Nuclear medicine in Europe: education

The technical developments that have taken place in the preceding years (PET, hybrid imaging) have changed nuclear medicine. The future cooperation with radiologists will be challenging as well as positioning nuclear medicine in an European context. It can also be expected that education in nuclear medicine will undergo a harmonization process in the states of the European Union. In this paper, we describe how nuclear medicine education is organized in several European countries. We aim to stimulate constructive discussions on the future development of the specialization in nuclear medicine in Germany.

First intercomparison study on the analysis of oxygenated polycyclic aromatic hydrocarbons (oxy-PAHs) and nitrogen heterocyclic polycyclic aromatic compounds (N-PACs) in contaminated soil

Oxygenated polycyclic aromatic hydrocarbons (oxy-PAHs) and nitrogen heterocyclic polycyclic aromatic compounds (N-PACs) are toxic, highly leachable and often abundant at sites that are also contaminated with PAHs. However, due to lack of regulations and standardized methods for their analysis, they are seldom included in monitoring and risk-assessment programs. This intercomparison study constitutes an important step in the harmonization of the analytical methods currently used, and may also be considered a first step towards the certification of reference materials for these compounds. The results showed that the participants were able to determine oxy-PAHs with accuracy similar to PAHs, with average determined mass fractions agreeing well with the known levels in a spiked soil and acceptable inter- and intra-laboratory precisions for all soils analyzed. For the N-PACs, the results were less satisfactory, and have to be improved by using analytical methods more specifically optimized for these compounds.

Intercomparison of stratospheric ozone profiles for the assessment of the upgraded GROMOS radiometer at Bern

Since November 1994, the GROund-based Millimeter-wave Ozone Spectrometer (GROMOS) measures stratospheric and lower mesospheric ozone in Bern, Switzerland (47.95° N, 7.44° E). GROMOS is part of the Network for the Detection of Atmospheric Composition Change (NDACC). In July 2009, a Fast-Fourier-Transform spectrometer (FFTS) has been added as backend to GROMOS. The new FFTS and the original filter bench (FB) measured parallel for over two years. In October 2011, the FB has been turned off and the FFTS is now used to continue the ozone time series. For a consolidated ozone time series in the frame of NDACC, the quality of the stratospheric ozone profiles obtained with the FFTS has to be assessed. The FFTS results from July 2009 to December 2011 are compared to ozone profiles retrieved by the FB. FFTS and FB of the GROMOS microwave radiometer agree within 5% above 20 hPa. A later harmonization of both time series will be realized by taking the FFTS as benchmark for the FB. Ozone profiles from the FFTS are also compared to coinciding lidar measurements from the Observatoire Haute Provence (OHP), France. For the time period studied a maximum mean difference (lidar – GROMOS FFTS) of +3.8% at 3.1 hPa and a minimum mean difference of +1.4% at 8 hPa is found. Further, intercomparisons with ozone profiles from other independent instruments are performed: satellite measurements include MIPAS onboard ENVISAT, SABER onboard TIMED, MLS onboard EOS Aura and ACE-FTS onboard SCISAT-1. Additionally, ozonesondes launched from Payerne, Switzerland, are used in the lower stratosphere. Mean relative differences of GROMOS FFTS and these independent instruments are less than 10% between 50 and 0.1 hPa.

Past and future carbon fluxes from land use change, shifting cultivation and wood harvest

Carbon emissions from anthropogenic land use (LU) and land use change (LUC) are quantified with a Dynamic Global Vegetation Model for the past and the 21st century following Representative Concentration Pathways (RCPs). Wood harvesting and parallel abandonment and expansion of agricultural land in areas of shifting cultivation are explicitly simulated (gross LUC) based on the Land Use Harmonization (LUH) dataset and a proposed alternative method that relies on minimum input data and generically accounts for gross LUC. Cumulative global LUC emissions are 72 GtC by 1850 and 243 GtC by 2004 and 27–151 GtC for the next 95 yr following the different RCP scenarios. The alternative method reproduces results based on LUH data with full transition information within <0.1 GtC/yr over the last decades and bears potential for applications in combination with other LU scenarios. In the last decade, shifting cultivation and wood harvest within remaining forests including slash each contributed 19% to the mean annual emissions of 1.2 GtC/yr. These factors, in combination with amplification effects under elevated CO2, contribute substantially to future emissions from LUC in all RCPs.

A new universal, standardized implant database for product identification: a unique tool for arthroplasty registries.

INTRODUCTION Every joint registry aims to improve patient care by identifying implants that have an inferior performance. For this reason, each registry records the implant name that has been used in the individual patient. In most registries, a paper-based approach has been utilized for this purpose. However, in addition to being time-consuming, this approach does not account for the fact that failure patterns are not necessarily implant specific but can be associated with design features that are used in a number of implants. Therefore, we aimed to develop and evaluate an implant product library that allows both time saving barcode scanning on site in the hospital for the registration of the implant components and a detailed description of implant specifications. MATERIALS AND METHODS A task force consisting of representatives of the German Arthroplasty Registry, industry, and computer specialists agreed on a solution that allows barcode scanning of implant components and that also uses a detailed standardized classification describing arthroplasty components. The manufacturers classified all their components that are sold in Germany according to this classification. The implant database was analyzed regarding the completeness of components by algorithms and real-time data. RESULTS The implant library could be set up successfully. At this point, the implant database includes more than 38,000 items, of which all were classified by the manufacturers according to the predefined scheme. Using patient data from the German Arthroplasty Registry, several errors in the database were detected, all of which were corrected by the respective implant manufacturers. CONCLUSIONS The implant library that was developed for the German Arthroplasty Registry allows not only on-site barcode scanning for the registration of the implant components but also its classification tree allows a sophisticated analysis regarding implant characteristics, regardless of brand or manufacturer. The database is maintained by the implant manufacturers, thereby allowing registries to focus their resources on other areas of research. The database might represent a possible global model, which might encourage harmonization between joint replacement registries enabling comparisons between joint replacement registries.

Discursive Practices Of Organizational Identity Negotiations

How do organizations discursively negotiate organizational identity? In a longitudinal interpretive case study, we investigate the discursive practices of identity negotiations in a non-profit organization. Drawing on semi-structured interviews, documents and participant observations, and in applying a discourse analytical framework, we first identify three distinct discourses that provide the discursive resources for three different identity propositions. Then and in order to understand how these discursive resources are activated and utilized, we reconstruct four distinct discursive practices of organizational identity negotiations: (1) external comparison and differentiation (2) denial of trade-offs and harmonization (3) historization, and (4) moralization. We discuss how this structure relates to other similarly pluralistic organizational contexts.

Collaborative Research in Childhood Cancer Survivorship: The Current Landscape.

Survivors of childhood cancer carry a substantial burden of morbidity and are at increased risk for premature death. Furthermore, clear associations exist between specific therapeutic exposures and the risk for a variety of long-term complications. The entire landscape of health issues encountered for decades after successful completion of treatment is currently being explored in various collaborative research settings. These settings include large population-based or multi-institutional cohorts and single-institution studies. The ascertainment of outcomes has depended on self-reporting, linkage to registries, or clinical assessments. Survivorship research in the cooperative group setting, such as the Children's Oncology Group, has leveraged the clinical trials infrastructure to explore the molecular underpinnings of treatment-related adverse events, and to understand specific complications in the setting of randomized risk-reduction strategies. This review highlights the salient findings from these large collaborative initiatives, emphasizing the need for life-long follow-up of survivors of childhood cancer, and describing the development of several guidelines and efforts toward harmonization. Finally, the review reinforces the need to identify populations at highest risk, facilitating the development of risk prediction models that would allow for targeted interventions across the entire trajectory of survivorship.

Ophthalmic epidemiology in Europe: the "European Eye Epidemiology" (E3) consortium.

The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170,000 European participants. The aim of the consortium is to promote and sustain collaboration and sharing of data and knowledge in the field of ophthalmic epidemiology in Europe, with particular focus on the harmonization of methods for future research, estimation and projection of frequency and impact of visual outcomes in European populations (including temporal trends and European subregions), identification of risk factors and pathways for eye diseases (lifestyle, vascular and metabolic factors, genetics, epigenetics and biomarkers) and development and validation of prediction models for eye diseases. Coordinating these existing data will allow a detailed study of the risk factors and consequences of eye diseases and visual impairment, including study of international geographical variation which is not possible in individual studies. It is expected that collaborative work on these existing data will provide additional knowledge, despite the fact that the risk factors and the methods for collecting them differ somewhat among the participating studies. Most studies also include biobanks of various biological samples, which will enable identification of biomarkers to detect and predict occurrence and progression of eye diseases. This article outlines the rationale of the consortium, its design and presents a summary of the methodology.

Comparability of Outcome Frameworks in Medical Education: Implications for framework development

Background: The demand for international harmonization in medical education increases with the growing mobility of students and health professionals. Many medical societies and governmental offices have issued outcome frameworks (OF), which describe aims and contents of medical education based on competencies. These national standards affect the development of curricula as well as assessment and licensing procedures. Comparing OF and identifying factors that limit their comparability may thus foster international harmonization of medical education. Summary of Work: We conducted a systematic search for national OF in MedLine, EmBase and the internet. We included all OF in German or English that resulted from a national consensus process and were published or endorsed by a national society or governmental body. We extracted information in five predetermined categories: history of origin, audience, formal structure, medical schooling system and key terms. Summary of Results: Out of 1816 results, 13 OF were included into further analyses. OF reference each other, often without addressing existing differences (e.g. in target audiences). The two most cited OF are “CanMEDs” and “Scottish Doctor”. OF differ especially in their level of detail as well as in the underlying educational system. Discussion and Conclusions: Based on our results we propose a two-step blueprint for OF, that may help to establish comparability for internationally aligned key features – so-called “core competencies” – while at the same time allowing for necessary regional adaptations in terms of “secondary competencies”. Take-home messages: Considerable differences in at least five categories of OF currently hinder the comparability of outcome frameworks.

A fractional vegetation cover remote sensing product on pan-arctic scale with link to geotiff image

The paper presents first results of a pan-boreal scale land cover harmonization and classification. A methodology is presented that combines global and regional vegetation datasets to extract percentage cover information for different vegetation physiognomy and barren for the pan-arctic region within the ESA Data User Element Permafrost. Based on the legend description of each land cover product the datasets are harmonized into four LCCS (Land Cover Classification System) classifiers which are linked to the MODIS Vegetation Continuous Field (VCF) product. Harmonized land cover and Vegetation Continuous Fields products are combined to derive a best estimate of percentage cover information for trees, shrubs, herbaceous and barren areas for Russia. Future work will concentrate on the expansion of the developed methodology to the pan-arctic scale. Since the vegetation builds an isolation layer, which protects the permafrost from heat and cold temperatures, a degradation of this layer due to fire strongly influences the frozen conditions in the soil. Fire is an important disturbance factor which affects vast processes and dynamics in ecosystems (e.g. biomass, biodiversity, hydrology, etc.). Especially in North Eurasia the fire occupancy has dramatically increased in the last 50 years and has doubled in the 1990s with respect to the last five decades. A comparison of global and regional fire products has shown discrepancies between the amounts of burn scars detected by different algorithms and satellite data.

On Labor Complementarity, Cultural Frictions and Strategic Immigration Policies

In this paper we consider a model with two industrialized countries that face a flow of immigration from the "rest of the world." The countries differ in three characteristics: the labor complementarity between the "native" population and immigrants, the population size, and the magnitude of the cultural friction between the natives and immigrants. We consider a non-cooperative game between two countries' when their strategic instrument is the choice of an immigration quota and the world immigrant wages introduce the spill-over effect between two countries. We first show that the quota game admits unique pure strategies Nash equilibrium. We then compare the equilibrium choices of two countries and show that even though the larger country attracts more immigrants, it chooses lower quota than its smaller counterpart. It also turns out that higher degree of labor complementarity between natives and immigrants and a lower degree of cultural friction between two groups yield higher immigration quota. We also examine the welfare implications of countries choices' and argue that coordinated and harmonized immigration policies may improve the welfare of both countries.

Impacts of common rules of origin on FTA utilization

This paper examines empirically the impacts of sharing rules of origin (RoOs) with other ASEAN+1 free trade agreements (FTAs) on ASEAN-Korea FTA/ASEAN-China FTA utilization in Thai exports in 2011. Our careful empirical analysis suggests that the harmonization of RoOs across FTAs play some role in reducing the costs yielded through the spaghetti bowl phenomenon. In particular, the harmonization to "change-in-tariff classification (CTC) or real value-added content (RVC)" will play a relatively positive role in not seriously discouraging firms’ use of multiple FTA schemes. On the other hand, the harmonization to CTC or CTC&RVC hinders firms from using those schemes.

Propuesta metodológica de aplicación sectorial de Análisis de Ciclo de Vida (ACV) para la evaluación ambiental de la edificación en España

La aplicación de criterios de sostenibilidad ha de entenderse como el procedimiento esencial para la necesaria reconversión del sector de la construcción, que movilizando el 10% de la economía mundial, representa más de la tercera parte del consumo mundial de recursos, en torno al 30-40% del consumo energético y emisiones de gases de efecto invernadero, 30-40% de la generación de residuos y el 12% de todo el gasto en agua dulce del planeta. La presente investigación se enmarca en una estrategia general de promover la evaluación de la sostenibilidad en la edificación en el contexto español, dando un primer paso centrado en la evaluación del comportamiento ambiental. El hilo conductor de la investigación parte de la necesidad de establecer un marco teórico de sostenibilidad, que permita clarificar conceptos y definir criterios de valoración adecuados. Como siguiente paso, la investigación se dirige a la revisión del panorama internacional de normativa e instrumentos voluntarios, con el objetivo de clarificar el difuso panorama que caracteriza a la sostenibilidad en el sector de la edificación en la actualidad y enmarcar la investigación en un contexto de políticas y programaciones ya existentes. El objetivo principal reside en el planteamiento de una metodología de evaluación de los aspectos o impactos ambientales asociados al ciclo de vida de la edificación, aplicable al contexto español, como una de las tres dimensiones que constituyen los pilares básicos de la sostenibilidad. Los ámbitos de evaluación de los aspectos sociales y económicos, para los que no existe actualmente un grado de definición metodológico suficientemente congruente, son adicionalmente examinados, de cara a ofrecer una visión holística de la evaluación. Previo al desarrollo de la propuesta, se aborda, en primer lugar, la descripción de las características básicas y limitaciones de la metodología de Análisis de Ciclo de Vida (ACV), para posteriormente proceder a profundizar en el estado del arte de aplicación de ACV a la edificación, realizando una revisión crítica de los trabajos de investigación que han sido desarrollados en los últimos años. Esta revisión permite extraer conclusiones sobre su grado de coherencia con el futuro entorno normativo e identificar dos necesidades prioritarias de actuación: -La necesidad de armonización, dadas las fuertes inconsistencias metodológicas detectadas, que imposibilitan la comparación de los resultados obtenidos en los trabajos de evaluación. -La necesidad de simplificación, dada la complejidad inherente a la evaluación, de modo que, manteniendo el máximo rigor, sea viable su aplicación práctica en el contexto español. A raíz de la participación en los trabajos de desarrollo normativo a nivel europeo, se ha adquirido una visión crítica sobre las implicaciones metodológicas de la normativa en definición, que permite identificar la hoja de ruta que marcará el escenario europeo en los próximos años. La definición de la propuesta metodológica integra los principios generales de aplicación de ACV con el protocolo metodológico establecido en la norma europea, considerando adicionalmente las referencias normativas de las prácticas constructivas en el contexto español. En el planteamiento de la propuesta se han analizado las posibles simplificaciones aplicables, con el objetivo de hacer viable su implementación, centrando los esfuerzos en la sistematización del concepto de equivalente funcional, el establecimiento de recomendaciones sobre el tipo de datos en función de su disponibilidad y la revisión crítica de los modelos de cálculo de los impactos ambientales. Las implicaciones metodológicas de la propuesta se describen a través de una serie de casos de estudio, que ilustran su viabilidad y las características básicas de aplicación. Finalmente, se realiza un recorrido por los aspectos que han sido identificados como prioritarios en la conformación del escenario de perspectivas futuras, líneas de investigación y líneas de acción. Abstract Sustainability criteria application must be understood as the essential procedure for the necessary restructuring of the construction sector, which mobilizes 10% of the world economy, accounting for more than one third of the consumption of the world's resources, around 30 - 40% of energy consumption and emissions of greenhouse gases, 30-40% of waste generation and 12% of all the fresh water use in the world. This research is in line with an overall strategy to promote the sustainability assessment of building in the Spanish context, taking a first step focused on the environmental performance assessment. The thread of the present research sets out from the need to establish a theoretical framework of sustainability which clarifies concepts and defines appropriate endpoints. As a next step, the research focuses on the review of the international panorama regulations and voluntary instruments, with the aim of clarifying the fuzzy picture that characterizes sustainability in the building sector at present while framing the research in the context of existing policies and programming. The main objective lies in the approach of a methodology for the assessment of the environmental impacts associated with the life cycle of building, applicable to the Spanish context, as one of the three dimensions that constitute the pillars of sustainability. The areas of assessment of social and economic issues, for which there is currently a degree of methodological definition consistent enough, are further examined, in order to provide a holistic view of the assessment. The description of the basic features and limitations of the methodology of Life Cycle Assessment (LCA) are previously addressed, later proceeding to deepen the state of the art of LCA applied to the building sector, conducting a critical review of the research works that have been developed in recent years. This review allows to establish conclusions about the degree of consistency with the future regulatory environment and to identify two priority needs for action: - The need for harmonization, given the strong methodological inconsistencies detected that prevent the comparison of results obtained in assessment works. - The need for simplification, given the inherent complexity of the assessment, so that, while maintaining the utmost rigor, make the practical application feasible in the Spanish context. The participation in the work of policy development at European level has helped to achieve a critical view of the methodological implications of the rules under debate, identifying the roadmap that will mark the European scene in the coming years. The definition of the proposed methodology integrates the general principles of LCA methodology with the protocol established in the European standard, also considering the regulatory standards to construction practices in the Spanish context. In the proposed approach, possible simplifications applicable have been analyzed, in order to make its implementation possible, focusing efforts in systematizing the functional equivalent concept, establishing recommendations on the type of data based on their availability and critical review of the calculation models of environmental impacts. The methodological implications of the proposal are described through a series of case studies, which illustrate the feasibility and the basic characteristics of its application. Finally, the main aspects related to future prospects, research lines and lines of action that have been identified as priorities are outlined.