Comparison Of Standards Research Articles

P-1952. SARS-CoV-2 Self-Testing Modalities Demonstrate Concerning Inaccuracies Among Rural, Minority Populations: The ALL-IN SC Study

Abstract Background At-home, diagnostic self-test assays provide a unique opportunity to reduce healthcare disparities by providing low-cost, immediate access to disease testing. Despite their utility, their real-world accuracy is unknown. Therefore, this study aimed to evaluate multiple testing modalities among diverse, marginalized populations in a large, multi-year, state-wide randomized controlled trial. Methods From 2022 to 2023, 2,195 individuals participated in testing events across South Carolina, USA. Participants provided medical personnel collected samples for gold standard laboratory comparison and were assigned to one of three groups for a matching self-test comparison. These groups were 1) no assistance self-test (only provided manufacturer self-test instructions), 2) unassisted hybrid (collected their own samples according to manufacturer instructions and mailed-in samples to laboratory), and 3) assisted (medical personnel verbally explained the manufacturer’s instructions). A robust statistical analysis plan was executed; however, only the results from multivariate regression are described here. Results Participants in the unassisted groups were significantly more likely to have an incorrect self-test result. Conversely, participants with assistance were 32% more likely to have a correct self-test result, regardless of testing modality (saliva, dried blood spot, nasal swab). Self-collection of saliva samples to send to a laboratory for testing had the highest odds of inaccuracy (OR=9.21, p-value < 0.001). Self-collection of dried blood spot samples sent for laboratory testing had the lowest odds of inaccuracy (OR=1.52, p-value< 0.021). Demographic risk factors varied by testing modality, with females, black, and lower income participants statistically more likely to have inaccurate testing results. Select infection symptoms at the time of testing also increased the odds of inaccuracy. Conclusion This study provides critical evidence that self-tests are a viable option for addressing health care access disparities, but telemedicine and/or community assistance programs must also be provided to ensure tests are conducted and interpreted correctly. Disclosures All Authors: No reported disclosures

Reliability, Objectivity, Validity and Reference Levels of the Austrian Balance Check (ABC)-A Novel Balance Field Test for Children, Adolescents and Young Adults to Assess Static Balance.

Balance is a relevant indicator of physical fitness and correlates with intellectual abilities. Due to limited resources, however, balance tests are underrepresented in fitness checks. To develop an effective field test to assess static balance with minimal cost, little spatial requirement and short testing time, a cross-sectional pilot study was conducted in three different school types (primary school, secondary school, and high school) and the reliability, objectivity and validity of the novel Austrian Balance Check (ABC) were assessed, with the generation of age- and gender-specific reference values. Tests were carried out with participants from regular school classes (RSC) and elite sports school classes (ESC). A total of 1005 participants were included (age range: 6.2 to 19.8 years). Participants in RSC (ICC2.1 = 0.92, 95% CI 0.90 to 0.93) showed excellent values, and those in ESC (ICC2.1 = 0.89, 95% CI 0.85 to 0.93) had good to excellent values in the reliability test. Objectivity was excellent in both groups (RSC (ICC2.1 = 0.99, 95% CI 0.98 to 0.99); ESC (ICC2.1 = 0.98, 95% CI 0.96 to 0.99)). A gold standard comparison using an electronic force plate showed a strong negative correlation: participants with high overall ABC scores showed less movement on the force plate (parameters of the center of pressure: surface area (ρ = -0.61), mean velocity (ρ = -0.65) and path length (ρ = -0.65). The test duration of ABC was significantly (p < 0.001) shorter compared with an established balance test. ABC offers potential benefits by allowing field-based static balance testing in large groups with low cost, minimal time and spatial requirements as well as high reliability, objectivity and validity.

Final report of the supplementary comparison between NIMT and LNE on pressure standards in the range 50 MPa to 500 MPa of hydraulic gauge pressure

Main textThis report describes the results of a bilateral supplementary comparison of hydraulic high-pressure standards between Laboratoire National de Métrologie et d'Essais (LNE) and National Institute of Metrology (Thailand) (NIMT) in order to check their degrees of equivalence in the pressure range from 50 MPa to 500 MPa in the gauge mode.This comparison was carried out during the period from March to December 2015. The results of this comparison will be essential to support the calibration and measurement capabilities (CMCs) of NIMT. The pilot laboratory was NIMTwhich provided the transfer standard (TS). The TS was a Piston-Cylinder Unit (PCU) without any pressure balance nor mass set.All the measurements were performed in accordance with the Technical Protocol prepared by NIMT and accepted by LNE.This report presents the results of NIMT and LNE. All uncertainties in this report are the standard ones (k = 1).To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database https://www.bipm.org/kcdb/.The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Comparison of primary standards for liquid flow in the range from 0.1 μL/min to 10 μL/min

Comparison of primary standards for liquid flow in the range from 0.1 μL/min to 10 μL/min

Synthetic Data Generation via Generative Adversarial Networks in Healthcare: A Systematic Review of Image- and Signal-Based Studies.

Generative Adversarial Networks (GANs) have emerged as a powerful tool in artificial intelligence, particularly for unsupervised learning. This systematic review analyzes GAN applications in healthcare, focusing on image and signal-based studies across various clinical domains. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we reviewed 72 relevant journal articles. Our findings reveal that magnetic resonance imaging (MRI) and electrocardiogram (ECG) signal acquisition techniques were most utilized, with brain studies (22%), cardiology (18%), cancer (15%), ophthalmology (12%), and lung studies (10%) being the most researched areas. We discuss key GAN architectures, including cGAN (31%) and CycleGAN (18%), along with datasets, evaluation metrics, and performance outcomes. The review highlights promising data augmentation, anonymization, and multi-task learning results. We identify current limitations, such as the lack of standardized metrics and direct comparisons, and propose future directions, including the development of no-reference metrics, immersive simulation scenarios, and enhanced interpretability.

The main components of international recognition of national standards, calibration, and measurement capabilities

International recognition of measurement results improves the development of international trade, science, and technology. It helps to reduce technical barriers in international trade, improve product quality, and increase confidence in calibration and testing laboratories. The recognition of national standards is critical for ensuring global metrological consistency between countries and ensuring international confidence in carried out measurements. National standards are subject to comparison with the standards of other countries. National Metrology Institutes (NMIs) and Designated Institutes (DIs) are responsible for establishing and maintaining national standards of units of measurement and ensuring their compliance with international standards. The results of comparisons of national standards, review, and adoption of calibration and measurement capabilities (CMC) of NMIs and DIs are published in the special Key Comparison Database (KCDB) of the International Bureau of Weights and Measures (BIPM). An analysis of the current state of implementation of the Mutual Recognition Agreement (MRA) of the International Committee for Weights and Measures (CIPM) — CIPM MRA was carried out. The basis of this analysis is the results of key and supplementary comparisons of national standards, structured by regional metrological organizations (RMOs), types of measurements, as well as CMC of NMIs and DIs both by RMOs and types of measurements and by countries. The place of Ukraine in the implementation of the CIRM MRA Agreement is shown.

Comparison of Adaptive and Nonadaptive Gap Detection in Noise Test in Typically Developing Children and Adults.

The purpose of this study is to examine whether the gap detection thresholds (GDT) obtained are similar between an adaptive and nonadaptive procedure in children and adults. Standard group comparison. Eighteen typically developing children and 20 young adults with hearing thresholds of 25 dB HL or lower participated in this study. Forced choice (FC) adaptive GDTs were obtained using psychoacoustic software, and nonadaptive GDTs were obtained using a clinically available gap in noise (GIN) test. Both children and adults showed significantly lower GDTs for the FC adaptive procedure when compared with thresholds obtained using the nonadaptive GIN test. GDTs were less variable for FC adaptive procedure when compared with the nonadaptive procedure. Lower and less variable GDTs can be obtained from children and adults using an FC adaptive procedure.

Assessing the suitability of water for irrigation purposes using irrigation water quality indices in the Irob catchment, Tigray, Northern Ethiopia

ABSTRACT Irrigation alleviates poverty in arid and semi-arid regions, such as Ethiopia, necessitating a water suitability assessment. This study evaluates irrigation water quality in the Irob catchment, Northern Ethiopia. It differs by using combined parameters of the irrigation water quality index (IWQI) for comprehensive assessment beyond standard comparisons. Eighteen water samples were collected and analyzed using ultraviolet spectrometry, titration, and atomic absorption spectrometry. The evaluation included parameters such as salinity, total dissolved solids (TDS), total hardness (TH), sodium adsorption ratio, sodium percentage, residual sodium carbonate, permeability index, magnesium ratio, Kelly's index, potential salinity, and the IWQI. The findings revealed that 22.2, 38.9, 88.8, 66.7, 83.3, 66.7, 100, 72.2, and 55.6% of samples exceeded recommended standards for electrical conductivity, TDS, TH, permeability index, manganese, cobalt, copper, cadmium, and nickel, respectively. Most water quality parameters meet standards, but improved irrigation management is crucial to reduce risks. The IWQI indicates that 22.2% of water samples have minor restrictions, while 77.8% have no restrictions. This method provides key insights for evaluating irrigation water quality in similar hydrogeological and environmental conditions, particularly in semi-arid and arid regions. The findings enhance the understanding of sustainable water quality, supporting local authorities in developing resilient irrigation strategies for regional agricultural sustainability.

Comparative efficacy of leniolisib (CDZ173) versus standard of care on rates of respiratory tract infection and serum immunoglobulin M (IgM) levels among individuals with activated phosphoinositide 3-kinase delta (PI3Kδ) syndrome (APDS): an externally controlled study.

Leniolisib, an oral, targeted phosphoinositide 3-kinase delta (PI3Kδ) inhibitor, was well-tolerated and efficacious versus placebo in treating individuals with activated PI3Kδ syndrome (APDS), an ultra-rare inborn error of immunity (IEI), in a 12-week randomised controlled trial. However, longer-term comparative data versus standard of care are lacking. This externally controlled study compared the long-term effects of leniolisib on annual rate of respiratory tract infections and change in serum immunoglobulin M (IgM) levels versus current standard of care, using data from the leniolisib single-arm open-label extension study 2201E1 (NCT02859727) and the European Society for Immunodeficiencies (ESID) registry. The endpoints were chosen following feasibility assessment considering comparability and availability of data from both sources. Baseline characteristics between groups were balanced through inverse probability of treatment weighting. The leniolisib-treated group included 37 participants, with 62 and 49 participants in the control group for the respiratory tract infections and serum IgM analyses, respectively. Significant reductions in the annual rate of respiratory tract infections (rate ratio: 0.34; 95% confidence interval [CI]: 0.19, 0.59) and serum IgM levels (treatment effect: -1.09g/L; 95% CI: -1.78, -0.39, P = 0.002) were observed in leniolisib-treated individuals versus standard of care. The results were consistent across all sensitivity analyses, regardless of censoring, baseline infection rate definition, missing data handling, or covariate selection. These novel data provide an extended comparison of leniolisib treatment versus standard of care, highlighting the potential for leniolisib to deliver long-term benefits by restoring immune system function and reducing infection rate, potentially reducing complications and treatment burden.

Comparison of optimization algorithms for automated method development of gradient profiles.

Optimization algorithms play an important role in method development workflows for gradient elution liquid chromatography. Their effectiveness has not been evaluated for chromatographic method development using standardized comparisons across factors such as sample complexity, chromatographic response functions (CRFs), gradient complexity, and application type. This study compares six optimization algorithms - Bayesian optimization (BO), differential evolution (DE), a genetic algorithm (GA), covariance-matrix adaptation evolution strategy (CMA-ES), random search, and grid search - for the development of gradient elution LC methods. Utilizing a multi-linear retention modeling framework, these algorithms were assessed across diverse samples, CRFs, and gradient segments, considering two observation modes: dry (in silico, deconvoluted), and wet (search-based, requiring peak detection). The optimization algorithms were evaluated based on their data (i.e. number of iterations) and time efficiency. Of the algorithms compared in this study, DE proved to be a highly competitive method for dry optimization purposes in terms of both data and time efficiency. BO outperformed all other algorithms in terms of data efficiency and was found to be most effective for search-based optimization, which requires a low number of iterations (<200). However, BO was found to be impractical for dry optimization requiring a large iteration budget due to its unfavorable computational scaling. It was observed that both the CRF and the sample have a strong influence on the efficiency of the algorithms, emphasizing the need for better benchmark samples and highlighting the importance of assessing CRF-induced complexity in the optimization landscape.

Bilateral comparison of gas microflow primary standards in the range between 0.12 mg/min and 2.4 mg/min

Bilateral comparison of gas microflow primary standards in the range between 0.12 mg/min and 2.4 mg/min

Trends (2017-2022) in adolescent metabolic and bariatric surgery.

Metabolic and Bariatric Surgery (MBS) is often difficult to access for the adolescent population. Eligibility criteria have been recently updated to attempt to remove barriers in accessing this care. Analyze recent trends in adolescent MBS in the context of these recent policy changes. Member programs of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Adolescents age 10-17 who underwent MBS from 2017 to 2022 were identified. Demographic trends and surgical details were analyzed through standard statistical comparison methods, linear regression, and multivariate logistic regression. From 2017-2022, 2229 adolescent patients underwent MBS. These approximately 372 cases per year represent about 15%-20% of the total estimated annual cases in the US. Of these, 69% were female, 59% were white, and mean age was 16.1 years. There were no significant differences in age and sex distributions by year. Body mass index (BMI) at surgery did not vary with age. Fourteen and 15 year olds had the highest rates of diabetes (20% and 21% versus 16% for the overall cohort), whereas sleep apnea was more common in 13-year-old patients (36% versus 22%). Females had lower BMI at surgery (46 versus 49) and higher rates of robotic-assisted surgery (16% versus 11%). Case volume decreased with COVID and rapidly increased thereafter. Sleeve gastrectomy increased in relative prevalence compared to bypass, and robotic-assisted cases are increasing twice as fast as laparoscopic procedures. The overall complication rate was 2.9%, with dehydration being most common. Readmission, reoperation, and reintervention did not vary by year. Despite recent efforts to expand care to younger patients, the majority of pediatric MBS is performed for white, female patients over age 16. Cases have returned to prepandemic levels, with robotic-assisted cases increasing. Complication rates and reoperation rates remain low.

X-Shooting ULLYSES: Massive Stars at low metallicity

Context. Current implementations of mass loss for hot, massive stars in stellar evolution models usually include a sharp increase in mass loss when blue supergiants become cooler than Teff ∼ 20 − 22 kK. Such a drastic mass-loss jump has traditionally been motivated by the potential presence of a so-called bistability ionisation effect, which may occur for line-driven winds in this temperature region due to recombination of important line-driving ions. Aims. We perform quantitative spectroscopy using UV (ULLYSES program) and optical (XShootU collaboration) data for 17 OB-supergiant stars in the LMC (covering the range Teff ∼ 14 − 32 kK), deriving absolute constraints on global stellar, wind, and clumping parameters. We examine whether there are any empirical signs of a mass-loss jump in the investigated region, and we study the clumped nature of the wind. Methods. We used a combination of the model atmosphere code FASTWIND and the genetic algorithm (GA) code Kiwi-GA to fit synthetic spectra of a multitude of diagnostic spectral lines in the optical and UV. Results. We find an almost monotonic decrease of mass-loss rate with effective temperature, with no signs of any upward mass loss jump anywhere in the examined region. Standard theoretical comparison models, which include a strong bistability jump thus severely overpredict the empirical mass-loss rates on the cool side of the predicted jump. Another key result is that across our sample we find that on average about 40% of the total wind mass seems to reside in the more diluted medium in between dense clumps. Conclusions. Our derived mass-loss rates suggest that for applications such as stellar evolution one should not include a drastic bistability jump in mass loss for stars in the temperature and luminosity region investigated here. The derived high values of interclump density further suggest that the common assumption of an effectively void interclump medium (applied in the vast majority of spectroscopic studies of hot star winds) is not generally valid in this parameter regime.

Wearable Blood Pressure Monitoring Devices: Understanding Heterogeneity in Design and Evaluation.

Rapid advances in cuffless blood pressure (BP) monitoring over the last decade have the potential to radically transform clinical care for cardiovascular health. However, due to the large heterogeneity in device design and evaluation, it is difficult to critically and quantitatively evaluate research progress in cuffless BP monitoring. In this two-part manuscript, we seek to provide a principled way of describing and accounting for the heterogeneity in device and study design. We first provide an overview of foundational elements and design principles of three critical aspects in the pipeline: 1) sensors and systems, 2) pre-processing and feature extraction, and 3) BP estimation algorithms. Then, we critically analyze the state-of-theart methods via a systematic review. We find a large amount of heterogeneity in study designs making fair comparisons challenging. In addition, many study designs lead to data leakage, and underpowered studies. We suggest a first opencontribution BP estimation benchmark based on existing public datasets for standardized algorithmic comparisons. Second, we observe that BP distribution in the study sample and the time between calibration and test in emerging personalized devices are significant confounders in BP estimation error. We suggest accounting for these using a metric "explained deviation" which is closely related to the coefficient of determination (R2, a frequently used statistic). Finally, we complement this manuscript with a website, https://wearablebp.github.io, containing a bibliography, meta-analysis results, datasets, and benchmarks, providing a timely platform to understand the state-of-the-art devices. There is large heterogeneity in device and study design, which should be carefully accounted for when designing, comparing, and contrasting studies. Our findings will allow readers to parse out the heterogeneous literature and move toward promising directions for safer and more reliable devices in clinical practice and beyond.

Large-Volume Injection and Assessment of Reference Standards for n-Alkane δD and δ13C Analysis via Gas Chromatography Isotope Ratio Mass Spectrometry.

Compound-specific stable isotope analysis of hydrogen (δD) and carbon (δ13C) in organic compounds is a valuable tool in biogeochemical research. A key limitation of this method is the relatively large amount of sample required to achieve desirable precision. We developed a large-volume (20 μL) injection method that allows for high throughput analysis of less concentrated samples and tested it for δ13C and δD measurements of n-alkanes. We also conducted a comparison of reference standards and assessed several methods to normalize and correct n-alkane δD and δ13C measurements. The mean precision of the δD method based on 233 environmental n-alkane samples (two to three replications per sample) is 4.0‰ (1σ, estimated from the weighted mean of the pooled unbiased standard deviations) and 0.46‰ (1σ) for δ13C from 37 environmental samples (two to three replications per sample). The evaluation of reference standards shows that the use of n-alkane standards with large offsets in δD values in adjacent n-alkane chains can lead to biases in measurement correction. The large-volume injection method shows good reproducibility of δ13C and δD measurements of n-alkanes and reduces the required sample concentration by about 80%. We propose that for δD measurements, a reference standard set should be used in which each reference standard has a limited range of δD values and no adjacent n-alkane chains, to minimize memory effects.

Overview of Terrain Traversability Evaluation for Autonomous Robots

ABSTRACTTraversability evaluation is the foundation and core of unmanned platforms for scene understanding and autonomous navigation, whose successful completion relies on the analysis of the platform's characteristics and the semantic and geometric features of the surrounding environment. This topic has been reviewed by many literatures, which are characterized by a single perspective and lack comprehensive evaluation frameworks. Thus, the concept and developmental trajectory of traversability evaluation are initially outlined in this paper, distinguishing it from other issues, while constructing an evaluation framework based on two categories: direct assessment and downstream task assessment. Subsequently, traversability evaluation methods are classified based on multiple dimensions, including sensor types, robot types, usage scenarios, and learning approaches. On the basis of the constructed evaluation framework, comparisons are made among existing algorithms in terms of performance and runtime. Subsequently, a summary is provided on commonly used features and their mainstream computation methods in terrain evaluation. Additionally, open‐source data sets in this field and projects for scene construction and algorithm validation are compiled and organized. Finally, an analysis is conducted on the development direction and trends, emphasizing the urgent need to establish standardized evaluation systems and comparison baselines. Furthermore, it is imperative that various environmental and platform information be comprehensively integrated into algorithms, while also ensuring that simulation, demonstration, and exploration are incorporated into a unified framework to enhance the robot's learning capability.

Using Operando NMR to Elucidate Degradation Mechanisms in Silicon Anodes

Replacing graphite anodes with Si anodes can greatly increase the energy of current Li-ion batteries. Detailed characterization of Si lithiation reactions, SEI formation, and reversibility are therefore active areas of research. Solid-state 7Li nuclear magnetic resonance (NMR) spectroscopy is a useful for characterizing different lithium local environments within Si anodes. Here, we developed an operando NMR methodology to characterize cycle and calendar aging of Si anodes in pouch cells paired with Ni-rich cathodes in a non-destructive manner. The developed pouch cells mimic long term performance of larger scale pouch cells. We observed a new lithiation mechanism for small Si nanoparticles: direct formation of over-lithiated Li15+xSi4 (x < 0.6) phase. Furthermore, our novel operando cells maintained good performance with long-term cycle and calendar aging allowing direct identification of Li-loss and degradation mechanisms in full cells with NMR. To this end, we identified trapped lithium silicides as a major contributor to capacity fade with aging in a number of different silicon electrodes. We will discuss the new capability and the quantitative information and insights gained from full cells such as Li-inventory losses. We envision a plethora of future operando NMR work with long term aged cells, comparing the effects of cycle aging with calendar aging as well as standardized comparison of aging mechanisms in various Si anode materials and other advanced materials with new electrolytes, additives, binders etc.Related publication: Evelyna Wang, Marco Rodrigues, Sohyun Park, Fulya Dogan and Baris Key, Journal of Power Sources, Volume 604, 2024, 234477 Figure 1

Abstract 4136023: Eligibility and Barriers of Mavacamten Therapy in Patients with Hypertrophic Cardiomyopathy: A Retrospective Analysis

Background: Hypertrophic Cardiomyopathy (HCM) is a common genetic heart disorder characterized by the thickening of the myocardium. Mavacamten has emerged as a novel medication for targeted therapy in HCM patients, but its adoption faces multiple hurdles. This study aims to evaluate the eligibility of HCM patients for Mavacamten treatment based on certain clinical criteria and to promote consideration of potential barriers patients face in obtaining this medication. Methods: We conducted a retrospective analysis of 115 HCM patients at Truman Medical Center that included demographic data, clinical characteristics, and treatment histories. Patient eligibility for Mavacamten was determined based on ejection fraction (EF) &gt; 55%, symptomatic obstructive HCM, and intolerance to first-line therapy (beta-blockers, calcium channel blockers). Statistical analysis was performed using standard deviation and mean comparisons to estimate the proportion of eligible patients. Results: Out of 115 patients, 96 patients have an EF&gt;55%. 76 patients (66.1%) have a clinical heart failure diagnosis. 94 patients (81.7%) are taking beta-blockers. 49 patients (42.6%) have uncontrolled hypertension indicated by blood pressure &gt;140. Considering these factors, 49 (42.6%) met the clinical criteria for Mavacamten treatment. Of these patients eligible to receive Mavacamten treatment, only one patient was actively taking Mavacamten. The most common obstacles to receiving the drug included lack of insurance coverage, high medication cost, and limited awareness among healthcare providers regarding new treatment options. Conclusion: While a considerable proportion of HCM patients qualify for Mavacamten based on clinical criteria, external factors significantly impede access to this potentially life-altering treatment. Efforts should address this treatment gap through raising awareness to healthcare professionals and improving insurance coverage. This will enhance patient access to Mavacamten, ultimately improving outcomes in HCM management. This study summarizes the eligibility and obstacles to Mavacamten in a sample of HCM patients, emphasizing the need for systemic changes to facilitate access to advanced therapies.

A comparison of historical versus proposed physical employment standards for flight paramedics performing helicopter winch rescue.

Paramedics working in helicopter teams undertake water and land rescues. Historical assessments of role-related fitness were not developed using physical employment standards methodology. To compare the historical selection tests with new tests developed via contemporary scientific methodology. Candidates undergoing selection to the role of flight paramedic (n = 14; age 37±5 yrs, body mass index [BMI] 26±4 kg.m2) undertook existing paramedic selection tests on land and in water, measurements of task duration, maximum heart rate (HRmax), rate of perceived exertion (RPE6-20) and capillary blood lactate (Lacmax) were recorded. These results were compared to the same variables in experienced paramedics (n = 14; age 44±5 yrs, BMI 25±3 kg.m2) who undertook the new tests. Land task duration (existing 17±2 min vs. proposed 7±2 min, p < 0.05) HRmax (existing 186±13 b.min-1 vs. proposed 173±11 b.min-1, p < 0.05), and Lacmax (existing 23±3 mmol.L-1 vs. proposed 8±2 mmol.L-1, p < 0.05) were higher in the existing test compared to the proposed tests. Water task duration (existing 12±2 min vs. proposed 10±1 min, p < 0.05) was longer in the existing test, but HRmax (existing 166±18 b.min-1 vs. proposed 167±15 b.min-1, p = 0.90), Lacmax (existing 11±4 mmol.L-1 vs. proposed 11±4 mmol.L-1, p = 0.90) did not differ. RPE6-20 did not differ between groups for water or land. The historical land-based physical tests for paramedics differed from the proposed tests, however the water-based tests had similar duration and physiological demands. Use of tests not developed via established scientific methodologies risks eliminating candidates suitable to work in the role, or including candidates that are not.

Optimal planning and operation of heterogeneous autonomous and grid-connected microgrids based on multi-criteria techno-economic, environmental, and social indices

Sustainable energy transition involves the execution of recent technologies as a means of ensuring energy access and security. However, the increasing adoption of such technologies, particularly in the presence of diverse constraints, poses significant challenges from a planning perspective. In this context, the multi-objective analysis offers valuable insights for decision-making that balances mutual benefits, as relying solely on a single objective may increase the risk level for stakeholders engaged in coordinated decisions. Based on the real dataset, this study presents a comparative multi-criteria techno-economic, environmental, and social evaluation of site-specific unified standalone and grid-connected hybrid microgrids. The study employs a modified Last Cluster Mean Carried Forward approach for data processing, incorporating the Proprietary Derivative-free Algorithm and Original Grid-Search Algorithm to ensure a standardized comparison. Results reveal the substantial advantages of grid-connected systems over standalone counterparts, with reductions of 12.54 % to 63.73 % and 68.93 % to 89.13 % in terms of Net Present Cost and Levelized Cost of Energy, respectively. Grid-connected systems exhibit superior adaptability, recovering 52.3 % to 98.1 % surplus energy with a Renewable Fraction averaging 77.1 % to 87.9 %. However, these systems were hindered by frequent interruptions and required a minimum capacity shortage of 2.5 % to 3.5 %. Furthermore, grid-connected systems have proved feasible when carbon emissions, forests required to absorb the emissions, and the Social Cost of Carbon Emissions are considered in the range of 4.65–67.13 kiloton (metric), 423.32–6108.53 ha, and $0.24-$3.42 million, respectively. Social analysis and sensitivity analyses are performed to justify the robustness and adaptability. Lastly, the findings are followed by policy recommendations and results validation by comparing prevailing government tariffs and other studies.