988 resultados para peaks over threshold
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The objective of this work was to evaluate the reliability of eddy covariance measurements, analyzing the energy balance components, evapotranspiration and energy balance closure in dry and wet growing seasons, in a banana orchard. The experiment was carried out at a farm located within the irrigation district of Quixeré, in the Lower Jaguaribe basin, in Ceará state, Brazil. An eddy covariance system was used to measure the turbulent flux. An automatic weather station was installed in a grass field to obtain the reference evapotranspiration (ET0) from the combined FAO-Penman-Monteith method. Wind speed and vapor pressure deficit are the most important variables on the evaporative process in both growing seasons. In the dry season, the heat fluxes have a similar order of magnitude, and during the wet season the latent heat flux is the largest. The eddy covariance system had acceptable reliability in measuring heat flux, with actual evapotranspiration results comparing well with those obtained by using the water balance method. The energy balance closure had good results for the study area, with mean values of 0.93 and 0.86 for the dry and wet growing seasons respectively.
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Report on a review of selected general and application controls over the State University of Iowa PeopleSoft Human Resources Information System (HRIS) for the period May 11, 2015 through July 31, 2015
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Report on a review of selected general and application controls over the Iowa Public Employees’ Retirement System (IPERS) I-QUE Pension Administration System for the period April 9, 2015 through May 7, 2015
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From 6 to 8 November 1982 one of the most catastrophic flash-flood events was recorded in the Eastern Pyrenees affecting Andorra and also France and Spain with rainfall accumulations exceeding 400 mm in 24 h, 44 fatalities and widespread damage. This paper aims to exhaustively document this heavy precipitation event and examines mesoscale simulations performed by the French Meso-NH non-hydrostatic atmospheric model. Large-scale simulations show the slow-evolving synoptic environment favourable for the development of a deep Atlantic cyclone which induced a strong southerly flow over the Eastern Pyrenees. From the evolution of the synoptic pattern four distinct phases have been identified during the event. The mesoscale analysis presents the second and the third phase as the most intense in terms of rainfall accumulations and highlights the interaction of the moist and conditionally unstable flows with the mountains. The presence of a SW low level jet (30 m s-1) around 1500 m also had a crucial role on focusing the precipitation over the exposed south slopes of the Eastern Pyrenees. Backward trajectories based on Eulerian on-line passive tracers indicate that the orographic uplift was the main forcing mechanism which triggered and maintained the precipitating systems more than 30 h over the Pyrenees. The moisture of the feeding flow mainly came from the Atlantic Ocean (7-9 g kg-1) and the role of the Mediterranean as a local moisture source was very limited (2-3 g kg-1) due to the high initial water vapour content of the parcels and the rapid passage over the basin along the Spanish Mediterranean coast (less than 12 h).
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Background: Pre-existing psychological factors can strongly influence coping with type 1 diabetes mellitus and interfere with self-monitoring. Psychiatric disorders seem to be positively associated with poor metabolic control. We present a case of extreme compulsive blood testing due to obsessive fear of hypoglycemia in an adolescent with type 1 diabetes mellitus. Case report: Type 1 diabetes mellitus (anti GAD-antibodies 2624 U/l, norm < 9.5) was diagnosed in a boy aged 14.3 years [170 cm (+ 0.93 SDS), weight 50.5 kg (+ 0.05 SDS)]. Laboratory work-up showed no evidence for other autoimmune disease. Family and past medical history were unremarkable. Growth and developmental milestones were normal. Insulin-analog based basal-bolus regime was initiated, associated to standard diabetic education. Routine psychological evaluation performed at the onset of diabetes revealed intermittent anxiety and obsessivecompulsive traits. Accordingly, a close psychiatric follow-up was initiated for the patient and his family. An adequate metabolic control (HbA1c drop from >14 to 8%) was achieved within 3 months, attributed to residual -cell function. In the following 6 months, HbA1c rose unexpectedly despite seemingly adequate adaptations of insulin doses. Obsessive fear of hypoglycemia leading to a severe compulsive behavior developed progressively with as many as 68 glycemia measurements per day (mean over 1 week). The patient reported that he could not bear leaving home with glycemia < 15 mmol/l, ending up with school eviction and severe intra-familial conflict. Despite intensive psychiatric outpatient support, HbA1c rose rapidly to >14% with glycemia-testing reaching peaks of 120 tests/day. The situation could only be discontinued through psychiatric hospitalization with intensive behavioral training. As a result, adequate metabolic balance was restored (HbA1c value: 7.1 %) with acceptable 10-15 daily glycemia measurements. Discussion: The association of overt psychiatric disorders to type 1 diabetes mellitus is very rare in the pediatric age group. It can lead to a pathological behavior with uncontrolled diabetes. Such exceptional situations require long-term admissions with specialized psychiatric care. Slow acceptation of a "less is better" principle in glycemia testing and amelioration of metabolic control are difficult to achieve.
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Report on a review of selected general and application controls over the University of Northern Iowa’s eBusiness Payroll and Human Resources System for the period April 1, 2015 through May 27, 2015
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BACKGROUND: Despite advances in treatment, survival of patients with GBM over 60 years is still often less than 1 year. In the perspective of a short expected survival, the quality of the remaining life and the effects of therapy on health-related quality of life (HRQoL) should be given special emphasis when recommending treatment for the individual patients. Several studies have focused on survival of the elderly, but few data are available on HRQoL for different treatments. In a randomized trial, we compared survival and HRQoL for 3 treatment options, 6 weeks of RT, vs hypofractionated RT, or chemotherapy with TMZ. MATERIALS AND METHODS: Newly diagnosed GBM patients, age ≥60 years with PS 0-2, were randomized to either standard RT (60 Gy in 2-Gy fractions over 6 weeks), hypofractionated RT (34 Gy in 3.4-Gy fractions over 2 weeks), or 6 cycles of chemotherapy with TMZ (200 mg/m2 day 1-5 every 28 days). QoL was determined by the EORTC QLQ 30 questionnaire and the Brain Cancer Module at inclusion, before start of therapy, at 6 weeks, 3 months, and 6 months after start of treatment. Patients were followed until death. The primary study endpoint was overall survival (OS) and secondary objectives were HRQoL, neurologic symptom control, and safety. RESULTS: A total of 342 patients were included and 292 patients were randomized between the 3 treatment options and 50 patients between hypofractionated RT and TMZ. Median age was 70 years (range 60-92) with 58% being male. Performance status was 0-1 for 75% of patients and 73% had undergone surgical resection. CONCLUSION: The results from the HRQoL analysis of this trial will be presented together with survival data at the upcoming EANO meeting.
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BACKGROUND: We investigated the incidence and outcome of progressive multifocal leukoencephalopathy (PML) in human immunodeficiency virus (HIV)-infected individuals before and after the introduction of combination antiretroviral therapy (cART) in 1996. METHODS: From 1988 through 2007, 226 cases of PML were reported to the Swiss HIV Cohort Study. By chart review, we confirmed 186 cases and recorded all-cause and PML-attributable mortality. For the survival analysis, 25 patients with postmortem diagnosis and 2 without CD4+ T cell counts were excluded, leaving a total of 159 patients (89 before 1996 and 70 during 1996-2007). RESULTS: The incidence rate of PML decreased from 0.24 cases per 100 patient-years (PY; 95% confidence interval [CI], 0.20-0.29 cases per 100 PY) before 1996 to 0.06 cases per 100 PY (95% CI, 0.04-0.10 cases per 100 PY) from 1996 onward. Patients who received a diagnosis before 1996 had a higher frequency of prior acquired immunodeficiency syndrome-defining conditions (P = .007) but similar CD4+ T cell counts (60 vs. 71 cells/microL; P = .25), compared with patients who received a diagnosis during 1996 or thereafter. The median time to PML-attributable death was 71 days (interquartile range, 44-140 days), compared with 90 days (interquartile range, 54-313 days) for all-cause mortality. The PML-attributable 1-year mortality rate decreased from 82.3 cases per 100 PY (95% CI, 58.8-115.1 cases per 100 PY) during the pre-cART era to 37.6 cases per 100 PY (95% CI, 23.4.-60.5 cases per 100 PY) during the cART era. In multivariate models, cART was the only factor associated with lower PML-attributable mortality (hazard ratio, 0.18; 95% CI, 0.07-0.50; P < .001), whereas all-cause mortality was associated with baseline CD4+ T cell count (hazard ratio per increase of 100 cells/microL, 0.52; 95% CI, 0.32-0.85; P = .010) and cART use (hazard ratio, 0.37; 95% CI, 0.19-0.75; P = .006). CONCLUSIONS: cART reduced the incidence and PML-attributable 1-year mortality, regardless of baseline CD4+ T cell count, whereas overall mortality was dependent on cART use and baseline CD4+ T cell count.
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Human T lymphocytes have a finite life span resulting from progressive telomere shortening that occurs at each cell division, eventually leading to chromosomal instability. It has been shown that ectopic expression of the human telomerase reverse transcriptase (hTERT) gene into various human cells results in the extension of their replicative life span, without inducing changes associated with transformation. However, it is still unclear whether cells that over-express telomerase are physiologically and biochemically indistinguishable from normal cells. To address this question, we compared the proteome of young and aged human CD8(+) T lymphocytes with that of T cells transduced with hTERT. Interestingly, we found no global changes in the protein pattern in young T cells, irrespective of telomerase expression. In contrast, several relevant proteins with differential expression patterns were observed in hTERT-transduced T cells with extended life span upon long-term culture. Altogether, our data revealed that T lymphocytes over-expressing telomerase displayed an intermediate protein pattern, sharing a similar protein expression not only with young T cells, but also with aged T cells. Finally, the results obtained from this global proteomic approach are in agreement with the overall gene transcription profiling performed on the same T-cell derived clones.
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BACKGROUND:: In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO). METHODS:: We analyzed anonymized data on patients with Crohn's disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals). RESULTS:: In total, 629 patients with Crohn's disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn's disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti-tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change. CONCLUSIONS:: Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.
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Pseudomonas aeruginosa is one of the leading nosocomial pathogens in intensive care units (ICUs). The source of this microorganism can be either endogenous or exogenous. The proportion of cases as a result of transmission is still debated, and its elucidation is important for implementing appropriate control measures. To understand the relative importance of exogenous vs. endogenous sources of P. aeruginosa, molecular typing was performed on all available P. aeruginosa isolated from ICU clinical and environmental specimens in 1998, 2000, 2003, 2004 and 2007. Patient samples were classified according to their P. aeruginosa genotypes into three categories: (A) identical to isolate from faucet; (B) identical to at least one other patient sample and not found in faucet; and (C) unique genotype. Cases in categories A and B were considered as possibly exogenous, and cases in category C as possibly endogenous. A mean of 34 cases per 1000 admissions per year were found to be colonized or infected by P. aeruginosa. Higher levels of faucet contamination were correlated with a higher number of cases in category A. The number of cases in category B varied from 1.9 to 20 cases per 1000 admissions. This number exceeded 10/1000 admissions on three occasions and was correlated with an outbreak on one occasion. The number of cases considered as endogenous (category C) was stable and independent of the number of cases in categories A and B. The present study shows that repeated molecular typing can help identify variations in the epidemiology of P. aeruginosa in ICU patients and guide infection control measures.
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THESIS ABSTRACT Garnets are one of the key metamorphic minerals used to study peak metamorphic conditions or crystallization ages. Equilibrium is typically assumed between the garnet and the matrix. This thesis attempts to understand garnet growth in the Zermatt-Saas Fee (ZSF) eclogites, and discusses consequences for Sm/Nd and Lu/Hf dating and the equilibrium assumption. All studied garnets from the ZSF eclogites are strongly zoned in Mn, Fe, Mg, and Ca. Methods based on chemical zoning patterns and on 3D spatial statistics indicate different growth mechanisms depending on the sample studied. Garnets from the Pfulwe area are grown in a system where surface kinetics likely dominated over intergranular diffusion kinetics. Garnets fram two other localities, Nuarsax and Lago di Cignana, seem to have grown in a system where intergranular diffusion kinetics were dominating over surface kinetics, at least during initial growth. Garnets reveal strong prograde REE+Y zoning. They contain narrow central peaks for Lu + Yb + Tm ± Er and at least one additional small peak towards the rim. The REE Sm + Eu + Gd + Tb ± Dy are depleted in the cores but show one prominent peak close to the rim. It is shown that these patterns cam be explained using a transient matrix diffusion model where REE uptake is limited by diffusion in the matrix surrounding the porphyroblast. The secondary peaks in the garnet profiles are interpreted to reflect thermally activated diffusion due to a temperature increase during prograde metamorphism. The model predicts anomalously low 176Lu/177Hf and 147Sm/144Nd ratios in garnets where growth rates are fast compared to diffusion of the REE, which decreases garnet isochron precisions. The sharp Lu zoning was further used to constrain maximum Lu volume diffusion rates in garnet. The modeled minimum pre-exponential diffusion coefficient which fits the measured central peak is in the order of Do = 5.7* 106 m2/s, taking an activation energy of 270 kJ/mol. The latter was chosen in agreement with experimentally determined values. This can be used to estimate a minimum closure temperature of around 630°C for the ZSF zone. Zoning of REE was combined with published Lu/Hf and Sm/Nd age information to redefine the prograde crystallization interval for Lago di Cignana UHP eclogites. Modeling revealed that a prograde growth interval in the order of 25 m.y. is needed to produce the measured spread in ages. RÉSUMÉ Le grenat est un minéral métamorphique clé pour déterminer les conditions du pic de métamorphisme ainsi que l'âge de cristallisation. L'équilibre entre le grenat et la matrice est requis. Cette étude a pour but de comprendre la croissance du grenat dans les éclogites de la zone de Zermatt-Saas Fee (ZSF) et d'examiner quelques conséquences sur les datations Sm/Nd et Lu/Hf. Tous les grenats des éclogites de ZSF étudiés sont fortement zonés en Mn, Fe, Mg et partiellement en Ca. Les différentes méthodes basées sur le modèle de zonation chimique ainsi que sur les statistiques de répartition spatiale en 3D indiquent un mécanisme de croissance différent en fonction de la localité d'échantillonnage. Les grenats provenant de la zone de Pfulwe ont probablement crû dans un système principalement dominé par la cinétique de surface au détriment de 1a cinétique de diffusion intergranulaire. Les grenats provenant de deux autres localités, Nuarsax et Lago di Cignana, semblent avoir cristallisé dans un système dominé par la diffusion intergranulaire, au moins durant les premiers stades de croissance. Les grenats montrent une forte zonation prograde en Terres Rares (REE) ainsi qu'en Y. Les profils présentent au coeur un pic étroit en Lu + Yb+ Tm ± Er et au moins un petit pic supplémentaire vers le bord. Les coeurs des grenats sont appauvris en Sm + Eu + Gd + Tb ± Dy, mais les bords sont marqués par un pic important de ces REE. Ces profils s'expliquent par un modèle de diffusion matricielle dans lequel l'apport en REE est limité par la diffusion dans la matrice environnant les porphyroblastes. Les pics secondaires en bordure de grain reflètent la diffusion activée par l'augmentation de la température lors du métamorphisme prograde. Ce modèle prédit des rapports 176Lu/177Hf et 147Sm/144Nd anormalement bas lorsque les taux de croissance sont plus rapides que la diffusion des REE, ce qui diminue la précision des isochrones impliquant le grenat. La zonation nette en Lu a permis de contraindre le maximum de diffusion volumique par une approche numérique. Le coefficient de diffusion minimum modélisé en adéquation avec les pics mesurés est de l'ordre de Do = 5.7*10-6 m2/s, en prenant une énergie d'activation ~270 kJ/mol déterminée expérimentalement. Ainsi, la température de clôture minimale est estimée aux alentours de 630°C pour la zone ZSF. Des nouvelles données de zonation de REE sont combinées aux âges obtenus avec les rapports Lu/Hf et Sm/Nd qui redéfissent l'intervalle de cristallisation prograde pour les éclogites UHP de Lago di Cignana. La modélisation permet d'attribuer au minimum un intervalle de croissance prograde de 25 Ma afin d'obtenir les âges préalablement mesurés. RESUME GRAND PUBLIC L'un des principaux buts du pétrologue .métamorphique est d'extraire des roches les informations sur l'évolution temporelle, thermique et barométrique qu'elles ont subi au cours de la formation d'une chaîne de montagne. Le grenat est l'un des minéraux clés dans une grande variété de roches métamorphiques. Il a fait l'objet de nombreuses études dans des terrains d'origines variées ou lors d'études expérimentales afin de comprendre ses domaines de stabilité, ses réactions et sa coexistence avec d'autres minéraux. Cela fait du grenat l'un des minéraux les plus attractifs pour la datation des roches. Cependant, lorsqu'on l'utilise pour la datation et/ou pour la géothermobarométrie, on suppose toujours que le grenat croît en équilibre avec les phases coexistantes de la matrice. Pourtant, la croissance d'un minéral est en général liée au processus de déséquilibre. Cette étude a pour but de comprendre comment croît le grenat dans les éclogites de Zermatt - Saas Fee et donc d'évaluer le degré de déséquilibre. Il s'agit aussi d'expliquer les différences d'âges obtenues grâce aux grenats dans les différentes localités de l'unité de Zermatt-Saas Fee. La principale question posée lors de l'étude des mécanismes de croissance du grenat est: Parmi les processus en jeu lors de la croissance du grenat (dissolution des anciens minéraux, transport des éléments vers le nouveau grenat, précipitation d'une nouvelle couche en surface du minéral), lequel est le plus lent et ainsi détermine le degré de déséquilibre? En effet, les grenats d'une des localités (Pfulwe) indiquent que le phénomène d'adhérence en surface est le plus lent, contrairement aux grenats des autres localités (Lago di Cignana, Nuarsax) dans lesquels ce sont les processus de transport qui sont les plus lents. Cela montre que les processus dominants sont variables, même dans des roches similaires de la même unité tectonique. Ceci implique que les processus doivent être déterminés individuellement pour chaque roche afin d'évaluer le degré de déséquilibre du grenat dans la roche. Tous les grenats analysés présentent au coeur une forte concentration de Terres Rares: Lu + Yb + Tm ± Er qui décroît vers le bord du grain. Inversement, les Terres Rares Sm + Eu + Gd + Tb ± Dy sont appauvries au coeur et se concentrent en bordure du grain. La modélisation révèle que ces profils sont-dus à des cinétiques lentes de transport des Terres Rares. De plus, les modèles prédisent des concentrations basses en éléments radiogéniques pères dans certaines roches, ce qui influence fortement sur la précision des âges obtenus par la méthode d'isochrone. Ceci signifie que les roches les plus adaptées pour les datations ne doivent contenir ni beaucoup de grenat ni de très gros cristaux, car dans ce cas, la compétition des éléments entre les cristaux limite à de faibles concentrations la quantité d'éléments pères dans chaque cristal.
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OBJECTIVE: To assess the seasonality of cardiovascular risk factors (CVRF) in a large set of population-based studies. METHODS: Cross-sectional data from 24 population-based studies from 15 countries, with a total sample size of 237 979 subjects. CVRFs included Body Mass Index (BMI) and waist circumference; systolic (SBP) and diastolic (DBP) blood pressure; total, high (HDL) and low (LDL) density lipoprotein cholesterol; triglycerides and glucose levels. Within each study, all data were adjusted for age, gender and current smoking. For blood pressure, lipids and glucose levels, further adjustments on BMI and drug treatment were performed. RESULTS: In the Northern and Southern Hemispheres, CVRFs levels tended to be higher in winter and lower in summer months. These patterns were observed for most studies. In the Northern Hemisphere, the estimated seasonal variations were 0.26 kg/m(2) for BMI, 0.6 cm for waist circumference, 2.9 mm Hg for SBP, 1.4 mm Hg for DBP, 0.02 mmol/L for triglycerides, 0.10 mmol/L for total cholesterol, 0.01 mmol/L for HDL cholesterol, 0.11 mmol/L for LDL cholesterol, and 0.07 mmol/L for glycaemia. Similar results were obtained when the analysis was restricted to studies collecting fasting blood samples. Similar seasonal variations were found for most CVRFs in the Southern Hemisphere, with the exception of waist circumference, HDL, and LDL cholesterol. CONCLUSIONS: CVRFs show a seasonal pattern characterised by higher levels in winter, and lower levels in summer. This pattern could contribute to the seasonality of CV mortality.
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Objective: This article presents a study of the change over time in the family interactions of couples who conceived through in-vitro fertilisation (IVF). Background: Observational methods are rarely used to study family interactions in families who used assisted reproductive techniques, but these methods are crucial for taking account of the communication that occurs in interactions with infants. Methods: Thirty-one couples expecting their first child were seen during the fifth month of pregnancy and when the child was nine months old. Family interactions were recorded in pre- and postnatal versions of the Lausanne Trilogue Play situation. Measures of marital satisfaction and parent-to-foetus/baby attachment or 'bonding' were also used to assess family relational dynamics. Results: Results showed that family alliance, marital satisfaction and parental attachment scores in the IVF sample were all similar to or higher than those in the reference sample during pregnancy. However, at nine months postnatally, the family alliance scores were lower. While marital satisfaction decreased over the period and parent-baby attachment increased, the family alliance scores were unstable, as no association was observed between the pre- and postnatal scores. In addition, neither prenatal marital satisfaction nor parent-foetus attachment predicted the postnatal family alliance. Conclusion: The change in the family alliance over the transition to parenthood appears to be specific to our IVF sample. Given that postnatal family functioning could not be predicted by prenatal family functioning, our observational data underline the importance of offering postnatal support to these families.
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Molecular monitoring of BCR/ABL transcripts by real time quantitative reverse transcription PCR (qRT-PCR) is an essential technique for clinical management of patients with BCR/ABL-positive CML and ALL. Though quantitative BCR/ABL assays are performed in hundreds of laboratories worldwide, results among these laboratories cannot be reliably compared due to heterogeneity in test methods, data analysis, reporting, and lack of quantitative standards. Recent efforts towards standardization have been limited in scope. Aliquots of RNA were sent to clinical test centers worldwide in order to evaluate methods and reporting for e1a2, b2a2, and b3a2 transcript levels using their own qRT-PCR assays. Total RNA was isolated from tissue culture cells that expressed each of the different BCR/ABL transcripts. Serial log dilutions were prepared, ranging from 100 to 10-5, in RNA isolated from HL60 cells. Laboratories performed 5 independent qRT-PCR reactions for each sample type at each dilution. In addition, 15 qRT-PCR reactions of the 10-3 b3a2 RNA dilution were run to assess reproducibility within and between laboratories. Participants were asked to run the samples following their standard protocols and to report cycle threshold (Ct), quantitative values for BCR/ABL and housekeeping genes, and ratios of BCR/ABL to housekeeping genes for each sample RNA. Thirty-seven (n=37) participants have submitted qRT-PCR results for analysis (36, 37, and 34 labs generated data for b2a2, b3a2, and e1a2, respectively). The limit of detection for this study was defined as the lowest dilution that a Ct value could be detected for all 5 replicates. For b2a2, 15, 16, 4, and 1 lab(s) showed a limit of detection at the 10-5, 10-4, 10-3, and 10-2 dilutions, respectively. For b3a2, 20, 13, and 4 labs showed a limit of detection at the 10-5, 10-4, and 10-3 dilutions, respectively. For e1a2, 10, 21, 2, and 1 lab(s) showed a limit of detection at the 10-5, 10-4, 10-3, and 10-2 dilutions, respectively. Log %BCR/ABL ratio values provided a method for comparing results between the different laboratories for each BCR/ABL dilution series. Linear regression analysis revealed concordance among the majority of participant data over the 10-1 to 10-4 dilutions. The overall slope values showed comparable results among the majority of b2a2 (mean=0.939; median=0.9627; range (0.399 - 1.1872)), b3a2 (mean=0.925; median=0.922; range (0.625 - 1.140)), and e1a2 (mean=0.897; median=0.909; range (0.5174 - 1.138)) laboratory results (Fig. 1-3)). Thirty-four (n=34) out of the 37 laboratories reported Ct values for all 15 replicates and only those with a complete data set were included in the inter-lab calculations. Eleven laboratories either did not report their copy number data or used other reporting units such as nanograms or cell numbers; therefore, only 26 laboratories were included in the overall analysis of copy numbers. The median copy number was 348.4, with a range from 15.6 to 547,000 copies (approximately a 4.5 log difference); the median intra-lab %CV was 19.2% with a range from 4.2% to 82.6%. While our international performance evaluation using serially diluted RNA samples has reinforced the fact that heterogeneity exists among clinical laboratories, it has also demonstrated that performance within a laboratory is overall very consistent. Accordingly, the availability of defined BCR/ABL RNAs may facilitate the validation of all phases of quantitative BCR/ABL analysis and may be extremely useful as a tool for monitoring assay performance. Ongoing analyses of these materials, along with the development of additional control materials, may solidify consensus around their application in routine laboratory testing and possible integration in worldwide efforts to standardize quantitative BCR/ABL testing.