15 CFR 200.113 - Use of results or reports.

Code of Federal Regulations, 2014 CFR

2014-01-01

... United States, NIST maintains and establishes the primary standards from which measurements in science... measurement standards to make appropriate reference to the relationship of their calibrations to NIST... agreement on the part of the NIST customer to be bound thereby in making reference to NIST calibration and...

15 CFR 200.113 - Use of results or reports.

Code of Federal Regulations, 2013 CFR

2013-01-01

... United States, NIST maintains and establishes the primary standards from which measurements in science... measurement standards to make appropriate reference to the relationship of their calibrations to NIST... agreement on the part of the NIST customer to be bound thereby in making reference to NIST calibration and...

15 CFR 200.113 - Use of results or reports.

Code of Federal Regulations, 2012 CFR

2012-01-01

... United States, NIST maintains and establishes the primary standards from which measurements in science... measurement standards to make appropriate reference to the relationship of their calibrations to NIST... agreement on the part of the NIST customer to be bound thereby in making reference to NIST calibration and...

15 CFR 200.113 - Use of results or reports.

Code of Federal Regulations, 2010 CFR

2010-01-01

... United States, NIST maintains and establishes the primary standards from which measurements in science... measurement standards to make appropriate reference to the relationship of their calibrations to NIST... agreement on the part of the NIST customer to be bound thereby in making reference to NIST calibration and...

Measurements | Photovoltaic Research | NREL

Science.gov Websites

to hold an ISO 17025 accreditation for primary reference cell and secondary module calibration, in addition to accreditation for secondary reference cell calibration under ASTM and IEC standards. Time

The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. I. A review of Kjeldahl methods adopted by laboratory medicine.

PubMed

Chromý, Vratislav; Vinklárková, Bára; Šprongl, Luděk; Bittová, Miroslava

2015-01-01

We found previously that albumin-calibrated total protein in certified reference materials causes unacceptable positive bias in analysis of human sera. The simplest way to cure this defect is the use of human-based serum/plasma standards calibrated by the Kjeldahl method. Such standards, commutative with serum samples, will compensate for bias caused by lipids and bilirubin in most human sera. To find a suitable primary reference procedure for total protein in reference materials, we reviewed Kjeldahl methods adopted by laboratory medicine. We found two methods recommended for total protein in human samples: an indirect analysis based on total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. The methods found will be assessed in a subsequent article.

Alsatian versus Standard German: Regional Language Bilingual Primary Education in Alsace

ERIC Educational Resources Information Center

Harrison, Michelle Anne

2016-01-01

This article examines the current situation of regional language bilingual primary education in Alsace and contends that the regional language presents a special case in the context of France. The language comprises two varieties: Alsatian, which traditionally has been widely spoken, and Standard German, used as the language of reference and…

The Calibration of Gloss Reference Standards

NASA Astrophysics Data System (ADS)

Budde, W.

1980-04-01

In present international and national standards for the measurement of specular gloss the primary and secondary reference standards are defined for monochromatic radiation. However the glossmeter specified is using polychromatic radiation (CIE Standard Illuminant C) and the CIE Standard Photometric Observer. This produces errors in practical gloss measurements of up to 0.5%. Although this may be considered small as compared to the accuracy of most practical gloss measurements, such an error should not be tolerated in the calibration of secondary standards. Corrections for such errors are presented and various alternatives for amendments of the existing documentary standards are discussed.

RBS as a new primary direct reference method for measuring quantity of material

NASA Astrophysics Data System (ADS)

Jeynes, C.

2017-09-01

The quantity of material in thin films can be measured reliably, non-destructively, and at an absolute traceable accuracy with a combined standard uncertainty of 1% by Rutherford backscattering spectrometry (RBS). We have demonstrated a measurement protocol for the determination of quantity of material by RBS that has been accredited at this accuracy to the ISO 17025 standard by the United Kingdom Accreditation Service (UKAS). The method is entirely traceable to SI units relying on no artefacts, and thus qualifies as a primary direct reference method as defined by the ISO Guide 35:1985 (paragraph 9.4.1).

Factors affecting cardiac rehabilitation referral by physician specialty.

PubMed

Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

2008-01-01

Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P < .001), lack of standardized referral forms (P < .001), inconvenience (P = .04), program quality (P = .004), and lack of discharge communication from CR (P = .001) as factors negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P < .001). Where differences emerged, primary care physicians were more likely to perceive factors that would impede CR referral, some of which are modifiable. Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain

PubMed Central

Konstantinou, Kika; Ogollah, Reuben; Hay, Elaine M.; Dunn, Kate M.

2018-01-01

Background Identification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare. Methods Data on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard. Results Model (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii). Conclusion Four clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients. PMID:29621243

Quantification of drugs in plasma without primary reference standards by liquid chromatography-chemiluminescence nitrogen detection: application to tramadol metabolite ratios.

PubMed

Ojanperä, Suvi; Rasanen, Ilpo; Sistonen, Johanna; Pelander, Anna; Vuori, Erkki; Ojanperä, Ilkka

2007-08-01

Lack of availability of reference standards for drug metabolites, newly released drugs, and illicit drugs hinders the analysis of these substances in biologic samples. To counter this problem, an approach is presented here for quantitative drug analysis in plasma without primary reference standards by liquid chromatography-chemiluminescence nitrogen detection (LC-CLND). To demonstrate the feasibility of the method, metabolic ratios of the opioid drug tramadol were determined in the setting of a pharmacogenetic study. Four volunteers were given a single 100-mg oral dose of tramadol, and a blood sample was collected from each subject 1 hour later. Tramadol, O-desmethyltramadol, and nortramadol were determined in plasma by LC-CLND without reference standards and by a gas chromatography-mass spectrometry reference method. In contrast to previous CLND studies lacking an extraction step, a liquid-liquid extraction system was created for 5-mL plasma samples using n-butyl chloride-isopropyl alcohol (98 + 2) at pH 10. Extraction recovery estimation was based on model compounds chosen according to their similar physicochemical characteristics (retention time, pKa, logD). Instrument calibration was performed with a single secondary standard (caffeine) using the equimolar response of the detector to nitrogen. The mean differences between the results of the LC-CLND and gas chromatography-mass spectrometry methods for tramadol, O-desmethyltramadol, and nortramadol were 8%, 32%, and 19%, respectively. The sensitivity of LC-CLND was sufficient for therapeutic concentrations of tramadol and metabolites. A good correlation was obtained between genotype, expressed by the number of functional genes, and the plasma metabolite ratios. This experiment suggests that a recovery-corrected LC-CLND analysis produces sufficiently accurate results to be useful in a clinical context, particularly in instances in which reference standards are not readily accessible.

NED and SIMBAD Conventions for Bibliographic Reference Coding

NASA Technical Reports Server (NTRS)

Schmitz, M.; Helou, G.; Dubois, P.; LaGue, C.; Madore, B.; Jr., H. G. Corwin; Lesteven, S.

1995-01-01

The primary purpose of the 'reference code' is to provide a unique and traceable representation of a bibliographic reference within the structure of each database. The code is used frequently in the interfaces as a succinct abbreviation of a full bibliographic reference. Since its inception, it has become a standard code not only for NED and SIMBAD, but also for other bibliographic services.

Comparison of the NIST and NPL Air Kerma Standards Used for X-Ray Measurements Between 10 kV and 80 kV

PubMed Central

O’Brien, M.; Lamperti, P.; Williams, T.; Sander, T.

2000-01-01

A direct comparison was made between the air kerma primary standards used for the measurements of low-energy x rays at the National Institute of Standards and Technology (NIST) and the National Physical Laboratory (NPL). The comparison was conducted at the NPL using NPL reference radiation qualities between 10 kV and 80 kV. The results show the primary air-kerma standards to agree within 0.6 % of their values for beam qualities up to 80 kV. PMID:27551632

Methods for Environments and Contaminants: Criteria Air Pollutants

EPA Pesticide Factsheets

EPA’s Office of Air Quality Planning and Standards (OAQPS) has set primary (health-based) National Ambient Air Quality Standards (NAAQS) for six common air pollutants, often referred to as criteria air pollutants (or simply criteria pollutants).

Reference dosimeter system of the iaea

NASA Astrophysics Data System (ADS)

Mehta, Kishor; Girzikowsky, Reinhard

1995-09-01

Quality assurance programmes must be in operation at radiation processing facilities to satisfy national and international Standards. Since dosimetry has a vital function in these QA programmes, it is imperative that the dosimetry systems in use at these facilities are well calibrated with a traceability to a Primary Standard Dosimetry Laboratory. As a service to the Member States, the International Atomic Energy Agency operates the International Dose Assurance Service (IDAS) to assist in this process. The transfer standard dosimetry system that is used for this service is based on ESR spectrometry. The paper describes the activities undertaken at the IAEA Dosimetry Laboratory to establish the QA programme for its reference dosimetry system. There are four key elements of such a programme: quality assurance manual; calibration that is traceable to a Primary Standard Dosimetry Laboratory; a clear and detailed statement of uncertainty in the dose measurement; and, periodic quality audit.

Potential for improved radiation thermometry measurement uncertainty through implementing a primary scale in an industrial laboratory

NASA Astrophysics Data System (ADS)

Willmott, Jon R.; Lowe, David; Broughton, Mick; White, Ben S.; Machin, Graham

2016-09-01

A primary temperature scale requires realising a unit in terms of its definition. For high temperature radiation thermometry in terms of the International Temperature Scale of 1990 this means extrapolating from the signal measured at the freezing temperature of gold, silver or copper using Planck’s radiation law. The difficulty in doing this means that primary scales above 1000 °C require specialist equipment and careful characterisation in order to achieve the extrapolation with sufficient accuracy. As such, maintenance of the scale at high temperatures is usually only practicable for National Metrology Institutes, and calibration laboratories have to rely on a scale calibrated against transfer standards. At lower temperatures it is practicable for an industrial calibration laboratory to have its own primary temperature scale, which reduces the number of steps between the primary scale and end user. Proposed changes to the SI that will introduce internationally accepted high temperature reference standards might make it practicable to have a primary high temperature scale in a calibration laboratory. In this study such a scale was established by calibrating radiation thermometers directly to high temperature reference standards. The possible reduction in uncertainty to an end user as a result of the reduced calibration chain was evaluated.

40 CFR 63.841 - Incorporation by reference.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 63.841 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Primary Aluminum Reduction Plants § 63.841...

40 CFR 63.841 - Incorporation by reference.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 63.841 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Primary Aluminum Reduction Plants § 63.841...

40 CFR 63.841 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 63.841 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Primary Aluminum Reduction Plants § 63.841...

40 CFR 63.841 - Incorporation by reference.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 63.841 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Primary Aluminum Reduction Plants § 63.841...

40 CFR 421.271 - Specialized definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Primary Rare Earth Metals.... (b) The term rare earth metals refers to the elements scandium, yttrium, and lanthanum to lutetium, inclusive. (c) The term mischmetal refers to a rare earth metal alloy comprised of the natural mixture of...

40 CFR 421.271 - Specialized definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Primary Rare Earth Metals.... (b) The term rare earth metals refers to the elements scandium, yttrium, and lanthanum to lutetium, inclusive. (c) The term mischmetal refers to a rare earth metal alloy comprised of the natural mixture of...

40 CFR 421.271 - Specialized definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Primary Rare Earth Metals.... (b) The term rare earth metals refers to the elements scandium, yttrium, and lanthanum to lutetium, inclusive. (c) The term mischmetal refers to a rare earth metal alloy comprised of the natural mixture of...

40 CFR 421.271 - Specialized definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Primary Rare Earth Metals.... (b) The term rare earth metals refers to the elements scandium, yttrium, and lanthanum to lutetium, inclusive. (c) The term mischmetal refers to a rare earth metal alloy comprised of the natural mixture of...

Sodium content of foods contributing to sodium intake: A comparison between selected foods from the CDC Packaged Food Database and the USDA National Nutrient Database for Standard Reference

USDA-ARS?s Scientific Manuscript database

The sodium concentration (mg/100g) for 23 of 125 Sentinel Foods were identified in the 2009 CDC Packaged Food Database (PFD) and compared with data in the USDA’s 2013 Standard Reference 26 (SR 26) database. Sentinel Foods are foods and beverages identified by USDA to be monitored as primary indicat...

Development of a NIST standard reference material containing thirty volatile organic compounds at 5 nmol/mol in nitrogen.

PubMed

Rhoderick, George C; Yen, James H

2006-05-01

Primary gravimetric gas cylinder standards containing 30 volatile organic compounds (VOCs) in nitrogen were prepared using a procedure previously developed to prepare gas mixture cylinder standards of VOCs at the 5 nmol/mol level. This set of primary standards was intercompared to existing gas cylinder standards, containing as many as 19 of the 30 volatile organics present in these new primaries, using gas chromatography with a hydrogen flame ionization detector coupled with cryogenic preconcentration. The linear regression analysis showed excellent agreement among the standards for each compound. Similar mixtures containing many of these compounds in treated aluminum gas cylinders have been evaluated over time and have shown stability for as much as 10 years. The development of these 30-component primary standards led to the preparation and certification of a reissue of Standard Reference Material (SRM) 1804 at the nominal amount-of-substance fraction of 5 nmol/mol for each analyte. A lot of 20 cylinders containing the mixture was prepared at NIST following previously demonstrated protocols for preparation of the cylinders. Each cylinder was analyzed against one cylinder from the lot, designated as the "lot standard," for each of the 30 compounds. As a result of the uncertainty analysis, the data showed that rather than declaring the lot homogeneous with a much higher uncertainty, each cylinder could be individually certified. The expanded uncertainty limits ranged from 1.5 to 10% for 28 of the 30 analytes, with two of the analytes having uncertainties as high as 19% in those SRM cylinders certified. Due to stability issues and some high uncertainties for a few analytes in 2 of the samples, 18 of the 20 candidate SRM samples were certified. These volatile organic gas mixtures represent the most complex gas SRMs developed at NIST.

Assessment of international reference materials for isotope-ratio analysis (IUPAC Technical Report)

USGS Publications Warehouse

Brand, Willi A.; Coplen, Tyler B.; Vogl, Jochen; Rosner, Martin; Prohaska, Thomas

2014-01-01

Since the early 1950s, the number of international measurement standards for anchoring stable isotope delta scales has mushroomed from 3 to more than 30, expanding to more than 25 chemical elements. With the development of new instrumentation, along with new and improved measurement procedures for studying naturally occurring isotopic abundance variations in natural and technical samples, the number of internationally distributed, secondary isotopic reference materials with a specified delta value has blossomed in the last six decades to more than 150 materials. More than half of these isotopic reference materials were produced for isotope-delta measurements of seven elements: H, Li, B, C, N, O, and S. The number of isotopic reference materials for other, heavier elements has grown considerably over the last decade. Nevertheless, even primary international measurement standards for isotope-delta measurements are still needed for some elements, including Mg, Fe, Te, Sb, Mo, and Ge. It is recommended that authors publish the delta values of internationally distributed, secondary isotopic reference materials that were used for anchoring their measurement results to the respective primary stable isotope scale.

Development of a Primary Standard for Calibration of [18F]FDG Activity Measurement Systems

NASA Astrophysics Data System (ADS)

Capogni, M.; DeFelice, P.; Fazio, A.; Simonelli, F.; D'Ursi, V.; Pecorale, A.; Giliberti, C.; Abbas, K.

2006-05-01

The 18F national primary standard was developed by the INMRI-ENEA using the 4πβ Liquid Scintillation Spectrometry Method with 3H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement.

Issues concerning international comparison of free-field calibrations of acoustical standards

NASA Astrophysics Data System (ADS)

Nedzelnitsky, Victor

2002-11-01

Primary free-field calibrations of laboratory standard microphones by the reciprocity method establish these microphones as reference standard devices for calibrating working standard microphones, other measuring microphones, and practical instruments such as sound level meters and personal sound exposure meters (noise dosimeters). These primary, secondary, and other calibrations are indispensable to the support of regulatory requirements, standards, and product characterization and quality control procedures important for industry, commerce, health, and safety. International Electrotechnical Commission (IEC) Technical Committee 29 Electroacoustics produces international documentary standards, including standards for primary and secondary free-field calibration and measurement procedures and their critically important application to practical instruments. This paper addresses some issues concerning calibrations, standards activities, and the international key comparison of primary free-field calibrations of IEC-type LS2 laboratory standard microphones that is being planned by the Consultative Committee for Acoustics, Ultrasound, and Vibration (CCAUV) of the International Committee for Weights and Measures (CIPM). This comparison will include free-field calibrations by the reciprocity method at participating major national metrology laboratories throughout the world.

Accurate quantitation standards of glutathione via traceable sulfur measurement by inductively coupled plasma optical emission spectrometry and ion chromatography

PubMed Central

Rastogi, L.; Dash, K.; Arunachalam, J.

2013-01-01

The quantitative analysis of glutathione (GSH) is important in different fields like medicine, biology, and biotechnology. Accurate quantitative measurements of this analyte have been hampered by the lack of well characterized reference standards. The proposed procedure is intended to provide an accurate and definitive method for the quantitation of GSH for reference measurements. Measurement of the stoichiometrically existing sulfur content in purified GSH offers an approach for its quantitation and calibration through an appropriate characterized reference material (CRM) for sulfur would provide a methodology for the certification of GSH quantity, that is traceable to SI (International system of units). The inductively coupled plasma optical emission spectrometry (ICP-OES) approach negates the need for any sample digestion. The sulfur content of the purified GSH is quantitatively converted into sulfate ions by microwave-assisted UV digestion in the presence of hydrogen peroxide prior to ion chromatography (IC) measurements. The measurement of sulfur by ICP-OES and IC (as sulfate) using the “high performance” methodology could be useful for characterizing primary calibration standards and certified reference materials with low uncertainties. The relative expanded uncertainties (% U) expressed at 95% confidence interval for ICP-OES analyses varied from 0.1% to 0.3%, while in the case of IC, they were between 0.2% and 1.2%. The described methods are more suitable for characterizing primary calibration standards and certifying reference materials of GSH, than for routine measurements. PMID:29403814

Metrological approaches to organic chemical purity: primary reference materials for vitamin D metabolites.

PubMed

Nelson, Michael A; Bedner, Mary; Lang, Brian E; Toman, Blaza; Lippa, Katrice A

2015-11-01

Given the critical role of pure, organic compound primary reference standards used to characterize and certify chemical Certified Reference Materials (CRMs), it is essential that associated mass purity assessments be fit-for-purpose, represented by an appropriate uncertainty interval, and metrologically sound. The mass fraction purities (% g/g) of 25-hydroxyvitamin D (25(OH)D) reference standards used to produce and certify values for clinical vitamin D metabolite CRMs were investigated by multiple orthogonal quantitative measurement techniques. Quantitative (1)H-nuclear magnetic resonance spectroscopy (qNMR) was performed to establish traceability of these materials to the International System of Units (SI) and to directly assess the principal analyte species. The 25(OH)D standards contained volatile and water impurities, as well as structurally-related impurities that are difficult to observe by chromatographic methods or to distinguish from the principal 25(OH)D species by one-dimensional NMR. These impurities have the potential to introduce significant biases to purity investigations in which a limited number of measurands are quantified. Combining complementary information from multiple analytical methods, using both direct and indirect measurement techniques, enabled mitigation of these biases. Purities of 25(OH)D reference standards and associated uncertainties were determined using frequentist and Bayesian statistical models to combine data acquired via qNMR, liquid chromatography with UV absorbance and atmospheric pressure-chemical ionization mass spectrometric detection (LC-UV, LC-ACPI-MS), thermogravimetric analysis (TGA), and Karl Fischer (KF) titration.

Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

PubMed Central

2011-01-01

Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index), were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990), with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778), the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who also had diabetes and in those aged 70 years or over. Conclusions Our results substantiate the validity of using diagnoses of diabetes and hypertension found within the computerized clinical records for epidemiologic studies. PMID:22035202

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology

PubMed Central

Mukhopadhyay, Sanjay; Feldman, Michael D.; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G.; Cathro, Helen P.; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E.; Gill, Ryan M.; Heaton, Robert P.; Kerstens, René; Lindberg, Guy M.; Malhotra, Reenu K.; Mandell, James W.; Manlucu, Ellen D.; Mills, Anne M.; Mills, Stacey E.; Moskaluk, Christopher A.; Nelis, Mischa; Patil, Deepa T.; Przybycin, Christopher G.; Reynolds, Jordan P.; Rubin, Brian P.; Saboorian, Mohammad H.; Salicru, Mauricio; Samols, Mark A.; Sturgis, Charles D.; Turner, Kevin O.; Wick, Mark R.; Yoon, Ji Y.; Zhao, Po

2018-01-01

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, −0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types. PMID:28961557

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study).

PubMed

Mukhopadhyay, Sanjay; Feldman, Michael D; Abels, Esther; Ashfaq, Raheela; Beltaifa, Senda; Cacciabeve, Nicolas G; Cathro, Helen P; Cheng, Liang; Cooper, Kumarasen; Dickey, Glenn E; Gill, Ryan M; Heaton, Robert P; Kerstens, René; Lindberg, Guy M; Malhotra, Reenu K; Mandell, James W; Manlucu, Ellen D; Mills, Anne M; Mills, Stacey E; Moskaluk, Christopher A; Nelis, Mischa; Patil, Deepa T; Przybycin, Christopher G; Reynolds, Jordan P; Rubin, Brian P; Saboorian, Mohammad H; Salicru, Mauricio; Samols, Mark A; Sturgis, Charles D; Turner, Kevin O; Wick, Mark R; Yoon, Ji Y; Zhao, Po; Taylor, Clive R

2018-01-01

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types.

The prognostic value of standardized reference values for speckle-tracking global longitudinal strain in hypertrophic cardiomyopathy.

PubMed

Hartlage, Gregory R; Kim, Jonathan H; Strickland, Patrick T; Cheng, Alan C; Ghasemzadeh, Nima; Pernetz, Maria A; Clements, Stephen D; Williams, B Robinson

2015-03-01

Speckle-tracking left ventricular global longitudinal strain (GLS) assessment may provide substantial prognostic information for hypertrophic cardiomyopathy (HCM) patients. Reference values for GLS have been recently published. We aimed to evaluate the prognostic value of standardized reference values for GLS in HCM patients. An analysis of HCM clinic patients who underwent GLS was performed. GLS was defined as normal (more negative or equal to -16%) and abnormal (less negative than -16%) based on recently published reference values. Patients were followed for a composite of events including heart failure hospitalization, sustained ventricular arrhythmia, and all-cause death. The power of GLS to predict outcomes was assessed relative to traditional clinical and echocardiographic variables present in HCM. 79 HCM patients were followed for a median of 22 months (interquartile range 9-30 months) after imaging. During follow-up, 15 patients (19%) met the primary outcome. Abnormal GLS was the only echocardiographic variable independently predictive of the primary outcome [multivariate Hazard ratio 5.05 (95% confidence interval 1.09-23.4, p = 0.038)]. When combined with traditional clinical variables, abnormal GLS remained independently predictive of the primary outcome [multivariate Hazard ratio 5.31 (95 % confidence interval 1.18-24, p = 0.030)]. In a model including the strongest clinical and echocardiographic predictors of the primary outcome, abnormal GLS demonstrated significant incremental benefit for risk stratification [net reclassification improvement 0.75 (95 % confidence interval 0.21-1.23, p < 0.0001)]. Abnormal GLS is an independent predictor of adverse outcomes in HCM patients. Standardized use of GLS may provide significant incremental value over traditional variables for risk stratification.

Comparison of the NIST and PTB Air-Kerma Standards for Low-Energy X-Rays.

PubMed

O'Brien, Michelle; Bueermann, Ludwig

2009-01-01

A comparison has been made of the air-kerma standards for low-energy x rays at the National Institute of Standards and Technology (NIST) and the Physikalisch-Technische Bundesanstalt (PTB). The comparison involved a series of measurements at the PTB and the NIST using the air-kerma standards and two NIST reference-class transfer ionization chamber standards. Results are presented for the reference radiation beam qualities in the range from 25 kV to 50 kV for low energy x rays, including the techniques used for mammography dose traceability. The tungsten generated reference radiation qualities, between 25 kV and 50 kV used for this comparison, are new to NIST; therefore this comparison will serve as the preliminary comparison for NIST and a verification of the primary standard correction factors. The mammography comparison will repeat two previously unpublished comparisons between PTB and NIST. The results show the standards to be in reasonable agreement within the standard uncertainty of the comparison of about 0.4 %.

Gold standards and expert panels: a pulmonary nodule case study with challenges and solutions

NASA Astrophysics Data System (ADS)

Miller, Dave P.; O'Shaughnessy, Kathryn F.; Wood, Susan A.; Castellino, Ronald A.

2004-05-01

Comparative evaluations of reader performance using different modalities, e.g. CT with computer-aided detection (CAD) vs. CT without CAD, generally require a "truth" definition based on a gold standard. There are many situations in which a true invariant gold standard is impractical or impossible to obtain. For instance, small pulmonary nodules are generally not assessed by biopsy or resection. In such cases, it is common to use a unanimous consensus or majority agreement from an expert panel as a reference standard for actionability in lieu of the unknown gold standard for disease. Nonetheless, there are three major concerns about expert panel reference standards: (1) actionability is not synonymous with disease (2) it may be possible to obtain different conclusions about which modality is better using different rules (e.g. majority vs. unanimous consensus), and (3) the variability associated with the panelists is not formally captured in the p-values or confidence intervals that are generally produced for estimating the extent to which one modality is superior to the other. A multi-reader-multi-case (MRMC) receiver operating characteristic (ROC) study was performed using 90 cases, 15 readers, and a reference truth based on 3 experienced panelists. The primary analyses were conducted using a reference truth of unanimous consensus regarding actionability (3 out of 3 panelists). To assess the three concerns noted above: (1) additional data from the original radiology reports were compared to the panel (2) the complete analysis was repeated using different definitions of truth, and (3) bootstrap analyses were conducted in which new truth panels were constructed by picking 1, 2, or 3 panelists at random. The definition of the reference truth affected the results for each modality (CT with CAD and CT without CAD) considered by itself, but the effects were similar, so the primary analysis comparing the modalities was robust to the choice of the reference truth.

Evaluation of Xpert MTB/RIF assay in children with presumed pulmonary tuberculosis in Papua New Guinea.

PubMed

Kasa Tom, Sharon; Welch, Henry; Kilalang, Cornelia; Tefuarani, Nakapi; Vince, John; Lavu, Evelyn; Johnson, Karen; Magaye, Ruth; Duke, Trevor

2018-05-01

The Gene Xpert MTB/ RIF assay (Xpert) is used for rapid, simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. This study examined the accuracy of Xpert in children with suspected pulmonary tuberculosis (PTB). Children admitted to Port Moresby General Hospital with suspected PTB were prospectively enrolled between September 2014 and March 2015. They were classified into probable, possible and TB-unlikely groups. Sputum or gastric aspirates were tested by Xpert and smear microscopy; mycobacterial culture was undertaken on a subset. Children were diagnosed with TB on the basis of standard criteria which were used as the primary reference standard. Xpert, smear for acid-fast bacilli (AFB) and the Edwards TB score were compared with the primary reference standard. A total of 93 children ≤14 years with suspected PTB were enrolled; 67 (72%) were classified as probable, 21 (22%) possible and 5 (5.4%) TB-unlikely. Eighty were treated for TB based on the primary reference standard. Xpert was positive in 26/93 (28%) MTB cases overall, including 22/67 (33%) with probable TB and 4/21 (19%) with possible TB. Three (13%) samples identified rifampicin resistance. Xpert confirmed more cases of TB than AFB smear (26 vs 13, p = 0.019). The sensitivity of Xpert, AFB smear and an Edwards TB score of ≥7 was 31% (25/80), 16% (13/80) and 90% (72/80), respectively, and the specificity was 92% (12/13), 100% (13/13) and 31% (4/13), respectively, when compared with the primary reference standard. Xpert sensitivity is sub-optimal and cannot be relied upon for diagnosing TB, although a positive result is confirmatory. A detailed history and examination, standardised clinical criteria, radiographs and available tests remain the most appropriate way of diagnosing TB in children in resource-limited countries. Xpert helps confirm PTB better than AFB smear, and identifies rifampicin resistance. Practical guidelines should be used to identify children who will benefit from an Xpert assay.

Harmonization in laboratory medicine: Requests, samples, measurements and reports.

PubMed

Plebani, Mario

2016-01-01

In laboratory medicine, the terms "standardization" and "harmonization" are frequently used interchangeably as the final goal is the same: the equivalence of measurement results among different routine measurement procedures over time and space according to defined analytical and clinical quality specifications. However, the terms define two distinct, albeit closely linked, concepts based on traceability principles. The word "standardization" is used when results for a measurement are equivalent and traceable to the International System of Units (SI) through a high-order primary reference material and/or a reference measurement procedure (RMP). "Harmonization" is generally used when results are equivalent, but neither a high-order primary reference material nor a reference measurement procedure is available. Harmonization is a fundamental aspect of quality in laboratory medicine as its ultimate goal is to improve patient outcomes through the provision of accurate and actionable laboratory information. Patients, clinicians and other healthcare professionals assume that clinical laboratory tests performed by different laboratories at different times on the same sample and specimen can be compared, and that results can be reliably and consistently interpreted. Unfortunately, this is not necessarily the case, because many laboratory test results are still highly variable and poorly standardized and harmonized. Although the initial focus was mainly on harmonizing and standardizing analytical processes and methods, the scope of harmonization now also includes all other aspects of the total testing process (TTP), such as terminology and units, report formats, reference intervals and decision limits as well as tests and test profiles, requests and criteria for interpretation. Several projects and initiatives aiming to improve standardization and harmonization in the testing process are now underway. Laboratory professionals should therefore step up their efforts to provide interchangeable and comparable laboratory information in order to ultimately assure better diagnosis and treatment in patient care.

Teaching Primary School Mathematics and Statistics: Evidence-Based Practice

ERIC Educational Resources Information Center

Averill, Robin; Harvey, Roger

2010-01-01

Here is the only reference book you will ever need for teaching primary school mathematics and statistics. It is full of exciting and engaging snapshots of excellent classroom practice relevant to "The New Zealand Curriculum" and national mathematics standards. There are many fascinating examples of investigative learning experiences,…

[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.

Comparison of absorbed-dose-to-water units for Co-60 and high-energy x-rays between PTB and LNE-LNHB

NASA Astrophysics Data System (ADS)

Delaunay, F.; Kapsch, R.-P.; Gouriou, J.; Illemann, J.; Krauss, A.; Le Roy, M.; Ostrowsky, A.; Sommier, L.; Vermesse, D.

2012-10-01

During the Euramet project JRP7 ‘External Beam Cancer Therapy’, PTB and LNE-LNHB used primary standards to determine the absorbed dose to water under IMRT conditions (in small fields). PTB used a water calorimeter to determine the absorbed-dose-to-water references in 6 MV and 10 MV beams for field sizes of 10 cm × 10 cm and 3 cm × 3 cm while LNE-LNHB used graphite calorimeters in 6 MV and 12 MV beams for field sizes of 10 cm × 10 cm, 4 cm × 4 cm and 2 cm × 2 cm. The purpose of this study is to compare PTB and LNE-LNHB new absorbed-dose-to-water references. LNE-LNHB sent an Exradin A1SL ionization chamber traceable to its primary standard to the PTB for calibration in 60Co and in linac beams and PTB sent a PTW 31010 ionization chamber traceable to its primary standard to LNE-LNHB for calibration in 60Co and in linac beams. Calculated Sw,air will be used as beam quality specifier for the ionization chamber comparison at different field sizes. The standard uncertainties (k = 1) of PTB and LNE-LNHB calibration coefficients lie respectively between 0.25% (60Co) and 0.40% (linac) and between 0.29% and 0.46%. PTB and LNE-LNHB absorbed-dose-to-water references developed for this project, based respectively on water calorimetry and on graphite calorimetry, agree within 1.5 standard deviations for field size of 10 cm × 10 cm down to 2 cm × 2 cm and for beams of 6 MV to 10 MV.

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

PubMed

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

2017-09-01

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

Reference Correlation for the Density and Viscosity of Eutectic Liquid Alloys Al+Si, Pb+Bi, and Pb+Sn

NASA Astrophysics Data System (ADS)

Assael, M. J.; Mihailidou, E. K.; Brillo, J.; Stankus, S. V.; Wu, J. T.; Wakeham, W. A.

2012-09-01

In this paper, the available experimental data for the density and viscosity of eutectic liquid alloys Al+Si, Pb+Bi, and Pb+Sn have been critically examined with the intention of establishing a reference standard representation of both density and viscosity. All experimental data have been categorized as primary or secondary according to the quality of measurement, the technique employed, and the presentation of the data, as specified by a series of carefully defined criteria. The proposed standard reference correlations for the density of liquid Al+Si, Pb+Bi, and Pb+Sn are, respectively, characterized by deviations of 2.0%, 2.9%, and 0.5% at the 95% confidence level. The standard reference correlations for the viscosity of liquid Al+Si, Pb+Bi, and Pb+Sn are, respectively, characterized by deviations of 7.7%, 14.2%, and 12.4% at the 95% confidence level.

Reevaluation of the NOAA/CMDL carbon monoxide reference scale and comparisons with CO reference gases at NASA-Langley and the Fraunhofer Institut

NASA Technical Reports Server (NTRS)

Novelli, P. C.; Collins, J. E., Jr.; Myers, R. C.; Sachse, G. W.; Scheel, H. E.

1994-01-01

The carbon monoxide (CO) reference scale created by the National Oceanic and Atmospheric Administration/Climate Monitoring and Diagnostics Laboratory (NOAA/CMDL) is used to quantify measurements of CO in the atmosphere, calibrate standards of other laboratories and to otherwise provide reference gases to the community measuring atmospheric CO. This reference scale was created based upon a set of primary standards prepared by gravimetric methods at CMDL and has been propagated to a set of working standards. In this paper we compare CO mixing ratios assigned to the working standards by three approaches: (1) calibration against the original gravimetric standards, (2) calibration using only working standards as the reference gas, and (3) calibration against three new gravimetric standards prepared to CMDL. The agreement between these values was typically better than 1%. The calibration histories of CMDL working standards are reviewed with respect to expected rates of CO change in the atmosphere. Using a Monte Carlo approach to simulate the effect of drifting standards on calculated mixing ratios, we conclude that the error solely associated with the maintenance of standards will limit the ability to detect small CO changes in the atmosphere. We also report results of intercalibration experiments conducted between CMDL and the Diode Laser Sensor Group (DACOM) at the NASA Langley Research Center (Hampton, Virginia), and CMDL and the Fraunhofer-Institut (Garmisch-Partenkirchen, Germany). Each laboratory calibrated several working standards for CO using their reference gases, and these results were compared to calibrations conducted by CMDL. The intercomparison of eight standards (CO concentrations between approximately 100 and approximately 165 ppb) by CMDL and NASA agreed to better than +/- 2%. The calibration of six standards (CO concentrations between approximately 50 and approximately 210 ppb) by CMDL and the Fraunhofer-Institut agreed to within +/- 2% for four standards, and to within +/- 5% for all six standards.

Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

PubMed

Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

2015-10-01

Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

76 FR 14805 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Lead Standards and Related... SIP revisions add the primary and secondary lead standards of 0.15 micrograms per cubic meter ([mu]g... CFR Part 52 Environmental protection, Air pollution control, Incorporation by reference, Ozone...

Chemical thermodynamic data. 1. The concept of links to the chemical elements and the historical development of key thermodynamic data

NASA Astrophysics Data System (ADS)

Wolery, Thomas J.; Jové Colón, Carlos F.

2017-09-01

Chemical thermodynamic data remain a keystone for geochemical modeling and reactive transport simulation as applied to an increasing number of applications in the earth sciences, as well as applications in other areas including metallurgy, material science, and industrial process design. The last century has seen the development of a large body of thermodynamic data and a number of major compilations. The past several decades have seen the development of thermodynamic databases in digital form designed to support computer calculations. However, problems with thermodynamic data appear to be persistent. One problem pertains to the use of inconsistent primary key reference data. Such data pertain to elemental reference forms and key, stoichiometrically simple chemical species including metal oxides, CO2, water, and aqueous species such as Na+ and Cl-. A consistent set of primary key data (standard Gibbs energies, standard enthalpies, and standard entropies for key chemical species) for 298.15 K and 1 bar pressure is essential. Thermochemical convention is to define the standard Gibbs energy and the standard enthalpy of an individual chemical species in terms of formation from reference forms of the constituent chemical elements. We propose a formal concept of "links" to the elemental reference forms. This concept involves a documented understanding of all reactions and calculations leading to values for a formation property (standard Gibbs energy or enthalpy). A valid link consists of two parts: (a) the path of reactions and corrections and (b) the associated data, which are key data. Such a link differs from a bare "key" or "reference" datum in that it requires additional information. Some or all of its associated data may also be key data. In evaluating a reported thermodynamic datum, one should identify the links to the chemical elements, a process which can be time-consuming and which may lead to a dead end (an incomplete link). The use of two or more inconsistent links to the same elemental reference form in a thermodynamic database will result in an inconsistency in the database. Thus, in constructing a database, it is important to establish a set of reliable links (generally resulting in a set of primary reference data) and then correct all data adopted subsequently for consistency with that set. Recommended values of key data have not been constant through history. We review some of this history through the lens of major compilations and other influential reports, and note a number of problem areas. Finally, we illustrate the concepts developed in this paper by applying them to some key species of geochemical interest, including liquid water; quartz and aqueous silica; and gibbsite, corundum, and the aqueous aluminum ion.

NIST Standard Reference Material 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering

DOE PAGES

Allen, Andrew J.; Zhang, Fan; Kline, R. Joseph; ...

2017-03-07

The certification of a new standard reference material for small-angle scattering [NIST Standard Reference Material (SRM) 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering (SAXS)], based on glassy carbon, is presented. Creation of this SRM relies on the intrinsic primary calibration capabilities of the ultra-small-angle X-ray scattering technique. This article describes how the intensity calibration has been achieved and validated in the certified Q range, Q = 0.008–0.25 Å –1, together with the purpose, use and availability of the SRM. The intensity calibration afforded by this robust and stable SRM should be applicable universally to all SAXS instruments thatmore » employ a transmission measurement geometry, working with a wide range of X-ray energies or wavelengths. As a result, the validation of the SRM SAXS intensity calibration using small-angle neutron scattering (SANS) is discussed, together with the prospects for including SANS in a future renewal certification.« less

NIST Standard Reference Material 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering

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

Allen, Andrew J.; Zhang, Fan; Kline, R. Joseph

The certification of a new standard reference material for small-angle scattering [NIST Standard Reference Material (SRM) 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering (SAXS)], based on glassy carbon, is presented. Creation of this SRM relies on the intrinsic primary calibration capabilities of the ultra-small-angle X-ray scattering technique. This article describes how the intensity calibration has been achieved and validated in the certified Q range, Q = 0.008–0.25 Å –1, together with the purpose, use and availability of the SRM. The intensity calibration afforded by this robust and stable SRM should be applicable universally to all SAXS instruments thatmore » employ a transmission measurement geometry, working with a wide range of X-ray energies or wavelengths. As a result, the validation of the SRM SAXS intensity calibration using small-angle neutron scattering (SANS) is discussed, together with the prospects for including SANS in a future renewal certification.« less

NIST Standard Reference Material 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering.

PubMed

Allen, Andrew J; Zhang, Fan; Kline, R Joseph; Guthrie, William F; Ilavsky, Jan

2017-04-01

The certification of a new standard reference material for small-angle scattering [NIST Standard Reference Material (SRM) 3600: Absolute Intensity Calibration Standard for Small-Angle X-ray Scattering (SAXS)], based on glassy carbon, is presented. Creation of this SRM relies on the intrinsic primary calibration capabilities of the ultra-small-angle X-ray scattering technique. This article describes how the intensity calibration has been achieved and validated in the certified Q range, Q = 0.008-0.25 Å -1 , together with the purpose, use and availability of the SRM. The intensity calibration afforded by this robust and stable SRM should be applicable universally to all SAXS instruments that employ a transmission measurement geometry, working with a wide range of X-ray energies or wavelengths. The validation of the SRM SAXS intensity calibration using small-angle neutron scattering (SANS) is discussed, together with the prospects for including SANS in a future renewal certification.

Construction of Home-Made Tin Fixed-Point Cell at TUBITAK UME

NASA Astrophysics Data System (ADS)

Kalemci, M.; Arifovic, N.; Bağçe, A.; Aytekin, S. O.; Ince, A. T.

2015-08-01

TUBITAK UME Temperature Laboratory initiated a new study which focuses on the construction of a tin freezing-point cell as a primary temperature standard. The design is an open-cell type similar to the National Institute of Standards and Technology design. With this aim, a brand new vacuum and filling line employing an oil diffusion pump and two cold traps (liquid nitrogen and dry ice) was set-up. The graphite parts (crucible, thermometer well, etc.) have been baked at high temperature under vacuum. Each cell was filled with approximately 1 kg of high-purity tin (99.9999 %) in a three-zone furnace. Then several melting and freezing curves were obtained to assess the quality of the home-made cell, and also the new cell was compared with the existing reference cell of the laboratory. The results obtained are very close to the reference cell of UME, indicating that the method used for fabrication was promising and satisfactory and also seems to meet the requirements to have a primary level temperature standard.

Nursing competency standards in primary health care: an integrative review.

PubMed

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2016-05-01

This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content of competency standards internationally is an important step to understanding this growing workforce. © 2016 John Wiley & Sons Ltd.

Geography Standards in the United States: Past Influences and Future Prospects

ERIC Educational Resources Information Center

Bednarz, Sarah Witham; Heffron, Susan Gallagher; Solem, Michael

2014-01-01

The purpose of this article is to examine how geography is represented and positioned in primary and secondary (referred to here as K-12) education in the United States through a critical analysis of the content and implementation of the National Geography Standards, "Geography for Life." We begin by providing context on the organization…

Chemical thermodynamic data. 1. The concept of links to the chemical elements and the historical development of key thermodynamic data [plus Supplementary Electronic Annex 2

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

Wolery, Thomas J.; Jove Colon, Carlos F.

Chemical thermodynamic data remain a keystone for geochemical modeling and reactive transport simulation as applied to an increasing number of applications in the earth sciences, as well as applications in other areas including metallurgy, material science, and industrial process design. The last century has seen the development of a large body of thermodynamic data and a number of major compilations. The past several decades have seen the development of thermodynamic databases in digital form designed to support computer calculations. However, problems with thermodynamic data appear to be persistent. One problem pertains to the use of inconsistent primary key reference data.more » Such data pertain to elemental reference forms and key, stoichiometrically simple chemical species including metal oxides, CO 2, water, and aqueous species such as Na + and Cl -. A consistent set of primary key data (standard Gibbs energies, standard enthalpies, and standard entropies for key chemical species) for 298.15K and 1 bar pressure is essential. Thermochemical convention is to define the standard Gibbs energy and the standard enthalpy of an individual chemical species in terms of formation from reference forms of the constituent chemical elements. We propose a formal concept of “links” to the elemental reference forms. This concept involves a documented understanding of all reactions and calculations leading to values for a formation property (standard Gibbs energy or enthalpy). A valid link consists of two parts: (a) the path of reactions and corrections and (b) the associated data, which are key data. Such a link differs from a bare “key” or “reference” datum in that it requires additional information. Some or all of its associated data may also be key data. In evaluating a reported thermodynamic datum, one should identify the links to the chemical elements, a process which can be time-consuming and which may lead to a dead end (an incomplete link). The use of two or more inconsistent links to the same elemental reference form in a thermodynamic database will result in an inconsistency in the database. Thus, in constructing a database, it is important to establish a set of reliable links (generally resulting in a set of primary reference data) and then correct all data adopted subsequently for consistency with that set. Recommended values of key data have not been constant through history. We review some of this history through the lens of major compilations and other influential reports, and note a number of problem areas. Finally, we illustrate the concepts developed in this paper by applying them to some key species of geochemical interest, including liquid water; quartz and aqueous silica; and gibbsite, corundum, and the aqueous aluminum ion.« less

Chemical thermodynamic data. 1. The concept of links to the chemical elements and the historical development of key thermodynamic data [plus Supplementary Electronic Annex 2

DOE PAGES

Wolery, Thomas J.; Jove Colon, Carlos F.

2016-09-26

Chemical thermodynamic data remain a keystone for geochemical modeling and reactive transport simulation as applied to an increasing number of applications in the earth sciences, as well as applications in other areas including metallurgy, material science, and industrial process design. The last century has seen the development of a large body of thermodynamic data and a number of major compilations. The past several decades have seen the development of thermodynamic databases in digital form designed to support computer calculations. However, problems with thermodynamic data appear to be persistent. One problem pertains to the use of inconsistent primary key reference data.more » Such data pertain to elemental reference forms and key, stoichiometrically simple chemical species including metal oxides, CO 2, water, and aqueous species such as Na + and Cl -. A consistent set of primary key data (standard Gibbs energies, standard enthalpies, and standard entropies for key chemical species) for 298.15K and 1 bar pressure is essential. Thermochemical convention is to define the standard Gibbs energy and the standard enthalpy of an individual chemical species in terms of formation from reference forms of the constituent chemical elements. We propose a formal concept of “links” to the elemental reference forms. This concept involves a documented understanding of all reactions and calculations leading to values for a formation property (standard Gibbs energy or enthalpy). A valid link consists of two parts: (a) the path of reactions and corrections and (b) the associated data, which are key data. Such a link differs from a bare “key” or “reference” datum in that it requires additional information. Some or all of its associated data may also be key data. In evaluating a reported thermodynamic datum, one should identify the links to the chemical elements, a process which can be time-consuming and which may lead to a dead end (an incomplete link). The use of two or more inconsistent links to the same elemental reference form in a thermodynamic database will result in an inconsistency in the database. Thus, in constructing a database, it is important to establish a set of reliable links (generally resulting in a set of primary reference data) and then correct all data adopted subsequently for consistency with that set. Recommended values of key data have not been constant through history. We review some of this history through the lens of major compilations and other influential reports, and note a number of problem areas. Finally, we illustrate the concepts developed in this paper by applying them to some key species of geochemical interest, including liquid water; quartz and aqueous silica; and gibbsite, corundum, and the aqueous aluminum ion.« less

New National Air-Kerma Standard for Low-Energy Electronic Brachytherapy Sources

PubMed Central

Seltzer, Stephen M; O’Brien, Michelle; Mitch, Michael G

2014-01-01

The new primary standard for low-energy electronic brachytherapy sources for the United States is described. These miniature x-ray tubes are inserted in catheters for interstitial radiation therapy and operate at tube potentials of up to about 50 kV. The standard is based on the realization of the air kerma produced by the x-ray beam at a reference distance in air of 50 cm. PMID:26601044

Progress toward Brazilian cesium fountain second generation

NASA Astrophysics Data System (ADS)

Bueno, Caio; Rodriguez Salas, Andrés; Torres Müller, Stella; Bagnato, Vanderlei Salvador; Varela Magalhães, Daniel

2018-03-01

The operation of a Cesium fountain primary frequency standard is strongly influenced by the characteristics of two important subsystems. The first is a stable frequency reference and the second is the frequency-transfer system. A stable standard frequency reference is key factor for experiments that require high accuracy and precision. The frequency stability of this reference has a significant impact on the procedures for evaluating certain systematic biases in frequency standards. This paper presents the second generation of the Brazilian Cesium Fountain (Br-CsF) through the opto-mechanical assembly and vacuum chamber to trap atoms. We used a squared section glass profile to build the region where the atoms are trapped and colled by magneto-optical technique. The opto-mechanical system was reduced to increase stability and robustness. This newest Atomic Fountain is essential to contribute with time and frequency development in metrology systems.

Design concept for the microwave interrogation structure in PARCS

NASA Technical Reports Server (NTRS)

Dick, G. J.; Klipstein, W. M.; Heavner, T. P.; Jefferts, S. R.

2002-01-01

In this paper we will describe key aspects of the conceptual design of the microwave interrogation structure in the laser-cooled cesium frequency standard that is part of the Primary Atomic Reference Clock in Space (PARCS) experiment.

Establishment and validation of analytical reference panels for the standardization of quantitative BCR-ABL1 measurements on the international scale.

PubMed

White, Helen E; Hedges, John; Bendit, Israel; Branford, Susan; Colomer, Dolors; Hochhaus, Andreas; Hughes, Timothy; Kamel-Reid, Suzanne; Kim, Dong-Wook; Modur, Vijay; Müller, Martin C; Pagnano, Katia B; Pane, Fabrizio; Radich, Jerry; Cross, Nicholas C P; Labourier, Emmanuel

2013-06-01

Current guidelines for managing Philadelphia-positive chronic myeloid leukemia include monitoring the expression of the BCR-ABL1 (breakpoint cluster region/c-abl oncogene 1, non-receptor tyrosine kinase) fusion gene by quantitative reverse-transcription PCR (RT-qPCR). Our goal was to establish and validate reference panels to mitigate the interlaboratory imprecision of quantitative BCR-ABL1 measurements and to facilitate global standardization on the international scale (IS). Four-level secondary reference panels were manufactured under controlled and validated processes with synthetic Armored RNA Quant molecules (Asuragen) calibrated to reference standards from the WHO and the NIST. Performance was evaluated in IS reference laboratories and with non-IS-standardized RT-qPCR methods. For most methods, percent ratios for BCR-ABL1 e13a2 and e14a2 relative to ABL1 or BCR were robust at 4 different levels and linear over 3 logarithms, from 10% to 0.01% on the IS. The intraassay and interassay imprecision was <2-fold overall. Performance was stable across 3 consecutive lots, in multiple laboratories, and over a period of 18 months to date. International field trials demonstrated the commutability of the reagents and their accurate alignment to the IS within the intra- and interlaboratory imprecision of IS-standardized methods. The synthetic calibrator panels are robust, reproducibly manufactured, analytically calibrated to the WHO primary standards, and compatible with most BCR-ABL1 RT-qPCR assay designs. The broad availability of secondary reference reagents will further facilitate interlaboratory comparative studies and independent quality assessment programs, which are of paramount importance for worldwide standardization of BCR-ABL1 monitoring results and the optimization of current and new therapeutic approaches for chronic myeloid leukemia. © 2013 American Association for Clinical Chemistry.

Development of a primary standard for dynamic pressure based on drop weight method covering a range of 10 MPa-400 MPa

NASA Astrophysics Data System (ADS)

Salminen, J.; Högström, R.; Saxholm, S.; Lakka, A.; Riski, K.; Heinonen, M.

2018-04-01

In this paper we present the development of a primary standard for dynamic pressures that is based on the drop weight method. At the moment dynamic pressure transducers are typically calibrated using reference transducers, which are calibrated against static pressure standards. Because dynamic and static characteristics of pressure transducers may significantly differ from each other, it is important that these transducers are calibrated against dynamic pressure standards. In a method developed in VTT Technical Research Centre of Finland Ltd, Centre for Metrology MIKES, a pressure pulse is generated by impact between a dropping weight and a piston of a liquid-filled piston-cylinder assembly. The traceability to SI-units is realized through interferometric measurement of the acceleration of the dropping weight during impact, the effective area of the piston-cylinder assembly and the mass of the weight. Based on experimental validation and an uncertainty evaluation, the developed primary standard provides traceability for peak pressures in the range from 10 MPa to 400 MPa with a few millisecond pulse width and a typical relative expanded uncertainty (k  =  2) of 1.5%. The performance of the primary standard is demonstrated by test calibrations of two dynamic pressure transducers.

40 CFR 278.3 - Criteria for use of chat in Federally funded transportation projects.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., incorporated by reference in § 260.11 of this chapter, and the leachate testing results show that concentrations in the leachate do not exceed the National Primary Drinking Water Standards for lead and cadmium...

40 CFR 278.3 - Criteria for use of chat in Federally funded transportation projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., incorporated by reference in § 260.11 of this chapter, and the leachate testing results show that concentrations in the leachate do not exceed the National Primary Drinking Water Standards for lead and cadmium...

40 CFR 278.3 - Criteria for use of chat in Federally funded transportation projects.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., incorporated by reference in § 260.11 of this chapter, and the leachate testing results show that concentrations in the leachate do not exceed the National Primary Drinking Water Standards for lead and cadmium...

40 CFR 278.3 - Criteria for use of chat in Federally funded transportation projects.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., incorporated by reference in § 260.11 of this chapter, and the leachate testing results show that concentrations in the leachate do not exceed the National Primary Drinking Water Standards for lead and cadmium...

Calibration standards for major greenhouse gases and carbon monoxide: status and challenges.

NASA Astrophysics Data System (ADS)

Zellweger, Christoph; Mohn, Joachim; Wyss, Simon A.; Brewer, Paul; Mace, Tatiana; Nieuwenkamp, Gerard; Pearce-Hill, Ruth; Tarhan, Tanil; Walden, Jari; Emmenegger, Lukas

2017-04-01

Human influence on increasing greenhouse gas mole fractions in the atmosphere and effects on positive radiative forcing as well as observed global warming and sea level rise are well accepted [1]. For interpretation of global or continental scale greenhouse gas data, obtained from different laboratories, measurement results have to coincide within compatibility goals set by the World Meteorological Organization (WMO) [2]. Despite significant advances in measurement techniques [3], WMO compatibility goals are regularly missed, shown by round-robin experiments of standard gases and comparisons of field samples or parallel measurements. Therefore, precise and accurate calibration using standards with good long-term stability is needed to reduce uncertainties of atmospheric measurements. This is addressed by the WMO Global Atmosphere Watch Programme (GAW), where Central Calibration Laboratories (CCLs) maintain calibration scales to ensure consistency of measurements within the network to primary reference materials. Furthermore, participating GAW laboratories are supported by World Calibration Centres (WCCs) performing audits and organizing round-robin comparisons. The CCL participates regularly in comparisons with independent primary scales to assure traceability of established primary reference materials to fundamental quantities (SI) [e.g. 4]. Within the European Metrology Research Programme (EMRP) ENV52 project "Metrology for high-impact greenhouse gases" (HIGHGAS), static and dynamic primary reference gas mixtures for ambient levels of CO2, CH4, N2O and CO in air were prepared by different National Metrology Institutes (NMIs). In order to progress beyond the state of the art, research focused on improving passivation chemistry, quantification of target impurities in the air matrix, and determining the isotopic composition. These primary reference gas mixtures were compared in a round robin experiment against standards calibrated against reference gases currently used by the GAW community. We will show results of the comparison of the HIGHGAS and the WMO reference standards, and put this into the context of the WMO/GAW quality management framework. [1] IPCC, 2013: Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Stocker, T.F., D. Qin, G.-K. Plattner, M. Tignor, S.K. Allen, J. Boschung, A. Nauels, Y. Xia, V. Bex and P.M. Midgley (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, 1535 pp. [2] WMO: 18th WMO/IAEA Meeting on Carbon Dioxide, Other Greenhouse Gases and Related Tracers Measurement Techniques (GGMT-2015), La Jolla, CA, USA, 13-17 September 2015, GAW Report No. 229, World Meteorological Organization, Geneva, Switzerland, 2016. [3] Zellweger, C., Emmenegger, L., Firdaus, M., Hatakka, J., Heimann, M., Kozlova, E., Spain, T. G., Steinbacher, M., van der Schoot, M. V., and Buchmann, B.: Assessment of recent advances in measurement techniques for atmospheric carbon dioxide and methane observations, Atmos. Meas. Tech., 9, 4737-4757, 2016. [4] Flores, E., Viallon, J., Choteau, T., Moussay, P., Wielgosz, R., Kang, N., Kim, B. M., Zalewska, E., van der Veen, A., Konopelko, L., Wu, H., Han, Q., Rhoderick, G., Guenther, F. R., Watanabe, T., Shimosaka, T., Kato, K., Hall, B., and Brewer, P.: International comparison CCQM-K82: methane in air at ambient level (1800 to 2200) nmol/mol, Metrologia, 52, 08001, 2015.

On the traceability of gaseous reference materials

NASA Astrophysics Data System (ADS)

Brown, Richard J. C.; Brewer, Paul J.; Harris, Peter M.; Davidson, Stuart; van der Veen, Adriaan M. H.; Ent, Hugo

2017-06-01

The complex and multi-parameter nature of chemical composition measurement means that establishing traceability is a challenging task. As a result incorrect interpretations about the origin of the metrological traceability of chemical measurement results can occur. This discussion paper examines why this is the case by scrutinising the peculiarities of the gas metrology area. It considers in particular: primary methods, dissemination of metrological traceability and the role of documentary standards and accreditation bodies in promulgating best practice. There is also a discussion of documentary standards relevant to the NMI and reference material producer community which need clarification, and the impact which key stakeholders in the quality infrastructure can bring to these issues.

Collaborative studies on the development of national reference standards for potency determination of H7N9 influenza vaccine

PubMed Central

Li, Changgui; Xu, Kangwei; Hashem, Anwar; Shao, Ming; Liu, Shuzhen; Zou, Yong; Gao, Qiang; Zhang, Yongchao; Yuan, Liyong; Xu, Miao; Li, Xuguang; Wang, Junzhi

2015-01-01

The outbreak of human infections of a novel avian influenza virus A (H7N9) prompted the development of the vaccines against this virus. Like all types of influenza vaccines, H7N9 vaccine must be tested for its potency prior to being used in humans. However, the unavailability of international reference reagents for the potency determination of H7N9 vaccines substantially hinders the progress in vaccine development. To facilitate clinical development, we enlisted 5 participants in a collaborative study to develop critical reagents used in Single Radial Immunodiffusion (SRID), the currently acceptable assay for potency determination of influenza vaccine. Specifically, the hemagglutinin (HA) content of one vaccine bulk for influenza A (H7N9), herein designated as Primary Liquid Standard (PLS), was determined by SDS-PAGE. In addition, the freeze-dried antigen references derived from PLS were prepared to enhance the stability for long term storage. The final HA content of lyophilized antigen references were calibrated against PLS by SRID assay in a collaborative study. Importantly, application of these national reference standards to potency analyses greatly facilitated the development of H7N9 vaccines in China. PMID:25970793

Reference Data for the Density and Viscosity of Liquid Cadmium, Cobalt, Gallium, Indium, Mercury, Silicon, Thallium, and Zinc

NASA Astrophysics Data System (ADS)

Assael, Marc J.; Armyra, Ivi J.; Brillo, Juergen; Stankus, Sergei V.; Wu, Jiangtao; Wakeham, William A.

2012-09-01

The available experimental data for the density and viscosity of liquid cadmium, cobalt, gallium, indium, mercury, silicon, thallium, and zinc have been critically examined with the intention of establishing both a density and a viscosity standard. All experimental data have been categorized into primary and secondary data according to the quality of measurement, the technique employed and the presentation of the data, as specified by a series of criteria. The proposed standard reference correlations for the density of liquid cadmium, cobalt, gallium, indium, silicon, thallium, and zinc are characterized by percent deviations at the 95% confidence level of 0.6, 2.1, 0.4, 0.5, 2.2, 0.9, and 0.7, respectively. In the case of mercury, since density reference values already exist, no further work was carried out. The standard reference correlations for the viscosity of liquid cadmium, cobalt, gallium, indium, mercury, silicon, thallium, and zinc are characterized by percent deviations at the 95% confidence level of 9.4, 14.0, 13.5, 2.1, 7.3, 15.7, 5.1, and 9.3, respectively.

Development of a Comprehensive Osteochondral Allograft MRI Scoring System (OCAMRISS) With Histopathologic, Micro–Computed Tomography, and Biomechanical Validation

PubMed Central

Pallante-Kichura, Andrea L.; Bae, Won C.; Du, Jiang; Statum, Sheronda; Wolfson, Tanya; Gamst, Anthony C.; Cory, Esther; Amiel, David; Bugbee, William D.; Sah, Robert L.; Chung, Christine B.

2014-01-01

Objective: To describe and apply a semiquantitative MRI scoring system for multifeature analysis of cartilage defect repair in the knee by osteochondral allografts and to correlate this scoring system with histopathologic, micro–computed tomography (µCT), and biomechanical reference standards using a goat repair model. Design: Fourteen adult goats had 2 osteochondral allografts implanted into each knee: one in the medial femoral condyle and one in the lateral trochlea. At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated 9 primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histologic and µCT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen’s κ, Spearman’s correlation, and Kruskal-Wallis tests were used as appropriate. Results: There was substantial agreement (κ > 0.6, P < 0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (κ = 0.6). There was a strong positive correlation between MRI and reference standard scores (ρ = 0.86, P < 0.01). Osteochondral allograft MRI scoring system was sensitive to differences in outcomes between the types of allografts. Conclusions: We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and µCT reference standards as well as biomechanical indentation testing. PMID:24489999

Primary hypolactasia diagnosis: Comparison between the gaxilose test, shortened lactose tolerance test, and clinical parameters corresponding to the C/T-13910 polymorphism.

PubMed

Domínguez Jiménez, José Luis; Fernández Suárez, Antonio; Muñoz Colmenero, Aurora Úrsula; Fatela Cantillo, Daniel; López Pelayo, Iratxe

2017-04-01

There is no consensus on the most accurate method to diagnose primary hypolactasia. We aimed to compare the diagnostic accuracy of the new gaxilose test with 2 traditional tests (lactose tolerance test and clinical criteria) for the diagnosis of primary hypolactasia using the C/T-13910 polymorphism as a reference standard. Patients with a clinical suspicion of lactose intolerance were subjected to gaxilose tests, shortened lactose tolerance tests, and symptom questionnaires before and after overload with 50 g lactose and after a lactose-free diet. The diagnostic accuracy and degree of agreement and correlation were assessed using a genetic test (C/T-13910 polymorphism) as a reference standard and their respective 95% confidence intervals. Thirty consecutive patients (70% women) participated in the study. The genetic test confirmed the C/T-13910 polymorphism in 11 patients (36.8%). The presence of diarrhoea and the symptom score after lactose overload, along with the tolerance test, were the variables with the highest degree of agreement (κ > 0.60). Area under the ROC curve was >0.82 (p < 0.05), with sensitivity and specificity values of >0.80. However, the gaxilose test obtained lower values: κ, 0.47; area under curve, 0.75 (0.57-0.94); sensitivity, 0.82 (0.55-1); and specificity, 0.68 (0.45-0.92). The multivariate analysis showed an association between the post-overload symptom questionnaire and the results of the genetic test (odds ratio: 1.17; 1.04-1.31; p < 0.01). The presence of diarrhoea and the symptom score after overload with 50 g lactose showed a higher degree of agreement and diagnostic accuracy for primary hypolactasia than the gaxilose test when the genetic test is used as a reference standard. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Implications of the new Centers for Disease Control and Prevention blood lead reference value.

PubMed

Burns, Mackenzie S; Gerstenberger, Shawn L

2014-06-01

The Centers for Disease Control and Prevention recently established a new reference value (≥ 5 μg/dL) as the standard for identifying children with elevated blood lead levels (EBLs). At present, 535,000 US children aged 1 to 5 years (2.6%) are estimated to have EBLs according to the new standard, versus 0.8% according to the previous standard (≥ 10 μg/dL). Because EBLs signify the threshold for public health intervention, this new definition increases demands on lead poisoning prevention efforts. Primary prevention has been proven to reduce lead poisoning cases and is also cost effective; however, federal budget cuts threaten the existence of such programs. Protection for the highest-risk children necessitates a reinstatement of federal funding to previous levels.

Physical tests for shoulder impingements and local lesions of bursa, tendon or labrum that may accompany impingement.

PubMed

Hanchard, Nigel C A; Lenza, Mário; Handoll, Helen H G; Takwoingi, Yemisi

2013-04-30

Impingement is a common cause of shoulder pain. Impingement mechanisms may occur subacromially (under the coraco-acromial arch) or internally (within the shoulder joint), and a number of secondary pathologies may be associated. These include subacromial-subdeltoid bursitis (inflammation of the subacromial portion of the bursa, the subdeltoid portion, or both), tendinopathy or tears affecting the rotator cuff or the long head of biceps tendon, and glenoid labral damage. Accurate diagnosis based on physical tests would facilitate early optimisation of the clinical management approach. Most people with shoulder pain are diagnosed and managed in the primary care setting. To evaluate the diagnostic accuracy of physical tests for shoulder impingements (subacromial or internal) or local lesions of bursa, rotator cuff or labrum that may accompany impingement, in people whose symptoms and/or history suggest any of these disorders. We searched electronic databases for primary studies in two stages. In the first stage, we searched MEDLINE, EMBASE, CINAHL, AMED and DARE (all from inception to November 2005). In the second stage, we searched MEDLINE, EMBASE and AMED (2005 to 15 February 2010). Searches were delimited to articles written in English. We considered for inclusion diagnostic test accuracy studies that directly compared the accuracy of one or more physical index tests for shoulder impingement against a reference test in any clinical setting. We considered diagnostic test accuracy studies with cross-sectional or cohort designs (retrospective or prospective), case-control studies and randomised controlled trials. Two pairs of review authors independently performed study selection, assessed the study quality using QUADAS, and extracted data onto a purpose-designed form, noting patient characteristics (including care setting), study design, index tests and reference standard, and the diagnostic 2 x 2 table. We presented information on sensitivities and specificities with 95% confidence intervals (95% CI) for the index tests. Meta-analysis was not performed. We included 33 studies involving 4002 shoulders in 3852 patients. Although 28 studies were prospective, study quality was still generally poor. Mainly reflecting the use of surgery as a reference test in most studies, all but two studies were judged as not meeting the criteria for having a representative spectrum of patients. However, even these two studies only partly recruited from primary care.The target conditions assessed in the 33 studies were grouped under five main categories: subacromial or internal impingement, rotator cuff tendinopathy or tears, long head of biceps tendinopathy or tears, glenoid labral lesions and multiple undifferentiated target conditions. The majority of studies used arthroscopic surgery as the reference standard. Eight studies utilised reference standards which were potentially applicable to primary care (local anaesthesia, one study; ultrasound, three studies) or the hospital outpatient setting (magnetic resonance imaging, four studies). One study used a variety of reference standards, some applicable to primary care or the hospital outpatient setting. In two of these studies the reference standard used was acceptable for identifying the target condition, but in six it was only partially so. The studies evaluated numerous standard, modified, or combination index tests and 14 novel index tests. There were 170 target condition/index test combinations, but only six instances of any index test being performed and interpreted similarly in two studies. Only two studies of a modified empty can test for full thickness tear of the rotator cuff, and two studies of a modified anterior slide test for type II superior labrum anterior to posterior (SLAP) lesions, were clinically homogenous. Due to the limited number of studies, meta-analyses were considered inappropriate. Sensitivity and specificity estimates from each study are presented on forest plots for the 170 target condition/index test combinations grouped according to target condition. There is insufficient evidence upon which to base selection of physical tests for shoulder impingements, and local lesions of bursa, tendon or labrum that may accompany impingement, in primary care. The large body of literature revealed extreme diversity in the performance and interpretation of tests, which hinders synthesis of the evidence and/or clinical applicability.

An approach to an acute emotional stress reference scale.

PubMed

Garzon-Rey, J M; Arza, A; de-la-Camara, C; Lobo, A; Armario, A; Aguilo, J

2017-06-16

The clinical diagnosis aims to identify the degree of affectation of the psycho-physical state of the patient as a guide to therapeutic intervention. In stress, the lack of a measurement tool based on a reference makes it difficult to quantitatively assess this degree of affectation. To define and perform a primary assessment of a standard reference in order to measure acute emotional stress from the markers identified as indicators of the degree. Psychometric tests and biochemical variables are, in general, the most accepted stress measurements by the scientific community. Each one of them probably responds to different and complementary processes related to the reaction to a stress stimulus. The reference that is proposed is a weighted mean of these indicators by assigning them relative weights in accordance with a principal components analysis. An experimental study was conducted on 40 healthy young people subjected to the psychosocial stress stimulus of the Trier Social Stress Test in order to perform a primary assessment and consistency check of the proposed reference. The proposed scale clearly differentiates between the induced relax and stress states. Accepting the subjectivity of the definition and the lack of a subsequent validation with new experimental data, the proposed standard differentiates between a relax state and an emotional stress state triggered by a moderate stress stimulus, as it is the Trier Social Stress Test. The scale is robust. Although the variations in the percentage composition slightly affect the score, but they do not affect the valid differentiation between states.

A new NIST primary standardization of 18F.

PubMed

Fitzgerald, R; Zimmerman, B E; Bergeron, D E; Cessna, J C; Pibida, L; Moreira, D S

2014-02-01

A new primary standardization of (18)F by NIST is reported. The standard is based on live-timed beta-gamma anticoincidence counting with confirmatory measurements by three other methods: (i) liquid scintillation (LS) counting using CIEMAT/NIST (3)H efficiency tracing; (ii) triple-to-double coincidence ratio (TDCR) counting; and (iii) NaI integral counting and HPGe γ-ray spectrometry. The results are reported as calibration factors for NIST-maintained ionization chambers (including some "dose calibrators"). The LS-based methods reveal evidence for cocktail instability for one LS cocktail. Using an ionization chamber to link this work with previous NIST results, the new value differs from the previous reports by about 4%, but appears to be in good agreement with the key comparison reference value (KCRV) of 2005. © 2013 Published by Elsevier Ltd.

Nist Microwave Blackbody: The Design, Testing, and Verification of a Conical Brightness Temperature Source

NASA Astrophysics Data System (ADS)

Houtz, Derek Anderson

Microwave radiometers allow remote sensing of earth and atmospheric temperatures from space, anytime, anywhere, through clouds, and in the dark. Data from microwave radiometers are high-impact operational inputs to weather forecasts, and are used to provide a vast array of climate data products including land and sea surface temperatures, soil moisture, ocean salinity, cloud precipitation and moisture height profiles, and even wind speed and direction, to name a few. Space-borne microwave radiometers have a major weakness when it comes to long-term climate trends due to their lack of traceability. Because there is no standard, or absolute reference, for microwave brightness temperature, nationally or internationally, individual instruments must each rely on their own internal calibration source to set an absolute reference to the fundamental unit of Kelvin. This causes each subsequent instrument to have a calibration offset and there is no 'true' reference. The work introduced in this thesis addresses this vacancy by proposing and introducing a NIST microwave brightness temperature source that may act as the primary reference. The NIST standard will allow pre-launch calibration of radiometers across a broad range of remote sensing pertinent frequencies between 18 GHz and 220 GHz. The blackbody will be capable of reaching temperatures ranging between liquid nitrogen boiling at approximately 77 K and warm-target temperature of 350 K. The brightness temperature of the source has associated standard uncertainty ranging as a function of frequency between 0.084 K and 0.111 K. The standard can be transferred to the calibration source in the instrument, providing traceability of all subsequent measurements back to the primary standard. The development of the NIST standard source involved predicting and measuring its brightness temperature, and minimizing the associated uncertainty of this quantity. Uniform and constant physical temperature along with well characterized and maximized emissivity are fundamental to a well characterized blackbody. The chosen geometry is a microwave absorber coated copper cone. Electromagnetic and thermal simulations are introduced to optimize the design. Experimental verifications of the simulated quantities confirm the predicted performance of the blackbody.

Standard Specimen Reference Set: Pancreatic — EDRN Public Portal

Cancer.gov

The primary objective of the EDRN Pancreatic Cancer Working Group Proposal is to create a reference set consisting of well-characterized serum/plasma specimens to use as a resource for the development of biomarkers for the early detection of pancreatic adenocarcinoma. The testing of biomarkers on the same sample set permits direct comparison among them; thereby, allowing the development of a biomarker panel that can be evaluated in a future validation study. Additionally, the establishment of an infrastructure with core data elements and standardized operating procedures for specimen collection, processing and storage, will provide the necessary preparatory platform for larger validation studies when the appropriate marker/panel for pancreatic adenocarcinoma has been identified.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - FIELD PORTABLE X-RAY FLUORESCENCE ANALYZER - SCITEC, MAP SPECTRUM ANALYZER

EPA Science Inventory

In April 1995, the U.S. Environmental Protection Agency (EPA) sponsored a demonstration of field portable X-ray fluorescence (FPXRF) analyzers. The primary objectives of this demonstration were (1) to determine how well FPXRF analyzers perform in comparison to standard reference...

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - FIELD PORTABLE X-RAY FLUORESCENCE ANALYZER - HNU SYSTEMS, SEFA-P

EPA Science Inventory

In April 1995, the Environmental Protection Agency (EPA) conducted a demonstration of field portable X-ray fluorescence (FPXRF) Analyzers. The primary objectives of this demonstration were (1) to determine how well FPXRF analyzers perform in comparison to a standard reference m...

Spirometry in primary care: An analysis of spirometry test quality in a regional primary care asthma program

PubMed Central

Licskai, Christopher J; Sands, Todd W; Paolatto, Lisa; Nicoletti, Ivan; Ferrone, Madonna

2012-01-01

BACKGROUND: Primary care office spirometry can improve access to testing and concordance between clinical practice and asthma guidelines. Compliance with test quality standards is essential to implementation. OBJECTIVE: To evaluate the quality of spirometry performed onsite in a regional primary care asthma program (RAP) by health care professionals with limited training. METHODS: Asthma educators were trained to perform spirometry during two 2 h workshops and supervised during up to six patient encounters. Quality was analyzed using American Thoracic Society (ATS) 1994 and ATS/European Respiratory Society (ERS) 2003 (ATS/ERS) standards. These results were compared with two regional reference sites: a primary care group practice (Family Medical Centre [FMC], Windsor, Ontario) and a teaching hospital pulmonary function laboratory (London Health Sciences Centre [LHSC], London, Ontario). RESULTS: A total of 12,815 flow-volume loops (FVL) were evaluated: RAP – 1606 FVL in 472 patient sessions; reference sites – FMC 4013 FVL in 573 sessions; and LHSC – 7196 in 1151 sessions. RAP: There were three acceptable FVL in 392 of 472 (83%) sessions, two reproducible FVL according to ATS criteria in 428 of 469 (91%) sessions, and 395 of 469 (84%) according to ATS/ERS criteria. All quality criteria – minimum of three acceptable and two reproducible FVL according to ATS criteria in 361 of 472 (77%) sessions and according to ATS/ERS criteria in 337 of 472 (71%) sessions. RAP met ATS criteria more often than the FMC (388 of 573 [68%]); however, less often than LHSC (1050 of 1151 [91%]; P<0.001). CONCLUSIONS: Health care providers with limited training and experience operating within a simple quality program achieved ATS/ERS quality spirometry in the majority of sessions in a primary care setting. The quality performance approached pulmonary function laboratory standards. PMID:22891184

Realization of the medium and high vacuum primary standard in CENAM, Mexico

NASA Astrophysics Data System (ADS)

Torres-Guzman, J. C.; Santander, L. A.; Jousten, K.

2005-12-01

A medium and high vacuum primary standard, based on the static expansion method, has been set up at Centro Nacional de Metrología (CENAM), Mexico. This system has four volumes and covers a measuring range of 1 × 10-5 Pa to 1 × 103 Pa of absolute pressure. As part of its realization, a characterization was performed, which included volume calibrations, several tests and a bilateral key comparison. To determine the expansion ratios, two methods were applied: the gravimetric method and the method with a linearized spinning rotor gauge. The outgassing ratios for the whole system were also determined. A comparison was performed with Physikalisch-Technische Bundesanstalt (comparison SIM-Euromet.M.P-BK3). By means of this comparison, a link has been achieved with the Euromet comparison (Euromet.M.P-K1.b). As a result, it is concluded that the value obtained at CENAM is equivalent to the Euromet reference value, and therefore the design, construction and operation of CENAM's SEE-1 vacuum primary standard were successful.

Implications of the New Centers for Disease Control and Prevention Blood Lead Reference Value

PubMed Central

Burns, Mackenzie S.; Gerstenberger, Shawn L.

2014-01-01

The Centers for Disease Control and Prevention recently established a new reference value (≥ 5 μg/dL) as the standard for identifying children with elevated blood lead levels (EBLs). At present, 535 000 US children aged 1 to 5 years (2.6%) are estimated to have EBLs according to the new standard, versus 0.8% according to the previous standard (≥ 10 μg/dL). Because EBLs signify the threshold for public health intervention, this new definition increases demands on lead poisoning prevention efforts. Primary prevention has been proven to reduce lead poisoning cases and is also cost effective; however, federal budget cuts threaten the existence of such programs. Protection for the highest-risk children necessitates a reinstatement of federal funding to previous levels. PMID:24825227

Simultaneous 11C-Methionine Positron Emission Tomography/Magnetic Resonance Imaging of Suspected Primary Brain Tumors

PubMed Central

Deuschl, Cornelius; Goericke, Sophia; Grueneisen, Johannes; Sawicki, Lino Morris; Goebel, Juliane; El Hindy, Nicolai; Wrede, Karsten; Binse, Ina; Poeppel, Thorsten; Quick, Harald; Forsting, Michael; Hense, Joerg; Umutlu, Lale; Schlamann, Marc

2016-01-01

Introduction The objective of this study was to assess the diagnostic value of integrated 11C- methionine PET/MRI for suspected primary brain tumors, in comparison to MRI alone. Material and Methods Forty-eight consecutive patients with suspected primary brain tumor were prospectively enrolled for an integrated 11C-methionine PET/MRI. Two neuro-radiologists separately evaluated the MRI alone and the integrated PET/MRI data sets regarding most likely diagnosis and diagnostic confidence on a 5-point scale. Reference standard was histopathology or follow-up imaging. Results Fifty-one suspicious lesions were detected: 16 high-grade glioma and 25 low-grade glioma. Ten non-malignant cerebral lesions were described by the reference standard. MRI alone and integrated PET/MRI each correctly classified 42 of the 51 lesions (82.4%) as neoplastic lesions (WHO grade II, III and IV) or non-malignant lesions (infectious and neoplastic lesions). Diagnostic confidence for all lesions, low-grade astrocytoma and high-grade astrocytoma (3.7 vs. 4.2, 3,1 vs. 3.8, 4.0 vs. 4,7) were significantly (p < 0.05) better with integrated PET/MRI than in MRI alone. Conclusions The present study demonstrates the high potential of integrated 11C-methionine-PET/MRI for the assessment of suspected primary brain tumors. Although integrated methionine PET/MRI does not lead to an improvement of correct diagnoses, diagnostic confidence is significantly improved. PMID:27907162

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - FIELD PORTABLE X-RAY FLUORESCENCE ANALYZER - METOREX, INC. X-MET 920-P AND 940

EPA Science Inventory

In April 1995, the U.S. Environmental Protection Agency (EPA) sponsored a demonstration of field portable X-ray fluorescence (FPXRF) analyzers. The primary objectives of this demonstration were (1) to determine how well FPXRF analyzers perform in comparison to standard reference...

The Delis-Kaplan Executive Function System: A Review

ERIC Educational Resources Information Center

Swanson, Jewel

2005-01-01

The Delis-Kaplan Executive Function System (D-KEFS; Delis, Kaplan, & Kramer, 2001a) is a set of standardized tests for comprehensively assessing higher-level cognitive functions, referred to as "executive functions," in both children and adults (aged 8 to 89). Executive functions draw on the individual's more fundamental or primary cognitive…

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.

International Laser Ranging Service (ILRS): Terms of Reference

NASA Technical Reports Server (NTRS)

Husson, Van; Noll, Carey

2000-01-01

The International Laser Ranging Service (ILRS) is an established Service within Section II , Advanced Space Technology, of the International Association of Geodesy (IAG). The primary objective of the ILRS is to provide a service to support, through Satellite and Lunar Laser Ranging data and related products, geodetic and geophysical research activities as well as International Earth Rotation Service (IERS) products important to the maintenance of an accurate International Terrestrial Reference Frame (ITRF). The service also develops the necessary standards/specifications and encourages international adherence to its conventions.

New Primary Standards for Establishing SI Traceability for Moisture Measurements in Solid Materials

NASA Astrophysics Data System (ADS)

Heinonen, M.; Bell, S.; Choi, B. Il; Cortellessa, G.; Fernicola, V.; Georgin, E.; Hudoklin, D.; Ionescu, G. V.; Ismail, N.; Keawprasert, T.; Krasheninina, M.; Aro, R.; Nielsen, J.; Oğuz Aytekin, S.; Österberg, P.; Skabar, J.; Strnad, R.

2018-01-01

A European research project METefnet addresses a fundamental obstacle to improving energy-intensive drying process control: due to ambiguous reference analysis methods and insufficient methods for estimating uncertainty in moisture measurements, the achievable accuracy in the past was limited and measurement uncertainties were largely unknown. This paper reports the developments in METefnet that provide a sound basis for the SI traceability: four new primary standards for realizing the water mass fraction were set up, analyzed and compared to each other. The operation of these standards is based on combining sample weighing with different water vapor detection techniques: cold trap, chilled mirror, electrolytic and coulometric Karl Fischer titration. The results show that an equivalence of 0.2 % has been achieved between the water mass fraction realizations and that the developed methods are applicable to a wide range of materials.

PTB’s Primary Clock CS1: First Results After Its Reconstruction

DTIC Science & Technology

1996-12-01

intense atomic beam and the frequency instability up (7 = 1 s) is predicted to be 4.10- la , based on the 62.5 Hz linewidth and the signal-to-noise...will be put into final operation as a clock again. REFERENCES [I] K. Dorenwendt 1986, "Realization and dissemination of the second, " Metrologia ...T. HeindorfT, R. Schroder, and B. Fischer 1996, "The P T B primary clod CS3: type B evaluation of its standard uncertainty," Metrologia , 33, 249

Reference correlations for the thermal conductivity of liquid copper, gallium, indium, iron, lead, nickel and tin**

PubMed Central

Assael, Marc J.; Chatzimichailidis, Arsenios; Antoniadis, Konstantinos D.; Wakeham, William A.; Huber, Marcia L.; Fukuyama, Hiroyuki

2017-01-01

The available experimental data for the thermal conductivity of liquid copper, gallium, indium, iron, lead, nickel, and tin has been critically examined with the intention of establishing thermal conductivity reference correlations. All experimental data have been categorized into primary and secondary data according to the quality of measurement specified by a series of criteria. The proposed standard reference correlations for the thermal conductivity of liquid copper, gallium, indium, iron, lead, nickel, and tin are respectively characterized by uncertainties of 9.8, 15.9, 9.7, 13.7, 16.9, 7.7, and 12.6% at the 95% confidence level. PMID:29353915

Adjusting for partial verification or workup bias in meta-analyses of diagnostic accuracy studies.

PubMed

de Groot, Joris A H; Dendukuri, Nandini; Janssen, Kristel J M; Reitsma, Johannes B; Brophy, James; Joseph, Lawrence; Bossuyt, Patrick M M; Moons, Karel G M

2012-04-15

A key requirement in the design of diagnostic accuracy studies is that all study participants receive both the test under evaluation and the reference standard test. For a variety of practical and ethical reasons, sometimes only a proportion of patients receive the reference standard, which can bias the accuracy estimates. Numerous methods have been described for correcting this partial verification bias or workup bias in individual studies. In this article, the authors describe a Bayesian method for obtaining adjusted results from a diagnostic meta-analysis when partial verification or workup bias is present in a subset of the primary studies. The method corrects for verification bias without having to exclude primary studies with verification bias, thus preserving the main advantages of a meta-analysis: increased precision and better generalizability. The results of this method are compared with the existing methods for dealing with verification bias in diagnostic meta-analyses. For illustration, the authors use empirical data from a systematic review of studies of the accuracy of the immunohistochemistry test for diagnosis of human epidermal growth factor receptor 2 status in breast cancer patients.

Science Goals of the Primary Atomic Reference Clock in Space (PARCS) Experiment

NASA Technical Reports Server (NTRS)

Ashby, N.

2003-01-01

The PARCS (Primary Atomic Reference Clock in Space) experiment will use a laser-cooled Cesium atomic clock operating in the microgravity environment aboard the International Space Station (ISS) to provide both advanced tests of gravitational theory and to demonstrate a new cold-atom clock technology for space. PARCS is a joint project of the National Institute of Standards and Technology (NIST), NASA's Jet Propulsion Laboratory (JPL), and the University of Colorado (CU). This paper concentrates on the scientific goals of the PARCS mission. The microgravity space environment allows laser-cooled Cs atoms to have Ramsey times in excess of those feasible on Earth, resulting in improved clock performance. Clock stabilities of 5x10(exp -14) at one second, and accuracies better than 10(exp -16) are projected.

Standard services for the capture, processing, and distribution of packetized telemetry data

NASA Technical Reports Server (NTRS)

Stallings, William H.

1989-01-01

Standard functional services for the capture, processing, and distribution of packetized data are discussed with particular reference to the future implementation of packet processing systems, such as those for the Space Station Freedom. The major functions are listed under the following major categories: input processing, packet processing, and output processing. A functional block diagram of a packet data processing facility is presented, showing the distribution of the various processing functions as well as the primary data flow through the facility.

Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care.

PubMed

Ebell, Mark H; Hansen, Jens Georg

2017-07-01

To reduce inappropriate antibiotic prescribing, we sought to develop a clinical decision rule for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Multivariate analysis and classification and regression tree (CART) analysis were used to develop clinical decision rules for the diagnosis of acute rhinosinusitis, defined using 3 different reference standards (purulent antral puncture fluid or abnormal finding on a computed tomographic (CT) scan; for acute bacterial rhinosinusitis, we used a positive bacterial culture of antral fluid). Signs, symptoms, C-reactive protein (CRP), and reference standard tests were prospectively recorded in 175 Danish patients aged 18 to 65 years seeking care for suspected acute rhinosinusitis. For each reference standard, we developed 2 clinical decision rules: a point score based on a logistic regression model and an algorithm based on a CART model. We identified low-, moderate-, and high-risk groups for acute rhinosinusitis or acute bacterial rhinosinusitis for each clinical decision rule. The point scores each had between 5 and 6 predictors, and an area under the receiver operating characteristic curve (AUROCC) between 0.721 and 0.767. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a 16%, 49%, and 73% likelihood of acute bacterial rhinosinusitis, respectively. CART models had an AUROCC ranging from 0.783 to 0.827. For positive bacterial culture as the reference standard, low-, moderate-, and high-risk groups had a likelihood of acute bacterial rhinosinusitis of 6%, 31%, and 59% respectively. We have developed a series of clinical decision rules integrating signs, symptoms, and CRP to diagnose acute rhinosinusitis and acute bacterial rhinosinusitis with good accuracy. They now require prospective validation and an assessment of their effect on clinical and process outcomes. © 2017 Annals of Family Medicine, Inc.

Patient safety principles in family medicine residency accreditation standards and curriculum objectives

PubMed Central

Kassam, Aliya; Sharma, Nishan; Harvie, Margot; O’Beirne, Maeve; Topps, Maureen

2016-01-01

Abstract Objective To conduct a thematic analysis of the College of Family Physicians of Canada’s (CFPC’s) Red Book accreditation standards and the Triple C Competency-based Curriculum objectives with respect to patient safety principles. Design Thematic content analysis of the CFPC’s Red Book accreditation standards and the Triple C curriculum. Setting Canada. Main outcome measures Coding frequency of the patient safety principles (ie, patient engagement; respectful, transparent relationships; complex systems; a just and trusting culture; responsibility and accountability for actions; and continuous learning and improvement) found in the analyzed CFPC documents. Results Within the analyzed CFPC documents, the most commonly found patient safety principle was patient engagement (n = 51 coding references); the least commonly found patient safety principles were a just and trusting culture (n = 5 coding references) and complex systems (n = 5 coding references). Other patient safety principles that were uncommon included responsibility and accountability for actions (n = 7 coding references) and continuous learning and improvement (n = 12 coding references). Conclusion Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID:27965349

Validation of Radiometric Standards for the Laboratory Calibration of Reflected-Solar Earth Observing Satellite Instruments

NASA Technical Reports Server (NTRS)

Butler, James J.; Johnson, B. Carol; Rice, Joseph P.; Brown, Steven W.; Barnes, Robert A.

2007-01-01

Historically, the traceability of the laboratory calibration of Earth-observing satellite instruments to a primary radiometric reference scale (SI units) is the responsibility of each instrument builder. For the NASA Earth Observing System (EOS), a program has been developed using laboratory transfer radiometers, each with its own traceability to the primary radiance scale of a national metrology laboratory, to independently validate the radiances assigned to the laboratory sources of the instrument builders. The EOS Project Science Office also developed a validation program for the measurement of onboard diffuse reflecting plaques, which are also used as radiometric standards for Earth-observing satellite instruments. Summarized results of these validation campaigns, with an emphasis on the current state-of-the-art uncertainties in laboratory radiometric standards, will be presented. Future mission uncertainty requirements, and possible enhancements to the EOS validation program to ensure that those uncertainties can be met, will be presented.

Calibrating NIST SRM 683 as A New International Reference Standard for Zn Isotopes

NASA Astrophysics Data System (ADS)

Yang, Y.; Zhang, X.; Yu, H.; Huang, F.

2017-12-01

Zinc isotopes have been widely applied in the cosmochemical, geochemical, and environmental studies (Moynier et al. 2017). Obtaining precise Zn isotopic data for inter-laboratory comparison is a prerequisite to these applications. Currently, the JMC3-0749L is the primary reference standard for Zn isotopes (Albarède 2004), but it is not commercially available now. Thus, it is necessary to calibrate a new international primary reference standard for Zn isotopic analysis. Chen et al. (2016) showed that NIST SRM 683 (a pure Zn metal nugget of 140 grams) has a δ66ZnJMC of 0.12‰, which is falling within the range of natural Zn isotopic compositions, and it may a good candidate for the next generation of international reference standard (Chen et al. 2016). In order to further examine whether NIST SRM 683 has a homogeneous Zn isotopic composition, we measured more NIST SRM 683 by double-spike methods using MC-ICPMS (Conway et al. 2013). The metal nuggets of NIST SRM 683 were intensively sampled by micro-drilling. Zinc isotope analyses for two nuggets show that they have δ66Zn of 0.14 ± 0.02‰ (2SD, N = 32) and 0.13 ± 0.02‰ (2SD, N = 33), respectively. These values are similar to those of two Zn metal nuggets (0.11 ± 0.02‰ vs. 0.12 ± 0.02‰) reported previously by Chen et al. (2016). We fully dissolved one nugget, producing pure Zn solution with identical Zn isotopic composition with the drilling samples. All results strongly support that NIST SRM 683 is homogeneous in Zn isotopic compositions which could be an ideal candidate for the next reference for Zn isotopes. Tests on more metal nuggets will be performed in a few months for further confirming the Zn isotope compositions and homogeneity. Reference: Albarède et al., 2004. 'The stable isotope geochemistry of copper and zinc', Reviews in Mineralogy and Geochemistry, 55: 409-27. Chen et al., 2016. 'Zinc Isotopic Compositions of NIST SRM 683 and Whole-Rock Reference Materials', Geostandards and Geoanalytical Research, 40: 417-32. Conway et al., 2013. 'A new method for precise determination of iron, zinc and cadmium stable isotope ratios in seawater by double-spike mass spectrometry', Analytica chimica acta, 793: 44-52. Moynier et al., 2017. 'The isotope geochemistry of zinc and copper', Reviews in Mineralogy and Geochemistry, 82: 543-600.

Prevalence of chromosomal aberrations in Mexican women with primary amenorrhoea.

PubMed

Cortés-Gutiérrez, Elva I; Dávila-Rodríguez, Martha I; Vargas-Villarreal, Javier; Cerda-Flores, Ricardo M

2007-10-01

Primary amenorrhoea refers to the absence of menarche by the age of 16-18 years in the presence of secondary sexual characteristics, and occurs in 1-3% of women of reproductive age. To study the prevalence of chromosomal abnormalities and the different options available for clinical management of women in Mexico with primary amenorrhoea, a cross-sectional study was conducted in 187 women with primary amenorrhoea referred from Department of Reproductive Medicine of Morones Prieto Hospital, IMSS in Monterrey, Mexico during 1995-2003. Peripheral blood lymphocytes were cultured for chromosomal studies by the standard methods. Numerical or structural abnormalities of the sex chromosome were found in 78 women (41.71%). These women were classified into four categories: X-chromosome aneuploidies (22.99%: 12.83% pure line and 10.16% mosaicism association with a 45, X cell line); presence of chromosome Y (10.70%); structural anomalies of the X chromosome (4.28%); and marker chromosomes (3.74%). In conclusion, the prevalence of chromosomal abnormalities in Mexican women with primary amenorrhoea is within the range (24-46%) reported in world literature. Chromosomal analysis is absolutely necessary for appropriate clinical management of these patients.

Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region

PubMed Central

Fluet, Norman R.; Reis, Michael D.; Stern, Charles H.; Thompson, Alexander W.; Jolly, Gillian A.

2016-01-01

The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process. PMID:27034543

A compensated multi-pole linear ion trap mercury frequency standard for ultra-stable timekeeping.

PubMed

Burt, Eric A; Diener, William A; Tjoelker, Robert L

2008-12-01

The multi-pole linear ion trap frequency standard (LITS) being developed at the Jet Propulsion Laboratory (JPL) has demonstrated excellent short- and long-term stability. The technology has now demonstrated long-term field operation providing a new capability for timekeeping standards. Recently implemented enhancements have resulted in a record line Q of 5 x 10(12) for a room temperature microwave atomic transition and a short-term fractional frequency stability of 5 x 10(-14)/tau(1/2). A scheme for compensating the second order Doppler shift has led to a reduction of the combined sensitivity to the primary LITS systematic effects below 5 x 10(-17) fractional frequency. Initial comparisons to JPL's cesium fountain clock show a systematic floor of less than 2 x 10(-16). The compensated multi-pole LITS at JPL was operated continuously and unattended for a 9-mo period from October 2006 to July 2007. During that time it was used as the frequency reference for the JPL geodetic receiver known as JPLT, enabling comparisons to any clock used as a reference for an International GNSS Service (IGS) site. Comparisons with the laser-cooled primary frequency standards that reported to the Bureau International des Poids et Mesures (BIPM) over this period show a frequency deviation less than 2.7 x 10(-17)/day. In the capacity of a stand-alone ultra-stable flywheel, such a standard could be invaluable for long-term timekeeping applications in metrology labs while its methodology and robustness make it ideal for space applications as well.

The Community Health Worker. Working Guide. Guidelines for Training. Guidelines for Adaptation.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

This book is a revised and enlarged edition of "The Primary Health Worker," a standard teaching text and reference manual developed for community health workers and their trainers and supervisors. The new edition has been updated with practical knowledge gained during the extensive field use of the previous work. The book also incorporates new…

Teaching evolution, the Kansas School Board of Education, and the democratization of science

NASA Astrophysics Data System (ADS)

Lin, Johnny Wei-Bing

In the August 1st Republican primaries for the Kansas State Board of Education, three board members were defeated who voted for the 1999 decision to remove most references regarding evolution from state education standards. This makes it likely that the board will in some way overturn or modify the 1999 decision.

Positive animal welfare states and reference standards for welfare assessment.

PubMed

Mellor, D J

2015-01-01

Developments in affective neuroscience and behavioural science during the last 10-15 years have together made it increasingly apparent that sentient animals are potentially much more sensitive to their environmental and social circumstances than was previously thought to be the case. It therefore seems likely that both the range and magnitude of welfare trade-offs that occur when animals are managed for human purposes have been underestimated even when minimalistic but arguably well-intentioned attempts have been made to maintain high levels of welfare. In light of these neuroscience-supported behaviour-based insights, the present review considers the extent to which the use of currently available reference standards might draw attention to these previously neglected areas of concern. It is concluded that the natural living orientation cannot provide an all-embracing or definitive welfare benchmark because of its primary focus on behavioural freedom. However assessments of this type, supported by neuroscience insights into behavioural motivation, may now carry greater weight when used to identify management practices that should be avoided, discontinued or substantially modified. Using currently accepted baseline standards as welfare reference points may result in small changes being accorded greater significance than would be the case if they were compared with higher standards, and this could slow the progress towards better levels of welfare. On the other hand, using "what animals want" as a reference standard has the appeal of focusing on the specific resources or conditions the animals would choose themselves and can potentially improve their welfare more quickly than the approach of making small increments above baseline standards. It is concluded that the cautious use of these approaches in different combinations could lead to recommendations that would more effectively promote positive welfare states in hitherto neglected areas of concern.

76 FR 54293 - Review of National Ambient Air Quality Standards for Carbon Monoxide

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

...This rule is being issued at this time as required by a court order governing the schedule for completion of this review of the air quality criteria and the national ambient air quality standards (NAAQS) for carbon monoxide (CO). Based on its review, the EPA concludes the current primary standards are requisite to protect public health with an adequate margin of safety, and is retaining those standards. After review of the air quality criteria, EPA further concludes that no secondary standard should be set for CO at this time. EPA is also making changes to the ambient air monitoring requirements for CO, including those related to network design, and is updating, without substantive change, aspects of the Federal reference method.

A systematic review and meta-analysis of the diagnostic accuracy of point-of-care tests for the detection of hyperketonemia in dairy cows.

PubMed

Tatone, Elise H; Gordon, Jessica L; Hubbs, Jessie; LeBlanc, Stephen J; DeVries, Trevor J; Duffield, Todd F

2016-08-01

Several rapid tests for use on farm have been validated for the detection of hyperketonemia (HK) in dairy cattle, however the reported sensitivity and specificity of each method varies and no single study has compared them all. Meta-analysis of diagnostic test accuracy is becoming more common in human medical literature but there are few veterinary examples. The objective of this work was to perform a systematic review and meta-analysis to determine the point-of-care testing method with the highest combined sensitivity and specificity, the optimal threshold for each method, and to identify gaps in the literature. A comprehensive literature search resulted in 5196 references. After removing duplicates and performing relevance screening, 23 studies were included for the qualitative synthesis and 18 for the meta-analysis. The three index tests evaluated in the meta-analysis were: the Precision Xtra(®) handheld device measuring beta-hydroxybutyrate (BHB) concentration in whole blood, and Ketostix(®) and KetoTest(®) semi-quantitative strips measuring the concentration of acetoacetate in urine and BHB in milk, respectively. The diagnostic accuracy of the 3 index tests relative to the reference standard measurement of BHB in serum or whole blood between 1.0-1.4mmol/L was compared using the hierarchical summary receiver operator characteristic (HSROC) method. Subgroup analysis was conducted for each index test to examine the accuracy at different thresholds. The impact of the reference standard threshold, the reference standard method, the prevalence of HK in the population, the primary study source and risk of bias of the primary study was explored using meta-regression. The Precision Xtra(®) device had the highest summary sensitivity in whole blood BHB at 1.2mmol/L, 94.8% (CI95%: 92.6-97.0), and specificity, 97.5% (CI95%: 96.9-98.1). The threshold employed (1.2-1.4mmol/L) did not impact the diagnostic accuracy of the test. The Ketostix(®) and KetoTest(®) strips had the highest summary sensitivity and specificity when the trace and weak positive thresholds were used, respectively. Controlling for the source of publication, HK prevalence and reference standard employed did not impact the estimated sensitivity and specificity of the tests. Including only peer-reviewed studies reduced the number of primary studies evaluating the Precision Xtra(®) by 43% and Ketostix(®) by 33%. Diagnosing HK with blood, urine or milk are valid options, however, the diagnostic inaccuracy of urine and milk should be considered when making economic and treatment decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

PubMed Central

van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

2016-01-01

Objective Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. Setting The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Primary and secondary outcome measures Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Results Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Conclusions Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce human errors in patient identification and transcribing of results. PMID:27503860

Performance and System Validation of a New Cellular-Enabled Blood Glucose Monitoring System Using a New Standard Reference Measurement Procedure of Isotope Dilution UPLC-MRM Mass Spectrometry

PubMed Central

Angelides, Kimon; Matsunami, Risë K.; Engler, David A.

2015-01-01

Background: We evaluated the accuracy, precision, and linearity of the In Touch® blood glucose monitoring system (BGMS), a new color touch screen and cellular-enabled blood glucose meter, using a new rapid, highly precise and accurate 13C6 isotope-dilution liquid chromatography-mass spectrometry method (IDLC-MS). Methods: Blood glucose measurements from the In Touch® BGMS were referenced to a validated UPLC-MRM standard reference measurement procedure previously shown to be highly accurate and precise. Readings from the In Touch® BGMS were taken over the blood glucose range of 24-640 mg/dL using 12 concentrations of blood glucose. Ten In Touch® BGMS and 3 lots of test strips were used with 10 replicates at each concentration. A lay user study was also performed to assess the ease of use. Results: At blood glucose concentrations <75 mg/dL 100% of the measurements are within ±8 mg/dL from the true reference standard; at blood glucose levels >75 mg/dL 100% of the measurements are within ±15% of the true reference standard. 100% of the results are within category A of the consensus grid. Within-run precision show CV < 3.72% between 24-50 mg/dL and CV<2.22% between 500 and 600 mg/dL. The results show that the In Touch® meter exceeds the minimum criteria of both the ISO 15197:2003 and ISO 15197:2013 standards. The results from a user panel show that 100% of the respondents reported that the color touch screen, with its graphic user interface (GUI), is well labeled and easy to navigate. Conclusions: To our knowledge this is the first touch screen glucose meter and the first study where accuracy of a new BGMS has been measured against a true primary reference standard, namely IDLC-MS. PMID:26002836

Group art therapy as an adjunctive treatment for people with schizophrenia: multicentre pragmatic randomised trial

PubMed Central

Killaspy, Helen; Barnes, Thomas R E; Barrett, Barbara; Byford, Sarah; Clayton, Katie; Dinsmore, John; Floyd, Siobhan; Hoadley, Angela; Johnson, Tony; Kalaitzaki, Eleftheria; King, Michael; Leurent, Baptiste; Maratos, Anna; O’Neill, Francis A; Osborn, David P; Patterson, Sue; Soteriou, Tony; Tyrer, Peter; Waller, Diane

2012-01-01

Objectives To evaluate the clinical effectiveness of group art therapy for people with schizophrenia and to test whether any benefits exceed those of an active control treatment. Design Three arm, rater blinded, pragmatic, randomised controlled trial. Setting Secondary care services across 15 sites in the United Kingdom. Participants 417 people aged 18 or over, who had a diagnosis of schizophrenia and provided written informed consent to take part in the study. Interventions Participants, stratified by site, were randomised to 12 months of weekly group art therapy plus standard care, 12 months of weekly activity groups plus standard care, or standard care alone. Art therapy and activity groups had up to eight members and lasted for 90 minutes. In art therapy, members were given access to a range of art materials and encouraged to use these to express themselves freely. Members of activity groups were offered various activities that did not involve use of art or craft materials and were encouraged to collectively select those they wanted to pursue. Main outcome measures The primary outcomes were global functioning, measured using the global assessment of functioning scale, and mental health symptoms, measured using the positive and negative syndrome scale, 24 months after randomisation. Main secondary outcomes were levels of group attendance, social functioning, and satisfaction with care at 12 and 24 months. Results 417 participants were assigned to either art therapy (n=140), activity groups (n=140), or standard care alone (n=137). Primary outcomes between the three study arms did not differ. The adjusted mean difference between art therapy and standard care at 24 months on the global assessment of functioning scale was −0.9 (95% confidence interval −3.8 to 2.1), and on the positive and negative syndrome scale was 0.7 (−3.1 to 4.6). Secondary outcomes did not differ between those referred to art therapy or those referred to standard care at 12 or 24 months. Conclusions Referring people with established schizophrenia to group art therapy as delivered in this trial did not improve global functioning, mental health, or other health related outcomes. Trial registration Current Controlled Trials ISRCTN46150447. PMID:22374932

Standardization of protein biomarker measurements: is it feasible?

PubMed

Schimmel, Heinz; Zegers, Ingrid; Emons, Hendrik

2010-01-01

The standardisation of measurements of protein biomarkers, which are potentially heterogeneous in terms of fragmentation, modification, substitution, primary, secondary, tertiary and quaternary structure, is a demanding task. However, they are a prime target for standardisation efforts due to the importance of protein biomarkers in diagnostics and health care and the typically observed significant discrepancies in measurement results obtained with non-standardized platforms. Based on the experience gathered during successfully completed projects for the production of reference materials, pragmatic approaches are described how standardisation could become feasible despite the fuzziness of the target analytes.

Programmable, secondary frequency standard based infrared synthesizer using tunable lead-salt diode lasers

NASA Technical Reports Server (NTRS)

Freed, C.; Bielinski, J. W.; Lo, W.

1983-01-01

Quantum phase noise limited Lorentzian power spectral densities were achieved with tunable lead-salt diode lasers. Linewidths as narrow as 22 kHz were observed. A truly programmable infrared synthesizer was produced by frequency-offset-locking the tunable diode lasers to the combination of a stable CO2 (or CO) reference laser and a programmable microwave frequency synthesizer. Absolute frequency accuracy and reproducibility of about + or - 30 kHz (0.000001 kaysers) relative to the primary Cs frequency standard may now be obtained with this technique.

GPS Disciplined Oscillators for Traceability to the Italian Time Standard

NASA Technical Reports Server (NTRS)

Cordara, Franco; Pettiti, Valerio

1996-01-01

The Istituo Elettrotecnico Nazionale (IEN) is one of the Italian primary institutes which is responsible for the accreditation of secondary laboratories belong to the national calibration system (SNT) established by law in 1991. The Times and Frequency Department that has accredited in this frame 14 calibration centers for frequency, performs also the remote calibration of their reference oscillators by means of different synchronization systems. The problem of establishing the traceability of the national time standard of the Global Positioning System (GPS) disciplined oscillators has been investigated and the results obtained are reported.

Automated acid and base number determination of mineral-based lubricants by fourier transform infrared spectroscopy: commercial laboratory evaluation.

PubMed

Winterfield, Craig; van de Voort, F R

2014-12-01

The Fluid Life Corporation assessed and implemented Fourier transform infrared spectroscopy (FTIR)-based methods using American Society for Testing and Materials (ASTM)-like stoichiometric reactions for determination of acid and base number for in-service mineral-based oils. The basic protocols, quality control procedures, calibration, validation, and performance of these new quantitative methods are assessed. ASTM correspondence is attained using a mixed-mode calibration, using primary reference standards to anchor the calibration, supplemented by representative sample lubricants analyzed by ASTM procedures. A partial least squares calibration is devised by combining primary acid/base reference standards and representative samples, focusing on the main spectral stoichiometric response with chemometrics assisting in accounting for matrix variability. FTIR(AN/BN) methodology is precise, accurate, and free of most interference that affects ASTM D664 and D4739 results. Extensive side-by-side operational runs produced normally distributed differences with mean differences close to zero and standard deviations of 0.18 and 0.26 mg KOH/g, respectively. Statistically, the FTIR methods are a direct match to the ASTM methods, with superior performance in terms of analytical throughput, preparation time, and solvent use. FTIR(AN/BN) analysis is a viable, significant advance for in-service lubricant analysis, providing an economic means of trending samples instead of tedious and expensive conventional ASTM(AN/BN) procedures. © 2014 Society for Laboratory Automation and Screening.

Improved reliability of pH measurements.

PubMed

Spitzer, Petra; Werner, Barbara

2002-11-01

Measurements of pH are performed on a large scale at laboratory level, and in industry. To meet the quality-control requirements and other technical specifications there is a need for traceability in measurement results. The prerequisite for the international acceptance of analytical data is reliability. To measure means to compare. Comparability entails use of recognised references to which the standard buffer solutions used for calibration of pH meter-electrode assemblies can be traced. The new recommendation on the measurement of pH recently published as a provisional document by the International Union on Pure and Applied Chemistry (IUPAC) enables traceability for measured pH values to a conventional reference frame which is recognised world-wide. The primary method for pH will be described. If analytical data are to be accepted internationally it is necessary to demonstrate the equivalence of the national traceability structures, including national measurement standards. For the first time key comparisons for pH have been performed by the Consultative Committee for Amount of Substance (CCQM, set up by the International Bureau of Weights and Measures, BIPM) to assess the equivalence of the national measurement procedures used to determine the pH of primary standard buffer solutions. The results of the first key comparison on pH CCQM-K9, and other international initiatives to improve the consistency of the results of measurement for pH, are reported.

Establishment of reference scores and interquartile ranges for the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) in patients with low back pain.

PubMed

Tominaga, Ryoji; Sekiguchi, Miho; Yonemoto, Koji; Kakuma, Tatsuyuki; Konno, Shin-Ichi

2018-05-01

The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was developed in 2007, including the five domains of Pain-related disorder, Lumbar spine dysfunction, Gait disturbance, Social life disturbance, and Psychological disorder. It is used by physicians to evaluate treatment efficacy by comparing scores before and after treatment. However, the JOABPEQ does not allow evaluation of the severity of a patient's condition compared to the general population at a single time point. Given the unavailability of a standard measurement of back pain, we sought to establish reference scores and interquartile ranges using data obtained from a multicenter, cross-sectional survey taken in Japanese primary care settings. The Lumbar Spinal Stenosis Diagnosis Support Tool project was conducted from 2011 to 2012 in 1657 hospitals in Japan to investigate the establishment of reference scores using JOABPEQ. Patients aged ≥ 20 years undergoing medical examinations by either non-orthopaedic primary care physicians or general orthopedists were considered for enrollment. A total of 10,651 consecutive low back pain patients (5331 men, 5320 women, 18 subjects with missing sex data) who had undergone a medical examination were included. Reference scores and interquartile ranges for each of the five domains of the JOABPEQ according to age and sex were recorded. The median score and interquartile range are the same in the domain of Pain-related disorder in all ages and sexes. The reference scores for Gait disturbance, Social life disturbance and Psychological disorder declined with increasing age in both age- and sex-stratified groups, while there was some different trend in Lumbar spine dysfunction between men and women. Reference scores and interquartile ranges for JOABPEQ were generated based on the data from the examination data. These provide a measurement standard to assess patient perceptions of low back pain at any time point during evaluation or therapy. Copyright © 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Management of heart transplant recipients: reference for primary care physicians.

PubMed

Kansara, Pranav; Kobashigawa, Jon A

2012-07-01

Heart transplantation is the treatment of choice for a select group of patients with end-stage heart failure. Survival rates have increased and complication rates have decreased due to better immunosuppressive agents, improvement in organ procurement and surgical technique, and overall increase in experience for performing heart transplantation. Involvement from primary care physicians is very important to optimize postoperative management of heart transplant recipients. In this article, we discuss the indications for heart transplantation, physiology of the denervated heart, the standard postoperative care of adult heart transplant recipients, and long-term complications. Primary care physicians must play an increasing role in the management of heart transplant recipients in the age of managed care and increasing survival rates.

Isotope dilution inductively coupled plasma mass spectrometry (ID ICP-MS) for the certification of lead and cadmium in environmental standard reference materials.

PubMed

Murphy, K E; Beary, E S; Rearick, M S; Vocke, R D

2000-10-01

Lead (Pb) and cadmium (Cd) have been determined in six new environmental standard reference materials (SRMs) using isotope dilution inductively coupled plasma mass spectrometry (ID ICP-MS). The SRMs are the following: SRM 1944, New York-New Jersey Waterway Sediment, SRMs 2583 and 2584, Trace Elements in Indoor Dust, Nominal 90 mg/kg and 10,000 mg/kg Lead, respectively, SRMs 2586 and 2587, Trace Elements in Soil Containing Lead from Paint, Nominal 500 mg/kg and 3,000 mg/kg Lead, respectively, and SRM 2782, Industrial Sludge. The capabilities of ID ICP-MS for the certification of Pb and Cd in these materials are assessed. Sample preparation and ratio measurement uncertainties have been evaluated. Reproducibility and accuracy of the established procedures are demonstrated by determination of gravimetrically prepared primary standard solutions and by comparison with isotope dilution thermal ionization mass spectrometry (ID TIMS). Material heterogeneity was readily demonstrated to be the dominant source of uncertainty in the certified values.

Analytical performance, agreement and user-friendliness of six point-of-care testing urine analysers for urinary tract infection in general practice

PubMed Central

Schot, Marjolein J C; van Delft, Sanne; Kooijman-Buiting, Antoinette M J; de Wit, Niek J; Hopstaken, Rogier M

2015-01-01

Objective Various point-of-care testing (POCT) urine analysers are commercially available for routine urine analysis in general practice. The present study compares analytical performance, agreement and user-friendliness of six different POCT urine analysers for diagnosing urinary tract infection in general practice. Setting All testing procedures were performed at a diagnostic centre for primary care in the Netherlands. Urine samples were collected at four general practices. Primary and secondary outcome measures Analytical performance and agreement of the POCT analysers regarding nitrite, leucocytes and erythrocytes, with the laboratory reference standard, was the primary outcome measure, and analysed by calculating sensitivity, specificity, positive and negative predictive value, and Cohen's κ coefficient for agreement. Secondary outcome measures were the user-friendliness of the POCT analysers, in addition to other characteristics of the analysers. Results The following six POCT analysers were evaluated: Uryxxon Relax (Macherey Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) and Urilyzer (Analyticon). Analytical performance was good for all analysers. Compared with laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. Agreement for leucocytes varied between good to very good, and for the erythrocyte test between fair and good. First-time users indicated that the analysers were easy to use. They expected higher productivity and accuracy when using these analysers in daily practice. Conclusions The overall performance and user-friendliness of all six commercially available POCT urine analysers was sufficient to justify routine use in suspected urinary tract infections in general practice. PMID:25986635

Cryogenic flow rate measurement with a laser Doppler velocimetry standard

NASA Astrophysics Data System (ADS)

Maury, R.; Strzelecki, A.; Auclercq, C.; Lehot, Y.; Loubat, S.; Chevalier, J.; Ben Rayana, F.

2018-03-01

A very promising alternative to the state-of-the-art static volume measurements for liquefied natural gas (LNG) custody transfer processes is the dynamic principle of flow metering. As the Designated Institute (DI) of the LNE (‘Laboratoire National de métrologie et d’Essais’, being the French National Metrology Institute) for high-pressure gas flow metering, Cesame-Exadebit is involved in various research and development programs. Within the framework of the first (2010-2013) and second (2014-2017) EURAMET Joint Research Project (JRP), named ‘Metrological support for LNG custody transfer and transport fuel applications’, Cesame-Exadebit explored a novel cryogenic flow metering technology using laser Doppler velocimetry (LDV) as an alternative to ultrasonic and Coriolis flow metering. Cesame-Exadebit is trying to develop this technique as a primary standard for cryogenic flow meters. Currently, cryogenic flow meters are calibrated at ambient temperatures with water. Results are then extrapolated to be in the Reynolds number range of real applications. The LDV standard offers a unique capability to perform online calibration of cryogenic flow meters in real conditions (temperature, pressure, piping and real flow disturbances). The primary reference has been tested on an industrial process in a LNG terminal during truck refuelling. The reference can calibrate Coriolis flow meters being used daily with all the real environmental constraints, and its utilisation is transparent for LNG terminal operators. The standard is traceable to Standard International units and the combined extended uncertainties have been determined and estimated to be lower than 0.6% (an ongoing improvement to reducing the correlation function uncertainty, which has a major impact in the uncertainty estimation).

Implementing the HL7v3 standard in Croatian primary healthcare domain.

PubMed

Koncar, Miroslav

2004-01-01

The mission of HL7 Inc. is to provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services. The scope of this work includes the specifications of flexible, cost-effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems. In the field of medical information technologies, HL7 provides the world's most advanced information standards. Versions 1 and 2 of the HL7 standard have on the one hand solved many issues, but on the other demonstrated the size and complexity of the health information sharing problem. As the solution, a complete new methodology has been adopted, which is being encompassed in version 3 recommendations. This approach standardizes the Reference Information Model (RIM), which is the source of all domain models and message structures. Message design is now defined in detail, enabling interoperability between loosely-coupled systems that are designed by different vendors and deployed in various environments. At the start of the Primary Healthcare Information System project, we have decided to go directly to HL7v3. Implementing the HL7v3 standard in healthcare applications represents a challenging task. By using standardized refinement and localization methods we were able to define information models for Croatian primary healthcare domain. The scope of our work includes clinical, financial and administrative data management, where in some cases we were compelled to introduce new HL7v3-compliant models. All of the HL7v3 transactions are digitally signed, using the W3C XML Digital Signature standard.

Building-up a database of spectro-photometric standards from the UV to the NIR

NASA Astrophysics Data System (ADS)

Vernet, J.; Kerber, F.; Mainieri, V.; Rauch, T.; Saitta, F.; D'Odorico, S.; Bohlin, R.; Ivanov, V.; Lidman, C.; Mason, E.; Smette, A.; Walsh, J.; Fosbury, R.; Goldoni, P.; Groot, P.; Hammer, F.; Kaper, L.; Horrobin, M.; Kjaergaard-Rasmussen, P.; Royer, F.

2010-11-01

We present results of a project aimed at establishing a set of 12 spectro-photometric standards over a wide wavelength range from 320 to 2500 nm. Currently no such set of standard stars covering the near-IR is available. Our strategy is to extend the useful range of existing well-established optical flux standards (Oke 1990, Hamuy et al. 1992, 1994) into the near-IR by means of integral field spectroscopy with SINFONI at the VLT combined with state-of-the-art white dwarf stellar atmospheric models (TMAP, Holberg et al. 2008). As a solid reference, we use two primary HST standard white dwarfs GD71 and GD153 and one HST secondary standard BD+17 4708. The data were collected through an ESO “Observatory Programme” over ~40 nights between February 2007 and September 2008.

Development and validation of electronic surveillance tool for acute kidney injury: A retrospective analysis.

PubMed

Ahmed, Adil; Vairavan, Srinivasan; Akhoundi, Abbasali; Wilson, Gregory; Chiofolo, Caitlyn; Chbat, Nicolas; Cartin-Ceba, Rodrigo; Li, Guangxi; Kashani, Kianoush

2015-10-01

Timely detection of acute kidney injury (AKI) facilitates prevention of its progress and potentially therapeutic interventions. The study objective is to develop and validate an electronic surveillance tool (AKI sniffer) to detect AKI in 2 independent retrospective cohorts of intensive care unit (ICU) patients. The primary aim is to compare the sensitivity, specificity, and positive and negative predictive values of AKI sniffer performance against a reference standard. This study is conducted in the ICUs of a tertiary care center. The derivation cohort study subjects were Olmsted County, MN, residents admitted to all Mayo Clinic ICUs from July 1, 2010, through December 31, 2010, and the validation cohort study subjects were all patients admitted to a Mayo Clinic, Rochester, campus medical/surgical ICU on January 12, 2010, through March 23, 2010. All included records were reviewed by 2 independent investigators who adjudicated AKI using the Acute Kidney Injury Network criteria; disagreements were resolved by a third reviewer. This constituted the reference standard. An electronic algorithm was developed; its precision and reliability were assessed in comparison with the reference standard in 2 separate cohorts, derivation and validation. Of 1466 screened patients, a total of 944 patients were included in the study: 482 for derivation and 462 for validation. Compared with the reference standard in the validation cohort, the sensitivity and specificity of the AKI sniffer were 88% and 96%, respectively. The Cohen κ (95% confidence interval) agreement between the electronic and the reference standard was 0.84 (0.78-0.89) and 0.85 (0.80-0.90) in the derivation and validation cohorts. Acute kidney injury can reliably and accurately be detected electronically in ICU patients. The presented method is applicable for both clinical (decision support) and research (enrollment for clinical trials) settings. Prospective validation is required. Copyright © 2015 Elsevier Inc. All rights reserved.

Determination of chemical purity and isotopic composition of natural and carbon-13-labeled arsenobetaine bromide standards by quantitative(1)H-NMR.

PubMed

Le, Phuong-Mai; Ding, Jianfu; Leek, Donald M; Mester, Zoltan; Robertson, Gilles; Windust, Anthony; Meija, Juris

2016-10-01

In this study, we report the characterization of three arsenobetaine-certified reference materials by quantitative NMR. We have synthesized an arsenobetaine bromide high-purity standard of natural isotopic composition (ABET-1) and two carbon-13-labeled isotopic standards (BBET-1 and CBET-1). Assignments of the chemical purity and isotopic composition are not trivial in the case of arsenobetaine, and in this study we utilized quantitative(1)H-NMR techniques for the determination of the mass fractions (chemical purity). The isotopic purity of all three standards was also assessed by NMR from the carbon-13 satellite signals. The standards are non-hygroscopic, high-purity (ca. 0.99 g/g), and the carbon-13 enrichment for both isotopic standards is x((13)C)≈0.99. These standards are designed for use as primary calibrators for mass spectrometric determination of arsenobetaine in environmental samples.

Gravimetric preparation and characterization of primary reference solutions of molybdenum and rhodium.

PubMed

Kaltenbach, Angela; Noordmann, Janine; Görlitz, Volker; Pape, Carola; Richter, Silke; Kipphardt, Heinrich; Kopp, Gernot; Jährling, Reinhard; Rienitz, Olaf; Güttler, Bernd

2015-04-01

Gravimetrically prepared mono-elemental reference solutions having a well-known mass fraction of approximately 1 g/kg (or a mass concentration of 1 g/L) define the very basis of virtually all measurements in inorganic analysis. Serving as the starting materials of all standard/calibration solutions, they link virtually all measurements of inorganic analytes (regardless of the method applied) to the purity of the solid materials (high-purity metals or salts) they were prepared from. In case these solid materials are characterized comprehensively with respect to their purity, this link also establishes direct metrological traceability to The International System of Units (SI). This, in turn, ensures the comparability of all results on the highest level achievable. Several national metrology institutes (NMIs) and designated institutes (DIs) have been working for nearly two decades in close cooperation with commercial producers on making an increasing number of traceable reference solutions available. Besides the comprehensive characterization of the solid starting materials, dissolving them both loss-free and completely under strict gravimetric control is a challenging problem in the case of several elements like molybdenum and rhodium. Within the framework of the European Metrology Research Programme (EMRP), in the Joint Research Project (JRP) called SIB09 Primary standards for challenging elements, reference solutions of molybdenum and rhodium were prepared directly from the respective metals with a relative expanded uncertainty associated with the mass fraction of U rel(w) < 0.05 %. To achieve this, a microwave-assisted digestion procedure for Rh and a hotplate digestion procedure for Mo were developed along with highly accurate and precise inductively coupled plasma optical emission spectrometry (ICP OES) and multicollector inductively coupled plasma mass spectrometry (MC-ICP-MS) methods required to assist with the preparation and as dissemination tools.

Predicting oropharyngeal tumor volume throughout the course of radiation therapy from pretreatment computed tomography data using general linear models.

PubMed

Yock, Adam D; Rao, Arvind; Dong, Lei; Beadle, Beth M; Garden, Adam S; Kudchadker, Rajat J; Court, Laurence E

2014-05-01

The purpose of this work was to develop and evaluate the accuracy of several predictive models of variation in tumor volume throughout the course of radiation therapy. Nineteen patients with oropharyngeal cancers were imaged daily with CT-on-rails for image-guided alignment per an institutional protocol. The daily volumes of 35 tumors in these 19 patients were determined and used to generate (1) a linear model in which tumor volume changed at a constant rate, (2) a general linear model that utilized the power fit relationship between the daily and initial tumor volumes, and (3) a functional general linear model that identified and exploited the primary modes of variation between time series describing the changing tumor volumes. Primary and nodal tumor volumes were examined separately. The accuracy of these models in predicting daily tumor volumes were compared with those of static and linear reference models using leave-one-out cross-validation. In predicting the daily volume of primary tumors, the general linear model and the functional general linear model were more accurate than the static reference model by 9.9% (range: -11.6%-23.8%) and 14.6% (range: -7.3%-27.5%), respectively, and were more accurate than the linear reference model by 14.2% (range: -6.8%-40.3%) and 13.1% (range: -1.5%-52.5%), respectively. In predicting the daily volume of nodal tumors, only the 14.4% (range: -11.1%-20.5%) improvement in accuracy of the functional general linear model compared to the static reference model was statistically significant. A general linear model and a functional general linear model trained on data from a small population of patients can predict the primary tumor volume throughout the course of radiation therapy with greater accuracy than standard reference models. These more accurate models may increase the prognostic value of information about the tumor garnered from pretreatment computed tomography images and facilitate improved treatment management.

New Zealand environmental standards and energy policies

NASA Astrophysics Data System (ADS)

vant, William N.; McGlinchy, Brian J.

1983-11-01

This paper describes the primary energy resources of New Zealand and their relative importance. It describes the principal legislation that provides environmental protection and public participation with which State and private agencies are bound to comply. The paper then discusses air pollution in further detail and cites three examples where there is cause for concern. By international standards, air pollution is not a serious problem in New Zealand and so the economic consequences have received little attention Two simple examples are cited. A map showing the main centers and the location of facilities referred to in the text is included

Standardized 3D Bioprinting of Soft Tissue Models with Human Primary Cells.

PubMed

Rimann, Markus; Bono, Epifania; Annaheim, Helene; Bleisch, Matthias; Graf-Hausner, Ursula

2016-08-01

Cells grown in 3D are more physiologically relevant than cells cultured in 2D. To use 3D models in substance testing and regenerative medicine, reproducibility and standardization are important. Bioprinting offers not only automated standardizable processes but also the production of complex tissue-like structures in an additive manner. We developed an all-in-one bioprinting solution to produce soft tissue models. The holistic approach included (1) a bioprinter in a sterile environment, (2) a light-induced bioink polymerization unit, (3) a user-friendly software, (4) the capability to print in standard labware for high-throughput screening, (5) cell-compatible inkjet-based printheads, (6) a cell-compatible ready-to-use BioInk, and (7) standard operating procedures. In a proof-of-concept study, skin as a reference soft tissue model was printed. To produce dermal equivalents, primary human dermal fibroblasts were printed in alternating layers with BioInk and cultured for up to 7 weeks. During long-term cultures, the models were remodeled and fully populated with viable and spreaded fibroblasts. Primary human dermal keratinocytes were seeded on top of dermal equivalents, and epidermis-like structures were formed as verified with hematoxylin and eosin staining and immunostaining. However, a fully stratified epidermis was not achieved. Nevertheless, this is one of the first reports of an integrative bioprinting strategy for industrial routine application. © 2015 Society for Laboratory Automation and Screening.

Impact of a dedicated cancer-associated thrombosis service on clinical outcomes: a mixed-methods evaluation of a clinical improvement exercise

PubMed Central

Noble, Simon; Pease, Nikki; Sui, Jessica; Davies, James; Lewis, Sarah; Malik, Usman; Alikhan, Raza; Prout, Hayley; Nelson, Annmarie

2016-01-01

Objectives Cancer-associated thrombosis (CAT) complex condition, which may present to any healthcare professional and at any point during the cancer journey. As such, patients may be managed by a number of specialties, resulting in inconsistent practice and suboptimal care. We describe the development of a dedicated CAT service and its evaluation. Setting Specialist cancer centre, district general hospital and primary care. Participants Patients with CAT and their referring clinicians. Intervention A cross specialty team developed a dedicated CAT service , including clear referral pathways, consistent access to medicines, patient's information and a specialist clinic. Primary and secondary outcome measures The service was evaluated using a mixed-methods evaluation , including audits of clinical practice, clinical outcomes, staff surveys and qualitative interviewing of patients and healthcare professionals. Results Data from 457 consecutive referrals over an 18-month period were evaluated. The CAT service has led to an 88% increase in safe and consistent community prescribing of low-molecular-weight heparin, with improved access to specialist advice and information. Patients reported improved understanding of their condition, enabling better self-management as well as better access to support and information. Referring clinicians reported better care standards for their patients with improved access to expertise and appropriate management. Conclusions A dedicated CAT service improves overall standards of care and is viewed positively by patients and clinicians alike. Further health economic evaluation would enhance the case for establishing this as the standard model of care. PMID:27895068

TH-A-204-00: Key Dosimetry Data - Impact of New ICRU Recommendations

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

NONE

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV xrays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less

TH-A-204-01: Part I - Key Data for Ionizing-Radiation Dosimetry

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

Seltzer, S.

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV x-rays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less

TH-A-204-02: Part II - Worldwide Radiation Metrology

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

McEwen, M.

The ICRU is currently finalizing a report on key data for radiation dosimetry. This multi-year review has resulted in a number of recommendations regarding “fundamental” data that are used in dosimetry related to radiation therapy. This educational session will explain the background for the ICRU committee’s work, the content and conclusions of the report and the impact on outputs, including NIST primary standards, ADCL calibration coefficients and clinical reference dosimetry. Parameters and beam modalities potentially affected by this report include: The mean excitation energy, I, for graphite, air, and water, The average energy required to create an ion pair inmore » dry air (commonly referred to as W/e), The uncertainty in the determination of air kerma in kV x-rays The absolute value of Co-60 and Cs-137 primary standards and the dissemination of calibration coefficients, The determination of air kerma strength for Ir-192 HDR brachytherapy sources Ion chamber kQ factors for linac MV beams Ion chamber kQ factors for proton beams. The changes in reference dosimetry that would result from adoption of the ICRU recommendations are of the order of 0.5% to 1%, an effect that will not impact clinical dose delivery but will be detectable in the clinical setting. This session will also outline how worldwide metrology is coordinated through the Convention of the Meter and therefore how the international dosimetry community will proceed with adopting these recommendations so that uniformity from country to country in reference dosimetry is maintained. Timelines and communications methods will also be discussed to ensure that users, such as clinical medical physicists, are not surprised when their chamber’s calibration coefficient apparently changes. Learning Objectives: Understand the background for the ICRU committee’s work on key dosimetry data. Understand the proposed changes to key data and the impacts on reference dosimetry. Understand the methodology and timeline for adoption of the ICRU recommendations.« less

Systematic reviews identify important methodological flaws in stroke rehabilitation therapy primary studies: review of reviews.

PubMed

Santaguida, Pasqualina; Oremus, Mark; Walker, Kathryn; Wishart, Laurie R; Siegel, Karen Lohmann; Raina, Parminder

2012-04-01

A "review of reviews" was undertaken to assess methodological issues in studies evaluating nondrug rehabilitation interventions in stroke patients. MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from January 2000 to January 2008 within the stroke rehabilitation setting. Electronic searches were supplemented by reviews of reference lists and citations identified by experts. Eligible studies were systematic reviews; excluded citations were narrative reviews or reviews of reviews. Review characteristics and criteria for assessing methodological quality of primary studies within them were extracted. The search yielded 949 English-language citations. We included a final set of 38 systematic reviews. Cochrane reviews, which have a standardized methodology, were generally of higher methodological quality than non-Cochrane reviews. Most systematic reviews used standardized quality assessment criteria for primary studies, but not all were comprehensive. Reviews showed that primary studies had problems with randomization, allocation concealment, and blinding. Baseline comparability, adverse events, and co-intervention or contamination were not consistently assessed. Blinding of patients and providers was often not feasible and was not evaluated as a source of bias. The eligible systematic reviews identified important methodological flaws in the evaluated primary studies, suggesting the need for improvement of research methods and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

Endogenous Reference Genes and Their Quantitative Real-Time PCR Assays for Genetically Modified Bread Wheat (Triticum aestivum L.) Detection.

PubMed

Yang, Litao; Quan, Sheng; Zhang, Dabing

2017-01-01

Endogenous reference genes (ERG) and their derivate analytical methods are standard requirements for analysis of genetically modified organisms (GMOs). Development and validation of suitable ERGs is the primary step for establishing assays that monitoring the genetically modified (GM) contents in food/feed samples. Herein, we give a review of the ERGs currently used for GM wheat analysis, such as ACC1, PKABA1, ALMT1, and Waxy-D1, as well as their performances in GM wheat analysis. Also, we discussed one model for developing and validating one ideal RG for one plant species based on our previous research work.

Age and sex variation in serum albumin concentration: an observational study.

PubMed

Weaving, Gary; Batstone, Gifford F; Jones, Richard G

2016-01-01

In the UK, a common reference interval for serum albumin is widely used irrespective of age or sex. Implicit in this is that laboratories produce analytically similar results. This paper challenges the validity of this approach. A three-week collection of results sent to all primary care centres in England has been analysed by age, sex and laboratory. In all, 1,079,193 serum albumin reports were included in this analysis. The mean population serum albumin concentration increases to peak at around age 20 years and then decreases with increasing age. Values in females decrease more rapidly but become close to male values at 60 years. The variation between laboratories was large and potentially clinically significant. Reference intervals for serum albumin should be stratified by age and sex. Until there is greater methodological standardization, laboratories should determine their own reference intervals and not accept a single consensus reference interval. © The Author(s) 2015.

A synthetic zero air standard

NASA Astrophysics Data System (ADS)

Pearce, Ruth

2016-04-01

A Synthetic Zero Air Standard R. E. Hill-Pearce, K. V. Resner, D. R. Worton, P. J. Brewer The National Physical Laboratory Teddington, Middlesex TW11 0LW UK We present work towards providing traceability for measurements of high impact greenhouse gases identified by the World Meteorological Organisation (WMO) as critical for global monitoring. Standards for these components are required with challengingly low uncertainties to improve the quality assurance and control processes used for the global networks to better assess climate trends. Currently the WMO compatibility goals require reference standards with uncertainties of < 100 nmolmol-1 for CO2 (northern hemisphere) and < 2 nmolmol-1 for CH4 and CO. High purity zero gas is required for both the balance gas in the preparation of reference standards and for baseline calibrations of instrumentation. Quantification of the amount fraction of the target components in the zero gas is a significant contributor to the uncertainty and is challenging due to limited availability of reference standard at the amount fraction of the measurand and limited analytical techniques with sufficient detection limits. A novel dilutor was used to blend NPL Primary Reference Gas Mixtures containing CO2, CH4 and CO at atmospheric amount fractions with a zero gas under test. Several mixtures were generated with nominal dilution ratios ranging from 2000:1 to 350:1. The baseline of two cavity ring down spectrometers was calibrated using the zero gas under test after purification by oxidative removal of CO and hydrocarbons to < 1 nmolmol-1 (SAES PS15-GC50) followed by the removal of CO2 and water vapour to < 100 pmolmol-1 (SAES MC190). Using the standard addition method.[1] we have quantified the amount fraction of CO, CO2, and CH4 in scrubbed whole air (Scott Marrin) and NPL synthetic zero air. This is the first synthetic zero air standard with a matrix of N2, O2 and Ar closely matching ambient composition with gravimetrically assigned values and with accurate quantification of the CO, CO2, and CH4 impurities. [1] Brown, R.J.C et al.,Analytica Chimica Acta 587, 158-163 (2007)

Impact of new clock technologies on the stability and accuracy of the International Atomic Time TAI.

NASA Astrophysics Data System (ADS)

Thomas, C.

1997-05-01

The BIPM Time Section is in charge of the generation of the reference time scales TAI and UTC. Both time scales are obtained in deferred-time by combining the data front a number of atomic clocks spread worldwide. The accuracy of TAI is estimated by the departure between the duration of the TAI scale interval and the SI second as produced on the rotating geoid by primary frequency standards. It is now possible to estimate TAI accuracy through the combination of results obtained from six different primary standards: LPTF-FO1, PTB CS1, PTB CS2, PTB CS3, NIST-7, and SU MCsR 102, all corrected for the black-body radiation shift. This led to a mean departure of the TAI scale interval of +2.0×10-14s over 1995, known with a relative uncertainty of 0.5×10-14(1σ).

Autism, intellectual disability, and a challenge to our understanding of proxy consent.

PubMed

Graber, Abraham

2017-06-01

This paper focuses on a hypothetical case that represents an intervention request familiar to those who work with individuals with intellectual disability. Stacy has autism and moderate intellectual disability. Her parents have requested treatment for her hand flapping. Stacy is not competent to make her own treatment decisions; proxy consent is required. There are three primary justifications for proxy consent: the right to an open future, substituted judgment, and the best interest standard. The right to an open future justifies proxy consent on the assumption of future autonomy whereas substituted judgment justifies proxy consent via reference to past autonomy. Neither applies. Stacy has not been, nor will she be, competent to make her own treatment decisions. The best interest standard justifies proxy consent on the grounds of beneficence. It is unlikely that hand flapping harms Stacy. None of the three primary means of justifying proxy consent apply to Stacy's case.

Patient and Clinician Openness to Including a Broader Range of Healing Options in Primary Care

PubMed Central

Hsu, Clarissa; Cherkin, Daniel C.; Hoffmeyer, Sylvia; Sherman, Karen J.; Phillips, William R.

2011-01-01

PURPOSE We studied the openness of patients and clinicians to introducing a broader range of healing options into primary care. METHODS Focus groups were conducted with primary care patients (4 groups) and clinicians (3 groups) from an integrated medical care system in 2008. Transcripts of discussions were analyzed using an immersion/crystallization approach. RESULTS Both patients (n = 44) and clinicians (n = 32) were open to including a wider variety of healing options in primary care. Patients desired some evidence of effectiveness, although there was wide variation in the type of evidence required. Many patients believed that the clinician’s personal and practice experience was an important form of evidence. Patients wanted to share in the decision to refer and the choice of options. Clinicians were most concerned with safety of specific treatments, including some of the herbs and dietary supplements. They also believed they lacked adequate information about the nature, benefits, and risks of many alternatives, and they were not aware of local practitioners and resources to whom they could confidently refer their patients. Both patients and clinicians were concerned that services recommended be covered by insurance or be affordable to patients. CONCLUSIONS Integrating additional healing options into primary care may be feasible and desirable, as well as help meet the needs of patients with conditions that have not been responsive to standard medical treatments. PMID:21911764

Validity of the Patient Health Questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africa.

PubMed

Cholera, R; Gaynes, B N; Pence, B W; Bassett, J; Qangule, N; Macphail, C; Bernhardt, S; Pettifor, A; Miller, W C

2014-01-01

Integration of depression screening into primary care may increase access to mental health services in sub-Saharan Africa, but this approach requires validated screening instruments. We sought to validate the Patient Health Questionnaire-9 (PHQ-9) as a depression screening tool at a high HIV-burden primary care clinic in Johannesburg, South Africa. We conducted a validation study of an interviewer-administered PHQ-9 among 397 patients. Sensitivity and specificity of the PHQ-9 were calculated with the Mini International Neuropsychiatric Interview (MINI) as the reference standard; receiver operating characteristic (ROC) curve analyses were performed. The prevalence of depression was 11.8%. One-third of participants tested positive for HIV. HIV-infected patients were more likely to be depressed (15%) than uninfected patients (9%; p=0.08). Using the standard cutoff score of ≥10, the PHQ-9 had a sensitivity of 78.7% (95% CI: 64.3-89.3) and specificity of 83.4% (95% CI: 79.1-87.2). The area under the ROC curve was 0.88 (95% CI: 0.83-0.92). Test performance did not vary by HIV status or language. In sensitivity analyses, reference test bias associated with the MINI appeared unlikely. We were unable to conduct qualitative work to adapt the PHQ-9 to this cultural context. This is the first validation study of the PHQ-9 in a primary care clinic in sub-Saharan Africa. It highlights the potential for using primary care as an access point for identifying depressive symptoms during routine HIV testing. The PHQ-9 showed reasonable accuracy in classifying cases of depression, was easily implemented by lay health workers, and is a useful screening tool in this setting. Copyright © 2014 Elsevier B.V. All rights reserved.

Specular gloss scales comparison between the SIMT and the NIST

NASA Astrophysics Data System (ADS)

Yin, Dejin; Li, Tiecheng; Huang, Biyong; Cheng, Weihai; Lin, Fangsheng

2016-09-01

Specular gloss is the fraction of light reflected in the specular direction for specified incident and receptor apertures, it is the perception by an observer of the mirror-like appearance of a surface. The measurement of specular gloss consists of comparing the luminous reflectance from a test sample to that from a calibrated gloss standard which generally is a polished piece of black glass, under the same experimental conditions. Gloss is a dimensionless quantity whose accurate determination requires standardized experimental conditions such as spectral distribution of the incident beam of light, incident and viewing angles, and a gloss standard. The Shanghai Institute of Measurement and Testing Technology (SIMT) provides test service to calibrate gloss reference standards. This facility is built around a reference goniophotometer, containing an instrument that measures flux as a function of angles of illumination or observation and a primary gloss standard, which is a piece of three wedges of highly polished, high-quality optical glass. The system has an overall (k=2) uncertainty of 0.5 Gloss Unit(GU). The service offers calibration measurements of working gloss standards at the geometries of 20°, 60°, and 85°, in compliance with the ISO 2813 and the ASTM D523 documentary standards. This article describes a bilateral comparison of specular gloss scales between SIMT and the National Institute of Standards and Technology (NIST) that has been performed. The results of this comparison show agreement within the combined uncertainties for the measurement of specular gloss of highly polished black glass.

[Preparation and certification of mussel reference material for organochlorine pesticides and polychlorinated biphenyls using isotope dilution-high resolution mass spectrometry].

PubMed

Lu, Xianbo; Chen, Jiping; Wang, Shuqiu; Zou, Lili; Tian, Yuzeng; Ni, Yuwen; Su, Fan

2012-09-01

A method for the preparation and certification of the reference material of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in mussel tissue is described. The mussel tissue from Dalian Bay was frozen-dried, comminuted, sieved, homogenized, packaged, and sterilized by 60Co radiation sterilization in turn. The certified values for 18 OCPs and 16 PCBs were determined by high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) using isotope dilution and internal standard quantitation techniques. The certified values were validated and given based on seven accredited laboratories, and these values are traceable to the SI (international system of units) through gravimetrically prepared standards of established purity and measurement intercomparisons. The certified values of PCBs and OCPs in mussel span 4 orders of magnitude with a relative uncertainty of about 10%. This material is a natural biological material with confirmed good homogeneity and stability, and it was approved as the grade "primary reference material" (GBW10069) in June 2012 in China. This reference material provided necessary quality control products for our country to implement the Stockholm Treaty on the monitoring of persistent organic pollutants (POPs). The material is intended to be used for the method validation and quality control in the determination of OCPs and PCBs in biota samples.

A pilot study of clinical agreement in cardiovascular preparticipation examinations: how good is the standard of care?

PubMed

O'Connor, Francis G; Johnson, Jeremy D; Chapin, Mark; Oriscello, Ralph G; Taylor, Dean C

2005-05-01

To evaluate the interobserver agreement between physicians regarding a abnormal cardiovascular assessment on athletic preparticipation examinations. Cross-sectional clinical survey. Outpatient Clinic, United States Military Academy, West Point, NY. We randomly selected 101 out of 539 cadet-athletes presenting for a preparticipation examination. Two primary care sports medicine fellows and a cardiologist examined the cadets. After obtaining informed consent from all participants, all 3 physicians separately evaluated all 101 cadets. The physicians recorded their clinical findings and whether they thought further cardiovascular evaluation (echocardiography) was indicated. Rate of referral for further cardiovascular evaluation, clinical agreement between sports medicine fellows, and clinical agreement between sports medicine fellows and the cardiologist. Each fellow referred 6 of the 101 evaluated cadets (5.9%). The cardiologist referred none. Although each fellow referred 6 cadets, only 1 cadet was referred by both. The kappa statistic for clinical agreement between fellows is 0.114 (95% CI, -0.182 to 0.411). There was no clinical agreement between the fellows and the cardiologist. This pilot study reveals a low level of agreement between physicians regarding which athletes with an abnormal examination deserved further testing. It challenges the standard of care and questions whether there is a need for improved technologies or improved training in cardiovascular clinical assessment.

Dose comparisons of clopidogrel and aspirin in acute coronary syndromes.

PubMed

Mehta, Shamir R; Bassand, Jean-Pierre; Chrolavicius, Susan; Diaz, Rafael; Eikelboom, John W; Fox, Keith A A; Granger, Christopher B; Jolly, Sanjit; Joyner, Campbell D; Rupprecht, Hans-Jurgen; Widimsky, Petr; Afzal, Rizwan; Pogue, Janice; Yusuf, Salim

2010-09-02

Clopidogrel and aspirin are widely used for patients with acute coronary syndromes and those undergoing percutaneous coronary intervention (PCI). However, evidence-based guidelines for dosing have not been established for either agent. We randomly assigned, in a 2-by-2 factorial design, 25,086 patients with an acute coronary syndrome who were referred for an invasive strategy to either double-dose clopidogrel (a 600-mg loading dose on day 1, followed by 150 mg daily for 6 days and 75 mg daily thereafter) or standard-dose clopidogrel (a 300-mg loading dose and 75 mg daily thereafter) and either higher-dose aspirin (300 to 325 mg daily) or lower-dose aspirin (75 to 100 mg daily). The primary outcome was cardiovascular death, myocardial infarction, or stroke at 30 days. The primary outcome occurred in 4.2% of patients assigned to double-dose clopidogrel as compared with 4.4% assigned to standard-dose clopidogrel (hazard ratio, 0.94; 95% confidence interval [CI], 0.83 to 1.06; P=0.30). Major bleeding occurred in 2.5% of patients in the double-dose group and in 2.0% in the standard-dose group (hazard ratio, 1.24; 95% CI, 1.05 to 1.46; P=0.01). Double-dose clopidogrel was associated with a significant reduction in the secondary outcome of stent thrombosis among the 17,263 patients who underwent PCI (1.6% vs. 2.3%; hazard ratio, 0.68; 95% CI, 0.55 to 0.85; P=0.001). There was no significant difference between higher-dose and lower-dose aspirin with respect to the primary outcome (4.2% vs. 4.4%; hazard ratio, 0.97; 95% CI, 0.86 to 1.09; P=0.61) or major bleeding (2.3% vs. 2.3%; hazard ratio, 0.99; 95% CI, 0.84 to 1.17; P=0.90). In patients with an acute coronary syndrome who were referred for an invasive strategy, there was no significant difference between a 7-day, double-dose clopidogrel regimen and the standard-dose regimen, or between higher-dose aspirin and lower-dose aspirin, with respect to the primary outcome of cardiovascular death, myocardial infarction, or stroke. (Funded by Sanofi-Aventis and Bristol-Myers Squibb; ClinicalTrials.gov number, NCT00335452.)

Allanite age-dating: Non-matrix-matched standardization in quadrupole LA-ICP-MS

NASA Astrophysics Data System (ADS)

Burn, M.; Lanari, P.; Pettke, T.; Engi, M.

2014-12-01

Allanite Th-U-Pb age-dating has recently been found to be powerful in unraveling the timing of geological processes such as the metamorphic dynamics in subduction zones and crystallization velocity of magmas. However, inconsistencies among analytical techniques have raised doubts about the accuracy of allanite age data. Spot analysis techniques such as LA-ICP-MS are claimed to be crucially dependent on matrix-matched standards, the quality of which is variable. We present a new approach in LA-ICP-MS data reduction that allows non-matrix-matched standardization via well constrained zircon reference materials as primary standards. Our data were obtained using a GeoLas Pro 193 nm ArF excimer laser ablation system coupled to an ELAN DRC-e quadrupole ICP-MS. We use 32 μm and 24 μm spot sizes; laser operating conditions of 9 Hz repetition rate and 2.5 J/cm2 fluence have proven advantageous. Matrix dependent downhole fractionation evolution is empirically determined by analyzing 208Pb/232Th and 206Pb/238U and applied prior to standardization. The new data reduction technique was tested on three magmatic allanite reference materials (SISSb, CAPb, TARA); within error these show the same downhole fractionation evolution for all allanite types and in different analytical sessions, provided measurement conditions remain the same. Although the downhole evolution of allanite and zircon differs significantly, a link between zircon and allanite matrix is established by assuming CAPb and TARA to be fixed at the corresponding reference ages. Our weighted mean 208Pb/232Th ages are 30.06 ± 0.22 (2σ) for SISSb, 275.4 ± 1.3 (2σ) for CAPb, and 409.9 ± 1.8 (2σ) for TARA. Precision of single spot age data varies between 1.5 and 8 % (2σ), dependent on spot size and common lead concentrations. Quadrupole LA-ICP-MS allanite age-dating has thus similar uncertainties as do other spot analysis techniques. The new data reduction technique is much less dependent on quality and homogeneity of allanite standard reference materials. This method of correcting for matrix-dependent downhole fractionation evolution opens new possibilities in the field of LA-ICP-MS data acquisition, e.g. the use of a NIST standard glass to date all material types given a set of well constrained reference materials.

Setting nutrient thresholds to support an ecological assessment based on nutrient enrichment, potential primary production and undesirable disturbance.

PubMed

Devlin, Michelle; Painting, Suzanne; Best, Mike

2007-01-01

The EU Water Framework Directive recognises that ecological status is supported by the prevailing physico-chemical conditions in each water body. This paper describes an approach to providing guidance on setting thresholds for nutrients taking account of the biological response to nutrient enrichment evident in different types of water. Indices of pressure, state and impact are used to achieve a robust nutrient (nitrogen) threshold by considering each individual index relative to a defined standard, scale or threshold. These indices include winter nitrogen concentrations relative to a predetermined reference value; the potential of the waterbody to support phytoplankton growth (estimated as primary production); and detection of an undesirable disturbance (measured as dissolved oxygen). Proposed reference values are based on a combination of historical records, offshore (limited human influence) nutrient concentrations, literature values and modelled data. Statistical confidence is based on a number of attributes, including distance of confidence limits away from a reference threshold and how well the model is populated with real data. This evidence based approach ensures that nutrient thresholds are based on knowledge of real and measurable biological responses in transitional and coastal waters.

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a prospective study.

PubMed

da Costa, Bruno R; Beckett, Brooke; Diaz, Alison; Resta, Nina M; Johnston, Bradley C; Egger, Matthias; Jüni, Peter; Armijo-Olivo, Susan

2017-03-03

The Cochrane risk of bias tool is commonly criticized for having a low reliability. We aimed to investigate whether training of raters, with objective and standardized instructions on how to assess risk of bias, can improve the reliability of the Cochrane risk of bias tool. In this pilot study, four raters inexperienced in risk of bias assessment were randomly allocated to minimal or intensive standardized training for risk of bias assessment of randomized trials of physical therapy treatments for patients with knee osteoarthritis pain. Two raters were experienced risk of bias assessors who served as reference. The primary outcome of our study was between-group reliability, defined as the agreement of the risk of bias assessments of inexperienced raters with the reference assessments of experienced raters. Consensus-based assessments were used for this purpose. The secondary outcome was within-group reliability, defined as the agreement of assessments within pairs of inexperienced raters. We calculated the chance-corrected weighted Kappa to quantify agreement within and between groups of raters for each of the domains of the risk of bias tool. A total of 56 trials were included in our analysis. The Kappa for the agreement of inexperienced raters with reference across items of the risk of bias tool ranged from 0.10 to 0.81 for the minimal training group and from 0.41 to 0.90 for the standardized training group. The Kappa values for the agreement within pairs of inexperienced raters across the items of the risk of bias tool ranged from 0 to 0.38 for the minimal training group and from 0.93 to 1 for the standardized training group. Between-group differences in Kappa for the agreement of inexperienced raters with reference always favored the standardized training group and was most pronounced for incomplete outcome data (difference in Kappa 0.52, p < 0.001) and allocation concealment (difference in Kappa 0.30, p = 0.004). Intensive, standardized training on risk of bias assessment may significantly improve the reliability of the Cochrane risk of bias tool.

Bilateral Comparison of 1 V and 10 V Standards between the SMD (Belgium) and the BIPM October to December 2014 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Vlad, D.

2015-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the Service Métrologie—Metrologische Dienst (SMD), Brussel, Belgium, was carried out from October to November 2014. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPM4 (Z4) and BIPM5 (Z5), were transported by freight to SMD and also back to BIPM. At SMD, the reference standard for DC voltage is a Josephson Voltage Standard (JVS). The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at SMD, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned toDC voltage standards by SMD, at the level of 1.018 V and 10 V, at SMD, USMD, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of 5 November 2014. USMD - UBIPM = 0.14 mV; uc = 0.07 mV, at 1 V USMD - UBIPM = 0.09 mV; uc = 0.49 mV , at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at SMD, based on KJ-90, and the uncertainty related to the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral Comparison of 1 V and 10 V Standards between the JV (Norway) and the BIPM, January to February 2015 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Sengebush, F.

2015-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the Justervesenet (JV), Kjeller, Norway, was carried out from January to February 2015. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPM4 (Z4) and BIPM5 (Z5), were transported by freight to JV and also back to BIPM. At JV, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at JV, withthe Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned toDC voltage standards by JV, at the level of 1.018 V and 10 V, at JV, UJV, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of 28 January 2015. UJV - UBIPM = 0.23 μV uc = 0.03 μV , at 1 V UJV - UBIPM = 0.63 μV uc = 0.28 μV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at JV, based on KJ-90, and the uncertainty related to the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral Comparison of 1 V and 10 V Standards between the NIMT (Thailand) and the BIPM October to December 2014 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Pimsut, S.

2015-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the National Institute of Metrology (Thailand), NIMT, was carried out from October to December 2014. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPMA (ZA) and BIPM6 (Z6), were transported by freight to NIMT and back to BIPM. At NIMT, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at NIMT, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned toDC voltage standards by NIMT, at the level of 1.018 V and 10 V, at NIMT, UNIMT, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of 23 November 2014. UNIMT - UBIPM = 0.16 mV; uc = 0.14 mV, at 1 V UNIMT - UBIPM = - 0.03 mV; uc = 0.11 mV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at NIMT, based on KJ-90, and the uncertainty related to the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

High-resolution interferometic microscope for traceable dimensional nanometrology in Brazil

NASA Astrophysics Data System (ADS)

Malinovski, I.; França, R. S.; Lima, M. S.; Bessa, M. S.; Silva, C. R.; Couceiro, I. B.

2016-07-01

The double color interferometric microscope is developed for step height standards nanometrology traceable to meter definition via primary wavelength laser standards. The setup is based on two stabilized lasers to provide traceable measurements of highest possible resolution down to the physical limits of the optical instruments in sub-nanometer to micrometer range of the heights. The wavelength reference is He-Ne 633 nm stabilized laser, the secondary source is Blue-Green 488 nm grating laser diode. Accurate fringe portion is measured by modulated phase-shift technique combined with imaging interferometry and Fourier processing. Self calibrating methods are developed to correct systematic interferometric errors.

Performance of the PARCS Testbed Cesium Fountain Frequency Standard

NASA Technical Reports Server (NTRS)

Enzer, Daphna G.; Klipstein, William M.

2004-01-01

A cesium fountain frequency standard has been developed as a ground testbed for the PARCS (Primary Atomic Reference Clock in Space) experiment, an experiment intended to fly on the International Space Station. We report on the performance of the fountain and describe some of the implementations motivated in large part by flight considerations, but of relevance for ground fountains. In particular, we report on a new technique for delivering cooling and trapping laser beams to the atom collection region, in which a given beam is recirculated three times effectively providing much more optical power than traditional configurations. Allan deviations down to 10 have been achieved with this method.

Verification of the Polish Geodetic Reference Frame by Means of a New Solution Based on Permanent GNSS Data from the Years 2011-2014

NASA Astrophysics Data System (ADS)

Liwosz, T.; Ryczywolski, M.

2016-12-01

The new solution for the Polish geodetic primary GNSS network was created to verify the currently used reference frame (PL-ETRF2000). The new solution is based on more GNSS data (more daily observation sessions included, a longer data timespan, GLONASS observations added) which were processed in a newer reference frame (IGb08) according to up-to-date methodology and using the latest version of Bernese GNSS Software. The new long-term solution (spanning 3.7 years) was aligned to the IGb08 reference frame using a minimum constraints approach. We categorized Polish reference stations into two categories according to their data length. We obtained good agreement of the new solution with the PL-ETRF2000: for most stations position differences did not exceed 5 mm in horizontal, and 10 mm in vertical components. However, for 30 stations we observed discontinuities in position time series, mostly due to GNSS equipment changes, which occured after the introduction of PL-ETRF2000. Position changes due to the discontinuities reached 9.1 mm in horizontal components, and 26.9 mm in vertical components. The new solution takes into account position discontinuities, and in addition also includes six new stations which were installed after the introduction of the PL-ETRF2000. Therefore, we propose to update the currently-used reference frame for the Polish geodetic primary network (PL-ETRF2000) with the new solution. The new solution was also accepted by the EUREF Technical Working Group as a class A solution (highest accuracy) according to EUREF standards.

Positioning navigation and timing service applications in cyber physical systems

NASA Astrophysics Data System (ADS)

Qu, Yi; Wu, Xiaojing; Zeng, Lingchuan

2017-10-01

The positioning navigation and timing (PNT) architecture was discussed in detail, whose history, evolvement, current status and future plan were presented, main technologies were listed, advantages and limitations of most technologies were compared, novel approaches were introduced, and future capacities were sketched. The concept of cyber-physical system (CPS) was described and their primary features were interpreted. Then the three-layer architecture of CPS was illustrated. Next CPS requirements on PNT services were analyzed, including requirements on position reference and time reference, requirements on temporal-spatial error monitor, requirements on dynamic services, real-time services, autonomous services, security services and standard services. Finally challenges faced by PNT applications in CPS were concluded. The conclusion was expected to facilitate PNT applications in CPS, and furthermore to provide references to the design and implementation of both architectures.

Performance of Mercury Triple-Point Cells Made in Brazil

NASA Astrophysics Data System (ADS)

Petkovic, S. G.; Santiago, J. F. N.; Filho, R. R.; Teixeira, R. N.; Santos, P. R. F.

2003-09-01

Fixed-points cells are primary standards in ITS-90. They contain reference material with a purity of 99.999 % or more. The gallium in a melting-point cell, for example, can reach a purity of 99.99999 %. This level of purity is not easy to obtain. However, substances like water and mercury can be purified by means of distillation and chemical procedures. This paper presents the results of mercury triple-point cells made in Brazil that were directly compared to a mercury triple-point cell of 99.999% purity. This reference cell, made by Isotech (England), was previously compared to cells from CENAM (Mexico) and NRC (Canada) and the maximum deviation found was approximately 0.4 mK. The purification stage started with a sample of mercury 99.3 % pure, and the repeated use of both mechanical and chemical processes led to a purification grade considered good enough for calibration of standard platinum resistance thermometers. The purification procedures, the method of construction of the cell, the laboratory facilities, the comparison results and the budget of uncertainties are described in this paper. All of the cells tested have a triple-point temperature within 0.25 mK of the triple-point temperature of the Inmetro reference cell.

High accuracy Primary Reference gas Mixtures for high-impact greenhouse gases

NASA Astrophysics Data System (ADS)

Nieuwenkamp, Gerard; Zalewska, Ewelina; Pearce-Hill, Ruth; Brewer, Paul; Resner, Kate; Mace, Tatiana; Tarhan, Tanil; Zellweger, Christophe; Mohn, Joachim

2017-04-01

Climate change, due to increased man-made emissions of greenhouse gases, poses one of the greatest risks to society worldwide. High-impact greenhouse gases (CO2, CH4 and N2O) and indirect drivers for global warming (e.g. CO) are measured by the global monitoring stations for greenhouse gases, operated and organized by the World Meteorological Organization (WMO). Reference gases for the calibration of analyzers have to meet very challenging low level of measurement uncertainty to comply with the Data Quality Objectives (DQOs) set by the WMO. Within the framework of the European Metrology Research Programme (EMRP), a project to improve the metrology for high-impact greenhouse gases was granted (HIGHGAS, June 2014-May 2017). As a result of the HIGHGAS project, primary reference gas mixtures in cylinders for ambient levels of CO2, CH4, N2O and CO in air have been prepared with unprecedented low uncertainties, typically 3-10 times lower than usually previously achieved by the NMIs. To accomplish these low uncertainties in the reference standards, a number of preparation and analysis steps have been studied and improved. The purity analysis of the parent gases had to be performed with lower detection limits than previously achievable. E.g., to achieve an uncertainty of 2•10-9 mol/mol (absolute) on the amount fraction for N2O, the detection limit for the N2O analysis in the parent gases has to be in the sub nmol/mol domain. Results of an OPO-CRDS analyzer set-up in the 5µm wavelength domain, with a 200•10-12 mol/mol detection limit for N2O, will be presented. The adsorption effects of greenhouse gas components at cylinder surfaces are critical, and have been studied for different cylinder passivation techniques. Results of a two-year stability study will be presented. The fit-for-purpose of the reference materials was studied for possible variation on isotopic composition between the reference material and the sample. Measurement results for a suit of CO2 in air mixtures with varying δ13C values (from -5‰ to -40‰) analyzed with both cavity ringdown spectroscopy (CRDS) and isotope-ratio mass spectrometry (IRMS) will be presented. Round robins were organized to assess the agreement of the new reference gas mixtures developed by different project partners and to compare the new reference gases with the reference standards currently used by the atmospheric monitoring community (NOAA and AGAGE). These results will also be presented.

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia.

PubMed

Lucas, Jane S; Barbato, Angelo; Collins, Samuel A; Goutaki, Myrofora; Behan, Laura; Caudri, Daan; Dell, Sharon; Eber, Ernst; Escudier, Estelle; Hirst, Robert A; Hogg, Claire; Jorissen, Mark; Latzin, Philipp; Legendre, Marie; Leigh, Margaret W; Midulla, Fabio; Nielsen, Kim G; Omran, Heymut; Papon, Jean-Francois; Pohunek, Petr; Redfern, Beatrice; Rigau, David; Rindlisbacher, Bernhard; Santamaria, Francesca; Shoemark, Amelia; Snijders, Deborah; Tonia, Thomy; Titieni, Andrea; Walker, Woolf T; Werner, Claudius; Bush, Andrew; Kuehni, Claudia E

2017-01-01

The diagnosis of primary ciliary dyskinesia is often confirmed with standard, albeit complex and expensive, tests. In many cases, however, the diagnosis remains difficult despite the array of sophisticated diagnostic tests. There is no "gold standard" reference test. Hence, a Task Force supported by the European Respiratory Society has developed this guideline to provide evidence-based recommendations on diagnostic testing, especially in light of new developments in such tests, and the need for robust diagnoses of patients who might enter randomised controlled trials of treatments. The guideline is based on pre-defined questions relevant for clinical care, a systematic review of the literature, and assessment of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. It focuses on clinical presentation, nasal nitric oxide, analysis of ciliary beat frequency and pattern by high-speed video-microscopy analysis, transmission electron microscopy, genotyping and immunofluorescence. It then used a modified Delphi survey to develop an algorithm for the use of diagnostic tests to definitively confirm and exclude the diagnosis of primary ciliary dyskinesia; and to provide advice when the diagnosis was not conclusive. Finally, this guideline proposes a set of quality criteria for future research on the validity of diagnostic methods for primary ciliary dyskinesia. Copyright ©ERS 2017.

Exploring Valid Reference Genes for Quantitative Real-time PCR Analysis in Plutella xylostella (Lepidoptera: Plutellidae)

PubMed Central

Fu, Wei; Xie, Wen; Zhang, Zhuo; Wang, Shaoli; Wu, Qingjun; Liu, Yong; Zhou, Xiaomao; Zhou, Xuguo; Zhang, Youjun

2013-01-01

Abstract: Quantitative real-time PCR (qRT-PCR), a primary tool in gene expression analysis, requires an appropriate normalization strategy to control for variation among samples. The best option is to compare the mRNA level of a target gene with that of reference gene(s) whose expression level is stable across various experimental conditions. In this study, expression profiles of eight candidate reference genes from the diamondback moth, Plutella xylostella, were evaluated under diverse experimental conditions. RefFinder, a web-based analysis tool, integrates four major computational programs including geNorm, Normfinder, BestKeeper, and the comparative ΔCt method to comprehensively rank the tested candidate genes. Elongation factor 1 (EF1) was the most suited reference gene for the biotic factors (development stage, tissue, and strain). In contrast, although appropriate reference gene(s) do exist for several abiotic factors (temperature, photoperiod, insecticide, and mechanical injury), we were not able to identify a single universal reference gene. Nevertheless, a suite of candidate reference genes were specifically recommended for selected experimental conditions. Our finding is the first step toward establishing a standardized qRT-PCR analysis of this agriculturally important insect pest. PMID:23983612

KEY COMPARISON: Final report of the SIM 60Co absorbed-dose-to-water comparison SIM.RI(I)-K4

NASA Astrophysics Data System (ADS)

Ross, C. K.; Shortt, K. R.; Saravi, M.; Meghzifene, A.; Tovar, V. M.; Barbosa, R. A.; da Silva, C. N.; Carrizales, L.; Seltzer, S. M.

2008-01-01

Transfer chambers were used to compare the standards for 60Co absorbed dose to water maintained by seven laboratories. Six of the laboratories were members of the Sistema Interamericano de Metrología (SIM) regional metrology organization while the seventh was the International Atomic Energy Agency (IAEA) laboratory in Vienna. The National Research Council (NRC) acted as the pilot laboratory for the comparison. Because of the participation of laboratories holding primary standards, the comparison results could be linked to the key comparison reference value maintained by the Bureau International des Poids et Mesures (BIPM). The results for all laboratories were within the expanded uncertainty (two standard deviations) of the reference value. The estimated relative standard uncertainty on the comparison between any pair of laboratories ranged from 0.6% to 1.4%. The largest discrepancy between any two laboratories was 1.3%. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI Section I, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

KEY COMPARISON: Final report of the SIM 60Co air-kerma comparison SIM.RI(I)-K1

NASA Astrophysics Data System (ADS)

Ross, C. K.; Shortt, K. R.; Saravi, M.; Meghzifene, A.; Tovar, V. M.; Barbosa, R. A.; da Silva, C. N.; Carrizales, L.; Seltzer, S. M.

2008-01-01

Transfer chambers were used to compare the standards for 60Co air kerma maintained by seven laboratories. Six of the laboratories are members of the Sistema Interamericano de Metrología (SIM) regional metrology organization while the seventh is the International Atomic Energy Agency (IAEA) laboratory in Vienna. The National Research Council (NRC) acted as the pilot laboratory for the comparison. Because of the participation of laboratories holding primary standards, the comparison results could be linked to the key comparison reference value maintained by the Bureau International des Poids et Mesures (BIPM). The results for all laboratories were within the expanded uncertainty (two standard deviations) of the reference value. The estimated relative standard uncertainty of the comparison between any pair of laboratories ranged from 0.5% to 1.0%. The largest discrepancy between any two laboratories was 1.0%. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI Section I, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

Enhancing the Evidence for Behavioral Counseling

PubMed Central

Alcántara, Carmela; Klesges, Lisa M.; Resnicow, Ken; Stone, Amy; Davidson, Karina W.

2015-01-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care–focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)—a multidisciplinary scientific organization committed to improving population health through behavior change—we review the USPSTF mandate and current recommendations for behavioral counseling interventions, and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care–focused behavioral counseling interventions. This perspective highlights five areas for further development, including: (1) behavioral counseling–focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care–based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. PMID:26296553

Effect of Transitioning from Standard Reference Material 2806a to Standard Reference Material 2806b for Light Obscuration Particle Countering

DTIC Science & Technology

2016-04-01

Reference Material 2806b for Light Obscuration Particle Countering April 2016 UNCLASSIFIED UNCLASSIFIED Joel Schmitigal 27809 Standard Form 298 (Rev...Standard Reference Material 2806b for Light Obscuration Particle Countering 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Reference Material 2806a to Standard Reference Material 2806b for Light Obscuration Particle Countering Joel Schmitigal Force Projection

Online Lifestyle Modification Intervention: Survey of Primary Care Providers' Attitudes and Views.

PubMed

Hanna, Reem M; Fischer, Gary; Conroy, Molly B; Bryce, Cindy; Hess, Rachel; McTigue, Kathleen

2018-06-08

Online tools are a convenient and effective method of delivering lifestyle interventions to obese adult primary care patients. A referral model allows physicians to efficiently direct their patients to the intervention during a primary care visit. However, little is known of physicians' perspectives and utilization of the referral model for an online lifestyle modification intervention. The aim was to evaluate the response of primary care providers (PCPs) to a referral model for implementing a year-long online intervention for weight loss to obese adult patients. The PCPs at six primary care clinics were asked to refer adult obese patients to a year-long online lifestyle intervention providing self-management support for weight loss. Following the 1-year intervention, all providers at the participating practices were surveyed regarding their views of the program. Respondents completed survey items assessing their attitudes regarding the 1-year intensive weight loss intervention and identifying resources they would find helpful for assisting patients with weight loss. Referring physicians were asked about their level of satisfaction with implementing the counseling services using standard electronic health record referral processes. Attitudes toward obesity counseling among referring and nonreferring providers were compared. Impressions of how smoothly the referral model of obesity treatment integrated with the clinical workflow were also quantified. Of the 67 providers who completed the surveys, nonreferring providers (n=17) were more likely to prefer counseling themselves (P=.04) and to report having sufficient time to do so (P=.03) than referring providers (n=50) were. Nonreferring providers were more likely to report that their patients lacked computer skills (76%, 13/17 vs 34%, 17/50) or had less access to the Internet (65%, 11/17 vs 32%, 16/50). Understanding providers' views and barriers regarding the integration of online tools will facilitate widespread implementation of an online lifestyle modification intervention. ©Reem M Hanna, Gary Fischer, Molly B Conroy, Cindy Bryce, Rachel Hess, Kathleen McTigue. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.06.2018.

Bilateral Comparison of 1 V and 10 V Standards between the NIS (Egypt) and the BIPM, August to September 2014 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Abdel Mageed, Hala M.; Aladdin, Omar M.; Raouf, M. Helmy A.

2015-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the National Institute for Standards (NIS), Giza, Egypt, was carried out from August to September 2014. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPMB (ZB) and BIPMC (ZC), were transported as hand luggage on board an airplane to NIS and back to BIPM. At NIS, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at NIS, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned to DC voltage standards by NIS, at the level of 1.018 V and 10 V, at NIS, UNIS, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of the 7 September 2014. UNIS - UBIPM = 0.09 µV uc = 0.08 µV, at 1 V UNIS - UBIPM = 0.22 µV uc = 0.14 µV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at NIS, based on KJ-90, and the uncertainty related to the comparison. This is a satisfactory result. The comparison result shows that the voltage standards maintained by NIS and the BIPM were equivalent, within their stated standard uncertainties, on the mean date of the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

On the status of IAEA delta-13C stable isotope reference materials.

NASA Astrophysics Data System (ADS)

Assonov, Sergey; Groening, Manfred; Fajgelj, Ales

2016-04-01

For practical reasons all isotope measurements are performed on relative scales realized through the use of international, scale-defining primary standards. In fact these standards were materials (artefacts, similar to prototypes of meter and kg) selected based on their properties. The VPDB delta-13C scale is realised via two highest-level reference materials NBS19 and LSVEC, the first defining the scale and the second aimed to normalise lab-to-lab calibrations. These two reference materials (RMs) have been maintained and distributed by IAEA and NIST. The priority task is to maintain these primary RMs at the required uncertainty level, thus ensuring the long-term scale consistency. The second task is to introduce replacements when needed (currently for exhausted NBS19, work in progress). The next is to produce a family of lower level RMs (secondary, tertiary) addressing needs of various applications (with different delta values, in different physical-chemical forms) and their needs for the uncertainty; these RMs should be traceable to the highest level RMs. Presently three is a need for a range of RMs addressing existing and newly emerging analytical techniques (e.g. optical isotopic analysers) in form of calibrated CO2 gases with different delta-13C values. All that implies creating a family of delta-13C stable isotope reference materials. Presently IAEA works on replacement for NBS19 and planning new RMs. Besides, we found that LSVEC (introduced as second anchor for the VPDB scale in 2006) demonstrate a considerable scatter of its delta-13C value which implies a potential bias of the property value and increased value uncertainty which may conflict with uncertainty requirements for atmospheric monitoring. That is not compatible with the status of LSVEC, and therefore it should be replaced as soon as possible. The presentation will give an overview of the current status, the strategic plan of developments and the near future steps.

Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy.

PubMed

Venkatesh, Arjun K; Savage, Dan; Sandefur, Benjamin; Bernard, Kenneth R; Rothenberg, Craig; Schuur, Jeremiah D

2017-01-01

Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence. Systematic review of clinical practice guidelines (Clinical Policies) published by the American College of Emergency Physicians from January 1990 to January 2016. Standardized data were abstracted from each Clinical Policy including the number and level of recommendations as well as the reported class of evidence. Primary outcomes were the proportion of Level C equivalent recommendations and Class III equivalent evidence. The primary analysis was limited to current Clinical Policies, while secondary analysis included all Clinical Policies. A total of 54 Clinical Policies including 421 recommendations and 2801 cited references, with an average of 7.8 recommendations and 52 references per guideline were included. Of 19 current Clinical Policies, 13 of 141 (9.2%) recommendations were Level A, 57 (40.4%) Level B, and 71 (50.4%) Level C. Of 845 references in current Clinical Policies, 67 (7.9%) were Class I, 272 (32.3%) Class II, and 506 (59.9%) Class III equivalent. Among all Clinical Policies, 200 (47.5%) recommendations were Level C equivalent, and 1371 (48.9%) of references were Class III equivalent. Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert opinion based. Emergency medicine appears to suffer from an evidence gap that should be prioritized in the national research agenda and considered by policymakers prior to developing future quality standards.

Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice.

PubMed

van Delft, Sanne; Goedhart, Annelijn; Spigt, Mark; van Pinxteren, Bart; de Wit, Niek; Hopstaken, Rogier

2016-08-08

Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. The study was performed in six general practitioner (GP) group practices in the Netherlands. Automated urinalysis was compared with visual urinalysis in these practices. Reference testing was performed in a primary care laboratory (Saltro, Utrecht, The Netherlands). Analytical performance of automated and visual urinalysis compared with the reference laboratory method was the primary outcome measure, analysed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and Cohen's κ coefficient for agreement. Secondary outcome measure was the user-friendliness of the POCT analyser. Automated urinalysis by experienced and routinely trained practice assistants in general practice performs as good as visual urinalysis for nitrite, leucocytes and erythrocytes. Agreement for nitrite is high for automated and visual urinalysis. κ's are 0.824 and 0.803 (ranked as very good and good, respectively). Agreement with the central laboratory reference standard for automated and visual urinalysis for leucocytes is rather poor (0.256 for POCT and 0.197 for visual, respectively, ranked as fair and poor). κ's for erythrocytes are higher: 0.517 (automated) and 0.416 (visual), both ranked as moderate. The Urisys 1100 analyser was easy to use and considered to be not prone to flaws. Automated urinalysis performed as good as traditional visual urinalysis on reading of nitrite, leucocytes and erythrocytes in routine general practice. Implementation of automated urinalysis in general practice is justified as automation is expected to reduce human errors in patient identification and transcribing of results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Reference measurement procedure for total glycerides by isotope dilution GC-MS.

PubMed

Edwards, Selvin H; Stribling, Shelton L; Pyatt, Susan D; Kimberly, Mary M

2012-04-01

The CDC's Lipid Standardization Program established the chromotropic acid (CA) reference measurement procedure (RMP) as the accuracy base for standardization and metrological traceability for triglyceride testing. The CA RMP has several disadvantages, including lack of ruggedness. It uses obsolete instrumentation and hazardous reagents. To overcome these problems the CDC developed an isotope dilution GC-MS (ID-GC-MS) RMP for total glycerides in serum. We diluted serum samples with Tris-HCl buffer solution and spiked 200-μL aliquots with [(13)C(3)]-glycerol. These samples were incubated and hydrolyzed under basic conditions. The samples were dried, derivatized with acetic anhydride and pyridine, extracted with ethyl acetate, and analyzed by ID-GC-MS. Linearity, imprecision, and accuracy were evaluated by analyzing calibrator solutions, 10 serum pools, and a standard reference material (SRM 1951b). The calibration response was linear for the range of calibrator concentrations examined (0-1.24 mmol/L) with a slope and intercept of 0.717 (95% CI, 0.7123-0.7225) and 0.3122 (95% CI, 0.3096-0.3140), respectively. The limit of detection was 14.8 μmol/L. The mean %CV for the sample set (serum pools and SRM) was 1.2%. The mean %bias from NIST isotope dilution MS values for SRM 1951b was 0.7%. This ID-GC-MS RMP has the specificity and ruggedness to accurately quantify total glycerides in the serum pools used in the CDC's Lipid Standardization Program and demonstrates sufficiently acceptable agreement with the NIST primary RMP for total glyceride measurement.

A single-question screening test for drug use in primary care.

PubMed

Smith, Peter C; Schmidt, Susan M; Allensworth-Davies, Donald; Saitz, Richard

2010-07-12

Drug use (illicit drug use and nonmedical use of prescription drugs) is common but underrecognized in primary care settings. We validated a single-question screening test for drug use and drug use disorders in primary care. Adult patients recruited from primary care waiting rooms were asked the single screening question, "How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?" A response of at least 1 time was considered positive for drug use. They were also asked the 10-item Drug Abuse Screening Test (DAST-10). The reference standard was the presence or absence of current (past year) drug use or a drug use disorder (abuse or dependence) as determined by a standardized diagnostic interview. Drug use was also determined by oral fluid testing for common drugs of abuse. Of 394 eligible primary care patients, 286 (73%) completed the interview. The single screening question was 100% sensitive (95% confidence interval [CI], 90.6%-100%) and 73.5% specific (95% CI, 67.7%-78.6%) for the detection of a drug use disorder. It was less sensitive for the detection of self-reported current drug use (92.9%; 95% CI, 86.1%-96.5%) and drug use detected by oral fluid testing or self-report (81.8%; 95% CI, 72.5%-88.5%). Test characteristics were similar to those of the DAST-10 and were affected very little by participant demographic characteristics. The single screening question accurately identified drug use in this sample of primary care patients, supporting the usefulness of this brief screen in primary care.

Impact of a product-specific reference standard for the measurement of a PEGylated rFVIII activity: the Swiss Multicentre Field Study.

PubMed

Bulla, O; Poncet, A; Alberio, L; Asmis, L M; Gähler, A; Graf, L; Nagler, M; Studt, J-D; Tsakiris, D A; Fontana, P

2017-07-01

Measuring factor VIII (FVIII) activity can be challenging when it has been modified, such as when FVIII is pegylated to increase its circulating half-life. Use of a product-specific reference standard may help avoid this issue. Evaluate the impact of using a product-specific reference standard for measuring the FVIII activity of BAX 855 - a pegylated FVIII - in eight of Switzerland's main laboratories. Factor VIII-deficient plasma, spiked with five different concentrations of BAX 855, plus a control FVIII sample, was sent to the participating laboratories. They measured FVIII activity by using either with a one-stage (OSA) or the chromogenic assay (CA) against their local or a product-specific reference standard. When using a local reference standard, there was an overestimation of BAX 855 activity compared to the target concentrations, both with the OSA and CA. The use of a product-specific reference standard reduced this effect: mean recovery ranged from 127.7% to 213.5% using the OSA with local reference standards, compared to 110% to 183.8% with a product-specific reference standard, and from 146.3% to 182.4% using the CA with local reference standards compared to 72.7% to 103.7% with a product-specific reference standard. In this in vitro study, the type of reference standard had a major impact on the measurement of BAX 855 activity. Evaluation was more accurate and precise when using a product-specific reference standard. © 2017 John Wiley & Sons Ltd.

Preparation and characterization of a suite of ephedra-containing standard reference materials.

PubMed

Sharpless, Katherine E; Anderson, David L; Betz, Joseph M; Butler, Therese A; Capar, Stephen G; Cheng, John; Fraser, Catharine A; Gardner, Graeme; Gay, Martha L; Howell, Daniel W; Ihara, Toshihide; Khan, Mansoor A; Lam, Joseph W; Long, Stephen E; McCooeye, Margaret; Mackey, Elizabeth A; Mindak, William R; Mitvalsky, Staci; Murphy, Karen E; NguyenPho, Agnes; Phinney, Karen W; Porter, Barbara J; Roman, Mark; Sander, Lane C; Satterfield, Mary B; Scriver, Christine; Sturgeon, Ralph; Thomas, Jeanice Brown; Vocke, Robert D; Wise, Stephen A; Wood, Laura J; Yang, Lu; Yen, James H; Ziobro, George C

2006-01-01

The National Institute of Standards and Technology, the U.S. Food and Drug Administration, Center for Drug Evaluation and Research and Center for Food Safety and Applied Nutrition, and the National Institutes of Health, Office of Dietary Supplements, are collaborating to produce a series of Standard Reference Materials (SRMs) for dietary supplements. A suite of ephedra materials is the first in the series, and this paper describes the acquisition, preparation, and value assignment of these materials: SRMs 3240 Ephedra sinica Stapf Aerial Parts, 3241 E. sinica Stapf Native Extract, 3242 E. sinica Stapf Commercial Extract, 3243 Ephedra-Containing Solid Oral Dosage Form, and 3244 Ephedra-Containing Protein Powder. Values are assigned for ephedrine alkaloids and toxic elements in all 5 materials. Values are assigned for other analytes (e.g., caffeine, nutrient elements, proximates, etc.) in some of the materials, as appropriate. Materials in this suite of SRMs are intended for use as primary control materials when values are assigned to in-house (secondary) control materials and for validation of analytical methods for the measurement of alkaloids, toxic elements, and, in the case of SRM 3244, nutrients in similar materials.

Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs

PubMed Central

2010-01-01

Background Acute urinary tract infections (UTI) are one of the most common bacterial infections among women presenting to primary care. However, there is a lack of consensus regarding the optimal reference standard threshold for diagnosing UTI. The objective of this systematic review is to determine the diagnostic accuracy of symptoms and signs in women presenting with suspected UTI, across three different reference standards (102 or 103 or 105 CFU/ml). We also examine the diagnostic value of individual symptoms and signs combined with dipstick test results in terms of clinical decision making. Methods Searches were performed through PubMed (1966 to April 2010), EMBASE (1973 to April 2010), Cochrane library (1973 to April 2010), Google scholar and reference checking. Studies that assessed the diagnostic accuracy of symptoms and signs of an uncomplicated UTI using a urine culture from a clean-catch or catherised urine specimen as the reference standard, with a reference standard of at least ≥ 102 CFU/ml were included. Synthesised data from a high quality systematic review were used regarding dipstick results. Studies were combined using a bivariate random effects model. Results Sixteen studies incorporating 3,711 patients are included. The weighted prior probability of UTI varies across diagnostic threshold, 65.1% at ≥ 102 CFU/ml; 55.4% at ≥ 103 CFU/ml and 44.8% at ≥ 102 CFU/ml ≥ 105 CFU/ml. Six symptoms are identified as useful diagnostic symptoms when a threshold of ≥ 102 CFU/ml is the reference standard. Presence of dysuria (+LR 1.30 95% CI 1.20-1.41), frequency (+LR 1.10 95% CI 1.04-1.16), hematuria (+LR 1.72 95%CI 1.30-2.27), nocturia (+LR 1.30 95% CI 1.08-1.56) and urgency (+LR 1.22 95% CI 1.11-1.34) all increase the probability of UTI. The presence of vaginal discharge (+LR 0.65 95% CI 0.51-0.83) decreases the probability of UTI. Presence of hematuria has the highest diagnostic utility, raising the post-test probability of UTI to 75.8% at ≥ 102 CFU/ml and 67.4% at ≥ 103 CFU/ml. Probability of UTI increases to 93.3% and 90.1% at ≥ 102 CFU/ml and ≥ 103 CFU/ml respectively when presence of hematuria is combined with a positive dipstick result for nitrites. Subgroup analysis shows improved diagnostic accuracy using lower reference standards ≥ 102 CFU/ml and ≥ 103 CFU/ml. Conclusions Individual symptoms and signs have a modest ability to raise the pretest-risk of UTI. Diagnostic accuracy improves considerably when combined with dipstick tests particularly tests for nitrites. PMID:20969801

Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs.

PubMed

Giesen, Leonie G M; Cousins, Gráinne; Dimitrov, Borislav D; van de Laar, Floris A; Fahey, Tom

2010-10-24

Acute urinary tract infections (UTI) are one of the most common bacterial infections among women presenting to primary care. However, there is a lack of consensus regarding the optimal reference standard threshold for diagnosing UTI. The objective of this systematic review is to determine the diagnostic accuracy of symptoms and signs in women presenting with suspected UTI, across three different reference standards (10(2) or 10(3) or 10(5) CFU/ml). We also examine the diagnostic value of individual symptoms and signs combined with dipstick test results in terms of clinical decision making. Searches were performed through PubMed (1966 to April 2010), EMBASE (1973 to April 2010), Cochrane library (1973 to April 2010), Google scholar and reference checking.Studies that assessed the diagnostic accuracy of symptoms and signs of an uncomplicated UTI using a urine culture from a clean-catch or catherised urine specimen as the reference standard, with a reference standard of at least ≥ 10(2) CFU/ml were included. Synthesised data from a high quality systematic review were used regarding dipstick results. Studies were combined using a bivariate random effects model. Sixteen studies incorporating 3,711 patients are included. The weighted prior probability of UTI varies across diagnostic threshold, 65.1% at ≥ 10(2) CFU/ml; 55.4% at ≥ 10(3) CFU/ml and 44.8% at ≥ 10(2) CFU/ml ≥ 10(5) CFU/ml. Six symptoms are identified as useful diagnostic symptoms when a threshold of ≥ 10(2) CFU/ml is the reference standard. Presence of dysuria (+LR 1.30 95% CI 1.20-1.41), frequency (+LR 1.10 95% CI 1.04-1.16), hematuria (+LR 1.72 95%CI 1.30-2.27), nocturia (+LR 1.30 95% CI 1.08-1.56) and urgency (+LR 1.22 95% CI 1.11-1.34) all increase the probability of UTI. The presence of vaginal discharge (+LR 0.65 95% CI 0.51-0.83) decreases the probability of UTI. Presence of hematuria has the highest diagnostic utility, raising the post-test probability of UTI to 75.8% at ≥ 10(2) CFU/ml and 67.4% at ≥ 10(3) CFU/ml. Probability of UTI increases to 93.3% and 90.1% at ≥ 10(2) CFU/ml and ≥ 10(3) CFU/ml respectively when presence of hematuria is combined with a positive dipstick result for nitrites. Subgroup analysis shows improved diagnostic accuracy using lower reference standards ≥ 10(2) CFU/ml and ≥ 10(3) CFU/ml. Individual symptoms and signs have a modest ability to raise the pretest-risk of UTI. Diagnostic accuracy improves considerably when combined with dipstick tests particularly tests for nitrites.

PTB’s radiometric scales for UV and VUV source calibration based on synchrotron radiation

NASA Astrophysics Data System (ADS)

Klein, Roman; Kroth, Simone; Paustian, Wolfgang; Richter, Mathias; Thornagel, Reiner

2018-06-01

The radiant intensity of synchrotron radiation can be accurately calculated with classical electrodynamics. This primary realization of the spectral radiant intensity has been used by PTB at several electron storage rings which have been optimized to be operated as primary source standards for the calibration of transfer sources in the spectral range of UV and VUV for almost 30 years. The transfer sources are compared to the primary source standard by means of suitable wavelength-dispersive transfer stations. The spectral range covered by deuterium lamps, which represent transfer sources that are easy to handle, is of particular relevance in practice. Here, we report on developments in the realization and preservation of the radiometric scales for spectral radiant intensity and spectral radiance in the wavelength region from 116 nm to 400 nm, based on a set of deuterium reference lamps, over the last few decades. An inside view and recommendations on the operation of the D2 lamps used for the realization of the radiometric scale are presented. The data has been recently compiled to illustrate the chronological behaviour at various wavelengths. Moreover, an overview of the internal and external validation measurements and intercomparisons is given.

Dynamic-gravimetric preparation of metrologically traceable primary calibration standards for halogenated greenhouse gases

NASA Astrophysics Data System (ADS)

Guillevic, Myriam; Vollmer, Martin K.; Wyss, Simon A.; Leuenberger, Daiana; Ackermann, Andreas; Pascale, Céline; Niederhauser, Bernhard; Reimann, Stefan

2018-06-01

For many years, the comparability of measurements obtained with various instruments within a global-scale air quality monitoring network has been ensured by anchoring all results to a unique suite of reference gas mixtures, also called a primary calibration scale. Such suites of reference gas mixtures are usually prepared and then stored over decades in pressurised cylinders by a designated laboratory. For the halogenated gases which have been measured over the last 40 years, this anchoring method is highly relevant as measurement reproducibility is currently much better ( < 1 %, k = 2 or 95 % confidence interval) than the expanded uncertainty of a reference gas mixture (usually > 2 %). Meanwhile, newly emitted halogenated gases are already measured in the atmosphere at pmol mol-1 levels, while still lacking an established reference standard. For compounds prone to adsorption on material surfaces, it is difficult to evaluate mixture stability and thus variations in the molar fractions over time in cylinders at pmol mol-1 levels.To support atmospheric monitoring of halogenated gases, we create new primary calibration scales for SF6 (sulfur hexafluoride), HFC-125 (pentafluoroethane), HFO-1234yf (or HFC-1234yf, 2,3,3,3-tetrafluoroprop-1-ene), HCFC-132b (1,2-dichloro-1,1-difluoroethane) and CFC-13 (chlorotrifluoromethane). The preparation method, newly applied to halocarbons, is dynamic and gravimetric: it is based on the permeation principle followed by dynamic dilution and cryo-filling of the mixture in cylinders. The obtained METAS-2017 primary calibration scales are made of 11 cylinders containing these five substances at near-ambient and slightly varying molar fractions. Each prepared molar fraction is traceable to the realisation of SI units (International System of Units) and is assigned an uncertainty estimate following international guidelines (JCGM, 2008), ranging from 0.6 % for SF6 to 1.3 % (k = 2) for all other substances. The smallest uncertainty obtained for SF6 is mostly explained by the high substance purity level in the permeator and the low SF6 contamination of the matrix gas. The measured internal consistency of the suite ranges from 0.23 % for SF6 to 1.1 % for HFO-1234yf (k = 1). The expanded uncertainty after verification (i.e. measurement of the cylinders vs. each others) ranges from 1 to 2 % (k = 2).This work combines the advantages of SI-traceable reference gas mixture preparation with a calibration scale system for its use as anchor by a monitoring network. Such a combined system supports maximising compatibility within the network while linking all reference values to the SI and assigning carefully estimated uncertainties.For SF6, comparison of the METAS-2017 calibration scale with the scale prepared by SIO (Scripps Institution of Oceanography, SIO-05) shows excellent concordance, the ratio METAS-2017 / SIO-05 being 1.002. For HFC-125, the METAS-2017 calibration scale is measured as 7 % lower than SIO-14; for HFO-1234yf, it is 9 % lower than Empa-2013. No other scale for HCFC-132b was available for comparison. Finally, for CFC-13 the METAS-2017 primary calibration scale is 5 % higher than the interim calibration scale (Interim-98) that was in use within the Advanced Global Atmospheric Gases Experiment (AGAGE) network before adopting the scale established in the present work.

The Children's Body Image Scale: reliability and use with international standards for body mass index.

PubMed

Truby, Helen; Paxton, Susan J

2008-03-01

To test the reliability of the Children's Body Image Scale (CBIS) and assess its usefulness in the context of new body size charts for children. Participants were 281 primary schoolchildren with 50% being retested after 3 weeks. The CBIS figure scale was compared with a range of international body mass index (BMI) reference standards. Children had a high degree of body image dissatisfaction. The test-retest reliability of the CBIS was supported. The CBIS is a useful tool for assessing body image in children with sound scale properties. It can also be used to identify the body size of children, which lies outside the healthy weight range of BMI.

An analysis of packaging formats for complex digtal objects: review of principles

NASA Astrophysics Data System (ADS)

Bekaert, Jeroen L.; Hochstenbach, Patrick; De Kooning, Emiel; Van de Walle, Rik

2003-11-01

During recent years, the number of organizations making digital information available has massively increased. This evolution encouraged the development of standards for packaging and encoding digital representations of complex objects (such as a digital music albums or digitized books and photograph albums). The primary goal of this article is to offer a method to compare these packaging standards and best practices tailored to the needs of the digital library community and the rising digital preservation programs. The contribution of this paper is the definition of an integrated reference model, based on both the OAIS framework and some additional significant properties that affect the quality, usability, encoding and behavior of the digital objects.

Identification of Gambling Problems in Primary Care: Properties of the NODS-CLiP Screening Tool.

PubMed

Cowlishaw, Sean; McCambridge, Jim; Kessler, David

2018-06-25

There are several brief screening tools for gambling that possess promising psychometric properties, but have uncertain utility in generalist healthcare environments which prioritize prevention and brief interventions. This study describes an examination of the National Opinion Research Centre Diagnostic and Statistical Manual of Mental Disorders Screen for Gambling Problems (NODS-CLiP), in comparison with the Problem Gambling Severity Index (PGSI), when used to operationalize gambling problems across a spectrum of severity. Data were obtained from 1058 primary care attendees recruited from 11 practices in England who completed various measures including the NODS-CLiP and PGSI. The performance of the former was defined by estimates of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs), when PGSI indicators of problem gambling (5+) and any gambling problems (1+), respectively, were reference standards. The NODS-CLiP demonstrated perfect sensitivity for problem gambling, along with high specificity and a NPV, but a low PPV. There was much lower sensitivity when the indicator of any gambling problems was the reference standard, with capture rates indicating only 20% of patients exhibiting low to moderate severity gambling problems (PGSI 1-4) were identified by the NODS-CLiP. The NODS-CLiP performs well when identifying severe cases of problem gambling, but lacks sensitivity for less severe problems and may be unsuitable for settings which prioritize prevention and brief interventions. There is a need for screening measures which are sensitive across the full spectrum of risk and severity, and can support initiatives for improving identification and responses to gambling problems in healthcare settings such as primary care.

[Standards, options, and recommendations for initial management of patients with malignant ovarian epithelial tumors].

PubMed

Kerbrat, P; Lhommé, C; Fervers, B; Guastalla, J P; Thomas, L; Basuyau, J P; Duvillard, P; Cohen-Solal, C; Dauplat, J; Tournemaine, N

2000-12-09

Suprapubic and transvaginal pelvic ultrasound exploration is indicated for suspected ovarian tumor (standard). Diagnosis and search for extension require surgery and pathology examination. Systematic preoperative computed tomography is not recommended (standard). Surgery for cancer of the ovary is a specialized procedure requiring skill in cancer, gynecology, visceral surgery and laparoscopic surgery. If the patient is referred to a specialized center after a primary procedure considered to be inadequate, a new procedure is recommended for staging. Residual tumor volume after the primary procedure has prognostic value. Systematic second look procedures are not recommended for routine practice (standard). For patients with grade IA G1 tumors, there is no indication for complementary treatment (standard). For patients with grade IA G2-3 or clear cell tumors, IB, IC, IIA, there is no standard. no complementary treatment, complementary chemotherapy using platinum, complementary external abdominopelvic radiotherapy. A complementary treatment is recommended for grades IC and IIA. Complementary treatment for grades IIB (no residual tissue), IIC (with residual tissue), III (no residual tissue), is based on: complementary chemotherapy with platinium, complementary external abdominopelvic radiotherapy (options). Complementary treatment for advanced forms (IIB (with residual tissue), IIC (with residual tissue), III (with residual tissue) and IV) is based on polychemotherapy with platinium (standard). platinium combined with paclitaxel (intravenous), platinium combined with cyclophosphamide and/or doxorubicin (intravenous) or intraperitoneal cisplatin combined with cyclophosphamide (intravenous). The chemotherapy work-up includes physical examination, assay of serum markers (particularly CA125) and abdominopelvic computed tomography (proof level B) (standard). Physical examination is recommended for monitoring patients in complete remission with no sign of suspected recurrence (standard). This document was reviewed in April 1977. The working group again validated the Standards, OPTIONS and Recommendations, without modifications in June 1999.

Bilateral comparison of 1 V and 10 V standards between the INM (Romania) and the BIPM, August to October 2013 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Simionescu, M.; Cîrneanu, L.

2014-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the Institut National de Metrologie (INM), Bucharest, Romania, was carried out from August to October 2013. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPM_7 (Z7) and BIPM_8 (Z8), were transported by freight to INM. At INM, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (electromotive force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at INM, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned to DC voltage standards by INM, at the level of 1.018 V and 10 V, at INM, UINM, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of 6 September 2013. UINM - UBIPM = -0.014 µV uc = 0.051 µV, at 1 V UINM - UBIPM = -0.43 µV uc = 0.34 µV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at INM, based on KJ-90, and the uncertainty related to the comparison. These are satisfactory results. The comparison results show that the voltage standards maintained by INM and the BIPM were equivalent, within the comparison uncertainty, on the mean date of the comparison. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Advanced Transport Operating System (ATOPS) color displays software description microprocessor system

NASA Technical Reports Server (NTRS)

Slominski, Christopher J.; Plyler, Valerie E.; Dickson, Richard W.

1992-01-01

This document describes the software created for the Sperry Microprocessor Color Display System used for the Advanced Transport Operating Systems (ATOPS) project on the Transport Systems Research Vehicle (TSRV). The software delivery known as the 'baseline display system', is the one described in this document. Throughout this publication, module descriptions are presented in a standardized format which contains module purpose, calling sequence, detailed description, and global references. The global reference section includes procedures and common variables referenced by a particular module. The system described supports the Research Flight Deck (RFD) of the TSRV. The RFD contains eight cathode ray tubes (CRTs) which depict a Primary Flight Display, Navigation Display, System Warning Display, Takeoff Performance Monitoring System Display, and Engine Display.

A Further Brief Response from Mary Hilton to: "Measuring Standards in Primary English: The Validity of PIRLS--A Response to Mary Hilton" by Chris Whetton, Liz Twist and Marian Sainsbury

ERIC Educational Resources Information Center

Hilton, Mary

2007-01-01

The author has been invited to reply to this response to her article of December 2006 in this journal. This response can only be a summary of some of her findings and a reiteration, in very truncated form, of her arguments. She would refer any interested reader back to her original extended review of the PIRLS project as it was there that she lays…

Standard Specimen Reference Set: Lung — EDRN Public Portal

Cancer.gov

The NCI/EDRN/SPORE Lung Cancer Biomarkers Group (LCBG) began its activities back in November 2004 and developed clear objectives and strategies on how to begin validating a series of candidate biomarkers for the early detection of lung cancer. The initial goal of the LCBG is to develop the requisite sample resources to validate serum/plasma biomarkers for the early diagnosis of lung cancer. Researchers may use these resources and process for continued biomarker refinement but this is not the primary activity of the LCBG.

Unified Bayesian Estimator of EEG Reference at Infinity: rREST (Regularized Reference Electrode Standardization Technique).

PubMed

Hu, Shiang; Yao, Dezhong; Valdes-Sosa, Pedro A

2018-01-01

The choice of reference for the electroencephalogram (EEG) is a long-lasting unsolved issue resulting in inconsistent usages and endless debates. Currently, both the average reference (AR) and the reference electrode standardization technique (REST) are two primary, apparently irreconcilable contenders. We propose a theoretical framework to resolve this reference issue by formulating both (a) estimation of potentials at infinity, and (b) determination of the reference, as a unified Bayesian linear inverse problem, which can be solved by maximum a posterior estimation. We find that AR and REST are very particular cases of this unified framework: AR results from biophysically non-informative prior; while REST utilizes the prior based on the EEG generative model. To allow for simultaneous denoising and reference estimation, we develop the regularized versions of AR and REST, named rAR and rREST, respectively. Both depend on a regularization parameter that is the noise to signal variance ratio. Traditional and new estimators are evaluated with this framework, by both simulations and analysis of real resting EEGs. Toward this end, we leverage the MRI and EEG data from 89 subjects which participated in the Cuban Human Brain Mapping Project. Generated artificial EEGs-with a known ground truth, show that relative error in estimating the EEG potentials at infinity is lowest for rREST. It also reveals that realistic volume conductor models improve the performances of REST and rREST. Importantly, for practical applications, it is shown that an average lead field gives the results comparable to the individual lead field. Finally, it is shown that the selection of the regularization parameter with Generalized Cross-Validation (GCV) is close to the "oracle" choice based on the ground truth. When evaluated with the real 89 resting state EEGs, rREST consistently yields the lowest GCV. This study provides a novel perspective to the EEG reference problem by means of a unified inverse solution framework. It may allow additional principled theoretical formulations and numerical evaluation of performance.

Quantitative Measurements of X-ray Intensity

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

Haugh, M. J., Schneider, M.

This chapter describes the characterization of several X-ray sources and their use in calibrating different types of X-ray cameras at National Security Technologies, LLC (NSTec). The cameras are employed in experimental plasma studies at Lawrence Livermore National Laboratory (LLNL), including the National Ignition Facility (NIF). The sources provide X-rays in the energy range from several hundred eV to 110 keV. The key to this effort is measuring the X-ray beam intensity accurately and traceable to international standards. This is accomplished using photodiodes of several types that are calibrated using radioactive sources and a synchrotron source using methods and materials thatmore » are traceable to the U.S. National Institute of Standards and Technology (NIST). The accreditation procedures are described. The chapter begins with an introduction to the fundamental concepts of X-ray physics. The types of X-ray sources that are used for device calibration are described. The next section describes the photodiode types that are used for measuring X-ray intensity: power measuring photodiodes, energy dispersive photodiodes, and cameras comprising photodiodes as pixel elements. Following their description, the methods used to calibrate the primary detectors, the power measuring photodiodes and the energy dispersive photodiodes, as well as the method used to get traceability to international standards are described. The X-ray source beams can then be measured using the primary detectors. The final section then describes the use of the calibrated X-ray beams to calibrate X-ray cameras. Many of the references are web sites that provide databases, explanations of the data and how it was generated, and data calculations for specific cases. Several general reference books related to the major topics are included. Papers expanding some subjects are cited.« less

UTC(SU) and EOP(SU) - the only legal reference frames of Russian Federation

NASA Astrophysics Data System (ADS)

Koshelyaevsky, Nikolay B.; Blinov, Igor Yu; Pasynok, Sergey L.

2015-08-01

There are two legal time reference frames in Russian Federation. UTC(SU) deals with atomic time and play a role of reference for legal timing through the whole country. The other one, EOP(SU), deals with Earth's orientation parameters and provides the official EOP data for scientific, technical and metrological applications in Russia.The atomic time is based on two essential hardware components: primary Cs fountain standards and ensemble of continuously operating H-masers as a time unit/time scale keeper. Basing on H-maser intercomparison system data, regular H-maser frequency calibration against Cs standards and time algorithm autonomous TA(SU) time scale is maintained by the Main Metrological Center. Since 2013 time unit in TA(SU) is the second (SU) reproduced independently by VNIIFTRI Cs primary standards in accordance to it’s definition in the SI. UTC(SU) is relied on TA(SU) and steering to UTC basing on TWSTFT/GNSS time link data. As a result TA(SU) stability level relative to TT considerably exceeds 1×10-15 for sample time one month and more, RMS[UTC-UTC(SU)] ≤ 3 ns for the period of 2013-2015. UTC(SU) is broadcasted by different national means such as specialized radio and TV stations, NTP servers and GLONASS. Signals of Russian radio stations contains DUT1 and dUT1 values at 0.1s and 0.02s resolution respectively.The definitive EOP(SU) are calculated by the Main Metrological Center basing on composition of the eight independent individual EOP data streams delivered by four Russian analysis centers: VNIIFTRI, Institute of Applied Astronomy, Information-Analytical Center of Russian Space Agency and Analysis Center of Russian Space Agency. The accuracy of ultra-rapid EOP values for 2014 is estimated ≤ 0.0006" for polar motion, ≤ 70 microseconds for UT1-UTC and ≤ 0.0003" for celestial pole offsets respectively.The other VNIIFTRI EOP activities can be grouped in three basic directions:- arrangement and carrying out GNSS and SLR observations at five institutes- processing GNSS, SLR and VLBI observation data for EOP evaluation- combination of GLONASS satellites orbit/clocks.The paper will deliver more detailed and particular information on Russian legal reference frames.

Final report on CIPM key comparison CCM.FF-K6.2011: Comparison of the primary (national) standards of low-pressure gas flow

NASA Astrophysics Data System (ADS)

Benková, Miroslava; Makovnik, Stefan; Mickan, Bodo; Arias, Roberto; Chahine, Khaled; Funaki, Tatsuya; Li, Chunhui; Choi, Hae Man; Seredyuk, Denys; Su, Chun-Min; Windenberg, Christophe; Wright, John

2014-01-01

The comparison CCM.FF-K6.2011 was organized for the purpose of determination of the degree of equivalence of the national standards for low-pressure gas flow measurement over the range (2 to 100) m3/h. A rotary gas meter was used as a transfer standard. The measurements were provided at prescribed reference conditions. Eleven laboratories from four RMOs participated in this key comparison—EURAMET: PTB, Germany; SMU, Slovakia; LNE-LADG, France; SIM: NIST, USA; CENAM, Mexico; APMP: NMIJ AIST Japan; KRISS, Korea; NMI, Australia; NIM, China; CMS, Chinese Taipei; COOMET: GP GP Ivano-Frankivs'kstandart-metrologia, Ukraine and all participants reported independent traceability chains to the SI. All results were used in the determination of the key comparison reference value (KCRV) and the uncertainty of the KCRV. The reference value was determined at each flow separately following procedure A presented by M G Cox. The degree of equivalence with the KCRV was also calculated for each flow and laboratory. All reported results were consistent with the KCRV. This KCRV can now be used in the further regional comparisons. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

[Application of traditional Chinese medicine reference standards in quality control of Chinese herbal pieces].

PubMed

Lu, Tu-Lin; Li, Jin-Ci; Yu, Jiang-Yong; Cai, Bao-Chang; Mao, Chun-Qin; Yin, Fang-Zhou

2014-01-01

Traditional Chinese medicine (TCM) reference standards plays an important role in the quality control of Chinese herbal pieces. This paper overviewed the development of TCM reference standards. By analyzing the 2010 edition of Chinese pharmacopoeia, the application of TCM reference standards in the quality control of Chinese herbal pieces was summarized, and the problems exiting in the system were put forward. In the process of improving the quality control level of Chinese herbal pieces, various kinds of advanced methods and technology should be used to research the characteristic reference standards of Chinese herbal pieces, more and more reasonable reference standards should be introduced in the quality control system of Chinese herbal pieces. This article discussed the solutions in the aspect of TCM reference standards, and future development of quality control on Chinese herbal pieces is prospected.

Limitations of commonly used internal controls for real-time RT-PCR analysis of renal epithelial-mesenchymal cell transition.

PubMed

Elberg, Gerard; Elberg, Dorit; Logan, Charlotte J; Chen, Lijuan; Turman, Martin A

2006-01-01

Progressive renal fibrotic disease is accompanied by the massive accumulation of myofibroblasts as defined by alpha smooth muscle actin (alphaSMA) expression. We quantitated gene expression using real-time RT-PCR analysis during conversion of primary cultured human renal tubular cells (RTC) to myofibroblasts after treatment with transforming growth factor-beta1 (TGF-beta1). We report herein the limitations of commonly used reference genes for mRNA quantitation. We determined the expression of alphaSMA and megakaryoblastic leukemia-1 (MKL1), a transcriptional regulator of alphaSMA, by quantitative real-time PCR using three common internal controls, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), cyclophilin A and 18S rRNA. Expression of GAPDH mRNA and cyclophilin A mRNA, and to a lesser extent, 18S rRNA levels varied over time in culture and with exposure to TGF-beta1. Thus, depending on which reference gene was used, TGF-beta1 appeared to have different effects on expression of MKL1 and alphaSMA. RTC converting to myofibroblasts in primary culture is a valuable system to study renal fibrosis in humans. However, variability in expression of reference genes with TGF-beta1 treatment illustrates the need to validate mRNA quantitation with multiple reference genes to provide accurate interpretation of fibrosis studies in the absence of a universal internal standard for mRNA expression. 2006 S. Karger AG, Basel.

Report on the Project for Establishment of the Standardized Korean Laboratory Terminology Database, 2015.

PubMed

Jung, Bo Kyeung; Kim, Jeeyong; Cho, Chi Hyun; Kim, Ju Yeon; Nam, Myung Hyun; Shin, Bong Kyung; Rho, Eun Youn; Kim, Sollip; Sung, Heungsup; Kim, Shinyoung; Ki, Chang Seok; Park, Min Jung; Lee, Kap No; Yoon, Soo Young

2017-04-01

The National Health Information Standards Committee was established in 2004 in Korea. The practical subcommittee for laboratory test terminology was placed in charge of standardizing laboratory medicine terminology in Korean. We aimed to establish a standardized Korean laboratory terminology database, Korea-Logical Observation Identifier Names and Codes (K-LOINC) based on former products sponsored by this committee. The primary product was revised based on the opinions of specialists. Next, we mapped the electronic data interchange (EDI) codes that were revised in 2014, to the corresponding K-LOINC. We established a database of synonyms, including the laboratory codes of three reference laboratories and four tertiary hospitals in Korea. Furthermore, we supplemented the clinical microbiology section of K-LOINC using an alternative mapping strategy. We investigated other systems that utilize laboratory codes in order to investigate the compatibility of K-LOINC with statistical standards for a number of tests. A total of 48,990 laboratory codes were adopted (21,539 new and 16,330 revised). All of the LOINC synonyms were translated into Korean, and 39,347 Korean synonyms were added. Moreover, 21,773 synonyms were added from reference laboratories and tertiary hospitals. Alternative strategies were established for mapping within the microbiology domain. When we applied these to a smaller hospital, the mapping rate was successfully increased. Finally, we confirmed K-LOINC compatibility with other statistical standards, including a newly proposed EDI code system. This project successfully established an up-to-date standardized Korean laboratory terminology database, as well as an updated EDI mapping to facilitate the introduction of standard terminology into institutions. © 2017 The Korean Academy of Medical Sciences.

Uniformity under in vitro conditions: Changes in the phenotype of cancer cell lines derived from different medulloblastoma subgroups.

PubMed

Chlapek, Petr; Zitterbart, Karel; Kren, Leos; Filipova, Lenka; Sterba, Jaroslav; Veselska, Renata

2017-01-01

Medulloblastoma comprises four main subgroups (WNT, SHH, Group 3 and Group 4) originally defined by transcriptional profiling. In primary medulloblastoma tissues, these groups are thought to be distinguishable using the immunohistochemical detection of β-catenin, filamin A, GAB1 and YAP1 protein markers. To investigate the utility of these markers for in vitro studies using medulloblastoma cell lines, immunoblotting and indirect immunofluorescence were employed for the detection of β-catenin, filamin A, GAB1 and YAP1 in both DAOY and D283 Med reference cell lines and the panel of six medulloblastoma cell lines derived in our laboratory from the primary tumor tissues of known molecular subgroups. Immunohistochemical detection of these markers was performed on formalin-fixed paraffin-embedded tissue of the matching primary tumors. The results revealed substantial divergences between the primary tumor tissues and matching cell lines in the immunoreactivity pattern of medulloblastoma-subgroup-specific protein markers. Regardless of the molecular subgroup of the primary tumor, all six patient-derived medulloblastoma cell lines exhibited a uniform phenotype: immunofluorescence showed the nuclear localization of YAP1, accompanied by strong cytoplasmic positivity for β-catenin and filamin A, as well as weak positivity for GAB1. The same immunoreactivity pattern was also found in both DAOY and D283 Med reference medulloblastoma cell lines. Therefore, we can conclude that various medulloblastoma cell lines tend to exhibit the same characteristics of protein marker expression under standard in vitro conditions. Such a finding emphasizes the importance of the analyses of primary tumors in clinically oriented medulloblastoma research and the urgent need to develop in vitro models of improved clinical relevance, such as 3D cultures and organotypic slice cultures.

Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine.

PubMed

Alcántara, Carmela; Klesges, Lisa M; Resnicow, Ken; Stone, Amy; Davidson, Karina W

2015-09-01

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care-focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)--a multidisciplinary scientific organization committed to improving population health through behavior change--we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling-focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care-based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Influence of Installation Errors On the Output Data of the Piezoelectric Vibrations Transducers

NASA Astrophysics Data System (ADS)

Kozuch, Barbara; Chelmecki, Jaroslaw; Tatara, Tadeusz

2017-10-01

The paper examines an influence of installation errors of the piezoelectric vibrations transducers on the output data. PCB Piezotronics piezoelectric accelerometers were used to perform calibrations by comparison. The measurements were performed with TMS 9155 Calibration Workstation version 5.4.0 at frequency in the range of 5Hz - 2000Hz. Accelerometers were fixed on the calibration station in a so-called back-to-back configuration in accordance with the applicable international standard - ISO 16063-21: Methods for the calibration of vibration and shock transducers - Part 21: Vibration calibration by comparison to a reference transducer. The first accelerometer was calibrated by suitable methods with traceability to a primary reference transducer. Each subsequent calibration was performed when changing one setting in relation to the original calibration. The alterations were related to negligence and failures in relation to the above-mentioned standards and operating guidelines - e.g. the sensor was not tightened or appropriate substance was not placed. Also, there was modified the method of connection which was in the standards requirements. Different kind of wax, light oil, grease and other assembly methods were used. The aim of the study was to verify the significance of standards requirements and to estimate of their validity. The authors also wanted to highlight the most significant calibration errors. Moreover, relation between various appropriate methods of the connection was demonstrated.

The human secretome atlas initiative: Implications in health and disease conditions

PubMed Central

Brown, Kristy J; Seol, Haeri; Pillai, Dinesh K; Sankoorikal, Binu-John; Formolo, Catherine A; Mac, Jenny; Edwards, Nathan J.; Rose, Mary C; Hathout, Yetrib

2013-01-01

Proteomic analysis of human body fluids is highly challenging, therefore many researchers are redirecting efforts towards secretome profiling. The goal is to define potential biomarkers and therapeutic targets in the secretome that can be traced back in accessible human body fluids. However, currently there is a lack of secretome profiles of normal human primary cells making it difficult to assess the biological meaning of current findings. In this study we sought to establish secretome profiles of human primary cells obtained from healthy donors with the goal of building a human secretome atlas. Such an atlas can be used as a reference for discovery of potential disease associated biomarkers and eventually novel therapeutic targets. As a preliminary study, secretome profiles were established for six different types of human primary cell cultures and checked for overlaps with the three major human body fluids including plasma, cerebrospinal fluid and urine. About 67% of the 1054 identified proteins in the secretome of these primary cells occurred in at least one body fluid. Furthermore, comparison of the secretome profiles of two human glioblastoma cell lines to this new human secretome atlas enabled unambiguous identification of potential brain tumor biomarkers. These biomarkers can be easily monitored in different body fluids using stable isotope labeled standard proteins. The long term goal of this study is to establish a comprehensive online human secretome atlas for future use as a reference for any disease related secretome study. PMID:23603790

[Standardization of terminology in laboratory medicine I].

PubMed

Yoon, Soo Young; Yoon, Jong Hyun; Min, Won Ki; Lim, Hwan Sub; Song, Junghan; Chae, Seok Lae; Lee, Chang Kyu; Kwon, Jung Ah; Lee, Kap No

2007-04-01

Standardization of medical terminology is essential for data transmission between health-care institutions or clinical laboratories and for maximizing the benefits of information technology. Purpose of our study was to standardize the medical terms used in the clinical laboratory, such as test names, units, terms used in result descriptions, etc. During the first year of the study, we developed a standard database of concept names for laboratory terms, which covered the terms used in government health care centers, their branch offices, and primary health care units. Laboratory terms were collected from the electronic data interchange (EDI) codes from National Health Insurance Corporation (NHIC), Logical Observation Identifier Names and Codes (LOINC) database, community health centers and their branch offices, and clinical laboratories of representative university medical centers. For standard expression, we referred to the English-Korean/ Korean-English medical dictionary of Korean Medical Association and the rules for foreign language translation. Programs for mapping between LOINC DB and EDI code and for translating English to Korean were developed. A Korean standard laboratory terminology database containing six axial concept names such as components, property, time aspect, system (specimen), scale type, and method type was established for 7,508 test observations. Short names and a mapping table for EDI codes and Unified Medical Language System (UMLS) were added. Synonym tables for concept names, words used in the database, and six axial terms were prepared to make it easier to find the standard terminology with common terms used in the field of laboratory medicine. Here we report for the first time a Korean standard laboratory terminology database for test names, result description terms, result units covering most laboratory tests in primary healthcare centers.

[HL7 standard--features, principles, and methodology].

PubMed

Koncar, Miroslav

2005-01-01

The mission of HL7 Inc. non-profit organization is to provide standards for the exchange, management and integration of data that support clinical patient care, and the management, delivery and evaluation of healthcare services. As the standards developed by HL7 Inc. represent the world's most influential standardization efforts in the field of medical informatics, the HL7 family of standards has been recognized by the technical and scientific community as the foundation for the next generation healthcare information systems. Versions 1 and 2 of HL7 standard have solved many issues, but also demonstrated the size and complexity of health information sharing problem. As the solution complete new methodology has been adopted that is encompassed in the HL7 Version 3 recommendations. This approach standardizes Reference Information Model (RIM), which is the source of all derived domain models and message structures. Message design is now defined in detail, enabling interoperability between loosely coupled systems that are.designed by different vendors and deployed in various environments. At the start of the Primary Healthcare Information System project in the Republic of Croatia in 2002, the decision was to go directly to Version 3. The target scope of work includes clinical, financial and administrative data management in the domain of healthcare processes. By using HL7v3 standardized methodology we were able to completely map the Croatian primary healthcare domain to HL7v3 artefacts. Further refinement processes that are planned for the future will provide semantic interoperability and detailed description of all elements in HL7 messages. Our HL7 Business Component is in constant process of studying different legacy applications, making solid foundation for their integration to HL7-enabled communication environment.

Results of the 1973 NASA/JPL balloon flight solar cell calibration program

NASA Technical Reports Server (NTRS)

Yasui, R. K.; Greenwood, R. F.

1975-01-01

High altitude balloon flights carried 37 standard solar cells for calibration above 99.5 percent of the earth's atmosphere. The cells were assembled into standard modules with appropriate resistors to load each cell at short circuit current. Each standardized module was mounted at the apex of the balloon on a sun tracker which automatically maintained normal incidence to the sun within 1.0 deg. The balloons were launched to reach a float altitude of approximately 36.6 km two hours before solar noon and remain at float altitude for two hours beyond solar noon. Telemetered calibration data on each standard solar cell was collected and recorded on magnetic tape. At the end of each float period the solar cell payload was separated from the balloon by radio command and descended via parachute to a ground recovery crew. Standard solar cells calibrated and recovered in this manner are used as primary intensity reference standards in solar simulators and in terrestrial sunlight for evaluating the performance of other solar cells and solar arrays with similar spectral response characteristics.

Niyith NiyithWatmam [corrected] (the quiet story): exploring the experiences of Aboriginal women who give birth in their remote community.

PubMed

Ireland, Sarah; Wulili Narjic, Concepta; Belton, Suzanne; Kildea, Sue

2011-10-01

to investigate the beliefs and practices of Aboriginal women who decline transfer to urban hospitals and remain in their remote community to give birth. an ethnographic approach was used which included: the collection of birth histories and narratives, observation and participation in the community for 24 months, field notes, training and employment of an Aboriginal co-researcher, and consultation with and advice from a local reference group. a remote Aboriginal community in the Northern Territory, Australia. narratives were collected from seven Aboriginal women and five family members. findings showed that women, through their previous experiences of standard care, appeared to make conscious decisions and choices about managing their subsequent pregnancies and births. Women took into account their health, the baby's health, the care of their other children, and designated men with a helping role. narratives described a breakdown of traditional birthing practices and high levels of non-compliance with health-system-recommended care. standard care provided for women relocating for birth must be improved, and the provision of a primary maternity service in this particular community may allow Aboriginal Women's Business roles and cultural obligations to be recognised and invigorated. International examples of primary birthing services in remote areas demonstrate that they can be safe alternatives to urban transfer for childbirth. A primary maternity service would provide a safer environment for the women who choose to avoid standard care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Eddy-Current Reference Standard

NASA Technical Reports Server (NTRS)

Ambrose, H. H., Jr.

1985-01-01

Magnetic properties of metallic reference standards duplicated and stabilized for eddy-current coil measurements over long times. Concept uses precisely machined notched samples of known annealed materials as reference standards.

Advanced Transport Operating System (ATOPS) color displays software description: MicroVAX system

NASA Technical Reports Server (NTRS)

Slominski, Christopher J.; Plyler, Valerie E.; Dickson, Richard W.

1992-01-01

This document describes the software created for the Display MicroVAX computer used for the Advanced Transport Operating Systems (ATOPS) project on the Transport Systems Research Vehicle (TSRV). The software delivery of February 27, 1991, known as the 'baseline display system', is the one described in this document. Throughout this publication, module descriptions are presented in a standardized format which contains module purpose, calling sequence, detailed description, and global references. The global references section includes subroutines, functions, and common variables referenced by a particular module. The system described supports the Research Flight Deck (RFD) of the TSRV. The RFD contains eight Cathode Ray Tubes (CRTs) which depict a Primary Flight Display, Navigation Display, System Warning Display, Takeoff Performance Monitoring System Display, and Engine Display.

Stable isotope quality assurance using the 'calibrated IRMS' strategy.

PubMed

Meijer, Harro A J

2009-06-01

Procedures in our laboratory have always been directed towards complete understanding of all processes involved and corrections needed etc., instead of relying fully on laboratory reference materials. This rather principal strategy (or attitude) is probably not optimal in the economic sense, and is not necessarily more accurate either. Still, it has proven to be very rewarding in its capability to detect caveats that go undiscovered in the standard way of measurement, but that do influence the accuracy or reliability of the measurement procedure. An additional benefit of our laboratory procedures is that it makes us capable of assisting the International Atomic Energy Agency (IAEA) with primary questions like mutual scale assignments and comparison of isotope ratios of the same isotope in different matrices (like delta(18)O in water, carbonates and atmospheric CO(2)), establishment of the (17)O-(18)O relation, and the replenishment of the calibration standards. Finally, for manual preparation systems with a low sample throughput (and thus only few reference materials analysed) it may well be the only way to produce reliable results.

Validity of palpation of the C1 transverse process: comparison with a radiographic reference standard

PubMed Central

Cooperstein, Robert; Young, Morgan; Lew, Makani

2015-01-01

Objectives: Primary goal: to determine the validity of C1 transverse process (TVP) palpation compared to an imaging reference standard. Methods: Radiopaque markers were affixed to the skin at the putative location of the C1 TVPs in 21 participants receiving APOM radiographs. The radiographic vertical distances from the marker to the C1 TVP, mastoid process, and C2 TVP were evaluated to determine palpatory accuracy. Results: Interexaminer agreement for radiometric analysis was “excellent.” Stringent accuracy (marker placed ±4mm from the most lateral projection of the C1 TVP) = 57.1%; expansive accuracy (marker placed closer to contiguous structures) = 90.5%. Mean Absolute Deviation (MAD) = 4.34 (3.65, 5.03) mm; root-mean-squared error = 5.40mm. Conclusions: Manual palpation of the C1 TVP can be very accurate and likely to direct a manual therapist or other health professional to the intended diagnostic or therapeutic target. This work is relevant to manual therapists, anesthetists, surgeons, and other health professionals. PMID:26136601

Rabies vaccine standards: comparison of the 5th and 6th WHO international reference standards to the USDA veterinary reference standard.

PubMed

Hermann, J; Fry, A; Reising, M; Patterson, P; Siev, D; Gatewood, D

2012-11-06

Ensuring rabies vaccines are potent and effective is paramount in preventing transmission of this deadly disease and safeguarding public health. Efficacy of human and veterinary vaccines is ensured by evaluating relative potency estimates of the vaccine compared to a rabies reference standard using the National Institutes of Health (NIH) test. Reference vaccines are based on the International Standard for Rabies Vaccine provided by the World Health Organization (WHO). A comparison study was conducted to determine the relative potency of the 5th WHO, 6th WHO, and United States Department of Agriculture's (USDA) 08-14 reference standards using the NIH test. Results from the study demonstrate that the 6th WHO reference standard is approximately twice as potent as the 5th WHO reference when reconstituted to contain 1 IU per ml. Based on these results, the Center for Veterinary Biologics (CVB) doubled the reconstitution volume of USDA veterinary reference 08-14 from 13 ml to 26 ml, for an initial use dilution of 0.7 IU per ml for use by veterinary biologics manufacturers in the NIH test. This study emphasizes the importance of reference standard calibration for use in the National Institutes of Health test. Published by Elsevier Ltd.

Developing primary care in Hong Kong: evidence into practice and the development of reference frameworks.

PubMed

Griffiths, Sian M; Lee, Jeff P M

2012-10-01

Enhancing primary care is one of the proposals put forward in the Healthcare Reform Consultation Document "Your Health, Your Life" issued in March 2008. In 2009, the Working Group on Primary Care, chaired by the Secretary for Food and Health, recommended the development of age-group and disease-specific primary care conceptual models and reference frameworks. Drawing on international experience and best evidence, the Task Force on Conceptual Model and Preventive Protocols of the Working Group on Primary Care has developed two reference frameworks for the management of two common chronic diseases in Hong Kong, namely diabetes and hypertension, in primary care settings. Adopting a population approach for the prevention and control of diabetes and hypertension across the life course, the reference frameworks aim to provide evidence-based and appropriate recommendations for the provision of continuing and comprehensive care for patients with chronic diseases in the community.

Method and apparatus for rate integration supplement for attitude referencing with quaternion differencing

NASA Technical Reports Server (NTRS)

Rodden, John James (Inventor); Price, Xenophon (Inventor); Carrou, Stephane (Inventor); Stevens, Homer Darling (Inventor)

2002-01-01

A control system for providing attitude control in spacecraft. The control system comprising a primary attitude reference system, a secondary attitude reference system, and a hyper-complex number differencing system. The hyper-complex number differencing system is connectable to the primary attitude reference system and the secondary attitude reference system.

Development and Evaluation of Reference Standards for Image-based Telemedicine Diagnosis and Clinical Research Studies in Ophthalmology

PubMed Central

Ryan, Michael C.; Ostmo, Susan; Jonas, Karyn; Berrocal, Audina; Drenser, Kimberly; Horowitz, Jason; Lee, Thomas C.; Simmons, Charles; Martinez-Castellanos, Maria-Ana; Chan, R.V. Paul; Chiang, Michael F.

2014-01-01

Information systems managing image-based data for telemedicine or clinical research applications require a reference standard representing the correct diagnosis. Accurate reference standards are difficult to establish because of imperfect agreement among physicians, and discrepancies between clinical vs. image-based diagnosis. This study is designed to describe the development and evaluation of reference standards for image-based diagnosis, which combine diagnostic impressions of multiple image readers with the actual clinical diagnoses. We show that agreement between image reading and clinical examinations was imperfect (689 [32%] discrepancies in 2148 image readings), as was inter-reader agreement (kappa 0.490-0.652). This was improved by establishing an image-based reference standard defined as the majority diagnosis given by three readers (13% discrepancies with image readers). It was further improved by establishing an overall reference standard that incorporated the clinical diagnosis (10% discrepancies with image readers). These principles of establishing reference standards may be applied to improve robustness of real-world systems supporting image-based diagnosis. PMID:25954463

A statistically robust EEG re-referencing procedure to mitigate reference effect

PubMed Central

Lepage, Kyle Q.; Kramer, Mark A.; Chu, Catherine J.

2014-01-01

Background The electroencephalogram (EEG) remains the primary tool for diagnosis of abnormal brain activity in clinical neurology and for in vivo recordings of human neurophysiology in neuroscience research. In EEG data acquisition, voltage is measured at positions on the scalp with respect to a reference electrode. When this reference electrode responds to electrical activity or artifact all electrodes are affected. Successful analysis of EEG data often involves re-referencing procedures that modify the recorded traces and seek to minimize the impact of reference electrode activity upon functions of the original EEG recordings. New method We provide a novel, statistically robust procedure that adapts a robust maximum-likelihood type estimator to the problem of reference estimation, reduces the influence of neural activity from the re-referencing operation, and maintains good performance in a wide variety of empirical scenarios. Results The performance of the proposed and existing re-referencing procedures are validated in simulation and with examples of EEG recordings. To facilitate this comparison, channel-to-channel correlations are investigated theoretically and in simulation. Comparison with existing methods The proposed procedure avoids using data contaminated by neural signal and remains unbiased in recording scenarios where physical references, the common average reference (CAR) and the reference estimation standardization technique (REST) are not optimal. Conclusion The proposed procedure is simple, fast, and avoids the potential for substantial bias when analyzing low-density EEG data. PMID:24975291

Standardization of Assays That Detect Anti-Rubella Virus IgG Antibodies

PubMed Central

Grangeot-Keros, Liliane; Vauloup-Fellous, Christelle

2015-01-01

SUMMARY Rubella virus usually causes a mild infection in humans but can cause congenital rubella syndrome (CRS). Vaccination programs have significantly decreased primary rubella virus infection and CRS; however, vaccinated individuals usually have lower levels of rubella virus IgG than those with natural infections. Rubella virus IgG is quantified with enzyme immunoassays that have been calibrated against the World Health Organization (WHO) international standard and report results in international units per milliliter. It is recognized that the results reported by these assays are not standardized. This investigation into the reasons for the lack of standardization found that the current WHO international standard (RUB-1-94) fails by three key metrological principles. The standard is not a pure analyte but is composed of pooled human immunoglobulin. It was not calibrated by certified reference methods; rather, superseded tests were used. Finally, no measurement uncertainty estimations have been provided. There is an analytical and clinical consequence to the lack of standardization of rubella virus IgG assays, which leads to misinterpretation of results. The current approach to standardization of rubella virus IgG assays has not achieved the desired results. A new approach is required. PMID:26607813

Selection of reference standard during method development using the analytical hierarchy process.

PubMed

Sun, Wan-yang; Tong, Ling; Li, Dong-xiang; Huang, Jing-yi; Zhou, Shui-ping; Sun, Henry; Bi, Kai-shun

2015-03-25

Reference standard is critical for ensuring reliable and accurate method performance. One important issue is how to select the ideal one from the alternatives. Unlike the optimization of parameters, the criteria of the reference standard are always immeasurable. The aim of this paper is to recommend a quantitative approach for the selection of reference standard during method development based on the analytical hierarchy process (AHP) as a decision-making tool. Six alternative single reference standards were assessed in quantitative analysis of six phenolic acids from Salvia Miltiorrhiza and its preparations by using ultra-performance liquid chromatography. The AHP model simultaneously considered six criteria related to reference standard characteristics and method performance, containing feasibility to obtain, abundance in samples, chemical stability, accuracy, precision and robustness. The priority of each alternative was calculated using standard AHP analysis method. The results showed that protocatechuic aldehyde is the ideal reference standard, and rosmarinic acid is about 79.8% ability as the second choice. The determination results successfully verified the evaluation ability of this model. The AHP allowed us comprehensive considering the benefits and risks of the alternatives. It was an effective and practical tool for optimization of reference standards during method development. Copyright © 2015 Elsevier B.V. All rights reserved.

Diagnostic performance of semi-quantitative and quantitative stress CMR perfusion analysis: a meta-analysis.

PubMed

van Dijk, R; van Assen, M; Vliegenthart, R; de Bock, G H; van der Harst, P; Oudkerk, M

2017-11-27

Stress cardiovascular magnetic resonance (CMR) perfusion imaging is a promising modality for the evaluation of coronary artery disease (CAD) due to high spatial resolution and absence of radiation. Semi-quantitative and quantitative analysis of CMR perfusion are based on signal-intensity curves produced during the first-pass of gadolinium contrast. Multiple semi-quantitative and quantitative parameters have been introduced. Diagnostic performance of these parameters varies extensively among studies and standardized protocols are lacking. This study aims to determine the diagnostic accuracy of semi- quantitative and quantitative CMR perfusion parameters, compared to multiple reference standards. Pubmed, WebOfScience, and Embase were systematically searched using predefined criteria (3272 articles). A check for duplicates was performed (1967 articles). Eligibility and relevance of the articles was determined by two reviewers using pre-defined criteria. The primary data extraction was performed independently by two researchers with the use of a predefined template. Differences in extracted data were resolved by discussion between the two researchers. The quality of the included studies was assessed using the 'Quality Assessment of Diagnostic Accuracy Studies Tool' (QUADAS-2). True positives, false positives, true negatives, and false negatives were subtracted/calculated from the articles. The principal summary measures used to assess diagnostic accuracy were sensitivity, specificity, andarea under the receiver operating curve (AUC). Data was pooled according to analysis territory, reference standard and perfusion parameter. Twenty-two articles were eligible based on the predefined study eligibility criteria. The pooled diagnostic accuracy for segment-, territory- and patient-based analyses showed good diagnostic performance with sensitivity of 0.88, 0.82, and 0.83, specificity of 0.72, 0.83, and 0.76 and AUC of 0.90, 0.84, and 0.87, respectively. In per territory analysis our results show similar diagnostic accuracy comparing anatomical (AUC 0.86(0.83-0.89)) and functional reference standards (AUC 0.88(0.84-0.90)). Only the per territory analysis sensitivity did not show significant heterogeneity. None of the groups showed signs of publication bias. The clinical value of semi-quantitative and quantitative CMR perfusion analysis remains uncertain due to extensive inter-study heterogeneity and large differences in CMR perfusion acquisition protocols, reference standards, and methods of assessment of myocardial perfusion parameters. For wide spread implementation, standardization of CMR perfusion techniques is essential. CRD42016040176 .

15 CFR 200.105 - Standard reference data.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., PROCEDURES, AND FEES § 200.105 Standard reference data. Data on the physical and chemical properties of the... application in research, development, engineering design, and commerce. The Office of Standard Reference Data... Physical and Chemical Reference Data, published jointly with the American Chemical Society and the American...

15 CFR 200.105 - Standard reference data.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., PROCEDURES, AND FEES § 200.105 Standard reference data. Data on the physical and chemical properties of the... application in research, development, engineering design, and commerce. The Office of Standard Reference Data... Physical and Chemical Reference Data, published jointly with the American Chemical Society and the American...

15 CFR 200.105 - Standard reference data.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., PROCEDURES, AND FEES § 200.105 Standard reference data. Data on the physical and chemical properties of the... application in research, development, engineering design, and commerce. The Office of Standard Reference Data... Physical and Chemical Reference Data, published jointly with the American Chemical Society and the American...

15 CFR 200.105 - Standard reference data.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., PROCEDURES, AND FEES § 200.105 Standard reference data. Data on the physical and chemical properties of the... application in research, development, engineering design, and commerce. The Office of Standard Reference Data... Physical and Chemical Reference Data, published jointly with the American Chemical Society and the American...

Meeting a Forensic Podiatry Admissibility Challenge: A Daubert Case Study.

PubMed

Nirenberg, Michael

2016-05-01

This article is an introduction to the United States Supreme Court's standard of admissibility of forensic evidence and testimony at trial, known as the Daubert standard, with emphasis on how this standard applies to the field of forensic podiatry. The author, a forensic podiatrist, provided law enforcement with evidence tying a bloody sock-clad footprint found at the scene of a homicide to the suspect. In 2014, the author testified at a pretrial hearing, known as "a Daubert hearing," to address the admissibility of this evidence in court. This was the first instance of forensic podiatry being the primary subject of a Daubert hearing. The hearing resulted in the court ordering this evidence admissible. The expert's testimony contributed to the suspect's conviction. This article serves as a reference for forensic podiatrists and experts in similar fields that involve impression evidence, providing evidentiary standards and their impact on expert evidence and testimony. © 2016 American Academy of Forensic Sciences.

Metrological properties of {CO 2}/{OsO 4} optical frequency standard

NASA Astrophysics Data System (ADS)

Acef, O.

1997-02-01

Recent progress on the metrological performance of the BNM-LPTF {CO 2}/{OsO 4} frequency standards in the {28}/{29}THz range, using OsO 4 molecular transitions as a frequency reference is reported. Significant improvements in terms of both short-term stability ( {6.6×10 -14}/{τup to τ=300s }) and long-term stability (4 × 10 -15 up to τ = 1 000 s, Δν ˜ 0.1 Hz) are obtained. Long term reproducibility (over more than 18 months) of about 3 × 10 -13 has been achieved. This high level enables the transfer, in terms of absolute frequency at the 3 × 10 -13 level of uncertainty, from primary frequency standards in the microwave domain to near infrared and visible domains, using frequency chains with {CO 2}/{OsO 4} as a transfer frequency standard. Preliminary estimates of the main effects which may shift the OsO 4 center line are reported.

Security, safety, and related technology - the triangle of eHealth service provision.

PubMed

Savastano, Mario; Hovsto, Asbjorn; Pharow, Peter; Blobel, Bernd

2008-01-01

The developing of innovative solutions in the emerging eHealth market requires strong economic efforts which may be justified only in presence of particularly suitable boundary conditions. Among the factors retained of primary importance for the development of eHealth, a correct approach to id-management is unanimously considered fundamental. Three keywords in the id-management context appear particularly important: standardization, security and safety. Standardization may contribute to increase the size and duration of the eHealth market, while security and safety may encourage all the stakeholders to trust in a appropriate and safe management of all the very sensitive personal data involved in the eHealth applications. The aim of the present paper is analyzing some security and safety issues in eHealth from the particular prospective of the identity management and standardization. The paper highlights the mission of the EU funded "BioHealth" project whose mission is to increase the stakeholders' knowledge about existing and emerging standards in eHealth with particular reference to identity management.

Expanding rural primary care training by employing information technologies: the need for participation by medical reference librarians.

PubMed

Coggan, J M; Crandall, L A

1995-01-01

The use of rural sites to train badly needed primary care providers requires access to sophisticated medical information not traditionally available outside of academic health centers. Medical reference librarians can play a key role in the development of primary care training sites in rural settings. Electronic information technologies, with proactive support from medical reference librarians, can provide current and detailed information without concern for distance from the health science center library. This paper discusses recent developments in technology, describes current challenges to the application of this technology in rural settings, and provides policy recommendations for medical reference librarians to enhance rural primary care training.

Sex disparities in tuberculosis suspect evaluation: a cross-sectional analysis in rural Uganda.

PubMed

Miller, C R; Davis, J L; Katamba, A; Sserwanga, A; Kakeeto, S; Kizito, F; Cattamanchi, A

2013-04-01

Six primary health care centers in rural Uganda. To compare the quality of tuberculosis (TB) evaluation for men and women presenting to primary health care facilities in high-burden settings. Cross-sectional study using indicators derived from the International Standards of Tuberculosis Care (ISTC) to compare the quality of TB evaluation services provided to men and women. Of 161 230 patient visits between January 2009 and December 2010, 112 329 (69.7%) were women. We considered 3308 (2.1%) patients with cough ≥2 weeks as TB suspects, of whom 1871 (56.6%) were women. Female TB suspects were less likely to be referred for sputum smear examination (45.9% vs. 61.6%, P < 0.001), to complete sputum smear examination if referred (73.7% vs. 78.3%, P = 0.024) and to receive comprehensive evaluation and care as defined by the ISTC (33.0% vs. 45.6%, P < 0.001). After adjusting for age, clinic site and visit date, women remained less likely to be referred for sputum smear examination (risk ratio [RR] 0.81, 95%CI 0.74-0.89, P < 0.001) and to receive ISTC-recommended care (RR 0.79, 95%CI 0.72-0.86, P < 0.001). Strategies to ensure that women receive appropriate TB evaluation could provide a valuable opportunity for increasing case detection while also promoting equitable and universal access to care.

Designing image segmentation studies: Statistical power, sample size and reference standard quality.

PubMed

Gibson, Eli; Hu, Yipeng; Huisman, Henkjan J; Barratt, Dean C

2017-12-01

Segmentation algorithms are typically evaluated by comparison to an accepted reference standard. The cost of generating accurate reference standards for medical image segmentation can be substantial. Since the study cost and the likelihood of detecting a clinically meaningful difference in accuracy both depend on the size and on the quality of the study reference standard, balancing these trade-offs supports the efficient use of research resources. In this work, we derive a statistical power calculation that enables researchers to estimate the appropriate sample size to detect clinically meaningful differences in segmentation accuracy (i.e. the proportion of voxels matching the reference standard) between two algorithms. Furthermore, we derive a formula to relate reference standard errors to their effect on the sample sizes of studies using lower-quality (but potentially more affordable and practically available) reference standards. The accuracy of the derived sample size formula was estimated through Monte Carlo simulation, demonstrating, with 95% confidence, a predicted statistical power within 4% of simulated values across a range of model parameters. This corresponds to sample size errors of less than 4 subjects and errors in the detectable accuracy difference less than 0.6%. The applicability of the formula to real-world data was assessed using bootstrap resampling simulations for pairs of algorithms from the PROMISE12 prostate MR segmentation challenge data set. The model predicted the simulated power for the majority of algorithm pairs within 4% for simulated experiments using a high-quality reference standard and within 6% for simulated experiments using a low-quality reference standard. A case study, also based on the PROMISE12 data, illustrates using the formulae to evaluate whether to use a lower-quality reference standard in a prostate segmentation study. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A conversion method of air kerma from the primary, scatter, and leakage radiations to effective dose for calculating x-ray shielding barriers in mammography

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

Kharrati, Hedi

2005-05-01

In this study, a new approach has been introduced for derivation of the effective dose from air kerma to calculate shielding requirements in mammography facilities. This new approach has been used to compute the conversion coefficients relating air kerma to the effective dose for the mammography reference beam series of the Netherlands Metrology Institute Van Swinden Laboratorium, National Institute of Standards and Technology, and International Atomic Energy Agency laboratories. The results show that, in all cases, the effective dose in mammography energy range is less than 25% of the incident air kerma for the primary and the scatter radiations andmore » does not exceed 75% for the leakage radiation.« less

Validation of the Spanish SIRS with monolingual Hispanic outpatients.

PubMed

Correa, Amor A; Rogers, Richard; Hoersting, Raquel

2010-09-01

Psychologists are faced with formidable challenges in making their assessment methods relevant to growing numbers of Hispanic clients for whom English is not the primary or preferred language. Among other clinical issues, the determination of malingering has profound consequences for clients. In this investigation, we evaluated a Spanish translation of the Structured Interview of Reported Symptoms (SIRS; Rogers, Bagby, & Dickens, 1992) with 80 Spanish-speaking Hispanic American outpatients. Using a between-subjects simulation design, the Spanish SIRS was found to produce reliable results with small standard errors of measurement. Regarding validity, very large effect sizes (mean Cohen's d= 2.00) were observed between feigners and honest responders for the SIRS primary scales. We consider the potential role of the Spanish SIRS with reference to Spanish translations for other assessment instruments.

Bilateral comparison of 1 V and 10 V standards between the NMISA (South Africa) and the BIPM April to June 2017 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Matlejoane, A. M.; Magagula, L.; Stock, M.

2018-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1.018 V and 10 V voltage reference standards of the BIPM and the National Metrology Institute of South Africa, NMISA (South Africa), was carried out from April to June 2017. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPMA (ZA) and BIPMB (ZB), were transported by freight to NMISA and back to BIPM. In order to keep the Zeners powered during their transportation phase, a voltage stabilizer developed by BIPM was connected in parallel to the internal battery. It consists of a set of two batteries, electrically protected from surcharge-discharge, easy to recharge and is designed to power two transfer standards for ten consecutive days. At NMISA, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at NMISA, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned to DC voltage standards by NMISA, at the level of 1.018 V and 10 V, at NMISA, UNMISA, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference dates of the 19th and 18th of May 2017, respectively. UNMISA - UBIPM = + 0.07 μV uc = 0.02 μV, at 1.018 V UNMISA - UBIPM = + 0.001 μV uc = 0.34 μV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at NMISA, based on KJ-90, and the uncertainty related to the comparison. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Bilateral comparison of 1 V and 10 V standards between the DEFNAT (Tunisia) and the BIPM February to March 2016 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Ben Salah, B.; Mallat, A.; Abene, L.; Stock, M.

2016-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the Laboratoire de Métrologie Electrique, DEFNAT (Tunisia), was carried out from February to March 2016. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPMC (ZC) and BIPM6 (Z6), were transported by freight to DEFNAT and back to BIPM. In order to keep the Zeners powered during their transportation phase, a BIPM in-house voltage stabiliser was connected in parallel to the internal battery. The voltage stabiliser consists of a set of two batteries, electrically protected from surcharge-discharge, easy to recharge and is designed to power two transfer standards for 10 consecutive days. At DEFNAT, the reference standard for DC voltage is a Josephson Voltage Standard. The output EMF (Electromotive Force) of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at DEFNAT, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned to DC voltage standards by DEFNAT, at the level of 1.018 V and 10 V, at DEFNAT, UDEFNAT, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of the 26th of February 2016. UDEFNAT - UBIPM = + 0.07 μV uc = 0.04 μV, at 1.018 V UDEFNAT - UBIPM = + 0.38 μV uc = 0.10 μV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at NSAI-NML, based on KJ-90, and the uncertainty related to the comparison. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Reference Standard Test and the Diagnostic Ability of Spectral Domain Optical Coherence Tomography in Glaucoma.

PubMed

Rao, Harsha L; Yadav, Ravi K; Addepalli, Uday K; Begum, Viquar U; Senthil, Sirisha; Choudhari, Nikhil S; Garudadri, Chandra S

2015-08-01

To evaluate the relationship between the reference standard used to diagnose glaucoma and the diagnostic ability of spectral domain optical coherence tomograph (SDOCT). In a cross-sectional study, 280 eyes of 175 consecutive subjects, referred to a tertiary eye care center for glaucoma evaluation, underwent optic disc photography, visual field (VF) examination, and SDOCT examination. The cohort was divided into glaucoma and control groups based on 3 reference standards for glaucoma diagnosis: first based on the optic disc classification (179 glaucoma and 101 control eyes), second on VF classification (glaucoma hemifield test outside normal limits and pattern SD with P-value of <5%, 130 glaucoma and 150 control eyes), and third on the presence of both glaucomatous optic disc and glaucomatous VF (125 glaucoma and 155 control eyes). Relationship between the reference standards and the diagnostic parameters of SDOCT were evaluated using areas under the receiver operating characteristic curve, sensitivity, and specificity. Areas under the receiver operating characteristic curve and sensitivities of most of the SDOCT parameters obtained with the 3 reference standards (ranging from 0.74 to 0.88 and 72% to 88%, respectively) were comparable (P>0.05). However, specificities of SDOCT parameters were significantly greater (P<0.05) with optic disc classification as reference standard (74% to 88%) compared with VF classification as reference standard (57% to 74%). Diagnostic parameters of SDOCT that was significantly affected by reference standard was the specificity, which was greater with optic disc classification as the reference standard. This has to be considered when comparing the diagnostic ability of SDOCT across studies.

National Nutrition Education Clearing House Reference List, Preschool, Primary and Intermediate Teaching Materials and Teacher References.

ERIC Educational Resources Information Center

National Nutrition Education Clearing House, Berkeley, CA.

This is a reference list of teaching materials and teacher references of importance to teachers in the field of nutrition and nutrition education. It emphasizes resources for preschool, primary and intermediate grades. Although not a comprehensive list, resources include books, pamphlets, curriculum guides, article reprints, films and filmstrips,…

Subtype Diagnosis of Primary Aldosteronism: Is Adrenal Vein Sampling Always Necessary?

PubMed Central

Buffolo, Fabrizio; Monticone, Silvia; Williams, Tracy A.; Rossato, Denis; Burrello, Jacopo; Tetti, Martina; Veglio, Franco; Mulatero, Paolo

2017-01-01

Aldosterone producing adenoma and bilateral adrenal hyperplasia are the two most common subtypes of primary aldosteronism (PA) that require targeted and distinct therapeutic approaches: unilateral adrenalectomy or lifelong medical therapy with mineralocorticoid receptor antagonists. According to the 2016 Endocrine Society Guideline, adrenal venous sampling (AVS) is the gold standard test to distinguish between unilateral and bilateral aldosterone overproduction and therefore, to safely refer patients with PA to surgery. Despite significant advances in the optimization of the AVS procedure and the interpretation of hormonal data, a standardized protocol across centers is still lacking. Alternative methods are sought to either localize an aldosterone producing adenoma or to predict the presence of unilateral disease and thereby substantially reduce the number of patients with PA who proceed to AVS. In this review, we summarize the recent advances in subtyping PA for the diagnosis of unilateral and bilateral disease. We focus on the developments in the AVS procedure, the interpretation criteria, and comparisons of the performance of AVS with the alternative methods that are currently available. PMID:28420172

34 CFR 73.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Cross-reference to employee ethical conduct standards... of Education STANDARDS OF CONDUCT § 73.1 Cross-reference to employee ethical conduct standards and... branch-wide Standards of Ethical Conduct at 5 CFR part 2635 and to the Department of Education regulation...

34 CFR 73.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Cross-reference to employee ethical conduct standards... of Education STANDARDS OF CONDUCT § 73.1 Cross-reference to employee ethical conduct standards and... branch-wide Standards of Ethical Conduct at 5 CFR part 2635 and to the Department of Education regulation...

34 CFR 73.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 1 2014-07-01 2014-07-01 false Cross-reference to employee ethical conduct standards... of Education STANDARDS OF CONDUCT § 73.1 Cross-reference to employee ethical conduct standards and... branch-wide Standards of Ethical Conduct at 5 CFR part 2635 and to the Department of Education regulation...

34 CFR 73.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 1 2013-07-01 2013-07-01 false Cross-reference to employee ethical conduct standards... of Education STANDARDS OF CONDUCT § 73.1 Cross-reference to employee ethical conduct standards and... branch-wide Standards of Ethical Conduct at 5 CFR part 2635 and to the Department of Education regulation...

34 CFR 73.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Cross-reference to employee ethical conduct standards... of Education STANDARDS OF CONDUCT § 73.1 Cross-reference to employee ethical conduct standards and... branch-wide Standards of Ethical Conduct at 5 CFR part 2635 and to the Department of Education regulation...

Primary care patients in the emergency department: who are they? A review of the definition of the 'primary care patient' in the emergency department.

PubMed

Bezzina, Andrew J; Smith, Peter B; Cromwell, David; Eagar, Kathy

2005-01-01

To review the definition of 'primary care' and 'inappropriate' patients in ED and develop a generally acceptable working definition of a 'primary care' presentation in ED. A Medline review of articles on primary care in ED and the definitions used. A total of 34 reviewed papers contained a proposed definition or comment on the definition for potential 'primary care', 'general practice', or 'inappropriate' patients in ED. A representative definition was developed premised on the common factors in these papers: low urgency/acuity--triage categories four or five in the Australasian Triage Scale, self-referred--by definition, patients referred by general practitioner/community primary medical services are not primary care cases because a primary care service has referred them on, presenting for a new episode of care (i.e. not a planned return because planned returns are not self-referred), unlikely to be admitted (in the opinion of Emergency Nurse interviewers) or ultimately not admitted. This definition can be applied either prospectively or retrospectively, depending on the purpose. Appropriateness must be considered in light of a legitimate role for ED in primary care and the balance of resources between primary care and emergency medicine in local settings.

Standard setting processes and regulations for environmental contaminants in drinking water: State versus federal needs and viewpoints

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

Sidhu, K.S.

1991-06-01

The primary objective of a standard setting process is to arrive at a drinking water concentration at which exposure to a contaminant would result in no known or potential adverse health effect on human health. The drinking water standards also serve as guidelines to prevent pollution of water sources and may be applicable in some cases as regulatory remediation levels. The risk assessment methods along with various decision making parameters are used to establish drinking water standards. For carcinogens classified in Groups A and B by the United States Environmental Protection Agency (USEPA) the standards are set by using nonthresholdmore » cancer risk models. The linearized multistage model is commonly used for computation of potency factors for carcinogenic contaminants. The acceptable excess risk level may vary from 10(-6) to 10(-4). For noncarcinogens, a threshold model approach based on application of an uncertainty factor is used to arrive at a reference dose (RfD). The RfD approach may also be used for carcinogens classified in Group C by the USEPA. The RfD approach with an additional uncertainty factory of 10 for carcinogenicity has been applied in the formulation of risk assessment for Group C carcinogens. The assumptions commonly used in arriving at drinking water standards are human life expectancy, 70 years; average human body weight, 70 kg; human daily drinking water consumption, 2 liters; and contribution of exposure to the contaminant from drinking water (expressed as a part of the total environmental exposure), 20%. Currently, there are over 80 USEPA existing or proposed primary standards for organic and inorganic contaminants in drinking water. Some of the state versus federal needs and viewpoints are discussed.« less

7 CFR 1728.97 - Incorporation by reference of electric standards and specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 11 2014-01-01 2014-01-01 false Incorporation by reference of electric standards and...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC STANDARDS AND SPECIFICATIONS FOR MATERIALS AND CONSTRUCTION § 1728.97 Incorporation by reference of electric standards and specifications. The...

7 CFR 1728.97 - Incorporation by reference of electric standards and specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Incorporation by reference of electric standards and...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC STANDARDS AND SPECIFICATIONS FOR MATERIALS AND CONSTRUCTION § 1728.97 Incorporation by reference of electric standards and specifications. The...

Physician Surveys to Assess Customary Care in Medical Malpractice Cases

PubMed Central

Hartz, Arthur; Lucas, Joshua; Cramm, Timothy; Green, Michael; Bentler, Suzanne; Ely, John; Wolfe, Steven; James, Paul

2002-01-01

OBJECTIVE Physician experts hired and prepared by the litigants provide most information on standard of care for medical malpractice cases. Since this information may not be objective or accurate, we examined the feasibility and potential value of surveying community physicians to assess standard of care. DESIGN Seven physician surveys of mutually exclusive groups of randomly selected physicians. SETTING Iowa. PARTICIPANTS Community and academic primary care physicians and relevant specialists. INTERVENTIONS Included in each survey was a case vignette of a primary care malpractice case and key quotes from medical experts on each side of the case. Surveyed physicians were asked whether the patient should have been referred to a specialist for additional evaluation. The 7 case vignettes included 3 closed medical malpractice cases, 3 modifications of these cases, and 1 active case. MEASUREMENTS AND MAIN RESULTS Sixty-three percent of 350 community primary care physicians and 51% of 216 community specialists completed the questionnaire. For 3 closed cases, 47%, 78%, and 88% of primary care physician respondents reported that they would have made a different referral decision than the defendant. Referral percentages were minimally affected by modifying patient outcome but substantially changed by modifying patient presentation. Most physicians, even those whose referral decisions were unusual, assumed that other physicians would make similar referral decisions. For each case, at least 65% of the primary care physicians disagreed with the testimony of one of the expert witnesses. In the active case, the response rate was high (71%), and the respondents did not withhold criticism of the defendant doctor. CONCLUSIONS Randomly selected peer physicians are willing to participate in surveys of medical malpractice cases. The surveys can be used to construct the distribution of physician self-reported practice relevant to a particular malpractice case. This distribution may provide more information about customary practice or standard of care than the opinion of a single physician expert. PMID:12133145

Telemetry Standards, RCC Standard 106-17. Chapter 3. Frequency Division Multiplexing Telemetry Standards

DTIC Science & Technology

2017-07-01

any of the listed reference frequencies may be used provided the requirements for compensation rate of change are satisfied. If the reference...for in present discriminator systems when the nominal response rating of the channels is employed and a reference frequency is recorded with the...Telemetry Standards, RCC Standard 106-17 Chapter 3, July 2017 3-i CHAPTER 3 Frequency Division Multiplexing Telemetry Standards Acronyms

An explorative study of school performance and antipsychotic medication.

PubMed

van der Schans, J; Vardar, S; Çiçek, R; Bos, H J; Hoekstra, P J; de Vries, T W; Hak, E

2016-09-21

Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. A cross-sectional study was conducted using the University Groningen pharmacy database linked to academic achievement scores at the end of primary school (Dutch Cito-test) obtained from Statistics Netherlands. Mean Cito-test scores and standard deviations were obtained for children on antipsychotic therapy and reference children, and statistically compared using analyses of covariance. In addition, differences in subgroups as boys versus girls, ethnicity, household income, and late starters (start date within 12 months of the Cito-test) versus early starters (start date > 12 months before the Cito-test) were tested. In all, data from 7994 children could be linked to Cito-test scores. At the time of the Cito-test, 45 (0.6 %) were on treatment with antipsychotics. Children using antipsychotics scored on average 3.6 points lower than the reference peer group (534.5 ± 9.5). Scores were different across gender and levels of household income (p < 0.05). Scores of early starters were significantly higher than starters within 12 months (533.7 ± 1.7 vs. 524.1 ± 2.6). This first exploration showed that children on antipsychotic treatment have lower school performance compared to the reference peer group at the end of primary school. This was most noticeable for girls, but early starters were less affected than later starters. Due to the observational cross-sectional nature of this study, no causality can be inferred, but the results indicate that school performance should be closely monitored and causes of underperformance despite treatment warrants more research.

Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery

PubMed Central

Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

2016-01-01

Background/aims To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. Methods In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Results Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as ‘routine’ in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Conclusions Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. Trial registration number NCT02101359; Results. PMID:26531052

Development and Validation of a Rapid (13)C6-Glucose Isotope Dilution UPLC-MRM Mass Spectrometry Method for Use in Determining System Accuracy and Performance of Blood Glucose Monitoring Devices.

PubMed

Matsunami, Risë K; Angelides, Kimon; Engler, David A

2015-05-18

There is currently considerable discussion about the accuracy of blood glucose concentrations determined by personal blood glucose monitoring systems (BGMS). To date, the FDA has allowed new BGMS to demonstrate accuracy in reference to other glucose measurement systems that use the same or similar enzymatic-based methods to determine glucose concentration. These types of reference measurement procedures are only comparative in nature and are subject to the same potential sources of error in measurement and system perturbations as the device under evaluation. It would be ideal to have a completely orthogonal primary method that could serve as a true standard reference measurement procedure for establishing the accuracy of new BGMS. An isotope-dilution liquid chromatography/mass spectrometry (ID-UPLC-MRM) assay was developed using (13)C6-glucose as a stable isotope analogue to specifically measure glucose concentration in human plasma, and validated for use against NIST standard reference materials, and against fresh isolates of whole blood and plasma into which exogenous glucose had been spiked. Assay performance was quantified to NIST-traceable dry weight measures for both glucose and (13)C6-glucose. The newly developed assay method was shown to be rapid, highly specific, sensitive, accurate, and precise for measuring plasma glucose levels. The assay displayed sufficient dynamic range and linearity to measure across the range of both normal and diabetic blood glucose levels. Assay performance was measured to within the same uncertainty levels (<1%) as the NIST definitive method for glucose measurement in human serum. The newly developed ID UPLC-MRM assay can serve as a validated reference measurement procedure to which new BGMS can be assessed for glucose measurement performance. © 2015 Diabetes Technology Society.

Development and Validation of a Rapid 13C6-Glucose Isotope Dilution UPLC-MRM Mass Spectrometry Method for Use in Determining System Accuracy and Performance of Blood Glucose Monitoring Devices

PubMed Central

Matsunami, Risë K.; Angelides, Kimon; Engler, David A.

2015-01-01

Background: There is currently considerable discussion about the accuracy of blood glucose concentrations determined by personal blood glucose monitoring systems (BGMS). To date, the FDA has allowed new BGMS to demonstrate accuracy in reference to other glucose measurement systems that use the same or similar enzymatic-based methods to determine glucose concentration. These types of reference measurement procedures are only comparative in nature and are subject to the same potential sources of error in measurement and system perturbations as the device under evaluation. It would be ideal to have a completely orthogonal primary method that could serve as a true standard reference measurement procedure for establishing the accuracy of new BGMS. Methods: An isotope-dilution liquid chromatography/mass spectrometry (ID-UPLC-MRM) assay was developed using 13C6-glucose as a stable isotope analogue to specifically measure glucose concentration in human plasma, and validated for use against NIST standard reference materials, and against fresh isolates of whole blood and plasma into which exogenous glucose had been spiked. Assay performance was quantified to NIST-traceable dry weight measures for both glucose and 13C6-glucose. Results: The newly developed assay method was shown to be rapid, highly specific, sensitive, accurate, and precise for measuring plasma glucose levels. The assay displayed sufficient dynamic range and linearity to measure across the range of both normal and diabetic blood glucose levels. Assay performance was measured to within the same uncertainty levels (<1%) as the NIST definitive method for glucose measurement in human serum. Conclusions: The newly developed ID UPLC-MRM assay can serve as a validated reference measurement procedure to which new BGMS can be assessed for glucose measurement performance. PMID:25986627

Evaluation of the efficacy and safety of a standardised intracameral combination of mydriatics and anaesthetics for cataract surgery.

PubMed

Labetoulle, Marc; Findl, Oliver; Malecaze, François; Alió, Jorge; Cochener, Béatrice; Lobo, Conceição; Lazreg, Sihem; Hartani, Dahbia; Colin, Joseph; Tassignon, Marie-José; Behndig, Anders

2016-07-01

To compare the efficacy and safety of intracameral (IC) administration at the beginning of cataract surgery, of Mydrane, a standardised ophthalmic combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%, to a standard topical regimen. In this international phase III, prospective, randomised study, the selected eye of 555 patients undergoing phacoemulsification with intraocular lens (IOL) implantation received 200 μL of Mydrane (Mydrane group) just after the first incision or a topical regimen of one drop each of tropicamide 0.5% and phenylephrine 10% repeated three times (reference group). The primary efficacy variable was achievement of capsulorhexis without additional mydriatics. The non-inferiority of Mydrane to the topical regimen was tested. The main outcome measures were pupil size, patient perception of ocular discomfort and safety. Capsulorhexis without additional mydriatics was performed in 98.9% of patients and 94.7% in the Mydrane and reference groups, respectively. Both groups achieved adequate mydriasis (>7 mm) during capsulorhexis, phacoemulsification and IOL insertion. IOL insertion was classified as 'routine' in a statistically greater number of eyes in the Mydrane group compared with the reference group (p=0.047). Patients in the Mydrane group reported statistically greater comfort than the reference group before IOL insertion (p=0.034). Safety data were similar between groups. Mydrane is an effective and safe alternative to standard eye drops for initiating and maintaining intraoperative mydriasis and analgesia. Patients who received IC Mydrane were significantly more comfortable before IOL insertion than the reference group. Surgeons found IOL insertion less technically challenging with IC Mydrane. NCT02101359; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

49 CFR 1019.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 8 2011-10-01 2011-10-01 false Cross-reference to employee ethical conduct... Cross-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees of the Surface Transportation Board also should refer to the executive branch Standards of Ethical...

49 CFR 1019.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Cross-reference to employee ethical conduct... Cross-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees of the Surface Transportation Board also should refer to the executive branch Standards of Ethical...

49 CFR 1019.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 8 2014-10-01 2014-10-01 false Cross-reference to employee ethical conduct... Cross-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees of the Surface Transportation Board also should refer to the executive branch Standards of Ethical...

49 CFR 1019.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 8 2013-10-01 2013-10-01 false Cross-reference to employee ethical conduct... Cross-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees of the Surface Transportation Board also should refer to the executive branch Standards of Ethical...

49 CFR 1019.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 8 2012-10-01 2012-10-01 false Cross-reference to employee ethical conduct... Cross-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees of the Surface Transportation Board also should refer to the executive branch Standards of Ethical...

High-Level Primary Clarithromycin Resistance of Helicobacter pylori in Algiers, Algeria: A Prospective Multicenter Molecular Study.

PubMed

Djennane-Hadibi, Fazia; Bachtarzi, Mohamed; Layaida, Karim; Ali Arous, Nassima; Nakmouche, Mhamed; Saadi, Berkane; Tazir, Mohamed; Ramdani-Bouguessa, Nadjia; Burucoa, Christophe

2016-04-01

Knowledge of local antibiotic resistance is crucial to adaptation for the choice of the optimal first-line treatment for Helicobacter pylori infection. Clarithromycin is a key component of the standard triple therapy largely used worldwide and, more particularly, in Algeria. Clarithromycin resistance is the main risk factor for treatment failure. The aim of this study was to evaluate, for the first time in Algeria, the prevalence of the primary resistance of H. pylori to clarithromycin. We conducted a prospective study (2008-2014) that included 195 Algerian patients referred for gastroduodenal endoscopy to two University Hospitals, one General Hospital, and several private gastroenterologists in Algiers (Algeria). One gastric biopsy was collected for the molecular detection of H. pylori and the mutations in 23S rRNA genes that confer resistance to clarithromycin with a quadruplex real-time PCR using Scorpion primers. The Scorpion PCR detected H. pylori DNA in 91 biopsies (47%). A mutation conferring resistance to clarithromycin was detected in 32 of the 91 positive patients (35%) and in 29 of the 88 positive patients never previously treated for an H. pylori infection (33%). The prevalence of primary resistance of H. pylori to clarithromycin was 33% in the Algerian population being studied. The high level of primary clarithromycin resistance in the H. pylori strains infecting the Algerian population that we report leads us to recommend the abandonment of the standard clarithromycin-based triple therapy as a first-line treatment in Algeria.

Development of a Northern Continental Air Standard Reference Material.

PubMed

Rhoderick, George C; Kitzis, Duane R; Kelley, Michael E; Miller, Walter R; Hall, Bradley D; Dlugokencky, Edward J; Tans, Pieter P; Possolo, Antonio; Carney, Jennifer

2016-03-15

The National Institute of Standards and Technology (NIST) recently began to develop standard mixtures of greenhouse gases as part of a broad program mandated by the 2009 United States Congress to support research in climate change. To this end, NIST developed suites of gravimetrically assigned primary standard mixtures (PSMs) comprising carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O) in a dry-natural air balance at ambient mole fraction levels. In parallel, the National Oceanic and Atmospheric Administration (NOAA) in Boulder, Colorado, charged 30 aluminum gas cylinders with northern hemisphere air at Niwot Ridge, Colorado. These mixtures, which constitute NIST Standard Reference Material (SRM) 1720 Northern Continental Air, were certified by NIST for ambient mole fractions of CO2, CH4, and N2O relative to NIST PSMs. NOAA-assigned values are also provided as information in support of the World Meteorological Organization (WMO) Global Atmosphere Watch (GAW) Program for CO2, CH4, and N2O, since NOAA serves as the WMO Central Calibration Laboratory (CCL) for CO2, CH4, and N2O. Relative expanded uncertainties at the 95% confidence interval are <±0.06% of the certified values for CO2 and N2O and <0.2% for CH4, which represents the smallest relative uncertainties specified to date for a gaseous SRM produced by NIST. Agreement between the NOAA (WMO/GAW) and NIST values based on their respective calibration standards suites is within 0.05%, 0.13%, and 0.06% for CO2, CH4, and N2O, respectively. This collaborative development effort also represents the first of its kind for a gaseous SRM developed by NIST.

From plastic to gold: a unified classification scheme for reference standards in medical image processing

NASA Astrophysics Data System (ADS)

Lehmann, Thomas M.

2002-05-01

Reliable evaluation of medical image processing is of major importance for routine applications. Nonetheless, evaluation is often omitted or methodically defective when novel approaches or algorithms are introduced. Adopted from medical diagnosis, we define the following criteria to classify reference standards: 1. Reliance, if the generation or capturing of test images for evaluation follows an exactly determined and reproducible protocol. 2. Equivalence, if the image material or relationships considered within an algorithmic reference standard equal real-life data with respect to structure, noise, or other parameters of importance. 3. Independence, if any reference standard relies on a different procedure than that to be evaluated, or on other images or image modalities than that used routinely. This criterion bans the simultaneous use of one image for both, training and test phase. 4. Relevance, if the algorithm to be evaluated is self-reproducible. If random parameters or optimization strategies are applied, reliability of the algorithm must be shown before the reference standard is applied for evaluation. 5. Significance, if the number of reference standard images that are used for evaluation is sufficient large to enable statistically founded analysis. We demand that a true gold standard must satisfy the Criteria 1 to 3. Any standard only satisfying two criteria, i.e., Criterion 1 and Criterion 2 or Criterion 1 and Criterion 3, is referred to as silver standard. Other standards are termed to be from plastic. Before exhaustive evaluation based on gold or silver standards is performed, its relevance must be shown (Criterion 4) and sufficient tests must be carried out to found statistical analysis (Criterion 5). In this paper, examples are given for each class of reference standards.

Unified Bayesian Estimator of EEG Reference at Infinity: rREST (Regularized Reference Electrode Standardization Technique)

PubMed Central

Hu, Shiang; Yao, Dezhong; Valdes-Sosa, Pedro A.

2018-01-01

The choice of reference for the electroencephalogram (EEG) is a long-lasting unsolved issue resulting in inconsistent usages and endless debates. Currently, both the average reference (AR) and the reference electrode standardization technique (REST) are two primary, apparently irreconcilable contenders. We propose a theoretical framework to resolve this reference issue by formulating both (a) estimation of potentials at infinity, and (b) determination of the reference, as a unified Bayesian linear inverse problem, which can be solved by maximum a posterior estimation. We find that AR and REST are very particular cases of this unified framework: AR results from biophysically non-informative prior; while REST utilizes the prior based on the EEG generative model. To allow for simultaneous denoising and reference estimation, we develop the regularized versions of AR and REST, named rAR and rREST, respectively. Both depend on a regularization parameter that is the noise to signal variance ratio. Traditional and new estimators are evaluated with this framework, by both simulations and analysis of real resting EEGs. Toward this end, we leverage the MRI and EEG data from 89 subjects which participated in the Cuban Human Brain Mapping Project. Generated artificial EEGs—with a known ground truth, show that relative error in estimating the EEG potentials at infinity is lowest for rREST. It also reveals that realistic volume conductor models improve the performances of REST and rREST. Importantly, for practical applications, it is shown that an average lead field gives the results comparable to the individual lead field. Finally, it is shown that the selection of the regularization parameter with Generalized Cross-Validation (GCV) is close to the “oracle” choice based on the ground truth. When evaluated with the real 89 resting state EEGs, rREST consistently yields the lowest GCV. This study provides a novel perspective to the EEG reference problem by means of a unified inverse solution framework. It may allow additional principled theoretical formulations and numerical evaluation of performance. PMID:29780302

Impact of a deferred recruitment model in a randomised controlled trial in primary care (CREAM study).

PubMed

Shepherd, Victoria; Thomas-Jones, Emma; Ridd, Matthew J; Hood, Kerenza; Addison, Katy; Francis, Nick A

2017-11-10

Recruitment of participants is particularly challenging in primary care, with less than a third of randomised controlled trials (RCT) achieving their target within the original time frame. Participant identification, consent, randomisation and data collection can all be time-consuming. Trials recruiting an incident, as opposed to a prevalent, population may be particularly affected. This paper describes the impact of a deferred recruitment model in a RCT of antibiotics for children with infected eczema in primary care, which required the recruitment of cases presenting acutely. Eligible children were identified by participating general practitioners (GPs) and referred to a study research nurse, who then visited them at home. This allowed the consent and recruitment processes to take place outside the general practice setting. Information was recorded about patients who were referred and recruited, or if not, the reasons for non-recruitment. Data on recruitment challenges were collected through semi-structured interviews and questionnaires with a sample of participating GPs. Data were thematically analysed to identify key themes. Of the children referred to the study 34% (58/171) were not recruited - 48% (28/58) because of difficulties arranging a baseline visit within the defined time frame, 31% (18/58) did not meet the study inclusion criteria at the time of nurse assessment, and 21% (12/58) declined participation. GPs had positive views about the recruitment process, reporting that parents valued and benefitted from additional contact with a nurse. GPs felt that the deferred recruitment model did not negatively impact on the study. GPs and parents recognised the benefits of deferred recruitment, but these did not translate into enhanced recruitment of participants. The model resulted in the loss of a third of children who were identified by the GP as eligible, but not subsequently recruited to the study. If the potential for improving outcomes in primary care through complex studies is to be realised, new approaches to recruitment into primary care trials need to be developed and evaluated. International Standard Randomised Controlled Trials, ISRCTN96705420 . Registered on 27 June 2012.

28 CFR 45.1 - Cross-reference to ethical standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Cross-reference to ethical standards and...) EMPLOYEE RESPONSIBILITIES § 45.1 Cross-reference to ethical standards and financial disclosure regulations. Employees of the Department of Justice are subject to the executive branch-wide Standards of Ethical Conduct...

10 CFR 1010.102 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Cross-references to employee ethical conduct standards... Cross-references to employee ethical conduct standards, financial disclosure regulations, and other conduct rules. Employees of DOE are subject to the Standards of Ethical Conduct for Employees of the...

28 CFR 45.1 - Cross-reference to ethical standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cross-reference to ethical standards and...) EMPLOYEE RESPONSIBILITIES § 45.1 Cross-reference to ethical standards and financial disclosure regulations. Employees of the Department of Justice are subject to the executive branch-wide Standards of Ethical Conduct...

10 CFR 1010.102 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Cross-references to employee ethical conduct standards... Cross-references to employee ethical conduct standards, financial disclosure regulations, and other conduct rules. Employees of DOE are subject to the Standards of Ethical Conduct for Employees of the...

10 CFR 1010.102 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Cross-references to employee ethical conduct standards... Cross-references to employee ethical conduct standards, financial disclosure regulations, and other conduct rules. Employees of DOE are subject to the Standards of Ethical Conduct for Employees of the...

28 CFR 45.1 - Cross-reference to ethical standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Cross-reference to ethical standards and...) EMPLOYEE RESPONSIBILITIES § 45.1 Cross-reference to ethical standards and financial disclosure regulations. Employees of the Department of Justice are subject to the executive branch-wide Standards of Ethical Conduct...

10 CFR 1010.102 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Cross-references to employee ethical conduct standards... Cross-references to employee ethical conduct standards, financial disclosure regulations, and other conduct rules. Employees of DOE are subject to the Standards of Ethical Conduct for Employees of the...

28 CFR 45.1 - Cross-reference to ethical standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Cross-reference to ethical standards and...) EMPLOYEE RESPONSIBILITIES § 45.1 Cross-reference to ethical standards and financial disclosure regulations. Employees of the Department of Justice are subject to the executive branch-wide Standards of Ethical Conduct...

28 CFR 45.1 - Cross-reference to ethical standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Cross-reference to ethical standards and...) EMPLOYEE RESPONSIBILITIES § 45.1 Cross-reference to ethical standards and financial disclosure regulations. Employees of the Department of Justice are subject to the executive branch-wide Standards of Ethical Conduct...

A comparison of three infant skinfold reference standards: Tanner-Whitehouse, Cambridge Infant Growth Study, and WHO Child Growth Standards.

PubMed

Miller, Elizabeth M

2015-10-01

As researchers increasingly focus on early infancy as a critical period of development, there is a greater need for methodological tools that can address all aspects of infant growth. Infant skinfold measures, in particular, are measurements in need of reliable reference standards that encompass all ages of infants and provide an accurate assessment of the relative fatness of a population. This report evaluates three published reference standards for infant skinfold measurements: Tanner-Whitehouse, Cambridge Infant Growth Study, and the World Health Organization (WHO) Child Growth Standards. To assess these standards, triceps skinfolds from a population of rural Kenyan infants (n = 250) and triceps skinfolds and subscapular skinfolds from infants in the National Health and Nutrition Examination Survey 1999-2002 (NHANES; n = 1197) were calculated as z-scores from the lambda-mu-sigma curves provided by each reference population. The Tanner-Whitehouse standards represented both the Kenyan and US populations as lean, while the Cambridge standards represented both populations as overfat. The distribution of z-scores based on the WHO standards fell in the middle, but excluded infants from both populations who were below the age of 3 months. Based on these results, the WHO reference standard is the best skinfold reference standard for infants over the age of 3 months. For populations with infants of all ages, the Tanner-Whitehouse standards are recommended, despite representing both study populations as underfat. Ideally, the WHO will extend their reference standard to include infants between the ages of 0 and 3 months. © 2014 John Wiley & Sons Ltd.

Comparison of 10 single and stepped methods to identify frail older persons in primary care: diagnostic and prognostic accuracy.

PubMed

Sutorius, Fleur L; Hoogendijk, Emiel O; Prins, Bernard A H; van Hout, Hein P J

2016-08-03

Many instruments have been developed to identify frail older adults in primary care. A direct comparison of the accuracy and prevalence of identification methods is rare and most studies ignore the stepped selection typically employed in routine care practice. Also it is unclear whether the various methods select persons with different characteristics. We aimed to estimate the accuracy of 10 single and stepped methods to identify frailty in older adults and to predict adverse health outcomes. In addition, the methods were compared on their prevalence of the identified frail persons and on the characteristics of persons identified. The Groningen Frailty Indicator (GFI), the PRISMA-7, polypharmacy, the clinical judgment of the general practitioner (GP), the self-rated health of the older adult, the Edmonton Frail Scale (EFS), the Identification Seniors At Risk Primary Care (ISAR PC), the Frailty Index (FI), the InterRAI screener and gait speed were compared to three measures: two reference standards (the clinical judgment of a multidisciplinary expert panel and Fried's frailty criteria) and 6-years mortality or long term care admission. Data were used from the Dutch Identification of Frail Elderly Study, consisting of 102 people aged 65 and over from a primary care practice in Amsterdam. Frail older adults were oversampled. The accuracy of each instrument and several stepped strategies was estimated by calculating the area under the ROC-curve. Prevalence rates of frailty ranged from 14.8 to 52.9 %. The accuracy for recommended cut off values ranged from poor (AUC = 0.556 ISAR-PC) to good (AUC = 0.865 gait speed). PRISMA-7 performed best over two reference standards, GP predicted adversities best. Stepped strategies resulted in lower prevalence rates and accuracy. Persons selected by the different instruments varied greatly in age, IADL dependency, receiving homecare and mood. We found huge differences between methods to identify frail persons in prevalence, accuracy and in characteristics of persons they select. A necessary next step is to find out which frail persons can benefit from intervention before case finding programs are implemented. Further evidence is needed to guide this emerging clinical field.

The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

PubMed Central

Wood, Cristina Mae; Ruíz-Rodríguez, Paloma; Tomás-Tomás, Patricia; Gracia-Gracia, Irene; Dongil-Collado, Esperanza; Iruarrizaga, M. Iciar

2016-01-01

Introduction Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. Method We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. Results The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). Conclusion Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes. PMID:27525977

Metrological traceability of carbon dioxide measurements in atmosphere and seawater

NASA Astrophysics Data System (ADS)

Rolle, F.; Pessana, E.; Sega, M.

2017-05-01

The accurate determination of gaseous pollutants is fundamental for the monitoring of the trends of these analytes in the environment and the application of the metrological concepts to this field is necessary to assure the reliability of the measurement results. In this work, an overview of the activity carried out at Istituto Nazionale di Ricerca Metrologica to establish the metrological traceability of the measurements of gaseous atmospheric pollutants, in particular of carbon dioxide (CO2), is presented. Two primary methods, the gravimetry and the dynamic dilution, are used for the preparation of reference standards for composition which can be used to calibrate sensors and analytical instrumentation. At present, research is carried out to lower the measurement uncertainties of the primary gas mixtures and to extend their application to the oceanic field. The reason of such investigation is due to the evidence of the changes occurring in seawater carbonate chemistry, connected to the rising level of CO2 in the atmosphere. The well established activity to assure the metrological traceability of CO2 in the atmosphere will be applied to the determination of CO2 in seawater, by developing suitable reference materials for calibration and control of the sensors during their routine use.

Gender- and parity-specific reference charts for fetal size in low risk singleton pregnancies at the onset of the third trimester.

PubMed

De Reu, Paul; Smits, Luc J; Oosterbaan, Herman P; Snijders, Rosalinde J; De Reu-Cuppens, Marga J; Nijhuis, Jan G

2007-01-01

To determine fetal growth in low risk pregnancies at the beginning of the third trimester and to assess the relative importance of fetal gender and maternal parity. Dutch primary care midwifery practice. Retrospective cohort study on 3641 singleton pregnancies seen at a primary care midwifery center in the Netherlands. Parameters used for analysis were fetal abdominal circumference (AC), fetal head circumference (HC), gestational age, fetal gender and maternal parity. Regression analysis was applied to describe variation in AC and HC with gestational age. Means and standard deviations in the present population were compared with commonly used reference charts. Multiple regression analysis was applied to examine whether gender and parity should be taken into account. The fetal AC and HC increased significantly between the 27th and the 33rd week of pregnancy (AC r2=0.3652, P<0.0001; HC r2=0.3301, P<0.0001). Compared to some curves, our means and standard deviations were significantly smaller (at 30+0 weeks AC mean=258+/-13 mm; HC mean=281+/-14 mm), but corresponded well with other curves. Fetal gender was a significant determinant for both AC (P<0.0001) and HC (P<0.0001). Parity contributed significantly to AC only but the difference was small (beta=0.00464). At the beginning of the third trimester, fetal size is associated with fetal gender and, to a lesser extent, with parity. Some fetal growth charts (e.g., Chitty et al.) are more suitable for the low-risk population in the Netherlands than others.

A pilot study of reference vibrotactile perception thresholds on the fingertip obtained with Malaysian healthy people using ISO 13091-1 equipment.

PubMed

Daud, Roshada; Maeda, Setsuo; Kameel, Nur Nazmin Mustafa; Ripin, Muhamad Yunus; Bakrun, Norazman; Md Zein, Raemy; Kido, Masaharu; Higuchi, Kiyotaka

2004-04-01

The purpose of this paper is to clarify the reference vibrotactile perception thresholds (VPT) for healthy people in Malaysia. The measurement equipment standard, ISO 13091-1, of the vibrotactile perception thresholds for the assessment of nerve dysfunction and the analysis and interpretation of measurements at the fingertips standard, ISO 13091-2, were published in ISO/TC108/SC4/WG8 on 2001 and 2003 individually. In the ISO 13091-2 standard, the reference VPT data were obtained from few research papers. Malaysian people's VPT data don't include to this standard. In Malaysia, when the VPT is using to diagnose of the hand-arm vibration syndrome, the reference VPT data need to compare with the worker's ones. But, Malaysia does not have the reference VPT data yet. So, in this paper, the VPT was measured by using ISO 13091-1 standard equipment to obtain the reference data for Malaysian people. And these data were compared with the ISO reference data on the ISO 13091-2 standard. From the comparison of these data, it was clear that the Malaysian healthy people's VPT data were consistent with the reference data of the ISO 13091-2 standard.

The impact of US versus Indian BMD reference standards on the diagnosis of osteoporosis among South Asian Indians living in the United States

PubMed Central

Melamed, Alexander; Vittinghoff, Eric; Sriram, Usha; Schwartz, Ann V.; Kanaya, Alka M.

2010-01-01

The relationship between bone mineral density (BMD) and fracture risk is not well-established for non-white populations. There is no established BMD reference standard for South Asians. Dual energy x-ray absorptiometry (DXA) was used to measure BMD at total hip and lumbar spine in 150 US-based South Asian Indians. For each subject T-scores were calculated using BMD reference values based on US white, North Indian and South Indian populations, and the resulting WHO BMD category assignments were compared. Reference standards derived from Indian populations classified a larger proportion of US-based Indians as normal than did US white-based standards. The percentage of individuals reclassified when changing between reference standards varied by skeletal site and reference population origin, ranging from 13% (95% CI, 7–18%), when switching from US-white- to North Indian-based standard for total hip, to 40% (95% CI, 32–48%), when switching from US white to South Indian reference values for lumbar spine. These finding illustrate that choice of reference standard has a significant effect on the diagnosis of osteoporosis in South Asians, and underscore the importance of future research to quantify the relationship between BMD and fracture risk in this population. PMID:20663699

76 FR 8989 - Federal Acquisition Regulation; Updated Financial Accounting Standards Board Accounting References

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... Acquisition Regulation; Updated Financial Accounting Standards Board Accounting References AGENCIES... Acquisition Regulation (FAR) to update references to authoritative accounting standards owing to the Financial... Accounting Principles (GAAP) (``Codification of GAAP''). DATES: Interested parties should submit written...

Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes.

PubMed

Nolan, Winifred P; See, Jovina L; Chew, Paul T K; Friedman, David S; Smith, Scott D; Radhakrishnan, Sunita; Zheng, Ce; Foster, Paul J; Aung, Tin

2007-01-01

To evaluate noncontact anterior segment optical coherence technology (AS-OCT) as a qualitative method of imaging the anterior chamber angle and to determine its ability to detect primary angle closure when compared with gonioscopy in Asian subjects. Prospective observational case series. Two hundred three subjects were recruited from glaucoma clinics in Singapore with diagnoses of primary angle closure, primary open-angle glaucoma, ocular hypertension, or cataract. Both eyes (if eligible) of each patient were included in the study. Exclusion criteria were pseudophakia or previous glaucoma surgery. Images of the nasal, temporal, and inferior angles were obtained with AS-OCT in dark and then light conditions. Gonioscopic angle width was graded using the Spaeth classification for each quadrant in low lighting conditions. Angle closure was defined by AS-OCT as contact between the peripheral iris and angle wall anterior to the scleral spur and by gonioscopy as a Spaeth grade of 0 degree (posterior trabecular meshwork not visible). Comparison of the 2 methods in detecting angle closure was done by eye and by individual. Sensitivities and specificities of AS-OCT were calculated using gonioscopy as the reference standard. Complete data were available for 342 eyes of 200 patients. Of the patients, 70.9% had a clinical diagnosis of treated or untreated primary angle closure. Angle closure in > or =1 quadrants was detected by AS-OCT in 142 (71%) patients (228 [66.7%] eyes) and by gonioscopy in 99 (49.5%) patients (152 [44.4%] eyes). The inferior angle was closed more frequently than the nasal or temporal quadrants using both AS-OCT and gonioscopy. When performed under dark conditions, AS-OCT identified 98% of those subjects found to have angle closure on gonioscopy (95% confidence interval [CI], 92.2-99.6) and led to the characterization of 44.6% of those found to have open angles on gonioscopy to have angle closure as well. With gonioscopy as the reference standard, specificity of AS-OCT in the dark was 55.4% (95% CI, 45.2-65.2) for detecting individuals with angle closure. Anterior segment OCT is a rapid noncontact method of imaging angle structures. It is highly sensitive in detecting angle closure when compared with gonioscopy. More persons are found to have closed angles with AS-OCT than with gonioscopy.

Development of a 100 nmol mol(-1) propane-in-air SRM for automobile-exhaust testing for new low-emission requirements.

PubMed

Rhoderick, George C

2007-04-01

New US federal low-level automobile emission requirements, for example zero-level-emission vehicle (ZLEV), for hydrocarbons and other species, have resulted in the need by manufacturers for new certified reference materials. The new emission requirement for hydrocarbons requires the use, by automobile manufacturing testing facilities, of a 100 nmol mol(-1) propane in air gas standard. Emission-measurement instruments are required, by federal law, to be calibrated with National Institute of Standards and Technology (NIST) traceable reference materials. Because a NIST standard reference material (SRM) containing 100 nmol mol(-1) propane was not available, the US Environmental Protection Agency (EPA) and the Automobile Industry/Government Emissions Research Consortium (AIGER) requested that NIST develop such an SRM. A cylinder lot of 30 gas mixtures containing 100 nmol mol(-1) propane in air was prepared in 6-L aluminium gas cylinders by a specialty gas company and delivered to the Gas Metrology Group at NIST. Another mixture, contained in a 30-L aluminium cylinder and included in the lot, was used as a lot standard (LS). Using gas chromatography with flame-ionization detection all 30 samples were compared to the LS to obtain the average of six peak-area ratios to the LS for each sample with standard deviations of <0.31%. The average sample-to-LS ratio determinations resulted in a range of 0.9828 to 0.9888, a spread of 0.0060, which corresponds to a relative standard deviation of 0.15% of the average for all 30 samples. NIST developed its first set of five propane in air primary gravimetric standards covering a concentration range 91 to 103 nmol mol(-1) with relative uncertainties of 0.15%. This new suite of propane gravimetric standards was used to analyze and assign a concentration value to the SRM LS. On the basis of these data each SRM sample was individually certified, furnishing the desired relative expanded uncertainty of +/-0.5%. Because automobile companies use total hydrocarbons to make their measurements, it was also vital to assign a methane concentration to the SRM samples. Some of the SRM samples were analyzed and found to contain 1.2 nmol mol(-1) methane. Twenty-five of the samples were certified and released as SRM 2765.

In vitro vaccine potency testing: a proposal for reducing animal use for requalification testing.

PubMed

Brown, K; Stokes, W

2012-01-01

This paper proposes a program under which the use of animals for requalification of in vitro potency tests could be eliminated. Standard References (USDA/CVB nomenclature) would be developed, characterized, stored and monitored by selected reference laboratories worldwide. These laboratories would employ scientists skilled in protein and glycoprotein chemistry and equipped with state-of-the-art instruments for required analyses. After Standard References are established, the reference laboratories would provide them to the animal health industry as "gold standards". Companies would then establish and validate a correlation between the Standard Reference and the company Master Reference (USDA/CVB nomenclature) using an internal in vitro assay. After this correlation is established, the company could use the Standard References for qualifying, monitoring and requalifying company Master References without the use of animals. Such a program would eliminate the need for animals for requalification of Master References and the need for each company to develop and validate a battery of Master Reference Monitoring assays. It would also provide advantages in terms of reduced costs and reduced time for requalification testing. As such it would provide a strong incentive for companies to develop and use in vitro assays for potency testing.

Potassium Isotopic Compositions of NIST Potassium Standards and 40Ar/39Ar Mineral Standards

NASA Technical Reports Server (NTRS)

Morgan, Leah; Tappa, Mike; Ellam, Rob; Mark, Darren; Higgins, John; Simon, Justin I.

2013-01-01

Knowledge of the isotopic ratios of standards, spikes, and reference materials is fundamental to the accuracy of many geochronological methods. For example, the 238U/235U ratio relevant to U-Pb geochronology was recently re-determined [1] and shown to differ significantly from the previously accepted value employed during age determinations. These underlying values are fundamental to accurate age calculations in many isotopic systems, and uncertainty in these values can represent a significant (and often unrecognized) portion of the uncertainty budget for determined ages. The potassium isotopic composition of mineral standards, or neutron flux monitors, is a critical, but often overlooked component in the calculation of K-Ar and 40Ar/39Ar ages. It is currently assumed that all terrestrial materials have abundances indistinguishable from that of NIST SRM 985 [2]; this is apparently a reasonable assumption at the 0.25per mille level (1s) [3]. The 40Ar/39Ar method further relies on the assumption that standards and samples (including primary and secondary standards) have indistinguishable 40K/39K values. We will present data establishing the potassium isotopic compositions of NIST isotopic K SRM 985, elemental K SRM 999b, and 40Ar/39Ar biotite mineral standard GA1550 (sample MD-2). Stable isotopic compositions (41K/39K) were measured by the peak shoulder method with high resolution MC-ICP-MS (Thermo Scientific NEPTUNE Plus), using the accepted value of NIST isotopic SRM 985 [2] for fractionation [4] corrections [5]. 40K abundances were measured by TIMS (Thermo Scientific TRITON), using 41K/39K values from ICP-MS measurements (or, for SRM 985, values from [2]) for internal fractionation corrections. Collectively these data represent an important step towards a metrologically traceable calibration of 40K concentrations in primary 40Ar/39Ar mineral standards and improve uncertainties by ca. an order of magnitude in the potassium isotopic compositions of standards.

International documentary standards and comparison of national physical measurement standards for the calibration of accelerometers

NASA Astrophysics Data System (ADS)

Evans, David J.

2002-11-01

The documentary standards defining internationally adopted methodologies and protocols for calibrating transducers used to measure vibration are currently developed under the International Organization for Standardization (ISO) Technical Committee 108 Sub Committee 3 (Use and calibration of vibration and shock measuring instruments). Recent revisions of the documentary standards on primary methods for the calibration of accelerometers used to measure rectilinear motion have been completed. These standards can be, and have been, used as references in the technical protocols of key international and regional comparisons between National Measurement Institutes (NMIs) on the calibration of accelerometers. These key comparisons are occurring in part as a result of the creation of the Mutual Recognition Arrangement between NMIs which has appendices that document the uncertainties, and the comparisons completed in support of the uncertainties, claimed by the National Laboratories that are signatories of the MRA. The measurements for the first international and the first Interamerican System of Metrology (SIM) regional key comparisons in vibration have been completed. These intercomparisons were promulgated via the relatively new Consultative Committee for Acoustics, Ultrasound and Vibration (CCAUV) of the International Committee for Weights and Measures (CIPM) and SIM Metrology Working Group (MWG) 9, respectively.

Correction of anemia in a transfusion-dependent patient with primary myelofibrosis receiving iron chelation therapy with deferasirox (Exjade®, ICL670)

PubMed Central

Di Tucci, Anna Angela; Murru, Roberta; Alberti, Daniele; Rabault, Bertrand; Deplano, Simona; Angelucci, Emanuele

2007-01-01

Transfusional iron overload in patients with chronic anemias can result in multiple organ failure. Experience in the management of iron overload in patients with myelodysplastic syndromes is limited, as many do not receive chelation therapy due to short-life expectancy and the difficulties associated with the administration of the current reference standard chelator, deferoxamine. There have, however, been some reports of reduced transfusion requirement associated with chelation therapy in patients with myelodysplastic syndromes and myelofibrosis. Here, we discuss a patient with primary myelofibrosis and related transfusion-dependent anemia who received chelation therapy with the once-daily oral iron chelator, deferasirox. In addition to the reduced iron levels, the patient demonstrated an unexpected reduction in blood transfusion requirement, ultimately resulting in long-lasting transfusion-free survival. PMID:17391307

Comparison of psychosocial correlates in primary school age children with attention deficit/ hyperactivity disorder- combined type, with and without dysthymic disorder.

PubMed

Harris, Katrina; Boots, Marilyn; Talbot, Jessica; Vance, Alasdair

2006-01-01

In this study, standardized assessments of maternal psychopathology, family functioning and marital adjustment were compared between 115 medication naïve, clinically referred primary school age children with Attention Deficit Hyperactivity Disorder combined type (ADHD-CT) alone and 29 children with comorbid dysthymic disorder (DD) and ADHD-CT. The mothers of children with ADHD-CT and DD reported higher rates of anxiety and depression than those of children with ADHD-CT alone. These results reinforce the need for early recognition of comorbid DD when working with children with ADHD-CT. Increased rates of maternal anxiety and depression in children with ADHD-CT and DD may contribute to the children's symptoms, require specific psychological and/or medication treatments and careful ongoing monitoring of these specific treatments.

A Framework for Establishing Standard Reference Scale of Texture by Multivariate Statistical Analysis Based on Instrumental Measurement and Sensory Evaluation.

PubMed

Zhi, Ruicong; Zhao, Lei; Xie, Nan; Wang, Houyin; Shi, Bolin; Shi, Jingye

2016-01-13

A framework of establishing standard reference scale (texture) is proposed by multivariate statistical analysis according to instrumental measurement and sensory evaluation. Multivariate statistical analysis is conducted to rapidly select typical reference samples with characteristics of universality, representativeness, stability, substitutability, and traceability. The reasonableness of the framework method is verified by establishing standard reference scale of texture attribute (hardness) with Chinese well-known food. More than 100 food products in 16 categories were tested using instrumental measurement (TPA test), and the result was analyzed with clustering analysis, principal component analysis, relative standard deviation, and analysis of variance. As a result, nine kinds of foods were determined to construct the hardness standard reference scale. The results indicate that the regression coefficient between the estimated sensory value and the instrumentally measured value is significant (R(2) = 0.9765), which fits well with Stevens's theory. The research provides reliable a theoretical basis and practical guide for quantitative standard reference scale establishment on food texture characteristics.

18 CFR 38.2 - Incorporation by reference of North American Energy Standards Board Wholesale Electric Quadrant...

Code of Federal Regulations, 2011 CFR

2011-04-01

....13, 001-1.0, 001-9.7, 001-14.1.3, and 001-15.1.2); (2) Open Access Same-Time Information Systems... reference of North American Energy Standards Board Wholesale Electric Quadrant standards. 38.2 Section 38.2... UTILITIES § 38.2 Incorporation by reference of North American Energy Standards Board Wholesale Electric...

The IPEM code of practice for determination of the reference air kerma rate for HDR 192Ir brachytherapy sources based on the NPL air kerma standard

NASA Astrophysics Data System (ADS)

Bidmead, A. M.; Sander, T.; Locks, S. M.; Lee, C. D.; Aird, E. G. A.; Nutbrown, R. F.; Flynn, A.

2010-06-01

This paper contains the recommendations of the high dose rate (HDR) brachytherapy working party of the UK Institute of Physics and Engineering in Medicine (IPEM). The recommendations consist of a Code of Practice (COP) for the UK for measuring the reference air kerma rate (RAKR) of HDR 192Ir brachytherapy sources. In 2004, the National Physical Laboratory (NPL) commissioned a primary standard for the realization of RAKR of HDR 192Ir brachytherapy sources. This has meant that it is now possible to calibrate ionization chambers directly traceable to an air kerma standard using an 192Ir source (Sander and Nutbrown 2006 NPL Report DQL-RD 004 (Teddington: NPL) http://publications.npl.co.uk). In order to use the source specification in terms of either RAKR, \\dot K_R (ICRU 1985 ICRU Report No 38 (Washington, DC: ICRU); ICRU 1997 ICRU Report No 58 (Bethesda, MD: ICRU)), or air kerma strength, SK (Nath et al 1995 Med. Phys. 22 209-34), it has been necessary to develop algorithms that can calculate the dose at any point around brachytherapy sources within the patient tissues. The AAPM TG-43 protocol (Nath et al 1995 Med. Phys. 22 209-34) and the 2004 update TG-43U1 (Rivard et al 2004 Med. Phys. 31 633-74) have been developed more fully than any other protocol and are widely used in commercial treatment planning systems. Since the TG-43 formalism uses the quantity air kerma strength, whereas this COP uses RAKR, a unit conversion from RAKR to air kerma strength was included in the appendix to this COP. It is recommended that the measured RAKR determined with a calibrated well chamber traceable to the NPL 192Ir primary standard is used in the treatment planning system. The measurement uncertainty in the source calibration based on the system described in this COP has been reduced considerably compared to other methods based on interpolation techniques.

Analytical performance, agreement and user-friendliness of six point-of-care testing urine analysers for urinary tract infection in general practice.

PubMed

Schot, Marjolein J C; van Delft, Sanne; Kooijman-Buiting, Antoinette M J; de Wit, Niek J; Hopstaken, Rogier M

2015-05-18

Various point-of-care testing (POCT) urine analysers are commercially available for routine urine analysis in general practice. The present study compares analytical performance, agreement and user-friendliness of six different POCT urine analysers for diagnosing urinary tract infection in general practice. All testing procedures were performed at a diagnostic centre for primary care in the Netherlands. Urine samples were collected at four general practices. Analytical performance and agreement of the POCT analysers regarding nitrite, leucocytes and erythrocytes, with the laboratory reference standard, was the primary outcome measure, and analysed by calculating sensitivity, specificity, positive and negative predictive value, and Cohen's κ coefficient for agreement. Secondary outcome measures were the user-friendliness of the POCT analysers, in addition to other characteristics of the analysers. The following six POCT analysers were evaluated: Uryxxon Relax (Macherey Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) and Urilyzer (Analyticon). Analytical performance was good for all analysers. Compared with laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. Agreement for leucocytes varied between good to very good, and for the erythrocyte test between fair and good. First-time users indicated that the analysers were easy to use. They expected higher productivity and accuracy when using these analysers in daily practice. The overall performance and user-friendliness of all six commercially available POCT urine analysers was sufficient to justify routine use in suspected urinary tract infections in general practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A new framework for evaluating the impacts of drought on net primary productivity of grassland.

PubMed

Lei, Tianjie; Wu, Jianjun; Li, Xiaohan; Geng, Guangpo; Shao, Changliang; Zhou, Hongkui; Wang, Qianfeng; Liu, Leizhen

2015-12-01

This paper presented a valuable framework for evaluating the impacts of droughts (single factor) on grassland ecosystems. This framework was defined as the quantitative magnitude of drought impact that unacceptable short-term and long-term effects on ecosystems may experience relative to the reference standard. Long-term effects on ecosystems may occur relative to the reference standard. Net primary productivity (NPP) was selected as the response indicator of drought to assess the quantitative impact of drought on Inner Mongolia grassland based on the Standardized Precipitation Index (SPI) and BIOME-BGC model. The framework consists of six main steps: 1) clearly defining drought scenarios, such as moderate, severe and extreme drought; 2) selecting an appropriate indicator of drought impact; 3) selecting an appropriate ecosystem model and verifying its capabilities, calibrating the bias and assessing the uncertainty; 4) assigning a level of unacceptable impact of drought on the indicator; 5) determining the response of the indicator to drought and normal weather state under global-change; and 6) investigating the unacceptable impact of drought at different spatial scales. We found NPP losses assessed using the new framework were more sensitive to drought and had higher precision than the long-term average method. Moreover, the total and average losses of NPP are different in different grassland types during the drought years from 1961-2009. NPP loss was significantly increased along a gradient of increasing drought levels. Meanwhile, NPP loss variation under the same drought level was different in different grassland types. The operational framework was particularly suited for integrative assessing the effects of different drought events and long-term droughts at multiple spatial scales, which provided essential insights for sciences and societies that must develop coping strategies for ecosystems for such events. Copyright © 2015 Elsevier B.V. All rights reserved.

Towards a Framework for Developing Semantic Relatedness Reference Standards

PubMed Central

Pakhomov, Serguei V.S.; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B.; Ruggieri, Alexander; Chute, Christopher G.

2010-01-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the “moderate” range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. PMID:21044697

Value assignment of nutrient concentrations in five standard reference materials and six reference materials.

PubMed

Sharpless, K E; Gill, L M

2000-01-01

A number of food-matrix reference materials (RMs) are available from the National Institute of Standards and Technology (NIST) and from Agriculture Canada through NIST. Most of these materials were originally value-assigned for their elemental composition (major, minor, and trace elements), but no additional nutritional information was provided. Two of the materials were certified for selected organic constituents. Ten of these materials (Standard Reference Material [SRM] 1,563 Cholesterol and Fat-Soluble Vitamins in Coconut Oil [Natural and Fortified], SRM 1,566b Oyster Tissue, SRM 1,570a Spinach Leaves, SRM 1,974a Organics in Mussel Tissue (Mytilus edulis), RM 8,415 Whole Egg Powder, RM 8,418 Wheat Gluten, RM 8,432 Corn Starch, RM 8,433 Corn Bran, RM 8,435 Whole Milk Powder, and RM 8,436 Durum Wheat Flour) were recently distributed by NIST to 4 laboratories with expertise in food analysis for the measurement of proximates (solids, fat, protein, etc.), calories, and total dietary fiber, as appropriate. SRM 1846 Infant Formula was distributed as a quality control sample for the proximates and for analysis for individual fatty acids. Two of the materials (Whole Egg Powder and Whole Milk Powder) were distributed in an earlier interlaboratory comparison exercise in which they were analyzed for several vitamins. Value assignment of analyte concentrations in these 11 SRMs and RMs, based on analyses by the collaborating laboratories, is described in this paper. These materials are intended primarily for validation of analytical methods for the measurement of nutrients in foods of similar composition (based on AOAC INTERNATIONAL's fat-protein-carbohydrate triangle). They may also be used as "primary control materials" in the value assignment of in-house control materials of similar composition. The addition of proximate information for 10 existing reference materials means that RMs are now available from NIST with assigned values for proximates in 6 of the 9 sectors of the AOAC triangle. Five of these materials have values assigned for total dietary fiber-the first such information provided for materials available from NIST.

What is the most reliable solid culture medium for tuberculosis treatment trials?

PubMed

Joloba, Moses L; Johnson, John L; Feng, Pei-Jean I; Bozeman, Lorna; Goldberg, Stefan V; Morgan, Karen; Gitta, Phineas; Boom, Henry W; Heilig, Charles M; Mayanja-Kizza, Harriet; Eisenach, Kathleen D

2014-05-01

We conducted a prospective study to determine which solid medium is the most reliable overall and after two months of therapy to detect Mycobacterium tuberculosis complex (MTB). MTB isolation and contamination rates on LJ and Middlebrook 7H10 and 7H11 agar with and without selective antibiotics were examined in a single laboratory and compared against a constructed reference standard and MGIT 960 results. Of 50 smear positive adults with pulmonary TB enrolled, 45 successfully completed standard treatment. Two spot sputum specimens were collected before treatment and at week 8 and one spot specimen each at weeks 2, 4, 6, and 12. The MTB recovery rate among all solid media for pre-treatment specimens was similar. After 8 weeks, selective (S) 7H11 had the highest positivity rate. Latent class analysis was used to construct the primary reference standard. The 98.7% sensitivity of 7H11S (95% Wilson confidence interval 96.4%-99.6%) was highest among the 5 solid media (P = 0.003 by bootstrap); the 82.6% specificity of 7H10S (95% CI 75.7%-87.8%) was highest (P = 0.098). Our results support 7H11S as the medium of choice. Further studies in different areas where recovery and contamination are likely to vary, are recommended. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hg0 and HgCl2 Reference Gas Standards: ?NIST Traceability ...

EPA Pesticide Factsheets

EPA and NIST have collaborated to establish the necessary procedures for establishing the required NIST traceability of commercially-provided Hg0 and HgCl2 reference generators. This presentation will discuss the approach of a joint EPA/NIST study to accurately quantify the true concentrations of Hg0 and HgCl2 reference gases produced from high quality, NIST-traceable, commercial Hg0 and HgCl2 generators. This presentation will also discuss the availability of HCl and Hg0 compressed reference gas standards as a result of EPA's recently approved Alternative Methods 114 and 118. Gaseous elemental mercury (Hg0) and oxidized mercury (HgCl2) reference standards are integral to the use of mercury continuous emissions monitoring systems (Hg CEMS) for regulatory compliance emissions monitoring. However, a quantitative disparity of approximately 7-10% has been observed between commercial Hg0 and HgCl2 reference gases which currently limits the use of (HgCl2) reference gas standards. Resolving this disparity would enable the expanded use of (HgCl2) reference gas standards for regulatory compliance purposes.

EPA Office of Water (OW): 12-digit Hydrologic Unit Boundaries of the United States

EPA Pesticide Factsheets

The Watershed Boundary Dataset (WBD) is a complete digital hydrologic unit national boundary layer that is at the Subwatershed (12-digit) level. It is composed of the watershed boundaries delineated by state agencies at the 1:24,000 scale. Please refer to the individual state metadata as the primary reference source. To access state specific metadata, go to the following link to view documentation created by agencies that performed the watershed delineation. This data set is a complete digital hydrologic unit boundary layer to the Subwatershed (12-digit) 6th level. This data set consists of geo-referenced digital data and associated attributes created in accordance with the FGDC Proposal, Version 1.0 - Federal Standards For Delineation of Hydrologic Unit Boundaries 3/01/02. Polygons are attributed with hydrologic unit codes for 4th level sub-basins, 5th level watersheds, 6th level subwatersheds, name, size, downstream hydrologic unit, type of watershed, non-contributing areas and flow modification. Arcs are attributed with the highest hydrologic unit code for each watershed, linesource and a metadata reference file.Please refer to the Metadata contact if you want access to the WBD national data set.

NIST gold nanoparticle reference materials do not induce oxidative DNA damage.

PubMed

Nelson, Bryant C; Petersen, Elijah J; Marquis, Bryce J; Atha, Donald H; Elliott, John T; Cleveland, Danielle; Watson, Stephanie S; Tseng, I-Hsiang; Dillon, Andrew; Theodore, Mellisa; Jackman, Joany

2013-02-01

One primary challenge in nanotoxicology studies is the lack of well-characterised nanoparticle reference materials which could be used as positive or negative nanoparticle controls. The National Institute of Standards and Technology (NIST) has developed three gold nanoparticle (AuNP) reference materials (10, 30 and 60 nm). The genotoxicity of these nanoparticles was tested using HepG2 cells and calf-thymus DNA. DNA damage was assessed based on the specific and sensitive measurement of four oxidatively-modified DNA lesions (8-hydroxy-2´-deoxyguanosine, 8-hydroxy-2´-deoxyadenosine, (5´S)-8,5´-cyclo-2´-deoxyadenosine and (5´R)-8,5´-cyclo-2´-deoxyadenosine) using liquid chromatography/tandem mass spectrometry. Significantly elevated, dose-dependent DNA damage was not detected at concentrations up to 0.2 μg/ml, and free radicals were not detected using electron paramagnetic resonance spectroscopy. These data suggest that the NIST AuNPs could potentially serve as suitable negative-control nanoparticle reference materials for in vitro and in vivo genotoxicity studies. NIST AuNPs thus hold substantial promise for improving the reproducibility and reliability of nanoparticle genotoxicity studies.

Content validity of manual spinal palpatory exams - A systematic review

PubMed Central

Najm, Wadie I; Seffinger, Michael A; Mishra, Shiraz I; Dickerson, Vivian M; Adams, Alan; Reinsch, Sibylle; Murphy, Linda S; Goodman, Arnold F

2003-01-01

Background Many health care professionals use spinal palpatory exams as a primary and well-accepted part of the evaluation of spinal pathology. However, few studies have explored the validity of spinal palpatory exams. To evaluate the status of the current scientific evidence, we conducted a systematic review to assess the content validity of spinal palpatory tests used to identify spinal neuro-musculoskeletal dysfunction. Methods Review of eleven databases and a hand search of peer-reviewed literature, published between 1965–2002, was undertaken. Two blinded reviewers abstracted pertinent data from the retrieved papers, using a specially developed quality-scoring instrument. Five papers met the inclusion/exclusion criteria. Results Three of the five papers included in the review explored the content validity of motion tests. Two of these papers focused on identifying the level of fixation (decreased mobility) and one focused on range of motion. All three studies used a mechanical model as a reference standard. Two of the five papers included in the review explored the validity of pain assessment using the visual analogue scale or the subjects' own report as reference standards. Overall the sensitivity of studies looking at range of motion tests and pain varied greatly. Poor sensitivity was reported for range of motion studies regardless of the examiner's experience. A slightly better sensitivity (82%) was reported in one study that examined cervical pain. Conclusions The lack of acceptable reference standards may have contributed to the weak sensitivity findings. Given the importance of spinal palpatory tests as part of the spinal evaluation and treatment plan, effort is required by all involved disciplines to create well-designed and implemented studies in this area. PMID:12734016

Certified Reference Material for Use in 1H, 31P, and 19F Quantitative NMR, Ensuring Traceability to the International System of Units.

PubMed

Rigger, Romana; Rück, Alexander; Hellriegel, Christine; Sauermoser, Robert; Morf, Fabienne; Breitruck, KathrinBreitruck; Obkircher, Markus

2017-09-01

In recent years, quantitative NMR (qNMR) spectroscopy has become one of the most important tools for content determination of organic substances and quantitative evaluation of impurities. Using Certified Reference Materials (CRMs) as internal or external standards, the extensively used qNMR method can be applied for purity determination, including unbroken traceability to the International System of Units (SI). The implementation of qNMR toward new application fields, e.g., metabolomics, environmental analysis, and physiological pathway studies, brings along more complex molecules and systems, thus making use of 1H qNMR challenging. A smart workaround is possible by the use of other NMR active nuclei, namely 31P and 19F. This article presents the development of three classes of qNMR CRMs based on different NMR active nuclei (1H, 31P, and 19F), and the corresponding approaches to establish traceability to the SI through primary CRMs from the National Institute of Standards and Technology and the National Metrology Institute of Japan. These TraceCERT® qNMR CRMs are produced under ISO/IEC 17025 and ISO Guide 34 using high-performance qNMR.

Is the evaluation of risk of bias in periodontology and implant dentistry comprehensive? A systematic review.

PubMed

Faggion, Clovis Mariano; Listl, Stefan; Alarcón, Marco Antonio

2015-05-01

The objective of this study was to assess how authors of systematic reviews (SRs) with meta-analyses published in periodontology and implant dentistry evaluate risk of bias (ROB) in primary studies included in these reviews. A literature search for SRs with meta-analyses was performed in PubMed and Cochrane library databases up to July 20th 2014. The reference lists of included articles were screened for further reviews. The standards of evaluating ROB in primary studies were evaluated by using a 14-item checklist based on the Cochrane approach for evaluating ROB. Standards in ROB evaluations in Cochrane and paper-based SRs were compared using the Fisher's exact test. All searches, data extraction and evaluations were performed independently and in duplicate. Seventy SRs were included (45 paper-based and 25 Cochrane SRs, respectively). The median percentage of items addressed was 58% (interquartile range 4-100%). Cochrane SRs more frequently included ROB assessments than paper-based reviews in terms of examiner blinding (p = 0.0026), selective outcome reporting (p = 0.0207) and other bias (p = 0.0241). The ROB evaluation in primary studies currently included in SRs with meta-analyses in periodontology and implant dentistry is not sufficiently comprehensive. Cochrane SRs have more comprehensive ROB evaluation than paper-based reviews. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

76 FR 38396 - Notice of Availability of Proposed Data Collection Standards for Race, Ethnicity, Primary...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... Standards for Race, Ethnicity, Primary Language, Sex, and Disability Status Required by Section 4302 of the... standards for race, ethnicity, sex, primary language and disability status, as required by Section 4302 of... collection standards for race, ethnicity, sex, primary language, and disability status. The law requires that...

Sex disparities in tuberculosis suspect evaluation: a cross-sectional analysis in rural Uganda

PubMed Central

Miller, C. R.; Davis, J. L.; Katamba, A.; Sserwanga, A.; Kakeeto, S.; Kizito, F.; Cattamanchi, A.

2013-01-01

SUMMARY SETTING Six primary health care centers in rural Uganda. OBJECTIVE To compare the quality of tuberculosis (TB) evaluation for men and women presenting to primary health care facilities in high-burden settings. DESIGN Cross-sectional study using indicators derived from the International Standards of Tuberculosis Care (ISTC) to compare the quality of TB evaluation services provided to men and women. RESULTS Of 161 230 patient visits between January 2009 and December 2010, 112 329 (69.7%) were women. We considered 3308 (2.1%) patients with cough ≥ 2 weeks as TB suspects, of whom 1871 (56.6%) were women. Female TB suspects were less likely to be referred for sputum smear examination (45.9% vs. 61.6%, P < 0.001), to complete sputum smear examination if referred (73.7% vs. 78.3%, P = 0.024) and to receive comprehensive evaluation and care as defined by the ISTC (33.0% vs. 45.6%, P < 0.001). After adjusting for age, clinic site and visit date, women remained less likely to be referred for sputum smear examination (risk ratio [RR] 0.81, 95%CI 0.74–0.89, P < 0.001) and to receive ISTC-recommended care (RR 0.79, 95%CI 0.72–0.86, P < 0.001). CONCLUSION Strategies to ensure that women receive appropriate TB evaluation could provide a valuable opportunity for increasing case detection while also promoting equitable and universal access to care. PMID:23485382

22 CFR 705.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Cross-reference to employee ethical conduct... INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS EMPLOYEE ETHICAL CONDUCT STANDARDS AND FINANCIAL DISCLOSURE REGULATIONS § 705.101 Cross-reference to employee ethical conduct standards and financial disclosure...

Certification of elements in and use of standard reference material 3280 multivitamin/multielement tablets

USDA-ARS?s Scientific Manuscript database

Standard Reference Material (SRM) 3280 Multivitamin/Multielement Tablets was issued by the National Institute of Standards and Technology (NIST) in 2009 and has certified and reference mass fraction values for 13 vitamins, 26 elements, and 2 carotenoids. Elements were measured using two or more ana...

22 CFR 705.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Cross-reference to employee ethical conduct... INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS EMPLOYEE ETHICAL CONDUCT STANDARDS AND FINANCIAL DISCLOSURE REGULATIONS § 705.101 Cross-reference to employee ethical conduct standards and financial disclosure...

22 CFR 705.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Cross-reference to employee ethical conduct... INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS EMPLOYEE ETHICAL CONDUCT STANDARDS AND FINANCIAL DISCLOSURE REGULATIONS § 705.101 Cross-reference to employee ethical conduct standards and financial disclosure...

22 CFR 705.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Cross-reference to employee ethical conduct... INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS EMPLOYEE ETHICAL CONDUCT STANDARDS AND FINANCIAL DISCLOSURE REGULATIONS § 705.101 Cross-reference to employee ethical conduct standards and financial disclosure...

22 CFR 705.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Cross-reference to employee ethical conduct... INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS EMPLOYEE ETHICAL CONDUCT STANDARDS AND FINANCIAL DISCLOSURE REGULATIONS § 705.101 Cross-reference to employee ethical conduct standards and financial disclosure...

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

Role of radiology in the management of primary aldosteronism.

PubMed

Patel, Shilpan M; Lingam, Ravi K; Beaconsfield, Tina I; Tran, Tan L; Brown, Beata

2007-01-01

The diagnosis of primary aldosteronism, the most common form of secondary hypertension, is based on clinical and biochemical features. Although radiology plays no role in the initial diagnosis, it has an important role in differentiating between the two main causes of primary aldosteronism: aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH). This distinction is important because APAs are generally managed surgically and BAH medically. Adrenal venous sampling is considered the standard of reference for determining the cause of primary aldosteronism but is technically demanding, operator dependent, costly, and time consuming, with a low but significant complication rate. Other imaging modalities, including computed tomography, magnetic resonance imaging, and adrenal scintigraphy, have also been used to determine the cause of primary aldosteronism. Cross-sectional imaging has traditionally focused on establishing the diagnosis of an APA, with that of BAH being one of exclusion. A high specificity for detecting an APA is desirable, since it will avert unnecessary surgery in patients with BAH. However, an overreliance on cross-sectional imaging can lead to the incorrect treatment of affected patients, mainly due to the wide variation in the reported diagnostic performance of these modalities. A combination of modalities is usually required to confidently determine the cause of primary aldosteronism. The quest for optimal radiologic management of primary aldosteronism continues just over a half century since this disease entity was first described. RSNA, 2007

Bilateral comparison of 1 V and 10 V standards between the DMDM (Serbia) and the BIPM, January to March 2014 (part of the ongoing BIPM key comparison BIPM.EM-K11.a and b)

NASA Astrophysics Data System (ADS)

Solve, S.; Chayramy, R.; Stock, M.; Pantelic-Babic, J.; Sofranac, Z.; Zivkovic, V.

2015-01-01

As part of the ongoing BIPM key comparison BIPM.EM-K11.a and b, a comparison of the 1 V and 10 V voltage reference standards of the BIPM and the Directorate of Measures and Precious Metals (DMDM), Beograd, Serbia, was carried out from January to March 2014. Two BIPM Zener diode-based travelling standards (Fluke 732B), BIPM6 (Z6) and BIPMA (ZA), were transported by freight to DMDM. At DMDM, the reference standard for DC voltage is a Josephson Voltage Standard. The output electromotive force of each travelling standard was measured by direct comparison with the primary standard. At the BIPM, the travelling standards were calibrated, before and after the measurements at DMDM, with the Josephson Voltage Standard. Results of all measurements were corrected for the dependence of the output voltages of the Zener standards on internal temperature and ambient atmospheric pressure. The final result of the comparison is presented as the difference between the values assigned to DC voltage standards by DMDM, at the level of 1.018 V and 10 V, at DMDM, UDMDM, and those assigned by the BIPM, at the BIPM, UBIPM, at the reference date of the 13 February 2014. UDMDM - UBIPM = 0.094 µV uc = 0.072 µV, at 1 V UDMDM - UBIPM = 0.39 µV uc = 0.12 µV, at 10 V where uc is the combined standard uncertainty associated with the measured difference, including the uncertainty of the representation of the volt at the BIPM and at DMDM, based on KJ-90, and the uncertainty related to the comparison. The results at the 10 V level are not covered by the uncertainties with a coverage factor of 2. After the distribution of the Draft A, the DMDM discovered that the pressure gauge was defective. Some considerations on the correction to apply on the comparison result and the corresponding uncertainties are presented in the report. Nevertheless, the above results fully cover the CMCs of DMDM which are significantly larger. No corrections for temperature and pressure are applied in calibrations for customers' secondary standards. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Alternative mass reference standards for direct analysis in real time mass spectrometry.

PubMed

Cody, Robert B; Dane, A John

2016-05-30

Mass spectra were acquired with the Direct Analysis in Real Time (DART®) ion source for an amine-terminated polyether used as positive-ion mass reference standards and for several fluorinated materials commonly used as negative-ion reference standards for mass spectrometry. A commercial time-of-flight mass spectrometer equipped with a DART ion source was used for all measurements. Mass reference standards deposited onto the sealed end of a glass melting point tube were suspended in the DART gas stream for analysis. A polyetheramine (Jeffamine® M-600) produced intense peaks corresponding to protonated molecules. Perfluorotributylamine (PFTBA), and perfluorotripentylamine, gave useful reference spectra for different m/z ranges. DART mass spectra of Ultramark 1621® resembled those previously reported for Fast Atom Bombardment (FAB) and Electrospray Ionization (ESI). Fomblin®Y, a fluorinated ether, was the most useful negative-ion reference standard of the materials tested. The material is commercially available, inexpensive, and provides reference peaks covering the m/z range 85 to >3000. Jeffamine-M600 was found to be a convenient alternative to polyethers such as polyethylene glycol (PEG) for DART positive-ion mass calibration. Fomblin Y was suitable for use as a negative-ion reference standard. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Updating OSHA standards based on national consensus standards. Direct final rule.

PubMed

2007-12-14

In this direct final rule, the Agency is removing several references to consensus standards that have requirements that duplicate, or are comparable to, other OSHA rules; this action includes correcting a paragraph citation in one of these OSHA rules. The Agency also is removing a reference to American Welding Society standard A3.0-1969 ("Terms and Definitions") in its general-industry welding standards. This rulemaking is a continuation of OSHA's ongoing effort to update references to consensus and industry standards used throughout its rules.

Optical-Fiber Power Meter Comparison between NIST and KRISS.

PubMed

Vayshenker, I; Kim, S K; Hong, K; Lee, D-H; Livigni, D J; Li, X; Lehman, J H

2012-01-01

We describe the results of a comparison of reference standards between the National Institute of Standards and Technology (NIST-USA) and Korea Research Institute of Standards and Science (KRISS-R.O. Korea) for optical fiber-based power measurements at wavelengths of 1302 nm and 1546 nm. We compare the laboratories' reference standards by means of a temperature-controlled optical trap detector. Measurement results showed the largest difference of less than 2.5 parts in 10(3), which is within the combined standard (k=1) uncertainty for the two laboratories' reference standards.

Audit of dental practice record-keeping: a PCT-coordinated clinical audit by Worcestershire dentists.

PubMed

Cole, Andrew; McMichael, Alan

2009-07-01

A collaborative audit of clinical record-keeping standards was performed among Worcestershire dentists. Its aims were to improve the quality of National Health Service (NHS) patient care and to assist dentists to perform well during Dental Reference Service practice visits. Worcestershire dentists with NHS contracts were invited to take part in this audit. Each dentist audited a random selection of 30 of their dental clinical records against a common framework comprising eight domains. Record-keeping, and the presence or absence of key diagnostic and treatment planning details were recorded. Grading was applied in four categories, in which grades 1 and 2 were good (1) and adequate (2), captured on data-collection sheets and centrally analysed for frequency of each grade. Out of a total of 184 Worcestershire general dental practitioners, 161 (87.5%) submitted usable responses. The audit revealed wide variation between dentists in clinical record-keeping. The recording of soft tissues (36% below grade 2), periodontal status (30%), radiographic review (27%), and note-taking (25%) all fell below the standard that had been set (brackets show proportion not meeting the standard). The results provided baseline information about the standard of record-keeping in NHS dental practices in Worcestershire. The collaborative nature of the audit enabled dissemination of individual results to participants, to facilitate comparison (anonymously) against their peers. The audit provided impetus for the Primary Care Trust (PCT) to arrange postgraduate education on record-keeping and to raise awareness among local dentists about record-keeping. The subsequent report to dentists explored the record-keeping standards expected during practice inspections undertaken by the Dental Reference Service. Worcestershire PCT's method of collaborative dental audit could potentially replace the previous national programme of dental audit, formerly coordinated locally.

Towards Standardizing the Alcoholism Evaluation Of Potential Liver Transplant Recipients.

PubMed

Beresford, Thomas P; Lucey, Michael R

2018-03-01

For teams around the world, alcoholic liver disease patients comprise the largest, and clinically most controversial, group applying for liver transplant. And yet evaluation decisions for them remain highly variable by locale. Targeting standardized assessment, we provide guidelines on what information the transplant team should seek, from what sources, and how best to make use of it. This report focuses on 'what to do and how to do it' in providing appropriate assessments for this complex patient group. Proper evaluation includes (a) taking the clinical history from the patient and a required, corroborating third person, (b) assessing patient cognition, (c) establishing alcohol/substance use diagnosis to differentiate alcohol dependence, abuse and polysubstance dependence, (d) assessing ambivalence in primary alcohol addiction, (e) measuring social stability and (f) using Vaillant's factors for abstinence prognosis. Properly applied, these six factors will allow standardized selection in most cases taken across programs despite differences in resources, available expertise and decision practices. This report focuses on the essentials of the psychiatric/behavioral evaluation for 'alcoholic' persons referred for liver transplant. Attention to those essentials offers clinical standardization across transplant programs in different locales.

The GLAS Standard Data Products Specification-Data Dictionary, Version 1.0. Volume 15

NASA Technical Reports Server (NTRS)

Lee, Jeffrey E.

2013-01-01

The Geoscience Laser Altimeter System (GLAS) is the primary instrument for the ICESat (Ice, Cloud and Land Elevation Satellite) laser altimetry mission. ICESat was the benchmark Earth Observing System (EOS) mission for measuring ice sheet mass balance, cloud and aerosol heights, as well as land topography and vegetation characteristics. From 2003 to 2009, the ICESat mission provided multi-year elevation data needed to determine ice sheet mass balance as well as cloud property information, especially for stratospheric clouds common over polar areas. It also provided topography and vegetation data around the globe, in addition to the polar-specific coverage over the Greenland and Antarctic ice sheets.This document contains the data dictionary for the GLAS standard data products. It details the parameters present on GLAS standard data products. Each parameter is defined with a short name, a long name, units on product, type of variable, a long description and products that contain it. The term standard data products refers to those EOS instrument data that are routinely generated for public distribution. These products are distributed by the National Snow and Ice Data Center (NSDIC).

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

40 CFR 50.8 - National primary ambient air quality standards for carbon monoxide.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false National primary ambient air quality standards for carbon monoxide. 50.8 Section 50.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.8 National primary ambient air quality standards for...

[Design and validation of a questionnaire for psychosocial nursing diagnosis in Primary Care].

PubMed

Brito-Brito, Pedro Ruymán; Rodríguez-Álvarez, Cristobalina; Sierra-López, Antonio; Rodríguez-Gómez, José Ángel; Aguirre-Jaime, Armando

2012-01-01

To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain). Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 items. The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis. Copyright © 2011 Elsevier España, S.L. All rights reserved.

77 FR 181 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-55; Introduction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

... System. VI Updated Financial 2010-005 Chambers. Accounting Standards Board Accounting References. VII... Financial Accounting Standards Board Accounting References (FAR Case 2010-005) This final rule amends the... authoritative accounting standards owing to the Financial Accounting Standards Board's Accounting Standards...

10 CFR 50.150 - Aircraft impact assessment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13, 2009; (B) Renewal of standard design certifications in effect on July 13, 2009 which have not..., standard design approval, or manufactured reactor; or (B) Reference a standard design certification issued... certification or standard design approval; or (B) Reference a standard design certification issued before July...

10 CFR 50.150 - Aircraft impact assessment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13, 2009; (B) Renewal of standard design certifications in effect on July 13, 2009 which have not..., standard design approval, or manufactured reactor; or (B) Reference a standard design certification issued... certification or standard design approval; or (B) Reference a standard design certification issued before July...

10 CFR 50.150 - Aircraft impact assessment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13, 2009; (B) Renewal of standard design certifications in effect on July 13, 2009 which have not..., standard design approval, or manufactured reactor; or (B) Reference a standard design certification issued... certification or standard design approval; or (B) Reference a standard design certification issued before July...

10 CFR 50.150 - Aircraft impact assessment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13, 2009; (B) Renewal of standard design certifications in effect on July 13, 2009 which have not..., standard design approval, or manufactured reactor; or (B) Reference a standard design certification issued... certification or standard design approval; or (B) Reference a standard design certification issued before July...

Tipping Points: Teachers' Reported Reasons for Referring Primary School Children for Excessive Anxiety

ERIC Educational Resources Information Center

Hinchliffe, Kaitlin J.; Campbell, Marilyn A.

2016-01-01

The current study explored the reasons that primary school teachers reported were tipping points for them in deciding whether or not and when to refer a child to the school student support team for excessive anxiety. Twenty teachers in two Queensland primary schools were interviewed. Content analysis of interview transcripts revealed six themes…

Data on crystal organization in the structure of the Fab fragment from the NIST reference antibody, RM 8671.

PubMed

Gallagher, D T; Karageorgos, I; Hudgens, J W; Galvin, C V

2018-02-01

The reported data describe the crystallization, crystal packing, structure determination and twinning of the unliganded Fab (antigen-binding fragment) from the NISTmAb (standard reference material 8671). The raw atomic coordinates are available as Protein Data Bank structure 5K8A and biological aspects are described in the article, (Karageorgos et al., 2017) [1]. Crystal data show that the packing is unique, and show the basis for the crystal's twinned growth. Twinning is a common and often serious problem in protein structure determination by x-ray crystallography [2]. In the present case the twinning is due to a small deviation (about 0.3 nm) from 4-fold symmetry in the primary intermolecular interface. The deviation produces pseudosymmetry, generating slightly different conformations of the protein, and alternating strong and weak forms of key packing interfaces throughout the lattice.

Optical Fiber Power Meter Comparison Between NIST and NIM.

PubMed

Vayshenker, I; Livigni, D J; Li, X; Lehman, J H; Li, J; Xiong, L M; Zhang, Z X

2010-01-01

We describe the results of a comparison of reference standards between the National Institute of Standards and Technology (NIST-USA) and National Institute of Metrology (NIM-China). We report optical fiber-based power measurements at nominal wavelengths of 1310 nm and 1550 nm. We compare the laboratories' reference standards by means of a commercial optical power meter. Measurement results showed the largest difference of less than 2.6 parts in 10(3), which is within the combined standard (k = 1) uncertainty for the laboratories' reference standards.

Towards a framework for developing semantic relatedness reference standards.

PubMed

Pakhomov, Serguei V S; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B; Ruggieri, Alexander; Chute, Christopher G

2011-04-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the "moderate" range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. Copyright © 2010 Elsevier Inc. All rights reserved.

Asking For Help is Helpful: Validation of a Brief Lifestyle and Mood Assessment Tool in Primary Health Care

PubMed Central

Goodyear-Smith, Felicity; Arroll, Bruce; Coupe, Nicole

2009-01-01

PURPOSE The short, validated, self-administered, Case-finding and Help Assessment Tool (CHAT) for lifestyle and mental health assessment of adult patients in primary health care addresses inactivity, tobacco use, alcohol and other drug misuse, problem gambling, depression, anxiety and stress, abuse, and anger problems. For each issue patients are asked whether they would like help, either during the consultation or at a later date. This study aims to assess the value of the help question. METHODS Validation of the CHAT was conducted according to the STAndards for Reporting of Diagnostic accuracy studies statement for diagnostic tests. The setting was Auckland primary care practices with populations ranging from socioeconomically advantaged to deprived. Participants were 755 consecutive primary care patients who completed the CHAT plus the help question and reference standards. Sensitivity, specificity, and likelihood ratios with and without the addition of help the question were calculated. RESULTS Sensitivity ranged from 80% to 98% for the more-common conditions (depression, nicotine dependency, anxiety, problematic drinking). For each condition, specificity increased with the addition of the help question: depression increased from 73% to 98%; anxiety 77% to 99%; drinking 85% to 99%; verbal anger 92% to 99%; verbal abuse 97% to 99%; problematic drinking and gambling 98% to 99%. CONCLUSIONS The help question increased specificity without compromising sensitivity and reduced false positives, thereby increasing the positive predictive value. It allowed patients with comorbidities to prioritize issues they wished to address, indicate their readiness to change, promote self-determination, and give the clinician an indication of which topics to pursue. PMID:19433841

A hospital based pilot study on Epstein-Barr virus in suspected infectious mononucleosis pediatric patients in India.

PubMed

Janani, Madhuravasal Krishnan; Malathi, Jambulingam; Appaswamy, Andal; Singha, Nishi Rani; Madhavan, Hajib Nariharirao

2015-10-29

Infectious mononucleosis (IM) caused by the Epstein-Barr virus (EBV) is commonly diagnosed by detection of antibodies in the patient's sera. Differentiation of acute from chronic and differential diagnosis of EBV-induced IM from IM-like syndrome caused by human cytomegalovirus (CMV) is important. The objective of this study was to standardize and use polymerase chain reaction (PCR) for diagnosis of EBV and evaluate it against enzyme-linked immunosorbent assay (ELISA). ELISA for detection of IgM and IgG antibodies to viral capsid antigen (VCA) and PCR targeting the VCA and EBNA1 gene of EBV and mtrII gene of CMV were performed on180 peripheral blood samples collected from 180 patients with suspected IM. The analytical sensitivity of PCR was evaluated against that of ELISA. Using the standard serological profile as the reference, the EBV-VCA gene was detected in 41 (95%) of 45 samples collected from patients with early primary infections, in 41 (54%) of 75 with recent primary infections, and in7 (17%) of 39 with past infections. The result of VCA PCR was statistically significant in virus detection during early or primary stage of infection. Nineteen (49%) EBV-seropositive samples were positive for CMV by PCR. All control samples tested negative for both VCA and EBNA1by PCR. VCA PCR is sensitive for the detection of EBV DNA in the early or primary stage of infection and can be considered a reliable method to rule out the cross-reactivity and differential diagnosis of EBV-induced IM from IM-like syndrome.

Qualitative evaluation of the iris and ciliary body by ultrasound biomicroscopy in subjects with angle closure.

PubMed

Ku, Judy Y; Nongpiur, Monisha E; Park, Judy; Narayanaswamy, Arun K; Perera, Shamira A; Tun, Tin A; Kumar, Rajesh S; Baskaran, Mani; Aung, Tin

2014-12-01

To qualitatively analyze anterior chamber structures imaged by ultrasound biomicroscopy (UBM) in primary angle-closure patients. Subjects diagnosed as primary angle-closure suspect (PACS), primary angle-closure glaucoma (PACG), and previous acute primary angle closure (APAC) were recruited prospectively along with a group of normal controls. UBM was performed under standardized dark room conditions and qualitative assessment was carried out using a set of reference photographs of standard UBM images to categorize the various anatomic features related to angle configuration. These included overall and basal iris thicknesses, iris convexity, iris angulation, ciliary body size, and ciliary sulcus. A total of 60 PACS, 114 PACG, 41 APAC, and 33 normal controls were included. Patients were predominantly older Chinese females. After controlling the confounding effect of age and sex, eyes with overall thicker irides [medium odds ratio (OR) 3.58, thick OR 2.84] when compared with thin irides have a significantly higher likelihood of having PACS/PACG/APAC versus controls. Thicker basal iris component (medium OR 4.13, thick OR 3.39) also have higher likelihood of having angle closure when compared with thin basal iris thickness. Subjects with basal iris insertion, mild iris angulation, and large ciliary body have a higher OR of having angle closure. In contrast, the presence/absence of a ciliary sulcus did not influence the likelihood of angle closure. Eyes with thicker overall and basal iris thicknesses are more likely to have angle closure than controls. Other features that increase the likelihood of angle closure include basal iris insertion, mild iris angulation, and large ciliary body.

Correcting STIS CCD Point-Source Spectra for CTE Loss

NASA Technical Reports Server (NTRS)

Goudfrooij, Paul; Bohlin, Ralph C.; Maiz-Apellaniz, Jesus

2006-01-01

We review the on-orbit spectroscopic observations that are being used to characterize the Charge Transfer Efficiency (CTE) of the STIS CCD in spectroscopic mode. We parameterize the CTE-related loss for spectrophotometry of point sources in terms of dependencies on the brightness of the source, the background level, the signal in the PSF outside the standard extraction box, and the time of observation. Primary constraints on our correction algorithm are provided by measurements of the CTE loss rates for simulated spectra (images of a tungsten lamp taken through slits oriented along the dispersion axis) combined with estimates of CTE losses for actual spectra of spectrophotometric standard stars in the first order CCD modes. For point-source spectra at the standard reference position at the CCD center, CTE losses as large as 30% are corrected to within approx.1% RMS after application of the algorithm presented here, rendering the Poisson noise associated with the source detection itself to be the dominant contributor to the total flux calibration uncertainty.

40 CFR 50.16 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.16 National primary and secondary ambient air quality standards for lead. (a) The national primary and...

40 CFR 50.12 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.12 National primary and secondary ambient air quality standards for lead. (a) National primary and secondary...

Species specific isotope dilution for the accurate and SI traceable determination of arsenobetaine and methylmercury in cuttlefish and prawn.

PubMed

Kumkrong, Paramee; Thiensong, Benjaporn; Le, Phuong Mai; McRae, Garnet; Windust, Anthony; Deawtong, Suladda; Meija, Juris; Maxwell, Paulette; Yang, Lu; Mester, Zoltán

2016-11-02

Methods based on species specific isotope dilution were developed for the accurate and SI traceable determination of arsenobetaine (AsBet) and methylmercury (MeHg) in prawn and cuttlefish tissues by LC-MS/MS and SPME GC-ICPMS. Quantitation of AsBet and MeHg were achieved by using a 13 C-enriched AsBet spike (NRC CRM CBET-1) and an enriched spike of Me 198 Hg (NRC CRM EMMS-1), respectively, wherein analyte mass fractions in enriched spikes were determined by reverse isotope dilution using natural abundance AsBet and MeHg primary standards. Purity of these primary standards were characterized by quantitative 1 H-NMR with the use of NIST SRM 350b benzoic acid as a primary calibrator, ensuring the final measurement results traceable to SI. Validation of employed methods of ID LC-MS/MS and ID SPME GC-ICPMS was demonstrated by analysis of several biological CRMs (DORM-4, TORT-3, DOLT-5, BCR-627 and BCR-463) with satisfying results. The developed methods were applied for the determination of AsBet and MeHg in two new certified reference materials (CRMs) prawn (PRON-1) and cuttlefish (SQID-1) produced jointly by Thailand Institute of Scientific and Technological Research (TISTR) and National Research Council Canada (NRC). With additional measurements of AsBet using LC-ICPMS with standard additions calibration and external calibration at NRC and TISTR, respectively, certified values of 1.206 ± 0.058 and 13.96 ± 0.54 mg kg -1 for AsBet as As (expanded uncertainty, k = 2) were obtained for the new CRMs PRON-1 and SQID-1, respectively. The reference value of 0.324 ± 0.028 mg kg -1 as Hg (expanded uncertainty, k = 2) for MeHg was obtained for the SQID-1 based on the results obtained by ID SPME GC-ICPMS method only, whereas MeHg in PRON-1 was found to be < 0.015 mg kg -1 . It was found that AsBet comprised 69.7% and 99.0% of total As in the prawn and cuttlefish, respectively, whereas MeHg comprised 94.5% of total Hg in cuttlefish. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Stability and accuracy of International Atomic Time TAI.

NASA Astrophysics Data System (ADS)

Thomas, C.

Since the end of 1992, the quality of the timing data received at the BIPM has rapidly evolved dues to the extensive replacement of older designs of commercial Cs clocks. Consequently, the stability of the reference time scales has improved significantly. This was tested by running modified algorithms over the real clock data collected at the BIPM. Results of different studies are shown here; in particular the implementation of an upper relative contribution, chosen equal to 1.37% for any contributing clock, leads to σy(τ=40 d) = 1.8×10-15. The accuracy of TAI is estimated by the difference between the duration of the TAI scale interval and the SI second as produced on the rotating geoid by primary frequency standards. In this paper, TAI accuracy is evaluated from six primary frequency standards LPTF-FO1, PTB CS1, PTB CS2, PTB CS3, NIST-7 and SU MCsR 102 all corrected in a consistent manner for the gravitational shift and the black-body radiation shift. This led to a mean departure of the TAI scale interval of 1.8×10-14 s over 1995, known with a relative uncertainty of 0.5×10-14 (1σ).

Analytical and assay issues for use of cardiac troponin testing for risk stratification in primary care.

PubMed

Wu, Alan H B; Christenson, Robert H

2013-08-01

Cardiac troponin is the standard marker for diagnosis of acute myocardial infarction and risk stratification of patients who present to an emergency department with signs and symptoms of acute cardiac ischemia. Over the past few years, the analytical sensitivity of assays for cardiac troponin has improved significantly to the point where a detectable amount of troponin can be measured in essentially all healthy subjects. Recent studies have shown that use of a highly sensitive troponin assays may provide value to traditional markers of primary disease risk for patients, i.e., for those who have no history of heart disease. There are barriers to the adoption of cardiac troponin for screening high risk cohorts such as the elderly, diabetics and perhaps even the asymptomatic population. Strategies used for the assignment of cutoff concentrations in acute care, i.e., the 99 th percentile, may not be appropriate for primary care as changes over baseline levels may provide more accurate information of risk than cross-sectional results. A review of biological variation has shown that cardiac troponin as a biomarker has low index of individuality, indicating that reference values are of little utility. Whether or not cardiac troponin can be released in reversible injury is a debate that could have significance for detecting minor myocardial injury. A major hurdle for use of troponin in primary care is the lack of assay standardization and nomenclature for the different generations of troponin assays. Standardization requires knowledge of what is released after cardiac injury and what the various cardiac troponin assays are measuring. Currently it is not clear if the cardiac troponin release after ischemic injury is identical to that in circulation of healthy individuals. This may affect the design of future assays and standardization approaches. There is potential that a marker of myocardial injury such as troponin can add to the value of existing indicators and biomarkers of cardiovascular disease risk. Additional analytical and clinical validations are needed to fully elucidate cardiac troponin metabolism and resolve ongoing clinical and laboratory issues. While these issues are directed to the use of troponin in primary care, most of these concepts are relevant to the use of troponin in acute coronary syndromes as well. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

29 CFR 2703.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false Cross-reference to employee ethical conduct standards and...-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees... of Ethical Conduct at 5 CFR part 2635; the Commission's regulations at 5 CFR part 8401, which...

45 CFR 706.1 - Cross-references to employee ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Cross-references to employee ethical conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 706.1 Cross-references to employee ethical conduct standards... States Commission on Civil Rights are subject to the executive branch standards of ethical conduct...

45 CFR 1105.1 - Cross-reference to employee ethical conduct standards and financial disclosure and financial...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Cross-reference to employee ethical conduct... STANDARDS OF CONDUCT FOR EMPLOYEES § 1105.1 Cross-reference to employee ethical conduct standards and... ethical conduct at 5 CFR part 2635; the executive branch employees responsibilities and conduct...

49 CFR 99.735-1 - Cross-reference to ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Cross-reference to ethical conduct standards and... Transportation EMPLOYEE RESPONSIBILITIES AND CONDUCT General § 99.735-1 Cross-reference to ethical conduct... the executive branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Department of...

39 CFR 3000.735-101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Cross-reference to employee ethical conduct... employee ethical conduct standards and financial disclosure regulations. Employees of the Postal Regulatory Commission (Commission) are subject and should refer to the executive branch-wide Standards of Ethical...

45 CFR 706.1 - Cross-references to employee ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Cross-references to employee ethical conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 706.1 Cross-references to employee ethical conduct standards... States Commission on Civil Rights are subject to the executive branch standards of ethical conduct...

45 CFR 1105.1 - Cross-reference to employee ethical conduct standards and financial disclosure and financial...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Cross-reference to employee ethical conduct... STANDARDS OF CONDUCT FOR EMPLOYEES § 1105.1 Cross-reference to employee ethical conduct standards and... ethical conduct at 5 CFR part 2635; the executive branch employees responsibilities and conduct...

49 CFR 99.735-1 - Cross-reference to ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Cross-reference to ethical conduct standards and... Transportation EMPLOYEE RESPONSIBILITIES AND CONDUCT General § 99.735-1 Cross-reference to ethical conduct... the executive branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Department of...

39 CFR 3000.735-101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Cross-reference to employee ethical conduct... employee ethical conduct standards and financial disclosure regulations. Employees of the Postal Regulatory Commission (Commission) are subject and should refer to the executive branch-wide Standards of Ethical...

29 CFR 2703.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Cross-reference to employee ethical conduct standards and...-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees... of Ethical Conduct at 5 CFR part 2635; the Commission's regulations at 5 CFR part 8401, which...

29 CFR 2703.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Cross-reference to employee ethical conduct standards and...-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees... of Ethical Conduct at 5 CFR part 2635; the Commission's regulations at 5 CFR part 8401, which...

49 CFR 99.735-1 - Cross-reference to ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 1 2013-10-01 2013-10-01 false Cross-reference to ethical conduct standards and... Transportation EMPLOYEE RESPONSIBILITIES AND CONDUCT General § 99.735-1 Cross-reference to ethical conduct... the executive branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Department of...

16 CFR § 1030.101 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Cross-references to employee ethical conduct...-references to employee ethical conduct standards and financial disclosure regulations. Employees of the Consumer Product Safety Commission are subject to the Standards of Ethical Conduct, 5 CFR part 2635, which...

45 CFR 706.1 - Cross-references to employee ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Cross-references to employee ethical conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 706.1 Cross-references to employee ethical conduct standards... States Commission on Civil Rights are subject to the executive branch standards of ethical conduct...

49 CFR 99.735-1 - Cross-reference to ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Cross-reference to ethical conduct standards and... Transportation EMPLOYEE RESPONSIBILITIES AND CONDUCT General § 99.735-1 Cross-reference to ethical conduct... the executive branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Department of...

45 CFR 1105.1 - Cross-reference to employee ethical conduct standards and financial disclosure and financial...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Cross-reference to employee ethical conduct... STANDARDS OF CONDUCT FOR EMPLOYEES § 1105.1 Cross-reference to employee ethical conduct standards and... ethical conduct at 5 CFR part 2635; the executive branch employees responsibilities and conduct...

29 CFR 2703.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Cross-reference to employee ethical conduct standards and...-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees... of Ethical Conduct at 5 CFR part 2635; the Commission's regulations at 5 CFR part 8401, which...

39 CFR 3000.735-101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Cross-reference to employee ethical conduct... employee ethical conduct standards and financial disclosure regulations. Employees of the Postal Regulatory Commission (Commission) are subject and should refer to the executive branch-wide Standards of Ethical...

39 CFR 3000.735-101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Cross-reference to employee ethical conduct... employee ethical conduct standards and financial disclosure regulations. Employees of the Postal Regulatory Commission (Commission) are subject and should refer to the executive branch-wide Standards of Ethical...

45 CFR 1105.1 - Cross-reference to employee ethical conduct standards and financial disclosure and financial...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Cross-reference to employee ethical conduct... STANDARDS OF CONDUCT FOR EMPLOYEES § 1105.1 Cross-reference to employee ethical conduct standards and... ethical conduct at 5 CFR part 2635; the executive branch employees responsibilities and conduct...

29 CFR 2703.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Cross-reference to employee ethical conduct standards and...-reference to employee ethical conduct standards and financial disclosure regulations. Members and employees... of Ethical Conduct at 5 CFR part 2635; the Commission's regulations at 5 CFR part 8401, which...

45 CFR 1105.1 - Cross-reference to employee ethical conduct standards and financial disclosure and financial...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Cross-reference to employee ethical conduct... STANDARDS OF CONDUCT FOR EMPLOYEES § 1105.1 Cross-reference to employee ethical conduct standards and... ethical conduct at 5 CFR part 2635; the executive branch employees responsibilities and conduct...

39 CFR 3000.735-101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Cross-reference to employee ethical conduct... employee ethical conduct standards and financial disclosure regulations. Employees of the Postal Regulatory Commission (Commission) are subject and should refer to the executive branch-wide Standards of Ethical...

45 CFR 706.1 - Cross-references to employee ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Cross-references to employee ethical conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 706.1 Cross-references to employee ethical conduct standards... States Commission on Civil Rights are subject to the executive branch standards of ethical conduct...

45 CFR 706.1 - Cross-references to employee ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Cross-references to employee ethical conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 706.1 Cross-references to employee ethical conduct standards... States Commission on Civil Rights are subject to the executive branch standards of ethical conduct...

49 CFR 99.735-1 - Cross-reference to ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 1 2012-10-01 2012-10-01 false Cross-reference to ethical conduct standards and... Transportation EMPLOYEE RESPONSIBILITIES AND CONDUCT General § 99.735-1 Cross-reference to ethical conduct... the executive branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Department of...

SHORT COMMUNICATION: Transportable Zener-diode Voltage Standard

NASA Astrophysics Data System (ADS)

Karpov, O. V.; Shulga, V. M.; Shakirzyanova, F. R.; Sarandi, A. E.

1994-01-01

Five transportable Zener-diode dc voltage standards have been developed, fabricated and investigated at the NPO VNIIFTRI. The standards were designed to transfer the unit of electromotive force (emf) from Josephson reference standards to measuring instruments. Following the results of these investigations, standard N 02 has been used for intercomparison of the Russian Josephson reference standards.

77 FR 205 - Federal Acquisition Regulation; Federal Acquisition Circular 2005-55; Small Entity Compliance Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

... System. VI Updated Financial 2010-005 Chambers. Accounting Standards Board Accounting References. VII... Financial Accounting Standards Board Accounting References (FAR Case 2010-005) This final rule amends the... authoritative accounting standards owing to the Financial Accounting Standards Board's Accounting Standards...

Development of mass measurement equipment using an electronic mass-comparator for gravimetric preparation of reference gas mixtures

NASA Astrophysics Data System (ADS)

Matsumoto, Nobuhiro; Watanabe, Takuro; Maruyama, Masaaki; Horimoto, Yoshiyuki; Maeda, Tsuneaki; Kato, Kenji

2004-06-01

The gravimetric method is the most popular method for preparing reference gas mixtures with high accuracy. We have designed and manufactured novel mass measurement equipment for gravimetric preparation of reference gas mixtures. This equipment consists of an electronic mass-comparator with a maximum capacity of 15 kg and readability of 1 mg and an automatic cylinder exchanger. The structure of this equipment is simpler and the cost is much lower than a conventional mechanical knife-edge type large balance used for gravimetric preparation of primary gas mixtures in Japan. This cylinder exchanger can mount two cylinders alternatively on the weighing pan of the comparator. In this study, the performance of the equipment has been evaluated. At first, the linearity and repeatability of the mass measurement were evaluated using standard mass pieces. Then, binary gas mixtures of propane and nitrogen were prepared and compared with those prepared with the conventional knife-edge type balance. The comparison resulted in good consistency at the compatibility criterion described in ISO6143:2001.

Validation of the "early detection Primary Care Checklist" in an Italian community help-seeking sample: The "checklist per la Valutazione dell'Esordio Psicotico".

PubMed

Pelizza, Lorenzo; Raballo, Andrea; Semrov, Enrico; Chiri, Luigi Rocco; Azzali, Silvia; Scazza, Ilaria; Garlassi, Sara; Paterlini, Federica; Fontana, Francesca; Favazzo, Rosanna; Pensieri, Luana; Fabiani, Michela; Cioncolini, Leonardo; Pupo, Simona

2017-07-26

To establish the concordant validity of the "Checklist per la Valutazione dell'Esordio Psicotico" (CVEP) in an Italian help-seeking population. The CVEP is the Italian adaptation of the "early detection Primary Care Checklist," a 20-item tool specifically designed to assist primary care practitioners in identifying young people in the early stages of psychosis. The checklist was completed by the referring practitioners of 168 young people referred to the "Reggio Emilia At Risk Mental States" Project, an early detection infrastructure developed under the aegis of the Regional Project on Early Detection of Psychosis in the Reggio Emilia Department of Mental Health. The concordant validity of the CVEP was established by comparing screen results with the outcome of the "Comprehensive Assessment of At Risk Mental States" (CAARMS), a gold standard assessment for identifying young people who may be at risk of developing psychosis. The simple checklist as originally conceived had excellent sensitivity (98%), but lower specificity (58%). Using only a CVEP total score of 20 or above as cut-off, the tool showed a slightly lower sensitivity (93%) with a substantial improvement in specificity (87%). Simple cross-tabulations of the individual CVEP item scores against CAARMS outcome to identify the more discriminant item in terms of sensitivity and specificity were carried out. In comparison to other, much longer, screening tools, the CVEP performed well to identify young people in the early stages of psychosis. Therefore, the CVEP is well suited to optimize appropriate referrals to specialist services, building on the skills and knowledge already available in primary care settings. © 2017 John Wiley & Sons Australia, Ltd.

Analysis of exchanges between novice and cooperating teachers during internships using the NCATE/NASPE Standards for Teacher Preparation in Physical Education as guidelines.

PubMed

Banville, Dominique

2006-06-01

To be recognized as an accredited program, Physical Education Teacher Education (PETE) programs in the country must abide by guidelines put forward by the National Association for Sport and Physical Education (NASPE), in collaboration with the National Council for the Accreditation of Teacher Education (NCATE). The guidelines are divided into nine standards and identify a number of outcomes (NASPE, 1998). The purpose of this study was to determine the nature of the exchanges between novice teachers (NTs) and cooperating teachers (CTs), when using the NASPE Standards (1998) as a reference point, and determine if the focus of the exchanges differed over time and according to data source. Six pairs of CTs and their NT participated in the study. Data were collected through recorded conversations between NTs and their CT as well as NTs' logs. Data showed that the majority of conversations focused on planning and instruction (Standard 6) and management and motivation (Standard 4), while few related to diverse learners (Standard 3), growth and development (Standard 2), and communication (Standard 5). The small amount of information shared by CTs in some standards indicates a need for PETE programs to share the guidelines with CTs to make them aware of the importance of offering a variety of topics to interns, because CTs are the primary source of information during this crucial experience.

14 CFR Appendix F to Part 135 - Airplane Flight Recorder Specification

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Heading (Primary flight crew reference) 0−360° and Discrete “true” or “mag” ±2° 1 0.5° When true or magnetic heading can be selected as the primary heading reference, a discrete indicating selection must be... synchronization reference On-Off (Discrete)None 1 Preferably each crew member but one discrete acceptable for all...

Reference and Standard Atmosphere Models

NASA Technical Reports Server (NTRS)

Johnson, Dale L.; Roberts, Barry C.; Vaughan, William W.; Parker, Nelson C. (Technical Monitor)

2002-01-01

This paper describes the development of standard and reference atmosphere models along with the history of their origin and use since the mid 19th century. The first "Standard Atmospheres" were established by international agreement in the 1920's. Later some countries, notably the United States, also developed and published "Standard Atmospheres". The term "Reference Atmospheres" is used to identify atmosphere models for specific geographical locations. Range Reference Atmosphere Models developed first during the 1960's are examples of these descriptions of the atmosphere. This paper discusses the various models, scopes, applications and limitations relative to use in aerospace industry activities.

Scaling effects on spring phenology detections from MODIS data at multiple spatial resolutions over the contiguous United States

NASA Astrophysics Data System (ADS)

Peng, Dailiang; Zhang, Xiaoyang; Zhang, Bing; Liu, Liangyun; Liu, Xinjie; Huete, Alfredo R.; Huang, Wenjiang; Wang, Siyuan; Luo, Shezhou; Zhang, Xiao; Zhang, Helin

2017-10-01

Land surface phenology (LSP) has been widely retrieved from satellite data at multiple spatial resolutions, but the spatial scaling effects on LSP detection are poorly understood. In this study, we collected enhanced vegetation index (EVI, 250 m) from collection 6 MOD13Q1 product over the contiguous United States (CONUS) in 2007 and 2008, and generated a set of multiple spatial resolution EVI data by resampling 250 m to 2 × 250 m and 3 × 250 m, 4 × 250 m, …, 35 × 250 m. These EVI time series were then used to detect the start of spring season (SOS) at various spatial resolutions. Further the SOS variation across scales was examined at each coarse resolution grid (35 × 250 m ≈ 8 km, refer to as reference grid) and ecoregion. Finally, the SOS scaling effects were associated with landscape fragment, proportion of primary land cover type, and spatial variability of seasonal greenness variation within each reference grid. The results revealed the influences of satellite spatial resolutions on SOS retrievals and the related impact factors. Specifically, SOS significantly varied lineally or logarithmically across scales although the relationship could be either positive or negative. The overall SOS values averaged from spatial resolutions between 250 m and 35 × 250 m at large ecosystem regions were generally similar with a difference less than 5 days, while the SOS values within the reference grid could differ greatly in some local areas. Moreover, the standard deviation of SOS across scales in the reference grid was less than 5 days in more than 70% of area over the CONUS, which was smaller in northeastern than in southern and western regions. The SOS scaling effect was significantly associated with heterogeneity of vegetation properties characterized using land landscape fragment, proportion of primary land cover type, and spatial variability of seasonal greenness variation, but the latter was the most important impact factor.

40 CFR 50.7 - National primary and secondary ambient air quality standards for PM2.5.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.7 National primary and secondary ambient air quality standards for PM2.5. (a) The national primary and...

40 CFR 50.13 - National primary and secondary ambient air quality standards for PM2.5.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.13 National primary and secondary ambient air quality standards for PM2.5. (a) The national primary...

[Meta-analysis of diagnostic capability of frequency-doubling technology (FDT) for primary glaucoma].

PubMed

Liu, Ting; He, Xiang-ge

2006-05-01

To evaluate the overall diagnostic capabilities of frequency-doubling technology (FDT) in patients of primary glaucoma, with standard automated perimetry (SAP) and/or optic disc appearance as the gold standard. A comprehensive electric search in MEDLINE, EMBASE, Cochrane Library, BIOSIS, Previews, HMIC, IPA, OVID, CNKI, CBMdisc, VIP information, CMCC, CCPD, SSreader and 21dmedia and a manual search in related textbooks, journals, congress articles and their references were performed to identify relevant English and Chinese language articles. Criteria for adaptability were established according to validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Quality of the included articles was assessed and relevant materials were extracted for studying. Statistical analysis was performed with Meta Test version 0.6 software. Heterogeneity of the included articles was tested, which was used to select appropriate effect model to calculate pooled weighted sensitivity and specificity. Summary Receiver Operating Characteristic (SROC) curve was established and the area under the curve (AUC) was calculated. Finally, sensitivity analysis was performed. Fifteen English articles (21 studies) of 206 retrieved articles were included in the present study, with a total of 3172 patients. The reported sensitivity of FDT ranged from 0.51 to 1.00, and specificity from 0.58 to 1.00. The pooled weighted sensitivity and specificity for FDT with 95% confidence intervals (95% CI) after correction for standard error were 0.86 (0.80 - 0.90), 0.87 (0.81 - 0.91), respectively. The AUC of SROC was 93.01%. Sensitivity analysis demonstrated no disproportionate influences of individual study. The included articles are of good quality and FDT can be a highly efficient diagnostic test for primary glaucoma based on Meta-analysis. However, a high quality perspective study is still required for further analysis.

15 CFR 200.104 - Standard reference materials.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the NIST National Measurement Laboratory administers a program to provide many types of well... be readily referred to a common base. NIST SP 260 is a catalog of Standard Reference Materials available from NIST. ...

15 CFR 200.104 - Standard reference materials.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the NIST National Measurement Laboratory administers a program to provide many types of well... be readily referred to a common base. NIST SP 260 is a catalog of Standard Reference Materials available from NIST. ...

15 CFR 200.104 - Standard reference materials.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the NIST National Measurement Laboratory administers a program to provide many types of well... be readily referred to a common base. NIST SP 260 is a catalog of Standard Reference Materials available from NIST. ...

15 CFR 200.104 - Standard reference materials.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the NIST National Measurement Laboratory administers a program to provide many types of well... be readily referred to a common base. NIST SP 260 is a catalog of Standard Reference Materials available from NIST. ...

15 CFR 200.104 - Standard reference materials.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the NIST National Measurement Laboratory administers a program to provide many types of well... be readily referred to a common base. NIST SP 260 is a catalog of Standard Reference Materials available from NIST. ...

Coherent Frequency Reference System for the NASA Deep Space Network

NASA Technical Reports Server (NTRS)

Tucker, Blake C.; Lauf, John E.; Hamell, Robert L.; Gonzaler, Jorge, Jr.; Diener, William A.; Tjoelker, Robert L.

2010-01-01

The NASA Deep Space Network (DSN) requires state-of-the-art frequency references that are derived and distributed from very stable atomic frequency standards. A new Frequency Reference System (FRS) and Frequency Reference Distribution System (FRD) have been developed, which together replace the previous Coherent Reference Generator System (CRG). The FRS and FRD each provide new capabilities that significantly improve operability and reliability. The FRS allows for selection and switching between frequency standards, a flywheel capability (to avoid interruptions when switching frequency standards), and a frequency synthesis system (to generate standardized 5-, 10-, and 100-MHz reference signals). The FRS is powered by redundant, specially filtered, and sustainable power systems and includes a monitor and control capability for station operations to interact and control the frequency-standard selection process. The FRD receives the standardized 5-, 10-, and 100-MHz reference signals and distributes signals to distribution amplifiers in a fan out fashion to dozens of DSN users that require the highly stable reference signals. The FRD is also powered by redundant, specially filtered, and sustainable power systems. The new DSN Frequency Distribution System, which consists of the FRS and FRD systems described here, is central to all operational activities of the NASA DSN. The frequency generation and distribution system provides ultra-stable, coherent, and very low phase-noise references at 5, l0, and 100 MHz to between 60 and 100 separate users at each Deep Space Communications Complex.

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

PubMed Central

Pool, Jan J. M.; van Tulder, Maurits W.; Riphagen, Ingrid I.; de Vet, Henrica C. W.

2006-01-01

Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. A study was included if: (1) any provocative test of the neck for diagnosing cervical radiculopathy was identified; (2) any reference standard was used; (3) sensitivity and specificity were reported or could be (re-)calculated; and, (4) the publication was a full report. Two reviewers independently selected studies, and assessed methodological quality. Only six studies met the inclusion criteria, which evaluated five provocative tests. In general, Spurling’s test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva’s maneuver. The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity. Common methodological flaws included lack of an optimal reference standard, disease progression bias, spectrum bias, and review bias. Limitations include few primary studies, substantial heterogeneity, and numerous methodological flaws among the studies; therefore, a meta-analysis was not conducted. This review suggests that, when consistent with the history and other physical findings, a positive Spurling’s, traction/neck distraction, and Valsalva’s might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue. PMID:17013656

Health of children classified as underweight by CDC reference but normal by WHO standard.

PubMed

Meyers, Alan; Joyce, Katherine; Coleman, Sharon M; Cook, John T; Cutts, Diana; Ettinger de Cuba, Stephanie; Heeren, Timothy C; Rose-Jacobs, Ruth; Black, Maureen M; Casey, Patrick H; Chilton, Mariana; Sandel, Megan; Frank, Deborah A

2013-06-01

To ascertain measures of health status among 6- to 24-month-old children classified as below normal weight-for-age (underweight) by the Centers for Disease Control and Prevention (CDC) 2000 growth reference but as normal weight-for-age by the World Health Organization (WHO) 2006 standard. Data were gathered from children and primary caregivers at emergency departments and primary care clinics in 7 US cities. Outcome measures included caregiver rating of child health, parental evaluation of developmental status, history of hospitalizations, and admission to hospital at the time of visit. Children were classified as (1) not underweight by either CDC 2000 or WHO 2006 criteria, (2) underweight by CDC 2000 but not by WHO 2006 criteria, or (3) underweight by both criteria. Associations between these categories and health outcome measures were assessed by using multiple logistic regression analysis. Data were available for 18 420 children. For each health outcome measure, children classified as underweight by CDC 2000 but normal by WHO 2006 had higher adjusted odds ratios (aORs) of adverse health outcomes than children not classified as underweight by either; children classified as underweight by both had the highest aORs of adverse outcomes. For example, compared with children not underweight by either criteria, the aORs for fair/poor health rating were 2.54 (95% confidence interval: 2.20-2.93) among children underweight by CDC but not WHO and 3.76 (3.13-4.51) among children underweight by both. Children who are reclassified from underweight to normal weight in changing from CDC 2000 to WHO 2006 growth charts may still be affected by morbidities associated with underweight.

Lactase Non-Persistence Genotyping: Comparison of Two Real-Time PCR Assays and Assessment of Concomitant Fructose/Sorbitol Malabsorption Rates.

PubMed

Enko, Dietmar; Pollheimer, Verena; Németh, Stefan; Pühringer, Helene; Stolba, Robert; Halwachs-Baumann, Gabriele; Kriegshäuser, Gernot

2016-01-01

Genetic testing is a standard technique for the diagnosis of primary adult-type hypolactasia, also referred to as lactase non-persistence. The aim of this study was to compare the lactase gene (LCT) C/T-13910 polymorphism genotyping results of two commercially available real-time (RT)-PCR assays in patients referred to our outpatient clinic for primary lactose malabsorption testing. Furthermore, concomitant conditions of fructose/sorbitol malabsorption were assessed. Samples obtained from 100 patients were tested in parallel using the LCT T-13910C ToolSet for Light Cycler (Roche, Rotkreuz, Switzerland) and the LCT-13910C>T RealFast Assay (ViennaLab Diagnostics GmbH, Vienna, Austria). Additionally, patients were also screened for the presence of fructose/sorbitol malabsorption by functional hydrogen (H2)/methane (CH4) breath testing (HMBT). Cohen's Kappa (κ) was used to calculate the agreement between the two genotyping methods. The exact Chi-Square test was performed to compare fructose/sorbitol HMBT with LCT genotyping results. Twenty-one (21.0%) patients had a LCT C/C-13910 genotype suggestive of lactase non-persistence, and 79 (79.0%) patients were identified with either a LCT T/C-13910 or T/T-13910 genotype (i.e., lactase persistence). In all genotype groups, concordance between the two RT-PCR assays was 100%. Cohen's κ demonstrated perfect observed agreement (p < 0.001, κ = 1). Fructose and sorbitol malabsorption was observed in 13/100 (13.0%) and 25/100 (25.0%) individuals, respectively. Both RT-PCR assays are robust and reliable LCT genotyping tools in a routine clinical setting. Concomitant fructose and/or sorbitol malabsorption should be considered in individuals with suspected lactase-non-persistence. However, standardization of clinical interpretation of laboratory HMBT results is required.

Pump-probe imaging of pigmented cutaneous melanoma primary lesions gives insight into metastatic potential

PubMed Central

Robles, Francisco E.; Deb, Sanghamitra; Wilson, Jesse W.; Gainey, Christina S.; Selim, M. Angelica; Mosca, Paul J.; Tyler, Douglas S.; Fischer, Martin C.; Warren, Warren S.

2015-01-01

Metastatic melanoma is associated with a poor prognosis, but no method reliably predicts which melanomas of a given stage will ultimately metastasize and which will not. While sentinel lymph node biopsy (SLNB) has emerged as the most powerful predictor of metastatic disease, the majority of people dying from metastatic melanoma still have a negative SLNB. Here we analyze pump-probe microscopy images of thin biopsy slides of primary melanomas to assess their metastatic potential. Pump-probe microscopy reveals detailed chemical information of melanin with subcellular spatial resolution. Quantification of the molecular signatures without reference standards is achieved using a geometrical representation of principal component analysis. Melanin structure is analyzed in unison with the chemical information by applying principles of mathematical morphology. Results show that melanin in metastatic primary lesions has lower chemical diversity than non-metastatic primary lesions, and contains two distinct phenotypes that are indicative of aggressive disease. Further, the mathematical morphology analysis reveals melanin in metastatic primary lesions has a distinct “dusty” quality. Finally, a statistical analysis shows that the combination of the chemical information with spatial structures predicts metastatic potential with much better sensitivity than SLNB and high specificity, suggesting pump-probe microscopy can be an important tool to help predict the metastatic potential of melanomas. PMID:26417529

Assessing the impact of adjusting for maturity in weight status classification in a cross-sectional sample of UK children.

PubMed

Gillison, Fiona; Cumming, Sean; Standage, Martyn; Barnaby, Catherine; Katzmarzyk, Peter

2017-06-26

To compare the weight categorisation of a cohort of UK children using standard procedures (ie, comparing body mass index (BMI) centiles to age-matched UK reference data) versus an approach adjusted for maturation status (ie, matching relative to biological age). Analysis of data collected from an observational study of UK primary school children. Schools in South West England. Four hundred and seven 9-11 year-old children (98% white British). Weight status was classified using BMI centiles using (1) sex and chronological age-matched referents and (2) sex and biological age-matched referents (based on % of predicted adult stature) relative to UK 1990 reference growth charts. For both approaches, children were classified as a normal weight if >2nd centile and <85thcentile, overweight if 85th and <95thcentiles, and obese if ≥95thcentile. Fifty-one children (12.5%) were overweight, and a further 51 obese (12.5%) according to standard chronological age-matched classifications. Adjustment for maturity resulted in 32% of overweight girls, and 15% of overweight boys being reclassified as a normal weight, and 11% and 8% of obese girls and boys, respectively, being reclassified as overweight. Early maturing children were 4.9 times more likely to be reclassified from overweight to normal weight than 'on-time' maturers (OR 95% CI 1.3 to 19). Incorporating assessments of maturational status into weight classification resulted in significant changes to the classification of early-maturing adolescents. Further research exploring the implications for objective health risk and well-being is needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

12 CFR 336.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Cross-reference to employee ethical conduct... and Conduct § 336.1 Cross-reference to employee ethical conduct standards and financial disclosure... Branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Corporation regulation at 5 CFR part...

12 CFR 264.101 - Cross-reference to employees' ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Cross-reference to employees' ethical conduct... § 264.101 Cross-reference to employees' ethical conduct standards and financial disclosure regulations... branch-wide standards of ethical conduct at 5 CFR part 2635 and the Board's regulation at 5 CFR part 6801...

10 CFR 1010.102 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Cross-references to employee ethical conduct standards... ENERGY (GENERAL PROVISIONS) CONDUCT OF EMPLOYEES § 1010.102 Cross-references to employee ethical conduct... Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635, the DOE regulation at...

12 CFR 336.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Cross-reference to employee ethical conduct... and Conduct § 336.1 Cross-reference to employee ethical conduct standards and financial disclosure... Branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Corporation regulation at 5 CFR part...

12 CFR 264.101 - Cross-reference to employees' ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Cross-reference to employees' ethical conduct... § 264.101 Cross-reference to employees' ethical conduct standards and financial disclosure regulations... branch-wide standards of ethical conduct at 5 CFR part 2635 and the Board's regulation at 5 CFR part 6801...

12 CFR 264.101 - Cross-reference to employees' ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Cross-reference to employees' ethical conduct... AND CONDUCT § 264.101 Cross-reference to employees' ethical conduct standards and financial disclosure... executive branch-wide standards of ethical conduct at 5 CFR part 2635 and the Board's regulation at 5 CFR...

12 CFR 264.101 - Cross-reference to employees' ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Cross-reference to employees' ethical conduct... AND CONDUCT § 264.101 Cross-reference to employees' ethical conduct standards and financial disclosure... executive branch-wide standards of ethical conduct at 5 CFR part 2635 and the Board's regulation at 5 CFR...

12 CFR 336.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Cross-reference to employee ethical conduct... and Conduct § 336.1 Cross-reference to employee ethical conduct standards and financial disclosure... Branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Corporation regulation at 5 CFR part...

12 CFR 336.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Cross-reference to employee ethical conduct... and Conduct § 336.1 Cross-reference to employee ethical conduct standards and financial disclosure... Branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Corporation regulation at 5 CFR part...

12 CFR 336.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Cross-reference to employee ethical conduct... and Conduct § 336.1 Cross-reference to employee ethical conduct standards and financial disclosure... Branch-wide Standards of Ethical Conduct at 5 CFR part 2635, the Corporation regulation at 5 CFR part...

12 CFR 264.101 - Cross-reference to employees' ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Cross-reference to employees' ethical conduct... AND CONDUCT § 264.101 Cross-reference to employees' ethical conduct standards and financial disclosure... executive branch-wide standards of ethical conduct at 5 CFR part 2635 and the Board's regulation at 5 CFR...

Fundamental concepts of integrated and fiber optic sensors

NASA Technical Reports Server (NTRS)

Tuma, Margaret L.

1995-01-01

This chapter discusses fiber optic and integrated optic sensor concepts. Unfortunately, there is no standard method to categorize these sensor concepts. Here, fiber optic and integrated optic sensor concepts will be categorized by the primary modulation technique. These modulation techniques have been classified as: intensity, phase, wavelength, polarization, and time/frequency modulation. All modulate the output light with respect to changes in the physical or chemical property to be measured. Each primary modulation technique is then divided into fiber optic and integrated optic sections which are treated independently. For each sensor concept, possible sensor applications are discussed. The sensors and references discussed are not exhaustive, but sufficient to give the reader an overview of sensor concepts developed to date. Sensor multiplexing techniques such as wavelength division, time division, and frequency division will not be discussed as they are beyond the scope of this report.

How accurately can the peak skin dose in fluoroscopy be determined using indirect dose metrics?

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org; Ensor, Joe E.; Pasciak, Alexander S.

Purpose: Skin dosimetry is important for fluoroscopically-guided interventions, as peak skin doses (PSD) that result in skin reactions can be reached during these procedures. There is no consensus as to whether or not indirect skin dosimetry is sufficiently accurate for fluoroscopically-guided interventions. However, measuring PSD with film is difficult and the decision to do so must be madea priori. The purpose of this study was to assess the accuracy of different types of indirect dose estimates and to determine if PSD can be calculated within ±50% using indirect dose metrics for embolization procedures. Methods: PSD were measured directly using radiochromicmore » film for 41 consecutive embolization procedures at two sites. Indirect dose metrics from the procedures were collected, including reference air kerma. Four different estimates of PSD were calculated from the indirect dose metrics and compared along with reference air kerma to the measured PSD for each case. The four indirect estimates included a standard calculation method, the use of detailed information from the radiation dose structured report, and two simplified calculation methods based on the standard method. Indirect dosimetry results were compared with direct measurements, including an analysis of uncertainty associated with film dosimetry. Factors affecting the accuracy of the different indirect estimates were examined. Results: When using the standard calculation method, calculated PSD were within ±35% for all 41 procedures studied. Calculated PSD were within ±50% for a simplified method using a single source-to-patient distance for all calculations. Reference air kerma was within ±50% for all but one procedure. Cases for which reference air kerma or calculated PSD exhibited large (±35%) differences from the measured PSD were analyzed, and two main causative factors were identified: unusually small or large source-to-patient distances and large contributions to reference air kerma from cone beam computed tomography or acquisition runs acquired at large primary gantry angles. When calculated uncertainty limits [−12.8%, 10%] were applied to directly measured PSD, most indirect PSD estimates remained within ±50% of the measured PSD. Conclusions: Using indirect dose metrics, PSD can be determined within ±35% for embolization procedures. Reference air kerma can be used without modification to set notification limits and substantial radiation dose levels, provided the displayed reference air kerma is accurate. These results can reasonably be extended to similar procedures, including vascular and interventional oncology. Considering these results, film dosimetry is likely an unnecessary effort for these types of procedures when indirect dose metrics are available.« less

46 CFR 160.050-1 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 6 2010-10-01 2010-10-01 false Incorporation by reference. 160.050-1 Section 160.050-1....050-1 Incorporation by reference. (a) Standard. This subpart makes reference to Federal Standard No... Service Center, General Services Administration, Washington, DC 20407. [USCG-1999-6216, 64 FR 53228, Oct...

PREVALENCE AND DETERMINANTS OF STUNTING AMONG PRIMARY SCHOOL CHILDREN IN RURAL AND URBAN COMMUNITIES IN OBAFEMI OWODE LOCAL GOVERNMENT AREA, SOUTHWESTERN NIGERIA

PubMed Central

Adenuga, W.U.; Obembe, T.A.; Odebunmi, K.O.; Asuzu, M.C.

2017-01-01

Background: Studies on stunting in children have largely focused on the underfive, establishing it as a strong predictor of mortality in these children. Few studies have documented the prevalence or determinants of stunting among school children in southwestern Nigeria. The aim of the study was to determine the prevalence and predictors of stunting among selected primary school children in rural and urban communities of Obafemi Owode Local Government Area, Ogun State. Method: A cross-sectional study of rural and urban primary school children was conducted. An interviewer-administered questionnaire was used to collect information on respondents' and parents' socio-demographic characteristics. Stunting was defined as height-for-age less than two standard deviations from the median height-for-age of the standard World Health Organization reference population. Using EPI-INFO version 6.03, children were classified as stunted if z-scores of height-for-age were less than 2 standard deviations below the National Centre for Health statistics (NCHS)/WHO median. Height and weight were taken using a stadiometer and weighing scale respectively. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 16.0 while predictors were determined using logistic regression at 95% level of significance. Results: A total of 1,160 primary school children were studied with 52.2% from rural schools. Males constituted 57.1% and 51.8% in the rural and urban school respectively. Prevalence of stunting among rural school children was 46.2%, and was significantly higher (p≤0.001) than among urban children at 33.8%. Younger children <10 years (OR: 0.088; 95CI: 0.052 - 0.150) and children between 11-12 years (OR: 0.534; 95CI: 0.322 - 0.886) were at a significantly lower risk of stunting both in rural schools compared to children >13 years. Conclusion: The prevalence of stunting was high especially among pupils from schools in the rural communities. This underscores the need for urgent feasible and effective nutrition programs for primary school children especially those in rural schools within the study area. PMID:28970765

Optical-Fiber Power Meter Comparison Between NIST and PTB.

PubMed

Vayshenker, I; Haars, H; Li, X; Lehman, J H; Livigni, D J

2003-01-01

We describe the results of a comparison of reference standards between the National Institute of Standards and Technology (NIST-USA) and Physikalisch-Technische Bundesanstalt (PTB-Germany) at nominal wavelengths of 1300 nm and 1550 nm using an optical-fiber cable. Both laboratories used thermal detectors as reference standards. A novel temperature-controlled, optical-trap detector was used as a transfer standard to compare two reference standards. Measurement results showed differences of less than 1.5 × 10(-3), which is within the combined uncertainty for both laboratories.

Drinking Water Maximum Contaminant Levels (MCLs)

EPA Pesticide Factsheets

National Primary Drinking Water Regulations (NPDWRs or primary standards) are legally enforceable standards that apply to public water systems. Primary standards protect public health by limiting the levels of contaminants in drinking water.

Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett's esophagus.

PubMed

Shariff, Mohammed K; Varghese, Sibu; O'Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Fitzgerald, Rebecca C; di Pietro, Massimiliano

2016-02-01

The transnasal endosheath endoscope is a new disposable technology with potential applicability to the primary care setting. The aim of this study was to evaluate the efficacy of transnasal endosheath endoscopy (TEE) for the detection of Barrett's esophagus, by comparing the diagnostic accuracy of TEE with that of standard endoscopy. This was a prospective, randomized, crossover study performed in a single tertiary referral center. Consecutive patients undergoing surveillance for Barrett's esophagus or referred for diagnostic assessment were recruited. All patients were randomized to undergo TEE followed by standard endoscopy or the reverse. Endoscopy experiences and patient preferences were evaluated using a questionnaire. Endoscopic and histologic diagnosis of Barrett's esophagus, and optical image quality of both endoscopic procedures, were compared. A total of 21 of 25 patients completed the study. TEE had sensitivity and specificity of 100 % for an endoscopic diagnosis of Barrett's esophagus, and of 66.7 % and 100 %, respectively, for the histologic diagnosis of Barrett's esophagus. The mean optical quality of standard endoscopy was significantly better than that of TEE (7.11 ± 0.42 vs. 4.06 ± 0.27; P < 0.0001). However, following endoscopy, patients reported a significantly better experience with TEE compared with standard endoscopy (7.05 ± 0.49 vs. 4.35 ± 0.53; P = 0.0006), with 60 % preferring TEE and 25 % preferring sedated standard endoscopy. In this study, TEE had equal accuracy for an endoscopic diagnosis of Barrett's esophagus compared with standard endoscopy, at the expense of reduced image quality and a lower yield of intestinal metaplasia on biopsy. TEE was better tolerated and preferred by patients. Hence, TEE needs further evaluation in primary care as an initial diagnostic tool. © Georg Thieme Verlag KG Stuttgart · New York.

First international comparison of fountain primary frequency standards via a long distance optical fiber link

NASA Astrophysics Data System (ADS)

Guéna, J.; Weyers, S.; Abgrall, M.; Grebing, C.; Gerginov, V.; Rosenbusch, P.; Bize, S.; Lipphardt, B.; Denker, H.; Quintin, N.; Raupach, S. M. F.; Nicolodi, D.; Stefani, F.; Chiodo, N.; Koke, S.; Kuhl, A.; Wiotte, F.; Meynadier, F.; Camisard, E.; Chardonnet, C.; Le Coq, Y.; Lours, M.; Santarelli, G.; Amy-Klein, A.; Le Targat, R.; Lopez, O.; Pottie, P. E.; Grosche, G.

2017-06-01

We report on the first comparison of distant caesium fountain primary frequency standards (PFSs) via an optical fiber link. The 1415 km long optical link connects two PFSs at LNE-SYRTE (Laboratoire National de métrologie et d’Essais—SYstème de Références Temps-Espace) in Paris (France) with two at PTB (Physikalisch-Technische Bundesanstalt) in Braunschweig (Germany). For a long time, these PFSs have been major contributors to accuracy of the International Atomic Time (TAI), with stated accuracies of around 3× {{10}-16} . They have also been the references for a number of absolute measurements of clock transition frequencies in various optical frequency standards in view of a future redefinition of the second. The phase coherent optical frequency transfer via a stabilized telecom fiber link enables far better resolution than any other means of frequency transfer based on satellite links. The agreement for each pair of distant fountains compared is well within the combined uncertainty of a few 10-16 for all the comparisons, which fully supports the stated PFSs’ uncertainties. The comparison also includes a rubidium fountain frequency standard participating in the steering of TAI and enables a new absolute determination of the 87Rb ground state hyperfine transition frequency with an uncertainty of 3.1× {{10}-16} . This paper is dedicated to the memory of André Clairon, who passed away on 24 December 2015, for his pioneering and long-lasting efforts in atomic fountains. He also pioneered optical links from as early as 1997.

Field Demonstration and Validation of a New Device for Measuring Water and Solute Fluxes at CFB Borden

DTIC Science & Technology

2006-11-01

All Quality Control Reference Materials are acquired only from authorized vendors or sources commonly used by U.S. EPA Regional Laboratories...Institue of Standards and Testing (NITS) Standard Reference Materials (SRM) or to the U.S. EPA Reference Standards. Working Standards The commercial...contaminants from clothing or equipment by blowing, shaking or any other means that may disperse material into the air is prohibited. 7.1.3. All disposable

A standard satellite control reference model

NASA Technical Reports Server (NTRS)

Golden, Constance

1994-01-01

This paper describes a Satellite Control Reference Model that provides the basis for an approach to identify where standards would be beneficial in supporting space operations functions. The background and context for the development of the model and the approach are described. A process for using this reference model to trace top level interoperability directives to specific sets of engineering interface standards that must be implemented to meet these directives is discussed. Issues in developing a 'universal' reference model are also identified.

The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists.

PubMed

Chanques, Gérald; Ely, E Wesley; Garnier, Océane; Perrigault, Fanny; Eloi, Anaïs; Carr, Julie; Rowan, Christine M; Prades, Albert; de Jong, Audrey; Moritz-Gasser, Sylvie; Molinari, Nicolas; Jaber, Samir

2018-03-01

One third of patients admitted to an intensive care unit (ICU) will develop delirium. However, delirium is under-recognized by bedside clinicians without the use of delirium screening tools, such as the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU). The CAM-ICU was updated in 2014 to improve its use by clinicians throughout the world. It has never been validated compared to the new reference standard, the Diagnostic and Statistical Manual of Mental Disorders 5th version (DSM-5). We made a prospective psychometric study in a 16-bed medical-surgical ICU of a French academic hospital, to measure the diagnostic performance of the 2014 updated CAM-ICU compared to the DSM-5 as the reference standard. We included consecutive adult patients with a Richmond Agitation Sedation Scale (RASS) ≥ -3, without preexisting cognitive disorders, psychosis or cerebral injury. Delirium was independently assessed by neuropsychological experts using an operationalized approach to DSM-5, by investigators using the CAM-ICU and the ICDSC, by bedside clinicians and by ICU patients. The sensitivity, specificity, positive and negative predictive values were calculated considering neuropsychologist DSM-5 assessments as the reference standard (primary endpoint). CAM-ICU inter-observer agreement, as well as that between delirium diagnosis methods and the reference standard, was summarized using κ coefficients, which were subsequently compared using the Z-test. Delirium was diagnosed by experts in 38% of the 108 patients included for analysis. The CAM-ICU had a sensitivity of 83%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 91%. Compared to the reference standard, the CAM-ICU had a significantly (p < 0.05) higher agreement (κ = 0.86 ± 0.05) than the physicians,' residents' and nurses' diagnoses (κ = 0.65 ± 0.09; 0.63 ± 0.09; 0.61 ± 0.09, respectively), as well as the patient's own impression of feeling delirious (κ = 0.02 ± 0.11). Differences between the ICDSC (κ = 0.69 ± 0.07) and CAM-ICU were not significant (p = 0.054). The CAM-ICU demonstrated a high reliability for inter-observer agreement (κ = 0.87 ± 0.06). The 2014 updated version of the CAM-ICU is valid according to DSM-5 criteria and reliable regarding inter-observer agreement in a research setting. Delirium remains under-recognized by bedside clinicians.

The role of standards in the development and implementation of clinical laboratory tests: a domestic and global perspective.

PubMed

Michaud, Ginette Y

2005-01-01

In the field of clinical laboratory medicine, standardization is aimed at increasing the trueness and reliability of measured values. Standardization relies on the use of written standards, reference measurement procedures and reference materials. These are important tools for the design and validation of new tests, and for establishing the metrological traceability of diagnostic assays. Their use supports the translation of research technologies into new diagnostic assays and leads to more rapid advances in science and medicine, as well as improvements in the quality of patient care. The various standardization tools are described, as are the procedures by which written standards, reference procedures and reference materials are developed. Recent efforts to develop standards for use in the field of molecular diagnostics are discussed. The recognition of standardization tools by the FDA and other regulatory authorities is noted as evidence of their important role in ensuring the safety and performance of in vitro diagnostic devices.

KEY COMPARISON: Results of the APMP Pressure key comparison APMP.M.P-K1c in gas media and gauge mode from 0.4 MPa to 4.0 MPa

NASA Astrophysics Data System (ADS)

Bandyopadhyay, A. K.; Woo, Sam Yong; Fitzgerald, Mark; Man, John; Ooiwa, Akira; Jescheck, M.; Jian, Wu; Fatt, Chen Soo; Chan, T. K.; Moore, Ken; El-Tawil, Alaaeldin A. E.

2003-01-01

This report summarizes the results of a regional key comparison (APMP-IC-2-97) under the aegis of the Asia Pacific Metrology Program (APMP) for pressure measurements in gas media and in gauge mode from 0.4 MPa to 4.0 MPa. The transfer standard was a pressure-balance with a piston-cylinder assembly with nominal effective area 8.4 mm2 (V-407) and was supplied by the National Metrology Institute of Japan [NMIJ]. Ten standard laboratories from the APMP region with one specially invited laboratory from the EUROMET region, namely Physikalisch-Technische Bundesanstalt (PTB), Germany, participated in this comparison. The comparison started in October 1998 and was completed in May 2001. The pilot laboratory prepared the calibration procedure [1] as per the guidelines of APMP and the International Bureau of Weights and Measures (BIPM) [2-4]. Detailed instructions for performing this key comparison were provided in the calibration protocol [1] and the required data were described in: (1) Annex 3 - characteristics of the laboratory standards, (2) Annex 4 - the effective area (A'p'/mm2) (the prime indicates values based on measured quantities) at 23°C of the travelling standard as a function of nominal pressure (p'/MPa) (five cycles both increasing and decreasing pressures at ten pre-determined pressure points) and (3) Annex 5 - the average effective area at 23°C (A'p'/mm2) obtained for each pressure p'/MPa with all uncertainty statements. The pilot laboratory processed the information and the data provided by the participants for these three annexes, starting with the information about the standards as provided in Annex 3. Based on this information, the participating laboratories are classified into two categories: (I) laboratories that are maintaining primary standards, and (II) laboratories that are maintaining standards loosely classified as secondary standards with a clear traceability as per norm of the BIPM. It is observed that out of these eleven laboratories, six laboratories have primary standards [Category (I)], the remaining five laboratories are placed in Category (II). The obtained data were compiled and processed under the same program as per the Consultative Committee for Mass and Related Quantities (CCM)/BIPM guidelines. From the data of Category (I), we evaluated the APMP reference value as a function of p'/MPa. Then, we estimated the relative difference of the A'p' values with reference to the APMP reference value for all participating laboratories and we observed that they agree well within their expanded uncertainties. We further estimated the effective area at null pressure and at 23°C (A'0/mm2) and the pressure distortion coefficient (lambda'/MPa-1) of the transfer standard for all the participating laboratories. We then estimated the relative deviation of the A'0/mm2 from the reference value for all eleven laboratories and compared this with their estimated expanded uncertainties. The result is once again extremely encouraging and all these eleven laboratories are agreeing within their estimated maximum expanded uncertainties. We also estimated the degree of equivalence between any two participating laboratories following a matrix mechanism. This once again agrees extremely well within the estimated relative standard uncertainty, which is derived for the two participating laboratories. Finally, a new method has been introduced to evaluate these results and establish a link to CCM.P-K1c and EUROMET.M.P-K2 at two nominal pressures, near 1 MPa and 4 MPa. Again the results show an agreement of all participating laboratories in the present comparison to within the estimated expanded uncertainties using a coverage factor k = 2. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the APMP, according to the provisions of the Mutual Recognition Arrangement (MRA).

Australian Aboriginal and Torres Strait Islander-focused primary healthcare social and emotional wellbeing research: a systematic review protocol.

PubMed

Farnbach, Sara; Eades, Anne-Marie; Hackett, Maree Lisa

2015-12-30

Research with a focus on Aboriginal and Torres Strait Islander Australian's (hereafter referred to as Indigenous(1)) needs is crucial to ensure culturally appropriate evidence-based strategies are developed to improve health. However, concerns surrounding this research exist, arising from some previous research lacking community consultation, resulting in little community benefit or infringing on important cultural values. Values and Ethics: Guidelines for Ethical conduct in Aboriginal and Torres Strait Islander Health Research (hereafter referred to as Values and Ethics), developed by The National Health and Medical Research Council of Australia in 2003, is the ethical standard for Indigenous-focused health research. Researchers must address its Values in research design and conduct. However, its impact on research processes is unclear. Local Protocols should also be considered. This review aims to systematically examine practices related to Values and Ethics, Local Protocols and the processes of conducting Indigenous-focused primary healthcare research in collaboration with external researchers. The following electronic databases and grey literature will be searched (2003 to current): MEDLINE, EMBASE, CINAHL, Informit and HealthInfoNet--an Indigenous-specific research and program website. Indigenous-focused research will be included. Research must be conducted in one or more primary healthcare services, in collaboration with external researchers and with a focus on social and emotional well being. One reviewer will review titles and abstracts to remove obviously irrelevant research articles. Full-text research articles will be retrieved and independently examined by two reviewers. Data and quality assessment will be completed by one reviewer and verified by a second reviewer. Quality will be assessed using modified versions of established quality assessment tools. This review will provide information on research processes and the impact of Values and Ethics on Indigenous-focused primary healthcare research, informing communities and primary healthcare staff around research practices, and researchers and policy makers of strengths and weaknesses of practice. PROSPERO CRD42015024994.

EMRP JRP MetNH3: Towards a Consistent Metrological Infrastructure for Ammonia Measurements in Ambient Air

NASA Astrophysics Data System (ADS)

Leuenberger, Daiana; Balslev-Harder, David; Braban, Christine F.; Ebert, Volker; Ferracci, Valerio; Gieseking, Bjoern; Hieta, Tuomas; Martin, Nicholas A.; Pascale, Céline; Pogány, Andrea; Tiebe, Carlo; Twigg, Marsailidh M.; Vaittinen, Olavi; van Wijk, Janneke; Wirtz, Klaus; Niederhauser, Bernhard

2016-04-01

Measuring ammonia in ambient air is a sensitive and priority issue due to its harmful effects on human health and ecosystems. In addition to its acidifying effect on natural waters and soils and to the additional nitrogen input to ecosystems, ammonia is an important precursor for secondary aerosol formation in the atmosphere. The European Directive 2001/81/EC on "National Emission Ceilings for Certain Atmospheric Pollutants (NEC)" regulates ammonia emissions in the member states. However, there is a lack of regulation regarding certified reference material (CRM), applicable analytical methods, measurement uncertainty, quality assurance and quality control (QC/QA) procedures as well as in the infrastructure to attain metrological traceability. As shown in a key comparison in 2007, there are even discrepancies between reference materials provided by European National Metrology Institutes (NMIs) at amount fraction levels up to three orders of magnitude higher than ambient air levels. MetNH3 (Metrology for ammonia in ambient air), a three-year project that started in June 2014 in the framework of the European Metrology Research Programme (EMRP), aims to reduce the gap between requirements set by the European emission regulations and state-of-the-art of analytical methods and reference materials. The overarching objective of the JRP is to achieve metrological traceability for ammonia measurements in ambient air from primary certified reference material CRM and instrumental standards to the field level. This requires the successful completion of the three main goals, which have been assigned to three technical work packages: To develop improved reference gas mixtures by static and dynamic gravimetric generation methods Realisation and characterisation of traceable preparative calibration standards (in pressurised cylinders as well as mobile generators) of ammonia amount fractions similar to those in ambient air based on existing methods for other reactive analytes. The aimed uncertainty is < 1 % for static mixtures at the 10 to 100 μmol/mol level, and < 3 % for portable dynamic generators in the 0 to 500 nmol/mol amount fraction range. Special emphasis is put on the minimisation of adsorption losses. To develop and characterise laser based optical spectrometric standards Evaluation and characterisation of the applicability of a newly developed open-path as well as of existing extractive measurement techniques as optical transfer standards according to metrological standards. To establish the transfer from high-accuracy standards to field applicable methods Employment of characterised exposure chambers as well as field sites for validation and comparison experiments to test and evaluate the performance of different instruments and measurement methods at ammonia amount fractions of the ambient air. The active exchange in workshops and inter-comparisons, publications in technical journals as well as presentations at relevant conferences and standardisation bodies will transfer the knowledge to stakeholders and end-users. The work has been carried out in the framework of the EMRP. The EMRP is jointly funded by the EMRP participating countries within EURAMET and the European Union.

Primary care of adults with intellectual and developmental disabilities

PubMed Central

Sullivan, William F.; Diepstra, Heidi; Heng, John; Ally, Shara; Bradley, Elspeth; Casson, Ian; Hennen, Brian; Kelly, Maureen; Korossy, Marika; McNeil, Karen; Abells, Dara; Amaria, Khush; Boyd, Kerry; Gemmill, Meg; Grier, Elizabeth; Kennie-Kaulbach, Natalie; Ketchell, Mackenzie; Ladouceur, Jessica; Lepp, Amanda; Lunsky, Yona; McMillan, Shirley; Niel, Ullanda; Sacks, Samantha; Shea, Sarah; Stringer, Katherine; Sue, Kyle; Witherbee, Sandra

2018-01-01

Abstract Objective To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD). Methods Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations. Recommendations Adults with IDD are a heterogeneous group of patients and have health conditions and factors affecting their health that can vary in kind, manifestation, severity, or complexity from those of others in the community. They require approaches to care and interventions that are adapted to their needs. These guidelines provide advice regarding standards of care. References to clinical tools and other practical resources are incorporated. The approaches to care that are outlined here can be applied to other groups of patients that have impairments in cognitive, communicative, or other adaptive functioning. Conclusion As primary care providers, family physicians play a vital role in promoting the health and well-being of adults with IDD. These guidelines can aid their decision making with patients and caregivers. PMID:29650602

POTENTIAL RADIOACTIVE POLLUTANTS RESULTING FROM EXPANDED ENERGY PROGRAMS

EPA Science Inventory

An effective environmental monitoring program must have a quality assurance component to assure the production of valid data. Quality assurance has many components: calibration standards, standard reference materials, standard reference methods, interlaboratory comparison studies...

Evaluation of alanine as a reference dosimeter for therapy level dose comparisons in megavoltage electron beams

NASA Astrophysics Data System (ADS)

McEwen, Malcolm; Sharpe, Peter; Vörös, Sándor

2015-04-01

When comparing absorbed dose standards from different laboratories (e.g. National Measurement Institutes, NMIs, for Key or Supplementary comparisons) it is rarely possible to carry out a direct comparison of primary standard instruments, and therefore some form of transfer detector is required. Historically, air-filled, unsealed ionization chambers have been used because of the long history of using these instruments, very good stability over many years, and ease of transport. However, the use of ion chambers for therapy-level comparisons is not without its problems. Findings from recent investigations suggest that ion chambers are prone to non-random variations, they are not completely robust to standard courier practices, and failure at any step in a comparison can render all measurements potentially useless. An alternative approach is to identify a transfer system that is insensitive to some of these concerns—effectively a dosimeter that is inexpensive, simple to use, robust, but with sufficient precision and of a size relevant to the disseminated quantity in question. The alanine dosimetry system has been successfully used in a number of situations as an audit dosimeter and therefore the purpose of this investigation was to determine whether alanine could also be used as the transfer detector for dosimetric comparisons, which require a lower value for the measurement uncertainty. A measurement protocol was developed for comparing primary standards of absorbed dose to water in high-energy electron beams using alanine pellets irradiated in a water-equivalent plastic phantom. A trial comparison has been carried out between three NMIs and has indicated that alanine is a suitable alternative to ion chambers, with the system used achieving a precision of 0.1%. Although the focus of the evaluation was on the performance of the dosimeter, the comparison results are encouraging, showing agreement at the level of the combined uncertainties (~0.6%). Based on this investigation, a large-scale comparison of primary standards for high-energy electron beams is currently being developed under the auspices of the BIPM.

Blue guardian: an open architecture for rapid ISR demonstration

NASA Astrophysics Data System (ADS)

Barrett, Donald A.; Borntrager, Luke A.; Green, David M.

2016-05-01

Throughout the Department of Defense (DoD), acquisition, platform integration, and life cycle costs for weapons systems have continued to rise. Although Open Architecture (OA) interface standards are one of the primary methods being used to reduce these costs, the Air Force Rapid Capabilities Office (AFRCO) has extended the OA concept and chartered the Open Mission System (OMS) initiative with industry to develop and demonstrate a consensus-based, non-proprietary, OA standard for integrating subsystems and services into airborne platforms. The new OMS standard provides the capability to decouple vendor-specific sensors, payloads, and service implementations from platform-specific architectures and is still in the early stages of maturation and demonstration. The Air Force Research Laboratory (AFRL) - Sensors Directorate has developed the Blue Guardian program to demonstrate advanced sensing technology utilizing open architectures in operationally relevant environments. Over the past year, Blue Guardian has developed a platform architecture using the Air Force's OMS reference architecture and conducted a ground and flight test program of multiple payload combinations. Systems tested included a vendor-unique variety of Full Motion Video (FMV) systems, a Wide Area Motion Imagery (WAMI) system, a multi-mode radar system, processing and database functions, multiple decompression algorithms, multiple communications systems, and a suite of software tools. Initial results of the Blue Guardian program show the promise of OA to DoD acquisitions, especially for Intelligence, Surveillance and Reconnaissance (ISR) payload applications. Specifically, the OMS reference architecture was extremely useful in reducing the cost and time required for integrating new systems.

Active anterior rhinomanometry in paediatrics. Normality criteria.

PubMed

Juliá, J C; Burchés, M Enriqueta; Martorell, A

2011-01-01

Active anterior rhinomanometry with a face mask was used to establish the lower age limit for application of the technique, define normality reference standards, and determine the most appropriate pressure for referencing the nasal resistance values. A total of 409 children of both sexes and aged 5-14 years were studied. The subjects were selected from among healthy children in two primary care centres and one school. The Rhinospir 164 rhinomanometer was used for the tests. Rhinomanometry was performed according to the guidelines of the International Committee on Standardization of Rhinomanometry. The SPSS (Statistical Package for the Social Sciences) was used for the analysis of the results. The study sample was divided into five age groups involving intervals of two years from 5 to 14 years of age, and four body surface groups. The dependent variables studied (resistances and flows at pressure differences of 75 and 100) showed significantly different mean values according to age and body surface. All the mean ratios were over 1.4 units, i.e., the measures of each variable on one side and the other differed between 40% and 44%. 1.- The lower age limit for rhinomanometry is five years. 2.- The most appropriate pressures for referencing the resistance and flow values are 75 and 100. 3.- The reference standards are established with respect to total resistance and according to subject age and body surface. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

Comprehensive Assessment of Struggling Learners Referred to a Graduate Medical Education Remediation Program.

PubMed

Warburton, Karen M; Goren, Eric; Dine, C Jessica

2017-12-01

Implementation of the Next Accreditation System has provided a standardized framework for identifying learners not meeting milestones, but there is as yet no corresponding framework for remediation. We developed a comprehensive assessment process that allows correct diagnosis of a struggling learner's deficit(s) to promote successful remediation. At the University of Pennsylvania, resident learners within the Department of Medicine who are not meeting milestones are referred to the Early Intervention Remediation Committee (EIRC). The EIRC, composed of 14 faculty members with expertise in remediation, uses a standardized process to assess learners' deficits. These faculty members categorize primary deficits as follows: medical knowledge, clinical reasoning, organization and efficiency, professionalism, and communication skills. The standardized process of assessment includes an analysis of the learner's file, direct communication with evaluators, an interview focused on learner perception of the problem, screening for underlying medical or psychosocial issues, and a review of systems for deficits in the 6 core competencies. Participants were surveyed after participating in this process. Over a 2-year period, the EIRC assessed and developed remediation plans for 4% of learners (14 of a total 342). Following remediation and reassessment, the identified problems were satisfactorily resolved in all cases with no disciplinary action. While the process was time intensive, an average of 45 hours per learner, the majority of faculty and residents rated it as positive and beneficial. This structured assessment process identifies targeted areas for remediation and adds to the tools available to Clinical Competency Committees.

Anterior Segment Imaging for Angle Closure.

PubMed

Chansangpetch, Sunee; Rojanapongpun, Prin; Lin, Shan C

2018-04-01

To summarize the role of anterior segment imaging (AS-imaging) in angle closure diagnosis and management, and the possible advantages over the current standard of gonioscopy. Literature review and perspective. Review of the pertinent publications with interpretation and perspective in relation to the use of AS-imaging in angle closure assessment focusing on anterior segment optical coherence tomography and ultrasound biomicroscopy. Several limitations have been encountered with the reference standard of gonioscopy for angle assessment. AS-imaging has been shown to have performance in angle closure detection compared to gonioscopy. Also, imaging has greater reproducibility and serves as better documentation for long-term follow-up than conventional gonioscopy. The qualitative and quantitative information obtained from AS-imaging enables better understanding of the underlying mechanisms of angle closure and provides useful parameters for risk assessment and possible prediction of the response to laser and surgical intervention. The latest technologies-including 3-dimensional imaging-have allowed for the assessment of the angle that simulates the gonioscopic view. These advantages suggest that AS-imaging has a potential to be a reference standard for the diagnosis and monitoring of angle closure disease in the future. Although gonioscopy remains the primary method of angle assessment, AS-imaging has an increasing role in angle closure screening and management. The test should be integrated into clinical practice as an adjunctive tool for angle assessment. It is arguable that AS-imaging should be considered first-line screening for patients at risk for angle closure. Copyright © 2018 Elsevier Inc. All rights reserved.

A modeling analysis of alternative primary and secondary US ozone standards in urban and rural areas

NASA Astrophysics Data System (ADS)

Nopmongcol, Uarporn; Emery, Chris; Sakulyanontvittaya, Tanarit; Jung, Jaegun; Knipping, Eladio; Yarwood, Greg

2014-12-01

This study employed the High-Order Decoupled Direct Method (HDDM) of sensitivity analysis in a photochemical grid model to determine US anthropogenic emissions reductions required from 2006 levels to meet alternative US primary (health-based) and secondary (welfare-based) ozone (O3) standards. Applying the modeling techniques developed by Yarwood et al. (2013), we specifically evaluated sector-wide emission reductions needed to meet primary standards in the range of 60-75 ppb, and secondary standards in the range of 7-15 ppm-h, in 22 cities and at 20 rural sites across the US for NOx-only, combined NOx and VOC, and VOC-only scenarios. Site-specific model biases were taken into account by applying adjustment factors separately for the primary and secondary standard metrics, analogous to the US Environmental Protection Agency's (EPA) relative response factor technique. Both bias-adjusted and unadjusted results are presented and analyzed. We found that the secondary metric does not necessarily respond to emission reductions the same way the primary metric does, indicating sensitivity to their different forms. Combined NOx and VOC reductions are most effective for cities, whereas NOx-only reductions are sufficient at rural sites. Most cities we examined require more than 50% US anthropogenic emission reductions from 2006 levels to meet the current primary 75 ppb US standard and secondary 15 ppm-h target. Most rural sites require less than 20% reductions to meet the primary 75 ppb standard and less than 40% reductions to meet the secondary 15 ppm-h target. Whether the primary standard is protective of the secondary standard depends on the combination of alternative standard levels. Our modeling suggests that the current 75 ppb standard achieves a 15 ppm-h secondary target in most (17 of 22) cities, but only half of the rural sites; the inability for several western cities and rural areas to achieve the seasonally-summed secondary 15 ppm-h target while meeting the 75 ppb primary target is likely driven by higher background O3 that is commonly reported in the western US. However, a 70 ppb primary standard is protective of a 15 ppm-h secondary standard in all cities and 18 of 20 rural sites we examined, and a 60 ppb primary standard is protective of a 7 ppm-h secondary standard in all cities and 19 of 20 rural sites. If EPA promulgates separate primary and secondary standards, exceedance areas will need to develop and demonstrate control strategies to achieve both. This HDDM analysis provides an illustrative screening assessment by which to estimate emissions reductions necessary to satisfy both standards.

18 CFR 3c.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... employee ethical conduct standards and financial disclosure regulations. 3c.1 Section 3c.1 Conservation of... STANDARDS OF CONDUCT § 3c.1 Cross-reference to employee ethical conduct standards and financial disclosure... branch-wide financial disclosure regulations at 5 CFR part 2634, the Standards of Ethical Conduct for...

13 CFR 105.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ethical conduct standards and financial disclosure regulations. 105.101 Section 105.101 Business Credit... RESPONSIBILITIES Standards of Conduct § 105.101 Cross-reference to employee ethical conduct standards and financial... to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635 and the...

13 CFR 105.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ethical conduct standards and financial disclosure regulations. 105.101 Section 105.101 Business Credit... RESPONSIBILITIES Standards of Conduct § 105.101 Cross-reference to employee ethical conduct standards and financial... to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635 and the...

18 CFR 3c.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employee ethical conduct standards and financial disclosure regulations. 3c.1 Section 3c.1 Conservation of... STANDARDS OF CONDUCT § 3c.1 Cross-reference to employee ethical conduct standards and financial disclosure... branch-wide financial disclosure regulations at 5 CFR part 2634, the Standards of Ethical Conduct for...

18 CFR 3c.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... employee ethical conduct standards and financial disclosure regulations. 3c.1 Section 3c.1 Conservation of... STANDARDS OF CONDUCT § 3c.1 Cross-reference to employee ethical conduct standards and financial disclosure... branch-wide financial disclosure regulations at 5 CFR part 2634, the Standards of Ethical Conduct for...

18 CFR 3c.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... employee ethical conduct standards and financial disclosure regulations. 3c.1 Section 3c.1 Conservation of... STANDARDS OF CONDUCT § 3c.1 Cross-reference to employee ethical conduct standards and financial disclosure... branch-wide financial disclosure regulations at 5 CFR part 2634, the Standards of Ethical Conduct for...

18 CFR 3c.1 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... employee ethical conduct standards and financial disclosure regulations. 3c.1 Section 3c.1 Conservation of... STANDARDS OF CONDUCT § 3c.1 Cross-reference to employee ethical conduct standards and financial disclosure... branch-wide financial disclosure regulations at 5 CFR part 2634, the Standards of Ethical Conduct for...

13 CFR 105.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... ethical conduct standards and financial disclosure regulations. 105.101 Section 105.101 Business Credit... RESPONSIBILITIES Standards of Conduct § 105.101 Cross-reference to employee ethical conduct standards and financial... to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635 and the...

13 CFR 105.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ethical conduct standards and financial disclosure regulations. 105.101 Section 105.101 Business Credit... RESPONSIBILITIES Standards of Conduct § 105.101 Cross-reference to employee ethical conduct standards and financial... to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635 and the...

13 CFR 105.101 - Cross-reference to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... ethical conduct standards and financial disclosure regulations. 105.101 Section 105.101 Business Credit... RESPONSIBILITIES Standards of Conduct § 105.101 Cross-reference to employee ethical conduct standards and financial... to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR part 2635 and the...

Assessing Current State Science Teaching and Learning Standards for Ability to Achieve Climate Science Literacy

NASA Astrophysics Data System (ADS)

Busch, K. C.

2012-12-01

Even though there exists a high degree of consensus among scientists about climate change, doubt has actually increased over the last five years within the general U.S. public. In 2006, 79% of those polled agreed that there is evidence for global warming, while only 59% agreed in 2010 (Pew Research Center, 2010). The source for this doubt can be partially attributed to lack of knowledge. Formal education is one mechanism that potentially can address inadequate public understanding as school is the primary place where students - and future citizens - learn about the climate. In a joint effort, several governmental agencies, non-governmental organizations, scientists and educators have created a framework called The Essential Principles of Climate Science Literacy, detailing seven concepts that are deemed vital for individuals and communities to understand Earth's climate system (USGCRP, 2009). Can students reach climate literacy - as defined by these 7 concepts - if they are taught using a curriculum based on the current state standards? To answer this question, the K-12 state science teaching and learning standards for Texas and California - two states that heavily influence nation-wide textbook creation - were compared against the Essential Principles. The data analysis consisted of two stages, looking for: 1) direct reference to "climate" and "climate change" and 2) indirect reference to the 7 Essential Principles through axial coding. The word "climate" appears in the California K-12 science standards 4 times and in the Texas standards 7 times. The word "climate change" appears in the California and Texas standards only 3 times each. Indirect references to the 7 Essential Principles of climate science literacy were more numerous. Broadly, California covered 6 of the principles while Texas covered all 7. In looking at the 7 principles, the second one "Climate is regulated by complex interactions among component of the Earth system" was the most substantively addressed. Least covered were number 6 "Human activities are impacting the climate system" and number 7 "Climate change will have consequences for the Earth system and human lives." Most references, either direct or indirect, occurred in the high school standards for earth science, a class not required for graduation in either state. This research points to the gaps between what the 7 Essential Principles of Climate Literacy defines as essential knowledge and what students may learn in their K-12 science classes. Thus, the formal system does not seem to offer an experience which can potentially develop a more knowledgeable citizenry who will be able to make wise personal and policy decisions about climate change, falling short of the ultimate goal of achieving widespread climate literacy. Especially troubling was the sparse attention to the principles addressing the human connection to the climate - principles number 6 and 7. If climate literate citizens are to make "wise personal and policy decisions" (USGCRP, 2009), these two principles especially are vital. This research, therefore, has been valuable for identifying current shortcomings in state standards.

Standard Specimen Reference Set: Breast Cancer and Imaging — EDRN Public Portal

Cancer.gov

The primary objective of this study is to assemble a well-characterized set of blood specimens and images to test biomarkers that, in conjunction with mammography, can detect and discriminate breast cancer. These samples will be divided to provide “sets” of specimens that can be tested in a number of different laboratories. Since tests will be performed on the same sets of samples, the data will be directly comparable and decisions regarding which biomarker or set of biomarkers have value in breast cancer detection can be made. These sets will reside at a National Cancer Institute facility at Frederick, MD.

Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia.

PubMed

Gausia, Kaniz; Thompson, Sandra C; Nagel, Tricia; Schierhout, Gill; Matthews, Veronica; Bailie, Ross

2015-01-01

This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre. The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.15 - National primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... air quality standards for ozone. 50.15 Section 50.15 Protection of Environment ENVIRONMENTAL....15 National primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone (O3) is 0.075 parts per...

40 CFR 50.16 - National primary and secondary ambient air quality standards for lead.

Code of Federal Regulations, 2011 CFR

2011-07-01

... air quality standards for lead. 50.16 Section 50.16 Protection of Environment ENVIRONMENTAL PROTECTION... National primary and secondary ambient air quality standards for lead. (a) The national primary and secondary ambient air quality standards for lead (Pb) and its compounds are 0.15 micrograms per cubic meter...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2011 CFR

2011-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2012 CFR

2012-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2010 CFR

2010-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2013 CFR

2013-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

40 CFR 50.17 - National primary ambient air quality standards for sulfur oxides (sulfur dioxide).

Code of Federal Regulations, 2014 CFR

2014-07-01

... standards for sulfur oxides (sulfur dioxide). 50.17 Section 50.17 Protection of Environment ENVIRONMENTAL....17 National primary ambient air quality standards for sulfur oxides (sulfur dioxide). (a) The level of the national primary 1-hour annual ambient air quality standard for oxides of sulfur is 75 parts...

The Management of Patients with Depression In Primary Care: an Audit Review.

PubMed

Henfrey, Helen

2015-09-01

The IAPT scheme was introduced in 2007 to implement the recommendations from NICE guidelines regarding psychological therapy for depression. This retrospective audit carried out across two General Practice Surgeries evaluates the care being given in relation to the standards of NICE guidelines. Initial audit found variable concordance, however after discussion of this at a local audit meeting and the displaying of posters and leaflets detailing the IAPT scheme this was improved on re-audit. Training should be provided to General Practitioners regarding the standards of care for patients with low mood or depression. In this training there should be an emphasis on the role of psychological therapy and details given of local resources. Posters and leaflets should be clearly displayed to allow patients to self-refer to IAPT. A close watch must be given to waiting times for the IAPT service as demands increase.

Results of the 1974 through 1977 NASA/JPL balloon flight solar cell calibration program

NASA Technical Reports Server (NTRS)

Sidwell, L. B.

1978-01-01

From 1974 through 1977, seven solar cell calibration flights and two R&D flights with a spectroradiometer as a payload were attempted. There were two R&D flights, and one calibration flight that failed. Each calibration flight balloon was designed to carry its payload to an altitude of 36.6 km (120 kft). The R&D flight balloons were designed for a payload altitude of 47.5 km (150 kft). At the end of the flight period, the upper (solar cell calibration system) and lower (consolidated instrument package (DIP) payloads were separated from the balloon and descend via parachutes. The calibrated solar cells recovered in this manner were used as primary intensity reference standards during solar simulator testing of solar cells and solar arrays with similar spectral response characteristics. This method of calibration has become the most widely accepted technique for developing space standard solar cells.

US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

PubMed

Brauer, Simon G; Yoon, John D; Curlin, Farr A

2016-02-01

Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Evaluating ecological equivalence of created marshes: comparing structural indicators with stable isotope indicators of blue crab trophic support

USGS Publications Warehouse

Llewellyn, Chris; LaPeyre, Megan K.

2010-01-01

This study sought to examine ecological equivalence of created marshes of different ages using traditional structural measures of equivalence, and tested a relatively novel approach using stable isotopes as a measure of functional equivalence. We compared soil properties, vegetation, nekton communities, and δ13C and δ15N isotope values of blue crab muscle and hepatopancreas tissue and primary producers at created (5-24 years old) and paired reference marshes in SW Louisiana. Paired contrasts indicated that created and reference marshes supported equivalent plant and nekton communities, but differed in soil characteristics. Stable isotope indicators examining blue crab food web support found that the older marshes (8 years+) were characterized by comparable trophic diversity and breadth compared to their reference marshes. Interpretation of results for the youngest site was confounded by the fact that the paired reference, which represented the desired end goal of restoration, contained a greater diversity of basal resources. Stable isotope techniques may give coastal managers an additional tool to assess functional equivalency of created marshes, as measured by trophic support, but may be limited to comparisons of marshes with similar vegetative communities and basal resources, or require the development of robust standardization techniques.

A Proposal of New Reference System for the Standard Axial, Sagittal, Coronal Planes of Brain Based on the Serially-Sectioned Images

PubMed Central

Park, Jin Seo; Park, Hyo Seok; Shin, Dong Sun; Har, Dong-Hwan; Cho, Zang-Hee; Kim, Young-Bo; Han, Jae-Yong; Chi, Je-Geun

2010-01-01

Sectional anatomy of human brain is useful to examine the diseased brain as well as normal brain. However, intracerebral reference points for the axial, sagittal, and coronal planes of brain have not been standardized in anatomical sections or radiological images. We made 2,343 serially-sectioned images of a cadaver head with 0.1 mm intervals, 0.1 mm pixel size, and 48 bit color and obtained axial, sagittal, and coronal images based on the proposed reference system. This reference system consists of one principal reference point and two ancillary reference points. The two ancillary reference points are the anterior commissure and the posterior commissure. And the principal reference point is the midpoint of two ancillary reference points. It resides in the center of whole brain. From the principal reference point, Cartesian coordinate of x, y, z could be made to be the standard axial, sagittal, and coronal planes. PMID:20052359

12 CFR 400.101 - Cross-reference to employee financial disclosure and ethical conduct standards regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... disclosure and ethical conduct standards regulations. 400.101 Section 400.101 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES EMPLOYEE FINANCIAL DISCLOSURE AND ETHICAL CONDUCT STANDARDS REGULATIONS § 400.101 Cross-reference to employee financial disclosure and ethical conduct standards regulations...

36 CFR 811.1 - Cross-references to employees' ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2011 CFR

2011-07-01

...' ethical conduct standards, financial disclosure and financial interests regulations and other conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 811.1 Cross-references to employees' ethical conduct standards... Council on Historic Preservation are subject to the executive branch-wide standards of ethical conduct...

36 CFR 811.1 - Cross-references to employees' ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2010 CFR

2010-07-01

...' ethical conduct standards, financial disclosure and financial interests regulations and other conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 811.1 Cross-references to employees' ethical conduct standards... Council on Historic Preservation are subject to the executive branch-wide standards of ethical conduct...

12 CFR 400.101 - Cross-reference to employee financial disclosure and ethical conduct standards regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... disclosure and ethical conduct standards regulations. 400.101 Section 400.101 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES EMPLOYEE FINANCIAL DISCLOSURE AND ETHICAL CONDUCT STANDARDS REGULATIONS § 400.101 Cross-reference to employee financial disclosure and ethical conduct standards regulations...

12 CFR 400.101 - Cross-reference to employee financial disclosure and ethical conduct standards regulations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... disclosure and ethical conduct standards regulations. 400.101 Section 400.101 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES EMPLOYEE FINANCIAL DISCLOSURE AND ETHICAL CONDUCT STANDARDS REGULATIONS § 400.101 Cross-reference to employee financial disclosure and ethical conduct standards regulations...

12 CFR 400.101 - Cross-reference to employee financial disclosure and ethical conduct standards regulations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... disclosure and ethical conduct standards regulations. 400.101 Section 400.101 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES EMPLOYEE FINANCIAL DISCLOSURE AND ETHICAL CONDUCT STANDARDS REGULATIONS § 400.101 Cross-reference to employee financial disclosure and ethical conduct standards regulations...

36 CFR 811.1 - Cross-references to employees' ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2014 CFR

2014-07-01

...' ethical conduct standards, financial disclosure and financial interests regulations and other conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 811.1 Cross-references to employees' ethical conduct standards... Council on Historic Preservation are subject to the executive branch-wide standards of ethical conduct...

12 CFR 400.101 - Cross-reference to employee financial disclosure and ethical conduct standards regulations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... disclosure and ethical conduct standards regulations. 400.101 Section 400.101 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES EMPLOYEE FINANCIAL DISCLOSURE AND ETHICAL CONDUCT STANDARDS REGULATIONS § 400.101 Cross-reference to employee financial disclosure and ethical conduct standards regulations...

36 CFR 811.1 - Cross-references to employees' ethical conduct standards, financial disclosure and financial...

Code of Federal Regulations, 2012 CFR

2012-07-01

...' ethical conduct standards, financial disclosure and financial interests regulations and other conduct... EMPLOYEE RESPONSIBILITIES AND CONDUCT § 811.1 Cross-references to employees' ethical conduct standards... Council on Historic Preservation are subject to the executive branch-wide standards of ethical conduct...

Apparatus and method for mapping an area of interest

DOEpatents

Staab, Torsten A. Cohen, Daniel L.; Feller, Samuel [Fairfax, VA

2009-12-01

An apparatus and method are provided for mapping an area of interest using polar coordinates or Cartesian coordinates. The apparatus includes a range finder, an azimuth angle measuring device to provide a heading and an inclinometer to provide an angle of inclination of the range finder as it relates to primary reference points and points of interest. A computer is provided to receive signals from the range finder, inclinometer and azimuth angle measurer to record location data and calculate relative locations between one or more points of interest and one or more primary reference points. The method includes mapping of an area of interest to locate points of interest relative to one or more primary reference points and to store the information in the desired manner. The device may optionally also include an illuminator which can be utilized to paint the area of interest to indicate both points of interest and primary points of reference during and/or after data acquisition.

TH-CD-BRA-03: Direct Measurement of Magnetic Field Correction Factors, KQB, for Application in Future Codes of Practice for Reference Dosimetry

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

Wolthaus, J; Asselen, B van; Woodings, S

2016-06-15

Purpose: With an MR-linac, radiation is delivered in the presence of a magnetic field. Modifications in the codes of practice (CoPs) for reference dosimetry are required to incorporate the effect of the magnetic field. Methods: In most CoPs the absorbed dose is determined using the well-known kQ formalism as the product of the calibration coefficient, the corrected electrometer reading and kQ, to account for the difference in beam quality. To keep a similar formalism a single correction factor is introduced which replaces kQ, and which corrects for beam quality and B-field, kQ,B. In this study we propose a method tomore » determine kQ,B under reference conditions in the MRLinac without using a primary standard, as the product of:- the ratio between detector readings without and with B-field (kB),- the ratio between doses in the point of measurement with and without B-field (rho),- kQ in the absence of the B-field in the MRLinac beam (kQmrl0,Q0),The ratio of the readings, which covers the change in detector reading due to the different electron trajectories in the detector, was measured with a waterproof ionization chamber (IBA-FC65g) in a water phantom in the MRLinac without and with B-field. The change in dose-to-water in the point of measurement due to the B-field was determined with a Monte Carlo based TPS. Results: For the presented approach, the measured ratio of readings is 0.956, the calculated ratio of doses in the point of measurement is 0.995. Based on TPR20,10 measurements kQ was calculated as 0.989 using NCS-18. This yields a value of 0.9408 for kQ,B. Conclusion: The presented approach to determine kQ,B agrees with a method based on primary standards within 0.4% with an uncertainty of 1% (1 std.uncert). It differs from a similar approach using a PMMA-phantom and an NE2571 chamber with 1.3%.« less

22 CFR 1001.1 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Cross-references to employee ethical conduct... FOUNDATION EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.1 Cross-references to employee ethical conduct... Foundation should refer to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR...

15 CFR 230.7 - Description of services and list of fees, incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARD REFERENCE MATERIALS STANDARD REFERENCE MATERIALS Description of Services and List of Fees § 230.7 Description of services and list of fees, incorporation by reference. (a) The text of NIST Special Publication... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Description of services and list of...

22 CFR 1001.1 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Cross-references to employee ethical conduct... FOUNDATION EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.1 Cross-references to employee ethical conduct... Foundation should refer to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR...

22 CFR 1001.1 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Cross-references to employee ethical conduct... FOUNDATION EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.1 Cross-references to employee ethical conduct... Foundation should refer to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR...

22 CFR 1001.1 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Cross-references to employee ethical conduct... FOUNDATION EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.1 Cross-references to employee ethical conduct... Foundation should refer to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR...

22 CFR 1001.1 - Cross-references to employee ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Cross-references to employee ethical conduct... FOUNDATION EMPLOYEE RESPONSIBILITIES AND CONDUCT § 1001.1 Cross-references to employee ethical conduct... Foundation should refer to the Standards of Ethical Conduct for Employees of the Executive Branch at 5 CFR...

A series of strategies for solving the shortage of reference standards for multi-components determination of traditional Chinese medicine, Mahoniae Caulis as a case.

PubMed

Wang, Wenguang; Ma, Xiaoli; Guo, Xiaoyu; Zhao, Mingbo; Tu, Pengfei; Jiang, Yong

2015-09-18

In order to solve the bottleneck of reference standards shortage for comprehensive quality control of traditional Chinese medicines (TCMs), a series of strategies, including one single reference standard to determine multi-compounds (SSDMC), quantitative analysis by standardized reference extract (QASRE), and quantitative nuclear magnetic resonance spectroscopy (qNMR) were proposed, and Mahoniae Caulis was selected as an example to develop and validate these methods for simultaneous determination of four alkaloids, columbamine, jatrorrhizine, palmatine, and berberine. Comprehensive comparisons among these methods and with the conventional external standard method (ESM) were carried out. The relative expanded uncertainty of measurement was firstly used to compare their credibility. The results showed that all these three new developed methods can accurately accomplish the quantification by using only one purified reference standard, but each of them has its own advantages and disadvantages as well as the specific application scope, which were also discussed in detail in this paper. Copyright © 2015 Elsevier B.V. All rights reserved.

40 CFR 50.6 - National primary and secondary ambient air quality standards for PM10.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false National primary and secondary ambient... AGENCY (CONTINUED) AIR PROGRAMS NATIONAL PRIMARY AND SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.6 National primary and secondary ambient air quality standards for PM10. (a) The level of the national...

Determination of relative ion chamber calibration coefficients from depth-ionization measurements in clinical electron beams

NASA Astrophysics Data System (ADS)

Muir, B. R.; McEwen, M. R.; Rogers, D. W. O.

2014-10-01

A method is presented to obtain ion chamber calibration coefficients relative to secondary standard reference chambers in electron beams using depth-ionization measurements. Results are obtained as a function of depth and average electron energy at depth in 4, 8, 12 and 18 MeV electron beams from the NRC Elekta Precise linac. The PTW Roos, Scanditronix NACP-02, PTW Advanced Markus and NE 2571 ion chambers are investigated. The challenges and limitations of the method are discussed. The proposed method produces useful data at shallow depths. At depths past the reference depth, small shifts in positioning or drifts in the incident beam energy affect the results, thereby providing a built-in test of incident electron energy drifts and/or chamber set-up. Polarity corrections for ion chambers as a function of average electron energy at depth agree with literature data. The proposed method produces results consistent with those obtained using the conventional calibration procedure while gaining much more information about the behavior of the ion chamber with similar data acquisition time. Measurement uncertainties in calibration coefficients obtained with this method are estimated to be less than 0.5%. These results open up the possibility of using depth-ionization measurements to yield chamber ratios which may be suitable for primary standards-level dissemination.

The Optics and Alignment of the Divergent Beam Laboratory X-ray Powder Diffractometer and its Calibration Using NIST Standard Reference Materials.

PubMed

Cline, James P; Mendenhall, Marcus H; Black, David; Windover, Donald; Henins, Albert

2015-01-01

The laboratory X-ray powder diffractometer is one of the primary analytical tools in materials science. It is applicable to nearly any crystalline material, and with advanced data analysis methods, it can provide a wealth of information concerning sample character. Data from these machines, however, are beset by a complex aberration function that can be addressed through calibration with the use of NIST Standard Reference Materials (SRMs). Laboratory diffractometers can be set up in a range of optical geometries; considered herein are those of Bragg-Brentano divergent beam configuration using both incident and diffracted beam monochromators. We review the origin of the various aberrations affecting instruments of this geometry and the methods developed at NIST to align these machines in a first principles context. Data analysis methods are considered as being in two distinct categories: those that use empirical methods to parameterize the nature of the data for subsequent analysis, and those that use model functions to link the observation directly to a specific aspect of the experiment. We consider a multifaceted approach to instrument calibration using both the empirical and model based data analysis methods. The particular benefits of the fundamental parameters approach are reviewed.

Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients.

PubMed

Palhares, Daniel M F; Marcolino, Milena S; Santos, Thales M M; da Silva, José L P; Gomes, Paulo R; Ribeiro, Leonardo B; Macfarlane, Peter W; Ribeiro, Antonio L P

2017-06-13

Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.

Secondary analysis of anthropometric data from a South African national food consumption survey, using different growth reference standards.

PubMed

Bosman, L; Herselman, M G; Kruger, H S; Labadarios, D

2011-11-01

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12-60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.10 - National 8-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... ambient air quality standards for ozone. 50.10 Section 50.10 Protection of Environment ENVIRONMENTAL....10 National 8-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 8-hour primary and secondary ambient air quality standards for ozone, measured by a...

40 CFR 50.9 - National 1-hour primary and secondary ambient air quality standards for ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ambient air quality standards for ozone. 50.9 Section 50.9 Protection of Environment ENVIRONMENTAL....9 National 1-hour primary and secondary ambient air quality standards for ozone. (a) The level of the national 1-hour primary and secondary ambient air quality standards for ozone measured by a...

Effects of the length of central cancer registry operations on identification of subsequent cancers and on survival estimates.

PubMed

Qiao, Baozhen; Schymura, Maria J; Kahn, Amy R

2016-10-01

Population-based cancer survival analyses have traditionally been based on the first primary cancer. Recent studies have brought this practice into question, arguing that varying registry reference dates affect the ability to identify earlier cancers, resulting in selection bias. We used a theoretical approach to evaluate the extent to which the length of registry operations affects the classification of first versus subsequent cancers and consequently survival estimates. Sequence number central was used to classify tumors from the New York State Cancer Registry, diagnosed 2001-2010, as either first primaries (value=0 or 1) or subsequent primaries (≥2). A set of three sequence numbers, each based on an assumed reference year (1976, 1986 or 1996), was assigned to each tumor. Percent of subsequent cancers was evaluated by reference year, cancer site and age. 5-year relative survival estimates were compared under four different selection scenarios. The percent of cancer cases classified as subsequent primaries was 15.3%, 14.3% and 11.2% for reference years 1976, 1986 and 1996, respectively; and varied by cancer site and age. When only the first primary was included, shorter registry operation time was associated with slightly lower 5-year survival estimates. When all primary cancers were included, survival estimates decreased, with the largest decreases seen for the earliest reference year. Registry operation length affected the identification of subsequent cancers, but the overall effect of this misclassification on survival estimates was small. Survival estimates based on all primary cancers were slightly lower, but might be more comparable across registries. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. II. Selection of direct Kjeldahl analysis and its preliminary performance parameters.

PubMed

Vinklárková, Bára; Chromý, Vratislav; Šprongl, Luděk; Bittová, Miroslava; Rikanová, Milena; Ohnútková, Ivana; Žaludová, Lenka

2015-01-01

To select a Kjeldahl procedure suitable for the determination of total protein in reference materials used in laboratory medicine, we reviewed in our previous article Kjeldahl methods adopted by clinical chemistry and found an indirect two-step analysis by total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. In this article, we compare both procedures on various reference materials. An indirect Kjeldahl method gave falsely lower results than a direct analysis. Preliminary performance parameters qualify the direct Kjeldahl analysis as a suitable primary reference procedure for the certification of total protein in reference laboratories.

36 CFR 400.1 - Cross-references to employees' ethical conduct standards, financial disclosure regulations and...

Code of Federal Regulations, 2011 CFR

2011-07-01

...' ethical conduct standards, financial disclosure regulations and other conduct rules. 400.1 Section 400.1... CONDUCT § 400.1 Cross-references to employees' ethical conduct standards, financial disclosure regulations... executive branch-wide standards of ethical conduct and financial disclosure regulations at 5 CFR parts 2634...

24 CFR 0.1 - Cross-reference to employees ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ethical conduct standards and financial disclosure regulations. 0.1 Section 0.1 Housing and Urban... Cross-reference to employees ethical conduct standards and financial disclosure regulations. Employees...-wide standards of ethical conduct at 5 CFR part 2635, the Department's regulation at 5 CFR part 7501...

24 CFR 0.1 - Cross-reference to employees ethical conduct standards and financial disclosure regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ethical conduct standards and financial disclosure regulations. 0.1 Section 0.1 Housing and Urban... Cross-reference to employees ethical conduct standards and financial disclosure regulations. Employees...-wide standards of ethical conduct at 5 CFR part 2635, the Department's regulation at 5 CFR part 7501...

36 CFR 400.1 - Cross-references to employees' ethical conduct standards, financial disclosure regulations and...

Code of Federal Regulations, 2010 CFR

2010-07-01

...' ethical conduct standards, financial disclosure regulations and other conduct rules. 400.1 Section 400.1... CONDUCT § 400.1 Cross-references to employees' ethical conduct standards, financial disclosure regulations... executive branch-wide standards of ethical conduct and financial disclosure regulations at 5 CFR parts 2634...

41 CFR 105-735.1 - Cross-references to employee ethical conduct standards, financial disclosure regulations, and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee ethical conduct standards, financial disclosure regulations, and other regulations. 105-735.1... CONDUCT § 105-735.1 Cross-references to employee ethical conduct standards, financial disclosure... executive branch-wide standards of ethical conduct at 5 CFR part 2635, GSA's regulations at 5 CFR part 6701...