New considerations on the management of osteoporosis in Central and Eastern Europe (CEE): summary of the "3rd Summit on Osteoporosis-CEE", November 2009, Budapest, Hungary.

INTRODUCTION: In November 2009, the "3rd Summit on Osteoporosis-Central and Eastern Europe (CEE)" was held in Budapest, Hungary. The conference aimed to tackle issues regarding osteoporosis management in CEE identified during the second CEE summit in 2008 and to agree on approaches that allow most efficient and cost-effective diagnosis and therapy of osteoporosis in CEE countries in the future. DISCUSSION: The following topics were covered: past year experience from FRAX® implementation into local diagnostic algorithms; causes of secondary osteoporosis as a FRAX® risk factor; bone turnover markers to estimate bone loss, fracture risk, or monitor therapies; role of quantitative ultrasound in osteoporosis management; compliance and economical aspects of osteoporosis; and osteoporosis and genetics. Consensus and recommendations developed on these topics are summarised in the present progress report. CONCLUSION: Lectures on up-to-date data of topical interest, the distinct regional provenances of the participants, a special focus on practical aspects, intense mutual exchange of individual experiences, strong interest in cross-border cooperations, as well as the readiness to learn from each other considerably contributed to the establishment of these recommendations. The "4th Summit on Osteoporosis-CEE" held in Prague, Czech Republic, in December 2010 will reveal whether these recommendations prove of value when implemented in the clinical routine or whether further improvements are still required.

Peripheral dual-energy X-ray absorptiometry in the management of osteoporosis: the 2007 ISCD Official Positions.

Peripheral assessment of bone density using photon absorptiometry techniques has been available for over 40 yr. The initial use of radio-isotopes as the photon source has been replaced by the use of X-ray technology. A wide variety of models of single- or dual-energy X-ray measurement tools have been made available for purchase, although not all are still commercially available. The Official Positions of the International Society for Clinical Densitometry (ISCD) have been developed following a systematic review of the literature by an ISCD task force and a subsequent Position Development Conference. These cover the technological diversity among peripheral dual-energy X-ray absorptiometry (pDXA) devices; define whether pDXA can be used for fracture risk assessment and/or to diagnose osteoporosis; examine whether pDXA can be used to initiate treatment and/or monitor treatment; provide recommendations for pDXA reporting; and review quality assurance and quality control necessary for effective use of pDXA.

Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD Official Positions

Dual-energy X-ray absorptiometry (DXA) is commonly used in the care of patients for diagnostic classification of osteoporosis, low bone mass (osteopenia), or normal bone density; assessment of fracture risk; and monitoring changes in bone density over time. The development of other technologies for the evaluation of skeletal health has been associated with uncertainties regarding their applications in clinical practice. Quantitative ultrasound (QUS), a technology for measuring properties of bone at peripheral skeletal sites, is more portable and less expensive than DXA, without the use of ionizing radiation. The proliferation of QUS devices that are technologically diverse, measuring and reporting variable bone parameters in different ways, examining different skeletal sites, and having differing levels of validating data for association with DXA-measured bone density and fracture risk, has created many challenges in applying QUS for use in clinical practice. The International Society for Clinical Densitometry (ISCD) 2007 Position Development Conference (PDC) addressed clinical applications of QUS for fracture risk assessment, diagnosis of osteoporosis, treatment initiation, monitoring of treatment, and quality assurance/quality control. The ISCD Official Positions on QUS resulting from this PDC, the rationale for their establishment, and recommendations for further study are presented here.

Diseño e implementación de una Web dinámica como herramienta para el control de obras en base al coste del proceso de construcción

En la actualidad estamos sufriendo una situación de crisis económica de dimensiones desproporcionadas e inusuales, la cual está obligando a todas las empresas a globalizar en mayor medida el ámbito de actuación de sus negocios, por lo que muchas empresas que trabajaban exclusivamente en el ámbito local o nacional han tenido que expandirse hacia el exterior. Este hecho, añadido a la fortísima competencia existente en el mercado, obligará a todas estas empresas a tener que controlar en mayor medida la actividad productiva, y a hacerlo utilizando tecnologías que faciliten el flujo de la información dentro de la empresa, hagan que la distancia no sea un problema para la transmisión de esa información, y con las que todos los usuarios manejen los mismos datos. El sector de la construcción es uno de los más castigados por la citada crisis, y probablemente uno de los más retrasados en lo que respecta a utilización de Tecnologías de la Información y la Comunicación. El objetivo principal de este trabajo es el diseño e implementación de una web dinámica como herramienta para medir la eficiencia en el control de la actividad productiva de una empresa constructora. La manera de medir esta eficiencia será mediante la comparación mensual de los costes previstos para las diferentes obras que deba ejecutar la empresa (los cuales podemos llamar estándar) y los que se vayan produciendo realmente. La herramienta diseñada podría ir aumentando su utilidad si, añadiendo módulos mediante la ampliación de la base de datos y diseñando las pertinentes nuevas páginas web para el sitio, se usa también para otros menesteres además del control de la actividad productiva por comparación entre costes previstos y reales. Es decir, que se podría llegar a gestionar la información de todas las actividades de la empresa (compras, recursos humanos, contabilidad, gestión de calidad, etc.). Por lo tanto, una web dinámica como la expuesta en el trabajo podría servir como semilla para el desarrollo de un ERP (Enterprise Resource Planning).

Embankment Quality Phase IV: Application to Unsuitable Soils, TR-492, 2007

The Quality Management Earthwork (QM-E) special provision was implemented on a pilot project to evaluate quality control (QC) and quality assurance (QA) testing in predominately unsuitable soils. Control limits implemented on this pilot project included the following: 95% relative compaction, moisture content not exceeding +/- 2% of optimum moisture content, soil strength not exceeding a dynamic cone penetrometer (DCP) index of 70 mm/blow, vertical uniformity not exceeding a variation in DCP index of 40 mm/blow, and lift thickness not exceeding depth determined through construction of control strips. Four-point moving averages were used to allow for some variability in the measured parameter values. Management of the QC/QA data proved to be one of the most challenging aspects of the pilot project. Implementing use of the G-RAD data collection system has considerable potential to reduce the time required to develop and maintain QC/QA records for projects using the QM-E special provision. In many cases, results of a single Proctor test were used to establish control limits that were used for several months without retesting. While the data collected for the pilot project indicated that the DCP index control limits could be set more tightly, there is not enough evidence to support making a change. In situ borings, sampling, and testing in natural unsuitable cut material and compacted fill material revealed that the compacted fill had similar strength characteristics to that of the natural cut material after less than three months from the start of construction.

Embankment Quality: Phase III, TR-401, 2002

This report describes test results from a full-scale embankment pilot study conducted in Iowa. The intent of the pilot project was to field test and refine the proposed soil classification system and construction specifications developed in Phase II of this research and to evaluate the feasibility of implementing a contractor quality control (QC) and Iowa DOT quality assurance (QA) program for earthwork grading in the future. One of the primary questions for Phase III is “Was embankment quality improved?” The project involved a “quality conscious” contractor, well-qualified and experienced Iowa Department of Transportation field personnel, a good QC consultant technician, and some of our best soils in the state. If the answer to the above question is “yes” for this project, it would unquestionably be “yes” for other projects as well. The answer is yes, the quality was improved, even for this project, as evidenced by dynamic cone penetrometer test data and the amount of disking required to reduce the moisture content to within acceptable control limits (approximately 29% of soils by volume required disking). Perhaps as important is that we know what quality we have. Increased QC/QA field testing, however, increases construction costs, as expected. The quality management-earthwork program resulted in an additional $0.03 per cubic meter, or 1.6%, of the total construction costs. Disking added about $0.04 per cubic meter, or 1.7%, to the total project costs. In our opinion this is a nominal cost increase to improve quality. It is envisioned that future contractor innovations have the potential for negating this increase. The Phase III results show that the new soil classification system and the proposed field test methods worked well during the Iowa Department of Transportation soils design phase and during the construction phase. Recommendations are provided for future implementation of the results of this study by city, county, and state agencies.

Embankment Quality and Assessment of Moisture Control Implementation, TR-677, 2016

A specification for contractor moisture quality control (QC) in roadway embankment construction has been in use for approximately 10 years in Iowa on about 190 projects. The use of this QC specification and the development of the soils certification program for the Iowa Department of Transportation (DOT) originated from Iowa Highway Research Board (IHRB) embankment quality research projects. Since this research, the Iowa DOT has applied compaction with moisture control on most embankment work under pavements. This study set out to independently evaluate the actual quality of compaction using the current specifications. Results show that Proctor tests conducted by Iowa State University (ISU) using representative material obtained from each test section where field testing was conducted had optimum moisture contents and maximum dry densities that are different from what was selected by the Iowa DOT for QC/quality assurance (QA) testing. Comparisons between the measured and selected values showed a standard error of 2.9 lb/ft3 for maximum dry density and 2.1% for optimum moisture content. The difference in optimum moisture content was as high as 4% and the difference in maximum dry density was as high as 6.5 lb/ft3 . The difference at most test locations, however, were within the allowable variation suggested in AASHTO T 99 for test results between different laboratories. The ISU testing results showed higher rates of data outside of the target limits specified based on the available contractor QC data for cohesive materials. Also, during construction observations, wet fill materials were often observed. Several test points indicated that materials were placed and accepted at wet of the target moisture contents. The statistical analysis results indicate that the results obtained from this study showed improvements over results from previous embankment quality research projects (TR-401 Phases I through III and TR-492) in terms of the percentage of data that fell within the specification limits. Although there was evidence of improvement, QC/QA results are not consistently meeting the target limits/values. Recommendations are provided in this report for Iowa DOT consideration with three proposed options for improvements to the current specifications. Option 1 provides enhancements to current specifications in terms of material-dependent control limits, training, sampling, and process control. Option 2 addresses development of alternative specifications that incorporate dynamic cone penetrometer or light weight deflectometer testing into QC/QA. Option 3 addresses incorporating calibrated intelligent compaction measurements into QC/QA.

Quality in services marketing in infocom sector in Finland

Tutkielman tavoitteena oli selvittää, mikä on palvelun laadun taso infocom sektorilla Suomessa, ja miten sitä voidaan parantaa. Teoriaosassa tavoitteeseen pyrittiin muodostamalla teoriakirjallisuuteen, tieteellisiin julkaisuihin sekä aikaisempaan aihealuetta sivuavaan tutkimukseen perustuva viitekehysmalli. Empiirisessä osassa tavoitetta lähestyttiin tutkimalla infocom sektorin kunkin toimialueen (telekommunikaatio, informaatio teknologia ja sisältötuotanto) palvelujen laatua case-kuvausten muodossa. Tutkielman empiirinen osuus toteutettiin kvalitatiivisena multiple case -tutkimuksena teemahaastattelu-menetelmää soveltaen. Case-analyysi suorittiin käyttäen ns. explanation- building -menetelmää. Teoreettiset ja empiiriset tutkimustulokset yhdistettiin erityisiksi infocom sektorille soveltuviksi toimenpidesuosituksiksi. Tutkielman empiirinen osuus antoi tukea teoreettisen osuuden pohjalta kehitetylle viitekehykselle. Tutkimuksen tavoitteena oli case-analyysi- menetelmän mukaisesti luoda perusta syvemmälle aihepiiriä käsittelevälle jatkotutkimukselle ja luoda kuva infocom sektorin tämän hetkisestä laadullisesta tilasta. Yhteenvetona voidaan sanoa, että laatu palvelujen markkinoinnissa infocom sektorilla on suhteellisen heikkoa, vaikka tutkimusaineiston mukaan laatu arvostetaan hyvin korkealle. Yritysten tämänhetkiset panostukset laatuun liittyvät lähinnä liiketoiminnan tukifunktioihin ja prosessien ohjausmenetelmiä koskeviin järjestelmiin. Tutkimuksen pohjalta tehtävät varsinaiset toimenpidesuositukset liittyvät laadun sisäistämiseen jo strategiaa luotaessa, asiakaslähtöisyyteen, laatujohtamiseen, laatukoulutukseen ja kokonaisvaltaisen laatukulttuurin luomiseen organisaatioissa. Turbulentissa, nopeasti kansainvälistyvässä ja erittäin voimakkaasti kilpaillussa liiketoimintaympäristössä nämä ovat elintärkeitä menestymisen kriteerejä.

The effects of real time control of welding parameters on weld quality in plasma arc keyhole welding

Joints intended for welding frequently show variations in geometry and position, for which it is unfortunately not possible to apply a single set of operating parameters to ensure constant quality. The cause of this difficulty lies in a number of factors, including inaccurate joint preparation and joint fit up, tack welds, as well as thermal distortion of the workpiece. In plasma arc keyhole welding of butt joints, deviations in the gap width may cause weld defects such as an incomplete weld bead, excessive penetration and burn through. Manual adjustment of welding parameters to compensate for variations in the gap width is very difficult, and unsatisfactory weld quality is often obtained. In this study a control system for plasma arc keyhole welding has been developed and used to study the effects of the real time control of welding parameters on gap tolerance during welding of austenitic stainless steel AISI 304L. The welding tests demonstrated the beneficial effect of real time control on weld quality. Compared with welding using constant parameters, the maximum tolerable gap width with an acceptable weld quality was 47% higher when using the real time controlled parameters for a plate thickness of 5 mm. In addition, burn through occurred with significantly larger gap widths when parameters were controlled in real time. Increased gap tolerance enables joints to be prepared and fit up less accurately, saving time and preparation costs for welding. In addition to the control system, a novel technique for back face monitoring is described in this study. The test results showed that the technique could be successfully applied for penetration monitoring when welding non magnetic materials. The results also imply that it is possible to measure the dimensions of the plasma efflux or weld root, and use this information in a feedback control system and, thus, maintain the required weld quality.

Tabular cusum control charts of chemical variables applied to the control of surface water quality

The aim of this study was to evaluate the application possibility of tabular CUSUM control charts in the quality control of chemical variables in surface water. It was performed bibliographic and field research to collect water samples from 2003 to 2009, totaling 30 samples, some monthly and others semi-annual in order to observe the variables that regulate water quality. It was found that these charts may be applied to control the quality of river water; showing to be effective in the perception of changes during the process, especially for small samples (n=1) which there is no repetition as in this research. It was also concluded that the Mandurim River does not presents significant levels of pollution.

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months

ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

The application of Process Management for reliability enhancement of the Taguchi method

The concept of Process Management has been used by managers and consultants that search for the improvement of both operational or managerial industrial processes. Its strength is in focusing on the external client and on the optimization of the internal process in order to fulfill their needs. By the time the needs of internal clients are being sought, a set of improvements takes place. The Taguchi method, because of its claim for knowledge share between design engineers and people engaged in the process, is a candidate for process management implementation. The objective of this paper is to propose that kind of application aiming for improvements related with reliability of results revealed by the robust design of Taguchi method.

Weed control under integrated nutrient management systems in faba bean (Vicia faba) production in Egypt

Two field experiments were conducted in two successive seasons, 2005/2006 and 2006/2007, to determine whether management can improve faba bean competitiveness with weeds, thus helping to achieve its yield potential. The experiment included five treatments, composed of organic and mineral fertilizers, alone and mixed at different rates, along with a control and six weed control treatments, including oxadiargyl, prometryn, hand hoeing treatments alone or mixed with the herbicides, and a nonweeded treatment (control).The herbicide treatments were not superior to the two hand-hoeing treatments. Using compost favored growth and yield of faba bean more than of weeds. Adding fertilizer also improved most yield parameters. Application of compost alone or combined with 50 or 100% of the recommended NPK rate improved faba bean growth in terms of net assimilation rate, specific leaf area, and leaf weight ratio as components of relative growth rate. This improvement in growth resulted in increase of seed yield, yield components and protein of faba bean. Faba bean yield performance improved under interactive fertilizer effects and weed control treatments as growth improved, as a result of nutrient release from fertilizers and weed control.

Dual light barrier method for six degrees of freedom tool center point calibration of an industrial robot

Tool center point calibration is a known problem in industrial robotics. The major focus of academic research is to enhance the accuracy and repeatability of next generation robots. However, operators of currently available robots are working within the limits of the robot´s repeatability and require calibration methods suitable for these basic applications. This study was conducted in association with Stresstech Oy, which provides solutions for manufacturing quality control. Their sensor, based on the Barkhausen noise effect, requires accurate positioning. The accuracy requirement admits a tool center point calibration problem if measurements are executed with an industrial robot. Multiple possibilities are available in the market for automatic tool center point calibration. Manufacturers provide customized calibrators to most robot types and tools. With the handmade sensors and multiple robot types that Stresstech uses, this would require great deal of labor. This thesis introduces a calibration method that is suitable for all robots which have two digital input ports free. It functions with the traditional method of using a light barrier to detect the tool in the robot coordinate system. However, this method utilizes two parallel light barriers to simultaneously measure and detect the center axis of the tool. Rotations about two axes are defined with the center axis. The last rotation about the Z-axis is calculated for tools that have different width of X- and Y-axes. The results indicate that this method is suitable for calibrating the geometric tool center point of a Barkhausen noise sensor. In the repeatability tests, a standard deviation inside robot repeatability was acquired. The Barkhausen noise signal was also evaluated after recalibration and the results indicate correct calibration. However, future studies should be conducted using a more accurate manipulator, since the method employs the robot itself as a measuring device.

Microbiological and physicochemical evaluations of juice extracted from different parts of sugar cane stalks from three varieties cultivated under organic management

The artisanal production of cachaça, a beverage obtained by the fermentation of sugar cane juice after distillation, especially by small-sized producers, has traditionally used natural ferment ("fermento caipira") which consists of sugar cane juice with crushed corn, powdered rice, or citrus fruits. In despite of the difficulties in quality control due to the high level of contaminants and longer periods of preparation, the sensorial quality of the beverage may be attributed to the physiological activities of wild yeasts and even bacteria present during fermentation when this ferment is used. In this context, the aim here was to evaluate the microbiological (yeasts) and physicochemical characteristics of sugar cane juice extracted from different parts of three different varieties (RB72454, RB835486, and RB867515) of the cane stalk (lower, medium, and upper sections) in three harvesting periods (from May to December 2007) in an area under organic management. The juice from the upper section (from the eleventh internode to the top) of the sugar cane stalk could be indicated for the preparation of the natural ferment since it is as a source of yeasts and reducing sugars, especially the variety RB867515. Due to the seasonality, the best period for using this part of the sugar cane stalk is at the beginning of harvesting when the phenolic compounds are at low concentration, but there are higher number of Saccharomyces population and other yeast species. The high acidity in this section of the plant could result in a better control of bacterial contamination. These findings explain the traditional instructions of adding the upper sections for the preparation of natural ferment and can help its management in order to get a better performance with respect to organic cachaça production.