Standardized Measurement Methodology Research Articles

Advances in mechanotransduction and sonobiology: effects of audible acoustic waves and low-vibration stimulations on mammalian cells

AbstractIn recent decades, research on mechanotransduction has advanced considerably, focusing on the effects of audible acoustic waves (AAWs) and low-vibration stimulation (LVS), which has propelled the field of sonobiology forward. Taken together, the current evidence demonstrates the influence of these biosignals on key cellular processes, such as growth, differentiation and migration in mammalian cells, emphasizing the determining role of specific physical parameters during stimulation, such as frequency, sound pressure level/amplitude and exposure time. These mechanical waves interact with various cellular elements, including ion channels, primary cilia, cell–cell adhesion receptors, cell–matrix and extracellular matrix proteins, and focal adhesion complexes. These components connect with the cytoskeletal fibre network, enabling the transmission of mechanical stimuli towards the nucleus. The nucleus, in turn, linked to the cytoskeleton via the linkers of the nucleoskeleton and cytoskeleton complex, acts as a mechanosensitive centre, not only responding to changes in cytoskeletal stiffness and nuclear tension but also regulating gene expression through the transcriptional co-activator YAP/TAZ and interactions between chromatin and the nuclear envelope. This intricate chain of mechanisms highlights the potential of sonobiology in various fields, including dentistry, regenerative medicine, tissue engineering and cancer research. However, progress in these fields requires the establishment of standardized measurement methodologies and biocompatible experimental setups to ensure the reproducibility of results.

Quantification of UV Light-Induced Spectral Response Degradation of CMOS-Based Photodetectors.

High-energy radiation is known to potentially impact the optical performance of silicon-based sensors adversely. Nevertheless, a proper characterization and quantification of possible spectral response degradation effects due to UV stress is technically challenging. On one hand, typical illumination methods via UV lamps provide a poorly defined energy spectrum. On the other hand, a standardized measurement methodology is also missing. This work provides an approach where well-defined energy spectrum UV stress conditions are guaranteed via a customized optical set up, including a laser driven light source, a monochromator, and a non-solarizing optical fiber. The test methodology proposed here allows performing a controlled UV stress between 200 nm and 400 nm with well-defined energy conditions and offers a quantitative overview of the impact on the optical performance in CMOS-based photodiodes, along a wavelength range from 200 to 1100 nm and 1 nm step. This is of great importance for the characterization and development of new sensors with a high and stable UV spectral response, as well as for implementation of practical applications such as UV light sensing and UV-based sterilization.

Efficacy and Hurdles of Carbon Footprint Labels in Shaping Consumer Choices

The purpose of this study is to look into the impact of carbon footprint labels on consumer behavior and to examine the benefits and challenges associated with their adoption. The goal of the study is to shed light on the obstacles that prevent consumers from incorporating carbon footprint labels into their decision-making processes and how well they work to encourage eco-friendly behavior. Both primary and secondary data are used in the study, which has a descriptive research design. Primary data is obtained through the use of a structured questionnaire, and secondary data is obtained from a variety of sources, such as websites, journals, and research papers. The results are interpreted using statistical techniques like weighted mean, frequency analysis, and Henry Garrett analysis. With the focus of the world on environmental sustainability, this study aims to address the barriers that prevent carbon footprint labels from being successfully incorporated into consumer choices. The legitimacy of such labels is weakened by a number of issues, including the absence of standardized measurement methodologies, consumer skepticism, and the possibility of greenwashing. A varied consumer landscape with variable product usage durations and influential factors is revealed by the data analysis. Customers are motivated to make environmentally conscious decisions by media coverage, corporate responsibility, and health concerns. Although a significant percentage appreciates carbon footprint labels as a means of promoting sustainable decisions, opinions and understanding regarding environmental friendliness vary widely. The analysis prioritizes factors associated with the advantages of carbon footprint labeling, suggesting that businesses who wear these labels have an edge over competitors and are encouraged to improve supply chain efficiency. In order to promote sustainability, the study highlights the importance of consumer awareness, company CSR profiles, and open information sharing.

Test Structures for the Characterization of the Gate Resistance in 16 nm FinFET RF Transistors

The gate resistance is a parasitic element in transistors for RF and millimeter-wave circuits that can negatively impact power gain and noise figure. To develop accurate device models, a reliable measurement methodology is crucial. This article reviews the standard measurement methodology used in the literature and proposes also an additional method, which is evaluated using suitable test structures in a 16 nm FinFET process. The advantages and disadvantages of the two approaches are discussed along with their respective application scenarios.

Investigation of vibration measurements of heavy/hard impacts

Further to the ASTM field test standard currently under development for heavy/hard impacts, the potential inclusion of vibration measurements warrants additional investigation. This presentation will explore measurement methodology and parameters based on a combination of laboratory and field-testing experience. Broadly speaking, the authors will address the purpose of vibration measurements of heavy/hard impacts, the current uses of vibration measurements, and a range of relevant parameters that require consideration in outlining a standardized measurement methodology. The authors intend to present initial guidance on vibration measurement parameters based on their experience in laboratory and field measurements of heavy hard/hard impacts. These preliminary discussions are intended to inform and invigorate further investigation by the acoustics community with a goal of developing a more robust measurement methodology and standard.

Recent advances in eco-friendly quantum dots-based solar energy conversion applications

<p indent="0mm">Semiconductor quantum dots (QDs) are nanocrystals with three-dimensional confined excitons, showing size/shape/composition-dependent optical properties with broadband absorption from ultraviolet to near infrared, high quantum yield, large Stokes shift and good photo/chemical stability, which have been widely applied in solar energy conversion applications such as solar cells (SCs), luminescent solar concentrators (LSCs) and photoelectrochemical (PEC) cells. However, most of the high-performance QDs-solar energy conversion devices are still based on QDs containing highly toxic heavy metals (such as Pb, Cd, Hg-based chalcogenides), which can inevitably induce the human health and environmental pollution issues, thus hindering their future commercialization. Developing high-efficiency solar energy conversion devices based on environmentally friendly QDs is a promising research direction to promote the practical application. Towards this effort, a new generation of environment-friendly semiconductor QDs (such as carbon QDs, silicon QDs, III-V compound QDs, I-III-VI compound QDs and lead-free perovskite QDs) has recently attracted extensive research interests. Here, notable advances and developments of solar cells, luminescent solar concentrators and photoelectrochemical cells based on these environmentally friendly QDs are summarized. Various strategies including band gap engineering, core/shell structure construction, doping, defect states tuning and alloying of these eco-friendly QDs as well as relevant QDs-based device performance are discussed in detail. Specifically, growing core/shell structure can effectively passivate the surface defect states, inhibit the non-radiative recombination and improve the photoluminescence quantum yield (PLQY) as well as photo-/chemical-stability of QDs. The optical absorption and PL spectra of QDs can be precisely tuned by altering the concentration of dopants and chemical compositions of QDs to match the solar spectrum for high-efficiency utilization of solar energy. Alloying strategy also enables the realization of optimized intrinsic and surface defects, tailored band structure and improved photo-/chemical-stability of QDs, thus enhancing the performance of corresponding QDs-solar conversion devices. Furthermore, the current existing challenges and drawbacks are analyzed, providing guidelines for future developments of eco-friendly QDs-based solar energy conversion devices. In summary, the rational design and synthesis of eco-friendly QDs with broad light absorption, highly efficient charge separation/transfer and outstanding photo-/chemical-stability are beneficial to improve the performance of “green” QDs-solar energy conversion devices. For QD’s synthesis, low-temperature, less toxic and large-scale synthetic technology with reduced energy consumption and eliminated toxic organic solvents/surfactants should be developed to achieve future cost-effective and high quality QDs. For QDs-SCs, the best reported power conversion efficiency of state-of-the-art QDs-SCs is still much lower than that of the commercialized silicon SCs. It is of great significance to explore more SCs device performance and stability optimization strategies. For QDs-LSCs, the balance between reabsorption loss and PLQY should be further studied and the standard measurement methodology needs to be refined. For QDs-PEC devices, the long-term durability of QDs under device operation needs to be largely improved for real-life application. Besides, the electrolyte used in most of the current QDs-PEC systems contains sacrificial agents (e.g., Na₂S/Na₂SO₃) with highly corrosive feature, which may induce environmental issues and should be properly replaced by neutral solution for future commercial perspectives.

Reliability and Feasibility of the First-Episode Psychosis Services Fidelity Scale-Revised for Remote Assessment.

The authors sought to evaluate the interrater reliability and feasibility of the First-Episode Psychosis Services Fidelity Scale-Revised (FEPS-FS-R) for remote assessment of first-episode psychosis programs according to the coordinated specialty care model. The authors used the FEPS-FS-R to assess the fidelity of 36 first-episode psychosis program sites in the United States with information from three sources: administrative data, health record review, and phone interviews with staff. Four raters independently conducted fidelity assessments of five program sites by listening to each of the staff interviews and independently rating the two other data sources from each site. To calculate interrater reliability, the authors used intraclass correlation coefficients (ICCs) for each of the five sites and across the total scores for each site. Total interrater reliability was in the good to excellent range, with a mean ICC of 0.91 (95% confidence interval = 0.72-0.99, p<0.001). Two first-episode psychosis program sites (6%) achieved excellent fidelity, 25 (69%) good fidelity, and nine (25%) fair fidelity. Of the 32 distinct items on the FEPS-FS-R, 23 (72%) were used with good or excellent fidelity. Most sites achieved high fidelity on most items, but five items received ratings indicating low-fidelity use at most sites. The fidelity assessment proved feasible, and sites required on average 10.5 hours for preparing and conducting the fidelity review. The FEPS-FS-R has high interrater reliability and can differentiate high-, moderate-, and low-fidelity sites. Most sites had good overall fidelity, but the FEPS-FS-R identified some services that were challenging to implement at many sites.

Standardizing Performance Measurement of Dye-Sensitized Solar Cells for Indoor Light Harvesting

During the last five years the demand of indoor photovoltaic (IPV) technology is growing rapidly for the Internet of Things. Until now, there is no standardized measurement methodology for IPV devices. So, it is very hard to estimate device efficiency accurately in indoor illuminating condition. This is one of the main obstacles for the commercialization of IPV devices. A standardized universal measurement methodology is highly needed. Therefore in this study, a series of N719 dye based dye-sensitized photovoltaic (PV) cells have been fabricated by varying the working electrode thickness. Then, a low irradiance measurement system has been configured to develop an ideal indoor environment with diffused light by adjusting the distance (1.4 m) between the test cell and light source. Furthermore, the inner wall of the measurement system has been covered by white paper. PV cells are tested under the illumination of three different light sources such as cold cathode fluorescent lamp (CCFL), cool white LED (LED 5600 K), and warm white LED (LED 3200 K)), at the same irradiance power intensity (150 μW/cm 2 ) and luminance (500 Lux) values, to standardize the measurement methodology for PV cells in indoor environment. This study shows that, the response of a PV cell to different light sources can be realized more accurately, if the PV cell is tested under the illumination of different light sources at a fixed irradiance power intensity value instead of a fixed luminance value.

Assessing the Fidelity of Evidence-Based Practices: History and Current Status of a Standardized Measurement Methodology

Evidence-based practices are effective only when implemented faithfully. This paper explicates the history, standardization, and methods for developing and validating measures of fidelity. We overviewed the past 20years of developing fidelity measures, summarized standardization of the development procedures, and described needed psychometric assessments. Fidelity assessment has become the sine qua non of implementation, technical assistance, and research on evidence-based practices. Researchers have established standardized procedures for scale development and psychometric testing. Widescale use of fidelity measurement remains challenging. The implementation of evidence-based practice and the development and validation of fidelity measures are interdependent. International improvements of mental health care will require attention to both.

The Penile Sensitivity Ratio: A Novel Application of Biothesiometry to Assess Changes in Penile Sensitivity

IntroductionBiothesiometry allows for evaluation of penile vibratory sensitivity and can be used as a non-invasive and rapid surrogate test of penile sexual sensitivity. However, no standardized measurement methodology currently exists. AimTo describe and optimize a novel, standardized biothesiometry parameter—the penile sensitivity ratio (PSR). MethodsWe reviewed all biothesiometry data from men presenting to our institution from July 2013–May 2017. 3 iterations of the PSR were evaluated using the threshold for vibratory detection from a combination of different input variables including the penile glans, penile shaft, index finger, and thigh. Numerator values for the PSR included the penile glans and penile shaft, whereas denominator inputs included the index finger and thigh. PSR is inversely correlated with penile sensitivity. Main Outcome MeasureThe primary outcome measure was the association between reported diminished penile sensitivity and PSR value. Secondary outcome measures were the association between PSR and age, diabetes, ejaculatory dysfunction, and Peyronie’s disease (PD). ResultsBiothesiometry data were evaluated from 1,239 men. Mean age was 53.2 years (SD 14.0 years). Diabetes was present in 7.4% (n = 92); 52.0% (n = 644) had PD. Ejaculatory dysfunction was identified in 15.8% (n = 196), with 12.2% (n = 151) having premature ejaculation and 3.6% (n = 45) reporting delayed ejaculation. Decreased penile sensitivity was reported in 20.3% (n = 252). 3 PSR iterations were analyzed to identify associations with decreased penile sensation. On univariate and multivariate analysis controlling for age, diabetes, ejaculatory dysfunction, and PD, only the PSR iteration, which included data from the penile glans and finger (PSRG/F), was significantly different between patients reporting diminished penile sensitivity and those without reported diminished sensitivity (univariate P < .01, multivariate P = .03). On univariate analysis, a higher PSRG/F was associated with older age (P < .01) and diabetes (P < .01), whereas men with PD had a lower PSRG/F (P < .01). On multivariate analysis, PSRG/F remained increased for age (P < .01) and decreased for PD (P = .01); however, there was no association with diabetes (P = .12). No association existed between ejaculatory function and PSRG/F on univariate (P = .25) or multivariate analysis (P = .35). Clinical ImplicationsThe PSR may be used as a standardized biothesiometry parameter to evaluate penile sensitivity. Strength & LimitationsThis study included a large cohort of men undergoing biothesiometry (n = 1,239); however, it is limited by the multifactorial nature of perceived diminished penile sensitivity. ConclusionThe PSR using penile glans and index finger input variables is a non-invasive, painless, office-based, standardized biothesiometry parameter that is a clinically useful tool for measuring penile sexual sensitivity.Wiggins A, Farrell MR, Tsambarlis P, et al. The Penile Sensitivity Ratio: A Novel Application of Biothesiometry to Assess Changes in Penile Sensitivity. J Sex Med 2019;16:447–451.

Optical measurement standards for reflective e‐paper to predict colors displayed in ambient illumination environments

AbstractColor displays are viewed in ambient conditions ranging from indoor lighting to bright sunlight. For emissive displays such as phones or tablets, color and readability are disturbed by ambient light reflected from the screen. However, ambient light is required to view e‐paper, so color measurements must be reflection‐based. This article describes how a bidirectional reflectance distribution function‐based methodology for measuring the disturbing reflection on emissive displays has been applied to measure the useful reflection from e‐paper displays. These measurements have been embedded in recently developed optical measurement standards for e‐paper that contain color measurement specifications for spectral reflection and—if a front light is present—spectral radiance of each displayed color. Then the measurements are combined with ambient illumination models to predict how display colors would appear in realistic lighting conditions. Although developed for e‐paper, this concept can be applied to any type of color display. Examples illustrate the standard measurement methodology, and how to predict displayed colors on both handheld e‐paper and emissive displays in both indoor and daylight viewing conditions.

Physical Properties of Selected Silicates for a Long-Term Heat Container

Implementation of high temperature solar reservoirs is associated with problems related to the physical properties of materials, especially with temperature resistance of the material at temperature changes, with high heat capacity, with high thermal conductivity and with material fire resistance. In the case of silicate materials, more specific materials with favourable physical properties are available, which can be used for the construction of high temperature containers. The basic prerequisite for designing such container is the knowledge of the physical properties of the heat storage core and the thermal insulation ability of container cladding layers.The paper deals with the problem of identification of material properties of silicates in the wide temperature range up to 800 °C, using the standard measurement methodology, improved by additional temperature recording at a defined distance from the thermal source during the dynamic thermal development of the linear thermal source, well-known as the hot wire method.

Quantitative multi-slice computed tomography assessment of the mitral valvular complex for transcatheter mitral valve interventions part 2: geometrical measurements in patients with functional mitral regurgitation.

Transcatheter mitral valve replacement (TMVR) is an emerging technology with the potential to treat patients with mitral regurgitation at excessive risk for mitral valve surgery. Geometrical measurements of the mitral valvular complex may have implications for the design of TMVR devices and for patient selection. This study sought to quantify the dynamic geometry of the mitral valvular complex in patients with significant functional mitral regurgitation (FMR) using multi-slice computed tomography (MSCT). MSCT images were acquired in 32 patients with symptomatic, significant FMR. Two independent observers analysed image sets using a dedicated software package and a standard measurement methodology. In patients with FMR, the mean mitral annulus intercommissural and aorto-mural diameters were, respectively, 41.5±5.2 mm and 38.7±5.9 mm in systole, and were 41.5±4.4 mm and 40.0±4.7 mm in diastole. In patients without MR, the diameters were, respectively, 33.6±5.1 mm and 28.8±8.0 mm in systole, and 36.2±4.5 mm and 31.6±7.9 mm in diastole. The obstacle-free zone below the mitral annulus averaged more than 20.0 mm and varied by less than 1 mm between systole and diastole, which is not statistically significant. The aorto-mitral angle was 129.7±10.5° in systole and 131.0±9.4° in diastole. The mitral annulus is larger in dimension, more circular, and less dynamic in patients with FMR. The obstacle-free zone below the mitral annulus is relatively constant during the cardiac cycle. Measurements of the mitral valvular apparatus vary considerably between patients, which suggests that tridimensional imaging will play an important role in the sizing of TMVR devices.

A methodology to ensure and improve accuracy of Ki67 labelling index estimation by automated digital image analysis in breast cancer tissue

IntroductionImmunohistochemical Ki67 labelling index (Ki67 LI) reflects proliferative activity and is a potential prognostic/predictive marker of breast cancer. However, its clinical utility is hindered by the lack of standardized measurement methodologies. Besides tissue heterogeneity aspects, the key element of methodology remains accurate estimation of Ki67-stained/counterstained tumour cell profiles. We aimed to develop a methodology to ensure and improve accuracy of the digital image analysis (DIA) approach.MethodsTissue microarrays (one 1-mm spot per patient, n = 164) from invasive ductal breast carcinoma were stained for Ki67 and scanned. Criterion standard (Ki67-Count) was obtained by counting positive and negative tumour cell profiles using a stereology grid overlaid on a spot image. DIA was performed with Aperio Genie/Nuclear algorithms. A bias was estimated by ANOVA, correlation and regression analyses. Calibration steps of the DIA by adjusting the algorithm settings were performed: first, by subjective DIA quality assessment (DIA-1), and second, to compensate the bias established (DIA-2). Visual estimate (Ki67-VE) on the same images was performed by five pathologists independently.ResultsANOVA revealed significant underestimation bias (P < 0.05) for DIA-0, DIA-1 and two pathologists’ VE, while DIA-2, VE-median and three other VEs were within the same range. Regression analyses revealed best accuracy for the DIA-2 (R-square = 0.90) exceeding that of VE-median, individual VEs and other DIA settings. Bidirectional bias for the DIA-2 with overestimation at low, and underestimation at high ends of the scale was detected. Measurement error correction by inverse regression was applied to improve DIA-2-based prediction of the Ki67-Count, in particular for the clinically relevant interval of Ki67-Count < 40%. Potential clinical impact of the prediction was tested by dichotomising the cases at the cut-off values of 10, 15, and 20%. Misclassification rate of 5-7% was achieved, compared to that of 11-18% for the VE-median-based prediction.ConclusionsOur experiments provide methodology to achieve accurate Ki67-LI estimation by DIA, based on proper validation, calibration, and measurement error correction procedures, guided by quantified bias from reference values obtained by stereology grid count. This basic validation step is an important prerequisite for high-throughput automated DIA applications to investigate tissue heterogeneity and clinical utility aspects of Ki67 and other immunohistochemistry (IHC) biomarkers.

基于边界阵列的多输入多输出无线终端的在空中无线测试方法

多输入多输出(Multiple Input Multiple Output: MIMO)天线技术在当前高速无线通信领域(LTE, WIFI, WIMAX)，高性能雷达技术(MIMO radar)等得到了飞速发展趋势。市面上越来越多无线终端设备中具有MIMO天线技术，但如何评估这种技术的测试方法却没有达到标准化。国际两大组织3GPP[1], CTIA[2]以及国内中国通信学会CCSA[3]，都在进行测试方法的标准化工作；信道模型概念引入给系统带来复杂性使得进展较慢。其中基于边界阵列的多输入多输出无线终端在空中(Over The Air: OTA)测试方法是一种非常重要的评估方法。本文利用实际的测试系统为背景，通过对边界阵列的方法概念引入，测试链路和系统的校准方法，多方面系统性能验证，以及最终产品性能的测试，希望能够较全面的给出此方法的介绍。同时展望此方法的发展前景和给出相对于其他方法的比较。 MIMO antenna technology is commonly used in high speed wireless communication (LTE, WIFI, WIMAX) as well as in high performance radar (MIMO radar). There are more and more wireless terminals with MIMO antenna around the current market. However, there are no current standardized measurement methodologies to evaluate the new technology. The main international standardization organizations, including 3GPP, CTIA and the national organization of China (CCSA), are working to standardize the test methodology. Part of the difficulty in completing a standard of the test method is due to the fact that channel models of multi-path environments complicate the test system to a large degree. Such complexity can be taken into account by the methodology based on boundary array OTA method that makes it a very important evaluation candidate for MIMO OTA performance test. The paper presents a real MIMO OTA test system. After the introduction of boundary array concept, the system calibration is described, including input and output calibration of the entire system. Subsequently, the system validation is examined from several aspects, such as power validation, filed mapping, temporal correlation and so on. Finally, the measurement results of an actual wireless product, with three different antennas, are provided to further elaborate the test methodology. At the end, the current status of the MIMO OTA test methodology standardization is provided to conclude the paper.

Digital Moiré Subtraction Interferometry (DMS) for Electronics Cooling Applications in Enclosures

Optical noninvasive temperature measurement techniques, such as interferometry, are particularly advantageous in obtaining temperature information noninvasively from enclosed low velocity flows induced by thermal sources, as commonly arise in electronic systems. The single greatest restriction in the application of interferometry as a standard measurement methodology has been the enormous cost associated with the optical equipment required. This cost is due to the quality of the optics required, which exhibits an exponential dependence on size. Digital Moiré subtraction is a technique, which removes the restriction on the use of high quality optics, thereby, enabling reasonably large fields of view. In this paper, a digital Moiré subtraction interferometer configuration is presented with a 140 mm field of view. First, the ability of the interferometer to accurately measure the free convection temperature field about an isothermal horizontal cylinder is examined through a comparison with measurements from literature using classical interferometry. The technique is then applied to the thermal interaction between 2D components representing BGAs mounted on a vertical printed circuit board (PCB). Qualitative and quantitative evaluation of the interferograms show the significant influence of in-plane PCB conductivity on the temperature field about the PCB. The spacing to length ratio above, which upstream components on a PCB experience enhanced cooling, is reduced from 4 to 3 for a PCB with a high effective in-plane conductivity (15 W/m K).

Quantifying the Impoverishing Effects of Purchasing Medicines: A Cross-Country Comparison of the Affordability of Medicines in the Developing World

Increasing attention is being paid to the affordability of medicines in low- and middle-income countries (LICs and MICs) where medicines are often highly priced in relation to income levels. The impoverishing effect of medicine purchases can be estimated by determining pre- and postpayment incomes, which are then compared to a poverty line. Here we estimate the impoverishing effects of four medicines in 16 LICs and MICs using the impoverishment method as a metric of affordability. Affordability was assessed in terms of the proportion of the population being pushed below US$1.25 or US$2 per day poverty levels because of the purchase of medicines. The prices of salbutamol 100 mcg/dose inhaler, glibenclamide 5 mg cap/tab, atenolol 50 mg cap/tab, and amoxicillin 250 mg cap/tab were obtained from facility-based surveys undertaken using a standard measurement methodology. The World Bank's World Development Indicators provided household expenditure data and information on income distributions. In the countries studied, purchasing these medicines would impoverish large portions of the population (up to 86%). Originator brand products were less affordable than the lowest-priced generic equivalents. In the Philippines, for example, originator brand atenolol would push an additional 22% of the population below US$1.25 per day, whereas for the lowest priced generic equivalent this demographic shift is 7%. Given related prevalence figures, substantial numbers of people are affected by the unaffordability of medicines. Comparing medicine prices to available income in LICs and MICs shows that medicine purchases by individuals in those countries could lead to the impoverishment of large numbers of people. Action is needed to improve medicine affordability, such as promoting the use of quality assured, low-priced generics, and establishing health insurance systems. Please see later in the article for the Editors' Summary.

Measuring Medication Adherence

Several studies have shown that poor adherence to pharmaceutical treatment regimens increases health condition severity, mortality rates, and overall health care costs. The dimension of medication adherence in health management outcomes has been deficient of a comprehensive yet practical standardized measurement methodology. DMAA: The Care Continuum Alliance, along with its industry partners, noted this absence and assembled a clinical workgroup to undertake an appropriate standardization effort. The medication adherence clinical workgroup within DMAA's outcomes measurement and methodology steering committee convened in February 2008 to review literature, incorporate subject matter expertise, gain consensus on measurement techniques, and discuss known limitations. This workgroup has successfully completed a standardized methodology to measure medication adherence rates via medication possession ratio (MPR). The guidelines for this method were approved for inclusion in Volume III of DMAA's Outcomes Guidelines Report. Accordant Health Services, as a member of this workgroup, volunteered to test the recommended specification and measure. These tests would encompass not only measurement calculations but also feasibility considerations. The measurement period for these tests was the 2007 calendar year. Results showed that condition-specific MPRs for a health plan population ranged between 78.9% and 83.6%. The same methods applied to an employer group population revealed a condition-specific MPR range of 75.4% to 76.5%. Based on 2007 book of business data for CVS Caremark's Adherence to Drug Therapy program, those results are within the 95% confidence interval for employer group and health plan populations.

Electro-Photographic &amp;amp; Ink Jet Color Cartridge Yield Test Documents: Problems, Approaches, Suggestions

Reliably determining the yield for color electro-photographic (EP) or inkjet (IJ, including solid ink) cartridges is important to all involved with color printing products. For manufacturers, it provides design specification for monitoring processes. For marketers, it helps positioning against competing products. For consumers, it facilitates assessment and comparison of cost-of-ownership.Efforts toward agreement on a standardized measurement methodology have raised significant issues. Factors such as determination of end-of-life, environmental operating conditions, and sample testing size can be leveraged from the monochrome EP standard effort. However, color test document content raises new and unique problems.Although this effort is focused on office users, consumers have similar needs. In today's office and consumer environments, most digital documents are created in an RGB color space. The conversion from this RGB space to an individual printer's CMYK toner or ink color space is unique to each printer. A discussion of the relationship of this issue to color toner or ink yield measurement follows, along with suggestions for the parameters defining a set of color test documents to standardize an appropriate solution.

3D shoulder position measurements using a six-degree-of-freedom electromagnetic tracking device

Objective. To describe a recording and processing methodology for obtaining kinematic data of the shoulder which meets three more criteria besides usual requirements regarding precision and accuracy: sufficient speed, obtaining complete 3D kinematics including joint rotations, and usage of coordinate systems based on reference points. Design. Static recordings of shoulder bone orientations during standardized humerus elevations based on the palpation technique using a six-degree-of-freedom electromagnetic tracking device. Background. An easy, fast, well standardized measurement methodology for obtaining complete 3D shoulder kinematic data is urgently needed for fundamental musculoskeletal and clinical research. Methods. A measurement methodology was designed and developed. Shoulder kinematics were obtained from repeated measurements on 15 healthy subjects performed by two observers. Inter-trial, inter-day, inter-observer and inter-subject variability were established. Results were compared to literature. Results. Complete kinematic descriptions were obtained. A measurement speed of about one position per second could be reached. The measured kinematics and accuracy of the measurements were found to be in concordance with the literature. Conclusion. All previously formulated criteria for a clinical useful method for obtaining shoulder kinematics have been met.