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Background: The objective of this study was to extract maternal plasma D-dimer test results from a large medical records dataset and to establish a reference level for pregnant women in our center. This study aimed to investigate the role and efficacy of D-dimer levels for predicting complications in high-risk pregnant women. Methods: The clinical data of 19,117 women who delivered at Wenzhou People’s Hospital between January 1, 2020, and September 30, 2022, were retrospectively analyzed. A total of 74,401 D-dimer test results were extracted from the laboratory information system. Following data screening and matching, 7692 records of D-dimer test results for healthy pregnant women and 19,005 records for pregnant women with complications were selected. D-dimer reference values were calculated for early pregnancy (1–13 weeks gestation), mid-pregnancy (14–27 weeks gestation), late pregnancy (28–36 weeks gestation), and the end of pregnancy (37–41 weeks gestation). A logistic regression model was used to plot receiver operating characteristic (ROC) and determine cut-off values for predicting pregnancy complications in each phase. Results: The mean D-dimer levels in the healthy pregnancy group were 0.56 mg/L in early pregnancy, 1.08 mg/L in mid-pregnancy, 1.48 mg/L in late pregnancy, and 1.89 mg/L at the end of pregnancy. D-dimer levels were greater in the complication group (which contains 11 common pregnancy disorders, including premature rupture of membranes (PRM), gestational diabetes mellitus (GDM), gestational hypertension (GHP), preeclampsia (PE), placental abnormalities, thyroid dysfunction, hemorrhage, thrombophilia, fetal macrosomia, preterm delivery, and infections) than in the healthy group in all pregnancy phases, with statistically significant differences observed in early, medium, and the end of pregnancy. D-dimer levels showed good diagnostic performance in predicting pregnancy complications in early pregnancy (area under the curve (AUC) = 0.71, cut-off value = 0.87, odds ratio: 7.12, 95% confidence interval (CI): 5.41–9.36, p-value = 0.000). Conclusions: The reference range of D-dimer increases with the progression of gestational phases and demonstrates predictive efficacy for high-risk pregnancy complications during early pregnancy.

Objective: To evaluate whole-body, extremity and eye-lens occupational dose equivalents of ionizing radiation to Occupationally Exposed Workers (OEWs) in Gabon, monitored by the national Individual Monitoring Service (IMS), in the medical practice. Methods: A total of 816 dose records for 205 OEWs were evaluated. Doses were collected for an eight-year period, from 2013 to 2020. Twelve public and private hospitals were involved, including a cancer centre where radiotherapy (RT) and nuclear medicine (NM) procedures are regularly performed. OEWs were monitored, on a monthly or quarterly basis, for whole-body dose and extremity dose using an optically stimulated luminescence (OSL) dosimeter worn on the torso or the wrist, as appropriate. Eye-lens dose was estimated from whole-body dose results. Results: The whole-body dose distribution was skewed and the zero dose was associated with a probability of 47%. Some recorded doses were associated with estimated X-ray energies above those typically encountered in diagnostic radiology, thus suggesting that some doses attributed to workers and believed to be due to X-rays may in fact be due to background radiation (false positive dose records). For the period 2013–2020, annual doses to OEWs in diagnostic radiology (DR), NM and RT departments were 0.40 ​mSv, 0.38 ​mSv and 0.09 ​mSv, respectively. For the same period, the mean annual extremity and eye-lens doses were 0.78 ​mSv (range: 0–5.24 ​mSv) and 0.35 ​mSv (range: 0–3.74 ​mSv), respectively. Conclusion: With little effort by the national IMS and the regulatory body, annual whole-body doses to workers can be kept well below 6 ​mSv, thus efficiently contributing to the optimization of worker's protection. However, extremity doses may in fact be greater than those reported for OEWs in the NM department. Finally, eye-lens doses were well below the new annual dose limit of 20 ​mSv, thus demonstrating that, in the current situation, OEWs in the NM department do not require routine eye lens dose monitoring. Rather, whole-body dose may be used as an indicator of eye-lens dose.

Subclinical hypothyroidism’s clinical implications on pregnancy are controversial. Consequently, thyrotropin (TSH) cutoff-values for pregnancy are continuously a subject for debate. In subclinical hypothyroidism, altered levels of thyroid hormones may affect mitochondrial function. Objectives were i) to analyze thyroid hormone levels in offspring of women with and without subclinical hypothyroidism ii) to analyze mitochondrial “robustness” in terms of MTG/TMRM ratio in pregnant women and their offspring in relation to thyroid function and iii) to perform differentiate analyses on different TSH thresholds to determine the importance of cutoff-values to results. Pregnant women were included by blood collections prior to a planned cesarean section, and cord samples were collected after delivery. Thyroid status (analyzed by Siemens Healthcare Diagnostics by an electrochemical luminescent immunoassay based on LOCI-technology) grouped the women and their offspring in euthyroid or subclinical hypothyroid, with groups established from previous recommended third-trimester cutoff-value (TSH > 3.0 mIU/L) and the recently recommended cutoff-value in Denmark (TSH > 3.7 mIU/L). Flow cytometric measurements of mitochondrial function in mononuclear blood cells with the fluorophores TetraMethylRhodamine Methyl Ester (TMRM) and Mitotracker Green (MTG) were used to evaluate mitochondrial robustness as the MTG/TMRM ratio. No significant differences in mitochondrial robustness between euthyroid and subclinical hypothyroid cohorts were observed, irrespective of TSH-cutoff applied. Maternal and cord MTG/TMRM ratios were positively correlated. Cord-TSH was elevated in subclinical hypothyroid offspring, independent of TSH cutoff applied. Cord-TSH was associated with maternal TSH-level, maternal smoking and cord arterial-pH. [ABSTRACT FROM AUTHOR]

Background: Knowledge of radiation quantities delivered in routine practice is an essential responsibility of a pediatric interventional radiology department. Objective: To review radiation indices in frequently performed vascular and enterostomy access procedures at a quaternary pediatric hospital to formulate dosimetric reference levels and achievable levels. Materials and methods: A retrospective review of patient demographics, procedure information and quantitative dose metrics over a 2-year period was performed. Dosimetric details for common procedures (central line insertions, gastrostomy/gastrojejunostomy insertions and maintenance) were evaluated, correlated with demographic data and stratified across five weight groups (0–5 kg, 5–15 kg, 15–30 kg, 30–50 kg, 50–80 kg). Achievable (50th percentile) and reference (75th percentile) levels with confidence intervals were established for each procedure. Results: Within the evaluation period, 3,165 studies satisfied the inclusion criteria. Five were classified as device insertions (peripherally inserted central catheter, n=1,145; port-a-catheter, n=321; central venous line, n=285; gastrostomy-tube [G-tube], n=262, and gastrojejunostomy-tube [GJ-tube], n=66), and two were classified as maintenance procedures (G-tube, n=358, and GJ-tube, n=728, checks, exchanges and reinsertions). Representative reference and achievable levels were calculated for each procedure category and weight group. Conclusion: This work highlights the creation of local reference and achievable levels for common pediatric interventional procedures. These data establish a dosimetric reference to understand the quantity of radiation routinely applied, allowing for improved relative radiation risk assessment and enriched communication to interventionalists, health care providers, parents and patients. [ABSTRACT FROM AUTHOR]

Abstract Aims Available upper reference levels (URLs) in older adults for N‐terminal pro brain natriuretic peptide (NT‐proBNP), an established biomarker for heart failure, are mainly based on small samples. We aimed to identify NT‐proBNP URL in a population‐based reference sample of individuals aged ≥65 years. Methods and results We analysed established NT‐proBNP predictors using quantile regression among 2459 participants of two‐independent population‐based cohorts located in Germany, the Activity and Function in the Elderly Study (ActiFE, n = 1450) and the Study of Health in Pomerania (SHIP‐TREND‐0, n = 1009). Based on predictors a reference population of 441 subjects (ActiFE, n = 227; SHIP‐TREND‐0, n = 214) without history of diabetes, cardiovascular, or pulmonary diseases and with systolic blood pressure (BP) 125 ng/L in 165 participants (37.4%), with NT‐proBNP URL (97.5% quantiles) equal to 663, 824, 592, and 697 ng/L in men, and 343, 463, 2641, 1276 ng/L in women for ages 65–69, 70–74, 75–79, and 80+ years, respectively. In the secondary analysis with a LVEF ≥50 and no diastolic dysfunction (35 men and 62 women) NT‐proBNP levels >125 ng/L were still observed in 38 (39.2%) participants. Conclusions This reference sample of apparently healthy asymptomatic older adults showed an age‐related increment of NT‐proBNP levels with URL markedly higher than the European Society of Cardiology recommended cut‐off of 125 ng/L for the diagnosis of heart failure in ambulatory settings. Identifying URL in those ≥80 years remains complex. Our results attempt to provide a frame for the further investigation of age‐specific NT‐proBNP cut‐offs in older adults. Considering the demographic changes, further evaluation of NT‐proBNP URL in larger samples of older adults followed by the validation of age‐specific cut‐off values for the identification of heart failure in those 65 years or older are urgently needed.

As an efficient customer-oriented product design tool for converting customer requirements (CRs) into quality characteristics (QCs) of a product, quality function deployment (QFD) is applied to the selection of new product design schemes. However, the effective implementation of QFD is hampered by two fundamental challenges: (a) biases in people's understanding of customer satisfaction and (b) the ambiguously assessed relationship between CRs and QCs because of the inherent uncertainty in human judgment. Therefore, this paper provides a p -ary Choquet-based multicriteria decision-making model to rank new product design schemes considering customer psychological and risk attitudes. The selection of a new product design scheme is divided into two stages. In the first stage, the p -ary Choquet integral converts the objective technical parameters of a new product design scheme into utility, which is the subjective feeling from the perspective of two-factor theory. Then, the integration of 2-additive measures and the Choquet integral is used to account for the redundancy and complementary effects among customer requirements. Finally, a case study of an electric vehicle manufacturing company and a comparison analysis are presented to illustrate the validity of our proposal. The p -ary Choquet-based multicriteria decision-making model realizes customer-oriented product design scheme selection by systematically analyzing customer preferences and bridging the gap between products that are emotionally recognized by customers and those that exhibit excellent performance in terms of functionality and cost. • The contribution of motivators/hygienes to customer satisfaction is numerically analyzed. • Customer satisfaction is modeled by a p-ary Choquet integral embedded in MCDM. • A QFD and two-factor theory integration framework provides an effective way for product design scheme selection. • A linear programming allows elicitation of relationship matrix of HOQ in an uncertain context. [ABSTRACT FROM AUTHOR]

Abstract Background The kallikrein-kinin system is assumed to have a multifunctional role in health and disease, but its in vivo role in humans currently remains unclear owing to the divergence of plasma kinin level data published ranging from the low picomolar to high nanomolar range, even in healthy volunteers. Moreover, existing data are often restricted on reporting levels of single kinins, thus neglecting the distinct effects of active kinins on bradykinin (BK) receptors considering diverse metabolic pathways. A well-characterized and comprehensively evaluated healthy cohort is imperative for a better understanding of the biological variability of kinin profiles to enable reliable differentiation concerning disease-specific kinin profiles. Methods To study biological levels and variability of kinin profiles comprehensively, 28 healthy adult volunteers were enrolled. Nasal lavage fluid and plasma were sampled in customized protease inhibitor prespiked tubes using standardized protocols, proven to limit inter-day and interindividual variability significantly. Nine kinins were quantitatively assessed using validated LC–MS/MS platforms: kallidin (KD), Hyp4-KD, KD1-9, BK, Hyp3-BK, BK1-8, BK1-7, BK1-5, and BK2-9. Kinin concentrations in nasal epithelial lining fluid were estimated by correlation using urea. Results Circulating plasma kinin levels were confirmed in the very low picomolar range with levels below 4.2 pM for BK and even lower levels for the other kinins. Endogenous kinin levels in nasal epithelial lining fluids were substantially higher, including median levels of 80.0 pM for KD and 139.1 pM for BK. Hydroxylated BK levels were higher than mean BK concentrations (Hyp3-BK/BK = 1.6), but hydroxylated KD levels were substantially lower than KD (Hyp4-KD/KD = 0.37). No gender-specific differences on endogenous kinin levels were found. Conclusions This well-characterized healthy cohort enables investigation of the potential of kinins as biomarkers and would provide a valid control group to study alterations of kinin profiles in diseases, such as angioedema, sepsis, stroke, Alzheimer’s disease, and COVID-19.

Indices of contamination (IC) are usually employed to assess the hazardousness associated with potentially toxic elements (PTE) from mining wastes (MW). For such, it is necessary to know the total concentrations of the PTE and local, regional, or global background or reference levels which are tolerable or acceptable threshold values for total content in soils. Although scientific literature is vast regarding the application of IC to MW, there is scarce research on the reference levels that must be employed in locations with no established comparison values. This study proposes basic reference levels for the global application of PTE contents in MW, leading to a global index of contamination (ICG). To this end, it was determined that the PTE to be assessed in MW should be As, Cd, Co, Cr, Cu, Hg, Mo, Ni, Pb, Sb, Se, V, and Zn. From the analysis of background and baseline values for soils, reference values for the PTE compiled from worldwide standards or studies on soil and sediment evaluation, and PTE content in MW, a classification is proposed for ICG that considers MW as very low, low, moderate, high, and very high contamination potential. The findings presented herein can be helpful in the comparison of multiple types of MW, representing the contamination hazard by particle emission due to erosion processes that reach the soils or sediments of the surrounding environment. This evaluation can aid in the decision-making process regarding the reutilization of some types of MW that receive a low classification. [ABSTRACT FROM AUTHOR]

One of the main elements in the mechanisms proposed by REDD+ , is to pay countries (and then the users and/or forest owners, depending on each type of project), for real reductions in deforestation and the resulting GHG emissions, as well as to ensure other benefits, such as technical assistance and qualification, among others. To be able to estimate the emission reductions, it is necessary to establish a Reference Level either through different forms of a historical average or in the form of a BAU or "Business as Usual" scenario. In this sense, current proposals set the Reference Levels equal to historical deforestation, which apply another political logic to the predictions made by the Forest Transition (FT) theory. According to this theory, when using a simple historical extrapolation, it is possible that: "countries with a lot of forest and little deforestation", lose in the initial stages of forest transition, while "countries with little forest and a lot of deforestation", win in the later stages of the FT. Our study shows how the predictions of FT and other socio-economic variables can be incorporated into predictive models (historical trend), by including the forest area as an explanatory variable. Sub-national data from the 15 departments with forest cover in the Peruvian Amazon are used to develop 6 optional deforestation models for comparative purposes. It is observed that the most important predictive variable to explain current deforestation is historical deforestation. In the same way, it is observed that when applying and implementing econometric models with different variables, there are projections very close to the results of spatially explicit models for Peru (models that include spatial data for distance to roads, elevation, slope, distance to populated centers, among others). The variation of results is only 3–4%, so it can be concluded that the projections based on the historical trend considering the forest transition of each region and other socio-economic variables, are very good estimators of the deforestation expected in the future and are adequate to define the possible reductions by deforestation and degradation in the Peruvian Amazon or other areas with similar conditions. • How to set reference levels of deforestation for REDD, and REDD+ Schemes. • Amazon deforestation at a Sub National Level in Peru. • Test the Forest Transition Theory in Econometric Projections of Deforestation. • Comparisons between Spatially Explicit Models and Econometric Models of Deforestation. • Criteria for Choosing the Best Model for Deforestation Projections. [ABSTRACT FROM AUTHOR]

Vitamin B12 is essential for cell function and only accessible in food for mammals. To monitor vitamin B12 deficiency, methylmalonic acid (MMA) is used. Since MMA in serum/plasma is a frequently requested analyte at clinical laboratories the analytical method was improved and validated on a 96 well plate. Using a Tecan robot a working solution of acetonitrile containing MMA-D3 was added to plasma/serum samples. The solution was shaken for 1 min and then centrifuged for 10min. The supernatant was transferred to another plate and evaporated with nitrogen gas. The residual was redissolved with 0.2% formic acid in MilliQ-water and the plate was shaken for 1 min prior to LC-MS/MS analysis. The total analysis time was 3 min, retention time for MMA was 1.1 min and it was well separated from the interfering succinic acid. The calibrator curve was 0.044 – 1.63 μmol/L, which was also the linear range and LLOQ was 0.044 μmol/L. The within- and between-run CV:s were 3-7%. Age dependent clinical cut-offs at 0.28 (age <50 years) and 0.36 μmol/L (age ≥50 years) were applied. In 404 clinical routine samples 10% were >0.28, 7% > 0.4, and only 1% were >0.7 μmol/L. The method has been successfully implemented in the laboratory for routine MMA analysis. [ABSTRACT FROM AUTHOR]

This article examines the political and performative function of the deforestation 'reference level' within Guyana's Reducing Emissions from Deforestation and Forest Degradation (REDD+) agreement with Norway. It argues that the establishment of, and continual negotiations around, the reference level rate illustrate how the Guyana-Norway REDD+ agreement was always more about ensuring the programme's 'success' than materially reducing deforestation in Guyana. By setting the 'reference level' at 0.275% per year in 2010, far above Guyana's historical rate of 0.02%, Guyana's successful performance in terms of 'avoiding deforestation' against this inflated level was all but guaranteed – even as 'business as usual' forest use continued on the ground. The fact that the reference level was high moreover allowed Norway to claim that it had 'contributed' (through its REDD+ payments) to higher 'avoided emissions', even though there was never a clear relationship between its payments and Guyana's deforestation rate throughout the programme. The 'performative' nature of the programme was meanwhile confirmed in 2019, when Norway disbursed the entire remaining balance from the US$250 million originally pledged to Guyana, despite the fact that Guyana had infringed the adjusted reference level 'floor' of 0.056% in several years of the programme. The article concludes that if meaningful solutions for 'avoiding deforestation' are to be developed, especially in the context of a new centrality for offsetting within the global 'net zero' agenda, 'success' must mean more than achieving results on paper and resources must be committed that are commensurate with the scale of the stated policy challenge. • Guyana's REDD+ programme with Norway is examined. • The REDD+ deforestation 'reference level' is central to ensuing programme 'success'. • The ultimately 'performative' nature of the programme is underlined. • 'Avoiding deforestation' must mean more than merely achieving results on paper. • Resources must be commensurate with the scale of the stated policy challenge. [ABSTRACT FROM AUTHOR]

Aims Available upper reference levels (URLs) in older adults for N-terminal pro brain natriuretic peptide (NT-proBNP), an established biomarker for heart failure, are mainly based on small samples. We aimed to identify NT-proBNP URL in a population-based reference sample of individuals aged ≥65 years. Methods and results We analysed established NT-proBNP predictors using quantile regression among 2459 participants of two-independent population-based cohorts located in Germany, the Activity and Function in the Elderly Study (ActiFE, n = 1450) and the Study of Health in Pomerania (SHIP-TREND-0, n = 1009). Based on predictors a reference population of 441 subjects (ActiFE, n = 227; SHIP-TREND-0, n = 214) without history of diabetes, cardiovascular, or pulmonary diseases and with systolic blood pressure (BP) <140 mmHg, diastolic BP ≥60 and ≤90 mmHg, haemoglobin in men ≥14 and ≤18 g/dL and in women ≥12 and ≤16 g/dL, GFR ≥60 mL/min/1.73 m², CRP <5 mg/L, BMI ≥18 and ≤33 kg/m², and hs-cTnI <40 ng/L were built with NT-proBNP median levels and 97.5% quantiles reported stratified by sex and age. In a secondary analysis the URL among 97 SHIP-TREND-0 participants with a left ventricular ejection fraction (LVEF) ≥50 and no diastolic dysfunction were estimated. The median age in the identified reference sample was 70 years, with 41.9% and 40.2% male participants in ActiFE and SHIP-TREND-0, respectively. We observed an age-dependent increment of NT-proBNP levels with higher values in women compared to men. Notably, NT-proBNP levels were >125 ng/L in 165 participants (37.4%), with NT-proBNP URL (97.5% quantiles) equal to 663, 824, 592, and 697 ng/L in men, and 343, 463, 2641, 1276 ng/L in women for ages 65–69, 70–74, 75–79, and 80+ years, respectively. In the secondary analysis with a LVEF ≥50 and no diastolic dysfunction (35 men and 62 women) NT-proBNP levels >125 ng/L were still observed in 38 (39.2%) participants. Conclusions This reference sample of apparently healthy asymptomatic older adults showed an age-related increment of NT-proBNP levels with URL markedly higher than the European Society of Cardiology recommended cut-off of 125 ng/L for the diagnosis of heart failure in ambulatory settings. Identifying URL in those ≥80 years remains complex. Our results attempt to provide a frame for the further investigation of age-specific NT-proBNP cut-offs in older adults. Considering the demographic changes, further evaluation of NT-proBNP URL in larger samples of older adults followed by the validation of age-specific cut-off values for the identification of heart failure in those 65 years or older are urgently needed. [ABSTRACT FROM AUTHOR]

Background: The kallikrein-kinin system is assumed to have a multifunctional role in health and disease, but its in vivo role in humans currently remains unclear owing to the divergence of plasma kinin level data published ranging from the low picomolar to high nanomolar range, even in healthy volunteers. Moreover, existing data are often restricted on reporting levels of single kinins, thus neglecting the distinct effects of active kinins on bradykinin (BK) receptors considering diverse metabolic pathways. A well-characterized and comprehensively evaluated healthy cohort is imperative for a better understanding of the biological variability of kinin profiles to enable reliable differentiation concerning disease-specific kinin profiles.Methods: To study biological levels and variability of kinin profiles comprehensively, 28 healthy adult volunteers were enrolled. Nasal lavage fluid and plasma were sampled in customized protease inhibitor prespiked tubes using standardized protocols, proven to limit inter-day and interindividual variability significantly. Nine kinins were quantitatively assessed using validated LC-MS/MS platforms: kallidin (KD), Hyp4-KD, KD1-9, BK, Hyp3-BK, BK1-8, BK1-7, BK1-5, and BK2-9. Kinin concentrations in nasal epithelial lining fluid were estimated by correlation using urea.Results: Circulating plasma kinin levels were confirmed in the very low picomolar range with levels below 4.2 pM for BK and even lower levels for the other kinins. Endogenous kinin levels in nasal epithelial lining fluids were substantially higher, including median levels of 80.0 pM for KD and 139.1 pM for BK. Hydroxylated BK levels were higher than mean BK concentrations (Hyp3-BK/BK = 1.6), but hydroxylated KD levels were substantially lower than KD (Hyp4-KD/KD = 0.37). No gender-specific differences on endogenous kinin levels were found.Conclusions: This well-characterized healthy cohort enables investigation of the potential of kinins as biomarkers and would provide a valid control group to study alterations of kinin profiles in diseases, such as angioedema, sepsis, stroke, Alzheimer's disease, and COVID-19. [ABSTRACT FROM AUTHOR]

Antecedents and objective: The knowledge of the reference levels for diagnoses and therapeutic studies is important, because it contributes to the optimization of the radiological protection of the patients, avoiding them to be exposed to unnecessarily high doses. However, there was no evidence of these levels in interventionist cardiology procedures in Ecuador, so the objective of this study was to estimate the diagnostic reference levels of dose at the entrance surface in adult patients under-going interventional cardiology procedures (cinecoronariography, catheterization and coronary percutaneous interventionism) in the Unit of Hemodynamic of the Hospital of Specialties Carlos Andrade Marín in Ecuador. Materials and methods: The measurements of product dose-area, dose in input surface, number of images and the time of fluoroscopy performed using the Axiom Artis angiographer, and the obtained data was tabulated and processed with the Excel computer program. For this study, 145 patients older than 18 years were selected, and the values obtained from diagnostic reference dose levels were compared with others reported in previous investigations and with the permissible limits for the appearance of deterministic effects on the skin. Results: This study made it possible to establish reference levels for diagnosis in interventional cardiology procedures (coronary angiography, catheterization and percutaneous coronary intervention) in the Hemodynamics Unit of the Carlos Andrade Marín Specialty Hospital in Ecuador. Conclusions: The results showed that the intake surface doses obtained were lower than the maximum levels recommended by the International Atomic Energy Agency. [ABSTRACT FROM AUTHOR]

Standard serum creatinine (S–Cr) levels in healthy children fluctuate with age and sex. However, it is unclear if this fluctuation in S–Cr levels is present for children with Down syndrome (DS) who show atypical growth rate. Therefore, we aimed to establish specific reference S–Cr levels for DS and compare them with the prevailing standard levels. We retrospectively reviewed 984 children with DS aged 3 months to 18 years who visited our medical center. Patients with diseases affecting S–Cr levels were excluded. We calculated the reference S–Cr levels according to sex, age, and length/height using medical records. A total of 3765 examinations of 568 children with DS were registered for this study. Ages and S–Cr levels were examined for boys (y = 0.032x + 0.20; r = 0.868, P < 0.0001), and girls (y = 0.024x + 0.23; r = 0.835, P < 0.0001). S–Cr levels in children aged >9 years were significantly higher in boys than in girls. The 430 children with DS aged 2–8 years were examined 1867 times. Height and S–Cr levels showed a significantly strong positive correlation (r = 0.670, P < 0.001) with regression equation y = 0.37x. The quintic equations calculated with S–Cr levels and length/height for boys (336 children, 2043 tests, r = 0.887) and girls (232 children, 1722 tests, r = 0.805) werey = − 6.132x5 + 32.78x4 − 67.86x3 + 68.31x2 − 33.14x + 6.41, and y = 0.09542x5 + 1.295x4 − 6.401x3 + 10.35x2 − 6.746x + 1.772. All calculated results varied from the standard levels for healthy children. Conclusion: This study established reference S–Cr levels and quintic equations specific for children with DS. These reference levels would be potentially useful in evaluating S–Cr levels and renal function in this population. What is Known: •Standard serum creatinine levels vary with age and sex to reflect muscle mass. •Reference serum creatinine levels specific to children with Down syndrome who show growth rates different from those of healthy children have not been established. What is New: •Serum creatinine levels in children with Down syndrome showed different trajectories for sex, age, and length/height when compared with the standard levels for healthy children. •This report on specific reference serum creatinine levels for children with Down syndrome is useful in the assessment of renal function in these children. [ABSTRACT FROM AUTHOR]

Abstract Background Hypertension is a major cardiovascular illness worldwide with many underlying causes. The role of trace elements selenium, copper, and zinc in hypertension is uncertain. The objective of this study was to evaluate the role of these trace elements in hypertension. Method Data from 6683 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2016 were analyzed using Statistical Analytical System (SAS, version 9.4) software for the role of trace elements in hypertension in age range 8 to 80 years, irrespective of the antihypertensive medication taken. Recent American Heart Association guidelines and pediatric practice guidelines for hypertension were used. Results Findings showed a significant positive association between serum selenium levels and hypertension but not serum zinc and copper. At optimal levels for transport and distribution, serum selenium levels of 120 μg/L or higher (reference level 70–150 μg/L) were significantly associated with hypertension (OR = 1.46, 95% CI = 1.29–1.66) after adjusting for confounding factors. At serum selenium level greater than 150 μg/L, the association with hypertension strengthened (OR = 1.69, 95% CI = 1.32–2.17). Conclusion A positive association was found between serum selenium and hypertension, irrespective of age or anti-hypertensive medications intake. These findings also suggest that the reference levels of serum levels in healthy individuals may need to be re-determined, if supported by additional studies. If validated, patients with hypertension may also need to be cautioned about selenium intake.

Abstract Data and metadata products based on intensive terrestrial gravity measurements covering the Belgian territory have been established compliant to the new ISO19115‐1 profile for gravity‐related data. A short historical introduction on gravity measurements on the Belgian territory is presented, starting with the first gravity measurement in 1892. This paper focuses on gravity data acquired after 1971, which marks the adoption of IGSN71 as a reference for the world network by the International Association of Geodesy (IAG). Next to a complete dataset containing all Belgian gravity data, the available gravity data were reduced to the corresponding measurement campaign, enabling determination of specific metadata (e.g. used gravimeter, tide system parameters, time of acquisition, etc.). New gravity and spirit levelling measurements were executed by the Royal Observatory Belgium and the National Geographic Institute (Federal Mapping Agency) to validate the g‐value at the historical reference base station ‘Carte du Ciel’ in Brussels. Taking into account the instrumental errors and the varying ground water content, the retrieved data are validated and approved for use in further research.

Abstract Background In 2018, the European Union (EU) adopted Regulation 2018/841, which sets the accounting rules for the land use, land use change and forestry (LULUCF) sector for the period 2021–2030. This regulation is part of the EU’s commitments to comply with the Paris Agreement. According to the new regulation, emissions and removals for managed forest land are to be accounted against a projected forest reference level (FRL) that is estimated by each EU Member State based on the continuation of forest management practices of the reference period 2000–2009. The aim of this study is to assess how different modelling assumptions possible under the regulation may influence the FRL estimates. Applying the interlinked G4M and WoodCarbonMonitor modelling frameworks, we estimate potential FRLs for each individual EU Member State following a set of conceptual scenarios, each reflecting different modelling assumptions that are consistent with the regulation and the technical guidance document published by the European Commission. Results The simulations of the conceptual scenarios show that differences in the underlying modelling assumptions may have a large impact on the projected FRL. Depending on the assumptions taken, the projected annual carbon sink on managed forest land in the EU varies from −319 MtCO2 to −397 MtCO2 during the first compliance period (2021–2025) and from −296 MtCO2 to −376 MtCO2 during the second compliance period (i.e. 2026–2030). These estimates can be compared with the 2017 national GHG inventories which estimated that the forest carbon sink for managed forest land was −373 MtCO2 in 2015. On an aggregated EU level, the assumptions related to climate change and the allocation of forest management practices have the largest impacts on the FRL estimates. On the other hand, assumptions concerning the starting year of the projection, stratification of managed forest land, and timing of individual management activities are found to have relatively small impacts on the FRL estimates. Conclusions We provide a first assessment of the level of uncertainty associated with the different assumptions discussed in the technical guidance document and the LULUCF regulation, and the impact of these assumptions on the country-specific FRL. The results highlight the importance of transparent documentation by the EU Member States on how their FRL has been calculated, and on the underlying assumptions.

In 2020, the International Commission on Radiological Protection (ICRP) issued Publication 146 which provides a framework of the radiological protection of people and the environment in the case of a large nuclear accident. Mitigation of radiological consequences is achieved using the fundamental principles of justification of decisions and optimisation of protection. These recommendations emphasise the importance of the optimisation of protection for the rehabilitation of living and working conditions in the affected areas during the intermediate and long-term phases. They underline the role of co-operation between the authorities, experts, and the affected population in the co-expertise process to facilitate informed decisions about their own protection. ICRP defines reference levels to be selected within generic bands of exposure considering the induced risk of radiation, as well as the feasibility of controlling the situation. [ABSTRACT FROM AUTHOR]

Worldwide, large number of nuclear reactors are in operation and also are under construction and commissioning stage for power production which also saves significant amount of carbon. In India, the number of reactor units in operation are 22 with the capacity of 7680MWe, there are 9 units under construction and commissioning with capacity of 6700MWe. Safety measures in these reactors are strengthened over the period in all the stages of nuclear power plants to ensure safety of people and environment. The concept of defense in depth is used to achieve the safety objectives during the operation of the reactor with emergency management as the 5th level of defense that can be used in case of severe accidents. Two major nuclear accidents (i) Fukushima (Japan-March 11, 2011) and (ii) Chernobyl (Former USSR - April 26, 1986) has emphasized the need for strengthening 4th and 5th level of defense to meet the safety objectives in case of severe nuclear accident. To address low probability events at nuclear power plant, emergency management plans are established for the protection of people and environment. Prior to the issuance of a license for the operation of NPPs, it is ensured by regulatory body that the site specific emergency management plans are in place and tested. This paper presents the current developments in the nuclear emergency management to achieve safety objective. The elements of nuclear emergency management system includes legal and regulatory frame work, emergency preparedness and response plans, hazard assessment of the nuclear facilities considering the hypothetical severe accidents for deciding the preparedness category and sizes of emergency planning zones and distances, defining the goals for preparedness and response actions, criteria for classification & notification of emergency, consideration of health consequences and socioeconomic impact for deciding the implementation of protective emergency workers, response organization and their coordination, development of operation criteria (emergency action levels (EALs), operational intervention levels(OILs) and observables) from the generic criteria and use of operational criteria for emergency management, implementation of emergency operating procedures (EOPs), implementation of severe accident management guidelines (SAMGs) and emergency response plans and procedures(EPR), careful harmonization and integration of EOPs, SAMGs and EPR to meet emergency management objectives. This article identifies the important elements of emergency management that influence the decision making and implementation of protective action and protection strategy. The study identifies requirement to carry out research work to study the various factors affecting effectiveness of each important elements of emergency management to meet the goals of emergency response. [ABSTRACT FROM AUTHOR]

The International Commission on Radiological Protection (ICRP) publishes guidance on protection from radon in homes and workplaces, and dose coefficients for use in assessments of exposure for protection purposes. ICRP Publication 126 recommends an upper reference level for exposures in homes and workplaces of 300 Bq m−3. In general, protection can be optimised using measurements of air concentrations directly, without considering radiation doses. However, dose estimates are required for workers when radon is considered as an occupational exposure (e.g. in mines), and for higher exposures in other workplaces (e.g. offices) when the reference level is exceeded persistently. ICRP Publication 137 recommends a dose coefficient of 3 mSv per mJ h m−3 (approximately 10 mSv per working level month) for most circumstances of exposure in workplaces, equivalent to 6.7 nSv per Bq h m−3 using an equilibrium factor of 0.4. Using this dose coefficient, annual exposure of workers to 300 Bq m−3 corresponds to 4 mSv. For comparison, using the same coefficient for exposures in homes, 300 Bq m−3 corresponds to 14 mSv. If circumstances of occupational exposure warrant more detailed consideration and reliable alternative data are available, site-specific doses can be assessed using methodology provided in ICRP Publication 137. [ABSTRACT FROM AUTHOR]

Introduction: Thyroid dysfunction during gestation impacts on maternal-fetal health and may influence the neurocognitive development of the child. Thyroid physiology changes during pregnancy and requires the establishment of specific reference levels per trimester and for each population and method. The objectives of our study were to analyse thyroid function throughout pregnancy and to establish reference levels for TSH and T4L in each trimester for our population and methodology., Material and Methods: Prospective analytical study of 598 pregnant women from March 2018 to October 2020. TSH, T4L, T3L, ATPO and ATG were determined in all of them. A total of 151 pregnant women were excluded due to positive thyroid immunity, previous thyroid disease in treatment with levothyroxine, twin pregnancy, diagnosis of hypothyroidism and hyperthyroidism in the request or absence of some of the parameters studied, with a reference population of 447 pregnant women., Results: The reference levels for TSH were 0.07-3.14mIU/L for the first, 0.66-3.21mIU/L for the second and 0.52-2.97mIU/L for the third trimester. Reference levels for T4L were 0.81-1.19ng/dL for the first, 0.71-1.07ng/dL for the second and 0.69-1.06ng/dL for the third trimester., Conclusions: The reference levels for TSH and T4L obtained in this study differ from those used for the general population, which may have led to misclassification errors and unnecessary treatment in pregnant women., (Copyright © 2023 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Hypertension is a major cardiovascular illness worldwide with many underlying causes. The role of trace elements selenium, copper, and zinc in hypertension is uncertain. The objective of this study was to evaluate the role of these trace elements in hypertension.Method: Data from 6683 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2016 were analyzed using Statistical Analytical System (SAS, version 9.4) software for the role of trace elements in hypertension in age range 8 to 80 years, irrespective of the antihypertensive medication taken. Recent American Heart Association guidelines and pediatric practice guidelines for hypertension were used.Results: Findings showed a significant positive association between serum selenium levels and hypertension but not serum zinc and copper. At optimal levels for transport and distribution, serum selenium levels of 120 μg/L or higher (reference level 70-150 μg/L) were significantly associated with hypertension (OR = 1.46, 95% CI = 1.29-1.66) after adjusting for confounding factors. At serum selenium level greater than 150 μg/L, the association with hypertension strengthened (OR = 1.69, 95% CI = 1.32-2.17).Conclusion: A positive association was found between serum selenium and hypertension, irrespective of age or anti-hypertensive medications intake. These findings also suggest that the reference levels of serum levels in healthy individuals may need to be re-determined, if supported by additional studies. If validated, patients with hypertension may also need to be cautioned about selenium intake. [ABSTRACT FROM AUTHOR]

Data and metadata products based on intensive terrestrial gravity measurements covering the Belgian territory have been established compliant to the new ISO19115‐1 profile for gravity‐related data. A short historical introduction on gravity measurements on the Belgian territory is presented, starting with the first gravity measurement in 1892. This paper focuses on gravity data acquired after 1971, which marks the adoption of IGSN71 as a reference for the world network by the International Association of Geodesy (IAG). Next to a complete dataset containing all Belgian gravity data, the available gravity data were reduced to the corresponding measurement campaign, enabling determination of specific metadata (e.g. used gravimeter, tide system parameters, time of acquisition, etc.). New gravity and spirit levelling measurements were executed by the Royal Observatory Belgium and the National Geographic Institute (Federal Mapping Agency) to validate the g‐value at the historical reference base station 'Carte du Ciel' in Brussels. Taking into account the instrumental errors and the varying ground water content, the retrieved data are validated and approved for use in further research. [ABSTRACT FROM AUTHOR]

The movie and broadcast industries are gaining experience with high-dynamic-range (HDR) video technologies and are starting to produce HDR content at scale. This is accompanied by a learning process, particularly involving questions regarding the use of the extra dynamic range afforded by these technologies. To create further insight into the aspects of HDR content, in this paper, a variety of different types of content is analyzed. Manual annotation processes are used to determine the range of luminance values that, for example, diffuse white objects or white overlay graphics objects have in this content. We found that, for each type of object analyzed, the mean luminance value is reasonably constant across different types of content, but the spread of luminance values is remarkably large and strongly content dependent. Our results may form a basis for understanding HDR content and contribute toward forming opinions on defining reference levels in reports and standards, including International Telecommunications Union - Radiocommunication Rec. BT.2408. [ABSTRACT FROM AUTHOR]

The United Nations’ expanded program for Reducing Emissions from Deforestation and Forest Degradation (REDD+) aims to mobilize capital from developed countries in order to reduce emissions from these sources while enhancing the removal of greenhouse gases (GHGs) by forests. To achieve this goal, an agreement between the Parties on reference levels (RLs) is critical. RLs have profound implications for the effectiveness of the program, its cost efficiency, and the distribution of REDD+ financing among countries. In this paper, we introduce a methodological framework for setting RLs for REDD+ applications in tropical forests in Xishuangbanna, China, by coupling the Good Practice Guidance on Land Use, Land Use Change, and Forestry of the Intergovernmental Panel on Climate Change and land use scenario modeling. We used two methods to verify the accuracy for the reliability of land classification. Firstly the accuracy reached 84.43%, 85.35%, and 82.68% in 1990, 2000, and 2010, respectively, based on high spatial resolution image by building a hybrid matrix. Then especially, the 2010 Globeland30 data was used as the standard to verify the forest land accuracy and the extraction accuracy reached 86.92% and 83.66% for area and location, respectively. Based on the historical land use maps, we identified that rubber plantations are the main contributor to forest loss in the region. Furthermore, in the business-as-usual scenario for the RLs, Xishuangbanna will lose 158,535 ha (158,535 × 104 m2) of forest area in next 20 years, resulting in approximately 0.23 million t (0.23 × 109 kg) CO2e emissions per year. Our framework can potentially increase the effectiveness of the REDD+ program in Xishuangbanna by accounting for a wider range of forest-controlled GHGs.

The paper provides an overview of the motivation, development and major principles of the international project Merlin. The main output of this project is a unique trilingual learner corpus consisting of German, Italian and Czech. The corpus will be available as an online platform illustrating the Common European Framework of Reference for Languages (CEFR) with authentic learner data and enabling users to explore authentic written learner productions and related metadata (e.g. age, first language of the learner, etc.). Each text in the corpus is linguistically analysed during the multiphase error annotation. This process raises some problematic issues concerning the particularly specific character of Czech as a Slavic language. The paper summarises some of these problems and their possible solutions.

Technological development put international organisations to effort in order to issue and continuously reassess standards concerning electromagnetic radiation protection issues. Protection standards have to be continuously reviewed as new data become available. This article provides a brief overview of updates implemented by the latest available protection standards. Currently, standards do not incorporate appropriate safety factors for protection against long-term effects of exposure to electromagnetic fields, thus protection is provided only for the established short term effects of electromagnetic fields on the human body. However, there is still a great deal of questions related to differences in limitations set by international organisations that have issued recommendations for personnel protection against electromagnetic fields.

Abstract Multifunctionality is characterized by two key elements: the existence of jointly produced multiple commodity and non-commodity outputs (NCOs), and that NCOs exhibit the characteristics of public goods externalities. The term "multifunctionality" is almost not used outside agriculture. However, several issues discussed in fishery literature and in international contexts clearly refer to public goods provision and joint production. The key point is to recognize if fisheries, similar to agriculture, provide other (public) benefits beyond their primary food supply function. The paper establishes a theoretical framework for the classification and valuation of multifunctionality in fisheries, and outlines policy options to increase (through multifunctionality) social welfare. NCOs include: ecosystem- and biodiversity-related NCOs, other environmental public goods/bads, cultural heritage and coastal viability, coastal employment externalities, food security, and strategic benefits. The main NCO characteristics to be analysed are the degree of jointness between commodity outputs and NCOs, and the distribution of property rights over fish stocks and NCOs. Policy options to increase social welfare include, among others, command and control schemes, market based instruments (e.g., payment for ecosystem services), and marine protected areas. Customary marine tenure institutions, or other modern fishery organizations, may represent a framework for the communitarian provision of NCOs. Fishery subsidies, which can because of overfishing, are justified if they allow increasing social benefits, given by the sum of catch and NCOs value. Particularly, incentives may be necessary to support small-scale fisheries or other less efficient technologies. Highlights • Multifunctionality represents a policy paradigm in international contexts. • Fisheries supply bundles of commodity outputs and public goods/bads. • Fishers should be fostered to provide public goods in order to reach social optimum. • The direction of payments is driven by the existence of property rights on resources. [ABSTRACT FROM AUTHOR]

Abstract: In the case of grapevine (Vitis vinifera L.), leaf blade and petioles at different sampling times are used for nutritional diagnosis and planning fertilization practices. However, reference values for each nutrient depend on the scion‐rootstock combination. In this sense, the current study aimed at determining the reliability of leaf blade and petiole for diagnosis at different phenological stages and, also, of the period of validity, around flowering and veraison, in which the nutrient concentrations obtained could be compared with reference values. The study was carried out in three vineyards (two planted with cv. Mencía and one with cv. Sousón) within the Ribeira Sacra Designation of Origin (NW Spain). Blades and petioles were collected throughout a growth season (2014) and total concentrations of ten essential elements were determined in both tissues. In general, petioles showed greater variability between replicates for P, K, Ca, Mg, and Zn, while N, Fe, Mn, Cu, and B presented greater variability in blades. Differences between consecutive sampling dates suggest that references for flowering were valid until fruit‐set. Furthermore, blade and petiole references at the beginning of veraison were valid until the advanced ripening stage for most nutrients, with the exception of N, P, and Zn. The seasonal variation of the concentrations in both tissues confirmed the need for reference values for each phenological stage and tissue. [ABSTRACT FROM AUTHOR]

As standards for a complete high dynamic range (HDR) television ecosystem near completion, the industry is taking its first steps in HDR production. HDR is associated not only with a greater dynamic range but also brighter screens than conventional television, so the potential arises for unwanted, uncomfortable brightness jumps at program junctions and channel changes. To ensure a degree of consistency between programs, some production guidelines for HDR brightness are required. The guidelines should be applied to the signal during production, rather than in displays. In this paper, we summarize tests showing that the mean displayed pixel luminance is a good predictor of subjective brightness. We then explore viewer tolerance to brightness shifts of different sizes, and propose a potential normal operating range for the mean display luminance of 10 to 80 cd/m2, extending to 5 to 160 cdlm2 for special creative effect. [ABSTRACT FROM AUTHOR]

During the 23rd session of the FAO-Committee on Forestry (COFO 23) held in July 2016, the voluntary guidelines on national forest monitoring were approved. These guidelines were generated to support FAO member countries on the starting-up and the implementation of their national forest monitoring systems (NFMS). Under the United Nations Framework Convention on Climate Change (UNFCCC), the decision 1/CP.16 encouraged to developing country Parties to undertake actions for REDD+, and requested, inter alia: i) to develop a forest reference emission level and/of forest reference level (FREL/REL) as a baseline for the emission reductions report, and ii) a transparent and robust NFMS. This paper examines the technical assessments from UNFCCC of the FREL/REL submitted by six countries in relation to technical needs for the NFMS setting up. The analysis suggests the need to improve the procurement of ground-base data, to comply the quality of the estimations on forest emission changes, to complete the carbon stocks estimations, and to estimate the associated uncertainties. The strategic and technical planning of the NFMS is also needed, to be able to reach the acceptable preparation level for measuring, reporting and verification system of REDD+, and the FAO voluntary guidelines are a helpful tool for the step-wise approach development.

Promoting environmentally friendly farming products is crucial to meeting consumer demand. Although governments implement policy measures to improve the environmental performance of the agriculture sector, theirimpacts are difficult to assess. This study analyses the performance of agri‐environmental policies in Japan, by using the OECD’s policy impact model and reference level framework. In particular, it identifies the environmental impacts of three simulated agri‐environmental policies based on farms’ characteristics. The results suggest that a policy mix of regulation and an incentive payment would reduce environmental impacts, suggesting that targeted approaches could improve the cost‐effectiveness of agri‐environmental policies.

Objectives: Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished.Methods: Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (PKA), total air kerma at the reference point (Ka,r), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender.Results: The mean values for each site A, B, C, D, and E were: PKAs of 4343 ± 994 μGym2, 18,200 ± 2141 μGym2, 11,423 ± 1390 μGym2, 7796 ± 704 μGym2, 31,897 ± 5798 μGym2; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile PKA was 15,849 μGym2.Conclusion: Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures.Key Points: • Abdominal endovascular aneurysm repair (EVAR) requires the use of ionising radiation. • EVAR is a minimally invasive procedure for the treatment of abdominal aortic aneurysms. • Diagnostic reference levels (DRLs) are used to monitor patient radiation exposure. • Radiation dose data was collected from five European centres for EVAR procedures. • Local DRLs have been determined and an interim European DRL is proposed. [ABSTRACT FROM AUTHOR]

Objectives: A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom.Methods: Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions.Results: Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm2 and 11 mins for cerebral angiography, 35 Gy.cm2 and 16 mins for biliary drainage, 75 Gy.cm2 and 6 mins for lower limbs arteriography and 70 Gy.cm2 and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published.Conclusions: This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs.Key Points: • Delivered dose in interventional radiology depends on procedure, practice and patient. • National RLs are proposed for 15 interventional procedures. • Reference levels (RLs) are useful to benchmark practices and optimize protocols. • RLs are proposed for kerma area product, air kerma, fluoroscopy time and number of images. • RLs should be adapted to the procedure complexity and updated regularly. [ABSTRACT FROM AUTHOR]

Introduction Hair samples are used as a tool to evaluate environmental exposure to contaminants and metabolic status in the individual. However, the use of human hair is controversial, mainly because of the lack of well-defined reference levels. In the case of Spain, very few biomonitoring studies have investigated these issues in infants, children or adolescents. Objective To establish reference levels for trace elements in children and teenagers in Madrid, Spain. Material and methods Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure Al, As, Ag, Ba, Bi, Cd, Cr, Co, Cu, Fe, Mn, Mo, Ni, Pb, Se, Sr, Tl and Zn levels in hair samples from 648 healthy children and adolescents (253 boys and 395 girls) between April 2008 and December 2009. Results Median levels were as follows: Al 18.5 μg/g, As 0.07 μg/g, Ag 196 ng/g, Ba 0.5 μg/g, Bi 0.01 μg/g, Cd 18.3 ng/g, Cr 0.4 μg/g, Co 14.5 ng/g, Cu 25.7 μg/g, Fe 15.5 μg/g, Mn 328 ng/g, Mo 0.04 μg/g, Ni 0.5 μg/g, Pb 0.70 μg/g, Se 0.5 μg/g, Sr 1.29 μg/g, Tl 0.28 ng/g and Zn 121 μg/g. Discussion and conclusion The values of trace elements here described could be considered as possible reference ranges for hair samples from children and adolescents aged 0–18 years living in the Madrid region (central Spain). These values could also be selected as a preliminary screening tool to assess exposure sources and to generate information needed to develop prevention strategies and likewise could be a complement to other diagnostic procedures. [ABSTRACT FROM AUTHOR]

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New maximum permissible levels (reference levels RL) for the study of potentially contaminated soils by heavy metals were defined. Despite of anthropogenic contaminants in soils, there is also presented a certain amount of natural metals (background levels) in these soils according to the proper geographic region, which encouraged us to establish particular RL for the metals in soils. Currently, there is not an unique methodology to establish the RL for metals in soils, thus this study intend to review information on different methodologies applied to define RL. A general scheme covering all methodologies are presented.

The assessment of risks associated with environmental exposure to metals/metalloids requires well-established reference values for each population since it varies considerably according to distinct local/regional characteristics. However, very few studies establish baseline values for these elements (essential and toxic) in large population groups, especially in Latin American countries. This study was aimed at establishing urinary reference levels of 30 metals/metalloids: aluminum (Al), antimony (Sb), arsenic (As), barium (Ba), beryllium (Be), cadmium (Cd), cerium (Ce), cesium (Cs), chromium (Cr), cobalt (Co), copper (Cu), lanthanum (La), lead (Pb), lithium (Li), strontium (Sr), manganese (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni), platinum (Pt), rubidium (Rb), selenium (Se), silver (Ag), tin (Sn), tellurium (Te), thallium (Tl), thorium (Th), tungsten (W), uranium (U) and zinc (Zn) in a Brazilian southeast adult population. This pilot study is a cross-sectional analysis conducted with the first wave of the ELSA-Brasil cohort (baseline examination). A total of 996 adults (45.5% men, N = 453, mean age: 50.5, and 54.5% women, N = 543, mean age: 50.6) were included in the study. Sample analyses were performed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Percentiles (2.5, 10, 25, 50, 75, 95 (CI95%), and 97.5) of each element (μg/g of creatinine) in the study are presented according to sex. Moreover, differences in the mean metal/metalloid urinary levels according to age, education, smoking, and alcohol intake are also presented. Finally, median found values were compared to established values of large human biomonitoring surveys previously conducted in North America and France. This is the first comprehensive and systematic human biomonitoring study that established population reference ranges for 30 (essential and/or toxic elements) in a Brazilian population group. • We established reference ranges for 30 elements in a Brazilian population. • This study was the first wave of the ELSA-Brasil cohort (baseline examination). • Metal/metalloid urinary levels were stratified by sociodemographic factors. [ABSTRACT FROM AUTHOR]