Science.gov

Sample records for myeloablative megatherapy procedures

  1. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    SciTech Connect

    Flandin, Isabelle; Michon, Jean; Pinkerton, Ross; Coze, Carole; Stephan, Jean Louis; Fourquet, Bernard; Valteau-Couanet, Dominique; Bergeron, Christophe; Philip, Thierry; Carrie, Christian . E-mail: carrie@lyon.fnclcc.fr

    2006-04-01

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma.

  2. SIMILAR OUTCOMES USING MYELOABLATIVE VERSUS REDUCED INTENSITY ALLOGENEIC TRANSPLANT PREPARATIVE REGIMENS FOR AML OR MDS

    PubMed Central

    Luger, Selina M.; Ringdén, Olle; Zhang, Mei-Jie; Pérez, Waleska S.; Bishop, Michael R.; Bornhauser, Martin; Bredeson, Christopher N.; Cairo, Mitchell S.; Copelan, Edward A.; Gale, Robert Peter; Giralt, Sergio A.; Gulbas, Zafer; Gupta, Vikas; Hale, Gregory A.; Lazarus, Hillard M.; Lewis, Victor Anthony; Lill, Michael C.; McCarthy, Philip L.; Weisdorf, Daniel J.; Pulsipher, Michael A.

    2011-01-01

    Although reduced intensity (RIC) and nonmyeloablative (NMA) conditioning regimens have been used for over a decade, their relative efficacy versus myeloablative (MA) approaches to allogeneic hematopoietic cell transplantation (HCT) in patients with acute myelogenous leukemia (AML) and myelodysplasia (MDS) is unknown. We compared disease status, donor, graft and recipient characteristics with outcomes of 3731 MA with 1448 RIC/NMA procedures performed at 217 centers between 1997 and 2004. Five year univariate probabilities and multivariate relative risk (RR) outcomes of relapse, transplant related mortality (TRM), disease free survival (DFS) and overall survival (OS) are reported. Adjusted OS at 5 years was 34%, 33%, and 26% for MA, RIC and NMA transplants, respectively. NMA conditioning resulted in inferior DFS and OS but there was no difference in DFS and OS between RIC and MA regimens. Late TRM negates early decreases in toxicity with RIC and NMA regimens. Our data suggest higher regimen intensity may contribute to optimal survival in patients with AML/MDS, suggesting roles for both regimen intensity and graft vs. leukemia in these diseases. Prospective studies comparing regimens are needed to confirm this finding and determine the optimal approach to patients who are eligible for either MA or RIC/NMA conditioning. PMID:21441963

  3. Comparison of Non-myeloablative Conditioning Regimens for Lymphoproliferative Disorders

    PubMed Central

    Hong, Sanghee; Le-Rademacher, Jennifer; Artz, Andrew; McCarthy, Philip L.; Logan, Brent R.; Pasquini, Marcelo C.

    2014-01-01

    Hematopoietic cell transplantation (HCT) with non-myeloablative conditioning (NMA) for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose total body irradiation (TBI). Transplant outcomes were compared among patients ≥40 years with LD who received a HCT with TBI (N=382) and no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for graft-versus-host disease (GVHD), disease status and year of HCT. Cumulative incidences of grades II–IV GVHD at 100 days, were 29% and 20% (p=0.001), and chronic GVHD at 1 year were 54% and 44% (p=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs. 64% in the TBI and no-TBI groups, respectively (p=0.006). Subset of four most common conditioning/ GVHD prophylaxis combinations demonstrated higher rates of grades II–IV acute (p<0.001) and chronic GVHD (p<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared to other combinations. TBI-based NMA conditioning induces faster full donor chimerism but overall survival outcomes are comparable to no-TBI regimens. Combination of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD. PMID:25437248

  4. Favorable long-term outcome of patients with multiple myeloma using a frontline tandem approach with autologous and non-myeloablative allogeneic transplantation.

    PubMed

    Ahmad, I; LeBlanc, R; Cohen, S; Lachance, S; Kiss, T; Sauvageau, G; Roy, D C; Busque, L; Delisle, J-S; Bambace, N; Bernard, L; Sabry, W; Roy, J

    2016-04-01

    Despite survival improvement with novel agents and use of autologous hematopoietic stem cell transplantation (HSCT), cure of patients with multiple myeloma (MM) remains anecdotal. Initial observations suggested that chronic GvHD was accompanied by an anti-myeloma effect after myeloablative HSCT, but unfortunately this procedure was hampered by high non-relapse mortality (NRM). To maximize the anti-myeloma effect and minimize NRM, we developed a non-myeloablative (NMA) regimen associated with a high incidence of chronic GvHD and tested its efficacy on patient survival and disease eradication. From 2001 to 2010, 92 patients aged⩽65 years with a compatible sibling donor received autologous HSCT followed by an outpatient NMA allogeneic HSCT using a conditioning of fludarabine and cyclophosphamide. Patient median age was 52 years and 97% presented Durie-Salmon stages II-III disease. After a median follow-up of 8.8 years, probability of 10-year progression free and overall survival were 41% and 62%, respectively. Although the cumulative incidence of extensive chronic GvHD was high (at 79%), the majority of long-term survivors were off immunosuppressive drugs by year 5 and NRM was low (at 10%). Together, our results suggest that potential MM cure can be achieved with NMA transplantation regimens that maximize graft-versus-myeloma effect and minimize NRM. PMID:26691426

  5. Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

    SciTech Connect

    Kelsey, Chris R.; Horwitz, Mitchell E.; Chino, Junzo P.; Craciunescu, Oana; Steffey, Beverly; Folz, Rodney J.; Chao, Nelson J.; Rizzieri, David A.; Marks, Lawrence B.

    2011-11-01

    Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

  6. Pilot experience with opebacan/rBPI 21 in myeloablative hematopoietic cell transplantation

    PubMed Central

    Guinan, Eva; Avigan, David E; Soiffer, Robert J; Bunin, Nancy J; Brennan, Lisa L; Bergelson, Ilana; Brightman, Spencer; Ozonoff, Al; Scannon, Patrick J; Levy, Ofer

    2015-01-01

    Bacterial infection and inflammation contribute significantly to the morbidity and mortality of myeloablative allogeneic hematopoietic cell transplantation (HCT). Endotoxin, a component of the outer membrane of Gram-negative bacteria, is a potent inflammatory stimulus in humans. Bactericidal/permeability increasing protein (BPI), a constituent of human neutrophil granules, binds endotoxin thereby precluding endotoxin-induced inflammation and also has direct anti-infective properties against bacteria. As a consequence of myeloablative therapy used in preparation for hematopoietic cell infusion, patients experience gastrointestinal leak of bacteria and bacterial toxins into the systemic circulation and a period of inflammatory cytokine elevation associated with subsequent regimen-related toxicities.  Patients frequently become endotoxemic and febrile as well as BPI-deficient due to sustained neutropenia. To examine whether enhancing endotoxin-neutralizing and anti-infective activity by exogenous administration of a recombinant N-terminal fragment of BPI (rBPI 21, generic name opebacan) might ameliorate regimen-related toxicities including infection, we recruited patients scheduled to undergo myeloablative HCT to participate in a proof-of-concept prospective phase I/II trial. After the HCT preparative regimen was completed, opebacan was initiated 18-36 hours prior to administration of allogeneic hematopoietic stem cells (defined as Day 0) and continued for 72 hours. The trial was to have included escalation of rBPI 21 dose and duration but was stopped prematurely due to lack of further drug availability.  Therefore, to better understand the clinical course of opebacan-treated patients (n=6), we compared their outcomes with a comparable cohort meeting the same eligibility criteria and enrolled in a non-interventional myeloablative HCT observational study (n = 35).  Opebacan-treated participants had earlier platelet engraftment (p=0.005), mirroring beneficial effects

  7. Effects of hematopoietic growth factors following myeloablation in a primate model.

    PubMed

    O'Reilly, R J; Gillio, A; Gasparetto, C

    1990-01-01

    The complex effects of hematopoietic growth factors (granulocyte and granulocyte-macrophage colony-stimulating factors and interleukin 3 and interleukin 1 beta) following myeloablation in juvenile male cynomolgus monkeys was studied. Since the effects of a given cytokine in vivo do not necessarily reflect the in vitro situation, and since cytokines are frequently species specific, extrapolation from rodent models to man may be fraught with inaccuracies. A primate model, therefore, was developed which has provided useful preclinical information on hematopoietic responses, dose response relationships and toxicities associated with administration of recombinant hematopoietic growth factors. This information has direct application to human trials. PMID:1691247

  8. Tolerance Induction in Experimental Autoimmune Encephalomyelitis Using Non-myeloablative Hematopoietic Gene Therapy With Autoantigen

    PubMed Central

    Eixarch, Herena; Espejo, Carmen; Gómez, Alba; Mansilla, María José; Castillo, Mireia; Mildner, Alexander; Vidal, Francisco; Gimeno, Ramón; Prinz, Marco; Montalban, Xavier; Barquinero, Jordi

    2009-01-01

    Experimental autoimmune encephalomyelitis (EAE) constitutes a paradigm of antigen (Ag)-specific T cell driven autoimmune diseases. In this study, we transferred bone marrow cells (BMCs) expressing an autoantigen (autoAg), the peptide 40–55 of the myelin oligodendrocytic glycoprotein (MOG40–55), to induce preventive and therapeutic immune tolerance in a murine EAE model. Transfer of BMC expressing MOG40–55 (IiMOG-BMC) into partially myeloablated mice resulted in molecular chimerism and in robust protection from the experimental disease. In addition, in mice with established EAE, transfer of transduced BMC with or without partial myeloablation reduced the clinical and histopathological severity of the disease. In these experiments, improvement was observed even in the absence of engraftment of the transduced hematopoietic cells, probably rejected due to the previous immunization with the autoAg. Splenocytes from mice transplanted with IiMOG-BMC produced significantly higher amounts of interleukin (IL)-5 and IL-10 upon autoAg challenge than those of control animals, suggesting the participation of regulatory cells. Altogether, these results suggest that different tolerogenic mechanisms may be mediating the preventive and the therapeutic effects. In conclusion, this study demonstrates that a cell therapy using BMC expressing an autoAg can induce Ag-specific tolerance and ameliorate established EAE even in a nonmyeloablative setting. PMID:19277013

  9. Survival improvements in adolescents and young adults after myeloablative allogeneic transplantation for acute lymphoblastic leukemia.

    PubMed

    Wood, William A; Lee, Stephanie J; Brazauskas, Ruta; Wang, Zhiwei; Aljurf, Mahmoud D; Ballen, Karen K; Buchbinder, David K; Dehn, Jason; Freytes, Cesar O; Lazarus, Hillard M; Lemaistre, Charles F; Mehta, Paulette; Szwajcer, David; Joffe, Steven; Majhail, Navneet S

    2014-06-01

    Adolescents and young adults (AYAs, ages 15 to 40 years) with cancer have not experienced survival improvements to the same extent as younger and older patients. We compared changes in survival after myeloablative allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia (ALL) among children (n = 981), AYAs (n = 1218), and older adults (n = 469) who underwent transplantation over 3 time periods: 1990 to 1995, 1996 to 2001, and 2002 to 2007. Five-year survival varied inversely with age group. Survival improved over time in AYAs and paralleled that seen in children; however, overall survival did not change over time for older adults. Survival improvements were primarily related to lower rates of early treatment-related mortality in the most recent era. For all cohorts, relapse rates did not change over time. A subset of 222 AYAs between the ages of 15 and 25 at 46 pediatric or 49 adult centers were also analyzed to describe differences by center type. In this subgroup, there were differences in transplantation practices among pediatric and adult centers, although HCT outcomes did not differ by center type. Survival for AYAs undergoing myeloablative allogeneic HCT for ALL improved at a similar rate as survival for children. PMID:24607554

  10. The development of a myeloablative, reduced-toxicity, conditioning regimen for cord blood transplantation.

    PubMed

    Mehta, Rohtesh S; Di Stasi, Antonio; Andersson, Borje S; Nieto, Yago; Jones, Roy; de Lima, Marcos; Hosing, Chitra; Popat, Uday; Kebriaei, Partow; Oran, Betul; Alousi, Amin; Rezvani, Katayoun; Qazilbash, Muzaffar; Bashir, Qaiser; Bollard, Catherine; Cooper, Laurence; Worth, Laura; Tewari, Priti; McNiece, Ian; Willhelm, Kaci; Champlin, Richard; Shpall, Elizabeth J

    2014-02-01

    Cord blood transplantation is being used with increasing frequency for patients with high-risk hematologic malignancies. Myeloablative preparative regimens provide antitumor efficacy and facilitate engraftment but are associated with higher morbidity and nonrelapse mortality rates than nonablative regimens. We evaluated 3 sequential myeloablative regimens in the cord blood transplant setting. Regimen 1 (melphalan, fludarabine, and thiotepa) produced prompt engraftment and minimal engraftment failure but was associated with a high nonrelapse mortality rate. Regimen 2 (busulfan and fludarabine) was very well tolerated but was associated with a high rate of engraftment failure and relapse. Regimen 3 (busulfan, clofarabine, fludarabine, and low-dose total body irradiation given 9 days after the chemotherapy) was associated with a low rate of engraftment failure but was logistically difficult to administer. Finally, regimen 3 that included the total body irradiation given immediately after the chemotherapy was well tolerated, with prompt engraftment and tumor control. This latter regimen appears to be effective in preliminary studies and warrants further evaluation. PMID:24169268

  11. ALLOGENEIC TRANSPLANTS IN FOLLICULAR LYMPHOMA: HIGHER RISK OF DISEASE PROGRESSION AFTER REDUCED INTENSITY COMPARED TO MYELOABLATIVE CONDITIONING

    PubMed Central

    Hari, Parameswaran; Carreras, Jeanette; Zhang, Mei-Jie; Gale, Robert Peter; Bolwell, Brian J.; Bredeson, Christopher N.; Burns, Linda J.; Cairo, Mitchell S.; Freytes, César O.; Goldstein, Steven C.; Hale, Gregory A.; Inwards, David J.; LeMaistre, Charles F.; Maharaj, Dipnarine; Marks, David I.; Schouten, Harry C.; Slavin, Shimon; Vose, Julie M.; Lazarus, Hillard M.; van Besien, Koen

    2008-01-01

    Reduced intensity conditioning (RIC) regimens have been increasingly used for allogeneic hematopoietic stem cell transplantation (HSCT) in Follicular lymphoma (FL). We compared traditional myeloablative conditioning regimens to RIC in FL. Outcomes of HLA-identical sibling HSCT for follicular lymphoma in 208 recipients reported to the Center for International Blood and Marrow Transplant Research between 1997 and 2002 were studied. Conditioning regimens were categorized as myeloablative (N=120) or reduced-intensity (RIC; N=88). Use of RIC regimens increased from <10% of transplants in 1997 to >80% in 2002 signaling a major shift in practice. Patients receiving RIC were older and had a longer interval from diagnosis to transplant. These differences did not correlate with outcomes. Median follow-up of survivors was 50 mo (4–96 mo) after myeloablative conditioning versus 35 mo (4–82 mo) after RIC (p<0.001). At 3 years, overall survival (OS) for the myeloablative and RIC cohorts were 71 (63–79%) and 62 (51–72%; p=0.15) and progression free survival (PFS), 67 (58–75%) and 55 (44–65%; p=0.07) respectively. Lower Karnofsky performance score (KPS) and resistance to chemotherapy were associated with higher treatment related mortality (TRM), lower OS and PFS. On multivariate analysis, an increased risk of lymphoma progression after RIC was observed (RR=2.97, p=0.04) RIC has become the de facto standard in allogeneic HSCT for FL and appears to result in similar long term outcomes. Although disease free survival is similar compared to myeloablative conditioning, an increased risk of late disease progression after RIC is concerning. PMID:18215784

  12. Radiobiological Optimization of Combination Radiopharmaceutical Therapy Applied to Myeloablative Treatment of Non-Hodgkin’s Lymphoma

    PubMed Central

    Hobbs, Robert F; Wahl, Richard L; Frey, Eric C; Kasamon, Yvette; Song, Hong; Huang, Peng; Jones, Richard J; Sgouros, George

    2014-01-01

    Combination treatment is a hallmark of cancer therapy. Although the rationale for combination radiopharmaceutical therapy was described in the mid ‘90s, such treatment strategies have only been implemented clinically recently, and without a rigorous methodology for treatment optimization. Radiobiological and quantitative imaging-based dosimetry tools are now available that enable rational implementation of combined targeted radiopharmaceutical therapy. Optimal implementation should simultaneously account for radiobiological normal organ tolerance while optimizing the ratio of two different radiopharmaceuticals required to maximize tumor control. We have developed such a methodology and applied it to hypothetical myeloablative treatment of non-hodgkin’s lymphoma (NHL) patients using 131I-tositumomab and 90Y-ibritumomab tiuxetan. Methods The range of potential administered activities (AA) is limited by the normal organ maximum tolerated biologic effective doses (MTBEDs) arising from the combined radiopharmaceuticals. Dose limiting normal organs are expected to be the lungs for 131I-tositumomab and the liver for 90Y-ibritumomab tiuxetan in myeloablative NHL treatment regimens. By plotting the limiting normal organ constraints as a function of the AAs and calculating tumor biological effective dose (BED) along the normal organ MTBED limits, the optimal combination of activities is obtained. The model was tested using previously acquired patient normal organ and tumor kinetic data and MTBED values taken from the literature. Results The average AA values based solely on normal organ constraints was (19.0 ± 8.2) GBq with a range of 3.9 – 36.9 GBq for 131I-tositumomab, and (2.77 ± 1.64) GBq with a range of 0.42 – 7.54 GBq for 90Y-ibritumomab tiuxetan. Tumor BED optimization results were calculated and plotted as a function of AA for 5 different cases, established using patient normal organ kinetics for the two radiopharmaceuticals. Results included AA ranges

  13. Intravenous Busulfan-Based Myeloablative Conditioning Regimens Prior to Hematopoietic Cell Transplantation for Hematologic Malignancies.

    PubMed

    Pasquini, Marcelo C; Le-Rademacher, Jennifer; Zhu, Xiaochun; Artz, Andrew; DiPersio, John; Fernandez, Hugo F; Mineishi, Shin; Kamishohara, Masaru; Mehta, Jayesh; Nakamura, Yuki; Ratanatharathorn, Voravit; Sobecks, Ronald; Burkart, Jeanne; Bredeson, Christopher

    2016-08-01

    Busulfan (Bu)-containing regimens are commonly used in myeloablative conditioning regimens before allogeneic hematopoietic cell transplantation (HCT). Yet, there is considerable variability on how Bu is administered related to frequency (4 times a day [Q6] or daily [Q24]) and combinations with other chemotherapeutic agents (cyclophosphamide [Cy] or fludarabine [Flu]). We performed a prospective cohort study of recipients of Bu-based conditioning according to contemporary practices to compare different approaches (BuCy Q6, n = 495; BuFlu Q24, n = 331; BuCy Q24, n = 96; BuFlu Q6, n = 91) in patients with myeloid malignancies between 2009 and 2011. BuFlu Q24 recipients were more likely to be older and tended to have worse performance status and a higher comorbid burden. The cumulative incidences of hepatic veno-occlusive disease (P = .40), idiopathic pneumonia (P = .50), and seizures (P = .50) did not differ across groups. One-year HCT-related mortality ranged from 12% to 16% (P = .80), 3-year relapse incidence ranged from 32% to 36% (P = .80), and 3-year overall survival ranged from 51% to 58% (P = .20) across groups. This study demonstrates that HCT conditioning regimens using i.v. Bu Q6 or Q24 alone or in combination with Cy or Flu have similar outcomes in the myeloablative setting for treatment of myeloid malignancies. PMID:27154848

  14. The Myeloablative Drug Busulfan Converts Cysteine to Dehydroalanine and Lanthionine in Redoxins.

    PubMed

    Scian, Michele; Guttman, Miklos; Bouldin, Samantha D; Outten, Caryn E; Atkins, William M

    2016-08-23

    The myeloablative agent busulfan (1,4-butanediol dimethanesulfonate) is an old drug that is used routinely to eliminate cancerous bone marrow prior to hematopoietic stem cell transplant. The myeloablative activity and systemic toxicity of busulfan have been ascribed to its ability to cross-link DNA. In contrast, here we demonstrate that incubation of busulfan with the thiol redox proteins glutaredoxin or thioredoxin at pH 7.4 and 37 °C results in the formation of putative S-tetrahydrothiophenium adducts at their catalytic Cys residues, followed by β-elimination to yield dehydroalanine. Both proteins contain a second Cys, in their catalytic C-X-X-C motif, which reacts with the dehydroalanine, the initial Cys adduct with busulfan, or the S-tetrahydrothiophenium, to form novel intramolecular cross-links. The reactivity of the dehydroalanine (DHA) formed is further demonstrated by adduction with glutathione to yield a lanthionine and by a novel reaction with the reducing agent tris(2-carboxyethyl)phosphine (TCEP), which yields a phosphine adduct via Michael addition to the DHA. Formation of a second quaternary organophosphonium salt via nucleophilic substitution with TCEP on the initial busulfan-protein adduct or on the THT(+)-Redoxin species is also observed. These results reveal a rich potential for reactions of busulfan with proteins in vitro, and likely in vivo. It is striking that several of the chemically altered protein products retain none of the atoms of busulfan, in contrast to typical drug-protein adducts or traditional protein modification reagents. In particular, the ability of a clinically used drug to convert Cys to dehydrolanine in intact proteins, and its subsequent reaction with biological thiols, is unprecedented. PMID:27490699

  15. Perivascular, but not Parenchymal, Cerebral Engraftment of Donor Cells after Non-Myeloablative Bone Marrow Transplantation

    PubMed Central

    Yang, Yue; Jorstad, Nikolas L.; Shiao, Christine; Cherne, Makenzie K.; Khademi, Shawn B.; Montine, Kathleen S.; Montine, Thomas J.; Keene, C. Dirk

    2013-01-01

    Myeloablative (MyA) bone marrow transplantation (BMT) results in robust engraftment of BMT-derived cells in the central nervous system (CNS) and is neuroprotective in diverse experimental models of neurodegenerative diseases of brain and retina. However, MyA irradiation is associated with significant morbidity and mortality and does not represent a viable therapeutic option for the elderly. Non-myeloablative (NMyA) BMT is less toxic, but it is not known if the therapeutic efficacy observed with MyA BMT is preserved. As a first step to address this important gap in knowledge, we evaluated and compared engraftment characteristics of BMT-derived monocytes/microglia using several clinically relevant NMyA pretransplant conditioning regimens in C57BL/6 mice. These included chemotherapy (fludarabine and cyclophosphamide) with or without 2 Gy irradiation, and 5.5 Gy irradiation alone. Each regimen was followed by transplantation of whole bone marrow from green fluorescent protein-expressing wild type (wt) mice. While stable hematopoietic engraftment occurred, to varying degrees, in all NMyA regimens, only 5.5 Gy irradiation resulted in significant engraftment of BMT-derived cells in brain, where these cells were exclusively localized to perivascular, leptomeningeal, and related anatomic regions. Engraftment in retina under 5.5 Gy NMyA conditions was significantly reduced compared to MyA, but robust engraftment was identified in optic nerve. Advancing the therapeutic applications of BMT to neurodegenerative diseases will require identification of the barrier mechanisms MyA, but not NMyA, is able to overcome. PMID:23567123

  16. Nephrotic syndrome: an under-recognised immune-mediated complication of non-myeloablative allogeneic haematopoietic cell transplantation.

    PubMed

    Srinivasan, R; Balow, J E; Sabnis, S; Lundqvist, A; Igarashi, T; Takahashi, Y; Austin, H; Tisdale, J; Barrett, J; Geller, N; Childs, R

    2005-10-01

    Nephrotic syndrome (NS) is an extremely rare complication of myeloablative allogeneic haematopoietic cell transplantation (HCT) that usually occurs in association with chronic graft-versus-host disease (C-GVHD). We observed an unexpectedly high incidence of NS in a cohort of 163 consecutive patients undergoing non-myeloablative HCT from a related human leucocyte antigen-compatible donor. Seven patients developed NS at a median 318 d post-transplant (range 119-1203 d; cumulative incidence 6.1%). The median age at onset of NS was 46 years (range 33-59 years); three of the seven patients had no evidence of C-GVHD while four had accompanying limited C-GVHD. At diagnosis, median proteinuria was 16.5 g/24 h (range 3-24 g/24 h). Renal biopsy was performed in four cases and revealed membranous nephropathy. NS was not always associated with other symptoms of C-GVHD, and in contrast to previous reports, usually did not improve with the re-initiation of aggressive immunosuppression, resulting in progressive renal failure necessitating dialysis in three of seven cases. Membranous nephropathy resulting in NS is a previously unrecognised and clinically significant complication of non-myeloablative HCT. PMID:16173966

  17. Successful Treatment of Extra-Renal Noncerebral Rhabdoid Tumors with VIDE.

    PubMed

    Yasui, Naoko; Yoshida, Akihiko; Kobayashi, Eisuke; Nakatani, Fumihiko; Kawamoto, Hiroshi

    2016-02-01

    Extra-renal noncerebral rhabdoid tumors (ERRTs) are highly aggressive and often lethal. An optimal chemotherapy regimen for ERRT remains undetermined. We report on three pediatric patients successfully treated with vincristine, ifosfamide, doxorubicin, and etoposide (VIDE). Two of our patients who had metastatic or refractory disease have survived more than 2 years, one disease free without myeloablative megatherapy. The treatment with high-dose alkylator therapy is reported to have a beneficial effect on survival. A VIDE regimen containing high-dose ifosfamide is feasible and appears to prolong the survival of patients with ERRT. This regimen may be a promising option for ERRT treatment without myeloablative megatherapy. PMID:26469354

  18. Significance of Persistent Cytogenetic Abnormalities at Myeloablative Allogeneic Stem Cell Transplantation in First Complete Remission

    PubMed Central

    Oran, Betul; Popat, Uday; Rondon, Gabriella; Ravandi, Farhad; Garcia-Manero, Guillermo; Abruzzo, Lynn; Andersson, Borje S.; Bashir, Qaiser; Chen, Julianne; Kebriaei, Partow; Khouri, Issa F.; Koca, Ebru; Qazilbash, Muzaffar H.; Champlin, Richard; de Lima, Marcos

    2014-01-01

    Risk stratification is important to identify acute myeloid leukemia (AML) patients that might benefit from allogeneic hematopoietic stem cell transplantation (allo-HCT) in first complete remission (CR1). We retrospectively studied 150 AML patients with diagnostic cytogenetic abnormalities receiving myeloablative allo-HCT in CR1 to determine the prognostic impact of persistent cytogenetic abnormalities at allo-HCT. Three risk groups were identified: First group of patients with favorable/intermediate cytogenetics at diagnosis (n=49) and the second group with unfavorable cytogenetics at diagnosis but without the presence of persistent abnormal clone at allo-HCT (n=83) had similar 3-year leukemia free survival (LFS) of 58%-60% despite increased 3-year relapse incidence (RI) of 32.3% observed in the second risk group versus 16.8% in the first group. Third group of patients with unfavorable cytogenetics at diagnosis and persistence of that clone at allo-HCT (n=15) represented the worst prognostic group with 3-year RI of 57.5% and 3-year LFS of 29.2%. These data suggest that AML patients with unfavorable cytogenetics at diagnosis and persistence of abnormal clone at allo-HCT have high risk of relapse after allo-HCT. These patients should be considered for clinical trials designed to optimize conditioning regimens and/or to use preemptive strategies in the post-transplant setting to decrease the relapse incidence. PMID:22982533

  19. Transgene Expression Levels Determine the Immunogenicity of Transduced Hematopoietic Grafts in Partially Myeloablated Mice

    PubMed Central

    Eixarch, Herena; Gómez, Alba; Kádár, Elisabeth; George, Mónica; Martínez, Nuria; Espejo, Carmen; Pétriz, Jordi; Gimeno, Ramon; Barquinero, Jordi

    2009-01-01

    We investigated whether transgene expression levels influence the immunogenicity of transduced hematopoietic grafts upon transplantation into partially myeloablated mice. To this aim, bone marrow cells (BMCs) transduced with retroviral vectors driving green fluorescent protein (GFP) expression either at high (high-EGFP) or low levels (low-EGFP) were transplanted into congenic recipients conditioned with sublethal doses of total body irradiation (TBI) or busulfan. Virtually all recipients showed evidence of donor engraftment 4 weeks after transplantation. However, as opposed to recipients receiving low-EGFP transduced grafts, the risk of rejecting the EGFP+ cells by 30 days after transplantation was significantly higher in mice conditioned with busulfan and receiving high-EGFP transduced grafts. Anti-EGFP cellular immune responses were demonstrated in high-EGFP-treated mice conditioned with busulfan by interferon-γ (IFN-γ), enzyme-linked immunospot assay (ELISPOT), and cytotoxic T lymphocyte (CTL) assays, in contrast to that observed in mice transplanted with low-EGFP BMC. These results show for the first time that transgene expression levels can be critical for the immunogenicity of gene-modified hematopoietic grafts, especially in immunocompetent or in partially immunosuppressed recipients. These results have profound implications in vector choice and in the design of gene therapy (GT) protocols. PMID:19707185

  20. Comparison of donor chimerism following myeloablative and nonmyeloablative allogeneic hematopoietic SCT.

    PubMed

    Mickelson, D M; Sproat, L; Dean, R; Sobecks, R; Rybicki, L; Kalaycio, M; Pohlman, B; Sweetenham, J; Andresen, S; Bolwell, B; Copelan, E A

    2011-01-01

    Surveillance of hematopoietic chimerism following hematopoietic SCT (HSCT) with nonmyeloablative (NMA) preparative regimens is standard to assess the need for clinical intervention. Monitoring of donor chimerism following HSCT with myeloablative (MA) preparative regimens is, however, not considered useful because engraftment is thought to occur rapidly and consistently. This study compares the timing of donor hematopoietic cell engraftment in patients undergoing NMA conditioning with fludarabine and TBI with those receiving MA conditioning with BU- or TBI-based regimens. Achievement of ≥ 90% donor leukocyte chimerism occurred rapidly and consistently in all three groups and time to achievement of ≥ 90% donor T cells was similar among the three groups (P = 0.57). Achievement of ≥ 90% donor leukocyte chimerism was not associated with risk of acute or chronic GVHD, graft rejection, relapse or all cause mortality in multivariate analyses. Donor T-cell chimerism of ≥ 90% was significantly associated with development of extensive chronic GVHD. The value of routine surveillance of chimerism following any of the preparative regimens used in this study should be reevaluated. PMID:20305699

  1. Primary Graft Failure after Myeloablative Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies

    PubMed Central

    Olsson, Richard F.; Logan, Brent R.; Chaudhury, Sonali; Zhu, Xiaochun; Akpek, Görgün; Bolwell, Brian J.; Bredeson, Christopher N.; Dvorak, Christopher C.; Gupta, Vikas; Ho, Vincent T.; Lazarus, Hillard M.; Marks, David I.; Ringdén, Olle T.H.; Pasquini, Marcelo C.; Schriber, Jeffrey R.; Cooke, Kenneth R.

    2015-01-01

    Clinical outcomes after primary graft failure (PGF) remain poor. Here we present a large retrospective analysis (n=23,272) which investigates means to prevent PGF and early detection of patients at high risk. In patients with hematologic malignancies, who underwent their first myeloablative allogeneic hematopoietic cell transplantation, PGF was reported in 1,278 (5.5%), and there was a marked difference in PGFs using peripheral blood stem cell compared to bone marrow grafts (2.5 vs. 7.3%; P<0.001). A 4-fold increase of PGF was observed in myeloproliferative disorders compared to acute leukemia (P<0.001). Other risk factors for PGF included recipient age below 30, HLA-mismatch, male recipients of female donor grafts, ABO-incompatibility, busulfan/cyclophosphamide conditioning, and cryopreservation. In bone marrow transplants, total nucleated cell doses ≤2.4 × 108/kg were associated with PGF (OR 1.39; P<0.001). The use of tacrolimus-based immunosuppression and granulocyte colony-stimulating factor were associated with decreased PGF risk. These data, allow clinicians to do more informed choices with respect to graft source, donor selection, conditioning and immunosuppressive regimens to reduce the risk of PGF. Moreover, a novel risk score determined on day 21 post-transplant may provide the rationale for an early request for additional hematopoietic stem cells. PMID:25772027

  2. Effect of cord blood processing on transplantation outcomes after single myeloablative umbilical cord blood transplantation.

    PubMed

    Ballen, Karen K; Logan, Brent R; Laughlin, Mary J; He, Wensheng; Ambruso, Daniel R; Armitage, Susan E; Beddard, Rachel L; Bhatla, Deepika; Hwang, William Y K; Kiss, Joseph E; Koegler, Gesine; Kurtzberg, Joanne; Nagler, Arnon; Oh, David; Petz, Lawrence D; Price, Thomas H; Quinones, Ralph R; Ratanatharathorn, Voravit; Rizzo, J Douglas; Sazama, Kathleen; Scaradavou, Andromachi; Schuster, Michael W; Sender, Leonard S; Shpall, Elizabeth J; Spellman, Stephen R; Sutton, Millicent; Weitekamp, Lee Ann; Wingard, John R; Eapen, Mary

    2015-04-01

    Variations in cord blood manufacturing and administration are common, and the optimal practice is not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States and assessed transplantation outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies facilitated by these banks. UCB banking practices were separated into 3 mutually exclusive groups based on whether processing was automated or manual, units were plasma and red blood cell reduced, or buffy coat production method or plasma reduced. Compared with the automated processing system for units, the day 28 neutrophil recovery was significantly lower after transplantation of units that were manually processed and plasma reduced (red cell replete) (odds ratio, .19; P = .001) or plasma and red cell reduced (odds ratio, .54; P = .05). Day 100 survival did not differ by CBB. However, day 100 survival was better with units that were thawed with the dextran-albumin wash method compared with the "no wash" or "dilution only" techniques (odds ratio, 1.82; P = .04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery. PMID:25543094

  3. Effect of Cord Blood Processing on Transplant Outcomes after Single Myeloablative Umbilical Cord Blood Transplantation

    PubMed Central

    Ballen, Karen K.; Logan, Brent R.; Laughlin, Mary J.; He, Wensheng; Ambruso, Daniel R.; Armitage, Susan E.; Beddard, Rachel L.; Bhatla, Deepika; Hwang, William Y.K.; Kiss, Joseph E.; Koegler, Gesine; Kurtzberg, Joanne; Nagler, Arnon; Oh, David; Petz, Lawrence D.; Price, Thomas H.; Quinones, Ralph R.; Ratanatharathorn, Voravit; Rizzo, J. Douglas; Sazama, Kathleen; Scaradavou, Andromachi; Schuster, Michael W.; Sender, Leonard S.; Shpall, Elizabeth J.; Spellman, Stephen R.; Sutton, Millicent; Weitekamp, Lee Ann; Wingard, John R.; Eapen, Mary

    2015-01-01

    Variations in cord blood manufacturing and administration are common, and the optimal practice, not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States, and assessed transplant outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies, facilitated by these banks. UCB banking practices were separated into three mutually exclusive groups based on whether processing was automated or manual; units were plasma and red blood cell reduced or buffy coat production method or plasma reduced. Compared to the automated processing system for units, the day-28 neutrophil recovery was significantly lower after transplantation of units that were manually processed and plasma reduced (red cell replete) (odds ratio [OR] 0.19 p=0.001) or plasma and red cell reduced (OR 0.54, p=0.05). Day-100 survival did not differ by CBB. However, day-100 survival was better with units that were thawed with the dextran-albumin wash method compared to the “no wash” or “dilution only” techniques (OR 1.82, p=0.04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery. PMID:25543094

  4. Outcomes of transplantation using various hematopoietic cell sources in children with Hurler syndrome after myeloablative conditioning.

    PubMed

    Boelens, Jaap Jan; Aldenhoven, Mieke; Purtill, Duncan; Ruggeri, Annalisa; Defor, Todd; Wynn, Robert; Wraith, Ed; Cavazzana-Calvo, Marina; Rovelli, Attilio; Fischer, Alain; Tolar, Jakub; Prasad, Vinod K; Escolar, Maria; Gluckman, Eliane; O'Meara, Anne; Orchard, Paul J; Veys, Paul; Eapen, Mary; Kurtzberg, Joanne; Rocha, Vanderson

    2013-05-01

    We report transplantation outcomes of 258 children with Hurler syndrome (HS) after a myeloablative conditioning regimen from 1995 to 2007. Median age at transplant was 16.7 months and median follow-up was 57 months. The cumulative incidence of neutrophil recovery at day 60 was 91%, acute graft-versus-host disease (GVHD) (grade II-IV) at day 100 was 25%, and chronic GVHD and 5 years was 16%. Overall survival and event-free survival (EFS) at 5 years were 74% and 63%, respectively. EFS after HLA-matched sibling donor (MSD) and 6/6 matched unrelated cord blood (CB) donor were similar at 81%, 66% after 10/10 HLA-matched unrelated donor (UD), and 68% after 5/6 matched CB donor. EFS was lower after transplantation in 4/6 matched unrelated CB (UCB) (57%; P = .031) and HLA-mismatched UD (41%; P = .007). Full-donor chimerism (P = .039) and normal enzyme levels (P = .007) were higher after CB transplantation (92% and 98%, respectively) compared with the other grafts sources (69% and 59%, respectively). In conclusion, results of allogeneic transplantation for HS are encouraging, with similar EFS rates after MSD, 6/6 matched UCB, 5/6 UCB, and 10/10 matched UD. The use of mismatched UD and 4/6 matched UCB was associated with lower EFS. PMID:23493783

  5. Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

    PubMed

    Ruggeri, Annalisa; Labopin, Myriam; Sormani, Maria Pia; Sanz, Guillermo; Sanz, Jaime; Volt, Fernanda; Michel, Gerard; Locatelli, Franco; Diaz De Heredia, Cristina; O'Brien, Tracey; Arcese, William; Iori, Anna Paola; Querol, Sergi; Kogler, Gesine; Lecchi, Lucilla; Pouthier, Fabienne; Garnier, Federico; Navarrete, Cristina; Baudoux, Etienne; Fernandes, Juliana; Kenzey, Chantal; Eapen, Mary; Gluckman, Eliane; Rocha, Vanderson; Saccardi, Riccardo

    2014-09-01

    Umbilical cord blood transplant recipients are exposed to an increased risk of graft failure, a complication leading to a higher rate of transplant-related mortality. The decision and timing to offer a second transplant after graft failure is challenging. With the aim of addressing this issue, we analyzed engraftment kinetics and outcomes of 1268 patients (73% children) with acute leukemia (64% acute lymphoblastic leukemia, 36% acute myeloid leukemia) in remission who underwent single-unit umbilical cord blood transplantation after a myeloablative conditioning regimen. The median follow-up was 31 months. The overall survival rate at 3 years was 47%; the 100-day cumulative incidence of transplant-related mortality was 16%. Longer time to engraftment was associated with increased transplant-related mortality and shorter overall survival. The cumulative incidence of neutrophil engraftment at day 60 was 86%, while the median time to achieve engraftment was 24 days. Probability density analysis showed that the likelihood of engraftment after umbilical cord blood transplantation increased after day 10, peaked on day 21 and slowly decreased to 21% by day 31. Beyond day 31, the probability of engraftment dropped rapidly, and the residual probability of engrafting after day 42 was 5%. Graft failure was reported in 166 patients, and 66 of them received a second graft (allogeneic, n=45). Rescue actions, such as the search for another graft, should be considered starting after day 21. A diagnosis of graft failure can be established in patients who have not achieved neutrophil recovery by day 42. Moreover, subsequent transplants should not be postponed after day 42. PMID:24972767

  6. Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen

    PubMed Central

    Ruggeri, Annalisa; Labopin, Myriam; Sormani, Maria Pia; Sanz, Guillermo; Sanz, Jaime; Volt, Fernanda; Michel, Gerard; Locatelli, Franco; De Heredia, Cristina Diaz; O’Brien, Tracey; Arcese, William; Iori, Anna Paola; Querol, Sergi; Kogler, Gesine; Lecchi, Lucilla; Pouthier, Fabienne; Garnier, Federico; Navarrete, Cristina; Baudoux, Etienne; Fernandes, Juliana; Kenzey, Chantal; Eapen, Mary; Gluckman, Eliane; Rocha, Vanderson; Saccardi, Riccardo

    2014-01-01

    Umbilical cord blood transplant recipients are exposed to an increased risk of graft failure, a complication leading to a higher rate of transplant-related mortality. The decision and timing to offer a second transplant after graft failure is challenging. With the aim of addressing this issue, we analyzed engraftment kinetics and outcomes of 1268 patients (73% children) with acute leukemia (64% acute lymphoblastic leukemia, 36% acute myeloid leukemia) in remission who underwent single-unit umbilical cord blood transplantation after a myeloablative conditioning regimen. The median follow-up was 31 months. The overall survival rate at 3 years was 47%; the 100-day cumulative incidence of transplant-related mortality was 16%. Longer time to engraftment was associated with increased transplant-related mortality and shorter overall survival. The cumulative incidence of neutrophil engraftment at day 60 was 86%, while the median time to achieve engraftment was 24 days. Probability density analysis showed that the likelihood of engraftment after umbilical cord blood transplantation increased after day 10, peaked on day 21 and slowly decreased to 21% by day 31. Beyond day 31, the probability of engraftment dropped rapidly, and the residual probability of engrafting after day 42 was 5%. Graft failure was reported in 166 patients, and 66 of them received a second graft (allogeneic, n=45). Rescue actions, such as the search for another graft, should be considered starting after day 21. A diagnosis of graft failure can be established in patients who have not achieved neutrophil recovery by day 42. Moreover, subsequent transplants should not be postponed after day 42. PMID:24972767

  7. Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation

    PubMed Central

    Lee, Stephanie J.; Ahn, Kwang Woo; Spellman, Stephen; Wang, Hai-Lin; Aljurf, Mahmoud; Askar, Medhat; Dehn, Jason; Fernandez Viña, Marcelo; Gratwohl, Alois; Gupta, Vikas; Hanna, Rabi; Horowitz, Mary M.; Hurley, Carolyn K.; Inamoto, Yoshihiro; Kassim, Adetola A.; Nishihori, Taiga; Mueller, Carlheinz; Oudshoorn, Machteld; Petersdorf, Effie W.; Prasad, Vinod; Robinson, James; Saber, Wael; Schultz, Kirk R.; Shaw, Bronwen; Storek, Jan; Wood, William A.; Woolfrey, Ann E.; Anasetti, Claudio

    2014-01-01

    We examined current outcomes of unrelated donor allogeneic hematopoietic cell transplantation (HCT) to determine the clinical implications of donor-recipient HLA matching. Adult and pediatric patients who had first undergone myeloablative-unrelated bone marrow or peripheral blood HCT for acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome between 1999 and 2011 were included. All had high-resolution typing for HLA-A, -B, -C, and -DRB1. Of the total (n = 8003), cases were 8/8 (n = 5449), 7/8 (n = 2071), or 6/8 (n = 483) matched. HLA mismatch (6-7/8) conferred significantly increased risk for grades II to IV and III to IV acute graft vs host disease (GVHD), chronic GVHD, transplant-related mortality (TRM), and overall mortality compared with HLA-matched cases (8/8). Type (allele/antigen) and locus (HLA-A, -B, -C, and -DRB1) of mismatch were not associated with overall mortality. Among 8/8 matched cases, HLA-DPB1 and -DQB1 mismatch resulted in increased acute GVHD, and HLA-DPB1 mismatch had decreased relapse. Nonpermissive HLA-DPB1 allele mismatch was associated with higher TRM compared with permissive HLA-DPB1 mismatch or HLA-DPB1 match and increased overall mortality compared with permissive HLA-DPB1 mismatch in 8/8 (and 10/10) matched cases. Full matching at HLA-A, -B, -C, and -DRB1 is required for optimal unrelated donor HCT survival, and avoidance of nonpermissive HLA-DPB1 mismatches in otherwise HLA-matched pairs is indicated. PMID:25161269

  8. Extracorporeal Photopheresis for the Prevention of Acute GVHD in Patients Undergoing Standard Myeloablative Conditioning and Allogeneic Hematopoietic Stem Cell Transplantation

    PubMed Central

    Shaughnessy, Paul J; Bolwell, Brian J; van Besien, Koen; Mistrik, Martin; Grigg, Andrew; Dodds, Anthony; Prince, H Miles; Durrant, Simon; Ilhan, Osman; Parenti, Dennis; Rogers, Jon; Gallo, Jose; Foss, Francine; Apperley, Jane; Zhang, Mei-Jie; Horowitz, Mary M; Abhyankar, Sunil

    2012-01-01

    Summary Graft-versus-host disease (GVHD) is partly mediated by host antigen presenting cells (APCs) that activate donor T-cells. Extracorporeal photopheresis (ECP) can modulate APC function and benefit some patients with GVHD. We report the results of a study using ECP administered prior to a standard myeloablative preparative regimen intended to prevent GVHD. Grade II-IV aGVHD developed in 9 (30%) of 30 recipients of HLA-matched related transplants and 13 (42%) of 31 recipients of HLA-matched unrelated or HLA-mismatched related donor transplants. Actuarial estimates of overall survival (OS) at day 100 and 1 year post transplant were 89% (95% CI, 78%-94%) and 77% (95% CI, 64%-86%), respectively. There were no unexpected adverse effects of ECP. Historical controls receiving similar conditioning and GVHD prophylaxis regimens but no ECP were identified from the database of the Center for International Blood and Marrow Transplant Research and multivariate analysis indicated a lower risk of grade II-IV aGVHD in patients receiving ECP (p=0.04). Adjusted OS at one year was 83% in the ECP study group and 67% in the historical control group (relative risk 0.44, 95% CI, 0.24-0.80) (p= 0.007). These preliminary data may indicate a potential survival advantage with ECP for transplant recipients undergoing standard myeloablative hematopoietic cell transplantation. PMID:19915634

  9. In Vivo T Cell Depletion with Myeloablative Regimens on Outcomes after Cord Blood Transplantation for Acute Lymphoblastic Leukemia in Children.

    PubMed

    Ponce, Doris M; Eapen, Mary; Sparapani, Rodney; O'Brien, Tracey A; Chan, Ka Wah; Chen, Junfang; Craddock, John; Schultz, Kirk R; Wagner, John E; Perales, Miguel-Angel; Barker, Juliet N

    2015-12-01

    The inclusion of antithymocyte globulin (ATG) in cord blood transplantation is controversial. We evaluated outcomes according to ATG inclusion in 297 children and adolescents with acute lymphoblastic leukemia (ALL) who received myeloablative total body irradiation-based conditioning and either single-unit (74%) or double-unit (26%) grafts. Ninety-two patients (31%) received ATG and 205 (69%) did not. ATG recipients were more likely to be cytomegalovirus seronegative. The incidences of day 100 grades II to IV acute graft-versus-host disease (GVHD; 30% versus 54%, P = .0002) and chronic GVHD (22% versus 43%, P = .0008) were lower with ATG compared with non-ATG regimens. However, day 100 grades III to IV acute GVHD was comparable (11% versus 17%, P = .15). The 3-year incidences of transplant-related mortality (16% versus 17%, P = .98), relapse (17% versus 27%, P = .12), and leukemia-free survival (66% versus 55%, P = .23) in ATG and non-ATG recipients were similar. There were no differences in viral reactivation between treatment groups (60% versus 58%, P = .83). Therefore, the data suggest that incorporation of ATG with myeloablative conditioning regimens may be useful in reducing the risk of acute and chronic GVHD without any deleterious effect on transplant-related mortality, relapse, or leukemia-free survival in children and adolescents with ALL. PMID:26327630

  10. Clinical Comparison of Non-Myeloablative Conditioning with Anti-Thymocyte Globulin and Fludarabine for Patients with Hematologic Malignancies

    PubMed Central

    Li, Qingshan; Meng, Fanyi; Zhou, Ming; Yu, Bizhen; Mo, Wenjian; Du, Qinghua; Jiang, Xuejie; Wei, Yaming

    2015-01-01

    Background The influence of different non-myeloablative conditioning regimens on clinical outcome remains undefined. Material/Methods We retrospectively analyzed the hematopoietic reconstitution, graft-versus-host disease (GVHD), and quality of life (QOL) in 56 patients with hematologic malignancies who underwent non-myeloablative stem cell transplantation (NST) with a conditioning regimen based on anti-thymocyte globulin (ATG), followed by donor lymphocyte infusion (n=24), or Fludarabine (FLU) (n=32). Hematopoietic stem cells were derived from low-resolution HLA-matched identical sibling donors. Results The blood type transformation and platelet reconstitution presented significantly earlier in the FLU group than the ATG group (P<0.05). Within 100 days post-transplantation, the incidence of grade I–IV acute GVHD was significantly lower in the ATG group than the FLU group (P<0.05). After 100 days post-transplant, extensive chronic GVHD (cGVHD) was more prevalent in the ATG group than the FLU group (P<0.05). There were lower cumulative risk of relapse and higher non-relapse-related mortality in the ATG group, but better QOL in the FLU group within 24 months, and no difference in 3-year disease-free survival (DFS) or overall survival (OS) between the 2 groups (P>0.05). Conclusions The FLU-based conditioning regimen improved hematopoietic reconstitution and decreased extensive cGVHD, but there was no difference in 3-year DFS or OS between the 2 groups. PMID:26238068

  11. Successful second transplantation with non-myeloablative conditioning using haploidentical donors for young patients after graft failure following double umbilical cord cell transplantation.

    PubMed

    Liu, Huilan; Wang, Xingbing; Geng, Liangquan; Tang, Baolin; Tong, Juan; Yao, Wen; Wang, Zuyi; Sun, Zimin

    2010-06-01

    GF is a common and life-threatening complication of UCBT. Here, we report that successful second transplantation of five patients using G-CSF-mobilized maternal stem cells with non-myeloablative conditioning after GF following double UCBT. The median interval between the two transplants were 38 days. The first transplantation was administered after myeloablative conditioning for hematologic malignancies (n=3), and rabbit ATG in combination with cyclophosphamide for SAA (n=2). The second conditioning consisted of Flu and ATG-based non-myeloablative regimen. All five patients acquired quick and sustained engraftment after the second transplant. Treatment-related toxicity was minimal. Three patients developed acute GVHD (>grade II=1). Three patients developed chronic GVHD (limited=1, extensive=2). Severe infectious episodes were significant but manageable. With a median follow-up of 713 days (592-1127), all patients have currently had an event-free survival. These results indicate that a second transplant with non-myeloablative conditioning using mother as the donor for young patient after GF is feasible. PMID:19732379

  12. A paediatric case of successful non-myeloablative bone marrow transplantation after azacitidine therapy for non-Down syndrome acute megakaryoblastic leukaemia with monosomy 7.

    PubMed

    Koga, Yuhki; Oba, Utako; Kato, Wakako; Ono, Hiroaki; Nakashima, Kentaro; Takada, Hidetoshi

    2016-09-01

    We report a patient with non-Down syndrome AML, also known as AMKL, with monosomy 7, who was also obese and had a hearing impairment and mental retardation. Non-myeloablative bone marrow transplantation was performed successfully after the patient received less aggressive azacitidine treatment, without the usual intensive induction chemotherapy regimen for AML. PMID:27384975

  13. Non-myeloablative autologous haematopoietic stem cell transplantation expands regulatory cells and depletes IL-17 producing mucosal-associated invariant T cells in multiple sclerosis

    PubMed Central

    Abrahamsson, Sofia V.; Angelini, Daniela F.; Dubinsky, Amy N.; Morel, Esther; Oh, Unsong; Jones, Joanne L.; Carassiti, Daniele; Reynolds, Richard; Salvetti, Marco; Calabresi, Peter A.; Coles, Alasdair J.; Battistini, Luca; Martin, Roland; Burt, Richard K.

    2013-01-01

    Autologous haematopoietic stem cell transplantation has been tried as one experimental strategy for the treatment of patients with aggressive multiple sclerosis refractory to other immunotherapies. The procedure is aimed at ablating and repopulating the immune repertoire by sequentially mobilizing and harvesting haematopoietic stem cells, administering an immunosuppressive conditioning regimen, and re-infusing the autologous haematopoietic cell product. ‘Non-myeloablative’ conditioning regimens to achieve lymphocytic ablation without marrow suppression have been proposed to improve safety and tolerability. One trial with non-myeloablative autologous haematopoietic stem cell transplantation reported clinical improvement and inflammatory stabilization in treated patients with highly active multiple sclerosis. The aim of the present study was to understand the changes in the reconstituted immune repertoire bearing potential relevance to its mode of action. Peripheral blood was obtained from 12 patients with multiple sclerosis participating in the aforementioned trial and longitudinally followed for 2 years. We examined the phenotype and function of peripheral blood lymphocytes by cell surface or intracellular staining and multi-colour fluorescence activated cell sorting alone or in combination with proliferation assays. During immune reconstitution post-transplantation we observed significant though transient increases in the proportion of CD4+FoxP3+ T cells and CD56high natural killer cell subsets, which are cell subsets associated with immunoregulatory function. CD8+CD57+ cytotoxic T cells were persistently increased after therapy and were able to suppress CD4+ T cell proliferation with variable potency. In contrast, a CD161high proinflammatory CD8+ T cell subset was depleted at all time-points post-transplantation. Phenotypic characterization revealed that the CD161highCD8+ T cells were mucosal-associated invariant T cells, a novel cell population originating

  14. Peritransplant Serum Albumin Decline Predicts Subsequent Severe Acute Graft-versus-Host Disease after Mucotoxic Myeloablative Conditioning.

    PubMed

    Rashidi, Armin; DiPersio, John F; Westervelt, Peter; Abboud, Camille N; Schroeder, Mark A; Cashen, Amanda F; Pusic, Iskra; Romee, Rizwan

    2016-06-01

    Conditioning-related gut toxicity can result in a protein-losing enteropathy manifesting as a decline in serum albumin in the peritransplant period. Inspired by the pathogenesis of acute graft-versus-host disease (aGVHD), we hypothesized that the magnitude of decline in serum albumin from the day of conditioning initiation until its nadir in the first 2 weeks after hematopoietic cell transplantation HCT (DeltaAlb) predicts the risk for subsequent severe aGVHD. We reviewed the medical records of all 88 patients with acute myeloid leukemia or myelodysplastic syndrome who underwent highly mucotoxic myeloablative (busulfan/cyclophosphamide or cyclophosphamide/total body irradiation) allogeneic HCT from a matched related donor (MRD) or matched unrelated donor (MUD) at our institution between January 1, 2012 and January 1, 2015. Severe aGVHD was associated with MUD (47% versus 14% with MRD; P = .001) and DeltaAlb, which was significantly greater among patients who developed versus did not develop severe aGVHD (1.2 ± .5 versus .8 ± .4 g/dL, respectively; P < .001). In multivariate analysis DeltaAlb remained a significant predictor of severe aGVHD (odds ratio, 5.68; 95% CI, 1.65 to 19.64; P = .006; area under the ROC curve, .74; 95% CI, .63 to .86; P < .001). The best cutoff for DeltaAlb to predict severe aGVHD was .9, with a sensitivity, specificity, and overall classification accuracy of 77%, 66%, and 69%, respectively. The model was validated using the bootstrap technique, with no significant change in its performance. These results were not generalizable to a cohort of 30 patients who received less mucotoxic myeloablative or reduced-intensity conditioning. In conclusion, with mucotoxic myeloablative HCT, each .1-g/dL increase in DeltaAlb was associated with an approximately 23% increase in the odds of developing severe aGVHD. As an early biomarker of gut damage, DeltaAlb can be incorporated in composite risk models for aGVHD prediction, with hopes for

  15. Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

    SciTech Connect

    Mikell, John L.; Waller, Edmund K.; Switchenko, Jeffrey M.; Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael; Hall, William A.; Langston, Amelia A.; Esiashvili, Natia; Khoury, H. Jean; Khan, Mohammad K.

    2014-06-01

    Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

  16. Cytomegalovirus infections in allogeneic stem cell recipients after reduced-intensity or myeloablative conditioning assessed by quantitative PCR and pp65-antigenemia.

    PubMed

    Schetelig, J; Oswald, O; Steuer, N; Radonic, A; Thulke, S; Held, T K; Oertel, J; Nitsche, A; Siegert, W

    2003-10-01

    Since the incidence of cytomegalovirus (CMV) infections after hematopoietic stem cell transplantation (HSCT) may depend on the intensity of the pretreatment, we studied the incidence of CMV infections after reduced-intensity compared to myeloablative conditioning. A total of 82 patients with matched related or unrelated donors were prospectively monitored for CMV infections after HSCT by CMV-PCR techniques, CMV-antigenemia and clinical observation. A total of 45 patients received reduced-intensity conditioning consisting of fludarabine, busulfan and ATG and 37 patients received myeloablative conditioning. Leukocyte engraftment occurred after a median of 15 vs 18 days (P=0.012) and platelet engraftment after 12 days vs 20 days (P=0.001), respectively. Acute graft-versus-host disease (GVHD) grade II-IV was observed in 58 vs 54% patients (P=0.737), respectively. The onset and peak values of CMV-antigenemia and DNAemia and the incidence of CMV infections did not differ statistically significantly between the two treatment groups. Multivariate analysis confirmed CMV seropositivity of the recipient (P=0.035), acute GVHD II-IV (P=0.001) but not the type of conditioning as significant risk factors for CMV-antigenemia. In conclusion, the kinetics of CMV-antigenemia and DNAemia and the incidence of CMV infections were not statistically different in patients who received HSCT after reduced-intensity conditioning with fludarabine, busulfan and ATG compared to myeloablative conditioning. PMID:13130317

  17. Effect on lifespan of high yield non-myeloablating transplantation of bone marrow from young to old mice

    PubMed Central

    Kovina, Marina V.; Zuev, Viktor A.; Kagarlitskiy, German O.; Khodarovich, Yuriy M.

    2013-01-01

    Tissue renewal is a well-known phenomenon by which old and dying-off cells of various tissues of the body are replaced by progeny of local or circulating stem cells (SCs). An interesting question is whether donor SCs are capable to prolong the lifespan of an aging organism by tissue renewal. In this work, we investigated the possible use of bone marrow (BM) SC for lifespan extension. To this purpose, chimeric C57BL/6 mice were created by transplanting BM from young 1.5-month-old donors to 21.5-month-old recipients. Transplantation was carried out by means of a recently developed method which allowed to transplant without myeloablation up to 1.5 × 108 cells, that is, about 25% of the total BM cells of the mouse. As a result, the mean survival time, counting from the age of 21.5 months, the start of the experiment, was +3.6 and +5.0 (±0.1) months for the control and experimental groups, respectively, corresponding to a 39 ± 4% increase in the experimental group over the control. In earlier studies on BM transplantation, a considerably smaller quantity of donor cells (5 × 106) was used, about 1% of the total own BM cells. The recipients before transplantation were exposed to a lethal (for control animals) X-ray dose which eliminated the possibility of studying the lifespan extension by this method. PMID:23967009

  18. Pre-transplant MRD predicts outcome following reduced-intensity and myeloablative allogeneic hemopoietic SCT in AML.

    PubMed

    Anthias, C; Dignan, F L; Morilla, R; Morilla, A; Ethell, M E; Potter, M N; Shaw, B E

    2014-05-01

    The presence of minimal residual disease (MRD) by multiparametric flow cytometry (MFC) has been associated with adverse outcomes in AML patients treated with chemotherapy alone, but its impact in the setting of allogeneic hematopoietic SCT (HSCT) is less clear. We studied 88 patients who underwent myeloablative (MA) or reduced-intensity conditioned allogeneic HSCT for AML in first or subsequent remission at our center. MRD status was determined using three-color MFC on pre-HSCT BM aspirates, and patients were stratified by MRD status into MRD-negative, low-level MRD-positive (<1%) or high-level MRD-positive groups (1-4.9%). Two-year survival estimates in these groups were 66.8%, 51% and 30%, respectively (P=0.012), and 2-year estimates of relapse were 7.6, 37 and 70% (P<0.001). Pre-HSCT MRD was related to disease characteristics including secondary AML (P=0.002) and primary induction failure (P=0.005), but, despite these strong correlations, MRD remained independently associated with poorer survival in multivariate analysis (hazard ratio, 1.92; P=0.014). Pre-HSCT MRD is associated with adverse clinical outcomes in AML patients undergoing reduced-intensity or MA HSCT in first or subsequent remission and should be integrated into transplant strategies for patients with AML. PMID:24510069

  19. OBESITY DOES NOT PRECLUDE SAFE AND EFFECTIVE MYELOABLATIVE HEMATOPOIETIC CELL TRANSPLANTATION (HCT) FOR ACUTE MYELOID LEUKEMIA (AML) IN ADULTS

    PubMed Central

    Navarro, Willis H.; Agovi, Manza-A.; Logan, Brent R.; Ballen, Karen; Bolwell, Brian J.; Frangoul, Haydar; Gupta, Vikas; Hahn, Theresa; Ho, Vincent T.; Juckett, Mark; Lazarus, Hillard M.; Litzow, Mark R.; Liesveld, Jane L.; Moreb, Jan S.; Marks, David I.; McCarthy, Philip L.; Pasquini, Marcelo C.; Rizzo, J. Douglas

    2010-01-01

    The incidence of excessive adiposity is increasing worldwide and is associated with numerous adverse health outcomes. We compared outcomes by body mass index (BMI) for adult patients with acute myeloid leukemia (AML) who underwent autologous (auto, n=373), related donor (RD, n=2041), or unrelated donor (URD, n=1801) allogeneic myeloablative hematopoietic cell transplantation (HCT) using marrow or peripheral blood stem cells reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1995-2004. Four weight groups by BMI (kg/m2) were defined: underweight < 18; normal 18 – 25; overweight >25 – 30; and obese > 30. Multivariable analysis referenced to the normal weight group showed an increased risk of death for underweight patients in the RD group (RR, 1.92; 95% CI, 1.28-2.89; P = 0.002) but not in the URD group. There were no other differences in outcomes among the other weight groups within the other HCT groups. Overweight and obese patients enjoyed a modest decrease in relapse incidence, though this did not translate into a survival benefit. Small numbers of patients limit the ability to better characterize the adverse outcomes seen in the underweight RD but not the underweight URD allogeneic HCT patients. Obesity alone should not be considered a barrier to HCT. PMID:20412867

  20. Non-myeloablative conditioning is sufficient to induce mixed chimerism and subsequent acceptance of donor specific cardiac and skin grafts.

    PubMed

    Liu, Chi; Zhu, Ping; Saito, Taro; Isaka, Yoshitaka; Nagahara, Yukitoshi; Zhuang, Jian; Li, Xiao-Kang

    2013-07-01

    Organ transplant recipients have elevated cancer and viral infection risks due to immunosuppression and long-term results of organ transplantation remain unsatisfactory, mainly because of chronic rejection. The purpose of the current study is to establish a nonmyeloablative perioperative regimen, able to induce mixed chimerism and tolerance of allografts. To establish a nonmyeloablative perioperative regimen, we used Busulfan, an important component of many bone marrow transplantation preparative regimens for a variety of non-neoplastic diseases as an alternative to total body irradiation (TBI), and FTY720, a unique immunosuppression agent, inhibition lymphocyte homing. We found that creating a lymphohematopoietic chimera in which donor and recipient hematopoiesis coexist resulted in prolongation of the donor specific heart and skin allografts. Consistent with graft survival, pathological analysis indicated that the allografts from tolerant recipients were free of myocardial injury and had only a few interstitial infiltrates, and obliterative vasculopathy was not observed. Furthermore, we found that Treg cells were increased in the long-term graft acceptance recipients. Our data revealed that the therapeutic potential for using hematopoietic chimerism in non-myeloablated recipients hope the advances in rodent models described above in the development of minimal, nontoxic host conditioning regimens for mixed chimerism induction and subsequent acceptance of donor specific grafts. PMID:23428909

  1. The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplantation for Patients with Acute Leukemia.

    PubMed

    Holter-Chakrabarty, Jennifer L; Pierson, Namali; Zhang, Mei-Jie; Zhu, Xiaochun; Akpek, Görgün; Aljurf, Mahmoud D; Artz, Andrew S; Baron, Frédéric; Bredeson, Christopher N; Dvorak, Christopher C; Epstein, Robert B; Lazarus, Hillard M; Olsson, Richard F; Selby, George B; Williams, Kirsten M; Cooke, Kenneth R; Pasquini, Marcelo C; McCarthy, Philip L

    2015-07-01

    Limited clinical data are available to assess whether the sequencing of cyclophosphamide (Cy) and total body irradiation (TBI) changes outcomes. We evaluated the sequence in 1769 (CyTBI, n = 948; TBICy, n = 821) recipients of related or unrelated hematopoietic cell transplantation who received TBI (1200 to 1500 cGY) for acute leukemia from 2003 to 2010. The 2 cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Philadelphia chromosome-positive acute lymphoblastic leukemia, HLA-matched siblings, stem cell source, antithymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect transplantation-related mortality (24% versus 23% at 3 years, P = .67; relative risk, 1.01; P = .91), leukemia relapse (27% versus 29% at 3 years, P = .34; relative risk, .89, P = .18), leukemia-free survival (49% versus 48% at 3 years, P = .27; relative risk, .93; P = .29), chronic GVHD (45% versus 47% at 1 year, P = .39; relative risk, .9; P = .11), or overall survival (53% versus 52% at 3 years, P = .62; relative risk, .96; P = .57) for CyTBI and TBICy, respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (P = .08), respectively. This study demonstrates that the sequence of Cy and TBI does not impact transplantation outcomes and complications in patients with acute leukemia undergoing hematopoietic cell transplantation with myeloablative conditioning. PMID:25840335

  2. Single-agent GVHD prophylaxis with posttransplantation cyclophosphamide after myeloablative, HLA-matched BMT for AML, ALL, and MDS

    PubMed Central

    Kanakry, Christopher G.; Tsai, Hua-Ling; Bolaños-Meade, Javier; Smith, B. Douglas; Gojo, Ivana; Kanakry, Jennifer A.; Kasamon, Yvette L.; Gladstone, Douglas E.; Matsui, William; Borrello, Ivan; Huff, Carol Ann; Swinnen, Lode J.; Powell, Jonathan D.; Pratz, Keith W.; DeZern, Amy E.; Showel, Margaret M.; McDevitt, Michael A.; Brodsky, Robert A.; Levis, Mark J.; Ambinder, Richard F.; Fuchs, Ephraim J.; Rosner, Gary L.; Jones, Richard J.

    2014-01-01

    High-dose, posttransplantation cyclophosphamide (PTCy) reduces severe graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT), but the impact of PTCy on long-term, disease-specific outcomes is unclear. We conducted a retrospective study of 209 consecutive adult patients transplanted for acute myeloid leukemia (AML, n = 138), myelodysplastic syndrome (n = 28), or acute lymphoblastic leukemia (ALL, n = 43) using PTCy as sole GVHD prophylaxis after myeloablative conditioning and HLA-matched–related or –unrelated T-cell–replete allografting. At alloBMT, 30% of patients were not in morphologic complete remission. The cumulative incidences of grades II to IV and III to IV acute GVHD at 100 days and chronic GVHD at 2 years were 45%, 11%, and 13%, respectively. Forty-three percent of patients did not require immunosuppression for any reason beyond PTCy. At 3 years, relapse cumulative incidence was 36%, disease-free survival was 46%, survival free of disease and chronic GVHD was 39%, and overall survival was 58%. Lack of remission at alloBMT, adverse cytogenetics, and low allograft nucleated cell dose were associated with inferior survival for AML patients. Minimal residual disease but not t(9;22) was associated with inferior outcomes for ALL patients. The ability to limit posttransplantation immunosuppression makes PTCy a promising transplantation platform for the integration of postgrafting strategies to prevent relapse. PMID:25316679

  3. Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy.

    PubMed

    Sato, Atsushi; Saisho-Hattori, Takako; Koizumi, Yoshitsugu; Minegishi, Masayoshi; Iinuma, Kazuie; Imaizumi, Masue

    2006-12-01

    Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n = 12) or single prophylaxis (n = 5), or left untreated (n = 7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature > 38 degrees C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy. PMID:17146197

  4. Reduced toxicity, myeloablative conditioning with BU, fludarabine, alemtuzumab and SCT from sibling donors in children with sickle cell disease.

    PubMed

    Bhatia, M; Jin, Z; Baker, C; Geyer, M B; Radhakrishnan, K; Morris, E; Satwani, P; George, D; Garvin, J; Del Toro, G; Zuckerman, W; Lee, M T; Licursi, M; Hawks, R; Smilow, E; Baxter-Lowe, L A; Schwartz, J; Cairo, M S

    2014-07-01

    BU and CY (BU/CY; 200 mg/kg) before HLA-matched sibling allo-SCT in children with sickle cell disease (SCD) is associated with ~85% EFS but is limited by the acute and late effects of BU/CY myeloablative conditioning. Alternatives include reduced toxicity but more immunosuppressive conditioning. We investigated in a prospective single institutional study, the safety and efficacy of a reduced-toxicity conditioning (RTC) regimen of BU 12.8-16 mg/kg, fludarabine 180 mg/m(2), alemtuzumab 54 mg/m(2) (BFA) before HLA-matched sibling donor transplantation in pediatric recipients with symptomatic SCD. Eighteen patients, median age 8.9 years (2.3-20.2), M/F 15/3, 15 sibling BM and 3 sibling cord blood (CB) were transplanted. Mean whole blood and erythroid donor chimerism was 91% and 88%, at days +100 and +365, respectively. Probability of grade II-IV acute GVHD was 17%. Two-year EFS and OS were both 100%. Neurological, pulmonary and cardiovascular function were stable or improved at 2 years. BFA RTC and HLA-matched sibling BM and CB allo-SCT in pediatric recipients result in excellent EFS, long-term donor chimerism, low incidence of GVHD and stable/improved organ function. PMID:24797180

  5. Recovery of ovarian function and pregnancy in a patient with AML after myeloablative busulphan-based conditioning regimen.

    PubMed

    Balashov, Dmitry N; Papusha, Ludmila I; Nazarenko, Tatiana A; Trakhtman, Pavel E; Revishvili, Nino A; Maschan, Alexei A; Persiantseva, Marina I; Andriutsa, Anna V; Skorobogatova, Elena V; Skvortsova, Yulia V; Rumiantsev, Alexander G

    2011-05-01

    We report a rare case of ovarian function recovery and pregnancy after hormone-replacement therapy (HRT) in the acute myeloblastic leukemia (AML) patient in third complete remission received hematopoietic stem cell transplantation (HSCT) with busulphan-based conditioning regimen. Successful engraftment of the donor cells and full donor's chimerism was achieved without the signs of leukemia. One year after HSCT the patient received a course of HRT as a treatment of hypergonadotropic hypogonadism. After 12 months of HRT the recovery of ovarian function was confirmed. Eight years after the HSCT spontaneous pregnancy occurred; heartbeat of the fetus was registered on week 7. Three weeks later a nonsevere vaginal bleeding occurred and the ultrasound examination showed a nondeveloping pregnancy. Genetic examination of the abortion material showed a full triploid genotype (69 XXX). To our knowledge this is a first case of ovarian function restoration and spontaneous pregnancy in a AML patient after multiple courses of high-dose chemotherapy and busulphan-based myeloablative conditioning for HSCT. PMID:21423042

  6. Late Effects after Umbilical Cord Blood Transplantation in Very Young Children after Busulfan-Based, Myeloablative Conditioning.

    PubMed

    Allewelt, Heather; El-Khorazaty, Jill; Mendizabal, Adam; Taskindoust, Mahsa; Martin, Paul L; Prasad, Vinod; Page, Kristin; Sanders, Jean; Kurtzberg, Joanne

    2016-09-01

    Infants and young children who undergo allogeneic cord blood transplantation (CBT) are at increased risk for late effects because of exposure of developing organs to chemotherapy and radiation therapy typically used in transplant conditioning regimens. Busulfan (Bu)-based myeloablative regimens were developed to eliminate radiation exposure in these young children with the hope that late effects would be minimized. We now describe the late effects in 102 consecutive patients surviving a minimum of 5 years (median follow-up, 12.9 years) post-CBT. Patients were conditioned with high-dose chemotherapy using Bu-containing regimens. No patient received total body irradiation. The median age at transplant was 1 year (range, .1 to 2). Diagnoses included inherited metabolic diseases (59.8%), leukemia (17.6%), congenital immune deficiency (20.2%), bone marrow failure/myelodysplastic syndrome (3.9%), and hemoglobinopathy (2%). Among patients surviving 5 years, the overall survival rate at 10 years post-CBT was 93% (95% CI, 84.9 to 96.8). Virtually all patients (98%) experienced at least 1 significant late effect. Most (83.3%) experienced 2 or more late effects, and more than half of the patients (64.7%) experienced 3 or more late effects. The most commonly observed late effects included dental problems (92.2%), short stature (55.9%), cognitive deficits (53.6%), pulmonary dysfunction (18.6%), and abnormal pubertal development (27.9%). This is the first report of late effects of Bu-based conditioning in a cohort of very young patients at the time of transplant. These results will inform clinical care guidelines for long-term follow-up and add to the growing information regarding outcomes of hematopoietic stem cell transplantation. PMID:27264632

  7. 131I-tositumomab myeloablative radioimmunotherapy for non-Hodgkin’s lymphoma: radiation dose to the testes

    SciTech Connect

    Hattori, Naoya; Gopal, Ajay K.; Shields, Andrew T.; Fisher, Darrell R.; Gooley, Ted; Pagel, John M.; Press, Oliver W.; Rajendran, Joseph G.

    2012-12-01

    Purpose: To investigate radiation doses to the testes delivered by a radiolabeled anti-CD20 antibody and its effects on male sex hormone levels. Materials and methods: Testicular uptake and retention of 131I-tositumomab were measured, and testicular absorbed doses were calculated for 67 male patients (54+/-11 years of age) with non-Hodgkin's lymphoma who had undergone myeloablative radioimmunotherapy (RIT) using 131I-tositumomab. Time-activity curves for the major organs, testes, and whole body were generated from planar imaging studies. In a subset of patients, male sex hormones were measured before and 1 year after the therapy. Results: The absorbed dose to the testes showed considerable variability (range=4.4-70.2 Gy). Pretherapy levels of total testosterone were below the lower limit of the reference range, and post-therapy evaluation demonstrated further reduction [4.6+/-1.8 nmol/l (pre-RIT) vs. 3.8+/-2.9 nmol/l (post-RIT), P<0.05]. Patients receiving higher radiation doses to the testes (>=25 Gy) showed a greater reduction [4.7+/-1.6 nmol/l (pre-RIT) vs. 3.3+/-2.7 nmol/l (post-RIT), P<0.05] compared with patients receiving lower doses (<25 Gy), who showed no significant change in total testosterone levels. Conclusion: The testicular radiation absorbed dose varied highly among individual patients. Finally, patients receiving higher doses to the testes were more likely to show post-RIT suppression of testosterone levels.

  8. The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplant for Patients with Acute Leukemia

    PubMed Central

    Holter-Chakrabarty, Jennifer L.; Pierson, Namali; Zhang, Mei-Jie; Zhu, Xiaochun; Akpek, Görgün; Aljurf, Mahmoud D.; Artz, Andrew S.; Baron, Frédéric; Bredeson, Christopher N.; Dvorak, Christopher C.; Epstein, Robert B.; Lazarus, Hillard M.; Olsson, Richard F.; Selby, George B.; Williams, Kirsten M.; Cooke, Kenneth R.; Pasquini, Marcelo C.; McCarthy, Philip L.

    2015-01-01

    Limited clinical data are available to assess whether the sequencing of cyclophosphamide (Cy) and total body irradiation (TBI) changes outcomes. We evaluated the sequence in 1769 (CyTBI N=948, TBICy N=821) recipients of related or unrelated hematopoietic cell transplantation (HCT) who received TBI (1200-1500cGY) for acute leukemia from 2003 to 2010. The two cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Ph+ ALL, HLA matched siblings, stem cell source, anti-thymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect TRM (24% vs. 23% at 3y, p=0.67; relative risk [RR] 1.01, p=0.91), leukemia relapse (27% vs. 29% at 3y, p=0.34; RR 0.89, p=0.18), leukemia-free survival (49% vs. 48% at3y, p=0.27; RR 0.93, p=0.29), chronic GVHD (45% vs. 47% at 1y, p=0.39; RR 0.9, p=0.11) or overall survival (53% vs. 52% at 3y, p=0.62; RR 0.96, p=0.57) for CyTBI and TBICy respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (p=0.08). This study demonstrates that the sequence of Cy and TBI does not impact transplant outcomes and complications in patients with acute leukemia undergoing HCT with myeloablative conditioning. PMID:25840335

  9. Cardiopulmonary exercise testing prior to myeloablative allo-SCT: a feasibility study

    PubMed Central

    Kelsey, CR; Scott, JM; Lane, A; Schwitzer, E; West, MJ; Thomas, S; Herndon, JE; Michalski, MG; Horwitz, ME; Hennig, T; Jones, LW

    2015-01-01

    The feasibility of symptom-limited cardiopulmonary exercise testing (CPET) prior to allo-SCT was assessed in addition to the prognostic value of CPET-derived measures. CPET was performed prospectively on 21 patients with hematologic malignancies, with assessments of peak (for example, peak oxygen consumption, VO2peak) and submaximal (for example, ventilatory threshold (VT)) measures of cardiopulmonary function. No serious adverse events were observed during CPET procedures, with 95% of patients achieving criteria for a peak test. Mean VO2peak was 24.7±6.4 mL kg−1min−1 (range: 10.9–35.5), equivalent to 29%±17% below that of age-matched healthy controls. All patients proceeded with the conditioning regimen followed by allo-SCT. Median follow-up was 25 months. During this period, 11 (52.4%) patients died (n = 6, relapsed disease; n = 5, non-relapse mortality (NRM)); 9 patients (43%) developed pulmonary toxicity. In univariate analyses, both peak and submaximal markers of cardiopulmonary function were predictors of OS, pulmonary toxicity and NRM. For OS, the HR for VO2peak and VT were 0.89 (95% CI, 0.8–0.99, P = 0.04) and 0.84 (95% CI, 0.71–0.98, P = 0.03), respectively. In conclusion, CPET is safe and feasible prior to allo-SCT. Patients have marked impairments in cardiopulmonary function prior to allo-SCT. CPET-derived metrics may complement conventional measures to improve risk stratification. PMID:25068429

  10. Outcomes of HLA Matched Sibling Donor Hematopoietic Cell Transplantation in Chronic Lymphocytic Leukemia: Myeloablative vs. Reduced-Intensity Conditioning Regimens

    PubMed Central

    Sobecks, Ronald M.; Leis, Jose F.; Gale, Robert Peter; Ahn, Kwang Woo; Zhu, Xiaochun; Sabloff, Mitchell; de Lima, Marcos; Brown, Jennifer R.; Inamoto, Yoshihiro; Hale, Gregory A.; Aljurf, Mahmoud D.; Kamble, Rammurti T.; Hsu, Jack W.; Pavletic, Steven Z.; Wirk, Baldeep; Seftel, Matthew D.; Lewis, Ian D.; Alyea, Edwin P.; Cortes, Jorge; Kalaycio, Matt E.; Maziarz, Richard T.; Saber, Wael

    2014-01-01

    Purpose Allogeneic hematopoietic cell transplantation (HCT) can cure some chronic lymphocytic leukemia (CLL) subjects. This study compared outcomes of myeloablative (MA) and reduced-intensity conditioning (RIC) transplants from HLA-matched sibling donors (MSD) for CLL. Patients and Methods From 1995–2007 there were 297 CLL subjects reported to the CIBMTR who received MA (N=163) and RIC (N=134) MSD HCT. The MA subjects were less often transplanted after 2000 and less commonly received anti-thymocyte globulin (4% vs. 13%, p=0.004) or prior antibody therapy (14% vs. 53%; p<0.001). Results RIC was associated with a greater likelihood of platelet recovery and less grade 2–4 acute GvHD compared to MA conditioning. 1 and 5-year treatment related mortality (TRM) were 24% (95% confidence intervals (CI), 16–33%) vs. 37% (95% CI, 30–45%; p=0.023), and 40% (95% CI, 29–51%) vs. 54% (95% CI, 46–62%; p=0.036), and the relapse/progression rates were 21% (95% CI, 14–29%) vs. 10% (95% CI, 6–15%; p=0.020), and 35% (95% CI, 26–46%) vs. 17% (95% CI, 12–24%; p=0.003). MA conditioning was associated with better progression-free (PFS) (relative risk (RR) 0.60; 95% CI, 0.37–0.97, p=0.038) and 3-year survival in transplants before 2001, but for subsequent years RIC was associated with better PFS and survival (RR 1.49 (95% CI, 0.92–2.42), p=0.10; and RR 1.86 (95% CI, 1.11–3.13), p=0.019). Pre-transplant disease status was the most important predictor of relapse (p=0.003) and PFS (p=0.0007) for both forms of transplant conditioning. Conclusion MA and RIC MSD transplants are effective for CLL. Future strategies to decrease TRM and reduce relapses are warranted. PMID:24880021

  11. Impact of Pre-Transplant Anti-T Cell Globulin (ATG) on Immune Recovery after Myeloablative Allogeneic Peripheral Blood Stem Cell Transplantation

    PubMed Central

    Servais, Sophie; Menten-Dedoyart, Catherine; Beguin, Yves; Seidel, Laurence; Gothot, André; Daulne, Coline; Willems, Evelyne; Delens, Loïc; Humblet-Baron, Stéphanie; Hannon, Muriel; Baron, Frédéric

    2015-01-01

    Background Pre-transplant infusion of rabbit anti-T cell globulin (ATG) is increasingly used as prevention of graft-versus-host disease (GVHD) after allogeneic peripheral blood stem cell transplantation (PBSCT). However, the precise impact of pre-transplant ATG on immune recovery after PBSCT is still poorly documented. Methods In the current study, we compared immune recovery after myeloablative PBSCT in 65 patients who either received (n = 37) or did not (n = 28) pre-transplant ATG-Fresenius (ATG-F). Detailed phenotypes of circulating T, B, natural killer (NK) and invariant NKT (iNKT) cells were analyzed by multicolor flow cytometry at serial time-points from day 40 to day 365 after transplantation. Thymic function was also assessed by sjTREC quantification. Serious infectious events were collected up to 2 years post-transplantation. Results Pre-transplant ATG-F had a prolonged (for at least up to 1-year) and selective negative impact on the T-cell pool, while it did not impair the recovery of B, NK nor iNKT cells. Among T cells, ATG-F selectively compromised the recovery of naïve CD4+, central memory CD4+ and naïve CD8+ cells, while it spared effector memory T and regulatory T cells. Levels of sjTRECs were similar in both cohorts at 1-year after PBSCT, suggesting that ATG-F unlikely impaired thymopoiesis at long-term after PBSCT. Finally, the incidence and rate of serious infections were similar in both groups, while ATG-F patients had a lower incidence of grade II-IV acute graft-versus-host disease. Conclusions Pre-transplant ATG-F induces long-lasting modulation of the circulating T-cell pool after myeloablative PBSCT, that may participate in preventing graft-versus-host disease without deeply compromising anti-pathogen defenses. PMID:26098781

  12. A Phase IIb, Multicenter, Open-Label, Safety, and Efficacy Study of High-Dose, Propylene Glycol-Free Melphalan Hydrochloride for Injection (EVOMELA) for Myeloablative Conditioning in Multiple Myeloma Patients Undergoing Autologous Transplantation.

    PubMed

    Hari, Parameswaran; Aljitawi, Omar S; Arce-Lara, Carlos; Nath, Rajneesh; Callander, Natalie; Bhat, Gajanan; Allen, Lee F; Stockerl-Goldstein, Keith

    2015-12-01

    Autologous stem cell transplantation (ASCT) after high-dose melphalan conditioning is considered a standard of care procedure for patients with multiple myeloma (MM). Current formulations of melphalan (eg, Alkeran for Injection [melphalan hydrochloride]; GlaxoSmithKline, Research Triangle Park, NC, USA) have marginal solubility and limited chemical stability upon reconstitution. Alkeran requires the use of propylene glycol as a co-solvent, which itself has been reported to cause such complications as metabolic/renal dysfunction and arrhythmias. EVOMELA (propylene glycol-free melphalan HCl; Spectrum Pharmaceuticals, Inc., Irvine, CA, USA) is a new i.v. melphalan formulation that incorporates Captisol (Ligand Pharmaceuticals, Inc., La Jolla, CA, USA), a specially modified cyclodextrin that improves the solubility and stability of melphalan and eliminates the need for propylene glycol. This new formulation has been shown to be bioequivalent to Alkeran. EVOMELA (200 mg/m(2)) was administered as 2 doses of 100 mg/m(2) each in a phase IIb, open-label, multicenter study to confirm its safety and efficacy as a high-dose conditioning regimen for patients with MM undergoing ASCT. At 5 centers, 61 patients (26 women) with a median age of 62 years (range, 32-73) were enrolled. All patients achieved myeloablation with a median time of 5 days post-ASCT, and all successfully achieved neutrophil and platelet engraftment with median times of 12 days post-ASCT and 13 days post-ASCT, respectively; treatment-related mortality on day 100 was 0%. Overall response rate (according to independent, blinded review) was high (100%), with an overall complete response rate of 21% (13% stringent complete response; 8% complete response) and overall partial response rate of 79% (61% very good partial response; 18% partial response). The incidence of grade 3 mucositis and stomatitis was low (10% and 5%, respectively) with no grade 4 mucositis or stomatitis reported (graded according to National

  13. Comparison of Radiation Dose Estimation for Myeloablative Radioimmunotherapy for Relapsed or Recurrent Mantle Cell Lymphoma using 131I Tositumomab to that of Other Types of Non-Hodgkin's Lymphoma

    SciTech Connect

    Rajendran, Joseph G.; Gopal, Ajay K.; Durack, Larry; Fisher, Darrell R.; Press, Oliver W.; Eary, Janet F.

    2004-12-01

    Patients with relapsed or refractory mantle cell lymphoma (MCL) demonstrate poor survival after standard treatment. Myeloablative radioimmunotherapy (RIT) using 131I tositumomab (anti-CD20) has the ability to deliver specific radiation absorbed dose to antigen bearing tumor. We reviewed normal organ radiation absorbed doses in MCL patients. METHODS: Records of patients with MCL (n = 25), who received myeloablative RIT between January 1996 and December 2003 were reviewed. Individual patient radiation dosimetry was performed on all patients after a trace labeled infusion of 131I tositumomab (mean = 348 MBq), to calculate the required amount of radioactivity for therapy, based on MIRD schema. RESULTS: Mean organ residence times (hr) corrected for CT derived organ volumes for MCL, were as follows: Lungs:9.0; Liver:12.4; Kidneys:1.7; Spleen:2.17; Whole Body:62.4 and mean radiation absorbed doses mGy/Mbq were: Lungs:1.2; Liver:1.1; Kidneys:0.85; Spleen:1.7; Whole Body: 0.21. This is similar to patients with other NHL. Patients received a mean activity of 21 GBq of 131I (range = 11.5 - 41.4) for therapy estimated to deliver 25 Gy to the normal organ receiving the highest radiation absorbed dose. CONCLUSION: Myeloablative RIT using 131I tositumomab results in normal organ radiation absorbed doses similar to those in patients with other non-Hodgkin's lymphoma, and is suitable for treating patients with relapsed or refractory MCL.

  14. Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of the Gruppo Italiano Trapianto di Midollo Osseo nurses group.

    PubMed

    Gori, E; Arpinati, M; Bonifazi, F; Errico, A; Mega, A; Alberani, F; Sabbi, V; Costazza, G; Leanza, S; Borrelli, C; Berni, M; Feraut, C; Polato, E; Altieri, M C; Pirola, E; Loddo, M C; Banfi, M; Barzetti, L; Calza, S; Brignoli, C; Bandini, G; De Vivo, A; Bosi, A; Baccarani, M

    2007-03-01

    Severe oral mucositis is a major cause of morbidity following allogeneic hematopoietic stem cell transplantation (AHSCT). Cryotherapy, that is, the application of ice chips on the mucosa of the oral cavity during the administration of antineoplastic agents, may reduce the incidence and severity of chemotherapy-related oral mucositis. In this multicenter randomized study, we addressed whether cryotherapy during MTX administration is effective in the prevention of severe oral mucositis in patients undergoing myeloablative AHSCT. One hundred and thirty patients undergoing myeloablative AHSCT and MTX-containing GVHD prophylaxis were enrolled and randomized to receive or not receive cryotherapy during MTX administration. The incidence of severe (grade 3-4) oral mucositis, the primary end point of the study, was comparable in patients receiving or not cryotherapy. Moreover, no difference was observed in the incidence of oral mucositis grade 2-4 and the duration of oral mucositis grade 3-4 or 2-4, or in the kinetics of mucositis over time. In univariate and multivariate analysis, severe oral mucositis correlated with TBI in the conditioning regimen and lack of folinic acid rescue following MTX administration. Thus, cryotherapy during MTX administration does not reduce severe oral mucositis in patients undergoing myeloablative allogeneic HSCT. Future studies will assess cryotherapy before allogeneic HSCT. PMID:17277790

  15. Comparable incidence and severity of cytomegalovirus infections following T cell-depleted allogeneic stem cell transplantation preceded by reduced intensity or myeloablative conditioning.

    PubMed

    Kalpoe, J S; van der Heiden, P L J; Vaessen, N; Claas, E C J; Barge, R M; Kroes, A C M

    2007-07-01

    Reports on infectious complications following reduced intensity conditioning (RIC) before allogeneic stem cell transplantation (allo-SCT) are equivocal. This prospective follow-up study compared the impact of cytomegalovirus (CMV) infections following RIC with fludarabine, ATG and busulphan or conventional myeloablative conditioning (MAC). Forty-eight RIC and 59 MAC patients were enrolled. The occurrence and severity of CMV infections within 100 days following allo-SCT were assessed, using plasma CMV DNA load kinetics. CMV DNAemia was observed in 21 RIC (60%) and in 19 MAC (44%) patients at risk for CMV. The mean CMV DNAemia free survival time was comparable following RIC and MAC: 70 days (95% (confidence interval) CI: 59-80 days) and 77 days (95% CI: 68-86 days), respectively (P=0.24). Parameters indicative for the level of CMV reactivation, including the area under the curve of CMV DNA load over time as well as the onset, the peak values and duration of CMV infection episodes, the numbers and duration of CMV treatment episodes and recurrent infections, were not different in both groups. During follow-up, none of the patients developed CMV disease. RIC with fludarabine, ATG and busulphan demonstrated safety comparable to conventional MAC with regard to frequency and severity of CMV infections within 100 days following T cell-depleted allo-SCT. PMID:17530007

  16. Comparable kinetics of myeloablation between fludarabine/full-dose busulfan and fludarabine/melphalan conditioning regimens in allogeneic peripheral blood stem cell transplantation.

    PubMed

    Chunduri, S; Dobogai, L C; Peace, D; Saunthararajah, Y; Chen, H Y; Mahmud, N; Quigley, J; Hoffman, R; Jessop, E; Beri, R; Rondelli, D

    2006-10-01

    Fludarabine was utilized in the conditioning regimen of 30 adult patients undergoing an allogeneic hematopoietic stem cell transplant. In 18 patients it was combined with full-dose busulfan (FluBu) as a myeloablative regimen and in 12 cases with melphalan (FluMel) as a reduced intensity conditioning (RIC) regimen. Patients in the FluBu group were younger than in the FluMel group (P=0.03). Of 30 patients, 24 received peripheral blood stem cells (PBSC) whereas six patients in the FluBu group received bone marrow cells. The hematological toxicity of each regimen was evaluated by analyzing the kinetics of the neutropenia induced by preparative regimens and the time to recovery of the absolute neutrophils count (ANC) and platelets post transplantation. In PBSC transplants, the median day of severe neutropenia (<500 ANC/microl) occurred on day +6 after the FluBu regimen and on day +3 after FluMel (P=ns), whereas both groups had a duration of severe neutropenia of 9 days and a comparable time for ANC and platelet engraftment. Extra-hematological toxicities were also comparable in the two groups. These findings suggest that the hematological and extra-hematological toxicities induced by fludarabine/full-dose i.v. busulfan are similar to those induced by a standard RIC regimen such as fludarabine/melphalan. PMID:16980995

  17. Remarkably reduced transplant-related complications by dibromomannitol non-myeloablative conditioning before allogeneic bone marrow transplantation in chronic myeloid leukemia.

    PubMed

    Barta, A; Dénes, R; Masszi, T; Reményi, P; Bátai, A; Torbágyi, E; Sipos, A; Lengyel, L; Jakab, K; Gyódi, E; Réti, M; Földi, J; Páldi-Haris, P; Avalos, M; Pálóczi, K; Fekete, S; Török, J; Hoffer, I; Jakab, J; Váradi, G; Kelemen, E; Petrányi, G

    2001-01-01

    A non-myeloablative conditioning protocol containing dibromomannitol (DBM/cytosine arabinoside/cyclophosphamide) has been applied to 36 chronic myeloid leukemia (CML) patients followed by bone marrow transplantation (BMT) from sibling donors. Risk factors include: accelerated phase (10 patients), older age (17 patients over >40 years) and long interval between diagnosis and BMT (27 months on average). Severe mucositis did not occur. Venoocclusive liver disease was absent. Infectious complications were rare. Although grade II-IV acute graft-versus-host disease (GVHD) was present in 9 (25%) cases, there were only 2 serious (III-IV) ones. Chronic GVHD occurred in 25 (69%) cases, preceded by acute GVHD in 9 of the 25 affected patients. Early hematological relapse, 7-29 weeks after BMT, developed in 6 patients (17.6%). No relapse was noted in the completely chimeric patients, however molecular genetic residual disease was observed in 6 patients, in most of them after transient short-term mixed chimeric state. Overall actual survival rate is 83.3% for the 36 cases, and leukemia-free survival is 72.2% for the 34 engrafted patients. PMID:11408706

  18. Toxicity and efficacy of busulfan and fludarabine myeloablative conditioning for HLA-identical sibling allogeneic hematopoietic cell transplantation in AML and MDS.

    PubMed

    De La Serna, J; Sanz, J; Bermúdez, A; Cabrero, M; Serrano, D; Vallejo, C; Gómez, V; Moraleda, J M; Perez, S G; Caballero, M D; Conde, E; Lahuerta, J J; Sanz, G

    2016-07-01

    The safety and efficacy of a 4-day myeloablative conditioning (MAC) regimen consisting of Bu 3.2 mg/kg and fludarabine 40 mg/m(2)/day for HLA-identical sibling allogeneic hematopoietic cell transplantation (HCT) in myeloid malignancies was investigated in 133 patients (median age, 47 years; range 19-74 years) with de novo AML (60%), secondary AML (20%) or myelodysplastic syndrome (20%). All patients engrafted. Hepatic veno-occlusive disease occurred in five patients (4%), and severe toxicities, mostly mucositis, occurred in twenty-three (17%) patients. The non-relapse mortality (NRM) at 100 days was 1.5%. The incidences of acute GVHD grade 2-4 and grade 3-4 were 32 and 13%, respectively. At a median follow-up of 38 months, the cumulative incidence of chronic GVHD was 67%. The relapse incidence was 30% (27 and 31%, respectively, in patients with early- and late-stage disease), and the overall NRM was 15%. The actuarial 4-year disease-free survival (DFS) and overall survival (OS) were 54 and 62%, respectively. Patients aged <50 years had better outcomes compared with older patients (DFS 64 vs 42%, P=0.006; OS 73 vs 47%, P<0.001, respectively). PMID:26950372

  19. Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation

    PubMed Central

    Faridi, Rehan Mujeeb; Kemp, Taylor J.; Dharmani-Khan, Poonam; Lewis, Victor; Rajalingam, Raja; Berka, Noureddine; Storek, Jan; Masood Khan, Faisal

    2016-01-01

    Background Allogeneic hematopoietic cell transplantation (HCT) can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD) and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR)-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG) is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT Methods and Findings The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into ‘discovery’ (135 pairs) and ‘validation’ (146 pairs) cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD), chronic GVHD needing systemic therapy (cGVHD) and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS), cGVHD & relapse free survival (cGRFS) and overall survival (OS)] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa) and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50–5.17) and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33–5.11). High incidence of cGVHD associated

  20. Relapse and Late Mortality in 5-Year Survivors of Myeloablative Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia in First Chronic Phase

    PubMed Central

    Goldman, John M.; Majhail, Navneet S.; Klein, John P.; Wang, Zhiwei; Sobocinski, Kathleen A.; Arora, Mukta; Horowitz, Mary M.; Rizzo, J. Douglas

    2010-01-01

    Purpose Allogeneic hematopoietic cell transplantation (HCT) is curative therapy for chronic myeloid leukemia (CML), but its long-term outcomes are not well described. We studied the long-term outcomes of CML patients in first chronic phase who receive an allogeneic HCT. Patients and Methods Our study included 2,444 patients who received myeloablative HCT for CML in first chronic phase between 1978 and 1998 and survived in continuous complete remission for at least 5 years (median follow-up, 11 years; range, 5 to 25 years). Donor sources were human leukocyte antigen–matched siblings in 1,692 patients, unrelated donors in 639 patients, and other related donors in 113 patients. Results Overall survival rates at 15 years were 88% (95% CI, 86% to 90%) for sibling HCT and 87% (95% CI, 83% to 90%) for unrelated donor HCT. Corresponding cumulative incidences of relapse were 8% (95% CI, 7% to 10%) and 2% (95% CI, 1% to 4%), respectively. The latest relapse was reported 18 years post-HCT. In multivariable analyses, history of chronic graft-versus-host disease increased risks of late overall mortality and nonrelapse mortality but reduced risks of relapse. In comparison with age-, race-, and sex-adjusted normal populations, the mortality of HCT recipients was significantly higher until 14 years post-HCT; thereafter, mortality rates were similar to those of the general population (relative mortality ratio at 15 years, 2.3; 95% CI, 0 to 4.9). Conclusion Recipients of allogeneic HCT for CML in first chronic phase who remain in remission for at least 5 years have favorable subsequent long-term survival, and their mortality rates eventually approach those of the general population. PMID:20212247

  1. Non-myeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Adults with Relapsed and Refractory Mantle Cell Lymphoma: A Single Center Analysis in the Rituximab Era

    PubMed Central

    Mussetti, Alberto; Devlin, Sean M.; Castro-Malaspina, Hugo R; Barker, Juliet N.; Giralt, Sergio A.; Zelenetz, Andrew D.

    2015-01-01

    Relapsed and refractory (rel/ref) mantle cell lymphoma (MCL) portends a dismal prognosis. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) represents the only potentially curative therapy in this setting. We analyzed survival outcomes of 29 recipients of non-myeloablative allo-HSCT for rel/ref MCL, and studied possible prognostic factors in this setting. The cumulative incidence of disease progression and non-relapse mortality at 3 years were 28% (95% confidence interval [CI]: 13-46%) and 29% (95%CI: 13-47%), respectively. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) at days +100 and +180 were 34% (95%CI: 18-52%) and 45% (95%CI: 26-62%), respectively. With a median follow-up in survivors of 53 (range 24-83) months, the 3-year overall survival (OS) and progression-free survival (PFS) were 54% (95%CI: 38-76%) and 41% (95%CI: 26-64%), respectively. In vivo T-cell depletion with alemtuzumab (n=6) was associated with inferior 3-year PFS (0% vs. 51%, p=0.007) and OS (17% vs. 64%, p=0.014). Conversely, a second line international prognostic index (sIPI) at transplantation equal to 0 (no risk factors) was associated with an improved 3-year PFS (52% vs. 22%, p=0.020) and OS (71% vs. 22%, p=0.006) compared to sIPI ≥1. Performing an allo-HSCT before 2007 was associated with a decreased 3-year OS (25% vs. 76%, p=0.015) but not with a significantly inferior PFS (17% vs. 59%, p=0.058). In this single center series, we report encouraging results with allo-HSCT for patients with rel/ref MCL. High alemtuzumab doses should probably be avoided in this context. PMID:26146802

  2. Non-myeloablative conditioning for lower-risk myelodysplastic syndrome with bone marrow blasts less than 5 %-a feasibility study.

    PubMed

    Choi, Eun-Ji; Lee, Je-Hwan; Lee, Jung-Hee; Kim, Dae-Young; Park, Han-Seung; Seol, Miee; Lee, Young-Shin; Kang, Young-Ah; Jeon, Mijin; Lee, Kyoo-Hyung

    2016-06-01

    Reduced-intensity conditioning (RIC) regimens can cause decreased non-relapse mortality (NRM) but lead to higher relapse rates in higher-risk myelodysplastic syndrome (MDS). However, relapse is not the main problem after hematopoietic cell transplantation (HCT) in lower-risk MDS, and post-transplant outcomes may therefore improve with less intense non-myeloablative conditioning (NMC) regimens. We here report the results of a single-center feasibility study of NMC with cyclophosphamide-fludarabine-antithymocyte globulin (CyFluATG) in MDS patients with bone marrow blasts <5 %. We compared post-transplant outcomes between CyFluATG and a RIC regimen, busulfan-fludarabine-antithymocyte globulin (BuFluATG). Fifteen MDS patients received allogeneic HCT after CyFluATG conditioning comprising cyclophosphamide (100 mg/kg), fludarabine (150 mg/m(2)), and ATG, and 30 MDS historical control patients received BuFluATG conditioning which contained busulfan (8 [oral] or 6.4 [i.v.] mg/kg), fludarabine, and ATG. The 4-year overall survival (OS) and NRM rates were 80.0 and 20.0 % for CyFluATG and 73.3 and 20.0 % for BuFluATG, respectively. Neutrophil and platelet engraftment was significantly faster with CyFluATG than BuFluATG (median 12 vs. 14 days, P = 0.005 for neutrophils; median 15 vs. 21 days, P = 0.032 for platelets). CyFluATG produced a faster immune reconstitution of T-cells at 1 month after HCT than BuFluATG. Fertility was maintained after HCT with CyFluATG. In conclusion, the CyFluATG regimen is feasible in lower-risk MDS patients in terms of adequate engraftment and low NRM. PMID:27106699

  3. Immunomodulatory effects induced by cytotoxic T lymphocyte antigen 4 immunoglobulin with donor peripheral blood mononuclear cell infusion in canine major histocompatibility complex-haplo-identical non-myeloablative hematopoietic cell transplantation.

    PubMed

    Chen, Yun; Fukuda, Takahiro; Thakar, Monica S; Kornblit, Brian T; Storer, Barry E; Santos, Erlinda B; Storb, Rainer; Sandmaier, Brenda M

    2011-11-01

    BACKGROUND AIMS. Previously, cytotoxic T lymphocyte antigen 4 (CTLA4) immunoglobulin (Ig) has been shown to allow sustained engraftment in dog leukocyte antigen (DLA)-identical hematopoietic cell transplant (HCT) after non-myeloablative conditioning with 100 cGy total body irradiation (TBI). In the current study, we investigated the efficacy of pre-transplant CTLA4-Ig in promoting engraftment across a DLA-mismatched barrier after non-myeloablative conditioning. METHODS. Eight dogs were treated with CTLA4-Ig and donor peripheral blood mononuclear cells (PBMC) prior to receiving 200 cGy TBI followed by transplantation of granulocyte-colony-stimulating factor (G-CSF) mobilized peripheral blood stem cells from DLA haplo-identical littermates with post-grafting immunosuppression. A control group of six dogs was conditioned with 200 cGy only and transplanted with grafts from DLA haplo-identical littermates followed by post-grafting immunosuppression. RESULTS. In vitro and in vivo donor-specific hyporesponsiveness was demonstrated on day 0 before TBI in eight dogs that received CTLA4-Ig combined with donor PBMC infusions. Four of five dogs treated with increased doses of CTLA4-Ig achieved initial engraftment but eventually rejected, with a duration of mixed chimerism ranging from 12 to 22 weeks. CTLA4-Ig did not show any effect on host natural killer (NK) cell function in vitro or in vivo. No graft-versus-host disease (GvHD) was observed in dogs receiving CTLA4-Ig treatment. CONCLUSIONS. Non-myeloablative conditioning with 200 cGy TBI and CTLA4-Ig combined with donor PBMC infusion was able to overcome the T-cell barrier to achieve initial engraftment without GvHD in dogs receiving DLA haplo-identical grafts. However, rejection eventually occurred; we hypothesize because of the inability of CTLA4-Ig to abate natural killer cell function. PMID:21846291

  4. RAPID TRANSPORT AND INFUSION OF HEMATOPOIETIC CELLS IS ASSOCIATED WITH IMPROVED OUTCOME AFTER MYELOABLATIVE THERAPY AND UNRELATED DONOR TRANSPLANT

    PubMed Central

    Lazarus, Hillard M.; Kan, Fangyu; Tarima, Sergey; Champlin, Richard E.; Confer, Dennis L.; Frey, Noelle; Gee, Adrian P.; Wagner, John E.; Horowitz, Mary M.; Eapen, Mary

    2009-01-01

    We evaluated effects of graft transport time on outcomes after transplantation of 938 unrelated donor bone marrow (BM) or 507 peripheral blood progenitor cells (PBPC) in patients with acute or chronic leukemia and myelodysplasia. BM grafts were collected at 107 centers and PBPC, 89 centers. Median time from end of collection to infusion was 14 hours for BM and 15 hours for PBPC. Platelet recovery was less likely in BM recipients when the interval from end of collection to receipt at transplant center was ≥ 20 hours (odds ratio 0.47, p=0.010) and when the interval from receipt to infusion was ≥ 6 hours (odds ratio 0.57, p=0.001). Mortality rates were higher in recipients of HLA-matched BM when the interval from end of collection to receipt at transplant center was ≥ 20 hours (relative risk 2.67, p<0.001) after adjustment for other significant prognostic factors. Mortality after HLA-mismatched BM transplants was not associated with transport time. Transport times had no demonstrable effect on outcomes after PBPC transplants. These data support a general review of current transport procedures, especially for BM grafts requiring longer transport time and every effort made to minimize time from collection to infusion. PMID:19361751

  5. Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding.

    PubMed

    Nakano, Hirofumi; Ashizawa, Masahiro; Akahoshi, Yu; Ugai, Tomotaka; Wada, Hidenori; Yamasaki, Ryoko; Ishihara, Yuko; Kawamura, Koji; Sakamoto, Kana; Sato, Miki; Terasako-Saito, Kiriko; Kimura, Shun-Ichi; Kikuchi, Misato; Nakasone, Hideki; Kako, Shinichi; Kanda, Junya; Yamazaki, Rie; Tanihara, Aki; Nishida, Junji; Kanda, Yoshinobu

    2016-07-01

    Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients. PMID:27084256

  6. Safety, Pharmacokinetics, and Efficacy of Palifermin in Children and Adolescents with Acute Leukemias Undergoing Myeloablative Therapy and Allogeneic Hematopoietic Stem Cell Transplantation: A Pediatric Blood and Marrow Transplant Consortium Trial.

    PubMed

    Morris, Joan; Rudebeck, Mattias; Neudorf, Steven; Moore, Theodore; Duerst, Reggie; Shah, Ami J; Graham, Michael; Aquino, Victor; Morris, Christopher; Olsson, Birgitta

    2016-07-01

    Currently, effective pharmacologic treatment to reduce severe oral mucositis (OM) resulting from high-dose myeloablative cytotoxic therapy in the pediatric population is not available. Palifermin has been proven to decrease the incidence and duration of severe OM in adults with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT). In the pediatric population, however, data on palifermin treatment are limited. A phase I dose-escalation study of palifermin in pediatric patients with acute leukemias undergoing myeloablative HSCT with total body irradiation, etoposide, and cyclophosphamide was performed to determine a safe and tolerable dose and to characterize the pharmacokinetic (PK) profile and efficacy of palifermin. Twenty-seven patients in 3 age groups (1 to 2, 3 to 11, and 12 to 16 years) and 3 dose levels (40, 60, and 80 μg/kg/day) were studied. There were no deaths, dose-limiting toxicities, or treatment-related serious adverse events. Long-term safety outcomes did not differ from what would be expected in this population. PK data showed no differences between the 3 age groups. Exposure did not increase with increase in dose. The maximum severity of OM (WHO grade 4) occurred in 6 patients (22%), none of whom was in the 80-μg/kg/day dosing group. This study showed that all doses were well tolerated and a good safety profile in all 3 pediatric age groups was seen. PMID:26968792

  7. A phase II trial of liposomal busulphan as an intravenous myeloablative agent prior to stem cell transplantation: 500 mg/m(2) as a optimal total dose for conditioning.

    PubMed

    Hassan, M; Nilsson, C; Hassan, Z; Gungor, T; Aschan, J; Winiarski, J; Hentschke, P; Ringdén, O; Eber, S; Seger, R; Ljungman, P

    2002-12-01

    We conducted a phase I/II trial, to evaluate the efficacy and safety of an intravenous liposomal formulation of busulphan (LBu) as a myeloablative agent for stem cell transplantation (SCT). The liposomal busulphan was administered as a 3 h infusion twice daily over 4 consecutive days. Six adults received 1.6-2 mg/kg/dose and 18 children received 1.8-3 mg/kg/dose. Pharmacokinetic parameters were studied after the first and the last dose of busulphan. No significant difference in clearance, AUC, elimination half-lives or distribution volume between the first and the last dose was found in either groups. A significantly (P < 0.005) higher clearance was observed in children after the first and the last dose (3.61 and 3.79 ml/min/kg, respectively) compared to adults (2.40 and 2.33 ml/min/kg, respectively). The elimination half-lives after the first and the last dose were significantly (P < 0.005) shorter in children (2.59 and 2.72 h, respectively) compared to adults (3.35 and 3.61 h, respectively). Clearance correlated significantly with age. However, no significant correlation with age was observed when clearance was adjusted to the body surface area. Two cases of VOD following a total dose of 24 mg/kg were observed. Six patients experienced mucositis. No other organ toxicity was observed. We conclude that intravenous liposomal busulphan pharmacokinetics is age dependent. A dosage schedule based on body surface area should be used especially in young children to reduce the age-dependent difference in kinetics. An intravenous liposomal dose of busulphan of 500 mg/m(2) is suggested to reach a similar systemic exposure and myeloablative effect in both children and adults. Moreover, the novel liposomal form of busulphan showed a favorable toxicity profile and seems safe as a part of the high-dose therapy prior to SCT. PMID:12476274

  8. [Examination procedures].

    PubMed

    Vassault, A; Arnaud, J; Szymanovicz, A

    2010-12-01

    Examination procedures have to be written for each examination according to the standard requirements. Using CE marked devices, technical inserts can be used, but because of their lack of homogeneity, it could be easier to document their use as a standard procedure. Document control policy applies for those procedures, the content of which could be as provided in this document. Electronic manuals can be used as well. PMID:21613016

  9. Myeloablative 131I-Tositumomab Radioimmunotherapy in Treating Non-Hodgkin’s Lymphoma: Comparison of Dosimetry Based on Whole-Body Retention and Dose to Critical Organ Receiving the Highest Dose

    SciTech Connect

    Rajendran, Joseph G.; Gopal, Ajay K.; Fisher, Darrell R.; Durack, L. D.; Gooley, Ted; Press, Oliver W.

    2008-05-01

    Objectives: Myeloablative radioimmunotherapy (RIT) using 131I tositumomab (anti-CD 20) monoclonal antibodies is an effective new therapy for B-cell non-Hodgkins lymphoma (NHL). The goal of this work is to determine optimum methods to deliver maximal myeloablative radioactivity without exceeding the radiation tolerance of critical normal organs such as liver and lungs, and avoiding serious toxicity. Methods: We reviewed dosimetry records for 100 consecutive patients who underwent biodistribution and dosimetry after a test infusion of 131I- tositumomab. Serial gamma camera images were used to determine organ and tissue activities over time and to calculate radiation-absorbed doses. Volumes of critical normal organs were determined from CT scans to adjust the dose estimates for the individual patient. These dose estimates helped us determine an appropriate therapy based on projected dose to the critical normal organ receiving a maximum tolerable radiation dose. We compared our method of organ-specific dosimetry for treatment planning with the standard clinical approaches using a whole-body dose-assessment method by assessing the difference in projected amounts of radiation-absorbed doses, as well as the ratios of projected amounts, that would be prescribed for therapy by each of these two strategies. Results: The mean organ doses (mGy/MBq) estimated by both methods were (1) Whole body method: liver = 0.33 and lungs = 0.33; and (2) Organ-specific method: liver 1.52 and lungs 1.72 (p = .0001). The median difference between the radiation-absorbed dose estimates was 3.40 (range of 1.37 to 7.96) for the lungs, 3.05 (range of 1.04 to 6.20) for the liver, and –0.05 for whole body (range of –0.18 to 0.16). The median ratio (OS divided by WB method) of radiation-absorbed dose estimates was 5.12 (range of 2.33 to 10.01) for the lungs, 4.14 (range of 2.16 to 6.67) for the liver, and 0.94 (range of 0.79 to 1.22) for whole body. There was significant difference between the

  10. Sequential myeloablative autologous stem cell transplantation and reduced intensity allogeneic hematopoietic cell transplantation is safe and feasible in children, adolescents and young adults with poor-risk refractory or recurrent Hodgkin and non-Hodgkin lymphoma.

    PubMed

    Satwani, P; Jin, Z; Martin, P L; Bhatia, M; Garvin, J H; George, D; Chaudhury, S; Talano, J; Morris, E; Harrison, L; Sosna, J; Peterson, M; Militano, O; Foley, S; Kurtzberg, J; Cairo, M S

    2015-02-01

    The outcome of children, adolescents and young adults (CAYA) with poor-risk recurrent/refractory lymphoma is dismal (⩽30%). To overcome this poor prognosis, we designed an approach to maximize an allogeneic graft vs lymphoma effect in the setting of low disease burden. We conducted a multi-center prospective study of myeloablative conditioning (MAC) and autologous stem cell transplantation (AutoSCT), followed by a reduced intensity conditioning (RIC) and allogeneic hematopoietic cell transplantation (AlloHCT) in CAYA, with poor-risk refractory or recurrent lymphoma. Conditioning for MAC AutoSCT consisted of carmustine/etoposide/cyclophosphamide, RIC consisted of busulfan/fludarabine. Thirty patients, 16 Hodgkin lymphoma (HL) and 14 non-Hodgkin lymphoma (NHL), with a median age of 16 years and median follow-up of 5years, were enrolled. Twenty-three patients completed both MAC AutoSCT and RIC AlloHCT. Allogeneic donor sources included unrelated cord blood (n=9), unrelated donor (n=8) and matched siblings (n=6). The incidence of transplant-related mortality following RIC AlloHCT was only 12%. In patients with HL and NHL, 10 year EFS was 59.8% and 70% (P=0.613), respectively. In summary, this approach is safe, and long-term EFS with this approach is encouraging considering the poor-risk patient characteristics and the use of unrelated donors for RIC AlloHCT in the majority of cases. PMID:24938649

  11. Dental Procedures.

    PubMed

    Ramponi, Denise R

    2016-01-01

    Dental problems are a common complaint in emergency departments in the United States. There are a wide variety of dental issues addressed in emergency department visits such as dental caries, loose teeth, dental trauma, gingival infections, and dry socket syndrome. Review of the most common dental blocks and dental procedures will allow the practitioner the opportunity to make the patient more comfortable and reduce the amount of analgesia the patient will need upon discharge. Familiarity with the dental equipment, tooth, and mouth anatomy will help prepare the practitioner for to perform these dental procedures. PMID:27482994

  12. Procedural simulation.

    PubMed

    Patel, Aalpen A; Glaiberman, Craig; Gould, Derek A

    2007-06-01

    In the past few decades, medicine has started to look at the potential use of simulators in medical education. Procedural medicine lends itself well to the use of simulators. Efforts are under way to establish national agendas to change the way medical education is approached and thereby improve patient safety. Universities, credentialing organizations, and hospitals are investing large sums of money to build and use simulation centers for undergraduate and graduate medical education. PMID:17574195

  13. Comparison of reduced-intensity and myeloablative conditioning regimens for allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia and acute lymphoblastic leukemia: a meta-analysis.

    PubMed

    Abdul Wahid, S Fadilah; Ismail, Nor-Azimah; Mohd-Idris, Mohd-Razif; Jamaluddin, Fariza Wan; Tumian, NorRafeah; Sze-Wei, Ernie Yap; Muhammad, Norasiah; Nai, Ming Lai

    2014-11-01

    Currently, the indications to perform reduced-intensity conditioning allogeneic hematopoietic stem cell transplant (RIC-HCT) are based on data derived mainly from large registry and single-centre retrospective studies. Thus, at the present time, there is limited direct evidence supporting the current practice in selecting patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) for RIC versus myeloablative conditioning (MAC) transplants. To determine the relationship between dose intensity of conditioning regimen and survival outcomes after allografting in AML/ALL patients, we performed a meta-analysis of 23 clinical trials reported between 1990 and 2013 involving 15,258 adult patients that compare survival outcomes after RIC-HCT versus MAC-HCT. RIC-HCT resulted in comparable <2-year and 2-6 year overall survival (OS) rates post-transplantation even though the RIC-HCT recipients were older and had more active disease than MAC-HCT recipients. The 2-6 year progression-free survival (PFS), nonrelapse mortality, acute graft-versus-host disease (GvHD) and chronic GvHD rates were reduced after RIC-HCT, but relapse rate was increased. Similar outcomes were observed regardless of disease type and status at transplantation. Odds ratio for all outcomes remained comparable with or without performing separate analyses for the year of HCT and for retrospective versus prospective studies. Among RIC-HCT recipients, survival rates were superior if patients were in CR at transplantation. Significant inter-study heterogeneity for aGvHD data and publication bias for PFS data were observed. This meta-analysis showed no OS benefit of MAC-HCT over RIC-HCT across the entire cohort of patients suggesting that RIC-HCT could be an effective therapeutic option for AML/ALL patients who are ineligible for MAC-HCT and CR status is preferred before RIC-HCT. PMID:25072307

  14. Comparison of Reduced-Intensity and Myeloablative Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia: A Meta-Analysis

    PubMed Central

    Ismail, Nor-Azimah; Mohd-Idris, Mohd-Razif; Jamaluddin, Fariza Wan; Tumian, NorRafeah; Sze-Wei, Ernie Yap; Muhammad, Norasiah; Nai, Ming Lai

    2014-01-01

    Currently, the indications to perform reduced-intensity conditioning allogeneic hematopoietic stem cell transplant (RIC-HCT) are based on data derived mainly from large registry and single-centre retrospective studies. Thus, at the present time, there is limited direct evidence supporting the current practice in selecting patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) for RIC versus myeloablative conditioning (MAC) transplants. To determine the relationship between dose intensity of conditioning regimen and survival outcomes after allografting in AML/ALL patients, we performed a meta-analysis of 23 clinical trials reported between 1990 and 2013 involving 15,258 adult patients that compare survival outcomes after RIC-HCT versus MAC-HCT. RIC-HCT resulted in comparable <2-year and 2–6 year overall survival (OS) rates post-transplantation even though the RIC-HCT recipients were older and had more active disease than MAC-HCT recipients. The 2–6 year progression-free survival (PFS), nonrelapse mortality, acute graft-versus-host disease (GvHD) and chronic GvHD rates were reduced after RIC-HCT, but relapse rate was increased. Similar outcomes were observed regardless of disease type and status at transplantation. Odds ratio for all outcomes remained comparable with or without performing separate analyses for the year of HCT and for retrospective versus prospective studies. Among RIC-HCT recipients, survival rates were superior if patients were in CR at transplantation. Significant inter-study heterogeneity for aGvHD data and publication bias for PFS data were observed. This meta-analysis showed no OS benefit of MAC-HCT over RIC-HCT across the entire cohort of patients suggesting that RIC-HCT could be an effective therapeutic option for AML/ALL patients who are ineligible for MAC-HCT and CR status is preferred before RIC-HCT. PMID:25072307

  15. Thiotepa-based versus total body irradiation-based myeloablative conditioning prior to allogeneic stem cell transplantation for acute myeloid leukaemia in first complete remission: a retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

    PubMed

    Eder, Sandra; Labopin, Myriam; Arcese, William; Or, Reuven; Majolino, Ignazio; Bacigalupo, Andrea; de Rosa, Gennaro; Volin, Liisa; Beelen, Dietrich; Veelken, Hendrik; Schaap, Nicolaas P M; Kuball, Jurgen; Cornelissen, Jan; Nagler, Arnon; Mohty, Mohamad

    2016-01-01

    Thiotepa is an alkylating compound with an antineoplastic and myeloablative activity and can mimic the effect of radiation. However, it is unknown whether this new regimen could safely replace the long-established ones. This retrospective matched-pair analysis evaluated the outcome of adults with acute myeloid leukaemia in first complete remission who received myeloablative conditioning either with a thiotepa-based (n = 121) or a cyclophosphamide/total body irradiation-based (TBI; n = 358) regimen for allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling or an unrelated donor. With a median follow-up of 44 months, the outcome was similar in both groups. Acute graft-versus-host disease grade II-IV was observed in 25% after thiotepa-containing regimen versus 35% after TBI (P = 0.06). The 2-yr cumulative incidence of chronic graft-versus-host disease was 40.5% for thiotepa and 41% for TBI (P = 0.98). At 2 yrs, the cumulative incidences of non-relapse mortality and relapse incidence were 23.9% (thiotepa) vs. 22.4% (TBI; P = 0.66) and 17.2% (thiotepa) vs. 23.3% (TBI; P = 0.77), respectively. The probabilities of leukaemia-free and overall survival at 2 yrs were not significantly different between the thiotepa and TBI groups, at 58.9% vs. 54.2% (P = 0.95) and 61.4% vs. 58% (P = 0.72), respectively. Myeloablative regimens using combinations including thiotepa can provide satisfactory outcomes, but the optimal conditioning remains unclear for the individual patient in this setting. PMID:25807864

  16. Procedural knowledge

    NASA Technical Reports Server (NTRS)

    Georgeff, Michael P.; Lansky, Amy L.

    1986-01-01

    Much of commonsense knowledge about the real world is in the form of procedures or sequences of actions for achieving particular goals. In this paper, a formalism is presented for representing such knowledge using the notion of process. A declarative semantics for the representation is given, which allows a user to state facts about the effects of doing things in the problem domain of interest. An operational semantics is also provided, which shows how this knowledge can be used to achieve particular goals or to form intentions regarding their achievement. Given both semantics, the formalism additionally serves as an executable specification language suitable for constructing complex systems. A system based on this formalism is described, and examples involving control of an autonomous robot and fault diagnosis for NASA's Space Shuttle are provided.

  17. Filgrastim-Stimulated Bone Marrow Compared with Filgrastim-Mobilized Peripheral Blood in Myeloablative Sibling Allografting for Patients with Hematologic Malignancies: A Randomized Canadian Blood and Marrow Transplant Group Study.

    PubMed

    Couban, Stephen; Aljurf, Mahmoud; Lachance, Sylvie; Walker, Irwin; Toze, Cynthia; Rubinger, Morel; Lipton, Jeffrey H; Lee, Stephanie J; Szer, Richard; Doocey, R; Lewis, Ian D; Huebsch, Lothar; Howson-Jan, Kang; Lalancette, Michel; Almohareb, Fahad; Chaudhri, Nadeem; Ivison, Sabine; Broady, Raewyn; Levings, Megan; Fairclough, Diane; Devins, Gerald; Szwajcer, David; Foley, Ronan; Smith, Clayton; Panzarella, Tony; Kerr, Holly; Kariminia, Amina; Schultz, Kirk R

    2016-08-01

    In adult hematopoietic cell transplantation (HCT), filgrastim-mobilized peripheral blood (G-PB) has largely replaced unstimulated marrow for allografting. Although the use of G-PB results in faster hematopoietic recovery, it is also associated with more chronic graft-versus-host disease (cGVHD). A potential alternative allograft is filgrastim-stimulated marrow (G-BM), which we hypothesized may be associated with prompt hematopoietic recovery but with less cGVHD. We conducted a phase 3, open-label, multicenter randomized trial of 230 adults with hematologic malignancies receiving allografts from siblings after myeloablative conditioning to compare G-PB with G-BM. The primary endpoint was time to treatment failure, defined as a composite of extensive cGVHD, relapse/disease progression, and death. With a median follow-up of 36 months (range, 9.6 to 48), comparing G-BM with G-PB, there was no difference between the 2 arms with respect to the primary outcome of this study (hazard ratio [HR], .91; 95% confidence interval [CI], .68 to 1.22; P = .52). However, the cumulative incidence of overall cGVHD was lower with G-BM (HR, .66; 95% CI, .46 to .95; P = .007) and there was no difference in the risk of relapse or progression (P = .35). The median times to neutrophil recovery (P = .0004) and platelet recovery (P = .012) were 3 days shorter for recipients allocated to G-PB compared with those allocated to G-BM, but there were no differences in secondary engraftment-related outcomes, such as time to first hospital discharge (P = .17). In addition, there were no graft failures in either arm. This trial demonstrates that, compared with G-PB, the use of G-BM allografts leads to a significantly lower rate of overall cGVHD without a loss of the graft-versus-tumor effect and comparable overall survival. Our findings suggest that further study of this type of allograft is warranted. PMID:27154847

  18. The simplification of the SCT procedures in developing countries has resulted in cost-lowering and availability to more patients.

    PubMed

    Gómez-Almaguer, David

    2002-08-01

    In order to simplify and cutting down expenses of the bone marrow transplantation procedures we have made some efforts, trying to provide the best transplantation technique for the individual patient with scarce resources. In relation with the source of stem cells, we have found very attractive the use of peripheral blood stem cells (PBSC) instead of bone marrow cells. This procedure can produce substantially more rapid engraftment than observed with bone marrow. The rapid hematopoietic reconstitution in the recipient of PBSC lower expenses stemming from the use of antibiotics, blood bank products and days at the hospital. In Mexico, a country with a large number of cases of severe aplastic anemia we decided to use PBSC to transplant 10 patients with this disease, in order to take advantage of the large number of stem cells that this procedure can provide. We had excellent results in these patients, avoiding the high cost of the conventional transplantation and the use of ATG. In relation to autologous transplantation we have made efforts to perform autografts without the use of freezing devices, keeping the stem cells in liquid form using a conventional blood bank refrigerator for up to 96 hr. This modifications have resulted in diminishing costs and increasing the availability of the procedure to a large number of patients. Finally in Mexico we have had experience with non-myeloablative transplants, and obtained reasonably good results, with a median cost of 18,000 USD per allogeneic transplantation procedure. In some cases this is the only affordable therapeutic option. In developing countries where very few patients can afford the cost of conventional bone marrow transplants, any reasonable effort in the direction of simplification must be welcome. PMID:12430886

  19. Computerized procedures system

    DOEpatents

    Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

    2010-10-12

    An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

  20. Public Sector Impasse Procedures.

    ERIC Educational Resources Information Center

    Vadakin, James C.

    The subject of collective bargaining negotiation impasse procedures in the public sector, which includes public school systems, is a broad one. In this speech, the author introduces the various procedures, explains how they are used, and lists their advantages and disadvantages. Procedures discussed are mediation, fact-finding, arbitration,…

  1. Crew procedures development techniques

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.; Hawk, M. L.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.

    1975-01-01

    The study developed requirements, designed, developed, checked out and demonstrated the Procedures Generation Program (PGP). The PGP is a digital computer program which provides a computerized means of developing flight crew procedures based on crew action in the shuttle procedures simulator. In addition, it provides a real time display of procedures, difference procedures, performance data and performance evaluation data. Reconstruction of displays is possible post-run. Data may be copied, stored on magnetic tape and transferred to the document processor for editing and documentation distribution.

  2. The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation.

    PubMed

    Noriega, Víctor; Martínez-Laperche, Carolina; Buces, Elena; Pion, Marjorie; Sánchez-Hernández, Noemí; Martín-Antonio, Beatriz; Guillem, Vicent; Bosch-Vizcaya, Anna; Bento, Leyre; González-Rivera, Milagros; Balsalobre, Pascual; Kwon, Mi; Serrano, David; Gayoso, Jorge; de la Cámara, Rafael; Brunet, Salut; Rojas-Contreras, Rafael; Nieto, José B; Martínez, Carmen; Gónzalez, Marcos; Espigado, Ildefonso; Vallejo, Juan C; Sampol, Antonia; Jiménez-Velasco, Antonio; Urbano-Ispizua, Alvaro; Solano, Carlos; Gallardo, David; Díez-Martín, José L; Buño, Ismael

    2015-01-01

    The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≤(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08-0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients. PMID:26473355

  3. The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation

    PubMed Central

    Buces, Elena; Pion, Marjorie; Sánchez-Hernández, Noemí; Martín-Antonio, Beatriz; Guillem, Vicent; Bosch-Vizcaya, Anna; Bento, Leyre; González-Rivera, Milagros; Balsalobre, Pascual; Kwon, Mi; Serrano, David; Gayoso, Jorge; de la Cámara, Rafael; Brunet, Salut; Rojas-Contreras, Rafael; Nieto, José B.; Martínez, Carmen; Gónzalez, Marcos; Espigado, Ildefonso; Vallejo, Juan C.; Sampol, Antonia; Jiménez-Velasco, Antonio; Urbano-Ispizua, Alvaro; Solano, Carlos; Gallardo, David; Díez-Martín, José L.; Buño, Ismael

    2015-01-01

    The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≤(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08–0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients. PMID:26473355

  4. Procedure improvement enterprises

    SciTech Connect

    Davis, P.L.

    1992-01-01

    At Allied-Signal's Kansas City Division (KCD), we recognize the importance of clear, concise and timely procedures for sharing information, promoting consistency and documenting the way we do business. For these reasons, the KCD has gathered a team of employees to analyze the process we currently use to publish procedures, identify the procedure needs of KCD employees, and design a system that meets or exceeds the requirements and expectations of DOE. The name of our group is the Procedure Improvement Enterprise Critical Process Team, or PIE CPT. The mission statement of Procedure Improvement Enterprise is to develop and implement within the Kansas City Division an effective nd flexible procedure system that will establish a model of excellence, will emphasize team work and open communication, and will ensure compliance with corporate/government requirements.

  5. Procedure improvement enterprises

    SciTech Connect

    Davis, P.L.

    1992-01-01

    At Allied-Signal`s Kansas City Division (KCD), we recognize the importance of clear, concise and timely procedures for sharing information, promoting consistency and documenting the way we do business. For these reasons, the KCD has gathered a team of employees to analyze the process we currently use to publish procedures, identify the procedure needs of KCD employees, and design a system that meets or exceeds the requirements and expectations of DOE. The name of our group is the Procedure Improvement Enterprise Critical Process Team, or PIE CPT. The mission statement of Procedure Improvement Enterprise is to develop and implement within the Kansas City Division an effective nd flexible procedure system that will establish a model of excellence, will emphasize team work and open communication, and will ensure compliance with corporate/government requirements.

  6. Pyroshock prediction procedures

    NASA Astrophysics Data System (ADS)

    Piersol, Allan G.

    2002-05-01

    Given sufficient effort, pyroshock loads can be predicted by direct analytical procedures using Hydrocodes that analytically model the details of the pyrotechnic explosion and its interaction with adjacent structures, including nonlinear effects. However, it is more common to predict pyroshock environments using empirical procedures based upon extensive studies of past pyroshock data. Various empirical pyroshock prediction procedures are discussed, including those developed by the Jet Propulsion Laboratory, Lockheed-Martin, and Boeing.

  7. Candidate CDTI procedures study

    NASA Technical Reports Server (NTRS)

    Ace, R. E.

    1981-01-01

    A concept with potential for increasing airspace capacity by involving the pilot in the separation control loop is discussed. Some candidate options are presented. Both enroute and terminal area procedures are considered and, in many cases, a technologically advanced Air Traffic Control structure is assumed. Minimum display characteristics recommended for each of the described procedures are presented. Recommended sequencing of the operational testing of each of the candidate procedures is presented.

  8. Science Safety Procedure Handbook.

    ERIC Educational Resources Information Center

    Lynch, Mervyn A.; Offet, Lorna

    This booklet outlines general safety procedures in the areas of: (1) student supervision; (2) storage safety regulations, including lists of incompatible chemicals, techniques of disposal and storage; (3) fire; and (4) first aid. Specific sections exist for elementary, junior high school, senior high school, in which special procedures are…

  9. Handbook of radiologic procedures

    SciTech Connect

    Hedgcock, M.

    1986-01-01

    This book is organized around radiologic procedures with each discussed from the points of view of: indications, contraindications, materials, method of procedures and complications. Covered in this book are: emergency radiology chest radiology, bone radiology, gastrointestinal radiology, GU radiology, pediatric radiology, computerized tomography, neuroradiology, visceral and peripheral angiography, cardiovascular radiology, nuclear medicine, lymphangiography, and mammography.

  10. Procedural Learning and Dyslexia

    ERIC Educational Resources Information Center

    Nicolson, R. I.; Fawcett, A. J.; Brookes, R. L.; Needle, J.

    2010-01-01

    Three major "neural systems", specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed ("Trends Neurosci.",30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief…

  11. Coombs' Type Response Procedures.

    ERIC Educational Resources Information Center

    Koehler, Roger A.

    This paper provides substantial evidence in favor of the continued use of conventional objective testing procedures in lieu of either the Coombs' cross-out technique or the Dressel and Schmid free-choice response procedure. From the studies presented in this paper, the tendency is for the cross-out and the free choice methods to yield a decrement…

  12. Enucleation Procedure Manual.

    ERIC Educational Resources Information Center

    Davis, Kevin; Poston, George

    This manual provides information on the enucleation procedure (removal of the eyes for organ banks). An introductory section focuses on the anatomy of the eye and defines each of the parts. Diagrams of the eye are provided. A list of enucleation materials follows. Other sections present outlines of (1) a sterile procedure; (2) preparation for eye…

  13. Basic Planning Procedures.

    ERIC Educational Resources Information Center

    Nevada State Dept. of Education, Carson City.

    The procedure described herein entails the use of an educational planning consultant, statements of educational and service problems to be solved by proposed construction, a site plan, and architect selection. Also included in the outline of procedures is a tentative statement of specifications, tentative cost estimates and matrices for conducting…

  14. Policies and Procedures.

    ERIC Educational Resources Information Center

    Klein, William D.; McKenna, Bernard

    1997-01-01

    States that, although policies and procedure documents play an important role in developing and maintaining a consistent quality of interaction in organizations, research literature is weak in this area. Initiates further discussion by defining and describing policy/procedure documents. Identifies a third kind, work instructions. Uses a genre…

  15. Toddler test or procedure preparation

    MedlinePlus

    ... procedure; Test/procedure preparation - toddler; Preparing for a medical test or procedure - toddler ... A, Franz BE. Practical communication guide for paediatric procedures. Emerg ... PMID: 19588390 www.ncbi.nlm.nih.gov/pubmed/19588390 .

  16. Minimally invasive procedures

    PubMed Central

    Baltayiannis, Nikolaos; Michail, Chandrinos; Lazaridis, George; Anagnostopoulos, Dimitrios; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Lampaki, Sofia; Papaiwannou, Antonis; Karavergou, Anastasia; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

    2015-01-01

    Minimally invasive procedures, which include laparoscopic surgery, use state-of-the-art technology to reduce the damage to human tissue when performing surgery. Minimally invasive procedures require small “ports” from which the surgeon inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then a miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized equipment is inserted through the trocars based on the type of surgery. There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry—meaning only one small incision, like the “uniport” video-assisted thoracoscopic surgery (VATS). Not only do these procedures usually provide equivalent outcomes to traditional “open” surgery (which sometimes require a large incision), but minimally invasive procedures (using small incisions) may offer significant benefits as well: (I) faster recovery; (II) the patient remains for less days hospitalized; (III) less scarring and (IV) less pain. In our current mini review we will present the minimally invasive procedures for thoracic surgery. PMID:25861610

  17. Dynamic alarm response procedures

    SciTech Connect

    Martin, J.; Gordon, P.; Fitch, K.

    2006-07-01

    The Dynamic Alarm Response Procedure (DARP) system provides a robust, Web-based alternative to existing hard-copy alarm response procedures. This paperless system improves performance by eliminating time wasted looking up paper procedures by number, looking up plant process values and equipment and component status at graphical display or panels, and maintenance of the procedures. Because it is a Web-based system, it is platform independent. DARP's can be served from any Web server that supports CGI scripting, such as Apache{sup R}, IIS{sup R}, TclHTTPD, and others. DARP pages can be viewed in any Web browser that supports Javascript and Scalable Vector Graphics (SVG), such as Netscape{sup R}, Microsoft Internet Explorer{sup R}, Mozilla Firefox{sup R}, Opera{sup R}, and others. (authors)

  18. Definition of "experimental procedures".

    PubMed

    2009-11-01

    This Practice Committee Opinion provides a revised definition of "experimental procedures." This version replaces the document "Definition of Experimental" that was published most recently in November 2008. PMID:19836733

  19. Common Interventional Radiology Procedures

    MedlinePlus

    ... of common interventional techniques is below. Common Interventional Radiology Procedures Angiography An X-ray exam of the ... into the vertebra. Copyright © 2016 Society of Interventional Radiology. All rights reserved. 3975 Fair Ridge Drive • Suite ...

  20. Cardiac ablation procedures

    MedlinePlus

    ... Accessory pathway, such as Wolff-Parkinson-White Syndrome Atrial fibrillation and atrial flutter Ventricular tachycardia ... consensus statement on catheter and surgical ablation of atrial fibrillation: ... for personnel, policy, procedures and follow-up. ...

  1. Costing imaging procedures.

    PubMed

    Bretland, P M

    1988-01-01

    The existing National Health Service financial system makes comprehensive costing of any service very difficult. A method of costing using modern commercial methods has been devised, classifying costs into variable, semi-variable and fixed and using the principle of overhead absorption for expenditure not readily allocated to individual procedures. It proved possible to establish a cost spectrum over the financial year 1984-85. The cheapest examinations were plain radiographs outside normal working hours, followed by plain radiographs, ultrasound, special procedures, fluoroscopy, nuclear medicine, angiography and angiographic interventional procedures in normal working hours. This differs from some published figures, particularly those in the Körner report. There was some overlap between fluoroscopic interventional and the cheaper nuclear medicine procedures, and between some of the more expensive nuclear medicine procedures and the cheaper angiographic ones. Only angiographic and the few more expensive nuclear medicine procedures exceed the cost of the inpatient day. The total cost of the imaging service to the district was about 4% of total hospital expenditure. It is shown that where more procedures are undertaken, the semi-variable and fixed (including capital) elements of the cost decrease (and vice versa) so that careful study is required to assess the value of proposed economies. The method is initially time-consuming and requires a computer system with 512 Kb of memory, but once the basic costing system is established in a department, detailed financial monitoring should become practicable. The necessity for a standard comprehensive costing procedure of this nature, based on sound cost accounting principles, appears inescapable, particularly in view of its potential application to management budgeting. PMID:3349241

  2. Advance crew procedures development techniques: Procedures generation program requirements document

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.; Hawk, M. L.

    1974-01-01

    The Procedures Generation Program (PGP) is described as an automated crew procedures generation and performance monitoring system. Computer software requirements to be implemented in PGP for the Advanced Crew Procedures Development Techniques are outlined.

  3. Mobile Energy Laboratory Procedures

    SciTech Connect

    Armstrong, P.R.; Batishko, C.R.; Dittmer, A.L.; Hadley, D.L.; Stoops, J.L.

    1993-09-01

    Pacific Northwest Laboratory (PNL) has been tasked to plan and implement a framework for measuring and analyzing the efficiency of on-site energy conversion, distribution, and end-use application on federal facilities as part of its overall technical support to the US Department of Energy (DOE) Federal Energy Management Program (FEMP). The Mobile Energy Laboratory (MEL) Procedures establish guidelines for specific activities performed by PNL staff. PNL provided sophisticated energy monitoring, auditing, and analysis equipment for on-site evaluation of energy use efficiency. Specially trained engineers and technicians were provided to conduct tests in a safe and efficient manner with the assistance of host facility staff and contractors. Reports were produced to describe test procedures, results, and suggested courses of action. These reports may be used to justify changes in operating procedures, maintenance efforts, system designs, or energy-using equipment. The MEL capabilities can subsequently be used to assess the results of energy conservation projects. These procedures recognize the need for centralized NM administration, test procedure development, operator training, and technical oversight. This need is evidenced by increasing requests fbr MEL use and the economies available by having trained, full-time MEL operators and near continuous MEL operation. DOE will assign new equipment and upgrade existing equipment as new capabilities are developed. The equipment and trained technicians will be made available to federal agencies that provide funding for the direct costs associated with MEL use.

  4. Procedural learning and dyslexia.

    PubMed

    Nicolson, R I; Fawcett, A J; Brookes, R L; Needle, J

    2010-08-01

    Three major 'neural systems', specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed (Trends Neurosci., 30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief overview of the increasing evidence relating to the hypothesis, noting that the framework involves two main claims: first that 'neural systems' provides a productive level of description avoiding the underspecificity of cognitive descriptions and the overspecificity of brain structural accounts; and second that a distinctive feature of procedural learning is its extended time course, covering from minutes to months. In this article, we focus on the second claim. Three studies-speeded single word reading, long-term response learning, and overnight skill consolidation-are reviewed which together provide clear evidence of difficulties in procedural learning for individuals with dyslexia, even when the tasks are outside the literacy domain. The educational implications of the results are then discussed, and in particular the potential difficulties that impaired overnight procedural consolidation would entail. It is proposed that response to intervention could be better predicted if diagnostic tests on the different forms of learning were first undertaken. PMID:20680991

  5. Environmental Test Screening Procedure

    NASA Technical Reports Server (NTRS)

    Zeidler, Janet

    2000-01-01

    This procedure describes the methods to be used for environmental stress screening (ESS) of the Lightning Mapper Sensor (LMS) lens assembly. Unless otherwise specified, the procedures shall be completed in the order listed, prior to performance of the Acceptance Test Procedure (ATP). The first unit, S/N 001, will be subjected to the Qualification Vibration Levels, while the remainder will be tested at the Operational Level. Prior to ESS, all units will undergo Pre-ESS Functional Testing that includes measuring the on-axis and plus or minus 0.95 full field Modulation Transfer Function and Back Focal Length. Next, all units will undergo ESS testing, and then Acceptance testing per PR 460.

  6. Reasoning about procedural knowledge

    NASA Technical Reports Server (NTRS)

    Georgeff, M. P.

    1985-01-01

    A crucial aspect of automated reasoning about space operations is that knowledge of the problem domain is often procedural in nature - that is, the knowledge is often in the form of sequences of actions or procedures for achieving given goals or reacting to certain situations. In this paper a system is described that explicitly represents and reasons about procedural knowledge. The knowledge representation used is sufficiently rich to describe the effects of arbitrary sequences of tests and actions, and the inference mechanism provides a means for directly using this knowledge to reach desired operational goals. Furthermore, the representation has a declarative semantics that provides for incremental changes to the system, rich explanatory capabilities, and verifiability. The approach also provides a mechanism for reasoning about the use of this knowledge, thus enabling the system to choose effectively between alternative courses of action.

  7. The separation procedure.

    PubMed

    Kiely, Edward M; Spitz, Lewis

    2015-10-01

    The various stages of the separation are carefully planned but despite this, variations which will change the schedule of the procedure may exist. In general the operation commences on the opposite side from the main procedure and then the twins are turned for the remainder of the operation. Each type of conjoined twin is different but basically thoracopagus involves the hearts, omphalopagus involves the liver and small intestine and ischiopagus involves the large intestine and genito-urinary system. Our results are presented together with interesting cases from which lessons have been learned. PMID:26382263

  8. Toddler test or procedure preparation

    MedlinePlus

    Preparing toddler for test/procedure; Test/procedure preparation - toddler; Preparing for a medical test or procedure - toddler ... Before the test, know that your child will probably cry. Even if you prepare, your child may feel some discomfort or ...

  9. Preschooler test or procedure preparation

    MedlinePlus

    Preparing preschoolers for test/procedure; Test/procedure preparation - preschooler ... Preparing children for medical tests can reduce their distress. It can also make them less likely to cry and resist the procedure. Research shows that ...

  10. Common Dermatologic Procedures.

    PubMed

    Yang, Shelley; Kampp, Jeremy

    2015-11-01

    Dermatologists perform a wide variety of procedures on a daily basis. The skin biopsy is a fundamental technique that can be performed by all physicians who manage cutaneous conditions. Specimens should always be sent for pathologic evaluation, regardless of whether the sampled lesion appears benign. Postoperative care and education are critical for minimizing complications. PMID:26476254

  11. Parliamentary Procedure Made Easy.

    ERIC Educational Resources Information Center

    Hayden, Ellen T.

    Based on the newly revised "Robert's Rules of Order," these self-contained learning activities will help students successfully and actively participate in school, social, civic, political, or professional organizations. There are 13 lessons. Topics studied include the what, why, and history of parliamentary procedure; characteristics of the ideal…

  12. Simulating Laboratory Procedures.

    ERIC Educational Resources Information Center

    Baker, J. E.; And Others

    1986-01-01

    Describes the use of computer assisted instruction in a medical microbiology course. Presents examples of how computer assisted instruction can present case histories in which the laboratory procedures are simulated. Discusses an authoring system used to prepare computer simulations and provides one example of a case history dealing with fractured…

  13. Procedures of Mind.

    ERIC Educational Resources Information Center

    Kolers, Paul A.; Roediger, Henry L.

    1984-01-01

    Presents a "procedural view" of the learning mind, arguing against previous theories citing physical properties as its basis. A more process-oriented view of information processing is offered, which describes "mind" in terms of skill in manipulating symbols, and the notion of skills is shown to provide a useful framework for accounting for…

  14. Numerical Boundary Condition Procedures

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Topics include numerical procedures for treating inflow and outflow boundaries, steady and unsteady discontinuous surfaces, far field boundaries, and multiblock grids. In addition, the effects of numerical boundary approximations on stability, accuracy, and convergence rate of the numerical solution are discussed.

  15. Procedures and Policies Manual

    ERIC Educational Resources Information Center

    Davis, Jane M.

    2006-01-01

    This document was developed by the Middle Tennessee State University James E. Walker Library Collection Management Department to provide policies and procedural guidelines for the cataloging and processing of bibliographic materials. This document includes policies for cataloging monographs, serials, government documents, machine-readable data…

  16. PLATO Courseware Development Procedures.

    ERIC Educational Resources Information Center

    Mahler, William A.; And Others

    This is an exploratory study of methods for the preparation of computer curriculum materials. It deals with courseware development procedures for the PLATO IV computer-based education system, and draws on interviews with over 100 persons engaged in courseware production. The report presents a five stage model of development: (1) planning, (2)…

  17. Office Procedures Curriculum Guidelines.

    ERIC Educational Resources Information Center

    Washington Office of the State Superintendent of Public Instruction, Olympia. Div. of Vocational-Technical and Adult Education Services.

    This guideline is intended as a resource for instructors who are teaching an office procedures course. This course offers closure for all students completing a scope and sequence in the business education program--accounting, secretarial, office services, and related areas. The stated purpose of the course is to prepare a secondary learner for…

  18. Educational Accounting Procedures.

    ERIC Educational Resources Information Center

    Tidwell, Sam B.

    This chapter of "Principles of School Business Management" reviews the functions, procedures, and reports with which school business officials must be familiar in order to interpret and make decisions regarding the school district's financial position. Among the accounting functions discussed are financial management, internal auditing, annual…

  19. Visual Screening: A Procedure.

    ERIC Educational Resources Information Center

    Williams, Robert T.

    Vision is a complex process involving three phases: physical (acuity), physiological (integrative), and psychological (perceptual). Although these phases cannot be considered discrete, they provide the basis for the visual screening procedure used by the Reading Services of Colorado State University and described in this document. Ten tests are…

  20. Pediatric Procedural Pain

    ERIC Educational Resources Information Center

    Blount, Ronald L.; Piira, Tiina; Cohen, Lindsey L.; Cheng, Patricia S.

    2006-01-01

    This article reviews the various settings in which infants, children, and adolescents experience pain during acute medical procedures and issues related to referral of children to pain management teams. In addition, self-report, reports by others, physiological monitoring, and direct observation methods of assessment of pain and related constructs…

  1. Student Loan Collection Procedures.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    This manual on the collection of student loans is intended for the use of business officers and loan collection personnel of colleges and universities of all sizes. The introductory chapter is an overview of sound collection practices and procedures. It discusses the making of a loan, in-school servicing of the accounts, the exit interview, the…

  2. Grievance Procedure Problems.

    ERIC Educational Resources Information Center

    Green, Gary J.

    This paper presents two actual problems involving grievance procedures. Both problems involve pending litigation and one of them involves pending arbitration. The first problem occurred in a wealthy Minnesota school district and involved a seniority list. Because of changes in the financial basis for supporting public schools, it became necessary…

  3. Special Education: Procedural Guide.

    ERIC Educational Resources Information Center

    Dependents Schools (DOD), Washington, DC.

    The guide is intended to provide information to administrators and regional and local case study committees on special education procedures within Department of Defense Dependents Schools (DoDDS). The manual addresses a step-by step approach from referral to the implementation of individualized education programs (IEP). The following topics are…

  4. Procedural Quantum Programming

    NASA Astrophysics Data System (ADS)

    Ömer, Bernhard

    2002-09-01

    While classical computing science has developed a variety of methods and programming languages around the concept of the universal computer, the typical description of quantum algorithms still uses a purely mathematical, non-constructive formalism which makes no difference between a hydrogen atom and a quantum computer. This paper investigates, how the concept of procedural programming languages, the most widely used classical formalism for describing and implementing algorithms, can be adopted to the field of quantum computing, and how non-classical features like the reversibility of unitary transformations, the non-observability of quantum states or the lack of copy and erase operations can be reflected semantically. It introduces the key concepts of procedural quantum programming (hybrid target architecture, operator hierarchy, quantum data types, memory management, etc.) and presents the experimental language QCL, which implements these principles.

  5. Standards of neurosurgical procedures.

    PubMed

    Steiger, H J

    2001-01-01

    Written specifications with regard to procedures performed, equipment used, and training of the involved personnel are widely used in the industry and aviation to guarantee constant quality. Similar systems are progressively being introduced to medicine. We have made an effort to standardize surgical procedures by introducing step-by-step guidelines and checklists. The current experience shows that a system of written standards is applicable to neurosurgery and that the use of checklists contributes to the prevention of forgetting essential details. Written standards and checklists are also a useful training tool within a university hospital and facilitate communication of essentials to the residents. Comparison with aviation suggests that standardization leads to a remarkable but nonetheless limited reduction of adverse incidents. PMID:11840739

  6. Automatic beamline calibration procedures

    SciTech Connect

    Corbett, W.J.; Lee, M.J.; Zambre, Y.

    1992-03-01

    Recent experience with the SLC and SPEAR accelerators have led to a well-defined set of procedures for calibration of the beamline model using the orbit fitting program, RESOLVE. Difference orbit analysis is used to calibrate quadrupole strengths, BPM sensitivities, corrector strengths, focusing effects from insertion devices, and to determine the source of dispersion and coupling errors. Absolute orbit analysis is used to locate quadrupole misalignments, BPM offsets, or beam loss. For light source applications, the photon beam source coordinates can be found. The result is an accurate model of the accelerator which can be used for machine control. In this paper, automatable beamline calibration procedures are outlined and illustrated with recent examples. 5 refs.

  7. Hard tissue laser procedures.

    PubMed

    Gimbel, C B

    2000-10-01

    A more conservative, less invasive treatment of the carious lesion has intrigued researchers and clinicians for decades. With over 170 million restorations placed worldwide each year, many of which could be treated using a laser, there exists an increasing need for understanding hard tissue laser procedures. An historical review of past scientific and clinical hard research, biophysics, and histology are discussed. A complete review of present applications and procedures along with their capabilities and limitations will give the clinician a better understanding. Clinical case studies, along with guidelines for tooth preparation and hard tissue laser applications and technological advances for diagnosis and treatment will give the clinician a look into the future. PMID:11048281

  8. Practical procedures: oxygen therapy.

    PubMed

    Olive, Sandra

    Knowing when to start patients on oxygen therapy can save lives, but ongoing assessment and evaluation must be carried out to ensure the treatment is safe and effective. This article outlines when oxygen therapy should be used and the procedures to follow. It also describes the delivery methods applicable to different patient groups, along with the appropriate target saturation ranges, and details relevant nurse competencies. PMID:26901946

  9. Musculoskeletal Aspiration Procedures

    PubMed Central

    Hansford, Barry Glenn; Stacy, Gregory Scott

    2012-01-01

    With advances in imaging technology, there has been a significant increase in the number and range of interventional musculoskeletal image-guided procedures. One of the most commonly performed image-guided musculoskeletal interventions is the diagnostic and therapeutic percutaneous aspiration and drainage of multiple types of intra-articular, juxta-articular, and intramuscular pathologic fluid collections. These procedures may be performed under fluoroscopic, ultrasound, computed tomography, or even magnetic resonance guidance depending on the location to be accessed, type of pathology, patient characteristics, and operator preference. Musculoskeletal image-guided aspiration and drainage procedures are minimally invasive and generally very safe while offering valuable diagnostic information as well as therapeutic benefit. This article focuses on the appropriate indications, contraindications, and general technique for accessing the major joints via imaging guidance. For each joint, we discuss pertinent anatomy, appropriate imaging modalities, and preferred approaches to gaining intra-articular access. Additionally, the article discusses some of the more frequently encountered juxta-articular and intramuscular fluid collections that can be accessed and aspirated via percutaneous intervention, with mention of the importance of recognizing extremity sarcomas that can mimic these benign collections. PMID:24293800

  10. Pipe Cleaning Operating Procedures

    SciTech Connect

    Clark, D.; Wu, J.; /Fermilab

    1991-01-24

    This cleaning procedure outlines the steps involved in cleaning the high purity argon lines associated with the DO calorimeters. The procedure is broken down into 7 cycles: system setup, initial flush, wash, first rinse, second rinse, final rinse and drying. The system setup involves preparing the pump cart, line to be cleaned, distilled water, and interconnecting hoses and fittings. The initial flush is an off-line flush of the pump cart and its plumbing in order to preclude contaminating the line. The wash cycle circulates the detergent solution (Micro) at 180 degrees Fahrenheit through the line to be cleaned. The first rinse is then intended to rid the line of the majority of detergent and only needs to run for 30 minutes and at ambient temperature. The second rinse (if necessary) should eliminate the remaining soap residue. The final rinse is then intended to be a check that there is no remaining soap or other foreign particles in the line, particularly metal 'chips.' The final rinse should be run at 180 degrees Fahrenheit for at least 90 minutes. The filters should be changed after each cycle, paying particular attention to the wash cycle and the final rinse cycle return filters. These filters, which should be bagged and labeled, prove that the pipeline is clean. Only distilled water should be used for all cycles, especially rinsing. The level in the tank need not be excessive, merely enough to cover the heater float switch. The final rinse, however, may require a full 50 gallons. Note that most of the details of the procedure are included in the initial flush description. This section should be referred to if problems arise in the wash or rinse cycles.

  11. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation. PMID:27138033

  12. Radiometric correction procedure study

    NASA Technical Reports Server (NTRS)

    Colby, C.; Sands, R.; Murphrey, S.

    1978-01-01

    A comparison of MSS radiometric processing techniques identified as a preferred radiometric processing technique a procedure which equalizes the mean and standard deviation of detector-specific histograms of uncalibrated scene data. Evaluation of MSS calibration data demonstrated that the relationship between detector responses is essentially linear over the range of intensities typically observed in MSS data, and that the calibration wedge data possess a high degree of temporal stability. An analysis of the preferred radiometric processing technique showed that it could be incorporated into the MDP-MSS system without a major redesign of the system, and with minimal impact on system throughput.

  13. Clarification Procedure for Gels

    NASA Technical Reports Server (NTRS)

    Barber, Patrick G.; Simpson, Norman R.

    1987-01-01

    Procedure developed to obtain transparent gels with consistencies suitable for crystal growth, by replacing sodium ions in silicate solution with potassium ions. Clarification process uses cation-exchange resin to replace sodium ions in stock solution with potassium ions, placed in 1M solution of soluble potassium salt. Slurry stirred for several hours to allow potassium ions to replace all other cations on resin. Supernatant solution decanted through filter, and beads rinsed with distilled water. Rinsing removes excess salt but leaves cation-exchange beads fully charged with potassium ions.

  14. Surface cleanliness measurement procedure

    DOEpatents

    Schroder, Mark Stewart; Woodmansee, Donald Ernest; Beadie, Douglas Frank

    2002-01-01

    A procedure and tools for quantifying surface cleanliness are described. Cleanliness of a target surface is quantified by wiping a prescribed area of the surface with a flexible, bright white cloth swatch, preferably mounted on a special tool. The cloth picks up a substantial amount of any particulate surface contamination. The amount of contamination is determined by measuring the reflectivity loss of the cloth before and after wiping on the contaminated system and comparing that loss to a previous calibration with similar contamination. In the alternative, a visual comparison of the contaminated cloth to a contamination key provides an indication of the surface cleanliness.

  15. Advanced crew procedures development techniques: Procedures and performance program description

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Mangiaracina, A. A.

    1975-01-01

    The Procedures and Performance Program (PPP) for operation in conjunction with the Shuttle Procedures Simulator (SPS) is described. The PPP user interface, the SPS/PPP interface, and the PPP applications software are discussed.

  16. Interventional spinal procedures.

    PubMed

    Andreula, Cosma; Muto, Mario; Leonardi, Marco

    2004-05-01

    The interventional procedures for disk herniation and protrusion by percutaneous techniques are decompressive such as chemodiscolysis with chimopapain, nucleo-discectomy introduced by Onik, LASER discectomy, and recently nucleoplasty, and decompressive and direct antinflammatory such as chemiodiscolysis with an Oxygen-ozone mixture. These techniques have minimized the invasive nature of surgery and avoid or decrease complications like infection linked to surgery. Reducing intervertebral disc size by mechanical aspiration of a part of the disc or partially dissolving the herniation by drying reduces the conic pressure on the torn annulus and creates the space necessary for retropulsion whenever the circular fibres of the annulus regain a minimum capacity to contain the disc under tension. The proposed suggestion in these techniques is that a small change in volume produces large change in pressure. The success rates reported in different studies vary from 65 to 80% of excellent or good results with chemonucleolysis and aspiration. Vertebroplasty (VP) is done by percutaneous injection of acrylic cement (polymethylmetacrylate-PMMA) into the vertebrae under fluoroscopic and/or CT control to achieve an antalgic effect and stabilize the vertebral body. VP has been used for vertebral collapses caused by osteoporosis, long-term steroid treatment, aggressive symptomatic angiomas and lytic metastasis. The reported figures in literature are 80-95% of pain relief, within 7 days after procedure, commonly on the same day. PMID:15081127

  17. Designing Flight Deck Procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl

    2005-01-01

    Three reports address the design of flight-deck procedures and various aspects of human interaction with cockpit systems that have direct impact on flight safety. One report, On the Typography of Flight- Deck Documentation, discusses basic research about typography and the kind of information needed by designers of flight deck documentation. Flight crews reading poorly designed documentation may easily overlook a crucial item on the checklist. The report surveys and summarizes the available literature regarding the design and typographical aspects of printed material. It focuses on typographical factors such as proper typefaces, character height, use of lower- and upper-case characters, line length, and spacing. Graphical aspects such as layout, color coding, fonts, and character contrast are discussed; and several cockpit conditions such as lighting levels and glare are addressed, as well as usage factors such as angular alignment, paper quality, and colors. Most of the insights and recommendations discussed in this report are transferable to paperless cockpit systems of the future and computer-based procedure displays (e.g., "electronic flight bag") in aerospace systems and similar systems that are used in other industries such as medical, nuclear systems, maritime operations, and military systems.

  18. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  19. General procedure for gaging streams

    USGS Publications Warehouse

    Carter, R.W.; Davidian, Jacob

    1968-01-01

    This chapter briefly describes the objectives and procedures used in obtaining streamflow records. It is considered an introduction to other chapters on surface-water techniques which treat individual procedures in greater detail.

  20. Standards and procedures for INTERACT

    SciTech Connect

    Bonnet, J.M.

    1981-01-01

    There is presented a checklist of items that writers of execute procedures should consider when developing procedures for public use or exchange among INTERACT user sites. An example using the checklist is also given. 4 figures.

  1. MECHANIZATION OF CATALOGING PROCEDURES.

    PubMed

    KILGOUR, F G

    1965-04-01

    The Columbia-Harvard-Yale Medical Libraries Computerization Project has put into operation its mechanized procedure for the production of catalog cards. Cards produced are in final form ready to be filed into a card catalog. Catalogers prepare copy on a worksheet from which punched cards are punched. An IBM 1401 computer processes the decklets of punched cards on magnetic tape to produce the expanded decklets of punched cards needed to print the various packs of catalog cards required to go into different catalogs. Next, the computer punches the expanded decklets of cards to operate an 870 Document Writer, which types out the catalog cards in final form. Cost of cards ready to file is 12.5 cents per card. PMID:14271110

  2. Nursing Procedures. NAVMED P-5066.

    ERIC Educational Resources Information Center

    Bureau of Medicine and Surgery (Navy), Washington, DC.

    The revised manual of nursing procedures covers fundamental nursing care, admission and discharge of the patient, assisting with therapeutic measures, pre- and postoperative care, diagnostic tests and procedures, and isolation technique. Each of the over 300 topics includes the purpose, equipment, and procedure to be used and, where relevant, such…

  3. Policy and Procedures Manual. Revised.

    ERIC Educational Resources Information Center

    Mississippi State Board for Community and Junior Colleges, Jackson.

    The Mississippi State Board for Community and Junior College Policy and Procedures Manual has been established by the State Board to govern its actions and activities and those of the staff. It describes polices and procedures regarding board operations, staff employment, staff workplace, employee performance/grievance procedure, staff positions,…

  4. Group Syntality and Parliamentary Procedure.

    ERIC Educational Resources Information Center

    Winn, Larry James; Kell, Carl L.

    The group syntality concept of Raymond B. Cattell furnishes a useful framework for teaching parliamentary procedure. Although there are contrasts between the histories, subject matters, and perspectives of the areas of parliamentary procedure and group dynamics, teachers and students of parliamentary procedure might profitably draw from some of…

  5. Advanced crew procedures development techniques

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.; Tatum, I. C.

    1975-01-01

    The development of an operational computer program, the Procedures and Performance Program (PPP), is reported which provides a procedures recording and crew/vehicle performance monitoring capability. The PPP provides real time CRT displays and postrun hardcopy of procedures, difference procedures, performance, performance evaluation, and training script/training status data. During post-run, the program is designed to support evaluation through the reconstruction of displays to any point in time. A permanent record of the simulation exercise can be obtained via hardcopy output of the display data, and via magnetic tape transfer to the Generalized Documentation Processor (GDP). Reference procedures data may be transferred from the GDP to the PPP.

  6. [Neural basis of procedural memory].

    PubMed

    Mochizuki-Kawai, Hiroko

    2008-07-01

    Procedural memory is acquired by trial and error. Our daily life is supported by a number of procedural memories such as those for riding bicycle, typing, reading words, etc. Procedural memory is divided into 3 types; motor, perceptual, and cognitive. Here, the author reviews the cognitive and neural basis of procedural memory according to these 3 types. It is reported that the basal ganglia or cerebellum dysfunction causes deficits in procedural memory. Compared with age-matched healthy participants, patients with Parkinson disease (PD), Huntington disease (HD) or spinocerebellar degeneration (SCD) show deterioration in improvements in motor-type procedural memory tasks. Previous neuroimaging studies have reported that motor-type procedural memory may be supported by multiple brain regions, including the frontal and parietal regions as well as the basal ganglia (cerebellum); this was found with a serial reaction time task (SRT task). Although 2 other types of procedural memory are also maintained by multiple brain regions, the related cerebral areas depend on the type of memory. For example, it was suggested that acquisition of the perceptual type of procedural memory (e.g., ability to read mirror images of words) might be maintained by the bilateral fusiform region, while the acquisition of cognitive procedural memory might be supported by the frontal, parietal, or cerebellar regions as well as the basal ganglia. In the future, we need to cleary understand the neural "network" related to the procedural memory. PMID:18646622

  7. NASA trend analysis procedures

    NASA Technical Reports Server (NTRS)

    1993-01-01

    This publication is primarily intended for use by NASA personnel engaged in managing or implementing trend analysis programs. 'Trend analysis' refers to the observation of current activity in the context of the past in order to infer the expected level of future activity. NASA trend analysis was divided into 5 categories: problem, performance, supportability, programmatic, and reliability. Problem trend analysis uncovers multiple occurrences of historical hardware or software problems or failures in order to focus future corrective action. Performance trend analysis observes changing levels of real-time or historical flight vehicle performance parameters such as temperatures, pressures, and flow rates as compared to specification or 'safe' limits. Supportability trend analysis assesses the adequacy of the spaceflight logistics system; example indicators are repair-turn-around time and parts stockage levels. Programmatic trend analysis uses quantitative indicators to evaluate the 'health' of NASA programs of all types. Finally, reliability trend analysis attempts to evaluate the growth of system reliability based on a decreasing rate of occurrence of hardware problems over time. Procedures for conducting all five types of trend analysis are provided in this publication, prepared through the joint efforts of the NASA Trend Analysis Working Group.

  8. Transgenesis procedures in Xenopus

    PubMed Central

    Chesneau, Albert; Sachs, Laurent M.; Chai, Norin; Chen, Yonglong; Pasquier, Louis Du; Loeber, Jana; Pollet, Nicolas; Reilly, Michael; Weeks, Daniel L.; Bronchain, Odile J.

    2010-01-01

    Stable integration of foreign DNA into the frog genome has been the purpose of several studies aimed at generating transgenic animals or producing mutations of endogenous genes. Inserting DNA into a host genome can be achieved in a number of ways. In Xenopus, different strategies have been developed which exhibit specific molecular and technical features. Although several of these technologies were also applied in various model organizms, the attributes of each method have rarely been experimentally compared. Investigators are thus confronted with a difficult choice to discriminate which method would be best suited for their applications. To gain better understanding, a transgenesis workshop was organized by the X-omics consortium. Three procedures were assessed side-by-side, and the results obtained are used to illustrate this review. In addition, a number of reagents and tools have been set up for the purpose of gene expression and functional gene analyses. This not only improves the status of Xenopus as a powerful model for developmental studies, but also renders it suitable for sophisticated genetic approaches. Twenty years after the first reported transgenic Xenopus, we review the state of the art of transgenic research, focusing on the new perspectives in performing genetic studies in this species. PMID:18699776

  9. The procedure safety system

    NASA Technical Reports Server (NTRS)

    Obrien, Maureen E.

    1990-01-01

    Telerobotic operations, whether under autonomous or teleoperated control, require a much more sophisticated safety system than that needed for most industrial applications. Industrial robots generally perform very repetitive tasks in a controlled, static environment. The safety system in that case can be as simple as shutting down the robot if a human enters the work area, or even simply building a cage around the work space. Telerobotic operations, however, will take place in a dynamic, sometimes unpredictable environment, and will involve complicated and perhaps unrehearsed manipulations. This creates a much greater potential for damage to the robot or objects in its vicinity. The Procedural Safety System (PSS) collects data from external sensors and the robot, then processes it through an expert system shell to determine whether an unsafe condition or potential unsafe condition exists. Unsafe conditions could include exceeding velocity, acceleration, torque, or joint limits, imminent collision, exceeding temperature limits, and robot or sensor component failure. If a threat to safety exists, the operator is warned. If the threat is serious enough, the robot is halted. The PSS, therefore, uses expert system technology to enhance safety thus reducing operator work load, allowing him/her to focus on performing the task at hand without the distraction of worrying about violating safety criteria.

  10. Inflight IFR procedures simulator

    NASA Technical Reports Server (NTRS)

    Parker, L. C. (Inventor)

    1984-01-01

    An inflight IFR procedures simulator for generating signals and commands to conventional instruments provided in an airplane is described. The simulator includes a signal synthesizer which generates predetermined simulated signals corresponding to signals normally received from remote sources upon being activated. A computer is connected to the signal synthesizer and causes the signal synthesizer to produce simulated signals responsive to programs fed into the computer. A switching network is connected to the signal synthesizer, the antenna of the aircraft, and navigational instruments and communication devices for selectively connecting instruments and devices to the synthesizer and disconnecting the antenna from the navigational instruments and communication device. Pressure transducers are connected to the altimeter and speed indicator for supplying electrical signals to the computer indicating the altitude and speed of the aircraft. A compass is connected for supply electrical signals for the computer indicating the heading of the airplane. The computer upon receiving signals from the pressure transducer and compass, computes the signals that are fed to the signal synthesizer which, in turn, generates simulated navigational signals.

  11. 5-day/5-drug myeloablative outpatient regimen for resistant neuroblastoma.

    PubMed

    Kushner, B H; Modak, S; Kramer, K; Basu, E M; Roberts, S S; Cheung, N-Kv

    2013-05-01

    5-day/5-drug (5D/5D) is a novel high-dose regimen administered with autologous hematopoietic SCT (HSCT). It was designed to maximize cytoreduction via high dosing of synergistically interacting agents, while minimizing morbidity in patients with resistant neuroblastoma (NB) and ineligible for clinical trials due to myelosuppression from previous therapy. 5D/5D comprises carboplatin 500 mg/m(2)/day on days 1-2, irinotecan 50 mg/m(2)/day on days 1-3, temozolomide 250 mg/m(2)/day on days 1-3, etoposide 200 mg/m(2)/day on days 3-5 and cyclophosphamide 70 mg/kg/day on days 4-5. HSCT is on day 8. Sixteen patients received 21 courses. Treatment was in the outpatient clinic. Responses were noted against progressive disease (PD) that had developed while patients were off, or receiving only low-dose, chemotherapy but not against PD that emerged despite high-dose chemotherapy. Responses were also seen in patients with PD or stable disease after (131)I-metaiodobenzylguanidine therapy. Grade 3 toxicities were limited to transient elevations in liver enzymes (three courses) and hyponatremia (one course). Bacteremia occurred in 2/21 (10%) courses. Hematological recovery allowed patients to be enrolled on clinical trials. In conclusion, 5D/5D (including HSCT) spares vital organs, entails modest morbidity, shows activity against resistant NB and helps patients meet eligibility requirements for formal clinical trials. PMID:23085829

  12. Myeloablative Umbilical Cord Blood Transplantation in Hematological Diseases

    ClinicalTrials.gov

    2016-01-21

    Acute Myeloid Leukemia; Acute Lymphocytic Leukemia; Chronic Myelogenous Leukemia; Myelofibrosis; MDS; Refractory Anemia; Chronic Lymphocytic Leukemia; Prolymphocytic Leukemia; Non-Hodgkin's Lymphoma; Leukemia; Lymphoma; Multiple Myeloma; Myelodysplastic Syndromes

  13. UCB Transplant for Hematological Diseases Using a Non Myeloablative Prep

    ClinicalTrials.gov

    2016-04-08

    Acute Leukemia; Acute Myeloid Leukemia; Acute Lymphoblastic Leukemia/Lymphoma; Burkitt's Lymphoma; Natural Killer Cell Malignancies; Chronic Myelogenous Leukemia; Myelodysplastic Syndrome; Large-cell Lymphoma; Hodgkin Lymphoma; Multiple Myeloma; Chronic Lymphocytic Leukemia; Small Lymphocytic Lymphoma; Marginal Zone B-cell Lymphoma; Follicular Lymphoma; Lymphoplasmacytic Lymphoma; Mantle-cell Lymphoma; Prolymphocytic Leukemia; Bone Marrow Failure Syndromes; Myeloproliferative Syndromes

  14. MUSE optical alignment procedure

    NASA Astrophysics Data System (ADS)

    Laurent, Florence; Renault, Edgard; Loupias, Magali; Kosmalski, Johan; Anwand, Heiko; Bacon, Roland; Boudon, Didier; Caillier, Patrick; Daguisé, Eric; Dubois, Jean-Pierre; Dupuy, Christophe; Kelz, Andreas; Lizon, Jean-Louis; Nicklas, Harald; Parès, Laurent; Remillieux, Alban; Seifert, Walter; Valentin, Hervé; Xu, Wenli

    2012-09-01

    MUSE (Multi Unit Spectroscopic Explorer) is a second generation VLT integral field spectrograph (1x1arcmin² Field of View) developed for the European Southern Observatory (ESO), operating in the visible wavelength range (0.465-0.93 μm). A consortium of seven institutes is currently assembling and testing MUSE in the Integration Hall of the Observatoire de Lyon for the Preliminary Acceptance in Europe, scheduled for 2013. MUSE is composed of several subsystems which are under the responsibility of each institute. The Fore Optics derotates and anamorphoses the image at the focal plane. A Splitting and Relay Optics feed the 24 identical Integral Field Units (IFU), that are mounted within a large monolithic instrument mechanical structure. Each IFU incorporates an image slicer, a fully refractive spectrograph with VPH-grating and a detector system connected to a global vacuum and cryogenic system. During 2011, all MUSE subsystems were integrated, aligned and tested independently in each institute. After validations, the systems were shipped to the P.I. institute at Lyon and were assembled in the Integration Hall This paper describes the end-to-end optical alignment procedure of the MUSE instrument. The design strategy, mixing an optical alignment by manufacturing (plug and play approach) and few adjustments on key components, is presented. We depict the alignment method for identifying the optical axis using several references located in pupil and image planes. All tools required to perform the global alignment between each subsystem are described. The success of this alignment approach is demonstrated by the good results for the MUSE image quality. MUSE commissioning at the VLT (Very Large Telescope) is planned for 2013.

  15. Documenting Laboratory Procedures with Video

    PubMed Central

    Wyttenbach, Robert A.

    2015-01-01

    Demonstrating laboratory procedures in person during class time can be time-consuming. When procedures are done under a microscope, live demonstration is also impractical because of the limited number of students who can view the demonstration at once. Creating videos beforehand, which students can watch before class and review during lab sessions, solves both of these problems. This article suggests ways to make and distribute high quality video of microscopic procedures. PMID:26240520

  16. An evaluation of procedure 1

    NASA Technical Reports Server (NTRS)

    Wheeler, S. G.; Heydorn, R. P.; Misra, P. N.; Lee, W., Jr.; Smart, R. T. (Principal Investigator)

    1979-01-01

    LACIE Procedure 1 has undergone continuous testing and evaluation, starting with analytical and experimental studies even before it was implemented in ERIPS software and continuing to the present with performance evaluations using blind-site data. The strengths and weaknesses of the procedure are indicated and some areas for possible improvement are identified. Results from three of the experiments performed and an evaluation of LACIE Procedure 1 proportion estimates for some blind-site segments are discussed.

  17. Documenting Laboratory Procedures with Video.

    PubMed

    Wyttenbach, Robert A

    2015-01-01

    Demonstrating laboratory procedures in person during class time can be time-consuming. When procedures are done under a microscope, live demonstration is also impractical because of the limited number of students who can view the demonstration at once. Creating videos beforehand, which students can watch before class and review during lab sessions, solves both of these problems. This article suggests ways to make and distribute high quality video of microscopic procedures. PMID:26240520

  18. Electronic Procedures for Medical Operations

    NASA Technical Reports Server (NTRS)

    2015-01-01

    Electronic procedures are replacing text-based documents for recording the steps in performing medical operations aboard the International Space Station. S&K Aerospace, LLC, has developed a content-based electronic system-based on the Extensible Markup Language (XML) standard-that separates text from formatting standards and tags items contained in procedures so they can be recognized by other electronic systems. For example, to change a standard format, electronic procedures are changed in a single batch process, and the entire body of procedures will have the new format. Procedures can be quickly searched to determine which are affected by software and hardware changes. Similarly, procedures are easily shared with other electronic systems. The system also enables real-time data capture and automatic bookmarking of current procedure steps. In Phase II of the project, S&K Aerospace developed a Procedure Representation Language (PRL) and tools to support the creation and maintenance of electronic procedures for medical operations. The goal is to develop these tools in such a way that new advances can be inserted easily, leading to an eventual medical decision support system.

  19. Laboratory Procedures for Medical Assistants.

    ERIC Educational Resources Information Center

    Johnson, Pauline

    The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn to…

  20. A Procedure for Morphological Analysis.

    ERIC Educational Resources Information Center

    Chapin, Paul G.; Norton, Lewis M.

    A procedure, designated "MORPH," has been developed for the automatic morphological analysis of complex English words. Each word is reduced to a stem in canonical or dictionary form, plus affixes, inflectional and derivational, represented as morphemes or as syntactic features of the stem. The procedure includes the task of analyzing as many…

  1. Accounting Procedures for Student Organizations.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This two-part handbook presents information on accounting procedures for student organizations, with a focus on the laws, policies, and procedures that affect student body organizations. Part 1 contains information about: (1) legal status of a school's student body organization; (2) principles governing student body finance; (3) administration of…

  2. EVALUATION OF OZONE CALIBRATION PROCEDURES

    EPA Science Inventory

    In October of 1976, the U.S. Environmental Protection Agency announced that the calibration procedure then currently in use for reference methods for the measurement of ozone in the atmosphere -- the neutral buffered potassium iodide procedure -- had been found variable and in so...

  3. Characteristics of Multiple Comparison Procedures.

    ERIC Educational Resources Information Center

    Yusuf, Mian Muhammad; And Others

    Multiple comparison procedures (MCPs), in the context of analysis of variance, are becoming more popular than the overall F tests. An attempt is made to clarify confusion among the different MCPs by systematically comparing and contrasting the procedures in terms of their purposes, restrictions, robustness to assumptions, and other special…

  4. Developing Competency in Payroll Procedures

    ERIC Educational Resources Information Center

    Jackson, Allen L.

    1975-01-01

    The author describes a sequence of units that provides for competency in payroll procedures. The units could be the basis for a four to six week minicourse and are adaptable, so that the student, upon completion, will be able to apply his learning to any payroll procedures system. (Author/AJ)

  5. Ultrasound-Guided Hip Procedures.

    PubMed

    Payne, Jeffrey M

    2016-08-01

    This article describes the techniques for performing ultrasound-guided procedures in the hip region, including intra-articular hip injection, iliopsoas bursa injection, greater trochanter bursa injection, ischial bursa injection, and piriformis muscle injection. The common indications, pitfalls, accuracy, and efficacy of these procedures are also addressed. PMID:27468669

  6. Writer's Guide for technical procedures

    SciTech Connect

    Not Available

    1991-09-01

    A primary objective throughout the Department of Energy (DOE) complex is that operations be conducted in a deliberate and controlled manner with emphasis upon recognition and maintenance of the facility-specific safety envelope. One critical element of maintaining the safety envelope is procedures. DOE is providing guidance through this and other writer's guides to assist procedure writers across the DOE complex in producing accurate, complete, and usable procedures that promote safe and efficient operations in keeping with such DOE Orders as 5480.19, Conduct of Operations for DOE Facilities'', 5480.5, Safety of Nuclear facilities'', and 5480.6, Safety of Department of Energy-Owned Nuclear Reactors''. This Writer's Guide addresses the content, format, and style of technical procedures (procedures that prescribe production, operation of equipment and facilities, and maintenance activities) and is intended to be applied in a manner appropriate to the individual facility, 15 refs.

  7. Back to basics: procedural sedation.

    PubMed

    Spruce, Lisa

    2015-03-01

    Patients undergoing surgery frequently receive procedural sedation from RNs in the perioperative setting. With appropriate training, perioperative RNs can administer procedural sedation safely and effectively, helping to eliminate the pain and anxiety often experienced by patients. Facility sedation protocols should provide guidance on training requirements, the RN's role, the credentialing process, the medications the RN may use, and when anesthesia personnel should be consulted. Creating these protocols is guided by state scope of practice laws, Centers for Medicare & Medicaid Services Interpretive Guidelines, and accreditation requirements. Training, physician guidance, and appropriate protocols give the necessary support for perioperative nurses to provide safe and effective procedural sedation. PMID:25707727

  8. Practical pearls for oral procedures.

    PubMed

    Davari, Parastoo; Fazel, Nasim

    2016-01-01

    We provide an overview of clinically relevant principles of oral surgical procedures required in the workup and management of oral mucosal diseases. An understanding of the fundamental concepts of how to perform safely and effectively minor oral procedures is important to the practicing dermatologist and can minimize the need for patient referrals. This chapter reviews the principles of minor oral procedures, including incisional, excisional, and punch biopsies, as well as minor salivary gland excision. Pre- and postoperative patient care is also discussed. PMID:27343958

  9. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ... sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have you ...

  10. Loop Electrosurgical Excision Procedure (LEEP)

    MedlinePlus

    ... that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away ... A procedure in which an instrument works with electric current to destroy tissue. Local Anesthesia: The use of ...

  11. Surface Environmental Surveillance Procedures Manual

    SciTech Connect

    Hanf, RW; Dirkes, RL

    1990-02-01

    This manual establishes the procedures for the collection of environmental samples and the performance of radiation surveys and other field measurements. Responsibilities are defined for those personnel directly involved in the collection of samples and the performance of field measurements.

  12. Bronchoplastic procedures for lung cancer.

    PubMed

    Naruke, T; Yoneyama, T; Ogata, T; Suemasu, K

    1977-06-01

    Twenty patients with lung cancer have undergone bronchoplastic procedures September, 1965, to June, 1976 in our hospital. Bronchoplastic procedures are considered to be indicated for early cases of hilar lung cancer rather than for somewhat advanced cases. Endoscopic examination and roentgenograms of the bronchial arteries are needed to delineate resectional lines of bronchus, the former for deciding the mucosal extent and the latter the intrabronchial extent of the tumor. The bronchoplastic procedures we adopted were free from the risks and dangers generally accompanying the operation, and there were no postoperative deaths. For the prevention of postoperative complications, careful attention to suture technique is needed, and postoperative bronchoscopic suction of intrabronchial secretions is absolutely necessary. These procedures assure good quality of life postoperatively and improvement in the survival rate by preserving pulmonary function, enhancing curability, and increasing the operative indications. These advantages warrant high evaluation of the operation. PMID:870767

  13. Quarantine document system indexing procedure

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The Quarantine Document System (QDS) is described including the indexing procedures and thesaurus of indexing terms. The QDS consists of these functional elements: acquisition, cataloging, indexing, storage, and retrieval. A complete listing of the collection, and the thesaurus are included.

  14. Urinary incontinence - vaginal sling procedures

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007376.htm Urinary incontinence - vaginal sling procedures To use the sharing features ... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ...

  15. REMEDIAL ACTION COSTING PROCEDURES MANUAL

    EPA Science Inventory

    The manual provides specific procedures for the cost estimating and economic analysis steps required for preparing engineering cost estimates for selecting remedial action alternatives in response to the requirements of the Comprehensive Environmental Response, Compensation, and ...

  16. Adolescent test or procedure preparation

    MedlinePlus

    ... someone else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... effects the test may cause. Older adolescents may benefit from videos that show adolescents of the same ...

  17. Adolescent test or procedure preparation

    MedlinePlus

    ... else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... Alexander M. Managing patient stress in pediatric radiology. Radiol Technol . ... . Bray L, Callery P, Kirk S. A qualitative study ...

  18. Preschooler test or procedure preparation

    MedlinePlus

    ... procedure or other situation to ensure your child's safety. Restraints may be used to keep your child safe when staff temporarily have to leave the room during x-ray and nuclear studies. They may also be used when a ...

  19. Establishment of new asylum procedures.

    PubMed

    1988-01-01

    As of May 1988, the Austrian Government instituted new accelerated asylum procedures which enable applicants to know within a short time whether they are granted refugee status. Those who are not granted such status are refused further government assistance and asked to leave the country. This change in procedures was undertaken in part because of the increased number of applicants resulting from the abolishment of the visa requirement for citizens of Hungary and Poland travelling to Austria. PMID:12289355

  20. Collected radiochemical and geochemical procedures

    SciTech Connect

    Kleinberg, J

    1990-05-01

    This revision of LA-1721, 4th Ed., Collected Radiochemical Procedures, reflects the activities of two groups in the Isotope and Nuclear Chemistry Division of the Los Alamos National Laboratory: INC-11, Nuclear and radiochemistry; and INC-7, Isotope Geochemistry. The procedures fall into five categories: I. Separation of Radionuclides from Uranium, Fission-Product Solutions, and Nuclear Debris; II. Separation of Products from Irradiated Targets; III. Preparation of Samples for Mass Spectrometric Analysis; IV. Dissolution Procedures; and V. Geochemical Procedures. With one exception, the first category of procedures is ordered by the positions of the elements in the Periodic Table, with separate parts on the Representative Elements (the A groups); the d-Transition Elements (the B groups and the Transition Triads); and the Lanthanides (Rare Earths) and Actinides (the 4f- and 5f-Transition Elements). The members of Group IIIB-- scandium, yttrium, and lanthanum--are included with the lanthanides, elements they resemble closely in chemistry and with which they occur in nature. The procedures dealing with the isolation of products from irradiated targets are arranged by target element.

  1. Reporting Child Language Sampling Procedures

    PubMed Central

    Finestack, Lizbeth H.; Payesteh, Bita; Disher, Jill Rentmeester; Julien, Hannah M.

    2015-01-01

    Purpose Despite the long history of language sampling use in the study of child language development and disorders, there are no set guidelines specifying the reporting of language sampling procedures. The authors propose reporting standards for use by investigators who employ language samples in their research. Method The authors conducted a literature search of child-focused studies published in journals of the American Speech-Language-Hearing Association between January 2000 and December 2011 that included language sampling procedures to help characterize child participants or to derive measures to serve as dependent variables. Following this search, they reviewed each study and documented the language sampling procedures reported. Results The authors’ synthesis revealed that approximately 25% of all child-focused studies use language samples to help characterize participants and/or derive dependent variables. They found remarkable inconsistencies in the reporting of language sampling procedures. Conclusion To maximize the conclusions drawn from research using language samples, the authors strongly encourage investigators of child language to consistently report language sampling procedures using the proposed reporting checklist. PMID:25399013

  2. 7 CFR 47.20 - Documentary procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Documentary procedure. 47.20 Section 47.20 Agriculture... Documentary procedure. (a) In general. The documentary procedure described in this section shall, whenever it... oral hearing procedure hereinbefore provided. Under the documentary procedure, the pleadings of...

  3. 7 CFR 47.20 - Documentary procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Documentary procedure. 47.20 Section 47.20 Agriculture... Documentary procedure. (a) In general. The documentary procedure described in this section shall, whenever it... oral hearing procedure hereinbefore provided. Under the documentary procedure, the pleadings of...

  4. 40 CFR 1033.315 - Test procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We...

  5. 7 CFR 47.20 - Documentary procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Documentary procedure. 47.20 Section 47.20 Agriculture... Documentary procedure. (a) In general. The documentary procedure described in this section shall, whenever it... oral hearing procedure hereinbefore provided. Under the documentary procedure, the pleadings of...

  6. 7 CFR 47.20 - Documentary procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Documentary procedure. 47.20 Section 47.20 Agriculture... Documentary procedure. (a) In general. The documentary procedure described in this section shall, whenever it... oral hearing procedure hereinbefore provided. Under the documentary procedure, the pleadings of...

  7. 7 CFR 47.20 - Documentary procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Documentary procedure. 47.20 Section 47.20 Agriculture... Documentary procedure. (a) In general. The documentary procedure described in this section shall, whenever it... oral hearing procedure hereinbefore provided. Under the documentary procedure, the pleadings of...

  8. 40 CFR 1033.315 - Test procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We...

  9. 40 CFR 1033.315 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We...

  10. 34 CFR 303.170 - Procedural safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... process procedures in 34 CFR 300.506 through 300.512; or (2) The procedures that the State has developed... 34 Education 2 2011-07-01 2010-07-01 true Procedural safeguards. 303.170 Section 303.170 Education... Procedural safeguards. Each application must include procedural safeguards that— (a) Are consistent...

  11. 34 CFR 303.170 - Procedural safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...— (1) The due process procedures in 34 CFR 300.506 through 300.512; or (2) The procedures that the... 34 Education 2 2010-07-01 2010-07-01 false Procedural safeguards. 303.170 Section 303.170... Requirements § 303.170 Procedural safeguards. Each application must include procedural safeguards that— (a)...

  12. MITG test procedure and results

    SciTech Connect

    Eck, M.B.; Mukunda, M.

    1983-01-01

    Elements and modules for Radioisotope Thermoelectric Generator have been performance tested since the inception of the RTG program. These test articles seldom resembled flight hardware and often lacked adequate diagnostic instrumentation. Because of this, performance problems were not identified in the early stage of program development. The lack of test data in an unexpected area often hampered the development of a problem solution. A procedure for conducting the MITG Test was developed in an effort to obtain data in a systematic, unambiguous manner. This procedure required the development of extensive data acquisition software and test automation. The development of a facility to implement the test procedure, the facility hardware and software requirements, and the results of the MITG testing are the subject of this paper.

  13. Fluorometric procedures for dye tracing

    USGS Publications Warehouse

    Wilson, James F.; Cobb, Ernest D.; Kilpatrick, F.A.

    1986-01-01

    This manual describes the current fluorometric procedures used by the U.S. Geological Survey in dye tracer studies such as time of travel, dispersion, reaeration, and dilution-type discharge measurements. The advantages of dye tracing are (1) low detection and measurement limits and (2) simplicity and accuracy in measuring dye tracer concentrations using fluorometric techniques. The manual contains necessary background information about fluorescence, dyes, and fluorometers and a description of fluorometric operation and calibration procedures as a guide for laboratory and field use. The background information should be useful to anyone wishing to experiment with dyes, fluorometer components, or procedures different from those described. In addition, a brief section on aerial photography is included because of its possible use to supplement ground-level fluorometry.

  14. Fluorometric procedures for dye tracing

    USGS Publications Warehouse

    Wilson, James E., Jr.; Cobb, E.D.; Kilpatrick, F.A.

    1984-01-01

    This manual describes the current fluorometric procedures used by the U.S. Geological Survey in dye tracer studies such as time of travel, dispersion, reaeration, and dilution-type discharge measurements. The outstanding characteristics of dye tracing are: (1) the low detection and measurement limits, and (2) the simplicity and accuracy of measuring dye tracer concentrations using fluorometric techniques. The manual contains necessary background information about fluorescence, dyes, and fluorometers and a description of fluorometric operation and calibration procedures as a general guide for laboratory and field use. The background information should be useful to anyone wishing to experiment with dyes, fluorometer components, or procedures different from those described. In addition, a brief section is included on aerial photography because of its possible use to supplement ground-level fluorometry. (USGS)

  15. Fluorometric procedures for dye tracing

    USGS Publications Warehouse

    Wilson, James F.

    1968-01-01

    This manual describes the current fluorometric procedures used by the U.S. Geological Survey in dye tracer studies such as time of travel, dispersion, reaeration, and dilution-type discharge measurements. The advantages of dye tracing are (1) low detection and measurement limits and (2) simplicity and accuracy in measuring dye tracer concentrations using fluorometric techniques. The manual contains necessary background information about fluorescence, dyes, and fluorometers and a description of fluorometric operation and calibration procedures as a guide for laboratory and field use. The background information should be useful to anyone wishing to experiment with dyes, fluorometer components, or procedures different from those described. In addition, a brief section on aerial photography is included because of its possible use to supplement ground-level fluorometry.

  16. Authentication Procedures - The Procedures and Integration Working Group

    SciTech Connect

    Kouzes, Richard T.; Bratcher, Leigh; Gosnell, Tom; Langner, Diana; MacArthur, D.; Mihalczo, John T.; Pura, Carolyn; Riedy, Alex; Rexroth, Paul; Scott, Mary; Springarn, Jay

    2001-05-31

    Authentication is how we establish trust in monitoring systems and measurements to verify compliance with, for example, the storage of nuclear weapons material. Authentication helps assure the monitoring party that accurate and reliable information is provided by any measurement system and that any irregularities are detected. The U.S. is developing its point of view on the procedures for authentication of monitoring systems now planned or contemplated for arms reduction and control applications. The authentication of a system utilizes a set of approaches, including: functional testing using trusted calibration sources, evaluation of documentation, evaluation of software, evaluation of hardware, random selection of hardware and software, tamper-indicating devices, and operational procedures. Authentication of measurement systems should occur throughout their lifecycles, starting with the elements of design, and moving to off-site authentication, on-siste authentication, and continuing with authentication following repair. The most important of these is the initial design of systems. Hardware and software design criteria and procurement decisions can make future authentication relatively straightforward or conversely very difficult. Facility decisions can likewise ease the procedures for authentication since reliable and effective monitoring systems and tampering indicating devices can help provide the assurance needed in the integrity of such items as measurement systems, spare equipment, and reference sources. This paper will summarize the results of the U.S. Authentication Task Force discussion on the role of procedures in authentication.

  17. Tsallis’ entropy maximization procedure revisited

    NASA Astrophysics Data System (ADS)

    Martínez, S.; Nicolás, F.; Pennini, F.; Plastino, A.

    2000-11-01

    The proper way of averaging is an important question with regards to Tsallis’ Thermostatistics. Three different procedures have been thus far employed in the pertinent literature. The third one, i.e., the Tsallis-Mendes-Plastino (TMP) (Physica A 261 (1998) 534) normalization procedure, exhibits clear advantages with respect to earlier ones. In this work, we advance a distinct (from the TMP-one) way of handling the Lagrange multipliers involved in the extremization process that leads to Tsallis’ statistical operator. It is seen that the new approach considerably simplifies the pertinent analysis without losing the beautiful properties of the Tsallis-Mendes-Plastino formalism.

  18. [Procedures for establishing professional liability].

    PubMed

    Budić, Nikolina

    2008-01-01

    All the greater exposure to the procedures for determining liability for the conduct of medical activity points to the need that members of the Croatian Medical Chamber know the basis for establishing liability. Therefore, it is necessary to expose the reasons why the doctors are professionals and what kind of responsibility can be determined, in which procedures it is implemented, and what are the types of possible sanctions. Croatian Medical Chamber has a special role is, as it at the same time protects the rights and represents the interests of doctors, and enforces disciplinary proceedings. PMID:19146187

  19. 1995 Procedure for nominating Fellows

    NASA Astrophysics Data System (ADS)

    In 1994, there was a new procedure for nominating members of AGU for Fellowship for 1995. The new procedure was intended to increase the number of nominees. It required an initial nomination consisting only of a one-page letter and one-page cv. The Sections could make their selections prior to developing complete nomination packages for those candidates to be forwarded to the Union Committee. The timing of the process was changed so that Section committees would have more time to develop complete packages prior to forwarding their recommendations to the Union Committee.

  20. Landsat classification accuracy assessment procedures

    USGS Publications Warehouse

    Mead, R. R.; Szajgin, John

    1982-01-01

    A working conference was held in Sioux Falls, South Dakota, 12-14 November, 1980 dealing with Landsat classification Accuracy Assessment Procedures. Thirteen formal presentations were made on three general topics: (1) sampling procedures, (2) statistical analysis techniques, and (3) examples of projects which included accuracy assessment and the associated costs, logistical problems, and value of the accuracy data to the remote sensing specialist and the resource manager. Nearly twenty conference attendees participated in two discussion sessions addressing various issues associated with accuracy assessment. This paper presents an account of the accomplishments of the conference.

  1. 48 CFR 45.202 - Evaluation procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... offeror's property management plans, methods, practices, or procedures for accounting for property are... MANAGEMENT GOVERNMENT PROPERTY Solicitation and Evaluation Procedures 45.202 Evaluation procedures. (a) The contracting officer shall consider any potentially unfair competitive advantage that may result from...

  2. Budgetary Control Procedures for Institutions.

    ERIC Educational Resources Information Center

    Powell, Ray M.

    Budgetary control procedures for not-for-profit institutions are presented in this compilation of budgetary materials and ideas gathered at the Program for Institutional Administrators at the University of Notre Dame. Budgetary reporting and control are suggested as the most effective tools for coordinating and controlling the acquisition and use…

  3. Procedures for Handling Aerometric Data

    ERIC Educational Resources Information Center

    Akland, Gerald G.; Nehls, Gerald J.

    1973-01-01

    Applying to air quality data, procedures are presented for site characterization, method identification, data validation, and data summarization that are being established by the Environmental Protection Agency for the National Aerometric Data Bank. Topics review screening criteria, atypical results (data outliers), data accuracy and precision,…

  4. Concepts & Procedures. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Sarner, Ronald, Ed.; Mullick, Rosemary J., Ed.; Bauder, Deborah Y., Ed.

    This document contains the following full and short papers on concepts and procedures from the SITE (Society for Information Technology & Teacher Education) 2002 conference: "Exploring Minds Network" (Marino C. Alvarez and others); "Learning Communities: A Kaleidoscope of Ecological Designs" (Alain Breuleux and others); "PDA's and Research: A…

  5. Software Verification and Validation Procedure

    SciTech Connect

    Olund, Thomas S.

    2008-09-15

    This Software Verification and Validation procedure provides the action steps for the Tank Waste Information Network System (TWINS) testing process. The primary objective of the testing process is to provide assurance that the software functions as intended, and meets the requirements specified by the client. Verification and validation establish the primary basis for TWINS software product acceptance.

  6. Arkansas' Office Procedures Curriculum Guide.

    ERIC Educational Resources Information Center

    Clayton, Dean

    This curriculum guide provides teachers of office procedures classes with unit lesson plans and information about resource materials that can be examined, selected, and integrated into the instructional program. Contents are mainly established for the following two types of secondary-level programs: cooperative office education and intensive…

  7. Illustration of a Learning Procedure.

    ERIC Educational Resources Information Center

    Borghouts-van Erp, J. W. M.

    The paper describes evolution of an approach to teaching mathematically disabled and slow learning students through a Piagetian framework. It is explained that a step-by-step procedure is used to internalize material actions into mental actions via perception and verbalization. Formulae are introduced early, and emphasis is placed on promoting…

  8. Rules of Procedure for Investigation.

    ERIC Educational Resources Information Center

    National Education Association, Washington, DC. Commission on Professional Rights and Responsibilities.

    Among the functions of the Commission on Professional Rights and Responsibilities of the NEA is the investigation of cases of alleged unethical conduct by members of the teaching profession. The rules of procedure for investigations presented in this document are intended to assure all parties in a conflict of their individual rights of procedural…

  9. Motivational Procedures in School Settings.

    ERIC Educational Resources Information Center

    Klausmeier, Herbert J.

    Two concerns in education are student lack of motivation for achieving subject-matter knowledge and skills, and a high incidence of both disruptive and withdrawal behavior. The state of the art with respect to the motivational procedures teachers employ with students is in question. This paper attempts to answer by dealing with these related…

  10. The transfer of analytical procedures.

    PubMed

    Ermer, J; Limberger, M; Lis, K; Wätzig, H

    2013-11-01

    Analytical method transfers are certainly among the most discussed topics in the GMP regulated sector. However, they are surprisingly little regulated in detail. General information is provided by USP, WHO, and ISPE in particular. Most recently, the EU emphasized the importance of analytical transfer by including it in their draft of the revised GMP Guideline. In this article, an overview and comparison of these guidelines is provided. The key to success for method transfers is the excellent communication between sending and receiving unit. In order to facilitate this communication, procedures, flow charts and checklists for responsibilities, success factors, transfer categories, the transfer plan and report, strategies in case of failed transfers, tables with acceptance limits are provided here, together with a comprehensive glossary. Potential pitfalls are described such that they can be avoided. In order to assure an efficient and sustainable transfer of analytical procedures, a practically relevant and scientifically sound evaluation with corresponding acceptance criteria is crucial. Various strategies and statistical tools such as significance tests, absolute acceptance criteria, and equivalence tests are thoroughly descibed and compared in detail giving examples. Significance tests should be avoided. The success criterion is not statistical significance, but rather analytical relevance. Depending on a risk assessment of the analytical procedure in question, statistical equivalence tests are recommended, because they include both, a practically relevant acceptance limit and a direct control of the statistical risks. However, for lower risk procedures, a simple comparison of the transfer performance parameters to absolute limits is also regarded as sufficient. PMID:23978903

  11. Dynamic Assessment Procedure: A Validation.

    ERIC Educational Resources Information Center

    Bednar, Maryanne R.; Kletzien, Sharon B.

    A preliminary study investigated the value of the Dynamic Assessment Procedure (DAP) for understanding reading behaviors of at-risk high-school-age students. The study also sought to determine teacher interest in and ability to use the DAP information to develop instructional plans. Subjects, 19 students with reading difficulties enrolled in 1…

  12. Environmental Impact Assessment: A Procedure.

    ERIC Educational Resources Information Center

    Stover, Lloyd V.

    Prepared by a firm of consulting engineers, this booklet outlines the procedural "whys and hows" of assessing environmental impact, particularly for the construction industry. Section I explores the need for environmental assessment and evaluation to determine environmental impact. It utilizes a review of the National Environmental Policy Act and…

  13. Handbook on: Rights, Responsibilities, Procedures.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Rehabilitation Services, Springfield.

    This handbook presents policies and procedures that affect three schools operated by the Illinois Department of Rehabilitation Services to serve students with disabilities: the Illinois Center for Rehabilitation and Education-Roosevelt, Illinois School for the Deaf, and the Illinois School for the Visually Impaired. The handbook includes…

  14. Network-Based Management Procedures.

    ERIC Educational Resources Information Center

    Buckner, Allen L.

    Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

  15. Discourse Analysis Procedures: Reliability Issues.

    ERIC Educational Resources Information Center

    Hux, Karen; And Others

    1997-01-01

    A study evaluated and compared four methods of assessing reliability on one discourse analysis procedure--a modified version of Damico's Clinical Discourse Analysis. The methods were Pearson product-moment correlations; interobserver agreement; Cohen's kappa; and generalizability coefficients. The strengths and weaknesses of the methods are…

  16. Current procedural terminology; a primer.

    PubMed

    Hirsch, Joshua A; Leslie-Mazwi, Thabele M; Nicola, Gregory N; Barr, Robert M; Bello, Jacqueline A; Donovan, William D; Tu, Raymond; Alson, Mark D; Manchikanti, Laxmaiah

    2015-04-01

    In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies developed an iterative coding system for describing medical procedures and services using uniform language, the Current Procedural Terminology (CPT) system. The current code set, CPT IV, forms the basis of reporting most of the services performed by healthcare providers, physicians and non-physicians as well as facilities allowing effective, reliable communication among physician and other providers, third parties and patients. This coding system and its maintenance has evolved significantly since its inception, and now goes well beyond its readily perceived role in reimbursement. Additional roles include administrative management, tracking new and investigational procedures, and evolving aspects of 'pay for performance'. The system also allows for local, regional and national utilization comparisons for medical education and research. Neurointerventional specialists use CPT category I codes regularly--for example, 36,215 for first-order cerebrovascular angiography, 36,216 for second-order vessels, and 37,184 for acute stroke treatment by mechanical means. Additionally, physicians add relevant modifiers to the CPT codes, such as '-26' to indicate 'professional charge only,' or '-59' to indicate a distinct procedural service performed on the same day. PMID:24589819

  17. Program Planning Procedures Wall Chart.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Right to Read Unit.

    These ten program planning procedure wall charts include: "Right to Read Center Data," for identifying school, grade, enrollment by grade, size of community, ethnic balance, percentage on aid for Dependent Children, and transiency rate; "Needs Assessment Summary," for information on student performance, reading program, teacher performance,…

  18. Grievance Procedures. SPEC Kit 23.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    This collection of grievance procedures from member libraries of the Association of Research Libraries (ARL) contains: (1) documents on committee approaches to grievances from University of British Columbia, Center for Research Libraries, University of Connecticut, Harvard University, Michigan State University, and University of Nebraska; (2)…

  19. Teaching Assistant Policies and Procedures.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison.

    Policies and procedures covering graduate teaching assistants (TAs) at the University of Wisconsin-Madison are presented. A TA's duties may include classroom teaching under the direction of a faculty member, assisting in teaching classes, discussion groups, problem-solving sessions or laboratories, assisting in planning courses and developing…

  20. Concepts & Procedures. [SITE 2001 Section].

    ERIC Educational Resources Information Center

    Bauder, Deborah Y., Ed.; Mullick, Rosemary, Ed.; Sarner, Ronald, Ed.

    This document contains the following papers on concepts and procedures from the SITE (Society for Information Technology & Teacher Education) 2001 conference: "Using School District Standards To Develop Thematic Lessons for Electronic Portfolios" (Cindy L. Anderson and others); "Using Adobe Acrobat for Electronic Portfolio Development" (Helen C.…

  1. Reference Policies and Procedures Manual.

    ERIC Educational Resources Information Center

    George Mason Univ., Fairfax, VA.

    This guide to services of the reference department of Fenwick Library, George Mason University, is intended for use by staff in the department, as well as the general public. Areas covered include (1) reference desk services to users; (2) reference desk support procedures; (3) off desk services; (4) collection development, including staff…

  2. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... procedures prepared and followed for all significant steps in the infectious disease testing process under... procedures prepared, validated, and followed for prevention of infectious disease contamination or...

  3. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... procedures prepared and followed for all significant steps in the infectious disease testing process under... procedures prepared, validated, and followed for prevention of infectious disease contamination or...

  4. 76 FR 56969 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a regulatory evaluation... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  5. 76 FR 40600 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... Policies and Procedures (44 FR 11034; February 26,1979); and (3)does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  6. 75 FR 12977 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Takeoff Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  7. 75 FR 9095 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... Regulatory Policies and Procedures (44 FR 11034; February 26, 1979); and (3)does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  8. 76 FR 1354 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... Policies and Procedures (44 FR 11034; February 26,1979); and (3) does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  9. 76 FR 25232 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... Policies and Procedures (44 FR 11034; February 26,1979) ; and (3)does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  10. 76 FR 8291 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-14

    ... Procedures (44 FR 11034; February 26,1979); and (3) does not warrant preparation of a regulatory evaluation... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  11. Structured programming: Principles, notation, procedure

    NASA Technical Reports Server (NTRS)

    JOST

    1978-01-01

    Structured programs are best represented using a notation which gives a clear representation of the block encapsulation. In this report, a set of symbols which can be used until binding directives are republished is suggested. Structured programming also allows a new method of procedure for design and testing. Programs can be designed top down, that is, they can start at the highest program plane and can penetrate to the lowest plane by step-wise refinements. The testing methodology also is adapted to this procedure. First, the highest program plane is tested, and the programs which are not yet finished in the next lower plane are represented by so-called dummies. They are gradually replaced by the real programs.

  12. Streptococcal meningitis following myelogram procedures.

    PubMed

    Hsu, Jennifer; Jensen, Bette; Arduino, Matthew; Bergeron, Toni; Fox, Teresa; Gum, Greg; Pischke, Vera; Potts, David; Townes, John; Srinivasan, Arjun

    2007-05-01

    In September of 2004, we investigated 7 cases of post-myelography meningitis. Streptococcal species were recovered from blood or cerebrospinal fluid in all cases. Our findings suggest that droplet transmission of the oral flora of the clinician performing the procedure was the most likely source of these infections. The Centers for Disease Control and Prevention recommends the use of face masks by those performing myelograms. PMID:17464927

  13. Cytoreductive Surgery and Peritonectomy Procedures.

    PubMed

    Mehta, Sanket S; Bhatt, Aditi; Glehen, Olivier

    2016-06-01

    Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has become widely accepted as an effective method of treating peritoneal metastases (PM) from various cancers. CRS performed with the goal of removing all the macroscopic disease and comprises of peritonectomy procedures and visceral resections. CRS is a technically challenging surgery that requires a considerable amount of skill and appropriate patient selection. This article is a review of the techniques and current recommendations for performing CRS. PMID:27065704

  14. Feline onychectomy and elective procedures.

    PubMed

    Young, William Phillip

    2002-05-01

    The development of the carbon dioxide (CO2) surgical laser has given veterinarians a new perspective in the field of surgery. Recently developed techniques and improvisations of established procedures have opened the field of surgery to infinite applications never before dreamed of as little as 10 years ago. Today's CO2 surgical laser is an adaptable, indispensable tool for the everyday veterinary practitioner. Its use is becoming a common occurrence in offices of veterinarians around the world. PMID:12064043

  15. Cost analysis for procedure comparisons.

    PubMed

    Trowers, E A; Batra, S C; Buessler, J; Anderson, L K

    1995-01-01

    Using the methodology of activity-based costing as a conceptual framework, the authors present the potential cost reduction of a new office routine and a medical procedure. The costs of a new instrument for colorectal cancer screening and a new surveying and follow-up of at-risk patients show that time and relevant costs in the G.I Clinic and G.I Endoscopy Lab were significantly reduced. PMID:10153384

  16. Surface Environmental Surveillance Procedures Manual

    SciTech Connect

    RW Hanf; TM Poston

    2000-09-20

    Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual.

  17. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Contract Types SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  18. 47 CFR 1.1121 - Billing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Billing procedures. 1.1121 Section 1.1121 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule of Statutory Charges and Procedures for Payment § 1.1121 Billing procedures. (a) The fees required for the...

  19. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  20. 40 CFR 92.506 - Test procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 92.506 Section 92.506... and Audit Programs § 92.506 Test procedures. (a)(1) For locomotives and locomotive engines subject to the provisions of this subpart, the prescribed test procedures are those procedures described...

  1. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE...

  2. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE...

  3. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE...

  4. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE...

  5. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE...

  6. 49 CFR 193.2903 - Security procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures...

  7. 12 CFR 303.42 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Filing procedures. 303.42 Section 303.42 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Establishment and Relocation of Domestic Branches and Offices § 303.42 Filing procedures. (a) General. An applicant shall submit an application to...

  8. 19 CFR 351.221 - Review procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Review procedures. 351.221 Section 351.221 Customs... Antidumping and Countervailing Duty Procedures § 351.221 Review procedures. (a) Introduction. The procedures for reviews are similar to those followed in investigations. This section details the...

  9. 22 CFR 226.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procurement procedures. 226.44 Section 226.44...-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide, at...

  10. 31 CFR 510.801 - Procedures

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Procedures 510.801 Section 510.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Procedures § 510.801 Procedures For license application procedures...

  11. 44 CFR 78.14 - Alternative procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Alternative procedures. 78.14... ASSISTANCE § 78.14 Alternative procedures. For the purposes of this part, alternative procedures are... alternative procedures are available in the following circumstances. Native American tribes or...

  12. 44 CFR 78.14 - Alternative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Alternative procedures. 78.14... ASSISTANCE § 78.14 Alternative procedures. For the purposes of this part, alternative procedures are... alternative procedures are available in the following circumstances. Native American tribes or...

  13. 44 CFR 78.14 - Alternative procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Alternative procedures. 78.14... ASSISTANCE § 78.14 Alternative procedures. For the purposes of this part, alternative procedures are... alternative procedures are available in the following circumstances. Native American tribes or...

  14. 16 CFR 1.20 - Alternative procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures....

  15. 16 CFR 1.20 - Alternative procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures....

  16. 16 CFR 1.20 - Alternative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures....

  17. 16 CFR 1.20 - Alternative procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures....

  18. 44 CFR 78.14 - Alternative procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Alternative procedures. 78.14... ASSISTANCE § 78.14 Alternative procedures. For the purposes of this part, alternative procedures are... alternative procedures are available in the following circumstances. Native American tribes or...

  19. 16 CFR 1.20 - Alternative procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures....

  20. 44 CFR 78.14 - Alternative procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Alternative procedures. 78.14... ASSISTANCE § 78.14 Alternative procedures. For the purposes of this part, alternative procedures are... alternative procedures are available in the following circumstances. Native American tribes or...

  1. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for Public Transportation Systems § 601.47 Review Procedures....

  2. 40 CFR 154.34 - Expedited procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Expedited procedures. 154.34 Section 154.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.34 Expedited procedures. (a) The Agency may elect to issue...

  3. 10 CFR 820.63 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Procedures. 820.63 Section 820.63 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Exemption Relief § 820.63 Procedures. The Secretarial Officer shall utilize any procedures deemed necessary and appropriate to comply with his...

  4. 10 CFR 820.63 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Procedures. 820.63 Section 820.63 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Exemption Relief § 820.63 Procedures. The Secretarial Officer shall utilize any procedures deemed necessary and appropriate to comply with his...

  5. 10 CFR 820.63 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Procedures. 820.63 Section 820.63 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Exemption Relief § 820.63 Procedures. The Secretarial Officer shall utilize any procedures deemed necessary and appropriate to comply with his...

  6. 10 CFR 820.63 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Procedures. 820.63 Section 820.63 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Exemption Relief § 820.63 Procedures. The Secretarial Officer shall utilize any procedures deemed necessary and appropriate to comply with his...

  7. 42 CFR 488.110 - Procedural guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Procedural guidelines. 488.110 Section 488.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES SURVEY FORMS AND PROCEDURES § 488.110 Procedural guidelines....

  8. 5 CFR 1201.73 - Discovery procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Discovery procedures. 1201.73 Section... AND PROCEDURES Procedures for Appellate Cases Discovery § 1201.73 Discovery procedures. (a) Initiating discovery. A party seeking discovery must start the process by serving a request for discovery on...

  9. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  10. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  11. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  12. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  13. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  14. 12 CFR 303.161 - Filing procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Filing procedures. 303.161 Section 303.161 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Mutual-To-Stock Conversions § 303.161 Filing procedures. (a) Prior notice required. In addition to complying with the substantive requirements in...

  15. 12 CFR 303.121 - Filing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Filing procedures. 303.121 Section 303.121 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Activities of Insured State Banks § 303.121 Filing procedures. (a) Where to file. A notice...

  16. 49 CFR 193.2903 - Security procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures...

  17. 49 CFR 193.2903 - Security procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures...

  18. 10 CFR 431.154 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Test procedures. 431.154 Section 431.154 Energy DEPARTMENT... EQUIPMENT Commercial Clothers Washers Test Procedures § 431.154 Test procedures. The test procedures for residential clothes washers in Appendix J1 to subpart B of part 430 of this title shall be used to...

  19. 40 CFR 89.508 - Test procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Test procedures. 89.508 Section 89.508... Test procedures. (a)(1) For nonroad engines subject to the provisions of this subpart, the prescribed test procedures are the nonroad engine 8-mode test procedure as described in subpart E of this...

  20. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  1. 45 CFR 605.61 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Procedures. 605.61 Section 605.61 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 605.61 Procedures. The procedural...

  2. 45 CFR 605.61 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Procedures. 605.61 Section 605.61 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 605.61 Procedures. The procedural...

  3. 45 CFR 605.61 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Procedures. 605.61 Section 605.61 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 605.61 Procedures. The procedural...

  4. 28 CFR 40.8 - Emergency procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Emergency procedure. 40.8 Section 40.8... for Inmate Grievance Procedures § 40.8 Emergency procedure. The grievance procedure shall contain special provision for responding to grievances of an emergency nature. Emergency grievances shall...

  5. 28 CFR 40.8 - Emergency procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Emergency procedure. 40.8 Section 40.8... for Inmate Grievance Procedures § 40.8 Emergency procedure. The grievance procedure shall contain special provision for responding to grievances of an emergency nature. Emergency grievances shall...

  6. Procedural Messages in Small Group Interaction.

    ERIC Educational Resources Information Center

    Putnam, Linda L.

    Three studies were conducted to ascertain the relationship between predisposition for group work climate and the types of procedural messages that group members employ. In the studies, expectations about group work procedures fell into two categories: high procedural order (HPO) and low procedural order (LPO). Each category consisted of four…

  7. 21 CFR 1271.180 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Procedures. 1271.180 Section 1271.180 Food and... CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.180 Procedures. (a) General. You... and approve these procedures. (c) Availability. These procedures must be readily available to...

  8. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  9. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  10. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  11. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  12. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  13. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  14. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  15. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  16. 20 CFR 702.394 - Appeals; procedure.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Appeals; procedure. 702.394 Section 702.394 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Adjudication Procedures Appeals § 702.394 Appeals; procedure....

  17. Isolated Chylopericardium after Intrapericardial Procedures

    PubMed Central

    Kan, Chung-Dann; Wang, Jieh-Neng; Wu, Jing-Ming; Yang, Yu-Jen

    2007-01-01

    Chylopericardium after an intrapericardial procedure is rare, and satisfactory explanations of its possible causes are lacking. Herein, we present 4 cases of chylopericardium that developed after intrapericardial surgery, and we review the literature. Our literature review revealed 29 cases of chylopericardium that complicated intrapericardial operations, to which we added our 4 cases for analysis. The 33 surgical procedures involved repair for congenital heart disease (n=21), valve surgery (n=5), coronary artery bypass grafting (n=6), and other (n=1). Causes were verified in 7 patients: small lymphatic injury in 3 and high venous pressure or venous thrombosis in 4. Of the 26 patients with chylopericardium of unknown origin, 15 had congenital heart disease. Ten of these 15 had chromosomal abnormalities, especially trisomy 21 (Down syndrome); these patients typically had increased lymphatic permeability, which raised the likelihood of chylopericardium. Five revascularizations for coronary artery disease required harvesting of the left internal thoracic artery for reconstruction, incurring a risk of damage to the drainage site of the right efferent lymphatic trunk. In addition, all 26 patients with chylopericardium of unknown origin underwent dissection of the ascending aorta and the main pulmonary artery, near the right efferent lymphatic trunk. Inadvertent injury to the trunk during the dissection would have increased the risk of chylopericardium. Accordingly, even though the overall incidence of chylopericardium during intrapericardial procedures is low, we recommend a meticulous dissection of the ascending aorta from the main pulmonary artery. PMID:17420799

  18. Compound estimation procedures in reliability

    NASA Technical Reports Server (NTRS)

    Barnes, Ron

    1990-01-01

    At NASA, components and subsystems of components in the Space Shuttle and Space Station generally go through a number of redesign stages. While data on failures for various design stages are sometimes available, the classical procedures for evaluating reliability only utilize the failure data on the present design stage of the component or subsystem. Often, few or no failures have been recorded on the present design stage. Previously, Bayesian estimators for the reliability of a single component, conditioned on the failure data for the present design, were developed. These new estimators permit NASA to evaluate the reliability, even when few or no failures have been recorded. Point estimates for the latter evaluation were not possible with the classical procedures. Since different design stages of a component (or subsystem) generally have a good deal in common, the development of new statistical procedures for evaluating the reliability, which consider the entire failure record for all design stages, has great intuitive appeal. A typical subsystem consists of a number of different components and each component has evolved through a number of redesign stages. The present investigations considered compound estimation procedures and related models. Such models permit the statistical consideration of all design stages of each component and thus incorporate all the available failure data to obtain estimates for the reliability of the present version of the component (or subsystem). A number of models were considered to estimate the reliability of a component conditioned on its total failure history from two design stages. It was determined that reliability estimators for the present design stage, conditioned on the complete failure history for two design stages have lower risk than the corresponding estimators conditioned only on the most recent design failure data. Several models were explored and preliminary models involving bivariate Poisson distribution and the

  19. National Ignition Facility (NIF) operations procedures plan

    SciTech Connect

    Mantrom, D.

    1998-05-06

    The purpose of this Operations Procedures Plan is to establish a standard procedure which outlines how NIF Operations procedures will be developed (i.e , written, edited, reviewed, approved, published, revised) and accessed by the NIF Operations staff who must use procedures in order to accomplish their tasks. In addition, this Plan is designed to provide a guide to the NIF Project staff to assist them in planning and writing procedures. Also, resource and scheduling information is provided.

  20. Third-order RKR procedure

    NASA Astrophysics Data System (ADS)

    Pardo, A.; Camacho, J. J.; Poyato, J. M. L.; Fernandez-Alonso, J. I.

    1986-03-01

    Potential energy curves for the X 1Σ +state of 6LiH, 7LiH and 6LiD, 7LiD molecules have been calculated by the third-order RKR inversion procedure by including the Kaise correction. The results are in agreement with previously obtained curves by other authors using differents methods. As a check, the exact vibrational eigenfunctions, appropriate to these potentials, are obtained by direct numerical solutions of the radical Schrödinger equation.

  1. Interventional procedures for facial pain.

    PubMed

    Vorenkamp, Kevin E

    2013-01-01

    Interventional pain procedures are critical in the diagnosis and management of a variety of facial pain conditions. Trigeminal neuralgia (TN) is the most frequent diagnosis for facial pain, with a reported prevalence 10 times greater than persistent idiopathic facial pain (PIFP). Although pharmacological treatments and psychological interventions benefit many patients with these diagnoses, the pain remains disabling for a significant portion of others. Percutaneous interventions targeting the gasserian ganglion and its branches have proven effective in the management of TN, while there is also supportive evidence for treating the sphenopalatine ganglion in PIFP. PMID:23250793

  2. Ultrasound-Guided Elbow Procedures.

    PubMed

    Sussman, Walter I; Williams, Christopher J; Mautner, Ken

    2016-08-01

    High-resolution ultrasonography can help clinicians visualize key anatomic structures of the elbow and guide periarticular and intra-articular injections. Historically, most procedures done around the elbow have been done using landmark guidance, and few studies have reported the accuracy of ultrasonography-guided injections in the elbow region. This article reviews common musculoskeletal disorders about the elbow that can be evaluated with ultrasonography, reviews the literature on ultrasonography-guided injections of the elbow region, and describes the senior author's preferred approach for the most commonly performed elbow region injections. PMID:27468667

  3. A direct element resequencing procedure

    NASA Technical Reports Server (NTRS)

    Akin, J. E.; Fulford, R. E.

    1978-01-01

    Element by element frontal solution algorithms are utilized in many of the existing finite element codes. The overall computational efficiency of this type of procedure is directly related to the element data input sequence. Thus, it is important to have a pre-processor which will resequence these data so as to reduce the element wavefronts to be encountered in the solution algorithm. A direct element resequencing algorithm is detailed for reducing element wavefronts. It also generates computational by products that can be utilized in pre-front calculations and in various post-processors. Sample problems are presented and compared with other algorithms.

  4. Procedures for precap visual inspection

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Screening procedures for the final precap visual inspection of microcircuits used in electronic system components are described as an aid in training personnel unfamiliar with microcircuits. Processing techniques used in industry for the manufacture of monolithic and hybrid components are presented and imperfections that may be encountered during this inspection are discussed. Problem areas such as scratches, voids, adhesions, and wire bonding are illustrated by photomicrographs. This guide can serve as an effective tool in training personnel to perform precap visual inspections efficiently and reliably.

  5. Hemispherectomy Procedure in Proteus Syndrome.

    PubMed

    Gunawan, PrastiyaIndra; Lusiana, Lusiana; Saharso, Darto

    2016-01-01

    Objective Proteus syndrome is a rare overgrowth disorder including bone, soft tissue, and skin. Central nervous system manifestations were reported in about 40% of the patients including hemimegalencephaly and the resultant hemicranial hyperplasia, convulsions and mental deficiency. We report a 1-month-old male baby referred to Pediatric Neurology Clinic Soetomo Hospital, Surabaya, Indonesia in 2014 presented recurrent seizures since birth with asymmetric dysmorphic face with the right side larger than the left, subcutaneous mass and linear nevi. Craniocervical MRI revealed hemimegalencephaly right cerebral hemisphere. Triple antiepileptic drugs were already given as well as the ketogenic diet, but the seizures persisted. The seizure then was resolved after hemispherectomy procedure. PMID:27375761

  6. Procedures for computing site seismicity

    NASA Astrophysics Data System (ADS)

    Ferritto, John

    1994-02-01

    This report was prepared as part of the Navy's Seismic Hazard Mitigation Program. The Navy has numerous bases located in seismically active regions throughout the world. Safe effective design of waterfront structures requires determining expected earthquake ground motion. The Navy's problem is further complicated by the presence of soft saturated marginal soils that can significantly amplify the levels of seismic shaking as evidenced in the 1989 Loma Prieta earthquake. The Naval Facilities Engineering Command's seismic design manual, NAVFAC P355.l, requires a probabilistic assessment of ground motion for design of essential structures. This report presents the basis for the Navy's Seismic Hazard Analysis procedure that was developed and is intended to be used with the Seismic Hazard Analysis computer program and user's manual. This report also presents data on geology and seismology to establish the background for the seismic hazard model developed. The procedure uses the historical epicenter data base and available geologic data, together with source models, recurrence models, and attenuation relationships to compute the probability distribution of site acceleration and an appropriate spectra. This report discusses the developed stochastic model for seismic hazard evaluation and the associated research.

  7. Ice anaesthesia in procedural dermatology.

    PubMed

    Dixit, Shreya; Lowe, Patricia; Fischer, Gayle; Lim, Adrian

    2013-11-01

    This article presents findings from a survey of Australian dermatologists who were questioned about their preferred pain control methods when carrying out injectable procedures. We also present, what is to the best of our knowledge, the first proof-of-concept experiment exploring the relationship between ice-to-skin contact time and skin surface temperature, using both ice wrapped in latex and ice wrapped in aluminium foil. Of 79 dermatologists 32 responded to the survey (41% response rate): 31 (97%) injected botulinum toxin type A (BTA) for dynamic lines, 26 (81%) injected BTA for hyperhidrosis, and 24 (75%) injected skin fillers. Ice anaesthesia was the most common method of pain control (75%) followed by use of topical anaesthesia (50%) such as EMLA, compound agents and lignocaine 4%. Ice wrapped in latex or latex-like material was the most common ice packaging used by those surveyed and the median ice-to-skin contact time was 10 s. The ice experiment results indicated that ice wrapped with aluminium foil was equivalent to ice wrapped in latex for short contact times (< 20 s), but more effective at reducing skin temperature with longer contact times (> 20 s). These findings will be of relevance to cosmetic and paediatric dermatologists or any area of procedural medicine where effective non-injectable pain control is required. PMID:23617804

  8. Design procedures for compressor blades

    NASA Technical Reports Server (NTRS)

    Starken, H.

    1983-01-01

    The conventional methods for the design of the blades in the case of axial turbomachines are considered, taking into account difficulties concerning the determination of optimal blade profiles. These difficulties have been partly overcome as a consequence of the introduction of new numerical methods during the last few years. It is pointed out that, in the case of the subsonic range, a new procedure is now available for the determination of the form of blade profile on the basis of a given velocity distribution on the profile surface. The search for a profile form with favorable characteristics is consequently transformed into a search for a favorable velocity or pressure distribution on the blade. The distribution of velocities depends to a large degree on the characteristics of the profile boundary layers. The considered concept is not new. However, its practical implementation has only recently become possible. The employment of the new design procedure is illustrated with the aid of an example involving a concrete design problem.

  9. Taguchi optimisation of ELISA procedures.

    PubMed

    Jeney, C; Dobay, O; Lengyel, A; Adám, E; Nász, I

    1999-03-01

    We propose a new method in the field of ELISA optimization using an experimental design called the Taguchi method. This can be used to compare the net effects of different conditions which can be both qualitative and quantitative in nature. The method reduces the effects of the interactions of the optimized variables making it possible to access the optimum conditions even in cases where there are large interactions between the variables of the assay. Furthermore, the proposed special assignment of factors makes it possible to calculate the biochemical parameters of the ELISA procedure carried out under optimum conditions. Thus, the calibration curve, the sensitivity of the optimum assay, the intra-assay and inter-assay variability can be estimated. The method is fast, accessing the results in one step, compared to the traditional, time-consuming 'one-step-at-a-time' method. We exemplify the procedure with a method to optimize the detection of ScFv (single chain fragment of variable) phages by ELISA. All the necessary calculations can be carried out by a spreadsheet program without any special statistical knowledge. PMID:10089092

  10. 77 FR 18679 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  11. 78 FR 70494 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... ``significant rule '' under DOT Regulatory Policies and Procedures (44 FR 11034; February 26,1979); and (3) does... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  12. 76 FR 30534 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... Procedures (44 FR 11034; February 26,1979); and (3) does not warrant preparation of a regulatory evaluation... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures ] (SIAPs) and associated Takeoff Minimums and Obstacle Departure...

  13. 78 FR 40383 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034; February 26,1979); and (3) does... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  14. 76 FR 16686 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  15. 77 FR 59738 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  16. 78 FR 5254 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... ``significant rule '' under DOT Regulatory Policies and Procedures (44 FR 11034; February 26,1979); and (3) does... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  17. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  18. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  19. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  20. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  1. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  2. 40 CFR 1060.505 - Other procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... equivalent to allowed procedures or are more accurate or more precise than allowed procedures. See 40 CFR... CONTROL OF EVAPORATIVE EMISSIONS FROM NEW AND IN-USE NONROAD AND STATIONARY EQUIPMENT Test...

  3. 40 CFR 1060.505 - Other procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... equivalent to allowed procedures or are more accurate or more precise than allowed procedures. See 40 CFR... CONTROL OF EVAPORATIVE EMISSIONS FROM NEW AND IN-USE NONROAD AND STATIONARY EQUIPMENT Test...

  4. 40 CFR 1060.505 - Other procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... equivalent to allowed procedures or are more accurate or more precise than allowed procedures. See 40 CFR... CONTROL OF EVAPORATIVE EMISSIONS FROM NEW AND IN-USE NONROAD AND STATIONARY EQUIPMENT Test...

  5. 40 CFR 140.5 - Analytical procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) MARINE SANITATION DEVICE STANDARD § 140.5 Analytical procedures. In determining the composition and quality of effluent discharge from marine sanitation devices, the procedures contained in 40 CFR part...

  6. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  7. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  8. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  9. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  10. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  11. Sandia Satellite Program summary of operational procedures

    SciTech Connect

    Not Available

    1989-08-01

    Operational procedures for the Space Systems Department and Space Sensors Department are described. Departmental policies and procedures from design of systems for space applications through qualification for spaceflight are summarized. 1 fig.

  12. Procedures For Microbial-Ecology Laboratory

    NASA Technical Reports Server (NTRS)

    Huff, Timothy L.

    1993-01-01

    Microbial Ecology Laboratory Procedures Manual provides concise and well-defined instructions on routine technical procedures to be followed in microbiological laboratory to ensure safety, analytical control, and validity of results.

  13. 45 CFR 77.6 - Emergency procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... LETTER OF CREDIT ADMINISTRATION § 77.6 Emergency procedures. (a) Should the Department determine that it... its letter of credit without taking remedial action prior to the procedures specified in § 77.5,...

  14. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  15. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  16. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  17. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  18. PERFORMANCE AUDIT PROCEDURES FOR OPACITY MONITORS

    EPA Science Inventory

    The manual contains monitor-specific performance audit procedures and data forms for use in conducting audits of installed opacity continuous emission monitoring systems (CEMS). General auditing procedures and acceptance limits for various audit criteria are discussed. Practical ...

  19. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  20. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  1. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  2. 23 CFR 630.803 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project under... part of the agency constructing the dam to provide such bridge or approach roads to satisfy a...

  3. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  4. School age test or procedure preparation

    MedlinePlus

    ... your child understands, and use real terms. Avoid abstract terms. Make sure your child understands the exact ... be able to identify concerns through your child's art. DURING THE PROCEDURE If the procedure is performed ...

  5. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  6. Surgical procedures for voice restoration

    PubMed Central

    Nawka, Tadeus; Hosemann, Werner

    2005-01-01

    Surgical procedures for voice restoration serve to improve oral communication by better vocal function. They comprise of phonomicrosurgery, with direct and indirect access to the larynx; laryngoplasty; laryngeal injections; and surgical laryngeal reinnervation. The basis for modern surgical techniques for voice disorders is the knowledge about the ultrastructure of the vocal folds and the increasing experience of surgeons in voice surgery, while facing high social and professional demands on the voice. Vocal activity limitation and participation restriction has become more important in the artistic and social areas. A number of surgical methods that have been developed worldwide for this reason, are presented in this article. Functional oriented surgery has to meet high standards. The diagnostics of vocal function has to be multi-dimensional in order to determine the indication and the appropriate surgical intervention. PMID:22073062

  7. Pattern recognition systems and procedures

    NASA Technical Reports Server (NTRS)

    Nelson, G. D.; Serreyn, D. V.

    1972-01-01

    The objectives of the pattern recognition tasks are to develop (1) a man-machine interactive data processing system; and (2) procedures to determine effective features as a function of time for crops and soils. The signal analysis and dissemination equipment, SADE, is being developed as a man-machine interactive data processing system. SADE will provide imagery and multi-channel analog tape inputs for digitation and a color display of the data. SADE is an essential tool to aid in the investigation to determine useful features as a function of time for crops and soils. Four related studies are: (1) reliability of the multivariate Gaussian assumption; (2) usefulness of transforming features with regard to the classifier probability of error; (3) advantage of selecting quantizer parameters to minimize the classifier probability of error; and (4) advantage of using contextual data. The study of transformation of variables (features), especially those experimental studies which can be completed with the SADE system, will be done.

  8. On terms and procedures: Fluency

    PubMed Central

    Johnson, Kent R.; Layng, T. V. Joe

    1996-01-01

    Fluency is a metaphor for flowing, effortless, well-practiced, and accurate performance. Current practice in fluency building involves increasing the frequency of free-operant performances. Free-operant performance is defined as continuous responding in the presence of discriminative stimuli that are either varied or not varied from response to response. Free-operant performance is also distinguished from discrete-trial performance. Frequency-building procedures are also described, including defining the learning channel and stimulus control topography of a component performance (called a pinpoint), selecting an appropriate timing period, and displaying stimuli so that no performance ceilings occur. During frequency building, frequencies of pinpoints are continuously charted on standard celeration charts. Frequencies are increased to empirically derived performance standards, or aims, that predict retention, endurance, stability, application, and adduction of performance. Frequency is also described as a dimension of performance, not simply its measurement. Frequency building is described as possibly facilitating contingency adduction. PMID:22478264

  9. Modified Youngswick procedure for hallux limitus.

    PubMed

    Radovic, Philip; Yadav-Shah, Ekta; Choe, Ki

    2007-01-01

    Multiple surgical procedures have been described for the correction of hallux limitus deformity. We describe a new modification of the Youngswick procedure for the surgical treatment of hallux limitus. Other procedures for hallux limitus correction are also discussed. This modified Youngswick procedure will provide a new approach to treating hallux limitus secondary to metatarsus primus elevatus when shortening of the first metatarsal is not indicated. PMID:17901350

  10. Advances in Procedural Techniques - Antegrade

    PubMed Central

    Wilson, William; Spratt, James C.

    2014-01-01

    There have been many technological advances in antegrade CTO PCI, but perhaps most importantly has been the evolution of the “hybrid’ approach where ideally there exists a seamless interplay of antegrade wiring, antegrade dissection re-entry and retrograde approaches as dictated by procedural factors. Antegrade wire escalation with intimal tracking remains the preferred initial strategy in short CTOs without proximal cap ambiguity. More complex CTOs, however, usually require either a retrograde or an antegrade dissection re-entry approach, or both. Antegrade dissection re-entry is well suited to long occlusions where there is a healthy distal vessel and limited “interventional” collaterals. Early use of a dissection re-entry strategy will increase success rates, reduce complications, and minimise radiation exposure, contrast use as well as procedural times. Antegrade dissection can be achieved with a knuckle wire technique or the CrossBoss catheter whilst re-entry will be achieved in the most reproducible and reliable fashion by the Stingray balloon/wire. It should be avoided where there is potential for loss of large side branches. It remains to be seen whether use of newer dissection re-entry strategies will be associated with lower restenosis rates compared with the more uncontrolled subintimal tracking strategies such as STAR and whether stent insertion in the subintimal space is associated with higher rates of late stent malapposition and stent thrombosis. It is to be hoped that the algorithms, which have been developed to guide CTO operators, allow for a better transfer of knowledge and skills to increase uptake and acceptance of CTO PCI as a whole. PMID:24694104

  11. 12 CFR 797.7 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Procedures. 797.7 Section 797.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION PROCEDURES FOR DEBT COLLECTION Administrative Offset § 797.7 Procedures. Prior...

  12. 12 CFR 797.7 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Procedures. 797.7 Section 797.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION PROCEDURES FOR DEBT COLLECTION Administrative Offset § 797.7 Procedures. Prior...

  13. 12 CFR 797.7 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Procedures. 797.7 Section 797.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION PROCEDURES FOR DEBT COLLECTION Administrative Offset § 797.7 Procedures. Prior...

  14. 12 CFR 797.7 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Procedures. 797.7 Section 797.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION PROCEDURES FOR DEBT COLLECTION Administrative Offset § 797.7 Procedures. Prior...

  15. 12 CFR 797.7 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Procedures. 797.7 Section 797.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION PROCEDURES FOR DEBT COLLECTION Administrative Offset § 797.7 Procedures. Prior...

  16. 20 CFR 801.302 - Procedural rules.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Procedural rules. 801.302 Section 801.302... Action by the Board § 801.302 Procedural rules. Procedural rules for performance by the Board of its... amendments to the rules as may be necessary from time to time, shall be promulgated by the Deputy...

  17. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Survey procedures. 272.14 Section 272.14 Shipping... OPERATORS REQUIREMENTS AND PROCEDURES FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND... Survey procedures. (a) Prior to survey. Unless otherwise directed by MARAD, the Operator of a...

  18. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Survey procedures. 272.14 Section 272.14 Shipping... OPERATORS REQUIREMENTS AND PROCEDURES FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND... Survey procedures. (a) Prior to survey. Unless otherwise directed by MARAD, the Operator of a...

  19. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Survey procedures. 272.14 Section 272.14 Shipping... OPERATORS REQUIREMENTS AND PROCEDURES FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND... Survey procedures. (a) Prior to survey. Unless otherwise directed by MARAD, the Operator of a...

  20. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Survey procedures. 272.14 Section 272.14 Shipping... OPERATORS REQUIREMENTS AND PROCEDURES FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND... Survey procedures. (a) Prior to survey. Unless otherwise directed by MARAD, the Operator of a...

  1. 18 CFR 401.84 - Hearing procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Administrative and Other Hearings § 401.84 Hearing procedure. (a) Participation in the hearing. In any hearing, the person requesting the hearing shall be... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Hearing procedure....

  2. 22 CFR 33.8 - Claim procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Claim procedures. 33.8 Section 33.8 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY FISHERMEN'S PROTECTIVE ACT GUARANTY FUND PROCEDURES UNDER SECTION 7 § 33.8 Claim procedures. (a) Where and when to apply. Claims must be submitted to the Office Director, Office of...

  3. 22 CFR 33.8 - Claim procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Claim procedures. 33.8 Section 33.8 Foreign Relations DEPARTMENT OF STATE CLAIMS AND STOLEN PROPERTY FISHERMEN'S PROTECTIVE ACT GUARANTY FUND PROCEDURES UNDER SECTION 7 § 33.8 Claim procedures. (a) Where and when to apply. Claims must be submitted to the Office Director, Office of...

  4. 45 CFR 96.66 - Hearing procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Hearing procedure. 96.66 Section 96.66 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.66 Hearing procedure. (a) A hearing is public, except when the Secretary or the presiding officer determines that all or part of a hearing...

  5. 10 CFR 218.31 - Incorporated procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Incorporated procedures. 218.31 Section 218.31 Energy DEPARTMENT OF ENERGY OIL STANDBY MANDATORY INTERNATIONAL OIL ALLOCATION Procedures § 218.31 Incorporated procedures. The following subparts of part 205 of this chapter are, as appropriate, hereby made applicable...

  6. 38 CFR 17.133 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Procedures. 17.133 Section 17.133 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Reconsideration of Denied Claims § 17.133 Procedures. (a) Scope. This section sets forth reconsideration procedures regarding claims for benefits administered...

  7. 36 CFR 908.32 - Review procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Review procedures. 908.32... DEVELOPMENT AREA Review Procedure § 908.32 Review procedures. (a) Upon receipt of a request for review, the... applicable regulations; (2) Information submitted by the applicant including the request for review and...

  8. 36 CFR 908.32 - Review procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Review procedures. 908.32... DEVELOPMENT AREA Review Procedure § 908.32 Review procedures. (a) Upon receipt of a request for review, the... applicable regulations; (2) Information submitted by the applicant including the request for review and...

  9. 14 CFR 1274.505 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procurement procedures. 1274.505 Section 1274.505 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION COOPERATIVE AGREEMENTS WITH COMMERCIAL FIRMS Procurement Standards § 1274.505 Procurement procedures. (a) All recipients shall establish written procurement procedures....

  10. 45 CFR 96.66 - Hearing procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Hearing procedure. 96.66 Section 96.66 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.66 Hearing procedure. (a) A hearing is public, except when the Secretary or the presiding officer determines that all or part of a hearing...

  11. 40 CFR 1515.1 - FOIA procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false FOIA procedures. 1515.1 Section 1515.1... § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as FOIA, is a Federal law that creates a procedure for any person to request documents and other...

  12. 40 CFR 1515.1 - FOIA procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false FOIA procedures. 1515.1 Section 1515.1... § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as FOIA, is a Federal law that creates a procedure for any person to request documents and other...

  13. 40 CFR 1515.1 - FOIA procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false FOIA procedures. 1515.1 Section 1515.1... § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as FOIA, is a Federal law that creates a procedure for any person to request documents and other...

  14. 40 CFR 1515.1 - FOIA procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false FOIA procedures. 1515.1 Section 1515.1... § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as FOIA, is a Federal law that creates a procedure for any person to request documents and other...

  15. 46 CFR 148.5 - Alternative procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 5 2012-10-01 2012-10-01 false Alternative procedures. 148.5 Section 148.5 Shipping... MATERIALS THAT REQUIRE SPECIAL HANDLING General § 148.5 Alternative procedures. (a) The Commandant (CG-ENG-5) may authorize the use of an alternative procedure, including exemptions to the IMSBC...

  16. 29 CFR 102.93 - Alternative procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 2 2013-07-01 2013-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If,...

  17. 29 CFR 102.93 - Alternative procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 2 2014-07-01 2014-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If,...

  18. 46 CFR 148.5 - Alternative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Alternative procedures. 148.5 Section 148.5 Shipping... MATERIALS THAT REQUIRE SPECIAL HANDLING General § 148.5 Alternative procedures. (a) The Commandant (CG-5223) may authorize the use of an alternative procedure, including exemptions to the IMSBC...

  19. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Alternative procedures. 640.120 Section 640.120...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Alternative Procedures § 640.120 Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve...

  20. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Alternative procedures. 640.120 Section 640.120...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Alternative Procedures § 640.120 Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve...

  1. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Alternative procedures. 640.120 Section 640.120...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Alternative Procedures § 640.120 Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve...

  2. 46 CFR 148.5 - Alternative procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Alternative procedures. 148.5 Section 148.5 Shipping... MATERIALS THAT REQUIRE SPECIAL HANDLING General § 148.5 Alternative procedures. (a) The Commandant (CG-ENG-5) may authorize the use of an alternative procedure, including exemptions to the IMSBC...

  3. 29 CFR 102.93 - Alternative procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 2 2012-07-01 2012-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If,...

  4. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Alternative procedures. 640.120 Section 640.120...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Alternative Procedures § 640.120 Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve...

  5. 46 CFR 148.5 - Alternative procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Alternative procedures. 148.5 Section 148.5 Shipping... MATERIALS THAT REQUIRE SPECIAL HANDLING General § 148.5 Alternative procedures. (a) The Commandant (CG-ENG-5) may authorize the use of an alternative procedure, including exemptions to the IMSBC...

  6. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Alternative procedures. 640.120 Section 640.120...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Alternative Procedures § 640.120 Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve...

  7. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for...

  8. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for...

  9. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for...

  10. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for...

  11. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI...

  12. 40 CFR 53.43 - Test procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 6 2013-07-01 2013-07-01 false Test procedures. 53.43 Section 53.43... PM 10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio...) Test procedure. (i) Establish a wind speed specified in table D-2 and measure the wind speed...

  13. 40 CFR 53.43 - Test procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 6 2014-07-01 2014-07-01 false Test procedures. 53.43 Section 53.43... PM 10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio...) Test procedure. (i) Establish a wind speed specified in table D-2 and measure the wind speed...

  14. 29 CFR 102.93 - Alternative procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If,...

  15. 29 CFR 102.93 - Alternative procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If,...

  16. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI...

  17. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI...

  18. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI...

  19. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI...

  20. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  1. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  2. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  3. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  4. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  5. 49 CFR 1180.4 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) (acquisition of temporary trackage rights), in addition to the notice, the railroad must file a caption summary... TRANSPORTATION RULES OF PRACTICE RAILROAD ACQUISITION, CONTROL, MERGER, CONSOLIDATION PROJECT, TRACKAGE RIGHTS, AND LEASE PROCEDURES General Acquisition Procedures § 1180.4 Procedures. (a) General. (1) The...

  6. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  7. Medical Service Clinical Laboratory Procedures--Bacteriology.

    ERIC Educational Resources Information Center

    Department of the Army, Washington, DC.

    This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…

  8. 18 CFR 401.23 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project...

  9. 18 CFR 401.23 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project...

  10. 18 CFR 401.23 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project...

  11. 10 CFR 205.373 - Application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 3 2011-01-01 2011-01-01 false Application procedures. 205.373 Section 205.373 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Emergency Interconnection of Electric Facilities and the Transfer of Electricity...

  12. WSSDA's Guide to Parliamentary Procedures. Revised

    ERIC Educational Resources Information Center

    Randolph, Mary

    2004-01-01

    This guide to parliamentary procedures is presented by the Washington State School Directors' Association (WSSDA) for use by local school boards within the State of Washington. Parliamentary law and parliamentary procedure is the key to order and to provide justice and fairness to all. Through both formal and informal parliamentary procedures,…

  13. 40 CFR 1060.505 - Other procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... equivalent to allowed procedures or are more accurate or more precise than allowed procedures. See 40 CFR... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Other procedures. 1060.505 Section 1060.505 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION...

  14. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to this... where the language of the statute or HEW's interagency guidelines (43 FR 2132, January 13,...

  15. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to this... where the language of the statute or HEW's interagency guidelines (43 FR 2132, January 13,...

  16. 46 CFR 154.665 - Welding procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design...

  17. 49 CFR 195.214 - Welding procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler...

  18. 49 CFR 195.214 - Welding procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler...

  19. 49 CFR 195.214 - Welding procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler...

  20. 46 CFR 154.665 - Welding procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 5 2012-10-01 2012-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design...

  1. 46 CFR 154.665 - Welding procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design...

  2. 49 CFR 195.214 - Welding procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler...

  3. 46 CFR 154.665 - Welding procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design...

  4. 46 CFR 154.665 - Welding procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design...

  5. 8 CFR 1101.4 - Registration procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... officer under § 1101.3 is described in § 264.2 of 8 CFR chapter 1. (Secs. 101(a)(20), 103, 262, 264 of the... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Registration procedure. 1101.4 Section 1101... REGULATIONS PRESUMPTION OF LAWFUL ADMISSION § 1101.4 Registration procedure. The procedure for an...

  6. 8 CFR 101.4 - Registration procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Registration procedure. 101.4 Section 101.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS PRESUMPTION OF LAWFUL ADMISSION § 101.4 Registration procedure. The procedure for an application for creation of a record...

  7. 8 CFR 101.4 - Registration procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Registration procedure. 101.4 Section 101.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS PRESUMPTION OF LAWFUL ADMISSION § 101.4 Registration procedure. The procedure for an application for creation of a record...

  8. Cloze Procedure and the Teaching of Reading.

    ERIC Educational Resources Information Center

    Rye, James

    By examining the full range of uses of the cloze procedure, this book intends to help teachers use the procedure to better understand the reading behavior of their students and to assist their students in making reading progress. Chapter 1 defines the cloze procedure and discusses the similarities and differences in reading processes when using…

  9. 40 CFR 90.707 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may,...

  10. 40 CFR 90.707 - Test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may,...

  11. 32 CFR 57.6 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.6 Procedures. (a) The procedures..., ages 3 through 21 years, inclusive, on IEPs are prescribed in appendix B of this part. (c) The..., inclusive, are prescribed in appendix C of this part (d) Procedural safeguards and parent and student...

  12. 50 CFR 12.51 - Return procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Return procedure. 12.51 Section 12.51 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING... SEIZURE AND FORFEITURE PROCEDURES Return of Property § 12.51 Return procedure. If, at the conclusion...

  13. 23 CFR 630.803 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Procedures. 630.803 Section 630.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project...

  14. 23 CFR 668.213 - Application procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Application procedures. 668.213 Section 668.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS EMERGENCY RELIEF PROGRAM Procedures for Federal Agencies for Federal Roads § 668.213 Application procedures....

  15. 23 CFR 668.213 - Application procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 23 Highways 1 2014-04-01 2014-04-01 false Application procedures. 668.213 Section 668.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS EMERGENCY RELIEF PROGRAM Procedures for Federal Agencies for Federal Roads § 668.213 Application procedures....

  16. 23 CFR 668.213 - Application procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Application procedures. 668.213 Section 668.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS EMERGENCY RELIEF PROGRAM Procedures for Federal Agencies for Federal Roads § 668.213 Application procedures....

  17. 23 CFR 630.803 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Procedures. 630.803 Section 630.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project...

  18. 23 CFR 668.213 - Application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Application procedures. 668.213 Section 668.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS EMERGENCY RELIEF PROGRAM Procedures for Federal Agencies for Federal Roads § 668.213 Application procedures....

  19. 23 CFR 668.213 - Application procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 23 Highways 1 2013-04-01 2013-04-01 false Application procedures. 668.213 Section 668.213 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS EMERGENCY RELIEF PROGRAM Procedures for Federal Agencies for Federal Roads § 668.213 Application procedures....

  20. 23 CFR 630.803 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Procedures. 630.803 Section 630.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project...

  1. 23 CFR 630.803 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Procedures. 630.803 Section 630.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS PRECONSTRUCTION PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project...

  2. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  3. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified...

  4. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  5. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  6. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified...

  7. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  8. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  9. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  10. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  11. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified...

  12. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified...

  13. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  14. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  15. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  16. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified...

  17. 46 CFR 252.42 - Appeals procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and Procedures, 46 CFR part 201, subpart M, shall be followed for all hearings granted under 46 U.S.C. 1176 and 46 CFR 252.42. ... Payment and Billing Procedures § 252.42 Appeals procedures. (a) Appeals of annual or special audits....

  18. 39 CFR 5.2 - Committee procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Committee procedure. 5.2 Section 5.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE COMMITTEES (ARTICLE V) § 5.2 Committee procedure. Each committee establishes its own rules of procedure, consistent...

  19. 39 CFR 5.2 - Committee procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Committee procedure. 5.2 Section 5.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE COMMITTEES (ARTICLE V) § 5.2 Committee procedure. Each committee establishes its own rules of procedure, consistent...

  20. 7 CFR 356.8 - Return procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false Return procedure. 356.8 Section 356.8 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FORFEITURE PROCEDURES § 356.8 Return procedure. If, at the conclusion...

  1. 20 CFR 363.3 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Procedure. 363.3 Section 363.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES GARNISHMENT OF REMUNERATION OF BOARD PERSONNEL § 363.3 Procedure. (a) Service of legal process brought for the enforcement...

  2. 40 CFR 12.170 - Compliance procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... according to the procedures established by the Equal Employment Opportunity Commission in 29 CFR part 1613... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Compliance procedures. 12.170 Section... Compliance procedures. (a) Except as provided in paragraph (b) of this section, this section applies to...

  3. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  4. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  5. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  6. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures...

  7. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  8. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  9. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  10. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  11. 28 CFR 527.31 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures. 527.31 Section 527.31 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER TRANSFERS Transfer of Inmates to State Agents for Production on State Writs § 527.31 Procedures. (a) These procedures apply to state and...

  12. 28 CFR 54.605 - Enforcement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... regulations. These procedures may be found at 28 CFR 42.106 through 42.111. ....605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the...

  13. 40 CFR 90.707 - Test procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may,...

  14. 40 CFR 90.707 - Test procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may,...

  15. 40 CFR 90.707 - Test procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may,...

  16. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  17. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  18. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  19. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  20. 18 CFR 401.23 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project...

  1. 18 CFR 401.23 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project...

  2. Procedural Learning and Individual Differences in Language

    ERIC Educational Resources Information Center

    Lee, Joanna C.; Tomblin, J. Bruce

    2015-01-01

    The aim of the current study was to examine different aspects of procedural memory in young adults who varied with regard to their language abilities. We selected a sample of procedural memory tasks, each of which represented a unique type of procedural learning, and has been linked, at least partially, to the functionality of the corticostriatal…

  3. 16 CFR 1610.6 - Test procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with 5 U.S.C. 552(a) and 1 CFR part 51. You may obtain a copy from the American Association of... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Test procedure. 1610.6 Section 1610.6... FLAMMABILITY OF CLOTHING TEXTILES The Standard § 1610.6 Test procedure. The test procedure is divided into...

  4. 49 CFR 581.7 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times...

  5. 49 CFR 581.7 - Test procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times...

  6. 40 CFR 205.54 - Test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Test procedures. 205.54 Section 205.54... EQUIPMENT NOISE EMISSION CONTROLS Medium and Heavy Trucks § 205.54 Test procedures. The procedures described in this and subsequent sections will be the test program to determine the conformity of vehicles...

  7. 49 CFR 581.7 - Test procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times...

  8. 32 CFR 183.6 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures. 183.6 Section 183.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE CIVIL DEFENSE DEFENSE SUPPORT OF SPECIAL EVENTS § 183.6 Procedures. (a) General Provisions. (1) This section provides the basic procedures for DoD support to special events. (2) As...

  9. 14 CFR 21.441 - Procedure manual.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Procedure manual. 21.441 Section 21.441... manual. (a) No DAS may exercise any authority under this subpart unless it submits, and obtains approval of, a procedure manual containing— (1) The procedures for issuing STCs; and (2) The names,...

  10. 22 CFR 218.36 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Compliance procedure. 218.36 Section 218.36... OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 218.36 Compliance procedure. (a) An agency may enforce the Act and these regulations through:...

  11. 45 CFR 1156.19 - Compliance procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Compliance procedure. 1156.19 Section 1156.19..., and Enforcement Procedures § 1156.19 Compliance procedure. (a) The Endowment may enforce the Act and the regulations in this part through: (1) Termination of a recipient's Federal financial...

  12. 15 CFR 20.15 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Compliance procedure. 20.15 Section 20... AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 20.15 Compliance procedure. (a) DOC may enforce the Act and these regulations by:...

  13. 45 CFR 91.46 - Compliance procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Compliance procedure. 91.46 Section 91.46 Public... AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM HHS Investigation, Conciliation, and Enforcement Procedures § 91.46 Compliance procedure. (a) HHS may enforce the Act and...

  14. 14 CFR 1252.405 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Compliance procedure. 1252.405 Section 1252... OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 1252.405 Compliance procedure. (a) NASA may enforce the Act and...

  15. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Compliance procedure. 18... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations through: (1) Termination of Federal financial assistance from VA with respect to a recipient's program...

  16. 44 CFR 7.945 - Compliance procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Compliance procedure. 7.945... on the Basis of Age in Programs or Activities Receiving Federal Financial Assistance From FEMA Investigation, Conciliation, and Enforcement Procedures § 7.945 Compliance procedure. (a) FEMA may enforce...

  17. 34 CFR 110.35 - Compliance procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Compliance procedure. 110.35 Section 110.35 Education... NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.35 Compliance procedure. (a) ED may enforce the Act and...

  18. 34 CFR 110.35 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Compliance procedure. 110.35 Section 110.35 Education... NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.35 Compliance procedure. (a) ED may enforce the Act and...

  19. 43 CFR 17.335 - Compliance procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Compliance procedure. 17.335 Section 17..., Conciliation, and Enforcement Procedures § 17.335 Compliance procedure. (a) DOI may enforce the Act and these regulations through: (1) Termination of a recipient's Federal financial assistance from DOI under the...

  20. 34 CFR 110.35 - Compliance procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Compliance procedure. 110.35 Section 110.35 Education... NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Investigation, Conciliation, and Enforcement Procedures § 110.35 Compliance procedure. (a) ED may enforce the Act and...