Assessment Reference Values Research Articles

Italian vs. worldwide history of largest PGA and PGV

Earthquake engineering and engineering seismology greatly rely on the information gathered from observed data. This is especially true when it comes to ground motion intensity measures, which are related to the damaging potential of earthquakes. Observed maxima of peak ground acceleration (PGA) and peak ground velocity (PGV) can provide reference values for hazard assessment, which often needs to extrapolate towards large return periods. This simple study attempts to reconstruct the history of the largest values of PGA and PGV observed in Italy since 1972. Results reveal that the current maxima of PGA and PGV values were recorded during the 2016 central Italy earthquake sequence. For comparison, up-to-date global trends of PGA and PGV maxima are also compiled, following relevant literature on the topic and investigating a number of international databases. It is found that these trends, which are roughly linear in logarithmic scale, correspond to the increase of ground motion records worldwide.

Path relinking for the vertex separator problem

This paper presents the first population-based path relinking algorithm for solving the NP-hard vertex separator problem in graphs. The proposed algorithm employs a dedicated relinking procedure to generate intermediate solutions between an initiating solution and a guiding solution taken from a reference set of elite solutions (population) and uses a fast tabu search procedure to improve some selected intermediate solutions. Special care is taken to ensure the diversity of the reference set. Dedicated data structures based on bucket sorting are employed to ensure a high computational efficiency. The proposed algorithm is assessed on four sets of 365 benchmark instances with up to 20,000 vertices, and shows highly comparative results compared to the state-of-the-art methods in the literature. Specifically, we report improved best solutions (new upper bounds) for 67 instances which can serve as reference values for assessment of other algorithms for the problem.

Elimination Method of Multi-Criteria Decision Analysis (MCDA): A Simple Methodological Approach for Assessing Agricultural Sustainability

In the present world context, there is a need to assess the sustainability of agricultural systems. Various methods have been proposed to assess agricultural sustainability. Like in many other fields, Multi-Criteria Decision Analysis (MCDA) has recently been used as a methodological approach for the assessment of agricultural sustainability. In this paper, an attempt is made to apply Elimination, a MCDA method, to an agricultural sustainability assessment, and to investigate its benefits and drawbacks. This article starts by explaining the importance of agricultural sustainability. Common MCDA types are discussed, with a description of the state-of-the-art method for incorporating multi-criteria and reference values for agricultural sustainability assessment. Then, a generic description of the Elimination Method is provided, and its modeling approach is applied to a case study in coastal Bangladesh. An assessment of the results is provided, and the issues that need consideration before applying Elimination to agricultural sustainability, are examined. Whilst having some limitations, the case study shows that it is applicable for agricultural sustainability assessments and for ranking the sustainability of agricultural systems. The assessment is quick compared to other assessment methods and is shown to be helpful for agricultural sustainability assessment. It is a relatively simple and straightforward analytical tool that could be widely and easily applied. However, it is suggested that appropriate care must be taken to ensure the successful use of the Elimination Method during the assessment process.

Esophagogastric junction distensibility assessed using the functional lumen imaging probe

AIMTo assess reference values in the literature for esophageal distensibility and cross-sectional area in healthy and diseased subjects measured by the functional lumen imaging probe (FLIP).METHODSSystematic search and review of articles in Medline and Embase pertaining to the use of FLIP in the esophagus was conducted in accordance with the PRISMA guidelines. Cross-sectional area and distensibility at the esophagogastric junction (EGJ) were abstracted for normal subjects, achalasia, and gastroesophageal reflux disease (GERD) patients, stratified by balloon length and volume of inflation.RESULTSSix achalasia studies (n = 154), 3 GERD (n = 52), and 5 studies including healthy controls (n = 98) were included in the systematic review. Normative data varied widely amongst studies of healthy volunteers. In contrast, studies in achalasia patients uniformly demonstrated low point estimates in distensibility ≤ 1.6 mm2/mmHg prior to treatment that increased to ≥ 3.4 mm2/mmHg following treatment at 40mL bag volume. In GERD patients, distensibility fell to the range of untreated achalasia (≤ 2.85 mm2/mmHg) following fundoplication.CONCLUSIONFLIP may be a useful tool in assessment of treatment efficacy in achalasia. The drastic drop in EGJ distensibility after fundoplication suggests that FLIP measurements need to be interpreted in the context of esophageal body motility and highlights the importance of pre-operative screening for dysmotility. Future studies using standardized FLIP protocol and balloon size are needed.

Reference values for coagulation assessment in full-term newborns

Most data in the literature report reduced coagulation activities in the first few days of life with respect to adults and the effects of these differences must be considered when diagnosing and treating hemostatic disorders. The management of pediatric population is further complicated by the lack of age-related reference values and by the unreliability of currently-used hemostatic tests, while an accurate interpretation of results is required to reduce the cases of inappropriate investigation. Thromboelastography (TEG®) is a point-of-care test that provides an efficient analysis of the dynamic viscoelastic properties of whole blood that may provide superior evaluation and management of coagulopathies in newborn. This study was designed to determine reference values for kaolin-activated TEG in full-term healthy newborn by taking small blood samples from the umbilical cord and facilitate accurate interpretation of neonatal TEG results. Kaolin-activated TEG was performed in 85 full-term healthy newborn and 40 healthy adults. TEG data analyzed were: reaction time, clot formation time, α-angle, maximum amplitude, clot lysis at 30 minutes, Functional Fibrinogen and coagulation index. Reference values for kaolin-activated TEG in healthy full-term newborn are presented, despite a large variability in reaction time, clot formation time and in coagulation index, not significant impact on range values was evident and no significant differences between neonates and adults were observed. Neonatal coagulation tests are closer to adult standards and although significant age-related differences in kaolin-activated TEG variables do not appear to be present, the usefulness of TEG for pediatric population is an open field that needs to be further evaluated, the results of this study can be used to interpret the data for newborn.

Mechanical characterization of the structural components of Pre-Columbian earthen monuments: Analysis of bricks and mortar from Huaca de la Luna in Perú

The paper deals with the mechanical characterization of the materials that composes the structural system of the archaeological earthen complex of ‘Huaca de la Luna’ in Perú (100–900A.D.). The mechanical characterization was carried out through uniaxial compression, three-point bending and splitting tests. The results indicate differences in bricks and mortar samples in strength capacity and elastic stiffness in compression, as well as differences in rupture modulus and diametric compression strength. The study contributes to understand the linear and nonlinear behavior of archaeological earthen materials and structures and provides reference values for the structural assessment of similar buildings and monuments.

Biomechanical and Scaling Basis for Frontal and Side Impact Injury Assessment Reference Values.

In 1983, General Motors Corporation (GM) petitioned the National Highway Traffic Safety Administration (NHTSA) to allow the use of the biofidelic Hybrid III midsize adult male dummy as an alternate test device for FMVSS 208 compliance testing of frontal impact, passive restraint systems. To support their petition, GM made public to the international automotive community the limit values that they imposed on the Hybrid III measurements, which were called Injury Assessment Reference Values (IARVs). During the past 20 years, these IARVs have been updated based on relevant biomechanical studies that have been published and scaled to provide IARVs for the Hybrid III and CRABI families of frontal impact dummies. Limit values have also been developed for the biofidelic side impact dummies, BioSID, ES-2 and SID-IIs. The purpose of the original publication was to provide in a single document: 1) a listing of the IARVs for measurements made with the Hybrid III and CRABI families of frontal impact dummies, and for the biofidelic side impact dummies, 2) the biomechanical and/or scaling bases for these IARVs, and 3) a comparison of IARVs and regulatory compliance limits and how they affect restraint design. The purpose for republication is to correct errors in the original publication and update the regulatory compliance limits.

Mineral concentrations of fresh herbage from mixed grassland as influenced by botanical composition, harvest time and growth stage

The mineral concentrations in herbage from mixed grassland are variable which lead to challenging situations for animal’s mineral supplementation. The aim of this study consisted in assessing macro and micro mineral concentrations in fresh herbage from mixed grassland, according to a classification method used for nutrients and nutritive values. This classification consists of six classes of botanical composition, two classes of harvest time and seven classes of growth stage. Two hundred and thirty six samples of fresh herbage from mixed grassland were collected from one experimental site during five seasons. The analysed mineral concentrations were modelled using botanical composition and harvest time as fixed effects and growth stage as linear and quadratic effects. Whereas the repeatability of the models for calcium (Ca), phosphorus (P), magnesium (Mg), potassium (K), sulphur (S) and copper (Cu) were similar to the ones for crude protein and fibre, the repeatability for sodium (Na), chlorine (Cl), iron (Fe) and manganese (Mn) were low. Cobalt (Co, 0.113±0.173mg/kg DM) and selenium (Se, 0.020±0.022mg/kg DM) concentrations were hardly detected. Except Fe, mineral concentrations were influenced (P<0.05) by class of botanical composition. Herbage with increasing presence of grasses and thus a reduced presence of legumes and other herbaceous plants, had lower (P<0.05) Ca, P, K, Cu and zinc (Zn) concentrations. Herbage with ryegrass predominance had lower (P<0.01) Mg, S and Mn concentrations. Mineral concentrations, except Fe, were lower (P<0.05) in the first seasonal harvest than in subsequent harvests. With increasing growth stage, P (P<0.05, linear), Mg (P<0.001, linear and quadratic), K (P<0.001, quadratic), S (P<0.001, linear) and Cu, Mn and Zn (P<0.001, linear and P<0.05 quadratic) concentrations progressively decreased. Sodium and Cl concentrations responded quadratically (P<0.05) to the developing growth stages and Ca concentrations remained stable (P>0.10). The developed models may be considered to assess reference values in order to take into account the native mineral concentrations of fresh herbage from mixed grassland when optimizing herbivore diets. This, is a contribution for improving the sustainability of mineral supplementation.

Evaluation of driver lower extremity injuries in 16 oblique crashes with THOR

Injuries to the lower extremity (LE) continue to occur in frontal crashes despite increased attention on the vehicle structure and restraint design. This study focuses on thigh, leg, foot, and ankle injuries as well as occupant factors and intrusion levels. Sixteen vehicles, including three same types, with same moving deformable barriers of the same mass, velocity, and barrier face properties, and the same occupant Test Device for Human Occupant Restraint (THOR) 50th percentile adult male in the driver's seat were used to conduct oblique impact test. Data from the left (driver side) oblique crash tests conducted by National Highway Traffic Safety Administration (NHTSA) were used in this paper to analyse the detailed intrusion characteristics and the driver side THOR injuries from head to foot in these 16 tests. Different regions of the THOR dummy were analysed. Maximum values of all lower extremity injury criteria were obtained and analysed. Intrusion and lower extremity injuries correlation was found, knee airbag and lower extremity injury correlation was also analysed. The foot-well X and Y intrusions in the 16 tests rank from minimum 14 to maximum 309 mm and from −7 to 184 mm, independently. Sixty-nine per cent right knee displacement is greater than the left knee displacement. Thirty-one per cent knee displacement and 44% left upper tibia force of the 16 tests have values that exceed injury assessment reference values. Left upper tibia force was generally greater than other tibia forces. Half of the left upper tibia index (TI) and 37.5% of the right lower TI do not meet the standard value. The foot/ankle complex is generally at a higher risk than the other parts of the leg. Same vehicle reproducibility and injury were also analysed. Right knee displacement, left femur force, left upper tibia force, left upper TI, and left ankle rotation are the most critical injuries in the respective regions of the lower extremity. Intrusion may be more prominent in some frontal damage types than in others, but not the only reason for lower extremity injuries. Other factors that influence LE injuries are the position of driver foot, the geometry of the foot-well area, the direction of intrusion, the impact energy, and acceleration of the floor. Lower extremity is the most frequently injured body region with respect to more serious injuries in the analysed test data.

Patterns of Left Ventricular Longitudinal Strain and Strain Rate in Olympic Athletes

Two-dimensional speckle-tracking echocardiography is an emerging modality for the assessment of systolic and diastolic myocardial deformation in a broad variety of clinical scenarios. However, normal values and physiologic limits of left ventricular strain and strain rate in trained athletes are largely undefined. Two hundred consecutive Olympic athletes (grouped into skill, power, mixed, and endurance disciplines) and 50 untrained controls were evaluated by two-dimensional speckle-tracking echocardiography. Left ventricular global systolic longitudinal strain (GLS), systolic strain rate, early diastolic strain rate (SRE) and late diastolic strain rate (SRA) were calculated. GLS was normal, although mildly lower, in athletes compared with controls (-18.1 ± 2.2% vs -19.4 ± 2.3%, P < .001), without differences related to type of sport. Systolic strain rate was also lower in athletes (-1.00 ± 0.15 vs -1.11 ± 0.15 sec(-1), P < .001), with the lowest value in endurance disciplines (-0.96 ± 0.13 sec(-1), P < .001). No difference existed for SRE (1.45 ± 0.32 vs 1.51 ± 0.35 sec(-1), P = .277), while SRA was lower in athletes (0.67 ± 0.25 vs 0.81 ± 0.20 sec(-1), P < .001). Both SRE (1.37 ± 0.30 sec(-1), P < .001) and SRA (0.62 ± 0.23 sec(-1), P < .001) showed the lowest values in endurance disciplines. The fifth and 95th percentiles calculated as reference values in athletes were as follows: for GLS, -15% and -22%; for systolic strain rate, -0.8 and -1.2 sec(-1); for SRE, 1.00 and 2.00 sec(-1); and for SRA, 0.30 and 1.20 sec(-1). The present study shows that highly trained athletes have normal GLS and strain rate parameters of the left ventricle, despite mild differences compared with untrained controls. These data may be implemented as reference values for the clinical assessment of the athletes and to support the diagnosis of physiologic cardiac adaptations in borderline cases.

Head and Spine Injuries Sustained by Motorcyclists in Head-Leading Collisions With Fixed Roadside Objects

Objective: Motorcyclist collisions with fixed objects account for a substantial proportion of fatalities in many countries. Biomechanically valid crash test protocols are required to assess the injury potential of different fixed objects to motorcyclists and/or to develop safety devices that ameliorate this injury risk. The aim of the present article is to provide field-observed injury data pertaining to motorcyclist head-leading collisions with fixed objects to assist in the development of crash test protocols.Method: The Australian National Coronial Information System was used to identify fatal motorcyclist head-leading collisions with fixed objects. Head and spine injuries were identified from the autopsy reports for these individuals. The head impact locations and injuries were used to infer impact orientations and corresponding injury mechanisms.Results: A sample of 44 motorcyclists estimated to have impacted fixed objects in the head-leading orientation was identified. The analysis of autopsy reports indicated a predominance of basilar skull fractures, intracranial injuries to the frontal cerebrum and inferior aspects of the brain (brainstem and cerebellum), and upper cervical spine injuries. Analysis of head impact locations identified a predominance of impacts to the frontal and/or lateral aspects and when considered in combination with the injury mechanisms, a typical impact orientation of sliding in the prone position with head extension was inferred.Conclusions: The study results were used to suggest possible crash test protocols for motorcyclists sliding into fixed objects and/or safety devices designed to reduce the injury risk of fixed objects. The predominant orientation of lying prone with head extension led the authors to suggest a crash test using the motorcycle anthropomorphic test device (MATD) sliding prone. However, the occurrence of the supine orientation, albeit less frequent, indicates the utility of a crash test with an anthropomorphic test device (ATD) sliding supine. The 2 options are discussed, particularly with regard to appropriate injury assessment reference values.

Pretensioner Loading to Rear-Seat Occupants During Static and Dynamic Testing

Objective: Pretensioners reduce the seat belt slack and couple the occupant early to the restraint system. There is a growing prevalence of rear seat pretensioners and it is essential to determine whether the load from the pretensioner itself can cause injuries to rear-seated children. The aim of the study was to investigate the loading to the neck, chest, and abdomen of various sizes of anthropometric test devices (ATDs) during the pretensioner deployment phase and the crash phase in low-severity frontal sled tests and during static deployment.Methods: Low-severity frontal sled tests were conducted with the Hybrid III (HIII) 3-year-old, HIII 6-year-old, HIII 5th percentile, and HIII 50th percentile ATDs. Two different retractor pretensioners with varying pretensioner force were used. The child ATDs were restrained on a booster cushion (BC), with and without a back. The loading to the neck and chest was compared to injury assessment reference values (IARVs) reported by Mertz et al. (2003). The chest loading to the HIII 5th percentile and HIII 50th percentile ATDs was also analyzed using age-related injury risk curves. Static pretensioner tests with the Q-series 10-year-old ATD, equipped with an advanced abdominal loading device, were conducted in standard ATD position and out-of-position with the lap belt positioned high on the abdomen.Results: During the crash phase, head excursion and neck loading were reduced for both pretensioners for all ATDs compared to testing without a pretensioner. The pretensioner reduced chest deflection to the adult ATDs but not to child ATDs when seated on a BC with a back during the crash phase. When the back was removed, chest deflection was reduced below IARV. The head excursion was reduced for all ATDs with both pretensioners.During the pretensioner deployment phase, the chest deflection exceeded the IARV for the HIII 3-year-old with the stronger pretensioner when seated on booster with a back and it was reduced below the IARV with the lower force pretensioner. For all ATDs, neck and chest loading during the pretensioner deployment phase were reduced when a pretensioner with lower force was used.Abdominal loading to the Q10 in the static pretensioner deployments indicated a low risk of abdominal injury in all tested positions.Conclusion: This study indicates the need to balance the pretensioner force and seat belt geometry to gain good pretensioner performance in both the pretensioner deployment phase and the crash phase.

The Hybrid III Upper and Lower Neck Response in Compressive Loading Scenarios With Known Human Injury Outcomes

Objective: Physical biomechanical surrogates are critical for testing the efficacy of injury-mitigating safety strategies. The interpretation of measured Hybrid III neck loads in test scenarios resulting in compressive loading modes would be aided by a further understanding of the correlation between the mechanical responses in the Hybrid III neck and the probability of injury in the human cervical spine. The anthropomorphic test device (ATD) peak upper and lower neck responses were measured during dynamic compressive loading conditions comparable to those of postmortem human subject (PMHS) experiments. The peak ATD response could then be compared to the PMHS injury outcomes.Methods: A Hybrid III 50th percentile ATD head and neck assembly was tested under conditions matching those of male PMHS tests conducted on an inverted drop track. This includes variation in impact plate orientation (4 sagittal plane and 2 frontal plane orientations), impact plate surface friction, and ATD initial head/neck orientation. This unique matched data with known injury outcomes were used to evaluate existing ATD neck injury criteria.Results: The Hybrid III ATD head and neck assembly was found to be robust and repeatable under severe loading conditions. The initial axial force response of the ATD head and neck is very comparable to PMHS experiments up to the point of PMHS cervical column buckle or material failure. An ATD lower neck peak compressive force as low as 6,290 N was associated with an unstable orthopedic cervical injury in a PMHS under equivalent impact conditions. ATD upper neck peak compressive force associated with a 5% probability of unstable cervical orthopedic injury ranged from as low as 3,708 to 3,877 N depending on the initial ATD neck angle.Conclusions: The correlation between peak ATD compressive neck response and PMHS test outcome in the current study resulted in a relationship between axial load and injury probability consistent with the current Hybrid III injury assessment reference values. The results add to the current understanding of cervical injury probability based on ATD neck compressive loading in that it is the only known study, in addition to Mertz et al. (1978), formulated directly from ATD compressive loading scenarios with known human injury outcomes.

Performance of Certified Climbing Helmets During Simulated Climbing Falls

Abstract Climbing is a popular form of recreation [Gerdes, E. M., Hafner, J. W. and Aldag, J. C., “Injury Patterns and Safety Practices of Rock Climbers,” J. Trauma Inj., Infect., Crit. Care, Vol. 61, No. 6, 2006, pp. 1517–1525.]. Head injuries account for the majority of climbing fatalities; while they cannot always be prevented, wearing a certified climbing helmet can reduce head trauma. Current helmet certification procedures require impact testing only to the upper two-thirds, emphasizing protection from falling objects and resulting in helmet models that have little to no energy mitigating capabilities around their lower rim. This study presents the case for developing new helmet testing protocols emphasizing energy mitigation during climbing falls that produce head injuries 12 times more frequently than falling objects. Suspension helmets, foam helmets, and hybrid foam/suspension helmets were tested in drop and pendulum tests producing impacts to the frontal, occipital, upper parietal, and apex regions using two different headforms and a whole-body, instrumented Hybrid-III dummy. Pendulum drop tests from 1.6 m were used to create frontal and parietal impacts against a vertical steel barrier. The foam helmet delivered average values that were near the injury thresholds established for the Hybrid-III [Mertz, H. J., Irwin, A. L. and Prasad, P., “Biomechanical and Scaling Bases for Frontal and Side Impact Injury Assessment Reference Values,” Stapp Car Crash J., Vol. 47, 2003, pp. 155–188.]. All other helmet and headform combinations produced average values significantly greater than the injury thresholds. Free drops at 2.0 m from an initially upright, backward leaning orientation created occipital impacts. The dummy first struck the feet, and then rotated backward striking the back of the head, producing an impact velocity 15 % higher than that computed for a non-rotating free fall. Only the foam and magnesium headform combination delivered sub-threshold values. Average Head Injury Criterion and peak accelerations from other combinations exceeded 5000 and 500 g, respectively. Pendulum impacts to the apex following 1.0 m drops produced neck compressions, tensions, and extensions that were well beyond neck injury thresholds. These results indicate that the three certified helmets tested do not adequately protect the head during moderate height falls producing impacts to the frontal and occipital rim.

Spacecraft occupant protection requirements: a review of the recent changes.

NASA has recently updated spacecraft design requirements for protecting crewmembers during dynamic spaceflight phases. The details of the update are available in a NASA publication (NASA TM-2013-217380) and are summarized here. Previously, NASA's occupant protection requirements relied primarily on the multiaxial dynamic response criterion, which NASA refers to as the Brinkley Dynamic Response Criteria (BDRC). Although simple to implement, there are several important ground rules that must be met for the injury predictions to be applicable. These include proper restraint, flail controls, proper seating support, pressure suit considerations, head protection including consideration of helmet mass, and spaceflight deconditioning. Even if these ground rules are met, there are limitations to the model that must be addressed, including: model validation, sex differences, age effects, anthropometry effects, and differences between the physical fitness of military test subjects and future crewmembers. To address these limitations, new injury assessment reference values (IARV) have been prescribed for the 5(th) percentile female and 95(th) percentile male Hybrid III anthropomorphic test devices (ATD). These metrics are head-injury criterion, head-rotational acceleration, neck injury criterion, neck-axial-force limits, flail prevention, and lumbar-axial compression force. Using these new ATD IARVs, NASA can have increased confidence that vehicle designs mitigate the risk of injury during dynamic phases of flight.

Safety assessment characteristics of pedestrian legform impactors in vehicle-front impact tests

This study investigated the characteristics of safety assessment results of front-area vehicle impact tests carried out using the Transport Research Laboratory (TRL) legform impactor and a flexible legform impactor (FLEX legform impactor). Different types of vehicles (sedan, sport utility vehicle, high-roof K-car, and light cargo van) were examined. The impact locations in the study were the center of the bumper and an extremely stiff structure of the bumper (i.e., in front of the side member) of each tested vehicle. The measured injury criteria were normalized by injury assessment reference values of each legform impactor. The test results for center and side-member impacts indicated that there were no significant differences in ligament injury assessments derived from the normalized knee ligament injury measures between the TRL legform impactor and the FLEX legform impactor. Evaluations made using the TRL legform impactor and the FLEX legform impactor are thus similar in the vehicle safety investigation for knee ligament injury. Vehicle-center impact test results revealed that the tibia fracture assessments derived from the normalized tibia fracture measures did not significantly differ between the TRL legform impactor and the FLEX legform impactor. However, for an impact against an extremely stiff structure, there was a difference in the tibia fracture assessment between the FLEX legform impactor and the TRL legform impactor owing to their different sensor types.

Experts Opinion on the Use of Normative Data for Functional Capacity Evaluation in Occupational and Rehabilitation Medicine and Disability Claims

Application of normative values for functional capacity evaluation (FCE) is controversial for the assessment of clients for work ability. The objective of this study was to study when clinicians and researchers consider normative values of FCE useful or of no use for their purposes. A focus group meeting was organized among 43 FCE experts working in insurance, occupational and/or rehabilitation medicine from eight countries during the first international FCE research meeting on October 25th, 2012 in the Netherlands. Participants were asked to rate to which degree they agree or disagree with a statement concerning their position toward normative values for FCE on a 10 cm VAS ranging from 0 (completely disagree) to 100 (completely agree) at T0 and T1. Arguments for aspects that are useful and of no use for normative values were systematically collected during the meeting and afterwards independently clustered by two researchers in higher order topics. Baseline opinion of participants on their position toward normative values was 49 ± 29 points. After the meeting, mean VAS was 55 ± 23 (p = 0.07), indicating that participants did not significantly change their opinion toward normative values. Based on arguments provided by the experts, seven higher order topics were constructed namely 'Comparison with job demands or treatment goals'; 'Comparison with co-workers physical ability'; 'Sincerity of effort'; 'Validity for work ability and return to work'; 'Experience of referrer with assessment method'; 'Clinimetrics compared to alternative assessment methods or reference values'; and 'Ease of use for clinician and stakeholders'. Although experts state useful aspects for the use of normative values of FCE for these assessments, it may also lead to over-interpretation of results, leading to dualistic statements concerning work ability, with potential harmful consequences for work ability of patients.

Investigation of the THOR Anthropomorphic Test Device for Predicting Occupant Injuries during Spacecraft Launch Aborts and Landing.

The objective of this study was to investigate new methods for predicting injury from expected spaceflight dynamic loads by leveraging a broader range of available information in injury biomechanics. Although all spacecraft designs were considered, the primary focus was the National Aeronautics and Space Administration Orion capsule, as the authors have the most knowledge and experience related to this design. The team defined a list of critical injuries and selected the THOR anthropomorphic test device as the basis for new standards and requirements. In addition, the team down-selected the list of available injury metrics to the following: head injury criteria 15, kinematic brain rotational injury criteria, neck axial tension and compression force, maximum chest deflection, lateral shoulder force and displacement, acetabular lateral force, thoracic spine axial compression force, ankle moments, and average distal forearm speed limits. The team felt that these metrics capture all of the injuries that might be expected by a seated crewmember during vehicle aborts and landings. Using previously determined injury risk levels for nominal and off-nominal landings, appropriate injury assessment reference values (IARVs) were defined for each metric. Musculoskeletal deconditioning due to exposure to reduced gravity over time can affect injury risk during landing; therefore a deconditioning factor was applied to all IARVs. Although there are appropriate injury data for each anatomical region of interest, additional research is needed for several metrics to improve the confidence score.

Interpretation of Plasma PTH Concentrations According to 25OHD Status, Gender, Age, Weight Status, and Calcium Intake: Importance of the Reference Values

Reference values for plasma PTH assessment were generally established on small samples of apparently healthy subjects, without considering their 25-hydroxyvitamin D (25OHD) status or other potential modifiers of PTH concentration. Our objective was to assess ranges of plasma PTH concentration in a large sample of adults, stratifying by 25OHD status, age, gender, weight status, and calcium intake. This cross-sectional survey is based on 1824 middle-aged Caucasian adults from the Supplémentation en Vitamines et Minéraux Antioxydants study (1994). Plasma PTH and 25OHD concentrations were measured by an electrochemoluminescent immunoassay. Extreme percentiles of plasma PTH concentrations were assessed specifically in subjects who had plasmatic values of 25OHD of 20 ng/mL or greater and 30 ng/mL or greater. Among subjects with 25OHD status of 20 ng/mL or greater, the 97.5th percentile of plasma PTH concentration was 45.5 ng/L. By using this value as a reference, 5% of the subjects with plasma 25OHD less than 20 nmol/L had a high plasma PTH level, reflecting secondary hyperparathyroidism. Among vitamin D-replete subjects (25OHD status of 20 ng/mL or greater), the 97.5th percentile of plasma PTH was higher in overweight/obese subjects (51.9 vs 43.5 ng/L among normal weight subjects). The reference value for plasma PTH defined in this vitamin D-replete population was far below the value currently provided by the manufacturer (65 ng/L) and varied according to overweight status. These results may contribute to improve the diagnosis of primary and secondary hyperparathyroidism and subsequent therapeutic indication.

First normative reference of standing long jump indicates gender difference in lower muscular strength of Macedonian school children

Background: This is the first study to publish the normative reference values for assessment of the level of muscular strength through the “standing long jump” test carried out on a large sample of Macedonian school children. The normative values encompass a wide span of years (6 - 18). Methods: The research was realized in a large sample of 12618 school children at the age of 6 to 18 years from Macedonia. The sample was divided in 14 groups, according to chronological age and each age group was divided into two subgroups according to the criteria of gender. For estimation of the morphologic characteristics, the following anthropometric measures have been applied: body height in standing position (cm), body weight (kg), as well as the body mass index (BMI). Children aged 6 or above were invited to take a standing long jump test. Results: Boys show statistically better results in all age categories in the standing long jump test than girls, and these differences become bigger with the increase of age, especially after the 14th year (p