Physical Employment Standards for UK Firefighters

PubMed Central

Stevenson, Richard D.M.; Siddall, Andrew G.; Turner, Philip F.J.; Bilzon, James L.J.

2017-01-01

Objective: The aim of this study was to assess sensitivity and specificity of surrogate physical ability tests as predictors of criterion firefighting task performance and to identify corresponding minimum muscular strength and endurance standards. Methods: Fifty-one (26 male; 25 female) participants completed three criterion tasks (ladder lift, ladder lower, ladder extension) and three corresponding surrogate tests [one-repetition maximum (1RM) seated shoulder press; 1RM seated rope pull-down; repeated 28 kg seated rope pull-down]. Surrogate test standards were calculated that best identified individuals who passed (sensitivity; true positives) and failed (specificity; true negatives) criterion tasks. Results: Best sensitivity/specificity achieved were 1.00/1.00 for a 35 kg seated shoulder press, 0.79/0.92 for a 60 kg rope pull-down, and 0.83/0.93 for 23 repetitions of the 28 kg rope pull-down. Conclusions: These standards represent performance on surrogate tests commensurate with minimum acceptable performance of essential strength-based occupational tasks in UK firefighters. PMID:28045801

Standards for ESL/EFL Teachers of Adults

ERIC Educational Resources Information Center

TESOL Press, 2013

2013-01-01

"Standards for ESL/EFL Teachers of Adult Learners" offers performance indicators, vignettes, and evaluation tools for instructors. These clearly organized components will help instructors identify the qualities and practices to pursue in their teaching. The standards in this book address planning, instructing, and assessing as the basis…

A Comparison of Performance on a Silent Informal Reading Inventory and Achievement on a Standardized Reading Test.

ERIC Educational Resources Information Center

Birger, Barbara

A study compared performance on a silent informal reading inventory and achievement on a standardized reading test, focusing on students' individual skill needs and how effective tests were in identifying specific strengths and weaknesses in these skill areas. Subjects, 25 students entering fourth grade in a primarily middle class suburban…

Human Performance Optimization Metrics: Consensus Findings, Gaps, and Recommendations for Future Research.

PubMed

Nindl, Bradley C; Jaffin, Dianna P; Dretsch, Michael N; Cheuvront, Samuel N; Wesensten, Nancy J; Kent, Michael L; Grunberg, Neil E; Pierce, Joseph R; Barry, Erin S; Scott, Jonathan M; Young, Andrew J; OʼConnor, Francis G; Deuster, Patricia A

2015-11-01

Human performance optimization (HPO) is defined as "the process of applying knowledge, skills and emerging technologies to improve and preserve the capabilities of military members, and organizations to execute essential tasks." The lack of consensus for operationally relevant and standardized metrics that meet joint military requirements has been identified as the single most important gap for research and application of HPO. In 2013, the Consortium for Health and Military Performance hosted a meeting to develop a toolkit of standardized HPO metrics for use in military and civilian research, and potentially for field applications by commanders, units, and organizations. Performance was considered from a holistic perspective as being influenced by various behaviors and barriers. To accomplish the goal of developing a standardized toolkit, key metrics were identified and evaluated across a spectrum of domains that contribute to HPO: physical performance, nutritional status, psychological status, cognitive performance, environmental challenges, sleep, and pain. These domains were chosen based on relevant data with regard to performance enhancers and degraders. The specific objectives at this meeting were to (a) identify and evaluate current metrics for assessing human performance within selected domains; (b) prioritize metrics within each domain to establish a human performance assessment toolkit; and (c) identify scientific gaps and the needed research to more effectively assess human performance across domains. This article provides of a summary of 150 total HPO metrics across multiple domains that can be used as a starting point-the beginning of an HPO toolkit: physical fitness (29 metrics), nutrition (24 metrics), psychological status (36 metrics), cognitive performance (35 metrics), environment (12 metrics), sleep (9 metrics), and pain (5 metrics). These metrics can be particularly valuable as the military emphasizes a renewed interest in Human Dimension efforts, and leverages science, resources, programs, and policies to optimize the performance capacities of all Service members.

42 CFR 421.122 - Performance standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... performance, application of acceptable statistical measures of variation to nationwide intermediary experience... or criterion. (b) Factors beyond intermediary's control. To identify measurable factors that significantly affect an intermediary's performance, but that are not within the intermediary's control, CMS will...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... time. (c) Standard: Prioritizing improvement activities. The dialysis facility must set priorities for performance improvement, considering prevalence and severity of identified problems and giving priority to...

Religion, Public Education, and Gender: A Feminist Critical Analysis of Policies Implemented for Objections to Music in Mixed-Gender Elementary Education Courses

ERIC Educational Resources Information Center

Thiele, Margaret

2012-01-01

In 2008 the Michigan State Board of Education adopted new certification standards for teacher preparation institutions training elementary classroom teachers. Eight content areas were identified, one of which was visual and performing arts. Standard 1.5, Visual and Performing Arts states candidates are to demonstrate knowledge and understanding in…

Predictive Accuracy of Sweep Frequency Impedance Technology in Identifying Conductive Conditions in Newborns.

PubMed

Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie; Murakoshi, Michio; Wada, Hiroshi

2018-02-01

Diagnosing conductive conditions in newborns is challenging for both audiologists and otolaryngologists. Although high-frequency tympanometry (HFT), acoustic stapedial reflex tests, and wideband absorbance measures are useful diagnostic tools, there is performance measure variability in their detection of middle ear conditions. Additional diagnostic sensitivity and specificity measures gained through new technology such as sweep frequency impedance (SFI) measures may assist in the diagnosis of middle ear dysfunction in newborns. The purpose of this study was to determine the test performance of SFI to predict the status of the outer and middle ear in newborns against commonly used reference standards. Automated auditory brainstem response (AABR), HFT (1000 Hz), transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE), and SFI tests were administered to the study sample. A total of 188 neonates (98 males and 90 females) with a mean gestational age of 39.4 weeks were included in the sample. Mean age at the time of testing was 44.4 hr. Diagnostic accuracy of SFI was assessed in terms of its ability to identify conductive conditions in neonates when compared with nine different reference standards (including four single tests [AABR, HFT, TEOAE, and DPOAE] and five test batteries [HFT + DPOAE, HFT + TEOAE, DPOAE + TEOAE, DPOAE + AABR, and TEOAE + AABR]), using receiver operating characteristic (ROC) analysis and traditional test performance measures such as sensitivity and specificity. The test performance of SFI against the test battery reference standard of HFT + DPOAE and single reference standard of HFT was high with an area under the ROC curve (AROC) of 0.87 and 0.82, respectively. Although the HFT + DPOAE test battery reference standard performed better than the HFT reference standard in predicting middle ear conductive conditions in neonates, the difference in AROC was not significant. Further analysis revealed that the highest sensitivity and specificity for SFI (86% and 88%, respectively) was obtained when compared with the reference standard of HFT + DPOAE. Among the four single reference standards, SFI had the highest sensitivity and specificity (76% and 88%, respectively) when compared against the HFT reference standard. The high test performance of SFI against the HFT and HFT + DPOAE reference standards indicates that the SFI measure has appropriate diagnostic accuracy in detection of conductive conditions in newborns. Hence, the SFI test could be used as adjunct tool to identify conductive conditions in universal newborn hearing screening programs, and can also be used in diagnostic follow-up assessments. American Academy of Audiology

7 CFR 58.46 - Fees for service performed under cooperative agreement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT... provided for by such agreement. Marking, Branding, and Identifying Product ...

Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

PubMed

Szasz, Peter; Bonrath, Esther M; Louridas, Marisa; Fecso, Andras B; Howe, Brett; Fehr, Adam; Ott, Michael; Mack, Lloyd A; Harris, Kenneth A; Grantcharov, Teodor P

2017-07-01

The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. Scores on performance assessments are difficult to interpret in the absence of established standards. Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance. The global decision was used to divide the trainees into 2 contrasting groups and the OSATS or OSANTS scores were graphed per group to determine the performance standard. Parametric statistics were used to determine classification accuracy and concurrent standard acquisition, receiver operator characteristic (ROC) curves were used to delineate predictive factors. Thirty-six trainees were observed 101 times. The technical standard was an OSATS of 21.04/35.00 and the nontechnical standard an OSANTS of 22.49/35.00. Applying these standards, competent/noncompetent trainees could be discriminated in 94% of technical and 95% of nontechnical performances (P < 0.001). A 21% discordance between technically and nontechnically competent trainees was identified (P < 0.001). ROC analysis demonstrated case experience and trainee level were both able to predict achieving the standards with an area under the curve (AUC) between 0.83 and 0.96 (P < 0.001). The present study presents defensible standards for technical and nontechnical performance. Such standards are imperative to implementing summative assessments into surgical training.

Simulation-based Assessment of the Management of Critical Events by Board-certified Anesthesiologists.

PubMed

Weinger, Matthew B; Banerjee, Arna; Burden, Amanda R; McIvor, William R; Boulet, John; Cooper, Jeffrey B; Steadman, Randolph; Shotwell, Matthew S; Slagle, Jason M; DeMaria, Samuel; Torsher, Laurence; Sinz, Elizabeth; Levine, Adam I; Rask, John; Davis, Fred; Park, Christine; Gaba, David M

2017-09-01

We sought to determine whether mannequin-based simulation can reliably characterize how board-certified anesthesiologists manage simulated medical emergencies. Our primary focus was to identify gaps in performance and to establish psychometric properties of the assessment methods. A total of 263 consenting board-certified anesthesiologists participating in existing simulation-based maintenance of certification courses at one of eight simulation centers were video recorded performing simulated emergency scenarios. Each participated in two 20-min, standardized, high-fidelity simulated medical crisis scenarios, once each as primary anesthesiologist and first responder. Via a Delphi technique, an independent panel of expert anesthesiologists identified critical performance elements for each scenario. Trained, blinded anesthesiologists rated video recordings using standardized rating tools. Measures included the percentage of critical performance elements observed and holistic (one to nine ordinal scale) ratings of participant's technical and nontechnical performance. Raters also judged whether the performance was at a level expected of a board-certified anesthesiologist. Rater reliability for most measures was good. In 284 simulated emergencies, participants were rated as successfully completing 81% (interquartile range, 75 to 90%) of the critical performance elements. The median rating of both technical and nontechnical holistic performance was five, distributed across the nine-point scale. Approximately one-quarter of participants received low holistic ratings (i.e., three or less). Higher-rated performances were associated with younger age but not with previous simulation experience or other individual characteristics. Calling for help was associated with better individual and team performance. Standardized simulation-based assessment identified performance gaps informing opportunities for improvement. If a substantial proportion of experienced anesthesiologists struggle with managing medical emergencies, continuing medical education activities should be reevaluated.

National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

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

Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.

The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, becausemore » the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon examining the challenge, the following general process appears to be a reasonable approach for identifying and establishing existing standards that would be applicable to NIMS compliance. The suggested generalized steps to establishing existing SDO generated standards for NIMS compliance are: (1) establish search criteria from the NIMS and its support documents, (2) search SDO databases to identify key existing nationally and/or internationally recognized standards that have potential application to NIMS compliance needs, (3) review the identified standards against the specific component needs of the NIMS, (4) identify the pertinent aspects/components of those identified standards that clearly address specific NIMS compliance needs, (5) establish a process to adopt the pertinent standards, which includes the generation of formalized FEMA Guidance that identifies the specific NIMS component compliance needs addressed in the respective standard, (6) develop performance criteria for which to measure compliance with the identified NIMS components addressed by the respective adopted standard, and (7) adopt the standard, publish the guidance and performance criteria, and incorporate it into routine FEMA/NIC NIMS management operations. This review process will also help identify real gaps in standards for which new NIMS specific standards should be developed. To jump start this process and hopefully identify some key ''low hanging fruit'' standards the NIC could use to begin such a process, a panel of first-responder experts (familiar with the current standards of common use in the first-responder community) from various response disciplines was formed and a workshop held. The workshop included a pre-workshop information gathering process. This report discusses the workshop and its findings in detail.« less

The Use of a Performance Assessment for Identifying Gifted Lebanese Students: Is DISCOVER Effective?

ERIC Educational Resources Information Center

Sarouphim, Ketty M.

2009-01-01

The purpose of this study was to investigate the effectiveness of DISCOVER, a performance- based assessment in identifying gifted Lebanese students. The sample consisted of 248 students (121 boys, 127 girls) from Grades 3-5 at two private schools in Beirut, Lebanon. Students were administered DISCOVER and the Raven Standard Progressive Matrices…

Medical decision-making capacity in patients with malignant glioma.

PubMed

Triebel, Kristen L; Martin, Roy C; Nabors, Louis B; Marson, Daniel C

2009-12-15

Patients with malignant glioma (MG) must make ongoing medical treatment decisions concerning a progressive disease that erodes cognition. We prospectively assessed medical decision-making capacity (MDC) in patients with MG using a standardized psychometric instrument. Participants were 22 healthy controls and 26 patients with histologically verified MG. Group performance was compared on the Capacity to Consent to Treatment Instrument (CCTI), a psychometric measure of MDC incorporating 4 standards (choice, understanding, reasoning, and appreciation), and on neuropsychological and demographic variables. Capacity outcomes (capable, marginally capable, or incapable) on the CCTI standards were identified for the MG group. Within the MG group, scores on demographic, clinical, and neuropsychological variables were correlated with scores on each CCTI standard, and significant bivariate correlates were subsequently entered into exploratory stepwise regression analyses to identify multivariate cognitive predictors of the CCTI standards. Patients with MG performed significantly below controls on consent standards of understanding and reasoning, and showed a trend on appreciation. Relative to controls, more than 50% of the patients with MG demonstrated capacity compromise (marginally capable or incapable outcomes) in MDC. In the MG group, cognitive measures of verbal acquisition/recall and, to a lesser extent, semantic fluency predicted performance on the appreciation, reasoning, and understanding standards. Karnofsky score was also associated with CCTI performance. Soon after diagnosis, patients with malignant glioma (MG) have impaired capacity to make treatment decisions relative to controls. Medical decision-making capacity (MDC) impairment in MG seems to be primarily related to the effects of short-term verbal memory deficits. Ongoing assessment of MDC in patients with MG is strongly recommended.

Technical standing order : airborne supplemental navigation equipment using the global positioning system (GPS)

DOT National Transportation Integrated Search

2001-01-01

This technical standard order (TSO) prescribes the minimum performance standard that airborne supplemental area navigation equipment using the global positioning system (GPS) must meet in order to be identified with the applicable TSO marking. Airbor...

Corridor consultations and the medical microbiological record: is patient safety at risk?

PubMed Central

Heard, S R; Roberts, C; Furrows, S J; Kelsey, M; Southgate, L

2003-01-01

The performance procedures of the General Medical Council are aimed at identifying seriously deficient performance in a doctor. The performance procedures require the medical record to be of a standard that enables the next doctor seeing the patient to give adequate care based on the available information. Setting standards for microbiological record keeping has proved difficult. Over one fifth of practising medical microbiologists (including virologists) in the UK (139 of 676) responded to a survey undertaken by the working group developing the performance procedures for microbiology, to identify current practice and to develop recommendations for agreement within the profession about the standards of the microbiological record. The cumulative frequency for the surveyed recording methods used indicated that at various times 65% (90 of 139) of respondents used a daybook, 62% (86 of 139) used the back of the clinical request card, 57% (79 of 139) used a computer record, and 22% (30 of 139) used an index card system to record microbiological advice, suggesting wide variability in relation to how medical microbiologists maintain clinical records. PMID:12499432

Patternmaker. Apprenticeship Training Standards.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

This training document outlines the apprenticeship training standards for the trade of patternmaker that have been approved by the Ontario Ministry of Skills Development. The document consists of the following: (1) skills (competencies) identified by a trade analysis development group of practicing patternmakers; (2) general performance objectives…

Evaluating Library Staff: A Performance Appraisal System.

ERIC Educational Resources Information Center

Belcastro, Patricia

This manual provides librarians and library managers with a performance appraisal system that measures staff fairly and objectively and links performance to the goals of the library. The following topics are addressed: (1) identifying expectations for quality service or standards of performance; (2) the importance of a library's code of service,…

Academy of nutrition and dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.

PubMed

Steinmuller, Patricia L; Kruskall, Laura J; Karpinski, Christine A; Manore, Melinda M; Macedonio, Michele A; Meyer, Nanna L

2014-04-01

Sports nutrition and dietetics addresses relationships of nutrition with physical activity, including weight management, exercise, and physical performance. Nutrition plays a key role in the prevention and treatment of obesity and chronic disease and for maintenance of health, and the ability to engage in physical activity, sports, and other aspects of physical performance. Thus, the Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Practice and Standards of Professional Performance as a resource for Registered Dietitian Nutritionists working in sports nutrition and dietetics to assess their current skill levels and to identify areas for further professional development in this emerging practice area. The revised document reflects advances in sports nutrition and dietetics practice since the original standards were published in 2009 and replaces those standards. The Standards of Practice represents the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standards can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sports nutrition and dietetics. The Standards of Practice and Standards of Professional Performance are complementary resources for Registered Dietitian Nutritionists in sports nutrition and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Mortality Measures to Profile Hospital Performance for Patients With Septic Shock.

PubMed

Walkey, Allan J; Shieh, Meng-Shiou; Liu, Vincent X; Lindenauer, Peter K

2018-04-30

Sepsis care is becoming a more common target for hospital performance measurement, but few studies have evaluated the acceptability of sepsis or septic shock mortality as a potential performance measure. In the absence of a gold standard to identify septic shock in claims data, we assessed agreement and stability of hospital mortality performance under different case definitions. Retrospective cohort study. U.S. acute care hospitals. Hospitalized with septic shock at admission, identified by either implicit diagnosis criteria (charges for antibiotics, cultures, and vasopressors) or by explicit International Classification of Diseases, 9th revision, codes. None. We used hierarchical logistic regression models to determine hospital risk-standardized mortality rates and hospital performance outliers. We assessed agreement in hospital mortality rankings when septic shock cases were identified by either explicit International Classification of Diseases, 9th revision, codes or implicit diagnosis criteria. Kappa statistics and intraclass correlation coefficients were used to assess agreement in hospital risk-standardized mortality and hospital outlier status, respectively. Fifty-six thousand six-hundred seventy-three patients in 308 hospitals fulfilled at least one case definition for septic shock, whereas 19,136 (33.8%) met both the explicit International Classification of Diseases, 9th revision, and implicit septic shock definition. Hospitals varied widely in risk-standardized septic shock mortality (interquartile range of implicit diagnosis mortality: 25.4-33.5%; International Classification of Diseases, 9th revision, diagnosis: 30.2-38.0%). The median absolute difference in hospital ranking between septic shock cohorts defined by International Classification of Diseases, 9th revision, versus implicit criteria was 37 places (interquartile range, 16-70), with an intraclass correlation coefficient of 0.72, p value of less than 0.001; agreement between case definitions for identification of outlier hospitals was moderate (kappa, 0.44 [95% CI, 0.30-0.58]). Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.

Teaching Strategies for Specialized Ensembles.

ERIC Educational Resources Information Center

Teaching Music, 1999

1999-01-01

Provides a strategy, from the book "Strategies for Teaching Specialized Ensembles," that addresses Standard 9A of the National Standards for Music Education. Explains that students will identify and describe the musical and historical characteristics of the classical era in music they perform and in audio examples. (CMK)

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

O'Malley, Kathleen; Lopez, Hugo; Cairns, Julie

An overview of the main North American codes and standards associated with hydrogen safety sensors is provided. The distinction between a code and a standard is defined, and the relationship between standards and codes is clarified, especially for those circumstances where a standard or a certification requirement is explicitly referenced within a code. The report identifies three main types of standards commonly applied to hydrogen sensors (interface and controls standards, shock and hazard standards, and performance-based standards). The certification process and a list and description of the main standards and model codes associated with the use of hydrogen safety sensorsmore » in hydrogen infrastructure are presented.« less

Magnetic resonance imaging of the posterior cruciate ligament in flexion.

PubMed

Craddock, William; Smithers, Troy; Harris, Craig; du Moulin, William; Molnar, Robert

2018-06-01

Posterior cruciate ligament (PCL) injuries of the knee are common and sometimes difficult to diagnose. Magnetic resonance imaging (MRI), performed using standard orthogonal plane views, is the investigation of choice. It can be particularly difficult to differentiate acute partial and complete tears and identify elongation of chronic healed tears. The aim of the paper is to describe a new method of positioning the patient with the knee flexed at 90°, allowing the PCL to be visualised in a position of greatest length and tension which may assist in differentiating and identifying these injuries. Four symptomatic patients with suspected PCL injuries, two acute and two chronic, were MRI scanned using a routine protocol with the knee in extension before performing oblique sagittal fast spin-echo (FSE) proton-density (PD) sequences with the knee positioned in 90° of flexion. The appearance of the PCLs were then qualitatively assessed. MRI scanning with the knee in flexion identified more extensive PCL injury than standard imaging. In the two patients with acute injuries, partial tears on the standard orthogonal plane views were found to be complete ruptures. In the two patients with chronic injuries, elongation of the PCL not identifiable on the standard orthogonal plane views was apparent. MRI scanning of the PCL with the knee flexed at 90° may help in differentiating partial and complete ruptures of the PCL and identifying elongation of the PCL in chronic injuries. Copyright © 2018 Elsevier B.V. All rights reserved.

Do Clinical Standards for Diabetes Care Address Excess Risk for Hypoglycemia in Vulnerable Patients? A Systematic Review

PubMed Central

Berkowitz, Seth A; Aragon, Katherine; Hines, Jonas; Seligman, Hilary; Lee, Sei; Sarkar, Urmimala

2013-01-01

Objective To determine whether diabetes clinical standards consider increased hypoglycemia risk in vulnerable patients. Data Sources MEDLINE, the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, and supplemental sources. Study Design Systematic review of clinical standards (guidelines, quality metrics, or pay-for-performance programs) for glycemic control in adult diabetes patients. The primary outcome was discussion of increased risk for hypoglycemia in vulnerable populations. Data Collection/Extraction Methods Manuscripts identified were abstracted by two independent reviewers using prespecified inclusion/exclusion criteria and a standardized abstraction form. Principal Findings We screened 1,166 titles, and reviewed 220 manuscripts in full text. Forty-four guidelines, 17 quality metrics, and 8 pay-for-performance programs were included. Five (11 percent) guidelines and no quality metrics or pay-for-performance programs met the primary outcome. Conclusions Clinical standards do not substantively incorporate evidence about increased risk for hypoglycemia in vulnerable populations. PMID:23445498

Do clinical standards for diabetes care address excess risk for hypoglycemia in vulnerable patients? A systematic review.

PubMed

Berkowitz, Seth A; Aragon, Katherine; Hines, Jonas; Seligman, Hilary; Lee, Sei; Sarkar, Urmimala

2013-08-01

To determine whether diabetes clinical standards consider increased hypoglycemia risk in vulnerable patients. MEDLINE, the National Guidelines Clearinghouse, the National Quality Measures Clearinghouse, and supplemental sources. Systematic review of clinical standards (guidelines, quality metrics, or pay-for-performance programs) for glycemic control in adult diabetes patients. The primary outcome was discussion of increased risk for hypoglycemia in vulnerable populations. Manuscripts identified were abstracted by two independent reviewers using prespecified inclusion/exclusion criteria and a standardized abstraction form. We screened 1,166 titles, and reviewed 220 manuscripts in full text. Forty-four guidelines, 17 quality metrics, and 8 pay-for-performance programs were included. Five (11 percent) guidelines and no quality metrics or pay-for-performance programs met the primary outcome. Clinical standards do not substantively incorporate evidence about increased risk for hypoglycemia in vulnerable populations. © Health Research and Educational Trust.

PERMEABLE REACTIVE BARRIER PERFORMANCE MONITORING: LONG-TERM TRENDS IN GEOCHEMICAL PARAMETERS AT TWO SITES

EPA Science Inventory

A major goal of research on the long-term performance of subsurface reactive barriers is to identify standard ground water monitoring parameters that may be useful indicators of declining performance or impending system failure. Results are presented from ground water monitoring ...

PERMEABLE REACTIVE BARRIER PERFORMANCE MONITORING: LONG-TERM TRENDS IN GEOCHEMICAL PARAMETERS AT TWO SITES

EPA Science Inventory

A major goal of research on the long-term performance of subsurface reactive barriers is to identify standard ground-water monitoring parameters that may be useful indicators of declining performance or impending system failure. Results are presented from studies conducted over ...

The Body of Knowledge & Content Framework. Identifying the Important Knowledge Required for Productive Performance of a Plastics Machine Operator. Blow Molding, Extrusion, Injection Molding, Thermoforming.

ERIC Educational Resources Information Center

Society of the Plastics Industry, Inc., Washington, DC.

Designed to guide training and curriculum development to prepare machine operators for the national certification exam, this publication identifies the important knowledge required for productive performance by a plastics machine operator. Introductory material discusses the rationale for a national standard, uses of the Body of Knowledge,…

Qualification Journey in Teacher Training: Case in Northern Cyprus

ERIC Educational Resources Information Center

Erden, Hale

2016-01-01

Problem Statement: The identification of professional teaching standards has great value on initial teacher training, hiring teachers, assessing teacher performance, as well as planning and organizing teacher professional development. In Northern Cyprus there are not any identified professional teaching standards. This study aimed at filling this…

High Stakes in the Classroom, High Stakes on the Street: The Effects of Community Violence on Students' Standardized Test Performance. Working Paper #03-13

ERIC Educational Resources Information Center

Sharkey, Patrick; Schwartz, Amy Ellen; Ellen, Ingrid Gould; Lacoe, Johanna

2013-01-01

This paper examines the effect of exposure to violent crime on students' standardized test performance among a sample of students in New York City public schools. To identify the effect of exposure to community violence on children's test scores, we compare students exposed to an incident of violent crime on their own blockface in the week prior…

Diagnostic performance of BMI percentiles to identify adolescents with metabolic syndrome.

PubMed

Laurson, Kelly R; Welk, Gregory J; Eisenmann, Joey C

2014-02-01

To compare the diagnostic performance of the Centers for Disease Control and Prevention (CDC) and FITNESSGRAM (FGram) BMI standards for quantifying metabolic risk in youth. Adolescents in the NHANES (n = 3385) were measured for anthropometric variables and metabolic risk factors. BMI percentiles were calculated, and youth were categorized by weight status (using CDC and FGram thresholds). Participants were also categorized by presence or absence of metabolic syndrome. The CDC and FGram standards were compared by prevalence of metabolic abnormalities, various diagnostic criteria, and odds of metabolic syndrome. Receiver operating characteristic curves were also created to identify optimal BMI percentiles to detect metabolic syndrome. The prevalence of metabolic syndrome in obese youth was 19% to 35%, compared with <2% in the normal-weight groups. The odds of metabolic syndrome for obese boys and girls were 46 to 67 and 19 to 22 times greater, respectively, than for normal-weight youth. The receiver operating characteristic analyses identified optimal thresholds similar to the CDC standards for boys and the FGram standards for girls. Overall, BMI thresholds were more strongly associated with metabolic syndrome in boys than in girls. Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls. The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice.

Differences in Students' Reading Comprehension of International Financial Reporting Standards: A South African Case

ERIC Educational Resources Information Center

Coetzee, Stephen A.; Janse van Rensburg, Cecile; Schmulian, Astrid

2016-01-01

This study explores differences in students' reading comprehension of International Financial Reporting Standards in a South African financial reporting class with a heterogeneous student cohort. Statistically significant differences were identified for prior academic performance, language of instruction, first language and enrolment in the…

IBSTPI, Quality Matters, and Online Learning: What's Right and What Needs Changing?

ERIC Educational Resources Information Center

Bose, Eric V.

2012-01-01

This study sought to examine and extend the existing knowledge of IBSTPI competencies of instructional design (International Board of Standards for Training, Performance and Instruction, 2000), the instructional rubric standard expectations of Quality Matters (2010), the identified categories of online learning affordances (Kirschner, Strijbos,…

Complex Teacher Evaluation Systems Can Produce Negative Perceptions

ERIC Educational Resources Information Center

Schumacher, Gary

2010-01-01

The purpose of this study was to determine teacher perceptions of the impact on instructional practice when using a complex, standards-based performance evaluation system. The study used expectancy theory to investigate teacher expectancy (did they believe they could enhance their practice to the identified program standards?), instrumentality…

77 FR 30283 - Standards of Performance for New Stationary Sources, National Emission Standards for Hazardous...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... timeline and exceedances of the pressure, temperature, and oxygen and/or nitrogen concentration are... (AMP) that consists of monitoring the inlet scrubbing liquid temperature, flow rate, and acid content... request consisting of monitoring the inlet scrubbing liquid temperature and flow rate and identifying...

Validation of Testing for a Multi-Disciplinary Technical Position.

ERIC Educational Resources Information Center

Sheppard, Valarie

This paper describes a testing program that established job-related standards of performance and testing procedures for the technician position within a gas transportation company. New standards were being established in response to safety concerns stemming from investigations that identified training inadequacy as a cause of accidents. The job…

Evaluation of Alternative Field Buses for Lighting ControlApplications

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

Koch, Ed; Rubinstein, Francis

2005-03-21

The Subcontract Statement of Work consists of two major tasks. This report is the Final Report in fulfillment of the contract deliverable for Task 1. The purpose of Task 1 was to evaluate existing and emerging protocols and standards for interfacing sensors and controllers for communicating with integrated lighting control systems in commercial buildings. The detailed task description follows: Task 1. Evaluate alternative sensor/field buses. The objective of this task is to evaluate existing and emerging standards for interfacing sensors and controllers for communicating with integrated lighting control systems in commercial buildings. The protocols to be evaluated will include atmore » least: (1) 1-Wire Net, (2) DALI, (3) MODBUS (or appropriate substitute such as EIB) and (4) ZigBee. The evaluation will include a comparative matrix for comparing the technical performance features of the different alternative systems. The performance features to be considered include: (1) directionality and network speed, (2) error control, (3) latency times, (4) allowable cable voltage drop, (5) topology, and (6) polarization. Specifically, Subcontractor will: (1) Analyze the proposed network architecture and identify potential problems that may require further research and specification. (2) Help identify and specify additional software and hardware components that may be required for the communications network to operate properly. (3) Identify areas of the architecture that can benefit from existing standards and technology and enumerate those standards and technologies. (4) Identify existing companies that may have relevant technology that can be applied to this research. (5) Help determine if new standards or technologies need to be developed.« less

Technical support documentation for the Automated Residential Energy Standard (ARES) in support of proposed interim energy conservation voluntary performance standards for new non-federal residential buildings: Volume 2

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

NONE

The Automated Residential Energy Standard (ARES) program is designed to identify levels of thermal integrity (e.g., insulation levels, glazing layers, equipment efficiencies, etc.) that are cost effective for typical residential structures and to create a residential energy standard based on these levels. This document contains technical background the explains the data and the algorithms used by the program.

Comparison of three commercially available fit-test methods.

PubMed

Janssen, Larry L; Luinenburg, D Michael; Mullins, Haskell E; Nelson, Thomas J

2002-01-01

American National Standards Institute (ANSI) standard Z88.10, Respirator Fit Testing Methods, includes criteria to evaluate new fit-tests. The standard allows generated aerosol, particle counting, or controlled negative pressure quantitative fit-tests to be used as the reference method to determine acceptability of a new test. This study examined (1) comparability of three Occupational Safety and Health Administration-accepted fit-test methods, all of which were validated using generated aerosol as the reference method; and (2) the effect of the reference method on the apparent performance of a fit-test method under evaluation. Sequential fit-tests were performed using the controlled negative pressure and particle counting quantitative fit-tests and the bitter aerosol qualitative fit-test. Of 75 fit-tests conducted with each method, the controlled negative pressure method identified 24 failures; bitter aerosol identified 22 failures; and the particle counting method identified 15 failures. The sensitivity of each method, that is, agreement with the reference method in identifying unacceptable fits, was calculated using each of the other two methods as the reference. None of the test methods met the ANSI sensitivity criterion of 0.95 or greater when compared with either of the other two methods. These results demonstrate that (1) the apparent performance of any fit-test depends on the reference method used, and (2) the fit-tests evaluated use different criteria to identify inadequately fitting respirators. Although "acceptable fit" cannot be defined in absolute terms at this time, the ability of existing fit-test methods to reject poor fits can be inferred from workplace protection factor studies.

Development of a standardized battery of performance tests for the assessment of noise stress effects

NASA Technical Reports Server (NTRS)

Theologus, G. C.; Wheaton, G. R.; Mirabella, A.; Brahlek, R. E.

1973-01-01

A set of 36 relatively independent categories of human performance were identified. These categories encompass human performance in the cognitive, perceptual, and psychomotor areas, and include diagnostic measures and sensitive performance metrics. Then a prototype standardized test battery was constructed, and research was conducted to obtain information on the sensitivity of the tests to stress, the sensitivity of selected categories of performance degradation, the time course of stress effects on each of the selected tests, and the learning curves associated with each test. A research project utilizing a three factor partially repeated analysis of covariance design was conducted in which 60 male subjects were exposed to variations in noise level and quality during performance testing. Effects of randomly intermittent noise on performance of the reaction time tests were observed, but most of the other performance tests showed consistent stability. The results of 14 analyses of covariance of the data taken from the performance of the 60 subjects on the prototype standardized test battery provided information which will enable the final development and test of a standardized test battery and the associated development of differential sensitivity metrics and diagnostic classificatory system.

Experimental Evaluation of High Performance Integrated Heat Pump

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

Miller, William A; Berry, Robert; Durfee, Neal

2016-01-01

Integrated heat pump (IHP) technology provides significant potential for energy savings and comfort improvement for residential buildings. In this study, we evaluate the performance of a high performance IHP that provides space heating, cooling, and water heating services. Experiments were conducted according to the ASHRAE Standard 206-2013 where 24 test conditions were identified in order to evaluate the IHP performance indices based on the airside performance. Empirical curve fits of the unit s compressor maps are used in conjunction with saturated condensing and evaporating refrigerant conditions to deduce the refrigerant mass flowrate, which, in turn was used to evaluate themore » refrigerant side performance as a check on the airside performance. Heat pump (compressor, fans, and controls) and water pump power were measured separately per requirements of Standard 206. The system was charged per the system manufacturer s specifications. System test results are presented for each operating mode. The overall IHP performance metrics are determined from the test results per the Standard 206 calculation procedures.« less

How Well Does Physician Selection of Microbiologic Tests Identify Clostridium difficile and other Pathogens in Paediatric Diarrhoea? Insights Using Multiplex PCR-Based Detection

PubMed Central

Stockmann, Chris; Rogatcheva, Margarita; Harrel, Brian; Vaughn, Mike; Crisp, Rob; Poritz, Mark; Thatcher, Stephanie; Korgenski, Ernest K; Barney, Trenda; Daly, Judy; Pavia, Andrew T

2014-01-01

The objective of this study was to compare the aetiologic yield of standard of care microbiologic testing ordered by physicians with that of a multiplex PCR platform. Stool specimens obtained from children and young adults with gastrointestinal illness were evaluated by standard laboratory methods and a developmental version of the FilmArray Gastrointestinal Diagnostic System (FilmArray GI Panel), a rapid multiplex PCR platform that detects 23 bacterial, viral, and protozoal agents. Results were classified according to the microbiologic tests requested by the treating physician. A median of 3 (range 1-10) microbiologic tests were performed by the clinical laboratory during 378 unique diarrhoeal episodes. A potential aetiologic agent was identified in 46% of stool specimens by standard laboratory methods and in 65% of specimens tested using the FilmArray GI Panel (P<0.001). For those patients who only had Clostridium difficile testing requested, an alternative pathogen was identified in 29% of cases with the FilmArray GI Panel. Notably, 11 (12%) cases of norovirus were identified among children who only had testing for C. difficile ordered. Among those who had C. difficile testing ordered in combination with other tests, an additional pathogen was identified in 57% of stool specimens with the FilmArray GI Panel. For patients who had no C. difficile testing performed, the FilmArray GI Panel identified a pathogen in 63% of cases, including C. difficile in 8%. Physician-specified laboratory testing may miss important diarrhoeal pathogens. Additionally, standard laboratory testing is likely to underestimate co-infections with multiple infectious diarrhoeagenic agents. PMID:25599941

Performance metrics for the evaluation of hyperspectral chemical identification systems

NASA Astrophysics Data System (ADS)

Truslow, Eric; Golowich, Steven; Manolakis, Dimitris; Ingle, Vinay

2016-02-01

Remote sensing of chemical vapor plumes is a difficult but important task for many military and civilian applications. Hyperspectral sensors operating in the long-wave infrared regime have well-demonstrated detection capabilities. However, the identification of a plume's chemical constituents, based on a chemical library, is a multiple hypothesis testing problem which standard detection metrics do not fully describe. We propose using an additional performance metric for identification based on the so-called Dice index. Our approach partitions and weights a confusion matrix to develop both the standard detection metrics and identification metric. Using the proposed metrics, we demonstrate that the intuitive system design of a detector bank followed by an identifier is indeed justified when incorporating performance information beyond the standard detection metrics.

Computerized Tests of Team Performance and Crew Coordination Suitable for Military/Aviation Settings.

PubMed

Lawson, Ben D; Britt, Thomas W; Kelley, Amanda M; Athy, Jeremy R; Legan, Shauna M

2017-08-01

The coordination of team effort on shared tasks is an area of inquiry. A number of tests of team performance in challenging environments have been developed without comparison or standardization. This article provides a systematic review of the most accessible and usable low-to-medium fidelity computerized tests of team performance and determines which are most applicable to military- and aviation-relevant research, such as studies of group command, control, communication, and crew coordination. A search was conducted to identify computerized measures of team performance. In addition to extensive literature searches (DTIC, Psychinfo, PubMed), the authors reached out to team performance researchers at conferences and through electronic communication. Identified were 57 potential tests according to 6 specific selection criteria (e.g., the requirement for automated collection of team performance and coordination processes, the use of military-relevant scenarios). The following seven tests (listed alphabetically) were considered most suitable for military needs: Agent Enabled Decision Group Environment (AEDGE), C3Conflict, the C3 (Command, Control, & Communications) Interactive Task for Identifying Emerging Situations (NeoCITIES), Distributed Dynamic Decision Making (DDD), Duo Wondrous Original Method Basic Awareness/Airmanship Test (DuoWOMBAT), the Leader Development Simulator (LDS), and the Planning Task for Teams (PLATT). Strengths and weaknesses of these tests are described and recommendations offered to help researchers identify the test most suitable for their particular needs. Adoption of a few standard computerized test batteries to study team performance would facilitate the evaluation of interventions intended to enhance group performance in multiple challenging military and aerospace operational environments.Lawson BD, Britt TW, Kelley AM, Athy JR, Legan SM. Computerized tests of team performance and crew coordination suitable for military/aviation settings. Aerosp Med Hum Perform. 2017; 88(8):722-729.

Physical Education Performance Outcomes and Cognitive Function

ERIC Educational Resources Information Center

Castelli, Darla M.; Hillman, Charles H.

2007-01-01

This article intends to inform physical education teachers about the current research describing the relationship between physical education performance outcomes as identified by the national physical education standards (i.e., regular participation in physical activity, physical fitness, motor competence; National Association of Physical…

Beyond Performance Results: Analyzing the Informational and Developmental Potentials of Standardized Mathematics Tests

ERIC Educational Resources Information Center

di Martino, Pietro; Baccaglini-Frank, Anna

2017-01-01

In this article, we discuss the potential of a critical approach to standardized tests and their results. In particular, we explore and discuss this potential not only for the assessment of students' mathematical competence, but also for teachers' professional development. We identify and describe two kinds of potential: the Informational…

Standardized Tests of Handwriting Readiness: A Systematic Review of the Literature

ERIC Educational Resources Information Center

van Hartingsveldt, Margo J.; de Groot, Imelda J. M.; Aarts, Pauline B. M.; Nijhuis-van der Sanden, Maria W. G.

2011-01-01

Aim: To establish if there are psychometrically sound standardized tests or test items to assess handwriting readiness in 5- and 6-year-old children on the levels of occupations activities/tasks and performance. Method: Electronic databases were searched to identify measurement instruments. Tests were included in a systematic review if: (1)…

Simple and efficient machine learning frameworks for identifying protein-protein interaction relevant articles and experimental methods used to study the interactions.

PubMed

Agarwal, Shashank; Liu, Feifan; Yu, Hong

2011-10-03

Protein-protein interaction (PPI) is an important biomedical phenomenon. Automatically detecting PPI-relevant articles and identifying methods that are used to study PPI are important text mining tasks. In this study, we have explored domain independent features to develop two open source machine learning frameworks. One performs binary classification to determine whether the given article is PPI relevant or not, named "Simple Classifier", and the other one maps the PPI relevant articles with corresponding interaction method nodes in a standardized PSI-MI (Proteomics Standards Initiative-Molecular Interactions) ontology, named "OntoNorm". We evaluated our system in the context of BioCreative challenge competition using the standardized data set. Our systems are amongst the top systems reported by the organizers, attaining 60.8% F1-score for identifying relevant documents, and 52.3% F1-score for mapping articles to interaction method ontology. Our results show that domain-independent machine learning frameworks can perform competitively well at the tasks of detecting PPI relevant articles and identifying the methods that were used to study the interaction in such articles. Simple Classifier is available at http://sourceforge.net/p/simpleclassify/home/ and OntoNorm at http://sourceforge.net/p/ontonorm/home/.

Kent County Health Department: Using an Agency Strategic Plan to Drive Improvement.

PubMed

Saari, Chelsey K

The Kent County Health Department (KCHD) was accredited by the Public Health Accreditation Board (PHAB) in September 2014. Although Michigan has had a state-level accreditation process for local health departments since the late 1990s, the PHAB accreditation process presented a unique opportunity for KCHD to build on successes achieved through state accreditation and enhance performance in all areas of KCHD programs, services, and operations. PHAB's standards, measures, and peer-review process provided a standardized and structured way to identify meaningful opportunities for improvement and to plan and implement strategies for enhanced performance and established a platform for being recognized nationally as a high-performing local health department. The current case report highlights the way in which KCHD has developed and implemented its strategic plan to guide efforts aimed at addressing gaps identified through the accreditation process and to drive overall improvement within our agency.

Developing a Multi-Dimensional Evaluation Framework for Faculty Teaching and Service Performance

ERIC Educational Resources Information Center

Baker, Diane F.; Neely, Walter P.; Prenshaw, Penelope J.; Taylor, Patrick A.

2015-01-01

A task force was created in a small, AACSB-accredited business school to develop a more comprehensive set of standards for faculty performance. The task force relied heavily on faculty input to identify and describe key dimensions that capture effective teaching and service performance. The result is a multi-dimensional framework that will be used…

The Uses and Abuses of Educational Testing: Chicanos as a Case in Point. Chapter 8.

ERIC Educational Resources Information Center

Valencia, Richard R.; Aburto, Sofia

A persistent problem in U.S. educational research has been how to explain the continuing low performance on standardized tests by certain racial and ethnic minority-group students, such as Chicanos. This chapter identifies abusive practices stemming from standardized testing that help to shape school failure among Chicano students, and discusses…

Environmental assessment in support of proposed interim energy conservation voluntary performance standards for new non-federal residential buildings: Volume 7

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

NONE

1989-09-01

The objective of this environmental assessment (EA) is to identify the potential environmental impacts that could result from the proposed voluntary residential standard (VOLRES) on private sector construction of new residential buildings. In this report, the scope, objectives, and approach of this EA are presented.

Effect of poor control of film processors on mammographic image quality.

PubMed

Kimme-Smith, C; Sun, H; Bassett, L W; Gold, R H

1992-11-01

With the increasingly stringent standards of image quality in mammography, film processor quality control is especially important. Current methods are not sufficient for ensuring good processing. The authors used a sensitometer and densitometer system to evaluate the performance of 22 processors at 16 mammographic facilities. Standard sensitometric values of two films were established, and processor performance was assessed for variations from these standards. Developer chemistry of each processor was analyzed and correlated with its sensitometric values. Ten processors were retested, and nine were found to be out of calibration. The developer components of hydroquinone, sulfites, bromide, and alkalinity varied the most, and low concentrations of hydroquinone were associated with lower average gradients at two facilities. Use of the sensitometer and densitometer system helps identify out-of-calibration processors, but further study is needed to correlate sensitometric values with developer component values. The authors believe that present quality control would be improved if sensitometric or other tests could be used to identify developer components that are out of calibration.

Prechamber equipped laser ignition for improved performance in natural gas engines

DOE PAGES

Almansour, Bader; Vasu, Subith; Gupta, Sreenath B.; ...

2017-04-25

Lean-burn operation of stationary natural gas engines offers lower NO x emissions and improved efficiency. A proven pathway to extend lean-burn operation has been to use laser ignition instead of standard spark ignition. However, under lean conditions, flame speed reduces thereby offsetting any efficiency gains resulting from the higher ratio of specific heats, γ. The reduced flame speeds, in turn, can be compensated with the use of a prechamber to result in volumetric ignition, and thereby lead to faster combustion. In this study, the optimal geometry of PCLI was identified through several tests in a single-cylinder engine as a compromisemore » between autoignition, NO x and soot formation within the prechamber. Subsequently, tests were conducted in a single-cylinder natural gas engine comparing the performance of three ignition systems: standard electrical spark ignition (SI), single-point laser ignition (LI), and prechamber equipped laser ignition (PCLI). Out of the three, the performance of PCLI was far superior compared to the other two. Efficiency gain of 2.1% points could be achieved while complying with EPA regulation (BSNO x < 1.34 kW-hr) and the industry standard for ignition stability (COV_IMEP < 5%). Finally, test results and data analysis are presented identifying the combustion mechanisms leading to the improved performance.« less

Postdischarge surveillance for infection following cesarean section: A prospective cohort study comparing methodologies.

PubMed

Halwani, Muhammad A; Turnbull, Alison E; Harris, Meredith; Witter, Frank; Perl, Trish M

2016-04-01

To assess how enhanced postdischarge telephone follow-up calls would improve case finding for surgical site infection (SSI) surveillance after cesarean section. We conducted a prospective cohort study of all patients who delivered by cesarean section between April 22 and August 22, 2010. In addition to our routine surveillance, using clinical databases and electronic patient records, we also made follow-up calls to the patients at 7, 14, and 30 days postoperation. A standard questionnaire with questions about symptoms of SSI, health-seeking behaviors, and treatment received was administered. Descriptive statistics and univariate analysis were performed to assess the effect of the enhanced surveillance. One hundred ninety-three patients underwent cesarean section during this study period. Standard surveillance identified 14 infections with telephone follow-ups identifying an additional 5 infections. Using the call as a gold standard, the sensitivity of the standard methodology to capture SSI was 73.3%. The duration of the calls ranged from 1 to 5 minutes and were well received by the patients. Results suggest that follow-up telephone calls to patients following cesarean section identifies 26.3% of the total SSIs. Enhanced surveillance can provide more informed data to enhance performance and avoid underestimation of rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Up Periscope! Designing a New Perceptual Metric for Imaging System Performance

NASA Technical Reports Server (NTRS)

Watson, Andrew B.

2016-01-01

Modern electronic imaging systems include optics, sensors, sampling, noise, processing, compression, transmission and display elements, and are viewed by the human eye. Many of these elements cannot be assessed by traditional imaging system metrics such as the MTF. More complex metrics such as NVTherm do address these elements, but do so largely through parametric adjustment of an MTF-like metric. The parameters are adjusted through subjective testing of human observers identifying specific targets in a set of standard images. We have designed a new metric that is based on a model of human visual pattern classification. In contrast to previous metrics, ours simulates the human observer identifying the standard targets. One application of this metric is to quantify performance of modern electronic periscope systems on submarines.

Applying Tacit Knowledge Management Techniques for Performance Assessment

ERIC Educational Resources Information Center

Mitri, Michel

2003-01-01

Performance assessment is an important task in all levels of education, both as input for identifying remedial needs of individual students and for improving general quality of education. Although explicit assessment measures can be obtained through objective standardized testing, it is much more difficult to capture fuzzier, or tacit, performance…

Chronically Low-Performing Schools and Turnaround: Evidence from Three States

ERIC Educational Resources Information Center

Hansen, Michael; Choi, Kilchan

2012-01-01

The criteria for determining the student outcomes that define a school as having "turned around" are not well defined, and the definition of turnaround performance varies across studies. Although current policy initiatives offer guidelines for identifying CLP schools, there is no standard definition or methodology in common usage. This…

Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

PubMed

Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

2018-05-01

Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with greater than or equal to 10 initial conventional intubations, there were a total of 37,360 initial conventional intubations. Median reliability-adjusted and risk-standardized EMS agency initial conventional intubation success was 77.3% (interquartile range 70.9% to 83.6%; minimum 47.1%; maximum 95.8%). There were 64 initial conventional intubation low-performing and 45 high-performing EMS agencies. In this national series, EMS advanced airway management and initial conventional intubation performance varied widely. Reliability adjustment and risk standardization may influence EMS airway management performance assessments. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Evaluating gold standard corpora against gene/protein tagging solutions and lexical resources

PubMed Central

2013-01-01

Motivation The identification of protein and gene names (PGNs) from the scientific literature requires semantic resources: Terminological and lexical resources deliver the term candidates into PGN tagging solutions and the gold standard corpora (GSC) train them to identify term parameters and contextual features. Ideally all three resources, i.e. corpora, lexica and taggers, cover the same domain knowledge, and thus support identification of the same types of PGNs and cover all of them. Unfortunately, none of the three serves as a predominant standard and for this reason it is worth exploring, how these three resources comply with each other. We systematically compare different PGN taggers against publicly available corpora and analyze the impact of the included lexical resource in their performance. In particular, we determine the performance gains through false positive filtering, which contributes to the disambiguation of identified PGNs. Results In general, machine learning approaches (ML-Tag) for PGN tagging show higher F1-measure performance against the BioCreative-II and Jnlpba GSCs (exact matching), whereas the lexicon based approaches (LexTag) in combination with disambiguation methods show better results on FsuPrge and PennBio. The ML-Tag solutions balance precision and recall, whereas the LexTag solutions have different precision and recall profiles at the same F1-measure across all corpora. Higher recall is achieved with larger lexical resources, which also introduce more noise (false positive results). The ML-Tag solutions certainly perform best, if the test corpus is from the same GSC as the training corpus. As expected, the false negative errors characterize the test corpora and – on the other hand – the profiles of the false positive mistakes characterize the tagging solutions. Lex-Tag solutions that are based on a large terminological resource in combination with false positive filtering produce better results, which, in addition, provide concept identifiers from a knowledge source in contrast to ML-Tag solutions. Conclusion The standard ML-Tag solutions achieve high performance, but not across all corpora, and thus should be trained using several different corpora to reduce possible biases. The LexTag solutions have different profiles for their precision and recall performance, but with similar F1-measure. This result is surprising and suggests that they cover a portion of the most common naming standards, but cope differently with the term variability across the corpora. The false positive filtering applied to LexTag solutions does improve the results by increasing their precision without compromising significantly their recall. The harmonisation of the annotation schemes in combination with standardized lexical resources in the tagging solutions will enable their comparability and will pave the way for a shared standard. PMID:24112383

DGKI methylation status modulates the prognostic value of MGMT in glioblastoma patients treated with combined radio-chemotherapy with temozolomide.

PubMed

Etcheverry, Amandine; Aubry, Marc; Idbaih, Ahmed; Vauleon, Elodie; Marie, Yannick; Menei, Philippe; Boniface, Rachel; Figarella-Branger, Dominique; Karayan-Tapon, Lucie; Quillien, Veronique; Sanson, Marc; de Tayrac, Marie; Delattre, Jean-Yves; Mosser, Jean

2014-01-01

Consistently reported prognostic factors for glioblastoma (GBM) are age, extent of surgery, performance status, IDH1 mutational status, and MGMT promoter methylation status. We aimed to integrate biological and clinical prognostic factors into a nomogram intended to predict the survival time of an individual GBM patient treated with a standard regimen. In a previous study we showed that the methylation status of the DGKI promoter identified patients with MGMT-methylated tumors that responded poorly to the standard regimen. We further evaluated the potential prognostic value of DGKI methylation status. 399 patients with newly diagnosed GBM and treated with a standard regimen were retrospectively included in this study. Survival modelling was performed on two patient populations: intention-to-treat population of all included patients (population 1) and MGMT-methylated patients (population 2). Cox proportional hazard models were fitted to identify the main prognostic factors. A nomogram was developed for population 1. The prognostic value of DGKI promoter methylation status was evaluated on population 1 and population 2. The nomogram-based stratification of the cohort identified two risk groups (high/low) with significantly different median survival. We validated the prognostic value of DGKI methylation status for MGMT-methylated patients. We also demonstrated that the DGKI methylation status identified 22% of poorly responding patients in the low-risk group defined by the nomogram. Our results improve the conventional MGMT stratification of GBM patients receiving standard treatment. These results could help the interpretation of published or ongoing clinical trial outcomes and refine patient recruitment in the future.

Development of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia.

PubMed

Vervoort, Vera M; Vriezekolk, Johanna E; van den Ende, Cornelia H

2017-01-01

There is a need to identify individual treatment success in patients with fibromyalgia (FM) who received non-pharmacological treatment. The present study described responder criteria for multicomponent non-pharmacological treatment in FM, and estimated and compared their sensitivity and specificity. Candidate responder sets were 1) identified in literature; and 2) formulated by expert group consensus. All candidate responder sets were tested in a cohort of 129 patients with FM receiving multicomponent non-pharmacological treatment. We used two gold standards (both therapist's and patient's perspective), assessed at six months after the start of treatment. Seven responder sets were defined (three identified in literature and four formulated by expert group consensus), and comprised combinations of domains of 1) pain; 2) fatigue; 3) patient global assessment (PGA); 4) illness perceptions; 5) limitations in activities of daily living (ADL); and 6) sleep. The sensitivity and specificity of literature-based responder sets (n=3) ranged between 17%-99% and 15%-95% respectively, whereas the expert-based responder sets (n=4) performed slightly better with regard to sensitivity (range 41%-81%) and specificity (range 50%-96%). Of the literature-based responder sets the OMERACT-OARSI responder set with patient's gold standard performed best (sensitivity 63%, specificity 75% and ROC area = 0.69). Overall, the expert-based responder set comprising the domains illness perceptions and limitations in ADL with patient's gold standard performed best (sensitivity 47%, specificity 96% and ROC area = 0.71). We defined sets of responder criteria for multicomponent non-pharmacological treatment in fibromyalgia. Further research should focus on the validation of those sets with acceptable performance.

Measuring individual work performance: identifying and selecting indicators.

PubMed

Koopmans, Linda; Bernaards, Claire M; Hildebrandt, Vincent H; de Vet, Henrica C W; van der Beek, Allard J

2014-01-01

Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. This study was designed to (1) identify indicators for each dimension, (2) select the most relevant indicators, and (3) determine the relative weight of each dimension in ratings of work performance. IWP indicators were identified from multiple research disciplines, via literature, existing questionnaires, and expert interviews. Subsequently, experts selected the most relevant indicators per dimension and scored the relative weight of each dimension in ratings of IWP. In total, 128 unique indicators were identified. Twenty-three of these indicators were selected by experts as most relevant for measuring IWP. Task performance determined 36% of the work performance rating, while the other three dimensions respectively determined 22%, 20% and 21% of the rating. Notable consensus was found on relevant indicators of IWP, reducing the number from 128 to 23 relevant indicators. This provides an important step towards the development of a standardized, generic and short measurement instrument for assessing IWP.

[Preparation of flavonoid reference standards from Scutellariae Radix under the guidance of high performance liquid chromatography-mass spectrometry analysis].

PubMed

Guo, Henan; Yang, Xuedong; Liu, Jun; Zheng, Wenfeng

2012-07-01

Flavonoid reference standards were targeted-prepared from Scutellariae Radix under the guidance of high performance liquid chromatography-mass spectrometry (HPLC-MS) analysis. With HPLC-MS analysis of Scutellariae Radix, 19 flavonoid components were identified by analyzing and comparing their retention times, ultraviolet spectra, and mass spectrometry data with literature. The separation and purification protocols of all targeted flavonoid reference standards were optimally designed according to the results of HPLC-MS analysis and related literature. The ethanol extract of Scutellariae Radix was suspended in water and extracted with petroleum ether, ethyl acetate, and n-butanol successively. The ethyl acetate extract and n-butanol extract were separately subjected to primary separation by low pressure reverse phase preparative chromatography. Then the fractions containing targeted compounds were further purified by low pressure reverse and normal phases preparative chromatography. Finally, baicalin and wogonoside reference standards were obtained from n-butanol extract; baicaelin, wogonin, and oroxylin A reference standards were obtained from ethyl acetate extract. The structures of the 5 reference standards were identified by mass spectrometry (MS) and 1H nuclear magnetic resonance (1H NMR) spectroscopy. The HPLC analytical results showed that the purities of the 5 reference standards were all above 98%. It is demonstrated that the rapid targeted-preparation method under the guidance of the HPLC-MS analysis is applicable for the isolation and preparation of chemical components in traditional Chinese medicines.

Auto Body Repairer (Branch 2). Performance Demonstration Guidelines. Apprenticeship Training Program = Carrossiers automobiles (categorie 2). Programme de formation des apprentis.

ERIC Educational Resources Information Center

Ontario Ministry of Skills Development, Toronto.

This manual presents training standards for auto body repairers (branch 2) and is intended to be used by apprentice/trainees, instructors, and companies in Ontario, Canada as a blueprint for training or as a prerequisite for accreditation/certification. The training standards identify skills required for this occupation and its related training…

The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation.

PubMed

Cho, Gyu Chong; Sohn, You Dong; Kang, Ku Hyun; Lee, Won Woong; Lim, Kyung Soo; Kim, Won; Oh, Bum Jin; Choi, Dai Hai; Yeom, Seok Ran; Lim, Hoon

2010-06-01

Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR. The participants for this study were non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses. Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training. The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact

PubMed Central

2012-01-01

Background Healthcare accreditation standards are advocated as an important means of improving clinical practice and organisational performance. Standard development agencies have documented methodologies to promote open, transparent, inclusive development processes where standards are developed by members. They assert that their methodologies are effective and efficient at producing standards appropriate for the health industry. However, the evidence to support these claims requires scrutiny. The study’s purpose was to examine the empirical research that grounds the development methods and application of healthcare accreditation standards. Methods A multi-method strategy was employed over the period March 2010 to August 2011. Five academic health research databases (Medline, Psych INFO, Embase, Social work abstracts, and CINAHL) were interrogated, the websites of 36 agencies associated with the study topic were investigated, and a snowball search was undertaken. Search criteria included accreditation research studies, in English, addressing standards and their impact. Searching in stage 1 initially selected 9386 abstracts. In stage 2, this selection was refined against the inclusion criteria; empirical studies (n = 2111) were identified and refined to a selection of 140 papers with the exclusion of clinical or biomedical and commentary pieces. These were independently reviewed by two researchers and reduced to 13 articles that met the study criteria. Results The 13 articles were analysed according to four categories: overall findings; standards development; implementation issues; and impact of standards. Studies have only occurred in the acute care setting, predominately in 2003 (n = 5) and 2009 (n = 4), and in the United States (n = 8). A multidisciplinary focus (n = 9) and mixed method approach (n = 11) are common characteristics. Three interventional studies were identified, with the remaining 10 studies having research designs to investigate clinical or organisational impacts. No study directly examined standards development or other issues associated with their progression. Only one study noted implementation issues, identifying several enablers and barriers. Standards were reported to improve organisational efficiency and staff circumstances. However, the impact on clinical quality was mixed, with both improvements and a lack of measurable effects recorded. Conclusion Standards are ubiquitous within healthcare and are generally considered to be an important means by which to improve clinical practice and organisational performance. However, there is a lack of robust empirical evidence examining the development, writing, implementation and impacts of healthcare accreditation standards. PMID:22995152

The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact.

PubMed

Greenfield, David; Pawsey, Marjorie; Hinchcliff, Reece; Moldovan, Max; Braithwaite, Jeffrey

2012-09-20

Healthcare accreditation standards are advocated as an important means of improving clinical practice and organisational performance. Standard development agencies have documented methodologies to promote open, transparent, inclusive development processes where standards are developed by members. They assert that their methodologies are effective and efficient at producing standards appropriate for the health industry. However, the evidence to support these claims requires scrutiny. The study's purpose was to examine the empirical research that grounds the development methods and application of healthcare accreditation standards. A multi-method strategy was employed over the period March 2010 to August 2011. Five academic health research databases (Medline, Psych INFO, Embase, Social work abstracts, and CINAHL) were interrogated, the websites of 36 agencies associated with the study topic were investigated, and a snowball search was undertaken. Search criteria included accreditation research studies, in English, addressing standards and their impact. Searching in stage 1 initially selected 9386 abstracts. In stage 2, this selection was refined against the inclusion criteria; empirical studies (n = 2111) were identified and refined to a selection of 140 papers with the exclusion of clinical or biomedical and commentary pieces. These were independently reviewed by two researchers and reduced to 13 articles that met the study criteria. The 13 articles were analysed according to four categories: overall findings; standards development; implementation issues; and impact of standards. Studies have only occurred in the acute care setting, predominately in 2003 (n = 5) and 2009 (n = 4), and in the United States (n = 8). A multidisciplinary focus (n = 9) and mixed method approach (n = 11) are common characteristics. Three interventional studies were identified, with the remaining 10 studies having research designs to investigate clinical or organisational impacts. No study directly examined standards development or other issues associated with their progression. Only one study noted implementation issues, identifying several enablers and barriers. Standards were reported to improve organisational efficiency and staff circumstances. However, the impact on clinical quality was mixed, with both improvements and a lack of measurable effects recorded. Standards are ubiquitous within healthcare and are generally considered to be an important means by which to improve clinical practice and organisational performance. However, there is a lack of robust empirical evidence examining the development, writing, implementation and impacts of healthcare accreditation standards.

An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance.

PubMed

Widdifield, Jessica; Bombardier, Claire; Bernatsky, Sasha; Paterson, J Michael; Green, Diane; Young, Jacqueline; Ivers, Noah; Butt, Debra A; Jaakkimainen, R Liisa; Thorne, J Carter; Tu, Karen

2014-06-23

We have previously validated administrative data algorithms to identify patients with rheumatoid arthritis (RA) using rheumatology clinic records as the reference standard. Here we reassessed the accuracy of the algorithms using primary care records as the reference standard. We performed a retrospective chart abstraction study using a random sample of 7500 adult patients under the care of 83 family physicians contributing to the Electronic Medical Record Administrative data Linked Database (EMRALD) in Ontario, Canada. Using physician-reported diagnoses as the reference standard, we computed and compared the sensitivity, specificity, and predictive values for over 100 administrative data algorithms for RA case ascertainment. We identified 69 patients with RA for a lifetime RA prevalence of 0.9%. All algorithms had excellent specificity (>97%). However, sensitivity varied (75-90%) among physician billing algorithms. Despite the low prevalence of RA, most algorithms had adequate positive predictive value (PPV; 51-83%). The algorithm of "[1 hospitalization RA diagnosis code] or [3 physician RA diagnosis codes with ≥1 by a specialist over 2 years]" had a sensitivity of 78% (95% CI 69-88), specificity of 100% (95% CI 100-100), PPV of 78% (95% CI 69-88) and NPV of 100% (95% CI 100-100). Administrative data algorithms for detecting RA patients achieved a high degree of accuracy amongst the general population. However, results varied slightly from our previous report, which can be attributed to differences in the reference standards with respect to disease prevalence, spectrum of disease, and type of comparator group.

Setting Foundations for Developing Disaster Response Metrics.

PubMed

Abir, Mahshid; Bell, Sue Anne; Puppala, Neha; Awad, Osama; Moore, Melinda

2017-08-01

There are few reported efforts to define universal disaster response performance measures. Careful examination of responses to past disasters can inform the development of such measures. As a first step toward this goal, we conducted a literature review to identify key factors in responses to 3 recent events with significant loss of human life and economic impact: the 2003 Bam, Iran, earthquake; the 2004 Indian Ocean tsunami; and the 2010 Haiti earthquake. Using the PubMed (National Library of Medicine, Bethesda, MD) database, we identified 710 articles and retained 124 after applying inclusion and exclusion criteria. Seventy-two articles pertained to the Haiti earthquake, 38 to the Indian Ocean tsunami, and 14 to the Bam earthquake. On the basis of this review, we developed an organizational framework for disaster response performance measurement with 5 key disaster response categories: (1) personnel, (2) supplies and equipment, (3) transportation, (4) timeliness and efficiency, and (5) interagency cooperation. Under each of these, and again informed by the literature, we identified subcategories and specific items that could be developed into standardized performance measures. The validity and comprehensiveness of these measures can be tested by applying them to other recent and future disaster responses, after which standardized performance measures can be developed through a consensus process. (Disaster Med Public Health Preparedness. 2017;11:505-509).

Airport Fire and Rescue Personnel Protective Clothing

DOT National Transportation Integrated Search

1995-07-13

This advisory circular (AC) identifies minimum standards for design, performance, : testing, and safety of personnel protective equipment (PPE), frequently referred : to as personnel protective clothing for airport firefighting. This AC also : assist...

Physical and cognitive task analysis in interventional radiology.

PubMed

Johnson, S; Healey, A; Evans, J; Murphy, M; Crawshaw, M; Gould, D

2006-01-01

To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model.

Development of the private practice management standards for psychology.

PubMed

Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

2011-01-01

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

An improved genetic algorithm for designing optimal temporal patterns of neural stimulation

NASA Astrophysics Data System (ADS)

Cassar, Isaac R.; Titus, Nathan D.; Grill, Warren M.

2017-12-01

Objective. Electrical neuromodulation therapies typically apply constant frequency stimulation, but non-regular temporal patterns of stimulation may be more effective and more efficient. However, the design space for temporal patterns is exceedingly large, and model-based optimization is required for pattern design. We designed and implemented a modified genetic algorithm (GA) intended for design optimal temporal patterns of electrical neuromodulation. Approach. We tested and modified standard GA methods for application to designing temporal patterns of neural stimulation. We evaluated each modification individually and all modifications collectively by comparing performance to the standard GA across three test functions and two biophysically-based models of neural stimulation. Main results. The proposed modifications of the GA significantly improved performance across the test functions and performed best when all were used collectively. The standard GA found patterns that outperformed fixed-frequency, clinically-standard patterns in biophysically-based models of neural stimulation, but the modified GA, in many fewer iterations, consistently converged to higher-scoring, non-regular patterns of stimulation. Significance. The proposed improvements to standard GA methodology reduced the number of iterations required for convergence and identified superior solutions.

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

Clements, Samuel L.; Edgar, Thomas W.; Manz, David O.

The purpose of this workshop was to identify and discuss concerns with the use and adoption of IEC 62351 security standard for IEC 61850 compliant control system products. The industry participants discussed performance, interoperability, adoption, challenges, business cases, and future issues.

A New Tool for Identifying Research Standards and Evaluating Research Performance

ERIC Educational Resources Information Center

Bacon, Donald R.; Paul, Pallab; Stewart, Kim A.; Mukhopadhyay, Kausiki

2012-01-01

Much has been written about the evaluation of faculty research productivity in promotion and tenure decisions, including many articles that seek to determine the rank of various marketing journals. Yet how faculty evaluators combine journal quality, quantity, and author contribution to form judgments of a scholar's performance is unclear. A…

Arithmetic Abilities in Children with Developmental Dyslexia: Performance on French ZAREKI-R Test

ERIC Educational Resources Information Center

De Clercq-Quaegebeur, Maryse; Casalis, Séverine; Vilette, Bruno; Lemaitre, Marie-Pierre; Vallée, Louis

2018-01-01

A high comorbidity between reading and arithmetic disabilities has already been reported. The present study aims at identifying more precisely patterns of arithmetic performance in children with developmental dyslexia, defined with severe and specific criteria. By means of a standardized test of achievement in mathematics ("Calculation and…

Critical Thinking Skills among Elementary School Students: Comparing Identified Gifted and General Education Student Performance

ERIC Educational Resources Information Center

Kettler, Todd

2014-01-01

Education reform efforts, including the current adoption of Common Core State Standards, have increased attention to teaching critical thinking skills to all students. This study investigated the critical thinking skills of fourth-grade students from a school district in Texas, including 45 identified gifted students and 163 general education…

Fabrication of 12% {sup 240}Pu calorimetry standards

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

Long, S.M.; Hildner, S.; Gutierrez, D.

1995-08-01

Throughout the DOE complex, laboratories are performing calorimetric assays on items containing high burnup plutonium. These materials contain higher isotopic range and higher wattages than materials previously encountered in vault holdings. Currently, measurement control standards have been limited to utilizing 6% {sup 240}Pu standards. The lower isotopic and wattage value standards do not complement the measurement of the higher burnup material. Participants of the Calorimetry Exchange (CALEX) Program have identified the need for new calorimetric assay standards with a higher wattage and isotopic range. This paper describes the fabrication and verification measurements of the new CALEX standard containing 12% {supmore » 240}Pu oxide with a wattage of about 6 to 8 watts.« less

A case study of ISO 11064 in control centre design in the Norwegian petroleum industry.

PubMed

Aas, Andreas Lumbe; Skramstad, Torbjørn

2010-12-01

In 2006-2008 we performed a case study for the purpose of assessing the industrial application of the seven part Control Centre (CC) design standard ISO 11064 to identify positive and negative experiences among stakeholders in the Norwegian petroleum sector. We mainly focussed on ISO 11064 Part 1, because this was the most commonly used among the identified stakeholders. ISO 11064 is generally appreciated and applied in the industry, but we did observe a significant variance in use between the different parts of the standard. We also identified potential areas for improvements, like scope and application adaptation. Thus we suggest a more goal-based approach based on one normative part only. Copyright © 2010 Elsevier Ltd. All rights reserved.

2016 Standard Scenarios Report: A U.S. Electricity Sector Outlook

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

Cole, Wesley; Mai, Trieu; Logan, Jeffrey

The National Renewable Energy Laboratory is conducting a study sponsored by the Office of Energy Efficiency and Renewable Energy (EERE) that aims to document and implement an annual process designed to identify a realistic and timely set of input assumptions (e.g., technology cost and performance, fuel costs), and a diverse set of potential futures (standard scenarios), initially for electric sector analysis.

Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting

PubMed Central

Hotton, Paul Rex

2017-01-01

Objective Child maltreatment (CM) is a major public health problem globally. While there is evidence for the value of medical examination in the assessment of CM, little is known about the quality of clinical assessments for CM. South Western Sydney (SWS) has a large metropolitan population with many vulnerable subgroups. We aimed to describe acute presentations of CM in SWS over a 3-year period—with a focus on the quality of the clinical assessments. We wanted to determine whether the cases assessed fulfilled established minimum standards for clinical assessment of CM and whether the assessments were performed in a child-friendly manner. Design We gathered data from the acute child protection database on all children <16 years referred for assessment between 2013 and 2015. We performed simple descriptive analysis on the data. We measured the assessment, report writing and follow-up against criteria for minimum standards for CM assessments, and identified whether assessments were child-friendly from available clinical information. Results There were 304 children referred; 279 seen for acute assessment; most (73%) were for sexual abuse, 75 (27%) were for physical abuse/neglect. Over half the assessments identified other health concerns; joint assessments performed by paediatric and forensic doctors were better at identifying these health concerns than solo assessments. Most assessments were multidisciplinary and used protocols; half were not followed up; a third were performed after-hours and a third had no carer present during assessments. Conclusions We identified strengths and weaknesses in current CM assessments in our service. Locally relevant standards for CM assessments are achievable in the acute setting, more challenging is addressing appropriate medical and psychosocial follow-up for these children. While we have established baseline domains for measuring a child-friendly approach to CM assessments, more should be done to ensure these vulnerable children are assessed in a timely, child-friendly manner, with appropriate follow-up. PMID:29637146

Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting.

PubMed

Raman, Shanti; Hotton, Paul Rex

2017-01-01

Child maltreatment (CM) is a major public health problem globally. While there is evidence for the value of medical examination in the assessment of CM, little is known about the quality of clinical assessments for CM. South Western Sydney (SWS) has a large metropolitan population with many vulnerable subgroups. We aimed to describe acute presentations of CM in SWS over a 3-year period-with a focus on the quality of the clinical assessments. We wanted to determine whether the cases assessed fulfilled established minimum standards for clinical assessment of CM and whether the assessments were performed in a child-friendly manner. We gathered data from the acute child protection database on all children <16 years referred for assessment between 2013 and 2015. We performed simple descriptive analysis on the data. We measured the assessment, report writing and follow-up against criteria for minimum standards for CM assessments, and identified whether assessments were child-friendly from available clinical information. There were 304 children referred; 279 seen for acute assessment; most (73%) were for sexual abuse, 75 (27%) were for physical abuse/neglect. Over half the assessments identified other health concerns; joint assessments performed by paediatric and forensic doctors were better at identifying these health concerns than solo assessments. Most assessments were multidisciplinary and used protocols; half were not followed up; a third were performed after-hours and a third had no carer present during assessments. We identified strengths and weaknesses in current CM assessments in our service. Locally relevant standards for CM assessments are achievable in the acute setting, more challenging is addressing appropriate medical and psychosocial follow-up for these children. While we have established baseline domains for measuring a child-friendly approach to CM assessments, more should be done to ensure these vulnerable children are assessed in a timely, child-friendly manner, with appropriate follow-up.

Vehicle/Track Interaction Assessment Techniques. Volume 1, Part 1.

DOT National Transportation Integrated Search

1984-03-01

This report describes Vehicle/Track Interaction Assessment Techniques (IAT) which are developed to provide standardized procedures and tools in order to: Investigate the dynamic performance of railroad vehicles, and systematically identify and cure d...

Vehicle/Track Interaction Assessment Techniques. Volume 2, Part 2.

DOT National Transportation Integrated Search

1984-03-01

This report describes Vehicle/Track Interaction Assessment Techniques (IAT) which are developed to provide standardized procedures and tools in order to: Investigate the dynamic performance of railroad vehicles, and systematically identify and cure d...

Vehicle/Track Interaction Assessment Techniques. Volume 3, Part 2.

DOT National Transportation Integrated Search

1984-03-01

This report describes Vehicle/Track Interaction Assessment Techniques (IAT) which are developed to provide standardized procedures and tools in order to: Investigate the dynamic performance of railroad vehicles, and systematically identify and cure d...

Validity of maximal isometric knee extension strength measurements obtained via belt-stabilized hand-held dynamometry in healthy adults.

PubMed

Ushiyama, Naoko; Kurobe, Yasushi; Momose, Kimito

2017-11-01

[Purpose] To determine the validity of knee extension muscle strength measurements using belt-stabilized hand-held dynamometry with and without body stabilization compared with the gold standard isokinetic dynamometry in healthy adults. [Subjects and Methods] Twenty-nine healthy adults (mean age, 21.3 years) were included. Study parameters involved right side measurements of maximal isometric knee extension strength obtained using belt-stabilized hand-held dynamometry with and without body stabilization and the gold standard. Measurements were performed in all subjects. [Results] A moderate correlation and fixed bias were found between measurements obtained using belt-stabilized hand-held dynamometry with body stabilization and the gold standard. No significant correlation and proportional bias were found between measurements obtained using belt-stabilized hand-held dynamometry without body stabilization and the gold standard. The strength identified using belt-stabilized hand-held dynamometry with body stabilization may not be commensurate with the maximum strength individuals can generate; however, it reflects such strength. In contrast, the strength identified using belt-stabilized hand-held dynamometry without body stabilization does not reflect the maximum strength. Therefore, a chair should be used to stabilize the body when performing measurements of maximal isometric knee extension strength using belt-stabilized hand-held dynamometry in healthy adults. [Conclusion] Belt-stabilized hand-held dynamometry with body stabilization is more convenient than the gold standard in clinical settings.

Toward a neurologic model of competency: Cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards.

PubMed

Marson, D C; Chatterjee, A; Ingram, K K; Harrell, L E

1996-03-01

To identify cognitive predictors of competency performance and status in Alzheimer's disease (AD) using three differentially stringent legal standards for capacity to consent. Univariate and multivariate analyses of independent neuropsychological test measures with three dependent measures of competency to consent to treatment. University medical center. 15 normal older controls and 29 patients with probably AD (15 mild and 14 moderate). Subjects were administered a batter of neuropsychological measures theoretically linked to competency function, as well as two clinical vignettes testing capacity to consent to medical treatment under five legal standards (LSs). The present study focused on three differentially stringent LSs: the capacity simply to "evidence a treatment of choice" (LS1), which is a minimal standard; the capacity to "appreciate the consequences" of a treatment of choice (LS3), a moderately stringent standard; and the capacity to "understand the treatment situation and choices" (LS5), the most stringent standard. Control subject and AD patient neuropsychological test scores were correlated with scores on the three LSs. The resulting univariate correlates were than analyzed using stepwise regression and discriminant function to identify key multivariate predictors of competency performance and status under each LS. No neuropsychological measures predicted control group performance on the LSs. For the AD group, a measure of simple auditory comprehension predicted LS1 performance (r(2)=0.44, p < 0.0001), a word fluency measure predicted LS3 performance (r(2)=0.58, p < 0.0001), and measures of conceptualization and confrontation naming together predicted LS5 performance (r(2)=0.81, p < 0.0001). Under discriminant function analysis, confrontation naming was the best single predictor of LS1 competency status for all subjects, correctly classifying 96% of cases (42/44). Measures of visumotor tracking and confrontation naming were the best single predictors, respectively, of competency status under LS3 (91% [39/43]) and LS5 (98% [43/44]). Multiple cognitive functions are associated with loss of competency in AD. Deficits in conceptualization, semantic memory, and probably verbal recall are associated with the declining capacity of mild AD patients to understand a treatment situation and choices (LS5); executive dysfunction with the declining capacity of mild to moderate AD patients to identify the consequences of treatment choice (LS3); and receptive aphasia and severe dysnomia with the declining capacity of advanced AD patients to evidence a simple treatment choice (LS1). The results offer insight into the relationship between different legal thresholds of competency and the progressive cognitive changes characteristic of AD, and represent an initial step toward a neurologic model of competency.

Approach for Configuring a Standardized Vessel for Processing Radioactive Waste Slurries

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

Bamberger, Judith A.; Enderlin, Carl W.; Minette, Michael J.

2015-09-10

A standardized vessel design is being considered at the Waste Treatment and Immobilization Plant (WTP) that is under construction at Hanford, Washington. The standardized vessel design will be used for storing, blending, and chemical processing of slurries that exhibit a variable process feed including Newtonian to non-Newtonian rheologies over a range of solids loadings. Developing a standardized vessel is advantageous and reduces the testing required to evaluate the performance of the design. The objectives of this paper are to: 1) present a design strategy for developing a standard vessel mixing system design for the pretreatment portion of the waste treatmentmore » plant that must process rheologically and physically challenging process streams, 2) identify performance criteria that the design for the standard vessel must satisfy, 3) present parameters that are to be used for assessing the performance criteria, and 4) describe operation of the selected technology. Vessel design performance will be assessed for both Newtonian and non-Newtonian simulants which represent a range of waste types expected during operation. Desired conditions for the vessel operations are the ability to shear the slurry so that flammable gas does not accumulate within the vessel, that settled solids will be mobilized, that contents can be blended, and that contents can be transferred from the vessel. A strategy is presented for adjusting the vessel configuration to ensure that all these conditions are met.« less

Using Clinical Data Standards to Measure Quality: A New Approach.

PubMed

D'Amore, John D; Li, Chun; McCrary, Laura; Niloff, Jonathan M; Sittig, Dean F; McCoy, Allison B; Wright, Adam

2018-04-01

 Value-based payment for care requires the consistent, objective calculation of care quality. Previous initiatives to calculate ambulatory quality measures have relied on billing data or individual electronic health records (EHRs) to calculate and report performance. New methods for quality measure calculation promoted by federal regulations allow qualified clinical data registries to report quality outcomes based on data aggregated across facilities and EHRs using interoperability standards.  This research evaluates the use of clinical document interchange standards as the basis for quality measurement.  Using data on 1,100 patients from 11 ambulatory care facilities and 5 different EHRs, challenges to quality measurement are identified and addressed for 17 certified quality measures.  Iterative solutions were identified for 14 measures that improved patient inclusion and measure calculation accuracy. Findings validate this approach to improving measure accuracy while maintaining measure certification.  Organizations that report care quality should be aware of how identified issues affect quality measure selection and calculation. Quality measure authors should consider increasing real-world validation and the consistency of measure logic in respect to issues identified in this research. Schattauer GmbH Stuttgart.

Development of job standards for clinical nutrition therapy for dyslipidemia patients.

PubMed

Kang, Min-Jae; Seo, Jung-Sook; Kim, Eun-Mi; Park, Mi-Sun; Woo, Mi-Hye; Ju, Dal-Lae; Wie, Gyung-Ah; Lee, Song-Mi; Cha, Jin-A; Sohn, Cheong-Min

2015-04-01

Dyslipidemia has significantly contributed to the increase of death and morbidity rates related to cardiovascular diseases. Clinical nutrition service provided by dietitians has been reported to have a positive effect on relief of medical symptoms or reducing the further medical costs. However, there is a lack of researches to identify key competencies and job standard for clinical dietitians to care patients with dyslipidemia. Therefore, the purpose of this study was to analyze the job components of clinical dietitian and develop the standard for professional practice to provide effective nutrition management for dyslipidemia patients. The current status of clinical nutrition therapy for dyslipidemia patients in hospitals with 300 or more beds was studied. After duty tasks and task elements of nutrition care process for dyslipidemia clinical dietitians were developed by developing a curriculum (DACUM) analysis method. The developed job standards were pretested in order to evaluate job performance, difficulty, and job standards. As a result, the job standard included four jobs, 18 tasks, and 53 task elements, and specific job description includes 73 basic services and 26 recommended services. When clinical dietitians managing dyslipidemia patients performed their practice according to this job standard for 30 patients the job performance rate was 68.3%. Therefore, the job standards of clinical dietitians for clinical nutrition service for dyslipidemia patients proposed in this study can be effectively used by hospitals.

Georgia Long-Term Pavement Performance (GALTPP) Program – Maintaining Georgia’s Calibration Sites and Identifying the Potential for Using MEPDG for Characterization of Non-Standard Materials and Methods (Phase 1)

DOT National Transportation Integrated Search

2016-10-01

The Georgia Department of Transportation (GDOT) has initiated a Georgia Long-Term Pavement Performance (GALTPP) monitoring program 1) to provide data for calibrating the prediction models in the AASHTO Mechanistic-Empirical Pavement Design Guide (MEP...

Implementation of Professional Learning Communities in Title I Elementary Schools and Student Performance in Reading: A Correlational Study

ERIC Educational Resources Information Center

Lee, Stephanie A.

2016-01-01

Increasing standardized test scores and identifying factors that impact student performance are always on the minds of educators. Educators are continually challenged by experts to consider professional learning communities (PLCs) as a viable pathway to school reform. This treatise will report on the results of a quantitative research study…

A Relational Study of Elementary Principals' Leadership Traits, Teacher Morale, and School Performance

ERIC Educational Resources Information Center

Raines Evers, Carla Jean

2011-01-01

The purpose of the study was to determine if a significant relationship existed between elementary principals. leadership traits and teacher morale. The study sought to identify the impact of the principal-teacher relationship on school achievement as it relates to student performance on state standards as outlined in the Mississippi state…

U.S. Army physical demands study: Identification and validation of the physically demanding tasks of combat arms occupations.

PubMed

Sharp, Marilyn A; Cohen, Bruce S; Boye, Michael W; Foulis, Stephen A; Redmond, Jan E; Larcom, Kathleen; Hydren, Jay R; Gebhardt, Deborah L; Canino, Maria C; Warr, Bradley J; Zambraski, Edward J

2017-11-01

In 2013, the U.S. Army began developing physical tests to predict a recruit's ability to perform the critical, physically demanding tasks (CPDTs) of combat arms jobs previously not open to women. The purpose of this paper is to describe the methodology and results of analyses of the accuracy and inclusiveness of the critical physically demanding task list. While the job analysis included seven combat arms jobs, only data from the 19D Cavalry Scout occupation are presented as the process was similar for all seven jobs. Job analysis METHODS: As the foundation, senior subject matter experts from each job reviewed materials and reached consensus on the CPDTs and performance standards for each job. The list was reviewed by Army leadership and provided to the researchers. The job analysis consisted of reviewing job and task related documents and field manuals, observing >900 soldiers performing the 32 CPDTs, conducting two focus groups for each job, and analyzing responses to widely distributed job analysis questionnaires. Of the 32 CPDTs identified for seven combat jobs, nine were relevant to 19D soldiers. Focus group discussions and job analysis questionnaire results supported the tasks and standards identified by subject matter experts while also identifying additional tasks. The tasks identified by subject matter experts were representative of the physically demanding aspects of the 19D occupation. Published by Elsevier Ltd.

Ergonomics work analysis applied to dentistry--a Brazilian case study.

PubMed

Custódio, R A R; Silva, C E S; Brandão, J G T

2012-01-01

This paper presents the Ergonomic Work Analysis method in a Brazilian Dentist's office. Through the study, the constraints and the strategies in avoiding them were identified. It was found that dentists hardly use the position most indicated by the International Organization for Standardization (ISO) and the Federation Dentaire Internacionale (FDI) for both the patient and the dentist, which is respectively supine and 9 o'clock, due to the limited space and layout. Five types of treatments performed by the professional have been studied. The frequency and duration of actions in these treatments were accounted for and the standard positions adopted were identified. The AET was found to be a very suitable method to grasp the dentist's activity and build a point of view of the profession, which is characterized as: stressful, perfectionist and restrictive. Time management is presented as an important strategy to control the tension arising from performing the treatments.

Variables associated with work performance in multidisciplinary mental health teams

PubMed Central

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François

2017-01-01

Objectives: This study investigates work performance among 79 mental health teams in Quebec (Canada). We hypothesized that work performance was positively associated with the use of standardized clinical tools and clinical approaches, integration strategies, “clan culture,” and mental health funding per capita. Methods: Work performance was measured using an adapted version of the Work Role Questionnaire. Variables were organized into four key areas: (1) team attributes, (2) organizational culture, (3) inter-organizational interactions, and (4) external environment. Results: Work performance was associated with two types of organizational culture (clan and hierarchy) and with two team attributes (use of standardized clinical tools and approaches). Discussion and conclusion: This study was innovative in identifying associations between work performance and best practices, justifying their implementation. Recommendations are provided to develop organizational cultures promoting a greater focus on the external environment and integration strategies that strengthen external focus, service effectiveness, and innovation. PMID:28839935

Developing Air Defense Artillery Warrant Officers Cognitive Skills: An Analysis of Training Needs

DTIC Science & Technology

2018-02-01

statement of actions, conditions, and standards. The lesson descriptions were compared to the action verbs used in the lesson action text and standards...performance and compared these findings to the training WOs receive in formal courses during their career progression. Findings indicated differing...are all required cognitive skills for ADA WOs, decision- making and planning skills are the most prevalent. A comparative analysis identified three

The 1982-83 Promotional Gates Program: Mid-Year Assessment and Analysis of August, 1982 and January, 1983 Test Results. O.E.E. Evaluation Report.

ERIC Educational Resources Information Center

Opperman, Prudence; And Others

The Promotional Gates Program was initiated in the New York City Public Schools in order to set and maintain citywide curriculum and performance standards, identify students unable to meet the minimum standards, and provide remedial instruction. Under this program, the promotional policy sets "gates" at grades 4 and 7; students unable to…

Stepping Stones To Using "Caring for Our Children": National Health and Safety Performance Standards for Out-of-Home Child Care Programs. Protecting Children from Harm.

ERIC Educational Resources Information Center

Colorado Univ. Health Sciences Center, Denver.

Developed in support of state licensing and regulatory agencies as well as state child care, health, and resource and referral agencies, and a variety of other public and private organizations, parents, and advocacy groups, this guide identifies those standards most needed for the prevention of injury, morbidity, and mortality in child care…

An Interlaboratory Evaluation of Drift Tube Ion Mobility–Mass Spectrometry Collision Cross Section Measurements

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

Stow, Sarah M.; Causon, Tim J.; Zheng, Xueyun

Collision cross section (CCS) measurements resulting from ion mobility-mass spectrometry (IM-MS) experiments provide a promising orthogonal dimension of structural information in MS-based analytical separations. As with any molecular identifier, interlaboratory standardization must precede broad range integration into analytical workflows. In this study, we present a reference drift tube ion mobility mass spectrometer (DTIM-MS) where improvements on the measurement accuracy of experimental parameters influencing IM separations provide standardized drift tube, nitrogen CCS values (DTCCSN2) for over 120 unique ion species with the lowest measurement uncertainty to date. The reproducibility of these DTCCSN2 values are evaluated across three additional laboratories on amore » commercially available DTIM-MS instrument. The traditional stepped field CCS method performs with a relative standard deviation (RSD) of 0.29% for all ion species across the three additional laboratories. The calibrated single field CCS method, which is compatible with a wide range of chromatographic inlet systems, performs with an average, absolute bias of 0.54% to the standardized stepped field DTCCSN2 values on the reference system. The low RSD and biases observed in this interlaboratory study illustrate the potential of DTIM-MS for providing a molecular identifier for a broad range of discovery based analyses.« less

Analyses in Support of Risk-Informed Natural Gas Vehicle Maintenance Facility Codes and Standards: Phase II.

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

Blaylock, Myra L.; LaFleur, Chris Bensdotter; Muna, Alice Baca

Safety standards development for maintenance facilities of liquid and compressed natural gas fueled vehicles is required to ensure proper facility design and operating procedures. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase II work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest using risk ranking. Detailed simulations and modeling were performed to estimate the location and behaviormore » of natural gas releases based on these scenarios. Specific code conflicts were identified, and ineffective code requirements were highlighted and resolutions proposed. These include ventilation rate basis on area or volume, as well as a ceiling offset which seems ineffective at protecting against flammable gas concentrations. ACKNOWLEDGEMENTS The authors gratefully acknowledge Bill Houf (SNL -- Retired) for his assistance with the set-up and post-processing of the numerical simulations. The authors also acknowledge Doug Horne (retired) for his helpful discussions. We would also like to acknowledge the support from the Clean Cities program of DOE's Vehicle Technology Office.« less

Toward the establishment of standardized in vitro tests for lipid-based formulations, part 4: proposing a new lipid formulation performance classification system.

PubMed

Williams, Hywel D; Sassene, Philip; Kleberg, Karen; Calderone, Marilyn; Igonin, Annabel; Jule, Eduardo; Vertommen, Jan; Blundell, Ross; Benameur, Hassan; Müllertz, Anette; Porter, Christopher J H; Pouton, Colin W

2014-08-01

The Lipid Formulation Classification System Consortium looks to develop standardized in vitro tests and to generate much-needed performance criteria for lipid-based formulations (LBFs). This article highlights the value of performing a second, more stressful digestion test to identify LBFs near a performance threshold and to facilitate lead formulation selection in instances where several LBF prototypes perform adequately under standard digestion conditions (but where further discrimination is necessary). Stressed digestion tests can be designed based on an understanding of the factors that affect LBF performance, including the degree of supersaturation generated on dispersion/digestion. Stresses evaluated included decreasing LBF concentration (↓LBF), increasing bile salt, and decreasing pH. Their capacity to stress LBFs was dependent on LBF composition and drug type: ↓LBF was a stressor to medium-chain glyceride-rich LBFs, but not more hydrophilic surfactant-rich LBFs, whereas decreasing pH stressed tolfenamic acid LBFs, but not fenofibrate LBFs. Lastly, a new Performance Classification System, that is, LBF composition independent, is proposed to promote standardized LBF comparisons, encourage robust LBF development, and facilitate dialogue with the regulatory authorities. This classification system is based on the concept that performance evaluations across three in vitro tests, designed to subject a LBF to progressively more challenging conditions, will enable effective LBF discrimination and performance grading. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Transit car demonstration test program on the roll dynamics unit. Volume 2. Demonstration of a transit car performance test on the roll dynamic unit. Final report

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

Arnold, G.; Nelson, S.; Cooperrider, N.K.

1982-02-11

This report, Volume II, contains the results, conclusions, and recommendations of the first performance test of a transit care on the RDU. This report is limited to performance tests. The objective is to identify advantages and disadvantages of performance testing on the rollers of the RDU as highlighted by the SOAC test. The report involved separate testing, done by TTC personnel, in such traditional performance areas of transit vehicle operation ass traction, acceleration/deceleration, energy consumption, and spin/slide performance. The results of the successful performance test of a transit car on a roller unit is presented and the advantages of thismore » method of testing is discussed. Acceleration, deceleration, spin/slide, and power consumption tests, although of limited scope in comparison to the track tests performed on the same transit car, did show the feasibility of roller testing. It is concluded that the RDU is most suited for developmental testing of transit car systems particularly for power consumption and for cars with non-standard wheel gage. Tests should be of such scope as to justify the cost of car setup on the RDU. The following two test are recommended: (1) a power consumption study for a standard/non-standard gage transit car which investigates methods of reducing power consumption and (2) a non-standard gage full performance test.« less

Search Strategy to Identify Dental Survival Analysis Articles Indexed in MEDLINE.

PubMed

Layton, Danielle M; Clarke, Michael

2016-01-01

Articles reporting survival outcomes (time-to-event outcomes) in patients over time are challenging to identify in the literature. Research shows the words authors use to describe their dental survival analyses vary, and that allocation of medical subject headings by MEDLINE indexers is inconsistent. Together, this undermines accurate article identification. The present study aims to develop and validate a search strategy to identify dental survival analyses indexed in MEDLINE (Ovid). A gold standard cohort of articles was identified to derive the search terms, and an independent gold standard cohort of articles was identified to test and validate the proposed search strategies. The first cohort included all 6,955 articles published in the 50 dental journals with the highest impact factors in 2008, of which 95 articles were dental survival articles. The second cohort included all 6,514 articles published in the 50 dental journals with the highest impact factors for 2012, of which 148 were dental survival articles. Each cohort was identified by a systematic hand search. Performance parameters of sensitivity, precision, and number needed to read (NNR) for the search strategies were calculated. Sensitive, precise, and optimized search strategies were developed and validated. The performances of the search strategy maximizing sensitivity were 92% sensitivity, 14% precision, and 7.11 NNR; the performances of the strategy maximizing precision were 93% precision, 10% sensitivity, and 1.07 NNR; and the performances of the strategy optimizing the balance between sensitivity and precision were 83% sensitivity, 24% precision, and 4.13 NNR. The methods used to identify search terms were objective, not subjective. The search strategies were validated in an independent group of articles that included different journals and different publication years. Across the three search strategies, dental survival articles can be identified with sensitivity up to 92%, precision up to 93%, and NNR of less than two articles to identify relevant records. This research has highlighted the impact that variation in reporting and indexing has on article identification and has improved researchers' ability to identify dental survival articles.

Economic analysis of standard interface modules for use with the multi-mission spacecraft, volume 1

NASA Technical Reports Server (NTRS)

1976-01-01

A preliminary technical and economic feasibility study was made of the use of Standardized Interstate Modules (SIM) to perform electual interfacing functions that were historically incorporated into sensors. Sensor interface functions that are capable of standardization from the set of missions planned for the NASA Multi-Mission Spacecraft (MMS) in the 1981 to 1985 time period were identified. The cost savings that could be achieved through the replacement of nonstandard sensor interface flight hardware that might be used in these missions with SIM were examined.

Panel C report: Standards needed for the use of ISO Open Systems Interconnection - basic reference model

NASA Technical Reports Server (NTRS)

1981-01-01

The use of an International Standards Organization (ISO) Open Systems Interconnection (OSI) Reference Model and its relevance to interconnecting an Applications Data Service (ADS) pilot program for data sharing is discussed. A top level mapping between the conjectured ADS requirements and identified layers within the OSI Reference Model was performed. It was concluded that the OSI model represents an orderly architecture for the ADS networking planning and that the protocols being developed by the National Bureau of Standards offer the best available implementation approach.

Comparative performance analysis for computer aided lung nodule detection and segmentation on ultra-low-dose vs. standard-dose CT

NASA Astrophysics Data System (ADS)

Wiemker, Rafael; Rogalla, Patrik; Opfer, Roland; Ekin, Ahmet; Romano, Valentina; Bülow, Thomas

2006-03-01

The performance of computer aided lung nodule detection (CAD) and computer aided nodule volumetry is compared between standard-dose (70-100 mAs) and ultra-low-dose CT images (5-10 mAs). A direct quantitative performance comparison was possible, since for each patient both an ultra-low-dose and a standard-dose CT scan were acquired within the same examination session. The data sets were recorded with a multi-slice CT scanner at the Charite university hospital Berlin with 1 mm slice thickness. Our computer aided nodule detection and segmentation algorithms were deployed on both ultra-low-dose and standard-dose CT data without any dose-specific fine-tuning or preprocessing. As a reference standard 292 nodules from 20 patients were visually identified, each nodule both in ultra-low-dose and standard-dose data sets. The CAD performance was analyzed by virtue of multiple FROC curves for different lower thresholds of the nodule diameter. For nodules with a volume-equivalent diameter equal or larger than 4 mm (149 nodules pairs), we observed a detection rate of 88% at a median false positive rate of 2 per patient in standard-dose images, and 86% detection rate in ultra-low-dose images, also at 2 FPs per patient. Including even smaller nodules equal or larger than 2 mm (272 nodules pairs), we observed a detection rate of 86% in standard-dose images, and 84% detection rate in ultra-low-dose images, both at a rate of 5 FPs per patient. Moreover, we observed a correlation of 94% between the volume-equivalent nodule diameter as automatically measured on ultra-low-dose versus on standard-dose images, indicating that ultra-low-dose CT is also feasible for growth-rate assessment in follow-up examinations. The comparable performance of lung nodule CAD in ultra-low-dose and standard-dose images is of particular interest with respect to lung cancer screening of asymptomatic patients.

Identifying high-functioning dyslexics: is self-report of early reading problems enough?

PubMed

Deacon, S Hélène; Cook, Kathryn; Parrila, Rauno

2012-07-01

We used a questionnaire to identify university students with self-reported difficulties in reading acquisition during elementary school (self-report; n=31). The performance of the self-report group on standardized measures of word and non-word reading and fluency, passage comprehension and reading rate, and phonological awareness was compared to that of two other groups of university students: one with a recent diagnosis (diagnosed; n=20) and one with no self-reported reading acquisition problems (comparison group; n=33). The comparison group outperformed both groups with a history of reading difficulties (self-report and diagnosed) on almost all measures. The self-report and diagnosed groups performed similarly on most tasks, with the exception of untimed reading comprehension (better performance for diagnosed) and reading rate (better performance for self-report). The two recruitment methods likely sample from the same underlying population but identify individuals with different adaptive strategies.

Setting performance standards for medical practice: a theoretical framework.

PubMed

Southgate, L; Hays, R B; Norcini, J; Mulholland, H; Ayers, B; Woolliscroft, J; Cusimano, M; McAvoy, P; Ainsworth, M; Haist, S; Campbell, M

2001-05-01

The assessment of performance in the real world of medical practice is now widely accepted as the goal of assessment at the postgraduate level. This is largely a validity issue, as it is recognised that tests of knowledge and in clinical simulations cannot on their own really measure how medical practitioners function in the broader health care system. However, the development of standards for performance-based assessment is not as well understood as in competency assessment, where simulations can more readily reflect narrower issues of knowledge and skills. This paper proposes a theoretical framework for the development of standards that reflect the more complex world in which experienced medical practitioners work. The paper reflects the combined experiences of a group of education researchers and the results of literature searches that included identifying current health system data sources that might contribute information to the measurement of standards. Standards that reflect the complexity of medical practice may best be developed through an "expert systems" analysis of clinical conditions for which desired health care outcomes reflect the contribution of several health professionals within a complex, three-dimensional, contextual model. Examples of the model are provided, but further work is needed to test validity and measurability.

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

Evaluation of Blood Glucose Monitoring System in Screening for Neonatal Hypoglycemia: Tighter Accuracy Standard.

PubMed

Tsao, Mei-Fen; Chang, Hui-Wen; Chang, Chien-Hsi; Cheng, Chi-Hsuan; Lin, Hsiu-Chen

2017-05-01

Neonatal hypoglycemia may cause severe neurological damages; therefore, tight glycemic control is crucial to identify neonate at risk. Previous blood glucose monitoring system (BGMS) failed to perform well in neonates; there are calls for the tightening of accuracy requirements. It remains a need for accurate BGMS for effective bedside diabetes management in neonatal care within a hospital population. A total of 300 neonates were recruited from local hospitals. Accuracy performance of a commercially available BGMS was evaluated against reference instrument in screening for neonatal hypoglycemia, and assessment was made based on the ISO15197:2013 and a tighter standard. At blood glucose level < 47 mg/dl, BGMS assessed met the minimal accuracy requirement of ISO 15197:2013 and tighter standard at 100% and 97.2%, respectively.

[Indicators monitoring the process of specialized nutritional support. Grupo de Nutrición de la SEFH].

PubMed

Sirvent, Mariola; Victoria Calvo, María; Sagalés, María; Rodríguez-Penin, Isaura; Cervera, Mercedes; Piñeiro, Guadalupe; García-Rodicio, Sonsoles; Gomis, Pilar; Caba, Isabel; Vazquez, Amparo; Gomez, María E; Pedraza, Luis

2013-01-01

To identify and develop monitoring indicators of the process of specialized nutritional support that will allow measuring the level of adherence to the established practice standards. Those practice standards considered to be key elements of the process were selected to develop performance indicators. The construction of these indicators combined the scientific evidence with expert opinion. Key goals were identified within each standard provided that its consecution would allow increasing the achievement of the standard. Particular improvement initiatives associated to each key goal were generated. Lastly, monitoring indicators were defined allowing undertaking a follow-up of the implementation of the improvement initiatives or either to assess the level of achievement of the key goals identified. Nineteen practice standards were selected representative of the critical points of the process. The strategic map for each standard has been defined, with the identification of 43 key goals. In order to achieve these key goals, a portfolio of improvements has been generated comprising 56 actions. Finally, 44 monitoring indicators have been defined grouped into three categories: 1. Numeric: they assess the level of goal achievement; 2. Dichotomic (yes/no): they inform on the execution of the improvement actions; 3. Results of the practice audits. We have made available monitoring indicators that allow assessing the level of adherence to the practice standards of the process of specialized nutritional support and the impact of the implementation of improvement actions within this process. Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.

Interdisciplinary cognitive task analysis: a strategy to develop a comprehensive endoscopic retrograde cholangiopancreatography protocol for use in fellowship training.

PubMed

Canopy, Erin; Evans, Matt; Boehler, Margaret; Roberts, Nicole; Sanfey, Hilary; Mellinger, John

2015-10-01

Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. Standardized interviews were conducted with expert gastroenterologists (7) and surgeons (4) from 4 institutions. A procedural step and cognitive decision point protocol was created from audio-taped transcriptions and was refined by 5 additional surgeons. Conceptual elements, sequential actions, and decision points were iterated for 5 tasks: patient preparation, duodenal intubation, selective cannulation, imaging interpretation with related therapeutic intervention, and complication management. A total of 180 steps were identified. Gastroenterologists identified 34 steps not identified by surgeons, and surgeons identified 20 steps not identified by gastroenterologists. The findings suggest that for complex procedures performed by diverse practitioners, more experts may help delineate distinctive emphases differentiated by training background and type of practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Methodological Issues in Predicting Pediatric Epilepsy Surgery Candidates Through Natural Language Processing and Machine Learning

PubMed Central

Cohen, Kevin Bretonnel; Glass, Benjamin; Greiner, Hansel M.; Holland-Bouley, Katherine; Standridge, Shannon; Arya, Ravindra; Faist, Robert; Morita, Diego; Mangano, Francesco; Connolly, Brian; Glauser, Tracy; Pestian, John

2016-01-01

Objective: We describe the development and evaluation of a system that uses machine learning and natural language processing techniques to identify potential candidates for surgical intervention for drug-resistant pediatric epilepsy. The data are comprised of free-text clinical notes extracted from the electronic health record (EHR). Both known clinical outcomes from the EHR and manual chart annotations provide gold standards for the patient’s status. The following hypotheses are then tested: 1) machine learning methods can identify epilepsy surgery candidates as well as physicians do and 2) machine learning methods can identify candidates earlier than physicians do. These hypotheses are tested by systematically evaluating the effects of the data source, amount of training data, class balance, classification algorithm, and feature set on classifier performance. The results support both hypotheses, with F-measures ranging from 0.71 to 0.82. The feature set, classification algorithm, amount of training data, class balance, and gold standard all significantly affected classification performance. It was further observed that classification performance was better than the highest agreement between two annotators, even at one year before documented surgery referral. The results demonstrate that such machine learning methods can contribute to predicting pediatric epilepsy surgery candidates and reducing lag time to surgery referral. PMID:27257386

An Exploratory Study of Central Office Best Practices in Washington's Top 5% Performing School Districts

ERIC Educational Resources Information Center

Ansingh, Pamela Jean

2012-01-01

How prepared are central office administrators to lead school districts in the face of changing standards and changing student populations? The purpose of this mixed methods study was to examine the responses of central office administrators in the top 5% performing school districts in Washington State with the goal of identifying common attitudes…

Stereotype Threat and the Standardized Testing Experiences of African American Children at an Urban Elementary School

ERIC Educational Resources Information Center

Wasserberg, Martin J.

2009-01-01

Stereotype threat (Steele & Aronson, 1995) refers to the risk of confirming a negative stereotype about one's group in a particular performance domain. The theory assumes that performance in the stereotyped domain is most negatively affected when individuals are more highly identified with the domain in question. As federal law has increased the…

External quality assessment schemes raise standards: evidence from the UKNEQAS parasitology subschemes

PubMed Central

Kettelhut, M M; Chiodini, P L; Edwards, H; Moody, A

2003-01-01

Background: The burden of parasitic disease imported into the temperate zone is increasing, and in the tropics remains very high. Thus, high quality diagnostic parasitology services are needed, but to implement clinical governance a measure of quality of service is required. Aim: To examine performance in the United Kingdom National External Quality Assessment Scheme for Parasitology for evidence of improved standards in parasite diagnosis in clinical specimens. Methods: Analysis of performance was made for the period 1986 to 2001, to look for trends in performance scores. Results: An overall rise in performance in faecal and blood parasitology schemes was found from 1986 to 2001. This was seen particularly in the identification of ova, cysts, and larvae in the faecal scheme, the detection of Plasmodium ovale and Plasmodium vivax in the blood scheme, and also in the correct identification of non-malarial blood parasites. Despite this improvement, there are still problems. In the faecal scheme, participants still experience difficulty in recognising small protozoan cysts, differentiating vegetable matter from cysts, and detecting ova and cysts when more than one species is present. In the blood scheme, participants have problems in identifying mixed malarial infections, distinguishing between P ovale and P vivax, and estimating the percentage parasitaemia. The reasons underlying these problems have been identified via the educational part of the scheme, and have been dealt with by distributing teaching sheets and undertaking practical sessions. Conclusions: UK NEQAS for Parasitology has helped to raise the standard of diagnostic parasitology in the UK. PMID:14645352

Computer-Based Image Analysis for Plus Disease Diagnosis in Retinopathy of Prematurity: Performance of the "i-ROP" System and Image Features Associated With Expert Diagnosis.

PubMed

Ataer-Cansizoglu, Esra; Bolon-Canedo, Veronica; Campbell, J Peter; Bozkurt, Alican; Erdogmus, Deniz; Kalpathy-Cramer, Jayashree; Patel, Samir; Jonas, Karyn; Chan, R V Paul; Ostmo, Susan; Chiang, Michael F

2015-11-01

We developed and evaluated the performance of a novel computer-based image analysis system for grading plus disease in retinopathy of prematurity (ROP), and identified the image features, shapes, and sizes that best correlate with expert diagnosis. A dataset of 77 wide-angle retinal images from infants screened for ROP was collected. A reference standard diagnosis was determined for each image by combining image grading from 3 experts with the clinical diagnosis from ophthalmoscopic examination. Manually segmented images were cropped into a range of shapes and sizes, and a computer algorithm was developed to extract tortuosity and dilation features from arteries and veins. Each feature was fed into our system to identify the set of characteristics that yielded the highest-performing system compared to the reference standard, which we refer to as the "i-ROP" system. Among the tested crop shapes, sizes, and measured features, point-based measurements of arterial and venous tortuosity (combined), and a large circular cropped image (with radius 6 times the disc diameter), provided the highest diagnostic accuracy. The i-ROP system achieved 95% accuracy for classifying preplus and plus disease compared to the reference standard. This was comparable to the performance of the 3 individual experts (96%, 94%, 92%), and significantly higher than the mean performance of 31 nonexperts (81%). This comprehensive analysis of computer-based plus disease suggests that it may be feasible to develop a fully-automated system based on wide-angle retinal images that performs comparably to expert graders at three-level plus disease discrimination. Computer-based image analysis, using objective and quantitative retinal vascular features, has potential to complement clinical ROP diagnosis by ophthalmologists.

Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

PubMed

Whiteley, M S; Dos Santos, S J; Harrison, C C; Holdstock, J M; Lopez, A J

2015-12-01

To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women. A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified. Results from 100 sequential patients were analysed. Mean age 44.2 years (32-69) with mode average parity of 3 (0-5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian - 29 right, 81 left; internal iliac - 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 - 5 due to failure to cannulate the target vein. One false-positive diagnosis was made. Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux. © The Author(s) 2014.

Comparison of methodologies for calculating quality measures based on administrative data versus clinical data from an electronic health record system: implications for performance measures.

PubMed

Tang, Paul C; Ralston, Mary; Arrigotti, Michelle Fernandez; Qureshi, Lubna; Graham, Justin

2007-01-01

New reimbursement policies and pay-for-performance programs to reward providers for producing better outcomes are proliferating. Although electronic health record (EHR) systems could provide essential clinical data upon which to base quality measures, most metrics in use were derived from administrative claims data. We compared commonly used quality measures calculated from administrative data to those derived from clinical data in an EHR based on a random sample of 125 charts of Medicare patients with diabetes. Using standard definitions based on administrative data (which require two visits with an encounter diagnosis of diabetes during the measurement period), only 75% of diabetics determined by manually reviewing the EHR (the gold standard) were identified. In contrast, 97% of diabetics were identified using coded information in the EHR. The discrepancies in identified patients resulted in statistically significant differences in the quality measures for frequency of HbA1c testing, control of blood pressure, frequency of testing for urine protein, and frequency of eye exams for diabetic patients. New development of standardized quality measures should shift from claims-based measures to clinically based measures that can be derived from coded information in an EHR. Using data from EHRs will also leverage their clinical content without adding burden to the care process.

Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics.

PubMed

Georgsson, Mattias; Staggers, Nancy

2016-01-01

Mobile health (mHealth) systems are becoming more common for chronic disease management, but usability studies are still needed on patients' perspectives and mHealth interaction performance. This deficiency is addressed by our quantitative usability study of a mHealth diabetes system evaluating patients' task performance, satisfaction, and the relationship of these measures to user characteristics. We used metrics in the International Organization for Standardization (ISO) 9241-11 standard. After standardized training, 10 patients performed representative tasks and were assessed on individual task success, errors, efficiency (time on task), satisfaction (System Usability Scale [SUS]) and user characteristics. Tasks of exporting and correcting values proved the most difficult, had the most errors, the lowest task success rates, and consumed the longest times on task. The average SUS satisfaction score was 80.5, indicating good but not excellent system usability. Data trends showed males were more successful in task completion, and younger participants had higher performance scores. Educational level did not influence performance, but a more recent diabetes diagnosis did. Patients with more experience in information technology (IT) also had higher performance rates. Difficult task performance indicated areas for redesign. Our methods can assist others in identifying areas in need of improvement. Data about user background and IT skills also showed how user characteristics influence performance and can provide future considerations for targeted mHealth designs. Using the ISO 9241-11 usability standard, the SUS instrument for satisfaction and measuring user characteristics provided objective measures of patients' experienced usability. These could serve as an exemplar for standardized, quantitative methods for usability studies on mHealth systems. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics

PubMed Central

Staggers, Nancy

2016-01-01

Objective Mobile health (mHealth) systems are becoming more common for chronic disease management, but usability studies are still needed on patients’ perspectives and mHealth interaction performance. This deficiency is addressed by our quantitative usability study of a mHealth diabetes system evaluating patients’ task performance, satisfaction, and the relationship of these measures to user characteristics. Materials and Methods We used metrics in the International Organization for Standardization (ISO) 9241-11 standard. After standardized training, 10 patients performed representative tasks and were assessed on individual task success, errors, efficiency (time on task), satisfaction (System Usability Scale [SUS]) and user characteristics. Results Tasks of exporting and correcting values proved the most difficult, had the most errors, the lowest task success rates, and consumed the longest times on task. The average SUS satisfaction score was 80.5, indicating good but not excellent system usability. Data trends showed males were more successful in task completion, and younger participants had higher performance scores. Educational level did not influence performance, but a more recent diabetes diagnosis did. Patients with more experience in information technology (IT) also had higher performance rates. Discussion Difficult task performance indicated areas for redesign. Our methods can assist others in identifying areas in need of improvement. Data about user background and IT skills also showed how user characteristics influence performance and can provide future considerations for targeted mHealth designs. Conclusion Using the ISO 9241-11 usability standard, the SUS instrument for satisfaction and measuring user characteristics provided objective measures of patients’ experienced usability. These could serve as an exemplar for standardized, quantitative methods for usability studies on mHealth systems. PMID:26377990

Developing product quality standards for wheelchairs used in less-resourced environments

PubMed Central

McCambridge, Matt; Reese, Norman; Schoendorfer, Don; Wunderlich, Eric; Rushman, Chris; Mahilo, Dave

2017-01-01

Background Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs. Objectives This study was performed to identify the additional tests needed for LREs. Methods First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed. Results A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development. Conclusion The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies. PMID:28936410

Standard module approach to scanning requirements for second-generation airborne FLIRs

NASA Astrophysics Data System (ADS)

Ludwiszewski, Alan P.

1995-05-01

This paper examines the specification requirements for the development of standard module scanning components to be used in conjunction with SADA I and SADA II sensor arrays. System-level design considerations are presented to identify a selection of components that is consistent with optimum use of the SADA technology. A limited-rotation electromagnetic actuator, used in conjunction with an angular position sensor and a digital controller, is shown to have the necessary performance and flexibility to perform the frame scan function for a wide range of airborne systems. System level requirements and specifications for an optional interlace scan system are also provided.

Local identifiability and sensitivity analysis of neuromuscular blockade and depth of hypnosis models.

PubMed

Silva, M M; Lemos, J M; Coito, A; Costa, B A; Wigren, T; Mendonça, T

2014-01-01

This paper addresses the local identifiability and sensitivity properties of two classes of Wiener models for the neuromuscular blockade and depth of hypnosis, when drug dose profiles like the ones commonly administered in the clinical practice are used as model inputs. The local parameter identifiability was assessed based on the singular value decomposition of the normalized sensitivity matrix. For the given input signal excitation, the results show an over-parameterization of the standard pharmacokinetic/pharmacodynamic models. The same identifiability assessment was performed on recently proposed minimally parameterized parsimonious models for both the neuromuscular blockade and the depth of hypnosis. The results show that the majority of the model parameters are identifiable from the available input-output data. This indicates that any identification strategy based on the minimally parameterized parsimonious Wiener models for the neuromuscular blockade and for the depth of hypnosis is likely to be more successful than if standard models are used. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Identifying the critical physical demanding tasks of paramedic work: Towards the development of a physical employment standard.

PubMed

Fischer, Steven L; Sinden, Kathryn E; MacPhee, Renee S

2017-11-01

Public safety related occupations including police, fire and military commonly apply physical employment standard (PES) to facilitate job matching, an approach to evaluate if candidates demonstrate acceptable physical capabilities as required to perform the job safely and effectively. In Canada, paramedics remain as one of the few public safety occupations without an evidence-based, validated PES. The purpose of this study was to document and describe the physical demands of paramedic work and to identify the most physically demanding tasks. These outcomes are essential to inform the design and development of an evidence-based PES for the paramedic sector. Physical demands of paramedic work were documented and described using a direct observation-based task analysis technique. Five paramedic's were trained to document the physical demands of their work, then applied their training to observe more than 90 calls over the course of 20 full 12-h work shifts. Physical demands data were then listed in a survey, administered service-wide, where 155 frontline paramedics identified critically demanding tasks and rank-ordered physical demands from not physically demanding to very strongly demanding. Critically important and physically demanding tasks were identified such as: transferring a patient; loading or unloading a stretcher in to or out of the ambulance; performing CPR; and, raising and lowering a stretcher. It is important that a paramedic-based PES evaluate a candidate's physical capabilities to perform the critical and physically demanding tasks identified in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Determinants of ambulance response time: A study in Sabah, Malaysia

NASA Astrophysics Data System (ADS)

Chin, Su Na; Cheah, Phee Kheng; Arifin, Muhamad Yaakub; Wong, Boh Leng; Omar, Zaturrawiah; Yassin, Fouziah Md; Gabda, Darmesah

2017-04-01

Ambulance response time (ART) is one of the standard key performance indicators (KPI) in measuring the emergency medical services (EMS) delivery performances. When the mean time of ART of EMS system reaches the KPI target, it shows that the EMS system performs well. This paper considers the determinants of ART, using data sampled from 967 ambulance runs in a government hospital in Sabah. Multiple regression analysis with backward elimination was proposed for the identification of significant factors. Amongst the underlying factors, travel distance, age of patients, type of treatment and peak hours were identified to be significantly affecting ART. Identifying factors that influence ART helps the development of strategic improvement planning for reducing the ART.

Performance of Cleared Blood Glucose Monitors.

PubMed

Klonoff, David C; Prahalad, Priya

2015-07-01

Cleared blood glucose monitor (BGM) systems do not always perform as accurately for users as they did to become cleared. We performed a literature review of recent publications between 2010 and 2014 that present data about the frequency of inaccurate performance using ISO 15197 2003 and ISO 15197 2013 as target standards. We performed an additional literature review of publications that present data about the clinical and economic risks of inaccurate BGMs for making treatment decisions or calibrating continuous glucose monitors (CGMs). We found 11 publications describing performance of 98 unique BGM systems. 53 of these 98 (54%) systems met ISO 15197 2003 and 31 of the 98 (32%) tested systems met ISO 15197 2013 analytical accuracy standards in all studies in which they were evaluated. Of the tested systems, 33 were identified by us as FDA-cleared. Among these FDA-cleared BGM systems, 24 out of 32 (75%) met ISO 15197 2003 and 15 out of 31 (48.3%) met ISO 15197 2013 in all studies in which they were evaluated. Among the non-FDA-cleared BGM systems, 29 of 65 (45%) met ISO 15197 2003 and 15 out of 65 (23%) met ISO 15197 2013 in all studies in which they were evaluated. It is more likely that an FDA-cleared BGM system, compared to a non-FDA-cleared BGM system, will perform according to ISO 15197 2003 (χ(2) = 6.2, df = 3, P = 0.04) and ISO 15197 2013 (χ(2) = 11.4, df = 3, P = 0.003). We identified 7 articles about clinical risks and 3 articles about economic risks of inaccurate BGMs. We conclude that a significant proportion of cleared BGMs do not perform at the level for which they were cleared or according to international standards of accuracy. Such poor performance leads to adverse clinical and economic consequences. © 2015 Diabetes Technology Society.

14 CFR 23.671 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.671 General. (a) Each control must operate easily, smoothly, and positively enough to allow proper performance of its functions. (b) Controls must be arranged and identified to provide for...

14 CFR 23.671 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.671 General. (a) Each control must operate easily, smoothly, and positively enough to allow proper performance of its functions. (b) Controls must be arranged and identified to provide for...

14 CFR 23.671 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.671 General. (a) Each control must operate easily, smoothly, and positively enough to allow proper performance of its functions. (b) Controls must be arranged and identified to provide for...

14 CFR 23.671 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.671 General. (a) Each control must operate easily, smoothly, and positively enough to allow proper performance of its functions. (b) Controls must be arranged and identified to provide for...

14 CFR 23.671 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Design and Construction Control Systems § 23.671 General. (a) Each control must operate easily, smoothly, and positively enough to allow proper performance of its functions. (b) Controls must be arranged and identified to provide for...

Full-Envelope Launch Abort System Performance Analysis Methodology

NASA Technical Reports Server (NTRS)

Aubuchon, Vanessa V.

2014-01-01

The implementation of a new dispersion methodology is described, which dis-perses abort initiation altitude or time along with all other Launch Abort System (LAS) parameters during Monte Carlo simulations. In contrast, the standard methodology assumes that an abort initiation condition is held constant (e.g., aborts initiated at altitude for Mach 1, altitude for maximum dynamic pressure, etc.) while dispersing other LAS parameters. The standard method results in large gaps in performance information due to the discrete nature of initiation conditions, while the full-envelope dispersion method provides a significantly more comprehensive assessment of LAS abort performance for the full launch vehicle ascent flight envelope and identifies performance "pinch-points" that may occur at flight conditions outside of those contained in the discrete set. The new method has significantly increased the fidelity of LAS abort simulations and confidence in the results.

Predictive biological markers of systemic lupus erythematosus flares: a systematic literature review.

PubMed

Gensous, Noémie; Marti, Aurélie; Barnetche, Thomas; Blanco, Patrick; Lazaro, Estibaliz; Seneschal, Julien; Truchetet, Marie-Elise; Duffau, Pierre; Richez, Christophe

2017-10-24

The aim of this study was to identify the most reliable biomarkers in the literature that could be used as flare predictors in systemic lupus erythematosus (SLE). A systematic review of the literature was performed using two databases (MEDLINE and EMBASE) through April 2015 and congress abstracts from the American College of Rheumatology and the European League Against Rheumatism were reviewed from 2010 to 2014. Two independent reviewers screened titles and abstracts and analysed selected papers in detail, using a specific questionnaire. Reports addressing the relationships between one or more defined biological test(s) and the occurrence of disease exacerbation were included in the systematic review. From all of the databases, 4668 records were retrieved, of which 69 studies or congress abstracts were selected for the systematic review. The performance of seven types of biomarkers performed routinely in clinical practice and nine types of novel biological markers was evaluated. Despite some encouraging results for anti-double-stranded DNA antibodies, anti-C1q antibodies, B-lymphocyte stimulator and tumour necrosis factor-like weak inducer of apoptosis, none of the biomarkers stood out from the others as a potential gold standard for flare prediction. The results were heterogeneous, and a lack of standardized data prevented us from identifying a powerful biomarker. No powerful conclusions could be drawn from this systematic review due to a lack of standardized data. Efforts should be undertaken to optimize future research on potential SLE biomarkers to develop validated candidates. Thus, we propose a standardized pattern for future studies.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING.

PubMed

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-10-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly.

IDENTIFYING PERFORMANCE ASSURANCE CHALLENGES FOR SMART MANUFACTURING

PubMed Central

Helu, Moneer; Morris, Katherine; Jung, Kiwook; Lyons, Kevin; Leong, Swee

2015-01-01

Smart manufacturing has the potential to address many of the challenges faced by industry. However, the manufacturing community often needs assistance to leverage available technologies to improve their systems. To assure the performance of these technologies, this paper proposes a shared knowledge base that collects problem areas, solutions, and best practices for manufacturing technology. An Implementation Risk Assessment Framework (IRAF) is also described to identify the primary weaknesses of technologies in specific manufacturing contexts. Such approaches have the potential to stimulate new ideas and drive standardization activities critical to scale up and deploy smart manufacturing technologies successfully and quickly. PMID:26783512

Detection of biliary and vascular anatomy in living liver donors: value of gadobenate dimeglumine enhanced MR and MDCT angiography.

PubMed

Artioli, Diana; Tagliabue, Marianna; Aseni, Paolo; Sironi, Sandro; Vanzulli, Angelo

2010-11-01

To evaluate the performance of magnetic resonance (MR) and multidetector computed tomography (MDCT) in the assessment of living donor's vascular and biliary anatomy, having surgical findings as reference standard. Thirty-two living liver donors underwent MR cholangiography (1.5-T; standard cholangiography pulse sequences and delayed acquisitions after administration of biliary contrast agent) for biliary anatomy evaluation. MDCT (16-row multidetector scanner, multiphase protocol, 3mm slice thickness) was also performed in all cases for the assessment of vascular anatomy before transplantation. Hepatic veins (<4mm in diameter) were not considered. MR and MDCT images interpretation was performed by two reviewers by consensus, based on source axial images, multiplanar reformats, and three-dimensional (3D) postprocessing images. Surgical intraoperative findings were used as standard of reference. At surgery, 17 biliary anomalies, 3 portal anomalies, 32 venous and 8 arterial variants were found in the 32 patients. MR correctly identified 15/17 biliary anomalies, with a sensitivity of 88% and a specificity of 93%. MDCT correctly identified 8/8 arterial, 3/3 portal and 29/32 venous variants, with a sensitivity of 100% and 91%, respectively, and a specificity of 100%. MR and MDCT proved to be efficient in evaluating living liver donor's biliary and vascular anatomy. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Vacuum decay container/closure integrity testing technology. Part 2. Comparison to dye ingress tests.

PubMed

Wolf, Heinz; Stauffer, Tony; Chen, Shu-Chen Y; Lee, Yoojin; Forster, Ronald; Ludzinski, Miron; Kamat, Madhav; Mulhall, Brian; Guazzo, Dana Morton

2009-01-01

Part 1 of this series demonstrated that a container closure integrity test performed according to ASTM F2338-09 Standard Test Method for Nondestructive Detection of Leaks in Packages by Vacuum Decay Method using a VeriPac 325/LV vacuum decay leak tester by Packaging Technologies & Inspection, LLC (PTI) is capable of detecting leaks > or = 5.0 microm (nominal diameter) in rigid, nonporous package systems, such as prefilled glass syringes. The current study compared USP, Ph.Eur. and ISO dye ingress integrity test methods to PTI's vacuum decay technology for the detection of these same 5-, 10-, and 15-microm laser-drilled hole defects in 1-mL glass prefilled syringes. The study was performed at three test sites using several inspectors and a variety of inspection conditions. No standard dye ingress method was found to reliably identify all holed syringes. Modifications to these standard dye tests' challenge conditions increased the potential for dye ingress, and adjustments to the visual inspection environment improved dye ingress detection. However, the risk of false positive test results with dye ingress tests remained. In contrast, the nondestructive vacuum decay leak test method reliably identified syringes with holes > or = 5.0 microm.

Simplified Approach Charts Improve Data Retrieval Performance

PubMed Central

Stewart, Michael; Laraway, Sean; Jordan, Kevin; Feary, Michael S.

2016-01-01

The effectiveness of different instrument approach charts to deliver minimum visibility and altitude information during airport equipment outages was investigated. Eighteen pilots flew simulated instrument approaches in three conditions: (a) normal operations using a standard approach chart (standard-normal), (b) equipment outage conditions using a standard approach chart (standard-outage), and (c) equipment outage conditions using a prototype decluttered approach chart (prototype-outage). Errors and retrieval times in identifying minimum altitudes and visibilities were measured. The standard-outage condition produced significantly more errors and longer retrieval times versus the standard-normal condition. The prototype-outage condition had significantly fewer errors and shorter retrieval times than did the standard-outage condition. The prototype-outage condition produced significantly fewer errors but similar retrieval times when compared with the standard-normal condition. Thus, changing the presentation of minima may reduce risk and increase safety in instrument approaches, specifically with airport equipment outages. PMID:28491009

Demographic and academic-related differences between standard-entry and graduate-entry nursing students: a prospective correlational survey.

PubMed

Everett, Bronwyn; Salamonson, Yenna; Trajkovski, Suza; Fernandez, Ritin

2013-07-01

Students who enroll in graduate-entry nursing programs are described as more highly motivated, scoring higher in most learning strategies, and achieving greater academic success than standard-entry nursing students. A prospective correlational design was used to compare the demographic and academic-related characteristics of standard-entry and graduate-entry nursing students in their first year of study. Between 2007 and 2011, students enrolled in the Bachelor of Nursing, Standard Entry and the Bachelor Nursing, Graduate Entry at a large Australian university were surveyed in the first year of their program. Data included English-language usage and time spent in paid work, as well as four dimensions of Pintrich's Motivated Strategies for Learning Questionnaire. Survey data was linked to students' academic grades at the end of the semester. A total of 730 students completed the survey and consented to collection of their academic grades. Graduate-entry students were more likely to be older (28.6 vs. 24.3 years, P < 0.001), and there was a higher percentage of males (25.2% vs. 15.9%, P = 0.003). Although no difference was identified between groups for use of Extrinsic Goal Orientation as a learning strategy, the graduate-entry students were more likely to identify Peer Learning, Help Seeking and Critical Thinking as strategies for learning than the standard-entry students (P < 0.001). Further, while this group of students achieved a higher mean GPA (4.8 vs. 4.0, P < 0.001) compared to the standard-entry students, regression analyses revealed that in both groups, lower levels of English-language proficiency and increased time spent in paid work were predictors of poorer academic performance. Similar to US-based studies, demographic and academic-related differences were identified between standard-entry and graduate-entry nursing students. However, the study also highlights lower levels of English-language proficiency and increased time spent in paid work negatively impacted academic performance in both groups of nursing students. Copyright © 2013 Elsevier Ltd. All rights reserved.

Residential photovoltaic module and array requirements study

NASA Technical Reports Server (NTRS)

Nearhoof, S. L.; Oster, J. R.

1979-01-01

Design requirements for photovoltaic modules and arrays used in residential applications were identified. Building codes and referenced standards were reviewed for their applicability to residential photovoltaic array installations. Four installation types were identified - integral (replaces roofing), direct (mounted on top of roofing), stand-off (mounted away from roofing), and rack (for flat or low slope roofs, or ground mounted). Installation costs were developed for these mounting types as a function of panel/module size. Studies were performed to identify optimum module shapes and sizes and operating voltage cost drivers. It is concluded that there are no perceived major obstacles to the use of photovoltaic modules in residential arrays. However, there is no applicable building code category for residential photovoltaic modules and arrays and additional work with standards writing organizations is needed to develop residential module and array requirements.

Infection prevention and control.

PubMed

Pegram, Anne; Bloomfield, Jacqueline

2015-03-18

All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the third essential skills cluster - infection prevention and control. It provides an overview and discussion of the key skills and behaviours that must be demonstrated to meet the standards set by the Nursing and Midwifery Council. In doing so, it considers the key principles of infection prevention and control, including local and national policies, standard infection control precautions, risk assessment, standard isolation measures and asepsis.

Eyes in the sky

USDA-ARS?s Scientific Manuscript database

Unmanned aerial vehicles (UAVs) have tremendous potential as tools for evaluation of research field plots. Standard cameras mounted to UAVs can document plant growth throughout the season and provide a permanent record of field performance. They can also be used to identify regions of the field with...

Measurement Program for Evaluation of Concrete Ties and Fastenings in Transit Track

DOT National Transportation Integrated Search

1979-03-01

This report outlines a measurement program to obtain data on the performance of standard tie designs and associated fastening systems under field service conditions. In addition, the program identifies limited data to be obtained from a wood tie trac...

A systematic review of Investigator Global Assessment (IGA) in atopic dermatitis (AD) trials: Many options, no standards.

PubMed

Futamura, Masaki; Leshem, Yael A; Thomas, Kim S; Nankervis, Helen; Williams, Hywel C; Simpson, Eric L

2016-02-01

Investigators often use global assessments to provide a snapshot of overall disease severity in dermatologic clinical trials. Although easy to perform, the frequency of use and standardization of global assessments in studies of atopic dermatitis (AD) is unclear. We sought to assess the frequency, definitions, and methods of analysis of Investigator Global Assessment in randomized controlled trials of AD. We conducted a systematic review using all published randomized controlled trials of AD treatments in the Global Resource of Eczema Trials database (2000-2014). We determined the frequency of global scales application and defining features. Among 317 trials identified, 101 trials (32%) used an investigator-performed global assessment as an outcome measure. There was large variability in global assessments between studies in nomenclature, scale size, definitions, outcome description, and analysis. Both static and dynamic scales were identified that ranged from 4- to 7-point scales. North American studies used global assessments more commonly than studies from other countries. The search was restricted to the Global Resource of Eczema Trials database. Global assessments are used frequently in studies of AD, but their complete lack of standardized definitions and implementation preclude any meaningful comparisons between studies, which in turn impedes data synthesis to inform clinical decision-making. Standardization is urgently required. Copyright © 2015. Published by Elsevier Inc.

A Review of NIST Primary Activity Standards for (18)F: 1982 to 2013.

PubMed

Bergeron, Denis E; Cessna, Jeffrey T; Coursey, Bert M; Fitzgerald, Ryan; Zimmerman, Brian E

2014-01-01

The new NIST activity standardization for (18)F, described in 2014 in Applied Radiation and Isotopes (v. 85, p. 77), differs from results obtained between 1998 and 2008 by 4 %. The new results are considered to be very reliable; they are based on a battery of robust primary measurement techniques and bring the NIST standard into accord with other national metrology institutes. This paper reviews all ten (18)F activity standardizations performed at NIST from 1982 to 2013, with a focus on experimental variables that might account for discrepancies. We have identified many possible sources of measurement bias and eliminated most of them, but we have not adequately accounted for the 1998-2008 results.

Ada compiler validation summary report. Certificate number: 891116W1. 10191. Intel Corporation, IPSC/2 Ada, Release 1. 1, IPSC/2 parallel supercomputer, system resource manager host and IPSC/2 parallel supercomputer, CX-1 nodes target

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

Not Available

1989-11-16

This VSR documents the results of the validation testing performed on an Ada compiler. Testing was carried out for the following purposes: To attempt to identify any language constructs supported by the compiler that do not conform to the Ada Standard; To attempt to identify any language constructs not supported by the compiler but required by the Ada Standard; and To determine that the implementation-dependent behavior is allowed by the Ada Standard. Testing of this compiler was conducted by SofTech, Inc. under the direction of he AVF according to procedures established by the Ada Joint Program Office and administered bymore » the Ada Validation Organization (AVO). On-side testing was completed 16 November 1989 at Aloha OR.« less

Applied economics: The use of monetary incentives to modulate behavior.

PubMed

Strang, S; Park, S Q; Strombach, T; Kenning, P

2016-01-01

According to standard economic theory higher monetary incentives will lead to higher performance and higher effort independent of task, context, or individual. In many contexts this standard economic advice is implemented. Monetary incentives are, for example, used to enhance performance at workplace or to increase health-related behavior. However, the fundamental positive impact of monetary incentives has been questioned by psychologists as well as behavioral economists during the last decade, arguing that monetary incentives can sometimes even backfire. In this chapter, studies from proponents as well as opponents of monetary incentives will be presented. Specifically, the impact of monetary incentives on performance, prosocial, and health behavior will be discussed. Furthermore, variables determining whether incentives have a positive or negative impact will be identified. © 2016 Elsevier B.V. All rights reserved.

[Breast cancer screening process indicators in Mexico: a case study].

PubMed

Uscanga-Sánchez, Santos; Torres-Mejía, Gabriela; Ángeles-Llerenas, Angélica; Domínguez-Malpica, Raúl; Lazcano-Ponce, Eduardo

2014-01-01

To identify, measure and compare the performance indicators of productivity, effective access and quality service for the early detection breast cancer program in Mexico. By means of a study case based on the 2011 Women Cancer Information System (SICAM), the indicators were measured and compared with the Mexican official standard NOM-041-SSA2-2011 and international standards. The analysis showed insufficient installed capacity (37%), low coverage in screening (15%), diagnostic evaluation (16%), biopsy (44%) and treatment (57%), and very low effectiveness in confirmed cases by the total number of screening mammograms performed (0.04%). There was no information available, from SICAM, to estimate the rest of the indicators proposed. Efficient health information systems are required in order to monitor indicators and generate performance observatories of screening programs.

Sentinel lymph node mapping in minimally invasive surgery: Role of imaging with color-segmented fluorescence (CSF).

PubMed

Lopez Labrousse, Maite I; Frumovitz, Michael; Guadalupe Patrono, M; Ramirez, Pedro T

2017-09-01

Sentinel lymph node mapping, alone or in combination with pelvic lymphadenectomy, is considered a standard approach in staging of patients with cervical or endometrial cancer [1-3]. The goal of this video is to demonstrate the use of indocyanine green (ICG) and color-segmented fluorescence when performing lymphatic mapping in patients with gynecologic malignancies. Injection of ICG is performed in two cervical sites using 1mL (0.5mL superficial and deep, respectively) at the 3 and 9 o'clock position. Sentinel lymph nodes are identified intraoperatively using the Pinpoint near-infrared imaging system (Novadaq, Ontario, CA). Color-segmented fluorescence is used to image different levels of ICG uptake demonstrating higher levels of perfusion. A color key on the side of the monitor shows the colors that coordinate with different levels of ICG uptake. Color-segmented fluorescence may help surgeons identify true sentinel nodes from fatty tissue that, although absorbing fluorescent dye, does not contain true nodal tissue. It is not intended to differentiate the primary sentinel node from secondary sentinel nodes. The key ranges from low levels of ICG uptake (gray) to the highest rate of ICG uptake (red). Bilateral sentinel lymph nodes are identified along the external iliac vessels using both standard and color-segmented fluorescence. No evidence of disease was noted after ultra-staging was performed in each of the sentinel nodes. Use of ICG in sentinel lymph node mapping allows for high bilateral detection rates. Color-segmented fluorescence may increase accuracy of sentinel lymph node identification over standard fluorescent imaging. The following are the supplementary data related to this article. Copyright © 2017 Elsevier Inc. All rights reserved.

The Influence of Bilectalism and Non-standardization on the Perception of Native Grammatical Variants

PubMed Central

Leivada, Evelina; Papadopoulou, Elena; Kambanaros, Maria; Grohmann, Kleanthes K.

2017-01-01

Research in speakers of closely related varieties has shown that bilectalism and non-standardization affect speakers’ perception of the variants that exist in their native languages in a way that is absent from the performance of their monolingual peers. One possible explanation for this difference is that non-standardization blurs the boundaries of grammatical variants and increases grammatical fluidity. Affected by such factors, bilectals become less accurate in identifying the variety to which a grammatical variant pertains. Another explanation is that their differential performance derives from the fact that they are competent in two varieties. Under this scenario, the difference is due to the existence of two linguistic systems in the course of development, and not to how close or standardized these systems are. This study employs a novel variety-judgment task in order to elucidate which of the two explanations holds. Having administered the task to monolinguals, bilectals, and bilinguals, including heritage language learners and L1 attriters, we obtained a dataset of 16,245 sentences. The analysis shows differential performance between bilectal and bilingual speakers, granting support for the first explanation. We discuss the role of factors such as non-standardization and linguistic proximity in language development and flesh out the implications of the results in relation to different developmental trajectories. PMID:28265248

Ultra-high performance liquid chromatography tandem high-resolution mass spectrometry study of tricyclazole photodegradation products in water.

PubMed

Gosetti, Fabio; Chiuminatto, Ugo; Mazzucco, Eleonora; Mastroianni, Rita; Bolfi, Bianca; Marengo, Emilio

2015-06-01

This paper reports the study of the photodegradation reactions that tricyclazole can naturally undergo, under the action of sunlight, in aqueous solutions of standard tricyclazole and of the commercial BEAM(TM) formulation. The analyses are carried out by ultra-high performance liquid chromatography technique coupled with high-resolution tandem mass spectrometry. Analysis of both tricyclazole and BEAM(TM) water solutions undergone to hydrolysis does not evidence new chromatographic peaks with respect to the not treated solutions. On the contrary, analysis of the same samples subjected to sunlight irradiation shows a decreased intensity of tricyclazole signal and the presence of new chromatographic peaks. Two photodegradation products of tricyclazole have been identified, one of which has been also quantified, being the commercial standard available. The pattern is similar for the solutions of the standard fungicide and of the BEAM(TM) formulation. The results obtained from eco-toxicological tests show that toxicity of tricyclazole standard solutions is greater than that of the irradiated ones, whereas toxicity levels of all the BEAM(TM) solutions investigated (non-irradiated, irradiated, and hydrolyzed) are comparable and lower than those shown by tricyclazole standard solutions. Experiments performed in paddy water solution show that there is no difference in the degradation products formed.

Initial laboratory experience with a novel ultrasound probe for standard and single-port robotic kidney surgery: increasing console surgeon autonomy and minimizing instrument clashing.

PubMed

Yakoubi, Rachid; Autorino, Riccardo; Laydner, Humberto; Guillotreau, Julien; White, Michael A; Hillyer, Shahab; Spana, Gregory; Khanna, Rakesh; Isaac, Wahib; Haber, Georges-Pascal; Stein, Robert J; Kaouk, Jihad H

2012-06-01

The aim of this study was to evaluate a novel ultrasound probe specifically developed for robotic surgery by determining its efficiency in identifying renal tumors. The study was carried out using the Da Vinci™ surgical system in one female pig. Renal tumor targets were created by percutaneous injection of a tumor mimic mixture. Single-port and standard robotic partial nephrectomy were performed. Intraoperative ultrasound was performed using both standard laparoscopic probe and the new ProART™ Robotic probe. Probe maneuverability and ease of handling for tumor localization were recorded. The standard laparoscopic probe was guided by the assistant. Significant clashing with robotic arms was noted during the single-port procedure. The novel robotic probe was easily introduced through the assistant trocar, and held by the console surgeon using the robotic Prograsp™ with no registered clashing in the external operative field. The average time for grasping the new robotic probe was less than 10 s. Once inserted and grasped, no limitation was found in terms of instrument clashing during the single-port procedure. This novel ultrasound probe developed for robotic surgery was noted to be user-friendly when performing porcine standard and especially single-port robotic partial nephrectomy. Copyright © 2011 John Wiley & Sons, Ltd.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

PubMed

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

An overview of the competency movement in nursing and midwifery.

PubMed

Chiarella, Mary; Thoms, Debra; Lau, Cecilia; McInnes, Elizabeth

2008-01-01

The aim of this paper is to examine the purpose and growth of the development of general, advanced and specialist competency standards in nursing and midwifery in Australia. The definitions, content, types, utility and acceptability of competencies are reviewed. This paper also reports the results of a recent survey of nurses and midwives about the uses of competency standards. Challenges in identifying and assessing the impact of competency standards on practice and professional development; reasons for their proliferation and associated shortcomings such as their lack of cultural sensitivity and inability to reflect the complexity of nursing care are also explored. The rationale for this paper is that charting these issues and identifying gaps in the field will assist the further development and refinement of competency frameworks for Australian nursing. The paper concludes by recommending that future research in this area should focus on: (1) formal analysis of the validity and suitability of competency standards in relation to the purposes for which they are designed; (2) the mapping of competency domains, elements and performance criteria to identify similarities and differences in order to provide insight into the nature of both specialist and advanced practice nursing; and (3) a systematic review of the competency literature to ascertain the level of evidence that exists to support the use of competencies in terms of standard setting, safe practice and enhancement of patient outcomes.

Solar PV O&M Standards and Best Practices – Existing Gaps and Improvement Efforts

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

Klise, Geoffrey Taylor; Balfour, John R.; Keating, T. J.

2014-11-01

As greater numbers of photovoltaic (PV) systems are being installed, operations & maintenance (O&M) activities will need to be performed to ensure the PV system is operating as designed over its useful lifetime. To mitigate risks to PV system availability and performance, standardized procedures for O&M activities are needed to ensure high reliability and long-term system bankability. Efforts are just getting underway to address the need for standard O&M procedures as PV gains a larger share of U.S. generation capacity. Due to the existing landscape of how and where PV is installed, including distributed generation from small and medium PVmore » systems, as well as large, centralized utility-scale PV, O&M activities will require different levels of expertise and reporting, making standards even more important. This report summarizes recent efforts made by solar industry stakeholders to identify the existing standards and best practices applied to solar PV O&M activities, and determine the gaps that have yet to be, or are currently being addressed by industry.« less

Solar PV O&M Standards and Best Practices - Existing Gaps and Improvement Efforts

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

Klise, Geoffrey Taylor; Balfour, John R.; Keating, T. J.

2014-11-01

As greater numbers of photovoltaic (PV) systems are being installed, operations & maintenance (O&M) activities will need to be performed to ensure the PV system is operating as designed over its useful lifetime. To mitigate risks to PV system availability and performance, standardized procedures for O&M activities are needed to ensure high reliability and long-term system bankability. Efforts are just getting underway to address the need for standard O&M procedures as PV gains a larger share of U.S. generation capacity. Due to the existing landscape of how and where PV is installed, including distributed generation from small and medium PVmore » systems, as well as large, centralized utility-scale PV, O&M activities will require different levels of expertise and reporting, making standards even more important. This report summarizes recent efforts made by solar industry stakeholders to identify the existing standards and best practices applied to solar PV O&M activities, and determine the gaps that have yet to be, or are currently being addressed by industry.« less

The Effects of Using Space to Teach Standard Elementary School Curriculum

NASA Technical Reports Server (NTRS)

Ewell, Robert N.

1996-01-01

This brief report and recommendation for further research brings to a formal close this effort, the original purpose of which is described in detail in The effects of using space to teach standard elementary school curriculum, Volume 1, included here as the Appendix. Volume 1 describes the project as a 3-year research program to determine the effectiveness of using space to teach. The research design is quasi experimental using standardized test data on students from Aldrin Elementary School and a District-identified 'control' school, which shall be referred to as 'School B.' Students now in fourth through sixth grades will be compared now (after one year at Aldrin) and tracked at least until the present sixth graders are through the eighth grade. Appropriate statistical tests will be applied to standardized test scores to see if Aldrin students are 'better' than School B students in areas such as: Overall academic performance; Performance in math/science; and Enrollments in math/science in middle school.

ADEpedia: a scalable and standardized knowledge base of Adverse Drug Events using semantic web technology.

PubMed

Jiang, Guoqian; Solbrig, Harold R; Chute, Christopher G

2011-01-01

A source of semantically coded Adverse Drug Event (ADE) data can be useful for identifying common phenotypes related to ADEs. We proposed a comprehensive framework for building a standardized ADE knowledge base (called ADEpedia) through combining ontology-based approach with semantic web technology. The framework comprises four primary modules: 1) an XML2RDF transformation module; 2) a data normalization module based on NCBO Open Biomedical Annotator; 3) a RDF store based persistence module; and 4) a front-end module based on a Semantic Wiki for the review and curation. A prototype is successfully implemented to demonstrate the capability of the system to integrate multiple drug data and ontology resources and open web services for the ADE data standardization. A preliminary evaluation is performed to demonstrate the usefulness of the system, including the performance of the NCBO annotator. In conclusion, the semantic web technology provides a highly scalable framework for ADE data source integration and standard query service.

Performance of UNHCR nutrition programs in post-emergency refugee camps

PubMed Central

2011-01-01

Background The United Nations High Commissioner for Refugees (UNHCR) launched a health information system (HIS) in 2005 to enhance quality and consistency of routine health information available in post-emergency refugee camps. This paper reviews nutrition indicators and examines their application for monitoring and evaluating the performance of UNHCR nutrition programs in more than 90 refugee camps in 18 countries. Methods The HIS is a primary source of feeding program data which is collected using standardized case definitions and reporting formats across refugee camps in multiple settings. Data was aggregated across time periods and within and across countries for analysis. Basic descriptive statistics were then compared to UNHCR program performance standards. Results Camp populations covered by the HIS ranged from 192,000 to 219,000 between 2007 and mid-2009; 87% of under five children covered by the HIS were in Africa and 13% in Asia. Average moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) rates reported in 74 of 81 camps for the 2007-2009 time periods were 7.0% and 1.6%, respectively. The supplementary feeding program (SFP) admission rate was 151/1000/yr with 93% of SFP admissions occurring in Africa. SFP performance consistently exceeded all UNHCR standards with the exception of length of enrollment. Average length of SFP enrollment was 12 weeks in Africa and 22 weeks in Asia as compared to the UNHCR standard of < 8 weeks. The therapeutic feeding program (TFP) admission was 22/1000/yr with 95% of TFP admissions in Africa. TFP performance met UNHCR standards with the exception of daily weight gain. Conclusions Inclusion of children identified as moderately and severely wasted in the HIS would allow UNHCR to better track and respond to changes in nutrition status. Improved growth monitoring coverage or active malnutrition surveillance would increase UNHCR's ability to identify and treat cases of acute malnutrition. Expansion of nutrition reporting to address the transition to community-based therapeutic care is essential for adequate performance monitoring in the future. In terms of program priorities, a focus on camps and countries with large refugee populations and high feeding program enrollment rates would have the greatest impact in terms of absolute reductions in the incidence and prevalence of malnutrition. PMID:22029657

Tracking Progress in Improving Diagnosis: A Framework for Defining Undesirable Diagnostic Events.

PubMed

Olson, Andrew P J; Graber, Mark L; Singh, Hardeep

2018-01-29

Diagnostic error is a prevalent, harmful, and costly phenomenon. Multiple national health care and governmental organizations have recently identified the need to improve diagnostic safety as a high priority. A major barrier, however, is the lack of standardized, reliable methods for measuring diagnostic safety. Given the absence of reliable and valid measures for diagnostic errors, we need methods to help establish some type of baseline diagnostic performance across health systems, as well as to enable researchers and health systems to determine the impact of interventions for improving the diagnostic process. Multiple approaches have been suggested but none widely adopted. We propose a new framework for identifying "undesirable diagnostic events" (UDEs) that health systems, professional organizations, and researchers could further define and develop to enable standardized measurement and reporting related to diagnostic safety. We propose an outline for UDEs that identifies both conditions prone to diagnostic error and the contexts of care in which these errors are likely to occur. Refinement and adoption of this framework across health systems can facilitate standardized measurement and reporting of diagnostic safety.

Alternative Formats to Achieve More Efficient Energy Codes for Commercial Buildings

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

Conover, David R.; Rosenberg, Michael I.; Halverson, Mark A.

2013-01-26

This paper identifies and examines several formats or structures that could be used to create the next generation of more efficient energy codes and standards for commercial buildings. Pacific Northwest National Laboratory (PNNL) is funded by the U.S. Department of Energy’s Building Energy Codes Program (BECP) to provide technical support to the development of ANSI/ASHRAE/IES Standard 90.1. While the majority of PNNL’s ASHRAE Standard 90.1 support focuses on developing and evaluating new requirements, a portion of its work involves consideration of the format of energy standards. In its current working plan, the ASHRAE 90.1 committee has approved an energy goalmore » of 50% improvement in Standard 90.1-2013 relative to Standard 90.1-2004, and will likely be considering higher improvement targets for future versions of the standard. To cost-effectively achieve the 50% goal in manner that can gain stakeholder consensus, formats other than prescriptive must be considered. Alternative formats that include reducing the reliance on prescriptive requirements may make it easier to achieve these aggressive efficiency levels in new codes and standards. The focus on energy code and standard formats is meant to explore approaches to presenting the criteria that will foster compliance, enhance verification, and stimulate innovation while saving energy in buildings. New formats may also make it easier for building designers and owners to design and build the levels of efficiency called for in the new codes and standards. This paper examines a number of potential formats and structures, including prescriptive, performance-based (with sub-formats of performance equivalency and performance targets), capacity constraint-based, and outcome-based. The paper also discusses the pros and cons of each format from the viewpoint of code users and of code enforcers.« less

Indiana Academic Standards 2000: Final Version.

ERIC Educational Resources Information Center

Indiana State Dept. of Education, Indianapolis.

Quality music education in schools integrates fundamental musical activities and presents them in a sequential, pedagogically sound curriculum. As identified in the 1997 National Assessment for Educational Progress in music, the processes of creating, performing, and responding to music are interwoven throughout a balanced and complete music…

Ultra-high-performance liquid chromatography/tandem high-resolution mass spectrometry analysis of sixteen red beverages containing carminic acid: identification of degradation products by using principal component analysis/discriminant analysis.

PubMed

Gosetti, Fabio; Chiuminatto, Ugo; Mazzucco, Eleonora; Mastroianni, Rita; Marengo, Emilio

2015-01-15

The study investigates the sunlight photodegradation process of carminic acid, a natural red colourant used in beverages. For this purpose, both carminic acid aqueous standard solutions and sixteen different commercial beverages, ten containing carminic acid and six containing E120 dye, were subjected to photoirradiation. The results show different patterns of degradation, not only between the standard solutions and the beverages, but also from beverage to beverage. Due to the different beverage recipes, unpredictable reactions take place between the dye and the other ingredients. To identify the dye degradation products in a very complex scenario, a methodology was used, based on the combined use of principal component analysis with discriminant analysis and ultra-high-performance liquid chromatography coupled with tandem high resolution mass spectrometry. The methodology is unaffected by beverage composition and allows the degradation products of carminic acid dye to be identified for each beverage. Copyright © 2014 Elsevier Ltd. All rights reserved.

Performance scores and standings during the 43rd Artistic Gymnastics World Championships, 2011.

PubMed

Massidda, Myosotis; Calò, Carla M

2012-01-01

Scores in artistic gymnastics are subject to changes in the rules that occur each Olympic cycle as outlined in the Code of Points, because rules influence the composition of routines and therefore performance. The aim of this study was to identify the most important routine apparatus for success in a World competition. The data were the official results for the 478 gymnasts (262 men, 216 women) who competed in the 43rd Artistic Gymnastic World Championships in 2011 in Tokyo, Japan. The factors least influenced by the technical standard of competitors were performance scores on uneven bars and balance beam for women, and those on pommel horse for men. For uneven bars, balance beam, and pommel horse, scores were consistently good predictors of final standing. Our results suggest that high scores on these apparatus have a greater influence on overall performance than scores on the other apparatus, regardless of the competitors' standard.

Quality assessment of Herba Leonuri based on the analysis of multiple components using normal- and reversed-phase chromatographic methods.

PubMed

Dong, Shuya; He, Jiao; Hou, Huiping; Shuai, Yaping; Wang, Qi; Yang, Wenling; Sun, Zheng; Li, Qing; Bi, Kaishun; Liu, Ran

2017-12-01

A novel, improved, and comprehensive method for quality evaluation and discrimination of Herba Leonuri has been developed and validated based on normal- and reversed-phase chromatographic methods. To identify Herba Leonuri, normal- and reversed-phase high-performance thin-layer chromatography fingerprints were obtained by comparing the colors and R f values of the bands, and reversed-phase high-performance liquid chromatography fingerprints were obtained by using an Agilent Poroshell 120 SB-C18 within 28 min. By similarity analysis and hierarchical clustering analysis, we show that there are similar chromatographic patterns in Herba Leonuri samples, but significant differences in counterfeits and variants. To quantify the bio-active components of Herba Leonuri, reversed-phase high-performance liquid chromatography was performed to analyze syringate, leonurine, quercetin-3-O-robiniaglycoside, hyperoside, rutin, isoquercitrin, wogonin, and genkwanin simultaneously by single standard to determine multi-components method with rutin as internal standard. Meanwhile, normal-phase high-performance liquid chromatography was performed by using an Agilent ZORBAX HILIC Plus within 6 min to determine trigonelline and stachydrine using trigonelline as internal standard. Innovatively, among these compounds, bio-active components of quercetin-3-O-robiniaglycoside and trigonelline were first determined in Herba Leonuri. In general, the method integrating multi-chromatographic analyses offered an efficient way for the standardization and identification of Herba Leonuri. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Derivation and Validation of a Risk Standardization Model for Benchmarking Hospital Performance for Health-Related Quality of Life Outcomes after Acute Myocardial Infarction

PubMed Central

Arnold, Suzanne V.; Masoudi, Frederick A.; Rumsfeld, John S.; Li, Yan; Jones, Philip G.; Spertus, John A.

2014-01-01

Background Before outcomes-based measures of quality can be used to compare and improve care, they must be risk-standardized to account for variations in patient characteristics. Despite the importance of health-related quality of life (HRQL) outcomes among patients with acute myocardial infarction (AMI), no risk-standardized models have been developed. Methods and Results We assessed disease-specific HRQL using the Seattle Angina Questionnaire at baseline and 1 year later in 2693 unselected AMI patients from 24 hospitals enrolled in the TRIUMPH registry. Using 57 candidate sociodemographic, economic, and clinical variables present on admission, we developed a parsimonious, hierarchical linear regression model to predict HRQL. Eleven variables were independently associated with poor HRQL after AMI, including younger age, prior CABG, depressive symptoms, and financial difficulties (R2=20%). The model demonstrated excellent internal calibration and reasonable calibration in an independent sample of 1890 AMI patients in a separate registry, although the model slightly over-predicted HRQL scores in the higher deciles. Among the 24 TRIUMPH hospitals, 1-year unadjusted HRQL scores ranged from 67–89. After risk-standardization, HRQL scores variability narrowed substantially (range=79–83), and the group of hospital performance (bottom 20%/middle 60%/top 20%) changed in 14 of the 24 hospitals (58% reclassification with risk-standardization). Conclusions In this predictive model for HRQL after AMI, we identified risk factors, including economic and psychological characteristics, associated with HRQL outcomes. Adjusting for these factors substantially altered the rankings of hospitals as compared with unadjusted comparisons. Using this model to compare risk-standardized HRQL outcomes across hospitals may identify processes of care that maximize this important patient-centered outcome. PMID:24163068

Advances in Experiment Design for High Performance Aircraft

NASA Technical Reports Server (NTRS)

Morelli, Engene A.

1998-01-01

A general overview and summary of recent advances in experiment design for high performance aircraft is presented, along with results from flight tests. General theoretical background is included, with some discussion of various approaches to maneuver design. Flight test examples from the F-18 High Alpha Research Vehicle (HARV) are used to illustrate applications of the theory. Input forms are compared using Cramer-Rao bounds for the standard errors of estimated model parameters. Directions for future research in experiment design for high performance aircraft are identified.

Pragmatic Language Profiles of School-Age Children With Autism Spectrum Disorders and Williams Syndrome

PubMed Central

Philofsky, Amy; Fidler, Deborah J.; Hepburn, Susan

2015-01-01

Purpose To describe and compare the pragmatic language profiles of school-age children with autism spectrum disorders (ASD) and Williams syndrome (WS) on a standardized measure to determine whether a standard pragmatics tool can differentiate between 2 groups of children with opposing social presentations and pragmatic language difficulties. Method Twenty-two parents of school-age children with ASD, 21 parents of school-age children with WS, and 19 parents of school-age typically developing children rated their child on the Children’s Communication Checklist—Second Edition (CCC–2; D. Bishop, 2003), a standardized pragmatic language assessment tool. Results Both clinical groups demonstrated impairment in overall communication and pragmatic language functioning, but children with WS performed significantly better on overall pragmatic language functioning, and the magnitude of the effect was medium. Profile examination revealed equivalent performances between ASD and WS on most CCC–2 subscales; however, significantly better performances on the Coherence, Stereotyped Language, Nonverbal Communication, and Social Relations subscales were observed in WS. Conclusions The CCC–2 appears to provide an effective means to identify and characterize pragmatic language difficulties using a standardized approach in children with ASD and WS. PMID:17971496

Future United States Role in European Security

DTIC Science & Technology

1992-08-26

MONITORING ORGANIZATION REPORT NUMBER(S) 6a. NAME OF PERFORMING ORGANIZATION 6b. OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION US Army War College (if...necessary and identify by block number) FIELD GROUP SUB- GROUP 19, ABSTRACT (Continue on reverse if necessary and identify by block number) See reverse...concerning these forces: Of course, they used NATO rules of engagement and worked to NATO standards. They had trained together as NATO forces and

Tissue Adhesives for Battlefield Hemorrhage Control. Phase II.

DTIC Science & Technology

1997-04-01

adhesive, it became necessary to identify and quantify the constituents in the preparation solution to ensure accurate production of the agent...weights. Standard 0.05% concentrated solutions of Blue Dextrin (2000K), g-Globulin (150K), Bovine Serum Albumin (66.3K) and Myoglobin (17.6K). Figure 2...34 of the components. These were used later to identify the constituents when placed together in solution. The HPLC analyses were performed with the

MODIFIED FUNCTIONAL MOVEMENT SCREENING AS A PREDICTOR OF TACTICAL PERFORMANCE POTENTIAL IN RECREATIONALLY ACTIVE ADULTS.

PubMed

Glass, Stephen M; Ross, Scott E

2015-10-01

Failure to meet minimum performance standards is a leading cause of attrition from basic combat training. A standardized assessment such as the Functional Movement Screen™ (FMS™) could help identify movement behaviors relevant to physical performance in tactical occupations. Previous work has demonstrated only marginal association between FMS™ tests and performance outcomes, but adding a load challenge to this movement assessment may help highlight performance-limiting behaviors. The purposes of this investigation were to quantify the effect of load on FMS™ tests and determine the extent to which performance outcomes could be predicted using scores from both loaded and unloaded FMS™ conditions. Crossover Trial. Thirteen female and six male recreationally active college students (21 ± 1.37 years, 168 ± 9.8 cm, 66 ± 12.25 kg) completed the FMS™ under (1) a control condition (FMS™C), and (2) an 18.10kg weight vest condition (FMS™W). Balance was assessed using a force plate in double-legged stance and tactical physical performance was evaluated via completion times in a battery of field tests. For each condition, penalized regression was used to select models from the seven FMS™ component tests to predict balance and performance outcomes. Data were collected during a single session lasting approximately three hours per participant. For balance, significant predictors were identified from both conditions but primarily predicted poorer balance with increasing FMS™ scores. For tactical performance, models were retained almost exclusively from FMS™W and generally predicted better performance with higher item scores. The current results suggest that FMS™ screening with an external load could help predict performance relevant to tactical occupations. Sports medicine and fitness professionals interested in performance outcomes may consider assessing movement behaviors under a load. 3.

Cerebral Small Vessel Disease Burden Is Associated with Motor Performance of Lower and Upper Extremities in Community-Dwelling Populations

PubMed Central

Su, Ning; Zhai, Fei-Fei; Zhou, Li-Xin; Ni, Jun; Yao, Ming; Li, Ming-Li; Jin, Zheng-Yu; Gong, Gao-Lang; Zhang, Shu-Yang; Cui, Li-Ying; Tian, Feng; Zhu, Yi-Cheng

2017-01-01

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations. Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation–supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors. Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation–supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis. Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations. PMID:29021757

Cerebral Small Vessel Disease Burden Is Associated with Motor Performance of Lower and Upper Extremities in Community-Dwelling Populations.

PubMed

Su, Ning; Zhai, Fei-Fei; Zhou, Li-Xin; Ni, Jun; Yao, Ming; Li, Ming-Li; Jin, Zheng-Yu; Gong, Gao-Lang; Zhang, Shu-Yang; Cui, Li-Ying; Tian, Feng; Zhu, Yi-Cheng

2017-01-01

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) burden and motor performance of lower and upper extremities in community-dwelling populations. Methods: We performed a cross-sectional analysis on 770 participants enrolled in the Shunyi study, which is a population-based cohort study. CSVD burden, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy were measured using 3T magnetic resonance imaging. All participants underwent quantitative motor assessment of lower and upper extremities, which included 3-m walking speed, 5-repeat chair-stand time, 10-repeat pronation-supination time, and 10-repeat finger-tapping time. Data on demographic characteristics, vascular risk factors, and cognitive functions were collected. General linear model analysis was performed to identify potential correlations between motor performance measures and imaging markers of CSVD after controlling for confounding factors. Results: For motor performance of the lower extremities, WMH was negatively associated with gait speed (standardized β = -0.092, p = 0.022) and positively associated with chair-stand time (standardized β = 0.153, p < 0.0001, surviving FDR correction). For motor performance of the upper extremities, pronation-supination time was positively associated with WMH (standardized β = 0.155, p < 0.0001, surviving FDR correction) and negatively with brain parenchymal fraction (BPF; standardized β = -0.125, p = 0.011, surviving FDR correction). Only BPF was found to be negatively associated with finger-tapping time (standardized β = -0.123, p = 0.012). However, lacunes, CMBs, or PVS were not found to be associated with motor performance of lower or upper extremities in multivariable analysis. Conclusion: Our findings suggest that cerebral microstructural changes related to CSVD may affect motor performance of both lower and upper extremities. WMH and brain atrophy are most strongly associated with motor function deterioration in community-dwelling populations.

European hospital adherence to GOLD recommendations for chronic obstructive pulmonary disease (COPD) exacerbation admissions.

PubMed

Roberts, C Michael; Lopez-Campos, Jose Luis; Pozo-Rodriguez, Francisco; Hartl, Sylvia

2013-12-01

Understanding how European care of chronic obstructive pulmonary disease (COPD) admissions vary against guideline standards provides an opportunity to target appropriate quality improvement interventions. In 2010-2011 an audit of care against the 2010 'Global initiative for chronic Obstructive Lung Disease' (GOLD) standards was performed in 16 018 patients from 384 hospitals in 13 countries. Clinicians prospectively identified consecutive COPD admissions over a period of 8 weeks, recording clinical care measures on a web-based data tool. Data were analysed comparing adherence to 10 key management recommendations. Adherence varied between hospitals and across countries. The lack of available spirometry results and variable use of oxygen and non-invasive ventilation (NIV) are high impact areas identified for improvement.

Problematic Behavior: What Do CACREP Accredited Program Policies and Procedures Reflect

ERIC Educational Resources Information Center

Brown, Maranda

2011-01-01

Counselor Education programs are ethically obligated by accreditation standards and professional codes of ethics to identify counselors-in-training whose academic, clinical, and personal performance indicate problematic behavior that would potentially prevent them from entering the profession (McAdams, Foster, & Ward, 2007). Despite these…

A Content Analysis of Problematic Behavior in Counselor Education Programs

ERIC Educational Resources Information Center

Brown, Maranda

2013-01-01

Counselor education programs are obligated by accreditation standards and professional codes of ethics to identify counselors-in-training whose academic, clinical, and personal performance indicate problematic behavior that would potentially prevent them from entering the profession (McAdams, Foster, & Ward, 2007; Rust, Raskin, & Hill,…

Framework for Assessing Environmental, Social, and Economic Sustainability of ICT Organizations

ERIC Educational Resources Information Center

Odeh, Khuloud

2013-01-01

Key challenges that confront the Information and Communication Technology (ICT) industry today in defining and achieving social, environmental, and economic sustainability goals include identifying sustainable operating standards and best practices and measuring and assessing performance against those practices. The industry lacks a framework for…

ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards.

PubMed

Waxman, Alan G; Conageski, Christine; Silver, Michelle I; Tedeschi, Candice; Stier, Elizabeth A; Apgar, Barbara; Huh, Warner K; Wentzensen, Nicolas; Massad, L Stewart; Khan, Michelle J; Mayeaux, Edward J; Einstein, Mark H; Schiffman, Mark H; Guido, Richard S

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. Working group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Minimum and comprehensive colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up. These guidelines are intended to serve as a guide to standardize colposcopy across the United States.

Standard Operational Protocols in professional nursing practice: use, weaknesses and potentialities.

PubMed

Sales, Camila Balsero; Bernardes, Andrea; Gabriel, Carmen Silvia; Brito, Maria de Fátima Paiva; Moura, André Almeida de; Zanetti, Ariane Cristina Barboza

2018-01-01

to evaluate the use of Standard Operational Protocols (SOPs) in the professional practice of the nursing team based on the theoretical framework of Donabedian, as well as to identify the weaknesses and potentialities from its implementation. Evaluative research, with quantitative approach performed with nursing professionals working in the Health Units of a city of São Paulo, composed of two stages: document analysis and subsequent application of a questionnaire to nursing professionals. A total of 247 nursing professionals participated and reported changes in the way the interventions were performed. The main weaknesses were the small number of professionals, inadequate physical structure and lack of materials. Among the potentialities were: the standardization of materials and concern of the manager and professional related to patient safety. The reassessment of SOPs is necessary, as well as the adoption of a strategy of permanent education of professionals aiming at improving the quality of care provided.

Diagnostic accuracy of administrative data algorithms in the diagnosis of osteoarthritis: a systematic review.

PubMed

Shrestha, Swastina; Dave, Amish J; Losina, Elena; Katz, Jeffrey N

2016-07-07

Administrative health care data are frequently used to study disease burden and treatment outcomes in many conditions including osteoarthritis (OA). OA is a chronic condition with significant disease burden affecting over 27 million adults in the US. There are few studies examining the performance of administrative data algorithms to diagnose OA. The purpose of this study is to perform a systematic review of administrative data algorithms for OA diagnosis; and, to evaluate the diagnostic characteristics of algorithms based on restrictiveness and reference standards. Two reviewers independently screened English-language articles published in Medline, Embase, PubMed, and Cochrane databases that used administrative data to identify OA cases. Each algorithm was classified as restrictive or less restrictive based on number and type of administrative codes required to satisfy the case definition. We recorded sensitivity and specificity of algorithms and calculated positive likelihood ratio (LR+) and positive predictive value (PPV) based on assumed OA prevalence of 0.1, 0.25, and 0.50. The search identified 7 studies that used 13 algorithms. Of these 13 algorithms, 5 were classified as restrictive and 8 as less restrictive. Restrictive algorithms had lower median sensitivity and higher median specificity compared to less restrictive algorithms when reference standards were self-report and American college of Rheumatology (ACR) criteria. The algorithms compared to reference standard of physician diagnosis had higher sensitivity and specificity than those compared to self-reported diagnosis or ACR criteria. Restrictive algorithms are more specific for OA diagnosis and can be used to identify cases when false positives have higher costs e.g. interventional studies. Less restrictive algorithms are more sensitive and suited for studies that attempt to identify all cases e.g. screening programs.

Roadmap for Testing and Validation of Electric Vehicle Communication Standards

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

Pratt, Richard M.; Tuffner, Francis K.; Gowri, Krishnan

Vehicle to grid communication standards are critical to the charge management and interoperability among plug-in electric vehicles (PEVs), charging stations and utility providers. The Society of Automobile Engineers (SAE), International Organization for Standardization (ISO), International Electrotechnical Commission (IEC) and the ZigBee Alliance are developing requirements for communication messages and protocols. While interoperability standards development has been in progress for more than two years, no definitive guidelines are available for the automobile manufacturers, charging station manufacturers or utility backhaul network systems. At present, there is a wide range of proprietary communication options developed and supported in the industry. Recent work bymore » the Electric Power Research Institute (EPRI), in collaboration with SAE and automobile manufacturers, has identified performance requirements and developed a test plan based on possible communication pathways using power line communication (PLC). Though the communication pathways and power line communication technology options are identified, much work needs to be done in developing application software and testing of communication modules before these can be deployed in production vehicles. This paper presents a roadmap and results from testing power line communication modules developed to meet the requirements of SAE J2847/1 standard.« less

Developing Statistical Models to Assess Transplant Outcomes Using National Registries: The Process in the United States.

PubMed

Snyder, Jon J; Salkowski, Nicholas; Kim, S Joseph; Zaun, David; Xiong, Hui; Israni, Ajay K; Kasiske, Bertram L

2016-02-01

Created by the US National Organ Transplant Act in 1984, the Scientific Registry of Transplant Recipients (SRTR) is obligated to publicly report data on transplant program and organ procurement organization performance in the United States. These reports include risk-adjusted assessments of graft and patient survival, and programs performing worse or better than expected are identified. The SRTR currently maintains 43 risk adjustment models for assessing posttransplant patient and graft survival and, in collaboration with the SRTR Technical Advisory Committee, has developed and implemented a new systematic process for model evaluation and revision. Patient cohorts for the risk adjustment models are identified, and single-organ and multiorgan transplants are defined, then each risk adjustment model is developed following a prespecified set of steps. Model performance is assessed, the model is refit to a more recent cohort before each evaluation cycle, and then it is applied to the evaluation cohort. The field of solid organ transplantation is unique in the breadth of the standardized data that are collected. These data allow for quality assessment across all transplant providers in the United States. A standardized process of risk model development using data from national registries may enhance the field.

In search of standards to support circularity in product policies: A systematic approach.

PubMed

Tecchio, Paolo; McAlister, Catriona; Mathieux, Fabrice; Ardente, Fulvio

2017-12-01

The aspiration of a circular economy is to shift material flows toward a zero waste and pollution production system. The process of shifting to a circular economy has been initiated by the European Commission in their action plan for the circular economy. The EU Ecodesign Directive is a key policy in this transition. However, to date the focus of access to market requirements on products has primarily been upon energy efficiency. The absence of adequate metrics and standards has been a key barrier to the inclusion of resource efficiency requirements. This paper proposes a framework to boost sustainable engineering and resource use by systematically identifying standardization needs and features. Standards can then support the setting of appropriate material efficiency requirements in EU product policy. Three high-level policy goals concerning material efficiency of products were identified: embodied impact reduction, lifetime extension and residual waste reduction. Through a lifecycle perspective, a matrix of interactions among material efficiency topics (recycled content, re-used content, relevant material content, durability, upgradability, reparability, re-manufacturability, reusability, recyclability, recoverability, relevant material separability) and policy goals was created. The framework was tested on case studies for electronic displays and washing machines. For potential material efficiency requirements, specific standardization needs were identified, such as adequate metrics for performance measurements, reliable and repeatable tests, and calculation procedures. The proposed novel framework aims to provide a method by which to identify key material efficiency considerations within the policy context, and to map out the generic and product-specific standardisation needs to support ecodesign. Via such an approach, many different stakeholders (industry, academics, policy makers, non-governmental organizations etc.) can be involved in material efficiency standards and regulations. Requirements and standards concerning material efficiency would compel product manufacturers, but also help designers and interested parties in addressing the sustainable resource use issue.

Final Report. An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group

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

Rosenthal, Andrew

The DOE grant, “An Integrated Partnership to Create and Lead the Solar Codes and Standards Working Group,” to New Mexico State University created the Solar America Board for Codes and Standards (Solar ABCs). From 2007 – 2013 with funding from this grant, Solar ABCs identified current issues, established a dialogue among key stakeholders, and catalyzed appropriate activities to support the development of codes and standards that facilitated the installation of high quality, safe photovoltaic systems. Solar ABCs brought the following resources to the PV stakeholder community; Formal coordination in the planning or revision of interrelated codes and standards removing “stovemore » pipes” that have only roofing experts working on roofing codes, PV experts on PV codes, fire enforcement experts working on fire codes, etc.; A conduit through which all interested stakeholders were able to see the steps being taken in the development or modification of codes and standards and participate directly in the processes; A central clearing house for new documents, standards, proposed standards, analytical studies, and recommendations of best practices available to the PV community; A forum of experts that invites and welcomes all interested parties into the process of performing studies, evaluating results, and building consensus on standards and code-related topics that affect all aspects of the market; and A biennial gap analysis to formally survey the PV community to identify needs that are unmet and inhibiting the market and necessary technical developments.« less

Electric Vehicle Communication Standards Testing and Validation Phase I: SAE J2847/1

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

Pratt, Richard M.; Tuffner, Francis K.; Gowri, Krishnan

Executive Summary Vehicle to grid communication standards are critical to the charge management and interoperability among vehicles, charging stations and utility providers. Several standards initiatives by the Society of Automobile Engineers (SAE), International Standards Organization and International Electrotechnical Commission (ISO/IEC), and ZigBee / HomePlug Alliance are developing requirements for communication messages and protocols. While the standard development is in progress for more than two years, no definitive guidelines are available for the automobile manufacturers, charging station manufacturers and utility backhaul network systems. At present, there is a wide range of proprietary communication options developed and supported in the industry. Recentmore » work by the Electric Power Research Institute (EPRI) in collaboration with SAE and automobile manufacturers has identified performance requirements and test plan based on possible communication pathways using power line communication over the control pilot and mains. Though the communication pathways and power line communication technology options are identified, much work needs to be done in developing application software and testing of communication modules before these can be deployed in production vehicles. This report presents a test plan and results from initial testing of two power line communication modules developed to meet the requirements of SAE J2847/1 standard.« less

A Review of NIST Primary Activity Standards for 18F: 1982 to 2013

PubMed Central

Bergeron, Denis E; Cessna, Jeffrey T; Coursey, Bert M; Fitzgerald, Ryan; Zimmerman, Brian E

2014-01-01

The new NIST activity standardization for 18F, described in 2014 in Applied Radiation and Isotopes (v. 85, p. 77), differs from results obtained between 1998 and 2008 by 4 %. The new results are considered to be very reliable; they are based on a battery of robust primary measurement techniques and bring the NIST standard into accord with other national metrology institutes. This paper reviews all ten 18F activity standardizations performed at NIST from 1982 to 2013, with a focus on experimental variables that might account for discrepancies. We have identified many possible sources of measurement bias and eliminated most of them, but we have not adequately accounted for the 1998–2008 results. PMID:26601035

Comparison of a novel passive sampler to standard water-column sampling for organic contaminants associated with wastewater effluents entering a New Jersey stream

USGS Publications Warehouse

Alvarez, D.A.; Stackelberg, P.E.; Petty, J.D.; Huckins, J.N.; Furlong, E.T.; Zaugg, S.D.; Meyer, M.T.

2005-01-01

Four water samples collected using standard depth and width water-column sampling methodology were compared to an innovative passive, in situ, sampler (the polar organic chemical integrative sampler or POCIS) for the detection of 96 organic wastewater-related contaminants (OWCs) in a stream that receives agricultural, municipal, and industrial wastewaters. Thirty-two OWCs were identified in POCIS extracts whereas 9-24 were identified in individual water-column samples demonstrating the utility of POCIS for identifying contaminants whose occurrence are transient or whose concentrations are below routine analytical detection limits. Overall, 10 OWCs were identified exclusively in the POCIS extracts and only six solely identified in the water-column samples, however, repetitive water samples taken using the standard method during the POCIS deployment period required multiple trips to the sampling site and an increased number of samples to store, process, and analyze. Due to the greater number of OWCs detected in the POCIS extracts as compared to individual water-column samples, the ease of performing a single deployment as compared to collecting and processing multiple water samples, the greater mass of chemical residues sequestered, and the ability to detect chemicals which dissipate quickly, the passive sampling technique offers an efficient and effective alternative for detecting OWCs in our waterways for wastewater contaminants.

Risk assessment of student performance in the International Foundations of Medicine Clinical Science Examination by the use of statistical modeling.

PubMed

David, Michael C; Eley, Diann S; Schafer, Jennifer; Davies, Leo

2016-01-01

The primary aim of this study was to assess the predictive validity of cumulative grade point average (GPA) for performance in the International Foundations of Medicine (IFOM) Clinical Science Examination (CSE). A secondary aim was to develop a strategy for identifying students at risk of performing poorly in the IFOM CSE as determined by the National Board of Medical Examiners' International Standard of Competence. Final year medical students from an Australian university medical school took the IFOM CSE as a formative assessment. Measures included overall IFOM CSE score as the dependent variable, cumulative GPA as the predictor, and the factors age, gender, year of enrollment, international or domestic status of student, and language spoken at home as covariates. Multivariable linear regression was used to measure predictor and covariate effects. Optimal thresholds of risk assessment were based on receiver-operating characteristic (ROC) curves. Cumulative GPA (nonstandardized regression coefficient [B]: 81.83; 95% confidence interval [CI]: 68.13 to 95.53) and international status (B: -37.40; 95% CI: -57.85 to -16.96) from 427 students were found to be statistically associated with increased IFOM CSE performance. Cumulative GPAs of 5.30 (area under ROC [AROC]: 0.77; 95% CI: 0.72 to 0.82) and 4.90 (AROC: 0.72; 95% CI: 0.66 to 0.78) were identified as being thresholds of significant risk for domestic and international students, respectively. Using cumulative GPA as a predictor of IFOM CSE performance and accommodating for differences in international status, it is possible to identify students who are at risk of failing to satisfy the National Board of Medical Examiners' International Standard of Competence.

Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets

PubMed Central

2011-01-01

Background Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. Methods Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC) developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO) standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. Results Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths). Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. Conclusions This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems. PMID:21816095

Predictors of medical school clerkship performance: a multispecialty longitudinal analysis of standardized examination scores and clinical assessments.

PubMed

Casey, Petra M; Palmer, Brian A; Thompson, Geoffrey B; Laack, Torrey A; Thomas, Matthew R; Hartz, Martha F; Jensen, Jani R; Sandefur, Benjamin J; Hammack, Julie E; Swanson, Jerry W; Sheeler, Robert D; Grande, Joseph P

2016-04-27

Evidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships. We evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000-2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available. We assessed the correlation between scores and assessments and determined USMLE 1 cutoffs predictive of poor performance (≤10th percentile) on the NBME examinations. We also compared the mean faculty assessment scores of MMS students vs visiting students, and for the NBME, we determined the percentage of MMS students who scored at or below the tenth percentile of first-time national examinees. MCAT scores correlated robustly with USMLE 1 and 2, and USMLE 1 and 2 independently predicted NBME scores in all clerkships. USMLE 1 cutoffs corresponding to poor NBME performance ranged from 220 to 223. USMLE 1 scores were similar among MMS and visiting students. For most academic years and clerkships, NBME scores were similar for MMS students vs all first-time examinees. MCAT, USMLE 1 and 2, and subsequent clinical performance parameters were correlated with NBME scores across all core clerkships. Even more interestingly, faculty assessments correlated with NBME scores, affirming patient care as examination preparation. USMLE 1 scores identified students at risk of poor performance on NBME subject examinations, facilitating and supporting implementation of remediation before the clinical years. MMS students were representative of medical students across the nation.

Risk and Protective Factors for Educational Achievement among Serious Offending Girls

ERIC Educational Resources Information Center

Oudekerk, Barbara A.; Chauhan, Preeti; Reppucci, N. Dickon

2012-01-01

Using longitudinal data, this analysis: (1) documented educational outcomes for serious offending girls, and (2) identified risk and protective factors associated with academic achievement in mid-adolescence and degree attainment by early adulthood. In mid-adolescence, girls performed nearly one standard deviation below the population mean on…

Information Technology Training within Traineeships: Options for TAFE-Based Courses.

ERIC Educational Resources Information Center

Hall, W.; And Others

A study explored ways in which traineeship courses could be designed to include training in information technology. The skills and performance standards required of information technology training in the printing, tourism, banking, construction, and computer industries were identified. Next, the current provision of such training in Australia and…

Authentic Assessment: Creating a Blueprint for Course Design

ERIC Educational Resources Information Center

Villarroel, Verónica; Bloxham, Susan; Bruna, Daniela; Bruna, Carola; Herrera-Seda, Constanza

2018-01-01

Authenticity has been identified as a key characteristic of assessment design which promotes learning. Authentic assessment aims to replicate the tasks and performance standards typically found in the world of work, and has been found to have a positive impact on student learning, autonomy, motivation, self-regulation and metacognition; abilities…

Assessing NETS.T Performance in Teacher Candidates: Exploring the Wayfind Teacher Assessment

ERIC Educational Resources Information Center

Banister, Savilla; Vannatta Reinhart, Rachel

2013-01-01

To effectively integrate digital technologies in K-12 schools, teachers must be provided with undergraduate experiences that strongly support these integration resources and strategies. The National Educational Technology Standards for Teachers (NETS.T) provide a framework for teacher candidates and inservice teachers to identify their…

The Problem of Boys' Literacy Underachievement: Raising Some Questions

ERIC Educational Resources Information Center

Watson, Anne; Kehler, Michael; Martino, Wayne

2010-01-01

Boys' literacy underachievement continues to garner significant attention and has been identified by journalists, educational policymakers, and scholars in the field as the cause for much concern. It has been established that boys perform less well than girls on literacy benchmark or standardized tests. According to the National Assessment of…

42 CFR 425.316 - Monitoring of ACOs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... quality measurement data reported by the ACO as well as aggregate annual and quarterly reports. (ii... described in paragraph (a)(2) of this section (as appropriate) to identify trends and patterns suggesting... quality performance standards or fails to report on one or more quality measures, in addition to actions...

42 CFR 425.316 - Monitoring of ACOs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... quality measurement data reported by the ACO as well as aggregate annual and quarterly reports. (ii... described in paragraph (a)(2) of this section (as appropriate) to identify trends and patterns suggesting... quality performance standards or fails to report on one or more quality measures, in addition to actions...

42 CFR 425.316 - Monitoring of ACOs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... quality measurement data reported by the ACO as well as aggregate annual and quarterly reports. (ii... described in paragraph (a)(2) of this section (as appropriate) to identify trends and patterns suggesting... quality performance standards or fails to report on one or more quality measures, in addition to actions...

Assessment of Learning in Business Education: Standardized or Homegrown?

ERIC Educational Resources Information Center

Djoundourian, Salpie S.

2017-01-01

The author gives an overview of typical learning outcomes in business education and assessment instruments that help measure and test these outcomes. Using data from a recently accredited program the author investigated the determinants of performance on assessment exams to help identify and evaluate differences between homegrown and standardized…

The Complete Guide to Training Delivery: A Competency-Based Approach.

ERIC Educational Resources Information Center

King, Stephen B.; King, Marsha; Rothwell, William J.

This guide focuses on 14 instructor competencies identified by the International Board of Standards for Training, Performance, and Instruction. It provides examples, job aids, worksheets, case studies, and sample dialogs and contains actual experiences and critical incidents faced by trainers who participated in the survey study. Strategies to…

Intersectional Computer-Supported Collaboration in Business Writing: Learning through Challenged Performance

ERIC Educational Resources Information Center

Remley, Dirk

2009-01-01

Carter (2007) identifies four meta-genres associated with writing activities that can help students learn discipline-specific writing skills relative to standards within a given field: these include problem solving, empirical approaches to analysis, selection of sources to use within research, and production of materials that meet accepted…

EFFECTS OF HANDLING ON ENDOCRINOLOGY AND REPRODUCTIVE PERFORMANCE OF THE FATHEAD MINNOW (PIMEPHALES PROMELAS)

EPA Science Inventory

A short-term (21-d) reproductive toxicity test with the fatheadt minnow (Pimephales promelas) has been proposed as a standard method for identifying certain classes of endocrine-disrupting chemicals (EDCs). A potentially useful route of chemical exposure for the test is intraperi...

75 FR 25927 - Vehicle/Track Interaction Safety Standards; High-Speed and High Cant Deficiency Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... qualification process as an important tool for the assessment of vehicle performance. These simulations are... qualification process, simulations would be conducted using both a measured track geometry segment... on the results of simulation studies designed to identify track geometry irregularities associated...

A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia.

PubMed

Ash, Susan; O'Connor, Jackie; Anderson, Sarah; Ridgewell, Emily; Clarke, Leigh

2015-06-01

The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

Fire service and first responder thermal imaging camera (TIC) advances and standards

NASA Astrophysics Data System (ADS)

Konsin, Lawrence S.; Nixdorff, Stuart

2007-04-01

Fire Service and First Responder Thermal Imaging Camera (TIC) applications are growing, saving lives and preventing injury and property damage. Firefighters face a wide range of serious hazards. TICs help mitigate the risks by protecting Firefighters and preventing injury, while reducing time spent fighting the fire and resources needed to do so. Most fire safety equipment is covered by performance standards. Fire TICs, however, are not covered by such standards and are also subject to inadequate operational performance and insufficient user training. Meanwhile, advancements in Fire TICs and lower costs are driving product demand. The need for a Fire TIC Standard was spurred in late 2004 through a Government sponsored Workshop where experts from the First Responder community, component manufacturers, firefighter training, and those doing research on TICs discussed strategies, technologies, procedures, best practices and R&D that could improve Fire TICs. The workshop identified pressing image quality, performance metrics, and standards issues. Durability and ruggedness metrics and standard testing methods were also seen as important, as was TIC training and certification of end-users. A progress report on several efforts in these areas and their impact on the IR sensor industry will be given. This paper is a follow up to the SPIE Orlando 2004 paper on Fire TIC usage (entitled Emergency Responders' Critical Infrared) which explored the technological development of this IR industry segment from the viewpoint of the end user, in light of the studies and reports that had established TICs as a mission critical tool for firefighters.

Telemedicine Technologies for Diabetes in Pregnancy: A Systematic Review and Meta-Analysis.

PubMed

Ming, Wai-Kit; Mackillop, Lucy H; Farmer, Andrew J; Loerup, Lise; Bartlett, Katy; Levy, Jonathan C; Tarassenko, Lionel; Velardo, Carmelo; Kenworthy, Yvonne; Hirst, Jane E

2016-11-09

Diabetes in pregnancy is a global problem. Technological innovations present exciting opportunities for novel approaches to improve clinical care delivery for gestational and other forms of diabetes in pregnancy. To perform an updated and comprehensive systematic review and meta-analysis of the literature to determine whether telemedicine solutions offer any advantages compared with the standard care for women with diabetes in pregnancy. The review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Randomized controlled trials (RCT) in women with diabetes in pregnancy that compared telemedicine blood glucose monitoring with the standard care were identified. Searches were performed in SCOPUS and PubMed, limited to English language publications between January 2000 and January 2016. Trials that met the eligibility criteria were scored for risk of bias using the Cochrane Collaborations Risk of Bias Tool. A meta-analysis was performed using Review Manager software version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). A total of 7 trials were identified. Meta-analysis demonstrated a modest but statistically significant improvement in HbA1c associated with the use of a telemedicine technology. The mean HbA1c of women using telemedicine was 5.33% (SD 0.70) compared with 5.45% (SD 0.58) in the standard care group, representing a mean difference of -0.12% (95% CI -0.23% to -0.02%). When this comparison was limited to women with gestational diabetes mellitus (GDM) only, the mean HbA1c of women using telemedicine was 5.22% (SD 0.70) compared with 5.37% (SD 0.61) in the standard care group, mean difference -0.14% (95% CI -0.25% to -0.04%). There were no differences in other maternal and neonatal outcomes reported. There is currently insufficient evidence that telemedicine technology is superior to standard care for women with diabetes in pregnancy; however, there was no evidence of harm. No trials were identified that assessed patient satisfaction or cost of care delivery, and it may be in these areas where these technologies may be found most valuable. ©Wai-Kit Ming, Lucy H Mackillop, Andrew J Farmer, Lise Loerup, Katy Bartlett, Jonathan C Levy, Lionel Tarassenko, Carmelo Velardo, Yvonne Kenworthy, Jane E Hirst. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.11.2016.

Academy of Nutrition and Dietetics: Revised 2017 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Oncology Nutrition.

PubMed

Charuhas Macris, Paula; Schilling, Karen; Palko, Raymond

2018-04-01

Oncology nutrition encompasses nutrition care for individuals along the cancer care continuum. Nutrition is a vital component of prevention, treatment, and healthy survivorship. The practice of an oncology registered dietitian nutritionist (RDN) reflects the setting and population served with diverse cancer diagnoses, including expanded roles and responsibilities reflecting the RDN's interests and organization's activities. Provision of nutrition services in oncology requires that RDNs have advanced knowledge in the focus area of oncology nutrition. Thus, the Oncology Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for RDNs currently in practice or interested in working in oncology nutrition, to address their current skill level and to identify areas for additional professional development in this practice area. The Standards of Practice address and apply the Nutrition Care Process and workflow elements, which are screening, assessment, diagnosis, intervention, evaluation/monitoring, and discharge planning and transitions of care. The Standards of Professional Performance consist of the following six domains of professionalism including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements and describe three skill levels (competent, proficient, and expert) for RDNs working in oncology nutrition. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Analytical and Experimental Performance Evaluation of BLE Neighbor Discovery Process Including Non-Idealities of Real Chipsets

PubMed Central

Perez-Diaz de Cerio, David; Hernández, Ángela; Valenzuela, Jose Luis; Valdovinos, Antonio

2017-01-01

The purpose of this paper is to evaluate from a real perspective the performance of Bluetooth Low Energy (BLE) as a technology that enables fast and reliable discovery of a large number of users/devices in a short period of time. The BLE standard specifies a wide range of configurable parameter values that determine the discovery process and need to be set according to the particular application requirements. Many previous works have been addressed to investigate the discovery process through analytical and simulation models, according to the ideal specification of the standard. However, measurements show that additional scanning gaps appear in the scanning process, which reduce the discovery capabilities. These gaps have been identified in all of the analyzed devices and respond to both regular patterns and variable events associated with the decoding process. We have demonstrated that these non-idealities, which are not taken into account in other studies, have a severe impact on the discovery process performance. Extensive performance evaluation for a varying number of devices and feasible parameter combinations has been done by comparing simulations and experimental measurements. This work also includes a simple mathematical model that closely matches both the standard implementation and the different chipset peculiarities for any possible parameter value specified in the standard and for any number of simultaneous advertising devices under scanner coverage. PMID:28273801

Risk transfer and accountability in managed care organizations' carve-out contracts.

PubMed

Garnick, D W; Horgan, C M; Hodgkin, D; Merrick, E L; Goldin, D; Ritter, G; Skwara, K C

2001-11-01

This study examined characteristics of contracts between managed care organizations (MCOs) and managed behavioral health organizations (MBHOs) in terms of delegation of functions, financial arrangements between the MCO and the MBHO, and the use of performance standards. Nationally representative administrative and clinical information about the three largest types of commercial products offered by 434 MCOs in 60 market areas was gathered by telephone survey. These products comprised services provided by health maintenance organizations, preferred provider organizations, and point-of-service plans. Chi square tests were performed between pairings of all three types of products to ascertain differences in the degree to which claims processing, maintenance of provider networks, utilization management, case management, and quality improvement were delegated to MBHOs through specialty contracts among the various types of products. Contractual specifications about capitation arrangements, risk sharing, the use of performance standards, and final utilization review decisions were also compared. For all types of products, almost all the major functions were contracted by the MCO to the MBHO. Although most contracts assigned some risk for the costs of services to the MBHO, the degree of this risk varied by product type. Except in the case of preferred-provider organizations, a large number of performance standards were identified in MCOs' contracts with MBHOs, although financial incentives were rarely tied to such standards. MCOs that contract with MBHOs place major responsibility, both financial and administrative, on the vendors.

Analytical and Experimental Performance Evaluation of BLE Neighbor Discovery Process Including Non-Idealities of Real Chipsets.

PubMed

Perez-Diaz de Cerio, David; Hernández, Ángela; Valenzuela, Jose Luis; Valdovinos, Antonio

2017-03-03

The purpose of this paper is to evaluate from a real perspective the performance of Bluetooth Low Energy (BLE) as a technology that enables fast and reliable discovery of a large number of users/devices in a short period of time. The BLE standard specifies a wide range of configurable parameter values that determine the discovery process and need to be set according to the particular application requirements. Many previous works have been addressed to investigate the discovery process through analytical and simulation models, according to the ideal specification of the standard. However, measurements show that additional scanning gaps appear in the scanning process, which reduce the discovery capabilities. These gaps have been identified in all of the analyzed devices and respond to both regular patterns and variable events associated with the decoding process. We have demonstrated that these non-idealities, which are not taken into account in other studies, have a severe impact on the discovery process performance. Extensive performance evaluation for a varying number of devices and feasible parameter combinations has been done by comparing simulations and experimental measurements. This work also includes a simple mathematical model that closely matches both the standard implementation and the different chipset peculiarities for any possible parameter value specified in the standard and for any number of simultaneous advertising devices under scanner coverage.

Outlier experienced surgeon's performances impact on benchmark for technical surgical skills training.

PubMed

Gallagher, Anthony G; Henn, Patrick J; Neary, Paul C; Senagore, Anthony J; Marcello, Peter W; Bunting, Brendan P; Seymour, Neal E; Satava, Richard M

2018-05-01

Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency. In study one, 100 experienced laparoscopic surgeons' performances on virtual reality and box-trainer simulators were assessed for two similar laparoscopic tasks. In study two, 15 experienced surgeons and 16 trainee colorectal surgeons performed one simulated hand-assisted laparoscopic colorectal procedure. Performance scores of experienced surgeons in both studies were standardized (i.e. Z-scores) using the mean and standard deviations (SDs). Performances >1.96 SDs from the mean were excluded in proficiency definitions. In study one, 1-5% of surgeons' performances were excluded having performed significantly below their colleagues. Excluded surgeons made significantly fewer correct incisions (mean = 7 (SD = 2) versus 19.42 (SD = 4.6), P < 0.0001) and a greater proportion of incorrect incisions (mean = 45.71 (SD = 10.48) versus 5.25 (SD = 6.6), P < 0.0001). In study two, one experienced colorectal surgeon performance was >4 SDs for time to complete the procedure and >6 SDs for path length. After their exclusions, experienced surgeons' performances were significantly better than trainees for path length: P = 0.031 and for time: P = 0.002. Objectively assessed atypical expert performances were few. Z-score standardization identified them and produced a more robust quantitative definition of proficiency. © 2018 Royal Australasian College of Surgeons.

Interpreting the ASTM 'content standard for digital geospatial metadata'

USGS Publications Warehouse

Nebert, Douglas D.

1996-01-01

ASTM and the Federal Geographic Data Committee have developed a content standard for spatial metadata to facilitate documentation, discovery, and retrieval of digital spatial data using vendor-independent terminology. Spatial metadata elements are identifiable quality and content characteristics of a data set that can be tied to a geographic location or area. Several Office of Management and Budget Circulars and initiatives have been issued that specify improved cataloguing of and accessibility to federal data holdings. An Executive Order further requires the use of the metadata content standard to document digital spatial data sets. Collection and reporting of spatial metadata for field investigations performed for the federal government is an anticipated requirement. This paper provides an overview of the draft spatial metadata content standard and a description of how the standard could be applied to investigations collecting spatially-referenced field data.

The effect of instructional methodology on high school students natural sciences standardized tests scores

NASA Astrophysics Data System (ADS)

Powell, P. E.

Educators have recently come to consider inquiry based instruction as a more effective method of instruction than didactic instruction. Experience based learning theory suggests that student performance is linked to teaching method. However, research is limited on inquiry teaching and its effectiveness on preparing students to perform well on standardized tests. The purpose of the study to investigate whether one of these two teaching methodologies was more effective in increasing student performance on standardized science tests. The quasi experimental quantitative study was comprised of two stages. Stage 1 used a survey to identify teaching methods of a convenience sample of 57 teacher participants and determined level of inquiry used in instruction to place participants into instructional groups (the independent variable). Stage 2 used analysis of covariance (ANCOVA) to compare posttest scores on a standardized exam by teaching method. Additional analyses were conducted to examine the differences in science achievement by ethnicity, gender, and socioeconomic status by teaching methodology. Results demonstrated a statistically significant gain in test scores when taught using inquiry based instruction. Subpopulation analyses indicated all groups showed improved mean standardized test scores except African American students. The findings benefit teachers and students by presenting data supporting a method of content delivery that increases teacher efficacy and produces students with a greater cognition of science content that meets the school's mission and goals.

Standardizing bimanual vaginal examination using cognitive task analysis.

PubMed

Plumptre, Isabella; Mulki, Omar; Granados, Alejandro; Gayle, Claudine; Ahmed, Shahla; Low-Beer, Naomi; Higham, Jenny; Bello, Fernando

2017-10-01

To create a standardized universal list of procedural steps for bimanual vaginal examination (BVE) for teaching, assessment, and simulator development. This observational study, conducted from June-July 2012 and July-December 2014, collected video data of 10 expert clinicians performing BVE in a nonclinical environment. Video data were analyzed to produce a cognitive task analysis (CTA) of the examination steps performed. The CTA was further refined through structured interviews to make it suitable for teaching or assessment. It was validated through its use as a procedural examination checklist to rate expert clinician performance. BVE was deconstructed into 88 detailed steps outlining the complete examination process. These initial 88 steps were reduced to 35 by focusing on the unseen internal examination, then further refined through interviews with five experts into 30 essential procedural steps, five of which are additional steps if pathology is suspected. Using the CTA as a procedural checklist, the mean number of steps performed and/or verbalized was 21.6 ± 3.12 (72% ± 10.4%; range, 15.9-27.9, 53%-93%). This approach identified 30 essential steps for performing BVE, producing a new technique and standardized tool for teaching, assessment, and simulator development. © 2017 International Federation of Gynecology and Obstetrics.

[Risk management in anesthesia and critical care medicine].

PubMed

Eisold, C; Heller, A R

2017-03-01

Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems.

Behavioral and fMRI evidence of the differing cognitive load of domain-specific assessments.

PubMed

Howard, S J; Burianová, H; Ehrich, J; Kervin, L; Calleia, A; Barkus, E; Carmody, J; Humphry, S

2015-06-25

Standards-referenced educational reform has increased the prevalence of standardized testing; however, whether these tests accurately measure students' competencies has been questioned. This may be due to domain-specific assessments placing a differing domain-general cognitive load on test-takers. To investigate this possibility, functional magnetic resonance imaging (fMRI) was used to identify and quantify the neural correlates of performance on current, international standardized methods of spelling assessment. Out-of-scanner testing was used to further examine differences in assessment results. Results provide converging evidence that: (a) the spelling assessments differed in the cognitive load placed on test-takers; (b) performance decreased with increasing cognitive load of the assessment; and (c) brain regions associated with working memory were more highly activated during performance of assessments that were higher in cognitive load. These findings suggest that assessment design should optimize the cognitive load placed on test-takers, to ensure students' results are an accurate reflection of their true levels of competency. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The dysfunctional consequences of a performance measurement system: the case of the Iranian national hospital grading programme.

PubMed

Aryankhesal, Aidin; Sheldon, Trevor A; Mannion, Russell; Mahdipour, Saeade

2015-07-01

Performance measurement systems are increasingly used to reward and improve provider performance. However, such initiatives may also inadvertently induce a range of unintended and dysfunctional side-effects. This study explores the unintended and adverse consequences induced by the Iranian national hospital grading programme, which incorporates financial incentives for meeting nationally defined standards. We interviewed key informants across four key groups with a legitimate interest in healthcare performance: four purposively selected hospitals; four health insurance organizations; the Iranian hospital accreditation body; and one grading agency. The transcribed interviews and field notes were analysed thematically, and subsequently, member checking was conducted. Seven dysfunctional consequences were identified: misrepresentation of data by hospitals; increased anxiety and stress among hospital employees; tunnel vision; financial pressures on poorly graded hospitals; incentives to purchase unnecessary equipment; erosion of public trust; and restricting access to hospital services by patients. These were caused by the way the grading system was implemented: poor standards of audit; the way in which the audit process was conducted; and the timing of audits. The pay for performance element of the grading system and the focus on structural aspects in the standards made improvement in grading particularly difficult for those hospitals that had been assessed as under-performing. Although the Iranian hospital grading system has resulted in a significant increase in the adoption of national standards, it has nevertheless induced a range of perverse outcomes. To mitigate these requires further refinement and recalibration of the system. © The Author(s) 2015.

Multitasking TORT under UNICOS: Parallel performance models and measurements

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

Barnett, A.; Azmy, Y.Y.

1999-09-27

The existing parallel algorithms in the TORT discrete ordinates code were updated to function in a UNICOS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead.

Multitasking TORT Under UNICOS: Parallel Performance Models and Measurements

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

Azmy, Y.Y.; Barnett, D.A.

1999-09-27

The existing parallel algorithms in the TORT discrete ordinates were updated to function in a UNI-COS environment. A performance model for the parallel overhead was derived for the existing algorithms. The largest contributors to the parallel overhead were identified and a new algorithm was developed. A parallel overhead model was also derived for the new algorithm. The results of the comparison of parallel performance models were compared to applications of the code to two TORT standard test problems and a large production problem. The parallel performance models agree well with the measured parallel overhead.

A strategy for evaluating pathway analysis methods.

PubMed

Yu, Chenggang; Woo, Hyung Jun; Yu, Xueping; Oyama, Tatsuya; Wallqvist, Anders; Reifman, Jaques

2017-10-13

Researchers have previously developed a multitude of methods designed to identify biological pathways associated with specific clinical or experimental conditions of interest, with the aim of facilitating biological interpretation of high-throughput data. Before practically applying such pathway analysis (PA) methods, we must first evaluate their performance and reliability, using datasets where the pathways perturbed by the conditions of interest have been well characterized in advance. However, such 'ground truths' (or gold standards) are often unavailable. Furthermore, previous evaluation strategies that have focused on defining 'true answers' are unable to systematically and objectively assess PA methods under a wide range of conditions. In this work, we propose a novel strategy for evaluating PA methods independently of any gold standard, either established or assumed. The strategy involves the use of two mutually complementary metrics, recall and discrimination. Recall measures the consistency of the perturbed pathways identified by applying a particular analysis method to an original large dataset and those identified by the same method to a sub-dataset of the original dataset. In contrast, discrimination measures specificity-the degree to which the perturbed pathways identified by a particular method to a dataset from one experiment differ from those identifying by the same method to a dataset from a different experiment. We used these metrics and 24 datasets to evaluate six widely used PA methods. The results highlighted the common challenge in reliably identifying significant pathways from small datasets. Importantly, we confirmed the effectiveness of our proposed dual-metric strategy by showing that previous comparative studies corroborate the performance evaluations of the six methods obtained by our strategy. Unlike any previously proposed strategy for evaluating the performance of PA methods, our dual-metric strategy does not rely on any ground truth, either established or assumed, of the pathways perturbed by a specific clinical or experimental condition. As such, our strategy allows researchers to systematically and objectively evaluate pathway analysis methods by employing any number of datasets for a variety of conditions.

Keeping granny safe on July 1: a consensus on minimum geriatrics competencies for graduating medical students.

PubMed

Leipzig, Rosanne M; Granville, Lisa; Simpson, Deborah; Anderson, M Brownell; Sauvigné, Karen; Soriano, Rainier P

2009-05-01

Competency-based education prepares trainees to perform tasks occurring within the context of practice. There are currently no geriatrics-specific, competency-based consensus performance standards for medical students.The authors present the results of a systematic, multimethod process to identify and define the minimum geriatrics-specific competencies needed by a new intern to adequately care for older adults. An alpha draft was crafted by geriatricians, identifying measurable performance subtasks associated with accepted standards of evidence-based geriatric care, patient safety, and "do no harm" within the first-year resident's expected scope of practice. The competencies were then assessed for content validity by key stakeholders and informants. Of the 315 respondents, 26% were geriatricians, 21% family physicians, 24% general internists, 6% neurology program directors, 14% surgery program directors, and 9% other. Twenty-four were decanal appointees. Faculty from almost half (44%) of U.S. medical schools and representatives of several major medical education organizations were present at the working conference.The final document consists of 26 competencies nested within eight content domains: Medication Management; Self-Care Capacity; Falls, Balance and Gait Disorders; Hospital Care for Elders; Cognitive and Behavioral Disorders; Atypical Presentation of Disease; Health Care Planning and Promotion; and Palliative Care.Setting minimum geriatric competency standards establishes the performance benchmarks for medical school graduates who as first-year residents will care for geriatric patients. Only half-facetiously, they are referred to as the "Don't Kill Granny" competencies. Achievement of these minimum competencies by medical students, grounded in evidence-based principles of quality care for older adults, will assure that, each year, older patients are in safer hands on July 1.

The effects of dog breed development on genetic diversity and the relative influences of performance and conformation breeding.

PubMed

Pedersen, N; Liu, H; Theilen, G; Sacks, B

2013-06-01

Genetic diversity was compared among eight dog breeds selected primarily for conformation (Standard Poodle, Italian Greyhound and show English Setter), conformation and performance (Brittany), predominantly performance (German Shorthaired and Wirehaired Pointers) or solely performance (field English Setter and Red Setter). Modern village dogs, which better reflect ancestral genetic diversity, were used as the standard. Four to seven maternal and one to two Y haplotypes were found per breed, with one usually dominant. Diversity of maternal haplotypes was greatest in village dogs, intermediate in performance breeds and lowest in conformation breeds. Maternal haplotype sharing occurred across all breeds, while Y haplotypes were more breed specific. Almost all paternal haplotypes were identified among village dogs, with the exception of the dominant Y haplotype in Brittanys, which has not been identified heretofore. The highest heterozygosity based on 24 autosomal microsatellites was found in village dogs and the lowest in conformation (show) breeds. Principal coordinate analysis indicated that conformation-type breeds were distinct from breeds heavily used for performance, the latter clustering more closely with village dogs. The Brittany, a well-established dual show and field breed, was also genetically intermediate between the conformation and performance breeds. The number of DLA-DRB1 alleles varied from 3 to 10 per breed with extensive sharing. SNPs across the wider DLA region were more frequently homozygous in all pure breeds than in village dogs. Compared with their village dog relatives, all modern breed dogs exhibit reduced genetic diversity. Genetic diversity was even more reduced among breeds under selection for show/conformation. © 2012 Blackwell Verlag GmbH.

Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

PubMed

McKinnon-Howe, Leah; Dowdall, Jayme

2018-05-01

The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Experimental optimization of the FireFly 600 photovoltaic off-grid system.

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

Boyson, William Earl; Orozco, Ron; Ralph, Mark E.

2003-10-01

A comprehensive evaluation and experimental optimization of the FireFly{trademark} 600 off-grid photovoltaic system manufactured by Energia Total, Ltd. was conducted at Sandia National Laboratories in May and June of 2001. This evaluation was conducted at the request of the manufacturer and addressed performance of individual system components, overall system functionality and performance, safety concerns, and compliance with applicable codes and standards. A primary goal of the effort was to identify areas for improvement in performance, reliability, and safety. New system test procedures were developed during the effort.

Interference from Indian diet on the internal standard in a commercial method for the measurement of urinary metanephrines by high-performance liquid chromatography with electrochemical detection.

PubMed

Madhavaram, Hima; Woollard, Gerald A

2014-05-01

Urinary metanephrines are widely used in the diagnosis of catecholamine secreting tumours. Over the past two years we have been using the commercial Recipe(®) ClinRep(®) Complete Kit for Metanephrines in Urine coupled with high-performance liquid chromatography and coulometric detection. It was noticed that the internal standards on the patient chromatograms were sporadically raised due to interference. The interference had identical chromatographic and electrochemical properties to the Recipe(®) internal standard (undisclosed identity). Inspection of the patient names showed it seemingly had a higher frequency and magnitude in patients of Indian origin. The source of the interference was tracked by dietary observation and intervention to curry leaves, a common component of Indian foods. The interference was chromatographically and electrochemically indistinguishable from the internal standard. The mass spectrum of the pentafluoropropionate derivative of the interference matched the Recipe(®) internal standard and was identified as methoxyhydroxybenzylamine by library match. The component co-elutes exactly with internal standard and artifactually decreases the metanephrine and normetanephrine results. It is surprising that it has not been described previously. Patients being assessed for catecholamine secreting tumours should be advised to withdraw from eating Indian foods at least 24 h prior to commencement of urinary collection.

Metrological reliability of optical coherence tomography in biomedical applications

NASA Astrophysics Data System (ADS)

Goloni, C. M.; Temporão, G. P.; Monteiro, E. C.

2013-09-01

Optical coherence tomography (OCT) has been proving to be an efficient diagnostics technique for imaging in vivo tissues, an optical biopsy with important perspectives as a diagnostic tool for quantitative characterization of tissue structures. Despite its established clinical use, there is no international standard to address the specific requirements for basic safety and essential performance of OCT devices for biomedical imaging. The present work studies the parameters necessary for conformity assessment of optoelectronics equipment used in biomedical applications like Laser, Intense Pulsed Light (IPL), and OCT, targeting to identify the potential requirements to be considered in the case of a future development of a particular standard for OCT equipment. In addition to some of the particular requirements standards for laser and IPL, also applicable for metrological reliability analysis of OCT equipment, specific parameters for OCT's evaluation have been identified, considering its biomedical application. For each parameter identified, its information on the accompanying documents and/or its measurement has been recommended. Among the parameters for which the measurement requirement was recommended, including the uncertainty evaluation, the following are highlighted: optical radiation output, axial and transverse resolution, pulse duration and interval, and beam divergence.

Using formal methods to scope performance challenges for Smart Manufacturing Systems: focus on agility.

PubMed

Jung, Kiwook; Morris, K C; Lyons, Kevin W; Leong, Swee; Cho, Hyunbo

2015-12-01

Smart Manufacturing Systems (SMS) need to be agile to adapt to new situations by using detailed, precise, and appropriate data for intelligent decision-making. The intricacy of the relationship of strategic goals to operational performance across the many levels of a manufacturing system inhibits the realization of SMS. This paper proposes a method for identifying what aspects of a manufacturing system should be addressed to respond to changing strategic goals. The method uses standard modeling techniques in specifying a manufacturing system and the relationship between strategic goals and operational performance metrics. Two existing reference models related to manufacturing operations are represented formally and harmonized to support the proposed method. The method is illustrated for a single scenario using agility as a strategic goal. By replicating the proposed method for other strategic goals and with multiple scenarios, a comprehensive set of performance challenges can be identified.

Using formal methods to scope performance challenges for Smart Manufacturing Systems: focus on agility

PubMed Central

Jung, Kiwook; Morris, KC; Lyons, Kevin W.; Leong, Swee; Cho, Hyunbo

2016-01-01

Smart Manufacturing Systems (SMS) need to be agile to adapt to new situations by using detailed, precise, and appropriate data for intelligent decision-making. The intricacy of the relationship of strategic goals to operational performance across the many levels of a manufacturing system inhibits the realization of SMS. This paper proposes a method for identifying what aspects of a manufacturing system should be addressed to respond to changing strategic goals. The method uses standard modeling techniques in specifying a manufacturing system and the relationship between strategic goals and operational performance metrics. Two existing reference models related to manufacturing operations are represented formally and harmonized to support the proposed method. The method is illustrated for a single scenario using agility as a strategic goal. By replicating the proposed method for other strategic goals and with multiple scenarios, a comprehensive set of performance challenges can be identified. PMID:27141209

Using Arden Syntax to Identify Registry-Eligible Very Low Birth Weight Neonates from the Electronic Health Record

PubMed Central

Sarkar, Indra Neil; Chen, Elizabeth S.; Rosenau, Paul T.; Storer, Matthew B.; Anderson, Beth; Horbar, Jeffrey D.

2014-01-01

Condition-specific registries are essential resources for supporting epidemiological, quality improvement, and clinical trial studies. The identification of potentially eligible patients for a given registry often involves a manual process or use of ad hoc software tools. With the increased availability of electronic health data, such as within Electronic Health Record (EHR) systems, there is potential to develop healthcare standards based approaches for interacting with these data. Arden Syntax, which has traditionally been used to represent medical knowledge for clinical decision support, is one such standard that may be adapted for the purpose of registry eligibility determination. In this feasibility study, Arden Syntax was explored for its ability to represent eligibility criteria for a registry of very low birth weight neonates. The promising performance (100% recall; 97% precision) of the Arden Syntax approach at a single institution suggests that a standards-based methodology could be used to robustly identify registry-eligible patients from EHRs. PMID:25954412

A meta-analysis of instructional systems applied in science teaching

NASA Astrophysics Data System (ADS)

Willett, John B.; Yamashita, June J. M.; Anderson, Ronald D.

This article is a report of a meta-analysis on the question: What are the effects of different instructional systems used in science teaching? The studies utilized in this meta-analysis were identified by a process that included a systematic screening of all dissertations completed in the field of science education since 1950, an ERIC search of the literature, a systematic screening of selected research journals, and the standard procedure of identifying potentially relevant studies through examination of the bibliographies of the studies reviewed. In all, the 130 studies coded gave rise to 341 effect sizes. The mean effect size produced over all systems was 0.10 with a standard deviation of 0.41, indicating that, on the average, an innovative teaching system in this sample produced one-tenth of a standard deviation better performance than traditional science teaching. Particular kinds of teaching systems, however, produced results that varied from this overall result. Mean effect sizes were also computed by year of publication, form of publication, grade level, and subject matter.

Exploring local regularities for 3D object recognition

NASA Astrophysics Data System (ADS)

Tian, Huaiwen; Qin, Shengfeng

2016-11-01

In order to find better simplicity measurements for 3D object recognition, a new set of local regularities is developed and tested in a stepwise 3D reconstruction method, including localized minimizing standard deviation of angles(L-MSDA), localized minimizing standard deviation of segment magnitudes(L-MSDSM), localized minimum standard deviation of areas of child faces (L-MSDAF), localized minimum sum of segment magnitudes of common edges (L-MSSM), and localized minimum sum of areas of child face (L-MSAF). Based on their effectiveness measurements in terms of form and size distortions, it is found that when two local regularities: L-MSDA and L-MSDSM are combined together, they can produce better performance. In addition, the best weightings for them to work together are identified as 10% for L-MSDSM and 90% for L-MSDA. The test results show that the combined usage of L-MSDA and L-MSDSM with identified weightings has a potential to be applied in other optimization based 3D recognition methods to improve their efficacy and robustness.

Upgraded demonstration vehicle task report

NASA Technical Reports Server (NTRS)

Bryant, J.; Hardy, K.; Livingston, R.; Sandberg, J.

1981-01-01

Vehicle/battery performance capabilities and interface problems that occurred when upgraded developmental batteries were integrated with upgraded versions of comercially available electric vehicles were investigated. Developmental batteries used included nickel zinc batteries, a nickel iron battery, and an improved lead acid battery. Testing of the electric vehicles and upgraded batteries was performed in the complete vehicle system environment to characterize performance and identify problems unique to the vehicle/battery system. Constant speed tests and driving schedule range tests were performed on a chassis dynamometer. The results from these tests of the upgraded batteries and vehicles were compared to performance capabilities for the same vehicles equipped with standard batteries.

Ultrasound extraction and thin layer chromatography-flame ionization detection analysis of the lipid fraction in marine mucilage samples.

PubMed

Mecozzi, M; Amici, M; Romanelli, G; Pietrantonio, E; Deluca, A

2002-07-19

This paper reports an analytical procedure based on ultrasound to extract lipids in marine mucilage samples. The experimental conditions of the ultrasound procedure (solvent and time) were identified by a FT-IR study performed on different standard samples of lipids and of a standard humic sample, before and after the sonication treatment. This study showed that diethyl ether was a more suitable solvent than methanol for the ultrasonic extraction of lipids from environmental samples because it allowed to minimize the possible oxidative modifications of lipids due to the acoustic cavitation phenomena. The optimized conditions were applied to the extraction of total lipid amount in marine mucilage samples and TLC-flame ionization detection analysis was used to identify the relevant lipid sub-fractions present in samples.

Zwitterionic, cationic, and anionic fluorinated chemicals in aqueous film forming foam formulations and groundwater from U.S. military bases by nonaqueous large-volume injection HPLC-MS/MS.

PubMed

Backe, Will J; Day, Thomas C; Field, Jennifer A

2013-05-21

A new analytical method was developed to quantify 26 newly-identified and 21 legacy (e.g. perfluoroalkyl carboxylates, perfluoroalkyl sulfonates, and fluorotelomer sulfonates) per and polyfluorinated alkyl substances (PFAS) in groundwater and aqueous film forming foam (AFFF) formulations. Prior to analysis, AFFF formulations were diluted into methanol and PFAS in groundwater were micro liquid-liquid extracted. Methanolic dilutions of AFFF formulations and groundwater extracts were analyzed by large-volume injection (900 μL) high-performance liquid chromatography tandem mass spectrometry. Orthogonal chromatography was performed using cation exchange (silica) and anion exchange (propylamine) guard columns connected in series to a reverse-phase (C18) analytical column. Method detection limits for PFAS in groundwater ranged from 0.71 ng/L to 67 ng/L, and whole-method accuracy ranged from 96% to 106% for analytes for which matched authentic analytical standards were available. For analytes without authentic analytical standards, whole-method accuracy ranged from 78 % to 144 %, and whole-method precision was less than 15 % relative standard deviation for all analytes. A demonstration of the method on groundwater samples from five military bases revealed eight of the 26 newly-identified PFAS present at concentrations up to 6900 ng/L. The newly-identified PFAS represent a minor fraction of the fluorinated chemicals in groundwater relative to legacy PFAS. The profiles of PFAS in groundwater differ from those found in fluorotelomer- and electrofluorination-based AFFF formulations, which potentially indicates environmental transformation of PFAS.

A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

PubMed

Wylie, C E; Newton, J R

2018-05-01

Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

Assessment of a Microsoft Kinect-based 3D scanning system for taking body segment girth measurements: a comparison to ISAK and ISO standards.

PubMed

Clarkson, Sean; Wheat, Jon; Heller, Ben; Choppin, Simon

2016-01-01

Use of anthropometric data to infer sporting performance is increasing in popularity, particularly within elite sport programmes. Measurement typically follows standards set by the International Society for the Advancement of Kinanthropometry (ISAK). However, such techniques are time consuming, which reduces their practicality. Schranz et al. recently suggested 3D body scanners could replace current measurement techniques; however, current systems are costly. Recent interest in natural user interaction has led to a range of low-cost depth cameras capable of producing 3D body scans, from which anthropometrics can be calculated. A scanning system comprising 4 depth cameras was used to scan 4 cylinders, representative of the body segments. Girth measurements were calculated from the 3D scans and compared to gold standard measurements. Requirements of a Level 1 ISAK practitioner were met in all 4 cylinders, and ISO standards for scan-derived girth measurements were met in the 2 larger cylinders only. A fixed measurement bias was identified that could be corrected with a simple offset factor. Further work is required to determine comparable performance across a wider range of measurements performed upon living participants. Nevertheless, findings of the study suggest such a system offers many advantages over current techniques, having a range of potential applications.

Pay-for-virtue: an option to improve pay-for-performance?

PubMed

Buetow, Stephen; Entwistle, Vikki

2011-10-01

Pay-for-performance schemes reward standardized professional behaviours associated with effective care. However, they neglect the significance of virtue and devalue and erode professional motivation based on virtue. Pay for training to cultivate virtue, and/or pay-for-virtue, may mitigate these dangers. Although virtue is typically considered its own reward, and the assessment of virtue is problematic, pay-for-virtue could involve (1) stringent checks on the appropriateness of the standardized care currently rewarded by pay-for-performance for individual patients or (2) pay for indicators of virtue. These indicators could be based on virtues identified from a framework of universal virtues and through logical inferences from features of practice. It is possible that pay-for-virtue could ultimately strengthen health professionals' intrinsic motivation for good practice, but this and the broader effects of pay-for-virtue would need careful investigation. © 2011 Blackwell Publishing Ltd.

Energy consumption in commercial buildings: A comparison with BEPS budgets

NASA Astrophysics Data System (ADS)

1980-09-01

Metered energy consumption data were collected on existing commercial buildings to help establish the proposed building energy performance standards (BEPS). The search has identified 84 buildings whose metered energy consumption is equal to or less than that proposed for their BEPS budgets and another 7 buildings whose metered consumption is less than 20 percent above their BEPS budgets. The methodology used to identify the buildings and to collect their metered energy consumption data are described. The data are analyzed and summarized and conclusions are drawn.

More is still not better: testing the perturbation model of temporal reference memory across different modalities and tasks.

PubMed

Ogden, Ruth S; Jones, Luke A

2009-05-01

The ability of the perturbation model (Jones & Wearden, 2003) to account for reference memory function in a visual temporal generalization task and auditory and visual reproduction tasks was examined. In all tasks the number of presentations of the standard was manipulated (1, 3, or 5), and its effect on performance was compared. In visual temporal generalization the number of presentations of the standard did not affect the number of times the standard was correctly identified, nor did it affect the overall temporal generalization gradient. In auditory reproduction there was no effect of the number of times the standard was presented on mean reproductions. In visual reproduction mean reproductions were shorter when the standard was only presented once; however, this effect was reduced when a visual cue was provided before the first presentation of the standard. Whilst the results of all experiments are best accounted for by the perturbation model there appears to be some attentional benefit to multiple presentations of the standard in visual reproduction.

Clinical protein science developments for patient monitoring in hospital central laboratories.

PubMed

Malm, Johan; Marko-Varga, György

2016-12-01

Patient care relies heavily on standardized tests performed in hospital laboratories, typically including clinical chemistry, pathology and microbiology. With the introduction of personalized medicine tremendous efforts have been made to identify new biomarkers of disease with various omics technologies, often including mass spectrometry. In order to validate new biomarkers and perform clinical studies high quality biobank samples are of key importance. In this editorial different aspects of mass spectrometry in future personalized medicine are discussed.

The role of standardized data and terminological systems in computerized clinical decision support systems: literature review and survey.

PubMed

Ahmadian, Leila; van Engen-Verheul, Mariette; Bakhshi-Raiez, Ferishta; Peek, Niels; Cornet, Ronald; de Keizer, Nicolette F

2011-02-01

Clinical decision support systems (CDSSs) should be seamlessly integrated with existing clinical information systems to enable automatic provision of advice at the time and place where decisions are made. It has been suggested that a lack of agreed data standards frequently hampers this integration. We performed a literature review to investigate whether CDSSs used standardized (i.e. coded or numerical) data and which terminological systems have been used to code data. We also investigated whether a lack of standardized data was considered an impediment for CDSS implementation. Articles reporting an evaluation of a CDSS that provided a computerized advice based on patient-specific data items were identified based on a former literature review on CDSS and on CDSS studies identified in AMIA's 'Year in Review'. Authors of these articles were contacted to check and complete the extracted data. A questionnaire among the authors of included studies was used to determine the obstacles in CDSS implementation. We identified 77 articles published between 1995 and 2008. Twenty-two percent of the evaluated CDSSs used only numerical data. Fifty one percent of the CDSSs that used coded data applied an international terminology. The most frequently used international terminology were the ICD (International Classification of Diseases), used in 68% of the cases and LOINC (Logical Observation Identifiers Names and Codes) in 12% of the cases. More than half of the authors experienced barriers in CDSS implementation. In most cases these barriers were related to the lack of electronically available standardized data required to invoke or activate the CDSS. Many CDSSs applied different terminological systems to code data. This diversity hampers the possibility of sharing and reasoning with data within different systems. The results of the survey confirm the hypothesis that data standardization is a critical success factor for CDSS development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Targeting Learning Needs in an Australian Aid Project in Thailand.

ERIC Educational Resources Information Center

Kinder, Rex; Karawanan, Chaisak

1996-01-01

The Thailand Land Titling Project includes a training and development component aimed at long-term sustainability. A training target matrix was developed to identify the knowledge, skills, experience, and performance standards required and needs for training at various levels. Six broad and flexible career paths allow for logical succession,…

Organizational Change Efforts: Methodologies for Assessing Organizational Effectiveness and Program Costs versus Benefits.

ERIC Educational Resources Information Center

Macy, Barry A.; Mirvis, Philip H.

1982-01-01

A standardized methodology for identifying, defining, and measuring work behavior and performance rather than production, and a methodology that estimates the costs and benefits of work innovation are presented for assessing organizational effectiveness and program costs versus benefits in organizational change programs. Factors in a cost-benefit…

No One Way: Differentiating School District Leadership and Support for School Improvement

ERIC Educational Resources Information Center

Anderson, Stephen E.; Mascall, Blair; Stiegelbauer, Suzanne; Park, Jaddon

2012-01-01

This article examines findings from a qualitative investigation of how school district administrators in four mid to large sized urban school districts (10,000-50,000) identify and address differences in school performance. The analysis explores the interaction between district policies and actions that centralize and standardize expectations for…

Observations Guide

DTIC Science & Technology

2015-11-01

T) Organizational Performance (B) Sexual Harassment (C) Sex Harassment Retaliation (D) Discrimination - Sex (E) Discrimination - Race (F...standards?  Workplace and living conditions/environment. Look for graffiti, personal display of pictures, posters, artifacts, and general impressions...your briefing.  Determine the commander’s preferred style for an out-brief upon completion (ex. PowerPoint, executive summary).  Identify who else

Assessing Student Reasoning in Upper-Division Electricity and Magnetism at Oregon State University

ERIC Educational Resources Information Center

Zwolak, Justyna P.; Manogue, Corinne A.

2015-01-01

Standardized assessment tests that allow researchers to compare the performance of students under various curricula are highly desirable. There are several research-based conceptual tests that serve as instruments to assess and identify students' difficulties in lower-division courses. At the upper-division level assessing students' difficulties…

Report of the Education Technical Subcommittee on Food/Beverage Occupations.

ERIC Educational Resources Information Center

Oregon State Dept. of Education, Salem. Div. of Vocational Education.

Written by a technical committee of persons from industry, professional associations, and labor, as well as persons with special expertise, state officials, and educators in Oregon, this document lists the skills and knowledge required of employees in food and beverage occupations. It also identifies the industry standards (performance objectives)…

Who's in Charge Here? Sources of Leadership for Change in Eight Schools.

ERIC Educational Resources Information Center

Heller, Marjorie F.; Firestone, William A.

1995-01-01

Identifies a set of change leadership functions including sustaining a vision for change, encouraging staff, modifying standard operating procedures, and monitoring progress. Suggests that these functions do contribute to change, but are also performed redundantly by persons in a variety of overlapping roles, including central office personnel,…

Heating, Air-Conditioning, and Refrigeration Technician. National Skill Standards.

ERIC Educational Resources Information Center

Vocational Technical Education Consortium of States, Decatur, GA.

This guide contains information on the knowledge and skills identified by industry as essential to the job performance of heating, air-conditioning, and refrigeration technicians. It is intended to assist training providers in public and private institutions, as well as in industry, to develop and implement training that will provide workers with…

75 FR 52947 - Maximum Per Diem Rates for the Continental United States (CONUS)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

... where it is needed. In conjunction with the annual lodging study, GSA identified five new non-standard... Federal Travel Regulation allows for actual expense reimbursement as directed in Sec. 301-11.300 through... applies for travel performed on or after October 1, 2010 through September 30, 2011. FOR FURTHER...

Teaching English through Play in a Chinese Classroom

ERIC Educational Resources Information Center

Dai, Jinxin

2013-01-01

Many schools in China focus on memorization of facts for the purpose of performing on standardized tests, causing a lack of enthusiasm among teachers and students. This essay discusses some of the challenges surrounding education practices in China and identifies participatory environment, book-related pretend play, and the use of technology as…

Using an Early Skills Assessment to Assess Outcome of Early Intensive Behavioral Intervention for Children with Autism

ERIC Educational Resources Information Center

Parry-Cruwys, Diana

2013-01-01

Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing…

24 CFR 972.124 - Standards for identifying public housing developments subject to required conversion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... March 16, 2009, the specified vacancy rate is 15 percent. For a conversion analysis performed after that... housing developments subject to required conversion. 972.124 Section 972.124 Housing and Urban Development... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED...

76 FR 27030 - Intent To Prepare a Supplemental Environmental Impact Statement for the Indianapolis, White River...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... performance standards nor does it provide the level of protection for which the project was authorized. A full... consideration of all alternatives, the best plan will be selected to achieve acceptable risk levels. FOR FURTHER... identified alternatives, especially aesthetics, communities, economics, biological and cultural resources...

Basic Science Process Skills. An Inservice Workshop Kit: Outlines and Activities.

ERIC Educational Resources Information Center

Rowland, Paul; And Others

A science process skill project was developed to help elementary teachers meet competency standards in New Mexico for teaching the process approach in their science classes. An outline of the process skills along with recommended activities are presented in this document. Performance objectives are identified and a sample activity form is…

Unit Planning Grids for Music: Grade 9-12 Advanced.

ERIC Educational Resources Information Center

Delaware State Dept. of Education, Dover.

This unit planning grid outlines the expectations of Delaware high school students for advanced music studies. The grid identifies nine standards for music: (1) students will sing, independently and with others, a varied repertoire of music; (2) students will perform on instruments, independently and with others, a varied repertoire of music; (3)…

Unit Planning Grids for Music: Grade 9-12 Basic.

ERIC Educational Resources Information Center

Delaware State Dept. of Education, Dover.

This unit planning grid outlines the expectations of Delaware high school students for basic music studies. The grid identifies nine standards for music: (1) students will sing, independently and with others, a varied repertoire of music; (2) students will perform on instruments, independently and with others, a varied repertoire of music; (3)…

75 FR 76254 - Official Performance and Procedural Requirements for Grain Weighing Equipment and Related Grain...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... requirements of the 2008 edition of the National Institute of Standards and Technology (NIST) Handbook 44, ``Specifications, Tolerances, and Other Technical Requirements for Weighing and Measuring Devices,'' (NIST Handbook... identified as ``NIST Handbook 44 IBF Comments,'' making reference to the date and page number of this issue...

Characterization of Vertical Impact Device Acceleration Pulses Using Parametric Assessment: Phase II Accelerated Free-Fall

DTIC Science & Technology

2016-04-30

support contractor , Infoscitex, conducted a series of tests to identify the performance capabilities of the Vertical Impact Device (VID). The VID is a...C. Table 3. AFD Evaluation with Red IMPAC Programmer: Data Summary Showing Means and Standard Deviations Test Cell Drop Ht . (in) Mean Peak

40 CFR 125.87 - As an owner or operator of a new facility, must I perform monitoring?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS CRITERIA AND STANDARDS FOR THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM Requirements Applicable to Cooling Water Intake Structures for New Facilities Under Section... identified in either the Source Water Baseline Biological Characterization data required by 40 CFR 122.21(r...

Teaching Science Problem Solving: An Overview of Experimental Work.

ERIC Educational Resources Information Center

Taconis, R.; Ferguson-Hessler, M. G. M.; Broekkamp, H.

2001-01-01

Performs analysis on a number of articles published between 1985 and 1995 describing experimental research into the effectiveness of a wide variety of teaching strategies for science problem solving. Identifies 22 articles describing 40 experiments that met standards for meta-analysis. Indicates that few of the independent variables were found to…

78 FR 8551 - Federal Housing Administration (FHA) Risk Management Initiatives: Changes to Maximum Loan-to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... Administration (FHA) Risk Management Initiatives: Changes to Maximum Loan-to-Value Financing Solicitation of... performance of the portfolio, and adjust its standards to effectively manage financial risk. As a result, FHA has been continually evaluating its portfolio to identify and respond to risks in ways that benefit...

[Separation and identification of 5 glycosidic flavor precursors in tobacco by ultra performance liquid chromatography-electrospray ionization tandem mass spectrometry].

PubMed

Wu, Xinhua; Zhu, Ruizhi; Ren, Zhuoying; Wang, Kai; Mou, Dingrong; Wei, Wanzhi; Miao, Mingming

2009-11-01

A qualitative method for the identification of 5 main glycosidic flavor precursors in tobacco was developed by using ultra performance liquid chromatography-electrospray ionization tandem mass spectrometry (UPLC-ESI MS/MS) and gas chromatography-mass spectrometry (GC-MS). The glycosidic flavor precursors in tobacco were extracted with methanol, cleaned up with an XAD-2 column. The aglycones were later released by enzyme-mediated hydrolysis under the condition of pH 5. The 5 volatile aglycone moieties were identified by GC-MS standard spectra library. The precursor ions of glycosides were determined by using electrospray ionization mass spectrometry in negative ion mode, then the 5 glycosidic flavor precursors were identified by using product ion scan (MS2) finally, using UPLC-ESI MS/MS, separation and identification of 5 glycosidic flavor precursors were accomplished on an RP-C,8 column in the multiple reaction monitoring (MRM) mode by using methanol and acetic acid-ammonium acetate aqueous solution as eluent. This work lays a foundation for the analysis of glycosidic flavor precursors without the standards by using liquid chromatography-mass spectrometry.

Yarn supplier selection using analytical hierarchy process (AHP) and standardized unitless rating (SUR) method on textile industry

NASA Astrophysics Data System (ADS)

Erfaisalsyah, M. H.; Mansur, A.; Khasanah, A. U.

2017-11-01

For a company which engaged in the textile field, specify the supplier of raw materials for production is one important part of supply chain management which can affect the company's business processes. This study aims to identify the best suppliers of raw material suppliers of yarn for PC. PKBI based on several criteria. In this study, the integration between the Analytical Hierarchy Process (AHP) and the Standardized Unitless Rating (SUR) are used to assess the performance of the suppliers. By using AHP, it can be known the value of the relative weighting of each criterion. While SUR shows the sequence performance value of the supplier. The result of supplier ranking calculation can be used to know the strengths and weaknesses of each supplier based on its performance criteria. From the final result, it can be known which suppliers should improve their performance in order to create long term cooperation with the company.

Predictors of adolescent compliance with oral hygiene instructions during two-arch multibracket fixed orthodontic treatment.

PubMed

Al-Jewair, Thikriat S; Suri, Sunjay; Tompson, Bryan D

2011-05-01

To determine compliance with oral hygiene instructions (OHI) of adolescents receiving two-arch multibracket fixed appliances and identify its predictive factors. Forty-one patients in a longitudinal study were provided standardized OHI and assessed at baseline: before bonding (T0mo), approximately 30 days after bonding (T1mo), and approximately 150 days (T5mo) after bonding straight-wire appliances simultaneously in the maxillary and mandibular arches. Oral hygiene (OH) performance was measured using plaque and gingival indices. Compliance predictors were identified from questionnaires administered to patients and their parents and from patients' charts. OH performance worsened from T0mo to T1mo but then improved from T1mo to T5mo. At T5mo, 73% of the sample had good OH. Univariate analyses found perceived severity of malocclusion, school performance, and parental marital status to be significant predictors of good OH performance at T5mo. Multiple logistic regressions identified having married parents and good academic performance in school as significant predictors. In the sample studied, after initially worsening, compliance with OHI improved at 5 months after bonding. Adolescents with married parents and those reporting good academic performance in school were found more likely to have complied with OHI provided at baseline and to perform better OH.

Dealing with missing standard deviation and mean values in meta-analysis of continuous outcomes: a systematic review.

PubMed

Weir, Christopher J; Butcher, Isabella; Assi, Valentina; Lewis, Stephanie C; Murray, Gordon D; Langhorne, Peter; Brady, Marian C

2018-03-07

Rigorous, informative meta-analyses rely on availability of appropriate summary statistics or individual participant data. For continuous outcomes, especially those with naturally skewed distributions, summary information on the mean or variability often goes unreported. While full reporting of original trial data is the ideal, we sought to identify methods for handling unreported mean or variability summary statistics in meta-analysis. We undertook two systematic literature reviews to identify methodological approaches used to deal with missing mean or variability summary statistics. Five electronic databases were searched, in addition to the Cochrane Colloquium abstract books and the Cochrane Statistics Methods Group mailing list archive. We also conducted cited reference searching and emailed topic experts to identify recent methodological developments. Details recorded included the description of the method, the information required to implement the method, any underlying assumptions and whether the method could be readily applied in standard statistical software. We provided a summary description of the methods identified, illustrating selected methods in example meta-analysis scenarios. For missing standard deviations (SDs), following screening of 503 articles, fifteen methods were identified in addition to those reported in a previous review. These included Bayesian hierarchical modelling at the meta-analysis level; summary statistic level imputation based on observed SD values from other trials in the meta-analysis; a practical approximation based on the range; and algebraic estimation of the SD based on other summary statistics. Following screening of 1124 articles for methods estimating the mean, one approximate Bayesian computation approach and three papers based on alternative summary statistics were identified. Illustrative meta-analyses showed that when replacing a missing SD the approximation using the range minimised loss of precision and generally performed better than omitting trials. When estimating missing means, a formula using the median, lower quartile and upper quartile performed best in preserving the precision of the meta-analysis findings, although in some scenarios, omitting trials gave superior results. Methods based on summary statistics (minimum, maximum, lower quartile, upper quartile, median) reported in the literature facilitate more comprehensive inclusion of randomised controlled trials with missing mean or variability summary statistics within meta-analyses.

Polarization properties and microfacet-based modelling of white, grey and coloured matte diffuse reflection standards

NASA Astrophysics Data System (ADS)

Quast, T.; Schirmacher, A.; Hauer, K.-O.; Koo, A.

2018-02-01

To elucidate the influence of polarization in diffuse reflectometry, we performed a series of measurements in several bidirectional geometries and determined the Stokes parameters of the diffusely reflected radiation. Different types of matte reflection standards were used, including several common white standards and ceramic colour standards. The dependence of the polarization on the sample type, wavelength and geometry have been studied systematically, the main influence factors have been identified: The effect is largest at large angles of incidence or detection and at wavelengths where the magnitude of the reflectance is small. The results for the colour standards have been modelled using a microfacet-based reflection theory which is derived from the well-known model of Torrance and Sparrow. Although the theory is very simple and only has three free parameters, the agreement with the measured data is very good, all essential features of the data can be reproduced by the model.

Candidate gene prioritization by network analysis of differential expression using machine learning approaches

PubMed Central

2010-01-01

Background Discovering novel disease genes is still challenging for diseases for which no prior knowledge - such as known disease genes or disease-related pathways - is available. Performing genetic studies frequently results in large lists of candidate genes of which only few can be followed up for further investigation. We have recently developed a computational method for constitutional genetic disorders that identifies the most promising candidate genes by replacing prior knowledge by experimental data of differential gene expression between affected and healthy individuals. To improve the performance of our prioritization strategy, we have extended our previous work by applying different machine learning approaches that identify promising candidate genes by determining whether a gene is surrounded by highly differentially expressed genes in a functional association or protein-protein interaction network. Results We have proposed three strategies scoring disease candidate genes relying on network-based machine learning approaches, such as kernel ridge regression, heat kernel, and Arnoldi kernel approximation. For comparison purposes, a local measure based on the expression of the direct neighbors is also computed. We have benchmarked these strategies on 40 publicly available knockout experiments in mice, and performance was assessed against results obtained using a standard procedure in genetics that ranks candidate genes based solely on their differential expression levels (Simple Expression Ranking). Our results showed that our four strategies could outperform this standard procedure and that the best results were obtained using the Heat Kernel Diffusion Ranking leading to an average ranking position of 8 out of 100 genes, an AUC value of 92.3% and an error reduction of 52.8% relative to the standard procedure approach which ranked the knockout gene on average at position 17 with an AUC value of 83.7%. Conclusion In this study we could identify promising candidate genes using network based machine learning approaches even if no knowledge is available about the disease or phenotype. PMID:20840752

Methods development for total organic carbon accountability

NASA Technical Reports Server (NTRS)

Benson, Brian L.; Kilgore, Melvin V., Jr.

1991-01-01

This report describes the efforts completed during the contract period beginning November 1, 1990 and ending April 30, 1991. Samples of product hygiene and potable water from WRT 3A were supplied by NASA/MSFC prior to contract award on July 24, 1990. Humidity condensate samples were supplied on August 3, 1990. During the course of this contract chemical analyses were performed on these samples to qualitatively determine specific components comprising, the measured organic carbon concentration. In addition, these samples and known standard solutions were used to identify and develop methodology useful to future comprehensive characterization of similar samples. Standard analyses including pH, conductivity, and total organic carbon (TOC) were conducted. Colorimetric and enzyme linked assays for total protein, bile acid, B-hydroxybutyric acid, methylene blue active substances (MBAS), urea nitrogen, ammonia, and glucose were also performed. Gas chromatographic procedures for non-volatile fatty acids and EPA priority pollutants were also performed. Liquid chromatography was used to screen for non-volatile, water soluble compounds not amenable to GC techniques. Methods development efforts were initiated to separate and quantitate certain chemical classes not classically analyzed in water and wastewater samples. These included carbohydrates, organic acids, and amino acids. Finally, efforts were initiated to identify useful concentration techniques to enhance detection limits and recovery of non-volatile, water soluble compounds.

Sequence tagging reveals unexpected modifications in toxicoproteomics

PubMed Central

Dasari, Surendra; Chambers, Matthew C.; Codreanu, Simona G.; Liebler, Daniel C.; Collins, Ben C.; Pennington, Stephen R.; Gallagher, William M.; Tabb, David L.

2010-01-01

Toxicoproteomic samples are rich in posttranslational modifications (PTMs) of proteins. Identifying these modifications via standard database searching can incur significant performance penalties. Here we describe the latest developments in TagRecon, an algorithm that leverages inferred sequence tags to identify modified peptides in toxicoproteomic data sets. TagRecon identifies known modifications more effectively than the MyriMatch database search engine. TagRecon outperformed state of the art software in recognizing unanticipated modifications from LTQ, Orbitrap, and QTOF data sets. We developed user-friendly software for detecting persistent mass shifts from samples. We follow a three-step strategy for detecting unanticipated PTMs in samples. First, we identify the proteins present in the sample with a standard database search. Next, identified proteins are interrogated for unexpected PTMs with a sequence tag-based search. Finally, additional evidence is gathered for the detected mass shifts with a refinement search. Application of this technology on toxicoproteomic data sets revealed unintended cross-reactions between proteins and sample processing reagents. Twenty five proteins in rat liver showed signs of oxidative stress when exposed to potentially toxic drugs. These results demonstrate the value of mining toxicoproteomic data sets for modifications. PMID:21214251

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

PubMed

Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

2014-09-01

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition. Copyright © 2014 Academy of Nutrition and Dietetics and the National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Identifying High Potential Well Targets with 3D Seismic and Mineralogy

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

Mellors, R. J.

2015-10-30

Seismic reflection the primary tool used in petroleum exploration and production, but use in geothermal exploration is less standard, in part due to cost but also due to the challenges in identifying the highly-permeable zones essential for economic hydrothermal systems [e.g. Louie et al., 2011; Majer, 2003]. Newer technology, such as wireless sensors and low-cost high performance computing, has helped reduce the cost and effort needed to conduct 3D surveys. The second difficulty, identifying permeable zones, has been less tractable so far. Here we report on the use of seismic attributes from a 3D seismic survey to identify and mapmore » permeable zones in a hydrothermal area.« less

Neuropsychologic predictors of competency in Alzheimer's disease using a rational reasons legal standard.

PubMed

Marson, D C; Cody, H A; Ingram, K K; Harrell, L E

1995-10-01

To identify neuropsychologic predictors of competency performance and status in Alzheimer's disease (AD) using a specific legal standard (LS). This study is a follow-up to the competency assessment research reported in this issue of the archives. Univariate and multivariate analyses of independent neuropsychologic test measures with a dependent measure of competency to consent to treatment. University medical center. Fifteen normal older control subjects and 29 patients with probable AD. Subjects were administered a battery of neuropsychologic measures theoretically linked to competency function, as well as two clinical vignettes testing their capacity to consent to medical treatment under five different LSs. The present study focused on one specific LS: the capacity to provide "rational reasons" for a treatment choice (LS4). Neuropsychologic test scores were correlated with scores on LS4 for the normal control group and the AD group. The resulting univariate predictors were then analyzed using stepwise regression and discriminant function to identify the key multivariate predictors of competency performance and status under LS4. Measures of word fluency predicted the LS4 scores of controls (R2 = .33) and the AD group (R2 = .36). A word fluency measure also emerged as the best single predictor of competency status for the full subject sample (n = 44), correctly classifying 82% of cases. Dementia severity (Mini-Mental State Examination score) did not emerge as a multivariate predictor of competency performance or status. Interestingly, measures of verbal reasoning and memory were not strongly associated with LS4. Word fluency measures predicted the normative performance and intact competency status of older control subjects and the declining performance and compromised competency status of patients with AD on a "rational reasons" standard of competency to consent to treatment. Cognitive capacities related to frontal lobe function appear to underlie the capacity to formulate rational reasons for a treatment choice. Neuropsychologic studies of competency function have important theoretical and clinical value.

Performance Indicators in Spine Surgery.

PubMed

St-Pierre, Godefroy Hardy; Yang, Michael H; Bourget-Murray, Jonathan; Thomas, Ken C; Hurlbert, Robin John; Matthes, Nikolas

2018-02-15

Systematic review. To elucidate how performance indicators are currently used in spine surgery. The Patient Protection and Affordable Care Act has given significant traction to the idea that healthcare must provide value to the patient through the introduction of hospital value-based purchasing. The key to implementing this new paradigm is to measure this value notably through performance indicators. MEDLINE, CINAHL Plus, EMBASE, and Google Scholar were searched for studies reporting the use of performance indicators specific to spine surgery. We followed the Prisma-P methodology for a systematic review for entries from January 1980 to July 2016. All full text articles were then reviewed to identify any measure of performance published within the article. This measure was then examined as per the three criteria of established standard, exclusion/risk adjustment, and benchmarking to determine if it constituted a performance indicator. The initial search yielded 85 results among which two relevant studies were identified. The extended search gave a total of 865 citations across databases among which 15 new articles were identified. The grey literature search provided five additional reports which in turn led to six additional articles. A total of 27 full text articles and reports were retrieved and reviewed. We were unable to identify performance indicators. The articles presenting a measure of performance were organized based on how many criteria they lacked. We further examined the next steps to be taken to craft the first performance indicator in spine surgery. The science of performance measurement applied to spine surgery is still in its infancy. Current outcome metrics used in clinical settings require refinement to become performance indicators. Current registry work is providing the necessary foundation, but requires benchmarking to truly measure performance. 1.

LH750 hematology analyzers to identify malaria and dengue and distinguish them from other febrile illnesses.

PubMed

Sharma, P; Bhargava, M; Sukhachev, D; Datta, S; Wattal, C

2014-02-01

Tropical febrile illnesses such as malaria and dengue are challenging to differentiate clinically. Automated cellular indices from hematology analyzers may afford a preliminary rapid distinction. Blood count and VCS parameters from 114 malaria patients, 105 dengue patients, and 105 febrile controls without dengue or malaria were analyzed. Statistical discriminant functions were generated, and their diagnostic performances were assessed by ROC curve analysis. Three statistical functions were generated: (i) malaria-vs.-controls factor incorporating platelet count and standard deviations of lymphocyte volume and conductivity that identified malaria with 90.4% sensitivity, 88.6% specificity; (ii) dengue-vs.-controls factor incorporating platelet count, lymphocyte percentage and standard deviation of lymphocyte conductivity that identified dengue with 81.0% sensitivity and 77.1% specificity; and (iii) febrile-controls-vs.-malaria/dengue factor incorporating mean corpuscular hemoglobin concentration, neutrophil percentage, mean lymphocyte and monocyte volumes, and standard deviation of monocyte volume that distinguished malaria and dengue from other febrile illnesses with 85.1% sensitivity and 91.4% specificity. Leukocyte abnormalities quantitated by automated analyzers successfully identified malaria and dengue and distinguished them from other fevers. These economic discriminant functions can be rapidly calculated by analyzer software programs to generate electronic flags to trigger-specific testing. They could potentially transform diagnostic approaches to tropical febrile illnesses in cost-constrained settings. © 2013 John Wiley & Sons Ltd.

Systematic review: work-related stress and the HSE management standards.

PubMed

Brookes, K; Limbert, C; Deacy, C; O'Reilly, A; Scott, S; Thirlaway, K

2013-10-01

The Health and Safety Executive (HSE) has defined six management standards representing aspects of work that, if poorly managed, are associated with lower levels of employee health and productivity, and increased sickness absence. The HSE indicator tool aims to measure organizations' performance in managing the primary stressors identified by the HSE management standards. The aims of the study are to explore how the HSE indicator tool has been implemented within organizations and to identify contexts in which the tool has been used, its psychometric properties and relationships with alternative measures of well-being and stress. Studies that matched specific criteria were included in the review. Abstracts were considered by two researchers to ensure a reliable process. Full texts were obtained when abstracts met the inclusion criteria. Thirteen papers were included in the review. Using factor analysis and measures of reliability, the studies suggest that the HSE indicator tool is a psychometrically sound measure. The tool has been used to measure work-related stress across different occupational groups, with a clear relationship between the HSE tool and alternative measures of well-being. Limitations of the tool and recommendations for future research are discussed. The HSE indicator tool is a psychometrically sound measure of organizational performance against the HSE management standards. As such it can provide a broad overview of sources of work-related stress within organizations. More research is required to explore the use of the tool in the design of interventions to reduce stress, and its use in different contexts and with different cultural and gender groups.

An energy-efficient transmission scheme for real-time data in wireless sensor networks.

PubMed

Kim, Jin-Woo; Barrado, José Ramón Ramos; Jeon, Dong-Keun

2015-05-20

The Internet of things (IoT) is a novel paradigm where all things or objects in daily life can communicate with other devices and provide services over the Internet. Things or objects need identifying, sensing, networking and processing capabilities to make the IoT paradigm a reality. The IEEE 802.15.4 standard is one of the main communication protocols proposed for the IoT. The IEEE 802.15.4 standard provides the guaranteed time slot (GTS) mechanism that supports the quality of service (QoS) for the real-time data transmission. In spite of some QoS features in IEEE 802.15.4 standard, the problem of end-to-end delay still remains. In order to solve this problem, we propose a cooperative medium access scheme (MAC) protocol for real-time data transmission. We also evaluate the performance of the proposed scheme through simulation. The simulation results demonstrate that the proposed scheme can improve the network performance.

ASME B89.4.19 Performance Evaluation Tests and Geometric Misalignments in Laser Trackers

PubMed Central

Muralikrishnan, B.; Sawyer, D.; Blackburn, C.; Phillips, S.; Borchardt, B.; Estler, W. T.

2009-01-01

Small and unintended offsets, tilts, and eccentricity of the mechanical and optical components in laser trackers introduce systematic errors in the measured spherical coordinates (angles and range readings) and possibly in the calculated lengths of reference artifacts. It is desirable that the tests described in the ASME B89.4.19 Standard [1] be sensitive to these geometric misalignments so that any resulting systematic errors are identified during performance evaluation. In this paper, we present some analysis, using error models and numerical simulation, of the sensitivity of the length measurement system tests and two-face system tests in the B89.4.19 Standard to misalignments in laser trackers. We highlight key attributes of the testing strategy adopted in the Standard and propose new length measurement system tests that demonstrate improved sensitivity to some misalignments. Experimental results with a tracker that is not properly error corrected for the effects of the misalignments validate claims regarding the proposed new length tests. PMID:27504211

An Energy-Efficient Transmission Scheme for Real-Time Data in Wireless Sensor Networks

PubMed Central

Kim, Jin-Woo; Barrado, José Ramón Ramos; Jeon, Dong-Keun

2015-01-01

The Internet of things (IoT) is a novel paradigm where all things or objects in daily life can communicate with other devices and provide services over the Internet. Things or objects need identifying, sensing, networking and processing capabilities to make the IoT paradigm a reality. The IEEE 802.15.4 standard is one of the main communication protocols proposed for the IoT. The IEEE 802.15.4 standard provides the guaranteed time slot (GTS) mechanism that supports the quality of service (QoS) for the real-time data transmission. In spite of some QoS features in IEEE 802.15.4 standard, the problem of end-to-end delay still remains. In order to solve this problem, we propose a cooperative medium access scheme (MAC) protocol for real-time data transmission. We also evaluate the performance of the proposed scheme through simulation. The simulation results demonstrate that the proposed scheme can improve the network performance. PMID:26007722

Anxiety after completion of treatment for early-stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development.

PubMed

Harris, Jenny; Cornelius, Victoria; Ream, Emma; Cheevers, Katy; Armes, Jo

2017-07-01

The purpose of this review was to identify potential candidate predictors of anxiety in women with early-stage breast cancer (BC) after adjuvant treatments and evaluate methodological development of existing multivariable models to inform the future development of a predictive risk stratification model (PRSM). Databases (MEDLINE, Web of Science, CINAHL, CENTRAL and PsycINFO) were searched from inception to November 2015. Eligible studies were prospective, recruited women with stage 0-3 BC, used a validated anxiety outcome ≥3 months post-treatment completion and used multivariable prediction models. Internationally accepted quality standards were used to assess predictive risk of bias and strength of evidence. Seven studies were identified: five were observational cohorts and two secondary analyses of RCTs. Variability of measurement and selective reporting precluded meta-analysis. Twenty-one candidate predictors were identified in total. Younger age and previous mental health problems were identified as risk factors in ≥3 studies. Clinical variables (e.g. treatment, tumour grade) were not identified as predictors in any studies. No studies adhered to all quality standards. Pre-existing vulnerability to mental health problems and younger age increased the risk of anxiety after completion of treatment for BC survivors, but there was no evidence that chemotherapy was a predictor. Multiple predictors were identified but many lacked reproducibility or were not measured across studies, and inadequate reporting did not allow full evaluation of the multivariable models. The use of quality standards in the development of PRSM within supportive cancer care would improve model quality and performance, thereby allowing professionals to better target support for patients.

Methods of analysis by the U.S. Geological Survey National Water Quality Laboratory : determination of polycyclic aromatic hydrocarbon compounds in sediment by gas chromatography/mass spectrometry

USGS Publications Warehouse

Olson, Mary C.; Iverson, Jana L.; Furlong, Edward T.; Schroeder, Michael P.

2004-01-01

A method for the determination of 28 polycyclic aromatic hydrocarbons (PAHs) and 25 alkylated PAH homolog groups in sediment samples is described. The compounds are extracted from sediment by solvent extraction, followed by partial isolation using high-performance gel permeation chromatography. The compounds are identified and uantitated using capillary-column gas chromatography/mass spectrometry. The report presents performance data for full-scan ion monitoring. Method detection limits in laboratory reagent matrix samples range from 1.3 to 5.1 micrograms per kilogram for the 28 PAHs. The 25 groups of alkylated PAHs are homologs of five groups of isomeric parent PAHs. Because of the lack of authentic standards, these homologs are reported semiquantitatively using a response factor from a parent PAH or a specific alkylated PAH. Precision data for the alkylated PAH homologs are presented using two different standard reference manuals produced by the National Institute of Standards and Technology: SRM 1941b and SRM 1944. The percent relative standard deviations for identified alkylated PAH homolog groups ranged from 1.55 to 6.98 for SRM 1941b and from 6.11 to 12.0 for SRM 1944. Homolog group concentrations reported under this method include the concentrations of individually identified compounds that are members of the group. Organochlorine (OC) pesticides--including toxaphene, polychlorinated biphenyls (PCBs), and organophosphate (OP) pesticides--can be isolated simultaneously using this method. In brief, sediment samples are centrifuged to remove excess water and extracted overnight with dichloromethan (95 percent) and methanol (5 percent). The extract is concentrated and then filtered through a 0.2-micrometer polytetrafluoroethylene syringe filter. The PAH fraction is isolated by quantitatively injecting an aliquot of sample onto two polystyrene-divinylbenzene gel-permeation chromatographic columns connected in series. The compounds are eluted with dichloromethane, a PAH fraction is collected, and a portion of the coextracted interferences, including elemental sulfur, is separated and discarded. The extract is solvent exchanged, the volume is reduced, and internal standard is added. Sample analysis is completed using a gas chromatograph/mass spectrometer and full-scan acquisition.

Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania.

PubMed

Mgaya, Andrew H; Litorp, Helena; Kidanto, Hussein L; Nyström, Lennarth; Essén, Birgitta

2016-11-08

In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for standard diagnosis and management of foetal distress were developed based on international and national guidelines, and literature reviews, and then, stepwise applied, in an audit cycle. During the baseline audit, substandard care was identified, and recommendations for improvement of care were proposed and implemented. The effect of the implementations was assessed by the differences in percentage of standard diagnosis and management between the baseline and re-audit, using Chi-square test or Fisher's exact test, when appropriate. In the baseline audit and re-audit, 248 and 251 deliveries with a diagnosis of foetal distress were identified and audited, respectively. The standard of diagnosis increased significantly from 52 to 68 % (p < 0.001). Standards of management improved tenfold from 0.8 to 8.8 % (p < 0.001). Improved foetal heartbeat monitoring using a Fetal Doppler was the major improvement in diagnoses, while change of position of the mother and reduced time interval from decision to perform caesarean section to delivery were the major improvements in management (all p < 0.001). Percentage of cases with substandard diagnosis and management was significantly reduced in both referred public and non-referred private patients (all p ≤ 0.01) but not in non-referred public and referred private patients. The criteria-based audit was able to detect substandard diagnosis and management of foetal distress and improved care using feedback and available resources.

Specifying and Pilot Testing Quality Measures for the American Society of Addiction Medicine's Standards of Care.

PubMed

Harris, Alex H S; Weisner, Constance M; Chalk, Mady; Capoccia, Victor; Chen, Cheng; Thomas, Cindy Parks

2016-01-01

In 2013, the American Society of Addiction Medicine (ASAM) approved its Standards of Care for the Addiction Specialist Physician. Subsequently, an ASAM Performance Measures Panel identified and prioritized the standards to be operationalized into performance measures. The goal of this study is to describe the process of operationalizing 3 of these standards into quality measures, and to present the initial measure specifications and results of pilot testing these measures in a large health care system. By presenting the process rather than just the end results, we hope to shed light on the measure development process to educate, and also to stimulate debate about the decisions that were made. Each measure was decomposed into major concepts. Then each concept was operationalized using commonly available administrative data sources. Alternative specifications examined and sensitivity analyses were conducted to inform decisions that balanced accuracy, clinical nuance, and simplicity. Using data from the US Veterans Health Administration (VHA), overall performance and variation in performance across 119 VHA facilities were calculated. Three measures were operationalized and pilot tested: pharmacotherapy for alcohol use disorder, pharmacotherapy for opioid use disorder, and timely follow-up after medically managed withdrawal (aka detoxification). Each measure was calculable with available data, and showed ample room for improvement (no ceiling effects) and wide facility-level variability. Next steps include conducting feasibility and pilot testing in other health care systems and other contexts such as standalone addiction treatment programs, and also to study the specification and predictive validity of these measures.

Exploring the utility of narrative analysis in diagnostic decision making: picture-bound reference, elaboration, and fetal alcohol spectrum disorders.

PubMed

Thorne, John C; Coggins, Truman E; Carmichael Olson, Heather; Astley, Susan J

2007-04-01

To evaluate classification accuracy and clinical feasibility of a narrative analysis tool for identifying children with a fetal alcohol spectrum disorder (FASD). Picture-elicited narratives generated by 16 age-matched pairs of school-aged children (FASD vs. typical development [TD]) were coded for semantic elaboration and reference strategy by judges who were unaware of age, gender, and group membership of the participants. Receiver operating characteristic (ROC) curves were used to examine the classification accuracy of the resulting set of narrative measures for making 2 classifications: (a) for the 16 children diagnosed with FASD, low performance (n = 7) versus average performance (n = 9) on a standardized expressive language task and (b) FASD (n = 16) versus TD (n = 16). Combining the rates of semantic elaboration and pragmatically inappropriate reference perfectly matched a classification based on performance on the standardized language task. More importantly, the rate of ambiguous nominal reference was highly accurate in classifying children with an FASD regardless of their performance on the standardized language task (area under the ROC curve = .863, confidence interval = .736-.991). Results support further study of the diagnostic utility of narrative analysis using discourse level measures of elaboration and children's strategic use of reference.

Investigation of the agricultural resources in Sri Lanka

NASA Technical Reports Server (NTRS)

Silva, A. T. M.; Nanayakkara, S. D. F. C.; Herath, L. S. K. B. (Principal Investigator)

1976-01-01

The author has identified the following significant results. It is observed that LANDSAT data is easily adaptable to photogrammetric techniques. With such adaptations, revision of topographic or thematic maps can be performed at very little cost. Revision of maps up to scale 1:100,000 (or better) can be performed. The LANDSAT image has definite advantages over the standard methods in areas of extensive development where the synoptic view of the LANDSAT image offers the required control in the form of distant mapped data in one frame.

Behavioral Health and Performance (BHP) Work-Rest Cycles

NASA Technical Reports Server (NTRS)

Leveton, Lauren B.; Whitmire, Alexandra

2011-01-01

BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

Technology and Technique Standards for Camera-Acquired Digital Dermatologic Images: A Systematic Review.

PubMed

Quigley, Elizabeth A; Tokay, Barbara A; Jewell, Sarah T; Marchetti, Michael A; Halpern, Allan C

2015-08-01

Photographs are invaluable dermatologic diagnostic, management, research, teaching, and documentation tools. Digital Imaging and Communications in Medicine (DICOM) standards exist for many types of digital medical images, but there are no DICOM standards for camera-acquired dermatologic images to date. To identify and describe existing or proposed technology and technique standards for camera-acquired dermatologic images in the scientific literature. Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed in January 2013 using photography and digital imaging, standardization, and medical specialty and medical illustration search terms and augmented by a gray literature search of 14 websites using Google. Two reviewers independently screened titles of 7371 unique publications, followed by 3 sequential full-text reviews, leading to the selection of 49 publications with the most recent (1985-2013) or detailed description of technology or technique standards related to the acquisition or use of images of skin disease (or related conditions). No universally accepted existing technology or technique standards for camera-based digital images in dermatology were identified. Recommendations are summarized for technology imaging standards, including spatial resolution, color resolution, reproduction (magnification) ratios, postacquisition image processing, color calibration, compression, output, archiving and storage, and security during storage and transmission. Recommendations are also summarized for technique imaging standards, including environmental conditions (lighting, background, and camera position), patient pose and standard view sets, and patient consent, privacy, and confidentiality. Proposed standards for specific-use cases in total body photography, teledermatology, and dermoscopy are described. The literature is replete with descriptions of obtaining photographs of skin disease, but universal imaging standards have not been developed, validated, and adopted to date. Dermatologic imaging is evolving without defined standards for camera-acquired images, leading to variable image quality and limited exchangeability. The development and adoption of universal technology and technique standards may first emerge in scenarios when image use is most associated with a defined clinical benefit.

Novel search algorithms for a mid-infrared spectral library of cotton contaminants.

PubMed

Loudermilk, J Brian; Himmelsbach, David S; Barton, Franklin E; de Haseth, James A

2008-06-01

During harvest, a variety of plant based contaminants are collected along with cotton lint. The USDA previously created a mid-infrared, attenuated total reflection (ATR), Fourier transform infrared (FT-IR) spectral library of cotton contaminants for contaminant identification as the contaminants have negative impacts on yarn quality. This library has shown impressive identification rates for extremely similar cellulose based contaminants in cases where the library was representative of the samples searched. When spectra of contaminant samples from crops grown in different geographic locations, seasons, and conditions and measured with a different spectrometer and accessories were searched, identification rates for standard search algorithms decreased significantly. Six standard algorithms were examined: dot product, correlation, sum of absolute values of differences, sum of the square root of the absolute values of differences, sum of absolute values of differences of derivatives, and sum of squared differences of derivatives. Four categories of contaminants derived from cotton plants were considered: leaf, stem, seed coat, and hull. Experiments revealed that the performance of the standard search algorithms depended upon the category of sample being searched and that different algorithms provided complementary information about sample identity. These results indicated that choosing a single standard algorithm to search the library was not possible. Three voting scheme algorithms based on result frequency, result rank, category frequency, or a combination of these factors for the results returned by the standard algorithms were developed and tested for their capability to overcome the unpredictability of the standard algorithms' performances. The group voting scheme search was based on the number of spectra from each category of samples represented in the library returned in the top ten results of the standard algorithms. This group algorithm was able to identify correctly as many test spectra as the best standard algorithm without relying on human choice to select a standard algorithm to perform the searches.

Colour segmentation of multi variants tuberculosis sputum images using self organizing map

NASA Astrophysics Data System (ADS)

Rulaningtyas, Riries; Suksmono, Andriyan B.; Mengko, Tati L. R.; Saptawati, Putri

2017-05-01

Lung tuberculosis detection is still identified from Ziehl-Neelsen sputum smear images in low and middle countries. The clinicians decide the grade of this disease by counting manually the amount of tuberculosis bacilli. It is very tedious for clinicians with a lot number of patient and without standardization for sputum staining. The tuberculosis sputum images have multi variant characterizations in colour, because of no standardization in staining. The sputum has more variants colour and they are difficult to be identified. For helping the clinicians, this research examined the Self Organizing Map method for colouring image segmentation in sputum images based on colour clustering. This method has better performance than k-means clustering which also tried in this research. The Self Organizing Map could segment the sputum images with y good result and cluster the colours adaptively.

Assessment of the Draft AIAA S-119 Flight Dynamic Model Exchange Standard

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Murri, Daniel G.; Hill, Melissa A.; Jessick, Matthew V.; Penn, John M.; Hasan, David A.; Crues, Edwin Z.; Falck, Robert D.; McCarthy, Thomas G.; Vuong, Nghia;

Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years.

PubMed

Rikli, Roberta E; Jones, C Jessie

2013-04-01

To develop and validate criterion-referenced fitness standards for older adults that predict the level of capacity needed for maintaining physical independence into later life. The proposed standards were developed for use with a previously validated test battery for older adults-the Senior Fitness Test (Rikli, R. E., & Jones, C. J. (2001). Development and validation of a functional fitness test for community--residing older adults. Journal of Aging and Physical Activity, 6, 127-159; Rikli, R. E., & Jones, C. J. (1999a). Senior fitness test manual. Champaign, IL: Human Kinetics.). A criterion measure to assess physical independence was identified. Next, scores from a subset of 2,140 "moderate-functioning" older adults from a larger cross-sectional database, together with findings from longitudinal research on physical capacity and aging, were used as the basis for proposing fitness standards (performance cut points) associated with having the ability to function independently. Validity and reliability analyses were conducted to test the standards for their accuracy and consistency as predictors of physical independence. Performance standards are presented for men and women ages 60-94 indicating the level of fitness associated with remaining physically independent until late in life. Reliability and validity indicators for the standards ranged between .79 and .97. The proposed standards provide easy-to-use, previously unavailable methods for evaluating physical capacity in older adults relative to that associated with physical independence. Most importantly, the standards can be used in planning interventions that target specific areas of weakness, thus reducing risk for premature loss of mobility and independence.

Automatic Identification of Critical Follow-Up Recommendation Sentences in Radiology Reports

PubMed Central

Yetisgen-Yildiz, Meliha; Gunn, Martin L.; Xia, Fei; Payne, Thomas H.

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports. PMID:22195225

Automatic identification of critical follow-up recommendation sentences in radiology reports.

PubMed

Yetisgen-Yildiz, Meliha; Gunn, Martin L; Xia, Fei; Payne, Thomas H

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports.

Continuing assessment of the 5 day sodium carbonate-ammonium nitrate extraction assay as an indicator test for silicon fertilizers

USDA-ARS?s Scientific Manuscript database

The five day sodium carbonate-ammonium nitrate extraction assay has been proposed by the AAFPCO as a standard test to identify fertilizers that provide plant-available Si. A single-lab validation test was previously performed; however, the analysis lacked any correlation to a grow-out study. To do...

78 FR 70324 - Thy Hydrostatic Testing Provision of the Portable Fire Extinguishers Standard; Extension of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

..., as well as how they use it. Test Records (Sec. 1910.157(f)(16)) Paragraph (f)(16) requires employers... performed the test, and the serial number (or other identifier) of the fire extinguisher that was tested. Disclosure of Test Certification Records The certification record must be available to the Assistant...

An Exploratory Study Investigating How Adults with Intellectual Disabilities Perform on the Visual Association Test (VAT)

ERIC Educational Resources Information Center

McPaul, Ann; Walker, Brigid; Law, Jim; McKenzie, Karen

2017-01-01

Background: Neuropsychological tests of memory are believed to offer the greatest sensitivity at identifying people at the risk of developing dementia. There is a paucity of standardized and appropriate neuropsychological assessments of memory for adults with an intellectual disability. This study examines how adults with an intellectual…

A Causal-Comparative Analysis of the Effects of a Student Support Team (SST) Intervention Model at a Secondary School

ERIC Educational Resources Information Center

Johnson, Mid D.

2010-01-01

The purpose of this research was to identify and examine the effectiveness of a "Student Support Team" (SST) intervention model designed to increase the performance of struggling secondary students and to help them achieve prescribed state standards on the mathematics "Texas Assessment of Knowledge and Skills (TAKS)"…

The Validity of the Academic Rigor Index (ARI) for Predicting FYGPA. Research Report 2012-5

ERIC Educational Resources Information Center

Mattern, Krista D.; Wyatt, Jeffrey N.

2012-01-01

A recurrent trend in higher education research has been to identify additional predictors of college success beyond the traditional measures of high school grade point average (HSGPA) and standardized test scores, given that a large percentage of unaccounted variance in college performance remains. A recent study by Wyatt, Wiley, Camara, and…

24 CFR 1000.162 - How will a recipient know that non-dwelling structures assisted under the IHBG program meet the...

Code of Federal Regulations, 2010 CFR

2010-04-01

..., design, features, amenities, performance or other factors. The standards for such structures must be able to support the reasonableness and necessity for these factors and to clearly identify the affordable... change; (vi) Cultural relevance of design; (vii) Size and scope supported by population and need; (viii...

States Raise Proficiency Standards in Math and Reading

ERIC Educational Resources Information Center

Peterson, Paul E.; Ackerman, Matthew

2015-01-01

Since No Child Left Behind (NCLB) was enacted into federal law in 2002, states have been required to test students in grades 3 through 8 and again in high school to assess math and reading achievement. The federal law also asks states to establish the performance level students must reach on the exams in order to be identified as…

Robust Evaluation Matrix: Towards a More Principled Offline Exploration of Instructional Policies

ERIC Educational Resources Information Center

Doroudi, Shayan; Aleven, Vincent; Brunskill, Emma

2017-01-01

The gold standard for identifying more effective pedagogical approaches is to perform an experiment. Unfortunately, frequently a hypothesized alternate way of teaching does not yield an improved effect. Given the expense and logistics of each experiment, and the enormous space of potential ways to improve teaching, it would be highly preferable if…

Consequence Management - Ready or Not?

DTIC Science & Technology

2003-04-07

Defense will have sufficient capability and be ready to respond to a Weapons of Mass Destruction/ Effects attack. An effective consequence management...Defense adopts the National Military Strategy and its consequence management approach, it must identify Weapons of Mass Destruction/ Effects threats...that the Department of Defense: develop Weapons of Mass Destruction/ Effects performance standards for response assets; implement a consequence

National Technology Standards for K-12 Schools: A Case Study of Unresolved Issues in Public Relations

ERIC Educational Resources Information Center

Mullen, Carol A.; Kealy, William A.; Sullivan, Ashley

2004-01-01

This article addresses an important need--the dissemination of information relating to technology as a public relations tool--and the associated exigency for administrator and teacher technology training. Specifically, we identify the increased expectations for the performance of school leaders and teachers, as well as unresolved issues in public…

Development and evaluation of an off-the-slide genotyping technique for identifying Giardia cysts and Cryptosporidium oocysts directly from US EPA Method 1623 slides

EPA Science Inventory

ABSTRACT Aims This study developed and systematically evaluated performance and limit of detection of an off-the-slide genotyping procedure for both Cryptosporidium oocysts and Giardia cysts. Methods and Results Slide standards containing flow sorted (oo)cysts were used to e...

77 FR 7960 - Unified Agenda of Federal Regulatory and Deregulatory Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... Identifier No. 373 Secure Handling of 1601-AA52 Ammonium Nitrate Program (Reg Plan Seq No. 53). 374 Homeland...) Proposed Rule Stage 373. Secure Handling of Ammonium Nitrate Program Regulatory Plan: This entry is Seq. No... performance standards to 33 CFR part 151, subparts C and D, for discharges of ballast water. It supports the...

Moral distress and burnout syndrome: are there relationships between these phenomena in nursing workers?

PubMed

Dalmolin, Graziele de Lima; Lunardi, Valéria Lerch; Lunardi, Guilherme Lerch; Barlem, Edison Luiz Devos; Silveira, Rosemary Silva da

2014-01-01

to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers?1

PubMed Central

Dalmolin, Graziele de Lima; Lunardi, Valéria Lerch; Lunardi, Guilherme Lerch; Barlem, Edison Luiz Devos; da Silveira, Rosemary Silva

2014-01-01

Objective to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. Methods this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. Results the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. Conclusion the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied. PMID:24553701

An experimental study of graph connectivity for unsupervised word sense disambiguation.

PubMed

Navigli, Roberto; Lapata, Mirella

2010-04-01

Word sense disambiguation (WSD), the task of identifying the intended meanings (senses) of words in context, has been a long-standing research objective for natural language processing. In this paper, we are concerned with graph-based algorithms for large-scale WSD. Under this framework, finding the right sense for a given word amounts to identifying the most "important" node among the set of graph nodes representing its senses. We introduce a graph-based WSD algorithm which has few parameters and does not require sense-annotated data for training. Using this algorithm, we investigate several measures of graph connectivity with the aim of identifying those best suited for WSD. We also examine how the chosen lexicon and its connectivity influences WSD performance. We report results on standard data sets and show that our graph-based approach performs comparably to the state of the art.

Academy of Nutrition and Dietetics: Standards of professional performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems.

PubMed

Tagtow, Angie; Robien, Kim; Bergquist, Erin; Bruening, Meg; Dierks, Lisa; Hartman, Barbara E; Robinson-O'Brien, Ramona; Steinitz, Tamara; Tahsin, Bettina; Underwood, Teri; Wilkins, Jennifer

2014-03-01

Sustainability is the ability of a system to be maintained over the long term. Resilience is the ability of a system to withstand disturbances and continue to function in a sustainable manner. Issues of sustainability and resilience apply to all aspects of nutrition and dietetics practice, can be practiced at both the program and systems level, and are broader than any one specific practice setting or individual intervention. Given an increasing need to apply principles of sustainability and resilience to nutrition and dietetics practice, as well as growing interest among the public and by Registered Dietitian Nutritionists of health issues related to food and water systems, the Hunger and Environmental Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Standards of Professional Performance as a tool for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems to assess their current skill levels and to identify areas for further professional development in this emerging practice area. This Standards of Professional Performance document covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how sustainable, resilient, and healthy food and water systems principles can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sustainable, resilient, and healthy food and water systems. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Nucleic acid tests for the detection of alpha human papillomaviruses.

PubMed

Poljak, Mario; Cuzick, Jack; Kocjan, Boštjan J; Iftner, Thomas; Dillner, Joakim; Arbyn, Marc

2012-11-20

Testing for high-risk types of alpha human papillomaviruses (HPV) is an invaluable part of clinical guidelines for cervical carcinoma screening, management and treatment. In this comprehensive inventory of commercial tests for detection of alpha-HPV, we identified at least 125 distinct HPV tests and at least 84 variants of the original tests. However, only a small subset of HPV tests has documented clinical performance for any of the standard HPV testing indications. For more than 75% of HPV tests currently on the market, no single publication in peer-reviewed literature can be identified. HPV tests that have not been validated and lack proof of reliability, reproducibility and accuracy should not be used in clinical management. Once incorporated in the lab, it is essential that the whole procedure of HPV testing is subject to continuous and rigorous quality assurance to avoid sub-optimal, potentially harmful practices. Manufacturers of HPV tests are urged to put more effort into evaluating their current and future products analytically, using international standards, and for clinical applications, using clinically validated endpoints. To assist with analytical validation, the World Health Organization is developing international standards for HPV types other than HPV16 and HPV18 and is planning development of external quality control panels specifically designed to be used for performance evaluation of current and future HPV tests. There is a need for more competitively priced HPV tests, especially for resource-poor countries, and uniform test validation criteria based on international standards should enable issuing more competitive and fair tender notices for purchasing. Automation systems allowing large-scale testing, as well as further increases in clinical performance, are the main needs in the further improvement of HPV tests. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2012 Elsevier Ltd. All rights reserved.

Enhanced Recovery Pathway in Microvascular Autologous Tissue-Based Breast Reconstruction: Should It Become the Standard of Care?

PubMed

Kaoutzanis, Christodoulos; Ganesh Kumar, Nishant; O'Neill, Dillon; Wormer, Blair; Winocour, Julian; Layliev, John; McEvoy, Matthew; King, Adam; Braun, Stephane A; Higdon, K Kye

2018-04-01

Enhanced recovery pathway programs have demonstrated improved perioperative care and shorter length of hospital stay in several surgical disciplines. The purpose of this study was to compare outcomes of patients undergoing autologous tissue-based breast reconstruction before and after the implementation of an enhanced recovery pathway program. The authors retrospectively reviewed consecutive patients who underwent autologous tissue-based breast reconstruction performed by two surgeons before and after the implementation of the enhanced recovery pathway at a university center over a 3-year period. Patient demographics, perioperative data, and 45-day postoperative outcomes were compared between the traditional standard of care (pre-enhanced recovery pathway) and enhanced recovery pathway patients. Multivariate logistic regression was performed to identify risk factors for length of hospital stay. Cost analysis was performed. Between April of 2014 and January of 2017, 100 consecutive women were identified, with 50 women in each group. Both groups had similar demographics, comorbidities, and reconstruction types. Postoperatively, the enhanced recovery pathway cohort used significantly less opiate and more acetaminophen compared with the traditional standard of care cohort. Median length of stay was shorter in the enhanced recovery pathway cohort, which resulted in an extrapolated $279,258 savings from freeing up inpatient beds and increase in overall contribution margins of $189,342. Participation in an enhanced recovery pathway program and lower total morphine-equivalent use were independent predictors for decreased length of hospital stay. Overall 45-day major complication rates, partial flap loss rates, emergency room visits, hospital readmissions, and unplanned reoperations were similar between the two groups. Enhanced recovery pathway program implementation should be considered as the standard approach for perioperative care in autologous tissue-based breast reconstruction because it does not affect morbidity and is associated with accelerated recovery with reduced postoperative opiate use and decreased length of hospital stay, leading to downstream health care cost savings. Therapeutic, III.

Surgical Space Suits Increase Particle and Microbiological Emission Rates in a Simulated Surgical Environment.

PubMed

Vijaysegaran, Praveen; Knibbs, Luke D; Morawska, Lidia; Crawford, Ross W

2018-05-01

The role of space suits in the prevention of orthopedic prosthetic joint infection remains unclear. Recent evidence suggests that space suits may in fact contribute to increased infection rates, with bioaerosol emissions from space suits identified as a potential cause. This study aimed to compare the particle and microbiological emission rates (PER and MER) of space suits and standard surgical clothing. A comparison of emission rates between space suits and standard surgical clothing was performed in a simulated surgical environment during 5 separate experiments. Particle counts were analyzed with 2 separate particle counters capable of detecting particles between 0.1 and 20 μm. An Andersen impactor was used to sample bacteria, with culture counts performed at 24 and 48 hours. Four experiments consistently showed statistically significant increases in both PER and MER when space suits are used compared with standard surgical clothing. One experiment showed inconsistent results, with a trend toward increases in both PER and MER when space suits are used compared with standard surgical clothing. Space suits cause increased PER and MER compared with standard surgical clothing. This finding provides mechanistic evidence to support the increased prosthetic joint infection rates observed in clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessment of commercial NLP engines for medication information extraction from dictated clinical notes.

PubMed

Jagannathan, V; Mullett, Charles J; Arbogast, James G; Halbritter, Kevin A; Yellapragada, Deepthi; Regulapati, Sushmitha; Bandaru, Pavani

2009-04-01

We assessed the current state of commercial natural language processing (NLP) engines for their ability to extract medication information from textual clinical documents. Two thousand de-identified discharge summaries and family practice notes were submitted to four commercial NLP engines with the request to extract all medication information. The four sets of returned results were combined to create a comparison standard which was validated against a manual, physician-derived gold standard created from a subset of 100 reports. Once validated, the individual vendor results for medication names, strengths, route, and frequency were compared against this automated standard with precision, recall, and F measures calculated. Compared with the manual, physician-derived gold standard, the automated standard was successful at accurately capturing medication names (F measure=93.2%), but performed less well with strength (85.3%) and route (80.3%), and relatively poorly with dosing frequency (48.3%). Moderate variability was seen in the strengths of the four vendors. The vendors performed better with the structured discharge summaries than with the clinic notes in an analysis comparing the two document types. Although automated extraction may serve as the foundation for a manual review process, it is not ready to automate medication lists without human intervention.

Simulation-Based Training for Colonoscopy

PubMed Central

Preisler, Louise; Svendsen, Morten Bo Søndergaard; Nerup, Nikolaj; Svendsen, Lars Bo; Konge, Lars

2015-01-01

Abstract The aim of this study was to create simulation-based tests with credible pass/fail standards for 2 different fidelities of colonoscopy models. Only competent practitioners should perform colonoscopy. Reliable and valid simulation-based tests could be used to establish basic competency in colonoscopy before practicing on patients. Twenty-five physicians (10 consultants with endoscopic experience and 15 fellows with very little endoscopic experience) were tested on 2 different simulator models: a virtual-reality simulator and a physical model. Tests were repeated twice on each simulator model. Metrics with discriminatory ability were identified for both modalities and reliability was determined. The contrasting-groups method was used to create pass/fail standards and the consequences of these were explored. The consultants significantly performed faster and scored higher than the fellows on both the models (P < 0.001). Reliability analysis showed Cronbach α = 0.80 and 0.87 for the virtual-reality and the physical model, respectively. The established pass/fail standards failed one of the consultants (virtual-reality simulator) and allowed one fellow to pass (physical model). The 2 tested simulations-based modalities provided reliable and valid assessments of competence in colonoscopy and credible pass/fail standards were established for both the tests. We propose to use these standards in simulation-based training programs before proceeding to supervised training on patients. PMID:25634177

Non-specific filtering of beta-distributed data.

PubMed

Wang, Xinhui; Laird, Peter W; Hinoue, Toshinori; Groshen, Susan; Siegmund, Kimberly D

2014-06-19

Non-specific feature selection is a dimension reduction procedure performed prior to cluster analysis of high dimensional molecular data. Not all measured features are expected to show biological variation, so only the most varying are selected for analysis. In DNA methylation studies, DNA methylation is measured as a proportion, bounded between 0 and 1, with variance a function of the mean. Filtering on standard deviation biases the selection of probes to those with mean values near 0.5. We explore the effect this has on clustering, and develop alternate filter methods that utilize a variance stabilizing transformation for Beta distributed data and do not share this bias. We compared results for 11 different non-specific filters on eight Infinium HumanMethylation data sets, selected to span a variety of biological conditions. We found that for data sets having a small fraction of samples showing abnormal methylation of a subset of normally unmethylated CpGs, a characteristic of the CpG island methylator phenotype in cancer, a novel filter statistic that utilized a variance-stabilizing transformation for Beta distributed data outperformed the common filter of using standard deviation of the DNA methylation proportion, or its log-transformed M-value, in its ability to detect the cancer subtype in a cluster analysis. However, the standard deviation filter always performed among the best for distinguishing subgroups of normal tissue. The novel filter and standard deviation filter tended to favour features in different genome contexts; for the same data set, the novel filter always selected more features from CpG island promoters and the standard deviation filter always selected more features from non-CpG island intergenic regions. Interestingly, despite selecting largely non-overlapping sets of features, the two filters did find sample subsets that overlapped for some real data sets. We found two different filter statistics that tended to prioritize features with different characteristics, each performed well for identifying clusters of cancer and non-cancer tissue, and identifying a cancer CpG island hypermethylation phenotype. Since cluster analysis is for discovery, we would suggest trying both filters on any new data sets, evaluating the overlap of features selected and clusters discovered.

Evaluation of Eligibility Criteria Used to Identify Patients for Medication Therapy Management Services: A Retrospective Cohort Study in a Medicare Advantage Part D Population.

PubMed

Lee, Janet S; Yang, Jianing; Stockl, Karen M; Lew, Heidi; Solow, Brian K

2016-01-01

General eligibility criteria used by the Centers for Medicare & Medicaid Services (CMS) to identify patients for medication therapy management (MTM) services include having multiple chronic conditions, taking multiple Part D drugs, and being likely to incur annual drug costs that exceed a predetermined threshold. The performance of these criteria in identifying patients in greatest need of MTM services is unknown. Although there are numerous possible versions of MTM identification algorithms that satisfy these criteria, there are limited data that evaluate the performance of MTM services using eligibility thresholds representative of those used by the majority of Part D sponsors. To (a) evaluate the performance of the 2013 CMS MTM eligibility criteria thresholds in identifying Medicare Advantage Prescription Drug (MAPD) plan patients with at least 2 drug therapy problems (DTPs) relative to alternative criteria threshold levels and (b) identify additional patient risk factors significantly associated with the number of DTPs for consideration as potential future MTM eligibility criteria. All patients in the Medicare Advantage Part D population who had pharmacy eligibility as of December 31, 2013, were included in this retrospective cohort study. Study outcomes included 7 different types of DTPs: use of high-risk medications in the elderly, gaps in medication therapy, medication nonadherence, drug-drug interactions, duplicate therapy, drug-disease interactions, and brand-to-generic conversion opportunities. DTPs were identified for each member based on 6 months of most recent pharmacy claims data and 14 months of most recent medical claims data. Risk factors examined in this study included patient demographics and prior health care utilization in the most recent 6 months. Descriptive statistics were used to summarize patient characteristics and to evaluate unadjusted relationships between the average number of DTPs identified per patient and each risk factor. Quartile values identified in the study population for number of diseases, number of drugs, and annual spend were used as potential new criteria thresholds, resulting in 27 new MTM criteria combinations. The performance of each eligibility criterion was evaluated using sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs). Patients identified with at least 2 DTPs were defined as those who would benefit from MTM services and were used as the gold standard. As part of a sensitivity analysis, patients identified with at least 1 DTP were used as the gold standard. Lastly, a multivariable negative binomial regression model was used to evaluate the relationship between each risk factor and the number of identified DTPs per patient while controlling for the patients' number of drugs, number of chronic diseases, and annual drug spend. A total of 2,578,336 patients were included in the study. The sensitivity, specificity, PPV, and NPV of CMS MTM criteria for the 2013 plan year were 15.3%, 95.6%, 51.3%, and 78.8%, respectively. Sensitivity and PPV improved when the drug count threshold increased from 8 to 10, and when the annual drug cost decreased from $3,144 to $2,239 or less. Results were consistent when at least 1 DTP was used as the gold standard. The adjusted rate of DTPs was significantly greater among patients identified with higher drug and disease counts, annual drug spend, and prior ER or outpatient or hospital visits. Patients with higher median household incomes who were male, younger, or white had significantly lower rates of DTPs. The performance of MTM eligibility criteria can be improved by increasing the threshold values for drug count while decreasing the threshold value for annual drug spend. Furthermore, additional risk factors, such as a recent ER or hospital visit, may be considered as potential MTM eligibility criteria.

Palus Somni - Anomalies in the correlation of Al/Si X-ray fluorescence intensity ratios and broad-spectrum visible albedos. [lunar surface mineralogy

NASA Technical Reports Server (NTRS)

Clark, P. E.; Andre, C. G.; Adler, I.; Weidner, J.; Podwysocki, M.

1976-01-01

The positive correlation between Al/Si X-ray fluorescence intensity ratios determined during the Apollo 15 lunar mission and a broad-spectrum visible albedo of the moon is quantitatively established. Linear regression analysis performed on 246 1 degree geographic cells of X-ray fluorescence intensity and visible albedo data points produced a statistically significant correlation coefficient of .78. Three distinct distributions of data were identified as (1) within one standard deviation of the regression line, (2) greater than one standard deviation below the line, and (3) greater than one standard deviation above the line. The latter two distributions of data were found to occupy distinct geographic areas in the Palus Somni region.

Archival-grade optical disc design and international standards

NASA Astrophysics Data System (ADS)

Fujii, Toru; Kojyo, Shinichi; Endo, Akihisa; Kodaira, Takuo; Mori, Fumi; Shimizu, Atsuo

2015-09-01

Optical discs currently on the market exhibit large variations in life span among discs, making them unsuitable for certain business applications. To assess and potentially mitigate this problem, we performed accelerated degradation testing under standard ISO conditions, determined the probable disc failure mechanisms, and identified the essential criteria necessary for a stable disc composition. With these criteria as necessary conditions, we analyzed the physical and chemical changes that occur in the disc components, on the basis of which we determined technological measures to reduce these degradation processes. By applying these measures to disc fabrication, we were able to develop highly stable optical discs.

Use of Principal Components Analysis and Kriging to Predict Groundwater-Sourced Rural Drinking Water Quality in Saskatchewan

PubMed Central

McLeod, Lianne; Bharadwaj, Lalita; Epp, Tasha; Waldner, Cheryl L.

2017-01-01

Groundwater drinking water supply surveillance data were accessed to summarize water quality delivered as public and private water supplies in southern Saskatchewan as part of an exposure assessment for epidemiologic analyses of associations between water quality and type 2 diabetes or cardiovascular disease. Arsenic in drinking water has been linked to a variety of chronic diseases and previous studies have identified multiple wells with arsenic above the drinking water standard of 0.01 mg/L; therefore, arsenic concentrations were of specific interest. Principal components analysis was applied to obtain principal component (PC) scores to summarize mixtures of correlated parameters identified as health standards and those identified as aesthetic objectives in the Saskatchewan Drinking Water Quality Standards and Objective. Ordinary, universal, and empirical Bayesian kriging were used to interpolate arsenic concentrations and PC scores in southern Saskatchewan, and the results were compared. Empirical Bayesian kriging performed best across all analyses, based on having the greatest number of variables for which the root mean square error was lowest. While all of the kriging methods appeared to underestimate high values of arsenic and PC scores, empirical Bayesian kriging was chosen to summarize large scale geographic trends in groundwater-sourced drinking water quality and assess exposure to mixtures of trace metals and ions. PMID:28914824

Use of Principal Components Analysis and Kriging to Predict Groundwater-Sourced Rural Drinking Water Quality in Saskatchewan.

PubMed

McLeod, Lianne; Bharadwaj, Lalita; Epp, Tasha; Waldner, Cheryl L

2017-09-15

Groundwater drinking water supply surveillance data were accessed to summarize water quality delivered as public and private water supplies in southern Saskatchewan as part of an exposure assessment for epidemiologic analyses of associations between water quality and type 2 diabetes or cardiovascular disease. Arsenic in drinking water has been linked to a variety of chronic diseases and previous studies have identified multiple wells with arsenic above the drinking water standard of 0.01 mg/L; therefore, arsenic concentrations were of specific interest. Principal components analysis was applied to obtain principal component (PC) scores to summarize mixtures of correlated parameters identified as health standards and those identified as aesthetic objectives in the Saskatchewan Drinking Water Quality Standards and Objective. Ordinary, universal, and empirical Bayesian kriging were used to interpolate arsenic concentrations and PC scores in southern Saskatchewan, and the results were compared. Empirical Bayesian kriging performed best across all analyses, based on having the greatest number of variables for which the root mean square error was lowest. While all of the kriging methods appeared to underestimate high values of arsenic and PC scores, empirical Bayesian kriging was chosen to summarize large scale geographic trends in groundwater-sourced drinking water quality and assess exposure to mixtures of trace metals and ions.

45 CFR 162.506 - Standard unique health plan identifier.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standard unique health plan identifier. 162.506 Section 162.506 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier for Health Plans § 162...

45 CFR 162.506 - Standard unique health plan identifier.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standard unique health plan identifier. 162.506 Section 162.506 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier for Health Plans § 162...

EVA Health and Human Performance Benchmarking Study

NASA Technical Reports Server (NTRS)

Abercromby, A. F.; Norcross, J.; Jarvis, S. L.

2016-01-01

Multiple HRP Risks and Gaps require detailed characterization of human health and performance during exploration extravehicular activity (EVA) tasks; however, a rigorous and comprehensive methodology for characterizing and comparing the health and human performance implications of current and future EVA spacesuit designs does not exist. This study will identify and implement functional tasks and metrics, both objective and subjective, that are relevant to health and human performance, such as metabolic expenditure, suit fit, discomfort, suited postural stability, cognitive performance, and potentially biochemical responses for humans working inside different EVA suits doing functional tasks under the appropriate simulated reduced gravity environments. This study will provide health and human performance benchmark data for humans working in current EVA suits (EMU, Mark III, and Z2) as well as shirtsleeves using a standard set of tasks and metrics with quantified reliability. Results and methodologies developed during this test will provide benchmark data against which future EVA suits, and different suit configurations (eg, varied pressure, mass, CG) may be reliably compared in subsequent tests. Results will also inform fitness for duty standards as well as design requirements and operations concepts for future EVA suits and other exploration systems.

Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

PubMed

Tricarico, Pierfrancesco; Tardivo, Stefano; Sotgiu, Giovanni; Moretti, Francesca; Poletti, Piera; Fiore, Alberto; Monturano, Massimo; Mura, Ida; Privitera, Gaetano; Brusaferro, Silvio

2016-08-08

Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.

Steps towards the international regulatory acceptance of non-animal methodology in safety assessment.

PubMed

Sewell, Fiona; Doe, John; Gellatly, Nichola; Ragan, Ian; Burden, Natalie

2017-10-01

The current animal-based paradigm for safety assessment must change. In September 2016, the UK National Centre for Replacement, Refinement and Reduction of Animals in Research (NC3Rs) brought together scientists from regulatory authorities, academia and industry to review progress in bringing new methodology into regulatory use, and to identify ways to expedite progress. Progress has been slow. Science is advancing to make this possible but changes are necessary. The new paradigm should allow new methodology to be adopted once it is developed rather than being based on a fixed set of studies. Regulatory authorities can help by developing Performance-Based Standards. The most pressing need is in repeat dose toxicology, although setting standards will be more complex than in areas such as sensitization. Performance standards should be aimed directly at human safety, not at reproducing the results of animal studies. Regulatory authorities can also aid progress towards the acceptance of non-animal based methodology by promoting "safe-haven" trials where traditional and new methodology data can be submitted in parallel to build up experience in the new methods. Industry can play its part in the acceptance of new methodology, by contributing to the setting of performance standards and by actively contributing to "safe-haven" trials. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars.

PubMed

Sousa, Thiago Oliveira; Haiter-Neto, Francisco; Nascimento, Eduarda Helena Leandro; Peroni, Leonardo Vieira; Freitas, Deborah Queiroz; Hassan, Bassam

2017-07-01

The aim of this study was to assess the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in the detection of the root canal configuration (RCC) of human premolars. PR and CBCT imaging of 114 extracted human premolars were evaluated by 2 oral radiologists. RCC was recorded according to Vertucci's classification. Micro-computed tomographic imaging served as the gold standard to determine RCC. Accuracy, sensitivity, specificity, and predictive values were calculated. The Friedman test compared both PR and CBCT imaging with the gold standard. CBCT imaging showed higher values for all diagnostic tests compared with PR. Accuracy was 0.55 and 0.89 for PR and CBCT imaging, respectively. There was no difference between CBCT imaging and the gold standard, whereas PR differed from both CBCT and micro-computed tomographic imaging (P < .0001). CBCT imaging was more accurate than PR for evaluating different types of RCC individually. Canal configuration types III, VII, and "other" were poorly identified on CBCT imaging with a detection accuracy of 50%, 0%, and 43%, respectively. With PR, all canal configurations except type I were poorly visible. PR presented low performance in the detection of RCC in premolars, whereas CBCT imaging showed no difference compared with the gold standard. Canals with complex configurations were less identifiable using both imaging methods, especially PR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Goal-Directed Ultrasound for the Diagnosis of Long-Bone Fractures by Crew Medical Officer Analogs

NASA Technical Reports Server (NTRS)

Marshburn, Thomas H.; Legome, Eric; Li, James; Melton, Shannon; Sargsyan, Ashot; Noble, Vickie; Sims, Carrie; Thomsen, Todd; Peralta, Ruben; Briggs, Sue

2002-01-01

Current construction activities on-board the International space Station (ISS) may increase fracture incidence in space, and ultrasound (US) is the only tm-board diagnostic imaging capability. The clinical utility of US in identifying long-bone fractures is un1aowe, particularly using non-radiologist operators. We sought to determine the accuracy of US in identifying fractures of the humerus and femur, as performed by emergency medicine physicians and surgeons with minimal experience in ultrasound image acquisition and interpretation, after a standardized taming session.

Differences in Faculty and Standardized Patient Scores on Professionalism for Second-Year Podiatric Medical Students During a Standardized Simulated Patient Encounter.

PubMed

Mahoney, James M; Vardaxis, Vassilios; Anwar, Noreen; Hagenbucher, Jacob

2018-03-01

This study examined the differences between faculty and trained standardized patient (SP) evaluations on student professionalism during a second-year podiatric medicine standardized simulated patient encounter. Forty-nine second-year podiatric medicine students were evaluated for their professionalism behavior. Eleven SPs performed an assessment in real-time, and one faculty member performed a secondary assessment after observing a videotape of the encounter. Five domains were chosen for evaluation from a validated professionalism assessment tool. Significant differences were identified in the professionalism domains of "build a relationship" ( P = .008), "gather information" ( P = .001), and share information ( P = .002), where the faculty scored the students higher than the SP for 24.5%, 18.9%, and 26.5% of the cases, respectively. In addition, the faculty scores were higher than the SP scores in all of the "gather information" subdomains; however, the difference in scores was significant only in the "question appropriately" ( P = .001) and "listen and clarify" ( P = .003) subdomains. This study showed that professionalism scores for second-year podiatric medical students during a simulated patient encounter varied significantly between faculty and SPs. Further consideration needs to be given to determine the source of these differences.

IEC 61511 and the capital project process--a protective management system approach.

PubMed

Summers, Angela E

2006-03-17

This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.

45 CFR 162.406 - Standard unique health identifier for health care providers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier...

45 CFR 162.406 - Standard unique health identifier for health care providers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Standard unique health identifier for health care providers. 162.406 Section 162.406 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Standard Unique Health Identifier...

Identification of ecological thresholds from variations in phytoplankton communities among lakes: contribution to the definition of environmental standards.

PubMed

Roubeix, Vincent; Danis, Pierre-Alain; Feret, Thibaut; Baudoin, Jean-Marc

2016-04-01

In aquatic ecosystems, the identification of ecological thresholds may be useful for managers as it can help to diagnose ecosystem health and to identify key levers to enable the success of preservation and restoration measures. A recent statistical method, gradient forest, based on random forests, was used to detect thresholds of phytoplankton community change in lakes along different environmental gradients. It performs exploratory analyses of multivariate biological and environmental data to estimate the location and importance of community thresholds along gradients. The method was applied to a data set of 224 French lakes which were characterized by 29 environmental variables and the mean abundances of 196 phytoplankton species. Results showed the high importance of geographic variables for the prediction of species abundances at the scale of the study. A second analysis was performed on a subset of lakes defined by geographic thresholds and presenting a higher biological homogeneity. Community thresholds were identified for the most important physico-chemical variables including water transparency, total phosphorus, ammonia, nitrates, and dissolved organic carbon. Gradient forest appeared as a powerful method at a first exploratory step, to detect ecological thresholds at large spatial scale. The thresholds that were identified here must be reinforced by the separate analysis of other aquatic communities and may be used then to set protective environmental standards after consideration of natural variability among lakes.

Hourly air pollution concentrations and their important predictors over Houston, Texas using deep neural networks: case study of DISCOVER-AQ time period

NASA Astrophysics Data System (ADS)

Eslami, E.; Choi, Y.; Roy, A.

2017-12-01

Air quality forecasting carried out by chemical transport models often show significant error. This study uses a deep-learning approach over the Houston-Galveston-Brazoria (HGB) area to overcome this forecasting challenge, for the DISCOVER-AQ period (September 2013). Two approaches, deep neural network (DNN) using a Multi-Layer Perceptron (MLP) and Restricted Boltzmann Machine (RBM) were utilized. The proposed approaches analyzed input data by identifying features abstracted from its previous layer using a stepwise method. The approaches predicted hourly ozone and PM in September 2013 using several predictors of prior three days, including wind fields, temperature, relative humidity, cloud fraction, precipitation along with PM, ozone, and NOx concentrations. Model-measurement comparisons for available monitoring sites reported Indexes of Agreement (IOA) of around 0.95 for both DNN and RBM. A standard artificial neural network (ANN) (IOA=0.90) with similar architecture showed poorer performance than the deep networks, clearly demonstrating the superiority of the deep approaches. Additionally, each network (both deep and standard) performed significantly better than a previous CMAQ study, which showed an IOA of less than 0.80. The most influential input variables were identified using their associated weights, which represented the sensitivity of ozone to input parameters. The results indicate deep learning approaches can achieve more accurate ozone forecasting and identify the important input variables for ozone predictions in metropolitan areas.

Patient safety and systematic reviews: finding papers indexed in MEDLINE, EMBASE and CINAHL.

PubMed

Tanon, A A; Champagne, F; Contandriopoulos, A-P; Pomey, M-P; Vadeboncoeur, A; Nguyen, H

2010-10-01

To develop search strategies for identifying papers on patient safety in MEDLINE, EMBASE and CINAHL. Six journals were electronically searched for papers on patient safety published between 2000 and 2006. Identified papers were divided into two gold standards: one to build and the other to validate the search strategies. Candidate terms for strategy construction were identified using a word frequency analysis of titles, abstracts and keywords used to index the papers in the databases. Searches were run for each one of the selected terms independently in every database. Sensitivity, precision and specificity were calculated for each candidate term. Terms with sensitivity greater than 10% were combined to form the final strategies. The search strategies developed were run against the validation gold standard to assess their performance. A final step in the validation process was to compare the performance of each strategy to those of other strategies found in the literature. We developed strategies for all three databases that were highly sensitive (range 95%-100%), precise (range 40%-60%) and balanced (the product of sensitivity and precision being in the range of 30%-40%). The strategies were very specific and outperformed those found in the literature. The strategies we developed can meet the needs of users aiming to maximise either sensitivity or precision, or seeking a reasonable compromise between sensitivity and precision, when searching for papers on patient safety in MEDLINE, EMBASE or CINAHL.

Phonological Working Memory for Words and Nonwords in Cerebral Cortex.

PubMed

Perrachione, Tyler K; Ghosh, Satrajit S; Ostrovskaya, Irina; Gabrieli, John D E; Kovelman, Ioulia

2017-07-12

The primary purpose of this study was to identify the brain bases of phonological working memory (the short-term maintenance of speech sounds) using behavioral tasks analogous to clinically sensitive assessments of nonword repetition. The secondary purpose of the study was to identify how individual differences in brain activation were related to participants' nonword repetition abilities. We used functional magnetic resonance imaging to measure neurophysiological response during a nonword discrimination task derived from standard clinical assessments of phonological working memory. Healthy adult control participants (N = 16) discriminated pairs of real words or nonwords under varying phonological working memory load, which we manipulated by parametrically varying the number of syllables in target (non)words. Participants' cognitive and phonological abilities were also measured using standardized assessments. Neurophysiological responses in bilateral superior temporal gyrus, inferior frontal gyrus, and supplementary motor area increased with greater phonological working memory load. Activation in left superior temporal gyrus during nonword discrimination correlated with participants' performance on standard clinical nonword repetition tests. These results suggest that phonological working memory is related to the function of cortical structures that canonically underlie speech perception and production.

Computational intelligence for the Balanced Scorecard: studying performance trends of hemodialysis clinics.

PubMed

Cattinelli, Isabella; Bolzoni, Elena; Chermisi, Milena; Bellocchio, Francesco; Barbieri, Carlo; Mari, Flavio; Amato, Claudia; Menzer, Marcus; Stopper, Andrea; Gatti, Emanuele

2013-07-01

The Balanced Scorecard (BSC) is a general, widely employed instrument for enterprise performance monitoring based on the periodic assessment of strategic Key Performance Indicators that are scored against preset targets. The BSC is currently employed as an effective management support tool within Fresenius Medical Care (FME) and is routinely analyzed via standard statistical methods. More recently, the application of computational intelligence techniques (namely, self-organizing maps) to BSC data has been proposed as a way to enhance the quantity and quality of information that can be extracted from it. In this work, additional methods are presented to analyze the evolution of clinic performance over time. Performance evolution is studied at the single-clinic level by computing two complementary indexes that measure the proportion of time spent within performance clusters and improving/worsening trends. Self-organizing maps are used in conjunction with these indexes to identify the specific drivers of the observed performance. The performance evolution for groups of clinics is modeled under a probabilistic framework by resorting to Markov chain properties. These allow a study of the probability of transitioning between performance clusters as time progresses for the identification of the performance level that is expected to become dominant over time. We show the potential of the proposed methods through illustrative results derived from the analysis of BSC data of 109 FME clinics in three countries. We were able to identify the performance drivers for specific groups of clinics and to distinguish between countries whose performances are likely to improve from those where a decline in performance might be expected. According to the stationary distribution of the Markov chain, the expected trend is best in Turkey (where the highest performance cluster has the highest probability, P=0.46), followed by Portugal (where the second best performance cluster dominates, with P=0.50), and finally Italy (where the second best performance cluster has P=0.34). These results highlight the ability of the proposed methods to extract insights about performance trends that cannot be easily extrapolated using standard analyses and that are valuable in directing management strategies within a continuous quality improvement policy. Copyright © 2013 Elsevier B.V. All rights reserved.

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

Diagnostic performance of neck circumference to identify overweight and obesity as defined by body mass index in children and adolescents: systematic review and meta-analysis.

PubMed

Ma, Chunming; Wang, Rui; Liu, Yue; Lu, Qiang; Liu, Xiaoli; Yin, Fuzai

2017-05-01

The neck circumference (NC) has been shown to be an accurate index for screening overweight and obesity in children and adolescents. To perform a meta-analysis to assess the performance of NC for the assessment of overweight and obesity. Data sources were PubMed and EMBASE up to March 2016. Studies providing measures of diagnostic performance of NC and using body mass index as reference standard were included. Six eligible studies that evaluated 11 214 children and adolescents aged 6-18 years were included in the meta-analysis. NC showed pooled sensitivity to detect high body mass index of 0.780 (95% confidence interval [CI] = 0.765-0.794), specificity of 0.746 (95% CI =  0.736-0.756) and a diagnostic odds ratio of 17.343 (95% CI =  8.743-34.405). The NC had moderate diagnostic accuracy for identifying overweight and obesity in children and adolescents.

Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard.

PubMed

Dalbeth, Nicola; Schumacher, H Ralph; Fransen, Jaap; Neogi, Tuhina; Jansen, Tim L; Brown, Melanie; Louthrenoo, Worawit; Vazquez-Mellado, Janitzia; Eliseev, Maxim; McCarthy, Geraldine; Stamp, Lisa K; Perez-Ruiz, Fernando; Sivera, Francisca; Ea, Hang-Korng; Gerritsen, Martijn; Scire, Carlo A; Cavagna, Lorenzo; Lin, Chingtsai; Chou, Yin-Yi; Tausche, Anne-Kathrin; da Rocha Castelar-Pinheiro, Geraldo; Janssen, Matthijs; Chen, Jiunn-Horng; Cimmino, Marco A; Uhlig, Till; Taylor, William J

2016-12-01

To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard. For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%). A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered. © 2016, American College of Rheumatology.

Analytical and Clinical Performance of Blood Glucose Monitors

PubMed Central

Boren, Suzanne Austin; Clarke, William L.

2010-01-01

Background The objective of this study was to understand the level of performance of blood glucose monitors as assessed in the published literature. Methods Medline from January 2000 to October 2009 and reference lists of included articles were searched to identify eligible studies. Key information was abstracted from eligible studies: blood glucose meters tested, blood sample, meter operators, setting, sample of people (number, diabetes type, age, sex, and race), duration of diabetes, years using a glucose meter, insulin use, recommendations followed, performance evaluation measures, and specific factors affecting the accuracy evaluation of blood glucose monitors. Results Thirty-one articles were included in this review. Articles were categorized as review articles of blood glucose accuracy (6 articles), original studies that reported the performance of blood glucose meters in laboratory settings (14 articles) or clinical settings (9 articles), and simulation studies (2 articles). A variety of performance evaluation measures were used in the studies. The authors did not identify any studies that demonstrated a difference in clinical outcomes. Examples of analytical tools used in the description of accuracy (e.g., correlation coefficient, linear regression equations, and International Organization for Standardization standards) and how these traditional measures can complicate the achievement of target blood glucose levels for the patient were presented. The benefits of using error grid analysis to quantify the clinical accuracy of patient-determined blood glucose values were discussed. Conclusions When examining blood glucose monitor performance in the real world, it is important to consider if an improvement in analytical accuracy would lead to improved clinical outcomes for patients. There are several examples of how analytical tools used in the description of self-monitoring of blood glucose accuracy could be irrelevant to treatment decisions. PMID:20167171

Development and implementation of an international proficiency testing program for a neutralizing antibody assay for HIV-1 in TZM-bl cells.

PubMed

Todd, Christopher A; Greene, Kelli M; Yu, Xuesong; Ozaki, Daniel A; Gao, Hongmei; Huang, Yunda; Wang, Maggie; Li, Gary; Brown, Ronald; Wood, Blake; D'Souza, M Patricia; Gilbert, Peter; Montefiori, David C; Sarzotti-Kelsoe, Marcella

2012-01-31

Recent advances in assay technology have led to major improvements in how HIV-1 neutralizing antibodies are measured. A luciferase reporter gene assay performed in TZM-bl (JC53bl-13) cells has been optimized and validated. Because this assay has been adopted by multiple laboratories worldwide, an external proficiency testing program was developed to ensure data equivalency across laboratories performing this neutralizing antibody assay for HIV/AIDS vaccine clinical trials. The program was optimized by conducting three independent rounds of testing, with an increased level of stringency from the first to third round. Results from the participating domestic and international laboratories improved each round as factors that contributed to inter-assay variability were identified and minimized. Key contributors to increased agreement were experience among laboratories and standardization of reagents. A statistical qualification rule was developed using a simulation procedure based on the three optimization rounds of testing, where a laboratory qualifies if at least 25 of the 30 ID50 values lie within the acceptance ranges. This ensures no more than a 20% risk that a participating laboratory fails to qualify when it should, as defined by the simulation procedure. Five experienced reference laboratories were identified and tested a series of standardized reagents to derive the acceptance ranges for pass-fail criteria. This Standardized Proficiency Testing Program is the first available for the evaluation and documentation of assay equivalency for laboratories performing HIV-1 neutralizing antibody assays and may provide guidance for the development of future proficiency testing programs for other assay platforms. Copyright © 2011 Elsevier B.V. All rights reserved.

Multi-Quadrant Biopsy Technique Improves Diagnostic Ability in Large Heterogeneous Renal Masses.

PubMed

Abel, E Jason; Heckman, Jennifer E; Hinshaw, Louis; Best, Sara; Lubner, Meghan; Jarrard, David F; Downs, Tracy M; Nakada, Stephen Y; Lee, Fred T; Huang, Wei; Ziemlewicz, Timothy

2015-10-01

Percutaneous biopsy obtained from a single location is prone to sampling error in large heterogeneous renal masses, leading to nondiagnostic results or failure to detect poor prognostic features. We evaluated the accuracy of percutaneous biopsy for large renal masses using a modified multi-quadrant technique vs a standard biopsy technique. Clinical and pathological data for all patients with cT2 or greater renal masses who underwent percutaneous biopsy from 2009 to 2014 were reviewed. The multi-quadrant technique was defined as multiple core biopsies from at least 4 separate solid enhancing areas in the tumor. The incidence of nondiagnostic findings, sarcomatoid features and procedural complications was recorded, and concordance between biopsy specimens and nephrectomy pathology was compared. A total of 122 biopsies were performed for 117 tumors in 116 patients (46 using the standard biopsy technique and 76 using the multi-quadrant technique). Median tumor size was 10 cm (IQR 8-12). Biopsy was nondiagnostic in 5 of 46 (10.9%) standard and 0 of 76 (0%) multi-quadrant biopsies (p=0.007). Renal cell carcinoma was identified in 96 of 115 (82.0%) tumors and nonrenal cell carcinoma tumors were identified in 21 (18.0%). One complication occurred using the standard biopsy technique and no complications were reported using the multi-quadrant technique. Sarcomatoid features were present in 23 of 96 (23.9%) large renal cell carcinomas studied. Sensitivity for identifying sarcomatoid features was higher using the multi-quadrant technique compared to the standard biopsy technique at 13 of 15 (86.7%) vs 2 of 8 (25.0%) (p=0.0062). The multi-quadrant percutaneous biopsy technique increases the ability to identify aggressive pathological features in large renal tumors and decreases nondiagnostic biopsy rates. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Funnel plots, performance variation and the Myocardial Infarction National Audit Project 2003-2004.

PubMed

Gale, Christopher P; Roberts, Anthony P; Batin, Phil D; Hall, Alistair S

2006-08-02

Clinical governance requires health care professionals to improve standards of care and has resulted in comparison of clinical performance data. The Myocardial Infarction National Audit Project (a UK cardiology dataset) tabulates its performance. However funnel plots are the display method of choice for institutional comparison. We aimed to demonstrate that funnel plots may be derived from MINAP data and allow more meaningful interpretation of data. We examined the attainment of National Service Framework standards for all hospitals (n = 230) and all patients (n = 99,133) in the MINAP database between 1st April 2003 and 31st March 2004. We generated funnel plots (with control limits at 3 sigma) of Door to Needle and Call to Needle thrombolysis times, and the use of aspirin, beta-blockers and statins post myocardial infarction. Only 87,427 patients fulfilled criteria for analysis of the use of secondary prevention drugs and 15,111 patients for analysis by Door to Needle and Call to Needle times (163 hospitals achieved the standards for Door to Needle times and 215 were within or above their control limits). One hundred and sixteen hospitals fell outside the 'within 25%' and 'more than 25%' standards for Call to Needle times, but 28 were below the lower control limits. Sixteen hospitals failed to reach the standards for aspirin usage post AMI and 24 remained below the lower control limits. Thirty hospitals were below the lower CL for beta-blocker usage and 49 outside the standard. Statin use was comparable. Funnel plots may be applied to a complex dataset and allow visual comparison of data derived from multiple health-care units. Variation is readily identified permitting units to appraise their practices so that effective quality improvement may take place.

Antibacterial Metallic Touch Surfaces

PubMed Central

Villapún, Victor M.; Dover, Lynn G.; Cross, Andrew; González, Sergio

2016-01-01

Our aim is to present a comprehensive review of the development of modern antibacterial metallic materials as touch surfaces in healthcare settings. Initially we compare Japanese, European and US standards for the assessment of antimicrobial activity. The variations in methodologies defined in these standards are highlighted. Our review will also cover the most relevant factors that define the antimicrobial performance of metals, namely, the effect of humidity, material geometry, chemistry, physical properties and oxidation of the material. The state of the art in contact-killing materials will be described. Finally, the effect of cleaning products, including disinfectants, on the antimicrobial performance, either by direct contact or by altering the touch surface chemistry on which the microbes attach, will be discussed. We offer our outlook, identifying research areas that require further development and an overview of potential future directions of this exciting field. PMID:28773856

Analysis of alternative strategies for energy conservation in new buildings

NASA Astrophysics Data System (ADS)

Fang, J. M.; Tawil, J.

1980-12-01

The policy instruments considered include: greater reliance on market forces; research and development; information, education and demonstration programs; tax incentives and sanctions; mortgage and finance programs; and regulations and standards. The analysis starts with an explanation of the barriers to energy conservation in the residential and commercial sectors. Individual policy instruments are described and evaluated with respect to energy conservation, economic efficiency, equity, political impacts, and implementation and other transitional impacts. Five possible strategies are identified: (1) increased reliance on the market place; (2) energy consumption tax and supply subsidies; (3) Building Energy Performance Standards (BEPS) with no sanctions and no incentives; (4) BEPS with sanctions and incentives (price control); and (5) BEPS with sanctions and incentives (no price controls). A comparative analysis is performed. Elements are proposed for inclusion in a comprehensive strategy for conservation in new buildings.

The impact of testing accommodations on MCAT scores: descriptive results.

PubMed

Julian, Ellen R; Ingersoll, Deborah J; Etienne, Patricia M; Hilger, Anthony E

2004-04-01

Medical College Admission Test (MCAT) examinees with disabilities who receive accommodations receive flagged scores indicating nonstandard administration. This report compares MCAT examinees who received accommodations and their performances with standard examinees. Aggregate history records of all 1994-2000 MCAT examinees were identified as flagged (2,401) or standard (297,880), then further sorted by race/ethnicity (broadly identified as underrepresented minority and non-URM, at the time of testing) and gender. Those with flagged scores were also classified by disability (LD = learning disability, ADHD = attention deficit hyperactivity disorder, LD/ADHD = learning disability and attention deficit hyperactivity disorder, and Other = other disability) and type of accommodation. Mean MCAT scores were calculated for all groups. A group of 866 examinees took the MCAT first as a standard administration and subsequently with accommodations. In a separate analysis, their two sets of scores were compared. Less than 1% of examinees (2,401) had accommodations; of these, 55% were LD, 17% ADHD, 5% LD/ADHD, and 23% Other. Extended time was the most frequently provided accommodation. Mean flagged scores slightly exceeded mean standard scores on all MCAT sections. Examinees who retook the MCAT with accommodations after a standard administration increased their scores by six points, quadrupling the average gain Standard-Standard retest cohort from another study. The small but statistically significant different higher flagged scores may reflect either appropriate compensation or overly generous accommodations. Extended time had a positive impact on the scores of those who retested with this accommodation. The validity the flagged MCAT in predicting success in medical school is not known, and further investigation is underway.

Optical Methods for Identifying Hard Clay Core Samples During Petrophysical Studies

NASA Astrophysics Data System (ADS)

Morev, A. V.; Solovyeva, A. V.; Morev, V. A.

2018-01-01

X-ray phase analysis of the general mineralogical composition of core samples from one of the West Siberian fields was performed. Electronic absorption spectra of the clay core samples with an added indicator were studied. The speed and availability of applying the two methods in petrophysical laboratories during sample preparation for standard and special studies were estimated.

Estimating the Cost of an Adequate Education in New York. Working Paper.

ERIC Educational Resources Information Center

Duncombe, William

The New York State Board of Regents and the Commissioner of Education have identified a set of performance standards for students that reflect the knowledge and skills needed to function as productive citizens in the 21st century. The New York State Department of Education has developed new Regents Examinations, which all students must pass to…

Integrating Disciplinary Core Ideas, the Agriculture, Food and Natural Resources Career Pathways and Next Generation Science Standards

ERIC Educational Resources Information Center

Kirby, Barrick R.; Heinert, Seth B.; Myers, Brian E.; Thoron, Andrew C.; Stofer, Kathryn

2018-01-01

The purpose of this study was to identify disciplinary core ideas that should be included in secondary school agriscience programs using a panel of experts in agricultural education, and to create a matrix of disciplinary core ideas, Agriculture, Food and Natural Resources career pathways performance indicators, and the Next Generation Science…

What Do We Know about How Teachers Influence Student Performance on Standardized Tests: And Why Do We Know So Little about Other Student Outcomes?

ERIC Educational Resources Information Center

Good, Thomas L.

2014-01-01

Background/Context: Since the 1970s, researchers have attempted to link observational measures of instructional process to student achievement (and occasionally to other outcomes of schooling). This paper reviews extensively both historical and contemporary research to identify what is known about effective teaching. Purpose/Objective: Good, after…

Comparisons of modern United States and Canadian malting barley cultivars with those from pre-Prohibition: IV. Malting quality assessments using standard and nonstandard measures

USDA-ARS?s Scientific Manuscript database

This study was conducted to identify which traits or combination of traits associated with malting quality and mashing performance could best define the differences between and within a population of pre-Prohibition malting barley varieties and a population of modern elite malting barley cultivars. ...

The Influence of Properties of the Test and Their Interactions with Reader Characteristics on Reading Comprehension: An Explanatory Item Response Study

ERIC Educational Resources Information Center

Kulesz, Paulina A.; Francis, David J.; Barnes, Marcia A.; Fletcher, Jack M.

2016-01-01

Component skills and discourse frameworks of reading have identified characteristics of readers and texts that influence comprehension. However, these 2 frameworks have not previously been integrated in a comprehensive and systematic way to explain performance on any standardized assessment of reading comprehension that is in widespread use across…

Changing Distributions: How Online College Classes Alter Student and Professor Performance. CEPA Working Paper No. 15-10

ERIC Educational Resources Information Center

Bettinger, Eric; Fox, Lindsay; Loeb, Susanna; Taylor, Eric

2015-01-01

Online college courses are a rapidly expanding feature of higher education, yet little research identifies their effects. Using an instrumental variables approach and data from DeVry University, this study finds that, on average, online course-taking reduces student learning by one-third to one-quarter of a standard deviation compared to…

Learning Styles, Learning Abilities and Learning Problems in College: An Exploration of Learning Disabilities in College Students. Final Report.

ERIC Educational Resources Information Center

Goldberg, Renee L.; Zern, David S.

The study examined differences between 57 learning disabled (LD) and 24 non-LD college students on measures of psychoeducational assessment. In addition, differences between LD students with good and poor academic performance were studied, and coping strategies were identified for both sub-groups. A variety of standardized tests were administered…

Identification of Swallowing Tasks from a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

ERIC Educational Resources Information Center

Hazelwood, R. Jordan; Armeson, Kent E.; Hill, Elizabeth G.; Bonilha, Heather Shaw; Martin-Harris, Bonnie

2017-01-01

Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived…

Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

PubMed

Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

2016-01-01

To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

Developing a standard for de-identifying electronic patient records written in Swedish: precision, recall and F-measure in a manual and computerized annotation trial.

PubMed

Velupillai, Sumithra; Dalianis, Hercules; Hassel, Martin; Nilsson, Gunnar H

2009-12-01

Electronic patient records (EPRs) contain a large amount of information written in free text. This information is considered very valuable for research but is also very sensitive since the free text parts may contain information that could reveal the identity of a patient. Therefore, methods for de-identifying EPRs are needed. The work presented here aims to perform a manual and automatic Protected Health Information (PHI)-annotation trial for EPRs written in Swedish. This study consists of two main parts: the initial creation of a manually PHI-annotated gold standard, and the porting and evaluation of an existing de-identification software written for American English to Swedish in a preliminary automatic de-identification trial. Results are measured with precision, recall and F-measure. This study reports fairly high Inter-Annotator Agreement (IAA) results on the manually created gold standard, especially for specific tags such as names. The average IAA over all tags was 0.65 F-measure (0.84 F-measure highest pairwise agreement). For name tags the average IAA was 0.80 F-measure (0.91 F-measure highest pairwise agreement). Porting a de-identification software written for American English to Swedish directly was unfortunately non-trivial, yielding poor results. Developing gold standard sets as well as automatic systems for de-identification tasks in Swedish is feasible. However, discussions and definitions on identifiable information is needed, as well as further developments both on the tag sets and the annotation guidelines, in order to get a reliable gold standard. A completely new de-identification software needs to be developed.

Classification of Movement of People with Parkinsons Disease Using Wearable Inertial Movement Units and Machine Learning.

PubMed

Ireland, David; Wang, Ziwei; Lamont, Robyn; Liddle, Jacki

2016-01-01

In this work, inertial movement units were placed on people with Parkinsons disease (PwPD) who subsequently performed a standard test of walking endurance (six-minute walk test - 6MWT). Five devices were placed on each the limbs and small of the back. These devices captured the acceleration and rotational motion while the person walked as far as they can in six minutes. The wearable devices can objectively indicate the pattern and rhythmicity of limb and body movements. It is possible that this data, when subject to machine learning could provide additional objective measures that may support clinical observations related to the quality of movement. The aim of this work is two fold. First, to identify the most useful features of the captured signals; second, to identify the accuracy of using these features to predict the severity of PD as measured by standard clinical assessment.

Public health financial management competencies.

PubMed

Honoré, Peggy A; Costich, Julia F

2009-01-01

The absence of appropriate financial management competencies has impeded progress in advancing the field of public health finance. It also inhibits the ability to professionalize this sector of the workforce. Financial managers should play a critical role by providing information relevant to decision making. The lack of fundamental financial management knowledge and skills is a barrier to fulfilling this role. A national expert committee was convened to examine this issue. The committee reviewed standards related to financial and business management practices within public health and closely related areas. Alignments were made with national standards such as those established for government chief financial officers. On the basis of this analysis, a comprehensive set of public health financial management competencies was identified and examined further by a review panel. At a minimum, the competencies can be used to define job descriptions, assess job performance, identify critical gaps in financial analysis, create career paths, and design educational programs.

Reliability of the individual components of the Canadian Armed Forces Physical Employment Standard.

PubMed

Stockbrugger, Barry G; Reilly, Tara J; Blacklock, Rachel E; Gagnon, Patrick J

2018-01-29

This investigation recruited 24 participants from both the Canadian Armed Forces (CAF) and civilian populations to complete 4 separate trials at "best effort" of each of the 4 components in the CAF Physical Employment Standard named the FORCE Evaluation: Fitness for Operational Requirements of CAF Employment. Analyses were performed to examine the level of variability and reliability within each component. The results demonstrate that candidates should be provided with at least 1 retest if they have recently completed at least 2 previous best effort attempts as per the protocol. In addition, the minimal detectable difference is given for each of the 4 components in seconds which identifies the threshold for subsequent action, either retest or remedial training, for those unable to meet the minimum standard. These results will educate the delivery of this employment standard, function as a method of accommodation, in addition to providing direction for physical training programs.

California teachers' perceptions of standards-based reform in middle school science: A mixed-methods study

NASA Astrophysics Data System (ADS)

Leggett, Allison Gail Wilson

The No Child Left Behind (NCLB) Act of 2001 presented one of the most significant and comprehensive literacy reforms in many years (McDonnell, 2005; U.S. Department of Education, 2006). The era of school accountability and standards based reform has brought many challenges and changes to public schools. Increasingly, public officials and educational administrators are asked to use standards based assessments to make high-stakes decisions, such as whether a student will move on to the next grade level or receive a diploma (American Psychological Association, 2005). It is important to understand any shifts in teachers' perceptions and to identify the changes teachers are making as they implement standards-based reform. This mixed-methods study was designed to assess teachers' perceptions of changes related to standards-based reform as supported by Fullan's (2001) change theory and transformational leadership theory. Survey questions sought to identify teacher perceptions of changes in curriculum, instruction and daily practice as schools documented and incorporated standards-based reform and began focusing on preparing students for the California Standards Test in Science (CSTS). Using descriptive statistical analysis and in-depth interviews, results show favorable insight towards standards-based reform. The survey was distributed to 30 middle school science teachers from 10 low-performing schools in Los Angeles, California. Results were analyzed using Spearman rank-ordered correlations. Interviews were conducted on middle school teachers represented by each grade level. Teachers who receive more support from administrators have more positive attitudes toward all aspects of SBR and the CSTS as measured in this study. No school should overlook the potential of a supportive administration in its effort to improve school programs.

Best practices for evaluating single nucleotide variant calling methods for microbial genomics

PubMed Central

Olson, Nathan D.; Lund, Steven P.; Colman, Rebecca E.; Foster, Jeffrey T.; Sahl, Jason W.; Schupp, James M.; Keim, Paul; Morrow, Jayne B.; Salit, Marc L.; Zook, Justin M.

2015-01-01

Innovations in sequencing technologies have allowed biologists to make incredible advances in understanding biological systems. As experience grows, researchers increasingly recognize that analyzing the wealth of data provided by these new sequencing platforms requires careful attention to detail for robust results. Thus far, much of the scientific Communit’s focus for use in bacterial genomics has been on evaluating genome assembly algorithms and rigorously validating assembly program performance. Missing, however, is a focus on critical evaluation of variant callers for these genomes. Variant calling is essential for comparative genomics as it yields insights into nucleotide-level organismal differences. Variant calling is a multistep process with a host of potential error sources that may lead to incorrect variant calls. Identifying and resolving these incorrect calls is critical for bacterial genomics to advance. The goal of this review is to provide guidance on validating algorithms and pipelines used in variant calling for bacterial genomics. First, we will provide an overview of the variant calling procedures and the potential sources of error associated with the methods. We will then identify appropriate datasets for use in evaluating algorithms and describe statistical methods for evaluating algorithm performance. As variant calling moves from basic research to the applied setting, standardized methods for performance evaluation and reporting are required; it is our hope that this review provides the groundwork for the development of these standards. PMID:26217378

Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia.

PubMed

Malfuson, Jean-Valère; Etienne, Anne; Turlure, Pascal; de Revel, Thierry; Thomas, Xavier; Contentin, Nathalie; Terré, Christine; Rigaudeau, Sophie; Bordessoule, Dominique; Vey, Norbert; Gardin, Claude; Dombret, Hervé

2008-12-01

There is a need for standardization of treatment decisions in older patients with acute myeloid leukemia. The aim of the present study was to analyze the decisional value of poor risk factors in 416 elderly patients treated in the ALFA-9803 trial in order to derive a decisional index. Standard multivariate analysis was used to identify risk factors for overall survival. Risk factors were then considered as good decision tools if associated with a frequency >10% and a false positive rate <10% in predicting overall survival as poor as observed after low-dose cytarabine therapy (25% survival or less at 12 months). Among six independent risk factors (age, performance status, white blood cell count, hematopoietic cell transplantation comorbidity index, infection at baseline, and cytogenetics), cytogenetics was the only potent, independent decision tool. High hematopoietic cell transplantation comorbidity index scores or infections were found too rarely to guide further decisions. The three other factors (age, performance status, and white cell count) needed to be combined to provide a good specificity. The proposed decisional index, therefore, included high-risk cytogenetics and/or the presence of at least two of the following criteria: age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L. This simple two-class decisional index, which was validated in an independent patient set, enabled us to discriminate 100 patients (24%) who had an estimated overall survival of only 19% at 12 months, with a good 9% false positive rate. We propose waiting for cytogenetic information before making treatment decisions in elderly patients with acute myeloid leukemia. Those patients with unfavorable cytogenetics, as well as patients with at least two of the following features, age > or =75 years, performance status > or =2, and white cell count > or =50 x 10(9)/L, should not be considered for standard intensive chemotherapy (ClinicalTrials.gov identifier: NCT00363025).

Lunar Regolith Simulant Materials: Recommendations for Standardization, Production, and Usage

NASA Technical Reports Server (NTRS)

Sibille, L.; Carpenter, P.; Schlagheck, R.; French, R. A.

2006-01-01

Experience gained during the Apollo program demonstrated the need for extensive testing of surface systems in relevant environments, including regolith materials similar to those encountered on the lunar surface. As NASA embarks on a return to the Moon, it is clear that the current lunar sample inventory is not only insufficient to support lunar surface technology and system development, but its scientific value is too great to be consumed by destructive studies. Every effort must be made to utilize standard simulant materials, which will allow developers to reduce the cost, development, and operational risks to surface systems. The Lunar Regolith Simulant Materials Workshop held in Huntsville, AL, on January 24 26, 2005, identified the need for widely accepted standard reference lunar simulant materials to perform research and development of technologies required for lunar operations. The workshop also established a need for a common, traceable, and repeatable process regarding the standardization, characterization, and distribution of lunar simulants. This document presents recommendations for the standardization, production and usage of lunar regolith simulant materials.

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior.

PubMed

Delgado-Gomez, D; Baca-Garcia, E; Aguado, D; Courtet, P; Lopez-Castroman, J

2016-12-01

Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information. Copyright © 2016 Elsevier B.V. All rights reserved.

Detection of Early Ischemic Changes in Noncontrast CT Head Improved with "Stroke Windows".

PubMed

Mainali, Shraddha; Wahba, Mervat; Elijovich, Lucas

2014-01-01

Introduction. Noncontrast head CT (NCCT) is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes (EIC) are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation (Stroke Windows). Methods. We performed a retrospective chart review to identify patients with acute ischemic stroke who had NCCT at presentation. EIC was defined by the presence of hyperdense MCA/basilar artery sign; sulcal effacement; basal ganglia/subcortical hypodensity; and loss of cortical gray-white differentiation. NCCT was reviewed with standard window settings and with specialized Stroke Windows. Results. Fifty patients (42% females, 58% males) with a mean NIHSS of 13.4 were identified. EIC was detected in 9 patients with standard windows, while EIC was detected using Stroke Windows in 35 patients (18% versus 70%; P < 0.0001). Hyperdense MCA sign was the most commonly reported EIC; it was better detected with Stroke Windows (14% and 36%; P < 0.0198). Detection of the remaining EIC also improved with Stroke Windows (6% and 46%; P < 0.0001). Conclusions. Detection of EIC has important implications in diagnosis and treatment of acute ischemic stroke. Utilization of Stroke Windows significantly improved detection of EIC.

Hospital Readmission Risk: Isolating Hospital from Patient Effects

PubMed Central

Krumholz, Harlan M.; Wang, Kun; Lin, Zhenqiu; Dharmarajan, Kumar; Horwitz, Leora I.; Ross, Joseph S.; Drye, Elizabeth E.; Bernheim, Susannah M.; Normand, Sharon-Lise T.

2017-01-01

Background To isolate hospital effects on hospitals’ risk-standardized readmission rates, we examined readmission outcomes among patients with multiple admissions for a similar diagnosis at >1 hospital within a given year. Methods We divided the Centers for Medicare & Medicaid Services hospital-wide readmission measure cohort from July 2014–June 2015 into 2 random samples. We used the first sample to calculate each hospital’s risk-standardized readmission rate and classified hospitals into performance quartiles. In the second sample, we identified patients with 2 admissions for similar diagnoses at different hospitals that occurred more than a month and less than a year apart, and compared observed readmission rates for those admitted to hospitals in different performance quartiles. Results In the sample used to characterize hospital performance, the median risk-standardized readmission rate was 15.5% (IQR 15.3%–15.8%). The other sample included 37,508 patients with 2 admissions for similar diagnoses at 4,272 different hospitals. The observed readmission rate was consistently higher when patients were admitted to hospitals in the worse performing quartile, but the only statistically significant difference was observed when the same patients were admitted to hospitals in the best and worst performing quartiles, in which the absolute readmission rate difference was 1.95 percentage points (95% CI, 0.39%–3.50%). Conclusions When the same patients were admitted with similar diagnoses to hospitals in the best performing quartile compared with the worst performing quartile for hospital readmission performance, there is a significant difference in rates of readmission within 30 days. The findings suggest that hospital quality contributes in part to readmission rates independent of patient factors. PMID:28902587

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

Maloney, J.; Kiepper, A.F.; Simonetta, R.J.

The volume examines monitoring and reporting procedures applicable to performance and productivity. The managers of three transit systems of varying sizes discuss how productivity has been increased within their systems. The Pittsburgh discussion reviews a variety of capital projects and management improvement initiatives undertaken by Port Authority Transit, including development of maintenance manuals and an absenteeism reduction project. The Houston discussion describes how the property used a management study to identify needed organizational change and restructuring. The Ann Arbor discussion focuses on a set of service standards and performance indicators adopted to focus the management improvement process.

Goddard Conference on Mass Storage Systems and Technologies, volume 2

NASA Technical Reports Server (NTRS)

Kobler, Ben (Editor); Hariharan, P. C. (Editor)

1993-01-01

Papers and viewgraphs from the conference are presented. Discussion topics include the IEEE Mass Storage System Reference Model, data archiving standards, high-performance storage devices, magnetic and magneto-optic storage systems, magnetic and optical recording technologies, high-performance helical scan recording systems, and low end helical scan tape drives. Additional discussion topics addressed the evolution of the identifiable unit for processing (file, granule, data set, or some similar object) as data ingestion rates increase dramatically, and the present state of the art in mass storage technology.

A Study to Determine the Best Way for Letterman Army Medical Center to Comply with the 1981 JCAH (Joint Commission on Accreditation of Hospitals) Quality Assurance Standard

DTIC Science & Technology

1980-08-01

follow-up action taken would be prima facie evidence of the program’s positive impact on patient care/ clinical performance. Direct and indirect...demonstration of improved patient care/clinical performance must be shown. Prima facie evidence 57 of such improvement would include a summary of identified...even in relation to the seven other HSC medical cen- ters, because of the following reasons: - Active duty patients cannot- claim or file a law- suit

Cache-based error recovery for shared memory multiprocessor systems

NASA Technical Reports Server (NTRS)

Wu, Kun-Lung; Fuchs, W. Kent; Patel, Janak H.

1989-01-01

A multiprocessor cache-based checkpointing and recovery scheme for of recovering from transient processor errors in a shared-memory multiprocessor with private caches is presented. New implementation techniques that use checkpoint identifiers and recovery stacks to reduce performance degradation in processor utilization during normal execution are examined. This cache-based checkpointing technique prevents rollback propagation, provides for rapid recovery, and can be integrated into standard cache coherence protocols. An analytical model is used to estimate the relative performance of the scheme during normal execution. Extensions that take error latency into account are presented.

Human Health Countermeasures (HHC) Element Management Plan: Human Research Program. Revision B

NASA Technical Reports Server (NTRS)

Norsk, Peter; Baumann, David

2012-01-01

NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments.

PubMed

Westby, Carol; Washington, Karla N

2017-07-26

The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention. The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

A suggested emergency medicine boot camp curriculum for medical students based on the mapping of Core Entrustable Professional Activities to Emergency Medicine Level 1 milestones.

PubMed

Lamba, Sangeeta; Wilson, Bryan; Natal, Brenda; Nagurka, Roxanne; Anana, Michael; Sule, Harsh

2016-01-01

An increasing number of students rank Emergency Medicine (EM) as a top specialty choice, requiring medical schools to provide adequate exposure to EM. The Core Entrustable Professional Activities (EPAs) for Entering Residency by the Association of American Medical Colleges combined with the Milestone Project for EM residency training has attempted to standardize the undergraduate and graduate medical education goals. However, it remains unclear as to how the EPAs correlate to the milestones, and who owns the process of ensuring that an entering EM resident has competency at a certain minimum level. Recent trends establishing specialty-specific boot camps prepare students for residency and address the variability of skills of students coming from different medical schools. Our project's goal was therefore to perform a needs assessment to inform the design of an EM boot camp curriculum. Toward this goal, we 1) mapped the core EPAs for graduating medical students to the EM residency Level 1 milestones in order to identify the possible gaps/needs and 2) conducted a pilot procedure workshop that was designed to address some of the identified gaps/needs in procedural skills. In order to inform the curriculum of an EM boot camp, we used a systematic approach to 1) identify gaps between the EPAs and EM milestones (Level 1) and 2) determine what essential and supplemental competencies/skills an incoming EM resident should ideally possess. We then piloted a 1-day, three-station advanced ABCs procedure workshop based on the identified needs. A pre-workshop test and survey assessed knowledge, preparedness, confidence, and perceived competence. A post-workshop survey evaluated the program, and a posttest combined with psychomotor skills test using three simulation cases assessed students' skills. Students (n=9) reported increased confidence in the following procedures: intubation (1.5-2.1), thoracostomy (1.1-1.9), and central venous catheterization (1.3-2) (a three-point Likert-type scale, with 1= not yet confident/able to perform with supervision to 3= confident/able to perform without supervision). Psychomotor skills testing showed on average, 26% of students required verbal prompting with performance errors, 48% with minor performance errors, and 26% worked independently without performance errors. All participants reported: 1) increased knowledge and confidence in covered topics and 2) overall satisfaction with simulation experience. Mapping the Core EPAs for Entering Residency to the EM milestones at Level 1 identifies educational gaps for graduating medical students seeking a career in EM. Educators designing EM boot camps for medical students should consider these identified gaps, procedures, and clinical conditions during the development of a core standardized curriculum.

Simulation verification techniques study. Subsystem simulation validation techniques

NASA Technical Reports Server (NTRS)

Duncan, L. M.; Reddell, J. P.; Schoonmaker, P. B.

1974-01-01

Techniques for validation of software modules which simulate spacecraft onboard systems are discussed. An overview of the simulation software hierarchy for a shuttle mission simulator is provided. A set of guidelines for the identification of subsystem/module performance parameters and critical performance parameters are presented. Various sources of reference data to serve as standards of performance for simulation validation are identified. Environment, crew station, vehicle configuration, and vehicle dynamics simulation software are briefly discussed from the point of view of their interfaces with subsystem simulation modules. A detailed presentation of results in the area of vehicle subsystems simulation modules is included. A list of references, conclusions and recommendations are also given.

NASA Educational Product Development and Post-Secondary Program Assessment Planning

NASA Technical Reports Server (NTRS)

Salmons, Phyllis A.

1999-01-01

Producing "value-added students" involves proactively addressing how successfully students develop their skills, knowledge, and personal, social, and ethical growth due to their association with a program. NASA programs for higher education can certainly be responsive in aiding the academic community strive for quality in terms of "valueadded" students. By identifying essential characteristics of exemplary assessment practices, the standards developed by accrediting agencies serve as guides for developing quality practices and policies. Such a process is an effective tool for communicating the expectations of the educational components of a program to all concerned with the program and its expected results. When standards are connected to student performance, they provide a very compelling argument for refocusing the definition of quality in higher education. By linking standards and performance, student learning and development becomes the starting point for examining program quality. If the multiple stakeholders - faculty, peers, the professional community, addressed assessment issues, then accreditation can be a link among various constituencies, the parties can better understand the needs of each other and develop the necessary trust needed for understanding and support.

Developing a Planetary Spatial Data Infrastructure for Evaluating Landing Sites and Performing Surface Operations for the Mars 2020 Lander

NASA Astrophysics Data System (ADS)

Fergason, R. L.; Laura, J.; Hare, T. M.; Otero, R.; Edgar, L. A.

2017-12-01

A Spatial Data Infrastructure (SDI) is a robust framework for data and data products, metadata, data access mechanisms, standards, policy, and a user community that helps to define and standardize the data necessary to meet some specified goal. The primary objective of an SDI is to improve communication, to enhance data access, and to aid in identifying gaps in knowledge. We are developing an SDI that describes the foundational data sets and accuracy requirements to evaluate landing site safety, facilitate the successful operation of Terrain Relative Navigation (TRN), and assist in the operation of the rover once it has successfully landed on Mars. Thru current development efforts, an implicit SDI exists for the Mars 2020 mission. An explicit SDI will allow us to identify any potential gaps in knowledge, facilitate communication between the different institutions involved in landing site evaluation and TRN development, and help ensure a smooth transition from landing to surface operations. This SDI is currently relevant to the Mars 2020 rover mission, but can also serve as a means to document current requirements for foundational data products and standards for future landed missions to Mars and other planetary bodies. To generate a Mars 2020-specific SDI, we must first document and rationalize data set and accuracy requirements for evaluating landing sites, performing surface operations, and inventorying Mars 2020 mission needs in terms of an SDI framework. This step will allow us to 1) evaluate and define what is needed for the acquisition of data and the generation and validation of data products, 2) articulate the accuracy and co-registration requirements, and 3) identify needs for data access (and eventual archiving). This SDI document will serve as a means to communicate the existing foundational products, standards that were followed in producing these products, and where and how these products can be accessed by the planetary community. This SDI will also facilitate discussions between the landing and surface operations groups to communicate the available data and identify unique needs to surface operations. Our goal is to continually review and update this SDI throughout the Mars 2020 landing site evaluation and operations, so that it remains relevant and effective as data availability and needs evolve.

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories.

PubMed

Jang, Mi Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong Ho; Min, Won Ki; Lee, Ji Sung; Lee, Yong Wha; Lee, You Kyoung

2017-05-01

Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. © The Korean Society for Laboratory Medicine

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories

PubMed Central

Jang, Mi-Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong-Ho; Min, Won-Ki; Lee, Ji Sung

2017-01-01

Background Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. Methods We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Results Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. Conclusions These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. PMID:28224767

Agreement between diagnoses reached by clinical examination and available reference standards: a prospective study of 216 patients with lumbopelvic pain

PubMed Central

Laslett, Mark; McDonald, Barry; Tropp, Hans; Aprill, Charles N; Öberg, Birgitta

2005-01-01

Background The tissue origin of low back pain (LBP) or referred lower extremity symptoms (LES) may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC) statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216) with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement (PCC) was estimated at 13%. "Exact" agreement between clinical and reference standard diagnoses was 32% and "clinical agreement" 51%. For six pathoanatomic categories (disc, facet joint, sacroiliac joint, hip joint, nerve root and spinal stenosis), PCC was 33% with actual agreement 56%. There was no overlap of 95% confidence intervals on any comparison. Diagnostic agreement on the six most common patho-anatomic categories produced a kappa of 0.31. Conclusion Clinical diagnoses agree with reference standards diagnoses more often than chance. Using available reference standards, most patients can have a tissue source of pain identified. PMID:15943873

Performance of lung ultrasonography for the diagnosis of communityacquired pneumonia in hospitalized children.

PubMed

Man, Sorin Claudiu; Fufezan, Otilia; Sas, Valentina; Schnell, Cristina

2017-05-10

The objective of the study was to assess the performance of lung ultrasonography (LUS) as compared to chest radiography and the clinical criteria for the diagnosis of pneumonia in children. This was a retrospective study in which data were collected from medical files of 81 children admitted with a clinical suspicion of pneumonia in which both an LUS and a chest radiograph during the hospitalization were performed. Reference standard used for the diagnosis of pneumonia were chest radiographs (consolidation, parenchymal infiltrates, and interstitial infiltrate) and clinical criteria. LUSfindings were reported as normal, parenchymal consolidations and pleural effusions. Radiological pneumonia was reported in 72 of the 81 patients (88.9%). LUS identified parenchymal consolidations in 62 cases. LUS correctly identified radiological pneumonia with a sensitivity of 79.2% and a specificity of 44.4%. The positive predictive value (PPV) was 91.9% and the negative predictive value (NPV) was 21.0%. When clinical criteria were used as reference standard, the sensitivity, specificity, PPV and NPV of correctly identifying clinical pneumonia cases by LUS (only consolidations) were 80.0%, 66.7%, 96.8% and 21.0%. When indicative for the presence of pneumonia either the ultrasound consolidation or the ultrasound detected pleural effusion were considered when the sensitivity, PPV and NPV increased to 96.0% (95%CI: 88.8-99.2), 97.3% (95%CI: 92.0-99.1), and 57.1% (95%CI: 27.7-82.2), respectively. In our opinion, our findings together withprevious ones available in the literature recommend LUS as a valuable investigation for the diagnosis of community-acquiredpneumonia in children.

Quality assurance in melanoma surgery: The evolving experience at a large tertiary referral centre.

PubMed

Read, R L; Pasquali, S; Haydu, L; Thompson, J F; Stretch, J R; Saw, R P M; Quinn, M J; Shannon, K; Spillane, A J

2015-07-01

The quality of melanoma surgery needs to be assessed by oncological outcome and complication rates. There is no published consensus on complication rates for common melanoma surgeries, namely wide excision (WE), sentinel node biopsy (SNB) and regional lymph node dissection (RLND). Consequently there are no agreed standards by which surgeons can audit their practices. Surgical standards were proposed in 2008 following review of the literature and from expert opinion. Melanoma Institute Australia (MIA) self-reported audit data from 2011 and 2012 were compared with these standards. To quality check the self-reported audit, RLND data were extracted from the MIA database. Six surgeons performed a mean of 568 surgeries each quarter; with a mean of 106 major procedures. Following WE with primary closure or flap repair, wound infection or dehiscence occurred in <1% of cases. When skin grafting was required non-take of >20% of the grafted area was observed in 5.9% of cases. Following SNB wound infection and significant seroma occurred in 1.8% of cases. RLND node counts were below the 90% standard in 4 of 409 procedures. In comparison, data extraction identified 405 RLNDs, with node counts below the 90% standard in eight procedures. Two of these patients had previously undergone surgery removing nodes from the field and two had gross coalescing disease with extensive extra-nodal spread. The quality standards proposed in 2008 have been validated long-term by high volume caseloads. The data presented provide standards by which melanoma surgeons can audit their surgical performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Identifying depression with the PHQ-2: A diagnostic meta-analysis.

PubMed

Manea, Laura; Gilbody, Simon; Hewitt, Catherine; North, Alice; Plummer, Faye; Richardson, Rachel; Thombs, Brett D; Williams, Bethany; McMillan, Dean

2016-10-01

There is interest in the use of very brief instruments to identify depression because of the advantages they offer in busy clinical settings. The PHQ-2, consisting of two questions relating to core symptoms of depression (low mood and loss of interest or pleasure), is one such instrument. A systematic review was conducted to identify studies that had assessed the diagnostic performance of the PHQ-2 to detect major depression. Embase, MEDLINE, PsychINFO and grey literature databases were searched. Reference lists of included studies and previous relevant reviews were also examined. Studies were included that used the standard scoring system of the PHQ-2, assessed its performance against a gold-standard diagnostic interview and reported data on its performance at the recommended (≥3) or an alternative cut-off point (≥2). After assessing heterogeneity, where appropriate, data from studies were combined using bivariate diagnostic meta-analysis to derive sensitivity, specificity, likelihood ratios and diagnostic odds ratios. 21 studies met inclusion criteria totalling N=11,175 people out of which 1529 had major depressive disorder according to a gold standard. 19 of the 21 included studies reported data for a cut-off point of ≥3. Pooled sensitivity was 0.76 (95% CI =0.68-0.82), pooled specificity was 0.87 (95% CI =0.82-0.90). However there was substantial heterogeneity at this cut-off (I(2)=81.8%). 17 studies reported data on the performance of the measure at cut-off point ≥2. Heterogeneity was I(2)=43.2% pooled sensitivity at this cut-off point was 0.91 (95% CI =0.85-0.94), and pooled specificity was 0.70 (95% CI =0.64-0.76). The generally lower sensitivity of the PHQ-2 at cut-off ≥3 than the original validation study (0.83) suggests that ≥2 may be preferable if clinicians want to ensure that few cases of depression are missed. However, in situations in which the prevalence of depression is low, this may result in an unacceptably high false-positive rate because of the associated modest specificity. These results, however, need to be interpreted with caution given the possibility of selectively reported cut-offs. Copyright © 2016. Published by Elsevier B.V.

30 CFR 815.15 - Performance standards for coal exploration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Performance standards for coal exploration. 815... OF THE INTERIOR PERMANENT PROGRAM PERFORMANCE STANDARDS PERMANENT PROGRAM PERFORMANCE STANDARDS-COAL EXPLORATION § 815.15 Performance standards for coal exploration. (a) Habitats of unique or unusually high...

30 CFR 815.15 - Performance standards for coal exploration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Performance standards for coal exploration. 815... OF THE INTERIOR PERMANENT PROGRAM PERFORMANCE STANDARDS PERMANENT PROGRAM PERFORMANCE STANDARDS-COAL EXPLORATION § 815.15 Performance standards for coal exploration. (a) Habitats of unique or unusually high...

30 CFR 815.15 - Performance standards for coal exploration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Performance standards for coal exploration. 815... OF THE INTERIOR PERMANENT PROGRAM PERFORMANCE STANDARDS PERMANENT PROGRAM PERFORMANCE STANDARDS-COAL EXPLORATION § 815.15 Performance standards for coal exploration. (a) Habitats of unique or unusually high...

30 CFR 815.15 - Performance standards for coal exploration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Performance standards for coal exploration. 815... OF THE INTERIOR PERMANENT PROGRAM PERFORMANCE STANDARDS PERMANENT PROGRAM PERFORMANCE STANDARDS-COAL EXPLORATION § 815.15 Performance standards for coal exploration. (a) Habitats of unique or unusually high...

30 CFR 815.15 - Performance standards for coal exploration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Performance standards for coal exploration. 815... OF THE INTERIOR PERMANENT PROGRAM PERFORMANCE STANDARDS PERMANENT PROGRAM PERFORMANCE STANDARDS-COAL EXPLORATION § 815.15 Performance standards for coal exploration. (a) Habitats of unique or unusually high...

Dysbindin (DTNBP1, 6p22.3) is Associated with Childhood-Onset Psychosis and Endophenotypes Measured by the Premorbid Adjustment Scale (PAS)

ERIC Educational Resources Information Center

Gornick, M. C.; Addington, A. M.; Sporn, A.; Gogtay, N.; Greenstein, D.; Lenane, M.; Gochman, P.; Ordonez, A.; Balkissoon, R.; Vakkalanka, R.; Weinberger, D. R.; Rapoport, J. L.; Straub, R. E.

2005-01-01

Straub "et al." ("2002") recently identified the 6p22.3 gene dysbindin (DTNBP1) through positional cloning as a schizophrenia susceptibility gene. We studied a rare cohort of 102 children with onset of psychosis before age 13. Standardized ratings of early development, medication response, neuropsychological and cognitive performance, premorbid…

A Case Study of the Strategic Staffing Initiative Used in Charlotte-Mecklenburg Schools

ERIC Educational Resources Information Center

March, Kendra D.

2013-01-01

Accountability standards challenge schools to provide quality education for all students and to ensure that all students are on grade level by the end of the school year. If schools fall short of this challenge failing to make at least one year of progress, schools are at risk of being identified as low performing. In this age of accountability,…

Lithium-Ion Small Cell Battery Shorting Study

NASA Technical Reports Server (NTRS)

Pearson, Chris; Curzon, David; Blackmore, Paul; Rao, Gopalakrishna

2004-01-01

AEA performed a hard short study on various cell configurations whilst monitoring voltage, current and temperature. Video recording was also done to verify the evidence for cell venting. The presentation summarizes the results of the study including video footage of typical samples. Need for the diode protection in manned applications is identified. The standard AEA approach of using fused connectors during AIT for unmanned applications is also described.

Expert Meeting Report: HVAC Fault Detection, Diagnosis, and Repair/Replacement

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

Springer, David

The concept for the expert meeting described in this report was to bring together most of the stakeholders in the area of FDD, including academic researchers, manufacturers, educators, program managers and implementers, representatives of standards organizations, utilities, HVAC contractors, and home performance contractors to identify the major gaps and to develop ideas about what can be done to capitalize on the residential HVAC efficiency resource.

Expert Meeting Report: HVAC Fault Detection, DIagnosis, and Repair/Replacement

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

Springer, David

The concept for the expert meeting described in this report was to bring together most of the stakeholders in the area of FDD, including academic researchers, manufacturers, educators, program managers and implementers, representatives of standards organizations, utilities, HVAC contractors, and home performance contractors to identify the major gaps and to develop ideas about what can be done to capitalize on the residential HVAC efficiency resource.

SNPmplexViewer--toward a cost-effective traceability system

PubMed Central

2011-01-01

Background Beef traceability has become mandatory in many regions of the world and is typically achieved through the use of unique numerical codes on ear tags and animal passports. DNA-based traceability uses the animal's own DNA code to identify it and the products derived from it. Using SNaPshot, a primer-extension-based method, a multiplex of 25 SNPs in a single reaction has been practiced for reducing the expense of genotyping a panel of SNPs useful for identity control. Findings To further decrease SNaPshot's cost, we introduced the Perl script SNPmplexViewer, which facilitates the analysis of trace files for reactions performed without the use of fluorescent size standards. SNPmplexViewer automatically aligns reference and target trace electropherograms, run with and without fluorescent size standards, respectively. SNPmplexViewer produces a modified target trace file containing a normalised trace in which the reference size standards are embedded. SNPmplexViewer also outputs aligned images of the two electropherograms together with a difference profile. Conclusions Modified trace files generated by SNPmplexViewer enable genotyping of SnaPshot reactions performed without fluorescent size standards, using common fragment-sizing software packages. SNPmplexViewer's normalised output may also improve the genotyping software's performance. Thus, SNPmplexViewer is a general free tool enabling the reduction of SNaPshot's cost as well as the fast viewing and comparing of trace electropherograms for fragment analysis. SNPmplexViewer is available at http://cowry.agri.huji.ac.il/cgi-bin/SNPmplexViewer.cgi. PMID:21600063

Validated modified Lycopodium spore method development for standardisation of ingredients of an ayurvedic powdered formulation Shatavaryadi churna.

PubMed

Kumar, Puspendra; Jha, Shivesh; Naved, Tanveer

2013-01-01

Validated modified lycopodium spore method has been developed for simple and rapid quantification of herbal powdered drugs. Lycopodium spore method was performed on ingredients of Shatavaryadi churna, an ayurvedic formulation used as immunomodulator, galactagogue, aphrodisiac and rejuvenator. Estimation of diagnostic characters of each ingredient of Shatavaryadi churna individually was carried out. Microscopic determination, counting of identifying number, measurement of area, length and breadth of identifying characters were performed using Leica DMLS-2 microscope. The method was validated for intraday precision, linearity, specificity, repeatability, accuracy and system suitability, respectively. The method is simple, precise, sensitive, and accurate, and can be used for routine standardisation of raw materials of herbal drugs. This method gives the ratio of individual ingredients in the powdered drug so that any adulteration of genuine drug with its adulterant can be found out. The method shows very good linearity value between 0.988-0.999 for number of identifying character and area of identifying character. Percentage purity of the sample drug can be determined by using the linear equation of standard genuine drug.

Definition of Unfit for Standard Acute Myeloid Leukemia Therapy.

PubMed

Klepin, Heidi D

2016-12-01

Determining who is fit or unfit for standard treatments among older adults with acute myeloid leukemia (AML) remains a challenge. However, available evidence can provide guidance on strategies to assess and categorize fitness. Evidence is strongest to guide identification of "frail" older adults at the time of diagnosis based on performance status, physical function, and comorbidity. Many older adults, with adequate performance status and comorbidity burden, however, may be better characterized as "vulnerable". These patients have subclinical impairments that limit resilience when stressed with intensive therapies. More sensitive assessment strategies are needed to differentiate fit and vulnerable older adults regardless of chronologic age. Research is ongoing to identify tools and approaches, such as geriatric assessment, that can enhance characterization of fitness for AML therapies. This review will highlight available evidence for assessment of fitness among older adults with AML and discuss implications for practice and research.

Accuracy of user-friendly blood typing kits tested under simulated military field conditions.

PubMed

Bienek, Diane R; Charlton, David G

2011-04-01

Rapid user-friendly ABO-Rh blood typing kits (Eldon Home Kit 2511, ABO-Rh Combination Blood Typing Experiment Kit) were evaluated to determine their accuracy when used under simulated military field conditions and after long-term storage at various temperatures and humidities. Rates of positive tests between control groups, experimental groups, and industry standards were measured and analyzed using the Fisher's exact chi-square method to identify significant differences (p < or = 0.05). When Eldon Home Kits 2511 were used in various operational conditions, the results were comparable to those obtained with the control group and with the industry standard. The performance of the ABO-Rh Combination Blood Typing Experiment Kit was adversely affected by prolonged storage in temperatures above 37 degrees C. The diagnostic performance of commercial blood typing kits varies according to product and environmental storage conditions.

Behavioral Health and Performance Laboratory Standard Measures (BHP-SM)

NASA Technical Reports Server (NTRS)

Williams, Thomas J.; Cromwell, Ronita

2017-01-01

The Spaceflight Standard Measures is a NASA Johnson Space Center Human Research Project (HRP) project that proposes to collect a set of core measurements, representative of many of the human spaceflight risks, from astronauts before, during and after long-duration International Space Station (ISS) missions. The term "standard measures" is defined as a set of core measurements, including physiological, biochemical, psychosocial, cognitive, and functional, that are reliable, valid, and accepted in terrestrial science, are associated with a specific and measurable outcome known to occur as a consequence of spaceflight, that will be collected in a standardized fashion from all (or most) crewmembers. While such measures might be used to define standards of health and performance or readiness for flight, the prime intent in their collection is to allow longitudinal analysis of multiple parameters in order to answer a variety of operational, occupational, and research-based questions. These questions are generally at a high level, and the approach for this project is to populate the standard measures database with the smallest set of data necessary to indicate further detailed research is required. Also included as standard measures are parameters that are not outcome-based in and of-themselves, but provide ancillary information that supports interpretation of the outcome measures, e.g., nutritional assessment, vehicle environmental parameters, crew debriefs, etc. The project's main aim is to ensure that an optimized minimal set of measures is consistently captured from all ISS crewmembers until the end of Station in order to characterize the human in space. -This allows the HRP to identify, establish, and evaluate a common set of measures for use in spaceflight and analog research to: develop baselines, systematically characterize risk likelihood and consequences, and assess effectiveness of countermeasures that work for behavioral health and performance risk factors. -By standardizing the battery of measures on all crewmembers, it will allow the HRP to evaluate countermeasures that work for one physiological system and ensure another system is not negatively affected. -These measures, named "Standard Measures," will serve as a data repository and be available to other studies under data sharing agreements.

Improving Public Reporting and Data Validation for Complex Surgical Site Infections After Coronary Artery Bypass Graft Surgery and Hip Arthroplasty

PubMed Central

Calderwood, Michael S.; Kleinman, Ken; Murphy, Michael V.; Platt, Richard; Huang, Susan S.

2014-01-01

Background  Deep and organ/space surgical site infections (D/OS SSI) cause significant morbidity, mortality, and costs. Rates are publicly reported and increasingly used as quality metrics affecting hospital payment. Lack of standardized surveillance methods threaten the accuracy of reported data and decrease confidence in comparisons based upon these data. Methods  We analyzed data from national validation studies that used Medicare claims to trigger chart review for SSI confirmation after coronary artery bypass graft surgery (CABG) and hip arthroplasty. We evaluated code performance (sensitivity and positive predictive value) to select diagnosis codes that best identified D/OS SSI. Codes were analyzed individually and in combination. Results  Analysis included 143 patients with D/OS SSI after CABG and 175 patients with D/OS SSI after hip arthroplasty. For CABG, 9 International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes identified 92% of D/OS SSI, with 1 D/OS SSI identified for every 4 cases with a diagnosis code. For hip arthroplasty, 6 ICD-9 diagnosis codes identified 99% of D/OS SSI, with 1 D/OS SSI identified for every 2 cases with a diagnosis code. Conclusions  This standardized and efficient approach for identifying D/OS SSI can be used by hospitals to improve case detection and public reporting. This method can also be used to identify potential D/OS SSI cases for review during hospital audits for data validation. PMID:25734174

40 CFR 434.55 - New source performance standards (NSPS).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false New source performance standards (NSPS... PERFORMANCE STANDARDS Post-Mining Areas § 434.55 New source performance standards (NSPS). The following new source performance standards shall apply to the post-mining areas of all new source coal mines: (a...

Aiming High: Setting Performance Standards for Student Success

ERIC Educational Resources Information Center

Phillips, Gary; Garcia, Alicia N.

2015-01-01

Content standards, not performance standards, have been almost the sole focus of state policies and recent conversations about academic standards. Without rigorous content and performance standards, we cannot adequately prepare students for the global marketplace. A recent AIR study shows that state performance standards are consistently low and…

48 CFR 37.603 - Performance standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Performance standards. 37... CATEGORIES OF CONTRACTING SERVICE CONTRACTING Performance-Based Acquisition 37.603 Performance standards. (a) Performance standards establish the performance level required by the Government to meet the contract...

48 CFR 37.603 - Performance standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Performance standards. 37... CATEGORIES OF CONTRACTING SERVICE CONTRACTING Performance-Based Acquisition 37.603 Performance standards. (a) Performance standards establish the performance level required by the Government to meet the contract...

48 CFR 37.603 - Performance standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Performance standards. 37... CATEGORIES OF CONTRACTING SERVICE CONTRACTING Performance-Based Acquisition 37.603 Performance standards. (a) Performance standards establish the performance level required by the Government to meet the contract...

48 CFR 37.603 - Performance standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Performance standards. 37... CATEGORIES OF CONTRACTING SERVICE CONTRACTING Performance-Based Acquisition 37.603 Performance standards. (a) Performance standards establish the performance level required by the Government to meet the contract...

Longitudinal analysis of receptive vocabulary growth in young Spanish English-speaking children from migrant families.

PubMed

Jackson, Carla Wood; Schatschneider, Christopher; Leacox, Lindsey

2014-01-01

The authors of this study described developmental trajectories and predicted kindergarten performance of Spanish and English receptive vocabulary acquisition of young Latino/a English language learners (ELLs) from socioeconomically disadvantaged migrant families. In addition, the authors examined the extent to which gender and individual initial performance in Spanish predict receptive vocabulary performance and growth rate. The authors used hierarchical linear modeling of 64 children's receptive vocabulary performance to generate growth trajectories, predict performance at school entry, and examine potential predictors of rate of growth. The timing of testing varied across children. The ELLs (prekindergarten to 2nd grade) participated in 2-5 testing sessions, each 6-12 months apart. The ELLs' average predicted standard score on an English receptive vocabulary at kindergarten was nearly 2 SDs below the mean for monolingual peers. Significant growth in the ELLs' receptive vocabulary was observed between preschool and 2nd grade, indicating that the ELLs were slowly closing the receptive vocabulary gap, although their average score remained below the standard score mean for age-matched monolingual peers. The ELLs demonstrated a significant decrease in Spanish receptive vocabulary standard scores over time. Initial Spanish receptive vocabulary was a significant predictor of growth in English receptive vocabulary. High initial Spanish receptive vocabulary was associated with greater growth in English receptive vocabulary and decelerated growth in Spanish receptive vocabulary. Gender was not a significant predictor of growth in either English or Spanish receptive vocabulary. ELLs from low socioeconomic backgrounds may be expected to perform lower in English compared with their monolingual English peers in kindergarten. Performance in Spanish at school entry may be useful in identifying children who require more intensive instructional support for English vocabulary growth. Findings substantiate the need for progress monitoring across the early school years.

Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.

PubMed

Martin, Shelby; Wagner, Jesse; Lupulescu-Mann, Nicoleta; Ramsey, Katrina; Cohen, Aaron; Graven, Peter; Weiskopf, Nicole G; Dorr, David A

2017-08-02

To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization. Nine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard. EHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.

Correcting a Fundamental Flaw in the Paradigm for Antimicrobial Susceptibility Testing.

PubMed

Ersoy, Selvi C; Heithoff, Douglas M; Barnes, Lucien; Tripp, Geneva K; House, John K; Marth, Jamey D; Smith, Jeffrey W; Mahan, Michael J

2017-06-01

The emergence and prevalence of antibiotic-resistant bacteria are an increasing cause of death worldwide, resulting in a global 'call to action' to avoid receding into an era lacking effective antibiotics. Despite the urgency, the healthcare industry still relies on a single in vitro bioassay to determine antibiotic efficacy. This assay fails to incorporate environmental factors normally present during host-pathogen interactions in vivo that significantly impact antibiotic efficacy. Here we report that standard antimicrobial susceptibility testing (AST) failed to detect antibiotics that are in fact effective in vivo; and frequently identified antibiotics that were instead ineffective as further confirmed in mouse models of infection and sepsis. Notably, AST performed in media mimicking host environments succeeded in identifying specific antibiotics that were effective in bacterial clearance and host survival, even though these same antibiotics failed in results using standard test media. Similarly, our revised media further identified antibiotics that were ineffective in vivo despite passing the AST standard for clinical use. Supplementation of AST medium with sodium bicarbonate, an abundant in vivo molecule that stimulates global changes in bacterial structure and gene expression, was found to be an important factor improving the predictive value of AST in the assignment of appropriate therapy. These findings have the potential to improve the means by which antibiotics are developed, tested, and prescribed. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Identifying and quantifying heterogeneity in high content analysis: application of heterogeneity indices to drug discovery.

PubMed

Gough, Albert H; Chen, Ning; Shun, Tong Ying; Lezon, Timothy R; Boltz, Robert C; Reese, Celeste E; Wagner, Jacob; Vernetti, Lawrence A; Grandis, Jennifer R; Lee, Adrian V; Stern, Andrew M; Schurdak, Mark E; Taylor, D Lansing

2014-01-01

One of the greatest challenges in biomedical research, drug discovery and diagnostics is understanding how seemingly identical cells can respond differently to perturbagens including drugs for disease treatment. Although heterogeneity has become an accepted characteristic of a population of cells, in drug discovery it is not routinely evaluated or reported. The standard practice for cell-based, high content assays has been to assume a normal distribution and to report a well-to-well average value with a standard deviation. To address this important issue we sought to define a method that could be readily implemented to identify, quantify and characterize heterogeneity in cellular and small organism assays to guide decisions during drug discovery and experimental cell/tissue profiling. Our study revealed that heterogeneity can be effectively identified and quantified with three indices that indicate diversity, non-normality and percent outliers. The indices were evaluated using the induction and inhibition of STAT3 activation in five cell lines where the systems response including sample preparation and instrument performance were well characterized and controlled. These heterogeneity indices provide a standardized method that can easily be integrated into small and large scale screening or profiling projects to guide interpretation of the biology, as well as the development of therapeutics and diagnostics. Understanding the heterogeneity in the response to perturbagens will become a critical factor in designing strategies for the development of therapeutics including targeted polypharmacology.

Competency frameworks for advanced practice nursing: a literature review.

PubMed

Sastre-Fullana, P; De Pedro-Gómez, J E; Bennasar-Veny, M; Serrano-Gallardo, P; Morales-Asencio, J M

2014-12-01

This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes. © 2014 International Council of Nurses.

Functional assessment and performance evaluation for assistive robotic manipulators: Literature review.

PubMed

Chung, Cheng-Shiu; Wang, Hongwu; Cooper, Rory A

2013-07-01

The user interface development of assistive robotic manipulators can be traced back to the 1960s. Studies include kinematic designs, cost-efficiency, user experience involvements, and performance evaluation. This paper is to review studies conducted with clinical trials using activities of daily living (ADLs) tasks to evaluate performance categorized using the International Classification of Functioning, Disability, and Health (ICF) frameworks, in order to give the scope of current research and provide suggestions for future studies. We conducted a literature search of assistive robotic manipulators from 1970 to 2012 in PubMed, Google Scholar, and University of Pittsburgh Library System - PITTCat. Twenty relevant studies were identified. Studies were separated into two broad categories: user task preferences and user-interface performance measurements of commercialized and developing assistive robotic manipulators. The outcome measures and ICF codes associated with the performance evaluations are reported. Suggestions for the future studies include (1) standardized ADL tasks for the quantitative and qualitative evaluation of task efficiency and performance to build comparable measures between research groups, (2) studies relevant to the tasks from user priority lists and ICF codes, and (3) appropriate clinical functional assessment tests with consideration of constraints in assistive robotic manipulator user interfaces. In addition, these outcome measures will help physicians and therapists build standardized tools while prescribing and assessing assistive robotic manipulators.

Selection for Surgical Training: An Evidence-Based Review.

PubMed

Schaverien, Mark V

2016-01-01

The predictive relationship between candidate selection criteria for surgical training programs and future performance during and at the completion of training has been investigated for several surgical specialties, however there is no interspecialty agreement regarding which selection criteria should be used. Better understanding the predictive reliability between factors at selection and future performance may help to optimize the process and lead to greater standardization of the surgical selection process. PubMed and Ovid MEDLINE databases were searched. Over 560 potentially relevant publications were identified using the search strategy and screened using the Cochrane Collaboration Data Extraction and Assessment Template. 57 studies met the inclusion criteria. Several selection criteria used in the traditional selection demonstrated inconsistent correlation with subsequent performance during and at the end of surgical training. The following selection criteria, however, demonstrated good predictive relationships with subsequent resident performance: USMLE examination scores, Letters of Recommendation (LOR) including the Medical Student Performance Evaluation (MSPE), academic performance during clinical clerkships, the interview process, displaying excellence in extracurricular activities, and the use of unadjusted rank lists. This systematic review supports that the current selection process needs to be further evaluated and improved. Multicenter studies using standardized outcome measures of success are now required to improve the reliability of the selection process to select the best trainees. Published by Elsevier Inc.

[Using Interdisciplinary Cooperation to Improve the Rate of Proper Performance of a Hand Exercise Among Hemodialysis Patients With Arteriovenous Fistula Construction].

PubMed

Hsiao, Ya-Hsin; Shin, Miao-Ling; Huang, Cyong-Pei; Chen, Siang-Jyun; Huang, Tsuey-Yuan

2017-06-01

Patients who undergo new arteriovenous fistula (AVF) construction as part of their hemodialysis treatment program are required to perform hand exercises properly in order to maintain AVF function. However, poor performance of these hand exercises currently results in the failure of many patients to preserve AVF function. To increase the rate of performing this hand exercise properly from 55% to 80%. A comprehensive investigation identified the following five main problems: (a) Insufficient muscular endurance; (b) Resistance was not labeled on the ball; (c) Difficulties with maintaining a grip on the ball during the exercise; (d) Lack of standardized education procedures; and (e) Nurses lack latest knowledge on the hand exercise. The strategies used to improve the situation included: (a) Interdisciplinary team cooperation with physiotherapists to design individualized resistance training regimens; (b) Exercise tool improvement; (c) Standardized AVF care; (d) Continuous education for nursing staffs; and (e) Seed teacher program for hand exercise. The rate of proper hand exercise performance increased from 55% to 93%. This nursing project involved an interdisciplinary team that included physiotherapists in order to successfully improve the rate at which the hand exercise was performed properly. This positive experience may be applied to other hemodialysis departments in the treatment of patients with AVF.

Ultrasound Fracture Diagnosis in Space

NASA Technical Reports Server (NTRS)

Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix

2010-01-01

Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

Development of the NBT assay as a marker of sperm oxidative stress.

PubMed

Tunc, Ozlem; Thompson, Jeremy; Tremellen, Kelton

2010-02-01

Oxidative stress is a well-established cause of male infertility, with reactive oxygen species (ROS) causing infertility principally by impairing sperm motility and DNA integrity. Currently, most clinics do not test their infertile patients for the presence of oxidative stress because the available tests are expensive or difficult to perform. As antioxidant therapy may improve sperm DNA integrity and pregnancy outcomes, it has become apparent that there is an unmet clinical need for an inexpensive and easy-to-perform assay to identify sperm oxidative stress. The aim of this study was to develop a standardized protocol for performing a photometric nitro blue tetrazolium (NBT) assay for the measurement of seminal ROS production via production of coloured formazan, whilst correlating these results with impaired sperm function (motility and DNA integrity). Semen samples from 21 fertile and 36 male aetiology infertile men were assessed for ROS production (NBT assay), sperm DNA integrity (TUNEL), apoptosis (Annexin V) and sperm motility. Infertile men's semen contained on average fourfold higher levels of ROS than fertile men. The production of ROS by sperm was positively correlated with sperm DNA fragmentation and apoptosis, whilst being negatively correlated with sperm motility. Receiver-operating characteristic plot analysis established a cut-off point of 24 microg formazan/10(7) sperm having a sensitivity of 91.7% and a specificity of 81% for determining the fertility status of an individual. This study has been successful in establishing a standardized protocol for performing a photometric seminal NBT assay that has significant clinical utility in identifying men with impaired fertility because of oxidative stress.

An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study

PubMed Central

Drews, Steven J; Richardson, Susan E; Wray, Rick; Freeman, Renee; Goldman, Carol; Streitenberger, Laurie; Stevens, Derek; Goia, Cristina; Kovach, Danuta; Brophy, Jason; Matlow, Anne G

2008-01-01

BACKGROUND The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions. PMID:19412380

Synaptic proteomics as a means to identify the molecular basis of mental illness: Are we getting there?

PubMed

Reig-Viader, Rita; Sindreu, Carlos; Bayés, Àlex

2018-06-08

Synapses are centrally involved in many brain disorders, particularly in psychiatric and neurodevelopmental ones. However, our current understanding of the proteomic alterations affecting synaptic performance in the majority of mental illnesses is limited. As a result, novel pharmacotherapies with improved neurological efficacy have been scarce over the past decades. The main goal of synaptic proteomics in the context of mental illnesses is to identify dysregulated molecular mechanisms underlying these conditions. Here we reviewed and performed a meta-analysis of previous neuroproteomic research to identify proteins that may be consistently dysregulated in one or several mental disorders. Notably, we found very few proteins reproducibly altered among independent experiments for any given condition or between conditions, indicating that we are still far from identifying key pathophysiological mechanisms of mental illness. We suggest that future research in the field will require higher levels of standardization and larger-scale experiments to address the challenge posed by biological and methodological variability. We strongly believe that more resources should be placed in this field as the need to identify the molecular roots of mental illnesses is highly pressing. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Assessment of the nursing skill mix in Mozambique using a task analysis methodology

PubMed Central

2014-01-01

Background The density of the nursing and maternal child health nursing workforce in Mozambique (0.32/1000) is well below the WHO minimum standard of 1 nurse per 1000. Two levels of education were being offered for both nurses and maternal child health nurses, in programmes ranging from 18 to 30 months in length. The health care workforce in Mozambique also includes Medical Technicians and Medical Agents, who are also educated at either basic or mid-level. The Ministry of Health determined the need to document the tasks that each of the six cadres was performing within various health facilities to identify gaps, and duplications, in order to identify strategies for streamlining workforce production, while retaining highest educational and competency standards. The methodology of task analysis (TA) was used to achieve this objective. This article provides information about the TA methodology, and selected outcomes of the very broad study. Methods A cross-sectional descriptive task analysis survey was conducted over a 15 month period (2008–2009). A stratified sample of 1295 individuals was recruited from every type of health facility in all of Mozambique’s 10 provinces and in Maputo City. Respondents indicated how frequently they performed any of 233 patient care tasks. Data analysis focused on identifying areas where identical tasks were performed by the various cadres. Analyses addressed frequency of performance, grouped by level of educational preparation, within various types of health facilities. Results Task sharing ranged from 74% to 88% between basic and general nurse cadres and from 54% to 88% between maternal and child health nurse cadres, within various health facility types. Conversely, there was distinction between scope of practice for nursing and maternal/child health nursing cadres. Conclusion The educational pathways to general nursing and maternal/child health nursing careers were consolidated into one 24 month programme for each career. The scopes of practice were affirmed based on task analysis survey data. PMID:24460789

Rapid Determination of Major Compounds in the Ethanol Extract of Geopropolis from Malaysian Stingless Bees, Heterotrigona itama, by UHPLC-Q-TOF/MS and NMR.

PubMed

Zhao, Lingling; Yu, Mengjiao; Sun, Minghui; Xue, Xiaofeng; Wang, Tongtong; Cao, Wei; Sun, Liping

2017-11-10

A reliable, rapid analytical method was established for the characterization of constituents of the ethanol extract of geopropolis (EEGP) produced by Malaysian stingless bees- Heterotrigona itama -by combining ultra-high-performance liquid chromatography with quadruple time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Based on known standards, the online METLIN database, and published literature, 28 compounds were confirmed. Phenolic acids, flavones, triterpenes and phytosterol were identified or tentatively identified using characteristic diagnostic fragment ions. The results indicated that terpenoids were the main components of EEGP, accompanied by low levels of phenolic acids, flavonoids, and phytosterol. Two major components were further purified by preparative high-performance liquid chromatography (PHPLC) and identified by nuclear magnetic resonance (NMR) as 24( E )-cycloart-24-ene-26-ol-3-one and 20-hydroxy-24-dammaren-3-one. These two triterpenes, confirmed in this geopropolis for the first time, are potential chemical markers for the identification of geopropolis from Malaysian stingless bees, H. itama .

[Performance of a standardized interrogation to improve the screening of Chlamydia trachomatis infection].

PubMed

Grandcolin, S; de Hauteclocque, A; Lafoscade, A; Fritel, X

2015-10-01

To estimate the performance of a standardized interrogation tool facilitating the detection and screening of patients for the Chlamydia trachomatis infection, to estimate the prevalence of the infection in the family planning population studied. Prospective observational study, including the patients who had a consultation in the abortion center in the CHU of Poitiers. A sampling of the cervix was systematically carried out after the standardized interrogation in search of four clinical signs. The samples were analyzed by genetic amplification. Three hundred and eighty-six women were included and 56 (14.5 %) infections were identified. The medical history questionnaire was relatively effective for 2 or 3 clinical signs. The positive predictive value (PPV) was respectively 34.8 % and 53.8 % and was very relevant for 4 clinical signs with PPV at 83.3 % [CI 95 %: 74-93 %]. Among the infected women, 48.2 % had no clinical sign revealed by the medical history questionnaire. The presence of any clinical sign was strongly associated with the C. trachomatis infection (P<0.05). The clinical signs find in the standardized interrogation are all significantly associated with the C. trachomatis infection. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Normalization of metabolomics data with applications to correlation maps.

PubMed

Jauhiainen, Alexandra; Madhu, Basetti; Narita, Masako; Narita, Masashi; Griffiths, John; Tavaré, Simon

2014-08-01

In metabolomics, the goal is to identify and measure the concentrations of different metabolites (small molecules) in a cell or a biological system. The metabolites form an important layer in the complex metabolic network, and the interactions between different metabolites are often of interest. It is crucial to perform proper normalization of metabolomics data, but current methods may not be applicable when estimating interactions in the form of correlations between metabolites. We propose a normalization approach based on a mixed model, with simultaneous estimation of a correlation matrix. We also investigate how the common use of a calibration standard in nuclear magnetic resonance (NMR) experiments affects the estimation of correlations. We show with both real and simulated data that our proposed normalization method is robust and has good performance when discovering true correlations between metabolites. The standardization of NMR data is shown in simulation studies to affect our ability to discover true correlations to a small extent. However, comparing standardized and non-standardized real data does not result in any large differences in correlation estimates. Source code is freely available at https://sourceforge.net/projects/metabnorm/ alexandra.jauhiainen@ki.se Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

[Quality and compliance with the regulations of workers'health examinations in relation to their preventive purpose].

PubMed

Rodríguez-Jareño, Mari Cruz; Molinero, Emilia; De Montserrat, Jaume; Vallès, Antoni; Aymerich, Marta

2016-01-01

To analyze whether examinations for health surveillance in Catalonia are carried out with a high enough degree of quality as to comply with the preventive aim of the regulations, and to identify potential differences by type of prevention service. Qualitative and quantitative techniques. Body of data: Spanish regulations related to health surveillance, and a self-reported questionnaire answered by occupational health professionals who performed health examinations in their usual practice. Content analysis of regulations, identifying concepts, and linking them to survey questions. Quality criteria were established for each concept, referring to the minimum that must be met to ensure that the professional practice can be of quality; quality indicators (percentage of professionals whose practice met the quality criteria) were calculated globally and by type of prevention service; and quality standards (fulfilment of quality criteria by 75% or more of the professionals) were set. The concepts identified were: availability of clinical and exposure information, job-specificity, identification of workers with special susceptibilities, referral to mutual insurance companies for appropriate diagnosis and treatment, development of preventive proposals, and professional independence and non detriment for workers. Quality indicators ranged between 0 and 88%. None of the concepts globally reached the quality standard. The quality of health examinations performed for health surveillance in Catalonia, doesn't seem to be high enough as to comply with the preventive aim of the regulations. The situation is worse in external prevention services. Copyright belongs to the Societat Catalana de Salut Laboral.

Remediation of problematic residents--A national survey.

PubMed

Bhatti, Nasir I; Ahmed, Aadil; Stewart, Michael G; Miller, Robert H; Choi, Sukgi S

2016-04-01

Despite careful selection processes, residency programs face the challenge of training residents who fall below minimal performance standards. Poor performance of a resident can endanger both patient safety and the reputation of the residency program. It is important, therefore, for a program to identify such residents and implement strategies for their successful remediation. The purpose of our study was to gather information on evaluation and remediation strategies employed by different otolaryngology programs. Cross-sectional survey. We conducted a national survey, sending a questionnaire to the program directors of 106 otolaryngology residency programs. We collected information on demographics of the program, identification of problematic residents, and remediation strategies. The response rate was 74.5%, with a 2% cumulative incidence of problematic residents in otolaryngology programs during the past 10 years. The most frequently reported deficiencies of problematic residents were unprofessional behavior with colleagues/staff (38%), insufficient medical knowledge (37%), and poor clinical judgment (34%). Personal or professional stress was the most frequently identified underlying problem (70.5%). Remediation efforts included general counseling (78%), frequent feedback sessions (73%), assignment of a mentor (58%), and extra didactics (47%). These remediation efforts failed to produce improvement in 23% of the identified residents, ultimately leading to their dismissal. The apparent deficiencies, underlying causes, and remediation strategies vary among otolaryngology residency programs. Based on the results of this survey, we offer recommendations for the early identification of problematic residents and a standardized remediation plan. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Multicenter prospective evaluation of the express view reading mode for small-bowel capsule endoscopy studies.

PubMed

Saurin, Jean-Christophe; Jacob, Philippe; Heyries, Laurent; Pesanti, Christian; Cholet, Franck; Fassler, Isaac; Boulant, James; Bramli, Slim; De Leusse, Antoin; Rahmi, Gabriel

2018-05-01

 Reducing the reading time of capsule endoscopy films is of high priority for gastroenterologists. We report a prospective multicenter evaluation of an "express view" reading mode (Intromedic capsule system).  Eighty-three patients with obscure gastrointestinal bleeding were prospectively included in 10 centers. All patients underwent small-bowel capsule endoscopy (Intromedic, Seoul, Republic of Korea). Films were read in standard mode, then a second reading was performed in express view mode at a second center. For each lesion, the precise location, nature, and relevance were collected. A consensus reading and review were done by three experts, and considered to be the gold standard.  The mean reading time of capsule films was 39.7 minutes (11 - 180 minutes) and 19.7 minutes (4 - 40 minutes) by standard and express view mode, respectively ( P  < 1 × 10  - 4 ). The consensus review identified a significant lesion in 44/83 patients (53.0 %). Standard reading and express view reading had a 93.3 % and 82.2 % sensitivity, respectively (NS). Consensus review identified 70 significant images from which standard reading and express view reading detected 58 (82.9 %) and 55 (78.6 %), respectively. The informatics algorithm detected 66/70 images (94.3 %) thus missing four small-bowel angiodysplasia.  The express view algorithm allows an important shortening of Intromedic capsule film reading time with a high sensitivity.

Barriers to and facilitators of implementing quality standards in Hospital Day Care Units in Rheumatology: Qualitative approach to the VALORA study.

PubMed

Martín Martínez, María Auxiliadora; Zaragoza Gaynor, Gustavo Andrés; Martínez Fernández, Carmen; Gobbo Montoya, Milena; García-Vicuña, Rosario

2017-01-30

To identify barriers and facilitators in the implementation of quality standards in hospital day care units (HDCU) in rheumatology. We analyzed appraisals of HDCU in terms of standards for structure, processes and results. The qualitative approach was conducted through 13 discussion groups created by rheumatology health professionals (7), nursing professionals (4) and HDCU patients (2). The recruitment of informants was done through purposive sampling, attending to variables that form the perceptions of the HDCU. Data analysis was performed using a descriptive-interpretive method. The specialization of the HDCU and specific training in rheumatology for nursing are perceived as the main facilitator for the implementation of standards. Conversely, the delay in the availability of medicines at the HDCU is identified as a barrier that prolongs patient stay and wastes resources. Differences in local regulations are perceived as a potential barrier to equitable access to medicines. The patients gave higher ratings to the care received than to structural variables or those related to process. The findings of this study suggest that improvements in the implementation of quality standards in HDCU may include three levels of action: the HDCU, the hospital and a third related to local regulations to access to medicines. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

U.S. Food safety and Inspection Service testing for Salmonella in selected raw meat and poultry products in the United States, 1998 through 2003: an establishment-level analysis.

PubMed

Eblen, Denise R; Barlow, Kristina E; Naugle, Alecia Larew

2006-11-01

The U.S. Food Safety and Inspection Service (FSIS) pathogen reduction-hazard analysis critical control point systems final rule, published in 1996, established Salmonella performance standards for broiler chicken, cow and bull, market hog, and steer and heifer carcasses and for ground beef, chicken, and turkey meat. In 1998, the FSIS began testing to verify that establishments are meeting performance standards. Samples are collected in sets in which the number of samples is defined but varies according to product class. A sample set fails when the number of positive Salmonella samples exceeds the maximum number of positive samples allowed under the performance standard. Salmonella sample sets collected at 1,584 establishments from 1998 through 2003 were examined to identify factors associated with failure of one or more sets. Overall, 1,282 (80.9%) of establishments never had failed sets. In establishments that did experience set failure(s), generally the failed sets were collected early in the establishment testing history, with the exception of broiler establishments where failure(s) occurred both early and late in the course of testing. Small establishments were more likely to have experienced a set failure than were large or very small establishments, and broiler establishments were more likely to have failed than were ground beef, market hog, or steer-heifer establishments. Agency response to failed Salmonella sample sets in the form of in-depth verification reviews and related establishment-initiated corrective actions have likely contributed to declines in the number of establishments that failed sets. A focus on food safety measures in small establishments and broiler processing establishments should further reduce the number of sample sets that fail to meet the Salmonella performance standard.

Performing mathematics activities with non-standard units of measurement using robots controlled via speech-generating devices: three case studies.

PubMed

Adams, Kim D; Cook, Albert M

2017-07-01

Purpose To examine how using a Lego robot controlled via a speech-generating device (SGD) can contribute to how students with physical and communication impairments perform hands-on and communicative mathematics measurement activities. This study was a follow-up to a previous study. Method Three students with cerebral palsy used the robot to measure objects using non-standard units, such as straws, and then compared and ordered the objects using the resulting measurement. Their performance was assessed, and the manipulation and communication events were observed. Teachers and education assistants were interviewed regarding robot use. Results Similar benefits to the previous study were found in this study. Gaps in student procedural knowledge were identified such as knowing to place measurement units tip-to-tip, and students' reporting revealed gaps in conceptual understanding. However, performance improved with repeated practice. Stakeholders identified that some robot tasks took too long or were too difficult to perform. Conclusions Having access to both their SGD and a robot gave the students multiple ways to show their understanding of the measurement concepts. Though they could participate actively in the new mathematics activities, robot use is most appropriate in short tasks requiring reasonable operational skill. Implications for Rehabilitation Lego robots controlled via speech-generating devices (SGDs) can help students to engage in the mathematics pedagogy of performing hands-on activities while communicating about concepts. Students can "show what they know" using the Lego robots, and report and reflect on concepts using the SGD. Level 1 and Level 2 mathematics measurement activities have been adapted to be accomplished by the Lego robot. Other activities can likely be accomplished with similar robot adaptations (e.g., gripper, pen). It is not recommended to use the robot to measure items that are long, or perform measurements that require high operational competence in order to be successful.

Utilization of a Clinical Trial Management System for the Whole Clinical Trial Process as an Integrated Database: System Development

PubMed Central

Park, Yu Rang; Yoon, Young Jo; Koo, HaYeong; Yoo, Soyoung; Choi, Chang-Min; Beck, Sung-Ho

2018-01-01

Background Clinical trials pose potential risks in both communications and management due to the various stakeholders involved when performing clinical trials. The academic medical center has a responsibility and obligation to conduct and manage clinical trials while maintaining a sufficiently high level of quality, therefore it is necessary to build an information technology system to support standardized clinical trial processes and comply with relevant regulations. Objective The objective of the study was to address the challenges identified while performing clinical trials at an academic medical center, Asan Medical Center (AMC) in Korea, by developing and utilizing a clinical trial management system (CTMS) that complies with standardized processes from multiple departments or units, controlled vocabularies, security, and privacy regulations. Methods This study describes the methods, considerations, and recommendations for the development and utilization of the CTMS as a consolidated research database in an academic medical center. A task force was formed to define and standardize the clinical trial performance process at the site level. On the basis of the agreed standardized process, the CTMS was designed and developed as an all-in-one system complying with privacy and security regulations. Results In this study, the processes and standard mapped vocabularies of a clinical trial were established at the academic medical center. On the basis of these processes and vocabularies, a CTMS was built which interfaces with the existing trial systems such as the electronic institutional review board health information system, enterprise resource planning, and the barcode system. To protect patient data, the CTMS implements data governance and access rules, and excludes 21 personal health identifiers according to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule and Korean privacy laws. Since December 2014, the CTMS has been successfully implemented and used by 881 internal and external users for managing 11,645 studies and 146,943 subjects. Conclusions The CTMS was introduced in the Asan Medical Center to manage the large amounts of data involved with clinical trial operations. Inter- and intraunit control of data and resources can be easily conducted through the CTMS system. To our knowledge, this is the first CTMS developed in-house at an academic medical center side which can enhance the efficiency of clinical trial management in compliance with privacy and security laws. PMID:29691212

Is the Juice Worth the Squeeze? Costs and Benefits of Multiple Human Annotators for Clinical Text De-identification.

PubMed

Carrell, David S; Cronkite, David J; Malin, Bradley A; Aberdeen, John S; Hirschman, Lynette

2016-08-05

Clinical text contains valuable information but must be de-identified before it can be used for secondary purposes. Accurate annotation of personally identifiable information (PII) is essential to the development of automated de-identification systems and to manual redaction of PII. Yet the accuracy of annotations may vary considerably across individual annotators and annotation is costly. As such, the marginal benefit of incorporating additional annotators has not been well characterized. This study models the costs and benefits of incorporating increasing numbers of independent human annotators to identify the instances of PII in a corpus. We used a corpus with gold standard annotations to evaluate the performance of teams of annotators of increasing size. Four annotators independently identified PII in a 100-document corpus consisting of randomly selected clinical notes from Family Practice clinics in a large integrated health care system. These annotations were pooled and validated to generate a gold standard corpus for evaluation. Recall rates for all PII types ranged from 0.90 to 0.98 for individual annotators to 0.998 to 1.0 for teams of three, when meas-ured against the gold standard. Median cost per PII instance discovered during corpus annotation ranged from $ 0.71 for an individual annotator to $ 377 for annotations discovered only by a fourth annotator. Incorporating a second annotator into a PII annotation process reduces unredacted PII and improves the quality of annotations to 0.99 recall, yielding clear benefit at reasonable cost; the cost advantages of annotation teams larger than two diminish rapidly.

Environmental permitting in Thailand

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

Byers, A.C.

Thailand's 1992 enhancement and Conservation of Environmental Quality Act and regulations require any entry proposing to construct a thermal power plant with a capacity greater that 10 MW to perform various environmental studies and prepare an environmental Impact Assessment (EIA) report in accordance with the guidelines issued by the office of Environmental Policy and Planning (OEPP). Approval of the EIA is a prerequisite to the issuance of most other construction permits. Applicable environmental standards and regulation are promulgated by the Pollution Control Department (PCD), a wholly separate agency for the OEPP. The PCD is a fairly new organization and, asmore » a result, their staff is still gaining understanding of the multiple environmental aspects of power generation. Accordingly, the PCD is still in process of drafting key regulations applicable to the power industry. This paper examines the current guidelines, practices, procedures and legal requirements regarding environmental licensing of a thermal power plant in Thailand. The requisite scope and content of the EIA report will be identified, as well as the current procedure for its official review and approval by the OEPP. The paper will address the challenges of working with local consultants and identify potential pitfalls in the report preparation process. Areas of particular interest in the EIA review will be identified based on recent examples of OEPP comments on previous SPP and IPP projects. Additionally, the development of applicable environmental standards by the PCD will be identified along with their plans for implementing these standards. The paper will also examine the relationship of the OEPP and PCD, and reflect upon trends for environmental regulation in Thailand in the near future.« less

Automatic detection of end-diastolic and end-systolic frames in 2D echocardiography.

PubMed

Zolgharni, Massoud; Negoita, Madalina; Dhutia, Niti M; Mielewczik, Michael; Manoharan, Karikaran; Sohaib, S M Afzal; Finegold, Judith A; Sacchi, Stefania; Cole, Graham D; Francis, Darrel P

2017-07-01

Correctly selecting the end-diastolic and end-systolic frames on a 2D echocardiogram is important and challenging, for both human experts and automated algorithms. Manual selection is time-consuming and subject to uncertainty, and may affect the results obtained, especially for advanced measurements such as myocardial strain. We developed and evaluated algorithms which can automatically extract global and regional cardiac velocity, and identify end-diastolic and end-systolic frames. We acquired apical four-chamber 2D echocardiographic video recordings, each at least 10 heartbeats long, acquired twice at frame rates of 52 and 79 frames/s from 19 patients, yielding 38 recordings. Five experienced echocardiographers independently marked end-systolic and end-diastolic frames for the first 10 heartbeats of each recording. The automated algorithm also did this. Using the average of time points identified by five human operators as the reference gold standard, the individual operators had a root mean square difference from that gold standard of 46.5 ms. The algorithm had a root mean square difference from the human gold standard of 40.5 ms (P<.0001). Put another way, the algorithm-identified time point was an outlier in 122/564 heartbeats (21.6%), whereas the average human operator was an outlier in 254/564 heartbeats (45%). An automated algorithm can identify the end-systolic and end-diastolic frames with performance indistinguishable from that of human experts. This saves staff time, which could therefore be invested in assessing more beats, and reduces uncertainty about the reliability of the choice of frame. © 2017, Wiley Periodicals, Inc.

Automating Assessment of Lifestyle Counseling in Electronic Health Records

PubMed Central

Hazlehurst, Brian L.; Lawrence, Jean M.; Donahoo, William T.; Sherwood, Nancy E; Kurtz, Stephen E; Xu, Stan; Steiner, John F

2015-01-01

Background Numerous population-based surveys indicate that overweight and obese patients can benefit from lifestyle counseling during routine clinical care. Purpose To determine if natural language processing (NLP) could be applied to information in the electronic health record (EHR) to automatically assess delivery of counseling related to weight management in clinical health care encounters. Methods The MediClass system with NLP capabilities was used to identify weight management counseling in EHR encounter records. Knowledge for the NLP application was derived from the 5As framework for behavior counseling: Ask (evaluate weight and related disease), Advise at-risk patients to lose weight, Assess patients’ readiness to change behavior, Assist through discussion of weight loss methods and programs and Arrange follow-up efforts including referral. Using samples of EHR data in 1/1/2007-3/31/2011 period from two health systems, the accuracy of the MediClass processor for identifying these counseling elements was evaluated in post-partum visits of 600 women with gestational diabetes mellitus (GDM) compared to manual chart review as gold standard. Data were analyzed in 2013. Results Mean sensitivity and specificity for each of the 5As compared to the gold standard was at or above 85%, with the exception of sensitivity for Assist which was measured at 40% and 60% respectively for each of the two health systems. The automated method identified many valid cases of Assist not identified in the gold standard. Conclusions The MediClass processor has performance capability sufficiently similar to human abstractors to permit automated assessment of counseling for weight loss in post-partum encounter records. PMID:24745635

Automating assessment of lifestyle counseling in electronic health records.

PubMed

Hazlehurst, Brian L; Lawrence, Jean M; Donahoo, William T; Sherwood, Nancy E; Kurtz, Stephen E; Xu, Stan; Steiner, John F

2014-05-01

Numerous population-based surveys indicate that overweight and obese patients can benefit from lifestyle counseling during routine clinical care. To determine if natural language processing (NLP) could be applied to information in the electronic health record (EHR) to automatically assess delivery of weight management-related counseling in clinical healthcare encounters. The MediClass system with NLP capabilities was used to identify weight-management counseling in EHRs. Knowledge for the NLP application was derived from the 5As framework for behavior counseling: Ask (evaluate weight and related disease), Advise at-risk patients to lose weight, Assess patients' readiness to change behavior, Assist through discussion of weight-loss methods and programs, and Arrange follow-up efforts including referral. Using samples of EHR data between January 1, 2007, and March 31, 2011, from two health systems, the accuracy of the MediClass processor for identifying these counseling elements was evaluated in postpartum visits of 600 women with gestational diabetes mellitus (GDM) compared to manual chart review as the gold standard. Data were analyzed in 2013. Mean sensitivity and specificity for each of the 5As compared to the gold standard was at or above 85%, with the exception of sensitivity for Assist, which was 40% and 60% for each of the two health systems. The automated method identified many valid Assist cases not identified in the gold standard. The MediClass processor has performance capability sufficiently similar to human abstractors to permit automated assessment of counseling for weight loss in postpartum encounter records. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Phonological Working Memory for Words and Nonwords in Cerebral Cortex

PubMed Central

Ghosh, Satrajit S.; Ostrovskaya, Irina; Gabrieli, John D. E.; Kovelman, Ioulia

2017-01-01

Purpose The primary purpose of this study was to identify the brain bases of phonological working memory (the short-term maintenance of speech sounds) using behavioral tasks analogous to clinically sensitive assessments of nonword repetition. The secondary purpose of the study was to identify how individual differences in brain activation were related to participants' nonword repetition abilities. Method We used functional magnetic resonance imaging to measure neurophysiological response during a nonword discrimination task derived from standard clinical assessments of phonological working memory. Healthy adult control participants (N = 16) discriminated pairs of real words or nonwords under varying phonological working memory load, which we manipulated by parametrically varying the number of syllables in target (non)words. Participants' cognitive and phonological abilities were also measured using standardized assessments. Results Neurophysiological responses in bilateral superior temporal gyrus, inferior frontal gyrus, and supplementary motor area increased with greater phonological working memory load. Activation in left superior temporal gyrus during nonword discrimination correlated with participants' performance on standard clinical nonword repetition tests. Conclusion These results suggest that phonological working memory is related to the function of cortical structures that canonically underlie speech perception and production. PMID:28631005

Hanford business structure for HANDI 2000 business management system

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

Wilson, D.

The Hanford Business Structure integrates the project`s technical, schedule, and cost baselines; implements the use of a standard code of accounts; and streamlines performance reporting and cost collection. Technical requirements drive the technical functions and come from the RDD 100 database. The functions will be identified in the P3 scheduling system and also in the PeopleSoft system. Projects will break their work down from the technical requirements in the P3 schedules. When the level at which they want to track cost via the code of accounts is reached, a Project ID will be generated in the PeopleSoft system. P3 maymore » carry more detailed schedules below the Project ID level. The standard code of accounts will identify discrete work activities done across the site and various projects. They will include direct and overhead type work scopes. Activities in P3 will roll up to this standard code of accounts. The field that will be used to record this in PeopleSoft is ``Activity``. In Passport it is a user-defined field. It will have to be added to other feeder systems. Project ID and code of accounts are required fields on all cost records.« less

The Clinical Utility of ASRS-v1.1 for Identifying ADHD in Alcoholics Using PRISM as the Reference Standard.

PubMed

Reyes, Maria M; Schneekloth, Terry D; Hitschfeld, Mario J; Geske, Jennifer R; Atkinson, David L; Karpyak, Victor M

2016-05-02

The objective was to assess the clinical utility of the Adult ADHD Self-Report Scale (ASRS-v1.1) in identifying ADHD in alcoholics using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) as the diagnostic "gold standard." We performed a secondary analysis of data from 379 treatment-seeking alcoholics who completed the ASRS-v1.1 and the ADHD module of the PRISM. Data analysis included descriptive statistics. The prevalence of ADHD was 7.7% (95% CI = [5.4, 10.8]). The positive predictive value (PPV) of the ASRS-v1.1 was 18.1% (95% CI = [12.4, 25.7]) and the negative predictive value (NPV) was 97.6% (95% CI = [94.9, 98.9]). The ASRS-v1.1 demonstrated a sensitivity of 79.3% (95% CI = [61.6, 90.2]) and a specificity of 70.3% (95% CI = [65.3, 74.8]). The ASRS-v1.1 demonstrated acceptable sensitivity and specificity in a sample of treatment-seeking alcoholics when compared with the PRISM as the reference standard for ADHD diagnosis. © The Author(s) 2016.

Assessing the Genetics Content in the Next Generation Science Standards.

PubMed

Lontok, Katherine S; Zhang, Hubert; Dougherty, Michael J

2015-01-01

Science standards have a long history in the United States and currently form the backbone of efforts to improve primary and secondary education in science, technology, engineering, and math (STEM). Although there has been much political controversy over the influence of standards on teacher autonomy and student performance, little light has been shed on how well standards cover science content. We assessed the coverage of genetics content in the Next Generation Science Standards (NGSS) using a consensus list of American Society of Human Genetics (ASHG) core concepts. We also compared the NGSS against state science standards. Our goals were to assess the potential of the new standards to support genetic literacy and to determine if they improve the coverage of genetics concepts relative to state standards. We found that expert reviewers cannot identify ASHG core concepts within the new standards with high reliability, suggesting that the scope of content addressed by the standards may be inconsistently interpreted. Given results that indicate that the disciplinary core ideas (DCIs) included in the NGSS documents produced by Achieve, Inc. clarify the content covered by the standards statements themselves, we recommend that the NGSS standards statements always be viewed alongside their supporting disciplinary core ideas. In addition, gaps exist in the coverage of essential genetics concepts, most worryingly concepts dealing with patterns of inheritance, both Mendelian and complex. Finally, state standards vary widely in their coverage of genetics concepts when compared with the NGSS. On average, however, the NGSS support genetic literacy better than extant state standards.

Validation of a short cognitive battery to screen for fitness-to-drive of people with multiple sclerosis.

PubMed

Akinwuntan, A E; Backus, D; Grayson, J; Devos, H

2018-05-26

Some symptoms of multiple sclerosis (MS) affect driving. In a recent study, performance on five cognitive tests predicted the on-road test performance of individuals with relapsing-remitting MS with 91% accuracy, 70% sensitivity and 97% specificity. However, the accuracy with which the battery will predict the driving performance of a different cohort that includes all types of MS is unknown. Participants (n = 118; 48 ± 9 years of age; 97 females) performed a comprehensive off-road evaluation that lasted about 3 h and a standardized on-road test that lasted approximately 45 min over a 2-day period within the same week. Performance on the five cognitive tests was used to predict participants' performance on the standardized on-road test. Performance on the five tests together predicted outcome of the on-road test with 82% accuracy, 42% sensitivity and 90% specificity. The accuracy of predicting the on-road performance of a new MS cohort using performance on the battery of five cognitive tests remained very high (82%). The battery, which was administrable in <45 min and cost ~$150, was better at identifying those who actually passed the on-road test (90% specificity). The sensitivity (42%) of the battery indicated that it should not be used as the sole determinant of poor driving-related cognitive skills. A fail performance on the battery should only imply that more comprehensive testing is warranted. © 2018 EAN.

20 CFR 627.470 - Performance standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Performance standards. 627.470 Section 627... GOVERNING PROGRAMS UNDER TITLES I, II, AND III OF THE ACT Administrative Standards § 627.470 Performance standards. (a) General. The Secretary shall prescribe performance standards for adult programs under title...

20 CFR 627.470 - Performance standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Performance standards. 627.470 Section 627... GOVERNING PROGRAMS UNDER TITLES I, II, AND III OF THE ACT Administrative Standards § 627.470 Performance standards. (a) General. The Secretary shall prescribe performance standards for adult programs under title...

Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

PubMed

Widdifield, Jessica; Bernatsky, Sasha; Paterson, J Michael; Tu, Karen; Ng, Ryan; Thorne, J Carter; Pope, Janet E; Bombardier, Claire

2013-10-01

Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada. We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data. One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with ≥1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date. We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance. Copyright © 2013 by the American College of Rheumatology.

Use of the VITEK 2 system to identify and test the antifungal susceptibility of clinically relevant yeast species

PubMed Central

Melhem, MSC; Bertoletti, A; Lucca, HRL; Silva, RBO; Meneghin, FA; Szeszs, MW

2013-01-01

Eleven quality control isolates (Candida albicans ATCC 64548, C. tropicalis ATCC 200956, C. glabrata ATCC 90030, C. lusitaniae ATCC 200951, C. parapsilosis ATCC 22019, C. krusei ATCC 6258, C. dubliniensis ATCC 6330, Saccharomyces cerevisiae ATCC 9763, Cryptococcus neoformans ATCC 90012, C. gattii FIOCRUZ-CPF 60, and Trichosporon mucoides ATCC 204094) and 32 bloodstream isolates, including C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, C. krusei, C. guilliermondii, C. pelliculosa (Pichia anomala), C. haemulonii, C. lusitaniae, and C. kefyr were identified at the species level by the VITEK 2 system. A set of clinical isolates (32 total) were used as challenge strains to evaluate the ability of the VITEK 2 system to determine the antifungal susceptibility of yeasts compared with the CLSI and EUCAST BMD reference standards. The VITEK 2 system correctly identified 100% of the challenge strains. The identification of yeast species and the evaluation of their susceptibility profiles were performed in an automated manner by the VITEK 2 system after approximately 15 h of growth for most species of Candida. The VITEK 2 system ensures that each test is performed in a standardized manner and provides quantitative MIC results that are reproducible and accurate when compared with the BMD reference methods. This system was able to determine the MICs of amphotericin B, flucytosine, voriconazole, and fluconazole in 15 h or less for the most common clinically relevant Candida species. In addition, the VITEK 2 system could reliably identify resistance to flucytosine, voriconazole, and fluconazole and exhibits excellent quantitative and qualitative agreement with the CLSI or EUCAST broth microdilution reference methods. PMID:24688520

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis.

PubMed

Vanderveen, J A; Bassler, D; Robertson, C M T; Kirpalani, H

2009-05-01

To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older. Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported. Identified studies (n=25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N=2198 infants) found significantly higher mental (N=2198) and physical (N=1319) performance scores favoring the intervention group. At 24 months, the mental (N=1490) performance scores were improved, but physical (N=1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N=961) and 5 years (N=1017). Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

Assessment of a visually guided autonomous exploration robot

NASA Astrophysics Data System (ADS)

Harris, C.; Evans, R.; Tidey, E.

2008-10-01

A system has been developed to enable a robot vehicle to autonomously explore and map an indoor environment using only visual sensors. The vehicle is equipped with a single camera, whose output is wirelessly transmitted to an off-board standard PC for processing. Visual features within the camera imagery are extracted and tracked, and their 3D positions are calculated using a Structure from Motion algorithm. As the vehicle travels, obstacles in its surroundings are identified and a map of the explored region is generated. This paper discusses suitable criteria for assessing the performance of the system by computer-based simulation and practical experiments with a real vehicle. Performance measures identified include the positional accuracy of the 3D map and the vehicle's location, the efficiency and completeness of the exploration and the system reliability. Selected results are presented and the effect of key system parameters and algorithms on performance is assessed. This work was funded by the Systems Engineering for Autonomous Systems (SEAS) Defence Technology Centre established by the UK Ministry of Defence.

Nontargeted multicomponent analytical screening of plastic food contact materials using fast interpretation of deliverables via expert structure-activity relationship software.

PubMed

Rothenbacher, Thorsten; Schwack, Wolfgang

2009-01-01

Plastic packaging materials may release compounds into packed foodstuffs. To identify potential migrants of toxicological concern, resins, and multilayer foils (mainly polyethylene) intended for the production of food contact materials were extracted and analyzed by GC/mass spectrometry. To identify even compounds of low concentrations, AMDIS software was used and data evaluation was safeguarded by the Kovats retention index (RI) system. In this way, 46 compounds were identified as possible migrants. The expert structure-activity relationship software DEREK for Windows was utilized to evaluate all identified substances in terms of carcinogenicity, genotoxicity, thyroid toxicity, and miscellaneous endpoints for humans. Additionally, a literature search for these compounds was performed with Sci-Finder, but relevant data were missing for 28 substances. Seven compounds with adverse toxicological effects were identified. In addition, the RIs of 24 commercial additive standards, measured with a GC capillary column of intermediate polarity, are given.

The Analysis of the General Performance and Mechanical Behavior of Unirradiated FeCrAl Alloys Before and After Welding

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

Gussev, Maxim N.; Field, Kevin G.; Yamamoto, Yukinori

2016-06-03

The present report summarizes and discusses the preliminary results for the in-depth characterization of the modern, nuclear-grade FeCrAl alloys currently under development. The alloys were designed for enhanced radiation tolerance and weldability, and the research is currently being pursued by the Department of Energy (DOE) Nuclear Energy Enabling Technologies (NEET) program. Last year, seven candidate FeCrAl alloys with well-controlled chemistry and microstructures were designed and produced; welding was performed under well-controlled conditions. The structure and general performance of unirradiated alloys were assessed using standardized and advanced microstructural characterization techniques and mechanical testing. The primary objective is to identify the bestmore » candidate alloy, or at a minimum to identify the contributing factors that increase the weldability and radiation tolerance of FeCrAl alloys, therefore enabling future generations of FeCrAl alloys to deliver better performance parameters. This report is structured so as to describe these critical assessments of the weldability; radiation tolerance will be reported on in later reports from this program.« less

Automated annotation of functional imaging experiments via multi-label classification

PubMed Central

Turner, Matthew D.; Chakrabarti, Chayan; Jones, Thomas B.; Xu, Jiawei F.; Fox, Peter T.; Luger, George F.; Laird, Angela R.; Turner, Jessica A.

2013-01-01

Identifying the experimental methods in human neuroimaging papers is important for grouping meaningfully similar experiments for meta-analyses. Currently, this can only be done by human readers. We present the performance of common machine learning (text mining) methods applied to the problem of automatically classifying or labeling this literature. Labeling terms are from the Cognitive Paradigm Ontology (CogPO), the text corpora are abstracts of published functional neuroimaging papers, and the methods use the performance of a human expert as training data. We aim to replicate the expert's annotation of multiple labels per abstract identifying the experimental stimuli, cognitive paradigms, response types, and other relevant dimensions of the experiments. We use several standard machine learning methods: naive Bayes (NB), k-nearest neighbor, and support vector machines (specifically SMO or sequential minimal optimization). Exact match performance ranged from only 15% in the worst cases to 78% in the best cases. NB methods combined with binary relevance transformations performed strongly and were robust to overfitting. This collection of results demonstrates what can be achieved with off-the-shelf software components and little to no pre-processing of raw text. PMID:24409112

Recurrence Methods for the Identification of Morphogenetic Patterns

PubMed Central

Facchini, Angelo; Mocenni, Chiara

2013-01-01

This paper addresses the problem of identifying the parameters involved in the formation of spatial patterns in nonlinear two dimensional systems. To this aim, we perform numerical experiments on a prototypical model generating morphogenetic Turing patterns, by changing both the spatial frequency and shape of the patterns. The features of the patterns and their relationship with the model parameters are characterized by means of the Generalized Recurrence Quantification measures. We show that the recurrence measures Determinism and Recurrence Entropy, as well as the distribution of the line lengths, allow for a full characterization of the patterns in terms of power law decay with respect to the parameters involved in the determination of their spatial frequency and shape. A comparison with the standard two dimensional Fourier transform is performed and the results show a better performance of the recurrence indicators in identifying a reliable connection with the spatial frequency of the patterns. Finally, in order to evaluate the robustness of the estimation of the power low decay, extensive simulations have been performed by adding different levels of noise to the patterns. PMID:24066062

An extended set of yeast-based functional assays accurately identifies human disease mutations

PubMed Central

Sun, Song; Yang, Fan; Tan, Guihong; Costanzo, Michael; Oughtred, Rose; Hirschman, Jodi; Theesfeld, Chandra L.; Bansal, Pritpal; Sahni, Nidhi; Yi, Song; Yu, Analyn; Tyagi, Tanya; Tie, Cathy; Hill, David E.; Vidal, Marc; Andrews, Brenda J.; Boone, Charles; Dolinski, Kara; Roth, Frederick P.

2016-01-01

We can now routinely identify coding variants within individual human genomes. A pressing challenge is to determine which variants disrupt the function of disease-associated genes. Both experimental and computational methods exist to predict pathogenicity of human genetic variation. However, a systematic performance comparison between them has been lacking. Therefore, we developed and exploited a panel of 26 yeast-based functional complementation assays to measure the impact of 179 variants (101 disease- and 78 non-disease-associated variants) from 22 human disease genes. Using the resulting reference standard, we show that experimental functional assays in a 1-billion-year diverged model organism can identify pathogenic alleles with significantly higher precision and specificity than current computational methods. PMID:26975778

Analytic aerotriangulation utilizing Skylab earth terrain camera (S-190B) photography. [from Charlotte, North Carolina to Rappahannock River in Virginia

NASA Technical Reports Server (NTRS)

Keller, M. (Principal Investigator)

1975-01-01

The author has identified the following significant results. Inherent errors in using nonmetric Skylab photography and office-identified photo control made it necessary to perform numerous block adjustment solutions involving different combinations of control and weights. The final block adjustment was executed holding to 14 of the office-identified photo control points. Solution accuracy was evaluated by comparing the analytically computed ground positions of the withheld photo control points with their known ground positions and also by determining the standard errors of these points from variance values. A horizontal position RMS error of 15 meters was attained. The maximum observed error in position at a control point was 25 meters.

Toward a tactile language for human-robot interaction: two studies of tacton learning and performance.

PubMed

Barber, Daniel J; Reinerman-Jones, Lauren E; Matthews, Gerald

2015-05-01

Two experiments were performed to investigate the feasibility for robot-to-human communication of a tactile language using a lexicon of standardized tactons (tactile icons) within a sentence. Improvements in autonomous systems technology and a growing demand within military operations are spurring interest in communication via vibrotactile displays. Tactile communication may become an important element of human-robot interaction (HRI), but it requires the development of messaging capabilities approaching the communication power of the speech and visual signals used in the military. In Experiment 1 (N = 38), we trained participants to identify sets of directional, dynamic, and static tactons and tested performance and workload following training. In Experiment 2 (N = 76), we introduced an extended training procedure and tested participants' ability to correctly identify two-tacton phrases. We also investigated the impact of multitasking on performance and workload. Individual difference factors were assessed. Experiment 1 showed that participants found dynamic and static tactons difficult to learn, but the enhanced training procedure in Experiment 2 produced competency in performance for all tacton categories. Participants in the latter study also performed well on two-tacton phrases and when multitasking. However, some deficits in performance and elevation of workload were observed. Spatial ability predicted some aspects of performance in both studies. Participants may be trained to identify both single tactons and tacton phrases, demonstrating the feasibility of developing a tactile language for HRI. Tactile communication may be incorporated into multi-modal communication systems for HRI. It also has potential for human-human communication in challenging environments. © 2014, Human Factors and Ergonomics Society.

Improved high operating temperature MCT MWIR modules

NASA Astrophysics Data System (ADS)

Lutz, H.; Breiter, R.; Figgemeier, H.; Schallenberg, T.; Schirmacher, W.; Wollrab, R.

2014-06-01

High operating temperature (HOT) IR-detectors are a key factor to size, weight and power (SWaP) reduced IR-systems. Such systems are essential to provide infantrymen with low-weight handheld systems with increased battery lifetimes or most compact clip-on weapon sights in combination with high electro-optical performance offered by cooled IR-technology. AIM's MCT standard n-on-p technology with vacancy doping has been optimized over many years resulting in MWIR-detectors with excellent electro-optical performance up to operating temperatures of ~120K. In the last years the effort has been intensified to improve this standard technology by introducing extrinsic doping with Gold as an acceptor. As a consequence the dark current could considerably be suppressed and allows for operation at ~140K with good e/o performance. More detailed investigations showed that limitation for HOT > 140K is explained by consequences from rising dark current rather than from defective pixel level. Recently, several crucial parameters were identified showing great promise for further optimization of HOT-performance. Among those, p-type concentration could successfully be reduced from the mid 1016 / cm3 to the lower 1015/ cm3 range. Since AIM is one of the leading manufacturers of split linear cryocoolers, an increase in operating temperature will directly lead to IR-modules with improved SWaP characteristics by making use of the miniature members of its SX cooler family with single piston and balancer technology. The paper will present recent progress in the development of HOT MWIR-detector arrays at AIM and show electro-optical performance data in comparison to focal plane arrays produced in the standard technology.

The development of an imaging informatics-based multi-institutional platform to support sports performance and injury prevention in track and field

NASA Astrophysics Data System (ADS)

Liu, Joseph; Wang, Ximing; Verma, Sneha; McNitt-Gray, Jill; Liu, Brent

2018-03-01

The main goal of sports science and performance enhancement is to collect video and image data, process them, and quantify the results, giving insight to help athletes improve technique. For long jump in track and field, the processed output of video with force vector overlays and force calculations allow coaches to view specific stages of the hop, step, and jump, and identify how each stage can be improved to increase jump distance. Outputs also provide insight into how athletes can better maneuver to prevent injury. Currently, each data collection site collects and stores data with their own methods. There is no standard for data collection, formats, or storage. Video files and quantified results are stored in different formats, structures, and locations such as Dropbox and hard drives. Using imaging informatics-based principles we can develop a platform for multiple institutions that promotes the standardization of sports performance data. In addition, the system will provide user authentication and privacy as in clinical trials, with specific user access rights. Long jump data collected from different field sites will be standardized into specified formats before database storage. Quantified results from image-processing algorithms are stored similar to CAD algorithm results. The system will streamline the current sports performance data workflow and provide a user interface for athletes and coaches to view results of individual collections and also longitudinally across different collections. This streamlined platform and interface is a tool for coaches and athletes to easily access and review data to improve sports performance and prevent injury.

Modeling Canadian Quality Control Test Program for Steroid Hormone Receptors in Breast Cancer: Diagnostic Accuracy Study.

PubMed

Pérez, Teresa; Makrestsov, Nikita; Garatt, John; Torlakovic, Emina; Gilks, C Blake; Mallett, Susan

The Canadian Immunohistochemistry Quality Control program monitors clinical laboratory performance for estrogen receptor and progesterone receptor tests used in breast cancer treatment management in Canada. Current methods assess sensitivity and specificity at each time point, compared with a reference standard. We investigate alternative performance analysis methods to enhance the quality assessment. We used 3 methods of analysis: meta-analysis of sensitivity and specificity of each laboratory across all time points; sensitivity and specificity at each time point for each laboratory; and fitting models for repeated measurements to examine differences between laboratories adjusted by test and time point. Results show 88 laboratories participated in quality control at up to 13 time points using typically 37 to 54 histology samples. In meta-analysis across all time points no laboratories have sensitivity or specificity below 80%. Current methods, presenting sensitivity and specificity separately for each run, result in wide 95% confidence intervals, typically spanning 15% to 30%. Models of a single diagnostic outcome demonstrated that 82% to 100% of laboratories had no difference to reference standard for estrogen receptor and 75% to 100% for progesterone receptor, with the exception of 1 progesterone receptor run. Laboratories with significant differences to reference standard identified with Generalized Estimating Equation modeling also have reduced performance by meta-analysis across all time points. The Canadian Immunohistochemistry Quality Control program has a good design, and with this modeling approach has sufficient precision to measure performance at each time point and allow laboratories with a significantly lower performance to be targeted for advice.

A Delphi Consensus of the Crucial Steps in Gastric Bypass and Sleeve Gastrectomy Procedures in the Netherlands.

PubMed

Kaijser, Mirjam A; van Ramshorst, Gabrielle H; Emous, Marloes; Veeger, Nic J G M; van Wagensveld, Bart A; Pierie, Jean-Pierre E N

2018-04-09

Bariatric procedures are technically complex and skill demanding. In order to standardize the procedures for research and training, a Delphi analysis was performed to reach consensus on the practice of the laparoscopic gastric bypass and sleeve gastrectomy in the Netherlands. After a pre-round identifying all possible steps from literature and expert opinion within our study group, questionnaires were send to 68 registered Dutch bariatric surgeons, with 73 steps for bypass surgery and 51 steps for sleeve gastrectomy. Statistical analysis was performed to identify steps with and without consensus. This process was repeated to reach consensus of all necessary steps. Thirty-eight participants (56%) responded in the first round and 32 participants (47%) in the second round. After the first Delphi round, 19 steps for gastric bypass (26%) and 14 for sleeve gastrectomy (27%) gained full consensus. After the second round, an additional amount of 10 and 12 sub-steps was confirmed as key steps, respectively. Thirteen steps in the gastric bypass and seven in the gastric sleeve were deemed advisable. Our expert panel showed a high level of consensus expressed in a Cronbach's alpha of 0.82 for the gastric bypass and 0.87 for the sleeve gastrectomy. The Delphi consensus defined 29 steps for gastric bypass and 26 for sleeve gastrectomy as being crucial for correct performance of these procedures to the standards of our expert panel. These results offer a clear framework for the technical execution of these procedures.

Analysis of major antioxidants from extracts of Myrmecodia pendans by UV/visible spectrophotometer, liquid chromatography/tandem mass spectrometry, and high-performance liquid chromatography/UV techniques.

PubMed

Engida, Adam Mekonnen; Faika, Sitti; Nguyen-Thi, Bich Thuyen; Ju, Yi-Hsu

2015-06-01

In the present work, heat reflux extraction with ethanol/water (80:20; v/v) as the solvent was used to extract antioxidants from Myrmecodia pendans. The crude extract (CE) was fractionated using hexane and ethyl acetate. Ethyl acetate fraction (EAF) and aqueous fraction were collected. Antioxidant activity against 1,1-diphenyl-2-picrylhydrazyl-radical radical and ferric reducing power of the CE, EAF, and aqueous fraction were evaluated. EAF showed comparable antioxidant activity against 1,1-diphenyl-2-picrylhydrazyl-radical radical and ferric reducing power to those of the CE. UV/visible, liquid chromatography/electrospray ionization/tandem mass spectrometry, and high-performance liquid chromatography were employed for identifying the major antioxidant compounds in the EAF. Three major phenolic compounds (rosmarinic acid, procyanidin B1, and polymer of procyanidin B1) were identified. The first two compounds were confirmed and quantified by high-performance liquid chromatography using authentic standards, but confirmation of the third compound was hampered by a lack of commercial standard. Concentrations of rosmarinic acid and procyanidin B1 in the EAF were found to be 20.688 ± 1.573 mg/g dry sample and 3.236 ± 0.280 mg/g dry sample, respectively. All these three compounds are reported for the first time in sarang semut. Copyright © 2014. Published by Elsevier B.V.

Quality indicators for eye bank.

PubMed

Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

2018-03-01

The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

1980 scrubber highlights: dry-process startups, dual-alkali progress highlight scrubber advances

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

Not Available

1981-06-01

A survey of electric utilities reports scrubbers on 13% of existing capacity and estimates 29% by 1990, but compliance with the New Source Performance Standards may raise the total even higher. Dry scrubbers at two Northern States Power installations show test performances that indicate sound design and report modest manpower requirements. Other utilities are ordering demonstration dry-scrubber units, although orders for wet scrubbers continue to do well. A new dual-alkali scrubber is performing well at three installations in terms of availability and sulfur-dioxide-removal efficiency. A full-scale utility dump site test will identify any hazardous materials in pollution control ash andmore » sludge wastes. (DCK)« less

Improving Jet Engine Reliability and Maintainability: A Conceptual Approach

DTIC Science & Technology

1976-05-05

MANAGEMENT COLLEGE FT. BELVOIR, VA 22060 11. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE DEFENSE SYSTEMS MANAGMNT COLLEGE 76-1 ___ FT. 1BELVOIR... relationship to the end item; identifying the failure processes that each part is susceptible to; defining the failure rate for each process, determining the...Icontractor had performed in relationship to the established goal. The above standard of measurement appears to satisfy the criteria for an adequate

Armed Forces Recreation Center-Orlando

DTIC Science & Technology

1995-09-21

million annually (1995 value ) to HCMF. PKF Consulting stated that IG, DoD, estimates of cash flow are understated, and that AFRC-Orlando can attain an...took the corrected 1995 value of major repairs identified by PKF Consulting ($21.1 million corrected) and escalated the cost to the year 2020, at...to determine whether MWR standards of financial performance were met, and to determine whether the terms of the lease agreement were fair and

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

None

In this project, three production home builders—K. Hovnanian Homes, David Weekley Homes, and Transformations, Inc.—partnered with Building America team Building Science Corporation to evaluate the certification of five test homes to the new DOE Challenge Home program performance standard (now DOE Zero Energy Ready Home program). The builders identified key benefits and barriers that impacted the certification of the test homes, and the likelihood of whether DOE Challenge Home certification would be pursued in future homes

Weight Reduction Techniques Adopted When Weight Standards are Enforced

DTIC Science & Technology

1993-01-01

ORGANIZATION NAME(S) AND ADDRESS(ES) 8, PERFORMING ORGANIZATION Military Nutrition Division REPORT NUMBER U. S. Army Research Institute of Environmental...affecting more soldiers than those Identified by the AWCP and possibly developing during a career In the Army. Nutrition /education programs should...that appeas to be Inevitable with aging and a career in the’Army. 14. SUBJECT TERMS 15. NUMBIEN OF PAGES Nutrition , weight reduction, Army weight

Endoscopic ultrasound as an adjunctive evaluation in patients with esophageal motor disorders subtyped by high-resolution manometry.

PubMed

Krishnan, K; Lin, C-Y; Keswani, R; Pandolfino, J E; Kahrilas, P J; Komanduri, S

2014-08-01

Esophageal motor disorders are a heterogeneous group of conditions identified by esophageal manometry that lead to esophageal dysfunction. The aim of this study was to assess the clinical utility of endoscopic ultrasound (EUS) in the further evaluation of patients with esophageal motor disorders categorized using the updated Chicago Classification. We performed a retrospective, single center study of 62 patients with esophageal motor disorders categorized according to the Chicago Classification. All patients underwent standard radial endosonography to assess for extra-esophageal findings or alternative explanations for esophageal outflow obstruction. Secondary outcomes included esophageal wall thickness among the different patient subsets within the Chicago Classification. EUS identified 9/62 (15%) clinically relevant findings that altered patient management and explained the etiology of esophageal outflow obstruction. We further identified substantial variability in esophageal wall thickness in a proportion of patients including some with a significantly thickened non-muscular layer. EUS findings are clinically relevant in a significant number of patients with motor disorders and can alter clinical management. Variability in esophageal wall thickness of the muscularis propria and non-muscular layers identified by EUS may also explain the observed variability in response to standard therapies for achalasia. © 2014 John Wiley & Sons Ltd.

Endoscopic ultrasound as an adjunctive evaluation in patients with esophageal motor disorders subtyped by high-resolution manometry

PubMed Central

Krishnan, Kumar; Lin, Chen-Yuan; Keswani, Rajesh; Pandolfino, John E; Kahrilas, Peter J; Komanduri, Srinadh

2015-01-01

Background and aims Esophageal motor disorders are a heterogenous group of conditions identified by esophageal manometry that lead to esophageal dysfunction. The aim of this study was to assess the clinical utility of endoscopic ultrasound in the further evaluation of patients with esophageal motor disorders categorized using the updated Chicago Classification. Methods We performed a retrospective, single center study of 62 patients with esophageal motor disorders categorized according to the Chicago Classification. All patients underwent standard radial endosonography to assess for extra esophageal findings or alternative explanations for esophageal outflow obstruction. Secondary outcomes included esophageal wall thickness among the different patient subsets within the Chicago Classification Key Results EUS identified 9/62 (15%) clinically relevant findings that altered patient management and explained the etiology of esophageal outflow obstruction. We further identified substantial variability in esophageal wall thickness in a proportion of patients including some with a significantly thickened non-muscular layer. Conclusions EUS findings are clinically relevant in a significant number of patients with motor disorders and can alter clinical management. Variability in esophageal wall thickness of the muscularis propria and non-muscular layers identified by EUS may also explain the observed variability in response to standard therapies for achalasia. PMID:25041229

[Rapid analysis on phenolic compounds in Rheum palmatum based on UPLC-Q-TOF/MSE combined with diagnostic ions filter].

PubMed

Wang, Qing; Lu, Zhi-Wei; Liu, Yue-Hong; Wang, Ming-Ling; Fu, Shuang; Zhang, Qing-Qing; Zhao, Hui-Zhen; Zhang, Zhi-Xin; Xie, Zi-Ye; Huang, Zheng-Hai; Yu, Hong-Hong; Zhou, Wen-Juan; Gao, Xiao-Yan

2017-05-01

Diagnostic ions filter method was used to rapidly detect and identify the phenolic compounds in Rheum palmatum based on ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MSE). The representative authentic standards of phenolic compounds, including gallic acid, (+)-catechin, (－)-epicatechin, (－)-epicatechin-3-O-gallate and procyanidin B2, were subjected to analysis by UPLC-Q-TOF/MSE system with negative ion mode. Fragmentation patterns of each standard were summarized based on assigned fragment ions. The prominent product ions were selected as diagnostic ions. Subsequently, diagnostic ions filter was employed to rapidly recognize analogous skeletons. Combined with retention time, accurate mass, characteristic fragments and previous literature data, the structures of the filtered compounds were identified or tentatively characterized. A total 63 phenolic compounds (36 phenolic acid derivatives, 8 flavonoid derivatives and 19 tennis derivatives) in R. palmatum were identified, including 6 potential new compounds. The method of diagnostic ions filter could rapidly detect and identify phenolic compounds in R. palmatum This study provides a method for rapid detection of phenolic compounds in R. palmatum and is expected to complete the material basis of rhubarb. Copyright© by the Chinese Pharmaceutical Association.

Comparison of duplex PCR and phenotypic analysis in differentiating Candida dubliniensis from Candida albicans from oral samples.

PubMed

Sampath, Asanga; Weerasekera, Manjula; Dilhari, Ayomi; Gunasekara, Chinthika; Bulugahapitiya, Uditha; Fernando, Neluka; Samaranayake, Lakshman

2017-12-01

Candida dubliniensis shares a wide range of phenotypic characteristics with Candida albicans including a common trait called germ tube positivity. Hence, laboratory differentiation of these two species is cumbersome. Duplex PCR analyses for C. albicans and C. dubliniensis was performed directly on DNA extracted from a total of 122 germ tube positive isolates derived from 100 concentrated oral rinse samples from a random cohort of diabetics attending a clinic in Sri Lanka. These results were confirmed by DNA sequencing of internal transcribed spacer (ITS) region of rDNA of the yeasts. Performance efficacy of duplex PCR was then compared with phenotypic identification using a standard battery of phenotypic tests. Of the 122 germ tube positive isolates three were identified by duplex PCR as C. dubliniensis and the remainder as C. albicans. On the contrary, when the standard phenotypic tests, sugar assimilation and chlamydospore formation, were used to differentiate the two species 13 germ tube positive isolates were erroneously identified as C. dubliniensis. Duplex PCR was found to be rapid, sensitive and more specific than phenotypic identification methods in discriminating C. dubliniensis from C. albicans. This is also the first report on the oral carriage of C. dubliniensis in a Sri Lankan population.

Bench-top validation testing of selected immunological and molecular Renibacterium salmoninarum diagnostic assays by comparison with quantitative bacteriological culture

USGS Publications Warehouse

Elliott, D.G.; Applegate, L.J.; Murray, A.L.; Purcell, M.K.; McKibben, C.L.

2013-01-01

No gold standard assay exhibiting error-free classification of results has been identified for detection of Renibacterium salmoninarum, the causative agent of salmonid bacterial kidney disease. Validation of diagnostic assays for R. salmoninarum has been hindered by its unique characteristics and biology, and difficulties in locating suitable populations of reference test animals. Infection status of fish in test populations is often unknown, and it is commonly assumed that the assay yielding the most positive results has the highest diagnostic accuracy, without consideration of misclassification of results. In this research, quantification of R. salmoninarum in samples by bacteriological culture provided a standardized measure of viable bacteria to evaluate analytical performance characteristics (sensitivity, specificity and repeatability) of non-culture assays in three matrices (phosphate-buffered saline, ovarian fluid and kidney tissue). Non-culture assays included polyclonal enzyme-linked immunosorbent assay (ELISA), direct smear fluorescent antibody technique (FAT), membrane-filtration FAT, nested polymerase chain reaction (nested PCR) and three real-time quantitative PCR assays. Injection challenge of specific pathogen-free Chinook salmon, Oncorhynchus tshawytscha (Walbaum), with R. salmoninarum was used to estimate diagnostic sensitivity and specificity. Results did not identify a single assay demonstrating the highest analytical and diagnostic performance characteristics, but revealed strengths and weaknesses of each test.

40 CFR 428.15 - Standards of performance for new sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Standards of performance for new...) EFFLUENT GUIDELINES AND STANDARDS RUBBER MANUFACTURING POINT SOURCE CATEGORY Tire and Inner Tube Plants Subcategory § 428.15 Standards of performance for new sources. The following standards of performance...

Texture-based segmentation of temperate-zone woodland in panchromatic IKONOS imagery

NASA Astrophysics Data System (ADS)

Gagnon, Langis; Bugnet, Pierre; Cavayas, Francois

2003-08-01

We have performed a study to identify optimal texture parameters for woodland segmentation in a highly non-homogeneous urban area from a temperate-zone panchromatic IKONOS image. Texture images are produced with the sum- and difference-histograms depend on two parameters: window size f and displacement step p. The four texture features yielding the best discrimination between classes are the mean, contrast, correlation and standard deviation. The f-p combinations 17-1, 17-2, 35-1 and 35-2 are those which give the best performance, with an average classification rate of 90%.

Detection of AGXT bgene mutations by denaturing high-performance liquid chromatography for diagnosis of hyperoxaluria type 1.

PubMed

Pirulli, D; Giordano, M; Lessi, M; Spanò, A; Puzzer, D; Zezlina, S; Boniotto, M; Crovella, S; Florian, F; Marangella, M; Momigliano-Richiardi, P; Savoldi, S; Amoroso, A

2001-06-01

Primary hyperoxaluria type 1 is an autosomal recessive disorder of glyoxylate metabolism, caused by a deficiency of alanine:glyoxylate aminotransferase, which is encoded by a single copy gene (AGXT. The aim of this research was to standardize denaturing high-performance liquid chromatography, a new, sensitive, relatively inexpensive, and automated technique, for the detection of AGXT mutation. Denaturing high-performance liquid chromatography was used to analyze in blind the AGXT gene in 20 unrelated Italian patients with primary hyperoxaluria type I previously studied by other standard methods (single-strand conformation polymorphism analysis and direct sequencing) and 50 controls. Denaturing high-performance liquid chromatography allowed us to identify 13 mutations and the polymorphism at position 154 in exon I of the AGXT gene. Hence the method is more sensitive and less time consuming than single-strand conformation polymorphism analysis for the detection of AGXT mutations, thus representing a useful and reliable tool for detecting the mutations responsible for primary hyperoxaluria type 1. The new technology could also be helpful in the search for healthy carriers of AGXT mutations amongst family members and their partners, and for screening of AGXT polymorphisms in patients with nephrolithiasis and healthy populations.

Review of Federal Motor Vehicle Safety Standards (FMVSS) for Automated Vehicles : Identifying Potential Barriers and Challenges for the Certification of Automated Vehicles Using Existing FMVSS

DOT National Transportation Integrated Search

2016-03-11

The purpose of this work is to identify instances where the existing Federal Motor Vehicle Safety Standards may pose challenges to the introduction of automated vehicles. It identifies standards requiring further review - both to ensure that existing...

A Hybrid Index for Characterizing Drought Based on a Nonparametric Kernel Estimator

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

Huang, Shengzhi; Huang, Qiang; Leng, Guoyong

This study develops a nonparametric multivariate drought index, namely, the Nonparametric Multivariate Standardized Drought Index (NMSDI), by considering the variations of both precipitation and streamflow. Building upon previous efforts in constructing Nonparametric Multivariate Drought Index, we use the nonparametric kernel estimator to derive the joint distribution of precipitation and streamflow, thus providing additional insights in drought index development. The proposed NMSDI are applied in the Wei River Basin (WRB), based on which the drought evolution characteristics are investigated. Results indicate: (1) generally, NMSDI captures the drought onset similar to Standardized Precipitation Index (SPI) and drought termination and persistence similar tomore » Standardized Streamflow Index (SSFI). The drought events identified by NMSDI match well with historical drought records in the WRB. The performances are also consistent with that by an existing Multivariate Standardized Drought Index (MSDI) at various timescales, confirming the validity of the newly constructed NMSDI in drought detections (2) An increasing risk of drought has been detected for the past decades, and will be persistent to a certain extent in future in most areas of the WRB; (3) the identified change points of annual NMSDI are mainly concentrated in the early 1970s and middle 1990s, coincident with extensive water use and soil reservation practices. This study highlights the nonparametric multivariable drought index, which can be used for drought detections and predictions efficiently and comprehensively.« less

Prospective comparison of RT-PCR/ESI-MS to Prodesse ProFlu Plus and Cepheid GenXpert for the detection of Influenza A and B viruses.

PubMed

Hardick, Justin; Dugas, Andrea; Goheen, Joshua; Rothman, Richard; Gaydos, Charlotte

2015-03-01

RT-PCR/ESI-MS has previously demonstrated the capability to detect and identify respiratory viral pathogens in nasopharyngeal swabs. This study expands on previous research by performing a prospective evaluation of RT-PCR/ESI-MS to detect and identify Influenza A and B viruses compared to Prodesse ProFlu Plus and combined ProFlu Plus and Cepheid Xpert Flu. ProFlu Plus was also used as a gold standard for comparison for respiratory syncytial virus detection. Using ProFlu Plus as a gold standard, RT-PCR/ESI-MS had sensitivity and specificity of 82.1% (23/28) and 100% (258/258), respectively, for Influenza A, 100% (16/16) and 99.6% (269/270), respectively for Influenza B, and 88.6% (39/44) and 99.6% (241/242) for any Influenza virus. Using matching results from ProFlu Plus and Xpert Flu as a gold standard, RT-PCR/ESI-MS had 85.2% (23/27) and 100% (259/259) sensitivity and specificity respectively for Influenza A, 100% (14/14) and 99.6% (270/272), respectively for Influenza B virus. Overall, RT-PCR/ESI-MS was not as sensitive as the combined gold standard of ProFlu Plus and Xpert Flu, although it has the capability of detecting other respiratory viruses. Copyright © 2015 Elsevier B.V. All rights reserved.

Computer-enhanced laparoscopic training system (CELTS): bridging the gap.

PubMed

Stylopoulos, N; Cotin, S; Maithel, S K; Ottensmeye, M; Jackson, P G; Bardsley, R S; Neumann, P F; Rattner, D W; Dawson, S L

2004-05-01

There is a large and growing gap between the need for better surgical training methodologies and the systems currently available for such training. In an effort to bridge this gap and overcome the disadvantages of the training simulators now in use, we developed the Computer-Enhanced Laparoscopic Training System (CELTS). CELTS is a computer-based system capable of tracking the motion of laparoscopic instruments and providing feedback about performance in real time. CELTS consists of a mechanical interface, a customizable set of tasks, and an Internet-based software interface. The special cognitive and psychomotor skills a laparoscopic surgeon should master were explicitly defined and transformed into quantitative metrics based on kinematics analysis theory. A single global standardized and task-independent scoring system utilizing a z-score statistic was developed. Validation exercises were performed. The scoring system clearly revealed a gap between experts and trainees, irrespective of the task performed; none of the trainees obtained a score above the threshold that distinguishes the two groups. Moreover, CELTS provided educational feedback by identifying the key factors that contributed to the overall score. Among the defined metrics, depth perception, smoothness of motion, instrument orientation, and the outcome of the task are major indicators of performance and key parameters that distinguish experts from trainees. Time and path length alone, which are the most commonly used metrics in currently available systems, are not considered good indicators of performance. CELTS is a novel and standardized skills trainer that combines the advantages of computer simulation with the features of the traditional and popular training boxes. CELTS can easily be used with a wide array of tasks and ensures comparability across different training conditions. This report further shows that a set of appropriate and clinically relevant performance metrics can be defined and a standardized scoring system can be designed.

Semantic relatedness and similarity of biomedical terms: examining the effects of recency, size, and section of biomedical publications on the performance of word2vec.

PubMed

Zhu, Yongjun; Yan, Erjia; Wang, Fei

2017-07-03

Understanding semantic relatedness and similarity between biomedical terms has a great impact on a variety of applications such as biomedical information retrieval, information extraction, and recommender systems. The objective of this study is to examine word2vec's ability in deriving semantic relatedness and similarity between biomedical terms from large publication data. Specifically, we focus on the effects of recency, size, and section of biomedical publication data on the performance of word2vec. We download abstracts of 18,777,129 articles from PubMed and 766,326 full-text articles from PubMed Central (PMC). The datasets are preprocessed and grouped into subsets by recency, size, and section. Word2vec models are trained on these subtests. Cosine similarities between biomedical terms obtained from the word2vec models are compared against reference standards. Performance of models trained on different subsets are compared to examine recency, size, and section effects. Models trained on recent datasets did not boost the performance. Models trained on larger datasets identified more pairs of biomedical terms than models trained on smaller datasets in relatedness task (from 368 at the 10% level to 494 at the 100% level) and similarity task (from 374 at the 10% level to 491 at the 100% level). The model trained on abstracts produced results that have higher correlations with the reference standards than the one trained on article bodies (i.e., 0.65 vs. 0.62 in the similarity task and 0.66 vs. 0.59 in the relatedness task). However, the latter identified more pairs of biomedical terms than the former (i.e., 344 vs. 498 in the similarity task and 339 vs. 503 in the relatedness task). Increasing the size of dataset does not always enhance the performance. Increasing the size of datasets can result in the identification of more relations of biomedical terms even though it does not guarantee better precision. As summaries of research articles, compared with article bodies, abstracts excel in accuracy but lose in coverage of identifiable relations.