Reliability of the Knee Examination in Osteoarthritis: Effect of Standardization

Objective. To assess the reliability of physical examination of the osteoarthritic (OA) knee by rheumatologists, and to evaluate the benefits of standardization. Methods. Forty-two physical signs and techniques were evaluated using a 6 X 6 Latin square design. Patients with mild to severe knee OA, based on physical and radiographic signs, were examined in random order prior to and following standardization of techniques. For those signs with dichotomous scales, agreement among the rheumatologists was calculated as the prevalence-adjusted bias-adjusted kappa (PABAK), while for the signs with continuous and ordinal scales, a reliability coefficient (R-c) was calculated using analysis of variance. A PABAK of >0.60 and an Re of >0.80 were considered to indicate adequate reliability. Results. Adequate poststandardization reliability was achieved for 30 of 42 physical signs/techniques (71%). The most highly reliable signs identified by physical examination of the OA knee included alignment by goniometer (R-c = 0.99), bony swelling (R-c = 0.97), general passive crepitus (R-c = 0.96), gait by inspection (PABAK = 0.78), effusion bulge sign (R-c = 0.97), quadriceps atrophy (R. = 0.97), medial tibiofemoral tenderness (R-c = 0.94), lateral tibiofemoral tenderness (R-c = 0.85), patellofemoral tenderness by grind test (R-c = 0.94), and flexion contracture (R-c = 0.95). The standardization process resulted in substantial improvements in reliability for evaluation of a number of physical signs, although for some signs, minimal or no effect of standardization was noted. After standardization, warmth (PABAK = 0.14), medial instability at 30degrees flexion (PABAK = 0.02), and lateral instability at 30degrees flexion (PABAK = 0.34) were the only 3 signs that were highly unreliable. Conclusion. With the exception of physical examinations for instability, a comprehensive knee examination can be performed with adequate reliability. Standardization further improves the reliability for some physical signs and techniques. The application of these findings to future OA studies will contribute to improved outcome assessments in OA.

Comprehensive human urine standards for comparability and standardization in clinical proteome analysis

Urine proteomics is emerging as a powerful tool for biomarker discovery. The purpose of this study is the development of a well-characterized "real life" sample that can be used as reference standard in urine clinical proteomics studies.

Towards standardization of UV eye protection:what can be learned from photodermatology?

While knowledge about standardization of skin protection against ultraviolet radiation (UVR) has progressed over the past few decades, there is no uniform and generally accepted standardized measurement for UV eye protection. The literature provides solid evidence that UV can induce considerable damage to structures of the eye. As well as damaging the eyelids and periorbital skin, chronic UV exposure may also affect the conjunctiva and lens. Clinically, this damage can manifest as skin cancer and premature skin ageing as well as the development of pterygia and premature cortical cataracts. Modern eye protection, used daily, offers the opportunity to prevent these adverse sequelae of lifelong UV exposure. A standardized, reliable and comprehensive label for consumers and professionals is currently lacking. In this review we (i) summarize the existing literature about UV radiation-induced damage to the eye and surrounding skin; (ii) review the recent technological advances in UV protection by means of lenses; (iii) review the definition of the Eye-Sun Protection Factor (E-SPF®), which describes the intrinsic UV protection properties of lenses and lens coating materials based on their capacity to absorb or reflect UV radiation; and (iv) propose a strategy for establishing the biological relevance of the E-SPF. © 2013 John Wiley & Sons A/S.

Position Paper: Improving Source Code Reuse through Documentation Standardization

In the context of Software Reuse providing techniques to support source code retrieval has been widely experimented. However, much effort is required in order to find how to match classical Information Retrieval and source code characteristics and implicit information. Introducing linguistic theories in the software development process, in terms of documentation standardization may produce significant benefits when applying Information Retrieval techniques. The goal of our research is to provide a tool to improve source code search and retrieval In order to achieve this goal we apply some linguistic rules to the development process.

A tranzakciós költségek és a szabványosítás kapcsolata (Relationship between transaction costs and standardization)

Az elmúlt néhány évtizedben a szabványosítás terén igen komoly változások mentek végbe. Ugrásszerűen megnőtt a szabványok száma, és jelentősen átalakult a szabványosítás folyamata is. Ezzel párhuzamosan a téma gazdasági hatásaival foglalkozó kutatások száma is megsokszorozódott, ami elsősorban a hálózati externáliák irodalmának robbanásszerű gyarapodásának köszönhető. Jelen tanulmány – az elméletek fősodrától eltérően – a tranzakciós költségek elméletében (TKE) helyezi el a szabványosítást. A szabványok és a tranzakciós költségek kapcsolatáról már születtek korábban is tanulmányok, de ezek a szabványoknak a tranzakciós költségekre gyakorolt hatásaira fókuszáltak. A tanulmány ezzel szemben arra helyezi a hangsúlyt, hogy azonosítsa a tranzakciós költségeknek a szabványosításra gyakorolt hatásait. A kutatás célja, hogy olyan elméleti alapot adjon, amelyben a témakör átfogóan elemezhető. A fő kutatási kérdés az, hogy mitől függ az, hogy melyik mechanizmus kereteiben érdemes a szabványosítást lebonyolítani. ________ Significant changes have characterized the last few decades of standardization. The number of standards has dramatically increased and processes of standardization have also changed a lot. At the same time the amount of researches that are concerned with the economic impact of standardization has also multiplied due to the boom in the literature of network externalities. Unlike the mainstream, this paper places standardization in the theory of transaction cost economics. Although there are earlier papers that are concerned with the relationship between standards and transaction costs, these studies focus on the impact of standards on transaction costs. In contrast, this paper lays emphasis on the identification of the impact of transaction costs on standardization. This study aims to provide a theoretical basis for the comprehensive analyses. The main research question: What determines which coordination mechanism is used to evolve a standard?

Kit-of-parts architecture : an exploration into the standardization and simplification of an urban residential building unit

This thesis focuses on the design of a construction method that utilizes a single adaptable kit-of-parts system. The new system is designed to be flexible while also enhancing construction speeds without severely limiting the building's ability to merge into an urban fabric. This thesis proposes a residential structure to be built from a handful of simple structural units. This is accomplished through the design of a residential building situated in an area of Miami currently under reconstruction.

Language standardization in sociolinguistics and international business: Theory and practice across the table

This chapter addresses the issue of language standardization from two perspectives, bringing together a theoretical perspective offered by the discipline of sociolinguistics with a practical example from international business. We introduce the broad concept of standardization and embed the study of language standardization in the wider discussion of standards as a means of control across society. We analyse the language policy and practice of the Danish multinational, Grundfos, and use it as a “sociolinguistic laboratory” to “test” the theory of language standardization initially elaborated by Einar Haugen to explain the history of modern Norwegian. The table is then turned and a model from International Business by Piekkari, Welch and Welch is used to illuminate recent Norwegian language planning. It is found that the Grundfos case works well with the Haugen model, and the International Business model provides a valuable practical lesson for national language planners, both showing that a “comparative standardology” is a valuable undertaking. More voices “at the table” will allow both theory and practice to be further refined and for the role of standards across society to be better understood.

Standardization in the Pre-Columbian Pottery from El Caño, Panama: Specialization, Productivity and Consumption

The pottery found in the burials of El Cano is uniform in style to these made in the coclesanos valleys between 700 and 1000 AD. The coefficient of variability of the different pottery forms, evidence diverse standardizations values for polychrome and non-polychrome ceramics. Moreover, data of funerary contexts from the Cano recently excavated, suggest that elite has controlled ceramic production. This control over the production of certain goods reveals that these were important in the support or proper operational of the chiefdoms in Panama and mark the phase of splendour of this culture.

Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 Concerted Action BMH4-CT98-3936.

In a European BIOMED-2 collaborative study, multiplex PCR assays have successfully been developed and standardized for the detection of clonally rearranged immunoglobulin (Ig) and T-cell receptor (TCR) genes and the chromosome aberrations t(11;14) and t(14;18). This has resulted in 107 different primers in only 18 multiplex PCR tubes: three VH-JH, two DH-JH, two Ig kappa (IGK), one Ig lambda (IGL), three TCR beta (TCRB), two TCR gamma (TCRG), one TCR delta (TCRD), three BCL1-Ig heavy chain (IGH), and one BCL2-IGH. The PCR products of Ig/TCR genes can be analyzed for clonality assessment by heteroduplex analysis or GeneScanning. The detection rate of clonal rearrangements using the BIOMED-2 primer sets is unprecedentedly high. This is mainly based on the complementarity of the various BIOMED-2 tubes. In particular, combined application of IGH (VH-JH and DH-JH) and IGK tubes can detect virtually all clonal B-cell proliferations, even in B-cell malignancies with high levels of somatic mutations. The contribution of IGL gene rearrangements seems limited. Combined usage of the TCRB and TCRG tubes detects virtually all clonal T-cell populations, whereas the TCRD tube has added value in case of TCRgammadelta(+) T-cell proliferations. The BIOMED-2 multiplex tubes can now be used for diagnostic clonality studies as well as for the identification of PCR targets suitable for the detection of minimal residual disease.