locations or may further raise air pollution levels where external air masses originate from other hot-spots. Therefore, the knowledge of ground-wind circulation and potential long-range transports is fundamental not only to evaluate how local or external sources may affect the air quality at a receptor site but also to quantify it. This review is focussed on establishing the relationships among PM2.5 sources, meteorological condition and air mass origin in the Po Valley, which is one of the most polluted areas in Europe. We have chosen the results from a recent study carried out in Venice (Eastern Po Valley) and have analysed them using different statistical approaches to understand the influence of external and local contribution of PM2.5 sources. External contributions were evaluated by applying Trajectory Statistical Methods (TSMs) based on back-trajectory analysis including (i) back-trajectories cluster analysis, (ii) potential source contribution function (PSCF) and (iii) concentration weighted trajectory (CWT). Furthermore, the relationships between the source contributions and ground-wind circulation patterns were investigated by using (iv) cluster analysis on wind data and (v) conditional probability function (CPF). Finally, local source contribution have been estimated by applying the Lenschow' approach. In summary, the integrated approach of different techniques has successfully identified both local and external sources of particulate matter pollution in a European hot-spot affected by the worst air quality.

Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H and N-35 modules

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

Cengiz, Mustafa; Ozyar, Enis; Esassolak, Mustafa

2005-12-01

Purpose: The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey. Patients and Methods: Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module. Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage. Each patient's 33 QoLmore » scores, which included function, global health status, and symptoms, were calculated as instructed in EORTC QLQ-C30 scoring manual. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level. Kruskal-Wallis and Mann-Whitney U nonparametric tests were used for comparisons. Results: One hundred eighty-seven patients with median age of 46 years (range, 16-79 years) participated and completed the questionnaires. Median follow-up time was 3.4 years (range, 6 months-24 years). All patients have received external-beam radiotherapy. Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy. Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]). Mean global health status was calculated as 73. Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05). Functional parameters were better in males and in early-stage disease. Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores). Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores. Conclusion: Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies. The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up. Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL.« less

[Post-mortem examination prior to cremation--an instrument to verify the quality of medical post-mortems and uncover non-natural deaths?].

PubMed

Germerott, Tanja; Todt, Melanie; Bode-Jänisch, Stefanie; Albrecht, Knut; Breitmeier, Dirk

2012-01-01

The external post-mortem examination, its deficient quality and possible causes have been the subject of numerous political and professional discussions. The external post-mortem examination is the basis for the decision whether further criminal investigations are required to clarify the cause of death. It is thus an essential instrument to ensure legal certainty. Before cremation, a second external post-mortem examination is performed by a public medical officer to make sure that errors of the first post-mortem are corrected. In the present study, cases were retrospectively analyzed in which a forensic autopsy had been ordered on the basis of the results of the post-mortem examination performed before cremation. The entries on the death certificate regarding the manner and cause of death were compared with the autopsy results. Between 1998 and 2007, 387 autopsies were ordered after external examination before cremation. In 55 cases (14.2%), the autopsy revealed a non-natural death, although a natural death had been attested on the death certificate. In descending order, a wrong manner of death was attested by clinicians, general practitioners and emergency physicians. With regard to the place where the first external post-mortem had been performed the lowest error rate was seen in nursing homes. Concerning the cause of death, discrepancies between the first post-mortem and autopsy were found in 59.4% of the cases. In this respect, general practitioners and clinicians were ranking first, whereas in nursing homes the cause of death was wrongly assessed in over 70% of cases. At present, the medical post-mortem does not meet the required quality standards, especially with regard to legal certainty. Determination of the cause of death on the basis of the external post-mortem examination is a challenging task even for the experienced medical examiner. As to the categorization of the manner of death it has to be stated that non-natural deaths are often not recognized or that the possibility to certify a death as unclear is not sufficiently used. As a result, it seems important to demand intensive, qualified, additional training in external post-mortem examinations for physicians.

Reconstruction of large diaphyseal bone defect by simplified bone transport over nail technique: A 7-case series.

PubMed

Ferchaud, F; Rony, L; Ducellier, F; Cronier, P; Steiger, V; Hubert, L

2017-11-01

Reconstruction of large diaphyseal bone defect is complex and the complications rate is high. This study aimed to assess a simplified technique of segmental bone transport by monorail external fixator over an intramedullary nail.A prospective study included 7 patients: 2 femoral and 5 tibial defects. Mean age was 31years (range: 16-61years). Mean follow-up was 62 months (range: 46-84months). Defects were post-traumatic, with a mean length of 7.2cm (range: 4 to 9.5cm). For 3 patients, reconstruction followed primary failure. In 4 cases, a covering flap was necessary. Transport used an external fixator guided by an intramedullary nail, at a rate of 1mm per day. One pin was implanted on either side of the distraction zone. The external fixator was removed 1 month after bone contact at the docking site. Mean bone transport time was 11 weeks (range: 7-15 weeks). Mean external fixation time was 5.1months (range: 3.5 to 8months). Full weight-bearing was allowed 5.7months (range: 3.5-13months) after initiation of transport. In one patient, a pin had to be repositioned. In 3 patients, the transported segment re-ascended after external fixatorablation, requiring repeat external fixation and resumption of transport. There was just 1 case of superficial pin infection. Reconstruction quality was considered "excellent" on the Paley-Marr criteria in 6 cases. The present technique provided excellent reconstruction quality in 6 of the 7 cases. External fixation time was shorter and resumption of weight-bearing earlier than with other reconstruction techniques, notably including bone autograft, vascularized bone graft or the induced membrane technique. Nailing facilitated control of limb axis and length. The complications rate was 50%, comparable to other techniques. This study raises the question of systematic internal fixation of the docking site, to avoid any mobilization of the transported segment. The bone quality, axial control and rapidity shown by the present technique make it well-adapted to reconstruction of diaphyseal bone defect. Four-case series. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

NASA Astrophysics Data System (ADS)

Koblen, Ivan; Lestyánszka Škůrková, Katarína

2015-06-01

The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

External Validity of the New York University Caregiver Intervention: Key Caregiver Outcomes Across Multiple Demonstration Projects.

PubMed

Fauth, Elizabeth B; Jackson, Mark A; Walberg, Donna K; Lee, Nancy E; Easom, Leisa R; Alston, Gayle; Ramos, Angel; Felten, Kristen; LaRue, Asenath; Mittelman, Mary

2017-06-01

The Administration on Aging funded six New York University Caregiver Intervention (NYUCI) demonstration projects, a counseling/support intervention targeting dementia caregivers and families. Three sites (Georgia, Utah, Wisconsin) pooled data to inform external validity in nonresearch settings. This study (a) assesses collective changes over time, and (b) compares outcomes across sites on caregiver burden, depressive symptoms, satisfaction with social support, family conflict, and quality of life. Data included baseline/preintervention ( N = 294) and follow-up visits (approximately 4, 8, 12 months). Linear mixed models showed that social support satisfaction increased ( p < .05) and family conflict decreased ( p < .05; Cohen's d = 0.49 and 0.35, respectively). Marginally significant findings emerged for quality of life increases ( p = .05) and burden decreases ( p < .10). Depressive symptoms remained stable. Slopes did not differ much by site. NYUCI demonstrated external validity in nonresearch settings across diverse caregiver samples.

Quality Procedures in the European Higher Education Area and Beyond--Visions for the Future: Third ENQA Survey. ENQA Occasional Papers 18

ERIC Educational Resources Information Center

Grifoll, Josep; Hopbach, Achim; Kekalainen, Helka; Lugano, Nathalie; Rozsnyai, Christina; Shopov, Todor

2012-01-01

Higher education reforms over the last decade, resulting in the establishment of the European Higher Education Area, with new social demands and expectations, have greatly impacted quality assurance in higher education. As a follow-up activity to two previous surveys on external quality procedures, the European Association for Quality Assurance in…

ENQA: 10 Years (2000-2010): A Decade of European Co-Operation in Quality Assurance in Higher Education

ERIC Educational Resources Information Center

Crozier, Fiona, Ed.; Costes, Nathalie, Ed.; Ranne, Paula, Ed.; Stalter, Maria, Ed.

2010-01-01

The history of ENQA (European Association for Quality Assurance in Higher Education) arises in the late 1990s when the first formal procedures for quality assurance begun to stabilize on a national level. As a result of the European Pilot Projects in the field of external quality assurance during the nineties, participants felt the need for…

Use of quality indicators by obstetric caregivers in the Netherlands: A descriptive study.

PubMed

Cellissen, Evelien; Franx, Arie; Roes, Kit C B

2017-04-01

To evaluate the use of quality indicators by obstetric caregivers in hospitals in the Netherlands. An anonymous, self-administered survey was conducted in a convenience sample of obstetricians and clinical midwives in Dutch hospitals. Descriptive statistics were used to analyse the data, both for all caregivers and stratified by hospital setting and profession (obstetricians and midwives). Differences between strata were tested at a 5% significance level. The response rate to the online questionnaire was 61% (n=171/279). Of all respondents 83% were aware of the quality indicators and 63% contributed to their registration. Caregivers received information about the indicators by mail or in meetings according to 64% (internal indicators) and 48% (external indicators) of the respondents. Of the respondents 56% (internal indicators) and 41% (external indicators) stated to use the results of indicators when designing plans to improve the quality of care. We conclude that obstetric quality indicators are not widely used by obstetricians and midwives in Dutch hospitals to improve quality of care. To improve quality of care and the effective use of quality indicators we suggest to focus first on registering outcome indicators. These indicators should be implemented in quality structures that ensure that action is taken. Copyright © 2017 Elsevier B.V. All rights reserved.

A Public-Private Partnership Develops and Externally Validates a 30-Day Hospital Readmission Risk Prediction Model

PubMed Central

Choudhry, Shahid A.; Li, Jing; Davis, Darcy; Erdmann, Cole; Sikka, Rishi; Sutariya, Bharat

2013-01-01

Introduction: Preventing the occurrence of hospital readmissions is needed to improve quality of care and foster population health across the care continuum. Hospitals are being held accountable for improving transitions of care to avert unnecessary readmissions. Advocate Health Care in Chicago and Cerner (ACC) collaborated to develop all-cause, 30-day hospital readmission risk prediction models to identify patients that need interventional resources. Ideally, prediction models should encompass several qualities: they should have high predictive ability; use reliable and clinically relevant data; use vigorous performance metrics to assess the models; be validated in populations where they are applied; and be scalable in heterogeneous populations. However, a systematic review of prediction models for hospital readmission risk determined that most performed poorly (average C-statistic of 0.66) and efforts to improve their performance are needed for widespread usage. Methods: The ACC team incorporated electronic health record data, utilized a mixed-method approach to evaluate risk factors, and externally validated their prediction models for generalizability. Inclusion and exclusion criteria were applied on the patient cohort and then split for derivation and internal validation. Stepwise logistic regression was performed to develop two predictive models: one for admission and one for discharge. The prediction models were assessed for discrimination ability, calibration, overall performance, and then externally validated. Results: The ACC Admission and Discharge Models demonstrated modest discrimination ability during derivation, internal and external validation post-recalibration (C-statistic of 0.76 and 0.78, respectively), and reasonable model fit during external validation for utility in heterogeneous populations. Conclusions: The ACC Admission and Discharge Models embody the design qualities of ideal prediction models. The ACC plans to continue its partnership to further improve and develop valuable clinical models. PMID:24224068

The cost-effectiveness of family/family-based therapy for treatment of externalizing disorders, substance use disorders and delinquency: a systematic review.

PubMed

Goorden, Maartje; Schawo, Saskia J; Bouwmans-Frijters, Clazien A M; van der Schee, Evelien; Hendriks, Vincent M; Hakkaart-van Roijen, Leona

2016-07-13

Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency. A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included. Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis. The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.

Recovering task fMRI signals from highly under-sampled data with low-rank and temporal subspace constraints.

PubMed

Chiew, Mark; Graedel, Nadine N; Miller, Karla L

2018-07-01

Recent developments in highly accelerated fMRI data acquisition have employed low-rank and/or sparsity constraints for image reconstruction, as an alternative to conventional, time-independent parallel imaging. When under-sampling factors are high or the signals of interest are low-variance, however, functional data recovery can be poor or incomplete. We introduce a method for improving reconstruction fidelity using external constraints, like an experimental design matrix, to partially orient the estimated fMRI temporal subspace. Combining these external constraints with low-rank constraints introduces a new image reconstruction model that is analogous to using a mixture of subspace-decomposition (PCA/ICA) and regression (GLM) models in fMRI analysis. We show that this approach improves fMRI reconstruction quality in simulations and experimental data, focusing on the model problem of detecting subtle 1-s latency shifts between brain regions in a block-design task-fMRI experiment. Successful latency discrimination is shown at acceleration factors up to R = 16 in a radial-Cartesian acquisition. We show that this approach works with approximate, or not perfectly informative constraints, where the derived benefit is commensurate with the information content contained in the constraints. The proposed method extends low-rank approximation methods for under-sampled fMRI data acquisition by leveraging knowledge of expected task-based variance in the data, enabling improvements in the speed and efficiency of fMRI data acquisition without the loss of subtle features. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision.

PubMed

Schriver, Michael; Cubaka, Vincent Kalumire; Vedsted, Peter; Besigye, Innocent; Kallestrup, Per

2018-01-01

External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test-retest design, the second for confirmatory factor analysis. We included 16 items in section A ('The most recent experience with an external supervisor'), and 13 items in section B ('The overall experience with external supervisors'). Item-content validity index was acceptable. In field test I, test-retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

Clinical equivalence assessment of T2 synthesized pediatric brain magnetic resonance imaging.

PubMed

Kerleroux, Basile; Kober, Tobias; Hilbert, Tom; Serru, Maxence; Sirinelli, Dominique; Morel, Baptiste

2018-05-04

Automated synthetic magnetic resonance imaging (MRI) provides qualitative, weighted image contrasts as well as quantitative information from one scan and is well-suited for various applications such as analysis of white matter disorders. However, the synthesized contrasts have been poorly evaluated in pediatric applications. The purpose of this study was to compare the image quality of synthetic T2 to conventional turbo spin echo (TSE) T2 in pediatric brain MRI. This was a mono-center prospective study. Synthetic and conventional MRI acquisitions at 1.5 Tesla were performed for each patient during the same session using a prototype accelerated T2 mapping sequence package (TA synthetic =3:07min, TA conventional =2:33min). Image sets were blindly and randomly analyzed by pediatric neuro-radiologists. Global image quality, morphologic legibility of standard structures and artifacts were assessed using a 4-point Likert scale. Inter-observer kappa agreements were calculated. The capability of the synthesized contrasts and conventional TSE T2 to discern normal and pathologic cases was evaluated. Sixty patients were included. The overall diagnostic quality of the synthesized contrasts was non-inferior to conventional imaging scale (p=0.06). There was no significant difference in the legibility of normal and pathological anatomic structures of synthetized and conventional TSE T2 (all p > 0.05) as well as for artifacts except for phase encoding (p=0.008). Interobserver agreement was good to almost perfect (kappa between 0.66 and 1). T2 synthesized contrasts, which also provides quantitative T2 information that could be useful, could be suggested as an equivalent technique in pediatric neuro-imaging, compared to conventional TSE T2. Copyright © 2018. Published by Elsevier Masson SAS.

Lower limb vascular disease in diabetic patients: a study with calf compression contrast-enhanced magnetic resonance angiography at 3.0 Tesla.

PubMed

Li, Jie; Zhao, Jun-Gong; Li, Ming-Hua

2011-06-01

To retrospectively analyze the significance of 3.0-T contrast-enhanced (CE) magnetic resonance angiography (MRA) with calf compression in the lower limbs of diabetic patients with peripheral vascular disease. Sixty-one type 2 diabetes patients underwent both MRA and digital subtraction angiography (DSA) within 1 week. The patients were divided into two groups: one with (pressure) and one without (conventional) calf compression during MRA. Two radiologists evaluated the quality of MRA images and compared the two groups. Cohen's kappa statistic was used to determine the concordance between MRA and DSA. Image quality in the calf and foot was better in the group with calf pressure than the conventional group without applied pressure (P = .001 [calf], 0.008 [foot]). Significantly more runoff vessels in the calf were detected with MRA than with DSA (P = .0043 [conventional], 0.0031 [pressure]). The kappa values were 0.928 in the conventional group and 0.979 in the pressure group, but in the conventional group, the diagnostic accuracy of CE-MRA was lower than that of DSA (P = .002). Diagnostic accuracy in the pressure group was significantly higher than that in the conventional group (P = .009). The overall sensitivity and specificity for >50% stenosis or occlusion was 93.8% and 98.5%, respectively, in the conventional group and 98.7% and 99.6%, respectively, in the pressure group. With calf compression, venous overlap (P = .0396, .0425) and deep vein overlap (P = .022, .022) were significantly reduced in the leg and foot. Calf compression with 3.0-T CE-MRA was convenient and practical and could improve image quality and diagnostic accuracy in diabetic patients with peripheral vascular disease by reducing venous overlap. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Polyethersulfone-based ultrafiltration hollow fibre membrane for drinking water treatment systems

NASA Astrophysics Data System (ADS)

Chew, Chun Ming; Ng, K. M. David; Ooi, H. H. Richard

2017-12-01

Conventional media/sand filtration has been the mainstream water treatment process for most municipal water treatment plants in Malaysia. Filtrate qualities of conventional media/sand filtration are very much dependent on the coagulation-flocculation process prior to filtration and might be as high as 5 NTU. However, the demands for better quality of drinking water through public piped-water supply systems are growing. Polymeric ultrafiltration (UF) hollow fibre membrane made from modified polyethersulfone (PES) material is highly hydrophilic with high tensile strength and produces excellent quality filtrate of below 0.3 NTU in turbidity. This advanced membrane filtration material is also chemical resistance which allows a typical lifespan of 5 years. Comparisons between the conventional media/sand filtration and PES-based UF systems are carried out in this paper. UF has been considered as the emerging technology in municipal drinking water treatment plants due to its consistency in producing high quality filtrates even without the coagulation-flocculation process. The decreasing cost of PES-based membrane due to mass production and competitive pricing by manufacturers has made the UF technology affordable for industrial-scale water treatment plants.

22 CFR 96.39 - Information disclosure and quality control practices.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

22 CFR 96.39 - Information disclosure and quality control practices.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

22 CFR 96.39 - Information disclosure and quality control practices.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

22 CFR 96.39 - Information disclosure and quality control practices.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

22 CFR 96.39 - Information disclosure and quality control practices.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Information disclosure and quality control... for Convention Accreditation and Approval Information Disclosure, Fee Practices, and Quality Control Policies and Practices § 96.39 Information disclosure and quality control practices. (a) The agency or...

Unidirectional growth of benzil crystal from solution by Sankaranarayanan-Ramasamy method and its characterization.

PubMed

Rajalakshmi, M; Shyju, T S; Indirajith, R; Gopalakrishnan, R

2012-02-01

Good quality <100> benzil single crystal with a diameter 18 mm and length 75 mm was successfully grown from solution by the unidirectional growth method of Sankaranarayanan-Ramasamy (SR) for the first time in the literature. The seed crystals have been harvested from conventional solution growth technique and subsequently used for unidirectional growth. The grown crystal was subjected to various characterization studies. The results of UV-vis spectral analysis, photoluminescence, etching and microhardness studies were compared with conventional solution grown crystal to that of SR method grown crystal. The quality of SR method grown benzil crystal is better than conventional solution grown crystal. Copyright © 2011 Elsevier B.V. All rights reserved.

A laser beam quality definition based on induced temperature rise.

PubMed

Miller, Harold C

2012-12-17

Laser beam quality metrics like M(2) can be used to describe the spot sizes and propagation behavior of a wide variety of non-ideal laser beams. However, for beams that have been diffracted by limiting apertures in the near-field, or those with unusual near-field profiles, the conventional metrics can lead to an inconsistent or incomplete description of far-field performance. This paper motivates an alternative laser beam quality definition that can be used with any beam. The approach uses a consideration of the intrinsic ability of a laser beam profile to heat a material. Comparisons are made with conventional beam quality metrics. An analysis on an asymmetric Gaussian beam is used to establish a connection with the invariant beam propagation ratio.

The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

PubMed Central

Yu, Yang; Zhang, Fan; Gao, Ming-Xin; Li, Hai-Tao; Li, Jing-Xing; Song, Wei; Huang, Xin-Sheng; Gu, Cheng-Xiong

2013-01-01

OBJECTIVES Intraoperative transit time flow measurement (TTFM) is widely used to assess anastomotic quality in coronary artery bypass grafting (CABG). However, in sequential vein grafting, the flow characteristics collected by the conventional TTFM method are usually associated with total graft flow and might not accurately indicate the quality of every distal anastomosis in a sequential graft. The purpose of our study was to examine a new TTFM method that could assess the quality of each distal anastomosis in a sequential graft more reliably than the conventional TTFM approach. METHODS Two TTFM methods were tested in 84 patients who underwent sequential saphenous off-pump CABG in Beijing An Zhen Hospital between April and August 2012. In the conventional TTFM method, normal blood flow in the sequential graft was maintained during the measurement, and the flow probe was placed a few centimetres above the anastomosis to be evaluated. In the new method, blood flow in the sequential graft was temporarily reduced during the measurement by placing an atraumatic bulldog clamp at the graft a few centimetres distal to the anastomosis to be evaluated, while the position of the flow probe remained the same as in the conventional method. This new TTFM method was named the flow reduction TTFM. Graft flow parameters measured by both methods were compared. RESULTS Compared with the conventional TTFM, the flow reduction TTFM resulted in significantly lower mean graft blood flow (P < 0.05); in contrast, yielded significantly higher pulsatility index (P < 0.05). Diastolic filling was not significantly different between the two methods and was >50% in both cases. Interestingly, the flow reduction TTFM identified two defective middle distal anastomoses that the conventional TTFM failed to detect. Graft flows near the defective distal anastomoses were improved substantially after revision. CONCLUSIONS In this study, we found that temporary reduction of graft flow during TTFM seemed to enhance the sensitivity of TTFM to less-than-critical anastomotic defects in a sequential graft and to improve the overall accuracy of the intraoperative assessment of anastomotic quality in sequential vein grafting. PMID:24000314

Is TQM Right for Schools?

ERIC Educational Resources Information Center

Blankstein, Alan M.; Swain, Heather

1994-01-01

Examines eight reasons why Total Quality Management cannot succeed in education and shows how one Florida elementary school surmounted these obstacles and implemented Deming's quality principles. Principal Nancy Duden overcame resistance to change, leadership misconceptions, reliance on external motivators (promotions and grades), increased…

COMBUSTION OF HEAVY LIQUID FUELS

DTIC Science & Technology

characteristics of individual fuel droplets, as functions of the external conditions and fuel properties, the droplet combustion process in a flame ... length and the quality of atomization are examined. In addition, atomization quality is covered, and nozzle systems and the construction of nozzles are