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Sample records for official american thoracic

  1. An Official American Thoracic Society/American College of Chest Physicians Policy Statement

    PubMed Central

    Ouellette, Daniel R.; Diamond, Edward; Fan, Vincent S.; Maurer, Janet R.; Mularski, Richard A.; Peters, Jay I.; Halpern, Scott D.

    2014-01-01

    The American Board of Internal Medicine Foundation’s Choosing Wisely campaign aims to curb health-care costs and improve patient care by soliciting lists from medical societies of the top five tests or treatments in their specialty that are used too frequently and inappropriately. The American Thoracic Society (ATS) and American College of Chest Physicians created a joint task force, which produced a top five list for adult pulmonary medicine. Our top five recommendations, which were approved by the executive committees of the ATS and American College of Chest Physicians and published by Choosing Wisely in October 2013, are as follows: (1) Do not perform CT scan surveillance for evaluation of indeterminate pulmonary nodules at more frequent intervals or for a longer period of time than recommended by established guidelines; (2) do not routinely offer pharmacologic treatment with advanced vasoactive agents approved only for the management of pulmonary arterial hypertension to patients with pulmonary hypertension resulting from left heart disease or hypoxemic lung diseases (groups II or III pulmonary hypertension); (3) for patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, do not renew the prescription without assessing the patient for ongoing hypoxemia; (4) do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay; (5) do not perform CT scan screening for lung cancer among patients at low risk for lung cancer. We hope pulmonologists will use these recommendations to stimulate frank discussions with patients about when these tests and treatments are indicated—and when they are not. PMID:24889436

  2. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

    PubMed

    Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

    2015-04-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) research statement is to describe evidence related to diagnosis, assessment and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers, and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers, and patient advocates believe will have the greatest impact on patient-centred outcomes. PMID:25829431

  3. An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

    PubMed

    Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar A; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

    2015-06-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes. PMID:26028628

  4. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis.

    PubMed

    Mularski, Richard A; Reinke, Lynn F; Carrieri-Kohlman, Virginia; Fischer, Mark D; Campbell, Margaret L; Rocker, Graeme; Schneidman, Ann; Jacobs, Susan S; Arnold, Robert; Benditt, Joshua O; Booth, Sara; Byock, Ira; Chan, Garrett K; Curtis, J Randall; Donesky, Doranne; Hansen-Flaschen, John; Heffner, John; Klein, Russell; Limberg, Trina M; Manning, Harold L; Morrison, R Sean; Ries, Andrew L; Schmidt, Gregory A; Selecky, Paul A; Truog, Robert D; Wang, Angela C C; White, Douglas B

    2013-10-01

    In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic evidence-based reviews (SEBRs) using a modified AMSTAR approach and then summarized the palliative management knowledge base for participants to use in discourse at a 2009 ATS workshop. We used an informal consensus process to develop a working definition of this novel entity and established an Ad Hoc Committee on Palliative Management of Dyspnea Crisis to further develop an official ATS document on the topic. The Ad Hoc Committee members defined dyspnea crisis as "sustained and severe resting breathing discomfort that occurs in patients with advanced, often life-limiting illness and overwhelms the patient and caregivers' ability to achieve symptom relief." Dyspnea crisis can occur suddenly and is characteristically without a reversible etiology. The workshop participants focused on dyspnea crisis management for patients in whom the goals of care are focused on palliation and for whom endotracheal intubation and mechanical ventilation are not consistent with articulated preferences. However, approaches to dyspnea crisis may also be appropriate for patients electing life-sustaining treatment. The Ad Hoc Committee developed a Workshop Report concerning assessment of dyspnea crisis; ethical and professional considerations; efficient utilization, communication, and care coordination; clinical management of dyspnea crisis; development of patient education and provider aid products; and enhancing implementation with audit and quality improvement. PMID:24161068

  5. An Official American Thoracic Society Workshop Report 2015. Stem Cells and Cell Therapies in Lung Biology and Diseases.

    PubMed

    Wagner, Darcy E; Cardoso, Wellington V; Gilpin, Sarah E; Majka, Susan; Ott, Harald; Randell, Scott H; Thébaud, Bernard; Waddell, Thomas; Weiss, Daniel J

    2016-08-01

    The University of Vermont College of Medicine, in collaboration with the NHLBI, Alpha-1 Foundation, American Thoracic Society, Cystic Fibrosis Foundation, European Respiratory Society, International Society for Cellular Therapy, and the Pulmonary Fibrosis Foundation, convened a workshop, "Stem Cells and Cell Therapies in Lung Biology and Lung Diseases," held July 27 to 30, 2015, at the University of Vermont. The conference objectives were to review the current understanding of the role of stem and progenitor cells in lung repair after injury and to review the current status of cell therapy and ex vivo bioengineering approaches for lung diseases. These are all rapidly expanding areas of study that both provide further insight into and challenge traditional views of mechanisms of lung repair after injury and pathogenesis of several lung diseases. The goals of the conference were to summarize the current state of the field, discuss and debate current controversies, and identify future research directions and opportunities for both basic and translational research in cell-based therapies for lung diseases. This 10th anniversary conference was a follow up to five previous biennial conferences held at the University of Vermont in 2005, 2007, 2009, 2011, and 2013. Each of those conferences, also sponsored by the National Institutes of Health, American Thoracic Society, and respiratory disease foundations, has been important in helping guide research and funding priorities. The major conference recommendations are summarized at the end of the report and highlight both the significant progress and major challenges in these rapidly progressing fields. PMID:27509163

  6. An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

    2014-01-01

    Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem

  7. An Official American Thoracic Society Workshop Report. A Framework for Addressing Multimorbidity in Clinical Practice Guidelines for Pulmonary Disease, Critical Illness, and Sleep Disorders.

    PubMed

    Wilson, Kevin C; Gould, Michael K; Krishnan, Jerry A; Boyd, Cynthia M; Brozek, Jan L; Cooke, Colin R; Douglas, Ivor S; Goodman, Richard A; Joo, Min J; Lareau, Suzanne; Mularski, Richard A; Patel, Minal R; Rosenfeld, Richard M; Shanawani, Hasan; Slatore, Christopher; Sockrider, Marianna; Sufian, Beth; Thomson, Carey C; Wiener, Renda Soylemez

    2016-03-01

    Coexistence of multiple chronic conditions (i.e., multimorbidity) is the most common chronic health problem in adults. However, clinical practice guidelines have primarily focused on patients with a single disease, resulting in uncertainty about the care of patients with multimorbidity. The American Thoracic Society convened a workshop with the goal of establishing a strategy to address multimorbidity within clinical practice guidelines. In this Workshop Report, we describe a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations. For the consideration of multimorbidity in guidelines to be successful and sustainable, the process must be both feasible and pragmatic. It is likely that this will be achieved best by the step-wise addition and refinement of the various components of the framework. PMID:26963362

  8. Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    PubMed

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  9. An Official American Thoracic Society/European Respiratory Society Workshop Report: Evaluation of Respiratory Mechanics and Function in the Pediatric and Neonatal Intensive Care Units.

    PubMed

    Peterson-Carmichael, Stacey; Seddon, Paul C; Cheifetz, Ira M; Frerichs, Inéz; Hall, Graham L; Hammer, Jürg; Hantos, Zoltán; van Kaam, Anton H; McEvoy, Cindy T; Newth, Christopher J L; Pillow, J Jane; Rafferty, Gerrard F; Rosenfeld, Margaret; Stocks, Janet; Ranganathan, Sarath C

    2016-02-01

    Ready access to physiologic measures, including respiratory mechanics, lung volumes, and ventilation/perfusion inhomogeneity, could optimize the clinical management of the critically ill pediatric or neonatal patient and minimize lung injury. There are many techniques for measuring respiratory function in infants and children but very limited information on the technical ease and applicability of these tests in the pediatric and neonatal intensive care unit (PICU, NICU) environments. This report summarizes the proceedings of a 2011 American Thoracic Society Workshop critically reviewing techniques available for ventilated and spontaneously breathing infants and children in the ICU. It outlines for each test how readily it is performed at the bedside and how it may impact patient management as well as indicating future areas of potential research collaboration. From expert panel discussions and literature reviews, we conclude that many of the techniques can aid in optimizing respiratory support in the PICU and NICU, quantifying the effect of therapeutic interventions, and guiding ventilator weaning and extubation. Most techniques now have commercially available equipment for the PICU and NICU, and many can generate continuous data points to help with ventilator weaning and other interventions. Technical and validation studies in the PICU and NICU are published for the majority of techniques; some have been used as outcome measures in clinical trials, but few have been assessed specifically for their ability to improve clinical outcomes. Although they show considerable promise, these techniques still require further study in the PICU and NICU together with increased availability of commercial equipment before wider incorporation into daily clinical practice. PMID:26848609

  10. 1. Historic American Buildings Survey From The Blue Book, Official ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey From The Blue Book, Official Souvenir View Book Panama Pacific International Exposition - 1915 VIEW FROM THE EAST - Palace of Fine Arts, Baker Street, San Francisco, San Francisco County, CA

  11. The Official Ideology of American Law Schools

    ERIC Educational Resources Information Center

    Dent, George W., Jr.

    2011-01-01

    In this article, the author describes the seemingly all-powerful Association of American Law Schools (AALS) and the negative effects of its single-minded obsession with "diversity." He suggests ways in which true diversity of viewpoint might be injected into law school education. The key is to raise awareness and apply the same standards to all…

  12. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society.

    PubMed

    Abman, Steven H; Hansmann, Georg; Archer, Stephen L; Ivy, D Dunbar; Adatia, Ian; Chung, Wendy K; Hanna, Brian D; Rosenzweig, Erika B; Raj, J Usha; Cornfield, David; Stenmark, Kurt R; Steinhorn, Robin; Thébaud, Bernard; Fineman, Jeffrey R; Kuehne, Titus; Feinstein, Jeffrey A; Friedberg, Mark K; Earing, Michael; Barst, Robyn J; Keller, Roberta L; Kinsella, John P; Mullen, Mary; Deterding, Robin; Kulik, Thomas; Mallory, George; Humpl, Tilman; Wessel, David L

    2015-11-24

    Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension. PMID:26534956

  13. The Official Records of the American Civil War: A Researcher's Guide. 2nd Edition.

    ERIC Educational Resources Information Center

    Aimone, Alan Conrad

    Official reports and correspondence of the American Civil War were printed by the United States Government Printing Office as the "Official Records, Army" (O.R.) in 129 volumes and the "Official Records, Navy" (N.O.R.) in 31 volumes. This corrected and expanded edition of the guide provides a brief historical sketch of the O.R. and N.O.R. and…

  14. American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society-Recommended Standards, 2011-2013.

    PubMed

    Cromar, Kevin R; Gladson, Laura A; Perlmutt, Lars D; Ghazipura, Marya; Ewart, Gary W

    2016-08-01

    Estimates of the health impacts of air pollution are needed to make informed air quality management decisions at both the national and local levels. Using design values of ambient pollution concentrations from 2011-2013 as a baseline, the American Thoracic Society (ATS) and the Marron Institute of Urban Management estimated excess morbidity and mortality in the United States attributable to exposure to ambient ozone (O3) and fine particulate matter (PM2.5) at levels above the American Thoracic Society-recommended standards. Within the subset of counties with valid design values for each pollutant, 14% had PM2.5 concentrations greater than the ATS recommendation, whereas 91% had O3 concentrations greater than the ATS recommendation. Approximately 9,320 excess deaths (69% from O3; 31% from PM2.5), 21,400 excess morbidities (74% from O3; 26% from PM2.5), and 19,300,000 adversely impacted days (88% from O3; 12% from PM2.5) in the United States each year are attributable to pollution exceeding the ATS-recommended standards. California alone is responsible for 37% of the total estimated health impacts, and the next three states (Pennsylvania, Texas, and Ohio) together contributed to 20% of the total estimates. City-specific health estimates are provided in this report and through an accompanying online tool to help inform air quality management decisions made at the local level. Riverside and Los Angeles, California have the most to gain by attaining the ATS recommendations for O3 and PM2.5. This report will be revised and updated regularly to help cities track their progress. PMID:27509145

  15. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  16. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  17. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  18. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  19. 22 CFR 1008.400 - What are my responsibilities as a(n) Inter-American Foundation awarding official?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-American Foundation awarding official? 1008.400 Section 1008.400 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Responsibilities of Inter-American Foundation Awarding Officials § 1008.400 What are my responsibilities as a(n)...

  20. 78 FR 36571 - North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management North American Datum of 1983 (NAD 83) Outer Continental Shelf (OCS) Provisional Official Protraction Diagram (OPDs) AGENCY: Bureau of Ocean Energy Management (BOEM),...

  1. Evolution and revolution: the formation of today's American Thoracic Society, part 1.

    PubMed

    Murray, John F; Du Melle, Fran; Hopewell, Philip C

    2012-11-15

    The American Thoracic Society (ATS), the preeminent professional organization in the field of respiratory, critical care, and sleep medicine, is now 107 years old. For the most part, the Society's administrative and medical-scientific interests evolved in an orderly fashion, but two "revolutions" took place that should be remembered. What ultimately metamorphosed into the ATS in 1960 began in 1905 as the 34-member American Sanatorium Association, which in 1915 became the medical section of the National Association for the Study and Prevention of Tuberculosis (NASPT). In 1918, the NASPT became the National Tuberculosis Association and in 1939, the ASA became the American Trudeau Society, cosmetic revisions having no effect on either the medical section-parent relationship or the one-disease orientation of both organizations. After World War II, the narrow focus of the ATS on tuberculosis was progressively enlarged through coalescence of several factors that transformed the practice of pulmonary medicine: the growth of intensive care units and pulmonary function laboratories and the advent of fiberoptic bronchoscopy; the rise of asthma, chronic obstructive pulmonary disease, and lung cancer coincident with the withering of tuberculosis; and the arrival of pulmonary physician-scientists who sought enrichment through a professional society. The newcomers found a home in the ATS, but it was slow to fulfill their needs for scientific communication and administrative responsibility. The first revolution, the formation of Scientific Assemblies, got the job done quickly and well, as described in Part 1 of this perspective. The second revolution, separation from the American Lung Association, is described in Part 2. PMID:22822021

  2. Evolution and revolution: the formation of Today's American Thoracic Society, Part 2.

    PubMed

    Hopewell, Philip C; Du Melle, Fran; Murray, John F

    2012-12-01

    The major event in the recent history of the American Thoracic Society (ATS) is its separation from the American Lung Association (ALA), resulting in the Society's independence. The seeds of the separation were sown over the course of many years. The fundamental reason driving the separation was the organizational structure of the ALA, with the ATS being a division within the larger organization and having neither the standing to make independent decisions nor the ability to respond effectively to the expectations of a growing and diverse membership. Additional important factors included continual organizational conflicts; ongoing struggles over finances; reluctance by the ALA to provide what the ATS considered to be appropriate support for research; divergence of areas of interest as the Society became more broad based to include critical care and sleep medicine, as well as concerns with medical practice issues; and internationalization of the Society, with an increasing proportion of members residing outside the United States. Once it was decided that the ATS could only exist as an independent organization, the separation agreement was negotiated in less than 3 years. Although there were substantial unknowns immediately after the separation, a unified leadership, a strongly supportive membership, and a skilled and dedicated staff guided the organization through this difficult period, from which the Society emerged as a strong independent professional organization that remains true to the public-minded spirit that guided its formation 107 years ago. PMID:22822018

  3. Advancing Clinical Practice and Policy through Guidelines. The Role of the American Thoracic Society

    PubMed Central

    Gould, Michael K.

    2013-01-01

    In the face of an overwhelmingly large and growing medical literature, providers often turn to clinical practice guidelines to inform the decisions they make with patients. By systematically appraising the evidence and providing transparent recommendations for practice, guidelines have the potential to improve both bedside decision-making and health policy. This potential has not been fully realized because most guidelines lack transparency, are tainted by conflicts of interest, or fail to employ rigorous methods to appraise the evidence. To address the shortcomings of past guidelines, the Institute of Medicine (IOM) published recommendations for trustworthy guidelines, effectively setting the “gold standard” for what constitutes a high-quality guideline. Along with many other groups that develop guidelines, the American Thoracic Society (ATS) is rapidly evolving processes for development and implementation to meet many of the IOM standards. This Pulmonary Perspective describes the rapidly changing landscape of clinical practice guidelines, the role of the ATS in this landscape, and the activities the ATS is engaged in to ensure that the guidelines it produces are of the highest quality with the broadest impact. PMID:23392437

  4. American Thoracic Society and National Heart, Lung, and Blood Institute Implementation Research Workshop Report.

    PubMed

    Bender, Bruce G; Krishnan, Jerry A; Chambers, David A; Cloutier, Michelle M; Riekert, Kristin A; Rand, Cynthia S; Schatz, Michael; Thomson, Carey C; Wilson, Sandra R; Apter, Andrea; Carson, Shannon S; George, Maureen; Gerald, Joe K; Gerald, Lynn; Goss, Christopher H; Okelo, Sande O; Mularski, Richard A; Nguyen, Huong Q; Patel, Minal R; Szefler, Stanley J; Weiss, Curtis H; Wilson, Kevin C; Freemer, Michelle

    2015-12-01

    To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients' access to high-quality care. During the discussions that ensued, investigators' experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings. PMID:26653201

  5. Respiratory Health Equality in the United States. The American Thoracic Society Perspective

    PubMed Central

    Roman, Jesse; Schraufnagel, Dean E.; Thomas, Alvin; Samet, Jonathan

    2014-01-01

    Because the frequency of major risk factors for respiratory diseases (e.g., tobacco use) differs across demographic groups (defined by socioeconomic status, race/ethnicity, sexual orientation, health care access, occupation, or other characteristics), health disparities are commonly encountered in pediatric and adult pulmonary, critical care, and sleep medicine. As part of its policy on respiratory health disparities, the American Thoracic Society (ATS) Executive Committee created a Health Equality Subcommittee of the Health Policy Committee, with an initial mandate of defining respiratory health equality and, as a subsequent task, providing recommendations to the ATS leadership as to how our society may help attain such equality in the United States. After receiving input from the ATS assemblies and committees, the subcommittee developed this document on respiratory health equality. This document defines respiratory health disparities and respiratory health equality, and expands on a recent ATS and European Respiratory Society policy statement on disparities in respiratory health. Attainment of respiratory health equality requires the ending of respiratory health disparities, which can be achieved only through multidisciplinary efforts to eliminate detrimental environmental exposures while promoting a healthy lifestyle, implementing all components of high-quality health care (prevention, screening, diagnosis, and treatment), and conducting research that will lead to better prevention and management of respiratory diseases for everyone. The ATS recognizes that such efforts must include all stakeholders: members of society at large, governmental and nongovernmental organizations, and other professional societies. The ATS urges all of its members and those of sister societies to work to achieve this laudable goal. PMID:24625275

  6. Respiratory health equality in the United States. The American thoracic society perspective.

    PubMed

    Celedón, Juan C; Roman, Jesse; Schraufnagel, Dean E; Thomas, Alvin; Samet, Jonathan

    2014-05-01

    Because the frequency of major risk factors for respiratory diseases (e.g., tobacco use) differs across demographic groups (defined by socioeconomic status, race/ethnicity, sexual orientation, health care access, occupation, or other characteristics), health disparities are commonly encountered in pediatric and adult pulmonary, critical care, and sleep medicine. As part of its policy on respiratory health disparities, the American Thoracic Society (ATS) Executive Committee created a Health Equality Subcommittee of the Health Policy Committee, with an initial mandate of defining respiratory health equality and, as a subsequent task, providing recommendations to the ATS leadership as to how our society may help attain such equality in the United States. After receiving input from the ATS assemblies and committees, the subcommittee developed this document on respiratory health equality. This document defines respiratory health disparities and respiratory health equality, and expands on a recent ATS and European Respiratory Society policy statement on disparities in respiratory health. Attainment of respiratory health equality requires the ending of respiratory health disparities, which can be achieved only through multidisciplinary efforts to eliminate detrimental environmental exposures while promoting a healthy lifestyle, implementing all components of high-quality health care (prevention, screening, diagnosis, and treatment), and conducting research that will lead to better prevention and management of respiratory diseases for everyone. The ATS recognizes that such efforts must include all stakeholders: members of society at large, governmental and nongovernmental organizations, and other professional societies. The ATS urges all of its members and those of sister societies to work to achieve this laudable goal. PMID:24625275

  7. Political conservatism, rigidity, and dogmatism in American foreign policy officials: the 1966 Mennis data.

    PubMed

    Kemmelmeier, Markus

    2007-01-01

    Researchers have established a relationship between political orientation and cognitive styles (A. Chirumbolo, 2002; J. T. Jost, J. Glaser, A. W. Kruglanski, & F. Sulloway, 2003a, 2003b; M. Kemmelmeier, 1997). In this article, the author examined whether this finding is true in the political elite, whether the relationship is linear or curvilinear, and whether interest in politics moderates the relationship between political orientation and cognitive styles. He used a 1966 sample of American foreign policy officials (N = 95) to examine the relationship between self-described conservatism and party identification and individual differences in rigidity and dogmatism. Rigidity was related to self-described conservatism, but this relationship was only significant among participants high in political interest, whereas dogmatism was unconditionally related to party identification. All relationships were linear and did not contain a curvilinear component. PMID:17312688

  8. American Thoracic Society patient information series. Other therapies for sleep apnea.

    PubMed

    2015-01-15

    Treatment is needed for obstructive sleep apnea (OSA) because untreated OSA can result in serious health problems. Continuous positive airway pressure (CPAP) therapy is the most common treatment used for obstructive sleep apnea (OSA). (see ATS Patient Series http://patients.thoracic.org/wp-content/uploads/ 2014/03/obstructive-sleep-apnea.pdf) For those who cannot use CPAP or want to try another option, there are other therapies that can work for people with OSA. PMID:25590163

  9. Differential aspects of ascending thoracic aortic dissection and its treatment: the North American experience

    PubMed Central

    Coselli, Joseph S.

    2016-01-01

    Acute type A aortic dissection is a deadly disease with significant morbidity and mortality. We describe the differential aspects of the disease and the North American experience with its treatment. PMID:27563548

  10. An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy

    PubMed Central

    Kurland, Geoffrey; Deterding, Robin R.; Hagood, James S.; Young, Lisa R.; Brody, Alan S.; Castile, Robert G.; Dell, Sharon; Fan, Leland L.; Hamvas, Aaron; Hilman, Bettina C.; Langston, Claire; Nogee, Lawrence M.; Redding, Gregory J.

    2013-01-01

    Background: There is growing recognition and understanding of the entities that cause interstitial lung disease (ILD) in infants. These entities are distinct from those that cause ILD in older children and adults. Methods: A multidisciplinary panel was convened to develop evidence-based guidelines on the classification, diagnosis, and management of ILD in children, focusing on neonates and infants under 2 years of age. Recommendations were formulated using a systematic approach. Outcomes considered important included the accuracy of the diagnostic evaluation, complications of delayed or incorrect diagnosis, psychosocial complications affecting the patient’s or family’s quality of life, and death. Results: No controlled clinical trials were identified. Therefore, observational evidence and clinical experience informed judgments. These guidelines: (1) describe the clinical characteristics of neonates and infants (<2 yr of age) with diffuse lung disease (DLD); (2) list the common causes of DLD that should be eliminated during the evaluation of neonates and infants with DLD; (3) recommend methods for further clinical investigation of the remaining infants, who are regarded as having “childhood ILD syndrome”; (4) describe a new pathologic classification scheme of DLD in infants; (5) outline supportive and continuing care; and (6) suggest areas for future research. Conclusions: After common causes of DLD are excluded, neonates and infants with childhood ILD syndrome should be evaluated by a knowledgeable subspecialist. The evaluation may include echocardiography, controlled ventilation high-resolution computed tomography, infant pulmonary function testing, bronchoscopy with bronchoalveolar lavage, genetic testing, and/or lung biopsy. Preventive care, family education, and support are essential. PMID:23905526

  11. An Official American Thoracic Society Clinical Practice Guideline: Diagnosis, Risk Stratification, and Management of Pulmonary Hypertension of Sickle Cell Disease

    PubMed Central

    Klings, Elizabeth S.; Machado, Roberto F.; Barst, Robyn J.; Morris, Claudia R.; Mubarak, Kamal K.; Gordeuk, Victor R.; Kato, Gregory J.; Ataga, Kenneth I.; Gibbs, J. Simon; Castro, Oswaldo; Rosenzweig, Erika B.; Sood, Namita; Hsu, Lewis; Wilson, Kevin C.; Telen, Marilyn J.; DeCastro, Laura M.; Krishnamurti, Lakshmanan; Steinberg, Martin H.; Badesch, David B.; Gladwin, Mark T.

    2014-01-01

    Background: In adults with sickle cell disease (SCD), an increased tricuspid regurgitant velocity (TRV) measured by Doppler echocardiography, an increased serum N-terminal pro–brain natriuretic peptide (NT-pro-BNP) level, and pulmonary hypertension (PH) diagnosed by right heart catheterization (RHC) are independent risk factors for mortality. Methods: A multidisciplinary committee was formed by clinician-investigators experienced in the management of patients with PH and/or SCD. Clinically important questions were posed, related evidence was appraised, and questions were answered with evidence-based recommendations. Target audiences include all clinicians who take care of patients with SCD. Results: Mortality risk stratification guides decision making. An increased risk for mortality is defined as a TRV equal to or greater than 2.5 m/second, an NT-pro-BNP level equal to or greater than 160 pg/ml, or RHC-confirmed PH. For patients identified as having increased mortality risk, we make a strong recommendation for hydroxyurea as first-line therapy and a weak recommendation for chronic transfusions as an alternative therapy. For all patients with SCD with elevated TRV alone or elevated NT-pro-BNP alone, and for patients with SCD with RHC-confirmed PH with elevated pulmonary artery wedge pressure and low pulmonary vascular resistance, we make a strong recommendation against PAH-specific therapy. However, for select patients with SCD with RHC-confirmed PH who have elevated pulmonary vascular resistance and normal pulmonary capillary wedge pressure, we make a weak recommendation for either prostacyclin agonist or endothelin receptor antagonist therapy and a strong recommendation against phosphodiesterase-5 inhibitor therapy. Conclusions: Evidence-based recommendations for the management of patients with SCD with increased mortality risk are provided, but will require frequent reassessment and updating. PMID:24628312

  12. An Official American Thoracic Society Research Statement: Noninfectious Lung Injury after Hematopoietic Stem Cell Transplantation: Idiopathic Pneumonia Syndrome

    PubMed Central

    Panoskaltsis-Mortari, Angela; Griese, Matthias; Madtes, David K.; Belperio, John A.; Haddad, Imad Y.; Folz, Rodney J.; Cooke, Kenneth R.

    2011-01-01

    Rationale: Acute lung dysfunction of noninfectious etiology, known as idiopathic pneumonia syndrome (IPS), is a severe complication following hematopoietic stem cell transplantation (HSCT). Several mouse models have been recently developed to determine the underlying causes of IPS. A cohesive interpretation of experimental data and their relationship to the findings of clinical research studies in humans is needed to better understand the basis for current and future clinical trials for the prevention/treatment of IPS. Objectives: Our goal was to perform a comprehensive review of the preclinical (i.e., murine models) and clinical research on IPS. Methods: An ATS committee performed PubMed and OVID searches for published, peer-reviewed articles using the keywords “idiopathic pneumonia syndrome” or “lung injury” or “pulmonary complications” AND “bone marrow transplant” or “hematopoietic stem cell transplant.” No specific inclusion or exclusion criteria were determined a priori for this review. Measurements and Main Results: Experimental models that reproduce the various patterns of lung injury observed after HSCT have identified that both soluble and cellular inflammatory mediators contribute to the inflammation engendered during the development of IPS. To date, 10 preclinical murine models of the IPS spectrum have been established using various donor and host strain combinations used to study graft-versus-host disease (GVHD). This, as well as the demonstrated T cell dependency of IPS development in these models, supports the concept that the lung is a target of immune-mediated attack after HSCT. The most developed therapeutic strategy for IPS involves blocking TNF signaling with etanercept, which is currently being evaluated in clinical trials. Conclusions: IPS remains a frequently fatal complication that limits the broader use of allogeneic HSCT as a successful treatment modality. Faced with the clinical syndrome of IPS, one can categorize the disease entity with the appropriate tools, although cases of unclassifiable IPS will remain. Significant research efforts have resulted in a paradigm shift away from identifying noninfectious lung injury after HSCT solely as an idiopathic clinical syndrome and toward understanding IPS as a process involving aspects of both the adaptive and the innate immune response. Importantly, new laboratory insights are currently being translated to the clinic and will likely prove important to the development of future strategies to prevent or treat this serious disorder. PMID:21531955

  13. Insights from the early experience of the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

    PubMed

    Rumsfeld, John S; Holmes, David R; Stough, Wendy Gattis; Edwards, Fred H; Jacques, Louis B; Mack, Michael J

    2015-03-01

    The current system for postmarket surveillance of medical devices in the United States is limited. To help change this paradigm for transcatheter valve therapies (TVTs), starting with transcatheter aortic valve replacement, the Society of Thoracic Surgeons and the American College of Cardiology partnered to form the TVT Registry program in close collaboration with the U.S. Food and Drug Administration and the Center for Medicare and Medicaid Services. The goal of the TVT Registry is to measure and improve quality of care and patient outcomes in clinical practice and to have a pivotal role in the scientific evidence and surveillance for medical devices. Challenges were faced in the early experience of the registry included developing multistakeholder partnerships, data collection requirements, and the use of the registry for pre- and post-market device evaluations. In addressing these challenges, the TVT Registry demonstrates that it is feasible for professional societies to assume a pivotal role in pre- and/or post-market studies, leveraging a clinical registry infrastructure. Sharing the TVT Registry experience may help other professional societies and stakeholders better anticipate and plan for these challenges. PMID:25703888

  14. Generation of complex motor patterns in american grasshopper via current-controlled thoracic electrical interfacing.

    PubMed

    Giampalmo, Susan L; Absher, Benjamin F; Bourne, W Tucker; Steves, Lida E; Vodenski, Vassil V; O'Donnell, Peter M; Erickson, Jonathan C

    2011-01-01

    Micro-air vehicles (MAVs) have attracted attention for their potential application to military applications, environmental sensing, and search and rescue missions. While progress is being made toward fabrication of a completely human-engineered MAV, another promising approach seeks to interface to, and take control of, an insect's nervous system. Cyborg insects take advantage of their innate exquisite loco-motor, navigation, and sensing abilities. Recently, several groups have demonstrated the feasibility of radio-controlled flight in the hawkmoth and beetle via electrical neural interfaces. Here, we report a method for eliciting the "jump" response in the American grasshopper (S. Americana). We found that stimulating the metathoracic T3 ganglion with constant-current square wave pulses with amplitude 186 ± 40 μA and frequency 190 ± 13 Hz reproducibly evoked (≥95% success rate) the desired motor activity in N=3 test subjects. To the best of our knowledge, this is the first report of an insect cyborg with a synchronous neuromuscular system. PMID:22254549

  15. Official Policy Positions of the National Congress of American Indians for Convention Year 1977-1978.

    ERIC Educational Resources Information Center

    National Congress of American Indians, Washington, DC.

    During its convention year of 1977-78, the National Congress of American Indians held an annual convention in Dallas in September, 1977, an executive council meeting in Washington in January, 1978, a special conference on federal recognition and the impact of the Oliphant decision in Nashville, Tennessee in March, 1978, and a mid-year conference…

  16. The electronic cigarette. Official statement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on the efficacy, safety and regulation of electronic cigarettes.

    PubMed

    Jimenez Ruiz, Carlos A; Solano Reina, Segismundo; de Granda Orive, Jose Ignacio; Signes-Costa Minaya, Jaime; de Higes Martinez, Eva; Riesco Miranda, Juan Antonio; Altet Gómez, Neus; Lorza Blasco, Jose Javier; Barrueco Ferrero, Miguel; de Lucas Ramos, Pilar

    2014-08-01

    The electronic cigarette (EC) is a device formed by three basic elements: battery, atomizer and cartridge. When assembled, it looks like a cigarette. The cartridge contains different substances: propylene glycol, glycerine and, sometimes, nicotine. When the user "vapes", the battery is activated, the atomizer is heated and the liquid is drawn in and vaporized. The smoker inhales the mist produced. Various substances have been detected in this mist: formaldehyde, acetaldehyde and acrolein and some heavy metals. Although these are found in lower concentrations than in cigarettes, they may still be harmful for the human body. Several surveys show that 3-10% of smokers regularly use e-cigarettes. A randomized study has shown that the efficacy of e-cigarettes for helping smokers to quit is similar to nicotine patches. Nevertheless, the study has relevant methodological limitations and reliable conclusions cannot be deduced. This report sets down the Position Statement of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the efficacy and safety of e-cigarettes. This statement declares that e-cigarettes should be regulated as medicinal products. PMID:24684764

  17. American Thoracic Society

    MedlinePlus

    ... Health Services Research Clinical Problems Critical Care Environmental, Occupational & Population Health Microbiology, Tuberculosis & Pulmonary Infections Nursing Pediatrics Pulmonary Circulation Pulmonary Rehabilitation Respiratory Cell & Molecular ...

  18. Resisting Official Knowledge: The Incorporation and Abjection of Race and Poverty in High School American History Textbooks, 1960s-2000s

    ERIC Educational Resources Information Center

    Kearl, Benjamin Kelsey

    2014-01-01

    Through an interpretive analysis of how high school American history textbooks depict the urban-riots of the late-1960s, in this article the author discusses how textbooks incorporate and abject official knowledge related to the intersections of race and poverty. Incorporation is related with Raymond Williams' theory of the selective tradition and…

  19. 7 CFR 58.337 - Official test methods.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of Analysis of the Association of Official Analytical Chemists, published by the Association of Official Analytical Chemists, the Official and Tentative Methods of the American Oil Chemists Society...

  20. 7 CFR 58.337 - Official test methods.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of Analysis of the Association of Official Analytical Chemists, published by the Association of Official Analytical Chemists, the Official and Tentative Methods of the American Oil Chemists Society...

  1. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Dehmer, Gregory J; Patel, Manesh R; Smith, Peter K; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian C; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Russo, Andrea M; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

    2012-04-01

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  2. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2012-02-28

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  3. Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Pulmonary Disease: Review of Selected Guidelines: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

    PubMed

    Garvey, Chris; Bayles, Madeline Paternostro; Hamm, Larry F; Hill, Kylie; Holland, Anne; Limberg, Trina M; Spruit, Martijn A

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is associated with disabling dyspnea, skeletal muscle dysfunction, and significant morbidity and mortality. Current guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Translating exercise science into safe and effective exercise training requires interpretation and use of multiple guidelines and recommendations. The purpose of this statement is to summarize for clinicians 3 current chronic obstructive pulmonary disease guidelines for exercise that may be used to develop exercise prescriptions in the PR setting. The 3 guidelines have been published by the American College of Sports Medicine, the American Thoracic Society/European Respiratory Society, and the American Association of Cardiovascular and Pulmonary Rehabilitation. In addition to summarizing these 3 guidelines, this statement describes clinical applications, explores areas of uncertainty, and suggests strategies for providing effective exercise training, given the diversity of guidelines and patient complexity. PMID:26906147

  4. Thoracic emergencies.

    PubMed

    Worrell, Stephanie G; Demeester, Steven R

    2014-02-01

    This article discusses thoracic emergencies, including the anatomy, pathophysiology, clinical presentation, examination, diagnosis, technique, management, and treatment of acute upper airway obstruction, massive hemoptysis, spontaneous pneumothorax, and pulmonary empyema. PMID:24267505

  5. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-03-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  6. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization : a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology. Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Brindis, Ralph G; Beckman, Karen J; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Allen, Joseph M; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D

    2009-02-15

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  7. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-02-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  8. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass—Temperature Management during Cardiopulmonary Bypass

    PubMed Central

    Engelman, Richard; Baker, Robert A.; Likosky, Donald S.; Grigore, Alina; Dickinson, Timothy A.; Shore-Lesserson, Linda; Hammon, John W.

    2015-01-01

    Abstract: To improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendation. PMID:26543248

  9. 76 FR 54787 - Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Bureau of Ocean Energy Management, Regulation and Enforcement Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer Continental Shelf Block Diagrams AGENCY... revised North American Datum of 1927 (NAD 27) Outer Continental Shelf Official Protraction Diagram,...

  10. 76 FR 2919 - Outer Continental Shelf Official Protraction Diagram and Supplemental Official Outer Continental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-18

    ... Bureau of Ocean Energy Management, Regulation and Enforcement Outer Continental Shelf Official Protraction Diagram and Supplemental Official Outer Continental Shelf Block Diagrams AGENCY: Bureau of Ocean... American Datum of 1983 (NAD 83) Outer Continental Shelf Official Protraction Diagram and...

  11. Creating Official Language Policy from Local Practice: The Example of the Native American Languages Act 1990/1992

    ERIC Educational Resources Information Center

    Warhol, Larisa

    2012-01-01

    This research explores the development of landmark federal language policy in the United States: the Native American Languages Act of 1990/1992 (NALA). Overturning more than two centuries of United States American Indian policy, NALA established the federal role in preserving and protecting Native American languages. Indigenous languages in the…

  12. Regeneration of descending spinal axons after transection of the thoracic spinal cord during early development in the North American opossum, Didelphis virginiana.

    PubMed

    Martin, G F; Terman, J R; Wang, X M

    2000-11-15

    Opossums are born in an immature, fetal-like state, making it possible to lesion their spinal cord early in development without intrauterine surgery. When the thoracic spinal cord of the North American opossum, Didelphis virginiana, is transected on postnatal day 5, and injections of Fast Blue (FB) are made caudal to the lesion site 30-40 days or 6 months later, neurons are labeled in all of the spinal and supraspinal areas that are labeled after comparable injections in age-matched, unlesioned controls. Double-labeling studies document that regeneration of cut axons contributes to growth of axons through the lesion site and behavioral studies show that animals lesioned on postnatal day 5 use their hindlimbs in normal appearing locomotion as adults. The critical period for developmental plasticity of descending spinal axons extends to postnatal day 26, although axons which grow through the lesion site become fewer in number and more restricted as to origin with increasing age. Animals lesioned between postnatal day 12 and 26 use the hindlimbs better than animals lesioned as adults, but hindlimb function is markedly abnormal and uncoordinated with that of the forelimbs. We conclude that restoration of anatomical continuity occurs after transection of the spinal cord in developing opossums, that descending axons grow through the lesion site, that regeneration of cut axons contributes to such growth, and that animals lesioned early enough in development have relatively normal motor function as adults. PMID:11165803

  13. Thoracic aortic aneurysm

    MedlinePlus

    Aortic aneurysm - thoracic; Syphilitic aneurysm; Aneurysm - thoracic aortic ... The most common cause of a thoracic aortic aneurysm is hardening of the ... with high cholesterol, long-term high blood pressure, or who ...

  14. Thoracic actinomycosis

    PubMed Central

    Slade, P. R.; Slesser, B. V.; Southgate, J.

    1973-01-01

    Six cases of pulmonary infection with Actinomyces Israeli and one case of infection with Nocardia asteroides are described. The incidence of thoracic actinomycosis has declined recently and the classical presentation with chronic discharging sinuses is now uncommon. The cases described illustrate some of the forms which the disease may take. Actinomycotic infection has been noted, not infrequently, to co-exist with bronchial carcinoma and a case illustrating this association is described. Sputum cytology as practised for the diagnosis of bronchial carcinoma has helped to identify the fungi in the sputum. Treatment is discussed, particularly the possible use of oral antibiotics rather than penicillin by injection. Images PMID:4568119

  15. Staff Report to the Senior Department Official on Recognition Compliance Issues. Recommendation Page: American Speech-Language-Hearing Association

    ERIC Educational Resources Information Center

    US Department of Education, 2010

    2010-01-01

    The American Speech-Language-Hearing Association, Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) is a national accrediting agency of graduate education programs in audiology or speech-language pathology. The CAA currently accredits or or preaccredits 319 programs (247 in speech-language pathology and 72 in…

  16. Perceptions of German prison officials while visiting American correctional facilities: an example of a fruitful international collaboration.

    PubMed

    Dammer, Harry R; Bindzus, Dieter; Martens, Harald

    2011-10-01

    In June 2007, a group of 15 prison psychologists, social workers, wardens, and correctional administrators from across Germany visited the northeast United States for the purpose of conducting tours of various kinds of correctional facilities. The trip was organized through a collaborative effort from the authors over a period of 2 years. This article describes the correctional facilities visited and observations made by the Germans during their correctional facility tours and will focus on the similarities and differences between the German and American correctional systems. The article clearly reflects how international academic collaborations can provide a variety of benefits for those willing to physically venture beyond boarders. PMID:20656898

  17. Society of Thoracic Surgeons

    MedlinePlus

    ... With Its Intense Demands New Website from The Society of Thoracic Surgeons Puts the Power of Information ... Hotel Discount for STS Members Copyright © 2016 The Society of Thoracic Surgeons. All rights reserved. Expanded Proprietary ...

  18. Blunt thoracic trauma.

    PubMed

    Weyant, Michael J; Fullerton, David A

    2008-01-01

    Blunt thoracic trauma represents a significant portion of trauma admissions to hospitals in the United States. These injuries are encountered by physicians in many specialities such as emergency medicine, pediatrics, general surgery and thoracic surgery. Accurate diagnosis and treatment improves the chances of favorable outcomes and it is desirable for all treating physicians to have current knowledge of all aspects of blunt thoracic trauma. Cardiothoracic surgeons often treat the most severe forms of blunt thoracic injuries and we review the aspects of blunt thoracic trauma that are pertinent to the practicing cardiothoracic surgeon. PMID:18420123

  19. Official Flag Raising at MTO

    NASA Technical Reports Server (NTRS)

    1962-01-01

    Government officials officially raise the American flag for the first time in front of the Rouchon House in 1962 at the Mississippi Test Operations, denoting NASA's presence in South Mississippi. Pictured, from left, are: Bart Slattery, public affairs officer; Dr. Wernher von Braun, director; Capt. William Fortune, first site manager; Dr. George Constan, manager, Michoud Assembly Facility; Dr. Oswald Lange, chief, Saturn Program Office; Dr. Hermann Weidener, chief, Structures and Mechanics Laboratory; Dr. Karl Heimburg, director, Test Laboratory; and Dan Driscoll, Test Laboratory.

  20. Official portrait Astronaut Ellison S. Onizuka

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Official portrait of Astronaut Ellison S. Onizuka in the blue shuttle flight suit with an American flag in the background. There is a small model of the shuttle and a helmet on the table in front of him.

  1. Thoracic outlet anatomy (image)

    MedlinePlus

    ... spinal vertebra to the rib. There may be pain in the neck and shoulders, and numbess in the last 3 fingers and inner forearm. Thoracic outlet syndrome is usually treated with physical therapy which helps ...

  2. Thoracic Outlet Syndrome

    MedlinePlus

    Thoracic outlet syndrome (TOS) causes pain in the shoulder, arm, and neck. It happens when the nerves or blood vessels just below your ... vein is compressed, your hand might be sensitive to cold, or turn pale or bluish. Your arm ...

  3. 76 FR 63654 - Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Bureau of Ocean Energy Management Outer Continental Shelf Official Protraction Diagram, Lease Maps, and Supplemental Official Outer Continental Shelf Block Diagrams AGENCY: Bureau of Ocean Energy Management (BOEM), Interior. ACTION: Availability of revised North American Datum of 1927 (NAD 27) Outer Continental...

  4. Thoracic spine x-ray

    MedlinePlus

    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging . 6th ed. New ...

  5. Understanding Thoracic Outlet Syndrome

    PubMed Central

    Freischlag, Julie

    2014-01-01

    The diagnosis of thoracic outlet syndrome was once debated in the world of vascular surgery. Today, it is more understood and surprisingly less infrequent than once thought. Thoracic outlet syndrome (TOS) is composed of three types: neurogenic, venous, and arterial. Each type is in distinction to the others when considering patient presentation and diagnosis. Remarkable advances have been made in surgical approach, physical therapy, and rehabilitation of these patients. Dedicated centers of excellence with multidisciplinary teams have been developed and continue to lead the way in future research. PMID:25140278

  6. Radiology of thoracic diseases

    SciTech Connect

    Swensen, S.J.; Pugatch, R.D.

    1989-01-01

    This book presents the essential clinical and radiologic findings of a wide variety of thoracic diseases. The authors include conventional, CT and MR images of each disease discussed. In addition, they present practical differential diagnostic considerations for most of the radiographic findings or patterns portrayed.

  7. [Thoracic oncology: annual review].

    PubMed

    Sculier, J-P; Berghmans, T; Meert, A-P

    2013-01-01

    The objective of this paper is to review the literature published in 2011-12 in the field of thoracic oncology. Are discussed because of new original publications: epidemiology, screening, pulmonary nodule, diagnosis and assessment, treatment of lung cancer non-small cell, small cell lung cancer, prognosis, palliative care and end of life, organization of care, mesothelioma. PMID:23755717

  8. [Single Port Thoracic Surgery and Reduced Port Thoracic Surgery].

    PubMed

    Onodera, Ken; Noda, Masafumi

    2016-07-01

    Single port thoracic surgery, reduced port surgery and needlescopic surgery attract attention as one of the minimally invasive surgery in thoracic surgery recently. Single port thoracic surgery was advocated by Rocco in 2004, it was reported usefulness of single port thoracic surgery for primary spontaneous pneumothorax. The surgical procedure as single (or reduced) port thoracic surgery is roughly divided into the following. One is operated with instruments inserted from the single extended incision, and the other is operated with instruments punctured without extending incision. It is not generally complicated procedures in single port thoracic surgery. Primary spontaneous pneumothorax and biopsy for lung and pleura are considered the surgical indication for single (or reduced) port surgery. It is revealed that single port surgery for primary spontaneous pneumothorax is less invasive than conventional surgery. Single port and reduced port thoracic surgery will spread furthermore in the future. PMID:27440029

  9. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. PMID:25410842

  10. [Thoracic actinomycosis: three cases].

    PubMed

    Herrak, L; Msougar, Y; Ouadnouni, Y; Bouchikh, M; Benosmane, A

    2007-09-01

    Actinomycosis is a rare condition which, in the thoracic localisation, can mimic cancer or tuberculosis. We report a series of three case of thoracic actinomycosis treated in the Ibn Sina University Thoracic Surgery Unit in Rabat, Morocco. CASE N degrees 1: This 45-year-old patient presented a tumefaction on the left anterior aspect of the chest. Physical examination identified a parietal mass with fistulisation to the skin. Radiography demonstrated a left pulmonary mass. Transparietal puncture led to the pathological diagnosis of actinomycosis. The patient was given medical treatment and improved clinically and radiographically. CASE N degrees 2: This 68-year-old patient presented repeated episodes of hemoptysis. The chest x-ray revealed atelectasia of the middle lobe and bronchial fibroscopy demonstrated the presence of a bud in the middle lobar bronchus. Biopsies were negative. The patient underwent surgery and the histology examination of the operative specimen revealed pulmonary actinomycosis. The patient recovered well clinically and radiographically with antibiotic therapy. CASE N degrees 3: This 56-year-old patient presented cough and hemoptysis. Physical examination revealed a left condensation and destruction of the left lung was noted on the chest x-ray. Left pleuropulmonectomy was performed. Histological analysis of the surgical specimen identified associated Aspergillus and Actinomyces. The outcome was favorable with medical treatment. The purpose of this work was to recall the radiological, clinical, histological, therapeutic, outcome aspects of this condition and to relate the problems of differential diagnosis when can suggest other diseases. PMID:17978739

  11. American Orthopaedic Foot and Ankle Society

    MedlinePlus

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  12. Relationship of epidermal growth factor receptor activating mutations with histologic subtyping according to International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society 2011 adenocarcinoma classification and their impact on overall survival

    PubMed Central

    Maturu, Venkata Nagarjuna; Singh, Navneet; Bal, Amanjit; Gupta, Nalini; Das, Ashim; Behera, Digambar

    2016-01-01

    Background: There is limited Indian data on epidermal growth factor receptor (EGFR) gene activating mutations (AMs) prevalence and their clinicopathologic associations. The current study aimed to assess the relationship between EGFR AM and histologic subtypes and their impact on overall survival (OS) in a North Indian cohort. Patients and Methods: Retrospective analysis of nonsmall cell lung cancer patients who underwent EGFR mutation testing (n = 186) over 3 years period (2012–2014). EGFR mutations were tested using polymerase chain reaction amplification and direct sequencing. Patients were classified as EGFR AM, EGFR wild type (WT) or EGFR unknown (UKN). Histologically adenocarcinomas (ADC) were further categorized as per the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society-2011 classification. Results: Overall EGFR AM prevalence was 16.6%. The ratio of exon 19 deletions to exon 21 L858R mutations was 3.17:1. Female sex (P = 0.002), never smoking status (P = 0.002), metastatic disease (P = 0.032), and nonsolid subtype of ADC (P = 0.001) were associated with EGFR AM on univariate logistic regression analysis (LRA). On multivariate LRA, solid ADC was negatively associated with EGFR AM. Median OS was higher in patients with EGFR AM (750 days) as compared to EGFR-WT (459 days) or EGFR-UKN (291 days) for the overall population and in patients with Stage IV disease (750 days vs. 278 days for EGFR-WT, P = 0.024). On univariate Cox proportional hazard (CPH) analysis, smoking, poor performance status (Eastern Cooperative Oncology Group ≥ 2), EGFR-UKN status, and solid ADC were associated with worse OS while female sex and lepidic ADC had better OS. On multivariate CPH analysis, lepidic ADC (hazard ratio [HR] =0.12) and EGFR-WT/EGFR-UKN (HR = 2.39 and HR = 3.30 respectively) were independently associated with OS in separate analyses. Conclusions: Histologic subtyping of ADC performed on small biopsies is

  13. Nonintubated anesthesia for thoracic surgery

    PubMed Central

    Wang, Bei

    2014-01-01

    Nonintubated thoracic surgery has been used in procedures including pleura, lungs and mediastinum. Appropriate anesthesia techniques with or without sedation allow thoracic surgery patients to avoid the potential risks of intubated general anesthesia, particularly for the high-risk patients. However, nonintubated anesthesia for thoracic surgery has some benefits as well as problems. In this review, the background, indication, perioperative anesthetic consideration and management, and advantages and disadvantages are discussed and summarized. PMID:25589994

  14. Nonmalignant Adult Thoracic Lymphatic Disorders.

    PubMed

    Itkin, Maxim; McCormack, Francis X

    2016-09-01

    The thoracic lymphatic disorders are a heterogeneous group of uncommon conditions that are associated with thoracic masses, interstitial pulmonary infiltrates, and chylous complications. Accurate diagnosis of the thoracic lymphatic disorders has important implications for the newest approaches to management, including embolization and treatment with antilymphangiogenic drugs. New imaging techniques to characterize lymphatic flow, such as dynamic contrast-enhanced magnetic resonance lymphangiogram, are redefining approaches to disease classification and therapy. PMID:27514588

  15. Thoracic trauma in horses.

    PubMed

    Sprayberry, Kim A; Barrett, Elizabeth J

    2015-04-01

    Traumatic injuries involving the thorax can be superficial, necessitating only routine wound care, or they may extend to deeper tissue planes and disrupt structures immediately vital to respiratory and cardiac function. Diagnostic imaging, especially ultrasound, should be considered part of a comprehensive examination, both at admission and during follow-up. Horses generally respond well to diligent monitoring, intervention for complications, and appropriate medical or surgical care after sustaining traumatic wounds of the thorax. This article reviews the various types of thoracic injury and their management. PMID:25770070

  16. The State's Official Measures of School Performance

    ERIC Educational Resources Information Center

    EdSource, 2005

    2005-01-01

    This guide describes the measures California state officials use to evaluate schools and school districts, explaining what they are and what they indicate. Results of standard tests and the Academic Performance Index (API) indicate substantial gaps between the achievement of various groups of students in California. African American, Latino, and…

  17. Official portrait of Astronaut Vance D. Brand

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Official portrait of Astronaut Vance D. Brand. Brand is in the dark blue shuttle flight suit with his helmet under his arm and an American flag behind him. Above and to the right of his head is a view of the shuttle flying.

  18. 35th Annual Official Education Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2009-01-01

    Spending on construction by the nation's education institutions increased in 2008, reversing four years of declines in total annual expenditures, according to "American School & University"'s 35th annual Official Education Construction Report. One of the reasons for the increase in spending was the fact that the majority of the construction…

  19. 33rd Annual Official Education Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2007-01-01

    Construction spending by education institutions topped $36 billion in 2006. While strong by historical standards, it represents the third consecutive year that total spending on construction dropped from the year before. According to the "American School & University" 33rd annual Official Education Construction Report, total spending on new,…

  20. 34th Annual Official Education Construction Report

    ERIC Educational Resources Information Center

    Agron, Joe

    2008-01-01

    According to American School & University's 34th annual Official Education Construction Report, spending on construction by the nation's school districts and colleges slowed in 2007, representing the fourth consecutive year total expenditures dropped from the year before and setting a low point in spending so far this decade. A difficult economy…

  1. Thoracic spine x-ray

    MedlinePlus

    Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... The test is done in a hospital radiology department or in the health care provider's office. You will lie on the x-ray table in different positions. If the x-ray ...

  2. Aneurysms: thoracic aortic aneurysms.

    PubMed

    Chun, Kevin C; Lee, Eugene S

    2015-04-01

    Thoracic aortic aneurysms (TAAs) have many possible etiologies, including congenital heart defects (eg, bicuspid aortic valves, coarctation of the aorta), inherited connective tissue disorders (eg, Marfan, Ehlers-Danlos, Loeys-Dietz syndromes), and degenerative conditions (eg, medial necrosis, atherosclerosis of the aortic wall). Symptoms of rupture include a severe tearing pain in the chest, back, or neck, sometimes associated with cardiovascular collapse. Before rupture, TAAs may exert pressure on other thoracic structures, leading to a variety of symptoms. However, most TAAs are asymptomatic and are found incidentally during imaging for other conditions. Diagnosis is confirmed with computed tomography scan or echocardiography. Asymptomatic TAAs should be monitored with imaging at specified intervals and patients referred for repair if the TAAs are enlarging rapidly (greater than 0.5 cm in diameter over 6 months for heritable etiologies; greater than 0.5 cm over 1 year for degenerative etiologies) or reach a critical aortic diameter threshold for elective surgery (5.5 cm for TAAs due to degenerative etiologies, 5.0 cm when associated with inherited syndromes). Open surgery is used most often to treat asymptomatic TAAs in the ascending aorta and aortic arch. Asymptomatic TAAs in the descending aorta often are treated medically with aggressive blood pressure control, though recent data suggest that endovascular procedures may result in better long-term survival rates. PMID:25860136

  3. Vascular Thoracic Outlet Syndrome.

    PubMed

    Hussain, Mohamad Anas; Aljabri, Badr; Al-Omran, Mohammed

    2016-01-01

    Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous and arterial TOS have undergone considerable evolution due to the recent emergence of minimally invasive endovascular techniques such as catheter-directed arterial and venous thrombolysis, and balloon angioplasty. In this review, we discuss the anatomical factors, etiology, pathogenesis and clinical presentation of vascular TOS patients. In addition, we use the most up to date observational evidence available to provide a contemporary approach to the diagnosis and management of venous TOS and arterial TOS patients. PMID:27568153

  4. Thoracic outlet syndrome.

    PubMed

    Ozoa, Glenn; Alves, Daniel; Fish, David E

    2011-08-01

    Of the many clinical entities involving the neck region, one of the most intriguing is thoracic outlet syndrome (TOS). TOS is an array of disorders that involves injury to the neurovascular structures in the cervicobrachial region. A classification system based on etiology, symptoms, clinical presentation, and anatomy is supported by most physicians. The first type of TOS is vascular, involving compression of either the subclavian artery or vein. The second type is true neurogenic TOS, which involves injury to the brachial plexus. Finally, the third and most controversial type is referred to as disputed neurogenic TOS. This article aims to provide the reader some understanding of the pathophysiology, workup, and treatment of this fascinating clinical entity. PMID:21824588

  5. [Thoracic outlet syndrome].

    PubMed

    Sonoo, Masahiro

    2014-12-01

    Thoracic outlet syndrome (TOS) is a well-known disorder, but its definition has been disputed. TOS is differentiated into five distinct disorders: arterial vascular, venous vascular, traumatic neurovascular, true neurologic (TN-TOS), and nonspecific TOS. TN-TOS is caused by compression of the lower plexus (T1>C8 roots and/or lower trunk) by a fibrous band. The most frequent presenting symptoms are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digital flexors. Numbness and sensory loss are usually present, mainly in the ulnar forearm, although severe pain or pain/paresthesia proximal to the elbow can occur; however, sensory symptoms or signs can be absent in some patients. Nerve conduction studies are pathognomonic and show the loss or severe attenuation of the sensory nerve action potential (SNAP) of the medial antebrachial cutaneous nerve. Additionally, they show a severely depressed median compound muscle action potential (CMAP) and, subsequently, a depressed ulnar CMAP and SNAP. TN-TOS is a rare disorder, although its incidence may be higher than previously believed. Hirayama disease is an important differential diagnosis. Nonspecific TOS, which is mainly diagnosed by provocative maneuvers, corresponds to the classical concept of TOS. However, this concept is now challenged and the existence of nonspecific TOS is doubted. PMID:25475030

  6. Thoracic Radiculopathy due to Rare Causes

    PubMed Central

    2016-01-01

    Thoracic radiculopathy represents an uncommon spinal disorder that is frequently overlooked in the evaluation of thoracic, or abdominal pain syndrome. The clinical representation of this uncommon disorder is often atypical. With many differential diagnoses to consider, it is not surprising that the cause of thoracic radiculopathy is often not discovered for months, or years, after the symptoms arise. We report two rare cases of thoracic radiculopathy; one case was caused by extraskeletal Ewing sarcoma (EES) along the thoracic paraspinal area, and the other by foraminal stenosis, due to a bony spur of the thoracic vertebra. As such, thoracic radiculopathy should be considered in the diagnosis of patients with thoracic and abdominal pain, especially if initial diagnostic studies are inconclusive. PMID:27446792

  7. [Thoracic endometriosis and catamenial pneumothorax].

    PubMed

    Voskresenskiĭ, O V; Smoliar, A N; Damirov, M M; Galankina, I E; Zhelev, I G

    2014-01-01

    It was analyzed own experience of diagnosis and treatment of catamenial (menstrual) pneumothorax and thoracic endometriosis and literature review. It is shown that catamenial pneumothorax has specific clinical and instrumental signs allowing to establish the diagnosis before surgery. It was proposed surgical treatment including the removal of trans diaphragmatic way of pneumothorax development, removal of thoracic endometriosis and the establishment of reliable pleurodesis. It was demonstrated that this volume of surgery can be successfully implemented by using of thoracoscopic access. Relapse prevention includes hormonal therapy for the 6 months after surgery under the supervision of an obstetrician-gynecologist. PMID:25484144

  8. American Studies through Folk Speech.

    ERIC Educational Resources Information Center

    Pedersen, E. Martin

    1993-01-01

    American slang reflects diversity, imagination, self-confidence, and optimism of the American people. Its vitality is due in part to the guarantee of free speech and lack of a national academy of language or of any official attempt to purify American speech, in part to Americans' historic geographic mobility. Such "folksay" includes riddles and…

  9. [A case of thoracic actinomycosis].

    PubMed

    Denisova, O A; Cherniavskaia, G M; Beloborodova, É I; Topol'nitskiĭ, E B; Iakimenko, Iu V; Chernogoriuk, G É; Beloborodova, E V; Strezh, Iu A; Vil'danova, L R

    2014-01-01

    A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period. PMID:25265662

  10. NAGWS Volleyball Guide, 1989. Official Rules & Interpretations/Officiating.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA. National Association for Girls and Women in Sport.

    This booklet contains the official rules and interpretations for officiating in volleyball competitions. Section 1 states the National Association for Girls and Women in Sport (NAGWS) interscholastic and collegiate volleyball rules for 1989-90. Section 2 presents a summary and descriptions of officiating techniques and mechanics. Study questions…

  11. Emergency Thoracic US: The Essentials.

    PubMed

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Sawatmongkorngul, Sorravit; Kaewlai, Rathachai

    2016-01-01

    Acute thoracic symptoms are common among adults visiting emergency departments in the United States. Adults with these symptoms constitute a large burden on the overall resources used in the emergency department. The wide range of possible causes can make a definitive diagnosis challenging, even after clinical evaluation and initial laboratory testing. In addition to radiography and computed tomography, thoracic ultrasonography (US) is an alternative imaging modality that can be readily performed in real time at the patient's bedside to help diagnose many thoracic diseases manifesting acutely and in the trauma setting. Advantages of US include availability, relatively low cost, and lack of ionizing radiation. Emergency thoracic US consists of two main parts, lung and pleura US and focused cardiac US, which are closely related. Acoustic mismatches among aerated lungs, pleura, chest wall, and pathologic conditions produce artifacts useful for diagnosis of pneumothorax and pulmonary edema and help in detection of subpleural, pleural, and chest wall pathologic conditions such as pneumonia, pleural effusion, and fractures. Visual assessment of cardiac contractility and detection of right ventricular dilatation and pericardial effusion at focused cardiac US are critical in patients presenting with acute dyspnea and trauma. Additional US examinations of the inferior vena cava for noninvasive volume assessment and of the groin areas for detection of deep venous thrombosis are often performed at the same time. This multiorgan US approach can provide valuable information for emergency treatment of both traumatic and nontraumatic thoracic diseases involving the lungs, pleura, chest wall, heart, and vascular system. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27035835

  12. Endovascular Repair of Thoracic Aortic Aneurysms

    PubMed Central

    Findeiss, Laura K.; Cody, Michael E.

    2011-01-01

    Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here. PMID:22379281

  13. Reoperation for thoracic outlet syndrome.

    PubMed

    Sessions, R T

    1989-01-01

    The clinical history and operative findings in a group of 60 patients who underwent reoperation for thoracic outlet syndrome (TOS) are presented. The patients were severely disabled by arm, shoulder, and neck pain and presented with physical findings pointing to scar fixation of the brachial plexus in the neck (upper tract recurrence) or at the thoracic outlet (lower tract recurrence). The causes of recurrence of TOS as discovered at operation are outlined. Basic principles governing the surgical management of recurrent TOS are elimination of the known causes of recurrence, thorough neurolysis of the brachial plexus, and coverage of the nerves with healthy fat. The role of an expanded PTFE surgical membrane (Gortex) as an adjunct to prevent recurrent scarring is discussed. The surgeon who operates on patients with recurrent TOS must be capable of managing the potential intraoperative complications of severe nerve injury and life threatening bleeding. PMID:2745532

  14. Nanotechnology applications in thoracic surgery.

    PubMed

    Hofferberth, Sophie C; Grinstaff, Mark W; Colson, Yolonda L

    2016-07-01

    Nanotechnology is an emerging, rapidly evolving field with the potential to significantly impact care across the full spectrum of cancer therapy. Of note, several recent nanotechnological advances show particular promise to improve outcomes for thoracic surgical patients. A variety of nanotechnologies are described that offer possible solutions to existing challenges encountered in the detection, diagnosis and treatment of lung cancer. Nanotechnology-based imaging platforms have the ability to improve the surgical care of patients with thoracic malignancies through technological advances in intraoperative tumour localization, lymph node mapping and accuracy of tumour resection. Moreover, nanotechnology is poised to revolutionize adjuvant lung cancer therapy. Common chemotherapeutic drugs, such as paclitaxel, docetaxel and doxorubicin, are being formulated using various nanotechnologies to improve drug delivery, whereas nanoparticle (NP)-based imaging technologies can monitor the tumour microenvironment and facilitate molecularly targeted lung cancer therapy. Although early nanotechnology-based delivery systems show promise, the next frontier in lung cancer therapy is the development of 'theranostic' multifunctional NPs capable of integrating diagnosis, drug monitoring, tumour targeting and controlled drug release into various unifying platforms. This article provides an overview of key existing and emerging nanotechnology platforms that may find clinical application in thoracic surgery in the near future. PMID:26843431

  15. Officials of the Army Ballistic Missile Agency

    NASA Technical Reports Server (NTRS)

    1956-01-01

    Hermann Oberth (forefront) with officials of the Army Ballistic Missile Agency at Huntsville, Alabama in 1956. Left to right: Dr. Ernst Stuhlinger (seated); Major General H.N. Toftoy, Commanding Officer and person responsible for 'Project Paperclip,' which took scientists and engineers out of Germany after World War II to design rockets for American military use. Many of the scientists later helped to design the Saturn V rocket that took the Apollo 11 astronauts to the Moon. Dr. Eberhard Rees, Deputy Director, Development Operations Division Wernher von Braun, Director, Development Operations Division.

  16. Thoracic spine sports-related injuries.

    PubMed

    Menzer, Heather; Gill, G Keith; Paterson, Andrew

    2015-01-01

    Although sports-related injuries to the thoracic spine are relatively uncommon, they are among the most feared due to the potential for catastrophic neurologic injury. The increased biomechanical support of the thoracic spine makes injuries in this region particularly rare compared with the cervical and lumbar spine. As a result, thoracic spine injuries can be missed easily, difficult to diagnose, and problematic to treat. Recognition of mechanism and awareness of injury patterns help physicians determine a diagnosis and create an index of suspicion for unstable thoracic spine injuries. Aggressive full-contact sports receive the most attention for spinal injury; however several sports with repetitive loading of the spine can cause severe injuries, including rowing, gymnastics, and golf. The goal of this article was to provide an overview of the unique anatomic and biomechanical features of the thoracic spine and to discuss some of the more common thoracic injuries that can affect athletes. PMID:25574880

  17. 29 CFR 98.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Debarring official. 98.935 Section 98.935 Labor Office of... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  18. 29 CFR 98.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Debarring official. 98.935 Section 98.935 Labor Office of... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  19. 7 CFR 3017.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Debarring official. 3017.935 Section 3017.935... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  20. 29 CFR 98.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 1 2013-07-01 2013-07-01 false Debarring official. 98.935 Section 98.935 Labor Office of... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  1. 29 CFR 98.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 1 2012-07-01 2012-07-01 false Debarring official. 98.935 Section 98.935 Labor Office of... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  2. 2 CFR 180.930 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 2 Grants and Agreements 1 2012-01-01 2012-01-01 false Debarring official. 180.930 Section 180.930... Debarring official. Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (a) The agency head; or (b) An official designated by the agency head....

  3. 2 CFR 180.930 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Debarring official. 180.930 Section 180.930... § 180.930 Debarring official. Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (a) The agency head; or (b) An official designated by the...

  4. 2 CFR 180.930 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false Debarring official. 180.930 Section 180.930... Debarring official. Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (a) The agency head; or (b) An official designated by the agency head....

  5. 29 CFR 98.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 1 2014-07-01 2013-07-01 true Debarring official. 98.935 Section 98.935 Labor Office of... Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An official designated by the agency head. (b)...

  6. TEVAR: Endovascular Repair of the Thoracic Aorta

    PubMed Central

    Nation, David A.; Wang, Grace J.

    2015-01-01

    The development of thoracic endovascular aortic repair (TEVAR) has allowed a minimally invasive approach for management of an array of thoracic aortic pathologies. Initially developed specifically for exclusion of thoracic aortic aneurysms, TEVAR is now used as an alternative to open surgery for a variety of disease pathologies due to the lower morbidity of this approach. Advances in endograft technology continue to broaden the applications of this technique. PMID:26327745

  7. Practical genetics of thoracic aortic aneurysm.

    PubMed

    Elefteriades, John A; Pomianowski, Pawel

    2013-01-01

    This chapter will provide a practical look at the rapidly evolving field regarding the genetics of thoracic aortic aneurysm. It will start with a look at the history of the genetics of thoracic aortic aneurysm and will then move on to elucidating the discovery of familial patterns of thoracic aortic aneurysm. We will next review the Mendelian genetics of transmission of thoracic aortic aneurysm. We will move on to the molecular genetics at the DNA level and finish with a discussion of the molecular genetics at the RNA level, including a promising investigational "RNA Signature" test that we have been developing at Yale. PMID:23993238

  8. Traumatic injury of the thoracic duct.

    PubMed

    Guzman, A E; Rossi, L; Witte, C L; Smyth, S

    2002-03-01

    Injuries to the thoracic duct are infrequent but may become life-threatening when chylous leakage persists. This report describes 6 patients with such injuries in whom the leakage resolved spontaneously in one, was corrected using microsurgical lymphatic repair or lymphatic-venous anastomosis in two, successfully treated either by ligation of the thoracic duct or insertion of a peritoneovenous shunt in two, and was eventually controlled after bilateral pleurodesis and thoracic duct ligation by insertion of a peritoneo-venous shunt in one. Conventional lymphography is superior to lymphoscintigraphy and is usually required to document disruption of the thoracic duct. PMID:11939572

  9. Official portrait of Astronaut Charles F. Bolden, Jr.

    NASA Technical Reports Server (NTRS)

    1986-01-01

    New Official portrait of Astronaut Charles F. Bolden Jr. Bolden is in the blue shuttle flight suit with his helmet under his arm and an American flag behind him. Above and to the right of his head is a view of the shuttle flying.

  10. Official portrait Payload specialists Robert Cenker and Gerard Magilton

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait Robert J. Cenker (right) and Gerard Magilton, RCA Payload Specialists for STS 61-C. They are wearing the blue shuttle flight suit. They are sitting in front of a table with their helmets and an American flag behind them.

  11. Official portrait of astronaut Robert D.Cabana

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait of astronaut Robert D.Cabana, a colonel in the United States Marine Corps (USMC) and a member of the 1985 Astronaut Class 11. Cabana is wearing a blue flight suit and poses with an American flag and asmall model of the space shuttle orbiter.

  12. NAGWS Volleyball Guide 1990: Official Rules & Interpretations/Officiating.

    ERIC Educational Resources Information Center

    American Alliance for Health, Physical Education, Recreation and Dance, Reston, VA. National Association for Girls and Women in Sport.

    This guide presents the 1990 update of the National Association for Girls & Women in Sport (NAGWS) interscholastic and collegiate volleyball rules. It includes the official U.S. volleyball rules and a summary of rule changes, definitions of skills and fouls, and a summary of penalties. Officiating techniques and mechanics are covered with a…

  13. Calibration of high flow rate thoracic-size selective samplers.

    PubMed

    Lee, Taekhee; Thorpe, Andrew; Cauda, Emanuele; Harper, Martin

    2016-01-01

    High flow rate respirable size selective samplers, GK4.126 and FSP10 cyclones, were calibrated for thoracic-size selective sampling in two different laboratories. The National Institute for Occupational Safety and Health (NIOSH) utilized monodisperse ammonium fluorescein particles and scanning electron microscopy to determine the aerodynamic particle size of the monodisperse aerosol. Fluorescein intensity was measured to determine sampling efficiencies of the cyclones. The Health Safety and Laboratory (HSL) utilized a real time particle sizing instrument (Aerodynamic Particle Sizer) and polydisperse glass sphere particles and particle size distributions between the cyclone and reference sampler were compared. Sampling efficiency of the cyclones were compared to the thoracic convention defined by the American Conference of Governmental Industrial Hygienists (ACGIH)/Comité Européen de Normalisation (CEN)/International Standards Organization (ISO). The GK4.126 cyclone showed minimum bias compared to the thoracic convention at flow rates of 3.5 l min(-1) (NIOSH) and 2.7-3.3 l min(-1) (HSL) and the difference may be from the use of different test systems. In order to collect the most dust and reduce the limit of detection, HSL suggested using the upper end in range (3.3 l min(-1)). A flow rate of 3.4 l min(-1) would be a reasonable compromise, pending confirmation in other laboratories. The FSP10 cyclone showed minimum bias at the flow rate of 4.0 l min(-1) in the NIOSH laboratory test. The high flow rate thoracic-size selective samplers might be used for higher sample mass collection in order to meet analytical limits of quantification. PMID:26891196

  14. Calibration of high flow rate thoracic-size selective samplers

    PubMed Central

    Lee, Taekhee; Thorpe, Andrew; Cauda, Emanuele; Harper, Martin

    2016-01-01

    High flow rate respirable size selective samplers, GK4.126 and FSP10 cyclones, were calibrated for thoracic-size selective sampling in two different laboratories. The National Institute for Occupational Safety and Health (NIOSH) utilized monodisperse ammonium fluorescein particles and scanning electron microscopy to determine the aerodynamic particle size of the monodisperse aerosol. Fluorescein intensity was measured to determine sampling efficiencies of the cyclones. The Health Safety and Laboratory (HSL) utilized a real time particle sizing instrument (Aerodynamic Particle Sizer) and poly-disperse glass sphere particles and particle size distributions between the cyclone and reference sampler were compared. Sampling efficiency of the cyclones were compared to the thoracic convention defined by the American Conference of Governmental Industrial Hygienists (ACGIH)/Comité Européen de Normalisation (CEN)/International Standards Organization (ISO). The GK4.126 cyclone showed minimum bias compared to the thoracic convention at flow rates of 3.5 l min−1 (NIOSH) and 2.7–3.3 l min−1 (HSL) and the difference may be from the use of different test systems. In order to collect the most dust and reduce the limit of detection, HSL suggested using the upper end in range (3.3 l min−1). A flow rate of 3.4 l min−1 would be a reasonable compromise, pending confirmation in other laboratories. The FSP10 cyclone showed minimum bias at the flow rate of 4.0 l min−1 in the NIOSH laboratory test. The high flow rate thoracic-size selective samplers might be used for higher sample mass collection in order to meet analytical limits of quantification. PMID:26891196

  15. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

  16. Official portrait of Rep. Bill Nelson, STS 61-C payload specialist

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait of Congressman Bill Nelson, U.S. House of Representatives - Florida, STS 61-C payload specialist. He is in the blue shuttle flight suit, holding a model of the shuttle with an American flag behind him.

  17. Official portrait Robert J. Cenker, Payload specialist for STS 61-C

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Official portrait Robert J. Cenker, RCA Payload specialist for STS 61-C. He is wearing the blue shuttle flight suit. He is sitting in front of a table with a model of the shuttle and an American flag behind him.

  18. International Exchange of Official Publications.

    ERIC Educational Resources Information Center

    Metz, Johannes

    International exchange agreements potentially serve to facilitate the free access to official materials from abroad, similar to depository programs for national official publications collections and with corresponding issues of collecting and archiving electronic publications. In this connection, it is necessary to distinguish between exchange…

  19. Evolution of thoracic surgery in Canada

    PubMed Central

    Deslauriers, Jean; Griffith Pearson, F; Nelems, Bill

    2015-01-01

    BACKGROUND: Canada’s contributions toward the 21st century’s practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another. OBJECTIVE: To describe the numerous and important achievements of Canadian thoracic surgeons in the areas of surgery for pulmonary tuberculosis, thoracic oncology, airway surgery and lung transplantation. METHOD: Information was collected through reading of the numerous publications written by Canadian thoracic surgeons over the past 100 years, interviews with interested people from all thoracic surgery divisions across Canada and review of pertinent material form the archives of several Canadian hospitals and universities. RESULTS: Many of the developments occurred by chance. It was the early and specific focus on thoracic surgery, to the exclusion of cardiac and general surgery, that distinguishes the Canadian experience, a model that is now emerging everywhere. From lung transplantation in chimera twin calves to ex vivo organ preservation, from the removal of airways to tissue regeneration, and from intensive care research to complex science, Canadians have excelled in their commitment to research. Over the years, the influence of Canadian thoracic surgery on international practice has been significant. CONCLUSIONS: Canada spearheaded the development of thoracic surgery over the past 100 years to a greater degree than any other country. From research to education, from national infrastructures to the regionalization of local practices, it happened in Canada.

  20. The Thoracic Shape of Hominoids

    PubMed Central

    Chan, Lap Ki

    2014-01-01

    In hominoids, the broad thorax has been assumed to contribute to their dorsal scapular position. However, the dorsoventral diameter of their cranial thorax was found in one study to be longer in hominoids. There are insufficient data on thoracic shape to explain the relationship between broad thorax and dorsal scapular position. The current study presents data on multilevel cross-sectional shape and volume distribution in a range of primates. Biplanar radiographs of intact fluid-preserved cadavers were taken to measure the cross-sectional shape of ten equally spaced levels through the sternum (called decisternal levels) and the relative volume of the nine intervening thoracic segments. It was found that the cranial thorax of hominoids is larger and broader (except in the first two decisternal levels) than that of other primates. The cranial thorax of hominoids has a longer dorsoventral diameter because the increase in dorsoventral diameter caused by the increase in the volume of the cranial thorax overcompensates for the decrease caused by the broadening of the cranial thorax. The larger and broader cranial thorax in hominoids can be explained as a locomotor adaptation for scapular gliding and as a respiratory adaptation for reducing the effects of orthograde posture on ventilation-perfusion inequality. PMID:24818026

  1. Thoracic organ transplantation: laboratory methods.

    PubMed

    Patel, Jignesh K; Kobashigawa, Jon A

    2013-01-01

    Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques. PMID:23775735

  2. The thoracic shape of hominoids.

    PubMed

    Chan, Lap Ki

    2014-01-01

    In hominoids, the broad thorax has been assumed to contribute to their dorsal scapular position. However, the dorsoventral diameter of their cranial thorax was found in one study to be longer in hominoids. There are insufficient data on thoracic shape to explain the relationship between broad thorax and dorsal scapular position. The current study presents data on multilevel cross-sectional shape and volume distribution in a range of primates. Biplanar radiographs of intact fluid-preserved cadavers were taken to measure the cross-sectional shape of ten equally spaced levels through the sternum (called decisternal levels) and the relative volume of the nine intervening thoracic segments. It was found that the cranial thorax of hominoids is larger and broader (except in the first two decisternal levels) than that of other primates. The cranial thorax of hominoids has a longer dorsoventral diameter because the increase in dorsoventral diameter caused by the increase in the volume of the cranial thorax overcompensates for the decrease caused by the broadening of the cranial thorax. The larger and broader cranial thorax in hominoids can be explained as a locomotor adaptation for scapular gliding and as a respiratory adaptation for reducing the effects of orthograde posture on ventilation-perfusion inequality. PMID:24818026

  3. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  4. American Society of Nuclear Cardiology

    MedlinePlus

    ... of Nuclear Cardiology Official publication of the American Society of Nuclear Cardiology Clinical Guidelines Procedures, Appropriate Use Criteria, Information Statements and Joint Society Statements Member Login Enter Forgot your password? Meetings & ...

  5. 22 CFR 208.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Debarring official. 208.935 Section 208.935... (NONPROCUREMENT) Definitions § 208.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  6. 22 CFR 1006.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Debarring official. 1006.935 Section 1006.935...) Definitions § 1006.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  7. 22 CFR 1006.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Debarring official. 1006.935 Section 1006.935...) Definitions § 1006.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  8. 31 CFR 19.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Debarring official. 19.935 Section 19... SUSPENSION (NONPROCUREMENT) Definitions § 19.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or...

  9. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Debarring official. 93.206 Section 93.206 Public... MISCONDUCT Definitions § 93.206 Debarring official. Debarring official means an official authorized to impose debarment or suspension. The HHS debarring official is either— (a) The Secretary; or (b) An...

  10. 21 CFR 1404.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Debarring official. 1404.935 Section 1404.935 Food... (NONPROCUREMENT) Definitions § 1404.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  11. 22 CFR 208.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Debarring official. 208.935 Section 208.935... (NONPROCUREMENT) Definitions § 208.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  12. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Debarring official. 93.206 Section 93.206 Public... MISCONDUCT Definitions § 93.206 Debarring official. Debarring official means an official authorized to impose debarment or suspension. The HHS debarring official is either— (a) The Secretary; or (b) An...

  13. 2 CFR 180.930 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Debarring official. 180.930 Section 180.930... GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 180.930 Debarring official. Debarring official means an agency official who is authorized to impose debarment. A debarring official is either—...

  14. 21 CFR 1404.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Debarring official. 1404.935 Section 1404.935 Food... (NONPROCUREMENT) Definitions § 1404.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  15. 29 CFR 1471.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Debarring official. 1471.935 Section 1471.935 Labor... AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1)...

  16. 22 CFR 1508.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Debarring official. 1508.935 Section 1508.935...) Definitions § 1508.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  17. 21 CFR 1404.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Debarring official. 1404.935 Section 1404.935 Food... (NONPROCUREMENT) Definitions § 1404.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  18. 31 CFR 19.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Debarring official. 19.935 Section 19... SUSPENSION (NONPROCUREMENT) Definitions § 19.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or...

  19. 21 CFR 1404.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Debarring official. 1404.935 Section 1404.935 Food... (NONPROCUREMENT) Definitions § 1404.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  20. 22 CFR 1006.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Debarring official. 1006.935 Section 1006.935...) Definitions § 1006.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  1. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Debarring official. 93.206 Section 93.206 Public... MISCONDUCT Definitions § 93.206 Debarring official. Debarring official means an official authorized to impose debarment or suspension. The HHS debarring official is either— (a) The Secretary; or (b) An...

  2. 31 CFR 19.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Debarring official. 19.935 Section 19... SUSPENSION (NONPROCUREMENT) Definitions § 19.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or...

  3. 29 CFR 1471.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Debarring official. 1471.935 Section 1471.935 Labor... AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1)...

  4. 29 CFR 1471.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Debarring official. 1471.935 Section 1471.935 Labor... AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1)...

  5. 29 CFR 1471.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Debarring official. 1471.935 Section 1471.935 Labor... AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1)...

  6. 21 CFR 1404.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Debarring official. 1404.935 Section 1404.935 Food... (NONPROCUREMENT) Definitions § 1404.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  7. 2 CFR 180.930 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Debarring official. 180.930 Section 180.930... ON GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 180.930 Debarring official. Debarring official means an agency official who is authorized to impose debarment. A debarring official...

  8. 22 CFR 1006.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Debarring official. 1006.935 Section 1006.935...) Definitions § 1006.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  9. 22 CFR 1508.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Debarring official. 1508.935 Section 1508.935...) Definitions § 1508.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  10. 31 CFR 19.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Debarring official. 19.935 Section 19... SUSPENSION (NONPROCUREMENT) Definitions § 19.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or...

  11. 31 CFR 19.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Debarring official. 19.935 Section 19... SUSPENSION (NONPROCUREMENT) Definitions § 19.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or...

  12. 22 CFR 1006.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Debarring official. 1006.935 Section 1006.935...) Definitions § 1006.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  13. 22 CFR 1508.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Debarring official. 1508.935 Section 1508.935...) Definitions § 1508.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  14. 29 CFR 1471.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Debarring official. 1471.935 Section 1471.935 Labor... AND SUSPENSION (NONPROCUREMENT) Definitions § 1471.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1)...

  15. 22 CFR 1508.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Debarring official. 1508.935 Section 1508.935...) Definitions § 1508.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  16. 22 CFR 1508.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Debarring official. 1508.935 Section 1508.935...) Definitions § 1508.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A debarring official is either— (1) The agency head; or (2) An...

  17. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Debarring official. 93.206 Section 93.206 Public... MISCONDUCT Definitions § 93.206 Debarring official. Debarring official means an official authorized to impose debarment or suspension. The HHS debarring official is either— (a) The Secretary; or (b) An...

  18. [Thoracic nocardiosis - a clinical report].

    PubMed

    Vale, Artur; Guerra, Miguel; Martins, Daniel; Lameiras, Angelina; Miranda, José; Vouga, Luís

    2014-01-01

    Nocardia genus microorganisms are ubiquitous, Gram positive aerobic bacterias, responsible for disease mainly in immunocompromised hosts, with cellular immune response commitment. Inhalation is the main form of transmition and pulmonary disease is the most frequent presentation. Dissemination may occur by contiguity and also via hematogenous. The clinical and imaging presentation is not specific, and diagnosis is obtained after identification of Nocardia bacteria in biological samples. Since there are no reliable studies that indicate the best therapeutic option, treatment should be individualized and based on antimicrobial susceptibility testing. Surgical drainage should also be considered in all patients. The authors present a clinical case of a patient with thoracic nocardiosis, and make a short literature review on the theme. PMID:25596394

  19. Ossification of thoracic ligamenta flava

    SciTech Connect

    Kudo, S.; Minoru, O.; Russell, W.J.

    1983-07-01

    Although ligamentum flavum ossification (LFO) often occurs in normal persons, there are no reports of its detection on lateral chest radiographs made during screening examinations. Review of 1,744 consecutive lateral chest radiographs identified LFO in 6.2% of males and 4.8% of females. LFO occurred mainly at the intervertebral segments from T9-T10 through T12-L1. Most prevalent was the hook-shaped LFO, protruding inferoirly from the inferior facets into the projections of the intervertabral foramina. Though LFO can cause severe neurologic symptoms, none of the affected persons in this study reported such symptoms. LFO was first visualized radiographically when the subjects were 20-40 years old, and it may be a physiologic condition. The LFO in these cases existed independent of thoracic posterior longitudinal ligament ossification, diffuse idiopathic skeletal hyperostosis, and degenerative osteoarthritis.

  20. [Thoracic actinomycosis versus bronchial cancer].

    PubMed

    Brombacher-Frey, I; Wöckel, W; Kreusser, T

    1992-01-01

    We report on 4 thoracic actinomycoses; in three of these four cases a bronchial carcinoma was suspected, and in case No. 2 this carcinoma had been considered to be in a very advanced and inoperable stage. A man of 51 years of age was in a generally run-down condition. He also noticed that his sputum was tinged with blood. The x-ray film showed a large space-occupying growth at the right lung hilus. Repeated perbronchial biopsies of the focus did not yield any diagnosis. Actinomycosis was identified histologically only in the tissue samples obtained via thoracotomy. After a three-month penicillin course the hilar shadow receded. A 61-year old male patient was transferred to our Pneumological Hospital, being strongly suspected of suffering from an extensive bronchial carcinoma, and having multiple intrathoracic space-occupying growths as well as pleural effusions, a pericardial effusion, and an infiltration of the left thoracic wall with fistula formation; however, histological examination of skin biopsies revealed that he was suffering from actinomycosis. Antibiotic therapy cured him completely in a six-month course. In a man of 32 years of age who had been indulging for many years in a severe abuse of nicotin, we suspected a central bronchial carcinoma on the basis of his x-ray, but histology of the tissue taken from the space-occupying growth via diagnostic thoracotomy revealed that this patient, too, suffered from actinomycosis. Complete recession occurred after several months of antibiotic treatment. A woman of 82 years had been an inpatient for several months in another hospital because of relapsing pleuropneumonias on the right side. She was transferred to us as an outpatient after a renewed relapse. We conducted a transcutaneous fine-needle biopsy of the right indurating pleural effusion. A few actinomyces filaments were seen on histological examination of the purulent exudate. Hence, actinomycosis was confirmed. After antibiotic therapy the finding receded

  1. 42 CFR 93.206 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Definitions § 93.206 Debarring official. Debarring official means an official authorized to...

  2. Thoracic Wall Reconstruction in Advanced Breast Tumours

    PubMed Central

    Daigeler, A.; Harati, K.; Goertz, O.; Hirsch, T.; Behr, B.; Lehnhardt, M.; Kolbenschlag, J.

    2014-01-01

    In advanced mammary tumours, extensive resections, sometimes involving sections of the thoracic wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large thoracic wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of thoracic wall resection on the respiratory mechanism can be easily compensated for and patientsʼ quality of life in the palliative stage of disease can often be improved. PMID:24976636

  3. Management of a Left Internal Thoracic Artery Graft Injury during Left Thoracotomy for Thoracic Surgery.

    PubMed

    Oates, Matthew; Yadav, Sumit; Saxena, Pankaj

    2016-07-01

    There have been some recent reports on the surgical treatment of lung cancer in patients following previous coronary artery bypass graft surgery. Use of internal thoracic artery graft is a gold standard in cardiac surgery with superior long-term patency. Left internal thoracic artery graft is usually patent during left lung resection in patients who present to the surgeon with an operable lung cancer. We have presented our institutional experience with left-sided thoracic surgery in patients who have had previous coronary artery surgery with a patent internal thoracic artery graft. PMID:26907619

  4. Modern impact of video assisted thoracic surgery

    PubMed Central

    D’Amico, Thomas A.

    2014-01-01

    With advancement in technology, experience and training over the last two decades, video assisted thoracic surgery (VATS) has become widely accepted and utilized all over the world. VATS started as a diagnostic tool in the early 1990s, technique of VATS lobectomy evolved and became safer over the next 10-15 years and now it is being used for more advanced and hybrid operations. VATS has contributed to the development of minimally invasive surgical interventions for other thoracic disorders like mediastinal tumors and esophageal cancer as well. This article looks at the advantages of VATS, technique advancements and its applications in other thoracic operations and its influence on the present and future of thoracic surgery. PMID:25379201

  5. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  6. Nonintubated anesthesia in thoracic surgery: general issues

    PubMed Central

    Castillo, Maria

    2015-01-01

    Anesthetic management for awake thoracic surgery (ATS) is more difficult than under general anesthesia (GA), being technically extremely challenging for the anesthesiologist. Therefore, thorough preparation and vigilance are paramount for successful patient management. In this review, important considerations of nonintubated anesthesia for thoracic surgery are discussed in view of careful patient selection, anesthetic preparation, potential perioperative difficulties and the management of its complications. PMID:26046051

  7. Uniportal video-assisted thoracic (VATS) lobectomy.

    PubMed

    Sihoe, Alan D L

    2016-03-01

    Uniportal video assisted thoracic surgery (VATS) has become one of the most exciting new developments in minimally invasive thoracic surgery in recent years. While the debate over its purported advantages continues, this chapter instead focuses on the technical aspects of performing a lobectomy via the uniportal approach. Using clear medical illustrations to show how each step is performed, the key tips and tricks are laid out for the beginner hoping to learn the technique. PMID:27134841

  8. Uniportal video-assisted thoracic (VATS) lobectomy

    PubMed Central

    2016-01-01

    Uniportal video assisted thoracic surgery (VATS) has become one of the most exciting new developments in minimally invasive thoracic surgery in recent years. While the debate over its purported advantages continues, this chapter instead focuses on the technical aspects of performing a lobectomy via the uniportal approach. Using clear medical illustrations to show how each step is performed, the key tips and tricks are laid out for the beginner hoping to learn the technique. PMID:27134841

  9. Clinical use of pulse oximetry: official guidelines from the Thoracic Society of Australia and New Zealand.

    PubMed

    Pretto, Jeffrey J; Roebuck, Teanau; Beckert, Lutz; Hamilton, Garun

    2014-01-01

    Pulse oximetry provides a simple, non-invasive approximation of arterial oxygenation in a wide variety of clinical settings including emergency and critical-care medicine, hospital-based and ambulatory care, perioperative monitoring, inpatient and outpatient settings, and for specific diagnostic applications. Pulse oximetry is of utility in perinatal, paediatric, adult and geriatric populations but may require use of age-specific sensors in these groups. It plays a role in the monitoring and treatment of respiratory dysfunction by detecting hypoxaemia and is effective in guiding oxygen therapy in both adult and paediatric populations. Pulse oximetry does not provide information about the adequacy of ventilation or about precise arterial oxygenation, particularly when arterial oxygen levels are very high or very low. Arterial blood gas analysis is the gold standard in these settings. Pulse oximetry may be inaccurate as a marker of oxygenation in the presence of dyshaemoglobinaemias such as carbon monoxide poisoning or methaemoglobinaemia where arterial oxygen saturation values will be overestimated. Technical considerations such as sensor position, signal averaging time and data sampling rates may influence clinical interpretation of pulse oximetry readings. PMID:24251722

  10. [Thoracic endometriosis: A difficult diagnosis].

    PubMed

    Hagneré, P; Deswarte, S; Leleu, O

    2011-09-01

    Thoracic endometriosis is a rare disease, which presents in women at a mean age of 35 years, later than for pelvic endometriosis. There are no known predisposing factors for the condition and its pathogenesis is not yet clearly established. The symptoms always appear in connection with the periods of the person affected by the condition, occurring within 24-48 h after the start of menstruation. Catamenial pneumothorax is the most common clinical entity. It is associated with pelvic endometriosis in 30-50% of cases. Thoracoscopy, preferably performed during menstruation, allows full inspection of the diaphragm and the pleural cavity for defects in the diaphragm, endometrial nodules and bullae. The level of CA 125 is often elevated but this is not a reliable or specific marker. Medical treatment is aimed at blocking the action of estrogen on the endometrium and ectopic endometrial implants. GnRH analogues or danazol are the preferred treatments. Surgery to repair and strengthen the diaphragm and/or resect nodules or bullae also has a role, supplemented by pleurodesis to prevent further pneumothorax or effusions. The main risk is recurrence, and thus the current usual practice is to combine surgery, immediately followed by hormone therapy focusing on GnRH analogues. PMID:21943537

  11. Cytomegalovirus Immunoglobulin After Thoracic Transplantation

    PubMed Central

    Grossi, Paolo; Mohacsi, Paul; Szabolcs, Zoltán; Potena, Luciano

    2016-01-01

    Abstract Cytomegalovirus (CMV) is a highly complex pathogen which, despite modern prophylactic regimens, continues to affect a high proportion of thoracic organ transplant recipients. The symptomatic manifestations of CMV infection are compounded by adverse indirect effects induced by the multiple immunomodulatory actions of CMV. These include a higher risk of acute rejection, cardiac allograft vasculopathy after heart transplantation, and potentially bronchiolitis obliterans syndrome in lung transplant recipients, with a greater propensity for opportunistic secondary infections. Prophylaxis for CMV using antiviral agents (typically oral valganciclovir or intravenous ganciclovir) is now almost universal, at least in high-risk transplants (D+/R−). Even with extended prophylactic regimens, however, challenges remain. The CMV events can still occur despite antiviral prophylaxis, including late-onset infection or recurrent disease, and patients with ganciclovir-resistant CMV infection or who are intolerant to antiviral therapy require alternative strategies. The CMV immunoglobulin (CMVIG) and antiviral agents have complementary modes of action. High-titer CMVIG preparations provide passive CMV-specific immunity but also exert complex immunomodulatory properties which augment the antiviral effect of antiviral agents and offer the potential to suppress the indirect effects of CMV infection. This supplement discusses the available data concerning the immunological and clinical effects of CMVIG after heart or lung transplantation. PMID:26900989

  12. 7 CFR 62.207 - Official assessment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Official assessment. 62.207 Section 62.207 Agriculture... Definitions Service § 62.207 Official assessment. Official assessment of an applicant's program shall include: (a) Documentation assessment. Auditors and other USDA officials shall review the applicant's...

  13. 7 CFR 62.207 - Official assessment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Official assessment. 62.207 Section 62.207 Agriculture... Definitions Service § 62.207 Official assessment. Official assessment of an applicant's program shall include: (a) Documentation assessment. Auditors and other USDA officials shall review the applicant's...

  14. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  15. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  16. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  17. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  18. 30 CFR 1.1 - Official emblem.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Official emblem. 1.1 Section 1.1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OFFICIAL EMBLEM AND OMB CONTROL NUMBERS... OFFICIAL EMBLEM § 1.1 Official emblem. The following emblem is established and shall be used as...

  19. 5 CFR 919.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Debarring official. 919.935 Section 919... (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A...

  20. 34 CFR 85.935 - Debarring official.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the agency head. (b) (Authority: E.O. 12549 (3 CFR, 1986 Comp., p. 189); E.O 12689 (3 CFR, 1989 Comp... 34 Education 1 2011-07-01 2011-07-01 false Debarring official. 85.935 Section 85.935 Education...) Definitions § 85.935 Debarring official. (a) Debarring official means an agency official who is authorized...

  1. 5 CFR 919.935 - Debarring official.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Debarring official. 919.935 Section 919... (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A...

  2. 5 CFR 919.935 - Debarring official.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Debarring official. 919.935 Section 919... (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A...

  3. 5 CFR 919.935 - Debarring official.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Debarring official. 919.935 Section 919... (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A...

  4. 5 CFR 919.935 - Debarring official.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Debarring official. 919.935 Section 919... (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.935 Debarring official. (a) Debarring official means an agency official who is authorized to impose debarment. A...

  5. 22 CFR 41.27 - Official visas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Official visas. 41.27 Section 41.27 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.27 Official visas. (a) Definition. Official...

  6. 22 CFR 41.27 - Official visas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Official visas. 41.27 Section 41.27 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.27 Official visas. (a) Definition. Official...

  7. 22 CFR 41.27 - Official visas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Official visas. 41.27 Section 41.27 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.27 Official visas. (a) Definition. Official...

  8. 22 CFR 41.27 - Official visas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Official visas. 41.27 Section 41.27 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Foreign Government Officials § 41.27 Official visas. (a) Definition. Official...

  9. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Ethics officials. 20.201 Section...

  10. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Ethics officials. 20.201 Section...

  11. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Ethics officials. 20.201 Section...

  12. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Ethics officials. 20.201 Section...

  13. 43 CFR 20.201 - Ethics officials.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Department Ethics Program § 20.201 Ethics officials. (a) Designated Agency Ethics Official refers to the official designated under 5 CFR 2638.201 to coordinate and manage the Department's ethics program. (b) The... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Ethics officials. 20.201 Section...

  14. Teaching Japanese-American Incarceration

    ERIC Educational Resources Information Center

    Miksch, Karen L.; Ghere, David

    2004-01-01

    Few events in American history are so universally deplored as the incarceration of Japanese Americans during World War II. The United States government has acknowledged the error and the injustice that resulted with an official Presidential apology and a Congressional disbursement of reparations to the victims of the incarceration policy. The…

  15. [Video-assisted thoracic surgery, lung transplantation and mediastinitis: major issues in thoracic surgery in 2010].

    PubMed

    Borro, José M; Moreno, Ramón; Gómez, Ana; Duque, José Luis

    2011-01-01

    We reviewed the major issues in thoracic surgery relating to the advances made in our specialty in 2010. To do this, the 43(rd) Congress of the Spanish Society of Pneumology and Thoracic Surgery held in La Coruña and the articles published in the Society's journal, Archivos de Bronconeumología, were reviewed. The main areas of interest were related to the development of video-assisted thoracic surgery, lung transplantation and descending mediastinitis. The new tumor-node-metastasis (TNM) classification (7(th) edition), presented last year, was still a topical issue this year. The First Forum of Thoracic Surgeons and the Update in Thoracic Surgery together with the Nurses' Area have constituted an excellent teaching program. PMID:21300211

  16. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  17. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  18. 9 CFR 325.5 - Unmarked inspected product transported under official seal between official establishments for...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... under official seal between official establishments for further processing; certificate. 325.5 Section... CERTIFICATION TRANSPORTATION § 325.5 Unmarked inspected product transported under official seal between official... other means of conveyance which is sealed by a Program employee with an official seal of the...

  19. Thoracoscopic Ligation of the Thoracic Duct

    PubMed Central

    Teixeira, Julio A.

    2000-01-01

    Objective: When nonoperative treatment of chylothorax fails, thoracic duct ligation is usually performed through a thoracotomy. We describe two cases of persistent chylothorax, in a child and an adult, successfully treated with thoracoscopic ligation of the thoracic duct. Methods: A 4-year-old girl developed a right chylothorax following a Fontan procedure. Aggressive nonoperative management failed to eliminate the persistent chyle loss. A 72-year-old insulin-dependent diabetic man was involved in a motor vehicle accident, in which he sustained multiple fractured ribs, a right hemopneumothorax, a right femoral shaft fracture, and a T-11 thoracic vertebral fracture. Subsequently, he developed a right chylothorax, which did not respond to nonoperative management. Both patients were successfully treated with thoracoscopic ligation of the thoracic duct. Results: The child had significant decrease of chyle drainage following surgery. Increased drainage that appeared after the introduction of full feedings five days postoperatively was controlled with the somatostatin analog octreotide. The chest tube was removed two weeks after surgery. After two years' follow-up, she has had no recurrence of chylothorax. The adult had no chyle drainage following surgery. He was maintained on a medium-chain triglyceride diet postoperatively for two weeks. The chest tube was removed four days after surgery. After six months' follow-up, he has had no recurrence of chylothorax. Conclusions: Thoracoscopic ligation of the thoracic duct provides a safe and effective treatment of chylothorax and may avoid thoracotomy and its associated morbidity. PMID:10987402

  20. Chapter 2: Official Programmatic Descriptions

    ERIC Educational Resources Information Center

    Roholt, Ross VeLure; Hildreth, R. W.; Baizerman, Michael

    2007-01-01

    Youth civic engagement is a diverse field of practice, with each initiative claiming it has a unique approach. This chapter describes three initiatives, Youth-in-Government, Youth Science Center, and Public Achievement from the point-of-view of program staff. Their view is often privileged; it is the one used for official communication and public…

  1. [Big data in official statistics].

    PubMed

    Zwick, Markus

    2015-08-01

    The concept of "big data" stands to change the face of official statistics over the coming years, having an impact on almost all aspects of data production. The tasks of future statisticians will not necessarily be to produce new data, but rather to identify and make use of existing data to adequately describe social and economic phenomena. Until big data can be used correctly in official statistics, a lot of questions need to be answered and problems solved: the quality of data, data protection, privacy, and the sustainable availability are some of the more pressing issues to be addressed. The essential skills of official statisticians will undoubtedly change, and this implies a number of challenges to be faced by statistical education systems, in universities, and inside the statistical offices. The national statistical offices of the European Union have concluded a concrete strategy for exploring the possibilities of big data for official statistics, by means of the Big Data Roadmap and Action Plan 1.0. This is an important first step and will have a significant influence on implementing the concept of big data inside the statistical offices of Germany. PMID:26077871

  2. 22 CFR 1006.875 - May I ask the debarring official to reconsider a decision to debar me?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false May I ask the debarring official to reconsider a decision to debar me? 1006.875 Section 1006.875 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1006.875 May I ask the debarring official...

  3. 22 CFR 1006.875 - May I ask the debarring official to reconsider a decision to debar me?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true May I ask the debarring official to reconsider a decision to debar me? 1006.875 Section 1006.875 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1006.875 May I ask the debarring official...

  4. 22 CFR 1006.875 - May I ask the debarring official to reconsider a decision to debar me?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true May I ask the debarring official to reconsider a decision to debar me? 1006.875 Section 1006.875 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1006.875 May I ask the debarring official...

  5. 22 CFR 1006.875 - May I ask the debarring official to reconsider a decision to debar me?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true May I ask the debarring official to reconsider a decision to debar me? 1006.875 Section 1006.875 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Debarment § 1006.875 May I ask the debarring official...

  6. Assessing Crime as a Problem: The Relationship between Residents' Perception of Crime and Official Crime Rates over 25 Years

    ERIC Educational Resources Information Center

    Hipp, John R.

    2013-01-01

    This study compares the relationship between official crime rates in census tracts and resident perceptions of crime. Using a unique data set that links household-level data from the American Housing Survey metro samples over 25 years (1976-1999) with official crime rate data for census tracts in selected cities during selected years, this study…

  7. Acute Shingles after Resection of Thoracic Schwannoma

    PubMed Central

    Muesse, Jason L.; Blackmon, Shanda H.; Harris, Richard L.; Kim, Min P.

    2012-01-01

    Herpes zoster is relatively uncommon after surgery in immunocompetent patients. To our knowledge, there have been no reports of herpes zoster after the resection of a thoracic schwannoma. We report the case of a 48-year-old woman in whom acute shingles developed after the video-assisted thoracic surgical resection of a posterior mediastinal schwannoma adjacent to the 4th thoracic vertebral body. The patient recovered after receiving timely antiviral therapy. Rash and pain are common in patients who have wound infections and contact dermatitis after surgery, so the possible reactivation of varicella virus might not be prominent in the surgeon's mind. This case serves as a reminder that viral infections such as shingles should be considered in the differential diagnosis of postoperative erythema and pain. PMID:22740749

  8. Pleural abnormalities: thoracic ultrasound to the rescue!

    PubMed Central

    Pathmanathan, Sega; Lakshminarayana, Umesh B.; Avery, Gerard R.; Kastelik, Jack A.; Morjaria, Jaymin B.

    2013-01-01

    Diaphragmatic hernias that are diagnosed in adulthood may be traumatic or congenital in nature. Therefore, respiratory specialists need to be aware of the presentation of patients with these conditions. In this report, we describe a case series of patients with congenital and traumatic diaphragmatic hernias and highlight a varied range of their presentations. Abnormalities were noted in the thorax on the chest radiographs, but it was unclear as to the nature of the anomaly. The findings on thoracic ultrasound conducted by a pulmonologist helped to direct appropriate investigations avoiding unnecessary interventions. Instead of pleural effusions, consolidation or collapse, thoracic computed tomography demonstrated diaphragmatic hernias which were managed either conservatively or by surgery. There is increasing evidence that pulmonary specialists should be trained in thoracic ultrasonography to identify pleural pathology as well as safely conducting pleural-based interventions. PMID:23819018

  9. Pleural abnormalities: thoracic ultrasound to the rescue!

    PubMed

    Aslam, Imran; Pathmanathan, Sega; Lakshminarayana, Umesh B; Avery, Gerard R; Kastelik, Jack A; Morjaria, Jaymin B

    2013-07-01

    Diaphragmatic hernias that are diagnosed in adulthood may be traumatic or congenital in nature. Therefore, respiratory specialists need to be aware of the presentation of patients with these conditions. In this report, we describe a case series of patients with congenital and traumatic diaphragmatic hernias and highlight a varied range of their presentations. Abnormalities were noted in the thorax on the chest radiographs, but it was unclear as to the nature of the anomaly. The findings on thoracic ultrasound conducted by a pulmonologist helped to direct appropriate investigations avoiding unnecessary interventions. Instead of pleural effusions, consolidation or collapse, thoracic computed tomography demonstrated diaphragmatic hernias which were managed either conservatively or by surgery. There is increasing evidence that pulmonary specialists should be trained in thoracic ultrasonography to identify pleural pathology as well as safely conducting pleural-based interventions. PMID:23819018

  10. Penetrating injuries to the thoracic great vessels.

    PubMed

    Demetriades, D

    1997-01-01

    Penetrating injuries to the thoracic great vessels have been diagnosed with increased frequency because of the escalating use of automatic weapons. The overall incidence is 5.3% of gunshot wounds and 2% of stab wounds to the chest. Most of these patients reach the hospital dead or in severe shock. The overall mortality of thoracic aortic injuries is higher than 90% and in subclavian vascular injuries higher than 65%. In the prehospital phase, the "scoop and run" policy offers the best chances of survival and no attempts should be made for any form of stabilization. Investigations should be reserved only for fairly stable patients. Angiography, color flow Doppler, and transesophageal echocardiography may be useful in selected cases. Patients in cardiac arrest or imminent cardiac arrest may benefit from an emergency room thoracotomy. The surgical approach to specific thoracic great vessels is described. PMID:9271743

  11. European institutional accreditation of general thoracic surgery.

    PubMed

    Brunelli, Alessandro; Falcoz, Pierre Emmanuel

    2014-05-01

    To improve standardization of general thoracic surgery (GTS) practice across Europe, the European Society of Thoracic Surgeons (ESTS) has implemented a program of Institutional Accreditation. We reviewed the methods and rules of engagement of this program. A composite performance score (CPS) including outcome and process indicators is used to measure institutional performance and assess eligibility for accreditation. Eligible units are invited to participate and accept a local audit performed by an external auditors team composed by data inspectors and thoracic surgeons. In addition to data quality, a series of structural, procedural and qualification characteristics are inspected. Once the visit is complete, the team will produce an audit report to be sent to the members of the database committee for deliberation on the institutional accreditation of that unit. The Database committee will send an executive report to the ESTS Executive Committee for their final decision on the accreditation. PMID:24868447

  12. Change of paradigm in thoracic radionecrosis management.

    PubMed

    Dast, S; Assaf, N; Dessena, L; Almousawi, H; Herlin, C; Berna, P; Sinna, R

    2016-06-01

    Classically, muscular or omental flaps are the gold standard in the management of thoracic defects following radionecrosis debridement. Their vascular supply and antibacterial property was supposed to enhance healing compared with cutaneous flaps. The evolution of reconstructive surgery allowed us to challenge this dogma. Therefore, we present five consecutive cases of thoracic radionecrosis reconstructed with cutaneous perforator flaps. In four patients, we performed a free deep inferior epigastric perforator (DIEP) flap and one patient had a thoracodorsal perforator (TDAP) flap. Median time healing was 22.6 days with satisfactory cutaneous covering and good aesthetic results. There were no flap necrosis, no donor site complications. We believe that perforator flaps are a new alternative, reliable and elegant option that questions the dogma of muscular flaps in the management of thoracic radionecrosis. PMID:26831037

  13. Genetics Home Reference: familial thoracic aortic aneurysm and dissection

    MedlinePlus

    ... Home Health Conditions familial TAAD familial thoracic aortic aneurysm and dissection Enable Javascript to view the expand/ ... Open All Close All Description Familial thoracic aortic aneurysm and dissection ( familial TAAD ) involves problems with the ...

  14. CT of nontraumatic thoracic aortic emergencies.

    PubMed

    Bhalla, Sanjeev; West, O Clark

    2005-10-01

    Computed tomography (CT), especially multidetector row CT (MDCT), is often the preferred imaging test used for evaluation of nontraumatic thoracic aortic abnormalities. Unenhanced images, usually followed by contrast-enhanced arterial imaging, allow for rapid detailed aortic assessment. Understanding the spectrum of acute thoracic aortic conditions which may present similarly (aortic dissection, aneurysm rupture, penetrating atherosclerotic ulcer, intramural hematoma) will ensure that patients are diagnosed and treated appropriately. Familiarity with imaging protocols and potential mimics will prevent confusion of normal anatomy and variants with aortic disease. PMID:16274000

  15. The History of Duke Thoracic Surgery.

    PubMed

    Smith, Peter K; Mulvihill, Michael S; D'Amico, Thomas A

    2015-01-01

    Since 1931, Duke Thoracic Surgery has been defined by excellence in patient care, research, and the education of leaders in surgery. In this work, the history, contributions, historic figures, and current structure of the program are reviewed. The program has cultivated a commitment to surgical investigation and training that persists to the present day. This commitment is manifest by the program's contributions to the field of cardiothoracic surgery, from the fundamental investigation of the coronary circulation and the development of the heat exchanger for myocardial preservation, to large-scale clinical trials in cardiac and thoracic surgery. PMID:26811042

  16. Mayo Clinic: An Institutional History of General Thoracic Surgery.

    PubMed

    Gillaspie, Erin A; Nichols, Francis C; Allen, Mark S

    2015-01-01

    The Mayo Clinic was started in Rochester, MN after a 1883 tornado disaster. The Mayo brothers, William and Charles began thoracic surgical procedures early in their career. Dr. Samuel Robinson is recognized as the first thoracic surgeon at Mayo. He was followed by Drs. Harrington and Claret who became famous surgeons. Many other notable surgeons have help to build the thoracic surgical practice into what is today a world renown center of excellence in thoracic surgery. PMID:26811041

  17. 7 CFR 62.207 - Official assessment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.207 Official assessment. Official assessment of an applicant's program shall...

  18. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  19. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  20. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  1. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  2. 7 CFR 58.646 - Official identification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Products Bearing Usda Official Identification § 58.646 Official identification. (a) Only ice cream and.... grades established (nonfat dry milk, whole milk, buttermilk and whey) shall be U.S. Extra Grade or...

  3. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  4. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  5. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  6. 12 CFR 328.1 - Official sign.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Official sign. 328.1 Section 328.1 Banks and... OF MEMBERSHIP § 328.1 Official sign. (a) The official sign referred to in this part shall be 7″ by 3... “symbol” of the Corporation, as used in this part, shall be that portion of the official sign...

  7. Functional chiral asymmetry in descending thoracic aorta.

    PubMed

    Frazin, L J; Lanza, G; Vonesh, M; Khasho, F; Spitzzeri, C; McGee, S; Mehlman, D; Chandran, K B; Talano, J; McPherson, D

    1990-12-01

    To determine whether rotational blood flow or chiral asymmetry exists in the human descending thoracic aorta, we established the ability of color Doppler ultrasound to detect rotational flow in a tornado tube model of a vortex descending fluid column. In a model of the human aortic arch with a pulse duplicator, color Doppler was then used to demonstrate that rotational flow occurs first in the transverse arch and then in the proximal descending thoracic aorta. With the use of color Doppler esophageal echocardiography, 53 patients (age range, 25-78 years; mean age, 56.4 years) were prospectively examined for rotational flow in the descending thoracic aorta. At 10 cm superior to retro-left ventricular position, 22 of 38 patients (58%) revealed rotational flow with obvious diastolic counterclockwise rotation but less obvious systolic clockwise rotation. At 5 cm superior to retro-left ventricular position, 29 of 46 patients (63%) revealed rotational flow with a tendency toward systolic clockwise and diastolic counterclockwise rotation. At the retro-left ventricular position, 47 of 53 patients (89%) revealed rotational flow, usually of a clockwise direction, occurring in systole. Our data suggest that aortic flow is not purely pulsatile and axial but has a rotational component. Rotational flow begins in the aortic arch and is carried through to the descending thoracic aorta, where flow is chirally asymmetric with systolic clockwise and diastolic counterclockwise components. These data demonstrate an aortic rotational flow component that may have physiological implications for organ perfusion. PMID:2242523

  8. 46 CFR 91.60-45 - American Bureau of Shipping.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false American Bureau of Shipping. 91.60-45 Section 91.60-45....60-45 American Bureau of Shipping. (a) The American Bureau of Shipping, with its home office at ABS... requirements in this subpart. The American Bureau of Shipping is authorized to place the official seal of...

  9. 46 CFR 91.60-45 - American Bureau of Shipping.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false American Bureau of Shipping. 91.60-45 Section 91.60-45....60-45 American Bureau of Shipping. (a) The American Bureau of Shipping, with its home office at ABS... requirements in this subpart. The American Bureau of Shipping is authorized to place the official seal of...

  10. 46 CFR 91.60-45 - American Bureau of Shipping.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false American Bureau of Shipping. 91.60-45 Section 91.60-45....60-45 American Bureau of Shipping. (a) The American Bureau of Shipping, with its home office at ABS... requirements in this subpart. The American Bureau of Shipping is authorized to place the official seal of...

  11. 46 CFR 91.60-45 - American Bureau of Shipping.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false American Bureau of Shipping. 91.60-45 Section 91.60-45....60-45 American Bureau of Shipping. (a) The American Bureau of Shipping, with its home office at ABS... requirements in this subpart. The American Bureau of Shipping is authorized to place the official seal of...

  12. 15 CFR 700.6 - Official actions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Official actions. 700.6 Section 700.6... PRIORITIES AND ALLOCATIONS SYSTEM Overview § 700.6 Official actions. When necessary, Commerce takes specific official actions to implement or enforce the provisions of this regulation and to provide...

  13. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Official assessment. 37.10 Section 37.10 Agriculture... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a...

  14. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Official assessment. 37.10 Section 37.10 Agriculture... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a...

  15. 7 CFR 37.10 - Official assessment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Official assessment. 37.10 Section 37.10 Agriculture... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a...

  16. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Official seal. 375.103... OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The Commission hereby prescribes as its official seal, judicial notice of which shall be taken pursuant...

  17. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  18. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  19. 39 CFR 3002.3 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Official seal. 3002.3 Section 3002.3 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.3 Official seal. (a) Authority. The Seal described in this section is hereby established as the official seal of the Postal Rate...

  20. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Official seal. 375.103... OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The Commission hereby prescribes as its official seal, judicial notice of which shall be taken pursuant...

  1. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 9 2014-10-01 2014-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  2. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  3. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  4. 39 CFR 3002.3 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Official seal. 3002.3 Section 3002.3 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.3 Official seal. (a) Authority. The Seal described in this section is hereby established as the official seal of the Postal Rate...

  5. 46 CFR 501.11 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 9 2012-10-01 2012-10-01 false Official seal. 501.11 Section 501.11 Shipping FEDERAL... Seal § 501.11 Official seal. (a) Description. Pursuant to section 201(c) of the Merchant Marine Act, 1936, as amended (46 U.S.C. 301(d)), the Commission prescribes its official seal, as adopted by...

  6. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Official seal. 375.103... OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The Commission hereby prescribes as its official seal, judicial notice of which shall be taken pursuant...

  7. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Official seal. 375.103... OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The Commission hereby prescribes as its official seal, judicial notice of which shall be taken pursuant...

  8. 9 CFR 381.98 - Official seal.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Official seal. 381.98 Section 381.98... Certificates; Certification Procedures § 381.98 Official seal. The official mark for use in sealing means of... and a serial number as shown below, and any seals approved by the Administrator for applying such...

  9. 39 CFR 3002.3 - Official seal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Official seal. 3002.3 Section 3002.3 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION § 3002.3 Official seal. (a) Authority. The Seal described in this section is hereby established as the official seal of the Postal Rate...

  10. 18 CFR 375.103 - Official seal.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Official seal. 375.103... OF ENERGY REVISED GENERAL RULES THE COMMISSION General Provisions § 375.103 Official seal. The Commission hereby prescribes as its official seal, judicial notice of which shall be taken pursuant...