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Sample records for standard case definition

  1. Testing Pneumonia Vaccines in the Elderly: Determining a Case Definition for Pneumococcal Pneumonia in the Absence of a Gold Standard.

    Science.gov (United States)

    Jokinen, Jukka; Snellman, Marja; Palmu, Arto A; Saukkoriipi, Annika; Verlant, Vincent; Pascal, Thierry; Devaster, Jeanne-Marie; Hausdorff, William P; Kilpi, Terhi M

    2017-12-15

    Clinical assessments of vaccines to prevent pneumococcal (Pnc) community-acquired pneumonia (CAP) require sensitive and specific case definitions, but there is no gold standard diagnostic test. To develop a new case definition suitable for vaccine efficacy studies, we applied latent class analysis (LCA) to the results from seven diagnostic tests for Pnc etiology on clinical specimens from 323 elderly radiologically-confirmed pneumonia cases enrolled in The Finnish Community-Acquired Pneumonia Epidemiology study during 2005-2007. Compared to the conventional use of LCA, which is mainly to determine sensitivities and specificities of different tests, we instead used LCA as an appropriate instrument to predict the probability of Pnc etiology for each CAP case based on their test profiles, and utilized the predictions to minimize the sample size that would be needed for a vaccine efficacy trial. When compared to the conventional laboratory criteria of encapsulated Pnc in blood culture or in high-quality sputum culture or urine antigen positivity, our optimized case definition for PncCAP resulted in a trial sample size which was almost 20,000 subjects smaller. We believe that our novel application of LCA detailed here to determine a case definition for PncCAP could also be similarly applied to other diseases without a gold standard. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  2. Assessment of severe malaria in a multicenter, phase III, RTS, S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care

    Directory of Open Access Journals (Sweden)

    Vekemans Johan

    2011-08-01

    Full Text Available Abstract Background An effective malaria vaccine, deployed in conjunction with other malaria interventions, is likely to substantially reduce the malaria burden. Efficacy against severe malaria will be a key driver for decisions on implementation. An initial study of an RTS, S vaccine candidate showed promising efficacy against severe malaria in children in Mozambique. Further evidence of its protective efficacy will be gained in a pivotal, multi-centre, phase III study. This paper describes the case definitions of severe malaria used in this study and the programme for standardized assessment of severe malaria according to the case definition. Methods Case definitions of severe malaria were developed from a literature review and a consensus meeting of expert consultants and the RTS, S Clinical Trial Partnership Committee, in collaboration with the World Health Organization and the Malaria Clinical Trials Alliance. The same groups, with input from an Independent Data Monitoring Committee, developed and implemented a programme for standardized data collection. The case definitions developed reflect the typical presentations of severe malaria in African hospitals. Markers of disease severity were chosen on the basis of their association with poor outcome, occurrence in a significant proportion of cases and on an ability to standardize their measurement across research centres. For the primary case definition, one or more clinical and/or laboratory markers of disease severity have to be present, four major co-morbidities (pneumonia, meningitis, bacteraemia or gastroenteritis with severe dehydration are excluded, and a Plasmodium falciparum parasite density threshold is introduced, in order to maximize the specificity of the case definition. Secondary case definitions allow inclusion of co-morbidities and/or allow for the presence of parasitaemia at any density. The programmatic implementation of standardized case assessment included a clinical

  3. Assessment of severe malaria in a multicenter, phase III, RTS, S/AS01 malaria candidate vaccine trial: case definition, standardization of data collection and patient care.

    Science.gov (United States)

    Vekemans, Johan; Marsh, Kevin; Greenwood, Brian; Leach, Amanda; Kabore, William; Soulanoudjingar, Solange; Asante, Kwaku Poku; Ansong, Daniel; Evans, Jennifer; Sacarlal, Jahit; Bejon, Philip; Kamthunzi, Portia; Salim, Nahya; Njuguna, Patricia; Hamel, Mary J; Otieno, Walter; Gesase, Samwel; Schellenberg, David

    2011-08-04

    An effective malaria vaccine, deployed in conjunction with other malaria interventions, is likely to substantially reduce the malaria burden. Efficacy against severe malaria will be a key driver for decisions on implementation. An initial study of an RTS, S vaccine candidate showed promising efficacy against severe malaria in children in Mozambique. Further evidence of its protective efficacy will be gained in a pivotal, multi-centre, phase III study. This paper describes the case definitions of severe malaria used in this study and the programme for standardized assessment of severe malaria according to the case definition. Case definitions of severe malaria were developed from a literature review and a consensus meeting of expert consultants and the RTS, S Clinical Trial Partnership Committee, in collaboration with the World Health Organization and the Malaria Clinical Trials Alliance. The same groups, with input from an Independent Data Monitoring Committee, developed and implemented a programme for standardized data collection.The case definitions developed reflect the typical presentations of severe malaria in African hospitals. Markers of disease severity were chosen on the basis of their association with poor outcome, occurrence in a significant proportion of cases and on an ability to standardize their measurement across research centres. For the primary case definition, one or more clinical and/or laboratory markers of disease severity have to be present, four major co-morbidities (pneumonia, meningitis, bacteraemia or gastroenteritis with severe dehydration) are excluded, and a Plasmodium falciparum parasite density threshold is introduced, in order to maximize the specificity of the case definition. Secondary case definitions allow inclusion of co-morbidities and/or allow for the presence of parasitaemia at any density. The programmatic implementation of standardized case assessment included a clinical algorithm for evaluating seriously sick children

  4. Standardized Definitions for Code Verification Test Problems

    Energy Technology Data Exchange (ETDEWEB)

    Doebling, Scott William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-09-14

    This document contains standardized definitions for several commonly used code verification test problems. These definitions are intended to contain sufficient information to set up the test problem in a computational physics code. These definitions are intended to be used in conjunction with exact solutions to these problems generated using Exact- Pack, www.github.com/lanl/exactpack.

  5. A case of standardization?

    DEFF Research Database (Denmark)

    Rod, Morten Hulvej; Høybye, Mette Terp

    2016-01-01

    Guidelines are increasingly used in an effort to standardize and systematize health practices at the local level and to promote evidence-based practice. The implementation of guidelines frequently faces problems, however, and standardization processes may in general have other outcomes than...... the ones envisioned by the makers of standards. In 2012, the Danish National Health Authorities introduced a set of health promotion guidelines that were meant to guide the decision making and priority setting of Denmark's 98 local governments. The guidelines provided recommendations for health promotion...... and standardization. It remains an open question whether or not the guidelines lead to more standardized policies and interventions, but we suggest that the guidelines promote a risk factor-oriented approach as the dominant frame for knowledge, reasoning, decision making and priority setting in health promotion. We...

  6. The comparison of high and standard definition computed ...

    African Journals Online (AJOL)

    Objectıve: The aim was to compare coronary high-definition CT (HDCT) with standard-definition CT (SDCT) angiography as to radiation dose, image quality and accuracy. Material and methods: 28 patients with history of coronary artery disease scanned by HDCT (Discovery CT750 HD) and SDCT (Somatom Definition AS).

  7. The comparison of high and standard definition computed ...

    African Journals Online (AJOL)

    Abstract. Objectıve: The aim was to compare coronary high-definition CT (HDCT) with standard-definition CT (SDCT) angiogra- phy as to radiation dose, image quality and accuracy. Material and methods: 28 patients with history of coronary artery disease scanned by HDCT (Discovery CT750 HD) and. SDCT (Somatom ...

  8. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  9. Standardized Definitions for Hemodialysis Vascular Access

    OpenAIRE

    Lee, Timmy; Mokrzycki, Michele; Moist, Louise; Maya, Ivan; Vazquez, Miguel; Lok, Charmaine

    2011-01-01

    Vascular access dysfunction is one of the leading causes of morbidity and mortality among end-stage renal disease patients 1,2. Vascular access dysfunction exists in all 3 types of available accesses: arteriovenous fistulas, arteriovenous grafts, and tunneled catheters. In order to improve clinical research and outcomes in hemodialysis access dysfunction, the development of a multidisciplinary network of collaborative investigators with various areas of expertise, and common standards for ter...

  10. Diagnostic utility of two case definitions for anaphylaxis: a comparison using a retrospective case notes analysis in the UK.

    Science.gov (United States)

    Erlewyn-Lajeunesse, Michel; Dymond, Sandra; Slade, Ingrid; Mansfield, Helen L; Fish, Rosie; Jones, Owen; Benger, Jonathan R

    2010-01-01

    Anaphylaxis is a clinical diagnosis with no gold-standard test. Recent case definitions have attempted to provide objective criteria for diagnosis. The aim of this study was to compare the diagnostic concordance of the Brighton Collaboration case definition (the 'Brighton' case definition) to the consensus case definition from the Second Symposium on the Definition and Management of Anaphylaxis (the 'Symposium' definition). The study setting was a hospital-based emergency department in the UK. We identified cases of anaphylaxis by physicians' discharge diagnoses over a 2-year period from 2005 to 2006, and used randomly selected cases of allergic reaction, asthma and urticaria as a control group. Data was extracted by clinicians (who were unaware of the content of either case definition), and the two case definitions were applied by Boolean operators in a Microsoft Excel spreadsheet. Concordance between the case definitions was measured using Cohen's kappa (kappa) statistic. We reviewed 128 sets of notes, with 47 cases of anaphylaxis. Brighton and Symposium definitions had sensitivities of 0.681 and 0.671, respectively, and specificities of 0.790 and 0.704, respectively. A discordant result was found in 36/128 cases (28.1%; kappa = 0.414 [95% CI 0.253, 0.574]), which represents a moderate level of agreement between case definitions. The Brighton case definition has a similar diagnostic concordance to the Symposium case definition. It does not seem to over- or underestimate cases and is sufficiently unique that the identification of an allergic trigger does not have to form part of the case definition. This will be important in the recognition of anaphylaxis resulting from the administration of drug and vaccines, where causality should be examined separately from case ascertainment.

  11. Static ankle joint equinus: toward a standard definition and diagnosis.

    Science.gov (United States)

    Charles, James; Scutter, Sheila D; Buckley, Jonathan

    2010-01-01

    Equinus is characterized by reduced dorsiflexion of the ankle joint, but there is a lack of consensus regarding criteria for definition and diagnosis. This review examines the literature relating to the definition, assessment, diagnosis, prevalence, and complications of equinus. Articles on equinus and assessment of ankle joint range of motion were identified by searching the EMBASE, Medline, PubMed, EBSCOhost, Cinahl, and Cochrane databases and by examining the reference lists of the articles found. There is inconsistency regarding the magnitude of reduction in dorsiflexion required to constitute a diagnosis of equinus and no standard method for assessment; hence, the prevalence of equinus is unknown. Goniometric assessment of ankle joint range of motion was shown to be unreliable, whereas purpose-built tools demonstrated good reliability. Reduced dorsiflexion is associated with alterations in gait, increased forefoot pressure, and ankle injury, the magnitude of reduction in range of motion required to predispose to foot or lower-limb abnormalities is not known. In the absence of definitive data, we propose a two-stage definition of equinus: the first stage would reflect dorsiflexion of less than 10 degrees with minor compensation and a minor increase in forefoot pressure, and the second stage would reflect dorsiflexion of less than 5 degrees with major compensation and a major increase in forefoot pressure. This proposed definition of equinus will assist with standardizing the diagnosis and will provide a basis for future studies of the prevalence, causes, and complications of this condition.

  12. Analyzing Ambiguity in the Standard Definition of Creativity

    Directory of Open Access Journals (Sweden)

    Thomas R. Colin

    2017-11-01

    Full Text Available The increasingly rich and diverse literature on creativity has its core in psychology, but spans the cognitive sciences from artificial intelligence to philosophy and borrows from the wider humanities. Perhaps because of this immense breadth, there remains considerable disagreement with respect to the identity of the object of research. How to define creativity? According to the “standard definition,” creativity consists of “effectiveness and originality.” This definition is (relatively consensual and therefore appears to capture something common to academic concepts of creativity. I conduct a conceptual analysis of the definition; thereby, I isolate and describe two ambiguities. Firstly, the defini-tion leaves open the choice of the context and norms against which to measure originality and effectiveness. Secondly, it does not discuss the possible role of a subjective judge. My goal is not to propose yet another model of creativity, but to clearly identify the possible meanings of the word creativity in academic research. The existence of different interpretations does not necessarily reflect a fundamental disagreement about reality, but rather a failure to achieve consensus on a shared technical language. Therefore, simply recognizing and acknowledging the competition between diverse interpretations can form the basis for successful communication and for a complementary division of labor; it could improve the viability of interdisciplinary collaborations and prevent unnecessary fragmentation of the field.

  13. DIN 51003: the standard of TXRF basics and definitions

    International Nuclear Information System (INIS)

    Reus, U.; Prange, A.

    2000-01-01

    As part of the world-wide effort to standardize analytical methods, a team of TXRF users has elaborated the draft of a new DIN standard (German Industry Standard) on basic terms and definitions related to TXRF analysis. This draft ('yellow-print') is now open for discussion, and its structure and principal contents will be presented here. The new standard is subdivided into the following subjects: introduction, scope of application and normative remarks; general terms (in x-ray spectroscopy); physics, of TXRF; x-ray sources; conditioning of the primary x-ray beam; measurement of x-ray fluorescence with energy-dispersive spectrometers; samples; measurement and evaluation of data; traceability; applications of TXRF. The more important items will be discussed in the present paper. It should be pointed out that this standard is meant primarily to give a common basis for physical terms and general denotations to be used in TXRF analysis, i.e. it does not include specific working prescriptions for analytical tasks. However, such prescriptions will be given - in a more generalized form - in a number of appendices to the main document, thus covering the major fields of application of TXRF. In order to enable acceptance of the standard on an international basis, an ISO standard is also in preparation. (author)

  14. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.

    NARCIS (Netherlands)

    Fitzner, Julia; Qasmieh, Saba; Mounts, Anthony Wayne; Alexander, Burmaa; Besselaar, Terry; Briand, Sylvie; Brown, Caroline; Clark, Seth; Dueger, Erica; Gross, Diane; Hauge, Siri; Hirve, Siddhivinayak; Jorgensen, Pernille; Katz, Mark A; Mafi, Ali; Malik, Mamunur; McCarron, Margaret; Meerhoff, Tamara; Mori, Yuichiro; Mott, Joshua; Olivera, Maria Teresa da Costa; Ortiz, Justin R; Palekar, Rakhee; Rebelo-de-Andrade, Helena; Soetens, Loes; Yahaya, Ali Ahmed; Zhang, Wenqing; Vandemaele, Katelijn

    2018-01-01

    The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of

  15. A comparison of standard definitions and sagittal abdominal ...

    Science.gov (United States)

    Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of componen

  16. Nurses need a standard definition of a deprivation of liberty.

    Science.gov (United States)

    Griffith, Richard

    The House of Commons health committee has called for an urgent review of the implementation of the deprivation of liberty safeguards. They are particularly concerned that nurses, as gatekeepers of the safeguards, often do not know when a deprivation of liberty occurs in practice. In this article the author argues that given the lack of a standard definition of what amounts to a deprivation of liberty and the introduction by the courts of often contradictory factors that nurses are required to consider when determining if a patient is being deprived of their liberty it is little wonder that confusion is common place.

  17. Aggressive periodontitis: case definition and diagnostic criteria.

    Science.gov (United States)

    Albandar, Jasim M

    2014-06-01

    Aggressive periodontitis is a destructive disease characterized by the following: the involvement of multiple teeth with a distinctive pattern of periodontal tissue loss; a high rate of disease progression; an early age of onset; and the absence of systemic diseases. In some patients periodontal tissue loss may commence before puberty, whereas in most patients the age of onset is during or somewhat after the circumpubertal period. Besides infection with specific microorganisms, a host predisposition seems to play a key role in the pathogenesis of aggressive periodontitis, as evidenced by the familial aggregation of the disease. In this article we review the historical background of the diagnostic criteria of aggressive periodontitis, present a contemporary case definition and describe the clinical parameters of the disease. At present, the diagnosis of aggressive periodontitis is achieved using case history, clinical examination and radiographic evaluation. The data gathered using these methods are prone to relatively high measurement errors. Besides, this diagnostic approach measures past disease history and may not reliably measure existing disease activity or accurately predict future tissue loss. A diagnosis is often made years after the onset of the disease, partly because current assessment methods detect established disease more readily and reliably than they detect incipient or initial lesions where the tissue loss is minimal and usually below the detection threshold of present examination methods. Future advancements in understanding the pathogenesis of this disease may contribute to an earlier diagnosis. Insofar, future case definitions may involve the identification of key etiologic and risk factors, combined with high-precision methodologies that enable the early detection of initial lesions. This may significantly enhance the predictive value of these tests and detect cases of aggressive periodontitis before significant tissue loss develops. © 2014

  18. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

    Science.gov (United States)

    Qasmieh, Saba; Mounts, Anthony Wayne; Alexander, Burmaa; Besselaar, Terry; Briand, Sylvie; Brown, Caroline; Clark, Seth; Dueger, Erica; Gross, Diane; Hauge, Siri; Hirve, Siddhivinayak; Jorgensen, Pernille; Katz, Mark A; Mafi, Ali; Malik, Mamunur; McCarron, Margaret; Meerhoff, Tamara; Mori, Yuichiro; Mott, Joshua; Olivera, Maria Teresa da Costa; Ortiz, Justin R; Palekar, Rakhee; Rebelo-de-Andrade, Helena; Soetens, Loes; Yahaya, Ali Ahmed; Zhang, Wenqing; Vandemaele, Katelijn

    2018-01-01

    Abstract The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009–2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza – i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden. PMID:29403115

  19. Reliability of case definitions for public health surveillance assessed by Round-Robin test methodology

    Directory of Open Access Journals (Sweden)

    Claus Hermann

    2006-05-01

    Full Text Available Abstract Background Case definitions have been recognized to be important elements of public health surveillance systems. They are to assure comparability and consistency of surveillance data and have crucial impact on the sensitivity and the positive predictive value of a surveillance system. The reliability of case definitions has rarely been investigated systematically. Methods We conducted a Round-Robin test by asking all 425 local health departments (LHD and the 16 state health departments (SHD in Germany to classify a selection of 68 case examples using case definitions. By multivariate analysis we investigated factors linked to classification agreement with a gold standard, which was defined by an expert panel. Results A total of 7870 classifications were done by 396 LHD (93% and all SHD. Reporting sensitivity was 90.0%, positive predictive value 76.6%. Polio case examples had the lowest reporting precision, salmonellosis case examples the highest (OR = 0.008; CI: 0.005–0.013. Case definitions with a check-list format of clinical criteria resulted in higher reporting precision than case definitions with a narrative description (OR = 3.08; CI: 2.47–3.83. Reporting precision was higher among SHD compared to LHD (OR = 1.52; CI: 1.14–2.02. Conclusion Our findings led to a systematic revision of the German case definitions and build the basis for general recommendations for the creation of case definitions. These include, among others, that testable yes/no criteria in a check-list format is likely to improve reliability, and that software used for data transmission should be designed in strict accordance with the case definitions. The findings of this study are largely applicable to case definitions in many other countries or international networks as they share the same structural and editorial characteristics of the case definitions evaluated in this study before their revision.

  20. High-definition vs. standard-definition endoscopy with indigo carmine for the in vivo diagnosis of colonic polyps.

    Science.gov (United States)

    Longcroft-Wheaton, Gaius; Brown, James; Cowlishaw, David; Higgins, Bernard; Bhandari, Pradeep

    2013-12-01

    There is growing evidence that indigo carmine chromoendoscopy is effective for the in vivo diagnosis of colonic polyps. However, the impact of colonoscope resolution on diagnostic accuracy has not been investigated. We aimed to compare the effectiveness of in vivo diagnosis of small colonic polyps using indigo carmine dye spray with standard-definition and high-definition colonoscopes. Procedures were performed using Fujinon colonoscopes and EPX 4400 processor. Fujinon standard-definition (SD) and high-definition (HD) colonoscopes were used, with the endoscopist blinded to colonoscope definition. Polyps indigo carmine dye spray, with the predicted diagnosis recorded. In each case the kind of colonoscope (SD or HD) was recorded. Polyps were removed and sent for histological analysis, with the pathologist blinded to the diagnosis made by the endoscopist. The predicted diagnosis was compared with the true histology to calculate the accuracy, sensitivity and specificity of in vivo assessment using either SD or HD scopes. In total 237 polyps indigo carmine dye spray is excellent with standard-definition colonoscopes and is not improved with high-definition colonoscopes.

  1. 76 FR 28434 - Notice of Issuance of Statement of Federal Financial Accounting Standard 40, Definitional Changes...

    Science.gov (United States)

    2011-05-17

    ... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Issuance of Statement of Federal Financial Accounting Standard 40, Definitional Changes Related to Deferred Maintenance and Repairs: Amending Statement of Federal Financial Accounting Standard 6, Accounting for Property, Plant, and Equipment AGENCY...

  2. Definitions Are Important: The Case of Linear Algebra

    Science.gov (United States)

    Berman, Abraham; Shvartsman, Ludmila

    2016-01-01

    In this paper we describe an experiment in a linear algebra course. The aim of the experiment was to promote the students' understanding of the studied concepts focusing on their definitions. It seems to be a given that students should understand concepts' definitions before working substantially with them. Unfortunately, in many cases they do…

  3. Case studies can support definitions of workplace innovation in practice

    NARCIS (Netherlands)

    Vaas, F.; Žiauberytė-Jakštienė, R.; Oeij, P.R.

    2017-01-01

    Many practitioners find it problematic to understand and describe workplace innovation (WPI). Whereas there are well-known definitions of WPI, these remain highly abstract. We argue that, for practitioners, case examples of WPI best practices can be a valuable addition to these definitions. In this

  4. Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium.

    Science.gov (United States)

    Kerkhof, H J M; Meulenbelt, I; Akune, T; Arden, N K; Aromaa, A; Bierma-Zeinstra, S M A; Carr, A; Cooper, C; Dai, J; Doherty, M; Doherty, S A; Felson, D; Gonzalez, A; Gordon, A; Harilainen, A; Hart, D J; Hauksson, V B; Heliovaara, M; Hofman, A; Ikegawa, S; Ingvarsson, T; Jiang, Q; Jonsson, H; Jonsdottir, I; Kawaguchi, H; Kloppenburg, M; Kujala, U M; Lane, N E; Leino-Arjas, P; Lohmander, L S; Luyten, F P; Malizos, K N; Nakajima, M; Nevitt, M C; Pols, H A P; Rivadeneira, F; Shi, D; Slagboom, E; Spector, T D; Stefansson, K; Sudo, A; Tamm, A; Tamm, A E; Tsezou, A; Uchida, A; Uitterlinden, A G; Wilkinson, J M; Yoshimura, N; Valdes, A M; van Meurs, J B J

    2011-03-01

    To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA consortium were collected. We investigated whether different OA definitions result in different association results by creating various hip OA definitions in one large population based cohort (the Rotterdam Study I (RSI)) and testing those for association with gender, age and body mass index using one-way ANOVA. For ROA, we standardized the hip-, knee- and hand ROA definitions and calculated prevalence's of ROA before and after standardization in nine cohort studies. This procedure could only be performed in cohort studies and standardization of SOA definitions was not feasible at this moment. In this consortium, all studies with SOA phenotypes (knee, hip and hand) used a different definition and/or assessment of OA status. For knee-, hip- and hand ROA five, four and seven different definitions were used, respectively. Different hip ROA definitions do lead to different association results. For example, we showed in the RSI that hip OA defined as "at least definite joint space narrowing (JSN) and one definite osteophyte" was not associated with gender (P =0.22), but defined as "at least one definite osteophyte" was significantly associated with gender (P=3×10(-9)). Therefore, a standardization process was undertaken for ROA definitions. Before standardization a wide range of ROA prevalence's was observed in the nine cohorts studied. After standardization the range in prevalence of knee- and hip ROA was small. Phenotype definitions influence the prevalence of OA and association with clinical variables. ROA phenotypes within the TREAT-OA consortium were standardized to reduce heterogeneity and improve power in future genetics studies. Copyright © 2010 Osteoarthritis Research Society International. Published

  5. 21 CFR 130.8 - Conformity to definitions and standards of identity.

    Science.gov (United States)

    2010-04-01

    ... identity. 130.8 Section 130.8 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Conformity to definitions and standards of identity. In the following conditions, among others, a food does not conform to the definition and standard of identity therefor: (a) If it contains an ingredient for...

  6. International Docking Standard (IDSS) Interface Definition Document (IDD) . E; Revision

    Science.gov (United States)

    Kelly, Sean M.; Cryan, Scott P.

    2016-01-01

    This International Docking System Standard (IDSS) Interface Definition Document (IDD) is the result of a collaboration by the International Space Station membership to establish a standard docking interface to enable on-orbit crew rescue operations and joint collaborative endeavors utilizing different spacecraft. This IDSS IDD details the physical geometric mating interface and design loads requirements. The physical geometric interface requirements must be strictly followed to ensure physical spacecraft mating compatibility. This includes both defined components and areas that are void of components. The IDD also identifies common design parameters as identified in section 3.0, e.g., docking initial conditions and vehicle mass properties. This information represents a recommended set of design values enveloping a broad set of design reference missions and conditions, which if accommodated in the docking system design, increases the probability of successful docking between different spacecraft. This IDD does not address operational procedures or off-nominal situations, nor does it dictate implementation or design features behind the mating interface. It is the responsibility of the spacecraft developer to perform all hardware verification and validation, and to perform final docking analyses to ensure the needed docking performance and to develop the final certification loads for their application. While there are many other critical requirements needed in the development of a docking system such as fault tolerance, reliability, and environments (e.g. vibration, etc.), it is not the intent of the IDSS IDD to mandate all of these requirements; these requirements must be addressed as part of the specific developer's unique program, spacecraft and mission needs. This approach allows designers the flexibility to design and build docking mechanisms to their unique program needs and requirements. The purpose of the IDSS IDD is to provide basic common design parameters

  7. The use of high definition colonoscopy versus standard definition: does it affect polyp detection rate?

    Science.gov (United States)

    Richardson, John; Thaventhiran, Anthony; Mackenzie, Hugh; Stubbs, Benjamin

    2017-11-03

    Polyp detection rate (PDR) during lower gastrointestinal endoscopy (LGIE) is of clinical importance. Detecting adenomatous polyps early in the adenoma-carcinoma sequence can halt disease progression, enabling treatment at a favourable stage. High definition colonoscopy (HDC) has been used in our hospital alongside standard definition equipment since 2011. We aim to determine what affect the use of HDC has on PDR. Post-hoc analysis of a prospectively maintained database on all patients undergoing LGIE was performed (01/01/2012-31/12/2015), n = 15,448. Analysis tested the primary outcome of HD's effect on PDR across LGIE and secondary outcome stratified this by endoscopist group (Physician (PE), Surgeon (SE) and Nurse Endoscopist (NE)). Of 15,448 patients, 1353 underwent HDC. Unmatched analysis showed PDR increased by 5.3% in this group (p < 0.001). Matched analysis considered 2288 patients from the total cohort (1144 HDC) and showed an increase of 1% in PDR with HDC (p = 0.578). Further unmatched analysis stratified by endoscopist groups showed a PDR increase of 1.8% (p = 0.375), 5.4% (p = 0.008) and 4.6% (p = 0.021) by PE, SE and NE respectively. Matched analysis demonstrated an increase of 1% (p = 0.734) and 1.5% (p = 0.701) amongst PE and NE, with a decrease of 0.6% (p = 0.883) by SE. The introduction of HDC increased PDR across all LGIE in our hospital, though this was not clinically significant. This marginal benefit was present across all endoscopist groups with no group benefiting over another in matched analysis.

  8. Surveillance case definitions for work related upper limb pain syndromes

    OpenAIRE

    Harrington, J. M.; Carter, J. T.; Birrell, L.; Gompertz, D.

    1998-01-01

    OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...

  9. Defining progression in nonmuscle invasive bladder cancer: it is time for a new, standard definition

    NARCIS (Netherlands)

    Lamm, D.; Persad, R.; Brausi, M.; Buckley, R.; Witjes, J.A.; Palou, J.; Bohle, A.; Kamat, A.M.; Colombel, M.; Soloway, M.

    2014-01-01

    PURPOSE: Despite being one of the most important clinical outcomes in nonmuscle invasive bladder cancer, there is currently no standard definition of disease progression. Major clinical trials and meta-analyses have used varying definitions or have failed to define this end point altogether. A

  10. Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update.

    Science.gov (United States)

    Graham, Stephen M; Cuevas, Luis E; Jean-Philippe, Patrick; Browning, Renee; Casenghi, Martina; Detjen, Anne K; Gnanashanmugam, Devasena; Hesseling, Anneke C; Kampmann, Beate; Mandalakas, Anna; Marais, Ben J; Schito, Marco; Spiegel, Hans M L; Starke, Jeffrey R; Worrell, Carol; Zar, Heather J

    2015-10-15

    Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Update of the case definitions for population-based surveillance of periodontitis.

    Science.gov (United States)

    Eke, Paul I; Page, Roy C; Wei, Liang; Thornton-Evans, Gina; Genco, Robert J

    2012-12-01

    This report adds a new definition for mild periodontitis that allows for better descriptions of the overall prevalence of periodontitis in populations. In 2007, the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology developed and reported standard case definitions for surveillance of moderate and severe periodontitis based on measurements of probing depth (PD) and clinical attachment loss (AL) at interproximal sites. However, combined cases of moderate and severe periodontitis are insufficient to determine the total prevalence of periodontitis in populations. The authors proposed a definition for mild periodontitis as ≥ 2 interproximal sites with AL ≥ 3 mm and ≥ 2 interproximal sites with PD ≥ 4 mm (not on the same tooth) or one site with PD ≥ 5 mm . The effect of the proposed definition on the total burden of periodontitis was assessed in a convenience sample of 456 adults ≥ 35 years old and compared with other previously reported definitions for similar categories of periodontitis. Addition of mild periodontitis increases the total prevalence of periodontitis by ≈31% in this sample when compared with the prevalence of severe and moderate disease. Total periodontitis using the case definitions in this study should be based on the sum of mild, moderate, and severe periodontitis.

  12. Case definitions for human poisonings postulated to palytoxins exposure.

    Science.gov (United States)

    Tubaro, A; Durando, P; Del Favero, G; Ansaldi, F; Icardi, G; Deeds, J R; Sosa, S

    2011-03-01

    A series of case reports and anecdotal references describe the adverse effects on human health ascribed to the marine toxin palytoxin (PLTX) after different exposure routes. They include poisonings after oral intake of contaminated seafood, but also inhalation and cutaneous/systemic exposures after direct contact with aerosolized seawater during Ostreopsis blooms and/or through maintaining aquaria containing cnidarian zoanthids. The symptoms commonly recorded during PLTX intoxication are general malaise and weakness, associated with myalgia, respiratory effects, impairment of the neuromuscular apparatus and abnormalities in cardiac function. Systemic symptoms are often recorded together with local damages whose intensity varies according to the route and length of exposure. Gastrointestinal malaise or respiratory distress is common for oral and inhalational exposure, respectively. In addition, irritant properties of PLTX probably account for the inflammatory reactions typical of cutaneous and inhalational contact. Unfortunately, the toxin identification and/or quantification are often incomplete or missing and cases of poisoning are indirectly ascribed to PLTXs, according only to symptoms, anamnesis and environmental/epidemiological investigations (i.e. zoanthid handling or ingestion of particular seafood). Based on the available literature, we suggest a "case definition of PLTX poisonings" according to the main exposure routes, and, we propose the main symptoms to be checked, as well as, hemato-clinical analysis to be carried out. We also suggest the performance of specific analyses both on biological specimens of patients, as well as, on the contaminated materials responsible for the poisoning. A standardized protocol for data collection could provide a more rapid and reliable diagnosis of palytoxin-poisoning, but also the collection of necessary data for the risk assessment for this family of toxins. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Making messaging standards work: from definition to interoperability at runtime.

    Science.gov (United States)

    Oemig, Frank; Bloebel, Bernd

    2003-01-01

    The synchronisation of data between healthcare IT applications is done by exchanging (in the broader sense) messages which are formatted according to one of many standards that are used in healthcare. The most successful standard enabling such communication and co-operation for health is HL7 established in the mid-eighties starting as a communication standard within hospitals. HL7 included soon other domains such as home care, clinical studies, and prescription communication. So, HL7 supports shared care between primary, secondary and territory healthcare establishments. Another very successful standard is DICOM for communicating image information among modalities and (radiology) information systems. This review paper discusses integration issues for specification and development of messaging standards and their impact on applications.

  14. HIV lipodystrophy case definition using artificial neural network modelling

    DEFF Research Database (Denmark)

    Ioannidis, John P A; Trikalinos, Thomas A; Law, Matthew

    2003-01-01

    OBJECTIVE: A case definition of HIV lipodystrophy has recently been developed from a combination of clinical, metabolic and imaging/body composition variables using logistic regression methods. We aimed to evaluate whether artificial neural networks could improve the diagnostic accuracy. METHODS:...

  15. Defining progression in nonmuscle invasive bladder cancer: it is time for a new, standard definition.

    Science.gov (United States)

    Lamm, Donald; Persad, Raj; Brausi, Maurizio; Buckley, Roger; Witjes, J Alfred; Palou, Joan; Böhle, Andreas; Kamat, Ashish M; Colombel, Marc; Soloway, Mark

    2014-01-01

    Despite being one of the most important clinical outcomes in nonmuscle invasive bladder cancer, there is currently no standard definition of disease progression. Major clinical trials and meta-analyses have used varying definitions or have failed to define this end point altogether. A standard definition of nonmuscle invasive bladder cancer progression as determined by reproducible and reliable procedures is needed. We examine current definitions of nonmuscle invasive bladder cancer progression, and propose a new definition that will be more clinically useful in determining patient prognosis and comparing treatment options. The IBCG (International Bladder Cancer Group) analyzed published clinical trials and meta-analyses that examined nonmuscle invasive bladder cancer progression as of December 2012. The limitations of the definitions of progression used in these trials were considered, as were additional parameters associated with the advancement of nonmuscle invasive bladder cancer. The most commonly used definition of nonmuscle invasive bladder cancer progression is an increase in stage from nonmuscle invasive to muscle invasive disease. Although this definition is clinically important, it fails to include other important parameters of advancing disease such as progression to lamina propria invasion and increase in grade. The IBCG proposes the definition of nonmuscle invasive bladder cancer progression as an increase in T stage from CIS or Ta to T1 (lamina propria invasion), development of T2 or greater or lymph node (N+) disease or distant metastasis (M1), or an increase in grade from low to high. Investigators should consider the use of this new definition to help standardize protocols and improve the reporting of progression. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Evaluation of a Consensus-Based Criterion Standard Definition of Trauma Center Need for Use in Field Triage Research.

    Science.gov (United States)

    Willenbring, Brian D; Lerner, E Brooke; Brasel, Karen; Cushman, Jeremy T; Guse, Clare E; Shah, Manish N; Swor, Robert

    2016-01-01

    Research on field triage of injured patients is limited by the lack of a widely used criterion standard for defining trauma center need. Injury Severity Score (ISS) >15 has been a commonly used outcome measure in research for determining trauma center need that has never been validated. A multidisciplinary team recently published a consensus-based criterion standard definition of trauma center need, but this measure has not yet been validated. The objective was to determine if the consensus-based criterion standard can be obtained by medical record review and compare patients identified as needing a trauma center by the consensus-based criterion standard vs. ISS >15. A subanalysis of data collected during a 2-year prospective cohort study of 4,528 adult trauma patients transported by EMS to a single trauma center was conducted. These data included ICD-9-CM codes, treatment times, and other patient care data. Presence of the consensus-based criterion standard was determined for each patient. ISS was calculated based on ICD-9-CM codes assigned for billing. The consensus-based criterion standard could be applied to 4,471 (98.7%) cases. ISS could be determined for 4,506 (99.5%) cases. Based on an ISS >15, 8.9% of cases were identified as needing a trauma center. Of those, only 48.2% met the consensus-based criterion standard. Almost all patients that did not meet the consensus-based criterion standard, but had an ISS >15 were diagnosed with chest (rib fractures (100/205 cases)/pneumothorax (57/205 cases), closed head (without surgical intervention 88/205 cases), vertebral (without spinal cord injury 45/205 cases), and/or extremity injuries (39/205 cases). There were 4,053 cases with an ISS <15. 5.0% of those with an ISS <15 met the consensus-based criterion standard with the majority requiring surgery (139/203 cases) or a blood transfusion (60/203 cases). The kappa coefficient of agreement for ISS and the consensus-based criterion standard was 0.43. We determined that

  17. Understanding death in custody: a case for a comprehensive definition.

    Science.gov (United States)

    Ruiz, Géraldine; Wangmo, Tenzin; Mutzenberg, Patrick; Sinclair, Jessica; Elger, Bernice Simone

    2014-09-01

    Prisoners sometimes die in prison, either due to natural illness, violence, suicide, or a result of imprisonment. The purpose of this study is to understand deaths in custody using qualitative methodology and to argue for a comprehensive definition of death in custody that acknowledges deaths related to the prison environment. Interviews were conducted with 33 experts, who primarily work as lawyers or forensic doctors with national and/or international organisations. Responses were coded and analysed qualitatively. Defining deaths in custody according to the place of death was deemed problematic. Experts favoured a dynamic approach emphasising the link between the detention environment and occurrence of death rather than the actual place of death. Causes of deaths and different patterns of deaths were discussed, indicating that many of these deaths are preventable. Lack of an internationally recognised standard definition of death in custody is a major concern. Key aspects such as place, time, and causes of death as well as relation to the prison environment should be debated and incorporated into the definition. Systematic identification of violence within prison institutions is critical and efforts are needed to prevent unnecessary deaths in prison and to protect vulnerable prisoners.

  18. Analysis of risk factors for schizophrenia with two different case definitions

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Tidselbak Larsen, Janne; Mors, Ole

    2015-01-01

    Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range...... of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient...... contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher...

  19. Case definition for clinical and subclinical bacterial kidney disease (BKD) in Atlantic Salmon (Salmo salar L.) in New Brunswick, Canada.

    Science.gov (United States)

    Boerlage, A S; Stryhn, H; Sanchez, J; Hammell, K L

    2017-03-01

    Bacterial kidney disease (BKD) is considered an important cause of loss in salmon aquaculture in Atlantic Canada. Causative agent of BKD is the Gram-positive bacteria Renibacterium salmoninarum. Infected salmon are often asymptomatic (subclinical infection), and the disease is considered chronic. One of the challenges in quantifying information from farm production and health records is the application of a standardized case definition. Case definitions for farm-level and cage-level clinical and subclinical BKD were developed using retrospective longitudinal data from aquaculture practices in New Brunswick, Canada, combining (i) industry records of weekly production data including mortalities, (ii) field observations for BKD using reports of veterinarians and/or fish health technicians, (iii) diagnostic submissions and test results and (iv) treatments used to control BKD. Case definitions were evaluated using veterinarians' expert judgements as reference standard. Eighty-nine and 66% of sites and fish groups, respectively, were associated with BKD at least once. For BKD present (subclinical or clinical), sensitivity and specificity of the case definition were 75-100% varying between event, fish group, site cycle and level (site pen). For clinical BKD, sensitivities were 29-64% and specificities 91-100%. Industry data can be used to develop sensitive case definitions. © 2016 John Wiley & Sons Ltd.

  20. 45 CFR 680.10 - Definitions; cross-references to employee ethical conduct standards and financial disclosure...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Definitions; cross-references to employee ethical... Foundation § 680.10 Definitions; cross-references to employee ethical conduct standards and financial...-references to employee ethical conduct standards and financial disclosure regulations. Members of the...

  1. Practical support for Lean Six Sigma software process definition using IEEE software engineering standards

    CERN Document Server

    Land, Susan K; Walz, John W

    2012-01-01

    Practical Support for Lean Six Sigma Software Process Definition: Using IEEE Software Engineering Standards addresses the task of meeting the specific documentation requirements in support of Lean Six Sigma. This book provides a set of templates supporting the documentation required for basic software project control and management and covers the integration of these templates for their entire product development life cycle. Find detailed documentation guidance in the form of organizational policy descriptions, integrated set of deployable document templates, artifacts required in suppo

  2. An Ontology to Improve Transparency in Case Definition and Increase Case Finding of Infectious Intestinal Disease: Database Study in English General Practice.

    Science.gov (United States)

    de Lusignan, Simon; Shinneman, Stacy; Yonova, Ivelina; van Vlymen, Jeremy; Elliot, Alex J; Bolton, Frederick; Smith, Gillian E; O'Brien, Sarah

    2017-09-28

    result was 19.68% (546/2775). The standard RCGP RSC definition of IID, and its mapping to ICD-10, underestimates disease incidence. The ontological approach identified a larger proportion of new IID cases; the ontology divides contributory elements and enables transparency and comparison of rates. Results illustrate how improved diagnostic coding of IID combined with an ontological approach to case definition would provide a clearer picture of IID in the community, better inform GPs and public health services about circulating disease, and empower them to respond. We need to improve the Pathology Bounded Code List (PBCL) currently used by laboratories to electronically report results. Given advances in stool microbiology testing with a move to nonculture, PCR-based methods, the way microbiology results are reported and coded via PBCL needs to be reviewed and modernized. ©Simon de Lusignan, Stacy Shinneman, Ivelina Yonova, Jeremy van Vlymen, Alex J Elliot, Frederick Bolton, Gillian E Smith, Sarah O'Brien. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 28.09.2017.

  3. Impact of the Definition of Peak Standardized Uptake Value on Quantification of Treatment Response

    Science.gov (United States)

    Vanderhoek, Matt; Perlman, Scott B.; Jeraj, Robert

    2012-01-01

    PET-based treatment response assessment typically measures the change in maximum standardized uptake value (SUVmax), which is adversely affected by noise. Peak SUV (SUVpeak) has been recommended as a more robust alternative, but its associated region of interest (ROIpeak) is not uniquely defined. We investigated the impact of different ROIpeak definitions on quantification of SUVpeak and tumor response. Methods Seventeen patients with solid malignancies were treated with a multitargeted receptor tyrosine kinase inhibitor resulting in a variety of responses. Using the cellular proliferation marker 3′-deoxy-3′-18F-fluorothymidine (18F-FLT), whole-body PET/CT scans were acquired at baseline and during treatment. 18F-FLT–avid lesions (~2/patient) were segmented on PET images, and tumor response was assessed via the relative change in SUVpeak. For each tumor, 24 different SUVpeaks were determined by changing ROIpeak shape (circles vs. spheres), size (7.5–20 mm), and location (centered on SUVmax vs. placed in highest-uptake region), encompassing different definitions from the literature. Within each tumor, variations in the 24 SUVpeaks and tumor responses were measured using coefficient of variation (CV), standardized deviation (SD), and range. For each ROIpeak definition, a population average SUVpeak and tumor response were determined over all tumors. Results A substantial variation in both SUVpeak and tumor response resulted from changing the ROIpeak definition. The variable ROIpeak definition led to an intratumor SUVpeak variation ranging from 49% above to 46% below the mean (CV, 17%) and an intratumor SUVpeak response variation ranging from 49% above to 35% below the mean (SD, 9%). The variable ROIpeak definition led to a population average SUVpeak variation ranging from 24% above to 28% below the mean (CV, 14%) and a population average SUVpeak response variation ranging from only 3% above to 3% below the mean (SD, 2%). The size of ROIpeak caused more

  4. A framework for the definition of standardized protocols for measuring upper-extremity kinematics.

    Science.gov (United States)

    Kontaxis, A; Cutti, A G; Johnson, G R; Veeger, H E J

    2009-03-01

    Increasing interest in upper extremity biomechanics has led to closer investigations of both segment movements and detailed joint motion. Unfortunately, conceptual and practical differences in the motion analysis protocols used up to date reduce compatibility for post data and cross validation analysis and so weaken the body of knowledge. This difficulty highlights a need for standardised protocols, each addressing a set of questions of comparable content. The aim of this work is therefore to open a discussion and propose a flexible framework to support: (1) the definition of standardised protocols, (2) a standardised description of these protocols, and (3) the formulation of general recommendations. Proposal of a framework for the definition of standardized protocols. The framework is composed by two nested flowcharts. The first defines what a motion analysis protocol is by pointing out its role in a motion analysis study. The second flowchart describes the steps to build a protocol, which requires decisions on the joints or segments to be investigated and the description of their mechanical equivalent model, the definition of the anatomical or functional coordinate frames, the choice of marker or sensor configuration and the validity of their use, the definition of the activities to be measured and the refinements that can be applied to the final measurements. Finally, general recommendations are proposed for each of the steps based on the current literature, and open issues are highlighted for future investigation and standardisation. Standardisation of motion analysis protocols is urgent. The proposed framework can guide this process through the rationalisation of the approach.

  5. Standardizing terms, definitions and concepts for describing and interpreting unwanted immunogenicity of biopharmaceuticals

    DEFF Research Database (Denmark)

    Rup, B; Pallardy, M; Sikkema, D

    2015-01-01

    Biopharmaceuticals (BPs) represent a rapidly growing class of approved and investigational drug therapies that is contributing significantly to advancing treatment in multiple disease areas, including inflammatory and autoimmune diseases, genetic deficiencies and cancer. Unfortunately, unwanted...... is made difficult due to lack of agreement on concepts, practices and standardized terms and definitions related to immunogenicity. The Innovative Medicines Initiative (IMI; www.imi-europe.org), ABIRISK consortium [Anti-Biopharmaceutical (BP) Immunization Prediction and Clinical Relevance to Reduce...... the Risk; www.abirisk.eu] was formed by leading clinicians, academic scientists and EFPIA (European Federation of Pharmaceutical Industries and Associations) members to elucidate underlying causes, improve methods for immunogenicity prediction and mitigation and establish common definitions around terms...

  6. Computing tools for implementing standards for single-case designs.

    Science.gov (United States)

    Chen, Li-Ting; Peng, Chao-Ying Joanne; Chen, Ming-E

    2015-11-01

    In the single-case design (SCD) literature, five sets of standards have been formulated and distinguished: design standards, assessment standards, analysis standards, reporting standards, and research synthesis standards. This article reviews computing tools that can assist researchers and practitioners in meeting the analysis standards recommended by the What Works Clearinghouse: Procedures and Standards Handbook-the WWC standards. These tools consist of specialized web-based calculators or downloadable software for SCD data, and algorithms or programs written in Excel, SAS procedures, SPSS commands/Macros, or the R programming language. We aligned these tools with the WWC standards and evaluated them for accuracy and treatment of missing data, using two published data sets. All tools were tested to be accurate. When missing data were present, most tools either gave an error message or conducted analysis based on the available data. Only one program used a single imputation method. This article concludes with suggestions for an inclusive computing tool or environment, additional research on the treatment of missing data, and reasonable and flexible interpretations of the WWC standards. © The Author(s) 2015.

  7. Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic.

    Science.gov (United States)

    Hsu, Christopher H; Champaloux, Steven W; Keïta, Sakoba; Martel, Lise; Bilivogui, Pepe; Knust, Barbara; McCollum, Andrea M

    2018-01-01

    Rapid early detection and control of Ebola virus disease (EVD) is contingent on accurate case definitions. Using an epidemic surveillance dataset from Guinea, we analyzed an EVD case definition developed by the World Health Organization (WHO) and used in Guinea. We used the surveillance dataset (March-October 2014; n = 2,847 persons) to identify patients who satisfied or did not satisfy case definition criteria. Laboratory confirmation determined cases from noncases, and we calculated sensitivity, specificity and predictive values. The sensitivity of the defintion was 68.9%, and the specificity of the definition was 49.6%. The presence of epidemiologic risk factors (i.e., recent contact with a known or suspected EVD case-patient) had the highest sensitivity (74.7%), and unexplained deaths had the highest specificity (92.8%). Results for case definition analyses were statistically significant (pdefinition used in Guinea contributed to improved overall sensitivity and specificity.

  8. Meso-scale resolution for the definition of environmental flow standards in Mediterranean streams

    Science.gov (United States)

    Vezza, Paolo; Martinez-Capel, Francisco; Muñoz-Mas, Rafael; Comoglio, Claudio; Spairani, Michele; Koutrakis, Emmanuil; Sapounidis, Argyris

    2013-04-01

    high sensitivity/specificity values, indicating substantial predictions with low cross-classification errors. In addition, the area under the ROC curve (AUC) was over 0.81 in all cases, indicating from good to excellent model performance. Finally, examples of model applications in regulated sites were also presented in order to quantify the available habitat under specific environmental conditions and to define environmental flow standards. The meso-scale approach showed its potential in modelling habitat for fish and the presented statistical techniques can be considered a promising tool for river restoration and ecological management of Mediterranean streams.

  9. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies.

    Science.gov (United States)

    Lozier, Matthew; Turcios-Ruiz, Reina Maria; Noonan, Gary; Ordunez, Pedro

    2016-11-01

    SYNOPSIS Over the last two decades, experts have reported a rising number of deaths caused by chronic kidney disease (CKD) along the Pacific coast of Central America, from southern Mexico to Costa Rica. However, this specific disease is not associated with traditional causes of CKD, such as aging, diabetes, or hypertension. Rather, this disease is a chronic interstitial nephritis termed chronic kidney disease of nontraditional etiology (CKDnT). According to the Pan American Health Organization (PAHO) mortality database, there are elevated rates of deaths related to kidney disease in many of these countries, with the highest rates being reported in El Salvador and Nicaragua. This condition has been identified in certain agricultural communities, predominantly among male farmworkers. Since CKD surveillance systems in Central America are under development or nonexistent, experts and governmental bodies have recommended creating standardized case definitions for surveillance purposes to monitor and characterize this epidemiological situation. A group of experts from Central American ministries of health, the U.S. Centers for Disease Control and Prevention (CDC), and PAHO held a workshop in Guatemala to discuss CKDnT epidemiologic case definitions. In this paper, we propose that CKD in general be identified by the standard definition internationally accepted and that a suspect case of CKDnT be defined as a person age diseases, and other well-known causes of CKD. A probable case of CKDnT is defined as a suspect case with the same findings confirmed three or more months later.

  10. Definition of Intellectual Disability in Criminal Court Cases

    Science.gov (United States)

    Olley, J. Gregory

    2013-01-01

    Definitions and associated descriptions of the condition now commonly known as "intellectual disability" serve many functions. The "Atkins v. Virginia" U.S. Supreme Court decision (2002) has called attention to the importance of clear, objective, and measureable wording of the definition. This article discusses the potential for misunderstanding…

  11. Construct representation and definitions in psychopathology: the case of delusion

    Directory of Open Access Journals (Sweden)

    Banzato Claudio EM

    2010-02-01

    Full Text Available Abstract Background Delusion is one of the most intriguing psychopathological phenomena and its conceptualization remains the subject of genuine debate. Claims that it is ill-defined, however, are typically grounded on essentialist expectations that a given definition should capture the core of every instance acknowledged as delusion in the clinical setting. Objective In this paper, we attempt to show the major limitations of the definition of delusion from a non-essentialist point of view. Method The problem is analyzed within the framework of constructs and their translation into definitions. Different linguistic and epistemological perspectives that do concur when one deals with psychopathological phenomena are also considered. Results The 'construct of delusion', rather than its clinical instances, is the reference in which its definition appears inept. Here we claim that the broad contextual and pragmatic bases that underpin the construct of delusion tend to be either overlooked or downplayed in the quest for a satisfactory definition of this phenomenon.

  12. Evaluation of a surveillance case definition for anogenital warts, Kaiser Permanente northwest.

    Science.gov (United States)

    Naleway, Allison L; Weinmann, Sheila; Crane, Brad; Gee, Julianne; Markowitz, Lauri E; Dunne, Eileen F

    2014-08-01

    Most studies of anogenital wart (AGW) epidemiology have used large clinical or administrative databases and unconfirmed case definitions based on combinations of diagnosis and procedure codes. We developed and validated an AGW case definition using a combination of diagnosis codes and other information available in the electronic medical record (provider type, laboratory testing). We calculated the positive predictive value (PPV) of this case definition compared with manual medical record review in a random sample of 250 cases. Using this case definition, we calculated the annual age- and sex-stratified prevalence of AGW among individuals 11 through 30 years of age from 2000 through 2005. We identified 2730 individuals who met the case definition. The PPV of the case definition was 82%, and the average annual prevalence was 4.16 per 1000. Prevalence of AGW was higher in females compared with males in every age group, with the exception of the 27- to 30-year-olds. Among females, prevalence peaked in the 19- to 22-year-olds, and among males, the peak was observed in 23- to 26-year-olds. The case definition developed in this study is the first to be validated with medical record review and has a good PPV for the detection of AGW. The prevalence rates observed in this study were higher than other published rates, but the age- and sex-specific patterns observed were consistent with previous reports.

  13. 21 CFR 130.20 - Food additives proposed for use in foods for which definitions and standards of identity are...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Food additives proposed for use in foods for which...: GENERAL Food Additives in Standardized Foods § 130.20 Food additives proposed for use in foods for which... the act, which proposes the inclusion of a food additive in such definition and standard of identity...

  14. Determination of the optimal case definition for the diagnosis of end-stage renal disease from administrative claims data in Manitoba, Canada.

    Science.gov (United States)

    Komenda, Paul; Yu, Nancy; Leung, Stella; Bernstein, Keevin; Blanchard, James; Sood, Manish; Rigatto, Claudio; Tangri, Navdeep

    2015-01-01

    End-stage renal disease (ESRD) is a major public health problem with increasing prevalence and costs. An understanding of the long-term trends in dialysis rates and outcomes can help inform health policy. We determined the optimal case definition for the diagnosis of ESRD using administrative claims data in the province of Manitoba over a 7-year period. We determined the sensitivity, specificity, predictive value and overall accuracy of 4 administrative case definitions for the diagnosis of ESRD requiring chronic dialysis over different time horizons from Jan. 1, 2004, to Mar. 31, 2011. The Manitoba Renal Program Database served as the gold standard for confirming dialysis status. During the study period, 2562 patients were registered as recipients of chronic dialysis in the Manitoba Renal Program Database. Over a 1-year period (2010), the optimal case definition was any 2 claims for outpatient dialysis, and it was 74.6% sensitive (95% confidence interval [CI] 72.3%-76.9%) and 94.4% specific (95% CI 93.6%-95.2%) for the diagnosis of ESRD. In contrast, a case definition of at least 2 claims for dialysis treatment more than 90 days apart was 64.8% sensitive (95% CI 62.2%-67.3%) and 97.1% specific (95% CI 96.5%-97.7%). Extending the period to 5 years greatly improved sensitivity for all case definitions, with minimal change to specificity; for example, for the optimal case definition of any 2 claims for dialysis treatment, sensitivity increased to 86.0% (95% CI 84.7%-87.4%) at 5 years. Accurate case definitions for the diagnosis of ESRD requiring dialysis can be derived from administrative claims data. The optimal definition required any 2 claims for outpatient dialysis. Extending the claims period to 5 years greatly improved sensitivity with minimal effects on specificity for all case definitions.

  15. Clinically significant cardiopulmonary events and the effect of definition standardization on apnea of prematurity management.

    Science.gov (United States)

    Powell, M B F; Ahlers-Schmidt, C R; Engel, M; Bloom, B T

    2017-01-01

    To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge. Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared. Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (Pdefinitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.

  16. Call for standardized definitions of osteoarthritis and risk stratification for clinical trials and clinical use.

    Science.gov (United States)

    Kraus, V B; Blanco, F J; Englund, M; Karsdal, M A; Lohmander, L S

    2015-08-01

    Osteoarthritis (OA) is a heterogeneous disorder. The goals of this review are (1) To stimulate use of standardized nomenclature for OA that could serve as building blocks for describing OA and defining OA phenotypes, in short to provide unifying disease concepts for a heterogeneous disorder; and (2) To stimulate establishment of ROAD (Risk of OA Development) and ROAP (Risk of OA Progression) tools analogous to the FRAX™ instrument for predicting risk of fracture in osteoporosis; and (3) To stimulate formulation of tools for identifying disease in its early preradiographic and/or molecular stages - REDI (Reliable Early Disease Identification). Consensus around more sensitive and specific diagnostic criteria for OA could spur development of disease modifying therapies for this entity that has proved so recalcitrant to date. We fully acknowledge that as we move forward, we expect to develop more sophisticated definitions, terminology and tools. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

    Science.gov (United States)

    Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

    2018-04-01

    The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Clinical and epidemiological features of typhoid fever in Pemba, Zanzibar: assessment of the performance of the WHO case definitions.

    Directory of Open Access Journals (Sweden)

    Kamala Thriemer

    Full Text Available BACKGROUND: The gold standard for diagnosis of typhoid fever is blood culture (BC. Because blood culture is often not available in impoverished settings it would be helpful to have alternative diagnostic approaches. We therefore investigated the usefulness of clinical signs, WHO case definition and Widal test for the diagnosis of typhoid fever. METHODOLOGY/PRINCIPAL FINDINGS: Participants with a body temperature ≥37.5°C or a history of fever were enrolled over 17 to 22 months in three hospitals on Pemba Island, Tanzania. Clinical signs and symptoms of participants upon presentation as well as blood and serum for BC and Widal testing were collected. Clinical signs and symptoms of typhoid fever cases were compared to other cases of invasive bacterial diseases and BC negative participants. The relationship of typhoid fever cases with rainfall, temperature, and religious festivals was explored. The performance of the WHO case definitions for suspected and probable typhoid fever and a local cut off titre for the Widal test was assessed. 79 of 2209 participants had invasive bacterial disease. 46 isolates were identified as typhoid fever. Apart from a longer duration of fever prior to admission clinical signs and symptoms were not significantly different among patients with typhoid fever than from other febrile patients. We did not detect any significant seasonal patterns nor correlation with rainfall or festivals. The sensitivity and specificity of the WHO case definition for suspected and probable typhoid fever were 82.6% and 41.3% and 36.3 and 99.7% respectively. Sensitivity and specificity of the Widal test was 47.8% and 99.4 both forfor O-agglutinin and H- agglutinin at a cut-off titre of 1:80. CONCLUSIONS/SIGNIFICANCE: Typhoid fever prevalence rates on Pemba are high and its clinical signs and symptoms are non-specific. The sensitivity of the Widal test is low and the WHO case definition performed better than the Widal test.

  19. The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

    Science.gov (United States)

    Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

    2009-07-01

    The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points.

  20. Evaluation of the diagnostic utility of the traditional and revised WHO dengue case definitions.

    Directory of Open Access Journals (Sweden)

    Gamaliel Gutiérrez

    Full Text Available Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed. In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6% and higher specificity (55.2%, p<0.001. In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001 but lower specificity (8.5%, p<0.001. We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting

  1. Three-camera setup to record simultaneously standardized high-definition video for smile analysis.

    Science.gov (United States)

    Husain, Akhter; Makhija, Parmanand G; Ummer, Aseena Alungal; Kuijpers-Jagtman, Anne Marie; Kuijpers, Mette A R

    2017-11-01

    Our objective was to develop a photographic setup that would simultaneously capture subjects' smiles from 3 views, both statically and dynamically, and develop a software to crop the produced video clip and slice the frames to study the smile at different stages. Facial images were made of 96 subjects, aged 18 to 28 years, in natural head position using a standardized setup of 3 digital single lens reflex cameras, with a reference sticker (10 × 10 mm) on the forehead of each subject. To test the reproducibility of the setup, 1 operator took 3 images of all subjects on the same day and on 3 different days in a subset of 26 subjects. For the same-day observations, correlation coefficients varied between 0.87 and 0.93. For the observations on 3 different days, correlation coefficients were also high. The duplicate measurement error and the mean difference between measurements were small and not significant, pointing to good reliability. This new technique to capture standardized high-definition video and still images simultaneously from 3 positions is a reliable and practical tool. The technique is easy to learn and implement in the orthodontic office. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  2. The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study

    NARCIS (Netherlands)

    Scott, J. Anthony G.; Wonodi, Chizoba; Moïsi, Jennifer C.; Deloria-Knoll, Maria; DeLuca, Andrea N.; Karron, Ruth A.; Bhat, Niranjan; Murdoch, David R.; Crawley, Jane; Levine, Orin S.; O'Brien, Katherine L.; Feikin, Daniel R.; Black, Robert E.; Bhutta, Zulfiqar A.; Campbell, Harry; Cherian, Thomas; Crook, Derrick W.; de Jong, Menno D.; Dowell, Scott F.; Graham, Stephen M.; Klugman, Keith P.; Lanata, Claudio F.; Madhi, Shabir A.; Martin, Paul; Nataro, James P.; Piazza, Franco M.; Qazi, Shamim A.; Zar, Heather J.

    2012-01-01

    To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very

  3. Wind turbines and health: An examination of a proposed case definition

    Science.gov (United States)

    McCunney, Robert J.; Morfeld, Peter; Colby, W. David; Mundt, Kenneth A.

    2015-01-01

    Renewable energy demands have increased the need for new wind farms. In turn, concerns have been raised about potential adverse health effects on nearby residents. A case definition has been proposed to diagnose “Adverse Health Effects in the Environs of Industrial Wind Turbines” (AHE/IWT); initially in 2011 and then with an update in 2014. The authors invited commentary and in turn, we assessed its scientific merits by quantitatively evaluating its proposed application. We used binomial coefficients to quantitatively assess the potential of obtaining a diagnosis of AHE/IWT. We also reviewed the methodology and process of the development of the case definition by contrasting it with guidelines on case definition criteria of the USA Institute of Medicine. The case definition allows at least 3,264 and up to 400,000 possibilities for meeting second- and third-order criteria, once the limited first-order criteria are met. IOM guidelines for clinical case definitions were not followed. The case definition has virtually no specificity and lacks scientific support from peer-reviewed literature. If applied as proposed, its application will lead to substantial potential for false-positive assessments and missed diagnoses. Virtually any new illness that develops or any prevalent illness that worsens after the installation of wind turbines within 10 km of a residence could be considered AHE/IWT if the patient feels better away from home. The use of this case definition in the absence of a thorough medical evaluation with appropriate diagnostic studies poses risks to patients in that treatable disorders would be overlooked. The case definition has significant potential to mislead patients and its use cannot be recommended for application in any health-care or decision-making setting. PMID:26168947

  4. Wind turbines and health: An examination of a proposed case definition.

    Science.gov (United States)

    McCunney, Robert J; Morfeld, Peter; Colby, W David; Mundt, Kenneth A

    2015-01-01

    Renewable energy demands have increased the need for new wind farms. In turn, concerns have been raised about potential adverse health effects on nearby residents. A case definition has been proposed to diagnose "Adverse Health Effects in the Environs of Industrial Wind Turbines" (AHE/IWT); initially in 2011 and then with an update in 2014. The authors invited commentary and in turn, we assessed its scientific merits by quantitatively evaluating its proposed application. We used binomial coefficients to quantitatively assess the potential of obtaining a diagnosis of AHE/IWT. We also reviewed the methodology and process of the development of the case definition by contrasting it with guidelines on case definition criteria of the USA Institute of Medicine. The case definition allows at least 3,264 and up to 400,000 possibilities for meeting second- and third-order criteria, once the limited first-order criteria are met. IOM guidelines for clinical case definitions were not followed. The case definition has virtually no specificity and lacks scientific support from peer-reviewed literature. If applied as proposed, its application will lead to substantial potential for false-positive assessments and missed diagnoses. Virtually any new illness that develops or any prevalent illness that worsens after the installation of wind turbines within 10 km of a residence could be considered AHE/IWT if the patient feels better away from home. The use of this case definition in the absence of a thorough medical evaluation with appropriate diagnostic studies poses risks to patients in that treatable disorders would be overlooked. The case definition has significant potential to mislead patients and its use cannot be recommended for application in any health-care or decision-making setting.

  5. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies

    Directory of Open Access Journals (Sweden)

    Matthew Lozier

    Full Text Available SYNOPSIS Over the last two decades, experts have reported a rising number of deaths caused by chronic kidney disease (CKD along the Pacific coast of Central America, from southern Mexico to Costa Rica. However, this specific disease is not associated with traditional causes of CKD, such as aging, diabetes, or hypertension. Rather, this disease is a chronic interstitial nephritis termed chronic kidney disease of nontraditional etiology (CKDnT. According to the Pan American Health Organization (PAHO mortality database, there are elevated rates of deaths related to kidney disease in many of these countries, with the highest rates being reported in El Salvador and Nicaragua. This condition has been identified in certain agricultural communities, predominantly among male farmworkers. Since CKD surveillance systems in Central America are under development or nonexistent, experts and governmental bodies have recommended creating standardized case definitions for surveillance purposes to monitor and characterize this epidemiological situation. A group of experts from Central American ministries of health, the U.S. Centers for Disease Control and Prevention (CDC, and PAHO held a workshop in Guatemala to discuss CKDnT epidemiologic case definitions. In this paper, we propose that CKD in general be identified by the standard definition internationally accepted and that a suspect case of CKDnT be defined as a person age < 60 years with CKD, without type 1 diabetes mellitus, hypertensive diseases, and other well-known causes of CKD. A probable case of CKDnT is defined as a suspect case with the same findings confirmed three or more months later.

  6. Data mining: comparing the empiric CFS to the Canadian ME/CFS case definition.

    Science.gov (United States)

    Jason, Leonard A; Skendrovic, Beth; Furst, Jacob; Brown, Abigail; Weng, Angela; Bronikowski, Christine

    2012-01-01

    This article contrasts two case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We compared the empiric CFS case definition (Reeves et al., 2005) and the Canadian ME/CFS clinical case definition (Carruthers et al., 2003) with a sample of individuals with CFS versus those without. Data mining with decision trees was used to identify the best items to identify patients with CFS. Data mining is a statistical technique that was used to help determine which of the survey questions were most effective for accurately classifying cases. The empiric criteria identified about 79% of patients with CFS and the Canadian criteria identified 87% of patients. Items identified by the Canadian criteria had more construct validity. The implications of these findings are discussed. © 2011 Wiley Periodicals, Inc.

  7. Course and Outcome of Bacteremia Due to Staphylococcus Aureus: Evaluation of Different Clinical Case Definitions

    NARCIS (Netherlands)

    S. Lautenschlager (Stephan); C. Herzog (Christian); W. Zimmerli (Werner)

    1993-01-01

    textabstractIn a retrospective survey of patients hospitalized in the University Hospital of Basel, Switzerland, the course and outcome of 281 cases of true bacteremia due to Staphylococcus aureus over a 7-year period were analyzed. The main purpose was to evaluate different case definitions. In 78%

  8. Model-based methods for case definitions from administrative health data: application to rheumatoid arthritis.

    Science.gov (United States)

    Kroeker, Kristine; Widdifield, Jessica; Muthukumarana, Saman; Jiang, Depeng; Lix, Lisa M

    2017-06-23

    This research proposes a model-based method to facilitate the selection of disease case definitions from validation studies for administrative health data. The method is demonstrated for a rheumatoid arthritis (RA) validation study. Data were from 148 definitions to ascertain cases of RA in hospital, physician and prescription medication administrative data. We considered: (A) separate univariate models for sensitivity and specificity, (B) univariate model for Youden's summary index and (C) bivariate (ie, joint) mixed-effects model for sensitivity and specificity. Model covariates included the number of diagnoses in physician, hospital and emergency department records, physician diagnosis observation time, duration of time between physician diagnoses and number of RA-related prescription medication records. The most common case definition attributes were: 1+ hospital diagnosis (65%), 2+ physician diagnoses (43%), 1+ specialist physician diagnosis (51%) and 2+ years of physician diagnosis observation time (27%). Statistically significant improvements in sensitivity and/or specificity for separate univariate models were associated with (all p values model produced similar results. Youden's index was associated with these same case definition criteria, except for the length of the physician diagnosis observation time. A model-based method provides valuable empirical evidence to aid in selecting a definition(s) for ascertaining diagnosed disease cases from administrative health data. The choice between univariate and bivariate models depends on the goals of the validation study and number of case definitions. © 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.

  9. Generic project definitions for improvement of health care delivery: a case-based approach.

    Science.gov (United States)

    Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

    2011-01-01

    The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

  10. Osteoporosis-related fracture case definitions for population-based administrative data

    Directory of Open Access Journals (Sweden)

    Lix Lisa M

    2012-05-01

    Full Text Available Abstract Background Population-based administrative data have been used to study osteoporosis-related fracture risk factors and outcomes, but there has been limited research about the validity of these data for ascertaining fracture cases. The objectives of this study were to: (a compare fracture incidence estimates from administrative data with estimates from population-based clinically-validated data, and (b test for differences in incidence estimates from multiple administrative data case definitions. Methods Thirty-five case definitions for incident fractures of the hip, wrist, humerus, and clinical vertebrae were constructed using diagnosis codes in hospital data and diagnosis and service codes in physician billing data from Manitoba, Canada. Clinically-validated fractures were identified from the Canadian Multicentre Osteoporosis Study (CaMos. Generalized linear models were used to test for differences in incidence estimates. Results For hip fracture, sex-specific differences were observed in the magnitude of under- and over-ascertainment of administrative data case definitions when compared with CaMos data. The length of the fracture-free period to ascertain incident cases had a variable effect on over-ascertainment across fracture sites, as did the use of imaging, fixation, or repair service codes. Case definitions based on hospital data resulted in under-ascertainment of incident clinical vertebral fractures. There were no significant differences in trend estimates for wrist, humerus, and clinical vertebral case definitions. Conclusions The validity of administrative data for estimating fracture incidence depends on the site and features of the case definition.

  11. Generic project definitions for improvement of health care delivery: A case-base approach

    OpenAIRE

    Niemeijer, G.C.; Does, R.J.M.M.; de Mast, J.; Trip, A.; van den Heuvel, J.

    2011-01-01

    Background: The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. Methods: This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and aca...

  12. Evaluation of Tuberculosis Diagnostics in Children: 1. Proposed Clinical Case Definitions for Classification of Intrathoracic Tuberculosis Disease. Consensus From an Expert Panel

    Science.gov (United States)

    Graham, Stephen M.; Ahmed, Tahmeed; Amanullah, Farhana; Browning, Renee; Cardenas, Vicky; Casenghi, Martina; Cuevas, Luis E.; Gale, Marianne; Gie, Robert P.; Grzemska, Malgosia; Handelsman, Ed; Hatherill, Mark; Hesseling, Anneke C.; Jean-Philippe, Patrick; Kampmann, Beate; Kabra, Sushil Kumar; Lienhardt, Christian; Lighter-Fisher, Jennifer; Madhi, Shabir; Makhene, Mamodikoe; Marais, Ben J.; McNeeley, David F.; Menzies, Heather; Mitchell, Charles; Modi, Surbhi; Mofenson, Lynne; Musoke, Philippa; Nachman, Sharon; Powell, Clydette; Rigaud, Mona; Rouzier, Vanessa; Starke, Jeffrey R.; Swaminathan, Soumya; Wingfield, Claire

    2012-01-01

    There is a critical need for improved diagnosis of tuberculosis in children, particularly in young children with intrathoracic disease as this represents the most common type of tuberculosis in children and the greatest diagnostic challenge. There is also a need for standardized clinical case definitions for the evaluation of diagnostics in prospective clinical research studies that include children in whom tuberculosis is suspected but not confirmed by culture of Mycobacterium tuberculosis. A panel representing a wide range of expertise and child tuberculosis research experience aimed to develop standardized clinical research case definitions for intrathoracic tuberculosis in children to enable harmonized evaluation of new tuberculosis diagnostic technologies in pediatric populations. Draft definitions and statements were proposed and circulated widely for feedback. An expert panel then considered each of the proposed definitions and statements relating to clinical definitions. Formal group consensus rules were established and consensus was reached for each statement. The definitions presented in this article are intended for use in clinical research to evaluate diagnostic assays and not for individual patient diagnosis or treatment decisions. A complementary article addresses methodological issues to consider for research of diagnostics in children with suspected tuberculosis. PMID:22448023

  13. A medical-legal review regarding the standard of care for epidural injections, with particular reference to a closed case.

    Science.gov (United States)

    Helm, Standiford; Glaser, Scott; Falco, Frank; Henry, Brian

    2010-01-01

    Interventional pain management is an evolving field, with a primary focus on the safety of the patient. One major source of risk to patients is intraarterial or intraneural injections. Interventional pain physicians have considerable interest in identifying techniques which avoid these complications. A recent article has reviewed complications associated with interventional procedures and concluded that the complications were due to deviation from a specific prescribed protocol. One of the cases reviewed went to jury trial and the record of that case is in the public domain. Two of the authors of the recent review were expert witnesses in the trial. They provided conflicting testimony as to alleged violations of the standard of care. Their criticisms also differed from a third criticism contained in the article as well as the protocol being advocated in the article, thus contravening the claim that there is one prescribed protocol which must be followed. The definition of standard of care varies amongst jurisdictions, but is generally defined as either that care which a reasonably well-trained physician in that specialty would provide under similar circumstances or as what would constitute reasonable medical care under the circumstances presented. Analysis of the case which went to trial indicates that there is not one prescribed protocol which must be followed; the definition of standard of care is broader than that. Interventional pain management is an evolving field and the standard of care is broadly defined.

  14. Influence of the lack of a standard definition of “family business” on research into their international strategies☆

    Directory of Open Access Journals (Sweden)

    Myriam Cano-Rubio

    2017-09-01

    Full Text Available Research into the internationalisation strategies of family businesses is plagued by the excessive use of many and varied concepts to define these companies, and often leads to diverse and disparate results. The conceptual spectrum used by researchers is very broad, ranging from the simplest definition, in which a company is classified as a family business on the basis of the perception of its owners and/or managers, to others which consider variables such as ownership, management, involvement of the family in the business, continuity and combinations thereof. The results obtained highlight the need for those researching family business internationalisation strategies to use a standard definition of family business, so enabling us to continue advancing in our knowledge of this topic and avoid coming to different conclusions merely as a result of having based our research on different definitions.

  15. Development of a Surveillance Definition for United States-Mexico Binational Cases of Tuberculosis.

    Science.gov (United States)

    Woodruff, Rachel S Yelk; Miner, Mark C; Miramontes, Roque

    Consistently collected binational surveillance data are important in advocating for resources to manage and treat binational cases of tuberculosis (TB). The objective of this study was to develop a surveillance definition for binational (United States-Mexico) cases of TB to assess the burden on US TB program resources. We collaborated with state and local TB program staff members in the United States to identify characteristics associated with binational cases of TB. We collected data on all cases of TB from 9 pilot sites in 5 states (Arizona, California, Colorado, New Mexico, and Texas) during January 1-June 30, 2014, that had at least 1 binational characteristic (eg, "crossed border while on TB treatment" and "received treatment in another country, coordinated by an established, US-funded, binational TB program"). A workgroup of US state, local, and federal partners reviewed results and used them to develop a practical surveillance definition. The pilot sites reported 87 cases of TB with at least 1 binational characteristic during the project period. The workgroup drafted a proposed surveillance definition to include 2 binational characteristics: "crossed border while on TB treatment" (34 of 87 cases, 39%) and "received treatment in another country, coordinated by an established, US-funded, binational TB program" (26 of 87 cases, 30%). Applying the new proposed definition, 39 of 87 pilot cases of TB (45%) met the definition of binational. Input from partners who were responsible for the care and treatment of patients who cross the United States-Mexico border was crucial in defining a binational case of TB.

  16. Definition and compositions of standard wastestreams for evaluation of Buried Waste Integrated Demonstration treatment technologies

    International Nuclear Information System (INIS)

    Bates, S.O.

    1993-06-01

    The Buried Waste Integrated Demonstration (BWID) Project was organized at the Idaho National Engineering Laboratory to support research, development, demonstration, testing, and evaluation of emerging technologies that offer promising solutions to remediation of buried waste. BWID will identify emerging technologies, screen them for applicability to the identified needs, select technologies for demonstration, and then evaluate the technologies based on prescribed performance objectives. The technical objective of the project is to establish solutions to Environmental Restoration and Waste Management's technological deficiencies and improve baseline remediation systems. This report establishes a set of standard wastestream compositions that will be used by BWID to evaluate the emerging technologies. Five wastestreams are proposed that use four types of waste and a nominal case that is a homogenized combination of the four wastes. The five wastestreams will provide data on the compositional extremes and indicate the technologies' effectiveness over the complete range of expected wastestream compositions

  17. Evaluating the offensive definition zone in football: a case study ...

    African Journals Online (AJOL)

    New technological solutions have greatly improved match analysis systems for investigating players' performance. Nevertheless, there still remains a large gap in the collective analysis where improvements need to be made, mainly in the use of automated information gathering. Thus, the aim of this case study was to ...

  18. Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics.

    Science.gov (United States)

    Braga, José Ueleres; Bressan, Clarisse; Dalvi, Ana Paula Razal; Calvet, Guilherme Amaral; Daumas, Regina Paiva; Rodrigues, Nadia; Wakimoto, Mayumi; Nogueira, Rita Maria Ribeiro; Nielsen-Saines, Karin; Brito, Carlos; Bispo de Filippis, Ana Maria; Brasil, Patrícia

    2017-01-01

    Zika is a new disease in the American continent and its surveillance is of utmost importance, especially because of its ability to cause neurological manifestations as Guillain-Barré syndrome and serious congenital malformations through vertical transmission. The detection of suspected cases by the surveillance system depends on the case definition adopted. As the laboratory diagnosis of Zika infection still relies on the use of expensive and complex molecular techniques with low sensitivity due to a narrow window of detection, most suspected cases are not confirmed by laboratory tests, mainly reserved for pregnant women and newborns. In this context, an accurate definition of a suspected Zika case is crucial in order for the surveillance system to gauge the magnitude of an epidemic. We evaluated the accuracy of various Zika case definitions in a scenario where Dengue and Chikungunya viruses co-circulate. Signs and symptoms that best discriminated PCR confirmed Zika from other laboratory confirmed febrile or exanthematic diseases were identified to propose and test predictive models for Zika infection based on these clinical features. Our derived score prediction model had the best performance because it demonstrated the highest sensitivity and specificity, 86·6% and 78·3%, respectively. This Zika case definition also had the highest values for auROC (0·903) and R2 (0·417), and the lowest Brier score 0·096. In areas where multiple arboviruses circulate, the presence of rash with pruritus or conjunctival hyperemia, without any other general clinical manifestations such as fever, petechia or anorexia is the best Zika case definition.

  19. Sustainable geothermal utilization - Case histories; definitions; research issues and modelling

    International Nuclear Information System (INIS)

    Axelsson, Gudni

    2010-01-01

    Sustainable development by definition meets the needs of the present without compromising the ability of future generations to meet their own needs. The Earth's enormous geothermal resources have the potential to contribute significantly to sustainable energy use worldwide as well as to help mitigate climate change. Experience from the use of numerous geothermal systems worldwide lasting several decades demonstrates that by maintaining production below a certain limit the systems reach a balance between net energy discharge and recharge that may be maintained for a long time (100-300 years). Modelling studies indicate that the effect of heavy utilization is often reversible on a time-scale comparable to the period of utilization. Thus, geothermal resources can be used in a sustainable manner either through (1) constant production below the sustainable limit, (2) step-wise increase in production, (3) intermittent excessive production with breaks, and (4) reduced production after a shorter period of heavy production. The long production histories that are available for low-temperature as well as high-temperature geothermal systems distributed throughout the world, provide the most valuable data available for studying sustainable management of geothermal resources, and reservoir modelling is the most powerful tool available for this purpose. The paper presents sustainability modelling studies for the Hamar and Nesjavellir geothermal systems in Iceland, the Beijing Urban system in China and the Olkaria system in Kenya as examples. Several relevant research issues have also been identified, such as the relevance of system boundary conditions during long-term utilization, how far reaching interference from utilization is, how effectively geothermal systems recover after heavy utilization and the reliability of long-term (more than 100 years) model predictions. (author)

  20. Evaluation of the uptake of the Australian standardized terminology and definitions for texture modified foods and fluids.

    Science.gov (United States)

    Jukes, Sarah; Cichero, Julie A Y; Haines, Terrence; Wilson, Christina; Paul, Kate; O'Rourke, Michelle

    2012-06-01

    This paper discusses the uptake of standardized terminology and definitions for texture modified foods and fluids. The Australian dietetic and speech-language pathology associations endorsed national standards in 2007. This project sought to determine the barriers and enablers for use of the national standards in clinical practice. Cross-sectional online surveys were developed, including open- and closed-response questions. The surveys targeted different professional groups in Australia including speech-language pathologists, dietitians, nurses, and food service personnel. Australian accredited universities were contacted to determine penetration of the standards. A total of 574 surveys were received. Sixty-five per cent of respondents indicated full implementation, 23% partial implementation, and 10% no implementation of the standards in their workplace. Speech-language pathologists and dietitians were most likely to have championed implementation of the standards. Barriers to implementation included: lack of knowledge about the standards, time, and resistance to change. Enablers included: encouragement to use the standards and 'buy-in' from stakeholders. Benefits of implementation included: consistent terminology and perceived improvements in patient safety. It was concluded that the standards have been successfully implemented in a majority of facilities and Australian universities. This study provides insight into the complexity of introducing and managing change in healthcare environments.

  1. The impact of standardizing the definition of visits on the consistency of multi-database observational health research.

    Science.gov (United States)

    Voss, Erica A; Ma, Qianli; Ryan, Patrick B

    2015-03-08

    Use of administrative claims from multiple sources for research purposes is challenged by the lack of consistency in the structure of the underlying data and definition of data across claims data providers. This paper evaluates the impact of applying a standardized revenue code-based logic for defining inpatient encounters across two different claims databases. We selected members who had complete enrollment in 2012 from the Truven MarketScan Commercial Claims and Encounters (CCAE) and the Optum Clinformatics (Optum) databases. The overall prevalence of inpatient conditions in the raw data was compared to that in the common data model (CDM) with the standardized visit definition applied. In CCAE, 87.18% of claims from 2012 that were classified as part of inpatient visits in the raw data were also classified as part of inpatient visits after the data were standardized to CDM, and this overlap was consistent from 2006 to 2011. In contrast, Optum had 83.18% concordance in classification of 2012 claims from inpatient encounters before and after standardization, but the consistency varied over time. The re-classification of inpatient encounters substantially impacted the observed prevalence of medical conditions occurring in the inpatient setting and the consistency in prevalence estimates between the databases. On average, before standardization, each condition in Optum was 12% more prevalent than that same condition in CCAE; after standardization, the prevalence of conditions had a mean difference of only 1% between databases. Amongst 7,039 conditions reviewed, the difference in the prevalence of 67% of conditions in these two databases was reduced after standardization. In an effort to improve consistency in research results across database one should review sources of database heterogeneity, such as the way data holders process raw claims data. Our study showed that applying the Observational Medical Outcomes Partnership (OMOP) CDM with a standardized approach for

  2. Non-standard dictionary definitions: What they cannot tell native speakers of Polish.

    Directory of Open Access Journals (Sweden)

    Robert Lew

    2006-04-01

    Full Text Available Recently, a new defining format has been gaining in popularity in abstract noun entries of monolingual English learners’ dictionaries: a single-clause when-definition. The present study attempts to investigate the role of the definition of this format, placed in a complete microstructure, in conveying information on the syntactic class of nominal headwords. To achieve this aim, tests were designed and run on several groups of Polish learners of English at the intermediate level. Balanced parallel forms were employed, where single-clause when-definitions were contrasted with their closest analytical analogs in full dictionary entries. It was found that both the new and the classical definition formats resulted in comparably frequent correct POS identification of the headword nouns. This is in stark contrast to the results yielded by Lew & Dziemianko’s research (in press, which has inspired the present analysis, where the definition formats were investigated in isolation from other components of the microstructure. Analysis of the consultation behaviour suggests that the syntactic label was the only element of the entry consulted with any frequency, which suggests that the subjects may have approached the task as a metalexicographic exercise.

  3. Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings

    NARCIS (Netherlands)

    Meintjes, Graeme; Lawn, Stephen D.; Scano, Fabio; Maartens, Gary; French, Martyn A.; Worodria, William; Elliott, Julian H.; Murdoch, David; Wilkinson, Robert J.; Seyler, Catherine; John, Laurence; van der Loeff, Maarten Schim; Reiss, Peter; Lynen, Lut; Janoff, Edward N.; Gilks, Charles; Colebunders, Robert

    2008-01-01

    The immune reconstitution inflammatory syndrome (IRIS) has emerged as an important early complication of antiretroviral therapy (ART) in resource-limited settings, especially in patients with tuberculosis. However, there are no consensus case definitions for IRIS or tuberculosis-associated IRIS.

  4. Generic project definitions for improvement of health care delivery: A case-base approach

    NARCIS (Netherlands)

    Niemeijer, G.C.; Does, R.J.M.M.; de Mast, J.; Trip, A.; van den Heuvel, J.

    2011-01-01

    Background: The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. Methods: This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning

  5. Development and Validation of an Administrative Case Definition for Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Ali Rezaie

    2012-01-01

    Full Text Available BACKGROUND: A population-based database of inflammatory bowel disease (IBD patients is invaluable to explore and monitor the epidemiology and outcome of the disease. In this context, an accurate and validated population-based case definition for IBD becomes critical for researchers and health care providers.

  6. Assessment of clinical case-definition for HIV/AIDS in Tanzania ...

    African Journals Online (AJOL)

    Objective: To evaluate the usefulness of World Health Organisation (WHO's) clinical case-definition (CCD) for AIDS in a private hospital. Design: A prospective study. Setting: Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania. Subjects: A total of 601 patients (> 14 years) were studied from January 1995 to December ...

  7. Axillary node metastatic carcinoma without definitive primary: a case report

    Directory of Open Access Journals (Sweden)

    Spencer R. Anderson

    2016-01-01

    Full Text Available Cancer of unknown primary (CUP is the finding of a metastatic cancerous lesion without an established primary source localized within the body. CUP can be of any cancer cell type, however, adenocarcinoma is most often identified by histology. Up to 5% of all malignant diagnoses are classified as CUP. PET is an imaging modality often utilized to distinguish a primary source in the setting of CUP, yet often a primary is never identified. CUP can be further stratified using specific qualifiers as favorable and unfavorable, indicating the potential therapeutic response to treatment regimens. Treatment approach to CUP relies heavily on the cell type identified by histology, the location of the lesion, and the amount of spread within the body. In the typical setting and presentation, per current literature, CUP arises in the 7th decade of life in patients with multiple comorbidities, and often has a poor prognostic value. This case report identifies an atypical presentation of CUP, a 38-year-old Caucasian female with an axillary mobile mass, and no associated systemic symptoms. Biopsy of the node and immunohistochemical staining showed histology consistent with metastatic carcinoma. Mammography, MRI, and PET scan found no evidence of tumor primary or distant metastasis. Further staining confirmed metastatic carcinoma consistent with breast origin, without an established breast primary. As in this case, CUP may present in an atypical manner, warranting a thorough investigation aiming to identify the tumor primary to aid in identification of a proper treatment regimen and approach.

  8. Natural history of benign prostatic hyperplasia: Appropriate case definition and estimation of its prevalence in the community

    NARCIS (Netherlands)

    J.L.H.R. Bosch (Ruud); W.C.J. Hop (Wim); W.J. Kirkels (Wim); F.H. Schröder (Fritz)

    1995-01-01

    textabstractThere is no consensus about a case definition of benign prostatic hyperplasia (BPH). In the present study, BPH prevalence rates were determined using various case definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism,

  9. A comparative study of standard vs. high definition colonoscopy for adenoma and hyperplastic polyp detection with optimized withdrawal technique.

    Science.gov (United States)

    East, J E; Stavrindis, M; Thomas-Gibson, S; Guenther, T; Tekkis, P P; Saunders, B P

    2008-09-15

    Colonoscopy has a known miss rate for polyps and adenomas. High definition (HD) colonoscopes may allow detection of subtle mucosal change, potentially aiding detection of adenomas and hyperplastic polyps. To compare detection rates between HD and standard definition (SD) colonoscopy. Prospective, cohort study with optimized withdrawal technique (withdrawal time >6 min, antispasmodic, position changes, re-examining flexures and folds). One hundred and thirty patients attending for routine colonoscopy were examined with either SD (n = 72) or HD (n = 58) colonoscopes. Groups were well matched. Sixty per cent of patients had at least one adenoma detected with SD vs. 71% with HD, P = 0.20, relative risk (benefit) 1.32 (95% CI 0.85-2.04). Eighty-eight adenomas (mean +/- standard deviation 1.2 +/- 1.4) were detected using SD vs. 93 (1.6 +/- 1.5) with HD, P = 0.12; however more nonflat, diminutive (9 mm) hyperplastic polyps was 7% (0.09 +/- 0.36). High definition did not lead to a significant increase in adenoma or hyperplastic polyp detection, but may help where comprehensive lesion detection is paramount. High detection rates appear possible with either SD or HD, when using an optimized withdrawal technique.

  10. Towards a Standardized Definition of Educational Expenditure. Statistical Reports and Studies, No. 34.

    Science.gov (United States)

    Lassibille, Gerard

    This document is an inventory of public and private educational expenditure from an international perspective and sets out the concepts, definitions and procedures useful in accounting for educational expenditure. The monograph defines the field within which expenditure is to be observed; details the necessary expenditure data to be collected from…

  11. Standardizing the definition of adverse pathology for lower risk men undergoing radical prostatectomy.

    Science.gov (United States)

    Kozminski, Michael A; Tomlins, Scott; Cole, Adam; Singhal, Udit; Lu, Louis; Skolarus, Ted A; Palapattu, Ganesh S; Montgomery, Jeffrey S; Weizer, Alon Z; Mehra, Rohit; Hollenbeck, Brent K; Miller, David C; He, Chang; Feng, Felix Y; Morgan, Todd M

    2016-09-01

    Numerous definitions of adverse pathology at radical prostatectomy (RP) have been proposed and implemented for both research and clinical care, and there is tremendous variation in the specific criteria used to define adverse pathology in these settings. Given the current landscape in which magnetic resonance imaging criteria and biomarker cutoffs are validated for disparate adverse pathology definitions, we sought to identify which of these is most closely tied to biochemical recurrence (BCR) after RP. A total of 2,837 patients who underwent RP at a single institution for localized prostate cancer (PCa) were included. We evaluated the following existing definitions of adverse pathology at RP: (1) Gleason score ≥7, (2) primary Gleason pattern ≥4, (3) Gleason score ≥7 or pathologic stage T3-4, (4) pathologic stage T3-4, (5) primary Gleason pattern ≥4 or pathologic stage T3-4. The primary outcome measure was BCR. Multiple statistical techniques were used to assess BCR prediction. Of the 5 definitions assessed, 1 (primary Gleason pattern ≥4 or pathologic stage T3-4, 540 patients [19% of cohort]) consistently outperformed the other definitions across all statistical measures. Additionally, a total of only 13 (6.6%) and 34 (10.3%) men with very-low-risk and low-risk cancer per National Comprehensive Cancer Network guideline, respectively, met this definition of adverse pathology at the time of RP. Varying definitions of adverse pathology differ in their prognostic performance. The criteria defined by either primary Gleason pattern ≥4 or pT3-4 disease appears to most accurately predict BCR in this subset of patients with lower risk PCa at the time of diagnosis. Additionally, men with very-low-risk or low-risk PCa per National Comprehensive Cancer Network guidelines are relatively unlikely to have adverse pathology at the time of surgical resection. These data may help inform the use of imaging and molecular markers as well as the intensity of surveillance in

  12. Validation of a computer case definition for sudden cardiac death in opioid users

    Directory of Open Access Journals (Sweden)

    Kawai Vivian K

    2012-08-01

    Full Text Available Abstract Background To facilitate the use of automated databases for studies of sudden cardiac death, we previously developed a computerized case definition that had a positive predictive value between 86% and 88%. However, the definition has not been specifically validated for prescription opioid users, for whom out-of-hospital overdose deaths may be difficult to distinguish from sudden cardiac death. Findings We assembled a cohort of persons 30-74 years of age prescribed propoxyphene or hydrocodone who had no life-threatening non-cardiovascular illness, diagnosed drug abuse, residence in a nursing home in the past year, or hospital stay within the past 30 days. Medical records were sought for a sample of 140 cohort deaths within 30 days of a prescription fill meeting the computer case definition. Of the 140 sampled deaths, 81 were adjudicated; 73 (90% were sudden cardiac deaths. Two deaths had possible opioid overdose; after removing these two the positive predictive value was 88%. Conclusions These findings are consistent with our previous validation studies and suggest the computer case definition of sudden cardiac death is a useful tool for pharmacoepidemiologic studies of opioid analgesics.

  13. Validation of a case definition to define hypertension using administrative data.

    Science.gov (United States)

    Quan, Hude; Khan, Nadia; Hemmelgarn, Brenda R; Tu, Karen; Chen, Guanmin; Campbell, Norm; Hill, Michael D; Ghali, William A; McAlister, Finlay A

    2009-12-01

    We validated the accuracy of case definitions for hypertension derived from administrative data across time periods (year 2001 versus 2004) and geographic regions using physician charts. Physician charts were randomly selected in rural and urban areas from Alberta and British Columbia, Canada, during years 2001 and 2004. Physician charts were linked with administrative data through unique personal health number. We reviewed charts of approximately 50 randomly selected patients >35 years of age from each clinic within 48 urban and 16 rural family physician clinics to identify physician diagnoses of hypertension during the years 2001 and 2004. The validity indices were estimated for diagnosed hypertension using 3 years of administrative data for the 8 case-definition combinations. Of the 3,362 patient charts reviewed, the prevalence of hypertension ranged from 18.8% to 33.3%, depending on the year and region studied. The administrative data hypertension definition of "2 claims within 2 years or 1 hospitalization" had the highest validity relative to the other definitions evaluated (sensitivity 75%, specificity 94%, positive predictive value 81%, negative predictive value 92%, and kappa 0.71). After adjustment for age, sex, and comorbid conditions, the sensitivities between regions, years, and provinces were not significantly different, but the positive predictive value varied slightly across geographic regions. These results provide evidence that administrative data can be used as a relatively valid source of data to define cases of hypertension for surveillance and research purposes.

  14. Differences in Approach between Nuclear and Conventional Seismic Standards with regard to Hazard Definition - CSNI Integrity And Ageing Working Group

    International Nuclear Information System (INIS)

    Djaoudi, Ali; Labbe, Pierre; Murphy, Andrew; Kitada, Yoshio

    2008-01-01

    The Committee on the safety of Nuclear Installations (CSNI) of the OECD-NEA co-ordinates the NEA activities related to maintaining and advancing the scientific and technological knowledge base of the safety of nuclear installations. The Integrity and Ageing of Components and Structures Working Group of the CSNI is responsible for work related to the development and use of methods, data and information to assess the behaviour of materials and structures. It has three sub-groups, dealing with the integrity of metal components and structures, ageing of concrete structures, and the seismic behaviour of structures. The CSNI, at its meeting in June 2003, agreed to initiate an activity aimed to identify any difference between nuclear and non-nuclear conventional standards and their potential significance with regard to seismic hazards and design methods. There was a perception, mainly in some of the European countries that nuclear seismic hazard and design standards may be lagging behind developments in similar standards for conventional facilities. Adequate answer to such perception, need the examination of the following aspects and their significance on the seismic assessment of structures and components: - The safety philosophy behind the seismic nuclear and conventional standards. - The differences in approach regarding the seismic hazard definition. - The difference in approach regarding the design and the methods of analysis. These topics are examined in this report. Appendices A to H of this report contain a brief description of the conventional and the nuclear approaches in the NEA member countries: Belgium, Canada, Czech Republic, Germany, Japan, South Korea, Spain,and USA. The following general conclusions can be drawn: - The approach adopted by the nuclear seismic standards is more conservative and more reliable (in particular for meeting the continued operation criteria) than the recommended by the currently applicable force based conventional seismic codes

  15. Monopolization by "Raising Rivals' Costs": The Standard Oil Case.

    OpenAIRE

    Granitz, Elizabeth; Klein, Benjamin

    1996-01-01

    Standard monopolized the petroleum industry during the 1870s by cartelizing the stage of production where entry was difficult--petroleum transportation. Standard enforced the transportation cartel by shifting its refinery shipments among railroads to stabilize individual railroad market shares at collusively agreed-on levels. This method of cartel policing was effective because Standard possessed a dominant share of refining, a dominance made possible with the assistance of the railroads. The...

  16. 106-17 Telemetry Standards Appendix A.3 ADARIO Data Block Field Definitions

    Science.gov (United States)

    2017-07-01

    bit flag. 1 = The channel is operated as a digital channel . 0 = The channel is operated as an analog channel . (bit 21) ROVR - Rate overrun in...data block experienced an analog-to- digital conversion overrange condition. 0 = The nth channel in the current data block did not experience an analog... digital single channel implementations except that the present hardware implementation expects an all zero field. Would be subject to future definition

  17. Modern standardization case studies at the crossroads of technology, economics, and politics

    CERN Document Server

    Schneiderman, R

    2015-01-01

    Modern Standardization -- Case Studies at the Crossroads of Technology, Economics, and Politics covers the development of new technical standards, how these standards are typically triggered, and how they are submitted to standards development organizations (SDOs) for review and evaluation. It fills the gap in the shortage of reference material in the development of real-world standards. The increasing pace of innovation in technology has accelerated the competitive nature of standardization, particularly in emerging markets. Modern Standardization addresses these and other issues through a series of case studies in a format designed for academics and their engineering, business, and law school students.

  18. Maintenance of Light Standards, a Case-Study

    NARCIS (Netherlands)

    R. Dekker (Rommert); J.R. van der Meer (Robert); R.P. Plasmeijer; R.E. Wildeman (Ralph); J.J. de Bruin (Jacco)

    1996-01-01

    textabstractThis paper discusses several strategies for the maintenance of light standards, where each light standard consists of n independent and identical lamps screwed on a chandelier. The lamps are subject to stochastic failures, and must be correctively replaced if the number of failed lamps

  19. Integrating standardization into engineering education: the case of forerunner Korea

    NARCIS (Netherlands)

    D.G. Choi (Dong Geun); H.J. de Vries (Henk)

    2013-01-01

    textabstractThe Republic of Korea is a forerunner in integrating the topic of standardization into engineering education at the academic level. This study investigates developments and evolutions in the planning and operating of the University Education Promotion on Standardization (UEPS) in Korea.

  20. Standardized testing: a case of annual national assessments in ...

    African Journals Online (AJOL)

    Standardized assessments are becoming a norm internationally. Governments have turned to standardized assessments due to mounting pressure by citizens for accountability, quality education, transparency, and increased public confidence in education. In South Africa, the observed learning deficiencies and prolonged ...

  1. Guest Editorial: The "NGSS" Case Studies: All Standards, All Students

    Science.gov (United States)

    Miller, Emily; Januszyk, Rita

    2014-01-01

    To teachers of diverse classrooms, more rigorous standards in science may seem intimidating, as the past years of rigid accountability have failed to close the achievement gap. However, the "Next Generation Science Standards" ("NGSS") were written with all students in mind, with input and full review by a diversity and equity…

  2. Integrating Standardization into Engineering Education: The Case of Forerunner Korea

    Science.gov (United States)

    Choi, Dong Geun; de Vries, Henk J.

    2013-01-01

    The Republic of Korea is a forerunner in integrating the topic of standardization into engineering education at the academic level. This study investigates developments and evolutions in the planning and operating of the University Education Promotion on Standardization (UEPS) in Korea. This paper examines why the Korean government initiated the…

  3. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil.

    Science.gov (United States)

    Albuquerque Filho, Alfredo Pereira Leite de; Araújo, Jéssica Guido de; Souza, Inacelli Queiroz de; Martins, Luciana Cardoso; Oliveira, Marta Iglis de; Silva, Maria Jesuíta Bezerra da; Montarroyos, Ulisses Ramos; Miranda Filho, Demócrito de Barros

    2011-01-01

    Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture). Test properties were determined for each cutoff number of the criteria from the case definition. Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (pdefinition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  4. A local reaction at or near injection site: case definition and guidelines for collection, analysis, and presentation of immunization safety data.

    Science.gov (United States)

    Gidudu, Jane; Kohl, Katrin S; Halperin, Scott; Hammer, Sandra Jo; Heath, Paul T; Hennig, Renald; Hoet, Bernard; Rothstein, Edward; Schuind, Anne; Varricchio, Frederick; Walop, Wikke

    2008-12-09

    The need for developing a case definition and guidelines for a local reaction at or near the injection site, methods for the development of the case definition and guidelines as an adverse event following immunization as well as the rationale for selected decisions about the case definition for a local reaction at or near the injection site are explained in the Preamble section. The case definition is structured in 2 levels of diagnostic certainty: level 1 includes any description of morphological or physiological change at or near the injection site that is described or identified by a healthcare provider. Level 2 is any description of morphological or physiological change at or near injection site that is described by any other person. In Guidelines section, the working group recommends to enable meaningful and standardized data collection, analysis, and presentation of information about a local reaction at or near the injection site. However, implementation of all guidelines might not be possible in all settings. The availability of information may vary depending upon resources, geographic region, and whether the source of information is a prospectively designed clinical trial, a post-marketing surveillance or epidemiologic study, or an individual report of a local reaction at injection site.

  5. Standards on Noise Measurements, Rating Schemes, and Definitions: A Compilation. NBS Special Publication 386, 1976 Edition.

    Science.gov (United States)

    Quindry, Thomas L., Ed.

    This compilation deals with material assembled from the various standards set forth by industrial and trade organizations, or technical and scientific societies concerned with acoustics. There has been no attempt to review or evaluate the standards, but rather just to list documents covering measurement techniques, calibration methods,…

  6. GENERIC QUALITY STANDARDS VS. SPECIFIC QUALITY STANDARDS: THE CASE OF HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Laila El Abbadi

    2011-06-01

    Full Text Available Quality as a new requirement for the field of higher education leads institutions to seek to satisfy generic or specific quality standards imposed directly or indirectly by its customers. The aim of this study is to compare between ISO9001, as a generic quality standard, and the Code of Practice of the Quality Assurance Agency for Higher Education (QAA, as a specific quality standard. A correlation matrix is drawn and correlation rates are calculated to show similarities and differences between them. This paper shows, first, that ISO9001 and QAA Code of Practice are compatible. Second, implementing a quality management system in accordance with ISO9001 requirements can constitute an adequate framework for the application of the QAA Code of Practice requirements. Third, to make the ISO9001 requirements closer to a specific quality standard in the field of higher education, it is recommended to complete these standards by specific requirements to the field of higher education.

  7. A single standard for memory: the case for reconsolidation.

    Science.gov (United States)

    Nader, Karim; Hardt, Oliver

    2009-03-01

    Consolidated memories can re-enter states of transient instability following reactivation, from which they must again stabilize in order to persist, contradicting the previously dominant view that memory and its associated plasticity mechanisms progressively and irreversibly decline with time. We witness exciting times, as neuroscience begins embracing a position, long-held in cognitive psychology, that recognizes memory as a principally dynamic process. In light of remaining controversy, we here establish that the same operational definitions and types of evidence underpin the deduction of both reconsolidation and consolidation, thus validating the extrapolation that post-retrieval memory plasticity reflects processes akin to those that stabilized the memory following acquisition.

  8. Chronic Fatigue Syndrome and Myalgic Encephalomyelitis: Toward An Empirical Case Definition.

    Science.gov (United States)

    Jason, Leonard A; Kot, Bobby; Sunnquist, Madison; Brown, Abigail; Evans, Meredyth; Jantke, Rachel; Williams, Yolonda; Furst, Jacob; Vernon, Suzanne D

    Current case definitions of Myalgic Encephalomyelitis (ME) and chronic fatigue syndrome (CFS) have been based on consensus methods, but empirical methods could be used to identify core symptoms and thereby improve the reliability. In the present study, several methods (i.e., continuous scores of symptoms, theoretically and empirically derived cut off scores of symptoms) were used to identify core symptoms best differentiating patients from controls. In addition, data mining with decision trees was conducted. Our study found a small number of core symptoms that have good sensitivity and specificity, and these included fatigue, post-exertional malaise, a neurocognitive symptom, and unrefreshing sleep. Outcomes from these analyses suggest that using empirically selected symptoms can help guide the creation of a more reliable case definition.

  9. Are You Experienced The Case for Acquisition Professional Qualification Standards

    Science.gov (United States)

    2015-10-01

    however, is the lack of a clearly defined set of qualification standards that delineate experience -based proficiencies (or skill sets) required to... experience it takes to learn the field.” Despite this clear emphasis on qualification by the DoD’s se- nior acquisition official, there has been...organizations to new standards for our workforce that include qualification through hands-on experiences in roles of increasing responsibility

  10. International Accounting Standards Harmonisation: the Case of Iran Privatisation

    OpenAIRE

    Roudaki, Jamal

    2005-01-01

    Accounting standards harmonisation literature shows that from the beginning of the twenty first century IASs and IFRSs are receiving increasing attention from professional accounting bodies and stock market authorities of developed and developing countries more than ever before. Consequently number of countries chose to join the IAS users have increased dramatically in recent years. The objective of this paper is to explore how Iranian Accounting Standards Board achieves harmonisation with IA...

  11. Developing a standard definition of whole-grain foods for dietary recommendations: summary report of a multidisciplinary expert roundtable discussion.

    Science.gov (United States)

    Ferruzzi, Mario G; Jonnalagadda, Satya S; Liu, Simin; Marquart, Len; McKeown, Nicola; Reicks, Marla; Riccardi, Gabriele; Seal, Chris; Slavin, Joanne; Thielecke, Frank; van der Kamp, Jan-Willem; Webb, Densie

    2014-03-01

    Although the term "whole grain" is well defined, there has been no universal standard of what constitutes a "whole-grain food," creating challenges for researchers, the food industry, regulatory authorities, and consumers around the world. As part of the 2010 Dietary Guidelines for Americans, the U.S. Dietary Guidelines Technical Advisory Committee issued a call to action to develop definitions for whole-grain foods that could be universally accepted and applied to dietary recommendations and planning. The Committee's call to action, and the lack of a global whole-grain food definition, was the impetus for the Whole Grain Roundtable held 3-5 December 2012 in Chicago, Illinois. The objective was to develop a whole-grain food definition that is consistent with the quartet of needs of science, food product formulation, consumer behavior, and label education. The roundtable's expert panel represented a broad range of expertise from the United States and Europe, including epidemiology and dietary intervention researchers, consumer educators, government policy makers, and food and nutrition scientists from academia and the grain food industry. Taking into account the totality, quality, and consistency of available scientific evidence, the expert panel recommended that 8 g of whole grain/30 g serving (27 g/100 g), without a fiber requirement, be considered a minimum content of whole grains that is nutritionally meaningful and that a food providing at least 8 g of whole grains/30-g serving be defined as a whole-grain food. Having an established whole-grain food definition will encourage manufacturers to produce foods with meaningful amounts of whole grain, allow consistent product labeling and messaging, and empower consumers to readily identify whole-grain foods and achieve whole-grain dietary recommendations.

  12. Standard CMMIsm Appraisal Method for Process Improvement (SCAMPIsm), Version 1.1: Method Definition Document

    National Research Council Canada - National Science Library

    2001-01-01

    The Standard CMMI Appraisal Method for Process Improvement (SCAMPI(Service Mark)) is designed to provide benchmark quality ratings relative to Capability Maturity Model(registered) Integration (CMMI(Service Mark)) models...

  13. Puffy skin disease (PSD) in rainbow trout, Oncorhynchus mykiss (Walbaum): a case definition.

    Science.gov (United States)

    Maddocks, C E; Nolan, E T; Feist, S W; Crumlish, M; Richards, R H; Williams, C F

    2015-07-01

    Puffy skin disease (PSD) is a disease that causes skin pathology in rainbow trout, Oncorhynchus mykiss (Walbaum). Incidence of PSD in UK fish farms and fisheries has increased sharply in the last decade, with growing concern from both industry sectors. This paper provides the first comprehensive case definition of PSD, combining clinical and pathological observations of diseased rainbow trout from both fish farms and fisheries. The defining features of PSD, as summarized in the case definition, were focal lateral flank skin lesions that appeared as cutaneous swelling with pigment loss and petechiae. These were associated with lethargy, poor body condition, inappetance and low level mortality. Epidermal hyperplasia and spongiosis, oedema of the dermis stratum spongiosum and a mild diffuse inflammatory cellularity were typical in histopathology of skin. A specific pathogen or aetiology was not identified. Prevalence and severity of skin lesions was greatest during late summer and autumn, with the highest prevalence being 95%. Atypical lesions seen in winter and spring were suggestive of clinical resolution. PSD holds important implications for both trout aquaculture and still water trout fisheries. This case definition will aid future diagnosis, help avoid confusion with other skin conditions and promote prompt and consistent reporting. © 2014 John Wiley & Sons Ltd.

  14. The measures for achieving nZEB standard of retrofitted educational building for specific polish location - case study

    Science.gov (United States)

    Kwiatkowski, Jerzy; Mijakowski, Maciej; Trząski, Adrian

    2017-11-01

    Most of the EU member states have already set a definition of nZEB for new buildings and some of the countries also done it for existing buildings. As there is no definition of nZEB for existing buildings in Poland, the paper will include various considerations of such a standard. Next, a case study of educational building retrofitting to a proposed nZEB standard will be presented. The aim of the paper is to present what measures can be used in order to decrease energy consumption in existing building. The measures are divided into three parts: architectural and construction, installations and energy sources. Thus a complexity of the solutions are presented. As the nZEB standard is related to available energy sources, also an influence of local condition will be considered. Building chosen for analysis is located in an area under historic protection which makes the work even more difficult. It was proved that used solutions were chosen not only to reduce energy demand or increase energy production from renewable energy sources, but also to increase social and aesthetic features of the building.

  15. Exploring novel diabetes surveillance methods: a comparison of administrative, laboratory and pharmacy data case definitions using THIN.

    Science.gov (United States)

    Khokhar, Bushra; Quan, Hude; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

    2017-07-28

    The objective of this study was to identify patients with diabetes in a comprehensive primary care electronic medical records database using a number of different case definitions (clinical, pharmacy, laboratory definitions and a combination thereof) and understand the differences in patient populations being captured by each definition. Data for this population-based retrospective cohort study was obtained from The Health Information Network (THIN). THIN is a longitudinal, primary care medical records database of over 9 million patients in UK. Primary outcome was a diagnosis of diabetes, defined by the presence of a diabetes read code, or an abnormal laboratory result, or a prescription for an Oral Anti-diabetic drug or insulin. A 2-year washout period was applied prior to the index of diabetes to avoid inclusion of prevalent cases for each case definition. This study demonstrated that different case definitions of diabetes identify different sub-populations of patients. When the cohorts were observed based on any measure of central tendency, each of the cohorts were reasonably comparable to each other. However, the distribution of each of the cohorts when grouped by age categories and sex, reveal differences. For example, using pharmacy case definition results in a bimodal distribution among women, one between 1-19 year and 35-39 age categories, and then again between 60-64 and 85 years-however, the histogram becomes more normally distributed when metformin was removed from the case definition. Our results suggest that clinical, pharmacy, laboratory case definitions identify different sub-populations and using multiple case definitions is likely required to optimally identify the entire diabetes population within THIN. Our study also suggests that age and sex of patients may affect the indexing of diabetes in THIN and is critical to better understand these variations.

  16. Of Atkins and men: deviations from clinical definitions of mental retardation in death penalty cases.

    Science.gov (United States)

    Blume, John H; Johnson, Sheri Lynn; Seeds, Christopher

    2009-01-01

    Under Atkins v. Virginia, the Eighth Amendment exempts from execution individuals who meet the clinical definitions of mental retardation set forth by the American Association on Intellectual and Developmental Disabilities and the American Psychiatric Association. Both define mental retardation as significantly subaverage intellectual functioning accompanied by significant limitations in adaptive functioning, originating before the age of 18. Since Atkins, most jurisdictions have adopted definitions of mental retardation that conform to those definitions. But some states, looking often to stereotypes of persons with mental retardation, apply exclusion criteria that deviate from and are more restrictive than the accepted scientific and clinical definitions. These state deviations have the effect of excluding from Atkins's reach some individuals who plainly fall within the class it protects. This article focuses on the cases of Roger Cherry, Jeffrey Williams, Michael Stallings, and others, who represent an ever-growing number of individuals inappropriately excluded from Atkins. Left unaddressed, the state deviations discussed herein permit what Atkins does not: the death-sentencing and execution of some capital defendants who have mental retardation.

  17. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    Alfredo Pereira Leite de Albuquerque Filho

    2011-12-01

    Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001. Best sensitivity (85.3% and specificity (68.2% combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

  18. International trade and endogenous standards: the case of GMO regulations

    OpenAIRE

    Vigani, Mauro; Raimondi, V; Olper, A

    2012-01-01

    This paper quantifies the effect of GMO regulation on bilateral trade flows of agricultural products. We develop a composite index of GMO regulations and using a gravity model we show that bilateral differences in GMO regulation negatively affect trade flows. This effect is especially driven by labeling, approval process and traceability. Our results are robust to the endogeneity of GMO standards to trade flows.

  19. Definition of apparent, true, and standardized ileal digestibility of amino acids in pigs

    NARCIS (Netherlands)

    Stein, H.H.; Fuller, M.F.; Moughan, P.J.; Seve, B.; Mosenthin, R.; Jansman, A.J.M.; Fernandez, J.A.; Lange, de C.F.M.

    2007-01-01

    Measures of ileal digestibility (ID) are used routinely as estimates of amino acid (AA) bio-availability in pig feed ingredients. Values for ID may be expressed as apparent (AID), standardized (SID), or true (TID). Values for AID are calculated by deducting the total ileal outflow of AA (the sum of

  20. Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: The TREAT-OA consortium

    NARCIS (Netherlands)

    J.M. Kerkhof (Hanneke); I. Meulenbelt (Ingrid); T. Akune (Toru); N.K. Arden (Nigel); A. Aromaa (Arpo); S.M. Bierma-Zeinstra (Sita); C. Cooper (Charles); J. Dai; M. Doherty (Michael); S. Doherty (Sally); D. Felson; A. Gonzalez (Antonio); A. Gordon; A. Harilainen (Arsi); D.J. Hart; V.B. Hauksson (Valdimar); M. Heliovaara (Markku); A. Hofman (Albert); S. Ikegawa; T. Ingvarsson (Torvaldur); Q. Jiang; H. Jonsson; I. Jonsdottir (Ingileif); H. Kawaguchi; M. Kloppenburg (Margreet); U.M. Kujala (Urho); N.E. Lane; P. Leino-Arjas (Päivi I.); L.S. Lohmander (Stefan); F.P. Luyten (Frank); K.N. Malizos (Konstantinos); M. Nakajima; M.C. Nevitt (Michael); H.A.P. Pols (Huib); F. Rivadeneira Ramirez (Fernando); D. Shi; E. Slagboom (Eline); T.D. Spector (Timothy); K. Stefansson (Kari); A. Sudo (Akihiro); A. Tamm; A.E. Tamm (Aile); A. Tsezou (Aspasia); A. Uchida; A.G. Uitterlinden (André); J.M. Wilkinson (Mark); N. Yoshimura; A.M. Valdes (Ana Maria); J.B.J. van Meurs (Joyce); A.J. Carr (Andrew Jonathan)

    2011-01-01

    textabstractObjective: To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. Methods: Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA

  1. Beyond Externalising and Finalising Definitions: Standards for Teachers of English Language and Literacy in Australia (STELLA)

    Science.gov (United States)

    Doecke, Brenton

    2007-01-01

    This article explores issues relating to the development of the Standards for Teachers of English Language and Literacy in Australia (STELLA). STELLA is the product of work by members of the Australian Association for the Teaching of English (AATE) and the Australian Literacy Educators' Association (ALEA), the two key professional bodies in…

  2. Establishing a standard definition for child overweight and obesity worldwide: international survey

    Science.gov (United States)

    Cole, Tim J; Bellizzi, Mary C; Flegal, Katherine M; Dietz, William H

    2000-01-01

    Objective To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. Design International survey of six large nationally representative cross sectional growth studies. Setting Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. Subjects 97 876 males and 94 851 females from birth to 25 years of age. Main outcome measure Body mass index (weight/height2). Results For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m2 for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. Conclusions The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children. PMID:10797032

  3. 29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.

    Science.gov (United States)

    2010-07-01

    ... under OSHA standards. 1904.9 Section 1904.9 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL... removal under OSHA standards. (a) Basic requirement. If an employee is medically removed under the medical surveillance requirements of an OSHA standard, you must record the case on the OSHA 300 Log. (b) Implementation...

  4. Standardization of the Definitions of Vertical Resolution and Uncertainty in the NDACC-archived Ozone and Temperature Lidar Measurements

    Science.gov (United States)

    Leblanc, T.; Godin-Beekmann, S.; Payen, Godin-Beekmann; Gabarrot, Franck; vanGijsel, Anne; Bandoro, J.; Sica, R.; Trickl, T.

    2012-01-01

    The international Network for the Detection of Atmospheric Composition Change (NDACC) is a global network of high-quality, remote-sensing research stations for observing and understanding the physical and chemical state of the Earth atmosphere. As part of NDACC, over 20 ground-based lidar instruments are dedicated to the long-term monitoring of atmospheric composition and to the validation of space-borne measurements of the atmosphere from environmental satellites such as Aura and ENVISAT. One caveat of large networks such as NDACC is the difficulty to archive measurement and analysis information consistently from one research group (or instrument) to another [1][2][3]. Yet the need for consistent definitions has strengthened as datasets of various origin (e.g., satellite and ground-based) are increasingly used for intercomparisons, validation, and ingested together in global assimilation systems.In the framework of the 2010 Call for Proposals by the International Space Science Institute (ISSI) located in Bern, Switzerland, a Team of lidar experts was created to address existing issues in three critical aspects of the NDACC lidar ozone and temperature data retrievals: signal filtering and the vertical filtering of the retrieved profiles, the quantification and propagation of the uncertainties, and the consistent definition and reporting of filtering and uncertainties in the NDACC- archived products. Additional experts from the satellite and global data standards communities complement the team to help address issues specific to the latter aspect.

  5. Maternal mortality in rural South Africa: the impact of case definition on levels and trends

    Directory of Open Access Journals (Sweden)

    Garenne M

    2013-08-01

    Full Text Available Michel Garenne,1–3 Kathleen Kahn,1,4,5 Mark A Collinson,1,4,5 F Xavier Gómez-Olivé,1,5 Stephen Tollman1,4,51MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Institut Pasteur, Epidémiologie des Maladies Emergentes, Paris, France; 3Institut de Recherche pour le Développement, UMI Résiliences, Centre Ile de France, Bondy, France; 4Centre for Global Health Research, Umeå University, Umeå, Sweden; 5INDEPTH Network, East Legon, Accra, GhanaBackground: Uncertainty in the levels of global maternal mortality reflects data deficiencies, as well as differences in methods and definitions. This study presents levels and trends in maternal mortality in Agincourt, a rural subdistrict of South Africa, under long-term health and sociodemographic surveillance.Methods: All deaths of women aged 15 years–49 years occurring in the study area between 1992 and 2010 were investigated, and causes of death were assessed by verbal autopsy. Two case definitions were used: “obstetrical” (direct causes, defined as deaths caused by conditions listed under O00-O95 in International Classification of Diseases-10; and “pregnancy-related deaths”, defined as any death occurring during the maternal risk period (pregnancy, delivery, 6 weeks postpartum, irrespective of cause.Results: The case definition had a major impact on levels and trends in maternal mortality. The obstetric mortality ratio averaged 185 per 100,000 live births over the period (60 deaths, whereas the pregnancy-related mortality ratio averaged 423 per 100,000 live births (137 deaths. Results from both calculations increased over the period, with a peak around 2006, followed by a decline coincident with the national roll-out of Prevention of Mother-to-Child Transmission of HIV and antiretroviral treatment programs. Mortality increase from direct causes was

  6. Dengue hemorrhagic fever: the sensitivity and specificity of the world health organization definition for identification of severe cases of dengue in Thailand, 1994-2005.

    Science.gov (United States)

    Srikiatkhachorn, Anon; Gibbons, Robert V; Green, Sharone; Libraty, Daniel H; Thomas, Stephen J; Endy, Timothy P; Vaughn, David W; Nisalak, Ananda; Ennis, Francis A; Rothman, Alan L; Nimmannitaya, Suchitra; Kalayanarooj, Siripen

    2010-04-15

    Dengue virus infection causes a spectrum of clinical manifestations, usually classified according to the World Health Organization (WHO) guidelines into dengue fever (DF) and dengue hemorrhagic fever (DHF). The ability of these guidelines to categorize severe dengue illness has recently been questioned. We evaluated dengue case definitions in a prospective study at a pediatric hospital in Bangkok, Thailand, during 1994-2005. One thousand thirteen children were enrolled within the first 3 days after onset of fever and observed with standardized data collection. Cases were classified on the basis of application of the strict WHO criteria. All dengue virus infections were laboratory confirmed. We retrospectively grouped patients on the basis of whether they received significant intervention based on fluid replacement and/or requirements for blood transfusion. Eighty-five (58%) of 150 persons with DHF, 40 (15%) of 264 with DF, and 73 (12%) of 599 with other febrile illnesses (OFIs) received significant intervention. Sixty-eight percent of dengue cases requiring intervention met strict WHO criteria for DHF. In contrast, only 1% of OFI cases met WHO criteria for DHF. Plasma leakage and thrombocytopenia were the 2 components contributing to the specificity of the WHO case definition and identified dengue cases that required intervention. Hemorrhagic tendency did not reliably differentiate DF and DHF. In DF cases, thrombocytopenia and bleeding were associated with severity. Dengue illness is heterogeneous in severity, and severe clinical features occurred in patients whose cases were not characterized as DHF. The WHO case definition of DHF demonstrated sensitivity of 62% and specificity of 92% for identification of dengue illness requiring intervention, without the need for laboratory confirmation of dengue virus infection, in an area of endemicity.

  7. Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa.

    Science.gov (United States)

    Nadri, Johara; Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Baltazar, Cynthia S; Banla Kere, Abiba; Bwire, Godfrey; Coulibaly, Daouda; Kacou N'Douba, Adele; Kagirita, Atek; Keita, Sakoba; Koivogui, Lamine; Landoh, Dadja E; Langa, Jose P; Miwanda, Berthe N; Mutombo Ndongala, Guy; Mwakapeje, Elibariki R; Mwambeta, Jacob L; Mengel, Martin A; Gessner, Bradford D

    2018-04-01

    During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.

  8. Call for standardized definitions of osteoarthritis and risk stratification for clinical trials and clinical use

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M

    2015-01-01

    Osteoarthritis (OA) is a heterogeneous disorder. The goals of this review are (1) To stimulate use of standardized nomenclature for OA that could serve as building blocks for describing OA and defining OA phenotypes, in short to provide unifying disease concepts for a heterogeneous disorder; and (2......) To stimulate establishment of ROAD (Risk of OA Development) and ROAP (Risk of OA Progression) tools analogous to the FRAX™ instrument for predicting risk of fracture in osteoporosis; and (3) To stimulate formulation of tools for identifying disease in its early preradiographic and/or molecular stages - REDI...... (Reliable Early Disease Identification). Consensus around more sensitive and specific diagnostic criteria for OA could spur development of disease modifying therapies for this entity that has proved so recalcitrant to date. We fully acknowledge that as we move forward, we expect to develop more...

  9. 49 CFR 1111.9 - Procedural schedule in cases using simplified standards.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Procedural schedule in cases using simplified... PROCEDURES § 1111.9 Procedural schedule in cases using simplified standards. (a) Procedural schedule. Absent a specific order by the Board, the following general procedural schedules will apply in cases using...

  10. Scope Definition on End-of-Life Chain Performance Assessment: Recycling Rate and French E-Waste Chain Case Study

    OpenAIRE

    ARDUIN, Rachel Horta; LEAL, Jorge Martinez; GRIMAUD, Guilhem; CHARBUILLET, Carole; Pompidou, Stéphane; LARATTE, Bertrand; PERRY, Nicolas

    2017-01-01

    International audience; Efficiency indicators have been frequently used to assess end-of-life chain performance. While legislations give a standard definition, sometimes stakeholders redefine them to fit their own scopes and objectives. It is therefore necessary to fully understand the indicators calculation scope in order to accurately interpret the results during a decision-making process. This work discusses the influence of scope definition when establishing performance rates using the Fr...

  11. Fulfillment of GMP standard, halal standard, and applying HACCP for production process of beef floss (Case study: Ksatria enterprise)

    Science.gov (United States)

    A'diat, Arkan Addien Al; Liquiddanu, Eko; Laksono, Pringgo Widyo; Sutopo, Wahyudi; Suletra, I. Wayan

    2018-02-01

    Along with the increasing number of the modern retail business in Indonesia, give an opportunity to small and medium enterprise (SME) to sell its products through the modern retailer. There are some obstacles faced by the SMEs, one of them is about product standard. Product standard that must be owned by SMEs are GMP standard and halal standard. This research was conducted to know the fulfillment by the beef floss enterprise in jagalan in fulfilling the GMP standard and halal. In addition, Hazard Analysis and Critical Control Points (HACCP) system was applied to analyze the process. HACCP which used in this research was based on the seven principles in SNI (Indonesian National Standard) 01-4852-1998. The seven principles included hazard analysis, critical control point (CCP) determination, critical limit establishment, CCP monitor system establishment, corrective action establishment, verification, and also documentation establishment that must be applied in preparing HACCP plan. Based on this case study, it is concluded that there were 5 CCPs : the boiling process, roasting process, frying process, the beef floss draining process, and the packaging process.

  12. Cervical chondroid chordoma in a standard dachshund: a case report

    Directory of Open Access Journals (Sweden)

    Stigen Øyvind

    2011-10-01

    Full Text Available Abstract A ten-year-old male standard dachshund was presented with a history of neck pain and progressive gait disturbances. Following a neurological examination and diagnostic imaging, including CT, a neoplastic lesion involving the third and fourth cervical vertebrae was suspected. The lesion included an extradural mass on the right side of the spinal canal causing a local compression of the cervical cord. Surgery, using a modified dorsal laminectomy procedure, was performed in order to decompress the cervical spinal cord. Histopathological examination of the extradural mass indicated that the tumour was a chondroid chordoma. Following discharge, the quality of life for the dog was very good for a sustained period, but clinical signs recurred at 22 months. The dog was euthanased 25 months post-surgery. On post-mortem examination, a regrowth of neoplastic tissue was found to have infiltrated the bone and spinal cord at C3-C4. This is the first report to show that palliative surgery can offer successful long-lasting treatment of chondroid chordoma of the cervical spine in the dog.

  13. Changing the renewable fuel standard to a renewable material standard: bioethylene case study.

    Science.gov (United States)

    Posen, I Daniel; Griffin, W Michael; Matthews, H Scott; Azevedo, Inês L

    2015-01-06

    The narrow scope of the U.S. renewable fuel standard (RFS2) is a missed opportunity to spur a wider range of biomass use. This is especially relevant as RFS2 targets are being missed due to demand-side limitations for ethanol consumption. This paper examines the greenhouse gas (GHG) implications of a more flexible policy based on RFS2, which includes credits for chemical use of bioethanol (to produce bioethylene). A Monte Carlo simulation is employed to estimate the life-cycle GHG emissions of conventional low-density polyethylene (LDPE), made from natural gas derived ethane (mean: 1.8 kg CO2e/kg LDPE). The life-cycle GHG emissions from bioethanol and bio-LDPE are examined for three biomass feedstocks: U.S. corn (mean: 97g CO2e/MJ and 2.6 kg CO2e/kg LDPE), U.S. switchgrass (mean: -18g CO2e/MJ and -2.9 kg CO2e/kg LDPE), and Brazilian sugar cane (mean: 33g CO2e/MJ and -1.3 kg CO2e/kg LDPE); bioproduct and fossil-product emissions are compared. Results suggest that neither corn product (bioethanol or bio-LDPE) can meet regulatory GHG targets, while switchgrass and sugar cane ethanol and bio-LDPE likely do. For U.S. production, bioethanol achieves slightly greater GHG reductions than bio-LDPE. For imported Brazilian products, bio-LDPE achieves greater GHG reductions than bioethanol. An expanded policy that includes bio-LDPE provides added flexibility without compromising GHG targets.

  14. Exploring Stakeholder Definitions within the Aerospace Industry: A Qualitative Case Study

    Science.gov (United States)

    Hebert, Jonathan R.

    A best practice in the discipline of project management is to identify all key project stakeholders prior to the execution of a project. When stakeholders are properly identified, they can be consulted to provide expert advice on project activities so that the project manager can ensure the project stays within the budget and schedule constraints. The problem addressed by this study is that managers fail to properly identify key project stakeholders when using stakeholder theory because there are multiple conflicting definitions for the term stakeholder. Poor stakeholder identification has been linked to multiple negative project outcomes such as budget and schedules overruns, and this problem is heightened in certain industries such as aerospace. The purpose of this qualitative study was to explore project managers' and project stakeholders' perceptions of how they define and use the term stakeholder within the aerospace industry. This qualitative exploratory single-case study had two embedded units of analysis: project managers and project stakeholders. Six aerospace project managers and five aerospace project stakeholders were purposively selected for this study. Data were collected through individual semi-structured interviews with both project managers and project stakeholders. All data were analyzed using Yin's (2011) five-phased cycle approach for qualitative research. The results indicated that the aerospace project managers and project stakeholder define the term stakeholder as "those who do the work of a company." The participants build upon this well-known concept by adding that, "a company should list specific job titles" that correspond to their company specific-stakeholder definition. Results also indicated that the definition of the term stakeholder is used when management is assigning human resources to a project to mitigate or control project risk. Results showed that project managers tended to include the customer in their stakeholder definitions

  15. Airside HVAC BESTEST: HVAC Air-Distribution System Model Test Cases for ASHRAE Standard 140

    Energy Technology Data Exchange (ETDEWEB)

    Judkoff, Ronald [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Neymark, Joel [J. Neymark & Associates; Kennedy, Mike D. [Mike D. Kennedy, Inc.; Gall, J. [AAON, Inc.; Henninger, R. [GARD Analytics, Inc.; Hong, T. [Lawrence Berkeley National Laboratory; Knebel, D. [AAON, Inc.; McDowell, T. [Thermal Energy System Specialists, LLC; Witte, M. [GARD Analytics, Inc.; Yan, D. [Tsinghua University; Zhou, X. [Tsinghua University

    2017-08-07

    This paper summarizes recent work to develop new airside HVAC equipment model analytical verification test cases for ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs. The analytical verification test method allows comparison of simulation results from a wide variety of building energy simulation programs with quasi-analytical solutions, further described below. Standard 140 is widely cited for evaluating software for use with performance-path energy efficiency analysis, in conjunction with well-known energy-efficiency standards including ASHRAE Standard 90.1, the International Energy Conservation Code, and other international standards. Airside HVAC Equipment is a common area of modelling not previously explicitly tested by Standard 140. Integration of the completed test suite into Standard 140 is in progress.

  16. Application of the "Personnel Evaluation Standards" to Local District Teacher Evaluation Programs: Analyses of 14 Cases.

    Science.gov (United States)

    Loup, Karen S.; Ellett, Chad D.

    Local school district teacher evaluation plans, processes, and procedures were studied to determine whether they measure up to the criteria outlined by D. Stufflebeam's "Personnel Evaluation Standards" (1988). The applicability and interpretability of the "Standards" across 14 actual cases from local school districts in…

  17. EMBEDding the CEFR in Academic Writing Assessment : A case study in training and standardization

    NARCIS (Netherlands)

    Haines, Kevin; Lowie, Wander; Jansma, Petra; Schmidt, Nicole

    2013-01-01

    The CEFR is increasingly being used as the framework of choice for the assessment of language proficiency at universities across Europe. However, to attain consistent assessment, familiarization and standardization are essential. In this paper we report a case study of embedding a standardization

  18. [A Research on the origin and development of standardization of Chinese medical case records].

    Science.gov (United States)

    Zhang, Lei

    2014-11-01

    The origin of Chinese medical case history is rather early. Chunyu Yi's medical cases (zhen ji) of the Western Han Dynasty were the earliest actual extant medical case with the practical contents. In the Ming Dynasty, Han Mao put forward firstly the principles of "six aspects must be recorded" for writing the pulse record, as the beginning of the standardization of medical case record. Later, Wu Kun, Yu Yan, Li Yanzhen, He Lianchen et al. supplemented, adjusted and changed the format of medical case record. After 1949, the format of medical case record was revised several times to form the national standard. In fact, the clinical medical case record is different from the case history. The modern medical case record could not reflect fully the thinking process of traditional Chinese medicine (TCM) and the essence of the treatment based on syndrome differentiation. Exploring the origin and development of the standardization of medical case record will benefit for the improvement of modern format of medical case record.

  19. Teaching Undergraduate Accounting Majors How to Interpret the Accounting Standards Codification: An Alternative to Research Cases

    Science.gov (United States)

    Toerner, Michael C.; Swindle, C. Bruce; Burckel, Daryl V.

    2014-01-01

    Professional accountants regularly search the FASB'S Accounting Standards Codification to find answers to financial accounting questions. Accounting educators know this and frequently use research cases in an attempt to help students begin developing this ability. But many students struggle with these cases because they have not been taught how to…

  20. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics.

    Science.gov (United States)

    Lusk, M Josephine; Garden, Frances L; Rawlinson, William D; Naing, Zin W; Cumming, Robert G; Konecny, Pam

    2016-05-01

    Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best case definition. A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006-2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: 'microscopy' (>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), 'cervical discharge' (yellow and/or mucopurulent cervical discharge) or 'micro+cervical discharge' (combined 'microscopy' and 'cervical discharge'). Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions 'micro+cervical discharge': CT adjusted prevalence ratio (APR)=2.13 (95% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) pcervical discharge': CT APR=1.90 (1.25 to 2.89) p=0.003, MG APR=1.93 (1.17 to 3.19) p=0.011, TV APR=2.02 (1.24 to 3.31) p=0.005 NG PR=3.88 (3.36 to 4.48) pcervicitis risk: ('micro+cervical discharge') APR=0.69 (0.51 to 0.93) p=0.016. Combined population attributable risk % (PAR%) of these four pathogens was only 18.0% with a protective PAR% of condoms of 25.7%. Exposures not associated with cervicitis included bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum, herpes simplex virus 1&2, cytomegalovirus, Candida, age, smoking and hormonal contraception. Cervicitis was associated with CT, MG, TV and NG with combined PAR% of these pathogens only 18% in this setting, suggesting other factors are involved. Condoms significantly reduced cervicitis risk. Cervicitis definitions with best clinical utility and pathogen prediction were 'cervical discharge' and 'micro+cervical discharge'. Published by the BMJ Publishing Group Limited. For

  1. Duration of Hemodialysis Following Peritoneal Dialysis Cessation in Australia and New Zealand: Proposal for a Standardized Definition of Technique Failure.

    Science.gov (United States)

    Lan, Patrick G; Clayton, Philip A; Johnson, David W; McDonald, Stephen P; Borlace, Monique; Badve, Sunil V; Sud, Kamal; Boudville, Neil

    ♦ BACKGROUND: Although technique failure is a key outcome in peritoneal dialysis (PD), there is currently no agreement on a uniform definition. We explored different definitions of PD technique failure using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. ♦ METHODS: We included 16,612 incident PD patients in Australia and New Zealand from January 1998 to December 2012. Different definitions of technique failure were applied according to the minimum number of days (30, 60, 90, 180, or 365) the patient received hemodialysis after cessation of PD. ♦ RESULTS: Median technique survival varied from 2.0 years with the 30-day definition to 2.4 years with the 365-day definition. For all definitions, the most common causes of technique failure were death, followed by infectious complications. The likelihood of a patient returning to PD within 12 months of technique failure was highest in the 30-day definition (24%), and was very small when using the 180- and 365-day definitions (3% and 0.8%, respectively). Patients whose technique failed due to mechanical reasons were the most likely to return to PD (46% within 12 months using the 30-day definition). ♦ CONCLUSIONS: Both 30- and 180-day definitions have clinical relevance but offer different perspectives with very different prognostic implications for further PD. Therefore, we propose that PD technique failure be defined by a composite endpoint of death or transfer to hemodialysis using both 30-day and 180-day definitions. Copyright © 2016 International Society for Peritoneal Dialysis.

  2. Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.

    Science.gov (United States)

    Sminkey, Patrice V; LeDoux, Jeannie

    2016-01-01

    The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.

  3. Travel case scenarios as a demonstration of risk assessment of VFR travelers: introduction to criteria and evidence-based definition and framework.

    Science.gov (United States)

    Behrens, Ron H; Stauffer, William M; Barnett, Elizabeth D; Loutan, Louis; Hatz, Christoph F; Matteelli, Alberto; Macpherson, Douglas W

    2010-01-01

    Travel-associated health risks need to be balanced against the positive opportunities associated with interregional travel. As the perceived and real spectrum of health risks related to international travel increase both quantitatively and qualitatively, the need for more discriminating tools in clinical assessment for the purpose of mitigation, public health management, and research are needed. One group of international travelers identified as having increased risk of poor travel-related health outcomes are those who travel with the specific intent of visiting friends or relatives (VFR travelers). Due to variations in defining VFR travel in the health context there are issues in applying this designation uniformly from multiple perspectives. This article supports the standardization of VFR traveler definitions based on objective criteria and provides illustrations of the application of this definition through an illustrated approach to risk assessment based on these criteria and the differentials in the determinants of health between source and destination regions. A working group was established by the Migration Health Sub-committee, International Society for Travel Medicine to assess the literature on VFR travel and health, review an evidence-based approach to managing health risk related to travel, and to propose criteria-based definition for VFR travel. The new definition of a VFR is a traveler whose primary purpose of travel is to visit friends or relatives where there is a gradient of epidemiological risk between home and destination. A case scenario discussion of VFR travel defined by criteria and risk assessment based on differential determinants of health is presented in this article. The goal of this article is to encourage discussion on travel health evaluation for the most "at risk" populations and to standardize the application of clinical, public health, and research approaches to defining VFR travelers in a risk management context.

  4. High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

    Science.gov (United States)

    Meiron, Oded; Gale, Rena; Namestnic, Julia; Bennet-Back, Odeya; David, Jonathan; Gebodh, Nigel; Adair, Devin; Esmaeilpour, Zeinab; Bikson, Marom

    2018-01-01

    Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy. HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring. There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study. These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

  5. Indigenous Peoples’ Natural Resources and Business: Inter-American Standards and Chilean Case Law

    Directory of Open Access Journals (Sweden)

    Gonzalo Aguilar Cavallo

    2015-10-01

    Full Text Available In this brief analysis we will review the difficulties faced in establishing responsibility for human rights violation to companies as well as the Inter-American Court of Human Rights’ case law in the field. We will analyze the international standards established in corporate responsibility. Finally, we will examine if the Chilean national courts incorporate the standards set by the Inter-American Court of Human Rights, especially concerning private companies.

  6. Cost optimal and nearly zero-energy buildings (nZEB) definitions, calculation principles and case studies

    CERN Document Server

    Kurnitski, Jarek

    2013-01-01

    This book introduces technical definitions, system boundaries, energy calculation methods and input data for setting primary energy based minimum/cost optimal and nZEB requirements in national energy frames. Offers five case studies of nZEB office buildings.

  7. Problems Associated with Coordination and Role Definitions in Health Care Teams: A Hospice Program Evaluation and Intervention Case Study.

    Science.gov (United States)

    Berteotti, Carol R.; And Others

    Using an evaluation of a hospital-based hospice as a case study, this paper analyzes problematic issues surrounding health care teams (HCTs) in light of findings revealed in the literature concerning HCT structures and processes. The factors of coordination and role definitions in HCTs and their manifestations in a particular hospice HCT in terms…

  8. Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis.

    Science.gov (United States)

    Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J

    2009-05-01

    Urban clinic, Nairobi. To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. Prospective study among TB suspects. A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immuno-deficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.

  9. Standardization and Green Economic Change - the Case of Energy Efficiency in Buildings

    DEFF Research Database (Denmark)

    Andersen, Maj Munch; Faria, Lourenco

    2015-01-01

    is that the rise of the green economy can only take place accompanied by considerable institution formation in the form of standards. In this sense, the presence of standards may be seen as an important indicator on the maturity of the greening of the economy. The paper presents early empirical work......This paper investigates the role of standardization for green economic change using energy efficiency in buildings as a case. Innovation research on standards tends to focus on the competition between competing emerging standards as well as the economic impacts of these. The idea pursued here...... and contributes as much to formulating a research agenda and provide methodological clarifications as presenting solid findings. The paper feeds more fundamentally into an evolutionary economic understanding of (green) economic change....

  10. Biofuel sustainability standards and public policy: A case study of Swedish ethanol imports from Brazil

    DEFF Research Database (Denmark)

    Bolwig, Simon; Gibbon, Peter

    is that it reduces consumer doubts about their product, and reduces competition from producers not participating in the Initiative; for SEKAB it increases the company’s credibility in various private and public forums working on sustainability standards for biofuels, and gives it a first-mover advantage once...... sustainability standards for those fuels. Central to these standards are criteria addressing the direct, and sometimes also indirect, greenhouse gas emissions resulting from the production, transport and use of the biofuels. This case study examines the first scheme applied to a traded biofuel, the Verified...... Sustainable Ethanol Initiative (VSEI), a private initiative of the Swedish fuel-ethanol supplier, SEKAB. VSEI went into operation in August 2008 to verify that the ethanol it was importing from Brazil met its own minimum standards for ―field-to-wheel‖ (life-cycle) greenhouse-gas emission standards...

  11. New Definitions of Electromagnetic Screening of Cases in Front of Radiates Interferences

    Science.gov (United States)

    Garcia Perez, Luis Gines

    results have been obtained for some definitions and used SE indicators for incident plane wave against enclosures in a specific bandwidth. The plane wave has been treated as a reference interference to compare to other electromagnetic interference cases. It has been verified that the laboratory measurements and the simulations are in good agreement. The effects of the electric (dipole) and magnetic (loop) probes presences have been analysed too, as they can modified the results. In this study new SE definitions (new indicators) have been evaluated too, and they have been compared with the classical time-domain SE definitions. These new indicators have been studied as function of several parameters that can be modified in the enclosures as the aperture dimensions or the enclosure dimensions. Finally, in order to get more generic solutions that can be useful to later SE studies, the new SE results have been analysed and interpreted for an aperture size scanning that provide an unique value for the more critical SE indicator and for an specific bandwidth allowing direct SE comparisons with other enclosures.

  12. The origin of the cliticness of the west Germanic definite article: the case of Beowulf

    Directory of Open Access Journals (Sweden)

    Janez Orešnik

    1984-12-01

    Full Text Available The present paper is mainly concerned with the definite ar­ ticle of Beowulf. The literature about the West Germanic definite article has always allotted a prime place among the old Germanic texts to this poem: it is undisputably archaic (Kuhn 1933: 105, D. Hofmann 1959:189, and suitable for statistical genera­lisations. Its more than 6,000 hemistichs contain about 300 in­stances of the. definite article (Lichtenheld 1872:332.

  13. Confirmed clinical case of chronic kidney disease of nontraditional causes in agricultural communities in Central America: a case definition for surveillance

    Directory of Open Access Journals (Sweden)

    Alejandro Ferreiro

    Full Text Available ABSTRACT Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty. In response to a resolution approved by the Directing Council of the Pan American Health Organization (PAHO in 2013, PAHO, the U.S. Centers for Disease Control and Prevention, and the Latin American Society of Nephrology and Hypertension (SLANH organized a consultation process in order to expand knowledge on the epidemic of CKDnT and to develop appropriate surveillance instruments. The Clinical Working Group from SLANH was put in charge of finding a consensus definition of a confirmed clinical case of CKDnT. The resulting definition establishes mandatory criteria and exclusion criteria necessary for classifying a case of CKDnT. The definition includes a combination of universally accepted definitions of CKD and the main clinical manifestations of CKDnT. Based on the best available evidence, the Clinical Working Group also formulated general recommendations about clinical management that apply to any patient with CKDnT. Adhering to the definition of a confirmed clinical case of CKDnT and implementing it appropriately is expected to be a powerful instrument for understanding the prevalence of the epidemic, evaluating the results of interventions, and promoting appropriate advocacy and planning efforts.

  14. Confirmed clinical case of chronic kidney disease of nontraditional causes in agricultural communities in Central America: a case definition for surveillance.

    Science.gov (United States)

    Ferreiro, Alejandro; Álvarez-Estévez, Guillermo; Cerdas-Calderón, Manuel; Cruz-Trujillo, Zulma; Mena, Elio; Reyes, Marina; Sandoval-Diaz, Mabel; Sánchez-Polo, Vicente; Valdés, Régulo; Ordúnez, Pedro

    2016-11-01

    Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public health problem. Most of these cases are not associated with traditional risk factors for CKD, such as aging, diabetes mellitus, and hypertension. This CKD of nontraditional causes (CKDnT) might be linked to environmental and/or occupational exposure or working conditions, limited access to health services, and poverty. In response to a resolution approved by the Directing Council of the Pan American Health Organization (PAHO) in 2013, PAHO, the U.S. Centers for Disease Control and Prevention, and the Latin American Society of Nephrology and Hypertension (SLANH) organized a consultation process in order to expand knowledge on the epidemic of CKDnT and to develop appropriate surveillance instruments. The Clinical Working Group from SLANH was put in charge of finding a consensus definition of a confirmed clinical case of CKDnT. The resulting definition establishes mandatory criteria and exclusion criteria necessary for classifying a case of CKDnT. The definition includes a combination of universally accepted definitions of CKD and the main clinical manifestations of CKDnT. Based on the best available evidence, the Clinical Working Group also formulated general recommendations about clinical management that apply to any patient with CKDnT. Adhering to the definition of a confirmed clinical case of CKDnT and implementing it appropriately is expected to be a powerful instrument for understanding the prevalence of the epidemic, evaluating the results of interventions, and promoting appropriate advocacy and planning efforts.

  15. A new tool for assessing standard of care in medical malpractice cases.

    Science.gov (United States)

    Hartz, Arthur; Green, Michael D; Yoho, Robert; Lee, Harrison

    2006-04-15

    Physician experts hired and prepared by litigants provide most of the information on standard of care for medical malpractice cases. Since this information may not be objective or accurate, the authors examined the feasibility and potential value of surveying peer physicians to assess standard of care. The survey method for assessing standard of care was evaluated for a medical malpractice case involving an abdominoplasty that had a poor cosmetic result. An abstract of the case that included the patient's characteristics and physician's decisions that were most likely to influence patient outcome was created from the transcribed testimony of the plaintiff's expert witness. This abstract and a survey that included questions about four decisions made by the defendant were sent to 28 plastic surgeons in the Midwest who were identified by searches of public documents. Eleven plastic surgeons experienced in abdominoplasty completed the survey. Their responses in all four areas contrasted sharply with those of the highly credentialed medical expert for the plaintiff. These results suggest that physician surveys are feasible and may provide very different results than those from expert witnesses about standard of care in medical malpractice cases.

  16. Randomization and Data-Analysis Items in Quality Standards for Single-Case Experimental Studies

    Science.gov (United States)

    Heyvaert, Mieke; Wendt, Oliver; Van den Noortgate, Wim; Onghena, Patrick

    2015-01-01

    Reporting standards and critical appraisal tools serve as beacons for researchers, reviewers, and research consumers. Parallel to existing guidelines for researchers to report and evaluate group-comparison studies, single-case experimental (SCE) researchers are in need of guidelines for reporting and evaluating SCE studies. A systematic search was…

  17. Assessment of a Motivational Interviewing Curriculum for Year 3 Medical Students Using a Standardized Patient Case

    Science.gov (United States)

    Haeseler, Frederick; Fortin, Auguste H.; Pfeiffer, Carol; Walters, Cheryl; Martino, Steve

    2013-01-01

    Objective We sought to evaluate a year 3 motivational interviewing (MI) curriculum using a standardized patient case. Methods The 2-hour small group MI curriculum included a didactic presentation followed by interactive role plays. During a clinical skills assessment at the end of year 3 the MI skills of 80 students who had participated in the curriculum were compared with those of 19 students who had not participated. Results The standardized patient reliably rated the students on their performance of 8 items. Students who had participated in the MI curriculum were significantly more proficient than nonparticipating students in the performance of 2 strategic MI skills, importance and confidence rulers (ps motivations for change. Practice Implications Medical schools should consider providing students with MI training and MI skill assessments using standardized patient cases to help students prepare to counsel patients for behavior change. PMID:21123019

  18. Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution

    Directory of Open Access Journals (Sweden)

    Stouten Bart

    2005-05-01

    Full Text Available Abstract Background A recent article by Reeves et al. on the identification and resolution of ambiguities in the 1994 chronic fatigue syndrome (CFS research case definition recommended the Checklist Individual Strength, the Chalder Fatigue Scale, and the Krupp Fatigue Severity Scale for evaluating fatigue in CFS studies. To be able to discriminate between various levels of severe fatigue, extreme scoring on the individual items of these questionnaires must not occur too often. Methods We derived an expression that allows us to compute a lower bound for the number of items with the maximum item score for a given study from the reported mean scale score, the number of reported subjects, and the properties of the fatigue rating scale. Several CFS studies that used the recommended fatigue rating scales were selected from literature and analyzed to verify whether abundant extreme scoring had occurred. Results Extreme scoring occurred on a large number of the items for all three recommended fatigue rating scales across several studies. The percentage of items with the maximum score exceeded 40% in several cases. The amount of extreme scoring for a certain scale varied from one study to another, which suggests heterogeneity in the selected subjects across studies. Conclusion Because all three instruments easily reach the extreme ends of their scales on a large number of the individual items, they do not accurately represent the severe fatigue that is characteristic for CFS. This should lead to serious questions about the validity and suitability of the Checklist Individual Strength, the Chalder Fatigue Scale, and the Krupp Fatigue Severity Scale for evaluating fatigue in CFS research.

  19. Experiences from Implementation of Lean Production: Standardization versus Self-management: A Swedish Case Study

    Directory of Open Access Journals (Sweden)

    Margareta Oudhuis

    2013-01-01

    Full Text Available In this article, we discuss important aspects of the perceived problematic relationship between self-management and standardization. The article presents data from three case studies conducted within manufacturing companies in Sweden, where the popularity of lean production has led to a renaissance for short-cycle and standardized assembly work in settings that traditionally have made use of sociotechnical production design. The data suggest that the implementation has not contributed to an increased commitment, smooth operations, and capacity for change and innovation. Despite these not so positive results, it is argued that it is possible to combine self-management principles with lean production and standardization if 1 the implementation of lean is done with a contextual sensitivity, 2 a balance is reached between the use of standards on the one hand and work enrichment on the other, and 3 a feeling of ownership as regards both implementation and production process is upheld among the product on personnel.

  20. Standardization of the Descemet membrane endothelial keratoplasty technique: Outcomes of the first 450 consecutive cases.

    Science.gov (United States)

    Satué, M; Rodríguez-Calvo-de-Mora, M; Naveiras, M; Cabrerizo, J; Dapena, I; Melles, G R J

    2015-08-01

    To evaluate the clinical outcome of the first 450 consecutive cases after Descemet membrane endothelial keratoplasty (DMEK), as well as the effect of standardization of the technique. Comparison between 3 groups: Group I: (cases 1-125), as the extended learning curve; Group II: (cases 126-250), transition to technique standardization; Group III: (cases 251-450), surgery with standardized technique. Best corrected visual acuity, endothelial cell density, pachymetry and intra- and postoperative complications were evaluated before, and 1, 3 and 6 months after DMEK. At 6 months after surgery, 79% of eyes reached a best corrected visual acuity of≥0.8 and 43%≥1.0. Mean preoperative endothelial cell density was 2,530±220 cells/mm2 and 1,613±495 at 6 months after surgery. Mean pachymetry measured 668±92 μm and 526±46 μm pre- and (6 months) postoperatively, respectively. There were no significant differences in best corrected visual acuity, endothelial cell density and pachymetry between the 3 groups (P > .05). Graft detachment presented in 17.3% of the eyes. The detachment rate declined from 24% to 12%, and the rate of secondary surgeries from 9.6% to 3.5%, from group I to III respectively. Visual outcomes and endothelial cell density after DMEK are independent of the technique standardization. However, technique standardization may have contributed to a lower graft detachment rate and a relatively low number of secondary interventions required. As such, DMEK may become the first choice of treatment in corneal endothelial disease. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Consistent Reduction in Periprocedural Myocardial Infarction With Cangrelor as Assessed by Multiple Definitions: Findings From CHAMPION PHOENIX (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition).

    Science.gov (United States)

    Cavender, Matthew A; Bhatt, Deepak L; Stone, Gregg W; White, Harvey D; Steg, Ph Gabriel; Gibson, C Michael; Hamm, Christian W; Price, Matthew J; Leonardi, Sergio; Prats, Jayne; Deliargyris, Efthymios N; Mahaffey, Kenneth W; Harrington, Robert A

    2016-09-06

    Cangrelor is an intravenous P2Y12 inhibitor approved to reduce periprocedural ischemic events in patients undergoing percutaneous coronary intervention not pretreated with a P2Y12 inhibitor. A total of 11 145 patients were randomized to cangrelor or clopidogrel in the CHAMPION PHOENIX trial (Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition). We explored the effects of cangrelor on myocardial infarction (MI) using different definitions and performed sensitivity analyses on the primary end point of the trial. A total of 462 patients (4.2%) undergoing percutaneous coronary intervention had an MI as defined by the second universal definition. The majority of these MIs (n=433, 93.7%) were type 4a. Treatment with cangrelor reduced the incidence of MI at 48 hours (3.8% versus 4.7%; odds ratio [OR], 0.80; 95% confidence interval [CI], 0.67-0.97; P=0.02). When the Society of Coronary Angiography and Intervention definition of periprocedural MI was applied to potential ischemic events, there were fewer total MIs (n=134); however, the effects of cangrelor on MI remained significant (OR, 0.65; 95% CI, 0.46-0.92; P=0.01). Similar effects were seen in the evaluation of the effects of cangrelor on MIs with peak creatinine kinase-MB ≥10 times the upper limit of normal (OR, 0.64; 95% CI, 0.45-0.91) and those with peak creatinine kinase-MB ≥10 times the upper limit of normal, ischemic symptoms, or ECG changes (OR, 0.63; 95% CI, 0.48-0.84). MIs defined by any of these definitions were associated with increased risk of death at 30 days. Treatment with cangrelor reduced the composite end point of death, MI (Society of Coronary Angiography and Intervention definition), ischemia-driven revascularization, or Academic Research Consortium definite stent thrombosis (1.4% versus 2.1%; OR, 0.69; 95% CI, 0.51-0.92). MI in patients undergoing percutaneous coronary intervention, regardless of definition, remains associated with increased risk of death

  2. Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document

    NARCIS (Netherlands)

    A.P. Kappetein (Arie Pieter); S.J. Head (Stuart); P. Généreux (Philippe); N. Piazza (Nicolo); N.M. van Mieghem (Nicolas); E.H. Blackstone (Eugene); T.G. Brott (Thomas); D.J. Cohen (David J.); D.E. Cutlip (Donald); G.A. van Es (Gerrit Anne); R.T. Hahn (Rebecca); A.J. Kirtane (Ajay); M. Krucoff (Mitchell); S. Kodali (Susheel); M.J. Mack (Michael); R. Mehran (Roxana); J. Rodés-Cabau (Josep); P. Vranckx (Pascal); J.G. Webb (John); S.W. Windecker (Stephan); P.W.J.C. Serruys (Patrick); M.B. Leon (Martin)

    2012-01-01

    textabstractObjectives: The aim of the current Valvular Academic Research Consortium (VARC)-2 initiative was to revisit the selection and definitions of transcatheter aortic valve implantation (TAVI)- clinical endpoints to make them more suitable to the present and future needs of clinical trials.

  3. DICOM Standard Conformance in Veterinary Medicine in Germany: a Survey of Imaging Studies in Referral Cases.

    Science.gov (United States)

    Brühschwein, Andreas; Klever, Julius; Wilkinson, Tom; Meyer-Lindenberg, Andrea

    2018-02-01

    In 2016, the recommendations of the DICOM Standards Committee for the use of veterinary identification DICOM tags had its 10th anniversary. The goal of our study was to survey veterinary DICOM standard conformance in Germany regarding the specific identification tags veterinarians should use in veterinary diagnostic imaging. We hypothesized that most veterinarians in Germany do not follow the guidelines of the DICOM Standards Committee. We analyzed the metadata of 488 imaging studies of referral cases from 115 different veterinary institutions in Germany by computer-aided DICOM header readout. We found that 25 (5.1%) of the imaging studies fully complied with the "veterinary DICOM standard" in this survey. The results confirmed our hypothesis that the recommendations of the DICOM Standards Committee for the consistent and advantageous use of veterinary identification tags have found minimal acceptance amongst German veterinarians. DICOM does not only enable connectivity between machines, DICOM also improves communication between veterinarians by sharing correct and valuable metadata for better patient care. Therefore, we recommend that lecturers, universities, societies, authorities, vendors, and other stakeholders should increase their effort to improve the spread of the veterinary DICOM standard in the veterinary world.

  4. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a definitive treatment? Retrospective analysis of 63 cases.

    Science.gov (United States)

    Sorrentino, M; Brizzolari, M; Scarpa, E; Malisan, D; Bruschi, F; Bertozzi, S; Bernardi, S; Petri, R

    2015-02-01

    The ideal treatment of perforated diverticulitis and the indications for elective colon resection remain controversial. Considering the significant morbidity and mortality rates related to traditional resection, efforts have been made to reduce the invasiveness of surgery in recent decades. Laparoscopic peritoneal lavage has emerged as an effective alternative option. We retrospectively investigated the effectiveness of laparoscopic peritoneal lavage for perforated diverticulitis and the possibility that it could be a definitive treatment. We included patients treated with laparoscopic peritoneal lavage for perforated diverticulitis. The inclusion criteria were all emergency patients with generalized peritonitis due to Hinchey III perforated diverticulitis and some cases of Hinchey II and IV. Sixty-three patients were treated with laparoscopic peritoneal lavage. Six patients (9.5 %) had Hinchey II diverticulitis; 54 patients (85.7 %) had Hinchey III; and three patients (4.8 %) had Hinchey IV. The mean operative time was 87.3 min (±25.4 min), and the overall morbidity rate was 14.3 %. One patient died because of pulmonary embolism, and there were six early reinterventions because of treatment failure. Delayed colon resection was performed in four of the remaining 57 patients (7 %) because of recurrent diverticulitis. In the other 53 patients (93 %), we saw no recurrence of diverticulitis and no intervention was performed after a median follow-up period of 54 months (interquartile range 27-98 months). Laparoscopic peritoneal lavage for perforated diverticulitis can be considered a safe and effective alternative to traditional surgical resection, and using this approach, most elective colon resection might be avoided.

  5. Does change in definition of psychotic symptoms in diagnosis of schizophrenia in DSM-5 affect caseness?

    Science.gov (United States)

    Tandon, Rajiv; Bruijnzeel, Dawn; Rankupalli, Babu

    2013-08-01

    Psychotic symptoms are a central element in the diagnosis of schizophrenia, although their precise definition has varied through the multiple iterations of DSM and the ICD. Schneiderian first-rank symptoms (FRS) have received a particularly prominent position in the diagnostic criteria of schizophrenia since ICD-9 and DSM-III. In the current iteration of DSM (DSM-IV-TR), whereas two characteristic symptoms are ordinarily required to meet criterion A, only a single symptom is necessary if the psychotic symptom happens to be a FRS, notably a bizarre delusion or auditory hallucination of a running commentary or 'conversing voices'. Because of limited data in support of the special treatment of FRS, DSM-5 has made changes to criterion A, requiring that at least two psychotic symptoms be present in all cases with at least one of these symptoms being a delusion, hallucination, or disorganized speech. To assess the impact of these changes on the prevalence of schizophrenia, we examined a research dataset of 221 individuals with DSM-IV schizophrenia to study the prevalence and co-occurrence of various criterion A symptoms. Although bizarre delusions and/or Schneiderian hallucinations were present in 124 patients (56.1%), they were singly determinative of diagnosis in only one patient (0.46%). Additionally, only three of the 221 patients (1.4%) with DSM-IV schizophrenia did not have a delusion, hallucination, or disorganized speech. DSM-5 changes in criteria A should have a negligible effect on the prevalence of schizophrenia, with over 98% of individuals with DSM-IV schizophrenia continuing to receive a DSM-5 diagnosis of schizophrenia in this dataset. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. ESIP's Emerging Provenance and Context Content Standard Use Cases: Developing Examples and Models for Data Stewardship

    Science.gov (United States)

    Ramdeen, S.; Hills, D. J.

    2013-12-01

    Earth science data collections range from individual researchers' private collections to large-scale data warehouses, from computer-generated data to field or lab based observations. These collections require stewardship. Fundamentally, stewardship ensures long term preservation and the provision of access to the user community. In particular, stewardship includes capturing appropriate metadata and documentation--and thus the context of the data's creation and any changes they underwent over time --to enable data reuse. But scientists and science data managers must translate these ideas into practice. How does one balance the needs of current and (projected) future stakeholders? In 2011, the Data Stewardship Committee (DSC) of the Federation of Earth Science Information Partners (ESIP) began developing the Provenance and Context Content Standard (PCCS). As an emerging standard, PCCS provides a framework for 'what' must be captured or preserved as opposed to describing only 'how' it should be done. Originally based on the experiences of NASA and NOAA researchers within ESIP, the standard currently provides data managers with content items aligned to eight key categories. While the categories and content items are based on data life cycles of remote sensing missions, they can be generalized to cover a broader set of activities, for example, preservation of physical objects. These categories will include the information needed to ensure the long-term understandability and usability of earth science data products. In addition to the PCCS, the DSC is developing a series of use cases based on the perspectives of the data archiver, data user, and the data consumer that will connect theory and practice. These cases will act as specifications for developing PCCS-based systems. They will also provide for examination of the categories and content items covered in the PCCS to determine if any additions are needed to cover the various use cases, and also provide rationale and

  7. Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report

    Directory of Open Access Journals (Sweden)

    Servadei Franco

    2010-04-01

    Full Text Available Abstract Background Management of glioblastoma multiforme (GBM has been difficult using standard therapy (radiation with temozolomide chemotherapy. The ketogenic diet is used commonly to treat refractory epilepsy in children and, when administered in restricted amounts, can also target energy metabolism in brain tumors. We report the case of a 65-year-old woman who presented with progressive memory loss, chronic headaches, nausea, and a right hemisphere multi-centric tumor seen with magnetic resonance imaging (MRI. Following incomplete surgical resection, the patient was diagnosed with glioblastoma multiforme expressing hypermethylation of the MGMT gene promoter. Methods Prior to initiation of the standard therapy, the patient conducted water-only therapeutic fasting and a restricted 4:1 (fat: carbohydrate + protein ketogenic diet that delivered about 600 kcal/day. The patient also received the restricted ketogenic diet concomitantly during the standard treatment period. The diet was supplemented with vitamins and minerals. Steroid medication (dexamethasone was removed during the course of the treatment. The patient was followed using MRI and positron emission tomography with fluoro-deoxy-glucose (FDG-PET. Results After two months treatment, the patient's body weight was reduced by about 20% and no discernable brain tumor tissue was detected using either FDG-PET or MRI imaging. Biomarker changes showed reduced levels of blood glucose and elevated levels of urinary ketones. MRI evidence of tumor recurrence was found 10 weeks after suspension of strict diet therapy. Conclusion This is the first report of confirmed GBM treated with standard therapy together with a restricted ketogenic diet. As rapid regression of GBM is rare in older patients following incomplete surgical resection and standard therapy alone, the response observed in this case could result in part from the action of the calorie restricted ketogenic diet. Further studies are needed

  8. 466 Bee venom Immunotherapy with Standardized Extract, Two Case Comunication and Clinical Progress

    Science.gov (United States)

    Cardona, Aristoteles Alvarez; Nieto, Leticia Hernandez; Melendez, Alvaro Pedroza

    2012-01-01

    Background Bee venom immunotherapy is a safe and effective treatment, indicated in patients with previous history of severe systemic reactions to bee venom, demonstrating succesful desensitization in more than 90% of cases with standardized extract. Currently in Mexico there is no standardized extract commercially available for treatment, despite of having high activity of beekeeping and occupational exposure with at least 17,478 registered stings per year and an annually honey production of nearly 70 tons. Methods We present the clinical progress of 2 patients with history of severe systemic reactions to bee venom and occupational exposure, both with demonstrated sensitization by specific IgE and who underwent specific immunotherapy with standardized extract (Alk-US) reaching a maintenance weekly dose of 100 mcg (PLA2) for the last 4 years. Results Both patients sufered of accidental stings after reached the maintenance dose presenting mild local reactions to stings. Both patients had very different clinical course presenting a wide variety of adverse reactions during desensitization protocol; from mild local to generalized reactions all generally well tolerated allowed to reach the maintenance dose with succesful desensitization proved by accidental exposure without severe systemic reactions. Conclusions Bee venom specific immunotherapy with standardized extract is a well tolerated and efective treatment preventing the development of life threathening reactions in sensitized patients. It is important to promote the use and availability of standardized extract in developing countries with poor safety measures and high occupational exposure.

  9. The problem of epistemic jurisdiction in global governance: The case of sustainability standards for biofuels.

    Science.gov (United States)

    Winickoff, David E; Mondou, Matthieu

    2017-02-01

    While there is ample scholarly work on regulatory science within the state, or single-sited global institutions, there is less on its operation within complex modes of global governance that are decentered, overlapping, multi-sectorial and multi-leveled. Using a co-productionist framework, this study identifies 'epistemic jurisdiction' - the power to produce or warrant technical knowledge for a given political community, topical arena or geographical territory - as a central problem for regulatory science in complex governance. We explore these dynamics in the arena of global sustainability standards for biofuels. We select three institutional fora as sites of inquiry: the European Union's Renewable Energy Directive, the Roundtable on Sustainable Biomaterials, and the International Organization for Standardization. These cases allow us to analyze how the co-production of sustainability science responds to problems of epistemic jurisdiction in the global regulatory order. First, different problems of epistemic jurisdiction beset different standard-setting bodies, and these problems shape both the content of regulatory science and the procedures designed to make it authoritative. Second, in order to produce global regulatory science, technical bodies must manage an array of conflicting imperatives - including scientific virtue, due process and the need to recruit adoptees to perpetuate the standard. At different levels of governance, standard drafters struggle to balance loyalties to country, to company or constituency and to the larger project of internationalization. Confronted with these sometimes conflicting pressures, actors across the standards system quite self-consciously maneuver to build or retain authority for their forum through a combination of scientific adjustment and political negotiation. Third, the evidentiary demands of regulatory science in global administrative spaces are deeply affected by 1) a market for standards, in which firms and states can

  10. Using standardized patients versus video cases for representing clinical problems in problem-based learning

    Directory of Open Access Journals (Sweden)

    Bo Young Yoon

    2016-06-01

    Full Text Available Purpose: The quality of problem representation is critical for developing students’ problem-solving abilities in problem-based learning (PBL. This study investigates preclinical students’ experience with standardized patients (SPs as a problem representation method compared to using video cases in PBL. Methods: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. Results: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. Conclusion: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

  11. Using standardized patients versus video cases for representing clinical problems in problem-based learning.

    Science.gov (United States)

    Yoon, Bo Young; Choi, Ikseon; Choi, Seokjin; Kim, Tae-Hee; Roh, Hyerin; Rhee, Byoung Doo; Lee, Jong-Tae

    2016-06-01

    The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

  12. Starworld: Preparing Accountants for the Future: A Case-Based Approach to Teach International Financial Reporting Standards Using ERP Software

    Science.gov (United States)

    Ragan, Joseph M.; Savino, Christopher J.; Parashac, Paul; Hosler, Jonathan C.

    2010-01-01

    International Financial Reporting Standards now constitute an important part of educating young professional accountants. This paper looks at a case based process to teach International Financial Reporting Standards using integrated Enterprise Resource Planning software. The case contained within the paper can be used within a variety of courses…

  13. ASSESSING BUSINESS TRANSACTION STANDARDS AND THEIR ADOPTION A cross case analysis between the SETU and Vektis standards

    NARCIS (Netherlands)

    Berends, Wouter; Folmer, Erwin Johan Albert

    2010-01-01

    Nowadays businesses increasingly want to be interoperable so that they can collaborate with other organizations. Interoperability can be achieved through the use of business transaction standards, by which the organizations that use the standards collectively form a value added network. However the

  14. THE COST MANAGEMENT BY APPLYING THE STANDARD COSTING METHOD IN THE FURNITURE INDUSTRY-Case study

    Directory of Open Access Journals (Sweden)

    Radu Mărginean

    2013-06-01

    Full Text Available Among the modern calculation methods used in managerial accounting, with a large applicability in the industrial production field, we can find the standard costing method. This managerial approach of cost calculation has a real value in the managerial accounting field, due to its usefulness in forecasting production costs, helping the managers in the decision making process. The standard costing method in managerial accounting is part of modern managerial accounting methods, used in many enterprises with production activity. As research objectives for this paper, we propose studying the possibility of implementing this modern method of cost calculation in a company from the Romanian furniture industry, using real financial data. In order to achieve this aim, we used some specialized literature in the field of managerial accounting, showing the strengths and weaknesses of this method. The case study demonstrates that the standard costing modern method of cost calculation has full applicability in our case, and in conclusion it has a real value in the cost management process for enterprises in the Romanian furniture industry.

  15. Building a gold standard to construct search filters: a case study with biomarkers for oral cancer.

    Science.gov (United States)

    Frazier, John J; Stein, Corey D; Tseytlin, Eugene; Bekhuis, Tanja

    2015-01-01

    To support clinical researchers, librarians and informationists may need search filters for particular tasks. Development of filters typically depends on a "gold standard" dataset. This paper describes generalizable methods for creating a gold standard to support future filter development and evaluation using oral squamous cell carcinoma (OSCC) as a case study. OSCC is the most common malignancy affecting the oral cavity. Investigation of biomarkers with potential prognostic utility is an active area of research in OSCC. The methods discussed here should be useful for designing quality search filters in similar domains. The authors searched MEDLINE for prognostic studies of OSCC, developed annotation guidelines for screeners, ran three calibration trials before annotating the remaining body of citations, and measured inter-annotator agreement (IAA). We retrieved 1,818 citations. After calibration, we screened the remaining citations (n = 1,767; 97.2%); IAA was substantial (kappa = 0.76). The dataset has 497 (27.3%) citations representing OSCC studies of potential prognostic biomarkers. The gold standard dataset is likely to be high quality and useful for future development and evaluation of filters for OSCC studies of potential prognostic biomarkers. The methodology we used is generalizable to other domains requiring a reference standard to evaluate the performance of search filters. A gold standard is essential because the labels regarding relevance enable computation of diagnostic metrics, such as sensitivity and specificity. Librarians and informationists with data analysis skills could contribute to developing gold standard datasets and subsequent filters tuned for their patrons' domains of interest.

  16. Admission time to hospital: a varying standard for a critical definition for admissions to an intensive care unit from the emergency department.

    Science.gov (United States)

    Nanayakkara, Shane; Weiss, Heike; Bailey, Michael; van Lint, Allison; Cameron, Peter; Pilcher, David

    2014-11-01

    Time spent in the emergency department (ED) before admission to hospital is often considered an important key performance indicator (KPI). Throughout Australia and New Zealand, there is no standard definition of 'time of admission' for patients admitted through the ED. By using data submitted to the Australian and New Zealand Intensive Care Society Adult Patient Database, the aim was to determine the differing methods used to define hospital admission time and assess how these impact on the calculation of time spent in the ED before admission to an intensive care unit (ICU). Between March and December of 2010, 61 hospitals were contacted directly. Decision methods for determining time of admission to the ED were matched to 67,787 patient records. Univariate and multivariate analyses were conducted to assess the relationship between decision method and the reported time spent in the ED. Four mechanisms of recording time of admission were identified, with time of triage being the most common (28/61 hospitals). Reported median time spent in the ED varied from 2.5 (IQR 0.83-5.35) to 5.1 h (2.82-8.68), depending on the decision method. After adjusting for illness severity, hospital type and location, decision method remained a significant factor in determining measurement of ED length of stay. Different methods are used in Australia and New Zealand to define admission time to hospital. Professional bodies, hospitals and jurisdictions should ensure standardisation of definitions for appropriate interpretation of KPIs as well as for the interpretation of studies assessing the impact of admission time to ICU from the ED. WHAT IS KNOWN ABOUT THE TOPIC?: There are standards for the maximum time spent in the ED internationally, but these standards vary greatly across Australia. The definition of such a standard is critically important not only to patient care, but also in the assessment of hospital outcomes. Key performance indicators rely on quality data to improve decision

  17. Description of children identified as suffering from MAM in Bangladesh: Varying results based on case definitions

    International Nuclear Information System (INIS)

    Waid, Jillian

    2014-01-01

    Full text: Background: There is a wide discrepancy between the proportion of children classified as acutely malnourished when MUAC criteria are used compared to weight for height. This has greatly complicated setting targets for the coverage of SAM and MAM programs in Bangladesh. This difference is much larger for children identified with MAM than for those with SAM, largely because identification as MAM can overlap both with SAM and with children not identified as acutely malnourished. Objective: To review existing data sets in order to determine the relationship between MUAC and other anthropometric measures, helping to provide a better understanding of the implications of different admission criteria to therapeutic and supplementary feeding programs. Methodology: This study uses data collected through national nutritional surveillance projects over multiple seasons in Bangladesh. For the years 1990 to 2006, sub-samples of data from the Nutritional Surveillance Project were pulled from areas of the country that remained constant over a set period. Data from 2010 to 2012 was pulled from the Food Security and Nutrition Surveillance Project. Case definition: Cases of moderate acute malnutrition were identified using MUAC- for-age z-scores (-3>z-score>-2), MUAC cut-offs (115mm>MUAC>125mm), and weight-for-height z-scores (-3>z-score>-2). Results: In all years more than 50% of all children identified as moderately malnourished were classified as such by only one measure (1990 selected sub-districts: 52%, 2012 national sample: 69%) In 1990 a higher proportion of children were categorized as moderately malnourished based on MUAC-for-age z-scores than by weight for height z-scores, but since 2000 the opposite has been true. This change is closely tied to the increasing height of children sampled, due to the declining rates of stunting in the country. After controlling for age and weight-for-height z-scores, an increase in height of one cm was associated with an increase

  18. Case suitability for definitive through knee amputation following lower extremity blast trauma: analysis of 146 combat casualties, 2008-2010.

    Science.gov (United States)

    Singleton, James A G; Walker, N M; Gibb, I E; Bull, A M J; Clasper, J C

    2014-06-01

    Analysis of recent UK Armed Forces combat casualty data has highlighted a significant number of through joint traumatic amputations (TAs), most commonly through knee (through knee amputations (TKAs)). Previously, a consensus statement on lower limb amputation from the UK Defence Medical Services reported better outcomes in some patients with TKAs when compared with those with above knee amputations. This study sought to define the proportion of recent combat casualties sustaining severe lower extremity trauma with acute osseous and soft tissue injury anatomy amenable to definitive TKA. The UK Joint Theatre Trauma Registry and post mortem CT (PM-CT) databases were used to identify all UK Armed Forces personnel (survivors and fatalities) sustaining a major extremity TA (through/proximal to wrist or ankle joint) between August 2008 and August 2010. Through knee and all below knee TAs were grouped as 'potential TKAs' (pTKAs), that is, possible candidates for definitive TKA. 146 Cases (75 survivors and 71 fatalities) sustaining 271 TAs (130 in survivors, 141 in fatalities) were identified. The through-joint TA rate was 47/271 (17.3%); 34/47 through-joint injuries (72.3%) were TKAs. Overall, 63/130 TAs in survivors and 66/140 TAs in fatalities merited analysis as the pTKA group. Detailed anatomical data on pre-debridement osseous and soft tissue injury levels were only consistently available for fatalities through PM-CT findings. Further analysis of the soft tissue injury profile revealed that a definitive TKA in the pTKA group (all BKAs as well as TKAs) would have been proximal to the zone of injury (ZOI) in only 3/66 cases. Traumatic TKAs following explosive blast are more common than previously reported. The majority of lower limb TAs are skeletally amenable to a definitive TKA. Maximising residual stump length carries the risks of definitive level amputation within the original ZOI but this study demonstrates that the proximal extent of the soft tissue injury may

  19. Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

    Science.gov (United States)

    Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

    2013-06-01

    The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  20. Interpreting Definiteness in a Second Language without Articles: The Case of L2 Russian

    Science.gov (United States)

    Cho, Jacee; Slabakova, Roumyana

    2014-01-01

    This article investigates the second language (L2) acquisition of two expressions of the semantic feature [definite] in Russian, a language without articles, by English and Korean native speakers. Within the Feature Reassembly approach (Lardiere, 2009), Slabakova (2009) has argued that reassembling features that are represented overtly in the…

  1. The definition of cross polarization

    DEFF Research Database (Denmark)

    Ludwig, Arthur

    1973-01-01

    There are at least three different definitions of cross polarization used in the literature. The alternative definitions are discussed with respect to several applications, and the definition which corresponds to one standard measurement practice is proposed as the best choice....

  2. Realizing business benefits from company IT standardization : Case study research into the organizational value of IT standards, towards a company IT standardization management framework

    NARCIS (Netherlands)

    van Wessel, R.M.

    2008-01-01

    From a practical point of view, this research provides insight into how company IT standards affect business process performance. Furthermore it gives recommendations on how to govern and manage such standards successfully with regard to their selection, implementation and usage. After evaluating

  3. The definitive diagnostic process and successful treatment for ABPM caused by Schizophyllum commune: a report of two cases.

    Science.gov (United States)

    Ogawa, Haruhiko; Fujimura, Masaki; Takeuchi, Yasuo; Makimura, Koichi; Satoh, Kazuo

    2012-03-01

    Although mucoid impaction of the bronchi (MIB) is a well-known manifestation in allergic bronchopulmonary mycosis (ABPM), when unknown samples or plural eumycetes are cultured from bronchial materials, several problems are encountered which can affect the definitive diagnostic process or successful treatment. The definitive diagnostic process of two patients [a 58-(Case 1) and a 70-(Case 2) year-old female] with MIB was: 1) to identify the existence of any allergic respiratory disorder, 2) to detect the fungi obtained from bronchial materials, with use of the 28S rDNA sequencing and analysis, 3) to investigate whether the detected fungus was a probable etiologic antigen, and 4) to make the final diagnosis based on the results of the inhalation examinations using the antigenic solution of the fungi. As a treatment strategy, bronchial toilet and low dose itraconazole therapy were planned according to the clinical manifestations of each patient. The two patients with MIB were successfully diagnosed as ABPM caused by Schizophyllum commune (Sc-ABPM) accompanied with hyperattenuating mucoid impaction. The reliability of some allergological makers as a substitution for the bronchoprovocation test should be clarified in near future. Clinical manifestations demonstrated in our cases suggested that the allergic reaction such as eosinophilic bronchoalveolitis spreading around the mucus plug was a primary lesion underlying the Sc-ABPM. The success of the treatment for Sc-ABPM will be achieved by the strategy targeting to fundamental condition and by the control of the disease recurrence by means of effective environmental management.

  4. Case management.

    Science.gov (United States)

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Airside HVAC BESTEST. Adaptation of ASHRAE RP 865 Airside HVAC Equipment Modeling Test Cases for ASHRAE Standard 140. Volume 1, Cases AE101-AE445

    Energy Technology Data Exchange (ETDEWEB)

    Neymark, J. [J. Neymark & Associates, Golden, CO (United States); Kennedy, M. [Mike D. Kennedy, Inc., Townsend, WA (United States); Judkoff, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gall, J. [AAON, Inc., Tulsa, OK (United States); Knebel, D. [AAON, Inc., Tulsa, OK (United States); Henninger, R. [GARD Analytics, Inc., Arlington Heights, IL (United States); Witte, M. [GARD Analytics, Inc., Arlington Heights, IL (United States); Hong, T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McDowell, T. [Thermal Energy System Specialists, Madison, WI (United States); Yan, D. [Tsinghua Univ., Beijing (China); Zhou, X. [Tsinghua Univ., Beijing (China)

    2016-03-01

    This report documents a set of diagnostic analytical verification cases for testing the ability of whole building simulation software to model the air distribution side of typical heating, ventilating and air conditioning (HVAC) equipment. These cases complement the unitary equipment cases included in American National Standards Institute (ANSI)/American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs, which test the ability to model the heat-transfer fluid side of HVAC equipment.

  6. Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis

    OpenAIRE

    Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J

    2009-01-01

    SETTING: Urban clinic, Nairobi. OBJECTIVES: To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. DESIGN: Prospective study among TB suspects. RESULTS: A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly ...

  7. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures.

    Science.gov (United States)

    Jammer, Ib; Wickboldt, Nadine; Sander, Michael; Smith, Andrew; Schultz, Marcus J; Pelosi, Paolo; Leva, Brigitte; Rhodes, Andrew; Hoeft, Andreas; Walder, Bernhard; Chew, Michelle S; Pearse, Rupert M

    2015-02-01

    There is a need for large trials that test the clinical effectiveness of interventions in the field of perioperative medicine. Clinical outcome measures used in such trials must be robust, clearly defined and patient-relevant. Our objective was to develop standards for the use of clinical outcome measures to strengthen the methodological quality of perioperative medicine research. A literature search was conducted using PubMed and opinion leaders worldwide were invited to nominate papers that they believed the group should consider. The full texts of relevant articles were reviewed by the taskforce members and then discussed to reach a consensus on the required standards. The report was then circulated to opinion leaders for comment and review. This report describes definitions for 22 individual adverse events with a system of severity grading for each. In addition, four composite outcome measures were identified, which were designed to evaluate postoperative outcomes. The group also agreed on standards for four outcome measures for the evaluation of healthcare resource use and quality of life. Guidance for use of these outcome measures is provided, with particular emphasis on appropriate duration of follow-up. This report provides clearly defined and patient-relevant outcome measures for large clinical trials in perioperative medicine. These outcome measures may also be of use in clinical audit. This report is intended to complement and not replace other related work to improve assessment of clinical outcomes following specific surgical procedures.

  8. Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Judkoff, R.; Neymark, J.

    2013-07-01

    ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and the informative example results.

  9. Single-Case Experimental Designs: A Systematic Review of Published Research and Current Standards

    Science.gov (United States)

    Smith, Justin D.

    2013-01-01

    This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support amongst those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods. PMID:22845874

  10. THE ADAPTATION VS. STANDARDIZATION DILEMMA: THE CASE OF AN AMERICAN COMPANY IN BRAZIL

    Directory of Open Access Journals (Sweden)

    Thelma Valéria Rocha

    2011-01-01

    Full Text Available This study analyzes the adaptation versus standardization dilemma in International Marketing in subsidiaries of multinationals corporations. It highlights the importance of GMS – global marketing strategies – in the ability to innovate in subsidiaries in emerging economies, as Brazil. The objective is to find out how the level of autonomy displayed by subsidiaries influences the adaptation vs. standardization dilemma, and, consequently, the marketing-mix program. The methodology followed is qualitative research using a case-study approach in an American multinational from the food sector. In this case, we found out that firm's brands are very important to this firm's success overseas, which sustains that brand policies should be defined carefully at both levels: subsidiaries and headquarters. This brand policy influences direct the autonomy to innovate in marketing at subsidiaries level. This study is useful for managers at subsidiaries who need to understand the importance of global marketing strategies, and also for managers at headquarters who need to verify in which circumstances autonomy pays off.

  11. Developing a standard definition of whole-grain foods for dietary recommendations : Summary report of a multidisciplinary expert roundtable discussion

    NARCIS (Netherlands)

    Ferruzzi, M.G.; Jonnalagadda, S.S.; Liu, S.; Marquart, L.; McKeown, N.; Reicks, M.; Riccardi, G.; Seal, C.; Slavin, J.; Thielecke, F.; Kamp, J.W. van der; Webb, D.

    2014-01-01

    Although the term “whole grain” is well defined, there has been no universal standard of what constitutes a “whole-grain food,” creating challenges for researchers, the food industry, regulatory authorities, and consumers around the world. As part of the 2010 Dietary Guidelines for Americans, the

  12. MIGRATION POLICIES FROM ORIGIN PERSPECTIVE IN THE CASE OF ROMANIA. TESTING A DEFINITION

    OpenAIRE

    Monica SERBAN

    2015-01-01

    Recently, the effort of investigating migration policies and the role they play in international migration development has consistently increased. The most consistent part of this interest is related to immigration and associated policies to manage it. Just few studies approach the issues from the origin side perspective. This paper addresses the gap by discussing how migration policies from the origin perspective may be defined and operationalized and trying to test one such a definition/ope...

  13. Differences in safety margins between nuclear and conventional design standards with regards to seismic hazard definition and design criteria

    International Nuclear Information System (INIS)

    Elgohary, M.; Saudy, A.; Orbovic, N.; Dejan, D.

    2006-01-01

    With the surging interest in new build nuclear all over the world and a permanent interest in earthquake resistance of nuclear plants, there is a need to quantify the safety margins in nuclear buildings design in comparison to conventional buildings in order to increase the public confidence in the safety of nuclear power plants. Nuclear (CAN3-N289 series) and conventional (NBCC 2005) seismic standards have different approaches regarding the design of civil structures. The origin of the differences lays in the safety philosophy behind the seismic nuclear and conventional standards. Conventional seismic codes contain the minimal requirement destined primarily to safeguard against major structural failure and loss of life. It doesn't limit damage to a certain acceptable degree or maintain function. Nuclear seismic code requires that structures, systems and components important to safety, withstand the effects of earthquakes. The requirement states that for equipment important to safety, both integrity and functionality should be ascertained. The seismic hazard is generally defined on the basis of the annual probability of exceedence (return period). There is a major difference on the return period and the confidence level for design earthquakes between the conventional and the nuclear seismic standards. The seismic design criteria of conventional structures are based on the use of Force Modification Factors to take into account the energy dissipation by incursion in non-elastic domain and the reserve of strength. The use of such factors to lower intentionally the seismic input is consistent with the safety philosophy of the conventional seismic standard which is the 'non collapse' rather than the integrity and/or the operability of the structures or components. Nuclear seismic standard requires that the structure remain in the elastic domain; energy dissipation by incursion in non-elastic domain is not allowed for design basis earthquake conditions. This is

  14. The improvement of environmental performances by applying ISO 14001 standard: A case study

    Directory of Open Access Journals (Sweden)

    Živković Snežana

    2013-01-01

    Full Text Available This paper presents the analysis of the advantages of applying ISO 14001 system in an environmental protection management system. The environmental protection management system which is not licensed, i.e., compatible with the principles and standard pre-conditions considerably increases the plausibility for ecological risk. There are some issues that remain to be solved in the areas which are not expressed by financial values only but also have a non-financial character with the aim of expanding markets, company image improvement and improvement of the environmental performance indicators. By improving a company’s environmental management system efficiency we expect to achieve the minimization and elimination of damaging influences on the environment which are the consequence of company’s activities. A case study in the Oil Refinery Belgrade (RNB analyses the implementation of the standard ISO 14001:2004 into its environment protection management system, particularly emphasizing the company’s own way of evaluating the environment aspects with the aim of establishing results of ecological performances indicators improvement. The average values of the first ecological indicator of the plant, the total amount of the waste waters in m3 per a ton of product, clearly show the downturn trend, which is confirmed by the proportional reduction of the second ecological plant indicator, that is by the flocculants consumption (Al2(SO43, Na2CO3 in kg per m3 of the waste water of the Oil Refinery of Belgrade for the given period 2008-2010. Case study RNB confirms the improvement of environmental performances using the ISO 14001 standard.

  15. The use of definitive implant abutments for the fabrication of provisional crowns: a case series.

    Science.gov (United States)

    Bilhan, Hakan; Geckili, Onur; Mumcu, Emre

    2011-10-01

    The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this paper describes a practical method for chair-side fabrication of non-occlusal loaded provisional crowns used by the authors for several years successfully. Twenty two patients (9 males, 13 females; mean age, 36,72 years) with one missing anterior tooth were treated by using the presented method. Metal definitive abutments instead of provisional abutments were used and provisional crowns were fabricated on the definitive abutments for all of the patients. The marginal fit was finished on a laboratory analogue and temporarily cemented to the abutments. The marginal adaptation of the crowns was evaluated radiographically. The patients were all satisfied with the final appearance and no complications occurred until the implants were loaded with permanent restorations. The use of the definitive abutments for provisional crowns instead of provisional abutments reduces the costs and the same results can be obtained.

  16. Do placebo based validation standards mimic real batch products behaviour? Case studies.

    Science.gov (United States)

    Bouabidi, A; Talbi, M; Bouklouze, A; El Karbane, M; Bourichi, H; El Guezzar, M; Ziemons, E; Hubert, Ph; Rozet, E

    2011-06-01

    Analytical methods validation is a mandatory step to evaluate the ability of developed methods to provide accurate results for their routine application. Validation usually involves validation standards or quality control samples that are prepared in placebo or reconstituted matrix made of a mixture of all the ingredients composing the drug product except the active substance or the analyte under investigation. However, one of the main concerns that can be made with this approach is that it may lack an important source of variability that come from the manufacturing process. The question that remains at the end of the validation step is about the transferability of the quantitative performance from validation standards to real authentic drug product samples. In this work, this topic is investigated through three case studies. Three analytical methods were validated using the commonly spiked placebo validation standards at several concentration levels as well as using samples coming from authentic batch samples (tablets and syrups). The results showed that, depending on the type of response function used as calibration curve, there were various degrees of differences in the results accuracy obtained with the two types of samples. Nonetheless the use of spiked placebo validation standards was showed to mimic relatively well the quantitative behaviour of the analytical methods with authentic batch samples. Adding these authentic batch samples into the validation design may help the analyst to select and confirm the most fit for purpose calibration curve and thus increase the accuracy and reliability of the results generated by the method in routine application. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. The Diffusion of Labour Standards: The Case of the US and Guatemala

    Directory of Open Access Journals (Sweden)

    Gerda van Roozendaal

    2015-05-01

    Full Text Available The number of free trade agreements (FTAs concluded by the United States of America (US has grown vastly over the past two decades. While FTAs contribute to increased global competition and as such may also contribute to socially-undesirable practices in the area of working conditions and the environment, the proliferation in FTAs has paradoxically also augmented the potential for making free trade more fair as some of these agreements now include labour provisions. However, the question is whether these trade agreements have also actually diffused internationally recognised labour standards. This article studies the FTA the US signed in 2004 with a number of Central American countries and which, at a later stage, also included the Dominican Republic. This FTA is commonly referred to as CAFTA-DR and includes a chapter on labour standards. The article argues that the effects of the inclusion of labour standards in CAFTA-DR have been limited and therefore should be viewed as an unsuccessful attempt at policy transfer. This is illustrated by the case of Guatemala, a country known for its lack of respect for labour standards and which is currently the subject of a complaints procedure under the CAFTA-DR. It is maintained that this lack of effectiveness is the result of many factors. Among these is the weakness of the labour chapter of CAFTA-DR resulting from the fact that the chapter is the outcome of bargaining processes both within the US and between the US and Guatemala, where symbolic results were valued more highly than actual substance.

  18. Standard terminology relating to nuclear materials

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This terminology standard contains terms, definitions, descriptions of terms, nomenclature, and explanations of acronyms and symbols specifically associated with standards under the jurisdiction of Committee C26 on Nuclear Fuel Cycle. This terminology may also be applicable to documents not under the jurisdiction of Committee C26, in which case this terminology may be referenced in those documents.

  19. Comparison of Vital Statistics Definitions of Suicide against a Coroner Reference Standard: A Population-Based Linkage Study.

    Science.gov (United States)

    Gatov, Evgenia; Kurdyak, Paul; Sinyor, Mark; Holder, Laura; Schaffer, Ayal

    2018-03-01

    We sought to determine the utility of health administrative databases for population-based suicide surveillance, as these data are generally more accessible and more integrated with other data sources compared to coroners' records. In this retrospective validation study, we identified all coroner-confirmed suicides between 2003 and 2012 in Ontario residents aged 21 and over and linked this information to Statistics Canada's vital statistics data set. We examined the overlap between the underlying cause of death field and secondary causes of death using ICD-9 and ICD-10 codes for deliberate self-harm (i.e., suicide) and examined the sociodemographic and clinical characteristics of misclassified records. Among 10,153 linked deaths, there was a very high degree of overlap between records coded as deliberate self-harm in the vital statistics data set and coroner-confirmed suicides using both ICD-9 and ICD-10 definitions (96.88% and 96.84% sensitivity, respectively). This alignment steadily increased throughout the study period (from 95.9% to 98.8%). Other vital statistics diagnoses in primary fields included uncategorised signs and symptoms. Vital statistics records that were misclassified did not differ from valid records in terms of sociodemographic characteristics but were more likely to have had an unspecified place of injury on the death certificate ( P statistics and coroner classification of suicide deaths suggests that health administrative data can reliably be used to identify suicide deaths.

  20. Incorporating Lean Construction agent into the Building Standards Act: the Spanish case study

    Directory of Open Access Journals (Sweden)

    Brioso Xavier

    2016-12-01

    Full Text Available There is a demand for lean construction in Europe; even though lean construction is still an emerging field and there is growing interest, there are no regulations on this topic. The main objective of this research is to regulate this role when in a project and to define and develop a building agent structure, according to the Building Standards Act (LOE by its acronym in Spanish, to be able to incorporate it into the Spanish law, protecting it from civil liabilities. In Spain, there is jurisprudence in civil jurisdiction based on the LOE to acquit or convict building agents, who are defined in the courts as “constructive managers” or similar. For this reason, courts could establish in the future several liabilities for the lean construction specialist and other agents of the project, depending on their actions and based on the implementation of the lean project delivery system, the target value design and the integrated project delivery. Conversely, it is possible that the level of action of the lean construction specialist may comprise design management, construction management and contract management. Accordingly, one or more building agents should be appropriately incorporated into the LOE according to their functions and responsibilities and based on the levels of action of the lean construction specialist. The creation of the following agents is proposed: design manager, construction manager and contract manager, definitions that are developed in this study. These agents are loosely defined, because any project manager, building information modeling manager or similar may act as one or as more-than-one of them. Finally, the creation of the lean construction manager is also proposed, as the agent who takes on the role of the design manager, construction manager and contract manager, but focused on the lean production principles.

  1. Using standardized video cases for assessment of medical communication skills: reliability of an objective structured video examination by computer

    NARCIS (Netherlands)

    Hulsman, R. L.; Mollema, E. D.; Oort, F. J.; Hoos, A. M.; de Haes, J. C. J. M.

    2006-01-01

    OBJECTIVE: Using standardized video cases in a computerized objective structured video examination (OSVE) aims to measure cognitive scripts underlying overt communication behavior by questions on knowledge, understanding and performance. In this study the reliability of the OSVE assessment is

  2. Strategies for using international domain standards within a national context: The case of the Dutch temporary staffing industry

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack

    2009-01-01

    This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.

  3. Characteristics of fatal abusive head trauma among children in the USA: 2003-2007: an application of the CDC operational case definition to national vital statistics data.

    Science.gov (United States)

    Parks, Sharyn E; Kegler, Scott R; Annest, Joseph L; Mercy, James A

    2012-06-01

    In March of 2008, an expert panel was convened at the Centers for Disease Control and Prevention to develop code-based case definitions for abusive head trauma (AHT) in children under 5 years of age based on the International Classification of Diseases, 10th Revision (ICD-10) nature and cause of injury codes. This study presents the operational case definition and applies it to US death data. National Center for Health Statistics National Vital Statistics System data on multiple cause-of-death from 2003 to 2007 were examined. Inspection of records with at least one ICD-10 injury/disease code and at least one ICD-10 cause code from the AHT case definition resulted in the identification of 780 fatal AHT cases, with 699 classified as definite/presumptive AHT and 81 classified as probable AHT. The fatal AHT rate was highest among children age definition can help to identify population subgroups at higher risk for AHT defined by year and month of death, age, sex and race/ethnicity. This type of definition may be useful for various epidemiological applications including research and surveillance. These activities can in turn inform further development of prevention activities, including educating parents about the dangers of shaking and strategies for managing infant crying.

  4. Human exposure standards in the frequency range 1 Hz To 100 kHz: the case for adoption of the IEEE standard.

    Science.gov (United States)

    Patrick Reilly, J

    2014-10-01

    Differences between IEEE C95 Standards (C95.6-2002 and C95.1-2005) in the low-frequency (1 Hz-100 kHz) and the ICNIRP-2010 guidelines appear across the frequency spectrum. Factors accounting for lack of convergence include: differences between the IEEE standards and the ICNIRP guidelines with respect to biological induction models, stated objectives, data trail from experimentally derived thresholds through physical and biological principles, selection and justification of safety/reduction factors, use of probability models, compliance standards for the limbs as distinct from the whole body, defined population categories, strategies for central nervous system protection below 20 Hz, and correspondence of environmental electric field limits with contact currents. This paper discusses these factors and makes the case for adoption of the limits in the IEEE standards.

  5. Intelligence and Security Standards on Industrial Facilities Protection in Case of Terrorism and Military Attack

    International Nuclear Information System (INIS)

    Stipetic, D.

    2007-01-01

    Industrial facilities, which use toxic chemicals in their production processes, are tempting targets for military and terrorist strategists. They know that these facilities when attacked could produce effects not realizable with conventional weapons. The resulting legal, policy and political consequences would be minimal as compared to that of disseminating toxic chemicals or chemical agents as weapons on enemy territory. At this time there is no clear definition of the legality or illegality of these types of actions used against specific industrial targets for the purpose of mass destruction or disruption. Without clearly defined international regulations covering these actions, we must depend solely on national defense systems. Not only are these regulation not defined, there are no implementation tools, which would be available if the various treaties (CWC/BWC) etc., were able to incorporate needed legislative action. Consequently we must depend on and put into practice defense security standards for industrial facilities for protection against both possible terrorist and military attacks. Emergency responses to incidents involving violent criminals and terrorists are extremely dangerous. Incidents involving weapons of mass destruction, firearms, and hazardous materials have resulted in the injury and death of many firefighters, police officers and medical personnel. We wish to intend display place and role of intelligence and counter intelligence system to prevention potential target and military attack. Security needs to be incorporated into the public safety culture and it must become the routine for how we operate. The recognition and identification process is an important skill that needs continual refinement. The use of transportation or facility paperwork assists in recognizing what potential hazards. A key factor in the successful command and management of a hazmat incident or terrorism event is the ability of public safety agencies to function as a

  6. Applying the Emerging Provenance and Context Content Standard to Physical Objects in a Core Repository: A Use Case to Demonstrate Validity of Broader Community Adaptation

    Science.gov (United States)

    Hills, D. J.; Ramdeen, S.; Ramapriyan, H. K.

    2013-12-01

    The Data Stewardship Committee (DSC) within the Earth Science Information Partners' (ESIP) Federation helped in part to develop the emerging Provenance and Context Content Standard (PCCS). The focus of PCCS is on the 'what' that needs to be preserved, rather than the 'how.' The input to the development of the PCCS has been based on ESIP members' experience with NASA and NOAA missions. The intent has always been to identify a more comprehensive set of items to evolve a robust standard. PCCS development has primarily focused on satellite remote sensing data. However, the DSC recognizes the need to ensure coverage of other types of geoscience data to expand the applicability of PCCS throughout the geoscience data community. Here, we explore the viability of the current PCCS to application towards physical objects within a core repository. We apply the PCCS as a use case to a subset of the cores housed in the Geological Survey of Alabama's core collection. Although the term 'use case' may be used in different ways, here we are using the term to define an approach to develop the functional specifications of a system. The model or standard is carried through to design and implementation, and then applied to a particular situation to test the standard for applied use. The current PCCS has identified eight high-level categories, with several content items under each category being further defined. Information for these content items includes a definition and description, an indication of why the item needs to be preserved, quality criteria, and priority for preservation of the item. For the use case of applying PCCS to physical objects in a core repository, we examine the aspects of each item for relevance with respect to the collection. For example, under Category 1, Preflight/Pre-operations, currently identified content items include 'Instrument Description' and 'Preflight/pre-operational Calibration Data.' With respect to the GSA core repository, these might be mapped

  7. Regional income differences and the definition of income: the case of Malaysia.

    Science.gov (United States)

    Davanzo, J; Kusnic, M

    1984-09-01

    "Data from the Malaysian Family Life Survey are used to examine the sensitivity of urban/rural income differentials to the definition and measurement of income. Measured income differentials vary with the extent to which nonmarket activities are included in the scope of income, how the distribution of income is summarized, and whether one adjusts for differences in hours of work, household size and composition, ethnic composition, and other sociodemographic characteristics. For example, depending on the measure chosen, estimates of the amount by which urban income exceeds rural income in Malaysia range from 9 percent to 141 percent." excerpt

  8. Natural Hazard Problem and Solution Definition in the News Media: the Case of Tropical Storm Allison

    Science.gov (United States)

    Lindquist, Eric; Mosher-Howe, Katrina

    2010-05-01

    Focusing events such as natural or technological disasters can have significant impacts on public policy and planning in both the near and long term. These impacts can manifest at different temporal scales ranging from the period of immediate attention and disaster relief through the period of recovery and reconstruction and beyond. These impacts and associated decisions can be studied in retrospect and understood as not only short-term reactions, but as long-term components of subsequent natural hazard planning and public policy. By studying in detail how an event was defined, and the policy and planning alternatives that were raised or recommended in response to a disaster event, we can better understand the role that disaster-related focusing events play in the long-term evolution of a community's public policy, infrastructural planning efforts, and responses to natural disasters. This paper will use a focusing event framework to explore the local and regional policy impacts over time of a major urban flood in Houston, Texas, Tropical Storm Allison. Tropical Storm Allison (TSA), dropped 36 inches of rain on Houston over a period of four days in early June 2001, and was responsible for 22 deaths, 70,000 flood damaged homes, and 5 billion in damage to the region. The primary data source for this effort is a database of 500 articles from the major regional newspaper, the Houston Chronicle, over the period of 2001 through 2008. These articles were coded for multiple variables, including, cause, effect and impact (financial and social), blame, problem and solution definition and solution acceptance). This paper focuses primarily on the measures of problem definition (how was TSA, as an event, defined in the media, for example, as an act of God, or as a result of poor planning or decision making, etc), and on solution definition (what solutions were proposed to mitigate or adapt to future storms of this magnitude, how were they linked to the definition of the problem

  9. Merging fluxgate and induction coil data to produce low-noise geomagnetic observatory data meeting the INTERMAGNET definitive 1 s data standard

    Science.gov (United States)

    Brunke, Heinz-Peter; Widmer-Schnidrig, Rudolf; Korte, Monika

    2017-11-01

    For frequencies above 30 mHz the instrument intrinsic noise level of typical fluxgate magnetometers used at geomagnetic observatories usually masks ambient magnetic field variations on magnetically quiet days. This is especially true for stations located at middle and low latitudes, where variations are generally smaller than at high latitudes. INTERMAGNET has set a minimum quality standard for definitive 1 s data. Natural field variations referred to as pulsations (Pc-1, Pc-2, Pi-1) fall in this band. Usually their intensity is so small that they rarely surpass the instrumental noise of fluxgate magnetometers. Moreover, high-quality magnetic field observations in the band 30 mHz-0.5 Hz contain interesting information, e.g., for the study of ionospheric electron interactions with electromagnetic ion cyclotron plasma waves. We propose a method to improve 1 Hz observatory data by merging data from the proven and tested fluxgate magnetometers currently in use with induction coil magnetometers into a single data stream. We show how measurements of both instruments can be combined without information loss or phase distortion. The result is a time series of the magnetic field vector components, combining the benefits of both instruments: long-term stability (fluxgate) and low noise at high frequencies (induction coil). This new data stream fits perfectly into the data management procedures of INTERMAGNET and meets the requirements defined in the definitive 1 s data standard. We describe the applied algorithm and validate the result by comparing power spectra of the fluxgate magnetometer output with the merged signal. Daily spectrograms from the Niemegk observatory show that the resulting data series reveal information at frequencies above 30 mHz that cannot be seen in raw fluxgate data.

  10. Merging fluxgate and induction coil data to produce low-noise geomagnetic observatory data meeting the INTERMAGNET definitive 1 s data standard

    Directory of Open Access Journals (Sweden)

    H.-P. Brunke

    2017-11-01

    Full Text Available For frequencies above 30 mHz the instrument intrinsic noise level of typical fluxgate magnetometers used at geomagnetic observatories usually masks ambient magnetic field variations on magnetically quiet days. This is especially true for stations located at middle and low latitudes, where variations are generally smaller than at high latitudes. INTERMAGNET has set a minimum quality standard for definitive 1 s data. Natural field variations referred to as pulsations (Pc-1, Pc-2, Pi-1 fall in this band. Usually their intensity is so small that they rarely surpass the instrumental noise of fluxgate magnetometers. Moreover, high-quality magnetic field observations in the band 30 mHz–0.5 Hz contain interesting information, e.g., for the study of ionospheric electron interactions with electromagnetic ion cyclotron plasma waves. We propose a method to improve 1 Hz observatory data by merging data from the proven and tested fluxgate magnetometers currently in use with induction coil magnetometers into a single data stream. We show how measurements of both instruments can be combined without information loss or phase distortion. The result is a time series of the magnetic field vector components, combining the benefits of both instruments: long-term stability (fluxgate and low noise at high frequencies (induction coil. This new data stream fits perfectly into the data management procedures of INTERMAGNET and meets the requirements defined in the definitive 1 s data standard. We describe the applied algorithm and validate the result by comparing power spectra of the fluxgate magnetometer output with the merged signal. Daily spectrograms from the Niemegk observatory show that the resulting data series reveal information at frequencies above 30 mHz that cannot be seen in raw fluxgate data.

  11. Obsolete Laws: Economic and Moral Aspects, Case Study-Composting Standards.

    Science.gov (United States)

    Vochozka, Marek; Maroušková, Anna; Šuleř, Petr

    2017-12-01

    From the early days of philosophy, ethics and justice, there is wide consensus that the constancy of the laws establishes the legal system. On the other hand, the rate at which we accumulate knowledge is gaining speed like never before. Due to the recently increased attention of academics to climate change and other environmental issues, a lot of new knowledge has been obtained about carbon management, its role in nature and mechanisms regarding the formation and degradation of organic matter. A multidisciplinary techno-economic assessment of current composting standards and laws that took into account the current state of knowledge about carbon management was carried out as a case study. Economic and environmental damage caused by outdated laws was revealed. In addition, it was found that the introduction of the best composts into the market is permitted, causing additional negative environmental as well as economic impacts.

  12. New definition of complexity for self-gravitating fluid distributions: The spherically symmetric, static case

    Science.gov (United States)

    Herrera, L.

    2018-02-01

    We put forward a new definition of complexity, for static and spherically symmetric self-gravitating systems, based on a quantity, hereafter referred to as complexity factor, that appears in the orthogonal splitting of the Riemann tensor, in the context of general relativity. We start by assuming that the homogeneous (in the energy density) fluid, with isotropic pressure is endowed with minimal complexity. For this kind of fluid distribution, the value of complexity factor is zero. So, the rationale behind our proposal for the definition of complexity factor stems from the fact that it measures the departure, in the value of the active gravitational mass (Tolman mass), with respect to its value for a zero complexity system. Such departure is produced by a specific combination of energy density inhomogeneity and pressure anisotropy. Thus, zero complexity factor may also be found in self-gravitating systems with inhomogeneous energy density and anisotropic pressure, provided the effects of these two factors, on the complexity factor, cancel each other. Some exact interior solutions to the Einstein equations satisfying the zero complexity criterium are found, and prospective applications of this newly defined concept, to the study of the structure and evolution of compact objects, are discussed.

  13. Evaluation of the New World Health Organization Case Definition of Severe Acute Respiratory Infection for Influenza Surveillance During the Peak Weeks of Two Influenza Seasons in Quebec, Canada.

    Science.gov (United States)

    Amini, R; Gilca, R; Douville-Fradet, M; Boulianne, N; De Serres, G

    2017-09-01

    During the peak of the 2012-2013 and 2014-2015 influenza seasons in Quebec, Canada, the sensitivity of the new World Health Organization (WHO) case definition of severe acute respiratory infection (SARI) in definition for influenza surveillance in children should be interpreted with caution according to the specific surveillance goals. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    OpenAIRE

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric AF; Riley, Ian

    2008-01-01

    Abstract Background The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory da...

  15. Punica granatum L. Hydrogel for Wound Care Treatment: From Case Study to Phytomedicine Standardization

    Directory of Open Access Journals (Sweden)

    Aline Fleck

    2016-08-01

    Full Text Available The pharmacological activities of many Punica granatum L. components suggest a wide range of clinical applications for the prevention and treatment of diseases where chronic inflammation is believed to play an essential etiologic role. The current work reports a case study analyzing the effect produced by a magistral formulation of ethanolic extracts of Punica granatum peels on a non-healing chronic ulcer. The complete closure of the chronic ulcer that was initially not responsive to standard medical care was observed. A 2% (w/w P. granatum peels ethanolic extract hydrogel-based formulation (PGHF was standardized and subjected to physicochemical studies to establish the quality control parameters using, among others, assessment criteria such as optimum appearance, pH range, viscosity and hydrogel disintegration. The stability and quantitative chromatographic data was assessed in storage for six months under two temperature regimes. An efficient HPLC-DAD method was established distinguishing the biomarkers punicalin and punicalagin simultaneously in a single 8 min run. PGHF presented suitable sensorial and physicochemical performance, showing that punicalagin was not significantly affected by storage (p > 0.05. Formulations containing extracts with not less than 0.49% (w/w total punicalagin might find good use in wound healing therapy.

  16. Punica granatum L. Hydrogel for Wound Care Treatment: From Case Study to Phytomedicine Standardization.

    Science.gov (United States)

    Fleck, Aline; Cabral, Patrik F G; Vieira, Felipe F M; Pinheiro, Deo A; Pereira, Carlos R; Santos, Wilson C; Machado, Thelma B

    2016-08-22

    The pharmacological activities of many Punica granatum L. components suggest a wide range of clinical applications for the prevention and treatment of diseases where chronic inflammation is believed to play an essential etiologic role. The current work reports a case study analyzing the effect produced by a magistral formulation of ethanolic extracts of Punica granatum peels on a non-healing chronic ulcer. The complete closure of the chronic ulcer that was initially not responsive to standard medical care was observed. A 2% (w/w) P. granatum peels ethanolic extract hydrogel-based formulation (PGHF) was standardized and subjected to physicochemical studies to establish the quality control parameters using, among others, assessment criteria such as optimum appearance, pH range, viscosity and hydrogel disintegration. The stability and quantitative chromatographic data was assessed in storage for six months under two temperature regimes. An efficient HPLC-DAD method was established distinguishing the biomarkers punicalin and punicalagin simultaneously in a single 8 min run. PGHF presented suitable sensorial and physicochemical performance, showing that punicalagin was not significantly affected by storage (p > 0.05). Formulations containing extracts with not less than 0.49% (w/w) total punicalagin might find good use in wound healing therapy.

  17. Organizational Context Matters: A Research Toolkit for Conducting Standardized Case Studies of Integrated Care Initiatives

    Directory of Open Access Journals (Sweden)

    Jenna M. Evans

    2017-06-01

    Full Text Available Introduction: The variable success of integrated care initiatives has led experts to recommend tailoring design and implementation to the organizational context. Yet, organizational contexts are rarely described, understood, or measured with sufficient depth and breadth in empirical studies or in practice. We thus lack knowledge of when and specifically how organizational contexts matter. To facilitate the accumulation of evidence, we developed a research toolkit for conducting case studies using standardized measures of the (inter-organizational context for integrating care.  Theory and Methods: We used a multi-method approach to develop the research toolkit: (1 development and validation of the Context and Capabilities for Integrating Care (CCIC Framework, (2 identification, assessment, and selection of survey instruments, (3 development of document review methods, (4 development of interview guide resources, and (5 pilot testing of the document review guidelines, consolidated survey, and interview guide.  Results: The toolkit provides a framework and measurement tools that examine 18 organizational and inter-organizational factors that affect the implementation and success of integrated care initiatives.  Discussion and Conclusion: The toolkit can be used to characterize and compare organizational contexts across cases and enable comparison of results across studies. This information can enhance our understanding of the influence of organizational contexts, support the transfer of best practices, and help explain why some integrated care initiatives succeed and some fail.

  18. Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

    Science.gov (United States)

    Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

    2017-06-01

    To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. IAEA CRP on HTGR Uncertainty Analysis: Benchmark Definition and Test Cases

    Energy Technology Data Exchange (ETDEWEB)

    Gerhard Strydom; Frederik Reitsma; Hans Gougar; Bismark Tyobeka; Kostadin Ivanov

    2012-11-01

    Uncertainty and sensitivity studies are essential elements of the reactor simulation code verification and validation process. Although several international uncertainty quantification activities have been launched in recent years in the LWR, BWR and VVER domains (e.g. the OECD/NEA BEMUSE program [1], from which the current OECD/NEA LWR Uncertainty Analysis in Modelling (UAM) benchmark [2] effort was derived), the systematic propagation of uncertainties in cross-section, manufacturing and model parameters for High Temperature Reactor (HTGR) designs has not been attempted yet. This paper summarises the scope, objectives and exercise definitions of the IAEA Coordinated Research Project (CRP) on HTGR UAM [3]. Note that no results will be included here, as the HTGR UAM benchmark was only launched formally in April 2012, and the specification is currently still under development.

  20. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities

    Directory of Open Access Journals (Sweden)

    Martin A. Mörsdorf

    2015-03-01

    Full Text Available In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in

  1. Global case studies of soft-sediment deformation structures (SSDS: Definitions, classifications, advances, origins, and problems

    Directory of Open Access Journals (Sweden)

    G. Shanmugam

    2017-10-01

    Problems that hinder our understanding of SSDS still remain. They are: (1 vague definitions of the phrase “soft-sediment deformation”; (2 complex factors that govern the origin of SSDS; (3 omission of vital empirical data in documenting vertical changes in facies using measured sedimentological logs; (4 difficulties in distinguishing depositional processes from tectonic events; (5 a model-driven interpretation of SSDS (i.e., earthquake being the singular cause; (6 routine application of the genetic term “seismites” to the “SSDS”, thus undermining the basic tenet of process sedimentology (i.e., separation of interpretation from observation; (7 the absence of objective criteria to differentiate 21 triggering mechanisms of liquefaction and related SSDS; (8 application of the process concept “high-density turbidity currents”, a process that has never been documented in modern oceans; (9 application of the process concept “sediment creep” with a velocity connotation that cannot be inferred from the ancient record; (10 classification of pockmarks, which are hollow spaces (i.e., without sediments as SSDS, with their problematic origins by fluid expulsion, sediment degassing, fish activity, etc.; (11 application of the Earth's climate-change model; and most importantly, (12 an arbitrary distinction between depositional process and sediment deformation. Despite a profusion of literature on SSDS, our understanding of their origin remains muddled. A solution to the chronic SSDS problem is to utilize the robust core dataset from scientific drilling at sea (DSDP/ODP/IODP with a constrained definition of SSDS.

  2. Comparing the predictive abilities of different metabolic syndrome definitions for acute coronary syndrome: a case-control study in Chinese adults.

    Science.gov (United States)

    Wang, Qun; Chair, Sek Ying; Wong, Eliza Mi Ling; Li, Xiaomei; Liu, Meili; Zhang, Yulian

    2014-09-01

    Different institutions have proposed various definitions for metabolic syndrome, which is a combination of risk factors for cardiovascular diseases (CVD). This study aimed to compare the feasibilities and abilities of different metabolic syndrome definitions in predicting acute coronary syndrome (ACS) in Chinese adults. A case-control study was designed. This study recruited 162 newly diagnosed ACS patients (the case group) and 162 non-ACS patients (the control group) according to the study criteria. Metabolic syndrome definitions proposed by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), Chinese Diabetes Society (CDS), and Joint Committee for Developing Chinese Guidelines on Dyslipidemia in Adults (JCDCG) were studied. After collecting demographic and clinical data, sensitivity, specificity, positive and negative predictive values (PPV, NPV), the likelihood ratio of a positive test and a negative test (LR+, LR-), odds ratios (OR), diagnostic accuracy, and the Youden index (YI) were compared. Of the 324 participants, the mean age was 59.1 ± 10.5 years, and 56.8% were males. The AHA/NHLBI and IDF definitions had better sensitivity (53.09%, 48.77%). The CDS definition was more specific (76.54%), but less sensitive (25.93%). The IDF definition performed better in PPV (53.74%), NPV (53.11%), LR+ (1.15) and LR- (0.89), OR (1.32), and diagnostic accuracy (53.4%). The IDF definition also provided optimal cutoff points with the biggest YI. The IDF definition performed better in detecting the onsets of nonfatal ACS in the northwestern Chinese population. All studied definitions were feasible in Chinese clinical settings.

  3. Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system

    Directory of Open Access Journals (Sweden)

    Juliana P. Santos

    2015-12-01

    Full Text Available In Latin American, there is currently a regional action with the main purposes of putting the concept of severe neonatal morbidity in practice and formulating proposals for interventions. A general overview of neonatal health conditions, including morbidity and mortality, is provided to update regional knowledge on the topic. An example of the development and implementation of the concept of maternal near miss is also provided, followed by results from a systematic review covering all previously published studies on Neonatal Near Miss. Finally, some proposals for building a common concept on the topic and for launching a prospective surveillance study are presented. A Neonatal Near Miss is a neonate who had a severe morbidity (organ dysfunction or failure but who survived this condition within the first 27 days of life. The pragmatic criteria recommended to be used are as follows: birth weight below 1700 g, Apgar score below 7 at 5 minutes of life and gestational age below 33 weeks. As a proxy for organ dysfunction, the following management criteria are also confirmed: parenteral therapeutic antibiotics; nasal continuous positive airway pressure; any intubation during the first 27 days of life; phototherapy within the first 24 h of life; cardiopulmonary resuscitation; the use of vasoactive drugs, anticonvulsants, surfactants, blood products and steroids for refractory hypoglycemia and any surgical procedure. Although this study starts from a regional perspective, this topic is clearly globally relevant. All nations, especially low and middle-income countries, could benefit from the proposed standardization.

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

    Science.gov (United States)

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

    2016-04-01

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

  5. Standardizing data exchange for clinical research protocols and case report forms: An assessment of the suitability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM)

    Science.gov (United States)

    Huser, Vojtech; Sastry, Chandan; Breymaier, Matthew; Idriss, Asma; Cimino, James J.

    2015-01-01

    Efficient communication of a clinical study protocol and case report forms during all stages of a human clinical study is important for many stakeholders. An electronic and structured study representation format that can be used throughout the whole study life-span can improve such communication and potentially lower total study costs. The most relevant standard for representing clinical study data, applicable to unregulated as well as regulated studies, is the Operational Data Model (ODM) in development since 1999 by the Clinical Data Interchange Standards Consortium (CDISC). ODM's initial objective was exchange of case report forms data but it is increasingly utilized in other contexts. An ODM extension called Study Design Model, introduced in 2011, provides additional protocol representation elements. Using a case study approach, we evaluated ODM's ability to capture all necessary protocol elements during a complete clinical study lifecycle in the Intramural Research Program of the National Institutes of Health. ODM offers the advantage of a single format for institutions that deal with hundreds or thousands of concurrent clinical studies and maintain a data warehouse for these studies. For each study stage, we present a list of gaps in the ODM standard and identify necessary vendor or institutional extensions that can compensate for such gaps. The current version of ODM (1.3.2) has only partial support for study protocol and study registration data mainly because it is outside the original development goal. ODM provides comprehensive support for representation of case report forms (in both the design stage and with patient level data). Inclusion of requirements of observational, non-regulated or investigator-initiated studies (outside Food and Drug Administration (FDA) regulation) can further improve future revisions of the standard. PMID:26188274

  6. Standardizing data exchange for clinical research protocols and case report forms: An assessment of the suitability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM).

    Science.gov (United States)

    Huser, Vojtech; Sastry, Chandan; Breymaier, Matthew; Idriss, Asma; Cimino, James J

    2015-10-01

    Efficient communication of a clinical study protocol and case report forms during all stages of a human clinical study is important for many stakeholders. An electronic and structured study representation format that can be used throughout the whole study life-span can improve such communication and potentially lower total study costs. The most relevant standard for representing clinical study data, applicable to unregulated as well as regulated studies, is the Operational Data Model (ODM) in development since 1999 by the Clinical Data Interchange Standards Consortium (CDISC). ODM's initial objective was exchange of case report forms data but it is increasingly utilized in other contexts. An ODM extension called Study Design Model, introduced in 2011, provides additional protocol representation elements. Using a case study approach, we evaluated ODM's ability to capture all necessary protocol elements during a complete clinical study lifecycle in the Intramural Research Program of the National Institutes of Health. ODM offers the advantage of a single format for institutions that deal with hundreds or thousands of concurrent clinical studies and maintain a data warehouse for these studies. For each study stage, we present a list of gaps in the ODM standard and identify necessary vendor or institutional extensions that can compensate for such gaps. The current version of ODM (1.3.2) has only partial support for study protocol and study registration data mainly because it is outside the original development goal. ODM provides comprehensive support for representation of case report forms (in both the design stage and with patient level data). Inclusion of requirements of observational, non-regulated or investigator-initiated studies (outside Food and Drug Administration (FDA) regulation) can further improve future revisions of the standard. Published by Elsevier Inc.

  7. Osteonecrosis of the Jaw (ONJ in Osteoporosis Patients: Report of Delayed Diagnosis of a Multisite Case and Commentary about Risks Coming from a Restricted ONJ Definition

    Directory of Open Access Journals (Sweden)

    Mario Migliario

    2017-03-01

    Full Text Available Osteonecrosis of the jaws (ONJ in osteoporosis patients has been defined as rare, but the number of reported cases is increasing. We report a case of delayed ONJ diagnosis in a patient, who was being treated with alendronate, developing bone alterations both in maxilla and in mandible. Underestimation of ONJ incidence and missed or delayed ONJ diagnosis in osteoporosis patients might derive from lack of awareness of health providers as well as from an ONJ definition that is too restricted. The more recent definition of medication-related osteonecrosis of the jaws (MRONJ released in 2014 by the American Association of Oral Maxillofacial Surgeons (AAOMS accept fistula, besides bone exposure, as a major sign of disease, but it seems to be insufficient since it excludes all cases of ONJ disease without bone exposure. A new MRONJ definition is needed to avoid missing or delayed diagnosis.

  8. Managing Effectively National and Regional projects-A Case of Kenya Bureau of Standards

    International Nuclear Information System (INIS)

    Kioko, J

    2009-01-01

    Discusses the functions of Kenya Bureau of Standards as standards development, testing,metrology,implementation of standards in commerce and industry, accredit ion,certification,inspection of imports and exports,training and education in Metrology,standards,testing and quality assurance

  9. [Orthotopic cardiac transplantation with caval anastomosis: a comparative randomized study with standard procedure in 81 cases].

    Science.gov (United States)

    Deleuze, P; Benvenuti, C; Mazzucotelli, J P; Perdrix, C; Le Besnerais, P; Mourtada, A; Hillion, M L; Patrat, J F; Loisance, D Y

    1996-01-01

    Complete resection of the right atrium with conservation of a strip of left atrium around the 4 pulmonary veins followed by direct anastomosis on the vena cava has recently been proposed as an alternative to the standard orthotopic cardiac transplantation described by Shumway and Lower. In order to determine whether this "anatomical" transplantation should now be considered to be the procedure of choice, a prospective randomised study was undertaken in 1991 including 78 patients undergoing 81 cardiac transplantations by one of the two techniques: gr. I: classical transplantation (n = 40), gr. II: "anatomical" transplantation (n = 41). The groups were comparable in age, sex, weight, nature of the underlying cardiac disease and clinical status at the time of transplantation. Similarly, the parameters of the donors were comparable with respect to age, sex, weight and dosage of inotropic drugs at the time of explantation. All patients came of cardiopulmonary bypass with comparable ischaemia time of the graft (gr. I: 136 +/- 46 min; gr. II: 138 +/- 51 min). Immediate return to sinus rhythm occurred in 20 cases in gr. I and 36 cases in gr. II. Atrial arrhythmia persisted in 5 cases in gr. I but in no cases of gr. II. These differences were very significant (p < 0.001). There were 13 early deaths in gr. I and 8 in gr. II. Doppler echocardiography was performed two to three months after transplantation. The right atrial surface was significantly decreased in gr. II (18 +/- 4.7 cm2) compared with gr. I (24 +/- 7 cm2): the same difference was observed for the left atrium (gr. I: 24 +/- 4.5 cm2; gr. II: 20 +/- 5 cm2), p = 0.001. Tricuspid regurgitation was observed in 82% of patients in gr. I compared with 57% in gr. II (p < 0.005). Exercise stress tests during the same period showed no difference in peak oxygen consumption between the groups. Holter ECG monitoring led to permanent pacing in 2 patients of gr. I (5%). The technical simplicity and reduction of postoperative

  10. Standardized Interpretation of Chest Radiographs in Cases of Pediatric Pneumonia From the PERCH Study.

    Science.gov (United States)

    Fancourt, Nicholas; Deloria Knoll, Maria; Barger-Kamate, Breanna; de Campo, John; de Campo, Margaret; Diallo, Mahamadou; Ebruke, Bernard E; Feikin, Daniel R; Gleeson, Fergus; Gong, Wenfeng; Hammitt, Laura L; Izadnegahdar, Rasa; Kruatrachue, Anchalee; Madhi, Shabir A; Manduku, Veronica; Matin, Fariha Bushra; Mahomed, Nasreen; Moore, David P; Mwenechanya, Musaku; Nahar, Kamrun; Oluwalana, Claire; Ominde, Micah Silaba; Prosperi, Christine; Sande, Joyce; Suntarattiwong, Piyarat; O'Brien, Katherine L

    2017-06-15

    Chest radiographs (CXRs) are a valuable diagnostic tool in epidemiologic studies of pneumonia. The World Health Organization (WHO) methodology for the interpretation of pediatric CXRs has not been evaluated beyond its intended application as an endpoint measure for bacterial vaccine trials. The Pneumonia Etiology Research for Child Health (PERCH) study enrolled children aged 1-59 months hospitalized with WHO-defined severe and very severe pneumonia from 7 low- and middle-income countries. An interpretation process categorized each CXR into 1 of 5 conclusions: consolidation, other infiltrate, both consolidation and other infiltrate, normal, or uninterpretable. Two members of a 14-person reading panel, who had undertaken training and standardization in CXR interpretation, interpreted each CXR. Two members of an arbitration panel provided additional independent reviews of CXRs with discordant interpretations at the primary reading, blinded to previous reports. Further discordance was resolved with consensus discussion. A total of 4172 CXRs were obtained from 4232 cases. Observed agreement for detecting consolidation (with or without other infiltrate) between primary readers was 78% (κ = 0.50) and between arbitrators was 84% (κ = 0.61); agreement for primary readers and arbitrators across 5 conclusion categories was 43.5% (κ = 0.25) and 48.5% (κ = 0.32), respectively. Disagreement was most frequent between conclusions of other infiltrate and normal for both the reading panel and the arbitration panel (32% and 30% of discordant CXRs, respectively). Agreement was similar to that of previous evaluations using the WHO methodology for detecting consolidation, but poor for other infiltrates despite attempts at a rigorous standardization process. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  11. Temporising external fixation of calcaneus fractures prior to definitive plate fixation: a case series.

    Science.gov (United States)

    Farrell, Brian M; Lin, Carol A; Moon, Charles N

    2015-09-01

    Surgical management of calcaneus fractures is technically demanding and has a high risk of wound complications. These fractures are traditionally managed with splinting until swelling has subsided, which can take weeks and leaves the fracture fragments displaced. We describe a novel protocol for the management of displaced intraarticular calcaneus fractures that utilises a temporising external fixator and staged conversion to plate fixation through a sinus tarsi approach. The goal of this technique was to enable earlier treatment with open reduction and internal fixation, minimise the amount of manipulation required at the time of definitive fixation and reduce the wound complication rate seen with the traditional extensile approach. The records of patients with displaced calcaneus fractures from 2010-2014 were reviewed retrospectively. A total of nine patients with 10 calcaneus fractures were treated using this protocol. All patients underwent ankle-spanning medial external fixation within 48 hours after injury. Patients underwent conversion to open plate fixation through a sinus tarsi approach when skin turgor had returned to normal. Time to surgery, infection rate, wound complications, radiographic alignment, and time to radiographic union were recorded. The average Bohler's angle improved from 13.2 (range -2 to 34) degrees preoperatively to 34.3 (range 26 to 42) degrees postoperatively. The average time from external fixation to conversion to internal fixation was 4.8 (range 3 to 7) days. There were no immediate post-surgical complications. The average time to weight-bearing was 8.5 weeks. The average time to radiographic union was 9.5 (range 8 to 12) weeks. There were no infections or wound complications at the time of last follow-up. Early temporising external fixation for the acute management of displaced calcaneus fractures is a safe and effective method to reduce and stabilise the foot and may decrease the time to definitive fixation. There were no

  12. Definition of the OPERA safety case for radioactive waste disposal in the Netherlands

    International Nuclear Information System (INIS)

    Hart, Jaap; Wildenborg, Ton; Davis, Paul; Becker, Dirk-Alexander; Verhoef, Ewoud

    2014-01-01

    This paper first gives a short introduction on OPERA, the current Dutch five-year research programme on disposal of radioactive waste. It then zooms in on OPERA WP (Work Package) 2 Safety Case - the OSCAR project, and presents (preliminary) results on the structure of the OPERA safety case, the subject of safety statements, and the OPERA safety assessment methodology. The structure of the initial long-term, post-closure safety case for a disposal facility for radioactive waste in Boom Clay in the Netherlands is being developed in the OSCAR project. Hereto a selection of relevant national and international efforts concerning the set-up of a safety case for geological disposal of radioactive waste (safety case structure, safety assessment methodology, FEP database) has been reviewed considering the objectives and outlines of the OPERA programme described in the OPERA research plan. Not surprisingly, it turned out that the guidelines and databases of the IAEA and NEA developed by the international community pretty well covered all aspects of nationally developed safety cases. Although in OPERA only 'initial and conditional' safety cases (for disposal in low permeable clay and rock salt) will be developed, the programme objective is detailing a first road-map for the long-term research on geological disposal of radioactive waste in the Netherlands. The safety case being developed will serve as a basis for the further development of the subsequent stages of the Dutch radioactive waste disposal programme. The focus of OSCAR is, therefore, to develop and propose a 'future proof' structure for the safety case, drawing on the NEA and IAEA/PRISM methodologies. The OPERA safety case structure being developed will encompass all relevant aspects, or components, of a modern safety case and will link the different components in a practical and transparent way. It will assist in steering the flow of information generated within the different OPERA and as such provide a structured

  13. Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding.

    Science.gov (United States)

    Ashktorab, Hassan; Etaati, Firoozeh; Rezaeean, Farahnaz; Nouraie, Mehdi; Paydar, Mansour; Namin, Hassan Hassanzadeh; Sanderson, Andrew; Begum, Rehana; Alkhalloufi, Kawtar; Brim, Hassan; Laiyemo, Adeyinka O

    2016-07-28

    To study the accuracy of using high definition (HD) scope with narrow band imaging (NBI) vs standard white light colonoscope without NBI (ST), to predict the histology of the colon polyps, particularly those high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. Of participants in the study, 55 (37%) were male and median (interquartile range) of age was 56 (19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were scope (P = 0.7). The ST scope had a positive predictive value (PPV) and positive likelihood ratio (PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope (68%) compare to ST scope (53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp (HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were similar. Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training, it may be possible to increase the sensitivity and specificity of the scopes and hence save money for eliminating time and the cost of Immunohistochemistry/pathology.

  14. A functional interaction approach to the definition of meso regions: The case of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Erlebach Martin

    2016-06-01

    Full Text Available The definition of functional meso regions for the territory of the Czech Republic is articulated in this article. Functional regions reflect horizontal interactions in space and are presented as a useful tool for various types of geographical analyses, and also for spatial planning, economic policy designs, etc. This paper attempts to add to the discussion on the need to delineate areal units at different hierarchical levels, and to understand the functional flows and spatial behaviours of the population in a given space. Three agglomerative methods are applied in the paper (the CURDS regionalisation algorithm, Intramax, and cluster analysis, and they have not been used previously in Czech geography for the delineation of functional meso regions. Existing functional regions at the micro-level, based on daily travel-to-work flows from the 2001 census, have served as the building blocks. The analyses have produced five regional systems at the meso level, based on daily labour commuting movements of the population. Basic statistics and a characterisation of these systems are provided in this paper.

  15. Biopharming, bananas and bureaucracy: the banana vaccine as a case study for products that straddle the definitional food/drug divide.

    Science.gov (United States)

    Birdsall, Margaux

    2011-01-01

    This paper examines the definition of the terms "food" and "drug" as used in the Food, Drug and Cosmetic Act through the lens of biopharmed products. The paper uses the so-called "banana vaccine" as a case study to highlight the problems that occur when attempting to regulate a product that could be safely used as a food or as a drug. Specifically, the examination of this model illustrates the problems in the current definitional scheme. The paper considers how a product that straddles the definitional line between food and drug could be regulated and proposes a reformation to how the definitions are applied to products to better suit new technology in food and drugs.

  16. Note on Definition of Reactivity, and Related Concepts

    International Nuclear Information System (INIS)

    Spinrad, B.I.

    1969-01-01

    Sometimes, it appears that problems involved in the interpretation of reactivity experiments are partially caused by varying definitions of reactivity. The standard literature often does not give a definition of reactivity which is model-independent? and some cases where the definition is, in fact, general do not seem to be so. Moreover, conflicting concepts (flux and importance definitions of lifetime, for example) are found in the sources. This note has been written in the hope of providing a frame of reference for the discussions of this Panel. It is, deliberately, not detailed. I have tried to achieve correctness without overlaying the physical problems with excessive mathematics

  17. Medical acupuncture enhances standard wilderness medical care: a case study from the Inca Trail, Machu Picchu, Peru, April 2, 1997.

    Science.gov (United States)

    Frank, B L

    1997-08-01

    This case report shows the integration of medical acupuncture into the standard medical care of a wilderness emergency situation. Despite conventional medical attention, a trekker suffering from an extremely painful conjunctivitis continued to suffer severe eye pain. The addition of medical acupuncture to his care resolved his eye pain promptly, enabling him to continue his trekking activities without further distress. Acupuncture has many potential applications to enhance the effects of standard medical care in wilderness and third world travel settings.

  18. JPL Thermal Design Modeling Philosophy and NASA-STD-7009 Standard for Models and Simulations - A Case Study

    Science.gov (United States)

    Avila, Arturo

    2011-01-01

    The Standard JPL thermal engineering practice prescribes worst-case methodologies for design. In this process, environmental and key uncertain thermal parameters (e.g., thermal blanket performance, interface conductance, optical properties) are stacked in a worst case fashion to yield the most hot- or cold-biased temperature. Thus, these simulations would represent the upper and lower bounds. This, effectively, represents JPL thermal design margin philosophy. Uncertainty in the margins and the absolute temperatures is usually estimated by sensitivity analyses and/or by comparing the worst-case results with "expected" results. Applicability of the analytical model for specific design purposes along with any temperature requirement violations are documented in peer and project design review material. In 2008, NASA released NASA-STD-7009, Standard for Models and Simulations. The scope of this standard covers the development and maintenance of models, the operation of simulations, the analysis of the results, training, recommended practices, the assessment of the Modeling and Simulation (M&S) credibility, and the reporting of the M&S results. The Mars Exploration Rover (MER) project thermal control system M&S activity was chosen as a case study determining whether JPL practice is in line with the standard and to identify areas of non-compliance. This paper summarizes the results and makes recommendations regarding the application of this standard to JPL thermal M&S practices.

  19. Making the Case for a Model-Based Definition of Engineering Materials (Postprint)

    Science.gov (United States)

    2017-09-12

    explored. These efforts are driven exten- sively by Edisonian trial-and-error approaches that are time consuming and costly. It is common to use...be issued from that information, either publicly as in the case of Aerospace Materials Specifica- tions (AMS) published by the Society of Automotive ...location is shown below the forging shape, with each narrow distribu- tion profile representing the behavior of a specific region. Note that there is

  20. A Case of Definitive Therapy for Localised Prostate Cancer: Report of a Urological Nightmare

    Directory of Open Access Journals (Sweden)

    Andreas Sommerhuber

    2012-01-01

    Full Text Available Radical prostatectomy, external beam radiotherapy and permanent brachytherapy are the most common treatment options for nonmetastatic localised adenocarcinoma of the prostate (PCa. Accurate pretherapeutic clinical staging is difficult, the number of positive cores after biopsy does not imperatively represent the extension of the cancer. Furthermore postoperative upgrading in Gleason score is frequently observed. Even in a localised setting a certain amount of patients with organ-confined PCa will develop biochemical progression. In case of a rise in PSA level after radiation the majority of patients will receive androgen deprivation therapy what must be considered as palliative. If local or systemic progressive disease is associated with evolving neuroendocrine differentiation hormonal manipulation is increasingly ineffective; radiotherapy and systemic chemotherapy with a platinum agent and etoposide are recommended. In case of local progression complications such as pelvic pain, gross haematuria, infravesical obstruction and rectal invasion with obstruction and consecutive ileus can possibly occur. In this situation palliative radical surgery is a therapy option especially in the absence of distant metastases. A case with local and later systemic progression after permanent brachytherapy is presented here.

  1. Parkinson's disease-related fatigue: A case definition and recommendations for clinical research.

    Science.gov (United States)

    Kluger, Benzi M; Herlofson, Karen; Chou, Kelvin L; Lou, Jau-Shin; Goetz, Christopher G; Lang, Anthony E; Weintraub, Daniel; Friedman, Joseph

    2016-05-01

    Fatigue is one of the most common and disabling symptoms in Parkinson's disease (PD). Since fatigue was first described as a common feature of PD 20 years ago, little progress has been made in understanding its causes or treatment. Importantly, PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. In response, the Parkinson Disease Foundation and ProjectSpark assembled an international team of experts to create recommendations for clinical research to advance this field. The working group identified several areas in which shared standards would improve research quality and foster progress including terminology, diagnostic criteria, and measurement. Terminology needs to (1) clearly distinguish fatigue from related phenomena (eg, sleepiness, apathy, depression); (2) differentiate subjective fatigue complaints from objective performance fatigability; and (3) specify domains affected by fatigue and causal factors. We propose diagnostic criteria for PD-related fatigue to guide participant selection for clinical trials and add rigor to mechanistic studies. Recommendations are made for measurement of subjective fatigue complaints, performance fatigability, and neurophysiologic changes. We also suggest areas in which future research is needed to address methodological issues and validate or optimize current practices. Many limitations in current PD-related fatigue research may be addressed by improving methodological standards, many of which are already being successfully applied in clinical fatigue research in other medical conditions (eg, cancer, multiple sclerosis). © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  2. Antipoaching standards in onshore hydrocarbon concessions drawn from a Central African case study.

    Science.gov (United States)

    Vanthomme, Hadrien P A; Tobi, Elie; Todd, Angelique F; Korte, Lisa; Alonso, Alfonso

    2017-06-01

    Unsustainable hunting outside protected areas is threatening tropical biodiversity worldwide and requires conservationists to engage increasingly in antipoaching activities. Following the example of ecocertified logging companies, we argue that other extractive industries managing large concessions should engage in antipoaching activities as part of their environmental management plans. Onshore hydrocarbon concessions should also adopt antipoaching protocols as a standard because they represent a biodiversity threat comparable to logging. We examined the spatiotemporal patterns of small- and large-mammal poaching in an onshore oil concession in Gabon, Central Africa, with a Bayesian occupancy model based on signs of poaching collected from 2010 to 2015 on antipoaching patrols. Patrol locations were initially determined based on local intelligence and past patrol successes (adaptive management) and subsequently with a systematic sampling of the concession. We generated maps of poaching probability in the concession and determined the temporal trends of this threat over 5 years. The spatiotemporal patterns of large- and small-mammal poaching differed throughout the concession, and likely these groups will need different management strategies. By elucidating the relationship between site-specific sampling effort and detection probability, the Bayesian method allowed us to set goals for future antipoaching patrols. Our results indicate that a combination of systematic sampling and adaptive management data is necessary to infer spatiotemporal patterns with the statistical method we used. On the basis of our case study, we recommend hydrocarbon companies interested in implementing efficient antipoaching activities in their onshore concessions to lay the foundation of long-needed industry standards by: adequately measuring antipoaching effort; mixing adaptive management and balanced sampling; setting goals for antipoaching effort; pairing patrols with large

  3. Removal of foot-and-mouth disease virus infectivity in salted natural casings by minor adaptation of standardized industrial procedures.

    Science.gov (United States)

    Wijnker, J J; Haas, B; Berends, B R

    2007-04-10

    Intestines are used for the production of natural casings as edible sausage containers. Derived from animals (pigs and sheep) experimentally infected with FMDV (initial dosage 10(7.3) PFU/ml, strain O(1Kaufbeuren)), these natural casings were treated with sodium chloride or a phosphate salts/sodium chloride mixture and the residual FMDV titres measured. After storage at about 20 degrees C, no remaining infectivity was found after either treatment, whereas casings stored at 4 degrees C still contained infectivity. Storage of salted casings at about 20 degrees C for 30 days is already part of the Standard Operating Procedures (included in HACCP) of the international casing industry and can therefore be considered as a protective measure for the international trade in natural casings.

  4. Incidence and risk factors of AIDS-defining cancers in a cohort of HIV-positive adults: Importance of the definition of incident cases.

    Science.gov (United States)

    Suárez-García, Inés; Jarrín, Inmaculada; Iribarren, José Antonio; López-Cortés, Luis Fernando; Lacruz-Rodrigo, José; Masiá, Mar; Gómez-Sirvent, Juan Luis; Hernández-Quero, José; Vidal, Francesc; Alejos-Ferreras, Belén; Moreno, Santiago; Del Amo, Julia

    2013-05-01

    The aim of this study was to investigate the incidence and risk factors for the development of AIDS-defining cancers (ADCs); and to investigate the effect of making different assumptions on the definition of incident cases. A multicentre cohort study was designed. Poisson regression was used to assess incidence and risk factors. To account for misclassification, incident cases were defined using lag-times of 0, 14 and 30 days after enrolment. A total of 6393 HIV-positive subjects were included in the study. The incidences of ADCs changed as the lag periods were varied from 0 to 30 days. Different risk factors emerged as the definition of incident cases was changed. For a lag time of 0, the risk of Kaposi sarcoma [KS] and non-Hodgkin lymphoma [NHL] increased at CD4 counts sex with men had a higher risk of KS. KS and NHL were not associated with viral load, gender, or hepatitis B or C. The results were similar for a lag-time of 14 and 30 days; however, hepatitis C was significantly associated with NHL. This analysis shows the importance of the definition of incident cases in cohort studies. Alternative definitions gave different incidence estimates, and may have implications for the analysis of risk factors. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  5. Radiographic case definitions and prevalence of osteoarthrosis of the hip: a survey of 4 151 subjects in the Osteoarthritis Substudy of the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, Kjeld

    2004-01-01

    BACKGROUND: The diagnosis of osteoarthrosis (OA) is founded on radiographic evidence of joint degeneration and characteristic subjective symptoms. Due to the lack of consensus radiographic case definitions, the prevalence and incidence of OA reported in the literature varies. The aims of the curr...

  6. Surgical standardization to prevent gastric stenosis after laparoscopic sleeve gastrectomy: a case series.

    Science.gov (United States)

    Chang, Po-Chih; Tai, Chi-Ming; Hsin, Ming-Che; Hung, Chao-Ming; Huang, Ivy Ya-Wei; Huang, Chih-Kun

    2017-03-01

    Laparoscopic sleeve gastrectomy (LSG) is accepted as a stand-alone bariatric procedure. A specific and potentially severe complication of LSG is gastric stenosis (GS). Reviewing the treatment and prevention of GS after LSG. University hospital, Taiwan. A retrospective analysis was conducted involving all of the LSG cases (n = 927) at our institution between February 2007 and December 2015. Eight patients (0.8%) with GS were identified in our unit and 1 patient was transferred from another institution with symptomatic GS. The median intervals from initial LSG to the presence of symptoms, endoscopic dilation, and surgical revision were 14±30 days (range, 7-103 days), 21±35.6 days (range, 9-110 days), and 36±473.9 days (range, 11-1185 days), respectively. The majority of stenoses were located at the incisura angularis (8/9 [88.9%]). Among the 9 patients, only 1 responded satisfactorily to repetitive endoscopic dilation and the remaining 8 patients required revisional laparoscopic surgery, including conversion to Roux-en-Y gastric bypass (n = 6), stricturoplasty (n = 1), and Roux-en-Y gastric bypass after failed seromyotomy (n = 1). No patients experienced recurrent symptoms of GS after revisional surgery. In September 2013, we modified our surgical techniques for the subsequent 489 patients and GS did not occur after the change in surgical procedures. A combined treatment modality, endoscopic intervention with and without surgical revision is essential for managing GSs. Based on our own experience, we emphasize the clinical significance of surgical standardization to prevent the occurrence of GS. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. Validating the 8 CPCSSN case definitions for chronic disease surveillance in a primary care database of electronic health records.

    Science.gov (United States)

    Williamson, Tyler; Green, Michael E; Birtwhistle, Richard; Khan, Shahriar; Garies, Stephanie; Wong, Sabrina T; Natarajan, Nandini; Manca, Donna; Drummond, Neil

    2014-07-01

    The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is Canada's first national chronic disease surveillance system based on electronic health record (EHR) data. The purpose of this study was to develop and validate case definitions and case-finding algorithms used to identify 8 common chronic conditions in primary care: chronic obstructive pulmonary disease (COPD), dementia, depression, diabetes, hypertension, osteoarthritis, parkinsonism, and epilepsy. Using a cross-sectional data validation study design, regional and local CPCSSN networks from British Columbia, Alberta (2), Ontario, Nova Scotia, and Newfoundland participated in validating EHR case-finding algorithms. A random sample of EHR charts were reviewed, oversampling for patients older than 60 years and for those with epilepsy or parkinsonism. Charts were reviewed by trained research assistants and residents who were blinded to the algorithmic diagnosis. Sensitivity, specificity, and positive and negative predictive values (PPVs, NPVs) were calculated. We obtained data from 1,920 charts from 4 different EHR systems (Wolf, Med Access, Nightingale, and PS Suite). For the total sample, sensitivity ranged from 78% (osteoarthritis) to more than 95% (diabetes, epilepsy, and parkinsonism); specificity was greater than 94% for all diseases; PPV ranged from 72% (dementia) to 93% (hypertension); NPV ranged from 86% (hypertension) to greater than 99% (diabetes, dementia, epilepsy, and parkinsonism). The CPCSSN diagnostic algorithms showed excellent sensitivity and specificity for hypertension, diabetes, epilepsy, and parkinsonism and acceptable values for the other conditions. CPCSSN data are appropriate for use in public health surveillance, primary care, and health services research, as well as to inform policy for these diseases. © 2014 Annals of Family Medicine, Inc.

  8. Developing K-16 Student Standards for Language Learning: A Critical Examination of the Case of Esperanto

    Science.gov (United States)

    Fonseca-Greber, Bonnie; Reagan, Timothy

    2008-01-01

    In light of the ongoing attention to standards-based education in U.S. schools and the concern over how to effectively develop literacy skills in a first, let alone a second, language, this article reports on the drafting of the K-16 Student Standards for Learning Esperanto in the United States. Esperanto is ideally suited to aid children in the…

  9. Identifying Professional Teaching Standards Using Rasch Model Analysis: The Case of Northern Cyprus

    Science.gov (United States)

    Alibaba Erden, Hale; Özer, Bekir

    2013-01-01

    Problem Statement: The Teacher's-Act defined for the state-school teachers of North Cyprus shows that teachers are not selected according to any specific standards. In North Cyprus, apart from the exam topics defined at the teacher's exam regulations, there is not any kind of identified standard for teachers. Training qualified teachers based upon…

  10. Ending tobacco-caused mortality and morbidity: the case for performance standards for tobacco products.

    Science.gov (United States)

    Hatsukami, Dorothy K

    2013-05-01

    The US Family Smoking Prevention and Tobacco Control Act and WHO Framework Convention on Tobacco Control provide us with powerful tools to reduce the death and disease caused by the use of tobacco products. One tool that can contribute substantially toward this goal is the authority to establish performance standards for tobacco products. Conjointly with reducing levels of nicotine in cigarettes, performance and quality control standards need to be established for non-combusted tobacco products. Performance standards and incentives should be provided so that tobacco companies are compelled to manufacture and market products with very low or almost non-existent toxicity (eg, nicotine-only products).

  11. Development and evaluation of standardized narrative cases depicting the general surgery professionalism milestones.

    Science.gov (United States)

    Rawlings, Arthur; Knox, Aaron D C; Park, Yoon Soo; Reddy, Shalini; Williams, Sarah R; Issa, Nabil; Jameel, Abid; Tekian, Ara

    2015-08-01

    Residency programs now are required to use educational milestones, which has led to the need for new methods of assessment. The literature suggests that narrative cases are a promising tool to track residents' progress. This study demonstrates the process for developing and evaluating narrative cases representing the five levels of the professionalism milestones. In 2013, the authors identified 28 behaviors in the Accreditation Council for Graduate Medical Education general surgery professionalism milestones. They modified previously published narrative cases to fit these behaviors. To evaluate the quality of these cases, the authors developed a 28-item, five-point scale instrument, which 29 interdisciplinary faculty completed. The authors compared the faculty ratings by narrative case and specialty with the authors' initial rankings of the cases by milestone level. They used t tests and analysis of variance to compare mean scores across specialties. The authors developed 10 narrative cases, 2 for each of the 5 milestone levels. Each case contained at least 20 of the 28 behaviors identified in the milestones. Mean faculty ratings matched the milestone levels. Reliability was good (G coefficient = 0.86, phi coefficient = 0.85), indicating consistency in raters' ability to determine the proper milestone level for each case. The authors demonstrate a process for using specialty-specific milestones to develop narrative cases that map to a spectrum of professionalism behaviors. This process can be applied to other competencies and specialties to facilitate faculty awareness of resident performance descriptors and provide a frame of reference for milestones assessment.

  12. Standardization of SOPs to Evaluations: Impacts on Regulatory Decisions using Learning and Memory as Case Studies

    Science.gov (United States)

    In an era of global trade and regulatory cooperation, consistent and scientifically based interpretation of developmental neurotoxicity (DNT) studies is essential, particularly for non­ standard assays and variable endpoints. Because there is flexibility in the selection of ...

  13. Unintended consequences of changing accounting standards: the case of fair value accounting and mandatory dividends

    NARCIS (Netherlands)

    Goncharov, I.; van Triest, S.

    2014-01-01

    A growing body of literature investigates the interaction of changes in accounting standards with institutions such as investor protection laws and corporate governance mechanisms. We examine the unintended consequences of fair value accounting in determining mandated preferred dividends. We study

  14. Clinical case review: a method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia.

    Science.gov (United States)

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric A F; Riley, Ian

    2008-07-21

    The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing) had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. ISRCTN62323832.

  15. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    Directory of Open Access Journals (Sweden)

    Ruutu Petri

    2008-07-01

    Full Text Available Abstract Background The World Health Organization's (WHO case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Results Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. Conclusion The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. Trial registration ISRCTN62323832

  16. A Case Study in Integrating Multiple E-commerce Standards via Semantic Web Technology

    Science.gov (United States)

    Yu, Yang; Hillman, Donald; Setio, Basuki; Heflin, Jeff

    Internet business-to-business transactions present great challenges in merging information from different sources. In this paper we describe a project to integrate four representative commercial classification systems with the Federal Cataloging System (FCS). The FCS is used by the US Defense Logistics Agency to name, describe and classify all items under inventory control by the DoD. Our approach uses the ECCMA Open Technical Dictionary (eOTD) as a common vocabulary to accommodate all different classifications. We create a semantic bridging ontology between each classification and the eOTD to describe their logical relationships in OWL DL. The essential idea is that since each classification has formal definitions in a common vocabulary, we can use subsumption to automatically integrate them, thus mitigating the need for pairwise mappings. Furthermore our system provides an interactive interface to let users choose and browse the results and more importantly it can translate catalogs that commit to these classifications using compiled mapping results.

  17. Report About a New Standard for Radiation Protection Training of Intervention Persons. In the Case of Radiological emergency Situations

    International Nuclear Information System (INIS)

    Geringer, T.; Steurer, A.; Schmitzer, C.

    2004-01-01

    In autumn 2003 the Austrian standard OENORM S 5207 with the title R adiation protection training of intervention persons in the case of radiological emergency situations w ill be published. The standard is directed to persons who have to invent in case of a radiological emergency, security forces and as well training centres. The standard has to fulfil three objectives: 1. Regulation of the minimum requirements for the radiation protection training and education of intervention persons. 2. Harmonization of the radiation protection and training of different security forces, for instance Austrian army, Red Cross Austria, Fire Department, Police Department. 3. Mutual recognition of parts of the education between the different security forces. To fulfil these aims the standard is structured in different education modules. If , for instance, a person attended a special training module at the Austrian military, this part of the education is also valid for a career at the Fire Department. Further the modular structure of the education gives the possibility for persons of a special security force to attend one or more modules at another security force. This will lead to an improved cooperation between the different security forces in case of a radiological emergency situation. The education is structured in four levels. The topics of the standard are: 1. Requirements for training centres 2. Guidelines for the examinations of the candidates 3. Topics and goals of the basic education 4. Topics and goals of the advanced education level one 5. Topics and goals of the advanced education level two 6. Topics and examples of specialised education 7. Obligatory further education once every year. (Author)

  18. Public relations: a re-examination of definition, role, and function based on community relations of the Standard Oil (Indiana) refinery at Sugar Creek, MO

    Energy Technology Data Exchange (ETDEWEB)

    Kruckeberg, D.A.

    1985-01-01

    This study describes public relations as it is commonly practiced today as: a vocation utilizing persuasive communication to obtain a vested nonmarketing goal on behalf of a represented client. It argues that public relation is better defined and practiced as: the active attempt to restore/maintain a sense of community. To illustrate what this dissertation advocates, a case study is used. Probably no organization had designed a community relations program with the specific and express purpose of fostering a sense of community, at least to the extent this dissertation calls for. However, the Standard Oil Company (Indiana) refinery at Sugar Creek, MO, has done this sufficiently to merit study. Based on the findings of the case study, which covers a 75-year period of time, specific recommendations are made in practicing public relations as advocated in this dissertation: the active attempt to restore/maintain a sense of community. The theoretical basis comes from the writings of the Chicago School of Social Thought. It is demonstrated that the Chicago School can provide an excellent theoretical basis to provide insight into public relations practice from a perspective that eliminates the problems that now exist in the role and function of public relations.

  19. Technology and Standardization Strategies Related to The Diffusion of Smart Houses: The Case of ECHONET in Japan

    Directory of Open Access Journals (Sweden)

    Kumiko Miyazaki

    2016-07-01

    Full Text Available In this paper, an analysis is made of the technology and standardization strategies regarding ECHONET and KNX, which are the de jure standards for smart houses in Japan and Europe. Eleven interviews with the main actors related to the ECHONET Consortium and KNX were conducted. Three research questions were set. What are the technology strategy related concerns of the main actors related to ECHONET? What are the issues related to the diffusion of smart houses? What are the underlying strengths and weaknesses of ECHONET when compared with KNX? The analyses showed that the strategies of the various actors towards the diffusion of smart houses were different, based on their different perspectives, visions and competences. A comparison between Japanese and European case highlighted the different standardization strategies and areas of focus. The main bottlenecks towards the diffusion of smart houses were identified.

  20. Conscious worst case definition for risk assessment, part I. A knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials

    DEFF Research Database (Denmark)

    Sørensen, P.S.; Thomsen, M.; Assmuth, T.

    2010-01-01

    and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again...... a conceptual modelling procedure that is able to define appropriate worst case conditions in complex risk management. The result of the analysis is an assembly of system models, denoted the Worst Case Definition (WCD) model, to set up and evaluate the conditions of multi-dimensional risk identification...... and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk components in cumulative risk management....

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Vehicle safety performance improvements using a performance-based standards approach: four case studies

    CSIR Research Space (South Africa)

    Nordengen, Paul A

    2014-01-01

    Full Text Available As part of a performance-based standards (PBS) research programme for heavy vehicles in South Africa, a need was identified to design, manufacture and operate a number of PBS or Smart Truck demonstration vehicles. The purpose of the demonstration...

  3. Setting standards for CSR : a comparative case study on criteria-formulating organizations

    NARCIS (Netherlands)

    Ingenbleek, P.T.M.; Binnekamp, M.H.A.; Goddijn, S.T.

    2007-01-01

    Though criteria-formulating organizations (CFOs) ¿ organizations in which business and community stakeholders cooperate to formulate standards for ethical issues ¿ play an important role in the relationship between firms and society, they receive scant attention from CSR researchers. Adopting an

  4. Evaluating spoken dialogue systems according to de-facto standards: A case study

    NARCIS (Netherlands)

    Möller, S.; Smeele, P.; Boland, H.; Krebber, J.

    2007-01-01

    In the present paper, we investigate the validity and reliability of de-facto evaluation standards, defined for measuring or predicting the quality of the interaction with spoken dialogue systems. Two experiments have been carried out with a dialogue system for controlling domestic devices. During

  5. Setting and Maintaining GCSE and GCE Grading Standards: The Case for Contextualised Cohort-Referencing

    Science.gov (United States)

    Stringer, Neil Simon

    2012-01-01

    General Certificate of Secondary Education (GCSE) and General Certificate of Education (GCE) grading standards are determined by Awarding Bodies using procedures that adhere to the Code of Practice published by the regulator, Ofqual. Grade boundary marks (cut scores) are set using subject experts' (senior examiners) judgement of the quality of…

  6. A Case Study of Implications and Applications of Standardized Nomenclature for Asset Management in Healthcare

    Science.gov (United States)

    DeFrancesco, Jennifer A.

    2016-01-01

    Healthcare organizations strive to adapt to the continuous change in what has become a fast-paced, high technology environment. Many organizations are charged to find efficiencies to better manage medical device assets. Increasingly, healthcare leaders opt to adopt a standardized medical device nomenclature under the purview of a set of national…

  7. Using Discipline-Based Professional Association Standards for Information Literacy Integration: A Review and Case Study

    Science.gov (United States)

    Gordon, Larissa; Bartoli, Eleonora

    2012-01-01

    This article describes the outcome of a collaboration between a faculty member and a librarian to integrate information literacy into a graduate counseling psychology program. This collaboration used discipline-based standards from a professional association (the Association of Counselor Education and Supervision, ACES) to provide instructional…

  8. Effective Change: A Case Study of Implementation of A Standards Based Grading Initiative

    Science.gov (United States)

    MacCrindle, Amy N.

    2017-01-01

    This study followed mindset changes in elementary teachers as they transitioned from traditional grading to standards based grading during the earliest stages of the change process. A pre- and post-survey of mindsets of participants, individual interviews, and a focus group interview were conducted. While the results of the pre- and post-survey…

  9. Evaluation of an Influenza-Like Illness Case Definition in the Diagnosis of Influenza Among Patients with Acute Febrile Illness in Cambodia

    Science.gov (United States)

    2010-01-01

    reassortment swine-origin influenza A virus which is the agent associated with the WHO declared influenza pan- demic [4]. Influenza viruses are...of a novel swine- origin influenza A ( H1N1 ) virus in humans. The New England journal of medicine 2009, 360(25):2605-2615. 5. Dilantika C, Sedyaningsih...RESEARCH ARTICLE Open Access Evaluation of an influenza -like illness case definition in the diagnosis of influenza among patients with acute febrile

  10. Standardized martingale residuals applied to grouped left truncated observations of dementia cases.

    Science.gov (United States)

    Commenges, D; Rondeau, V

    2000-09-01

    The use of martingale residuals have been proposed for model checking and also to get a non-parametric estimate of the effect of an explanatory variable. We apply this approach to an epidemiological problem which presents two characteristics: the data are left truncated due to delayed entry in the cohort; the data are grouped into geographical units (parishes). This grouping suggests a natural way of smoothing the graph of residuals which is to compute the sum of the residuals for each parish. It is also natural to present a graph with standardized residuals. We derive the variances of the estimated residuals for left truncated data which allows computing the standardized residuals. This method is applied to the study of dementia in a cohort of old people, and to the possible effect of the concentration of aluminum and silica in drinking water on the risk of developing dementia.

  11. Developing data interoperability using standards: A wheat community use case [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Esther Dzale Yeumo

    2017-12-01

    Full Text Available In this article, we present a joint effort of the wheat research community, along with data and ontology experts, to develop wheat data interoperability guidelines. Interoperability is the ability of two or more systems and devices to cooperate and exchange data, and interpret that shared information. Interoperability is a growing concern to the wheat scientific community, and agriculture in general, as the need to interpret the deluge of data obtained through high-throughput technologies grows. Agreeing on common data formats, metadata, and vocabulary standards is an important step to obtain the required data interoperability level in order to add value by encouraging data sharing, and subsequently facilitate the extraction of new information from existing and new datasets. During a period of more than 18 months, the RDA Wheat Data Interoperability Working Group (WDI-WG surveyed the wheat research community about the use of data standards, then discussed and selected a set of recommendations based on consensual criteria. The recommendations promote standards for data types identified by the wheat research community as the most important for the coming years: nucleotide sequence variants, genome annotations, phenotypes, germplasm data, gene expression experiments, and physical maps. For each of these data types, the guidelines recommend best practices in terms of use of data formats, metadata standards and ontologies. In addition to the best practices, the guidelines provide examples of tools and implementations that are likely to facilitate the adoption of the recommendations. To maximize the adoption of the recommendations, the WDI-WG used a community-driven approach that involved the wheat research community from the start, took into account their needs and practices, and provided them with a framework to keep the recommendations up to date. We also report this approach’s potential to be generalizable to other (agricultural domains.

  12. Updating Standard Procedures for Diagnosis and Treatment of Congenital Rubella Case

    Directory of Open Access Journals (Sweden)

    W. Buffolano

    2013-06-01

    Full Text Available Congenital Rubella is the dramatic consequence of rubella during gestation. A combined strategy of Measles and Rubella universal vaccination on children and selective vaccination of susceptible women has been shown effective in the elimination of congenital rubella requiring an incidence of <1 case of CRS per 100,000 live births. Verification processes of rubella elimination require that physicians early and appropriately diagnose all cases of congenital rubella, including those unpatent at birth. The paper highlights clinical and laboratory aspects channeling diagnosis of congenital rubella infection or syndrome even after the first year of life, and the short- and long-term management criteria.

  13. A Case Study of Academic Writing Development Through Principled Versus Standard Clt Method at Binus University

    Directory of Open Access Journals (Sweden)

    Almodad Biduk Asmani

    2013-10-01

    Full Text Available The purpose of the research project is to investigate how far the academic writing skills of Binus University students can be developed through two conflicting CLT methods: standard and principled. The research project is expected to result in computer-animated format which can be used as one of the main tools in teaching and learning grammar at Binus University. The research project uses the qualitative approach, and thus uses verbal data. The research project involves two subject groups (experimental and control. The experimental group will receive the treatment of grammar learning by using the Principled CLT approach, while the control group receives the standard CLT approach. Survey is then conducted to the two groups so as to find out their comments on the two teaching methods. From the results of the questionnaires, it is found that Principled CLT method is favored for its knowledge and accuracy factors, while the Standard CLT is preferred for its fun and independence factors.   

  14. Suggested improvements to the definitions of Standardized Plant Analysis of Risk-Human Reliability Analysis (SPAR-H) performance shaping factors, their levels and multipliers and the nominal tasks

    International Nuclear Information System (INIS)

    Laumann, Karin; Rasmussen, Martin

    2016-01-01

    This paper discusses the definitions and content of eight performance shaping factors (PSFs) used in Standardized Plant Analysis of Risk-Human Reliability Analysis (SPAR-H) and their levels and multipliers. Definitions of nominal tasks are also discussed. The discussion is based on a review of literature on PSFs, interviews with consultants who have carried out SPAR-H analysis in the petroleum industry and an evaluation of human reliability analysis reports based on SPAR-H analysis. We concluded that SPAR-H definitions and descriptions of the PSFs are unclear and overlap too much, making it difficult for the analyst to choose between them and select the appropriate level. This reduces inter-rater reliability and thus the consistency of SPAR-H analyses. New definitions of the PSFs, levels and multipliers are suggested with the aim to develop more specific definitions of the PSFs in order to increase the inter-rater reliability of SPAR-H. Another aim was to construct more varied and more nuanced levels and multipliers to improve the capacity of SPAR-H analysis to capture the degree of difficulty faced by operators in different scenarios. We also suggest that only one of two nominal SPAR-H tasks should be retained owing to the difficulty in distinguishing between them. - Highlights: • The SPAR-H guidelines should be revised. • Descriptions of the PSFs should be improved. • New definitions should reduce overlap between the PSFs. • The multipliers are based on an “old” method and should be revised. • Some PSF levels and multipliers in SPAR-H are not logical.

  15. A case study of primary teachers' personal theories and understandings of standards-based science education reform

    Science.gov (United States)

    Wieseman, Katherine Claire

    1998-08-01

    The purpose of this study was: (1) to contribute to current understandings of teachers' perspectives of standards-based science education reform, and (2) to describe and document the relationships between the personal theories about science teaching and learning held by three "unique" experienced primary teachers and the teachers' understandings of a state-level standards-based vision of school science. These teachers were unique because they had been members of a two year-long district-level standards-based science curriculum reform initiative. This study was framed by the conception of personal theories as a representation of teacher beliefs. This qualitative case study extended from the summer of 1996 through the spring of 1998. Methods of data collection were: interviewing and informal conversations, participant observation, video and audio taping, generation of field notes, and examination of documents and artifacts. Data analysis involved constant comparison of data, generation of categories, description of properties of and relationships between categories, and theorizing about the data. The results of this qualitative case study revealed that, overall, direct involvement in the science curriculum reform effort was a positive and meaningful professional development experience providing opportunities for personal and professional growth. For two of the teachers, the experience signified a turning point in the history of their personal theories about science teaching and learning. Although the reform effort was philosophically grounded in a state-level standards-based vision of school science, implementing the new hands-on science program, adopted as a dimension of the work of the reform effort, was in the forefront of teachers' thoughts. A standards vision played a secondary role as a referrent for thinking about the teaching of science. The findings suggest that teachers' personal theories could act as mediating forces in teachers' endeavors to understand

  16. The Impact of Professional and Administrative Standards on Court Cases Involving Criterion-Related Validity.

    Science.gov (United States)

    Faley, Robert H.; Kleiman, Lawrence S.

    This paper reviews 12 Title VII court cases litigated since 1978 to assess implications of recent professional and legal guidelines regarding criterion-related validity of paper and pencil tests used by employers to prove job relatedness. Major topics important to an understanding of predictor criterion, including procedural, and data analysis and…

  17. 18 CFR 4.106 - Standard terms and conditions of case-specific exemption from licensing.

    Science.gov (United States)

    2010-04-01

    ... LICENSES, PERMITS, EXEMPTIONS, AND DETERMINATION OF PROJECT COSTS Exemption of Small Hydroelectric Power... licensing. Any case-specific exemption from licensing granted for a small hydroelectric power project is... falsehoods were made by or on behalf of the applicant. (h) Article 8. Any exempted small hydroelectric power...

  18. A Case of Sheathless Transradial Coronary Intervention for Complex Coronary Lesions with a Standard Guiding Catheter

    Science.gov (United States)

    Choi, Jaehuk; Suh, Jon; Seo, Hye-Sun; Cho, Yoon Haeng

    2013-01-01

    One of the major limitations of transradial coronary intervention is the inability to use large guiding system, which leads to the development of dedicated sheathless guide catheter system. However, these devices are not available in the Republic of Korea. We present a case in which conventional guiding catheter was used for sheathless transradial coronary intervention in the treatment of complex coronary anatomy. PMID:23755083

  19. Adoption of the Spanish eco design standard UNE 150301. A case study; Adopcion de la norma UNE 150301 de ecodeseno. Un estudio de casos

    Energy Technology Data Exchange (ETDEWEB)

    Arana-Landin, G.; Heras-Saizarbitoria, I.

    2010-07-01

    This article analyses the implementation of the Spanish National Standard UNE 150301 launched by AENOR in 2003. After studying the framework of this standard, its objectives and potential impact, for the first time the actual process of its implementation is examined using three Spanish industrial companies as case studies, all of which are pioneers in the adoption of this environmental standard. (Author)

  20. 7 CFR 29.6001 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Definitions. 29.6001 Section 29.6001 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6001 Definitions. As used in these standards, the words and phrases...

  1. HARMONIZATION OF NATIONAL REGULATION AND INTERNATIONAL FINANCIAL REPORTING STANDARDS – PARTICULAR CASE OF NONCURRENT ASSETS

    Directory of Open Access Journals (Sweden)

    Coste Andreea Ioana

    2013-07-01

    Full Text Available In the scientific literature, accounting harmonization is a top topic because it helps to increase the comparability of financial statements. Also in Romania in the last 10 years becames a topic that is very often debated. The harmonization is trying to reduce differences of financial reporting statements between countries or, in the other words, it is trying to bring to a common denominator of existing rules when appear conflicts of comparability between them. The purpose of this paper is to measure the harmonisation between national and international regulation for a significant element of financial position statement, such as noncurrent assets. This paper provides an empirical research of information that must be presented by entities which apply national accounting standards or international ones when financial statements are prepared, trying to measure the harmonization between the two referential. Thus, in trying to determine the harmonisation, we use the Jaccard coefficient in order to provide an overview of the degree of harmonization of accounting practice. When measuring the degree of comparability of Romanian accounting regulations with International Accounting Standards we analyzed noncurrent assets and impairment of assets using the Jaccard coefficient for accounting treatments and we calculated an average of similarities between the two regulations. Further, the results suggest that there is an average level of harmonization for the accounting treatment of noncurrent assets and for determining the impairment of the assets, the methods are the same. The study contributes to the development of accounting literature about the harmonisation between national regulation and international standards regarding the noncurrent assets and impairment of the assets, which together with the other elements define the activity of the business. In addition, the study provides an analysis of how the regulations treats noncurrent assets, during the

  2. Gauging megadiversity with optimized and standardized sampling protocols: A case for tropical forest spiders.

    Science.gov (United States)

    Malumbres-Olarte, Jagoba; Scharff, Nikolaj; Pape, Thomas; Coddington, Jonathan A; Cardoso, Pedro

    2017-01-01

    Characterizing and monitoring biodiversity and assessing its drivers require accurate and comparable data on species assemblages, which, in turn, should rely on efficient and standardized field collection. Unfortunately, protocols that follow such criteria remain scarce and it is unclear whether they can be applied to megadiverse communities, whose study can be particularly challenging. Here, we develop and evaluate the first optimized and standardized sampling protocol for megadiverse communities, using tropical forest spiders as a model taxon. We designed the protocol COBRA-TF (Conservation Oriented Biodiversity Rapid Assessment for Tropical Forests) using a large dataset of semiquantitative field data from different continents. This protocol combines samples of different collecting methods to obtain as many species as possible with minimum effort (optimized) and widest applicability and comparability (standardized). We ran sampling simulations to assess the efficiency of COBRA-TF (optimized, non-site-specific) and its reliability for estimating taxonomic, phylogenetic, and functional diversity, and community structure by comparing it with (1) commonly used expert-based ad hoc protocols (nonoptimized, site-specific) and (2) optimal protocols (optimized, site-specific). We then tested the performance and feasibility of COBRA-TF in the field. COBRA-TF yielded similar results as ad hoc protocols for species (observed and estimated) and family richness, phylogenetic and functional diversity, and species abundance distribution. Optimal protocols detected more species than COBRA-TF. Data from the field test showed high sampling completeness and yielded low numbers of singletons and doubletons. Optimized and standardized protocols can be as effective in sampling and studying megadiverse communities as traditional sampling, while allowing data comparison. Although our target taxa are spiders, COBRA-TF can be modified to apply to any highly diverse taxon and habitat as

  3. Investigating the Concentration of Heavy Metals in Bottled Water and Comparing with its Standard: Case Study

    Directory of Open Access Journals (Sweden)

    Mohammad Hossien Salmani

    2017-09-01

    Results: Brand No. 1, the concentration of zinc ion was larger in Brand 2 while in Brand No. 2 had larger copper, nickel, and aluminum ions. The results indicated that the concentration of the measured metal ions were below the allowable limit of drinking water standard across all of the studied samples. Conclusion: Based on the obtained results from the investigated parameters, it can be concluded that the bottled water of both brands poses no health issue and is drinkable. Considering the changes in the concentration of ions and the increasing trend of consumption of bottled waters, their monitoring and qualitative control of pollutants are very crucial in terms of public health.

  4. Standardization and optimization of arthropod inventories-the case of Iberian spiders

    DEFF Research Database (Denmark)

    Bondoso Cardoso, Pedro Miguel

    2009-01-01

    algorithm that optimizes the combination of methods and samples per method tested in the different sites. Thirdly, defining the overall effort (stop-rules), considering not only desired sampling completeness levels, but also practical strategies during field work. Finally, standardizing the protocol......, by finding common results between the optimal options for the different sites. The steps listed were successfully followed in the determination of a sampling protocol for Iberian spiders. A protocol with three sub-protocols of varying degrees of effort (24, 96 and 320 h of sampling) is proposed. I also...

  5. Source authenticity in the UMLS--a case study of the Minimal Standard Terminology.

    Science.gov (United States)

    Elhanan, Gai; Huang, Kuo-Chuan; Perl, Yehoshua

    2010-12-01

    As the UMLS integrates multiple source vocabularies, the integration process requires that certain adaptation be applied to the source. Our interest is in examining the relationship between the UMLS representation of a source vocabulary and the source vocabulary itself. We investigated the integration of the Minimal Standard Terminology (MST) into the UMLS in order to examine how close its UMLS representation is to the source MST. The MST was conceived as a "minimal" list of terms and structure intended for use within computer systems to facilitate standardized reporting of gastrointestinal endoscopic examinations. Although the MST has an overall schema and implied relationship structure, many of the UMLS integrated MST terms were found to be hierarchically orphaned, and with lateral relationships that do not closely adhere to the source MST. Thus, the MST representation within the UMLS significantly differs from that of the source MST. These representation discrepancies may affect the usability of the MST representation in the UMLS for knowledge acquisition. Furthermore, they pose a problem from the perspective of application developers. While these findings may not necessarily apply to other source terminologies, they highlight the conflict between preservation of authentic concept orientation and the UMLS overall desire to provide fully specified names for all source terms. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Source Authenticity in the UMLS – A Case Study of the Minimal Standard Terminology

    Science.gov (United States)

    Elhanan, Gai; Huang, Kuo-Chuan; Perl, Yehoshua

    2010-01-01

    As the UMLS integrates multiple source vocabularies, the integration process requires that certain adaptation be applied to the source. Our interest is in examining the relationship between the UMLS representation of a source vocabulary and the source vocabulary itself. We investigated the integration of the Minimal Standard Terminology (MST) into the UMLS in order to examine how close its UMLS representation is to the source MST. The MST was conceived as a “minimal” list of terms and structure intended for use within computer systems to facilitate standardized reporting of gastrointestinal endoscopic examinations. Although the MST has an overall schema and implied relationship structure, many of the UMLS integrated MST terms were found to be hierarchically orphaned, and with lateral relationships that do not closely adhere to the source MST. Thus, the MST representation within the UMLS significantly differs from that of the source MST. These representation discrepancies may affect the usability of the MST representation in the UMLS for knowledge acquisition. Furthermore, they pose a problem from the perspective of application developers. While these findings may not necessarily apply to other source terminologies, they highlight the conflict between preservation of authentic concept orientation and the UMLS overall desire to provide fully specified names for all source terms. PMID:20692366

  7. Process' standardization and change management in higher education. The case of TEI of Athens

    Science.gov (United States)

    Chalaris, Ioannis; Chalaris, Manolis; Gritzalis, Stefanos; Belsis, Petros

    2015-02-01

    The establishment of mature operational procedures and the effort of standardizing and certifying these procedures is a particularly arduous and demanding task which requires strong commitment from management to the existing objectives, administrative stability and continuity, availability of resources, an adequate implementation team with support from all stakeholders and of course great tolerance until tangible results of the investment are shown. Ensuring these conditions, particularly in times of economic crisis, is an extremely difficult task for large organizations such as TEI of Athens where there is heterogeneity in personnel and changes in the administrative hierarchy arise plethora of additional difficulties and require an effective change management. In this work we depict the path of standardization and certification of administrative functions of TEI of Athens, with emphasis on difficulties encountered and how to address them and in particular issues of change management and the culture related to this effort. The requirement for infrastructure needed to be maintained in processes and tools process & strategic management is embodied, in order to evolve mechanisms for continuous improvement processes and storage / recovery of the resulting knowledge. The work concludes with a general design of a road map of internal audit and continuous improvement processes for a large institution of higher education.

  8. Carbon-ion radiotherapy for marginal lymph node recurrences of cervical cancer after definitive radiotherapy: a case report

    International Nuclear Information System (INIS)

    Tamaki, Tomoaki; Nakano, Takashi; Ohno, Tatsuya; Kiyohara, Hiroki; Noda, Shin-ei; Ohkubo, Yu; Ando, Ken; Wakatsuki, Masaru; Kato, Shingo; Kamada, Tadashi

    2013-01-01

    Recurrences of cervical cancer after definitive radiotherapy often occur at common iliac or para-aortic lymph nodes as marginal lymph node recurrences. Patients with these recurrences have a chance of long-term survival by optimal re-treatment with radiotherapy. However, the re-irradiation often overlaps the initial and the secondary radiotherapy fields and can result in increased normal tissue toxicities in the bowels or the stomach. Carbon-ion radiotherapy, a form of particle beam radiotherapy using accelerated carbon ions, offers more conformal and sharp dose distribution than X-ray radiotherapy. Therefore, this approach enables the delivery of high radiation doses to the target while sparing its surrounding normal tissues. Marginal lymph node recurrences in common iliac lymph nodes after radiotherapy were treated successfully by carbon-ion radiotherapy in two patients. These two patients were initially treated with a combination of external beam radiotherapy and intracavitary and interstitial brachytherapy. However, the diseases recurred in the lymph nodes near the border of the initial radiotherapy fields after 22 months and 23 months. Because re-irradiation with X-ray radiotherapy may deliver high doses to a section of the bowels, carbon-ion radiotherapy was selected to treat the lymph node recurrences. A total dose of 48 Gy (RBE) in 12 fractions over 3 weeks was given to the lymph node recurrences, and the tumors disappeared completely with no severe acute toxicities. The two patients showed no evidence of disease for 75 months and 63 months after the initial radiotherapy and for 50 months and 37 months after the carbon-ion radiotherapy, respectively. No severe late adverse effects are observed in these patients. The two presented cases suggest that the highly conformal dose distribution of carbon-ion radiotherapy may be beneficial in the treatment of marginal lymph node recurrences after radiotherapy. In addition, the higher biological effect of carbon

  9. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We...

  10. Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS)

    NARCIS (Netherlands)

    Tol, Johanna A. M. G.; Gouma, Dirk J.; Bassi, Claudio; Dervenis, Christos; Montorsi, Marco; Adham, Mustapha; Andrén-Sandberg, Ake; Asbun, Horacio J.; Bockhorn, Maximilian; Büchler, Markus W.; Conlon, Kevin C.; Fernández-Cruz, Laureano; Fingerhut, Abe; Friess, Helmut; Hartwig, Werner; Izbicki, Jakob R.; Lillemoe, Keith D.; Milicevic, Miroslav N.; Neoptolemos, John P.; Shrikhande, Shailesh V.; Vollmer, Charles M.; Yeo, Charles J.; Charnley, Richard M.

    2014-01-01

    The lymph node (Ln) status of patients with resectable pancreatic ductal adenocarcinoma is an important predictor of survival. The survival benefit of extended lymphadenectomy during pancreatectomy is, however, disputed, and there is no true definition of the optimal extent of the lymphadenectomy.

  11. Work Incapacity and Treatment Costs After Severe Accidents: Standard Versus Intensive Case Management in a 6-Year Randomized Controlled Trial.

    Science.gov (United States)

    Scholz, Stefan M; Andermatt, Peter; Tobler, Benno L; Spinnler, Dieter

    2016-09-01

    Purpose Case management is widely accepted as an effective method to support medical rehabilitation and vocational reintegration of accident victims with musculoskeletal injuries. This study investigates whether more intensive case management improves outcomes such as work incapacity and treatment costs for severely injured patients. Methods 8,050 patients were randomly allocated either to standard case management (SCM, administered by claims specialists) or intensive case management (ICM, administered by case managers). These study groups differ mainly by caseload, which was approximately 100 cases in SCM and 35 in ICM. The setting is equivalent to a prospective randomized controlled trial. A 6-year follow-up period was chosen in order to encompass both short-term insurance benefits and permanent disability costs. All data were extracted from administrative insurance databases. Results Average work incapacity over the 6-year follow-up, including contributions from daily allowances and permanent losses from disability, was slightly but insignificantly higher under ICM than under SCM (21.6 vs. 21.3 % of pre-accident work capacity). Remaining work incapacity after 6 years of follow-up showed no difference between ICM and SCM (8.9 vs. 8.8 % of pre-accident work incapacity). Treatment costs were 43,500 Swiss Francs (CHF) in ICM compared to 39,800 in SCM (+9.4 %, p = 0.01). The number of care providers involved in ICM was 10.5 compared to 10.0 in ICM (+5.0 %, p work incapacity as compared to SCM, but did increase healthcare consumption and treatment costs. It is concluded that the intensity of case management alone is not sufficient to improve rehabilitation and vocational reintegration of accident victims.

  12. Risk assessment of manual material handling activities (case study: PT BRS Standard Industry)

    Science.gov (United States)

    Deviani; Triyanti, V.

    2017-12-01

    The process of moving material manually has the potential for injury to workers. The risk of injury will increase if we do not pay attention to the working conditions. The purpose of this study is to assess and analyze the injury risk level in manual handling material activity, as well as to improve the condition. The observed manual material handling activities is pole lifting and goods loading. These activities were analyzed using Job Strain Index method, Rapid Entire Body Assessment, and Chaffin’s 2D Planar Static Model. The results show that most workers who perform almost all activities have a high level of risk level with the score of JSI and REBA exceeds 9 points. For some activities, the estimated compression forces in the lumbar area also exceed the standard limits of 3400 N. Concerning this condition, several suggestions for improvement were made, improving the composition of packing, improving body posture, and making guideline posters.

  13. Correlation of Standard and Cone Penetration Tests: Case Study from Tekirdag (Turkey)

    Science.gov (United States)

    Feda Aral, I.; Gunes, Ekrem

    2017-10-01

    In geotechnical engineering, the Standard Penetration Test (SPT-N value) is often used as an in-situ test. The Cone Penetration Test (CPT) is based on design and cone resistance (qc) and is becoming increasingly widespread. However, there is also a need for a SPT-CPT correlation association that can be used in the basic design. In this study, the values of the SPT-CPT tests applied to the ground were compared and tried to generate a certain statistical data. SPT and CPT experiments were performed side by side to determine the soil properties. Formulas have been developed using various statistical methods and correlation coefficients have been established between the data obtained for “high-medium-low plastic clay” and “sand and sandy clayey soils”. The obtained data were compared with the studies in the literature.

  14. Standard Rape Cases in the Criminal Justice System in Campinas, São Paulo

    Directory of Open Access Journals (Sweden)

    Joana Domingues Vargas

    2008-01-01

    Full Text Available This study presents a longitudinal analysis of the records found in the Women’s Defense Division of the Public Ministry and in the Criminal Courts of the municipality of Campinas, São Paulo State. The study identified both the characteristics of rape (the accused, victims and relations between them, as well as the processes of selection and filtering to which they are submit during their processing. The results found for Campinas reflect rape complaints found in international studies, which indicate that rape is a heterogeneous category, although the aggressors are invariably men and the victims young. On the other hand, when the criminal selection process is analyzed, a filtering of typologies is noticed, found in the complaint phase in three standards for the crime of rape: intrafamiliar, committed by an unknown aggressor and among youth who know each other.

  15. Will the changes proposed to the conceptual framework’s definitions and recognition criteria provide a better basis for the IASB standard setting?

    NARCIS (Netherlands)

    Brouwer, A.; Hoogendoorn, M.; Naarding, E.

    2015-01-01

    In this paper we evaluate the International Accounting Standards Board’s (IASB) efforts, in a discussion paper (DP) of 2013, to develop a new conceptual framework (CF) in the light of its stated ambition to establish a robust and consistent basis for future standard setting, thereby guiding standard

  16. Institutionalizing environmental protection through self-regulation: the case of environmental standards adoption in Lithuania.

    Science.gov (United States)

    Bileisis, Mantas; Misiune, Ieva

    2017-04-01

    The impacts of human activity in the environment have a global dimension, but there are no effective global governance instruments to enforce environmental standards. At the same time, many national governments lack incentives to pursue strict environmental policies. In this context, self-regulation is seen as an alternative venue to address environmental challenges. This work aims to identify factors that influence companies to engage in environmental self-regulation? For this aim in March 2015 a survey of 482 companies was conducted. The target group were companies operating in Lithuania that hold ISO14001 certificates - one of the most prolific instruments for self-regulation. The questionnaire was designed to test assumptions developed in new institutionalist literature which claim that common practices can emerge through isomorphism.- The results showed that the main motive for environmental self-regulation is the desire to improve company image, rather than protecting the environment per se. Another important finding was that the main source of pressure to adopt self-regulation was based less on the perceived demands but the customers. Rather the driver for the adoption was a feeling of a need no to fall behind industry leaders. Thus, normative isomorphism is the main mechanism through which environmental self-regulation proliferates. We claim for a rapid proliferation of environmental self-regulation perceived industry leaders need to be identified and they need to be persuaded that environmental standards are key for the development of the industry. However, this also raises questions of sustainability. Few industries have long standing leaders, and through successful investment and technological development new actors can arise and this may risk stalling or even reversing self-regulation.

  17. Splenomegaly unresponsive to standard and salvage chemotherapy in Langerhans cell histiocytosis: a case of extramedullary hematopoiesis.

    Science.gov (United States)

    Christiansen, Ellen C; Ellwein, Marcine; Neglia, Joseph P

    2012-06-01

    Langerhans cell histiocytosis (LCH) is a proliferative disorder of dendritic cells which has evaded efforts to clearly define pathogenesis, diagnostic criteria, and therapeutic response markers. Strides have been made at classification with the recent development of a quantified score of disease severity. Splenic involvement is an indicator of poor prognosis, with spleen size its surrogate marker in evaluation and scoring. We describe a case of pediatric LCH with progressive splenomegaly despite treatment, which when examined at splenectomy revealed no LCH involvement but extramedullary hematopoiesis. These findings thus challenge our understanding of splenomegaly as a marker of disease. Copyright © 2011 Wiley Periodicals, Inc.

  18. Reliability of individual doses relating to the epidemiological studies on nuclear industry workers in Japan (1). Historical changes on definition of radiation dose, historical changes on technical standards of measurement and radiation workplace

    International Nuclear Information System (INIS)

    Numakunai, Takao; Ishiguro, Hideharu; Kawada, Yasushi; Minami, Kentaro; Yoshimoto, Yasuhiko.

    1997-01-01

    Records of radiation workers collected in the Research Organization for Information of Science and Technology, concerning individual doses from 1957 to 1992 were used for epidemiological studies for obtaining the scientific information of the effect of low dose radiation. Since many changes were made on definition of radiation dose, dosimetry technology and so on during such a long time period, reliability of recorded individual doses and of their measurement should be evaluated for validation, which is the purpose of this paper. Followings were discussed and validation was made. Historical changes on standards for radiation protection: ICRP Recommendation and ICRU Report, and changes of law concerning radiation dose in Japan and of dose standards. Changes on dosimetry for radiation protection: ICRP Recommendation and working place dosimetry, trends of investigations for introduction of measured practical doses, ICRU sphere as a receptor, and introduction of measured practical doses. Characteristics of radiation field and radiation exposure: Radiation source and characteristics of radiation field; Research and development organizations for atomic power, atomic power plants, facilities for nuclear fuel, Classification of radiation works and characteristics of the exposure; BWR, PWR, GCR. Changes on the standards of individual dosemeter and on its use: method to use individual dosemeter and its installation, measurement of individual dose and Japanese Industrial Standard (JIS); Standard of the film badge for X and gamma rays, Standard of the film badge for neutron, Standard for thermoluminescence dosemeter, and changes on selection of the major apparatus and on its use. (K.H.)

  19. User-driven standards in a mutual help context

    DEFF Research Database (Denmark)

    Keis, Mille Kirstine Bygballe; Nielsen, Asger Nymann; Nissen, Morten

    2016-01-01

    fellowships seem a pure case of how the duality of social structure and personal definition is built into the fabric of standards. Yet, with a closer attention to practices, negotiations, and performances, it is possible to disturb this neat distribution of abstract-social versus concrete-personal. Drawing...... across different fellowships addressing different addictions. At the same time, 12-step literature and most academic analyses of the fellowships agree that the content of these standards is never definite; no one but oneself may decide whether one lives up to the standard in question. Thus, 12-step...

  20. Restructuring an undergraduate dental curriculum to global standards--a case study in an Indian dental school.

    Science.gov (United States)

    Kadagad, P; Tekian, A; Pinto, P X; Jirge, V L

    2012-05-01

    Globalisation has affected all aspects of life and dentistry is no exception. In the context of today's dentist being a global citizen, undergraduate training in dentistry is set to ensure converging standards so that international recognition of dental qualifications can move forward. The decision of the Dental Council of India to expand the undergraduate dental program to five years provides an opportunity to be part of the endeavor of the Global Dental Congress to achieve converging standards which was initially for the European Union, and now spreading out globally. Economic emergence in Indian subcontinent has resulted in growing oral health care needs both in quality and quantity. To address this issue, the graduating dentist needs to be trained following a competency based curricular model. Access to Internet facilitated the goal of achieving converging standards of dental schools to be feasible because of the instant communication and capacity to share information about training strategies via technology across the globe. Upgrading the undergraduate training to global standards by dental schools in India could be a wise and strategic move both for attracting students to study in India, as well as retaining the graduates after their training. The following is a case study of an Indian dental school set to restructure the undergraduate curriculum to global standards using the 8 steps of Kotter's transformational change. Change in curriculum and the subsequent accreditation of the school in global platform not only attracts prospective students but also results in producing competent dentists. Dental education provided by the institution can result in quality assurance, benchmarking the assessment system to achieve international recognition. This paper highlights the need and importance of facilitation of international convergence with long term aspirations for mutual recognition of international degrees. © 2011 John Wiley & Sons A/S.

  1. Evaluation of wet indices using standard precipitation index: A case study of Terengganu states

    Science.gov (United States)

    Fauzi, M. F.; Rauf, U. F. Abdul; Din, W. R. Wan; Hussin, A. G.

    2017-09-01

    In line with the current climate conditions, the study of prolonged precipitation is imperative as it may predict the flood events in the future. In 2014, Terengganu is amongst the state in Peninsular Malaysia was affected by floods and it experienced three waves of floods during the monsoon seasons. In this research study, Standard Precipitation Index (SPI) is used to analyse the monthly precipitation data for two selected rain gauge stations in Terengganu over the period of forty-five years from 1970 to 2014. The objective of this study is to monitor the extreme wet conditions that eventually could cause the occurrence of floods. Comparisons were made using 3-month, 6-month, 24-month and 48-month time scales. SPI time series is calculated from precipitation index data for two rain-gauge stations in Terengganu. The shortest of time scales of SPI indicate the condition of moisture in short and medium terms, which is then used to estimate the seasonal precipitation. The longest time scales reveal patterns of long-term precipitation before the flood events. The result clearly shows that the annual trends of the wet events for longest periods are regularly experienced in wet conditions compare to drought conditions and predicted to have a higher probability of flood disaster. SK Kuala Telemong station has recorded the highest SPI values for the wet event in the entire periods, which the shortest time scales is 3.43 and longest term of time scales closer to three (2.90) in this analysis.

  2. Adoption of dental innovations: The case of a standardized dental diagnostic terminology.

    Science.gov (United States)

    Ramoni, Rachel B; Etolue, Jini; Tokede, Oluwabunmi; McClellan, Lyle; Simmons, Kristen; Yansane, Alfa; White, Joel M; Walji, Muhammad F; Kalenderian, Elsbeth

    2017-05-01

    Standardized dental diagnostic terminologies (SDDxTs) were introduced decades ago. Their use has been on the rise, accompanying the adoption of electronic health records (EHRs). One of the most broadly used terminologies is the Dental Diagnostic System (DDS). Our aim was to assess the adoption of SDDxTs by US dental schools by using the Rogers diffusion of innovations framework, focusing on the DDS. The authors electronically surveyed clinic deans in all US dental schools (n = 61) to determine use of an EHR and SDDxT, perceived barriers to adoption of an SDDxT, and the effect of implementing an SDDxT on clinical productivity. The response rate was 57%. Of the 35 responses, 91% reported using an EHR to document patient care, with 84% using axiUm; 41% used the DDS. Fifty-four percent of those who did not use an SDDxT had considered adopting the DDS, but 38% had not, citing barriers such as complexity and compatibility. Adoption of an SDDxT, particularly the DDS, is on the rise. Nevertheless, a large number of institutions are in the Rogers late majority and laggards categories with respect to adoption. Several factors may discourage adoption, including the inability to try out the terminology on a small scale, poor usability within the EHR, the fact that it would be a cultural shift in practice, and a perception of unclear benefits. However, the consolidation of the DDS and American Dental Association terminology efforts stands to encourage adoption. The successful adoption of dental innovation depends not only on the intrinsic merit of the innovation, as some useful innovations do not achieve widespread traction. As such, it is important for health care providers to understand how to disseminate their ideas in order to ensure traction and widespread adoption. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  3. Feasibility of U.S. renewable portfolio standards under cost caps and case study for Illinois

    International Nuclear Information System (INIS)

    Johnson, Sean D.; Moyer, Elisabeth J.

    2012-01-01

    Recently enacted state renewable portfolio standards (RPSs) collectively require that U.S. electricity generation by non-hydro renewables more than double by 2025. These goals are not certain to be met, however, because many RPSs apply cost caps that alter requirements if costs exceed targets. We analyze here the 2008 Illinois RPS, which is fairly typical, and find that at current electricity prices, complete implementation will require significant decreases in renewables costs even given the continuation of federal renewables subsidies. Full implementation is possible but not assured. The statutory design raises additional concerns about unintended potential consequences. The fact that windpower and solar carveouts fall under a single cost cap means that in failure mode, a less cost-effective technology can curtail deployment of a more cost-effective one. Adjacent-state provisions mean the bulk of the RPS can be met by existing wind facilities, and that new wind builds will likely occur in Iowa. The Illinois RPS, like that of many other states, appears to combine objectives inherently in conflict: preferences for local jobs, for specific technologies, for environmental benefits, and for low costs. Revisiting the legislation may be needed to make legislative success likely and to ensure that failure modes do not compromise goals. - Highlights: ► RPSs mandate that generation by non-hydro renewables in the U.S. double by 2025. ► Implementation of many RPSs is impossible without decreases in renewable costs. ► The Illinois wind requirement can largely be met by existing Iowa windpower. ► Placing technology carveouts under one cost cap allows pernicious interactions. ► The Illinois RPS statute combines different objectives inherently in conflict.

  4. Quantitative Analysis of Torso FDG-PET Scans by Using Anatomical Standardization of Normal Cases from Thorough Physical Examinations.

    Directory of Open Access Journals (Sweden)

    Takeshi Hara

    Full Text Available Understanding of standardized uptake value (SUV of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography (FDG-PET depends on the background accumulations of glucose because the SUV often varies the status of patients. The purpose of this study was to develop a new method for quantitative analysis of SUV of FDG-PET scan images. The method included an anatomical standardization and a statistical comparison with normal cases by using Z-score that are often used in SPM or 3D-SSP approach for brain function analysis. Our scheme consisted of two approaches, which included the construction of a normal model and the determination of the SUV scores as Z-score index for measuring the abnormality of an FDG-PET scan image. To construct the normal torso model, all of the normal images were registered into one shape, which indicated the normal range of SUV at all voxels. The image deformation process consisted of a whole body rigid registration of shoulder to bladder region and liver registration and a non-linear registration of body surface by using the thin-plate spline technique. In order to validate usefulness of our method, we segment suspicious regions on FDG-PET images manually, and obtained the Z-scores of the regions based on the corresponding voxels that stores the mean and the standard deviations from the normal model. We collected 243 (143 males and 100 females normal cases to construct the normal model. We also extracted 432 abnormal spots from 63 abnormal cases (73 cancer lesions to validate the Z-scores. The Z-scores of 417 out of 432 abnormal spots were higher than 2.0, which statistically indicated the severity of the spots. In conclusions, the Z-scores obtained by our computerized scheme with anatomical standardization of torso region would be useful for visualization and detection of subtle lesions on FDG-PET scan images even when the SUV may not clearly show an abnormality.

  5. TGLF Recalibration for ITER Standard Case Parameters FY2015: Theory and Simulation Performance Target Final Report

    International Nuclear Information System (INIS)

    Candy, J.

    2015-01-01

    This work was motivated by the observation, as early as 2008, that GYRO simulations of some ITER operating scenarios exhibited nonlinear zonal-flow generation large enough to effectively quench turbulence inside r /a ~ 0.5. This observation of flow-dominated, low-transport states persisted even as more accurate and comprehensive predictions of ITER profiles were made using the state-of-the-art TGLF transport model. This core stabilization is in stark contrast to GYRO-TGLF comparisons for modern-day tokamaks, for which GYRO and TGLF are typically in very close agreement. So, we began to suspect that TGLF needed to be generalized to include the effect of zonal-flow stabilization in order to be more accurate for the conditions of reactor simulations. While the precise cause of the GYRO-TGLF discrepancy for ITER parameters was not known, it was speculated that closeness to threshold in the absence of driven rotation, as well as electromagnetic stabilization, created conditions more sensitive the self-generated zonal-flow stabilization than in modern tokamaks. Need for nonlinear zonal-flow stabilization: To explore the inclusion of a zonal-flow stabilization mechanism in TGLF, we started with a nominal ITER profile predicted by TGLF, and then performed linear and nonlinear GYRO simulations to characterize the behavior at and slightly above the nominal temperature gradients for finite levels of energy transport. Then, we ran TGLF on these cases to see where the discrepancies were largest. The predicted ITER profiles were indeed near to the TGLF threshold over most of the plasma core in the hybrid discharge studied (weak magnetic shear, q > 1). Scanning temperature gradients above the TGLF power balance values also showed that TGLF overpredicted the electron energy transport in the low-collisionality ITER plasma. At first (in Q3), a model of only the zonal-flow stabilization (Dimits shift) was attempted. Although we were able to construct an ad hoc model of the zonal

  6. TGLF Recalibration for ITER Standard Case Parameters FY2015: Theory and Simulation Performance Target Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Candy, J. [General Atomics, San Diego, CA (United States)

    2015-12-01

    This work was motivated by the observation, as early as 2008, that GYRO simulations of some ITER operating scenarios exhibited nonlinear zonal-flow generation large enough to effectively quench turbulence inside r /a ~ 0.5. This observation of flow-dominated, low-transport states persisted even as more accurate and comprehensive predictions of ITER profiles were made using the state-of-the-art TGLF transport model. This core stabilization is in stark contrast to GYRO-TGLF comparisons for modern-day tokamaks, for which GYRO and TGLF are typically in very close agreement. So, we began to suspect that TGLF needed to be generalized to include the effect of zonal-flow stabilization in order to be more accurate for the conditions of reactor simulations. While the precise cause of the GYRO-TGLF discrepancy for ITER parameters was not known, it was speculated that closeness to threshold in the absence of driven rotation, as well as electromagnetic stabilization, created conditions more sensitive the self-generated zonal-flow stabilization than in modern tokamaks. Need for nonlinear zonal-flow stabilization: To explore the inclusion of a zonal-flow stabilization mechanism in TGLF, we started with a nominal ITER profile predicted by TGLF, and then performed linear and nonlinear GYRO simulations to characterize the behavior at and slightly above the nominal temperature gradients for finite levels of energy transport. Then, we ran TGLF on these cases to see where the discrepancies were largest. The predicted ITER profiles were indeed near to the TGLF threshold over most of the plasma core in the hybrid discharge studied (weak magnetic shear, q > 1). Scanning temperature gradients above the TGLF power balance values also showed that TGLF overpredicted the electron energy transport in the low-collisionality ITER plasma. At first (in Q3), a model of only the zonal-flow stabilization (Dimits shift) was attempted. Although we were able to construct an ad hoc model of the zonal

  7. Standardization process for pipeline right-of-way activities: the case of TRANSPETRO's Oil Pipeline and Terminals Business Unit

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Kassandra Senra de Morais M.; Goncalves, Bruno Martins [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil). Diretoria de Terminais e Oleodutos; Almeida, Maria Fatima Ludovico de [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio/ITUC), Rio de Janeiro, RJ (Brazil). Instituto Tecnologico

    2009-07-01

    This paper describes the experience of PETROBRAS Transporte S.A. concerning the standardization process for its pipeline right-of-way (ROW) activities. This standardization initiative has been carried out within the Oil Pipelines and Terminals Standardization Program (PRONOT), focusing on planning, standardization and implementation of all norms and corporate procedures referring to TRANSPETRO's right-of-way activities. The process promoted the integration of isolated regional initiatives, a sense of unity and the creation of a learning network consisting of 60 employees. This paper presents the last phase's results concerning implementation of corporate standards, based upon achievements of previous phases. It covers the following topics: a general view of the whole process by way of introduction; the potential of integration of recent standardization results with TRANSPETRO's corporate management tools and information systems; definition of four performance indicators and their metrics related to pipeline right-of-way management, as well as a corporate standard for the requirements for contracting services related to rights-of-way inspection, maintenance and communication; challenges, barriers and benefits perceived by the team responsible for formulating and implementing standards and procedures in TRANSPETRO's Oil Pipelines and Terminals Unit. (author)

  8. CASE STUDIES ON THE ASSESSMENT OF A REAL ESTATE IN TOURISM BY APPLYING THE 2017 PROPERTY VALUATION STANDARDS AS COMPARED TO 2016 GOODS VALUATION STANDARDS

    Directory of Open Access Journals (Sweden)

    ENEA CONSTANTIN

    2017-12-01

    Full Text Available By means of evaluation, in the Romanian legislation, is the value estimation activity, materialized in a document, called an evaluation report, carried out in accordance with the standards specific to this activity and with professional ethics, by an authorized evaluator. By law, the competent authority to organize, coordinate and authorize the evaluation activity in Romania is the National Association of Authorized Assessors in Romania (ANEVAR or the Association, as an autonomous legal entity, Authorized evaluators are part of it. Due to the dynamic nature of the profession of assessor, the Romanian legislation and other professions with an impact on evaluation, evaluation standards require periodic review. The Standards Collection, 2017, is called the 2017 Property Valuation Standards and will enter into force on May 1, 2017. The structure of the standards of the previous edition has been retained in this edition.

  9. Dual, use-based definition of "system"

    CSIR Research Space (South Africa)

    Gonçalves, DP

    2015-09-01

    Full Text Available The standard definition (ISO 15288, 2008) of the concept of a system is not complete and is the definition of a closed system. Such a definition is inadequate for systems engineering. A use-based definition is proposed which spans the open...

  10. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures

    NARCIS (Netherlands)

    Jammer, Ib; Wickboldt, Nadine; Sander, Michael; Smith, Andrew; Schultz, Marcus J.; Pelosi, Paolo; Leva, Brigitte; Rhodes, Andrew; Hoeft, Andreas; Walder, Bernhard; Chew, Michelle S.; Pearse, Rupert M.

    2015-01-01

    There is a need for large trials that test the clinical effectiveness of interventions in the field of perioperative medicine. Clinical outcome measures used in such trials must be robust, clearly defined and patient-relevant. Our objective was to develop standards for the use of clinical outcome

  11. Age- and influenza activity-stratified case definitions of influenza-like illness: experience from hospital-based influenza surveillance in South Korea.

    Directory of Open Access Journals (Sweden)

    Tae Un Yang

    Full Text Available OBJECTIVES: This study aims to identify clinical case definitions of influenza with higher accuracy in patients stratified by age group and influenza activity using hospital-based surveillance system. METHODS: In seven tertiary hospitals across South Korea during 2011-2012 influenza season, respiratory specimens were obtained from patients presenting an influenza-like illness (ILI, defined as having fever plus at least one of following symptoms: cough, sore throat or rhinorrhea. Influenza was confirmed by reverse transcriptase-polymerase chain reaction. We performed multivariate logistic regression analyses to identify clinical variables with better relation with laboratory-confirmed influenza, and compared the accuracy of combinations. RESULTS: Over the study period, we enrolled 1417 patients, of which 647 had laboratory-confirmed influenza. Patients with cough, rhinorrhea, sore throat or headache were more likely to have influenza (p<0.05. The most accurate criterion across the study population was the combination of cough, rhinorrhea, sore throat and headache (sensitivity 71.3%, specificity 60.1% and AUROC 0.66. The combination of rhinorrhea, sore throat and sputum during the peak influenza activity period in the young age group showed higher accuracy than that using the whole population (sensitivity 89.3%, specificity 72.1%, and AUROC 0.81. CONCLUSIONS: The accuracy of clinical case definitions of influenza differed across age groups and influenza activity periods. Categorizing the entire population into subgroups would improve the detection of influenza patients in the hospital-based surveillance system.

  12. Standardize or Diversify Experimental Conditions in Ecotoxicology? A Case Study on Herbicide Toxicity to Larvae of Two Anuran Amphibians.

    Science.gov (United States)

    Mikó, Zsanett; Ujszegi, János; Gál, Zoltán; Hettyey, Attila

    2017-11-01

    Despite a steeply increasing number of ecotoxicological studies on the effects of pesticides on nontarget organisms, studies assessing the adequacy and reliability of different experimental approaches have remained scarce. We scrutinized effects of a glyphosate-based herbicide on larvae of two European anuran amphibians by estimating species-specific LC50 values, assessing how an additional stress factor may influence outcomes, and investigating whether replicate experiments yielded qualitatively the same results. We exposed Rana dalmatina and Bufo bufo tadpoles to two predator treatments (no predator vs. predator chemical cues) combined with varying herbicide concentrations, repeated the experiment with a subset of the experimental treatments and partly with slight modifications 1 week later and assessed survival. Our results indicated that the herbicide was moderately toxic to tadpoles. The presence of predator chemical cues did not affect the lethality of the herbicide in either species. The estimated sensitivity of R. dalmatina tadpoles varied considerably across experiments, whereas in case of B. bufo LC50 values remained very similar. Our results suggest that differences in the experimental setup may often have no influence on the measured effects of pesticides, whereas replicated experiments can deliver widely differing results in other cases, perhaps depending on the studied species, the population origin of the tested individuals, or the test conditions. This draws attention to the suggestion that strict standardization may not deliver widely applicable insights into the toxicity of contaminants and, instead, intentionally introducing variation into the design of ecotoxicological experiments and replicating entire experiments may prove highly beneficial.

  13. The Need for a Definition of Big Data for Nursing Science: A Case Study of Disaster Preparedness.

    Science.gov (United States)

    Wong, Ho Ting; Chiang, Vico Chung Lim; Choi, Kup Sze; Loke, Alice Yuen

    2016-10-17

    The rapid development of technology has made enormous volumes of data available and achievable anytime and anywhere around the world. Data scientists call this change a data era and have introduced the term "Big Data", which has drawn the attention of nursing scholars. Nevertheless, the concept of Big Data is quite fuzzy and there is no agreement on its definition among researchers of different disciplines. Without a clear consensus on this issue, nursing scholars who are relatively new to the concept may consider Big Data to be merely a dataset of a bigger size. Having a suitable definition for nurse researchers in their context of research and practice is essential for the advancement of nursing research. In view of the need for a better understanding on what Big Data is, the aim in this paper is to explore and discuss the concept. Furthermore, an example of a Big Data research study on disaster nursing preparedness involving six million patient records is used for discussion. The example demonstrates that a Big Data analysis can be conducted from many more perspectives than would be possible in traditional sampling, and is superior to traditional sampling. Experience gained from the process of using Big Data in this study will shed light on future opportunities for conducting evidence-based nursing research to achieve competence in disaster nursing.

  14. The Need for a Definition of Big Data for Nursing Science: A Case Study of Disaster Preparedness

    Science.gov (United States)

    Wong, Ho Ting; Chiang, Vico Chung Lim; Choi, Kup Sze; Loke, Alice Yuen

    2016-01-01

    The rapid development of technology has made enormous volumes of data available and achievable anytime and anywhere around the world. Data scientists call this change a data era and have introduced the term “Big Data”, which has drawn the attention of nursing scholars. Nevertheless, the concept of Big Data is quite fuzzy and there is no agreement on its definition among researchers of different disciplines. Without a clear consensus on this issue, nursing scholars who are relatively new to the concept may consider Big Data to be merely a dataset of a bigger size. Having a suitable definition for nurse researchers in their context of research and practice is essential for the advancement of nursing research. In view of the need for a better understanding on what Big Data is, the aim in this paper is to explore and discuss the concept. Furthermore, an example of a Big Data research study on disaster nursing preparedness involving six million patient records is used for discussion. The example demonstrates that a Big Data analysis can be conducted from many more perspectives than would be possible in traditional sampling, and is superior to traditional sampling. Experience gained from the process of using Big Data in this study will shed light on future opportunities for conducting evidence-based nursing research to achieve competence in disaster nursing. PMID:27763525

  15. The Need for a Definition of Big Data for Nursing Science: A Case Study of Disaster Preparedness

    Directory of Open Access Journals (Sweden)

    Ho Ting Wong

    2016-10-01

    Full Text Available The rapid development of technology has made enormous volumes of data available and achievable anytime and anywhere around the world. Data scientists call this change a data era and have introduced the term “Big Data”, which has drawn the attention of nursing scholars. Nevertheless, the concept of Big Data is quite fuzzy and there is no agreement on its definition among researchers of different disciplines. Without a clear consensus on this issue, nursing scholars who are relatively new to the concept may consider Big Data to be merely a dataset of a bigger size. Having a suitable definition for nurse researchers in their context of research and practice is essential for the advancement of nursing research. In view of the need for a better understanding on what Big Data is, the aim in this paper is to explore and discuss the concept. Furthermore, an example of a Big Data research study on disaster nursing preparedness involving six million patient records is used for discussion. The example demonstrates that a Big Data analysis can be conducted from many more perspectives than would be possible in traditional sampling, and is superior to traditional sampling. Experience gained from the process of using Big Data in this study will shed light on future opportunities for conducting evidence-based nursing research to achieve competence in disaster nursing.

  16. A definition of maximal CP-violation

    International Nuclear Information System (INIS)

    Roos, M.

    1985-01-01

    The unitary matrix of quark flavour mixing is parametrized in a general way, permitting a mathematically natural definition of maximal CP violation. Present data turn out to violate this definition by 2-3 standard deviations. (orig.)

  17. Standard software for CAMAC

    International Nuclear Information System (INIS)

    Lenkszus, F.R.

    1978-01-01

    The NIM Committee (National Instrumentation Methods Committee) of the U.S. Department of Energy and the ESONE Committee of European Laboratories have jointly specified standard software for use with CAMAC. Three general approaches were followed: the definition of a language called IML for use in CAMAC systems, the definition of a standard set of subroutine calls, and real-time extensions to the BASIC language. This paper summarizes the results of these efforts. 1 table

  18. A Case Study of the Process of Learning Standard Written English: An Interactive Classroom-Based Action Research of the Influences of Students' Language Background on Their Ability to Learn Standard Written English

    Science.gov (United States)

    Mathis-Wisseh, Ruth D.

    2011-01-01

    This case study, conducted in the context of an interactive classroom-based action research, has examined the process by which Language 1 (L1-native speakers of English) and Language 2 (L2-non-native speakers of English) students develop the ability to acquire the standard written form of the English language. The dissertation was designed to…

  19. Clinical Outcome of a Prospective Case Series of Patients With Ketamine Cystitis Who Underwent Standardized Treatment Protocol.

    Science.gov (United States)

    Yee, Chi-hang; Lai, Pui-tak; Lee, Wai-man; Tam, Yuk-him; Ng, Chi-fai

    2015-08-01

    To assess the outcome of a prospective cohort of patients with ketamine-associated uropathy after standardized treatment. This is a prospective case series of patients with ketamine-related urologic problems. Management for the patients includes a 4-tier approach, namely anti-inflammatory or anti-cholinergic drugs, opioid analgesics or pregabalin, intravesical hyaluronic acid, and finally, surgical intervention including hydrodistension and augmentation cystoplasty. Outcome was assessed with functional bladder capacity, pelvic pain and urgency or frequency (PUF) symptom scale, and the EuroQol visual analog scale. Between December 2011 and June 2014, 463 patients presented with ketamine-associated uropathy. All were managed by the same standardized protocol. Among these patients, 319 patients came back for follow-up assessment. Overall mean follow-up duration was 10.7 ± 8.5 months. For those patients who received first-line treatment (290 patients), there was a significant improvement in PUF scores, the EuroQol visual analog scale, and functional bladder capacity. Both abstinence from ketamine usage and the amount of ketamine consumed were factors predicting the improvement of PUF scores. For those patients who required second-line oral therapy (62 patients), 42 patients (67.7%) reported improvement in symptoms. Eight patients have completed intravesical therapy. There was a significant improvement in voided volume for the patients after treatment. The study demonstrated the efficacy of managing ketamine-associated uropathy using a 4-tier approach. Both anti-inflammatory drugs and analgesics could effectively alleviate symptoms. Being abstinent from ketamine abuse and the amount of ketamine consumed have bearings on treatment response. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. An idic(15) associated with POF (premature ovarian failure): molecular cytogenetic definition of a case and review of the literature.

    Science.gov (United States)

    Bertini, Veronica; Viola, David; Vitti, Paolo; Simi, Paolo; Valetto, Angelo

    2012-07-15

    We report on a 36-year-old infertile woman, presenting a premature ovarian failure with an otherwise normal female phenotype. Cytogenetic analyses showed the presence of a supernumerary marker chromosome, that was characterized by FISH (fluorescent in situ hybridization) and array CGH (comparative genomic hybridization). This marker chromosome was derived from chromosome 15, and contained only heterochromatic material. The Prader Willi/Angelman region was not present. No duplications of the 15q regions were detected by array CGH. Supernumerary markers of chromosome 15 have been reported in cases of infertility and amenorrhea, that is also described in cases with marker derived by other acrocentric chromosomes. The case here presented constitutes a further example that etiology of POF is not always associated with a defective gene, but in some cases oocytes atresia can be the consequence of the abnormal meiotic pairing of chromosomes. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Towards the integration of mouse databases - definition and implementation of solutions to two use-cases in mouse functional genomics

    Directory of Open Access Journals (Sweden)

    Schofield Paul

    2010-01-01

    Full Text Available Abstract Background The integration of information present in many disparate biological databases represents a major challenge in biomedical research. To define the problems and needs, and to explore strategies for database integration in mouse functional genomics, we consulted the biologist user community and implemented solutions to two user-defined use-cases. Results We organised workshops, meetings and used a questionnaire to identify the needs of biologist database users in mouse functional genomics. As a result, two use-cases were developed that can be used to drive future designs or extensions of mouse databases. Here, we present the use-cases and describe some initial computational solutions for them. The application for the gene-centric use-case, "MUSIG-Gen" starts from a list of gene names and collects a wide range of data types from several distributed databases in a "shopping cart"-like manner. The iterative user-driven approach is a response to strongly articulated requests from users, especially those without computational biology backgrounds. The application for the phenotype-centric use-case, "MUSIG-Phen", is based on a similar concept and starting from phenotype descriptions retrieves information for associated genes. Conclusion The use-cases created, and their prototype software implementations should help to better define biologists' needs for database integration and may serve as a starting point for future bioinformatics solutions aimed at end-user biologists.

  2. Measurement Decision Risk - The Importance of Definitions

    Science.gov (United States)

    Mimbs, Scott M.

    2007-01-01

    One of the more misunderstood areas of metrology is the Test Uncertainty Ratio (TUR) and its cousin, the Test Accuracy Ratio (TAR). There have been many definitions over the years, but why are these definitions important to a discussion on measurement decision risk? The importance lies in the clarity of communication. Problems can immediately arise in the application (or misapplication) of the definition of these terms. In other words, while it is important to understand the definitions, it is more important to understand concepts behind the definitions and to be precise in how they are applied. The objective of any measurement is a decision. Measurement Decision Risk is a way to look at the quality of a measurement and although it is not a new concept, it has generated a lot of attention since its addition as a requirement in the new U.S. National Standard, ANSI/NCSL Z540.3-2006. In addition to Measurement Decision Risk as the prime method of managing measurement risk, Z540.3 has also added, as a fall-back, an explicit definition for TUR. The impact these changes might have on calibration service providers if these requirements are levied on them has become the topic of much discussion and in some cases concern. This paper looks at the concepts behind the definitions and how they relate to Measurement Decision Risk. Using common examples, this paper will also provide a comparison of various elements of risk related to measurement science using the concepts of TAR, TUR, accuracy ratios, and Consumer Risk (False Accept Risk). The goal is to provide a better understanding of their relevance to the measurement decision process.

  3. Measurement Decision Risk - The Importance of Definitions

    Science.gov (United States)

    Mimbs, Scott M.

    2008-01-01

    One of the more misunderstood areas of metrology is the Test Uncertainty Ratio (TUR) and the Test Accuracy Ratio (TAR). There have been many definitions over the years, but why are these definitions important to a discussion on measurement decision risk? The importance lies in the clarity of communication. Problems can immediately arise in the application (or misapplication) of the definition of these terms. In other words, while it is important to understand the definitions, it is more important to understand concepts behind the definitions and to be precise in how they are applied. The objective of any measurement is a decision. Measurement Decision Risk is a way to look at the quality of a measurement, and although it is not a new concept, it has generated a lot of attention since its addition as a requirement in the new U.S. National Standard, ANSIINCSL Z540.3-2006. In addition to Measurement Decision Risk as the prime method of managing measurement risk, Z540.3 has added, as a fall-back, an explicit definition for TUR. The impact these new requirements may have on calibration service providers has become the topic of much discussion and in some cases concern. This paper will look at the concepts behind the definitions and how they relate to Measurement Decision Risk. Using common examples, this paper will also provide a comparison of various elements of risk related to measurement science using the concepts of TAR, TUR, accuracy ratios, and Consumer Risk (False Accept Risk). The goal of this paper is to provide a better understanding of their relevance to the measurement decision process.

  4. Consequences of a lack of standardization of continuing education terminology: the case of practice facilitation and educational outreach.

    Science.gov (United States)

    Van Hoof, Thomas J; Miller, Nicole E

    2014-01-01

    Systematic reviews published in the quality improvement and continuing education literature have noted that the lack of standardized terminology for categorizing and describing various interventions in published studies is a major obstacle to drawing conclusions about their effectiveness. A case in point is practice facilitation and educational outreach. Although they are 2 long-standing interventions with some common characteristics, researchers studying 1 intervention may be unfamiliar with the other given the relatively separate literatures that have developed around both sets of terms. A comparison of articles included in recent systematic reviews of practice facilitation and educational outreach revealed a small but significant overlap of articles, journals, key words, and noncorresponding authors, but no overlap of corresponding authors. Based on these findings, the authors join the call for the creation of an intervention taxonomy and its application to these and other continuing education interventions. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  5. Evaluation of Standard Concepts Design of Library Interior Physical Environment (Case Study at University of Ma Chung

    Directory of Open Access Journals (Sweden)

    Debri Haryndia Putri

    2016-12-01

    Full Text Available Currently the function of a room is not only used as a shelter, the function of the room itself to be increased as a refreshing or relaxation area for users to follow the development of creativity and technology in the field of design. The comfortable factor becomes the main factor that indicates a successful process of creating a space. No exception library. The nature of library seemed stiff because of its function as a place to read, now can be developed and made into more dynamic with the special design concepts or color patterns used. Libraries can be created a special concept that suits the characteristics of the users themselves. Most users of the library, especially in college libraries are teenagers. Naturally, teenagers like to gather with their friends and we have to facilitate this activity in our library design concept. In addition we can also determine the needs of users through research by questionnaire method. The answers of users can be mapped and drawn conclusions. To explore the research, the author reviewed some literature about library interior design and observed the library of Ma Chung University as a case study. The combined results of the method can be concluded and the discovery of ideal standards of physical environment. So, the library can be made as a comfortable reading environment so as to increased interest in reading behavior and the frequent visits of students in the library.

  6. 48 CFR 9904.403-30 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Section 9904.403-30 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.403-30 Definitions. (a) The following are definitions of terms...

  7. 48 CFR 9904.409-30 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Section 9904.409-30 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.409-30 Definitions. (a) The following are definitions of terms...

  8. 48 CFR 9904.405-30 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Section 9904.405-30 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.405-30 Definitions. (a) The following are definitions of terms...

  9. 48 CFR 9904.408-30 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Section 9904.408-30 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.408-30 Definitions. (a) The following are definitions of terms...

  10. 48 CFR 9904.401-30 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... Section 9904.401-30 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING STANDARDS 9904.401-30 Definitions. (a) The following are definitions of terms...

  11. 40 CFR 50.1 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Definitions. 50.1 Section 50.1... SECONDARY AMBIENT AIR QUALITY STANDARDS § 50.1 Definitions. (a) As used in this part, all terms not defined... Standards Standard Reference Material (NBS SRM), or a USEPA/NBS-approved Certified Reference Material (CRM...

  12. Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies : The Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K

    2010-01-01

    INTRODUCTION: The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morpholog......INTRODUCTION: The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio...... correlated to the Kellgren and Lawrence severity of OA. In a subgroup with no features of radiological OA, a significant and linear decline in JSW with increasing age was found. CONCLUSION: We found a clear relationship between self-reported knee pain and radiological osteoarthritis. Pain was proportionally...

  13. Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

    Science.gov (United States)

    Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

    2017-08-01

    To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

  14. Arguing about climate change. Judging the handling of climate risk to future generations by comparison to the general standards of conduct in the case of risk to contemporaries

    International Nuclear Information System (INIS)

    Davidson, M.D.

    2009-01-01

    Intergenerational justice requires that climate risks to future generations be handled with the same reasonable care deemed acceptable by society in the case of risks to contemporaries. Such general standards of conduct are laid down in tort law, for example. Consequently, the validity of arguments for or against more stringent climate policy can be judged by comparison to the general standards of conduct applying in the case of risk to contemporaries. That this consistency test is able to disqualify certain arguments in the climate debate is illustrated by a further investigation of the debate on the social discount rate, used in cost-benefit analysis of climate policy

  15. Application of Orem's self-care deficit theory and standardized nursing languages in a case study of a woman with diabetes.

    Science.gov (United States)

    Kumar, Coleen P

    2007-01-01

    This paper aims to illustrate the process of theory-based nursing practice by presenting a case study of a clinical nurse specialist's assessment and care of a woman with type 2 diabetes. Orem's self-care deficit theory and standardized nursing language, NANDA, NIC (Nursing Interventions Classification), and NOC (Nursing Outcomes Classification), guided assessment and the identification of outcomes and interventions related to the client's management of diabetes. Theory-based nursing care and standardized nursing language enhanced the client's ability to self-manage the chronic illness: diabetes. Nursing theory and standardized nursing language enhance communication among nurses and support a client's ability to self-manage a chronic illness.

  16. Medicare and Medicaid programs; modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and other changes to EHR Incentive Program; and health information technology: revision to the certified EHR technology definition and EHR certification changes related to standards. Final rule.

    Science.gov (United States)

    2014-09-04

    This final rule changes the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT) to allow options in the use of CEHRT for the EHR reporting period in 2014. It also sets the requirements for reporting on meaningful use objectives and measures as well as clinical quality measure (CQM) reporting in 2014 for providers who use one of the CEHRT options finalized in this rule for their EHR reporting period in 2014. In addition, it finalizes revisions to the Medicare and Medicaid EHR Incentive Programs to adopt an alternate measure for the Stage 2 meaningful use objective for hospitals to provide structured electronic laboratory results to ambulatory providers; to correct the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission; and to set a case number threshold exemption for CQM reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. Finally, this rule finalizes the provisionally adopted replacement of the Data Element Catalog (DEC) and the Quality Reporting Document Architecture (QRDA) Category III standards with updated versions of these standards.

  17. From survey to high definition representations of a continuous architectonical space. The case study of the Pomposa Abbey complex

    Directory of Open Access Journals (Sweden)

    Anna Maria Manferdini

    2015-01-01

    Full Text Available The aim of this paper is to show the main results about high resolution 3D digital survey and representations of Santa Maria di Pomposa complex.The project has been developed in order to compare different methodologies, evaluating their effectiveness in the survey and representation of a huge architectural complex. This digitizationcampaign was planned for reproducing different multi-scalar representations, analyzing the digital replica of the site from different points of view and for different communication purposes. The paper presents some exemplifications of graphic representations extracted from a complex and multi-scalar 3D digital model. The adopted approach and the methodology has been developed and tested on field about a specific case study, but it can be extended to other examples which will present similar characteristics in critical and potential terms, common in several Cultural Heritage case studies.

  18. An investigation into the minimum accelerometry wear time for reliable estimates of habitual physical activity and definition of a standard measurement day in pre-school children.

    Science.gov (United States)

    Hislop, Jane; Law, James; Rush, Robert; Grainger, Andrew; Bulley, Cathy; Reilly, John J; Mercer, Tom

    2014-11-01

    The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays.Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day.Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h  d(-1) offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.

  19. Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies. The Copenhagen osteoarthritis study

    Energy Technology Data Exchange (ETDEWEB)

    Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K.; Sonne-Holm, Stig [Copenhagen University Hospital of Hvidovre (Denmark). Department of Orthopaedic Surgery

    2010-09-15

    The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morphological change over age in individuals without radiological features of OA. The Copenhagen Osteoarthritis Study - COS is a substudy of the Copenhagen City Heart Study, a longitudinal regional health survey. From the third inclusion of the CCHS (1992-1994) 4,151 subjects were selected for subsequent standardized radiography of the pelvis, the knees, the hands, the wrists, and the lumbar spine. Images were analyzed and knee joint osteoarthritis (OA) was classified according to the radiographic atlas of Kellgren and Lawrence. Joint space width (JSW) was measured at three sites within both the medial and the lateral compartment. For the entire cohort the prevalence of radiological knee joint OA of all grades was 38.7% for men and 44.2% for women. Age stratification documented increasing knee joint OA both in regard to prevalence and morphological severity. Knee pain was universally correlated to the Kellgren and Lawrence severity of OA. In a subgroup with no features of radiological OA, a significant and linear decline in JSW with increasing age was found. We found a clear relationship between self-reported knee pain and radiological osteoarthritis. Pain was proportionally related to the severity of change. We also demonstrated a significant diminishing of joint space width with increasing age in individuals without apparent radiological degeneration. (orig.)

  20. Definition of a standard protocol to determine the growth potential of Listeria monocytogenes and Yersinia enterocolitica in pork sausage produced in Abruzzo Region, Italy

    Directory of Open Access Journals (Sweden)

    Anna Franca Sperandii

    2015-11-01

    Full Text Available Pork meat products consumed raw or after a short period of fermentation can be considered at risk for food safety. Sausages (fresh sausage made from pork meat are produced in several Italian regions, with variation in ingredients. In some Italian Regions, including Abruzzo, these products are frequently consumed raw or undercooked, after a variable period of fermentation. The European Community food regulation promotes the use of challenge tests to determine safety levels. This study is aimed to ensure safety of Abruzzo’s sausages, compared with growth potential (δ of Listeria monocytogenes and Yersinia enterocolitica, and also aims to define an experimental standard protocol document to carry out challenge tests. Guidelines classify ready-to-eat foods in categories that are able to support (δ>0.5 log10 ufc/g and not support (δ≤0.5 log10 ufc/g the growth of Listeria monocytogenes. The products were manufactured according to traditional recipes and were contaminated in laboratory. Results from the experiment yielded information useful to assess the ability of these products to support the growth of pathogenic microorganisms. The batches of sausages were stored at 8, 12, 18 and 20°C to get statistical evaluation. The results showed that, despite the conditioning of the storage temperature and the level of water activity, both organisms remain in the product in concentrations similar to those leading or being able to increase its charge. In particular, the period of greatest consumption of this product (7/8 days of preparation corresponds to the period of greatest growth of pathogenic microorganisms studied, except for those stored at a temperature of 8°C, which are safer for the consumer.

  1. Definition of a Standard Protocol to Determine the Growth Potential ofListeria MonotgenesandYersinia Enterocoliticain Pork Sausage Produced in Abruzzo Region, Italy.

    Science.gov (United States)

    Sperandii, Anna Franca; Neri, Diana; Romantini, Romina; Santarelli, Gino Angelo; Prencipe, Vincenza

    2015-11-02

    Pork meat products consumed raw or after a short period of fermentation can be considered at risk for food safety. Sausages (fresh sausage made from pork meat) are produced in several Italian regions, with variation in ingredients. In some Italian Regions, including Abruzzo, these products are frequently consumed raw or undercooked, after a variable period of fermentation. The European Community food regulation promotes the use of challenge tests to determine safety levels. This study is aimed to ensure safety of Abruzzo's sausages, compared with growth potential (δ) of Listeria monocytogenes and Yersinia enterocolitica , and also aims to define an experimental standard protocol document to carry out challenge tests. Guidelines classify ready-to-eat foods in categories that are able to support (δ>0.5 log 10 ufc/g) and not support (δ≤0.5 log 10 ufc/g) the growth of Listeria monocytogenes. The products were manufactured according to traditional recipes and were contaminated in laboratory. Results from the experiment yielded information useful to assess the ability of these products to support the growth of pathogenic microorganisms. The batches of sausages were stored at 8, 12, 18 and 20°C to get statistical evaluation. The results showed that, despite the conditioning of the storage temperature and the level of water activity, both organisms remain in the product in concentrations similar to those leading or being able to increase its charge. In particular, the period of greatest consumption of this product (7/8 days of preparation) corresponds to the period of greatest growth of pathogenic microorganisms studied, except for those stored at a temperature of 8°C, which are safer for the consumer.

  2. LD Definition.

    Science.gov (United States)

    Learning Disability Quarterly, 1987

    1987-01-01

    The position paper (1981) of the National Joint Committee on Learning Disabilities presents a revised definition of learning disabilities and identifies issues and concerns (such as the limitation to children and the exclusion clause) associated with the definition included in P.L. 94-142, the Education for All Handicapped Children Act. (DB)

  3. Multimodal Definition:

    African Journals Online (AJOL)

    user

    booming as a common tool of language learning and use. In the field of e-lexi- cography, such ... defining, as indicated under the entry of definition in Oxford Advanced Learner's. Dictionary of Current English (the ... In the above-mentioned context, this article argues for the establishment of the notion of multimodal definition ...

  4. Variation in Definition of Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Rose, Louise; McGinlay, Michael; Amin, Reshma; Burns, Karen Ea; Connolly, Bronwen; Hart, Nicholas; Jouvet, Philippe; Katz, Sherri; Leasa, David; Mawdsley, Cathy; McAuley, Danny F; Schultz, Marcus J; Blackwood, Bronagh

    2017-10-01

    Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym. We screened 5,331 references, reviewed 539 full-text references, and excluded 120. Of the 419 studies (representing 38 countries) meeting inclusion criteria, 297 (71%) reported data on a heterogeneous subject cohort, and 66 (16%) included surgical subjects only (46 of those 66, 70% cardiac surgery). Other studies described COPD (16, 4%), trauma (22, 5%), neuromuscular (17, 4%), and sepsis (1, 0.2%) cohorts. A total of 741 terms were used to refer to the 419 study cohorts. The most common terms were: prolonged mechanical ventilation (253, 60%), admission to specialized unit (107, 26%), and long-term mechanical ventilation (79, 19%). Some authors (282, 67%) defined their cohorts based on duration of mechanical ventilation, with 154 studies (55%) using this as the sole criterion. We identified 37 different durations of ventilation ranging from 5 h to 1 y, with > 21 d being the most common (28 of 282, 7%). For studies describing a surgical cohort, minimum ventilation duration required for inclusion was ≥ 24 h for 20 of 66 studies (30%). More than half of all studies (237, 57%) did not provide a reason/rationale for definitional criteria used, with only 28 studies (7%) referring to a consensus definition. We conclude that substantial variation exists in the terminology and definitional criteria for cohorts of subjects receiving prolonged mechanical ventilation. Standardization of

  5. Standards Collection Development and Management in an Academic Library: A Case Study at the University of Western Ontario Libraries

    Science.gov (United States)

    Dunn, Linda K.; Xie, Shiyi

    2017-01-01

    How can academic libraries ensure their standards collections meet the teaching and research needs of science and engineering faculties? Nowadays, most academic libraries face financial constraints that greatly impact collection development. This article documents an academic library's experience with standards collections and the investigation…

  6. Meeting the Standards for Foreign Language Leaming through an Internet-Based Newspaper Project: Case Studies of Advanced-Level Japanese Learners

    Directory of Open Access Journals (Sweden)

    Miyuki Fukai

    2005-01-01

    Full Text Available Published in 1996, the Standards far Foreign Language Learning (Standards, define knowledge and abilities that foreign language learners should acquire in the U.S. The Internet is believed to facilitate standards-based instruction because of its capabilities as a communication medium, information provider, and publication tool. This paper presents one part of a study that investigated this claim through examining an Internet-based newspaper project in an advanced-level college Japanese course in light of the Japanese Standards. Six students were selected to serve as case studies, with their experiences in relation to this project analyzed in depth. The results show that the students found using the Internet to read authentic materials with the help of an online dictionary to be a positive experience. This then resulted in their actively using Japanese for personal enjoyment outside the classroom. These results suggest that the project was particularly successful in two goal areas: Communication and Communities.

  7. Functional Case Test Design to Optimize the Software Development in Italian Tax Processes (Part I: Methodology Definition

    Directory of Open Access Journals (Sweden)

    Rolli Fernando

    2017-01-01

    Full Text Available In Europe's general context of economic integration, the National States have preserved a few competences. Among them, the most important competence is taxation management, which has now become an important lever to stabilize the State's budget and to meet the economic parameters set by the European Agreements. From this perspective, it is crucial to identify a software development mode to reduce the time spent for the implementation/adjustment of the tax payment software application and, at the same time, to minimize the overall risk level. In software development, approximately 40% of time is spent in a series of testing activities: this stage of the development process is mostly placed at the end of the implementation activities. Consequently, since many testing activities have to be waived in order to meet the deadlines for software delivery, applications that are not entirely in compliance with the user's needs and/or entailing non-compliance are more likely to be introduced. This paper focuses on improving the testing process in tax procedures. The proposed method aims to improve the process, by introducing an integrated procedure based on Axiomatic Design. The approach developed will facilitate a reduction both in the testing preparation time and in performing the test cases. In this scenario, it will be possible to optimize the data compilation process, to verify the compliance within the technical specifications as provided by the Italian Revenue Agency, to identify possible critical scenarios with a proactive approach, and to avoid classes of non-conformities.

  8. Goal Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

    2017-01-01

    The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

  9. Setting the legal standard of care for treatment and evidence-based medicine: a case study of antenatal corticosteroids.

    Science.gov (United States)

    McMurtrie, Lachlan

    2006-11-01

    This article argues that liability for negligent medical treatment should be predicated upon a standard of care reflecting what is medically and scientifically reasonable. Legal science (jurisprudence) and medical science (evidence-based medicine) should be reconciled to improve patient care and outcomes. The use of antenatal corticosteroids in obstetrics during the 1990s illustrates how most jurisprudence for setting the standard of care for treatment is ill equipped to meet the fundamental aims of tort law. The proliferation of evidence-based medical practice provides a unique opportunity for the law to encourage best medical practice when setting the standard of care for treatment. It is argued that, eventually, the law should recognise clinical practice guidelines as the prima facie standard of care for treatment. This will provide legal certainty, appropriate medical practitioner accountability, and ultimately improve patient care and outcomes.

  10. Role of research in the safety case of future reactor concepts definite needs, confirmatory areas, added value

    International Nuclear Information System (INIS)

    Timo, Okkonen; Juhani, Hyvarinen

    2002-01-01

    In this paper, we aim to describe the role(s) of research when assessing - and finally demonstrating - the safety of future reactor concepts. The term 'research' could be defined in quite a limited fashion, while in this paper, we will use it synonymously to all Research and Design (R and D) work. First, we will provide a top-down planning perspective by identifying the general set of safety factors related to new reactor projects; i.e., factors that have to be accounted for already in the safety case. The research needs can be based on such a set of safety factors and related challenges, and it is crucial that the research requirements remain reasonable. For this, suitable design choices have to be made, such that they limit the criticality of individual plant functions, related systems/ structures/components (SSC), and human actions. In this context, we will discuss the general ways of limiting excessive research needs. The critical plant functions and SSC, in their turn, will require a strong safety demonstration. Once major design decisions have been made according to the aforementioned lines, actual systems are designed, using available equipment or developing new. Research support is needed to establish the technological adequacy and confidence level of each decision at each design level; this is relatively easy where conventional technologies are used, but more challenging if novel technologies come into question. Maturity of technology also correlates strongly with the attainable certainty and qualification of analysis tools. Here, we will describe the general phases of R and D from exploratory work to safety demonstration, and also independent confirmation. We will also touch upon the roles of different actors - the vendor, the licensee and the regulator - as well as their strategies in attacking the above-mentioned safety factors through research. (authors)

  11. International Harmonisation Of Accounting Standards: The Case For A Mandatory Requirement For The Direct Method Of Reporting Operating Cash Flows

    OpenAIRE

    Christine Yap

    2011-01-01

    Even though standard setters have now embraced cash flow statements there remains ambivalence as to the best format (i.e. direct or indirect method) for disclosing cash flow from operations. In 1987 the FASB asserted that information about the gross amounts of cash receipts and cash payments is more relevant than information about the net amounts of cash receipts and payments. Yet apart from Australia and New Zealand, most standard setting bodies, including the International Accounting Standa...

  12. Determinant of Access to Rural Credit and Its Effect on Living Standard: Case Study about Poor Households in Northwest, Vietnam

    OpenAIRE

    Tran Thi Thanh Tu; Nguyen Quoc Viet; Hoang Huu Loi

    2015-01-01

    This study investigated the determinants of accessibility to formal credit and its effects on living standards from 2010 to 2012 based on dataset of Vietnam Households Living Standards Survey (VHLSS) from the General Statistics Office of Vietnam and support of Eview 7 program. It is evident that average of education level, land area per capita, owned residential area affect is key factors of accessing to credit; meanwhile, average of education level affects the probability to require and amou...

  13. Neuroretinitis -- definition

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007624.htm Neuroretinitis - definition To use the sharing features on this page, ... PhD, and the A.D.A.M. Editorial team. Retinal Disorders Read more NIH MedlinePlus Magazine Read ...

  14. Scope Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

    2017-01-01

    The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items...... making up a scope definition are elaborately explained: (1) Deliverables. (2) Object of assessment, (3) LCI modelling framework and handling of multifunctional processes, (4) System boundaries and completeness requirements, (5) Representativeness of LCI data, (6) Preparing the basis for the impact...... assessment, (7) Special requirements for system comparisons, (8) Critical review needs and (9) Planning reporting of results. The instructions relate both to the performance and reporting of a scope definition and are largely based on ILCD....

  15. 40 CFR 140.1 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) MARINE SANITATION DEVICE STANDARD § 140.1 Definitions. For the purpose of these standards the following definitions..., leaking, pumping, pouring, emitting, emptying, or dumping; (c) Marine sanitation device includes any...

  16. 9 CFR 439.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... “Correct chemical residue identification” definition. (e) Coefficient of variation (CV)—The standard... value—A number representing the performance standard deviation of an individual result. The number is... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Definitions. 439.1 Section 439.1...

  17. Blaming the Victim and Exonerating the Perpetrator in Cases of Rape and Robbery: Is There a Double Standard?

    Science.gov (United States)

    Bieneck, Steffen; Krahe, Barbara

    2011-01-01

    Research in legal decision making has demonstrated the tendency to blame the victim and exonerate the perpetrator of sexual assault. This study examined the hypothesis of a special leniency bias in rape cases by comparing them to cases of robbery. N = 288 participants received descriptions of rape and robbery of a female victim by a male…

  18. Feasibility of using training cases from International Spinal Cord Injury Core Data Set for testing of International Standards for Neurological Classification of Spinal Cord Injury items

    DEFF Research Database (Denmark)

    Liu, N; Hu, Z W; Zhou, M W

    2014-01-01

    STUDY DESIGN: Descriptive comparison analysis. OBJECTIVE: To evaluate whether five training cases of International Spinal Cord Injury Core Data Set (ISCICDS) are appropriate for testing the facts within the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI......) and could thus be used for testing its training effectiveness. METHODS: The authors reviewed the five training cases from the ISCICDS and determined the sensory level (SL), motor level (ML) and American Spinal Injury Association Impairment Scale (AIS) for the training cases. The key points from the training...... cases were compared with our interpretation of the key aspects of the ISNCSCI. RESULTS: For determining SL, three principles of ML, sacral sparing, complete injury, classification of AIS A, B, C and D, determining motor incomplete status through sparing of motor function more than three levels below...

  19. Definition of Information

    Directory of Open Access Journals (Sweden)

    Boris Sunik

    2011-12-01

    Full Text Available This definition can be applied to information of every kind, level and complexity. Information is considered as the feature manifesting itself in the relations between certain real world
    entities. The real world has to be seen in terms of objects, actions, relations and properties.. The defintion is used as the basis of the Theory of Meaningful Information [1] that explains the nature and functionality of information and enables the production of relevant definitions regarding language and knowledge, which remain operative also in the case of non-human languages and
    knowledge systems.

  20. Influence of new customs procedures and logistic security standards on companies competiveness – a Croatian company case study

    Directory of Open Access Journals (Sweden)

    Aleksandar Erceg

    2014-12-01

    Full Text Available In today’s global market, companies are constantly confronted with the competition on the local, national and international level. Companies therefore use a variety of strategies and tools to become and/or remain competitive. Potential areas for cost reduction in companies are supply chain management and logistic and customs procedures. Implementation of various logistic standards in supply chain management can provide significant cost savings for the company’s daily operations and thus reduce overall costs and improve the competitiveness. Using different customs procedures and logistic standards to reduce their costs and become more competitive in the market is necessary for Croatian companies. The method of using these tools is not a one-time process and requires constant efforts. Companies therefore have to be ready to improve daily to be and remain competitive. Using a variety of modern customs procedures can save their money and time, not only through these procedures, but also through better use of their employee’s time, their own vehicles and other equipment. The paper analyzes various customs procedures and logistic standards that can help companies save time and money and improve their competitiveness. In the example of Croatian company, which uses various available procedures and standards the benefits of their use are shown. Apart from bringing savings in operations, all these procedures and standards allow the company to be better, cheaper and more attractive to buyers.

  1. Implications of adopting the WHO 2006 Child Growth Standards: case study from urban South Africa, the Birth to Twenty cohort.

    Science.gov (United States)

    Norris, Shane A; Griffiths, P; Pettifor, John M; Dunger, David B; Cameron, N

    2009-01-01

    The World Health Organization (WHO) recently developed growth standards to overcome the limitations of previous references. The aim of this study was to compare the growth patterns of a cohort of children using the National Centre for Health Statistics (NCHS), the Centre for Disease Control (CDC), and WHO 2006 references/standards, and to evaluate the implications of adopting WHO standards. Using growth data (0-5 years) from the 1990 South African Birth to Twenty cohort in Johannesburg-Soweto, Z-scores were derived for weight-for-age, length/height-for age, and weight-for-length/height from the NCHS and CDC references, and WHO 2006 standards. The pattern of mean Z-score change observed when applying the NCHS and CDC references was similar to one another, but different to that obtained when using the WHO 2006 standard. WHO 2006 identified children as being generally more stunted and more overweight. Discourse on the implementation of WHO 2006 and the impact on the primary health care system and public health monitoring in South Africa is needed, and sufficient planning is critical around not only the implementation of WHO 2006 but also maintaining comparability with historical malnutrition data.

  2. Toward collecting a standardized nursing data set across the continuum: case of adult care nurse practitioner setting.

    Science.gov (United States)

    Keenan, Gail; Stocker, Julia; Barkauskas, Violet; Treder, Marcy; Heath, Crystal

    2003-01-01

    Viable strategies are needed to move toward collection of a standardized nursing data set across settings for eventual use in examining nursing effectiveness. One strategy is to introduce potential nurse adopters to subsets of valid setting-specific standardized terms and measures to support adoption and initial implementation. The present study was designed to identify the "most clinically useful" NANDA (North American Nursing Diagnoses Association) diagnoses, NOC (Nursing Outcomes Classifications) outcomes, and NIC (Nursing Intervention Classifications) interventions pertinent to the adult care nurse practitioner setting. Ultimately, clinicians must recognize, however, that they will need to use additional terms and measures outside the subsets to more fully describe the nursing care provided.

  3. Alignment of single-case design (SCD) research with individuals who are deaf or hard of hearing with the what Works Clearinghouse standards for SCD research.

    Science.gov (United States)

    Wendel, Erica; Cawthon, Stephanie W; Ge, Jin Jin; Beretvas, S Natasha

    2015-04-01

    The authors assessed the quality of single-case design (SCD) studies that assess the impact of interventions on outcomes for individuals who are deaf or hard-of-hearing (DHH). More specifically, the What Works Clearinghouse (WWC) standards for SCD research were used to assess design quality and the strength of evidence of peer-reviewed studies available in the peer-reviewed, published literature. The analysis yielded four studies that met the WWC standards for design quality, of which two demonstrated moderate to strong evidence for efficacy of the studied intervention. Results of this review are discussed in light of the benefits and the challenges to applying the WWC design standards to research with DHH individuals and other diverse, low-incidence populations. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. The mystery of the occluded port that allowed blood withdrawal: is it safe to use standard needles to access ports? A case report and literature review.

    Science.gov (United States)

    Cataldo, Rita; Costa, Fabio; Vitiello, Michelangelo; Brescia, Fabrizio; Proscia, Paola; Falco, Clementina; Carassiti, Massimiliano

    2014-04-01

    A frequent complication of totally implantable central venous access devices (TIVADs) is withdrawal occlusion. We describe a case of rare dysfunction of TIVADs: blood withdrawal was possible, whereas infusion was not. A further investigation demonstrated that during infusion, a silicone core, probably produced by hypodermic needle puncture, occluded the reservoir outlet hole. The silicone septum puncture by standard needles instead of non-coring ones may reduce the device effectiveness and expose patients to serious complications. © 2013 Wiley Periodicals, Inc.

  5. Matched case-control study of quality of life and xerostomia after intensity-modulated radiotherapy or standard radiotherapy for head-and-neck cancer: Initial report

    International Nuclear Information System (INIS)

    Jabbari, Siavash; Kim, Hyungjin M.; Feng, Mary; Lin, Alexander; Tsien, Christina; Elshaikh, Mohamed; Terrel, Jeffrey E.; Murdoch-Kinch, Carol; Eisbruch, Avraham

    2005-01-01

    Purpose: To compare quality of life (QOL) and xerostomia between head-and-neck cancer patients who received standard radiotherapy (RT) and patients matched by factors known to affect QOL who received intensity-modulated RT (IMRT). Methods and Materials: This was a prospective, longitudinal study of patients with head-and-neck cancer requiring bilateral neck irradiation who received IMRT at the University of Michigan and patients who received standard RT at affiliated clinics. Each patient received a validated head-and-neck cancer-related QOL questionnaire (HNQOL) consisting of four multi-item domains-Eating, Communication, Pain, and Emotion-and a validated patient-reported xerostomia questionnaire (XQ). In both questionnaires, the answers were scored 0-100, with higher scores denoting worse QOL or xerostomia. The questionnaires were given before therapy and at 1, 3, 6, 12, 18, and 24 months after the completion of therapy. Each standard RT patient was matched with several IMRT patients according to tumor site, stage, RT status (postoperative or definitive), and age. A linear mixed-effects model was fit to compare outcomes between the two treatment groups and to model trends over time. To account for matching, the differences in scores between the matched sets of patients were fit as a random intercept. Also, matching was taken into account in the model by using the standard error of the within-paired-groups differences. Results: Between 1997 and 2002, 10 patients who had received standard RT and answered the XQ and HNQOL through at least 1 year were included in the study. Each of these patients was matched with a subgroup of 2-5 patients (median, 3) who had received IMRT, had similar patient and tumor characteristics, and answered the same questionnaires. A total of 30 patients were included in the IMRT group. During the initial months after therapy, the XQ and HNQOL summary scores worsened significantly in both groups compared with the pretherapy scores. Starting

  6. Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bio-radiotherapy for locally advanced head and neck cancer: a monocentric case control study.

    Science.gov (United States)

    Kawai, Sadayuki; Yokota, Tomoya; Onozawa, Yusuke; Hamauchi, Satoshi; Fukutomi, Akira; Ogawa, Hirofumi; Onoe, Tsuyoshi; Onitsuka, Tetsuro; Yurikusa, Takashi; Todaka, Akiko; Tsushima, Takahiro; Yoshida, Yukio; Kito, Yosuke; Mori, Keita; Yasui, Hirofumi

    2017-01-17

    Chemoradiotherapy (CRT) and bio-radiotherapy (BRT) are recognized as standard therapies for head and neck cancer (HNC). Aspiration pneumonia after CRT or BRT is a common late adverse event. Our aim in this study was to evaluate the cause-specific incidence of aspiration pneumonia after CRT or BRT and to identify its clinical risk factors. We performed a retrospective analysis of 305 patients with locally advanced HNC treated by CRT or BRT between August 2006 and April 2015. Of these 305 patients, 65 (21.3%) developed aspiration pneumonia after treatment. The median onset was 161 days after treatment. The two-year cause-specific cumulative incidence by CRT or BRT was 21.0%. Multivariate analysis revealed five independent risk factors for aspiration pneumonia, namely, habitual alcoholic consumption, use of sleeping pills at the end of treatment, poor oral hygiene, hypoalbuminemia before treatment, and the coexistence of other malignancies. A predictive model using these risk factors and treatment efficacy was constructed, dividing patients into low- (0-2 predictive factors), moderate- (3-4 factors), and high-risk groups (5-6 factors), the two-year cumulative incidences of aspiration pneumonia of which were 3.0, 41.6, and 77.3%, respectively. Aspiration pneumonia tended to be associated with increased risk of death, although this was not statistically significant (multivariate-adjusted hazard ratio 1.39, P = 0.18). The cause-specific incidence and clinical risk factors for aspiration pneumonia after definitive CRT or BRT were investigated in patients with locally advanced HNC. Our predictive model may be useful for identifying patients at high risk for aspiration pneumonia.

  7. Utilizing Innovative Video Chat Technology to Meet National Standards: A Case Study on a STARTALK Hindi Language Program

    Science.gov (United States)

    Parveen, Shaheen; Pater, Cayley

    2012-01-01

    Responding to the need for foreign language fluency in ever-globalizing business and cultural spheres, the federal government and foreign language institutions in an eleven-member task force collaboratively published a set of nationally recognized, foundational standards for foreign language teaching. Rather than rely on teacher-centered…

  8. The effect of expertise on the quality of forest standards implementation: The case of FSC forest certification in Russia

    NARCIS (Netherlands)

    Maletz, O.; Tysiachniouk, M.S.

    2009-01-01

    The central question of the paper is how differences in expertise affect the implementation of voluntary environmental standards in the forestry sector. Specifically we analyze the experience of two large forest companies in Russia that certified their forest management under the Forest Stewardship

  9. The Role of the Colloquial Varieties in the Acquisition of the Standard Variety: The Case of Arabic Heritage Speakers

    Science.gov (United States)

    Albirini, Abdulkafi

    2014-01-01

    The study investigated the acquisition of Modern Standard Arabic (MSA) by second language (L2) learners and by heritage speakers of the colloquial varieties of Arabic. The study focused on three questions: (1) whether heritage speakers who enroll in college-level elementary MSA classes have an advantage over their L2 counterparts, (2) whether any…

  10. An Evaluation of the INEE Minimum Standards for Education in Emergencies, Chronic Crises and Early Reconstruction: A Uganda Case Study

    Science.gov (United States)

    Karpinska, Zuki

    2008-01-01

    A year and a half after the launch of the "INEE Minimum Standards" in December 2004, a small baseline study suggested that awareness of the existence of the handbook among educational stakeholders in Uganda was low; in addition, the study found no instance of utilization of the handbook. The present report contains the findings of a…

  11. Methodological issues when comparing hearing thresholds of a group with population standards: the case of the ferry engineers.

    Science.gov (United States)

    Dobie, Robert A

    2006-10-01

    To discuss appropriate and inappropriate methods for comparing distributions of hearing thresholds of a study group with distributions in population standards and to determine whether the thresholds of Washington State Ferries engineers are different from those of men in the general population, using both frequency-by-frequency comparisons and analysis of audiometric shape. The most recent hearing conservation program audiograms of 321 noise-exposed engineers, ages 35 to 64, were compared with the predictions of Annexes A, B, and C from ANSI S3.44. There was no screening by history or otoscopy; all audiograms were included. 95% confidence intervals (95% CIs) were calculated for the engineers' median thresholds for each ear, for the better ear (defined two ways), and for the binaural average. For Annex B, where 95% CIs are also available, it was possible to calculate z scores for the differences between Annex B and the engineers' better ears. Bulge depth, an audiometric shape statistic, measured curvature between 1 and 6 kHz. Engineers' better-ear median thresholds were worse than those in Annex A but (except at 1 kHz) were as good as or better than those in Annexes B and C, which are more appropriate for comparison to an unscreened noise-exposed group like the engineers. Average bulge depth for the engineers was similar to that of the Annex B standard (no added occupational noise) and was much less than that of audiograms created by using the standard with added occupational noise between 90 and 100 dBA. Audiograms from groups that have been selected for a particular exposure, but, without regard to severity, can appropriately be compared with population standards, if certain pitfalls are avoided. For unscreened study groups with large age-sex subgroups, a simple method to assess statistical significance, taking into consideration uncertainties in both the study group and the comparison standard, is the calculation of z scores for the proportion of better

  12. Definition and denomination of occupations in libraries

    Directory of Open Access Journals (Sweden)

    Jelka Gazvoda

    1998-01-01

    Full Text Available In the first part of the article, the author presents the modern definition of occupation as defined in the ISCO-88 standard, and consecutively in the Slovenian Standard Classification of Occupations; occupations in the field of library and information science are then placed in a wider frame of information occupations which are present in ali spheres of activities. The following part of the article is focused on information occupations in libraries, especially on their contents definitions and denominations.Based on the analysis of job descriptions in three Slovenian libraries (National and University Library, University Library of Maribor and Central Technical Library,the author came to the following conclusion: the existent practice in libraries shows that the contents and denominations of occupations in library and information jobs are defined too loosely. In most cases, the contents of occupation is defined by the contents of the job, while for its denomination the required educational title of the employee is often used. Therefore, the author proposes the establishment of a work force which would define the contents and design denominations to library and information occupations according to the principles contained in the Standard Classification of Occupations.

  13. Aid conditionalities, international Good Manufacturing Practice standards and local production rights: a case study of local production in Nepal.

    Science.gov (United States)

    Brhlikova, Petra; Harper, Ian; Subedi, Madhusudan; Bhattarai, Samita; Rawal, Nabin; Pollock, Allyson M

    2015-06-14

    Local pharmaceutical production has been endorsed by the WHO as a means of addressing health priorities of developing countries. However, local producers of essential medicines must comply with international pharmaceutical standards in order to be eligible to compete in donor tenders. These standards determine production rights for on-patent and off-patent medicines, and guide international procurement of medicines. We reviewed the literature on the impact of Good Manufacturing Practice (GMP) on local production; a gap analysis from the literature review indicated a need for further research. Over sixty interviews were conducted with people involved in the Nepali pharmaceutical production and distribution chain from 2006 to 2009 on the GMP areas of relevance: regulatory capacity, staffing, funding and training, resourcing of GMP, inspectors' interpretation of the rules and compliance. Although Nepal producers have increased their overall share of the domestic market, only the public manufacturer, Royal Drugs, focuses on medicines for public health programmes; private producers engage mainly in brand competition for private markets, not essential medicines. Nepali regulators and producers state that implementation of GMP standards is hindered by low regulatory capacity, insufficient training of staff in the industry, financial constraints and lack of investment for upgrading capital. The transition period to mandatory compliance with WHO GMP rules is lengthy. Less than half of private producers had WHO GMP in 2013. Producers are not directly affected by international harmonisation of standards as they do not export medicines and the Nepali regulator does not enforce the WHO standards strictly. Without an international GMP certificate they cannot tender for donor dependent health programmes. In Nepal, local private manufacturers focus mainly on brand competition for private consumption not essential medicines, the government preferentially procures essential

  14. Gravitational Field as a Pressure Force from Logarithmic Lagrangians and Non-Standard Hamiltonians: The Case of Stellar Halo of Milky Way

    Science.gov (United States)

    El-Nabulsi, Rami Ahmad

    2018-03-01

    Recently, the notion of non-standard Lagrangians was discussed widely in literature in an attempt to explore the inverse variational problem of nonlinear differential equations. Different forms of non-standard Lagrangians were introduced in literature and have revealed nice mathematical and physical properties. One interesting form related to the inverse variational problem is the logarithmic Lagrangian, which has a number of motivating features related to the Liénard-type and Emden nonlinear differential equations. Such types of Lagrangians lead to nonlinear dynamics based on non-standard Hamiltonians. In this communication, we show that some new dynamical properties are obtained in stellar dynamics if standard Lagrangians are replaced by Logarithmic Lagrangians and their corresponding non-standard Hamiltonians. One interesting consequence concerns the emergence of an extra pressure term, which is related to the gravitational field suggesting that gravitation may act as a pressure in a strong gravitational field. The case of the stellar halo of the Milky Way is considered.

  15. Reviewing the definition of crisis in dementia care

    NARCIS (Netherlands)

    Vroomen, Janet MacNeil; Bosmans, Judith E.; van Hout, Hein P. J.; de Rooij, Sophia E.

    2013-01-01

    Crisis is a term frequently used in dementia care lacking a standardized definition. This article systematically reviews existing definitions of crisis in dementia care literature to create a standardized definition that can be utilized for research, policy and clinical practice. We systematically

  16. Immune Reconstitution Inflammatory Syndrome and Cytomegalovirus Pneumonia Case Report: Highlights and Missing Links in Classification Criteria and Standardized Treatment

    Directory of Open Access Journals (Sweden)

    Stefania Petarra-Del Río

    2017-01-01

    Full Text Available Background. Cytomegalovirus (CMV pulmonary involvement is rarely associated with IRIS; therefore, limited information is available. Case Presentation. Here, we describe the case of a 43-year-old HIV-infected male who developed an unusual case of IRIS after cytomegalovirus (CMV pneumonia. Clinically there was a progressive and paradoxical worsening of respiratory distress, despite being treated for CMV after initiation with antiretroviral therapy. Chest X-ray revealed disseminated infiltrates in both lungs; chest CT-scan showed generalized lung involvement and mediastinal adenopathy. Pulmonary biopsy confirmed CMV pneumonia with the observation of typical viral inclusions on pneumocytes. Conclusions. CMV pneumonia can be associated with the development of IRIS requiring treatment with immunosuppressant’s and immunomodulatory drugs.

  17. Analysis and meta-analysis of single-case designs with a standardized mean difference statistic: a primer and applications.

    Science.gov (United States)

    Shadish, William R; Hedges, Larry V; Pustejovsky, James E

    2014-04-01

    This article presents a d-statistic for single-case designs that is in the same metric as the d-statistic used in between-subjects designs such as randomized experiments and offers some reasons why such a statistic would be useful in SCD research. The d has a formal statistical development, is accompanied by appropriate power analyses, and can be estimated using user-friendly SPSS macros. We discuss both advantages and disadvantages of d compared to other approaches such as previous d-statistics, overlap statistics, and multilevel modeling. It requires at least three cases for computation and assumes normally distributed outcomes and stationarity, assumptions that are discussed in some detail. We also show how to test these assumptions. The core of the article then demonstrates in depth how to compute d for one study, including estimation of the autocorrelation and the ratio of between case variance to total variance (between case plus within case variance), how to compute power using a macro, and how to use the d to conduct a meta-analysis of studies using single-case designs in the free program R, including syntax in an appendix. This syntax includes how to read data, compute fixed and random effect average effect sizes, prepare a forest plot and a cumulative meta-analysis, estimate various influence statistics to identify studies contributing to heterogeneity and effect size, and do various kinds of publication bias analyses. This d may prove useful for both the analysis and meta-analysis of data from SCDs. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  18. Proposed Standards for Variable Harmonization Documentation and Referencing: A Case Study Using QuickCharmStats 1.1.

    Directory of Open Access Journals (Sweden)

    Kristi Winters

    Full Text Available Comparative statistical analyses often require data harmonization, yet the social sciences do not have clear operationalization frameworks that guide and homogenize variable coding decisions across disciplines. When faced with a need to harmonize variables researchers often look for guidance from various international studies that employ output harmonization, such as the Comparative Survey of Election Studies, which offer recoding structures for the same variable (e.g. marital status. More problematically there are no agreed documentation standards or journal requirements for reporting variable harmonization to facilitate a transparent replication process. We propose a conceptual and data-driven digital solution that creates harmonization documentation standards for publication and scholarly citation: QuickCharmStats 1.1. It is free and open-source software that allows for the organizing, documenting and publishing of data harmonization projects. QuickCharmStats starts at the conceptual level and its workflow ends with a variable recording syntax. It is therefore flexible enough to reflect a variety of theoretical justifications for variable harmonization. Using the socio-demographic variable 'marital status', we demonstrate how the CharmStats workflow collates metadata while being guided by the scientific standards of transparency and replication. It encourages researchers to publish their harmonization work by providing researchers who complete the peer review process a permanent identifier. Those who contribute original data harmonization work to their discipline can now be credited through citations. Finally, we propose peer-review standards for harmonization documentation, describe a route to online publishing, and provide a referencing format to cite harmonization projects. Although CharmStats products are designed for social scientists our adherence to the scientific method ensures our products can be used by researchers across the

  19. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    This technical standards list (TSL) was prepared for use by personnel involved in the selection and use of US DOE technical standards and other government and non-government standards. This TSL provides listings of current DOE technical standards, non-government standards that have been adopted by DOE, other government documents in which DOE has a recorded interest, and cancelled DOE technical standards. Standards are indexed by type in the appendices to this document. Definitions of and general guidance for the use of standards are also provided.

  20. Standardization process aligned to integrated management system: the case of TRANSPETRO's Oil Pipelines and Terminals Unit

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Maria Fatima Ludovico de [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio/ITUC), Rio de Janeiro, RJ (Brazil). Instituto Tecnologico; Labrunie, Charles; Araujo, Dario Doria de [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil). Diretoria de Terminais e Oleodutos

    2009-07-01

    This paper presents the implementation by PETROBRAS Transporte S.A. - TRANSPETRO of its Oil Pipelines and Terminals Standardization Program (PRONOT) within the scope of the 'Integrated Management System' (IMS). This program, launched in 2006 in the regions where the company operates, aims at standardizing all of its oil pipeline and terminal operations. Its implementation was planned in two phases: the first, already successfully concluded, refers to pipeline operations, industrial maintenance and right-of-way activities management; and the second, initiated in 2009, encompasses cross-sectional activities including health, safety and environment (HSE); training and development of oil pipeline workforce; communication with stake holders; oil pipeline integrity; and engineering project requirements. The documental structures of TRANSPETRO IMS and PRONOT are described and represented graphically to emphasize the intentional alignment of the standardization process carried out by the Oil Pipelines and Terminals Unit to the corporate IMS, based upon national and international literature review and through practical research focusing on the best international practices. (author)

  1. Contribution to Energy Management of the Main Standards for Environmental Management Systems: The Case of ISO 14001 and EMAS

    Directory of Open Access Journals (Sweden)

    Iker Laskurain

    2017-11-01

    Full Text Available The adoption of Energy Management Systems (EnMSs based on international standards has gained momentum since the ISO 50001 standard was launched in 2011. Before that, the potential to improve the energy management with Environmental Management Systems (EMSs based on ISO 14001 and EMAS was identified in the literature. However, no in-depth analysis reported in the literature has explored this claim. The need for research is now even more evident with the development of new versions of the standards for environmental management―ISO 14001:2015 and EMAS III. Since many companies that already have a certified EMSs might be uncertain whether to adopt an ISO 50001 based EnMSs, the present work aims to shed light on the contribution of ISO 14001:2015 and EMAS III to energy management. Furthermore, the work summarizes the results of an empirical exploratory study carried out in eight Spanish organizations, four with an EMS implemented and certified based on ISO 14001:2015 and four more with an EMS registered to EMAS III. The findings show that both ISO14001 and EMAS certified organizations carry out energy management practices, even though they have no formal EnMSs implemented. Implications for managers and policy makers are discussed, together with avenues for further research.

  2. Predictive Ability from ePortfolios of Student Achievement Associated with Professional Teaching Standards: An Exploratory Case Study

    Science.gov (United States)

    Payne, Phillip; Burrack, Frederick

    2017-01-01

    This exploratory case study, focused on a music teacher preparation program, examined the coursework ePortfolios of pre-service music teachers to determine if any parts of the ePortfolio process predicted teaching effectiveness in the classroom during the student teaching semester. Sixty-five undergraduate pre-service music teachers made up the…

  3. $H^0 \\rightarrow Z^0 \\gamma$ channel in ATLAS. \\\\ A study of the Standard Model and \\\\ Minimal Supersymmetric SM case

    CERN Document Server

    Kiourkos, S

    1999-01-01

    One of the potentially accessible decay modes of the Higgs boson in the mass region $100 < m_H < 180$ GeV is the $H^0 \\rightarrow Z^0 \\gamma$ channel. The work presented in this note examines the Standard Model and Minimal Supersymmetric Standard Model predictions for the observability of this channel using particle level simulation as well as the ATLAS fast simulation (ATLFAST). It compares present estimates for the signal observability with previously reported ones in \\cite{unal} specifying the changes arising from the assumed energy of the colliding protons and the improvements in the treatment of theoretical predictions. With the present estimates, the expected significance for the SM Higgs does not exceed, in terms of $\\frac{S}{\\sqrt{B}}$, 1.5 $\\sigma$ (including $Z^0 \\rightarrow e^+ e^-$ and $Z^0 \\rightarrow {\\mu}^+ {\\mu}^-$) for an integrated luminosity of $10^5$ pb$^{-1}$ therefore not favouring this channel for SM Higgs searches. Comparable discovery potential is expected at most for the MSSM $...

  4. New JLS-Factor Model versus the Standard JLS Model: A Case Study on Chinese Stock Bubbles

    Directory of Open Access Journals (Sweden)

    Zongyi Hu

    2017-01-01

    Full Text Available In this paper, we extend the Johansen-Ledoit-Sornette (JLS model by introducing fundamental economic factors in China (including the interest rate and deposit reserve rate and the historical volatilities of targeted and US equity indices into the original model, which is a flexible tool to detect bubbles and predict regime changes in financial markets. We then derive a general method to incorporate these selected factors in addition to the log-periodic power law signature of herding and compare the prediction accuracy of the critical time between the original and the new JLS models (termed the JLS-factor model by applying these two models to fit two well-known Chinese stock indices in three bubble periods. The results show that the JLS-factor model with Chinese characteristics successfully depicts the evolutions of bubbles and “antibubbles” and constructs efficient end-of-bubble signals for all bubbles in Chinese stock markets. In addition, the results of standard statistical tests demonstrate the excellent explanatory power of these additive factors and confirm that the new JLS model provides useful improvements over the standard JLS model.

  5. Development of standardized bioassay protocols for the toxicity assessment of waste, manufactured products, and effluents in Latin America: Venezuela, a Case Study

    International Nuclear Information System (INIS)

    Rodriquez-Grau, J.

    1993-01-01

    The present status of the toxicity assessment of industrial products in Latin America is well below North America/EC standards. As an example, most of Latin America regulatory laws regarding effluent discharge are still based upon concentration limits of certain major pollutants, and BOD/COD measurements; no reference is made to the necessity of aquatic bioassay toxicity data. Aware of this imperative need, the Venezuelan Petroleum Industry (PDVSA), through its R ampersand D Corporative branch (INTEVEP) gave priority to the development of standardized acute/sublethal toxicity test protocols as sound means of evaluating their products and wastes. Throughout this presentation, the Venezuelan case will be studied, showing strategies undertaken to accelerate protocol development. Results will show the assessment of 14 different protocols encompassing a variety of species of aquatic/terrestrial organisms, and a series of toxicity test endpoints including mortality, reproductive, biological and immunological measurements, most of which are currently in use or being developed. These protocols have already yielded useful results in numerous cases where toxicity assessment was required, including evaluations of effluent, oil dispersants, drilling fluids, toxic wastes, fossil fuels and newly developed products. The Venezuelan case demonstrates that the integration of Industry, Academia and Government, which is an essential part of SETAC's philosophy, is absolutely necessary for the successful advancement of environmental scientific/regulatory issues

  6. Nearly Zero Energy Standard for Non-Residential Buildings with high Energy Demands—An Empirical Case Study Using the State-Related Properties of BAVARIA

    Directory of Open Access Journals (Sweden)

    Michael Keltsch

    2017-03-01

    Full Text Available The Energy Performance of Buildings Directive (EPBD 2010 calls for the Nearly Zero Energy Building (nZEB Standard for new buildings from 2021 onwards: Buildings using “almost no energy” are powered by renewable sources or by the energy produced by the building itself. For residential buildings, this ambitious new standard has already been reached. But for other building types, this goal is still far away. The potential of these buildings to meet a nZEB Standard was investigated by analyzing ten case studies, representing non-residential buildings with different uses. The analysis shows that the primary characteristics common to critical building types are a dense building context with a very high degree of technical installation (such as hospital, research, and laboratory buildings. The large primary energy demand of these types of buildings cannot be compensated by building- and property-related energy generation, including off-site renewables. If the future nZEB Standard were to be defined with lower requirements because of this, the state-related properties of Bavaria suggest that the real potential energy savings available in at least 85% of all new buildings would be insufficiently exploited. Therefore, it would be more useful to individualize the legal energy verification process for new buildings, to distinguish critical building types such as laboratories and hospitals from the other building types.

  7. Analysis the Appropriate using Standard Costing Applying in Land Cost Component of Real Estate Development Activities: A Case Study of PT Subur Agung

    Directory of Open Access Journals (Sweden)

    Elfrida Yanti

    2011-05-01

    Full Text Available Standard cost is generally used by manufacturing business, which direct material, labor, and factory overhead are cleared allocated. On real estate business in this case PT Subur Agung use standard cost based on three costs, raw land, land improvement and interest expense categories instead of direct material, direct labor and overhead. Developer use these cost to predict the project cost and estimate the pre-selling price, in accordance with the cost estimation classification matrix, the variance range is in the expected accuracy rate by testing the variance percentage between standard cost and actual cost. The additional similar projects in PT Subur Agung also follow the same scope. All these evidences have proved the appropriate using standard costing in land cost component of real estate development activities but how it applies this article will analyze in this particular project with using descriptive and exploratory method. The analysis started by knowing the conceptual situation of PT Subur Agung and the data was presented in tables and calculation with detail explanation. 

  8. Case Study of an Unsustainable Community-Academic Partnership: Toward Core Standards for the Structure of Emerging Participatory Research.

    Science.gov (United States)

    Calderón, José L; Norris, Keith C; Hardigan, Patrick C; Calderón, Lorrin A; Hays, Ron D

    2015-08-07

    This report retrospectively examines the structure of an emerging community-academic participatory research (PR) partnership that was not sustainable, despite attempts to adhere to PR principles and demonstrable success in research outcomes. The influence of community and academic parent organizations on the PR process and outcomes is presented in the context of the Donabedian Model. We dissected the structural elements contributed by parent organizations to forming the structure of the PR partnership (memorandum of understanding, policy environment, human resources and effort, community and academic resources, expertise and experience, and funding) and explored the influence of potential and actual conflicts on the PR partnership's sustainability. The effect of potential and actual conflict on the PR process and quality of PR outcomes is discussed. Based on this, we conclude by proposing seven core standards for the establishment and development of emerging community-academic PR partnerships.

  9. Design of standard operating procedure production proceses (case study on the home industry Bedugul Baturiti Tabanan Bali)

    Science.gov (United States)

    Kasiani; Suhantono, Djoko; Mirah Kencanawati, AAA

    2018-01-01

    Candikuning is part of the district of Baturiti, tourism village, better known by the name of Bedugul. No less interesting is the variety of chips produced by two partner groups as a souvenir after the tour, such as Chips: Spinach; beans; Tempeh. The purpose of this research were to design a Standard Operating Procedure (SOP): Production Processes on the Home Industry Bedugul Baturiti Tabanan Bali. The data technic collected use: observation; Documentation; and then interview to collect information. The data analysis technic done by using the Miles & Huberman. Result this research that the draft SOP: Production Processes Chips (Menu). The conclusion in this research SOP Production Processes use with flowchart and description on the Home Industry Bedugul Baturiti Tabanan Bali.

  10. Field Performance versus Standard Test Condition Efficiency of Tandem Solar Cells and the Specific Case of Perovskites/Silicon Devices

    KAUST Repository

    Dupre, Olivier

    2018-01-05

    Multijunction cells may offer a cost-effective route to boost the efficiency of industrial photovoltaics. For any technology to be deployed in the field, its performance under actual operating conditions is extremely important. In this perspective, we evaluate the impact of spectrum, light intensity, and module temperature variations on the efficiency of tandem devices with crystalline silicon bottom cells with a particular focus on perovskite top cells. We consider devices with different efficiencies and calculate their energy yields using field data from Denver. We find that annual losses due to differences between operating conditions and standard test conditions are similar for single-junction and four-terminal tandem devices. The additional loss for the two-terminal tandem configuration caused by current mismatch reduces its performance ratio by only 1.7% when an optimal top cell bandgap is used. Additionally, the unusual bandgap temperature dependence of perovskites is shown to have a positive, compensating effect on current mismatch.

  11. Use of MODIS Terra Imagery to Estimate Surface Water Quality Standards, Using Lake Thonotosassa, Florida, as a Case Study

    Science.gov (United States)

    Moreno, Max J.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.; Rickman, Douglas L.

    2010-01-01

    Lake Thonotosassa is a highly eutrophied lake located in an area with rapidly growing population in the Tampa Bay watershed, Florida. The Florida Administrative Code has designated its use for "recreation, propagation and maintenance of a healthy, well-balanced population of fish and wildlife." Although this lake has been the subject of efforts to improve water quality since 1970, overall water quality has remained below the acceptable state standards, and has a high concentration of nutrients. This condition is of great concern to public health since it has favored episodic blooms of Cyanobacteria. Some Cyanobacterial species release toxins that can reach humans through drinking water, fish consumption, and direct contact with contaminated water. The lake has been historically popular for fishing and water sports, and its overflow water drains into the Hillsborough River, the main supply of municipal water for the City of Tampa, this explains why it has being constantly monitored in situ for water quality by the Environmental Protection Commission of Hillsborough County (EPC). Advances in remote sensing technology, however, open the possibility of facilitating similar types of monitoring in this and similar lakes, further contributing to the implementation of surveillance systems that would benefit not just public health, but also tourism and ecosystems. Although traditional application of this technology to water quality has been focused on much larger coastal water bodies like bays and estuaries, this study evaluates the feasibility of its application on a 46.6 km2 freshwater lake. Using surface reflectance products from Moderate-Resolution Imaging Spectroradiometer (MODIS) Terra, this study evaluates associations between remotely sensed data and in situ data from the EPC. The parameters analyzed are the surface water quality standards used by the State of Florida and general indicators of trophic status.

  12. Addition of PM 2.5 into the national ambient air quality standards of China and the contribution to air pollution control: the case study of Wuhan, China.

    Science.gov (United States)

    You, Mingqing

    2014-01-01

    PM2.5 has gradually become a major environmental problem of China with its rapid economic development, urbanization, and increasing of motor vehicles. Findings and awareness of serious PM2.5 pollution make the PM2.5 a new criterion pollutant of the Chinese National Ambient Air Quality Standard (NAAQS) revised in 2012. The 2012 NAAQS sets the PM2.5 concentrate limitation with the 24-hour average value and the annual mean value. Wuhan is quite typical among central and southern China in climate, economy, development level, and energy consumption. The data are cited from the official website of Wuhan Environmental Protection Bureau and cover the period from 1 January to 30 June 2013. The data definitely confirm the existence of serious PM2.5 pollution in Wuhan and indicate that the addition of PM2.5 as a criterion pollutant significantly brings down the attainment rate of air quality. The example of Wuhan reveals that local governments should take measures to reduce the emission of PM2.5 if it affects the attainment rate and the performance evaluation value of air quality. The main contribution of 2012 NAAQS is that it brings down the attainment rate of the air quality and forces local governmental officials to take the measures accordingly.

  13. Addition of PM2.5 into the National Ambient Air Quality Standards of China and the Contribution to Air Pollution Control: The Case Study of Wuhan, China

    Directory of Open Access Journals (Sweden)

    Mingqing You

    2014-01-01

    Full Text Available PM2.5 has gradually become a major environmental problem of China with its rapid economic development, urbanization, and increasing of motor vehicles. Findings and awareness of serious PM2.5 pollution make the PM2.5 a new criterion pollutant of the Chinese National Ambient Air Quality Standard (NAAQS revised in 2012. The 2012 NAAQS sets the PM2.5 concentrate limitation with the 24-hour average value and the annual mean value. Wuhan is quite typical among central and southern China in climate, economy, development level, and energy consumption. The data are cited from the official website of Wuhan Environmental Protection Bureau and cover the period from 1 January to 30 June 2013. The data definitely confirm the existence of serious PM2.5 pollution in Wuhan and indicate that the addition of PM2.5 as a criterion pollutant significantly brings down the attainment rate of air quality. The example of Wuhan reveals that local governments should take measures to reduce the emission of PM2.5 if it affects the attainment rate and the performance evaluation value of air quality. The main contribution of 2012 NAAQS is that it brings down the attainment rate of the air quality and forces local governmental officials to take the measures accordingly.

  14. Application of best practice for setting minimum energy efficiency standards in technically disadvantaged countries: Case study of Air Conditioners in Brunei Darussalam

    International Nuclear Information System (INIS)

    Shi, Xunpeng

    2015-01-01

    Highlights: • Setting MEPS requires significant data, financial resources and technical capacity. • Application of best practice in technical disadvantaged countries (TDCs) was demonstrated. • Best practice was successfully applied to Brunei for its AC MEPS. • For Brunei, COP at 2.9 is recommended and 15% efficiency improvement is achievable. • The methodology is applicable to other appliances in any TDCs. - Abstract: Application of the best practice of setting minimum energy performance standards (MEPS) in technically disadvantaged countries (TDCs) faces many barriers. The best practice of determining MEPS has a comprehensive analytical framework including engineering-economic analysis, life-cycle cost-benefit analysis, as well stakeholders’ and market impact assessments. However, TDCs usually are lack of reference product classes, market data, and other necessary inputs data. This study demonstrated how to overcome those barriers to apply the best practice to TDCs using the actual experience in setting initial MEPS for Air Conditioners (ACs) in Brunei from scratch with limited secondary data as an example. The series of application works include definition of the product classes and the baseline group; collection of market data; formulation of cost-efficiency relationship from the market data; examination of the economic, environmental, and financial impacts of various MEPS options; revealing of the consumers’ willingness to pay; and analysis of the impacts and responses from the industry and consumers. The coordination with the compliance of the Montreal Protocol was also considered. The methodology should also be applicable to setting MEPF for other appliances in any TDCs.

  15. Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

    Directory of Open Access Journals (Sweden)

    Schwenk Michael

    2012-04-01

    Full Text Available Abstract Background The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs on fall prevention. Methods An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls". Results The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes. Conclusions No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.

  16. Reconceptualising the Standard of Care in Sport: The Case of Youth Rugby in England and South Africa

    Directory of Open Access Journals (Sweden)

    Steve Greenfield

    2015-12-01

    Full Text Available Sport is an important area of civil society in both South Africa and England, and this article is broadly concerned with the relationship between sport and personal injury. More specifically, the article compares how rugby is regulated by the tort of negligence in England and delict in South Africa respectively. Regarding liability, for sport there are very specific factors that need to be taken into account. The article is concerned with, firstly, the broader context of sport as an important social and cultural activity, and secondly the specific sporting context that includes the rules of the game as well as the playing culture, with a focus on rugby at junior level. Through a critical and comparative analysis of how the standards of care in sport have been developed in both jurisdictions, the aim of this article is to consider how sport specific elements can be incorporated into the traditional legal principles. This comparative analysis contextualises the various discussions in the light of the differences between the English tort of negligence and the South African law of delict. Our argument is that the context and specificity of rugby should be more explicitly taken into account when evaluating potential liability. To establish a standard of care for sport is complex, with many factors to be taken into account and balanced against one another. The law of negligence/delict therefore needs to be adaptable and flexible to resolve new situations where injuries have occurred. Even in established situations where liability has been previously determined, novel events do occur and knowledge develops that requires a reconsideration of the principles that govern liability. In junior rugby, the risk of very serious injuries is relatively small and the law needs to tread a cautious path through liability, ensuring it is a vehicle that promotes sport rather than creating barriers to its enjoyment and practice. A greater understanding of sport

  17. Web technology to support work processes in energy policy research - A case study with energy efficiency standards

    International Nuclear Information System (INIS)

    Benenson, Peter; McMahon, James E.; Brown, Stephen R.

    2002-01-01

    This paper focuses on a process to design and build a web-based system to assist staff in day-to-day management and contemporaneous documentation of their work. Other groups that want to use web technology to support their work could apply the approach presented here, but the design itself pertains to a particular set of issues in a unique context. Each user must apply the approach to identify their objectives and design a site to meet them. The main question that the Energy Efficiency Standards Group addressed was: ''How can we facilitate documentation of interim results and final products while conducting a complex, interdependent set of analyses by multiple authors under time pressures for delivering a final product?'' The approach to address this question includes categorization of the components of the work, discussions with staff, development of infrastructure support for documentation, implementation of the documentation process and integration with the workflow, and follow- up with staff. The search for a solution raised a number of issues such as the need for a thorough understanding of the work, consensus building by inclusion of key staff, and deliverable scheduling to allow for contemporaneous documentation. Documentation results vary among the product analyses, from extensive internal and external use to much slower adoption. Complaints include the length of the input forms and pressure from clients to deliver results. But with repeated demand for interim output, the need for thorough contemporaneous documentation still remains. Accordingly, as problems arise there is continued commitment among the staff to address them

  18. Factors Influencing Academic Performance Of Standard Eight Girls In National Examinations In Public Primary Schools A Case Of Matungu Division.

    Directory of Open Access Journals (Sweden)

    Oparanya Wamukoya Windrick

    2015-06-01

    Full Text Available ABSTARCT This study is designed to establish the factors influencing academic of standard eight girls in public primary schools in National exams in Matungu division. The researcher aimed at finding out why there is increased low performance of girls in public schools despite the fact that they are assessed through periodic performance tests do continuous assessment tests CATS midterm carry out tuition and the provision of free primary education which is aimed at improving academic performance. This study adapted a descriptive survey design as a major method of research where data was collected by the researcher members of a population under study. The target population comprised of Head teachers teachers pupils parents and parent schools representatives. Purposive sampling and simple random technique were used. Data was collected by use of questionnaires and interview guides. Data was analyzed by use of descriptive statistics constituting frequencies and percentages.The study established that girls were exposed to harsh school environmental conditions they walked long distances to school schools lacked facilities like toilets libraries and were exposed to male pest teachers. There were also teacher factors like training teacher shortage and motivation that affected girls performance.The study came up with recommendations for improvement of girls academic performance. More public schools should be build to reduce on distance and also overpopulation. The ministry of Education should monitor and evaluate the academic performance of girls in rural areas. The government should put up strict rules on pest teachers. The ministry should hire more teachers.

  19. Moving beyond the welfare standard of psychological well-being for nonhuman primates: the case of chimpanzees.

    Science.gov (United States)

    Gluck, John P

    2014-04-01

    Since 1985, the US Animal Welfare Act and Public Health Service policy have required that researchers using nonhuman primates in biomedical and behavioral research develop a plan "for a physical environment adequate to promote the psychological well-being of primates." In pursuing this charge, housing attributes such as social companionship, opportunities to express species-typical behavior, suitable space for expanded locomotor activity, and nonstressful relationships with laboratory personnel are dimensions that have dominated the discussion. Regulators were careful not to direct a specific set of prescriptions (i.e., engineering standards) for the attainment of these goals, but to leave the design of the programs substantially up to "professional judgment" at the local level. Recently, however, the Institute of Medicine, in its path-finding 2011 report on the necessity of chimpanzee use in research, bypassed this flexible and contingent concept, and instead, required as a central precondition that chimpanzees be housed in "ethologically appropriate" environments. In so doing, obligations of ethical treatment of one great ape species were elevated above the needs of some research. The evolution and significance of this change are discussed.

  20. Building America Case Study: Standard- Versus High-Velocity Air Distribution in High-Performance Townhomes, Denver, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    2017-06-09

    IBACOS investigated the performance of a small-diameter high velocity heat pump system compared to a conventional system in a new construction triplex townhouse. A ductless heat pump system also was installed for comparison, but the homebuyer backed out because of aesthetic concerns about that system. In total, two buildings, having identical solar orientation and comprised of six townhomes, were monitored for comfort and energy performance. Results show that the small-diameter system provides more uniform temperatures from floor to floor in the three-story townhome. No clear energy consumption benefit was observed from either system. The builder is continuing to explore the small-diameter system as its new standard system to provide better comfort and indoor air quality. The homebuilder also explored the possibility of shifting its townhome product to meet the U.S. Department of Energy Challenge Home National Program Requirements. Ultimately, the builder decided that adoption of these practices would be too disruptive midstream in the construction cycle. However, the townhomes met the ENERGY STAR Version 3.0 program requirements.

  1. The Effectiveness of Standardized Patient Experience (SPE Model in Teaching Critical Thinking Capability of Bachelor Nursing Students Compared to Case Study

    Directory of Open Access Journals (Sweden)

    Ryan Hara Permana

    2016-09-01

    Full Text Available Critical thinking is a main ability for nurses. However, the learning methods that are usually used by nursing education institutions cannot facilitate the development of critical thinking of nursing students optimally. This research investigated the effectiveness of Standardized Patient Experience (SPE model in practicing the critical thinking capability of nursing students compared to case study. This quasi-experiment study used 77 nursing students as the samples that were divided into control and experiment group. Although there are no significant different between the total critical thinking scores of the students who participated in SPE compared to case study (p= 0.146, but there are differences in analysis and problem solving aspect (p==0.019 and 0.00. the satisfaction and confidence level of the students toward the SPE are also significantly increased compared to case study (p=0.01 dan p=0.00. To conclude, both the SPE and case study method are effective in developing the critical thinking of the nursing students.

  2. Revealed willingness-to-pay versus standard cost-effectiveness thresholds: Evidence from the South African HIV Investment Case.

    Directory of Open Access Journals (Sweden)

    Gesine Meyer-Rath

    Full Text Available The use of cost-effectiveness thresholds based on a country's income per capita has been criticized for not being relevant to decision making, in particular in middle-income countries such as South Africa. The recent South African HIV Investment Case produced an alternative cost-effectiveness threshold for HIV prevention and treatment interventions based on estimates of life years saved and the country's committed HIV budget.We analysed the optimal mix of HIV interventions over a baseline of the current HIV programme under the committed HIV budget for 2016-2018. We calculated the incremental cost-effectiveness ratio (ICER as cost per life-year saved (LYS of 16 HIV prevention and treatment interventions over 20 years (2016-2035. We iteratively evaluated the most cost effective option (defined by an intervention and its coverage over a rolling baseline to which the more cost effective options had already been added, thereby allowing for diminishing marginal returns to interventions. We constrained the list of interventions to those whose combined cost was affordable under the current HIV budget. Costs are presented from the government perspective, unadjusted for inflation and undiscounted, in 2016 USD.The current HIV budget of about $1.6 billion per year was sufficient to pay for the expansion of condom availability, medical male circumcision, universal treatment, and infant testing at 6 weeks to maximum coverage levels, while also implementing a social and behavior change mass media campaign with a message geared at increasing testing uptake and reducing the number of sexual partners. The combined ICER of this package of services was $547/ LYS. The ICER of the next intervention that was above the affordability threshold was $872/LYS.The results of the South African HIV Investment Case point to an HIV cost-effectiveness threshold based on affordability under the current budget of $547-872 per life year saved, a small fraction of the country's GDP

  3. The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

    Science.gov (United States)

    Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

    2017-04-01

    The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Financial impact of energy efficiency under a federal combined efficiency and renewable electricity standard: Case study of a Kansas 'super-utility'

    International Nuclear Information System (INIS)

    Cappers, Peter; Goldman, Charles

    2010-01-01

    Historically, local, state and federal policies have separately promoted the generation of electricity from renewable technologies and the pursuit of energy efficiency to help mitigate the detrimental effects of global climate change and foster energy independence. Federal policymakers are currently considering and several states have enacted a combined efficiency and renewable electricity standard which proponents argue provides a comprehensive approach with greater flexibility and at lower cost. We examine the financial impacts on various stakeholders from alternative compliance strategies with a Combined Efficiency and Renewable Electricity Standard (CERES) using a case study approach for utilities in Kansas. Our results suggest that an investor-owned utility is likely to pursue the most lucrative compliance strategy for its shareholders-one that under-invests in energy efficiency resources. If a business model for energy efficiency inclusive of both a lost fixed cost recovery mechanism and a shareholder incentive mechanism is implemented, our analysis indicates that an investor-owned utility would be more willing to pursue energy efficiency as a lower-cost CERES compliance strategy. Absent implementing such a regulatory mechanism, separate energy efficiency and renewable portfolio standards would improve the likelihood of reducing reliance on fossil fuels at least-cost through the increased pursuit of energy efficiency.

  5. Darwin Core: An Evolving Community-Developed Biodiversity Data Standard

    Science.gov (United States)

    Wieczorek, John; Bloom, David; Guralnick, Robert; Blum, Stan; Döring, Markus; Giovanni, Renato; Robertson, Tim; Vieglais, David

    2012-01-01

    Biodiversity data derive from myriad sources stored in various formats on many distinct hardware and software platforms. An essential step towards understanding global patterns of biodiversity is to provide a standardized view of these heterogeneous data sources to improve interoperability. Fundamental to this advance are definitions of common terms. This paper describes the evolution and development of Darwin Core, a data standard for publishing and integrating biodiversity information. We focus on the categories of terms that define the standard, differences between simple and relational Darwin Core, how the standard has been implemented, and the community processes that are essential for maintenance and growth of the standard. We present case-study extensions of the Darwin Core into new research communities, including metagenomics and genetic resources. We close by showing how Darwin Core records are integrated to create new knowledge products documenting species distributions and changes due to environmental perturbations. PMID:22238640

  6. Involving stakeholders in policy research should not imply that they control the problem definition: lessons from a case study on new analgesics

    NARCIS (Netherlands)

    Moret-Hartman, M.; van der Wilt, G.J.; Grin, J.

    2009-01-01

    The Dutch Health Care Insurance Board (HCIB) commissions research to guide their policy recommendations. However, the studies conducted do not always yield relevant information. This may result from differences in problem definitions held by the HCIB and target populations. To compensate these

  7. 40 CFR 63.361 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... § 63.362 is required to be in compliance with the standard. Deviation means any instance in which an... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Definitions. 63.361 Section 63.361... EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES Ethylene Oxide Emissions Standards...

  8. 49 CFR 581.4 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Definitions. 581.4 Section 581.4 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.4 Definitions. All terms defined in 49 U.S.C...

  9. 5 CFR 179.302 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Definitions. 179.302 Section 179.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.302 Definitions. Administrative offset, as defined in 31 U.S.C. 3701(a)(1), means...

  10. 42 CFR 489.100 - Definition.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Definition. 489.100 Section 489.100 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Advance Directives § 489.100 Definition...

  11. 40 CFR 406.21 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 406.21 Section 406.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Dry Milling Subcategory § 406.21 Specialized definitions...

  12. 40 CFR 406.11 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 406.11 Section 406.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Corn Wet Milling Subcategory § 406.11 Specialized definitions...

  13. 40 CFR 406.51 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 406.51 Section 406.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Normal Rice Milling Subcategory § 406.51 Specialized definitions...

  14. 7 CFR 70.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... providing independent verification of written quality assurance and value added standards for production... MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF POULTRY PRODUCTS AND RABBIT PRODUCTS Grading of Poultry Products and Rabbit Products Definitions § 70.1 Definitions...

  15. 6 CFR 27.105 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Definitions. 27.105 Section 27.105 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS General § 27.105 Definitions. As used in this part: A Commercial Grade (ACG) shall refer to any...

  16. 40 CFR 408.151 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 408.151... AND STANDARDS CANNED AND PRESERVED SEAFOOD PROCESSING POINT SOURCE CATEGORY Fish Meal Processing Subcategory § 408.151 Specialized definitions. For the purpose of this subpart: (a) Except as provided below...

  17. 40 CFR 125.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Definitions. 125.2 Section 125.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS CRITERIA AND STANDARDS...-Based Treatment Requirements Under Sections 301(b) and 402 of the Act § 125.2 Definitions. For the...

  18. 49 CFR 193.2007 - Definitions.

    Science.gov (United States)

    2010-10-01

    ...: FEDERAL SAFETY STANDARDS General § 193.2007 Definitions. As used in this part: Administrator means the... 49 Transportation 3 2010-10-01 2010-10-01 false Definitions. 193.2007 Section 193.2007... a deviation from normal operation, a structural failure, or severe environmental conditions that...

  19. 30 CFR 75.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... SAFETY STANDARDS-UNDERGROUND COAL MINES General § 75.2 Definitions. The following definitions apply in.... Coal mine. Includes areas of adjoining mines connected underground. Filter Self-Rescuer (FSR). A type... operated equipment taken into or used inby the last open crosscut of an entry or a room of any coal mine...

  20. 46 CFR 197.505 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Definitions. 197.505 Section 197.505 Shipping COAST... GENERAL PROVISIONS Benzene § 197.505 Definitions. As used in this subpart— Action level means an airborne... standard in § 197.520. Person in charge means— (1) For a self propelled vessel, the master or licensed...

  1. 40 CFR 410.11 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 410.11 Section 410.11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Wool Scouring Subcategory § 410.11 Specialized definitions. In...

  2. 40 CFR 410.61 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 410.61 Section 410.61 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Carpet Finishing Subcategory § 410.61 Specialized definitions...

  3. 40 CFR 410.01 - General definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true General definitions. 410.01 Section 410.01 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY General Provisions § 410.01 General definitions. In addition...

  4. 40 CFR 410.21 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Specialized definitions. 410.21 Section 410.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TEXTILE MILLS POINT SOURCE CATEGORY Wool Finishing Subcategory § 410.21 Specialized definitions...

  5. A case study investigating the process of implementing the recommendations of the "National Science Education Standards" by a fourth-grade elementary teacher

    Science.gov (United States)

    Schepige, Adele Catherine

    The National Science Education Standards were published in 1996 (National Research Council (NRC)). The Standards recommend that elementary school science should be taught as inquiry-based, and that teachers should have the time, space, and resources to teach inquiry-based science. A case study was done of a fourth grade teacher who tried to implement the recommendations of the Standards. The teacher had expressed an interest in teaching inquiry-based science even though she had little experience teaching science, had previously avoided teaching science, and had a weak academic background in science. The study focused on the factors that influence a teacher while trying to develop an inquiry-based science program and the factors a teacher attends to while trying to provide student with the time, space, and resources needed to do inquiry-based science. The study also tried to determine what factors helped the teacher determine how a teacher is able to use children's literature with inquiry-based science. The researcher was a participant observer in the teacher's classroom during the 1996-1997 school year. The researcher was involved in planning and teaching science although all final decisions were left to the teacher. Data were obtained by taking extensive field notes, using structured and unstructured interviews, document analysis, and analyzing reflective journals. Results indicate that the teacher was influenced by six major factors: colleagues, reading materials, school context, student behavior, the participant observer, and experimentation. A model for the teacher as a theory builder was developed as a result of her learning, analyzing and experimenting throughout the year. Though not without some problems, children's literature was integrated with science in different ways for different reasons. Constraints to implementing the Standards (NRC, 1996) are discussed.

  6. Rate increase disclosure and review: definitions of "individual market" and "small group market." Final rule.

    Science.gov (United States)

    2011-09-06

    This final rule amends a May 23, 2011, final rule entitled "Rate Increase Disclosure and Review". The final rule provided that, for purposes of rate review only, definitions of "individual market" and "small group market" under State rate filing laws would govern even if those definitions departed from the definitions that otherwise apply under title XXVII of the Public Health Service Act (PHS Act). The preamble to the final rule requested comments on whether this policy should apply in cases in which State rate filing law definitions of "individual market" and "small group market" exclude association insurance policies that would be included in these definitions for other purposes under the PHS Act. In response to comments, this final rule amends the definitions of "individual market" and "small group market" that apply for rate review purposes to include coverage sold to individuals and small groups through associations even if the State does not include such coverage in its definitions of individual and small group market. This final rule also updates standards for health insurance issuers regarding disclosure and review of unreasonable premium increases under section 2794 of the Public Health Service Act.

  7. 40 CFR 792.3 - Definitions.

    Science.gov (United States)

    2010-07-01

    ...) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.3 Definitions. As used in this part the..., association, scientific or academic establishment, government agency, or organizational unit thereof, and any...

  8. 40 CFR 406.81 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Hot Cereal Subcategory § 406.81 Specialized definitions. For the... 40 CFR part 401 shall apply to this subpart. (b) The term cereal shall mean breakfast cereal. ...

  9. 40 CFR 406.91 - Specialized definitions.

    Science.gov (United States)

    2010-07-01

    ... STANDARDS GRAIN MILLS POINT SOURCE CATEGORY Ready-to-Eat Cereal Subcategory § 406.91 Specialized definitions... set forth in 40 CFR part 401 shall apply to this subpart. (b) The term cereal shall mean breakfast cereal. ...

  10. Quality assurance terms and definitions - approved 1973

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    Standards for certain terms and their definitions that are important to the uniform understanding of the intent of required quality assurance practices for the construction of nuclear power plants are presented

  11. Tacit definitions of informal caregiving.

    Science.gov (United States)

    Wrubel, J; Richards, T A; Folkman, S; Acree, M C

    2001-01-01

    This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time. There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to caregivers' understanding of what caregiving entails. These definitions are tacit because they arise from caregivers' taken-for-granted understanding rather than formally articulated positions concerning caregiving. A random sample of 60 men, all of whom were caregiving partners of men with acquired immunodeficiency syndrome (AIDS), was drawn from a larger cohort of 253 participants in the University of California San Francisco (UCSF) Coping Project (1990-1997). The caregivers were assessed bimonthly for 2 years with procedures that included a semi-structured interview focusing on a recent stressful event involving caregiving, and quantitative measures of well-being. Interpretive phenomenological case studies of the narrative accounts of the 60 caregivers produced three tacit definitions of caregiving - engagement, conflict and distance. These three tacit definitions were distinguished by differences in learning about caregiving, involvement in health care decisions, caregiving activities and reported sources of stress. The three groups differed on measures of dyadic adjustment, depression, anger and anxiety. Better understanding of caregivers' tacit definitions can facilitate and enhance effective support and interventions for caregivers.

  12. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

    Directory of Open Access Journals (Sweden)

    Diogo Turiani Hourneaux De Moura

    2016-12-01

    Full Text Available Abstract Background When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. Case presentation A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL. Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm, localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. Conclusions To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has

  13. Considerations concerning the definition of sarcopenia.

    Science.gov (United States)

    Dawson-Hughes, B; Bischoff-Ferrari, H

    2016-11-01

    In this commentary, we describe the sarcopenia spectrum that results in frailty and consider the impact of several components of the frailty definition on its global prevalence. We review proposed operational definitions of sarcopenia and the extent to which they have been shown to predict hard clinical outcomes, such as hip fracture, falls, and mortality. A head-to-head comparison of nine proposed operational definitions of sarcopenia as predictors of falls revealed that the definition involving appendicular lean mass (ALM)/ht 2 alone was a significant predictor; the prevalence of sarcopenia by this definition was 11 %. We consider the strengths and limitations of definitions that include functional measurements, such as gait speed and grip strength, along with measures of lean tissue mass. The functional assessments are harder to standardize than the more objective ALM measurements. The prevalence of sarcopenia by definitions that include functional and lean mass measurements tends to be lower than the prevalence by definitions that include lean mass alone. A low prevalence limits opportunity for early identification and application of prevention strategies. For these and other reasons, it seems advantageous to base the operational definition of sarcopenia on ALM/ht 2 alone. This commentary addresses the importance of a globally applicable operational definition of sarcopenia and both desirable and undesirable features of such a definition.

  14. The SGML Standardization Framework and the Introduction of XML

    Science.gov (United States)

    Grütter, Rolf

    2000-01-01

    Extensible Markup Language (XML) is on its way to becoming a global standard for the representation, exchange, and presentation of information on the World Wide Web (WWW). More than that, XML is creating a standardization framework, in terms of an open network of meta-standards and mediators that allows for the definition of further conventions and agreements in specific business domains. Such an approach is particularly needed in the healthcare domain; XML promises to especially suit the particularities of patient records and their lifelong storage, retrieval, and exchange. At a time when change rather than steadiness is becoming the faithful feature of our society, standardization frameworks which support a diversified growth of specifications that are appropriate to the actual needs of the users are becoming more and more important; and efforts should be made to encourage this new attempt at standardization to grow in a fruitful direction. Thus, the introduction of XML reflects a standardization process which is neither exclusively based on an acknowledged standardization authority, nor a pure market standard. Instead, a consortium of companies, academic institutions, and public bodies has agreed on a common recommendation based on an existing standardization framework. The consortium's process of agreeing to a standardization framework will doubtlessly be successful in the case of XML, and it is suggested that it should be considered as a generic model for standardization processes in the future. PMID:11720931

  15. The SGML standardization framework and the introduction of XML.

    Science.gov (United States)

    Fierz, W; Grütter, R

    2000-01-01

    Extensible Markup Language (XML) is on its way to becoming a global standard for the representation, exchange, and presentation of information on the World Wide Web (WWW). More than that, XML is creating a standardization framework, in terms of an open network of meta-standards and mediators that allows for the definition of further conventions and agreements in specific business domains. Such an approach is particularly needed in the healthcare domain; XML promises to especially suit the particularities of patient records and their lifelong storage, retrieval, and exchange. At a time when change rather than steadiness is becoming the faithful feature of our society, standardization frameworks which support a diversified growth of specifications that are appropriate to the actual needs of the users are becoming more and more important; and efforts should be made to encourage this new attempt at standardization to grow in a fruitful direction. Thus, the introduction of XML reflects a standardization process which is neither exclusively based on an acknowledged standardization authority, nor a pure market standard. Instead, a consortium of companies, academic institutions, and public bodies has agreed on a common recommendation based on an existing standardization framework. The consortium's process of agreeing to a standardization framework will doubtlessly be successful in the case of XML, and it is suggested that it should be considered as a generic model for standardization processes in the future.

  16. Establishing the isolated Standard Model

    International Nuclear Information System (INIS)

    Wells, James D.; Zhang, Zhengkang; Zhao, Yue

    2017-02-01

    The goal of this article is to initiate a discussion on what it takes to claim ''there is no new physics at the weak scale,'' namely that the Standard Model (SM) is ''isolated.'' The lack of discovery of beyond the SM (BSM) physics suggests that this may be the case. But to truly establish this statement requires proving all ''connected'' BSM theories are false, which presents a significant challenge. We propose a general approach to quantitatively assess the current status and future prospects of establishing the isolated SM (ISM), which we give a reasonable definition of. We consider broad elements of BSM theories, and show many examples where current experimental results are not sufficient to verify the ISM. In some cases, there is a clear roadmap for the future experimental program, which we outline, while in other cases, further efforts - both theoretical and experimental - are needed in order to robustly claim the establishment of the ISM in the absence of new physics discoveries.

  17. Establishing the isolated standard model

    Science.gov (United States)

    Wells, James D.; Zhang, Zhengkang; Zhao, Yue

    2017-07-01

    The goal of this article is to initiate a discussion on what it takes to claim "there is no new physics at the weak scale," namely that the Standard Model (SM) is "isolated." The lack of discovery of beyond the SM (BSM) physics suggests that this may be the case. But to truly establish this statement requires proving all "connected" BSM theories are false, which presents a significant challenge. We propose a general approach to quantitatively assess the current status and future prospects of establishing the isolated SM (ISM), which we give a reasonable definition of. We consider broad elements of BSM theories, and show many examples where current experimental results are not sufficient to verify the ISM. In some cases, there is a clear roadmap for the future experimental program, which we outline, while in other cases, further efforts—both theoretical and experimental—are needed in order to robustly claim the establishment of the ISM in the absence of new physics discoveries.

  18. On new methodological and other standards in planning: The case of the Master Plan of Belgrade 2021

    Directory of Open Access Journals (Sweden)

    Vujošević Miodrag L.

    2002-01-01

    changed structure of stakeholders and concomitant institutional arrangements. This also applies to 'educators' in general, because the prolonged international isolation of the FR Yugoslavia has caused the gross of their knowledge and capabilities irrelevant. In sum, it seems that many planners would not be able to assume new roles that they are expected to on the part of the society at large. (8The planning/policy information, research, institutional and other support provided by the state and other agents often does not satisfy even the most basic needs in this fields, partly for a general scarcity of resources concomitant to the overall and deep social, economic and political crisis the society found itself in the 1990s. (9 Most frightfully, manipulation, paternalism and clientelism still represent dominant forms of power, which is a problem by itself in Yugoslavia being one of the most corruptive countries in the world. What is now most missing is a non-manipulative persuasion, as well as the authority of professional values, as the communication and interaction forms that seem only promising for and supportive to developing of a democratic, emancipatory and transformative planning mode. A number of attempts during the last decade to embark upon the preparation of the new 'Master Plan of the City Belgrade' (in the sequel: MP came into realization not before the democratic political changes of October 2000 took place in Serbia. However, the so far undertaken steps do not seem promising, as they failed to satisfy a number of methodological and other standards, as well as to introduce necessary innovations. Unfortunately, the MP was commissioned to the Bureau of Urban Planning of the City of Belgrade (otherwise a 'faithful ally' of all non-democratic regimes in the City's urban planning and related matters over the last more than ten years now, during which there has been a so far unrecorded squandering and illegal privatization of public urban assets, mostly uncontrolled

  19. 7 CFR 29.24 - Official standards.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Official standards. 29.24 Section 29.24 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Regulations Definitions § 29.24 Official standards. Standards for tobacco promulgated by the...

  20. 7 CFR 29.25 - Tentative standards.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Tentative standards. 29.25 Section 29.25 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Regulations Definitions § 29.25 Tentative standards. Standards for tobacco prepared by the...

  1. A modern definition of mediastinal compartments.

    Science.gov (United States)

    Carter, Brett W; Tomiyama, Noriyuki; Bhora, Faiz Y; Rosado de Christenson, Melissa L; Nakajima, Jun; Boiselle, Phillip M; Detterbeck, Frank C; Marom, Edith M

    2014-09-01

    Division of the mediastinum into compartments is used to help narrow the differential diagnosis of newly detected mediastinal masses, to assist in planning biopsy and surgical procedures, and to facilitate communication among clinicians of multiple disciplines. Several traditional mediastinal division schemes exist based upon arbitrary landmarks on the lateral chest radiograph. We describe a modern, computed tomography-based mediastinal division scheme, which has been accepted by the International Thymic Malignancy Interest Group as a new standard. This clinical classification defines a prevascular (anterior), a visceral (middle), and a paravertebral (posterior) compartment, with anatomic boundaries defined clearly by computed tomography. It is our intention that this definition be used in the reporting of clinical cases and the design of prospective clinical trials.

  2. The Causal Effect of Student Mobility on Standardized Test Performance: A Case Study with Possible Implications for Accountability Mandates within the Elementary and Secondary Education Act

    Directory of Open Access Journals (Sweden)

    Arielle Selya

    2016-07-01

    Full Text Available This paper presents a limited case study examining the causal inference of student mobility on standardized test performance, within one middle-class high school in suburban Connecticut. Administrative data were used from a district public high school enrolling 319 10th graders in 2010. Propensity score methods were used to estimate the causal effect of student mobility on Math, Science, Reading, and Writing portions of the Connecticut Academic Performance Test (CAPT, after matching mobile vs. stable students on gender, race/ethnicity, eligibility for free/reduced lunches, and special education status. Analyses showed that mobility was associated with lower performance in the CAPT Writing exam. Follow-up analyses revealed that this trend was only significant among those who were ineligible for free/reduced lunches, but not among eligible students. Additionally, mobile students who were ineligible for free/reduced lunches had lower performance in the CAPT Science exam according to some analyses. Large numbers of students transferring into a school district may adversely affect standardized test performance. This is especially relevant for policies that affect student mobility in schools, given the accountability measures in the No Child Left Behind that are currently being re-considered in the recent Every Student Succeeds Act.

  3. The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: administrative case report.

    Science.gov (United States)

    Schreiber, Joseph; Marchetti, Gregory F; Racicot, Brook; Kaminski, Ellen

    2015-04-01

    Pediatric physical therapists face many challenges related to the application of research evidence to clinical practice. A multicomponent knowledge translation (KT) program may be an effective strategy to support practice change. The purpose of this case report is to describe the use of a KT program to improve the knowledge and frequency of use of standardized outcome measures by pediatric physical therapists practicing in an outpatient clinic. This program occurred at a pediatric outpatient facility with 1 primary clinic and 3 additional satellite clinics, and a total of 17 physical therapists. The initial underlying problem was inconsistency across staff recommendations for frequency and duration of physical therapist services. Formal and informal discussion with the department administrator and staff identified a need for increased use of standardized outcome measures to inform these decisions. The KT program to address this need spanned 6 months and included identification of barriers, the use of a knowledge broker, multiple workshop and practice sessions, online and hard-copy resources, and ongoing evaluation of the KT program with dissemination of results to staff. Outcome measures included pre- and post-knowledge assessment and self-report surveys and chart review data on use of outcome measures. Participants (N=17) gained knowledge and increased the frequency of use of standardized outcome measures based on data from self-report surveys, a knowledge assessment, and chart reviews. Administrators and others interested in supporting practice change in physical therapy may consider implementing a systematic KT program that includes a knowledge broker, ongoing engagement with staff, and a variety of accessible resources. © 2015 American Physical Therapy Association.

  4. 40 CFR 92.102 - Definitions and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... the number of carbon atoms in a molecule of that compound. Precision means the standard deviation of... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Definitions and abbreviations. 92.102... Definitions and abbreviations. The definitions and abbreviations of subpart A of this part apply to this...

  5. Hadoop The Definitive Guide

    CERN Document Server

    White, Tom

    2009-01-01

    Hadoop: The Definitive Guide helps you harness the power of your data. Ideal for processing large datasets, the Apache Hadoop framework is an open source implementation of the MapReduce algorithm on which Google built its empire. This comprehensive resource demonstrates how to use Hadoop to build reliable, scalable, distributed systems: programmers will find details for analyzing large datasets, and administrators will learn how to set up and run Hadoop clusters. Complete with case studies that illustrate how Hadoop solves specific problems, this book helps you: Use the Hadoop Distributed

  6. NASA Technology Readiness Level Definitions

    Science.gov (United States)

    Mcnamara, Karen M.

    2012-01-01

    This presentation will cover the basic Technology Readiness Level (TRL) definitions used by the National Aeronautics and Space Administration (NASA) and their specific wording. We will discuss how they are used in the NASA Project Life Cycle and their effectiveness in practice. We'll also discuss the recent efforts by the International Standards Organization (ISO) to develop a broadly acceptable set of TRL definitions for the international space community and some of the issues brought to light. This information will provide input for further discussion of the use of the TRL scale in manufacturing.

  7. Standard English and Language Attitudes

    OpenAIRE

    ソランキ, ネイディン

    2005-01-01

    This paper investigates the attitudes and opinions surrounding Standard English (SE) within the United Kingdom. The definition of SE, for the purposes of this study, is standard grammar and standard pronunciation of southern English, commonly referred to as 'BBC English'. The subject of SE and attitudes towards different accents and dialects of British English is emotive and attracts strong opinions. The main issues discussed here are the place of language in society, the social implications ...

  8. 12 CFR 233.2 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... participants in playing the game or contest or obtaining access to the Internet; or (B) Points or credits that... FUNDING OF UNLAWFUL INTERNET GAMBLING (REGULATION GG) § 233.2 Definitions. The following definitions apply... individuals (athletes in the case of sports events) in multiple real-world sporting or other events. (C) No...

  9. 25 CFR 23.2 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Purpose, Definitions, and Policy § 23.2 Definitions. Act means the Indian Child Welfare Act (ICWA), Pub. L. 95-608, 92 Stat. 3069... or, in the case of an Indian child who is a member of or is eligible for membership in more than one...

  10. 24 CFR 1006.10 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... expenses, in the case of an elderly or disabled family; and (ii) Reasonable attendant care and auxiliary... term is defined in section 102 of the Controlled Substances Act). Elderly families; near-elderly... NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.10 Definitions. The following definitions...

  11. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report.

    Science.gov (United States)

    De Moura, Diogo Turiani Hourneaux; Chacon, Danielle Azevedo; Tanigawa, Ryan; Coronel, Martin; Cheng, Spencer; Artifon, Éverson L A; Jukemura, José; De Moura, Eduardo Guimarães Hourneaux

    2016-12-01

    When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL). Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm) and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm), localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has proven to be the best method to diagnose solid pancreatic lesions. In

  12. Definitions of Quantities and Units.

    Science.gov (United States)

    Spurgin, C. B.

    1983-01-01

    Compares various methods of defining derived quantities, arguing for a definitional formula using base or fundamental units in a word equation, or symbol-equations with the symbols explained. Suggests that fundamental units be defined operationally or left regarded as intuitive as in the case of length and time. (JM)

  13. Analysis by multiple criteria for the definition of environmental fragility levels – A case study: watershed of Cará-Cará River, Ponta Grossa/PR

    Directory of Open Access Journals (Sweden)

    Marcos Antonio Miara

    2007-06-01

    Full Text Available The GIS (Geographical Information Systems, as a tool for theenvironmental analyses of specific modules, makes possiblethe use of different sources of information simultaneously. Inorder to exploit this characteristic, the present research applieda Multi criteria evaluation (MCE, using also the AHP (AnalyticHierarchy Process for the identification of differentiated levelsof environmental fragility from the definition of weights for theconsidered physical variables. The work has used the Cará-Cará River watershed, Ponta Grossa/PR, as its study area.The results have shown a five-class variation of environmentalfragility, which have been correlated witch the reality, givingsupport to a positive evaluation of the methods which wereused.

  14. The standard treatment protocol for paracetamol poisoning may be inadequate following overdose with modified release formulation: a pharmacokinetic and clinical analysis of 53 cases.

    Science.gov (United States)

    Salmonson, Heléne; Sjöberg, Gunilla; Brogren, Jacob

    2018-01-01

    The use of the standard procedure for managing overdoses with immediate release (IR) paracetamol is questionable when applied to overdoses with modified release (MR) formulations. This study describes the pharmacokinetics of paracetamol and the clinical outcomes following overdoses with a MR formulation. Medical records including laboratory analyses concerning overdoses of MR paracetamol from 2009 to 2015 were collected retrospectively. Inclusion criteria were ingestion of a toxic dose, known time of intake and documented measurements of serum paracetamol and liver function tests. Graphical analysis, descriptive statistics and population pharmacokinetic modelling were used to describe data. Fifty-three cases were identified. Median age was 26 years (range 13-68), median dose was 20 g (range 10-166) and 74% were females. The pharmacokinetic analysis showed a complex, dose dependent serum versus time profile with prolonged absorption and delayed serum peak concentrations with increasing dose. Ten patients had persistently high serum levels for 24 h or more, six of them had a second peak 8-19 h after ingestion. Seven of 34 patients receiving N-acetylcysteine (NAC) within 8 h had alanine aminotransferase (ALT) above reference range. Three of them developed hepatotoxicity (ALT >1000 IU/l). The pharmacokinetic and clinical analysis showed that the standard treatment protocol, including risk assessment and NAC regimen, used for IR paracetamol poisoning not appear suitable for MR formulation. Individual and tailored treatment may be valuable but further studies are warranted to determine optimal regimen of overdoses with MR formulation.

  15. Definitions of deafblindness and congenital deafblindness

    DEFF Research Database (Denmark)

    Ask Larsen, Flemming; Damen, Saskia

    2014-01-01

    . A systematic review of definitions used in (N = 30) studies employing psychological assessment of people with CDB served as a sample of the scientific literature on DB and CDB. Absent or heterogeneous definitions and inclusion criteria regarding both DB and CDB are evident in the sample. Fifty percent...... of the studies reported no definition of DB and 76.7% reported no definition of CDB. Main discrepancies are: (1) medical/functional versus ability/functioning definitions regarding DB; and (2) different criteria for onset of DB in the case of defining CDB (e.g. age versus developmental level). The results......: definitions of DB and CDB used; severity of sensory impairments; level of sensory ability in relation to mobility, access to information, and communication; age at onset of DB; and communication as well as language ability at onset of DB....

  16. 7 CFR 810.1801 - Definition of sunflower seed.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Definition of sunflower seed. 810.1801 Section 810... STATES STANDARDS FOR GRAIN United States Standards for Sunflower Seed Terms Defined § 810.1801 Definition of sunflower seed. Grain that, before the removal of foreign material, consists of 50.0 percent or...

  17. National standards for ACV's and the IMO code - 'Putting flesh on the skeleton'

    Science.gov (United States)

    Wade, R. G.

    The 'Code of Safety for Dynamically Supported Craft' is the international safety standard developed for air-cushion vehicles (ACVs), surface-effect ships, hydrofoils, etc. The relationship between this code and national domestic standards is presently discussed in light of Canadian Coast Guard experience to date. Several of the mode definitive requirements of the international code are noted to be in need of modification; attention is also drawn to cases in which a nationally-certified ACV will conform to the international code, but not to the standards of another nation which nevertheless conform with the international code.

  18. 29 CFR 6.2 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Definitions. 6.2 Section 6.2 Labor Office of the Secretary of Labor RULES OF PRACTICE FOR ADMINISTRATIVE PROCEEDINGS ENFORCING LABOR STANDARDS IN FEDERAL AND... Fair Labor Standards, Office of the Solicitor, U.S. Department of Labor, Washington, DC 20210. (c...

  19. 42 CFR 409.3 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... HOSPITAL INSURANCE BENEFITS Hospital Insurance Benefits: General Provisions § 409.3 Definitions. As used in..., or approved as meeting the standards for licensing, by the State or local licensing agency; and (e) If it is a foreign hospital, is licensed, or approved as meeting the standard for licensing, by the...

  20. 48 CFR 30.001 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION 30.001 Definitions. As used in this part— Affected CAS-covered contract or subcontract means a contract or subcontract subject to Cost Accounting Standards (CAS) rules and regulations for which a contractor or subcontractor— (1) Used one cost accounting practice to...

  1. 23 CFR 750.102 - Definitions.

    Science.gov (United States)

    2010-04-01

    ... National Standards for Regulation by States of Outdoor Advertising Adjacent to the Interstate System Under the 1958 Bonus Program § 750.102 Definitions. The following terms when used in the standards in this... particular scenic beauty or historical significance designated by or pursuant to State law as a scenic area...

  2. 40 CFR 60.271a - Definitions.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Definitions. 60.271a Section 60.271a Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Steel Plants: Electric Arc Furnaces and...

  3. 40 CFR 192.01 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... after some or all of such metal, such as uranium, has been extracted. (n) Disposal period means the... AND ENVIRONMENTAL PROTECTION STANDARDS FOR URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites § 192.01 Definitions. (a...

  4. 38 CFR 21.5021 - Definitions.

    Science.gov (United States)

    2010-07-01

    .... (Authority: 38 U.S.C. 3221(b)) (j) Benefit period means: (1) For a course leading to a standard college... standard college degree or for a correspondence course that period of time from the beginning of the.... Chapter 32 General § 21.5021 Definitions. For the purposes of subpart G and payment of benefits under 38 U...

  5. 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study.

    Science.gov (United States)

    Velayutham, Vimalraj; Fuks, David; Nomi, Takeo; Kawaguchi, Yoshikuni; Gayet, Brice

    2016-01-01

    To evaluate the effect of three-dimensional (3D) visualization on operative performance during elective laparoscopic liver resection (LLR). Major limitations of conventional laparoscopy are lack of depth perception and tactile feedback. Introduction of robotic technology, which employs 3D imaging, has removed only one of these technical obstacles. Despite the significant advantages claimed, 3D systems have not been widely accepted. In this single institutional study, 20 patients undergoing LLR by high-definition 3D laparoscope between April 2014 and August 2014 were matched to a retrospective control group of patients who underwent LLR by two-dimensional (2D) laparoscope. The number of patients who underwent major liver resection was 5 (25%) in the 3D group and 10 (25%) in the 2D group. There was no significant difference in contralateral wedge resection or combined resections between the 3D and 2D groups. There was no difference in the proportion of patients undergoing previous abdominal surgery (70 vs. 77%, p = 0.523) or previous hepatectomy (20 vs. 27.5%, p = 0.75). The operative time was significantly shorter in the 3D group when compared to 2D (225 ± 109 vs. 284 ± 71 min, p = 0.03). There was no significant difference in blood loss in the 3D group when compared to 2D group (204 ± 226 in 3D vs. 252 ± 349 ml in 2D group, p = 0.291). The major complication rates were similar, 5% (1/20) and 7.5% (3/40), respectively, (p ≥ 0.99). 3D visualization may reduce the operating time compared to high-definition 2D. Further large studies, preferably prospective randomized control trials are required to confirm this.

  6. A redesign of OGC Symbology Encoding standard for sharing cartography

    Directory of Open Access Journals (Sweden)

    Erwan Bocher

    2018-01-01

    Full Text Available Despite most Spatial Data Infrastructures offering service-based visualization of geospatial data, requirements are often at a very basic level leading to poor quality of maps. This is a general observation for any geospatial architecture as soon as open standards as those of the Open Geospatial Consortium (OGC are applied. To improve the situation, this paper does focus on improvements at the portrayal interoperability side by considering standardization aspects. We propose two major redesign recommendations. First to consolidate the cartographic theory at the core of the OGC Symbology Encoding standard. Secondly to build the standard in a modular way so as to be ready to be extended with upcoming future cartographic requirements. Thus, we start by defining portrayal interoperability by means of typical-use cases that frame the concept of sharing cartography. Then we bring to light the strengths and limits of the relevant open standards to consider in this context. Finally we propose a set of recommendations to overcome the limits so as to make these use cases a true reality. Even if the definition of a cartographic-oriented standard is not able to act as a complete cartographic design framework by itself, we argue that pushing forward the standardization work dedicated to cartography is a way to share and disseminate good practices and finally to improve the quality of the visualizations.

  7. Are Fish and Standardized FETAX Assays Protective Enough for Amphibians? A Case Study on Xenopus laevis Larvae Assay with Biologically Active Substances Present in Livestock Wastes

    Directory of Open Access Journals (Sweden)

    Federica Martini

    2012-01-01

    Full Text Available Biologically active substances could reach the aquatic compartment when livestock wastes are considered for recycling. Recently, the standardized FETAX assay has been questioned, and some researchers have considered that the risk assessment performed on fish could not be protective enough to cover amphibians. In the present study a Xenopus laevis acute assay was developed in order to compare the sensitivity of larvae relative to fish or FETAX assays; veterinary medicines (ivermectin, oxytetracycline, tetracycline, sulfamethoxazole, and trimethoprim and essential metals (zinc, copper, manganese, and selenium that may be found in livestock wastes were used for the larvae exposure. Lethal (LC50 and sublethal effects were estimated. Available data in both, fish and FETAX studies, were in general more protective than values found out in the current study, but not in all cases. Moreover, the presence of nonlethal effects, caused by ivermectin, zinc, and copper, suggested that several physiological mechanisms could be affected. Thus, this kind of effects should be deeply investigated. The results obtained in the present study could expand the information about micropollutants from livestock wastes on amphibians.

  8. The policy effects of feed-in tariff and renewable portfolio standard: A case study of China's waste incineration power industry.

    Science.gov (United States)

    Xin-Gang, Zhao; Yu-Zhuo, Zhang; Ling-Zhi, Ren; Yi, Zuo; Zhi-Gong, Wu

    2017-10-01

    Among the regulatory policies, feed-in tariffs (FIT) and renewable portfolio standards (RPS) are the most popular to promote the development of renewable energy power industry. They can significantly contribute to the expansion of domestic industrial activities in terms of sustainable energy. This paper uses system dynamics (SD) to establish models of long-term development of China's waste incineration power industry under FIT and RPS schemes, and provides a case study by using scenario analysis method. The model, on the one hand, not only clearly shows the complex logical relationship between the factors but also assesses policy effects of the two policy tools in the development of the industry. On the other hand, it provides a reference for scholars to study similar problems in different countries, thereby facilitating an understanding of waste incineration power's long-term sustainable development pattern under FIT and RPS schemes, and helping to provide references for policy-making institutions. The results show that in the perfect competitive market, the implementation of RPS can promote long-term and rapid development of China's waste incineration power industry given the constraints and actions of the mechanisms of RPS quota proportion, the TGC valid period, and fines, compared with FIT. At the end of the paper, policy implications are offered as references for the government. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Turkish Accounting Standards, IAS - 39 "Financial Instruments: Recognition and Measurement" Under the Cash Flow Hedge Derivative Products Use: The Case of Forward

    Directory of Open Access Journals (Sweden)

    Emine ÇINA BAL

    2013-06-01

    Full Text Available Businesses face interest rate, exchange rate, liquidity, use derivative financial instruments to hedge against such risks. Forward transactions with derivative financial instruments, the non-organized markets, interest rates pre-determined future date, foreign currency contracts that contain delivery of goods as well as financial assets. Cash flow hedge that forms the subject of this study, a recognized asset or liability or a highly probable forecast transaction and the net profit or loss attributable to a particular risk of affecting the nature of a cash flow hedge to hedge changes in the process. Study the case of the application of foreign money has a tangible fixed asset purchases. Related to the purchase of tangible fixed assets at future foreign mercenaries were forward contracts to hedge the cash flow risk. Forward contracts, principal accounts on the balance sheet in accordance with IAS 39 Standard, derivative financial instruments are shown as fixed assets. The fair value of the contract during the contract period at the end of the period to show the valuation differences arising from the valuation of equity shown in the balance sheet. Net valuation differences arising from the contract are accounted for by two separate options. The first option, the net costs associated with the asset valuation difference. The second option is deducted from the amount of depreciation for the asset at the end of the period.

  10. Diagnosis and definition of an action plan related to the management system conformed to the ISO 17025; case of the laboratory of Microbiology - CNSTN

    International Nuclear Information System (INIS)

    Adeili, Abderrahmen

    2007-01-01

    The accreditations permit the laboratories of tests and analysis to prove the quality of their organization and to ensure the reliability of their results. This report - ratio approaches the various stages of the installation from a system of management quality, within a microbiological analysis laboratory with the CNSTN ( National center for nuclear sciences and technologies). The setting is begin with the staff training on the requirements from the standard ISO 17025. In continuation a plan of initial diagnosis to locate the laboratory compared to the requirements of the standard to succeed finally an action plan detailing the actions to be carried out to reach the accreditation. (Author). 7 refs

  11. Governing through standards

    DEFF Research Database (Denmark)

    Brøgger, Katja

    This abstract adresses the ways in which new education standards have become integral to new modes of education governance. The paper explores the role of standards for accelerating the shift from national to transnational governance in higher education. Drawing on the case of higher education...... development in Scandinavia, the paper focuses on the unintended effects of the new international standards. The Bologna process was reframed and recontextualized in ways that undermined the very system it was set out to transform and govern....

  12. A definition of background independence

    International Nuclear Information System (INIS)

    Gryb, Sean

    2010-01-01

    We propose a definition for background (in)/dependence in dynamical theories of the evolution of configurations that have a continuous symmetry and test this definition on particle models and on gravity. Our definition draws from Barbour's best matching framework developed for the purpose of implementing spatial and temporal relationalism. Among other interesting theories, general relativity can be derived within this framework in novel ways. We study the detailed canonical structure of a wide range of best matching theories and show that their actions must have a local gauge symmetry. When gauge theory is derived in this way, we obtain at the same time a conceptual framework for distinguishing between background-dependent and -independent theories. Gauge invariant observables satisfying Kuchar's criterion are identified and, in simple cases, explicitly computed. We propose a procedure for inserting a global background time into temporally relational theories. Interestingly, using this procedure in general relativity leads to unimodular gravity.

  13. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same

  14. 77 FR 32444 - Minimum Internal Control Standards

    Science.gov (United States)

    2012-06-01

    ... discrepancy between the smart card definition and the patron deposit account standards by eliminating the definitional requirement that smart cards be the only source of account data. Second, it no longer lists... a player. Smart card. A card with embedded integrated circuits that possesses the means to...

  15. Product Structure, the Heart of Product Definition

    Science.gov (United States)

    DeHoog, C., Jr.

    1999-01-01

    This paper describes the LMMSS Product Definition System (PDS) philosophy and approach were the use of each item parts document or software can be traced to a specific end item (EI) serial/tail number of the product. It explains why a part-oriented approach to data organization and configuration management is required. The definition of part-oriented is that all appropriate product definition data products will be collected. Referenced and managed by their linkage/relationship to parts/items, The paper will touch upon how LMMSS store/controls product definition information under each project's top product designator in a two tiered approach. One tier for each product end item and another tier which contain/controls listings of drawings, documents. Specifications and standards that are required for hardware item definition.

  16. Definition of drug resistance of Mycobacterium tuberculosis to antituberculosis drugs in patients with multidrugresistant tuberculosis and TB with extremely drug resistant depending on the case of the disease

    Directory of Open Access Journals (Sweden)

    Kryzhanovsky D.G.

    2014-11-01

    Full Text Available There was studied the profile of drug resistance to the main (I line and reserve (II line antituberculosis drugs in patients with MDR and XDR tuberculosis, depending of the case of the disease. According to the randomized retrospective research 200 patients with MDR and XDR tuberculosis, who received treatment in the clinic of hospital Municipal institution «Dnipropetrovsk rigional clinical association «Phthisiology» Dnipropetrovsk regional Council» during the period 2010 – 2012 were involved. Data about patients contained the data on a case of the disease and the results of the test of drug sensitivity to MBT. XDR – TB was revealed in 7.5% of patients with MDR tuberculosis. In patients with MDR tuberculosis as compared with patients with XDR tuberculosis «new cases» were diagnosed in 19.5% against 18.5% (p <0.05. In patients with MDR tuberculosis and with XDR tuberculosis resistance to the antituberculosis drug more commonly developed to S - 88.5%, E - 55% and Z - 24%. The presence of MDR-TB and XDR-TB prevails in patients, who underwent previous courses of treatment with anti-TB drugs in case history as compared with patients with «new cases» of treatment. The development of resistance to anti-TB drugs depends on the availability of these drugs in the previous treatment regimens.

  17. Standard of Care Versus Metastases-directed Therapy for PET-detected Nodal Oligorecurrent Prostate Cancer Following Multimodality Treatment: A Multi-institutional Case-control Study.

    Science.gov (United States)

    Steuber, T; Jilg, C; Tennstedt, P; De Bruycker, A; Tilki, D; Decaestecker, K; Zilli, T; Jereczek-Fossa, B A; Wetterauer, U; Grosu, A L; Schultze-Seemann, W; Heinzer, H; Graefen, M; Morlacco, A; Karnes, R J; Ost, P

    2018-03-10

    Most prostate cancer (PCa) patients with a biochemical failure following primary multimodality treatment (surgery and postoperative radiotherapy) relapse in the nodes. To perform a matched-case analysis in men with lymph node recurrent PCa comparing standard of care (SOC) with metastasis-directed therapy (MDT). PCa patients with a prostate-specific antigen (PSA) progression following multimodality treatment were included in this retrospective multi-institutional analysis. The SOC cohort (n=1816) received immediate or delayed androgen deprivation therapy administered at PSA progression. The MDT cohort (n=263) received either salvage lymph node dissection (n=166) or stereotactic body radiotherapy (n=97) at PSA progression to a positron emission tomography-detected nodal recurrence. The primary endpoint, cancer-specific survival (CSS), was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. At a median follow-up of 70 (interquartile range: 48-98) mo, MDT was associated with an improved CSS on univariate (p=0.029) and multivariate analysis (hazard ratio: 0.33, 95% confidence interval [CI]: 0.17-0.64) adjusted for the year of radical prostatectomy (RP), age at RP, PSA at RP, time from RP to PSA progression, Gleason score, surgical margin status, pT- and pN-stage. In total, 659 men were matched (3:1 ratio). The 5-yr CSS was 98.6% (95% CI: 94.3-99.6) and 95.7% (95% CI: 93.2-97.3) for MDT and SOC, respectively (p=0.005, log-rank). The main limitations of our study are its retrospective design and lack of standardization of systemic treatment in the SOC cohort. MDT for nodal oligorecurrent PCa improves CSS as compared with SOC. These retrospective data from a multi-institutional pooled analysis should be considered as hypothesis-generating and inform future randomized trials in this setting. Prostate cancer patients experiencing a lymph node recurrence might benefit from local treatments directed at

  18. Grain Elevators: New Source Performance Standards (NSPS)

    Science.gov (United States)

    The New Source Performance Standards (NSPS) for Grain Elevators aims to reduce particulate matter pollution. The new amendments seek to clarify definitions, and requirements, as well as propose new regulations on particulate matter emissions

  19. The Epidemiology of Transfusion-related Acute Lung Injury Varies According to the Applied Definition of Lung Injury Onset Time.

    Science.gov (United States)

    Vande Vusse, Lisa K; Caldwell, Ellen; Tran, Edward; Hogl, Laurie; Dinwiddie, Steven; López, José A; Maier, Ronald V; Watkins, Timothy R

    2015-09-01

    Research that applies an unreliable definition for transfusion-related acute lung injury (TRALI) may draw false conclusions about its risk factors and biology. The effectiveness of preventive strategies may decrease as a consequence. However, the reliability of the consensus TRALI definition is unknown. To prospectively study the effect of applying two plausible definitions of acute respiratory distress syndrome onset time on TRALI epidemiology. We studied 316 adults admitted to the intensive care unit and transfused red blood cells within 24 hours of blunt trauma. We identified patients with acute respiratory distress syndrome, and defined acute respiratory distress syndrome onset time two ways: (1) the time at which the first radiographic or oxygenation criterion was met, and (2) the time both criteria were met. We categorized two corresponding groups of TRALI cases transfused in the 6 hours before acute respiratory distress syndrome onset. We used Cohen's kappa to measure agreement between the TRALI cases and implicated blood components identified by the two acute respiratory distress syndrome onset time definitions. In a nested case-control study, we examined potential risk factors for each group of TRALI cases, including demographics, injury severity, and characteristics of blood components transfused in the 6 hours before acute respiratory distress syndrome onset. Forty-two of 113 patients with acute respiratory distress syndrome were TRALI cases per the first acute respiratory distress syndrome onset time definition and 63 per the second definition. There was slight agreement between the two groups of TRALI cases (κ = 0.16; 95% confidence interval, -0.01 to 0.33) and between the implicated blood components (κ = 0.15, 95% confidence interval, 0.11-0.20). Age, Injury Severity Score, high plasma-volume components, and transfused plasma volume were risk factors for TRALI when applying the second acute respiratory distress syndrome onset time definition

  20. 40 CFR 88.102-94 - Definitions.

    Science.gov (United States)

    2010-07-01

    ...) CLEAN-FUEL VEHICLES Emission Standards for Clean-Fuel Vehicles § 88.102-94 Definitions. Any terms defined in 40 CFR part 86 and not defined in this part shall have the meaning given them in 40 CFR part 86... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Definitions. 88.102-94 Section 88.102...

  1. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed

  2. Advanced Tracheal Adenoid Cystic Carcinoma with Thyroid Invasion Mimicking Thyroid Cancer Treated with Definitive Radiation: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sondos Al Khatib

    2017-08-01

    Full Text Available A 54-year-old female patient, a breast cancer survivor and a case of unresectable adenoid cystic carcinoma of the trachea, with thyroid invasion, presented with suprasternal neck swelling mimicking thyroid primary. A literature search was undertaken to highlight this rare presentation. There have been few reports in the literature describing tracheal adenoid cystic carcinoma involving the thyroid.

  3. High prevalence of arthropathy, according to the definitions of radiological and clinical osteoarthritis, in patients with long-term cure of acromegaly: a case-control study

    NARCIS (Netherlands)

    Wassenaar, M. J. E.; Biermasz, N. R.; van Duinen, N.; van der Klaauw, A. A.; Pereira, A. M.; Roelfsema, F.; Smit, J. W. A.; Kroon, H. M.; Kloppenburg, M.; Romijn, J. A.

    2009-01-01

    To evaluate the prevalence and rheumatological and radiological characteristics of arthropathy in patients after long-term cure of acromegaly in comparison with age-matched controls. Case-control study. We compared 89 patients with adequate biochemical control of acromegaly (mean 14 years) and 67

  4. Consensus standard requirements and guidance

    International Nuclear Information System (INIS)

    Putman, V.L.

    1995-01-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

  5. Sociocultural definitions of risk

    Energy Technology Data Exchange (ETDEWEB)

    Rayner, S.

    1990-10-01

    Public constituencies frequently are criticized by technical experts as being irrational in response to low-probability risks. This presentation argued that most people are concerned with a variety of risk attributes other than probability and that is rather irrational to exclude these from the definition and analysis of technological risk. Risk communication, which is at the heart of the right-to-know concept, is described as the creation of shared meaning rather than the mere transmission of information. A case study of utilities, public utility commissions, and public interest groups illustrates how the diversity of institutional cultures in modern society leads to problems for the creation of shared meanings in establishing trust, distributing liability, and obtaining consent to risk. This holistic approach to risk analysis is most appropriate under conditions of high uncertainty and/or decision stakes. 1 fig., 5 tabs.

  6. Do as I say! …but who says what i should say-or do? On the definition of a standard spoken command vocabulary for ICT devices and services

    NARCIS (Netherlands)

    Niman, B. von; Chaplin, C.; Collado-Vega, J.A.; Groh, L.; McGlashan, S.; Mellors, W.; Leeuwen, D.A. van

    2002-01-01

    This paper describes the development of a new ETSI Standard (ES): Generic spoken command vocabulary for ICT devices and services. It’s basic approach focuses on simplifying the learning procedure for end-users, there by allowing for reuse of basic knowledge between different terminal devices and

  7. Model Based Definition

    Science.gov (United States)

    Rowe, Sidney E.

    2010-01-01

    In September 2007, the Engineering Directorate at the Marshall Space Flight Center (MSFC) created the Design System Focus Team (DSFT). MSFC was responsible for the in-house design and development of the Ares 1 Upper Stage and the Engineering Directorate was preparing to deploy a new electronic Configuration Management and Data Management System with the Design Data Management System (DDMS) based upon a Commercial Off The Shelf (COTS) Product Data Management (PDM) System. The DSFT was to establish standardized CAD practices and a new data life cycle for design data. Of special interest here, the design teams were to implement Model Based Definition (MBD) in support of the Upper Stage manufacturing contract. It is noted that this MBD does use partially dimensioned drawings for auxiliary information to the model. The design data lifecycle implemented several new release states to be used prior to formal release that allowed the models to move through a flow of progressive maturity. The DSFT identified some 17 Lessons Learned as outcomes of the standards development, pathfinder deployments and initial application to the Upper Stage design completion. Some of the high value examples are reviewed.

  8. MRI assessment of myelination: an age standardization

    Energy Technology Data Exchange (ETDEWEB)

    Staudt, M. (Kinderklinik Dritter Orden, Passau (Germany)); Schropp, C. (Kinderklinik Dritter Orden, Passau (Germany)); Staudt, F. (Kinderklinik Dritter Orden, Passau (Germany)); Obletter, N. (Radiologische Praxis, Klinikum Ingolstadt (Germany)); Bise, K. (Neuropathologisches Inst., Muenchen Univ. (Germany)); Breit, A. (MR Tomographie, Klinikum Passau (Germany)); Weinmann, H.M. (Kinderklinik Schwabing, Muenchen (Germany))

    1994-04-01

    777 cerebral MRI examinations of children aged 3 days to 14 years were staged for myelination to establish an age standardization. Staging was performed using a system proposed in a previous paper, separately ranking 10 different regions of the brain. Interpretation of the results led to the identification of foue clinical diagnoses that are frequently associated with delays in myelination: West syndrome, cerebral palsy, developmental retardation, and congenital anomalies. In addition, it was found that assessment of myelination in children with head injuries was not practical as alterations in MRI signal can simulate earlier stages of myelination. Age limits were therefore calculated from the case material after excluding all children with these conditions. When simplifications of the definition of the stages are applied, these age limits for the various stages of myelination of each of the 10 regions of the brain make the staging system applicable for routine assessment of myelination. (orig.)

  9. Information object definition-based unified modeling language representation of DICOM structured reporting: a case study of transcoding DICOM to XML.

    Science.gov (United States)

    Tirado-Ramos, Alfredo; Hu, Jingkun; Lee, K P

    2002-01-01

    Supplement 23 to DICOM (Digital Imaging and Communications for Medicine), Structured Reporting, is a specification that supports a semantically rich representation of image and waveform content, enabling experts to share image and related patient information. DICOM SR supports the representation of textual and coded data linked to images and waveforms. Nevertheless, the medical information technology community needs models that work as bridges between the DICOM relational model and open object-oriented technologies. The authors assert that representations of the DICOM Structured Reporting standard, using object-oriented modeling languages such as the Unified Modeling Language, can provide a high-level reference view of the semantically rich framework of DICOM and its complex structures. They have produced an object-oriented model to represent the DICOM SR standard and have derived XML-exchangeable representations of this model using World Wide Web Consortium specifications. They expect the model to benefit developers and system architects who are interested in developing applications that are compliant with the DICOM SR specification.

  10. Using Quality Management Systems to Improve Test Development and Standards and to Promote Good Practice: A Case Study of Testing Italian as a Foreign Language

    Science.gov (United States)

    Grego Bolli, Giuliana

    2014-01-01

    This article discusses the problem of quality in the production of language tests in the context of Italian language examinations. The concept of quality is closely related to the application of stated standards and related procedures. These standards, developed over the last thirty years, are mainly related to the concepts of the accountability…

  11. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  12. A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures.

    Science.gov (United States)

    Haussen, Diogo C; Van Der Bom, Imramsjah Martijn John; Nogueira, Raul G

    2016-10-01

    We aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures. Radiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot. The two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators' cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator. The ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection. 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/

  13. 9 CFR 96.1 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... FOREIGN ANIMAL CASINGS OFFERED FOR ENTRY INTO THE UNITED STATES § 96.1 Definitions. Administrator. The... States Department of Agriculture (APHIS or Service). Animal casings. Intestines, stomachs, esophagi, and... as sausage. APHIS representative. An individual employed by APHIS who is authorized to perform the...

  14. 45 CFR 1609.2 - Definition.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Definition. 1609.2 Section 1609.2 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION FEE-GENERATING CASES § 1609.2... services from an award to a client, from public funds or from the opposing party. (b) Fee-generating case...

  15. Interpretation of drinking water quality guidelines – The case of arsenic

    African Journals Online (AJOL)

    ... both in the creation of sound drinking water quality guidelines or standards, and in the problem of how to interpret the risk to human health when guideline values are exceeded. In this paper this problem is discussed using the case of arsenic, where the definition of the boundaries of the grey area is particularly uncertain.

  16. 功能用語請求項明確性之臺灣判決案例研究 Definiteness of Means/Steps-Plus-Function Clams—A Cases Study of Taiwan’s Courts Decisions

    Directory of Open Access Journals (Sweden)

    郭榮光 Jung-Kuang Kuo

    2015-12-01

    、流程,二者不得互換,否則該請求項即不明確。 Article 19(4 of Taiwan’s Enforcement Rules of the Patent Act permits meansplus- function and steps-plus-function claims. However, without reciting the structure, material or acts performing the claimed function, claims may face challenges about the definiteness requirement. One of the related debates is whether the specification should recite the corresponding structure, material or acts of the claimed function. This issue has been brought up both in Taiwan and U.S. jurisdictions. This study compares Taiwan court decisions with the U.S. decisions which touch on the definiteness of means-plus-function and steps-plus-function claims. We find that while the U.S. courts require that the specification has to recite the corresponding structure, material or acts of means-plus-function and steps-plus-function claims to satisfy the definiteness requirement, Taiwan courts do not adopt the same standard. This study argues that by requiring specifications disclose the corre-sponding structure, material or acts implementing claimed function to satisfy the definiteness requirement, the standard made by U.S. court decisions limits the metes and bounds of means-plus-function and steps-plus-function claims to a more reasonable extent in order to prevent the abuse of functional claims. This study further suggests that Taiwan’s legislative and judicial branches of the government should adopt the same standard to prevent future definiteness disputes. Additionally, this study contends that means-plus-function can be used for device claims while steps-plus-function can be used for method claims. Due to this distinction, this study concludes that the corresponding disclosure of means-plus-function claims in the specification should be structures or materials which have concrete forms, while the corresponding disclosure of steps-plus-function claims in the specification should be acts which should have no concrete forms.

  17. Definitional Arguments in Children’s Speech

    Directory of Open Access Journals (Sweden)

    Rebecca Schar

    2017-07-01

    Full Text Available Based on the debate on children’s ability to produce argumentative discourse in different edu­cational settings, this paper provides further support for the fact that small children are able to support their opinions with arguments. In particular, the paper makes a case in point on children’s appeal to definitional loci, when supporting their standpoints. The analysis of their reasoning’s implicit components shows how children apply different definitional arguments.

  18. Is structural interface standardization beneficial?

    Science.gov (United States)

    Dombert, W. E.

    1983-11-01

    Factors applicable to fixed angle, large field and fixed angle, large building flat plate photovoltaic (PV) generator arrays are discussed in the context of standardization. It is concluded that structural interface standardization may be highly desirable in any one major project, but not at this time in the overall PV industry. Attempts to mandate such standardization will act as a deterrent to long-range improvements. In specific projects, structural standardization should be defined at the largest practical interface, leaving the maximum possible freedom to the module and array manufacturer. There is a corollary area, however, where detailed standards would benefit the industry; the matter of Standard Practices. Work being done towards definition of acceptable/desirable practices in materials, finishes, fastening and locking methods, grounding techniques, lightning protection, etc., and in handling the environmental ranges, should be continued.

  19. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  20. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....