Health Research Associates: Dana Library Program Supporting the Information Needs of Small Hospitals & Public Health Agencies in Vermont

We will describe the purpose, methods, members and service changes, income-expense status, trends, and the value of this program

Variable density sampling based on physically plausible gradient waveform. Application to 3D MRI angiography

Performing k-space variable density sampling is a popular way of reducing scanning time in Magnetic Resonance Imaging (MRI). Unfortunately, given a sampling trajectory, it is not clear how to traverse it using gradient waveforms. In this paper, we actually show that existing methods [1, 2] can yield large traversal time if the trajectory contains high curvature areas. Therefore, we consider here a new method for gradient waveform design which is based on the projection of unrealistic initial trajectory onto the set of hardware constraints. Next, we show on realistic simulations that this algorithm allows implementing variable density trajectories resulting from the piecewise linear solution of the Travelling Salesman Problem in a reasonable time. Finally, we demonstrate the application of this approach to 2D MRI reconstruction and 3D angiography in the mouse brain.Comment: IEEE International Symposium on Biomedical Imaging (ISBI), Apr 2015, New-York, United State

A longitudinal study of narrative discourse in post-stroke aphasia

Background: Previous findings have demonstrated the importance of discourse analysis in post-stroke aphasia, as it allows for in-depth examination of language impairment and represents key components of functional communication. However, little is known about the recovery of discourse over time. Aims: The main aim of this study is to measure the longitudinal changes in descriptive discourse production from the acute to chronic stages of post-stroke aphasia recovery. The secondary aim is to explore the association between discourse measures and overall language impairment severity measures at different testing points. Methods & Procedure: Seventeen French Canadian speakers with various types and severities of aphasia following a first left middle cerebral artery stroke participated in this study. They underwent three language assessments (acute: 0 to 72 hours; subacute: 7 to 14 days; chronic: 6 to 12 months post-onset). The picture description from the Western Aphasia Battery was analyzed at three time points. Changes in terms of thematic informativeness and microstructural variables were analyzed. Outcomes & Results: Regarding the micro-structural variables, the mean length of utterances (MLU) and the number of words per minute showed significant positive changes between the acute and chronic phases. For the thematic informativeness measures, the number of thematic units (TUs), the number of thematic units per minute (TUs/min) and the number of thematic units per utterance (TUs/utt) 4 increased significantly between the acute and chronic phases. Positive correlations between TUs and MLU in the acute phase and a general language impairment severity measure in the acute and chronic phases suggest a relationship between these measures and global language performance suggesting the potential predictive value of these variables in the acute phase. Conclusions & Implications: These findings support the use of thematic units in descriptive discourse analysis during an acute clinical examination of language as they require minimal additional time to score and track changes in post-stroke aphasia recovery. They capture long-term changes in discourse abilities and appear related to overall language measures in both the acute and chronic stages of recovery. The interpretation of the changes in MLU and the number of words per minute is less straightforward, as improvements in these measures carry different interpretations depending on the type of aphasia. Nonetheless, further studies are required to investigate test-retest reliability and the effect of therapy on the changes observed over time when using thematic units to document change in discourse

Metabolomic biomarkers predictive of early structural lung disease in cystic fibrosis

Neutrophilic airway inflammation plays a role in early structural lung disease in cystic fibrosis (CF), but the mechanisms underlying this pathway are incompletely understood

Variable density sampling based on physically plausible gradient waveform. Application to 3D MRI angiography

International audiencePerforming k-space variable density sampling is a popular way of reducing scanning time in Magnetic Resonance Imaging (MRI). Un-fortunately, given a sampling trajectory, it is not clear how to traverse it using gradient waveforms. In this paper, we actually show that ex-isting methods [1, 2] can yield large traversal time if the trajectory contains high curvature areas. Therefore, we consider here a new method for gradient waveform design which is based on the pro-jection of unrealistic initial trajectory onto the set of hardware con-straints. Next, we show on realistic simulations that this algorithm allows implementing variable density trajectories resulting from the piecewise linear solution of the Travelling Salesman Problem in a reasonable time. Finally, we demonstrate the application of this ap-proach to 2D MRI reconstruction and 3D angiography in the mouse brain

The importance of thematic informativeness in narrative discourse recovery in acute post-stroke aphasia

Background: Discourse analysis allows the examination of functional and ecological language impairment in post-stroke aphasia. Given its complexity, various methods of analysis have been developed to measure the multiple components of discourse. Clinical assessment usually includes discourse analysis, but how clinicians should assess recovery of discourse, particularly in acute care settings, is still a matter of debate. Aims: This study aimed to measure improvements in discourse production in early post-stroke aphasia recovery. Methods & Procedure: Twenty-three persons with aphasia following a first left middle cerebral artery stroke were recruited in the stroke unit of Hôpital du Sacré-Coeur de Montréal (May 2015-July 2018). Patients treated with thrombolysis (n = 10) and untreated patients underwent two aphasia assessments (0 to 72 hours, 7 to 14 days post-onset). Discourse assessment consisted of the picture description task from the Western Aphasia Battery. Changes in microlinguistic and thematic informativeness measures between the two assessment periods were analyzed. Outcomes & Results: In-depth microlinguistic analyses showed no significant difference between the initial and follow-up assessments. Conversely, some thematic informativeness variables improved significantly during the same time period. Patients treated with thrombolysis produced more thematic units than untreated patients at both assessments, but the change between the two groups was not significant. Conclusions & Implications: This study suggests that thematic informativeness variables are sensitive to language improvement in early post-stroke aphasia recovery whereas no microlinguistic variables improved significantly in the same period. In contrast to previous evidence, the difference between patients treated with thrombolysis and untreated patients was not evident over time. The results suggest that thematic informativeness constitutes an interesting path to explore as a routine clinical assessment in acute-care settings because it is time-efficient, simple to conduct and reliable in assessing early changes in the discourse production of individuals with aphasia in the acute post-stroke phase

Seroprevalence of HIV, hepatitis b, and hepatitis c among opioid drug users on methadone treatment in the netherlands

Background: Injecting drug users (IDU) remain an important population at risk for blood-borne infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). In the Netherlands, a program is being implemented to offer annual voluntary screening for these infections to opioid drug users (ODUs) screened in methadone care. At two care sites where the program is now operating, our study aimed to estimate the seroprevalence among ODUs screened for HIV, HBV and HCV; to evaluate HBV vaccination coverage; and to assess the feasibility of monitoring seroprevalence trends by using routine annual screening data.Methods: Opioid drug users on methadone treatment are routinely offered voluntary screening for infectious diseases such as HIV, HBV and HCV. Data on uptake and outcome of anti-HIV, anti-HBc, and anti-HCV screening among ODUs receiving methadone were obtained from two regions: Amsterdam from 2004 to 2008 and Heerlen from 2003 to 2009.Findings: Annual screening uptake for HIV, HBV and HCV varied from 34 to 69%, depending on disease and screening site. Of users screened, 2.5% were HIV-positive in Amsterdam and 11% in Heerlen; 26% were HCV-positive in Amsterdam and 61% in Heerlen. Of those screened for HBV, evidence of current or previous infection (anti-HBc) was found among 33% in Amsterdam and 48% in Heerlen. In Amsterdam, 92% were fully vaccinated for HBV versus 45% in Heerlen.Conclusion: Annual screening for infectious diseases in all ODUs in methadone care is not fully implemented in the Netherlands. On average, more than half of the ODUs in methadone care in Heerlen and Amsterdam were screened for HIV, HBV and HCV. In addition, screening data indicate that HBV vaccination uptake was rather high. While the HIV prevalence among these ODUs was relatively low compared to other drug-using populations, the high HCV prevalence among this group underscores the need to expand annual screening and interventions to monitor HIV, HBV and HCV in the opioid drug-using population

Influenza A(H1N1) Oseltamivir Resistant Viruses in the Netherlands During the Winter 2007/2008

Background: Antiviral susceptibility surveillance in the Netherlands was intensified after the first reports about the emergence of influenza A(H1N1) oseltamivir resistant viruses in Norway in January, 2008. Methods: Within the existing influenza surveillance an additional questionnaire study was performed to retrospectively assess possible risk factors and establish clinical outcome of all patients with influenza virus A(H1N1) positive specimens. To discriminate resistant and sensitive viruses, fifty percent inhibitory concentrations for the neuramidase inhibitors oseltamivir and zanamivir were determined in a neuraminidase inhibition assay. Mutations previously associated with resistance to neuramidase inhibitors and M2 blockers (amantadine and rimantadine) were searched for by nucleotide sequencing of neuraminidase and M2 genes respectively. Results: Among 171 patients infected with A(H1N1) viruses an overall prevalence of oseltamivi resistance of 27% (95% CI: 20-34%) was found. None of influenza A(H1N1) oseltamivir resistant viruses tested was resistant against amantadine or zanamivir. Patient characteristics, underlying conditions, influenza vaccination, symptoms, complications, and exposure to oseltamivir and other antivirals did not differ significantly between patients infected with resistant and sensitive A(H1N1) viruses. Conclusion: In 2007/2008 a large proportion of influenza A(H1N1) viruses resistant to oseltamivir was detected. There were no clinical differences between patients infected with resistant and sensitive A(H1N1) viruses. Continuous monitoring of the antiviral drug sensitivity profile of influenza viruses is justified, preferably using the existing sentinel surveillance, however, complemented with data from the more severe end of the clinical spectrum. In order to act timely on emergencies of public health importance we suggest setting up a surveillance system that can guarantee rapid access to the latter. (aut. ref.

Updated analysis of the non-CO2 climate impacts of aviation and potential policy measures pursuant to EU Emissions Trading System Directive Article 30(4)

13TASK3: Potential policy action to reduce non-CO2climate impactsFollowing a review of scientific literature, and expert workshop discussions, a range of potential mitigation measures were identified to reduce the non-CO2climate impacts of aviation7. Basedon various criteria in line with EU climate policy goals, the below six options were shortlisted to be considered in greater detail in terms of design, administration, incentives, caveats and constraints, and further research needs. These six options wereconsidered representative of similar considerations and details exhibited by an original longer list of options. Type of MeasureMain non-CO2effect(s) addressed by the measureFinancial1.NOXchargeNOX2.Inclusion of aircraft NOXemissions in EU ETSNOXFuel3.Reduction in maximum limit of aromatics within fuel specificationsSoot particulates and contrail-cirrus4.Mandatory use of Sustainable Aviation Fuels (SAF)Soot particulates and contrail-cirrusATM5.Avoidance of ice-supersaturated areasContrail-cirrus6.A climate chargeAll (NOX, water vapour, soot, sulphates, contrails) 1.NOXchargeThis measure is defined as a monetary charge on the total NOXemissions over an entire flight, approximated by certified Landing Take-Off (LTO) NOXemissions data, the distance flown and a factor accounting for the relation between LTO and cruise emissions.A legal analysis from 2009 suggested that neither ICAO’s Chicago Convention nor ICAO’s recommended policies on taxes and charges should prevent the implementation of such a measure. This option would incentivise engine manufacturers to reduce LTO NOXemissions during their engine design process, and airlines to minimise NOXemissions in operation, while taking into account associated trade-offs.Further research would be needed in these key areas:oUnder certain future scenarios of declining emissions of tropospheric ozone precursors from surface sources, combined with increasing aviation emissions, aviation NOXmay lead to a net negative climate forcing (i.e. cooling). As such, there is a need to monitor the scientific understanding of this issue as it further evolves over time.7These options would be in addition to those already in place, such as the aircraft engine NOXand nvPM emissions standard and airport NOXcharging schemes. 14oExisting analytical methods, such as the Boeing fuel flow method (BFF2) and the DLR fuel flow method, have been used in the past to estimate cruise NOXemissions based on LTO NOXdata. However, the robustness of these methods when applied to recent technological developments, such as lean burn staged combustion, is still being assessed and the methods may need to be updated. Research to develop and agree on an accurate, internationally recognised methodology for estimating cruise NOXemissions will be important for the implementation of this measure.oIn order to compare the climate change impact of NOXemissions to CO2emissions, an appropriate CO2equivalent emissions metric and time horizon would need to be agreed politically. In doing so, it is important to ensure that the trade-off between NOXand CO2emissions in engine design does not result in unintended consequences and a resulting net warming effect. oThe level of the charge should reflect the climate damage costs of aircraft NOxemissions. Using the aforementioned metric, these costs could be related to the damage costs of CO2, which are an on-going point of discussion.The necessary legislation and implementation of this option would need to be considered within the context of the regulatory framework of the Single European Sky Performance and Charging Scheme8, as well as other financial policy options (including those already in place).If the outstanding research issues linked to this measure are addressed, and there is the political will to take the option forward, then the measure could potentially be implemented in the mid-term (5 to 8 years)9.2.Inclusion of aircraft NOXemissions in EU ETSThe EU Emissions Trading System (ETS) is a ‘cap and trade’ scheme in which emission allowances for CO2emissions are traded among incumbent operators in a number of different sectors, including aviation. The system allows opt-ins for emissions of N2O and PFCs for stationary installations.This measure would see the extension of the scope of the EU ETS by incorporating aviation NOXemissions. As the EU ETS legislation uses the CO2equivalent emissions metric ‘GWP100’ to convert other greenhouse gases to CO2equivalents, it is assumed that including aircraft NOXinto EU ETS would also require using GWP100.This option would incentivise engine manufacturers to reduce NOXemissions during their engine design process, and airlines to minimise NOXemissions in operation, while taking into account associated trade-offs.Further research would be needed on the sameissues as the ‘NOXcharge’ measure.In contrast to other measures outlined in this report, this measure could be implemented by adjusting existing ETS legislation and building on existing administrative processes and 8COMMISSION IMPLEMENTING REGULATION (EU) 2019/317 of 11 February 2019 laying down a performance and charging scheme in the single European sky and repealing Implementing Regulations (EU) No 390/2013 and (EU) No 391/2013.9Rough estimates of timescales to implement policy options have been provided, but are dependent on addressing the identified research needs and the political will to take the options forward. For the purpose of this study, short-term is defined as 2-5 years, mid-term as 5-8 years and long-term as 8+ years. 15precedents (e.g. monitoring, reporting, verification and accreditation -MRVA; baseline; cap and auctioned allowances). The same EU ETS geographical scope for aviation could be applied to NOXas that for CO2emissions.The uncertainty about the climate impact of NOX, and the potential unintended consequences, introduces a political risk for the integrity of the EU ETS which needs to be taken into account when considering it as an opt-in non-CO2gas in the EU ETS. In this sense, the measure differs from the ‘NOx charge’.If the outstanding research issues linked to this measure are addressed, and there is the political will to take the option forward, then the measure could potentially be implemented in the mid-term (5 to 8 years).3.Reduction in maximum limit of aromatics within fuel specifications This measure would entail reducing the maximum volume concentration of aromatics within fuel uplifted at European airports.Lower aromatics in fuels provide a cleaner burn and reduced non-volatile Particulate Matter (nvPM) emissions, which are directly linked to contrail cirrus formation and radiative properties. In addition, the reduction in aromatics improves the energy density of the fuel, which reduces the mass of fuel needed for a specific flight and results in a small reduction in overallfuel burn / CO2emissions (approx. 1%).The aromatics concentration could be reduced through blending certain sustainable aviation fuels (SAF) with conventional Jet A-1 fuel, through hydro-treatment of Jet A-1 fuel or through changes in production processes by refineries.Jet A-1 fuel is the most commonly used aviation fuel in the world. Its fuel specifications are managed through the four main standardisation committees, including US ASTM (D1655) and UK DEF STAN (91-091). Engagement with these committees to discuss the climate benefits of low aromatic fuels will be crucial. This measure would require fuel producers to adapt their production processes to meet the new standard, which may result in higher CO2emissions in refineries. Further research would be needed in these key areas:oThe scientific understanding of the contribution of nvPM to the formation of contrail cirrus is evolving, but confidence level in the magnitude of the net positive climate forcing effect (i.e. warming) is low. As such, there is a need to monitor the scientific understanding of this issue as it further develops over time.oA cost-effectiveness assessment is needed to assess options for reducing the aromatics limit. While the maximum volume concentration of aromatics is 25 volumepercent, the actual content in Jet A-1 fuel currently used within the aviation sector is not well known. Studies have revealed that it can vary extensively. As such, the specifications of fuels being used in Europe will need to be monitored in order to beable to assess the impact of a reduced maximum limit of aromatics. oSpecial consideration will need to be given to the effect on military aircraft, which can be relatively old compared to commercial aircraft, and theuse of lower aromatics fuels may have airworthiness consequences for parts of the engine (e.g. rubber seals) where the fuel supply is shared. For this reason, ASTM and DEF STAN are currently considering an 8% minimum aromatics limit for fossil based fuels, though this is currently just guidance. 16oA system to monitor the aromatics content of fuels used in the aviation sector would need to be set up to ensure that the policy delivers the anticipated benefits.Existing fuel specification committees use a consensus-driven, technical approach. While a legally imposed EU standard would ensure a specific outcome, it would disrupt the current global approach to managing fuel quality standards.An alternative option to this measure could be an incentive for the sale of fuel with low aromatics.If the outstanding research issues linked to this measure are addressed, and there is the political will to take the option forward, then the measure could potentially be implemented in the mid-(5 to 8 years) to long-term (+8 years).4.Mandatory use of Sustainable Aviation Fuels (SAF)This measure would entail the mandatory use of SAF, for instance through an EU blending mandate specifying that a certain percentage of the total Jet A-1 fuel sold in Europe over a set time period would have to be SAF.Within the European regulatory framework, SAF would be defined as per the criteria in the new Renewable Energy Directive (RED II) 2018/2001/EU.SAF typically have lower aromatic concentrations and thus the same benefits as summarised in the ‘Reduction in maximum limit of aromatics within fuel specifications’ measure, as long as the aromatics content in the fossil part of the blend does not increase and offset the benefits. In addition, SAF also have lower lifecycle CO2emissions compared to conventional fossil based fuels and lower sulphur content resulting in lower SO4emissions.This measure would incentivise the use of SAF in the single market by providing certainty to SAF producers and an impetus to up-scale their production and benefit from economies of scale. It may also increase airline operational costs, depending on the size of the mandate and subsequent supply-side response from the SAF market.Further research would be needed in these key areas:oBlending mandates have already been introduced or announced inindividual European states. A cost-benefit assessment would be needed to inform a decision on the level of an EU blending mandate. This assessment would need to consider realistic yet ambitious levels, the impact on stakeholders and potential implementation processes (e.g. a dynamic blending mandate that increases over time in order to provide certainty to the market for long-term investments).oAs per option (3), a system to monitor the characteristics of SAF being used in operation within Europe would be needed to ensure compliance with the mandate and provide valuable oversight on the environmental benefits from this measure.A ‘control point’ will need to be identified (e.g. blending location), where the total SAF going to the aviation sector in Europe can be identified and hence compliance with the blending mandate can be monitored. This could build on existing legislation (e.g. RED II, FQD).The mandating of SAF results could be considered as a holistic approach with simultaneous reductions in CO2, nvPM and sulphur emissions, although it does not address NOxemissions. 17If the outstanding research issues linked to this measure are resolved, and there is the political will to take the option forward, then the measure could potentially be implemented in the short-(2 to 5 years) to mid-term (5 to 8 years).5.Avoidance of ice-supersaturated areasThis measure involves optimizing flight trajectories to avoid climate-sensitive regions, such as ice-supersaturated areas, in order to reduce the climate impact of aviation. This can be considered a potential first step towards full optimisation of flight profiles for climate impacts.Contrails are largely formed in ice-supersaturated and low-temperature areas, and thus avoiding these regions reduces contrail cirrus occurrence that have a net positive radiative forcing effect (i.e. warming).Prior to a flight plan being filed, Air Navigation Service Providers (ANSPs) and airline operators would need to have all the relevant information (e.g. temperature, humidity) in order to identify the ice-supersaturated areas. The route network would also have to be designed to allow such deviations based on this pre-flight tactical planning. Further research would be needed in these key areas:oA pilot project involving ANSPs,ICAO, meteorological institutes and airlines operating over the Atlantic would be needed to assess the feasibility and benefits of this measure. This should include the effect of such a measure on existing Single European Sky operational initiatives such as Free Route Airspace. Implementation over mainland European airspace would be a challenge as this region already faces capacity constraints during daily peak periods.oFlight detours (horizontal and vertical) to avoid ice-supersaturated areas are likely to have an impact on airlines in terms of costs, and will also lead to trade-offs with regard to fuel burn and emissions (e.g. CO2and NOX). An appropriate CO2equivalent emissions metric that permits a comparison between the climate change impact of contrail-cirrus and other aviation emissions will be required to determine the maximum detour that still ensures an overall reduction in climate impact from a flight. oMost of the contrail cirrus forcing that results in significant warming is believed to be due to a few large-scale events. It would therefore be advisable to ‘target’ flights that impact these events, rather than all flights. Identification of these few large-scale events should be a topic of further research as meteorological forecast models presently have only limited capability to predict persistent contrails correctly in time and space.Demonstration and communication on the environmental benefits would be needed, as well as potentially additional incentives, to ensure buy-in from stakeholders. If the outstanding research issues are addressed, including positive results from a pilot-phase project in the short-term, and there is the political will totake the option forward, then the measure could potentially be implemented in a more complete form in the mid-term (5-8 years). 186.A climate chargeThe concept of this policy measure is to levy a charge on the full climate impact of each individual flight. This makes it both the measure with the broadest coverage and the one that is likely to be the most complicated to implement. The introduction of a charge requires a good estimate of the climate costs at a flight level. Currently, there is no scientific consensus on the methodology to calculate these costs.It could be argued that a levy that aims to internalise the external costs would be considered a charge and not a tax. In this case, the charge would be related to recover the external costs of the climate impact of aviationFurther research would be needed on the same issues as the ‘Avoidance of ice-supersaturated areas’ measure, but with a larger geographical scope and including the level of the charge to be set for the climate damage costs of CO2, which is an on-going point of discussion.The necessary legislation and implementation of this option will need to be considered within the context of the regulatory framework of the Single European Sky Performance and Charging Scheme10. Significant more research is needed to develop and define this measure. If there is the political will to take this forward, then the measure could potentially be implemented in the long-term (+8 years).10COMMISSION IMPLEMENTING REGULATION (EU) 2019/317 of 11 February 2019 laying down a performance and charging scheme in the single European sky and repealing Implementing Regulations (EU) No 390/2013 and (EU) No 391/2013. 19CONCLUDING REMARKSThe latest scientific understanding on the climate change effects of non-CO2emissions from aviation activities has advanced over the last 10 years. While uncertainties remain with regard to these impacts, and how to assess them in terms of CO2equivalent emissions metrics, there are a rangeof policy options with associated pros and cons that the European Commission could evaluate. Specific research issues, which are identified this report, would need to be addressed in order to take these options forward

Online dietary intake estimation : Reproducibility and validity of the Food4Me food frequency questionnaire against a 4-day weighed food record

©Rosalind Fallaize, Hannah Forster, Anna L Macready, Marianne C Walsh, John C Mathers, Lorraine Brennan, Eileen R Gibney, Michael J Gibney, Julie A Lovegrove. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.08.2014. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.Background: Advances in nutritional assessment are continuing to embrace developments in computer technology. The online Food4Me food frequency questionnaire (FFQ) was created as an electronic system for the collection of nutrient intake data. To ensure its accuracy in assessing both nutrient and food group intake, further validation against data obtained using a reliable, but independent, instrument and assessment of its reproducibility are required. Objective: The aim was to assess the reproducibility and validity of the Food4Me FFQ against a 4-day weighed food record (WFR). Methods: Reproducibility of the Food4Me FFQ was assessed using test-retest methodology by asking participants to complete the FFQ on 2 occasions 4 weeks apart. To assess the validity of the Food4Me FFQ against the 4-day WFR, half the participants were also asked to complete a 4-day WFR 1 week after the first administration of the Food4Me FFQ. Level of agreement between nutrient and food group intakes estimated by the repeated Food4Me FFQ and the Food4Me FFQ and 4-day WFR were evaluated using Bland-Altman methodology and classification into quartiles of daily intake. Crude unadjusted correlation coefficients were also calculated for nutrient and food group intakes. Results: In total, 100 people participated in the assessment of reproducibility (mean age 32, SD 12 years), and 49 of these (mean age 27, SD 8 years) also took part in the assessment of validity. Crude unadjusted correlations for repeated Food4Me FFQ ranged from .65 (vitamin D) to .90 (alcohol). The mean cross-classification into "exact agreement plus adjacent" was 92% for both nutrient and food group intakes, and Bland-Altman plots showed good agreement for energy-adjusted macronutrient intakes. Agreement between the Food4Me FFQ and 4-day WFR varied, with crude unadjusted correlations ranging from .23 (vitamin D) to .65 (protein, % total energy) for nutrient intakes and .11 (soups, sauces and miscellaneous foods) to .73 (yogurts) for food group intake. The mean cross-classification into "exact agreement plus adjacent" was 80% and 78% for nutrient and food group intake, respectively. There were no significant differences between energy intakes estimated using the Food4Me FFQ and 4-day WFR, and Bland-Altman plots showed good agreement for both energy and energy-controlled nutrient intakes. Conclusions: The results demonstrate that the online Food4Me FFQ is reproducible for assessing nutrient and food group intake and has moderate agreement with the 4-day WFR for assessing energy and energy-adjusted nutrient intakes. The Food4Me FFQ is a suitable online tool for assessing dietary intake in healthy adults.Peer reviewedFinal Published versio