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Sample records for acr appropriateness criteria

  1. ACR Appropriateness Criteria Head Trauma.

    PubMed

    Shetty, Vilaas S; Reis, Martin N; Aulino, Joseph M; Berger, Kevin L; Broder, Joshua; Choudhri, Asim F; Kendi, A Tuba; Kessler, Marcus M; Kirsch, Claudia F; Luttrull, Michael D; Mechtler, Laszlo L; Prall, J Adair; Raksin, Patricia B; Roth, Christopher J; Sharma, Aseem; West, O Clark; Wintermark, Max; Cornelius, Rebecca S; Bykowski, Julie

    2016-06-01

    Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury. In short-term follow-up neuroimaging of acute traumatic brain injury, CT and MRI may have complementary roles. In subacute to chronic traumatic brain injury, MRI is the most appropriate initial examination, though CT may have a complementary role in select circumstances. Advanced neuroimaging techniques are areas of active research but are not considered routine clinical practice at this time. In suspected intracranial vascular injury, CT angiography or venography or MR angiography or venography is the most appropriate imaging study. In suspected posttraumatic cerebrospinal fluid leak, high-resolution noncontrast skull base CT is the most appropriate initial imaging study to identify the source, with cisternography reserved for problem solving. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:27262056

  2. ACR Appropriateness Criteria Osteonecrosis of the Hip.

    PubMed

    Murphey, Mark D; Roberts, Catherine C; Bencardino, Jenny T; Appel, Marc; Arnold, Erin; Chang, Eric Y; Dempsey, Molly E; Fox, Michael G; Fries, Ian Blair; Greenspan, Bennett S; Hochman, Mary G; Jacobson, Jon A; Mintz, Douglas N; Newman, Joel S; Rosenberg, Zehava S; Rubin, David A; Small, Kirstin M; Weissman, Barbara N

    2016-02-01

    Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse. The likelihood of articular collapse is significantly increased with involvement of greater than 30%-50% of the femoral head area, which is optimally evaluated by MRI, often in the sagittal plane. Contrast-enhanced MRI may be needed to detect early osteonecrosis of the hip in pediatric patients, revealing hypoperfusion. In patients with a contraindication for MRI, use of either CT or bone scintigraphy with SPECT (single-photon emission CT) are alternative radiologic methods of assessment. Imaging helps guide treatment, which may include core decompression, osteotomy, and ultimately, need for joint replacement. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26846390

  3. ACR appropriateness Criteria® infertility.

    PubMed

    Wall, Darci J; Javitt, Marcia C; Glanc, Phyllis; Bhosale, Priyadarshani R; Harisinghani, Mukesh G; Harris, Robert D; Khati, Nadia J; Mitchell, Donald G; Nyberg, David A; Pandharipande, Pari V; Pannu, Harpreet K; Shipp, Thomas D; Siegel, Cary Lynn; Simpson, Lynn; Wong-You-Cheong, Jade J; Zelop, Carolyn M

    2015-03-01

    Appropriate imaging for women undergoing infertility workup depends upon the clinician's suspicion for potential causes of infertility. Transvaginal US is the preferred modality to assess the ovaries for features of polycystic ovary syndrome (PCOS), the leading cause of anovulatory infertility. For women who have a history or clinical suspicion of endometriosis, which affects at least one third of women with infertility, both MRI and pelvic US can provide valuable information. If tubal occlusion is suspected, whether due to endometriosis, previous pelvic inflammatory disease, or other cause, hysterosalpingogram (HSG) is the preferred method of evaluation. To assess for anatomic causes of recurrent pregnancy loss (RPL) such as Müllerian anomalies, synechiae, and leiomyomas, saline infusion sonohysterography, MRI and 3-D US are most appropriate. Up to 10% of women suffering recurrent pregnancy loss have a congenital Müllerian anomaly. When assessment of the pituitary gland is indicated, MRI is the imaging exam of choice.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:25706363

  4. Acr appropriateness Criteria management of vaginal cancer.

    PubMed

    Lee, Larissa J; Jhingran, Anuja; Kidd, Elizabeth; Cardenes, Higinia Rosa; Elshaikh, Mohamed A; Erickson, Beth; Mayr, Nina A; Moore, David; Puthawala, Ajmel A; Rao, Gautam G; Small, William; Varia, Mahesh A; Wahl, Andrew O; Wolfson, Aaron H; Yashar, Catheryn M; Yuh, William; Gaffney, David K

    2013-11-01

    Due to its rarity, treatment guidelines for vaginal cancer are extrapolated from institutional reports and prospective studies of cervical and anal cancer. An expert panel was convened to reach consensus on the selection of imaging and therapeutic modalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) used by the panel to rate the appropriateness of imaging and treatment procedures. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Four variants were developed to represent clinical scenarios in vaginal cancer management. Group members reached consensus on the appropriateness of the pretreatment evaluation and therapeutic interventions. This article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management. PMID:24575547

  5. ACR Appropriateness Criteria Clinically Suspected Pulmonary Arteriovenous Malformation.

    PubMed

    Hanley, Michael; Ahmed, Osmanuddin; Chandra, Ankur; Gage, Kenneth L; Gerhard-Herman, Marie D; Ginsburg, Michael; Gornik, Heather L; Johnson, Pamela T; Oliva, Isabel B; Ptak, Thomas; Steigner, Michael L; Strax, Richard; Rybicki, Frank J; Dill, Karin E

    2016-07-01

    Pulmonary arteriovenous malformations are often included in the differential diagnosis of common clinical presentations, including hypoxemia, hemoptysis, brain abscesses, and paradoxical stroke, as well as affecting 30% to 50% of patients with hereditary hemorrhagic telangiectasia (HHT). Various imaging studies are used in the diagnostic and screening settings, which have been reviewed by the ACR Appropriateness Criteria Vascular Imaging Panel. Pulmonary arteriovenous malformation screening in patients with HHT is commonly performed with transthoracic echocardiographic bubble study, followed by CT for positive cases. Although transthoracic echocardiographic bubble studies and radionuclide perfusion detect right-to-left shunts, they do not provide all of the information needed for treatment planning and may remain positive after embolization. Pulmonary angiography is appropriate for preintervention planning but not as an initial test. MR angiography has a potential role in younger patients with HHT who may require lifelong surveillance, despite lower spatial resolution compared with CT. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:27209598

  6. ACR Appropriateness Criteria Low Back Pain.

    PubMed

    Patel, Nandini D; Broderick, Daniel F; Burns, Judah; Deshmukh, Tejaswini K; Fries, Ian Blair; Harvey, H Benjamin; Holly, Langston; Hunt, Christopher H; Jagadeesan, Bharathi D; Kennedy, Tabassum A; O'Toole, John E; Perlmutter, Joel S; Policeni, Bruno; Rosenow, Joshua M; Schroeder, Jason W; Whitehead, Matthew T; Cornelius, Rebecca S; Corey, Amanda S

    2016-09-01

    Most patients presenting with uncomplicated acute low back pain (LBP) and/or radiculopathy do not require imaging. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their back pain. It is also considered for those patients presenting with red flags raising suspicion for serious underlying conditions, such as cauda equina syndrome, malignancy, fracture, and infection. Many imaging modalities are available to clinicians and radiologists for evaluating LBP. Application of these modalities depends largely on the working diagnosis, the urgency of the clinical problem, and comorbidities of the patient. When there is concern for fracture of the lumbar spine, multidetector CT is recommended. Those deemed to be interventional candidates, with LBP lasting for > 6 weeks having completed conservative management with persistent radiculopathic symptoms, may seek MRI. Patients with severe or progressive neurologic deficit on presentation and red flags should be evaluated with MRI. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

  7. ACR Appropriateness Criteria Low Back Pain.

    PubMed

    Patel, Nandini D; Broderick, Daniel F; Burns, Judah; Deshmukh, Tejaswini K; Fries, Ian Blair; Harvey, H Benjamin; Holly, Langston; Hunt, Christopher H; Jagadeesan, Bharathi D; Kennedy, Tabassum A; O'Toole, John E; Perlmutter, Joel S; Policeni, Bruno; Rosenow, Joshua M; Schroeder, Jason W; Whitehead, Matthew T; Cornelius, Rebecca S; Corey, Amanda S

    2016-09-01

    Most patients presenting with uncomplicated acute low back pain (LBP) and/or radiculopathy do not require imaging. Imaging is considered in those patients who have had up to 6 weeks of medical management and physical therapy that resulted in little or no improvement in their back pain. It is also considered for those patients presenting with red flags raising suspicion for serious underlying conditions, such as cauda equina syndrome, malignancy, fracture, and infection. Many imaging modalities are available to clinicians and radiologists for evaluating LBP. Application of these modalities depends largely on the working diagnosis, the urgency of the clinical problem, and comorbidities of the patient. When there is concern for fracture of the lumbar spine, multidetector CT is recommended. Those deemed to be interventional candidates, with LBP lasting for > 6 weeks having completed conservative management with persistent radiculopathic symptoms, may seek MRI. Patients with severe or progressive neurologic deficit on presentation and red flags should be evaluated with MRI. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. PMID:27496288

  8. ACR Appropriateness Criteria® Intensive Care Unit Patients.

    PubMed

    Suh, Robert D; Genshaft, Scott J; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Henry, Travis S; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H

    2015-11-01

    Portable chest radiography is a fundamental and frequently utilized examination in the critically ill patient population. The chest radiograph often represents a timely investigation of new or rapidly evolving clinical findings and an evaluation of proper positioning of support tubes and catheters. Thoughtful consideration of the use of this simple yet valuable resource is crucial as medical cost containment becomes even more mandatory. This review addresses the role of chest radiography in the intensive care unit on the basis of the existing literature and as formed by a consensus of an expert panel on thoracic imaging through the American College of Radiology. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26439890

  9. Promoting educational innovation: lessons from the request for proposals for ACR Appropriateness Criteria Usage in Medical Education.

    PubMed

    Gunderman, Richard B; Bettmann, Michael; Davis, Lawrence P

    2007-12-01

    This article describes the development of a new ACR grant program, ACR Appropriateness Criteria Usage in Medical Education. Developed and funded over the course of a single year, the program provides grants totaling up to $60,000 annually to support innovation in radiology education. The development and implementation of this program provides lessons that can help radiology educators and leaders craft a brighter future for radiology education.

  10. ACR Appropriateness Criteria® Adjuvant Management of Early-Stage Endometrial Cancer.

    PubMed

    Wahl, Andrew O; Gaffney, David K; Jhingran, Anuja; Yashar, Catheryn M; Biagioli, Matthew; Elshaikh, Mohamed A; Jolly, Shruti; Kidd, Elizabeth; Lee, Larissa J; Li, Linna; Moore, David H; Rao, Gautam G; Williams, Ned L; Small, William

    2016-09-15

    These consensus guidelines on adjuvant radiotherapy for early-stage endometrial cancer were developed from an expert panel convened by the American College of Radiology. The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method; and Grading of Recommendations Assessment, Development, and Evaluation, or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. After a review of the published literature, the panel voted on three variants to establish best practices for the utilization of imaging, radiotherapy, and chemotherapy after primary surgery for early-stage endometrial cancer. PMID:27633412

  11. ACR Appropriateness Criteria Fever Without Source or Unknown Origin-Child.

    PubMed

    Westra, Sjirk J; Karmazyn, Boaz K; Alazraki, Adina L; Dempsey, Molly E; Dillman, Jonathan R; Garber, Matthew; Moore, Sheila G; Raske, Molly E; Rice, Henry E; Rigsby, Cynthia K; Safdar, Nabile; Simoneaux, Stephen F; Strouse, Peter J; Trout, Andrew T; Wootton-Gorges, Sandra L; Coley, Brian D

    2016-08-01

    The cause of fever in a child can often be determined from history, physical examination, and laboratory tests; infections account for the majority of cases. Yet in 20%, no apparent cause can be found, designated as fever without source (FWS). The yield of chest radiography in children with FWS is low, and it is usually not appropriate. However, in children with respiratory signs, high fever (>39°C), or marked leukocytosis (≥20,000/mm(3)), chest radiography is usually appropriate, as it has a higher yield in detecting clinically occult pneumonia. In newborns with FWS, there is higher risk for serious bacterial infection, and the routine use of chest radiography is controversial. In children with neutropenia, fever is a major concern. In some clinical circumstances, such as after hematopoietic stem cell transplantation, chest CT scan may be appropriate even if the results of chest radiography are negative or nonspecific, as it has higher sensitivity and can demonstrate specific findings (such as lung nodule and "halo sign") that can guide management. In a child with prolonged fever of unknown origin despite extensive medical workup (fever of unknown origin), diagnosis is usually dependent on clinical and laboratory studies, and imaging tests have low yield. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or

  12. ACR Appropriateness Criteria® Acute Pelvic Pain in the Reproductive Age Group.

    PubMed

    Bhosale, Priyadarshani R; Javitt, Marcia C; Atri, Mostafa; Harris, Robert D; Kang, Stella K; Meyer, Benjamin J; Pandharipande, Pari V; Reinhold, Caroline; Salazar, Gloria M; Shipp, Thomas D; Simpson, Lynn; Sussman, Betsy L; Uyeda, Jennifer; Wall, Darci J; Zelop, Carolyn M; Glanc, Phyllis

    2016-06-01

    Acute pelvic pain in premenopausal women frequently poses a diagnostic dilemma. These patients may exhibit nonspecific signs and symptoms such as nausea, vomiting and leukocytosis. The cause of pelvic pain includes a myriad of diagnostic possibilities such as obstetric, gynecologic, urologic, gastrointestinal, and vascular etiologies. The choice of the imaging modality is usually determined by a suspected clinical differential diagnosis. Thus the patient should undergo careful evaluation and the suspected differential diagnosis should be narrowed before an optimal imaging modality is chosen. Transvaginal and transabdominal pelvic sonography is the modality of choice, to assess for pelvic pain, when an obstetric or gynecologic etiology is suspected and computed tomography is often more useful when gastrointestinal or genitourinary pathology is thought to be more likely. Magnetic resonance imaging, when available in the acute setting, is favored over computed tomography for assessing pregnant patients for nongynecologic etiologies owing to its lack of ionizing radiation.The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26588104

  13. ACR Appropriateness Criteria® Pre-Irradiation Evaluation and Management of Brain Metastases

    PubMed Central

    Gore, Elizabeth M.; Bradley, Jeffrey D.; Buatti, John M.; Germano, Isabelle; Ghafoori, A. Paiman; Henderson, Mark A.; Murad, Gregory J.A.; Patchell, Roy A.; Patel, Samir H.; Robbins, Jared R.; Robins, H. Ian; Vassil, Andrew D.; Wippold, Franz J.; Yunes, Michael J.; Videtic, Gregory M.M.

    2014-01-01

    Abstract Pretreatment evaluation is performed to determine the number, location, and size of the brain metastases and magnetic resonance imaging (MRI) is the recommended imaging technique, particularly in patients being considered for surgery or stereotactic radiosurgery. A contiguous thin-cut volumetric MRI with gadolinium with newer gadolinium-based agents can improve detection of small brain metastases. A systemic workup and medical evaluation are important, given that subsequent treatment for the brain metastases will also depend on the extent of the extracranial disease and on the age and performance status of the patient. Patients with hydrocephalus or impending brain herniation should be started on high doses of corticosteroids and evaluated for possible neurosurgical intervention. Patients with moderate symptoms should receive approximately 4–8 mg/d of dexamethasone in divided doses. The routine use of corticosteroids in patients without neurologic symptoms is not necessary. There is no proven benefit of anticonvulsants in patient without seizures. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:24971478

  14. ACR Appropriateness Criteria® Diffuse Large B-Cell Lymphoma.

    PubMed

    Dabaja, Bouthaina S; Advani, Ranjana; Hodgson, David C; Dhakal, Sughosh; Flowers, Christopher R; Ha, Chul S; Hoppe, Bradford S; Mendenhall, Nancy P; Metzger, Monika L; Plastaras, John P; Roberts, Kenneth B; Shapiro, Ronald; Smith, Sonali M; Terezakis, Stephanie A; Winkfield, Karen M; Younes, Anas; Constine, Louis S

    2015-12-01

    The management of diffuse large B-cell lymphoma depends on the initial diagnosis including molecular and immunophenotypic characteristics, Ann Arbor staging, and International Prognostic Index (IPI score). Treatment approaches with different chemotherapy regimens used is discussed in detail. The role of radiation as a consolidation is discussed including: (1) the prerituximab randomized trials that challenged the role of radiation, (2) recent prospective studies (UNFOLDER/RICOVER-60), and (3) retrospective studies; the last 2 showed a potential benefit of radiation both for early and advanced stage. The document also discusses the role of positron emission tomography/computed tomography for predicting outcome and potentially guiding therapy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:26583344

  15. ACR Appropriateness Criteria Retreatment of Recurrent Head and Neck Cancer After Prior Definitive Radiation

    SciTech Connect

    McDonald, Mark W.; Lawson, Joshua; Garg, Madhur Kumar; Quon, Harry; Ridge, John A.; Saba, Nabil; Salama, Joseph K.; Smith, Richard V.; Yeung, Anamaria Reyna; Yom, Sue S.; Beitler, Jonathan J.

    2011-08-01

    Recurrent and second primary head-and-neck squamous cell carcinomas arising within or in close proximity to previously irradiated fields are a common clinical challenge. Whereas surgical salvage therapy is recommended for resectable disease, randomized data support the role of postoperative reirradiation in high-risk patients. Definitive reirradiation is an established approach for patients with recurrent disease who are medically or technically inoperable or decline radical surgery. The American College of Radiology Expert Panel on Head and Neck Cancer reviewed the relevant literature addressing re-treatment after prior definitive radiation and developed appropriateness criteria for representative clinical scenarios. Examples of unresectable recurrent disease and microscopic residual disease after salvage surgery were addressed. The panel evaluated the appropriateness of reirradiation, the integration of concurrent chemotherapy, radiation technique, treatment volume, dose, and fractionation. The panel emphasized the importance of patient selection and recommended evaluation and treatment at tertiary-care centers with a head-and-neck oncology team equipped with the resources and experience to manage the complexities and toxicities of re-treatment.

  16. ACCF/ACR/AIUM/ASE/ASN/ICAVL/SCAI/SCCT/SIR/SVM/SVS 2012 Appropriate Use Criteria for Peripheral Vascular Ultrasound and Physiological Testing Part I: Arterial Ultrasound and Physiological Testing

    PubMed Central

    Mohler, Emile R.; Gornik, Heather L.; Gerhard-Herman, Marie; Misra, Sanjay; Olin, Jeffrey W.; Zierler, R. Eugene; Wolk, Michael J.; Mohler, Emile R.; Dixon, Bradley S.; Driver, Vickie R.; Fail, Peter S.; Fazel, Reza; Findeiss, Laura; Fuchs, Richard; Gillespie, John; Hughes, Joseph P.; Jaigobin, Cheryl; Leers, Steven A.; Moore, Colleen; Pellerito, John S.; Robbin, Michelle L.; Shugart, Rita E.; Weaver, Fred A.; White, Christopher J.; Yevzlin, Alexander 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.

    2015-01-01

    The American College of Cardiology Foundation (ACCF), in partnership with key specialty and subspecialty societies, conducted a review of common clinical scenarios where noninvasive vascular testing (ultrasound and physiological testing) 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 the original appropriate use criteria (AUC). The 159 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). A total of 255 indications (with the inclusion of surveillance timeframes) were rated. One hundred and seventeen indications were rated as appropriate, 84 were rated as uncertain, and 54 were rated as inappropriate. The AUC for peripheral vascular disease 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:22694840

  17. ACCF/ACR/AIUM/ASE/ASN/ICAVL/SCAI/SCCT/SIR/SVM/SVS 2012 appropriate use criteria for peripheral vascular ultrasound and physiological testing part I: Arterial ultrasound and physiological testing

    PubMed Central

    Mohler, Emile R.; Gornik, Heather L.; Gerhard-Herman, Marie; Misra, Sanjay; Olin, Jeffrey W.; Zierler, R. Eugene

    2015-01-01

    The American College of Cardiology Foundation (ACCF), in partnership with key specialty and subspecialty societies, conducted a review of common clinical scenarios where noninvasive vascular testing (ultrasound and physiological testing) 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 the original appropriate use criteria (AUC). The 159 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). A total of 255 indications (with the inclusion of surveillance timeframes) were rated. One hundred and seventeen indications were rated as appropriate, 84 were rated as uncertain, and 54 were rated as inappropriate. The AUC for peripheral vascular disease 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:22694919

  18. Hypothetical ratings of coronary angiography appropriateness: are they associated with actual angiographic findings, mortality, and revascularisation rate? The ACRE study

    PubMed Central

    Hemingway, H; Crook, A; Banerjee, S; Dawson, J; Feder, G; Magee, P; Wood, A; Philpott, S; Timmis, A

    2001-01-01

    OBJECTIVE—To determine whether ratings of coronary angiography appropriateness derived by an expert panel on hypothetical patients are associated with actual angiographic findings, mortality, and subsequent revascularisation in the ACRE (appropriateness of coronary revascularisation) study.
DESIGN—Population based, prospective study. The ACRE expert panel rated hypothetical clinical indications as inappropriate, uncertain, or appropriate before recruitment of a cohort of real patients.
SETTING—Royal Hospitals Trust, London, UK.
PARTICIPANTS—3631 consecutive patients undergoing coronary angiography (no exclusion criteria).
MAIN OUTCOME MEASURES—Angiographic findings, mortality (n = 226 deaths), and revascularisation (n = 1556 procedures) over 2.5 years of follow up.
RESULTS—The indications for coronary angiography were rated appropriate in 2253 (62%) patients. 166 (5%) coronary angiograms were performed for indications rated inappropriate, largely for asymptomatic or atypical chest pain presentations. The remaining 1212 (33%) angiograms were rated uncertain, of which 47% were in patients with mild angina and no exercise ECG or in patients with unstable angina controlled by inpatient management. Three vessel disease was more likely among appropriate cases and normal coronaries were more likely among inappropriate cases (p < 0.001). Mortality and revascularisation rates were highest among patients with an appropriate indication, intermediate in those with an uncertain indication, and lowest in the inappropriate group (log rank p = 0.018 and p < 0.0001, respectively).
CONCLUSION—The ACRE ratings of appropriateness for angiography predicted angiographic findings, mortality, and revascularisation rates. These findings support the clinical usefulness of expert panel methods in defining criteria for performing coronary angiography.


Keywords: coronary artery disease; coronary angiography; coronary artery bypass graft

  19. [The usefulness of the latest diagnostic and therapeutic criteria ACR/EULAR in the treatment of rheumatoid arthritis].

    PubMed

    Pytel, Aleksandra; Wrzosek, Zdzisława; Demczyszak, Iwona; Brzyski, Jakub

    2012-01-01

    In Poland nearly 400 thousand people are treated for rheumatoid arthritis and each year there are about 8 to 16 thousand new patients with this disease. Rheumatoid diseases constitute and enormous health problem which statistically encounters every the third person of the population. The condition for effective treatment of rheumatoid arthritis is early diagnosis and aggressive treatment of disease. So it became necessary to develop in 2010, the new ACR/ EULAR, much simpler than the ACR criteria of 1987, intended to enable the rapid implementation of appropriate intensive treatment, both conventional disease modifying drugs and biologicals.

  20. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine.

    PubMed

    Hendel, Robert C; Berman, Daniel S; Di Carli, Marcelo F; Heidenreich, Paul A; Henkin, Robert E; Pellikka, Patricia A; Pohost, Gerald M; Williams, Kim A

    2009-06-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac radionuclide imaging (RNI) is frequently considered. This document is a revision of the original Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI) Appropriateness Criteria, published 4 years earlier, written to reflect changes in test utilization and new clinical data, and to clarify RNI use where omissions or lack of clarity existed in the original criteria. This is in keeping with the commitment to revise and refine appropriate use criteria (AUC) on a frequent basis. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Sixty-seven clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of cardiac RNI for diagnosis and risk assessment in intermediate- and high-risk patients with coronary artery disease (CAD) was viewed favorably, while testing in low-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Additionally, use for perioperative testing was found to be inappropriate except for high selected groups of patients. It is anticipated that these results will have a significant impact on physician decision making, test performance, and reimbursement policy, and will help guide future research. PMID:19451357

  1. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-11-23

    The American College of Cardiology Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:20975004

  2. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D; Kramer, Christopher M; Berman, Daniel; Brown, Alan; Chaudhry, Farooq A; Cury, Ricardo C; Desai, Milind Y; Einstein, Andrew J; Gomes, Antoinette S; Harrington, Robert; Hoffmann, Udo; Khare, Rahul; Lesser, John; McGann, Christopher; Rosenberg, Alan; Schwartz, Robert; Shelton, Marc; Smetana, Gerald W; Smith, Sidney C

    2010-11-23

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21087721

  3. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-01-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21232696

  4. Developing a formal representation for medication appropriateness criteria.

    PubMed

    Salmasian, Hojjat; Tran, Tran H; Friedman, Carol

    2014-01-01

    Inappropriate medications use (IMU) is a serious issue of global concern that leads to a waste of resources and potentially harms the patients. IMU can usually be identified by extracting information about the patient's conditions and treatments, and comparing them with "medication appropriateness criteria". To enable automation of these criteria, we developed a formal representation for them, which we called Objective Medication Appropriateness Criteria (OMAC). OMAC represents four aspects of the criteria: trigger, rules, action and metadata. Our evaluation showed that OMAC can completely represent explicitly defined medication appropriateness criteria using links to external knowledge sources. OMAC is the first formal representation for medication appropriateness criteria, and will enable development of structured rules for appropriate use of medications that can be implemented using standards for clinical decision support.

  5. Development and validation of a simple lupus severity index using ACR criteria for classification of SLE

    PubMed Central

    Bello, Ghalib A; Brown, Michael A; Kelly, Jennifer A; Thanou, Aikaterini; James, Judith A; Montgomery, Courtney G

    2016-01-01

    Objective To develop a simple systemic lupus erythematosus (SLE) severity index that requires knowledge of only American College of Rheumatology (ACR) criteria and subcriteria. Methods This study used demographic, mortality and medical records data of 1915 patients with lupus from the Lupus Family Registry and Repository. The data were randomly split (2:1 ratio) into independent training and validation sets. A logistic regression with ridge penalty was used to model the probability of being prescribed major immunosuppressive drugs—a surrogate indicator of lupus severity. ACR criteria and subcriteria were used as predictor variables in this model, and the resulting regression coefficient estimates obtained from the training data were used as item weightings to construct the severity index. Results The resulting index was tested on the independent validation dataset and was found to have high predictive accuracy for immunosuppressive use and early mortality. The index was also found to be strongly correlated with a previously existing severity score for lupus. In addition, demographic factors known to influence lupus severity (eg, age of onset, gender and ethnicity) all showed robust associations with our severity index that were consistent with observed clinical trends. Conclusions This new index can be easily computed using ACR criteria, which may be among the most readily available data elements from patient medical records. This tool may be useful in lupus research, especially large dataset analyses to stratify patients by disease severity, an important prognostic indicator in SLE. PMID:27026812

  6. An Internet-based ontology editor for medical appropriateness criteria.

    PubMed

    Kahn, C E

    1998-04-01

    Appropriateness criteria and practice guidelines seek to promote the cost-effectiveness use of medical interventions, and can be most useful when integrated with computer-based patient records and order-entry systems. Building an abstract model (ontology) of appropriateness criteria can require considerable effort among investigators at geographically dispersed institutions. To facilitate the construction and maintenance of ontologies for clinical appropriateness criteria, the author developed an Internet-based system for viewing and editing the knowledge model. The system, called NEON (Network-based Editor for ONtologies), uses the World Wide Web as a platform-independent user interface. NEON allows users to edit the indexing terms and the semantic network that form the ontology for a set of appropriateness criteria. Ontologies built using the system can be imported and exported using an open, internationally standardized format based on the Standard Generalized Markup Language (SGML).

  7. Validation of prescribing appropriateness criteria for older Australians using the RAND/UCLA appropriateness method

    PubMed Central

    Basger, Benjamin Joseph; Chen, Timothy Frank; Moles, Rebekah Jane

    2012-01-01

    Objective To further develop and validate previously published national prescribing appropriateness criteria to assist in identifying drug-related problems (DRPs) for commonly occurring medications and medical conditions in older (≥65 years old) Australians. Design RAND/UCLA appropriateness method. Participants A panel of medication management experts were identified consisting of geriatricians/pharmacologists, clinical pharmacists and disease management advisors to organisations that produce Australian evidence-based therapeutic publications. This resulted in a round-one panel of 15 members, and a round-two panel of 12 members. Main outcome measure Agreement on all criteria. Results Forty-eight prescribing criteria were rated. In the first rating round via email, there was disagreement regarding 17 of the criteria according to median panel ratings. During a face-to-face second round meeting, discussion resulted in retention of 25 criteria after amendments, agreement for 14 criteria with no changes required and deletion of 9 criteria. Two new criteria were added, resulting in a final validated list of 41 prescribing appropriateness criteria. Agreement after round two was reached for all 41 criteria, measured by median panel ratings and the amount of dispersion of panel ratings, based on the interpercentile range. Conclusions A set of 41 Australian prescribing appropriateness criteria were validated by an expert panel. Use of these criteria, together with clinical judgement and other medication review processes such as patient interview, is intended to assist in improving patient care by efficiently detecting potential DRPs related to commonly occurring medicines and medical conditions in older Australians. These criteria may also contribute to the medication management education of healthcare professionals. PMID:22983875

  8. Application of appropriateness criteria for hospitalization in COPD exacerbation.

    PubMed

    Garcia-Gutierrez, Susana; Quintana, José M; Barrio, Irantzu; Bare, Marisa; Fernandez, Nerea; Vidal, Silvia; Gonzalez, Nerea; Lafuente, Iratxe; Arteta, Edurne; Esteban, Cristóbal; Pulido, Esther

    2013-06-01

    The IRYSS-COPD appropriateness study was developed in 16 hospitals belonging to the Spanish National Health Service from June 2008 to September 2010 (n = 2,877). The objectives were to apply a set of explicit criteria for the appropriateness of hospital admission created by the RAND/UCLA methodology to patients evaluated in the emergency department (ED) for exacerbations of COPD. This is a prospective cohort study. We explored the relationship between appropriateness of admission as defined by the explicit criteria and the final decision to admit or discharge. A total of 2,877 patients were included for analysis; of these, 1,747 (60.7 %) were admitted and 1,130 (39.3 %) were discharged from the ED to home. Among patients classified by the explicit criteria as appropriate for hospital admission, 81.3 % were admitted, compared with 64.81 % of those classified as uncertain and 48.65 % of those classified as inappropriate for admission. Severity of exacerbation was the most influencing variable in the decision. Application of our explicit criteria for appropriate hospital admission among a large sample of patients experiencing an exacerbation of COPD in the ED setting suggests that these criteria could be used as the basis for clinical decision-making and health-care assessment.

  9. Appropriateness criteria for bariatric surgery: beyond the NIH guidelines.

    PubMed

    Yermilov, Irina; McGory, Marcia L; Shekelle, Paul W; Ko, Clifford Y; Maggard, Melinda A

    2009-08-01

    Careful selection of bariatric patients is critical for successful outcomes. In 1991, the NIH first established patient selection guidelines; however, some surgeons operate on individuals outside of these criteria, i.e., extreme age groups. We developed appropriateness criteria for the spectrum of patient characteristics including age, BMI, and severity of eight obesity-related comorbidities. Candidate criteria were developed using combinations of patient characteristics including BMI: > or =40 kg/m(2), 35-39, 32-34, 30-31, <30; age: 12-18, 19-55, 56-64, 65+ years old; and comorbidities: prediabetes, diabetes, hypertension, dyslipidemia, sleep apnea, venous stasis disease, chronic joint pain, and gastroesophageal reflux (plus severity level). Criteria were formally validated on their appropriateness of whether the benefits of surgery clearly outweighed the risks, by an expert panel using the RAND/UCLA modified Delphi method. Nearly all comorbidity severity criteria for patients with BMI > or =40 kg/m(2) or BMI = 35-39 kg/m(2) in intermediate age groups were found to be appropriate for surgery. In contrast, patients in the extreme age categories were considered appropriate surgical candidates under fewer conditions, primarily the more severe comorbidities, such as diabetes and hypertension. For patients with a BMI of 32-34, only the most severe category of diabetes (Hgb A1c >9, on maximal medical therapy), is an appropriate criterion for those aged 19-64, whereas many mild to moderate severity comorbidity categories are "inappropriate." There is overwhelming agreement among the panelists that the current evidence does not support performing bariatric surgery in lower BMI individuals (BMI <32). This is the first development of appropriateness criteria for bariatric surgery that includes severity categories of comorbidities. Only for the most severe degrees of comorbidities were adolescent and elderly patients deemed appropriate for surgery. Patient selection for

  10. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy.

    PubMed

    Oliveira, Anderson de; Rezende, Maria Fernanda; Corrêa, Renato; Mousinho, Rodrigo; Azevedo, Jader Cunha; Miranda, Sandra Marina; Oliveira, Aline Ribeiro; Gutterres, Ricardo Fraga; Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco

    2014-11-01

    Background: Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods: We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results: Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. Conclusions: We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  11. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    PubMed Central

    de Oliveira, Anderson; Rezende, Maria Fernanda; Corrêa, Renato; Mousinho, Rodrigo; Azevedo, Jader Cunha; Miranda, Sandra Marina; Oliveira, Aline Ribeiro; Gutterres, Ricardo Fraga; Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco

    2014-01-01

    Background Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. Conclusions We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results. PMID:25252163

  12. Applying appropriate-use criteria to cardiac revascularisation in India

    PubMed Central

    Sood, Neeraj; Ugargol, Allen P; Barnes, Kayleigh; Mahajan, Anish

    2016-01-01

    Objectives The high prevalence of coronary heart disease and dramatic growth of cardiac interventions in India motivate an evaluation of the appropriateness of coronary revascularisation procedures in India. Although, appropriate-use criteria (AUC) have been used to analyse the appropriateness of cardiovascular care in the USA, they are yet to be applied to care in India. In our study, we apply AUC to cardiac care in Karnataka, India, compare our results to international applications of AUC, and suggest ways to improve the appropriateness of care in India. Setting Data were collected from the Vajpayee Arogyashree Scheme, a government-sponsored health insurance scheme in Karnataka, India. These data were collected as part of the preauthorisation process for cardiac procedures. Participants The final data included a random sample of 600 patients from 28 hospitals in Karnataka, who obtained coronary artery bypass grafting or percutaneous coronary intervention between 1 October 2014 and 31 December 2014. Primary and secondary outcome measures We obtained our primary baseline results using a random imputation simulation to fill in missing data. Our secondary outcome measure was a best case–worst case scenario where missing data were filled to give the lowest or highest number of appropriate cases. Results Of the cases, 86.7% (CI 0.837% to 0.892%) were deemed appropriate, 3.65% (CI 0.023% to 0.055%) were inappropriate and 9.63% (CI 0.074% to 0.123%) were uncertain. Conclusions The vast majority of cardiac revascularisation procedures performed on beneficiaries of a government-sponsored insurance programme in India were found to be appropriate. These results meet or exceed levels of appropriate use of cardiac care in the USA. PMID:27029773

  13. Automated classification of mammographic microcalcifications by using artificial neural networks and ACR BI-RADS criteria

    NASA Astrophysics Data System (ADS)

    Hara, Takeshi; Yamada, Akitsugu; Fujita, Hiroshi; Iwase, Takuji; Endo, Tokiko

    2001-07-01

    We have been developing an automated detection scheme for mammographic microcalcifications as a part of computer-assisted diagnosis (CAD) system. The purpose of this study is to develop an automated classification technique for the detected microcalcifications. Types of distributions of calcifications are known to be significantly relevant to their probability of malignancy, and are described on ACR BI-RADS (Breast Imaging Reporting and Data System) , in which five typical types are illustrated as diffuse/scattered, regional, segmental, linear and clustered. Detected microcalcifications by our CAD system are classified automatically into one of their five types based on shape of grouped microcalcifications and the number of microcalcifications within the grouped area. The type of distribution and other general image feature values are analyzed by artificial neural networks (ANNs) and the probability of malignancy is indicated. Eighty mammograms with biopsy-proven microcalcifications were employed and digitized with a laser scanner at a pixel size of 0.1mm and 12-bit density depth. The sensitivity and specificity were 93% and 93%, respectively. The performance was significantly improved in comparison with the case that the five criteria in BI-RADS were not employed.

  14. The appropriateness of employing imaging screening technologies: report of the methods committee of the ACR task force on screening technologies.

    PubMed

    Hillman, Bruce J; Black, William C; D'orsi, Carl; Hauser, J Bruce; Smith, Robert

    2004-11-01

    Screening for disease using imaging technologies is a growing phenomenon. For some applications (e.g., mammography and breast cancer), there is solid evidence that imaging screening reduces disease-specific mortality. However, for other applications, the public interest in imaging screening is progressing despite a lack of valid scientific evidence that such screening improves the public's health. Clinical trials promise to eventually shed light on the value of imaging screening, but the results of these trials will not be known for several years. In the meantime, physicians and the public need guidance on whether specific imaging screening examinations are appropriate. The ACR charged the Methods Committee of its Task Force on Screening Technologies to advise the organization on how it could best use available evidence to make public recommendations on imaging screening technologies. This article is the outcome of the committee's deliberations, including recommendations for the method of arriving at a recommendation, the approach to dissemination, and to whom the recommendations should be targeted.

  15. Developmentally Appropriate Criteria for Evaluating Sexual Abuse Prevention Programs.

    ERIC Educational Resources Information Center

    McLeod, Nancy S.; Wright, Cheryl

    1996-01-01

    Proposes using a developmentally appropriate practice framework to determine if a sexual abuse prevention program takes into consideration the unique learning abilities of preschool children. Reviews definition of and statistics related to sexual abuse. Compares appropriate and inappropriate teaching practices in child sexual abuse prevention…

  16. Teacher Criteria for Evaluating and Selecting Developmentally Appropriate Computer Software

    ERIC Educational Resources Information Center

    Ntuli, Esther; Kyei-Blankson, Lydia

    2011-01-01

    Although many teacher training programs and school districts offer courses and workshops on technology integration in instruction, research shows that teachers still face major challenges especially as it relates to selecting and using developmentally appropriate technology to meet the needs of diverse learners. The current study examines the…

  17. Appropriateness criteria of FDG PET/CT in oncology

    PubMed Central

    Agrawal, Archi; Rangarajan, Venkatesh

    2015-01-01

    18Fluorine-2-fluoro-2-Deoxy-d-glucose (18F-FDG) positron emission tomography/computerized tomography (PET/CT) is a well-established functional imaging method widely used in oncology. In this article, we have incorporated the various indications for 18FDG PET/CT in oncology based on available evidence and current guidelines. Growing body of evidence for use of 18FDG PET/CT in select tumors is also discussed. This article attempts to give the reader an overview of the appropriateness of using 18F-FDG PET/CT in various malignancies. PMID:25969632

  18. Towards Tailored Patient's Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

    PubMed Central

    El Miedany, Yasser; El Gaafary, Maha; Youssef, Sally; Ahmed, Ihab

    2016-01-01

    Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index), in addition to assessment of functional disability, quality of life (QoL), review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982). Content construct assessment of the functional disability and QoL revealed significant correlation (p < 0.01) with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p < 0.01) variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management. PMID:27190648

  19. Reliability of ACR criteria over time to differentiate classic fibromyalgia from nonspecific widespread pain syndrome: a 6-month prospective cohort study.

    PubMed

    Bidari, Ali; Ghavidel-Parsa, Banafsheh; Ghalehbaghi, Babak

    2009-01-01

    American College of Rheumatology (ACR) 1990 criteria, initially introduced to classify fibromyalgia (FM) syndrome, has gained popularity in research and clinical grounds for diagnostic purposes. The objectives of this study were designed to assess the consistency of ACR criteria against the time in classifying FM. This was a prospective cohort study performed in a multidisciplinary pain clinic from October 2002 to June 2005. Patients who were clinically suspected of having FM and had a normal screening laboratory evaluation were scheduled for dolorimetry. Those found to have 6 or more tender points were considered eligible and labeled as either classic or atypical FM if they did or did not, respectively, fulfil ACR criteria. The 2 groups were assessed using the Fibromyalgia Impact Questionnaire (FIQ) and compared using baseline characteristics. We reassessed dolorimetric exam and FIQ 6 months later. Of 91 patients who participated in this study,70 completed the follow-up. Of them, 34 (49%) patients were identified as atypical, and 36 (51%) were labeled as classic FM. At first visit, the classic FM group had higher scores on sleep quality, stiffness, anxiety, depression, and total FIQ score (p\\0.05) but not for other variables. At 6 months, there was no significant difference between the 2 groups in all measured variables. Labeling shift from classic to atypical FM and vice versa occurred at a rate of 36.1 and 32.4%, respectively. This study showed the ACR 1990 criteria was not able to consistently classify affected patients with FM syndrome within a group of patients having nonspecific body pain and multiple tender points over 6 months of follow-up.

  20. An algebraic approach to detect logical inconsistencies in medical appropriateness criteria.

    PubMed

    García-Remesal, Miguel; Maojo, Victor; Laita, Luis; Roanes-Lozano, Eugenio; Crespo, José

    2007-01-01

    In this paper, we present a computerized approach to detect inconsistencies in medical knowledge bases. The method has been applied to a set of medical appropriateness criteria developed for the review of coronary artery disease management. One of the main problems associated to medical appropriateness criteria is to detect logical inconsistencies in the criteria set, a process often manually carried out by health services specialists. In our approach, appropriateness criteria are automatically translated to rules containing propositional variables, using three-valued Łukasiewicz's logic augmented with modal operators to manage uncertainty. The method assigns a polynomial to each of the rules, integrity constraints, and facts from the rule-based set. This rule set is then checked for inconsistencies. The problem of determining if a formula is a tautological consequence of a set of formulae is reduced by our method into an ideal membership problem in computer algebra. Finally, the set of medical appropriateness criteria is represented in a flowchart format that can be disseminated and remotely accessed over Internet, and can be prospectively used for patient care and management. The method reported in this paper can be applied to other knowledge bases represented by means of IF-THEN rules. PMID:18003165

  1. 45 CFR 400.81 - Criteria for appropriate employability services and employment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Criteria for appropriate employability services and employment. 400.81 Section 400.81 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Requirements...

  2. The Evolution of Coronary Revascularization Appropriateness Use Criteria: From Mandatory to Forgotten.

    PubMed

    Sattur, Sudhakar; Brener, Sorin J

    2015-01-01

    The appropriateness use criteria (AUC) for coronary revascularization have been formulated through the joint efforts of several professional societies. The goals of AUC were to aid in physician decision making and to objectively define the need and context for revascularization. These criteria, developed using a standardized approach, were widely promoted and adopted in many practices. Rigorous use in daily practice and public reporting of adherence to these criteria has exposed some of their deficiencies. Revisions to the original version were made to accommodate public and physician sentiments. Not surprisingly, the recent percutaneous coronary intervention performance measures developed by the same professional societies that have proposed AUC, have suggested that AUC should be used for internal quality improvement only at this time. Therefore, the present role and future application of AUC to cardiology practice is uncertain. The goals of this review are to describe methodology and development of the coronary revascularization AUC, to focus on the strengths and limitations of AUC, and to identify challenges related to application of these criteria in daily practice. PMID:26827745

  3. The 1995 forum on appropriate criteria and methods for seismic design of nuclear piping

    SciTech Connect

    Slagis, G.C.

    1996-12-01

    A record of the 1995 Forum on Appropriate Criteria and Methods for Seismic Design of Nuclear Piping is provided. The focus of the forum was the earthquake experience data base and whether the data base demonstrates that seismic inertia loads will not cause failure in ductile piping systems. This was a follow-up to the 1994 Forum when the use of earthquake experience data, including the recent Northridge earthquake, to justify a design-by-rule method was explored. Two possible topics for the next forum were identified--inspection after an earthquake and design for safe-shutdown earthquake only.

  4. Cost Savings Associated With Implementation of Peer-Reviewed Appropriate Use Criteria for Percutaneous Coronary Interventions.

    PubMed

    Puri, Pranav; Carroll, Jennifer; Patterson, Bobette

    2016-04-15

    Appropriate use criteria (AUC) for coronary revascularization have been developed to provide a practical standard to assess the quality of patient selection for percutaneous coronary interventions (PCI). However, the economic impact of AUC implementation has yet to be quantified. A peer-reviewed AUC process was implemented at UnityPoint Trinity in February 2012. Volumes of PCI cases were measured in 12-month intervals for 2 years after AUC implementation and compared with volumes from the corresponding 12-month intervals in the 2 years preceding implementation of AUC. Hospital reimbursement was averaged based on each year's payer mix and reimbursement contracts. In the 2 years preceding AUC implementation, PCI volumes were similar (1,414 in 2010 and 1,411 in 2011). After AUC implementation, volumes of PCI decreased by 17% in both 2012 and 2013. From 2012 to 2013, the relative ratio of elective to acute interventions decreased from 1.36 to 1.02. In the same time frame, the proportion of appropriate PCI significantly increased from 76% to 84% (p <0.001). Total hospital reimbursement for PCI decreased by 36% after AUC implementation. In conclusion, implementation of a peer-reviewed AUC process at the UnityPoint Trinity led to significant cost savings through a large decrease in volume of PCI with concurrent improvement in PCI appropriateness. PMID:26899491

  5. Appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria.

    PubMed

    Saengcharoen, Woranuch; Jaisawang, Pornchanok; Udomcharoensab, Palita; Buathong, Kittika; Lerkiatbundit, Sanguan

    2016-10-01

    Background Inappropriate use of antibiotic treatment for pharyngitis by community pharmacists is prevalent in developing countries. Little is known about how the pharmacists identify patients with bacterial pharyngitis. Objective To ascertain the appropriateness of diagnosis of streptococcal pharyngitis among Thai community pharmacists according to the Centor criteria and to identify factors related to antibiotic dispensing. Setting 1040 Thai community pharmacists. Method A cross-sectional survey of community pharmacists was conducted in November 2012 to March 2013. The self-administered questionnaires were mailed to 57 % of community pharmacists in the south of Thailand (n = 1040). The survey included questions on diagnosis of streptococcal pharyngitis, knowledge on pharyngitis, and attitudes and control beliefs regarding antibiotic dispensing. Main outcome measure The appropriateness of diagnosis of streptococcal pharyngitis according to the original and modified Centor criteria and determinants of antibiotic dispensing including demographic characteristics of pharmacists, knowledge on pharyngitis, and attitudes and control beliefs on antibiotic dispensing. Results Approximately 68 % completed the questionnaires (n = 703). Compared to the pharmacists who reported not dispensing antibiotics in the hypothetical case with common cold, those reported dispensing antibiotics were more likely to consider the following conditions-presence of cough, mild sore throat and patients with age >60 years as cues for diagnosis of streptococcal pharyngitis (p < 0.05). The use of fewer scores of the clinical prediction rules for diagnosis was observed in antibiotic dispensers, compared to who did not do so (p < 0.005). Antibiotic dispensing was positively associated with period of dispensing experience (>5 years) [odds ratio (OR) 1.52; 95 % confidence interval (CI) 1.03-2.23], belief that antibiotics could shorten duration of pharyngitis (OR 1.48; 95 % CI 1

  6. Aggressive rheumatoid arthritis registry in Italy. Characteristics of the early rheumatoid arthritis subtype among patients classified according to the ACR criteria.

    PubMed

    2003-01-01

    The Italian Society of Rheumatology in the year 2000 decided to sponsor the creation of a data base (Registry) of consecutive patients who fulfilled the diagnosis of rheumatoid arthritis (RA) according to the American College of Rheumatology (ACR) criteria. The registry is designed to collect data on the "aggressive" type of RA all over the country in order to determine the percentage of patients who satisfy the established criteria among incident cases of RA and to define the therapeutic approach according to the characteristics of the enrolled patients. Predefined criteria set up by eight recognized opinion leaders on the disease were used by all the centers to create the database. The GIARA registry (Gruppo Italiano Artrite Reumatoide Aggressiva) has now enrolled 706 patients who will be followed up for 24 months. They have been divided into two major subsets--patients with early (< 4 months' disease duration) and late (> 4 months) RA--with the aim of establishing whether differences in clinical, serological, radiographic and therapeutic (DMARDs: disease modifying antirheumatic drugs) parameters may distinguish the two subsets. The major conclusion of this preliminary analysis is that an overall tendency to undertreatment is discernable.

  7. Indications for TEE before cardioversion for atrial fibrillation: implications for appropriateness criteria.

    PubMed

    Grewal, Gaganpreet K; Klosterman, Tristan B; Shrestha, Kevin; Yarmohammadi, Hirad; Zurick, Andrew O; Varr, Brandon C; Tang, W H Wilson; Lindsay, Bruce D; Klein, Allan L

    2012-06-01

    The purpose of this study was to evaluate appropriateness of transesophageal echocardiography (TEE) before direct current cardioversion (DCC), investigate indications for TEE, and analyze if indications are predictive of outcome. According to American College of Cardiology Foundation/American Society of Echocardiography 2011 Appropriateness Criteria, TEE is appropriate in the evaluation of patients with atrial fibrillation (AF) to facilitate clinical decision making with regards to anticoagulation and/or DCC. However, it is unclear in which instances physicians utilize TEE. We reviewed 671 TEE studies in 604 AF patients (age 66 ± 13 years, 67% male) in which TEE was performed before DCC for left atrial thrombus (LAT)/sludge. Studies were divided by the main indication for TEE into the following 8 categories: 1) congestive heart failure (CHF)/hemodynamic compromise; 2) symptomatic; 3) new onset AF; 4) hospitalized and symptomatic; 5) high stroke risk; 6) subtherapeutic anticoagulation; 7) miscellaneous; and 8) inappropriate for TEE. The main indications for TEE before DCC were symptomatic (26.4%) and CHF/hemodynamic compromise (26.1%). We deemed 2.7% of the studies as inappropriate. LAT/sludge was found in 8.2% of studies. Incidence of LAT/sludge differed significantly between indications (p = 0.0021) and the highest incidences occurred in the high stroke risk (17.6%) and hospitalized and symptomatic (14.1%) categories. No LAT/sludge was found in the miscellaneous or inappropriate groups. Stroke occurred in 2.5% (n = 15) of all patients and in all groups except for miscellaneous and inappropriate (p = 0.3). TEE is appropriately used prior to DCC for patients with the main indications of symptomatic and CHF/hemodynamic compromise. In a minority of studies, TEE utilization was inappropriate. Incidence of LAT/sludge differed between indications. PMID:22698535

  8. Application of appropriate use criteria for percutaneous coronary intervention in Japan.

    PubMed

    Inohara, Taku; Kohsaka, Shun; Ueda, Ikuko; Yagi, Takashi; Numasawa, Yohei; Suzuki, Masahiro; Maekawa, Yuichiro; Fukuda, Keiichi

    2016-08-26

    The aim of this review was to summarize the concept of appropriate use criteria (AUC) regarding percutaneous coronary intervention (PCI) and document AUC use and impact on clinical practice in Japan, in comparison with its application in the United States. AUC were originally developed to subjectively evaluate the indications and performance of various diagnostic and therapeutic modalities, including revascularization techniques. Over the years, application of AUC has significantly impacted patient selection for PCI in the United States, particularly in non-acute settings. After the broad implementation of AUC in 2009, the rate of inappropriate PCI decreased by half by 2014. The effect was further accentuated by incorporation of financial incentives (e.g., restriction of reimbursement for inappropriate procedures). On the other hand, when the United States-derived AUC were applied to Japanese patients undergoing elective PCI from 2008 to 2013, about one-third were classified as inappropriate, largely due to the perception gap between American and Japanese experts. For example, PCI for low-risk non-left atrial ascending artery lesion was more likely to be classified as appropriate by Japanese standards, and anatomical imaging with coronary computed tomography angiography was used relatively frequently in Japan, but no scenario within the current AUC includes this modality. To extrapolate the current AUC to Japan or any other region outside of the United States, these local discrepancies must be taken into consideration, and scenarios should be revised to reflect contemporary practice. Understanding the concept of AUC as well as its perception gap between different counties will result in the broader implementation of AUC, and lead to the quality improvement of patients' care in the field of coronary intervention. PMID:27621773

  9. Application of appropriate use criteria for percutaneous coronary intervention in Japan

    PubMed Central

    Inohara, Taku; Kohsaka, Shun; Ueda, Ikuko; Yagi, Takashi; Numasawa, Yohei; Suzuki, Masahiro; Maekawa, Yuichiro; Fukuda, Keiichi

    2016-01-01

    The aim of this review was to summarize the concept of appropriate use criteria (AUC) regarding percutaneous coronary intervention (PCI) and document AUC use and impact on clinical practice in Japan, in comparison with its application in the United States. AUC were originally developed to subjectively evaluate the indications and performance of various diagnostic and therapeutic modalities, including revascularization techniques. Over the years, application of AUC has significantly impacted patient selection for PCI in the United States, particularly in non-acute settings. After the broad implementation of AUC in 2009, the rate of inappropriate PCI decreased by half by 2014. The effect was further accentuated by incorporation of financial incentives (e.g., restriction of reimbursement for inappropriate procedures). On the other hand, when the United States-derived AUC were applied to Japanese patients undergoing elective PCI from 2008 to 2013, about one-third were classified as inappropriate, largely due to the perception gap between American and Japanese experts. For example, PCI for low-risk non-left atrial ascending artery lesion was more likely to be classified as appropriate by Japanese standards, and anatomical imaging with coronary computed tomography angiography was used relatively frequently in Japan, but no scenario within the current AUC includes this modality. To extrapolate the current AUC to Japan or any other region outside of the United States, these local discrepancies must be taken into consideration, and scenarios should be revised to reflect contemporary practice. Understanding the concept of AUC as well as its perception gap between different counties will result in the broader implementation of AUC, and lead to the quality improvement of patients’ care in the field of coronary intervention.

  10. Application of appropriate use criteria for percutaneous coronary intervention in Japan

    PubMed Central

    Inohara, Taku; Kohsaka, Shun; Ueda, Ikuko; Yagi, Takashi; Numasawa, Yohei; Suzuki, Masahiro; Maekawa, Yuichiro; Fukuda, Keiichi

    2016-01-01

    The aim of this review was to summarize the concept of appropriate use criteria (AUC) regarding percutaneous coronary intervention (PCI) and document AUC use and impact on clinical practice in Japan, in comparison with its application in the United States. AUC were originally developed to subjectively evaluate the indications and performance of various diagnostic and therapeutic modalities, including revascularization techniques. Over the years, application of AUC has significantly impacted patient selection for PCI in the United States, particularly in non-acute settings. After the broad implementation of AUC in 2009, the rate of inappropriate PCI decreased by half by 2014. The effect was further accentuated by incorporation of financial incentives (e.g., restriction of reimbursement for inappropriate procedures). On the other hand, when the United States-derived AUC were applied to Japanese patients undergoing elective PCI from 2008 to 2013, about one-third were classified as inappropriate, largely due to the perception gap between American and Japanese experts. For example, PCI for low-risk non-left atrial ascending artery lesion was more likely to be classified as appropriate by Japanese standards, and anatomical imaging with coronary computed tomography angiography was used relatively frequently in Japan, but no scenario within the current AUC includes this modality. To extrapolate the current AUC to Japan or any other region outside of the United States, these local discrepancies must be taken into consideration, and scenarios should be revised to reflect contemporary practice. Understanding the concept of AUC as well as its perception gap between different counties will result in the broader implementation of AUC, and lead to the quality improvement of patients’ care in the field of coronary intervention. PMID:27621773

  11. 45 CFR 400.81 - Criteria for appropriate employability services and employment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., creed, color, or national origin. (7) Appropriate work may be temporary, permanent, full-time,...

  12. Assessment of Children's Digital Courseware in Light of Developmentally Appropriate Courseware Criteria

    ERIC Educational Resources Information Center

    Ihmeideh, Fathi Mahmoud

    2015-01-01

    Developmentally appropriate courseware can play a crucial role in enhancing children's learning and development. Research studies have demonstrated that early childhood educators face major challenges in selecting and updating developmental courseware that supports young children's development. The primary purpose of this study was to assess…

  13. Overview of quality in cardiovascular imaging and procedures for clinicians: focus on appropriate-use-criteria guidelines.

    PubMed

    Stainback, Raymond F

    2014-01-01

    Cardiovascular imaging and procedures have experienced exponential growth over the past 20 years in terms of new modalities, procedure volume, technological sophistication, and cost. As a result, related quality improvement tools have become multifaceted works in progress. This article briefly summarizes the evolution of the time-honored American College of Cardiology Foundation/American Heart Association clinical practice guidelines versus the newer American College of Cardiology Foundation appropriate-use-criteria guidelines and how these may interact with emerging performance measures, clinical data registries, and cardiovascular laboratory accreditation initiatives.

  14. Appropriate Use Criteria in Echocardiography: An Observational Institutional Study with the Perspective of a Quality Improvement Project

    PubMed Central

    Rameh, Vanessa; Kossaify, Antoine

    2016-01-01

    BACKGROUND Appropriate use criteria (AUC) in echocardiography are essential tools for aligning the indications of echocardiography with the best clinical standards, improving clinical outcome, restraining abuse, and preserving health-care resources. OBJECTIVES The aim of this study was to ascertain the AUC for transthoracic echocardiography in a university hospital and create a quality improvement project (QIP). METHODS The assessment of 501 inpatients who received transthoracic cardiac echo was conducted according to the 2011 AUC report. Indications were classified as appropriate, uncertain, or inappropriate, and patients not matching any of the abovementioned divisions were grouped in the nonfitting category. RESULTS Of the 501 eligible patients, 374 patients (74.66%) were in the appropriate group, 85 patients (16.96%) in the inappropriate group, 20 patients (3.99%) in the uncertain group, and 22 patients (4.39%) in the nonfitting category. DISCUSSION Interpretation and analysis of the obtained results are presented, along with the results of many comparable studies; moreover, a QIP was set up accordingly. CONCLUSION AUC are useful to assess local practice, preserve health-care resources, and improve clinical outcome. PMID:26917982

  15. 75 FR 58448 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Future Plant Designs The ACRS Subcommittee on Future Plant Designs will hold a meeting on October 21, 2010, at 11545... Subcommittee will review current Design Acceptance Criteria associated with Digital Instrumentation and...

  16. 76 FR 11524 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... Boiling Water Reactors (ABWR); Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water Reactors... the meeting, if possible, so that appropriate arrangements can be made. Thirty five hard copies of... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-...

  17. 78 FR 20959 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... Boiling Water Reactor The ACRS Subcommittee on Advanced Boiling Water Reactor (ABWR) will hold a meeting... possible, so that appropriate arrangements can be made. Thirty-five hard copies of each presentation or... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR...

  18. 43 CFR 404.44 - What criteria will Reclamation apply to determine whether it is appropriate to recommend that a...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... reasonable and supported; (10) Is cost-effective and generates national net economic benefits as required... environmental benefits, including source water protection; (5) Applies a regional or watershed perspective and... determine whether at least one of the alternatives identified is appropriate for further analysis through...

  19. 43 CFR 404.44 - What criteria will Reclamation apply to determine whether it is appropriate to recommend that a...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... reasonable and supported; (10) Is cost-effective and generates national net economic benefits as required... environmental benefits, including source water protection; (5) Applies a regional or watershed perspective and... determine whether at least one of the alternatives identified is appropriate for further analysis through...

  20. 43 CFR 404.44 - What criteria will Reclamation apply to determine whether it is appropriate to recommend that a...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... reasonable and supported; (10) Is cost-effective and generates national net economic benefits as required... environmental benefits, including source water protection; (5) Applies a regional or watershed perspective and... determine whether at least one of the alternatives identified is appropriate for further analysis through...

  1. Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system.

    PubMed

    Santos, Juliana P; Cecatti, José G; Serruya, Suzanne J; Almeida, Paulo V; Duran, Pablo; Mucio, Bremen de; Pileggi-Castro, Cynthia

    2015-12-01

    In Latin American, there is currently a regional action with the main purposes of putting the concept of severe neonatal morbidity in practice and formulating proposals for interventions. A general overview of neonatal health conditions, including morbidity and mortality, is provided to update regional knowledge on the topic. An example of the development and implementation of the concept of maternal near miss is also provided, followed by results from a systematic review covering all previously published studies on Neonatal Near Miss. Finally, some proposals for building a common concept on the topic and for launching a prospective surveillance study are presented. A Neonatal Near Miss is a neonate who had a severe morbidity (organ dysfunction or failure) but who survived this condition within the first 27 days of life. The pragmatic criteria recommended to be used are as follows: birth weight below 1700 g, Apgar score below 7 at 5 minutes of life and gestational age below 33 weeks. As a proxy for organ dysfunction, the following management criteria are also confirmed: parenteral therapeutic antibiotics; nasal continuous positive airway pressure; any intubation during the first 27 days of life; phototherapy within the first 24 h of life; cardiopulmonary resuscitation; the use of vasoactive drugs, anticonvulsants, surfactants, blood products and steroids for refractory hypoglycemia and any surgical procedure. Although this study starts from a regional perspective, this topic is clearly globally relevant. All nations, especially low and middle-income countries, could benefit from the proposed standardization.

  2. Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system

    PubMed Central

    Santos, Juliana P; Cecatti, José G; Serruya, Suzanne J; Almeida, Paulo V; Duran, Pablo; de Mucio, Bremen; Pileggi-Castro,, Cynthia

    2015-01-01

    In Latin American, there is currently a regional action with the main purposes of putting the concept of severe neonatal morbidity in practice and formulating proposals for interventions. A general overview of neonatal health conditions, including morbidity and mortality, is provided to update regional knowledge on the topic. An example of the development and implementation of the concept of maternal near miss is also provided, followed by results from a systematic review covering all previously published studies on Neonatal Near Miss. Finally, some proposals for building a common concept on the topic and for launching a prospective surveillance study are presented. A Neonatal Near Miss is a neonate who had a severe morbidity (organ dysfunction or failure) but who survived this condition within the first 27 days of life. The pragmatic criteria recommended to be used are as follows: birth weight below 1700 g, Apgar score below 7 at 5 minutes of life and gestational age below 33 weeks. As a proxy for organ dysfunction, the following management criteria are also confirmed: parenteral therapeutic antibiotics; nasal continuous positive airway pressure; any intubation during the first 27 days of life; phototherapy within the first 24 h of life; cardiopulmonary resuscitation; the use of vasoactive drugs, anticonvulsants, surfactants, blood products and steroids for refractory hypoglycemia and any surgical procedure. Although this study starts from a regional perspective, this topic is clearly globally relevant. All nations, especially low and middle-income countries, could benefit from the proposed standardization. PMID:26735223

  3. Praise Acres Project

    ERIC Educational Resources Information Center

    Hayes, Carolyn

    2004-01-01

    In this article, the author presents the "Praise Acres Project," which was initiated from a letter written by a local resident. The resident wrote about an idea to develop a wetlands and outdoor lab facility on his property for students. Thus, a plan was conceived that would not only benefit the owner, but also enhance high school science…

  4. The Role of 18F-FDG PET/CT in Large-Vessel Vasculitis: Appropriateness of Current Classification Criteria?

    PubMed Central

    Balink, H.; Bennink, R. J.; van Eck-Smit, B. L. F.; Verberne, H. J.

    2014-01-01

    Patients with clinical suspicion of large-vessel vasculitis (LVV) may present with nonspecific signs and symptoms and increased inflammatory parameters and may remain without diagnosis after routine diagnostic procedures. Both the nonspecificity of the radiopharmaceutical 18F-FDG and the synergy of integrating functional and anatomical images with PET/CT offer substantial benefit in the diagnostic work-up of patients with clinical suspicion for LVV. A negative temporal artery biopsy, an ultrasonography without an arterial halo, or a MRI without aortic wall thickening or oedema do not exclude the presence of LVV and should therefore not exclude the use of 18F-FDG PET/CT when LVV is clinically suspected. This overview further discusses the notion that there is substantial underdiagnosis of LVV. Late diagnosis of LVV may lead to surgery or angioplasty in occlusive forms and is often accompanied by serious aortic complications and a fatal outcome. In contrast to the American College of Rheumatology 1990 criteria for vasculitis, based on late LVV effects like arterial stenosis and/or occlusion, 18F-FDG PET/CT sheds new light on the classification of giant cell arteritis (GCA) and Takayasu arteritis (TA). The combination of these observations makes the role of 18F-FDG PET/CT in the assessment of patients suspected for having LVV promising. PMID:25328890

  5. Are the WHO (1980) criteria for the 75 g oral glucose tolerance test appropriate for pregnant women?

    PubMed

    Cheng, L C; Salmon, Y M

    1993-07-01

    To assess the normal response to the 75 gm oral glucose tolerance test (OGTT) in normal pregnant women, healthy Chinese and Malay women who had been referred to the antenatal clinic of the Department of Reproductive Medicine, Kandang Kerbau Hospital, Singapore, were evaluated. The women were selected on the basis of having none of the generally accepted risk factors for diabetes mellitus: their age was 35 years, they weighed 80 kg, they did not have a personal history of diabetes or a family history of diabetes or a family history of diabetes in first degree relatives, nor did they have a history of babies weighing 4000 gm at birth, still-births, neonatal deaths, congenital malformations, or recurrent miscarriages. All OGTTs were performed after 28 weeks of gestation. The fasting blood sample was taken from the antecubital vein. Further samples were taken 1 and 2 hours after the glucose drink. A glucose analyzer using 5 mcl of plasma was employed. The analytical method was based on the glucose oxidase/peroxidase/aminophenazone process. There was no significant difference in mean glucose levels at corresponding points of the OGTT in Chinese and Malay women. correlation calculations confirmed the absence of any influence of gestational age after 28 weeks on glucose tolerance. Of the 64 women, 47 were Chinese and 17 Malays; 20 wee nulliparous, and 44 were parous. Their mean age was 27.2 years (range 18-35). The mean birthweight of the infants was 3140 gm (range 2094-4240 gm). There were 33 female and 31 male infants. The mean apgar scores at 1 and 5 min were 8.8 (range 7-9) and 9.0 (range 6-10). The mean values and the proposed upper limits of normality for the 75 gm OGTT were 3.9 and 4.9 mmol/1, respectively. 6 women had abnormal OGTT results according to the WHO criteria (fasting glucose 6 mmol/1; 2 hour glucose 8 mmol/1).

  6. ACR process for ethylene

    SciTech Connect

    Baldwin, R.L.; Kamm, G.R.

    1983-01-01

    Describes how the advanced cracking reactor process, which is ready for a logical commercial application, offers total liquids feedstock flexibility from light naphthenes through vacuum gas oils in the same production unit. Several processes are presently being developed which are aimed at maintaining olefin selectivity when cracking the heaviest feeds. Addresses the problems posed by such heavy feedstocks. The following trends favor the ACR process in the 1980s: natural gas price decontrol; limited natural gas reserves; few new domestic LPG-based ethylene plants will be built; an economic recovery will create the need for more ethylene capacity; modest increases in ''real'' crude oil prices; plentiful supplies of vacuum gas oil at prices making it an attractive ethylene feedstock; and increasing supplies of light naphtha at prices making it an attractive ethylene feedstock as well. Predicts that these factors will swing the preferred feedstocks for ethylene manufacture back to crude oil distillates before the end of the decade. Argues that in this environment, the ACR process can deliver the lowest cost ethylene in the industry. ACR has full-range feedstock flexibility, high selectivity to ethylene, and less sensitivity to feedstock costs and co-product credits.

  7. Development of a tool for defining and identifying the dying patient in hospital: Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL)

    PubMed Central

    Cardona-Morrell, Magnolia; Hillman, Ken

    2015-01-01

    Objective To develop a screening tool to identify elderly patients at the end of life and quantify the risk of death in hospital or soon after discharge for to minimise prognostic uncertainty and avoid potentially harmful and futile treatments. Design Narrative literature review of definitions, tools and measurements that could be combined into a screening tool based on routinely available or obtainable data at the point of care to identify elderly patients who are unavoidably dying at the time of admission or at risk of dying during hospitalisation. Main measurements Variables and thresholds proposed for the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL screening tool) were adopted from existing scales and published research findings showing association with either in-hospital, 30-day or 3-month mortality. Results Eighteen predictor instruments and their variants were examined. The final items for the new CriSTAL screening tool included: age ≥65; meeting ≥2 deterioration criteria; an index of frailty with ≥2 criteria; early warning score >4; presence of ≥1 selected comorbidities; nursing home placement; evidence of cognitive impairment; prior emergency hospitalisation or intensive care unit readmission in the past year; abnormal ECG; and proteinuria. Conclusions An unambiguous checklist may assist clinicians in reducing uncertainty patients who are likely to die within the next 3 months and help initiate transparent conversations with families and patients about end-of-life care. Retrospective chart review and prospective validation will be undertaken to optimise the number of prognostic items for easy administration and enhanced generalisability. Development of an evidence-based tool for defining and identifying the dying patient in hospital: CriSTAL. PMID:25613983

  8. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    PubMed Central

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  9. 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

  10. 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

  11. Licensing the ACR in the USA - A Status Report

    SciTech Connect

    Snell, Victor; Langman, Vince; Ion, Robert; Reid, Calvin

    2004-07-01

    The ACR-700 (ACR) is an evolutionary reactor design, which incorporates the inherent safety features of the Candu products, as well as the successful operating experience of the current Candu 6 reactors. The improvements to the ACR from Candu 6 result in significant reductions in capital and operating costs as well as enhanced safety. AECL Technologies (AECLT, a wholly owned US subsidiary of Atomic Energy of Canada Limited) is the proponent for the ongoing pre-application review of the ACR with the US Nuclear Regulatory Commission (NRC) in the United States. This pre-application review will be completed shortly and will support an application to the USNRC for Standard Design Certification (SDC). AECL Technologies' overall objective for the pre-application review of the ACR is to obtain an understanding of the scope, cost, and the schedule to obtain a Standard Design Certification for the ACR. The pre-application review will address licensing issues associated with the Candu reactor technologies in ACR that depart from the light water reactor, pressure-vessel based regulatory framework in the USA. Therefore, during the course of the ACR pre-application review, major USNRC issues with the ACR design will be identified early and the scope of the work required to address these concerns, along with associated completion schedules, will be formulated and ultimately agreed upon with the USNRC. AECLT has been informed by the NRC staff that the results of their pre-application review will be documented in a Safety Assessment Report (SAR), which will state whether there are any major impediments to licensing the ACR in the United States. In particular, the SAR should provide confirmation of the licensing criteria applicable to the ACR, provide an assessment of the completeness of AECL's Research and Development (R and D) programs that exist or are planned in support of the ACR, provide an assessment of the suitability for purpose of the computer codes used in the safety

  12. Advanced Component Research Facility (ACRES)

    SciTech Connect

    Bohn, M.

    1980-07-01

    A detailed description of the SERI Advanced Component Research Facility (ACRES) is given. Background information explicates the facility's history, developed around the two Omnium-G parabolic dish concentrators. The Omnium-G concentrators and electrical power plant are described. The purpose and a detailed descripttion of ACRES is also given. Included is a description of the measurement capabilities, the controls, and each component of the facility.

  13. Update on appropriate use criteria for amyloid PET imaging: dementia experts, mild cognitive impairment, and education. Amyloid Imaging Task Force of the Alzheimer’s Association and Society for Nuclear Medicine and Molecular Imaging.

    PubMed

    Johnson, Keith A; Minoshima, Satoshi; Bohnen, Nicolaas I; Donohoe, Kevin J; Foster, Norman L; Herscovitch, Peter; Karlawish, Jason H; Rowe, Christopher C; Hedrick, Saima; Pappas, Virginia; Carrillo, Maria C; Hartley, Dean M

    2013-07-01

    Amyloid PET imaging is a novel diagnostic test that can detect in living humans one of the two defining pathologic lesions of Alzheimer disease, amyloid-β deposition in the brain. The Amyloid Imaging Task Force of the Alzheimer's Association and Society for Nuclear Medicine and Molecular Imaging previously published appropriate use criteria for amyloid PET as an important tool for increasing the certainty of a diagnosis of Alzheimer disease in specific patient populations. Here, the task force further clarifies and expands 3 topics discussed in the original paper: first, defining dementia experts and their use of proper documentation to demonstrate the medical necessity of an amyloid PET scan; second, identifying a specific subset of individuals with mild cognitive impairment for whom an amyloid PET scan is appropriate; and finally, developing educational programs to increase awareness of the amyloid PET appropriate use criteria and providing instructions on how this test should be used in the clinical decision-making process.

  14. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians.

    PubMed

    Douglas, Pamela S; Garcia, Mario J; Haines, David E; Lai, Wyman W; Manning, Warren J; Patel, Ayan R; Picard, Michael H; Polk, Donna M; Ragosta, Michael; Parker Ward, R; Weiner, Rory B

    2011-03-01

    The American College of Cardiology Foundation (ACCF), in partnership with the American Society of Echocardiography (ASE) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 (1) and the original stress echocardiography appropriateness criteria published in 2008 (2). This revision reflects new clinical data, reflects changes in test utilization patterns,and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria.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 the original appropriate use criteria (AUC).The 202 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). Ninety-seven indications were rated as appropriate, 34 were rated as uncertain, and 71 were rated as inappropriate. In general,the use of echocardiography for initial diagnosis when there is a change in clinical status or when the results of the echocardiogram are anticipated to change patient management were rated appropriate. Routine testing when there was no change in clinical status or when results of testing were unlikely to modify management were more likely to be inappropriate than appropriate/uncertain.The AUC for echocardiography 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.

  15. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians.

    PubMed

    Douglas, Pamela S; Garcia, Mario J; Haines, David E; Lai, Wyman W; Manning, Warren J; Patel, Ayan R; Picard, Michael H; Polk, Donna M; Ragosta, Michael; Parker Ward, R; Weiner, Rory B

    2011-03-01

    The American College of Cardiology Foundation (ACCF), in partnership with the American Society of Echocardiography (ASE) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 (1) and the original stress echocardiography appropriateness criteria published in 2008 (2). This revision reflects new clinical data, reflects changes in test utilization patterns,and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria.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 the original appropriate use criteria (AUC).The 202 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). Ninety-seven indications were rated as appropriate, 34 were rated as uncertain, and 71 were rated as inappropriate. In general,the use of echocardiography for initial diagnosis when there is a change in clinical status or when the results of the echocardiogram are anticipated to change patient management were rated appropriate. Routine testing when there was no change in clinical status or when results of testing were unlikely to modify management were more likely to be inappropriate than appropriate/uncertain.The AUC for echocardiography 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

  16. AcrB-AcrA Fusion Proteins That Act as Multidrug Efflux Transporters

    PubMed Central

    Nakashima, Ryosuke; Sakurai, Keisuke; Kitagawa, Kimie; Yamasaki, Seiji; Nishino, Kunihiko

    2015-01-01

    ABSTRACT The AcrAB-TolC system in Escherichia coli is an intrinsic RND-type multidrug efflux transporter that functions as a tripartite complex of the inner membrane transporter AcrB, the outer membrane channel TolC, and the adaptor protein AcrA. Although the crystal structures of each component of this system have been elucidated, the crystal structure of the whole complex has not been solved. The available crystal structures have shown that AcrB and TolC function as trimers, but the number of AcrA molecules in the complex is now under debate. Disulfide chemical cross-linking experiments have indicated that the stoichiometry of AcrB-AcrA-TolC is 1:1:1; on the other hand, recent cryo-electron microscopy images of AcrAB-TolC suggested a 1:2:1 stoichiometry. In this study, we constructed 1:1-fixed AcrB-AcrA fusion proteins using various linkers. Surprisingly, all the 1:1-fixed linker proteins showed drug export activity under both acrAB-deficient conditions and acrAB acrEF double-pump-knockout conditions regardless of the lengths of the linkers. Finally, we optimized a shorter linker lacking the conformational freedom imparted by the AcrB C terminus. These results suggest that a complex with equal amounts of AcrA and AcrB is sufficient for drug export function. IMPORTANCE The structure and stoichiometry of the RND-type multidrug exporter AcrB-AcrA-TolC complex are still under debate. Recently, electron microscopic images of the AcrB-AcrA-TolC complex have been reported, suggesting a 1:2:1 stoichiometry. However, we report here that the AcrB-AcrA 1:1 fusion protein is active for drug export under acrAB-deficient conditions and also under acrAB acrEF double-deficient conditions, which eliminate the aid of free AcrA and its close homolog AcrE, indicating that the AcrB-AcrA 1:1 stoichiometry is enough for drug export function. In addition, the AcrB-AcrA fusion protein can function without the aid of free AcrA. We believe that these results are very important for

  17. 76 FR 44964 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  18. 75 FR 82092 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  19. 75 FR 27841 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials The ACRS Subcommittee on Radiation Protection and Nuclear Materials...

  20. 76 FR 61119 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  1. 76 FR 36160 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-21

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  2. 75 FR 82093 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  3. 77 FR 56240 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-12

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  4. 75 FR 58447 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials The ACRS Subcommittee on Radiation Protection and Nuclear Materials...

  5. 76 FR 27101 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  6. 77 FR 31044 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  7. 78 FR 70597 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  8. 78 FR 79020 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  9. 78 FR 17944 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  10. 77 FR 38099 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-26

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  11. 77 FR 68161 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  12. 78 FR 66967 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommitte on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-07

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommitte on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  13. 75 FR 27840 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials The ACRS Subcommittee on Radiation Protection and Nuclear Materials...

  14. 76 FR 55717 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  15. 75 FR 4881 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  16. 76 FR 55716 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of The ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of The ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  17. 75 FR 16874 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  18. 76 FR 34779 - Advisory Committee On Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  19. 78 FR 70598 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... From the Federal Register Online via the Government Publishing Office ] NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials, Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  20. Appropriate drinking water treatment processes for organic micropollutants removal based on experimental and model studies - a multi-criteria analysis study.

    PubMed

    Sudhakaran, Sairam; Lattemann, Sabine; Amy, Gary L

    2013-01-01

    The presence of organic micropollutants (OMPs), pharmaceuticals and personal care products (PPCPs) in potable water is of great environmental and public health concern. OMPs are included in the priority list of contaminants in United States EPA and European framework directives. Advanced treatment processes such as reverse osmosis, nanofiltration, ozonation and adsorption are the usual industry-recommended processes for OMPs removal, however, natural systems, e.g., riverbank filtration and constructed wetlands, are also potentially efficient options for OMPs removal. In this study, a decision support system (DSS) based on multi-criteria analysis (MCA) was created to compare processes for OMPs removal under various criteria. Multi-criteria analysis (MCA), a transparent and reliable procedure, was adopted. Models were built for both experimental and predicted percent-removals for a range of OMPs reflecting different physicochemical properties. The experimental percent-removals for several processes (riverbank filtration (RBF), ozonation, advanced oxidation, adsorption, reverse osmosis, and nanofiltration) were considered. The predicted percent-removals were taken from validated quantitative structure activity relationship (QSAR) models. Analytical methods to detect OMPs in water are very laborious, thus a modeling approach such as QSAR is an attractive option. A survey among two groups of participants including academics (PhD students and post-doctoral research associates) and industry (managers and operators) representatives was conducted to assign weights for the following criteria: treatability, costs, technical considerations, sustainability and time. The process rankings varied depending on the contaminant species and personal preferences (weights). The results indicated that RBF and oxidation were preferable over adsorption and membranes processes. The results also suggest that the use of a hybrid treatment process, e.g., combining a natural system with an

  1. Appropriate drinking water treatment processes for organic micropollutants removal based on experimental and model studies - a multi-criteria analysis study.

    PubMed

    Sudhakaran, Sairam; Lattemann, Sabine; Amy, Gary L

    2013-01-01

    The presence of organic micropollutants (OMPs), pharmaceuticals and personal care products (PPCPs) in potable water is of great environmental and public health concern. OMPs are included in the priority list of contaminants in United States EPA and European framework directives. Advanced treatment processes such as reverse osmosis, nanofiltration, ozonation and adsorption are the usual industry-recommended processes for OMPs removal, however, natural systems, e.g., riverbank filtration and constructed wetlands, are also potentially efficient options for OMPs removal. In this study, a decision support system (DSS) based on multi-criteria analysis (MCA) was created to compare processes for OMPs removal under various criteria. Multi-criteria analysis (MCA), a transparent and reliable procedure, was adopted. Models were built for both experimental and predicted percent-removals for a range of OMPs reflecting different physicochemical properties. The experimental percent-removals for several processes (riverbank filtration (RBF), ozonation, advanced oxidation, adsorption, reverse osmosis, and nanofiltration) were considered. The predicted percent-removals were taken from validated quantitative structure activity relationship (QSAR) models. Analytical methods to detect OMPs in water are very laborious, thus a modeling approach such as QSAR is an attractive option. A survey among two groups of participants including academics (PhD students and post-doctoral research associates) and industry (managers and operators) representatives was conducted to assign weights for the following criteria: treatability, costs, technical considerations, sustainability and time. The process rankings varied depending on the contaminant species and personal preferences (weights). The results indicated that RBF and oxidation were preferable over adsorption and membranes processes. The results also suggest that the use of a hybrid treatment process, e.g., combining a natural system with an

  2. 76 FR 44377 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    ... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-65039... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on August 16, 2011, Room...

  3. 78 FR 51752 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-21

    ... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on September 18, 2013, Room...

  4. 77 FR 74697 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

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    2012-12-17

    ... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on January 18, 2013, Room...

  5. 77 FR 28903 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126-64127). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on May 22, 2012, Room...

  6. 77 FR 28637 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

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    2012-05-15

    ... participation in ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126- 64127... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on May 22- 23, 2012, Room...

  7. 77 FR 45699 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... participation in ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126-64127... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on August 14, 2012, Room...

  8. 77 FR 45700 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126- 64127... COMMISSION Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on August 15, 2012, Room...

  9. 77 FR 59676 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

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    2012-09-28

    ... in ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126-64127... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on October 3, 2012, Room...

  10. 78 FR 2694 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Fukushima...

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    2013-01-14

    ... the Federal Register on Monday, December 17, 2012, (77 FR 74697-74698). Information regarding this... COMMISSION Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Fukushima; Cancellation of the January 18, 2013, ACRS Subcommittee Meeting The ACRS Subcommittee meeting on...

  11. 78 FR 37595 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced...

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    2013-06-21

    ... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor; Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water Reactor...

  12. 75 FR 52999 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On ESBWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On ESBWR The ACRS Subcommittee on Economic Simplified Boiling Water Reactor (ESBWR) will hold a meeting on...

  13. 75 FR 44818 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-29

    ... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR The ACRS Subcommittee on ESBWR will hold a meeting on August 16-17, 2010, Room T-2B1, 11545 Rockville...

  14. 75 FR 38564 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR The ACRS Subcommittee on ESBWR will hold a meeting on July 13, 2010, Room T-2B1, 11545 Rockville...

  15. 77 FR 60480 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126-64127). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Digital Instrumentation and Control Systems; Notice of Meeting The ACRS Subcommittee on Digital Instrumentation...

  16. TU-A-18C-01: ACR Accreditation Updates in CT, Ultrasound, Mammography and MRI

    SciTech Connect

    Price, R; Berns, E; Hangiandreou, N; McNitt-Gray, M

    2014-06-15

    A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, the ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, mammography, ultrasound, and computed tomography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program. To understand the new requirements of the ACR ultrasound accreditation program, and roles the physicist can play in annual equipment surveys and setting up and supervising the routine QC program. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process.

  17. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram

  18. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG

  19. 76 FR 55717 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... and Probabilistic Risk Assessment The ACRS Subcommittee on Reliability and PRA will hold a meeting... ACRS meetings were published in the Federal Register on October 21, 2010 (75 FR 65038-65039)....

  20. 78 FR 79019 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... participation in ACRS meetings were published in the Federal Register on November 8, 2013 (78 FR 67205-67206..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  1. 77 FR 45699 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Economic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64126-64127). Detailed... Simplified Boiling Water Reactors (ESBWR); Notice of Meeting The ACRS Subcommittee on ESBWR will hold...

  2. 76 FR 18586 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of The ACRS Subcommittee on United...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of The ACRS Subcommittee on United States-Advanced Pressurized Water Reactor (US-APWR); Notice of Meeting The ACRS Subcommittee on United States-Advanced Pressurized Water Reactor...

  3. 76 FR 32240 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital Instrumentation and Control Systems; Notice of Meeting The ACRS Subcommittee on Digital Instrumentation and Control Systems (DI&C) will hold a meeting on June 7, 2011, Room T-2B1, 11545 Rockville Pike,...

  4. 76 FR 52715 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital Instrumentation and Control Systems; Notice of Meeting The ACRS Subcommittee on Digital Instrumentation and... Diversity on Defense-In-Depth in Digital Computer-Based I&C Systems,'' and other related activities...

  5. 77 FR 52371 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... Register on October 17, 2011, (76 FR 64126- 64127). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on September 5, 2012, Room...

  6. 78 FR 65008 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on November 5, 2013, Room...

  7. 77 FR 68161 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... Register on October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on December 5, 2012, Room...

  8. 78 FR 50457 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on September 4, 2013, Room...

  9. 77 FR 64147 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... published in the Federal Register on October 17, 2011 (76 FR 64126- 64127). Detailed meeting agendas and... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on October 31, 2012, Room...

  10. 77 FR 68161 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... Register on October 18, 2012 (77 FR 64146- 64147). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on December 4, 2012, Room...

  11. 78 FR 27442 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147). Detailed meeting... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on May 23, Room T-2B1,...

  12. 76 FR 27103 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... were published in the Federal Register on October 21, 2010 (75 FR 65038-65039). Detailed meeting... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on May 26, 2011, Room...

  13. 76 FR 34778 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ..., (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on the NRC Web... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on June 23, 2011, Room...

  14. 77 FR 31676 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... October 17, 2011, (76 FR 64126- 64127). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on June 20, 2012, Room...

  15. 78 FR 17945 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... Register on October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Fukushima; Notice of Meeting The ACRS Subcommittee on Fukushima will hold a meeting on April 10, 2013, Room...

  16. 76 FR 5218 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... Register on October 21, 2010 (75 FR 65038- 65039). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor (ABWR); Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water...

  17. 77 FR 59678 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... October 17, 2011, (76 FR 64126-64127). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor; Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water Reactor...

  18. 77 FR 76089 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor; Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water Reactor...

  19. 76 FR 53979 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Thermal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... published in the Federal Register on October 21, 2010, (75 FR 65038-65039). Detailed meeting agendas and... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Thermal Hydraulics Phenomena; Notice of Meeting The ACRS Subcommittee on Thermal Hydraulics Phenomena will hold...

  20. 75 FR 51499 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Thermal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-20

    ... October 14, 2009, (74 FR 58268- 58269). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Thermal Hydraulics Phenomena The ACRS Subcommittee on Thermal Hydraulics Phenomena will hold a meeting on September...

  1. 75 FR 30077 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Register on October 14, 2009, (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on ESBWR The ACRS Subcommittee on Economic Simplified Boiling Water Reactor (ESBWR) will hold a meeting on June...

  2. 75 FR 25302 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on ESBWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ..., (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are available on the NRC Web... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on ESBWR The ACRS Subcommittee on ESBWR will hold a meeting on May 18-19, 2010, Room T-2B1, 11545 Rockville Pike,...

  3. 76 FR 34276 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Digital...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-13

    ... Register on October 21, 2010 (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Digital Instrumentation and Control Systems; Notice of Meeting The ACRS Subcommittee on Digital Instrumentation...

  4. Appropriateness of diagnostics tests.

    PubMed

    Cappelletti, P

    2016-05-01

    The evolution of the concept of 'appropriateness', in the three past decades, from 'no harm' and 'no waste' to 'medical decision-making' and 'determining outcomes' highlights two main points: its foundation is evidence-based medicine, and it is a quality of every phase of the total testing process, not only for the selection of tests. Nevertheless, appropriateness in Laboratory Hematology, as well as in Laboratory Medicine, is an elusive concept: 'Appropriateness' interplays with 'patient's safety', 'healthcare costs', 'clinical decision-making', and 'effectiveness', and the criteria for appropriateness, mainly adherence to clinical guidelines, are often not evidence-based and not always consensus-based. Moreover, practising appropriateness is a complex issue because of the ambiguity of the criteria and targets, the never-ending work of implementing guidelines and their audit, and the uniqueness of the clinical situation of the individual patient. Authors agree on some practical rules: establishing a multidisciplinary and multiprofessional team, choosing carefully clinical targets, finding or building evidences, sharing guidelines with clinicians, choosing adequate tools for changing, working hard on implementation, identifying the 'right' laboratory methods and processes, checking progress indefinitely, providing information, interpretations, and consultations, and promoting feedback and audits. The success depends on the 'right' combination of educational, operative, and reinforcing interventions. Competences in organization, in implementation science, and in interpersonal relationship management are essential as well as knowledge and experience in Hematology, not only in Laboratory Hematology. PMID:27161094

  5. ARM Cloud Retrieval Ensemble Data Set (ACRED)

    SciTech Connect

    Zhao, C; Xie, S; Klein, SA; McCoy, R; Comstock, JM; Delanoë, J; Deng, M; Dunn, M; Hogan, RJ; Jensen, MP; Mace, GG; McFarlane, SA; O’Connor, EJ; Protat, A; Shupe, MD; Turner, D; Wang, Z

    2011-09-12

    This document describes a new Atmospheric Radiation Measurement (ARM) data set, the ARM Cloud Retrieval Ensemble Data Set (ACRED), which is created by assembling nine existing ground-based cloud retrievals of ARM measurements from different cloud retrieval algorithms. The current version of ACRED includes an hourly average of nine ground-based retrievals with vertical resolution of 45 m for 512 layers. The techniques used for the nine cloud retrievals are briefly described in this document. This document also outlines the ACRED data availability, variables, and the nine retrieval products. Technical details about the generation of ACRED, such as the methods used for time average and vertical re-grid, are also provided.

  6. The Automated Conflict Resolution System (ACRS)

    NASA Technical Reports Server (NTRS)

    Kaplan, Ted; Musliner, Andrew; Wampler, David

    1993-01-01

    The Automated Conflict Resolution System (ACRS) is a mission-current scheduling aid that predicts periods of mutual interference when two or more orbiting spacecraft are scheduled to communicate with the same Tracking and Data Relay Satellite (TDRS) at the same time. The mutual interference predicted has the potential to degrade or prevent communications. Thus the ACRS system is a useful tool for aiding in the scheduling of Space Network (SN) communications.

  7. 78 FR 79019 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor Fuels... materials and metallurgy. The Subcommittee will hear presentations by and hold discussions with the...

  8. 76 FR 22934 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... and Probabilistic Risk Assessment; Notice of Meeting The ACRS Subcommittee on Reliability and Probabilistic Risk Assessment (PRA) will hold a meeting on May 11, 2011, Room T-2B3, 11545 Rockville Pike... ACRS meetings were published in the Federal Register on October 21, 2010 (75 FR 65038- 65039)....

  9. 76 FR 71609 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... and Probabilistic Risk Assessment; Notice of Meeting The ACRS Subcommittee on Reliability and Probabilistic Risk Assessment (PRA) will hold a meeting on December 14, 2011, Room T-2B3, 11545 Rockville Pike... ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR 64127-...

  10. 76 FR 55717 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... and Probabilistic Risk Assessment The ACRS Subcommittee on Reliability and Probabilistic Risk Assessment (PRA) will hold a meeting on September 20, 2011, Room T-2B1, 11545 Rockville Pike, Rockville... ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-...

  11. 77 FR 24745 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Thermal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-25

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Thermal..., ``Evaluation of Long- Term Cooling Considering Particulate, Fibrous and Chemical Debris in the Recirculating... October 17, 2011, (76 FR 64126- 64127). Detailed meeting agendas and meeting transcripts are available...

  12. 77 FR 2571 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Regulatory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... Power Plants.'' The Subcommittee will hear presentations by and hold discussions with the NRC staff and... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on...

  13. 77 FR 56239 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-12

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Plant License...-Besse Nuclear Power station and the associated draft Safety Evaluation Report (SER) with open items....

  14. 76 FR 4738 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Plant License... Canyon Power Plant, Units 1 and 2 and the associated Safety Evaluation Report (SER) with Open Items....

  15. Isolation of three contiguous genes, ACR1, ACR2 and ACR3, involved in resistance to arsenic compounds in the yeast Saccharomyces cerevisiae.

    PubMed

    Bobrowicz, P; Wysocki, R; Owsianik, G; Goffeau, A; Ułaszewski, S

    1997-07-01

    A 4.2 kb region from Saccharomyces cerevisiae chromosome XVI was isolated as a yeast fragment conferring resistance to 7 mM-sodium arsenite (NaAsO2), when put on a multicopy plasmid. Homology searches revealed a cluster of three new open reading frames named ACR1, ACR2 and ACR3. The hypothetical product of the ACR1 gene is similar to the transcriptional regulatory proteins, encoded by YAP1, and YAP2 genes from S. cerevisiae. Disruption of the ACR1 gene conduces to an arsenite and arsenate hypersensitivity phenotype. The ACR2 gene is indispensable for arsenate but not for arsenite resistance. The hypothetical product of the ACR3 gene shows high similarity to the hypothetical membrane protein encoded by Bacillus subtilis ORF1 of the skin element and weak similarity to the ArsB membrane protein of the Staphylococcus aureus arsenical-resistance operon. Overexpression of the ACR3 gene confers an arsenite- but not an arsenate-resistance phenotype. The presence of ACR3 together with ACR2 on a multicopy plasmid expands the resistance phenotype into arsenate. These findings suggest that all three novel genes: ACR1, ACR2 and ACR3 are involved in the arsenical-resistance phenomenon in S. cerevisiae.

  16. 75 FR 51501 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-20

    ... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and Procedures The ACRS Subcommittee on Planning and Procedures will hold a meeting on September 8, 2010,...

  17. 76 FR 44964 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-65039... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor...

  18. 75 FR 51499 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-20

    ... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C Systems The ACRS Subcommittee on Digital Instrumentation and Controls (I&C) Systems will hold a meeting...

  19. 77 FR 67688 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146-64147... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C; Notice of Meeting The ACRS Subcommittee on Digital I&C will hold a meeting on November 16, 2012, Room...

  20. The Expanding Significance of One Acre.

    ERIC Educational Resources Information Center

    Gilbert, Daniel R., Jr.

    2003-01-01

    A management class assignment requires students to study the history and complexity of one acre of land. The intent is to develop connections between the natural environment and human acts of management, focusing on the concept of privilege. (Contains 15 references.) (SK)

  1. 7 CFR 760.632 - Payment acres.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Payment acres. 760.632 Section 760.632 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... considered the same as a planting of an initial crop in tropical regions as defined in part 1437, subpart...

  2. 7 CFR 760.632 - Payment acres.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Payment acres. 760.632 Section 760.632 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... considered the same as a planting of an initial crop in tropical regions as defined in part 1437, subpart...

  3. 77 FR 47680 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittees on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... published in the Federal Register on Wednesday, August 1, 2012 (77 FR 45698-45699). Further information... and PRA and Fukushima; Revision to Notice of Meetings The (ACRS) Subcommittee on Fukushima...

  4. 77 FR 74698 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-17

    ... October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are available on..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  5. 76 FR 34778 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ..., (75 FR 65038- 65039). Detailed meeting agendas and meeting transcripts are available on the NRC Web..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  6. 78 FR 56756 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-13

    ... were published in the Federal Register on October 18, 2012, (77 FR 64146-64147). Detailed meeting..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  7. 78 FR 3474 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ... October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are available on..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  8. 75 FR 58449 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... Register on October 14, 2009, (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are..., Metallurgy & Reactor Fuels The ACRS Subcommittee on Materials, Metallurgy & Reactor Fuels will hold a...

  9. 76 FR 16016 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of The ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... October 21, 2010, (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on..., Metallurgy And Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy and...

  10. 78 FR 34677 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the Acrs Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-10

    ... Register on October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and meeting transcripts are..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  11. 76 FR 55718 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on the NRC Web..., Metallurgy & Reactor Fuels The ACRS Subcommittee on Materials, Metallurgy & Reactor Fuels will hold a...

  12. 76 FR 72451 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-23

    ... October 17, 2011, (76 FR 64127- 64128). Detailed meeting agendas and meeting transcripts are available on..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  13. 78 FR 29159 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... published in the Federal Register on October 18, 2012, (77 FR 64146-64147). Detailed meeting agendas and..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  14. 78 FR 31987 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... Register on October 18, 2012, (77 FR 64146- 64147). Detailed meeting agendas and meeting transcripts are..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  15. 75 FR 65036 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ... participation in ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269... protection program transition to National Fire Protection Association (NFPA) Standard 805. The...

  16. 76 FR 34276 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Advanced...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-13

    ... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-65039... the NRC staff, Nuclear Innovation North America (NINA), and other interested persons. The...

  17. 77 FR 24745 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-25

    ... Power Operations (INPO) Nuclear Safety Culture Survey. The Subcommittee will hear presentations by and... participation in ACRS meetings were published in the Federal Register on October 17, 2011, (76 FR...

  18. Radiology practice models: the 2008 ACR Forum.

    PubMed

    Gunderman, Richard B; Weinreb, Jeffrey C; Van Moore, Arl; Hillman, Bruce J; Neiman, Harvey L; Thrall, James H

    2008-09-01

    The 2008 ACR Forum brought together a diverse group of participants from clinical radiology, radiology leadership and practice management, managed care, economics, law, and entrepreneurship in Washington, DC, in January 2008 to discuss current models of radiology practice and anticipate new ones. It addressed what forces shape the practice of radiology, how these forces are changing, and how radiology practices can most effectively respond to them in the future.

  19. 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.

  20. 7 CFR 1412.44 - Notification of base acres.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Notification of base acres. 1412.44 Section 1412.44... Through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such...

  1. 7 CFR 1412.21 - Election of base acres.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in...

  2. 7 CFR 1412.21 - Election of base acres.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in...

  3. 7 CFR 1412.44 - Notification of base acres.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Notification of base acres. 1412.44 Section 1412.44... Through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such...

  4. 7 CFR 1412.44 - Notification of base acres.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Notification of base acres. 1412.44 Section 1412.44... through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such...

  5. 7 CFR 1412.44 - Notification of base acres.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Notification of base acres. 1412.44 Section 1412.44... through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such...

  6. 7 CFR 1412.21 - Election of base acres.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in...

  7. 7 CFR 1412.21 - Election of base acres.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in...

  8. 7 CFR 1412.44 - Notification of base acres.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Notification of base acres. 1412.44 Section 1412.44... through 2012 § 1412.44 Notification of base acres. The operator and owners of record of a farm will be notified in writing of the number of base acres eligible for enrollment in a contract, unless such...

  9. 7 CFR 1412.21 - Election of base acres.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Election of base acres. 1412.21 Section 1412.21... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Establishment of Base Acres for a Farm for Covered Commodities § 1412.21 Election of base acres. (a) Subject to adjustments in...

  10. 76 FR 22935 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-25

    ... Safety Branch B, Advisory Committee on Reactor Safeguards. BILLING CODE 7590-01-P ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on...

  11. 75 FR 67783 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and Procedures The ACRS Subcommittee on Planning and Procedures will hold a meeting on December 1, 2010, in Room... conduct of the meeting, persons planning to attend should check with these references if such...

  12. 77 FR 4838 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR); Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary...

  13. 75 FR 16203 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on EPR; Notice of Meeting The ACRS Subcommittee on the U.S. Evolutionary Power Reactor (EPR) will hold a meeting on April 20-21, 2010, at 11545 Rockville Pike, T2-...

  14. 77 FR 74698 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-17

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant Designs; Notice of Meeting The ACRS Subcommittee on Future Plant Designs will hold a meeting on January 17... were published in the Federal Register on October 18, 2012, (77 FR 64146-64147). Detailed...

  15. 76 FR 64123 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant Designs; Notice of Meeting The ACRS Subcommittee on Future Plant Designs will hold a meeting on November 2..., (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on the NRC...

  16. 78 FR 17945 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant Designs; Notice of Meeting The ACRS Subcommittee on Future Plant Designs will hold a meeting on April 9... were published in the Federal Register on October 18, 2012, (77 FR 64146-64147). Detailed...

  17. 76 FR 5220 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-28

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant Designs The ACRS Subcommittee on Future Plant Designs will hold a meeting on February 9, 2011, at 11545... small modular reactor applications. The Subcommittee will hear presentations by and hold...

  18. 76 FR 16016 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Future Plant Designs The ACRS Subcommittee on Future Plant Designs will hold a meeting on April 5, 2011, at 11545..., 10 a.m. until 5 p.m. The Subcommittee will review the NRC Staff's High Temperature Gas Cooled...

  19. 76 FR 7882 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ..., (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on the NRC Web... COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C Systems The ACRS Subcommittee on Digital Instrumentation & Control (DI&C) Systems will hold a meeting...

  20. 75 FR 30077 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Register on October 14, 2009, (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are... COMMISSION Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Digital I&C Systems The ACRS Subcommittee on Digital Instrumentation and Control (DI&C) Systems will hold a meeting...

  1. Simultaneous Exposure–Response Modeling of ACR20, ACR50, and ACR70 Improvement Scores in Rheumatoid Arthritis Patients Treated With Certolizumab Pegol

    PubMed Central

    Lacroix, B D; Karlsson, M O; Friberg, L E

    2014-01-01

    The Markovian approach has been proposed to model American College of Rheumatology's (ACR) response (ACR20, ACR50, or ACR70) reported in rheumatoid arthritis clinical trials to account for the dependency of the scores over time. However, dichotomizing the composite ACR assessment discards much information. Here, we propose a new approach for modeling together the three thresholds: a continuous-time Markov exposure–response model was developed, based on data from five placebo-controlled certolizumab pegol clinical trials. This approach allows adequate prediction of individual ACR20/50/70 time-response, even for non-periodic observations. An exposure–response was established over a large range of licensed and unlicensed doses including phase II dose-ranging data. Simulations from the model (50–400 mg every other week) illustrated the range and sustainability of response (ACR20: 56–68%, ACR50: 27–42%, ACR70: 11–22% at week 24) with maximum clinical effect achieved at the recommended maintenance dose of 200 mg every other week. PMID:25353186

  2. 78 FR 20958 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... & PRA The ACRS Subcommittee on Reliability & PRA will hold a meeting on April 24, 2013, Room T-2B1..., presenters should provide the DFO with a CD containing each presentation at least thirty minutes before the... published in the Federal Register on October 18, 2012, (77 FR 64146- 64147). Detailed meeting agendas...

  3. 78 FR 20958 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Regulatory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... April 23, 2013, Room T-2B1, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open... cannot be provided within this timeframe, presenters should provide the DFO with a CD containing each... participation in ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR...

  4. 75 FR 57536 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Thermal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... published in the Federal Register on October 14, 2009, (74 FR 58268-58269). Detailed meeting agendas and... Hydraulic Phenomena The ACRS Subcommittee on Thermal Hydraulic Phenomena will hold a meeting on October 18... 5 p.m. The Subcommittee will review the thermal-hydraulic research activities in the Office...

  5. 76 FR 24540 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... scheduled public comment period later in the year. A FR notice will be issued requesting public... October 21, 2010, (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available on..., Metallurgy & Reactor Fuels; Notice of Meeting The ACRS Subcommittee on Materials, Metallurgy & Reactor...

  6. 75 FR 66803 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Evolutionary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... ACRS meetings were ] published in the Federal Register on October 14, 2009, (74 FR 58268- 58269... with the NRC staff, AREVA, UniStar, and other interested persons. The Subcommittee will gather... rescheduling would result in a major inconvenience. Dated: October 21, 2010. Antonio F. Dias, Chief,...

  7. 77 FR 5063 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Thermal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ...), ``Preoperational Testing of Emergency Core Cooling Systems for Pressurized Water Reactors,'' and Draft Guide DG-1277, ``Initial Test Program of Emergency Core Cooling Systems for Boiling Water Reactors.'' The...-Hydraulics Phenomena; Notice of Meeting The ACRS Subcommittee on Thermal-Hydraulics Phenomena will hold...

  8. 76 FR 7882 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... Report (SSER), Supplement 22, associated with the staff's review of the Watts Bar Unit 2 Operating... ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-65039). Detailed... facilitate the conduct of the meeting, persons planning to attend should check with these references if...

  9. 76 FR 61118 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... Bar Unit 2 Operating License application. The Subcommittee will hear presentations by and hold... ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038- 65039... facilitate the conduct of the meeting, persons planning to attend should check with these references if...

  10. 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

  11. 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

  12. 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

  13. 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

  14. 12 CFR 1010.9 - Twenty acre lots.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Twenty acre lots. 1010.9 Section 1010.9 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.9 Twenty acre lots. (a) The sale of lots in a subdivision is exempt from the...

  15. 12 CFR 1010.9 - Twenty acre lots.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Twenty acre lots. 1010.9 Section 1010.9 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.9 Twenty acre lots. (a) The sale of lots in a subdivision is exempt from the...

  16. 12 CFR 1010.9 - Twenty acre lots.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Twenty acre lots. 1010.9 Section 1010.9 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION LAND REGISTRATION (REGULATION J) General Requirements § 1010.9 Twenty acre lots. (a) The sale of lots in a subdivision is exempt from the...

  17. 77 FR 36017 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ...; Cancellation of the June 19, 2012 ACRS Subcommittee Meeting The ACRS Subcommittee meeting on Digital I&C scheduled for June 19, 2012 has been cancelled. The notice of this meeting was previously published in the Federal Register on Monday, June 4, 2012, (77 FR 33003-33004). Information regarding this meeting can...

  18. 78 FR 8202 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on US-APWR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... and/or written comments should notify the Designated Federal Official (DFO), Girija Shukla (Telephone... ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147.../reading-rm/doc-collections/acrs . Information regarding topics to be discussed, changes to the...

  19. 78 FR 20959 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on US-APWR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on US-APWR The... that may be closed to protect information that is propriety pursuant to 5 U.S.C. 552(c)(4). The...

  20. 77 FR 56240 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on US-APWR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-12

    ... From the Federal Register Online via the Government Publishing Office ] NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on US-APWR...(c)(4). The agenda for the subject meeting shall be as follows: Thursday, September 20, 2012-8:30...

  1. 78 FR 47802 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on US-APWR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-06

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on US-APWR...)(4). The agenda for the subject meeting shall be as follows: Tuesday, September 17, 2013--8:30...

  2. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.

    PubMed

    Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

    2008-03-18

    The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research.

  3. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... of production flexibility contract acres or base acres protected by a Conservation Reserve...

  4. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... of production flexibility contract acres or base acres protected by a Conservation Reserve...

  5. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... of production flexibility contract acres or base acres protected by a Conservation Reserve...

  6. Criteria for Developing Criteria Sets.

    ERIC Educational Resources Information Center

    Martin, James L.

    Criteria sets are a necessary step in the systematic development of evaluation in education. Evaluation results from the combination of criteria and evidence. There is a need to develop explicit tools for evaluating criteria, similar to those used in evaluating evidence. The formulation of such criteria depends on distinguishing between terms…

  7. 6. View northeast of Ten Acre Lot with Joseph Fry ...

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

    6. View northeast of Ten Acre Lot with Joseph Fry Farm complex (center) and Beehive House (right)in the background - Joseph Fry Farm Landscape, 2153 South County Trail Road (U.S. Route 2), East Greenwich, Kent County, RI

  8. 24 CFR 1710.9 - Twenty acre lots.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... DEVELOPMENT (INTERSTATE LAND SALES REGISTRATION PROGRAM) LAND REGISTRATION General Requirements § 1710.9 Twenty acre lots. (a) The sale of lots in a subdivision is exempt from the registration requirements...

  9. 24 CFR 1710.9 - Twenty acre lots.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEVELOPMENT (INTERSTATE LAND SALES REGISTRATION PROGRAM) LAND REGISTRATION General Requirements § 1710.9 Twenty acre lots. (a) The sale of lots in a subdivision is exempt from the registration requirements...

  10. 75 FR 1831 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP1000...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ... October 14, 2009 (74 FR 58268-58269). Detailed ACRS meeting agendas and meeting transcripts are available... Federal Official (DFO), Mr. Peter Wen, (Telephone 301-415-2832, E-mail: Peter.Wen@nrc.gov ) five...

  11. 78 FR 27443 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ...-1210), ``Developing Software Life-Cycle Processes for Digital Computer Software Used in Safety Systems... ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146-64147)....

  12. 78 FR 50457 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ... identification of digital system failure modes and use of hazard analysis methods for digital safety systems. The... ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146-64147)....

  13. Critical appraisal of appropriateness in nuclear cardiology.

    PubMed

    Marcassa, Claudio

    2016-12-01

    Radionuclide myocardial perfusion imaging (MPI) is a large component of the healthcare spending both in developed and developing countries. MPI is also responsible for a significant increase in the exposition of patients and health care operators to ionizing radiations for medical purposes. Thus, health-care systems and pertinent scientific societies were involved in developing criteria to contain the non-appropriate use by implementing Appropriate Use Criteria and Clinical Indications Guidelines. The present manuscript will review the concept and limitations of such an approach. PMID:27611706

  14. Appropriateness of Percutaneous Coronary Intervention

    PubMed Central

    Chan, Paul S.; Patel, Manesh R.; Klein, Lloyd W.; Krone, Ronald J.; Dehmer, Gregory J.; Kennedy, Kevin; Nallamothu, Brahmajee K.; Douglas Weaver, W.; Masoudi, Frederick A.; Rumsfeld, John S.; Brindis, Ralph G.; Spertus, John A.

    2012-01-01

    Context Despite the widespread use of percutaneous coronary intervention (PCI), the appropriateness of these procedures in contemporary practice is unknown. Objective To assess the appropriateness of PCI in the United States. Design, Setting, and Patients Multicenter, prospective study of patients within the National Cardiovascular Data Registry undergoing PCI between July 1, 2009, and September 30, 2010, at 1091 US hospitals. The appropriateness of PCI was adjudicated using the appropriate use criteria for coronary revascularization. Results were stratified by whether the procedure was performed for an acute (ST-segment elevation myocardial infarction, non–ST-segment elevation myocardial infarction, or unstable angina with high-risk features) or nonacute indication. Main Outcome Measures Proportion of acute and nonacute PCIs classified as appropriate, uncertain, or inappropriate; extent of hospital-level variation in inappropriate procedures. Results Of 500 154 PCIs, 355 417 (71.1%) were for acute indications (ST-segment elevation myocardial infarction, 103 245 [20.6%]; non–ST-segment elevation myocardial infarction, 105 708 [21.1%]; high-risk unstable angina, 146 464 [29.3%]), and 144 737 (28.9%) for nonacute indications. For acute indications, 350 469 PCIs (98.6%) were classified as appropriate, 1055 (0.3%) as uncertain, and 3893 (1.1%) as inappropriate. For nonacute indications, 72 911 PCIs (50.4%) were classified as appropriate, 54 988 (38.0%) as uncertain, and 16 838 (11.6%) as inappropriate. The majority of inappropriate PCIs for nonacute indications were performed in patients with no angina (53.8%), low-risk ischemia on noninvasive stress testing (71.6%), or suboptimal (≤1 medication) antianginal therapy (95.8%). Furthermore, although variation in the proportion of inappropriate PCI across hospitals was minimal for acute procedures, there was substantial hospital variation for nonacute procedures (median hospital rate for inappropriate PCI, 10

  15. Continuing Appropriations Act, 2012

    THOMAS, 112th Congress

    Rep. Aderholt, Robert B. [R-AL-4

    2011-05-26

    09/30/2011 Became Public Law No: 112-33. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 10/4/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  16. Continuing Appropriations Act, 2012

    THOMAS, 112th Congress

    Rep. Graves, Sam [R-MO-6

    2011-07-21

    10/05/2011 Became Public Law No: 112-36. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 11/18/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  17. Continuing Appropriations Act, 2011

    THOMAS, 111th Congress

    Rep. Lowey, Nita M. [D-NY-18

    2009-06-26

    09/30/2010 Became Public Law No: 111-242. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 12/3/2010. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  18. Continuing Appropriations Resolution, 2015

    THOMAS, 113th Congress

    Rep. Rogers, Harold [R-KY-5

    2014-09-09

    09/19/2014 Became Public Law No: 113-164. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 12/11/2014. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  19. Omnibus Appropriations Act, 2009

    THOMAS, 111th Congress

    Rep. Obey, David R. [D-WI-7

    2009-02-23

    03/11/2009 Became Public Law No: 111-8. (TXT | PDF) (All Actions) Notes: An explanatory statement was submitted by Mr. Obey, Chairman of the House Committee on Appropriations "as if it were a joint explanatory statement of a committee of conference." See the statement in the 2/23/2009 Congressional Record or in the House Appropriations committee print. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  20. Regulatory applications of sediment criteria. Final report

    SciTech Connect

    Not Available

    1987-06-23

    The report briefly describes the development of sediment criteria, discusses their utility and appropriate regulatory applications, and recommends steps to enhance the acceptance of sediment criteria by the regulatory and regulated communities.

  1. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... year, adjust the base acres for covered commodities and peanuts with respect to the farm by the...

  2. 7 CFR 1412.23 - Base acres and Conservation Reserve Program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Base acres and Conservation Reserve Program. 1412.23... Base Acres for a Farm for Covered Commodities § 1412.23 Base acres and Conservation Reserve Program. (a... year, adjust the base acres for covered commodities and peanuts with respect to the farm by the...

  3. 78 FR 79020 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... ) five days prior to the meeting, if possible, so that appropriate arrangements can be made. Thirty-five... time allotted to present oral statements can be obtained from the Web site cited above or by...

  4. ACRS elections can minimize taxes on oil and gas income

    SciTech Connect

    Bandy, D.

    1983-06-01

    The Accelerated Cost Recovery System (ACRS) is composed of elections which make either increases or decreases on oil and gas income possible. Current taxes can be elected to be reduced, but future taxes will be increased as a result of that decision. The various decisions that can be made on ACRS elections and the impact they will make on taxes are discussed, using an after-tax rate of return and showing the before- and after-tax returns when possible. Pertinent areas of discussion include full investment credit vs. full basis; equipment trade-in considerations; factors to be considered in the disposition of real estate; and the impact of alternative minimum tax on ACRS elections. 3 tables.

  5. Continuing Appropriations Act, 2014

    THOMAS, 113th Congress

    Rep. Black, Diane [R-TN-6

    2013-07-22

    10/17/2013 Became Public Law No: 113-46. (TXT | PDF) (All Actions) Notes: The final version of the bill makes continuing appropriations through January 15, 2014, thus ending the government shutdown, and increases the debt limit through February 7, 2014. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  6. Consolidated Appropriations Act, 2012

    THOMAS, 112th Congress

    Rep. Culberson, John Abney [R-TX-7

    2011-05-31

    12/23/2011 Became Public Law No: 112-74. (TXT | PDF) (All Actions) Notes: The measure is the vehicle for making appropriations for most federal government operations for the remainder of FY2012. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  7. "Forty Acres and a Mule" as a Pedagogical Motif

    ERIC Educational Resources Information Center

    Burch, Kerry

    2008-01-01

    This essay revisits an iconic yet now languishing phrase in United States political culture--"Forty Acres and a Mule"--to clarify the meaning of freedom and to assess the contemporary meaning of its betrayal by the U.S. government immediately after the Civil War. Among the few citizens for whom the phrase still retains a semblance of…

  8. ACR testing of a dedicated head SPECT unit.

    PubMed

    Sensakovic, William F; Hough, Matthew C; Kimbley, Elizabeth A

    2014-07-08

    Physics testing necessary for program accreditation is rigorously defined by the ACR. This testing is easily applied to most conventional SPECT systems based on gamma camera technology. The inSPira HD is a dedicated head SPECT system based on a rotating dual clamshell design that acquires data in a dual-spiral geometry. The unique geometry and configuration force alterations of the standard ACR physics testing protocol. Various tests, such as intrinsic planar uniformity and/or resolution, do not apply. The Data Spectrum Deluxe Phantom used for conventional SPECT testing cannot fit in the inSPira HD scanner bore, making (currently) unapproved use of the Small Deluxe SPECT Phantom necessary. Matrix size, collimator type, scanning time, reconstruction method, and attenuation correction were all varied from the typically prescribed ACR instructions. Visible spheres, sphere contrast, visible rod groups, uniformity, and root mean square (RMS) noise were measured. The acquired SPECT images surpassed the minimum ACR requirements for both spatial resolution (9.5 mm spheres resolved) and contrast (6.4 mm rod groups resolved). Sphere contrast was generally high. Integral uniformity was 4% and RMS noise was 1.7%. Noise appeared more correlated than in images from a conventional SPECT scanner. Attenuation-corrected images produced from direct CT scanning of the phantom and a manufacturer supplied model of the phantom demonstrated negligible differences.

  9. ACR Electrical Systems. Teacher Edition [and] Student Edition.

    ERIC Educational Resources Information Center

    Clemons, Mark

    This document contains a teacher's guide and student guide for a high school-level competency-based course in air conditioning and refrigeration (ACR) equipment electrical systems. Presented in the teacher's guide are the following: explanation of the instructional units' use; competency profile for recording students' performance of the tasks in…

  10. 78 FR 37597 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Power...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    .../or written comments should notify the Designated Federal Official (DFO), Peter Wen (Telephone 301-415-2832 or Email: Peter.Wen@nrc.gov ) five days prior to the meeting, if possible, so that appropriate... were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147). Detailed...

  11. 76 FR 60938 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Power...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... comments should notify the Designated Federal Official (DFO), Peter Wen (Telephone 301-415-2832 or E-mail: Peter.Wen@nrc.gov ) five days prior to the meeting, if possible, so that appropriate arrangements can be... published in the Federal Register on October 21, 2010, (75 FR 65038- 65039). Detailed meeting agendas...

  12. 77 FR 64148 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Regulatory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-18

    ... (RG) RG 1.79, ````Preoperational Testing of Emergency Core Cooling Systems for Pressurized Water...-Water Reactors,'' Revision 0 (DG-1277).'' The Subcommittee will hear presentations by and hold... appropriate arrangements can be made. Thirty-five hard copies of each presentation or handout should...

  13. 42 CFR 476.100 - Use of norms and criteria.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... use national admission norms. (b) Use of criteria. In assessing the need for and appropriateness of an... conduct of review a QIO must— (1) Establish written criteria based upon typical patterns of practice in the QIO area, or use national criteria where appropriate; and (2) Establish written criteria...

  14. The Saccharomyces cerevisiae ACR3 gene encodes a putative membrane protein involved in arsenite transport.

    PubMed

    Wysocki, R; Bobrowicz, P; Ułaszewski, S

    1997-11-28

    The cluster of three genes, ACR1, ACR2, and ACR3, previously was shown to confer arsenical resistance in Saccharomyces cerevisiae. The overexpression of ACR3 induced high level arsenite resistance. The presence of ACR3 together with ACR2 on a multicopy plasmid was conducive to increased arsenate resistance. The function of ACR3 gene has now been investigated. Amino acid sequence analysis of Acr3p showed that this hypothetical protein has hydrophobic character with 10 putative transmembrane spans and is probably located in yeast plasma membrane. We constructed the acr3 null mutation. The resulting disruptants were 5-fold more sensitive to arsenate and arsenite than wild-type cells. The acr3 disruptants showed wild-type sensitivity to antimony, tellurite, cadmium, and phenylarsine oxide. The mechanism of arsenical resistance was assayed by transport experiments using radioactive arsenite. We did not observe any significant differences in the accumulation of 76AsO33- in wild-type cells, acr1 and acr3 disruptants. However, the high dosage of ACR3 gene resulted in loss of arsenite uptake. These results suggest that arsenite resistance in yeast is mediated by an arsenite transporter (Acr3p).

  15. Consolidated Appropriations Act, 2010

    THOMAS, 111th Congress

    Rep. Olver, John W. [D-MA-1

    2009-07-22

    12/16/2009 Became Public Law No: 111-117. (TXT | PDF) (All Actions) Notes: The conference report on the bill includes provisions for 6 of the 12 FY2010 appropriations: Transportation-HUD; Commerce-Justice-Science; Financial Services; Labor-HHS; Military Construction-VA; and State-Foreign Operations. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  16. 75 FR 67784 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP1000...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ...; Notice of Meeting The ACRS Subcommittee on AP1000 will hold a meeting on December 1, 2010, Room T-2B1... timeframe, presenters should provide the DFO with a CD containing each presentation at least thirty minutes... were published in the Federal Register on October 21, 2010 (75 FR 65038- 65039). Detailed...

  17. 75 FR 65036 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP1000...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ...; Notice of Meeting The ACRS Subcommittee on AP1000 will hold a meeting on November 17- 19, 2010, Room T... with a CD containing each presentation at least thirty minutes before the meeting. Electronic... October 14, 2009, (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are available...

  18. 76 FR 32240 - Advisory Committee on Reactor Safeguards (ACRS) Meeting on the ACRS Subcommittee on Power Uprates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ... Notice of Meeting The ACRS Subcommittee on Power Uprates will hold a meeting on June 7, 2011, Room T-2B3... with a CD containing each presentation at least thirty minutes before the meeting. Electronic... October 21, 2010, (75 FR 65038-65039). Detailed meeting agendas and meeting transcripts are available...

  19. 76 FR 32241 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-03

    ..., 2011, Room T-2B3, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public... cannot be provided within this timeframe, presenters should provide the DFO with a CD containing each... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR 65038-...

  20. 76 FR 11524 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ..., 2011, Room T-2B3, 11545 Rockville Pike, Rockville, Maryland. The entire meeting will be open to public... cannot be provided within this timeframe, presenters should provide the DFO with a CD containing each... participation in ACRS meetings were published in the Federal Register on October 21, 2010, (75 FR...

  1. 75 FR 28823 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-24

    ... ACRS meetings were published in the Federal Register on October 14, 2009 (74 FR 58268- 58269). Detailed... oral statements and/or written comments should notify the Designated Federal Official (DFO), Peter Wen (Telephone 301-415-2832 or E-mail ( Peter.Wen@nrc.gov ) five days prior to the meeting, if possible, so...

  2. 75 FR 36715 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Planning and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... and/or written comments should notify the Designated Federal Official (DFO), Jorge Cruz-Ayala (Telephone 301-415-0269 or E-mail ( Jorge.Cruz-Ayala@nrc.gov ) five days prior to the meeting, if possible... ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 58268-58269)....

  3. Nicotine-motivated behavior in Caenorhabditis elegans requires the nicotinic acetylcholine receptor subunits acr-5 and acr-15.

    PubMed

    Sellings, Laurie; Pereira, Schreiber; Qian, Cheng; Dixon-McDougall, Thomas; Nowak, Christina; Zhao, Bin; Tyndale, Rachel F; van der Kooy, Derek

    2013-03-01

    Signaling at nicotinic acetylcholine receptors in Caenorhabditis elegans controls many behaviors, including egg-laying and locomotor activity. Here, we show that C. elegans approaches a point source of nicotine in a time-, concentration- and age-dependent manner. Additionally, nicotine paired with butanone under starvation conditions prevented the reduced approach to butanone that is observed when butanone is paired with starvation alone and pairing with nicotine generates a preference for the tastes of either sodium or chloride over baseline. These results suggest nicotine acts as a rewarding substance in C. elegans. Furthermore, the nicotinic receptor antagonist mecamylamine, the smoking cessation pharmacotherapy varenicline, mutation of the dop-1 and dop-2 dopamine receptors, and mutations of either acr-5 or acr-15, two nicotinic receptor subunit genes with sequence homology to the mammalian α7 subunit, all reduced the nicotine approach behavior. These two mutants also were defective at associating the presence of nicotine with butanone under starvation conditions and acr-5 mutation could obviate the effect of pairing nicotine with salts. Furthermore, the approach deficit in acr-15 mutants was rescued by selective re-expression in a subset of neurons, but not in muscle. Caenorhabditis elegans may therefore serve as a useful model organism for nicotine-motivated behaviors that could aid in the identification of novel nicotine motivational molecular pathways and consequently the development of novel cessation aids.

  4. 75 FR 66401 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-28

    ... ACRS meetings were published in the Federal Register on October 14, 2009 (74 FR 58268-58269). Detailed... and/or written comments should notify the Designated Federal Official (DFO), Neil Coleman (Telephone 301-415-7656 or E-mail: Neil.Coleman@nrc.gov ) five days prior to the meeting, if possible, so...

  5. 75 FR 66401 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP1000...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-28

    ...; Revision to October 21, 2010, ACRS Meeting Federal Register Notice The Federal Register Notice for the..., October 21, 2010, . All other items remain the same as previously published. Further information regarding...- 6279, E-mail: Weidong.Wang@nrc.gov between 7:30 a.m. and 5:15 p.m. (ET)). Dated: October 21,...

  6. ACR-12 ionotropic acetylcholine receptor complexes regulate inhibitory motor neuron activity in Caenorhabditis elegans.

    PubMed

    Petrash, Hilary A; Philbrook, Alison; Haburcak, Marian; Barbagallo, Belinda; Francis, Michael M

    2013-03-27

    Heterogeneity in the composition of neurotransmitter receptors is thought to provide functional diversity that may be important in patterning neural activity and shaping behavior (Dani and Bertrand, 2007; Sassoè-Pognetto, 2011). However, this idea has remained difficult to evaluate directly because of the complexity of neuronal connectivity patterns and uncertainty about the molecular composition of specific receptor types in vivo. Here we dissect how molecular diversity across receptor types contributes to the coordinated activity of excitatory and inhibitory motor neurons in the nematode Caenorhabditis elegans. We show that excitatory and inhibitory motor neurons express distinct populations of ionotropic acetylcholine receptors (iAChRs) requiring the ACR-12 subunit. The activity level of excitatory motor neurons is influenced through activation of nonsynaptic iAChRs (Jospin et al., 2009; Barbagallo et al., 2010). In contrast, synaptic coupling of excitatory and inhibitory motor neurons is achieved through a second population of iAChRs specifically localized at postsynaptic sites on inhibitory motor neurons. Loss of ACR-12 iAChRs from inhibitory motor neurons leads to reduced synaptic drive, decreased inhibitory neuromuscular signaling, and variability in the sinusoidal motor pattern. Our results provide new insights into mechanisms that establish appropriately balanced excitation and inhibition in the generation of a rhythmic motor behavior and reveal functionally diverse roles for iAChR-mediated signaling in this process. PMID:23536067

  7. Significance of breast lesion descriptors in the ACR BI-RADS MRI lexicon.

    PubMed

    Agrawal, Garima; Su, Min-Ying; Nalcioglu, Orhan; Feig, Stephen A; Chen, Jeon-Hor

    2009-04-01

    In recent years, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has altered the clinical management for women with breast cancer. In March 2007, the American Cancer Society (ACS) issued a new guideline recommending annual MRI screening for high-risk women. This guideline is expected to substantially increase the number of women each year who receive breast MRI. The diagnosis of breast MRI involves the description of morphological and enhancement kinetics features. To standardize the communication language, the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon was developed by the American College of Radiology (ACR). In this article, the authors will review various appearances of breast lesions on MRI by using the standardized terms of the ACR BI-RADS MRI lexicon. The purpose is to familiarize all medical professionals with the breast MRI lexicon because the use of this imaging modality is rapidly growing in the field of breast disease. By using this common language, a comprehensive analysis of both morphological and kinetic features used in image interpretation will help radiologists and other clinicians to communicate more clearly and consistently. This may, in turn, help physicians and patients to jointly select an appropriate management protocol for each patient's clinical situation.

  8. 76 FR 80410 - Advisory Committee on Reactor Safeguards; Meeting of the ACRS Subcommittee on Radiation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards; Meeting of the ACRS Subcommittee on Radiation Protection and Nuclear Materials; Notice of Meeting The ACRS Subcommittee on Radiation Protection and...

  9. 76 FR 57082 - Advisory Committee on Reactor Safeguards; Meeting of the ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ..., Metallurgy & Reactor Fuels Revision to September 21, 2011, ACRS Meeting; Federal Register Notice The Federal Register Notice for the ACRS Subcommittee Meeting on Materials, Metallurgy and Reactor Fuels is...

  10. 76 FR 61118 - Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Advanced Boiling Water Reactor; Notice of Meeting The ACRS Subcommittee on Advanced Boiling Water Reactor (ABWR) will hold a meeting on October 4, 2011, Room...

  11. 76 FR 40406 - Advisory Committee on Reactor Safeguards; Meeting of the ACRS Subcommittee on Plant Operations...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards; Meeting of the ACRS Subcommittee on Plant Operations and Fire Protection; Revision to an ACRS Subcommittee Meeting Federal Register Notice The Federal Register Notice for the ACRS Subcommittee Meeting...

  12. 7 CFR 1412.79 - Executed ACRE contract not in conformity with regulations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Executed ACRE contract not in conformity with... Average Crop Revenue Election (ACRE) Program § 1412.79 Executed ACRE contract not in conformity with... conformity with the provisions of this part, the provisions of this part will prevail....

  13. New ACR EULAR guidelines for systemic sclerosis classification.

    PubMed

    Johnson, Sindhu R

    2015-05-01

    The American College of Rheumatology and European League Against Rheumatism classification criteria for systemic sclerosis are a significant advancement in the field. This article describes the innovative, rigorous, criteria development strategy that was used. The new criteria build upon previous criteria by incorporating important elements (proximal scleroderma, sclerodactyly, digital pits, pulmonary fibrosis, Raynaud's phenomenon, and scleroderma specific autoantibodies). The new criteria add emphasis to the vasculopathic manifestations, and include the early manifestation of puffy fingers. Together, these enhancements have resulted in a shift in the conceptual framework of the disease for the next generation. The new criteria have improved sensitivity and specifically, particularly among cases with early disease, mild disease, or limited disease. The ability to classify more cases, at an earlier stage, may confer the opportunity to intervene and prevent disease progression. Undoubtedly, this will lead to a paradigm shift in the conduct of clinical trials in systemic sclerosis.

  14. Characterization of the multidrug efflux regulator AcrR from Escherichia coli

    PubMed Central

    Su, Chih-Chia; Rutherford, Denae J.; Yu, Edward W.

    2007-01-01

    The Escherichia coli AcrR represses transcription of the acrB gene, which encodes the multidrug efflux pump AcrB that extrudes a wide variety of toxic compounds, by binding its target operator DNA. Fluorescence polarization was performed using purified, recombinant AcrR that contains a 6xHis tag at the C-terminus and a fluorescein-labeled 28-base pair oligonucleotide bearing a predicted palindrome (IR) operator sequence. Binding of AcrR to the predicted IR sequence occurred with a dissociation constant (KD) in the nanomolar range. Fluorescence polarization assays were also applied to characterize the affinity and specificity of AcrR interaction with three different fluorescent ligands, rhodamine 6G, ethidium and proflavin. The KD values for these ligands range from 4.2 to 10.1 μM, suggesting that AcrR is capable of recognizing a wide range of structurally dissimilar toxic compounds as it is in the case of the AcrB multidrug efflux pump. We found that the binding of rhodamine 6G to AcrR is inhibited by the presence of ethidium. In contrast, the dissociation constant of proflavin binding to AcrR was not affected by ethidium, a result suggesting that ethidium and proflavin are bound to distinct binding sites. PMID:17644067

  15. Substrate-dependent dynamics of the multidrug efflux transporter AcrB of Escherichia coli

    PubMed Central

    Yamamoto, Kentaro; Tamai, Rei; Yamazaki, Megumi; Inaba, Takehiko; Sowa, Yoshiyuki; Kawagishi, Ikuro

    2016-01-01

    The resistance-nodulation-cell division (RND)-type xenobiotic efflux system plays a major role in the multidrug resistance of gram-negative bacteria. The only constitutively expressed RND system of Escherichia coli consists of the inner membrane transporter AcrB, the membrane fusion protein AcrA, and the outer membrane channel TolC. The latter two components are shared with another RND-type transporter AcrD, whose expression is induced by environmental stimuli. Here, we demonstrate how RND-type ternary complexes, which span two membranes and the cell wall, form in vivo. Total internal reflection fluorescence (TIRF) microscopy revealed that most fluorescent foci formed by AcrB fused to green fluorescent protein (GFP) were stationary in the presence of TolC but showed lateral displacements when tolC was deleted. The fraction of stationary AcrB-GFP foci decreased with increasing levels of AcrD. We propose that the AcrB-containing complex becomes unstable upon the induction of AcrD, which presumably replaces AcrB, a process we call “transporter exchange.” This instability is suppressed by AcrB-specific substrates, suggesting that the ternary complex is stabilised when it is in action. These results suggest that the assembly of the RND-type efflux system is dynamically regulated in response to external stimuli, shedding new light on the adaptive antibiotic resistance of bacteria. PMID:26916090

  16. The ACR BI-RADS® Experience: Learning From History

    PubMed Central

    Burnside, Elizabeth S.; Sickles, Edward A.; Bassett, Lawrence W.; Rubin, Daniel L.; Lee, Carol H.; Ikeda, Debra M.; Mendelson, Ellen B.; Wilcox, Pamela A.; Butler, Priscilla F.; D’Orsi, Carl J.

    2011-01-01

    The Breast Imaging Reporting and Data System® (BI-RADS®) initiative, instituted by the ACR, was begun in the late 1980s to address a lack of standardization and uniformity in mammography practice reporting. An important component of the BI-RADS initiative is the lexicon, a dictionary of descriptors of specific imaging features. The BI-RADS lexicon has always been data driven, using descriptors that previously had been shown in the literature to be predictive of benign and malignant disease. Once established, the BI-RADS lexicon provided new opportunities for quality assurance, communication, research, and improved patient care. The history of this lexicon illustrates a series of challenges and instructive successes that provide a valuable guide for other groups that aspire to develop similar lexicons in the future. PMID:19945040

  17. The active commuting route environment scale (ACRES): development and evaluation

    PubMed Central

    2010-01-01

    Background Route environments can be a potentially important factor in influencing people's behaviours in relation to active commuting. To better understand these possible relationships, assessments of route environments are needed. We therefore developed a scale; the Active Commuting Route Environment Scale (ACRES), for the assessment of bicyclists' and pedestrians' perceptions of their commuting route environments. Here we will report on the development and the results of validity and reliability assessments thereof. Methods Active commuters (n = 54) were recruited when they bicycled in Stockholm, Sweden. Traffic planning and environmental experts from the Municipality of Stockholm were assembled to form an expert panel (n = 24). The active commuters responded to the scale on two occasions, and the expert panel responded to it once. To test criterion-related validity, differences in ratings of the inner urban and suburban environments of Greater Stockholm were compared between the experts and the commuters. Furthermore, four items were compared with existing objective measures. Test-retest reproducibility was assessed with three types of analysis: order effect, typical error and intraclass correlation. Results There was a concordance in sizes and directions of differences in ratings of inner urban and suburban environments between the experts and the commuters. Furthermore, both groups' ratings were in line with existing objectively measured differences between the two environmental settings. Order effects between test and retest were observed in 6 of 36 items. The typical errors ranged from 0.93 to 2.54, and the intraclass correlation coefficients ranged from 'moderate' (0.42) to 'almost perfect' (0.87). Conclusions The ACRES was characterized by considerable criterion-related validity and reasonable test-retest reproducibility. PMID:20609250

  18. Launch Commit Criteria Monitoring Agent

    NASA Technical Reports Server (NTRS)

    Semmel, Glenn S.; Davis, Steven R.; Leucht, Kurt W.; Rowe, Dan A.; Kelly, Andrew O.; Boeloeni, Ladislau

    2005-01-01

    The Spaceport Processing Systems Branch at NASA Kennedy Space Center has developed and deployed a software agent to monitor the Space Shuttle's ground processing telemetry stream. The application, the Launch Commit Criteria Monitoring Agent, increases situational awareness for system and hardware engineers during Shuttle launch countdown. The agent provides autonomous monitoring of the telemetry stream, automatically alerts system engineers when predefined criteria have been met, identifies limit warnings and violations of launch commit criteria, aids Shuttle engineers through troubleshooting procedures, and provides additional insight to verify appropriate troubleshooting of problems by contractors. The agent has successfully detected launch commit criteria warnings and violations on a simulated playback data stream. Efficiency and safety are improved through increased automation.

  19. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Computation of adjusted community rate (ACR). 417... community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1) Compute an... must compute its initial rate using either of the following systems: (i) A community rating system...

  20. Crystal structure of the transcriptional regulator AcrR from Escherichia coli

    PubMed Central

    Li, Ming; Gu, Ruoyu; Su, Chih-Chia; Routh, Mathew D.; Harris, Katherine C.; Jewell, Elizabeth S.; McDermott, Gerry; Yu, Edward W.

    2007-01-01

    The AcrAB multidrug efflux pump, which belongs to the resistance-nodulation-division (RND) family, recognizes and extrudes a wide range of antibiotics and chemotherapeutic agents, and causes the intrinsic antibiotic resistance in Escherichia coli. The expression of AcrAB is controlled by the transcriptional regulator AcrR, whose open reading frame is located 141-base-pair upstream of the acrAB operon. To understand the structural basis of AcrR regulation, we have determined the crystal structure of AcrR, to 2.55 Å resolution, revealing a dimeric two-domain molecule with an entirely helical architecture similar to members of the TetR family of transcriptional regulators. Each monomer of AcrR forms a multi-entrance pocket of 350 cubic angstroms in the ligand-binding domain. The ligand-binding pocket is surrounded with mostly hydrophobic residues. In addition, a completely buried negatively charged glutamate, expected to be critical for drug binding, is located at the center of the binding pocket. The crystal structure provides novel insight into the mechanisms of ligand binding and AcrR regulation. PMID:17950313

  1. 78 FR 22918 - Advisory Committee on Reactor Safeguards (RS); Meeting of the Acrs Subcommittees on Reliability...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... COMMISSION Advisory Committee on Reactor Safeguards (RS); Meeting of the Acrs Subcommittees on Reliability and PRA; Revision to Notice of Meetings The ACRS Subcommittee on Reliability and PRA originally... (DFO), John Lai (Telephone 301-415-5197 or Email: John.Lai@nrc.gov ) between 8:15 a.m. and 5:00...

  2. 75 FR 7632 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the Subcommittee on Advanced Boiling...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-22

    ... October 14, 2009 (74 FR 58268-58269). Detailed meeting agendas and meeting transcripts are available on... COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the Subcommittee on Advanced Boiling Water Reactor (ABWR) The ACRS Subcommittee on ABWR will hold a meeting on March 2, 2010, at...

  3. 78 FR 8202 - Meeting of the Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ... ACRS meetings were published in the Federal Register on October 18, 2012, (77 FR 64146- 64147... Hydraulic Phenomena and Materials, Metallurgy and Reactor Fuels; Notice of Meeting The Joint ACRS Subcommittees on Thermal Hydraulic Phenomena and Materials, Metallurgy and Reactor Fuels will hold a meeting...

  4. 7 CFR 1412.41 - Direct and counter-cyclical program contract or ACRE program contract.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... following provisions apply to DCP and ACRE program contracts: (1) With respect to Fiscal Year 2008 payments, CCC will offer to enter into an annual DCP contract with eligible producers of covered commodities and... will offer to annually enter into a DCP or ACRE program contract with an eligible producer on a...

  5. Effectiveness of urban stormwater control measures in a 100-acre test site

    EPA Science Inventory

    Kansas City, Missouri chose a test area (100 acres) and a control area (80 acres) to test the effectiveness of urban stormwater control (SCM) deployment in conjunction with the USEPA, University of Alabama, University of Missouri-Kansas City and TetraTech. Both the test and cont...

  6. 76 FR 76442 - Advisory Committee On Reactor Safeguards Meeting of The ACRS Subcommittee on Materials...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee On Reactor Safeguards Meeting of The ACRS Subcommittee on Materials, Metallurgy... Notice for the ACRS Subcommittee Meeting on Materials, Metallurgy & Reactor Fuels scheduled to be held...

  7. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Computation of adjusted community rate (ACR). 417... community rate (ACR). (a) Basic rule. Each HMO or CMP must compute its basic rate as follows: (1) Compute an... must compute its initial rate using either of the following systems: (i) A community rating system...

  8. 7 CFR 1412.41 - Direct and counter-cyclical program contract or ACRE program contract.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... following provisions apply to DCP and ACRE program contracts: (1) With respect to fiscal year 2008 payments, CCC will, through the date announced by CCC, entertain offers for DCP contracts by eligible producers... offers by eligible producers for an annual DCP or ACRE program contract through August 14, 2009....

  9. 7 CFR 1412.41 - Direct and counter-cyclical program contract or ACRE program contract.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... following provisions apply to DCP and ACRE program contracts: (1) With respect to fiscal year 2008 payments, CCC will, through the date announced by CCC, entertain offers for DCP contracts by eligible producers... offers by eligible producers for an annual DCP or ACRE program contract through August 14, 2009....

  10. 7 CFR 1412.41 - Direct and counter-cyclical program contract or ACRE program contract.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... following provisions apply to DCP and ACRE program contracts: (1) With respect to fiscal year 2008 payments, CCC will, through the date announced by CCC, entertain offers for DCP contracts by eligible producers... offers by eligible producers for an annual DCP or ACRE program contract through August 14, 2009....

  11. 7 CFR 1412.41 - Direct and counter-cyclical program contract or ACRE program contract.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... following provisions apply to DCP and ACRE program contracts: (1) With respect to fiscal year 2008 payments, CCC will, through the date announced by CCC, entertain offers for DCP contracts by eligible producers... offers by eligible producers for an annual DCP or ACRE program contract through August 14, 2009....

  12. A zinc-binding citrus protein metallothionein can act as a plant defense factor by controlling host-selective ACR-toxin production.

    PubMed

    Nishimura, Satoshi; Tatano, Satoshi; Miyamoto, Yoko; Ohtani, Kouhei; Fukumoto, Takeshi; Gomi, Kenji; Tada, Yasuomi; Ichimura, Kazuya; Akimitsu, Kazuya

    2013-01-01

    Metallothionein is a small cysteine-rich protein known to have a metal-binding function. We isolated three different lengths of rough lemon cDNAs encoding a metallothionein (RlemMT1, RlemMT2 and RlemMT3), and only RlemMT1-recombinant protein had zinc-binding activity. Appropriate concentration of zinc is an essential micronutrient for living organisms, while excess zinc is toxic. Zinc also stimulates the production of host-selective ACR-toxin for citrus leaf spot pathogen of Alternaria alternata rough lemon pathotype. Trapping of zinc by RlemMT1-recombinant protein or by a zinc-scavenging agent in the culture medium caused suppression of ACR-toxin production by the fungus. Since ACR-toxin is the disease determinant for A. alternata rough lemon pathotype, addition of RlemMT1 to the inoculum suspension led to a significant decrease in symptoms on rough lemon leaves as a result of reduced ACR-toxin production from the zinc trap around infection sites. RlemMT1-overexpression mutant of A. alternata rough lemon pathotype also produced less ACR-toxin and reduced virulence on rough lemon. This suppression was caused by an interruption of zinc absorption by cells from the trapping of the mineral by RlemMT1 and an excess supplement of ZnSO(4) restored toxin production and pathogenicity. Based on these results, we propose that zinc adsorbents including metallothionein likely can act as a plant defense factor by controlling toxin biosynthesis via inhibition of zinc absorption by the pathogen.

  13. Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice.

    PubMed

    Segall, Liviu; Nistor, Ionuţ; Pascual, Julio; Mucsi, Istvan; Guirado, Lluis; Higgins, Robert; Van Laecke, Steven; Oberbauer, Rainer; Van Biesen, Wim; Abramowicz, Daniel; Gavrilovici, Cristina; Farrington, Ken; Covic, Adrian

    2016-10-01

    During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

  14. Additional Continuing Appropriations Amendments, 2011

    THOMAS, 112th Congress

    Rep. Rogers, Harold [R-KY-5

    2011-03-11

    03/18/2011 Became Public Law No: 112-6. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 4/8/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  15. Further Continuing Appropriations Amendments, 2011

    THOMAS, 112th Congress

    Rep. Rogers, Harold [R-KY-5

    2011-02-28

    03/02/2011 Became Public Law No: 112-4. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 3/18/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  16. Conserved small protein associates with the multidrug efflux pump AcrB and differentially affects antibiotic resistance

    PubMed Central

    Hobbs, Errett C.; Yin, Xuefeng; Paul, Brian J.; Astarita, Jillian L.; Storz, Gisela

    2012-01-01

    The AcrAB–TolC multidrug efflux pump confers resistance to a wide variety of antibiotics and other compounds in Escherichia coli. Here we show that AcrZ (formerly named YbhT), a 49-amino-acid inner membrane protein, associates with the AcrAB-TolC complex. Co-purification of AcrZ with AcrB, in the absence of both AcrA and TolC, two-hybrid assays and suppressor mutations indicate that this interaction occurs through the inner membrane protein AcrB. The highly conserved acrZ gene is coregulated with acrAB through induction by the MarA, Rob, and SoxS transcription regulators. In addition, mutants lacking AcrZ are sensitive to many, but not all, of the antibiotics transported by AcrAB–TolC. This differential antibiotic sensitivity suggests that AcrZ may enhance the ability of the AcrAB–TolC pump to export certain classes of substrates. PMID:23010927

  17. Appropriate Technology--A Selected, Annotated Bibliography No. 8.

    ERIC Educational Resources Information Center

    Andree, Carolyn

    Presented is an annotated bibliography of "appropriate technology" (AT) publications. The bibliography is divided into the following sections. Philosophy and overview section includes works describing the interrelationship of technology with other facets of development; place of technology in international relations; criteria for…

  18. 78 FR 70596 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Power Uprates...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... prior to the meeting, if possible, so that appropriate arrangements can be made. Thirty-five hard copies... time allotted to present oral statements can be obtained from the Web site cited above or by...

  19. Pseudoatomic Structure of the Tripartite Multidrug Efflux Pump AcrAB-TolC Reveals the Intermeshing Cogwheel-like Interaction between AcrA and TolC.

    PubMed

    Jeong, Hyeongseop; Kim, Jin-Sik; Song, Saemee; Shigematsu, Hideki; Yokoyama, Takeshi; Hyun, Jaekyung; Ha, Nam-Chul

    2016-02-01

    The resistance-nodulation-division type tripartite pump AcrAB-TolC and its homologs are responsible for multidrug resistance in Gram-negative bacteria by expelling a wide variety of toxic substrates. The three essential components, AcrA, AcrB, and TolC, must function in concert with each respective binding partner within the complex. In this study, we report an 8.2-Å resolution cryo-electron microscopy (cryo-EM) 3D reconstruction of the complex that consists of an AcrAB fusion protein and a chimeric TolC protein. The pseudoatomic structure derived from the cryo-EM reconstruction clearly demonstrates a model only compatible with the adaptor bridging mechanism, wherein the funnel-like AcrA hexamer forms an intermeshing cogwheel-like interaction with the α-barrel tip region of TolC. These observations provide a structural milestone for understanding multidrug resistance in pathogenic Gram-negative bacteria, and may also lead to the design of new antibacterial drugs.

  20. Pseudoatomic Structure of the Tripartite Multidrug Efflux Pump AcrAB-TolC Reveals the Intermeshing Cogwheel-like Interaction between AcrA and TolC.

    PubMed

    Jeong, Hyeongseop; Kim, Jin-Sik; Song, Saemee; Shigematsu, Hideki; Yokoyama, Takeshi; Hyun, Jaekyung; Ha, Nam-Chul

    2016-02-01

    The resistance-nodulation-division type tripartite pump AcrAB-TolC and its homologs are responsible for multidrug resistance in Gram-negative bacteria by expelling a wide variety of toxic substrates. The three essential components, AcrA, AcrB, and TolC, must function in concert with each respective binding partner within the complex. In this study, we report an 8.2-Å resolution cryo-electron microscopy (cryo-EM) 3D reconstruction of the complex that consists of an AcrAB fusion protein and a chimeric TolC protein. The pseudoatomic structure derived from the cryo-EM reconstruction clearly demonstrates a model only compatible with the adaptor bridging mechanism, wherein the funnel-like AcrA hexamer forms an intermeshing cogwheel-like interaction with the α-barrel tip region of TolC. These observations provide a structural milestone for understanding multidrug resistance in pathogenic Gram-negative bacteria, and may also lead to the design of new antibacterial drugs. PMID:26777412

  1. Update of ACR guidelines for osteoarthritis: role of the coxibs.

    PubMed

    Schnitzer, Thomas J

    2002-04-01

    The American College of Rheumatology (ACR) recently provided an update to the guidelines published in 1995 on the management of osteoarthritis (OA) of the knee and hip. Members of the Ad Hoc Committee on OA Guidelines followed an evidence-based medicine approach to revise the guidelines by reviewing an extensive literature search of the Cochrane and Medline databases and published abstracts, and discussing evidence with expert rheumatologists. The goal of the guidelines is to provide recommendations to control patients' OA pain, improve function and health-related quality of life, and avoid therapeutic toxicity. As in the original guidelines, nonpharmacologic interventions involving patient education and physical measures are recommended following initial diagnosis of OA. The pharmacologic algorithm was updated to include currently available therapeutic agents. Acetaminophen remains first-line therapy because of its cost, efficacy, and safety profiles. Cyclooxygenase-2-selective inhibitors (coxibs) have been included as an alternative to nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) in patients at risk for upper gastrointestinal adverse events. Tramadol is an available alternative for patients who have a contraindication to coxibs or nonselective NSAIDs or for those who have not responded to previous oral therapy. Intra-articular injections or topical therapy may be used as monotherapy, or as an adjunct to oral analgesia. Surgical treatment of OA remains a last resort for patients who have failed to respond to nonpharmacologic and pharmacologic treatment approaches, and have progressive limitation in their activities of daily living. Several therapies for the prevention or treatment of OA are currently under investigation, including nutritional supplements, such as glucosamine and chondroitin, disease-modifying OA drugs, and devices, such as acupuncture and electromagnetic therapy. It is anticipated that the guidelines for the management of OA will

  2. Beyond Developmentally Appropriate Practice: Developing Community and Culturally Appropriate Practice.

    ERIC Educational Resources Information Center

    Ball, Jessica; Pence, Alan R.

    1999-01-01

    Describes how Canada's University of Victoria worked with the Meadow Lake Tribal Council representing Aboriginal communities to develop the generative preschool curriculum model, an early childhood education (ECE) training program embracing community- and culturally-appropriate practice. Concludes that early indicators of program impact support…

  3. Evaluation and critique of the ACR-NEMA standard for picture archiving and communications systems

    NASA Astrophysics Data System (ADS)

    Martinez, Ralph; Dallas, William J.; Komatsu, Ken-Ichi

    1990-08-01

    The ACR-NEMA standard for communications in digital radiology has been a topic for much discussion lately. The standard was developed to facilitate the development of multivender products which can communicate using a point-to-point standard interface. In this paper we describe, the combined experiences of Toshiba, Radiology, and Electrical and Computer Engineering at the University of Anzona with the ACR-NEMA standard. We also offer a candid evaluation and critique of the standard, for consideration by implementors of the current standard. The paper summarizes a prototype development effort using a high speed fiber optic network and the ACR-NEMA standard interface. We discuss the overall architecture of the prototype and the software design based on the International Standard Organization (ISO) upper layers. The transport layer and below was implemented using a Matrix-developed ACR-NEMA interface board. The paper discusses the problems encountered in the application of the ACR-NEMA standard in a networking environment for Picture Archiving and Communications Systems (PACS). We conclude that the current form of the ACR- NEMA standard does not provide a workable foundation for the development of cost effective and efficient digital radiology interfaces, especially in a networked PACS. We also discuss the PACS environment beyond the current ACR-NEMA standard and make recommendations for the feature direction of the standard.

  4. Institutional Quality Assessment of Higher Education: Dimensions, Criteria and Indicators

    ERIC Educational Resources Information Center

    Savickiene, Izabela; Pukelis, Kestutis

    2004-01-01

    The article discusses dimensions and criteria, which are used to assess the quality of higher education in different countries. The paper presents dimensions and criteria that could be appropriate for assessment of the quality of higher education at Lithuanian universities. Quality dimensions, assessment criteria and indicators are defined and…

  5. 77 FR 74697 - Meeting of the ACRS, Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-17

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS, Subcommittee on U.S. Evolutionary Power Reactor; Notice of Meeting The ACRS Subcommittee on U.S. Evolutionary Power Reactor (U.S. EPR) will hold a meeting on January 17,...

  6. Test Anxiety: Age Appropriate Interventions

    ERIC Educational Resources Information Center

    Ross, David B.; Driscoll, Richard

    2006-01-01

    The presentation covers information on test anxiety reduction strategies from over thirty years of experience with clients of a variety of ages. Dr. Ross is from the College of Lake County. Dr. Driscoll is a private practitioner and Director of the American Test Anxieties Association. The purpose is to address age appropriate test anxiety…

  7. Babies: Responding Appropriately to Infants.

    ERIC Educational Resources Information Center

    Fleer, Marilyn; Linke, Pam

    1999-01-01

    This issue of the Australian Early Childhood Association Research in Practice Series discusses how educators can observe and respond appropriately to the infants in their care. The booklet examines the two major opportunities for early childhood educators that have been shown to influence outcomes for infants: (1) the opportunity to help infants…

  8. Legislative Branch Appropriations Act, 2017

    THOMAS, 112th Congress

    Rep. Graves, Tom [R-GA-14

    2016-05-25

    09/28/2016 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Notes: Continuing appropriations through 12/9/2016. Tracker: This bill has the status Resolving DifferencesHere are the steps for Status of Legislation:

  9. Disaster Relief Appropriations Act, 2013

    THOMAS, 112th Congress

    Rep. Rogers, Harold [R-KY-5

    2011-02-11

    12/30/2012 Message on Senate action sent to the House. (All Actions) Notes: This bill was for a time the Senate legislative vehicle for Hurricane Sandy supplemental appropriations. Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:

  10. 75 FR 38564 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the Subcommittee on Plant Operations...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... published in the Federal Register on October 14, 2009 (74 FR 58268-58269). Detailed meeting agendas and... and Fire Protection The ACRS Subcommittee on Plant Operations and Fire Protection will hold a...

  11. 43 CFR 2524.7 - Disposal of lands in excess of 160 acres.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries Within a Reclamation Project § 2524.7 Disposal of lands in excess of 160 acres....

  12. 43 CFR 2524.7 - Disposal of lands in excess of 160 acres.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries Within a Reclamation Project § 2524.7 Disposal of lands in excess of 160 acres....

  13. 43 CFR 2524.7 - Disposal of lands in excess of 160 acres.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries Within a Reclamation Project § 2524.7 Disposal of lands in excess of 160 acres....

  14. 43 CFR 2524.7 - Disposal of lands in excess of 160 acres.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries Within a Reclamation Project § 2524.7 Disposal of lands in excess of 160 acres....

  15. 77 FR 74696 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on AP-1000...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-17

    ... published in the Federal Register on October 18, 2012, (77 FR 64146- 64147). Detailed meeting agendas and... comments should notify the Designated Federal Official (DFO), Peter Wen (Telephone 301-415-2832 or Email: Peter.Wen@nrc.gov ) five days prior to the meeting, if possible, so that appropriate arrangements can...

  16. 78 FR 68867 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on US-APWR...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... prior to the meeting, if possible, so that appropriate arrangements can be made. Thirty-five hard copies... October 18, 2012, (77 FR 64146- 64147). Detailed meeting agendas and meeting transcripts are available on... time allotted to present oral statements can be obtained from the Web site cited above or by...

  17. Effect of Antimicrobial Exposure on AcrAB Expression in Salmonella enterica Subspecies enterica Serovar Choleraesuis

    PubMed Central

    Usui, Masaru; Nagai, Hidetaka; Hiki, Mototaka; Tamura, Yutaka; Asai, Tetsuo

    2013-01-01

    Understanding the impact of antimicrobial use on the emergence of resistant bacteria is imperative to prevent its emergence. For instance, activation of the AcrAB efflux pumps is responsible for the emergence of antimicrobial-resistant Salmonella strains. Here, we examined the expression levels of acrB and its multiple regulator genes (RamA, SoxS, MarA, and Rob) in 17 field isolates of S. Choleraesuis by using quantitative PCR methods. The expression of acrB increased in eight of the field isolates (P < 0.05). The expression of acrB was associated with that of ramA in one isolate, soxS in one isolate, and both these genes in six isolates. Thereafter, to examine the effect of selected antimicrobials (enrofloxacin, ampicillin, oxytetracycline, kanamycin, and spectinomycin) on the expression of acrB and its regulator genes, mutants derived from five isolates of S. Choleraesuis were selected by culture on antimicrobial-containing plates. The expression of acrB and ramA was higher in the mutants selected using enrofloxacin (3.3–6.3- and 24.5–37.7-fold, respectively), ampicillin (1.8–7.7- and 16.1–55.9-fold, respectively), oxytetracycline (1.7–3.3- and 3.2–31.1-fold, respectively), and kanamycin (1.6–2.2- and 5.6–26.4-fold, respectively), which are AcrAB substrates, than in each of the parental strains (P < 0.05). In contrast, in AcrAB substrate-selected mutants, the expression of soxS, marA, and rob remained similar to that in parental strains. Of the four antimicrobials, the level of ramA expression was significantly higher in the enrofloxacin- and ampicillin-selected mutants than in the oxytetracycline- and kanamycin-selected mutants (P < 0.05), whereas the expression levels of acrB and multiple regulator genes in spectinomycin-selected mutants were similar to those in each parental strain. These data suggest that exposure to antimicrobials that are AcrAB substrates enhance the activation of the AcrAB efflux pump via RamA, but not via Sox

  18. AcrAB efflux pump plays a role in decreased susceptibility to tigecycline in Morganella morganii.

    PubMed

    Ruzin, Alexey; Keeney, David; Bradford, Patricia A

    2005-02-01

    Transposon mutagenesis of a clinical isolate of Morganella morganii, G1492 (tigecycline MIC of 4 microg/ml), yielded two insertion knockout mutants for which tigecycline MICs were 0.03 microg/ml. Transposon insertions mapped to acrA, which is constitutively overexpressed in G1492, suggesting a role of the AcrAB efflux pump in decreased susceptibility to tigecycline in M. morganii.

  19. Association between ACR1 gene product expression and cardiomyopathy in children

    PubMed Central

    Wang, Yan; Niu, Ling; He, Xiuhua; Xue, Ying; Ling, Nan; Wang, Zhenzhou; An, Xinjiang

    2016-01-01

    Cardiomyopathy is a heterogeneous heart disease. Although morbidity of pediatric cardiomyopathy has been on the increase, effective treatments have not been identified. The aim of the study was to examine the expression of ACR1 gene products in association with cardiomyopathy in children. In total, 73 patients and 76 healthy subjects were enrolled in the study, from April, 2013 to April, 2015. The relative expression of ACR1 mRNA and protein were quantified in all cases, using reverse transcription-quantitative polymerase chain reaction (RT-qPCR), ELISA and western blot analysis. Immunohistochemistry was used to stain cardiac tissue samples to reveal differences between the patients and the control group. The results showed that the level of ACR1 mRNA by RT-qPCR was not different between the two study groups. However, ELISA and western blot analysis showed a significant difference, with patients expressing lower levels of ACR1. Additionally, immunohistochemistry revealed the levels of ACR1 were reduced in patients as the time course of disease increased. Thus, there is an association between the inhibition of ACR1 expression and the development of the disease. These findings are useful in the elucidation of the pathogenesis of pediatric cardiomyopathy, a severe disease with few effective treatment options available. PMID:27588091

  20. Substrate binding accelerates the conformational transitions and substrate dissociation in multidrug efflux transporter AcrB

    PubMed Central

    Wang, Beibei; Weng, Jingwei; Wang, Wenning

    2015-01-01

    The tripartite efflux pump assembly AcrAB-TolC is the major multidrug resistance transporter in E. coli. The inner membrane transporter AcrB is a homotrimer, energized by the proton movement down the transmembrane electrochemical gradient. The asymmetric crystal structures of AcrB with three monomers in distinct conformational states [access (A), binding (B) and extrusion (E)] support a functional rotating mechanism, in which each monomer of AcrB cycles among the three states in a concerted way. However, the relationship between the conformational changes during functional rotation and drug translocation has not been totally understood. Here, we explored the conformational changes of the AcrB homotrimer during the ABE to BEA transition in different substrate-binding states using targeted MD simulations. It was found that the dissociation of substrate from the distal binding pocket of B monomer is closely related to the concerted conformational changes in the translocation pathway, especially the side chain reorientation of Phe628 and Tyr327. A second substrate binding at the proximal binding pocket of A monomer evidently accelerates the conformational transitions as well as substrate dissociation in B monomer. The acceleration effect of the multi-substrate binding mode provides a molecular explanation for the positive cooperativity observed in the kinetic studies of substrate efflux and deepens our understanding of the functional rotating mechanism of AcrB. PMID:25918513

  1. Increased expression of the multidrug efflux genes acrAB occurs during slow growth of Escherichia coli.

    PubMed

    Rand, Jonathan D; Danby, Simon G; Greenway, David L A; England, Reg R

    2002-01-22

    Intrinsic antimicrobial resistance of Escherichia coli is elicited by the gene products of the multidrug efflux acrAB-tolC operon. In this paper, we have shown that acrAB is regulated as a function of the growth rate of E. coli during growth in batch and chemostat culture. In chemostat culture, expression of acrAB is inversely related to growth rate irrespective of the limiting nutrient. The level of expression of acrAB is greater under glucose limitation compared with either iron or nitrogen limitation. Increase in expression of acrAB confers a greater resistance to ciprofloxacin, and the implications for a clinical situation are discussed. Slow growth rate regulation of acrAB transcription does not require the presence of the stationary-phase sigma factor. A putative gearbox consensus sequence was identified at the -10 region of the acrAB promoter.

  2. Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey

    PubMed Central

    Walitt, Brian; Katz, Robert S.; Bergman, Martin J.; Wolfe, Frederick

    2016-01-01

    Objectives Although fibromyalgia criteria have been in effect for decades, little is known about how the fibromyalgia diagnosis is applied and understood by clinicians and patients. We used the National Health Interview Survey (NHIS) to determine the prevalence of self-reported clinician diagnosed fibromyalgia and then compared demographics, symptoms, disability and medical utilization measures of persons with a clinical diagnosis of fibromyalgia that did not meet diagnostic criteria (false-positive or prior [F/P] fibromyalgia) to persons with and without criteria-positive fibromyalgia. Methods The National Health Interview Survey (NHIS) collected information about both clinical diagnosis and symptoms of fibromyalgia that was appropriately weighted to represent 225,726,257 US adults. Surrogate NHIS diagnostic criteria for fibromyalgia were developed based on the level of polysymptomatic distress (PSD) as characterized in the 2011 modified American College of Rheumatology criteria (ACR) for fibromyalgia. Persons with F/P fibromyalgia were compared with persons who do not have fibromyalgia and those meeting surrogate NHIS fibromyalgia criteria. Results Of the 1.78% of persons reporting a clinical diagnosis, 73.5% did not meet NHIS fibromyalgia criteria. The prevalence of F/P fibromyalgia is 1.3%. F/P fibromyalgia is associated with a mild degree of polysymptomatic distress (NHIS PSD score 6.2) and characterized by frequent but not widespread pain and insomnia. Measures of work disability and medical utilization in F/P fibromyalgia were equal to that seen with NHIS criteria positive fibromyalgia and were 6-7x greater in F/P fibromyalgia than in non-fibromyalgia persons. F/P fibromyalgia was best predicted by being female (Odds Ratio [OR] 8.81), married (OR 3.27), and white (OR 1.96). In contrast, being a white, married woman was only modestly predictive of NHIS (criteria positive) fibromyalgia (OR 2.1). Conclusions The majority of clinically diagnosed fibromyalgia

  3. Applicability of ACR breast dosimetry methodology to a digital mammography system

    SciTech Connect

    Tomon, John J.; Johnson, Thomas E.; Swenson, Kristin N.; Schauer, David A.

    2006-03-15

    Determination of mean glandular dose (MGD) to breast tissue is an essential aspect of mammography equipment evaluations and exposure controls. The American College of Radiology (ACR) Quality Control Manual outlines the procedure for MGD determination in screen-film mammography based upon conversions of entrance skin exposures (ESEs) measured with an ionization chamber (IC). The development of digital mammography has increased with the demand for improved object resolution and tissue contrast. This change in image receptor from screen-film to a solid-state detector has led to questions about the applicability of the ACR MGD methodology to digital mammography. This research has validated the applicability of the ACR MGD methodology to digital mammography in the GE digital mammography system Senographe 2000D[reg]. MGD was determined using light output measurements from thermoluminescent dosimeters (MGD{sub TL}), exposure measurements from an IC (MGD{sub IC}) and conversion factors from the ACR Mammography Quality Control Manual. MGD{sub TL} and MGD{sub IC} data indicate that there is a statistically significant difference between the two measurements with the Senographe 2000D[reg]. However, the applicability of the ACR's methodology was validated by calculating MGD at various depths in a 50/50 breast phantom. Additionally, the results of backscatter measurements from the image receptors of both mammography modalities indicate there is a difference (all P values <0.001) in the radiation backscattered from each image receptor.

  4. Metalloid tolerance based on phytochelatins is not functionally equivalent to the arsenite transporter Acr3p.

    PubMed

    Wysocki, Robert; Clemens, Stephan; Augustyniak, Daria; Golik, Pawel; Maciaszczyk, Ewa; Tamás, Markus J; Dziadkowiec, Dorota

    2003-05-01

    Active transport of metalloids by Acr3p and Ycf1p in Saccharomyces cerevisiae and chelation by phytochelatins in Schizosaccharomyces pombe, nematodes, and plants represent distinct strategies of metalloid detoxification. In this report, we present results of functional comparison of both resistance mechanisms. The S. pombe and wheat phytochelatin synthase (PCS) genes, when expressed in S. cerevisiae, mediate only modest resistance to arsenite and thus cannot functionally compensate for Acr3p. On the other hand, we show for the first time that phytochelatins also contribute to antimony tolerance as PCS fully complement antimonite sensitivity of ycf1Delta mutant. Remarkably, heterologous expression of PCS sensitizes S. cerevisiae to arsenate, while ACR3 confers much higher arsenic resistance in pcsDelta than in wild-type S. pombe. The analysis of PCS and ACR3 homologues distribution in various organisms and our experimental data suggest that separation of ACR3 and PCS genes may lead to the optimal tolerance status of the cell.

  5. Comparison of the 1987 American College of Rheumatology and the 2010 American College of Rheumatology/European League against Rheumatism criteria for classification of rheumatoid arthritis in the Nurses' Health Study cohorts.

    PubMed

    Kasturi, Shanthini; Goldstein, Barbara L; Malspeis, Susan; Karlson, Elizabeth W; Costenbader, Karen H

    2014-03-01

    Performance of rheumatoid arthritis (RA) classification by the 2010 American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria, compared to the 1987 ACR criteria, has not been assessed in population-based cohorts in which disease identification is by mailed questionnaire. Women followed in the Nurses' Health Study and Nurses' Health Study II cohorts self-reported new doctor-diagnosed RA on biennial questionnaires. Two RA experts reviewed medical records of 128 new RA self-reports to obtain individual 1987 and 2010 criteria and arrived at a consensus opinion. We compared agreement in classification by the two criteria sets (kappa), and calculated sensitivity and specificity, with reviewers' opinion as gold standard. Ninety-eight (77%) participants were classified as RA by reviewers' consensus opinion; 98 (77%) fulfilled 1987 criteria, while 79 (63%) fulfilled 2010 criteria. Seventy-two (56%) were classified as RA by both sets, 21 (16%) by neither, 26 (20%) by only 1987 criteria, and 9 (7%) by only 2010 criteria. Kappa for concordance was 0.36 (95% CI 0.20-0.53). Compared to reviewer's opinion, sensitivity and specificity were 0.93 and 0.77 for 1987 criteria, and 0.79 and 0.87 for 2010 criteria. Participants fulfilling 1987 criteria only were more likely to be seronegative. In these prospective population-based cohorts, significant discordance between 1987 ACR and 2010 ACR/EULAR criteria for classifying RA exists. Using the 2010 ACR/EULAR criteria alone had decreased sensitivity, and seronegative RA cases would be excluded in particular. Combined use of both will be necessary to maximize inclusion and allow sensitivity analyses.

  6. Structures of Gate Loop Variants of the AcrB Drug Efflux Pump Bound by Erythromycin Substrate

    PubMed Central

    Ababou, Abdessamad; Koronakis, Vassilis

    2016-01-01

    Gram-negative bacteria such as E. coli use tripartite efflux pumps such as AcrAB-TolC to expel antibiotics and noxious compounds. A key feature of the inner membrane transporter component, AcrB, is a short stretch of residues known as the gate/switch loop that divides the proximal and distal substrate binding pockets. Amino acid substitutions of the gate loop are known to decrease antibiotic resistance conferred by AcrB. Here we present two new AcrB gate loop variants, the first stripped of its bulky side chains, and a second in which the gate loop is removed entirely. By determining the crystal structures of the variant AcrB proteins in the presence and absence of erythromycin and assessing their ability to confer erythromycin tolerance, we demonstrate that the gate loop is important for AcrB export activity but is not required for erythromycin binding. PMID:27403665

  7. ACRES: An Efficient Method for First-Principles Electronic Structure Calculations of Complex Systems

    SciTech Connect

    WAGHMARE,R.V.; KIM,HANCHUL; PARK,I.J.; MODINE,NORMAND A.; MARAGAKIS,P.; KAXIRAS,EFTHIMIOS

    2000-08-29

    The authors discuss their new implementation of the Adaptive Coordinate Real-space Electronic Structure (ACRES) method for studying the atomic and electronic structure of infinite periodic as well as finite systems, based on density functional theory. This improved version aims at making the method widely applicable and efficient, using high performance Fortran on parallel architectures. The scaling of various parts of an ACRES calculation is analyzed and compared to that of plane-wave based methods. The new developments that lead to enhanced performance, and their parallel implementation, are presented in detail. They illustrate the application of ACRES to the study of elemental crystalline solids, molecules and complex crystalline materials, such as blue bronze and zeolites.

  8. Product Variables as Criteria of Teacher Effectiveness.

    ERIC Educational Resources Information Center

    Schofield, Hilary L.; Start, K. B.

    1979-01-01

    Explanations are offered for observed discrepant and null findings in the area of predictive information about teacher effectiveness. It is argued that if tautologies are to be avoided, only product variables are appropriate criteria of success. Some recommendations regarding future research are offered. (Author/GSK)

  9. Genetic inactivation of acrAB or inhibition of efflux induces expression of ramA

    PubMed Central

    Lawler, A. J.; Ricci, V.; Busby, S. J. W.; Piddock, L. J. V.

    2013-01-01

    Objectives The transcriptional activator RamA regulates production of the multidrug resistance efflux AcrAB–TolC system in several Enterobacteriaceae. This study investigated factors that lead to increased expression of ramA. Methods In order to monitor changes in ramA expression, the promoter region of ramA was fused to a gfp gene encoding an unstable green fluorescence protein (GFP) on the reporter plasmid, pMW82. The ramA reporter plasmid was transformed into Salmonella Typhimurium SL1344 and a ΔacrB mutant. The response of the reporter to subinhibitory concentrations of antibiotics, dyes, biocides, psychotropic agents and efflux inhibitors was measured during growth over a 5 h time period. Results Our data revealed that the expression of ramA was increased in a ΔacrB mutant and also in the presence of the efflux inhibitors phenylalanine-arginine-β-naphthylamide, carbonyl cyanide m-chlorophenylhydrazone and 1-(1-naphthylmethyl)-piperazine. The phenothiazines chlorpromazine and thioridazine also increased ramA expression, triggering the greatest increase in GFP expression. However, inducers of Escherichia coli marA and soxS and 12 of 17 tested antibiotic substrates of AcrAB–TolC did not induce ramA expression. Conclusions This study shows that expression of ramA is not induced by most substrates of the AcrAB–TolC efflux system, but is increased by mutational inactivation of acrB or when efflux is inhibited. PMID:23493314

  10. Furfural and hydroxymethylfurfural tolerance in Escherichia coli ΔacrR regulatory mutants.

    PubMed

    Luhe, Annette Lin; Lim, Chan Yuen; Gerken, Henri; Wu, Jinchuan; Zhao, Hua

    2015-01-01

    The presence of the highly toxic furfural and hydroxymethylfurfural (HMF) in the hydrolysate of lignocellulosic biomass prompted the investigation of the Escherichia coli ΔacrR regulatory mutant for higher tolerance to these compounds, to facilitate the production of biofuels and biochemicals, and further biocatalytic conversions. In comparison with the parental strain, the regulatory mutant with the upregulated efflux pump AcrAB-TolC produced moderately better growth and higher tolerance to concentrations of furfural and HMF between 1 and 2 g L(-1) .

  11. The year in gout: 2012-2013 - a walk through the 2012 ACR Gout Treatment Guidelines.

    PubMed

    Crittenden, Daria B; Pillinger, Michael H

    2013-01-01

    In 2012 the American College of Rheumatology (ACR) established its first-ever gout treatment guidelines. These guidelines address whom to treat, how to treat, and lifestyle and medication changes to make when treating patients with gout. In this manuscript, we review the ACR guidelines, with special attention to the issues of treating to target, and when and how to prevent attacks during urate- lowering therapy. Given that the quality of gout treatment in the USA is often suboptimal poor, these guidelines have the potential to improve the health of millions of gout sufferers in the USA and around the world.

  12. 23 CFR 636.202 - When are two-phase design-build selection procedures appropriate?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false When are two-phase design-build selection procedures... When are two-phase design-build selection procedures appropriate? You may consider the following criteria in deciding whether two-phase selection procedures are appropriate. A negative response...

  13. Rater Behaviour When Judging Language Learners' Pragmatic Appropriateness in Extended Discourse

    ERIC Educational Resources Information Center

    Sydorenko, Tetyana; Maynard, Carson; Guntly, Erin

    2014-01-01

    The criteria by which raters judge pragmatic appropriateness of language learners' speech acts are underexamined, especially when raters evaluate extended discourse. To shed more light on this process, the present study investigated what factors are salient to raters when scoring pragmatic appropriateness of extended request sequences, and which…

  14. 75 FR 1830 - Advisory Committee on Reactor Safeguards (ACRS), Planning and Procedures Subcommittee Meeting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ... participation in ACRS meetings were published in the Federal Register on October 14, 2009, (74 FR 52829-52830... oral statements and/or written comments should notify the Designated ] Federal Officer (DFO), Mr. Peter Wen, (Telephone: 301-415-2832, E-mail: Peter.Wen@nrc.gov ) five days prior to the meeting, if...

  15. Escherichia coli mar and acrAB mutants display no tolerance to simple alcohols.

    PubMed

    Ankarloo, Jonas; Wikman, Susanne; Nicholls, Ian A

    2010-01-01

    The inducible Mar phenotype of Escherichia coli is associated with increased tolerance to multiple hydrophobic antibiotics as well as some highly hydrophobic organic solvents such as cyclohexane, mediated mainly through the AcrAB/TolC efflux system. The influence of water miscible alcohols ethanol and 1-propanol on a Mar constitutive mutant and a mar deletion mutant of E. coli K-12, as well as the corresponding strains carrying the additional acrAB deletion, was investigated. In contrast to hydrophobic solvents, all strains were killed in exponential phase by 1-propanol and ethanol at rates comparable to the parent strain. Thus, the Mar phenotype does not protect E. coli from killing by these more polar solvents. Surprisingly, AcrAB does not contribute to an increased alcohol tolerance. In addition, sodium salicylate, at concentrations known to induce the mar operon, was unable to increase 1-propanol or ethanol tolerance. Rather, the toxicity of both solvents was increased in the presence of sodium salicylate. Collectively, the results imply that the resilience of E. coli to water miscible alcohols, in contrast to more hydrophobic solvents, does not depend upon the AcrAB/TolC efflux system, and suggests a lower limit for substrate molecular size and functionality. Implications for the application of microbiological systems in environments containing high contents of water miscible organic solvents, e.g., phage display screening, are discussed. PMID:20480026

  16. Biofilm formation ability of Salmonella enterica serovar Typhimurium acrAB mutants.

    PubMed

    Schlisselberg, Dov B; Kler, Edna; Kisluk, Guy; Shachar, Dina; Yaron, Sima

    2015-10-01

    Recent studies offer contradictory findings about the role of multidrug efflux pumps in bacterial biofilm development. Thus, the aim of this study was to investigate the involvement of the AcrAB efflux pump in biofilm formation by investigating the ability of AcrB and AcrAB null mutants of Salmonella enterica serovar Typhimurium to produce biofilms. Three models were used to compare the ability of S. Typhimurium wild-type and its mutants to form biofilms: formation of biofilm on polystyrene surfaces; production of biofilm (mat model) on the air/liquid interface; and expression of curli and cellulose on Congo red-supplemented agar plates. All three investigated genotypes formed biofilms with similar characteristics. However, upon exposure to chloramphenicol, formation of biofilms on solid surfaces as well as the production of curli were either reduced or were delayed more significantly in both mutants, whilst there was no visible effect on pellicle formation. It can be concluded that when no selective pressure is applied, S. Typhimurium is able to produce biofilms even when the AcrAB efflux pumps are inactivated, implying that the use of efflux pump inhibitors to prevent biofilm formation is not a general solution and that combined treatments might be more efficient. Other factors that affect the ability to produce biofilms depending on efflux pump activity are yet to be identified.

  17. The ACR Managed Care Committee: focusing private payers on radiology issues.

    PubMed

    Ullrich, Christopher G; Keysor, Kathryn J

    2007-02-01

    The ACR Managed Care/Private Payer Relations Committee is an important committee of the ACR Commission on Economics. This report reviews the committee's mission, structure, and processes and some of its current recommendations to ACR membership. The development of and participation in radiology advisory committees is a vital strategy in this process. Separating professional and technical charges, rather than submitting global charges, will help preserve radiology's professional integrity in the future. The Imaging Provider Report Card (IPRC) will allow radiology to define practice quality and performance in an era of pay-for-performance reimbursement. The IPRC also provides an external blueprint on what each practice needs to do to improve itself. American College of Radiology accreditation plays a key role in certifying radiology's quality to both payers and patients. Sound business management, group governance, and business size are also important elements of professional practice success. Working together through the ACR promotes the integrity of our profession and the quality of care patients want and deserve.

  18. AcrB drug-binding pocket substitution confers clinically relevant resistance and altered substrate specificity

    PubMed Central

    Blair, Jessica M. A.; Bavro, Vassiliy N.; Ricci, Vito; Modi, Niraj; Cacciotto, Pierpaolo; Kleinekathӧfer, Ulrich; Ruggerone, Paolo; Vargiu, Attilio V.; Baylay, Alison J.; Smith, Helen E.; Brandon, Yvonne; Galloway, David; Piddock, Laura J. V.

    2015-01-01

    The incidence of multidrug-resistant bacterial infections is increasing globally and the need to understand the underlying mechanisms is paramount to discover new therapeutics. The efflux pumps of Gram-negative bacteria have a broad substrate range and transport antibiotics out of the bacterium, conferring intrinsic multidrug resistance (MDR). The genomes of pre- and posttherapy MDR clinical isolates of Salmonella Typhimurium from a patient that failed antibacterial therapy and died were sequenced. In the posttherapy isolate we identified a novel G288D substitution in AcrB, the resistance-nodulation division transporter in the AcrAB-TolC tripartite MDR efflux pump system. Computational structural analysis suggested that G288D in AcrB heavily affects the structure, dynamics, and hydration properties of the distal binding pocket altering specificity for antibacterial drugs. Consistent with this hypothesis, recreation of the mutation in standard Escherichia coli and Salmonella strains showed that G288D AcrB altered substrate specificity, conferring decreased susceptibility to the fluoroquinolone antibiotic ciprofloxacin by increased efflux. At the same time, the substitution increased susceptibility to other drugs by decreased efflux. Information about drug transport is vital for the discovery of new antibacterials; the finding that one amino acid change can cause resistance to some drugs, while conferring increased susceptibility to others, could provide a basis for new drug development and treatment strategies. PMID:25737552

  19. 10 CFR 52.141 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.141 Section 52.141 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Approvals § 52.141 Referral to the...

  20. 10 CFR 52.141 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.141 Section 52.141 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Approvals § 52.141 Referral to the...

  1. 10 CFR 52.53 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.53 Section 52.53 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Certifications § 52.53 Referral to the...

  2. 10 CFR 52.141 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.141 Section 52.141 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Approvals § 52.141 Referral to the...

  3. 10 CFR 52.23 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.23 Section 52.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Early Site Permits § 52.23 Referral to the Advisory...

  4. 10 CFR 52.53 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.53 Section 52.53 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Certifications § 52.53 Referral to the...

  5. 10 CFR 52.53 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.53 Section 52.53 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Certifications § 52.53 Referral to the...

  6. 10 CFR 52.53 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.53 Section 52.53 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Certifications § 52.53 Referral to the...

  7. 10 CFR 52.141 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.141 Section 52.141 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Approvals § 52.141 Referral to the...

  8. 10 CFR 52.141 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Referral to the Advisory Committee on Reactor Safeguards..., AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Approvals § 52.141 Referral to the Advisory Committee on Reactor Safeguards (ACRS). The Commission shall refer a copy of the application to the...

  9. 10 CFR 52.53 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Referral to the Advisory Committee on Reactor Safeguards..., AND APPROVALS FOR NUCLEAR POWER PLANTS Standard Design Certifications § 52.53 Referral to the Advisory Committee on Reactor Safeguards (ACRS). The Commission shall refer a copy of the application to the...

  10. 10 CFR 52.165 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.165 Section 52.165 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Manufacturing Licenses § 52.165 Referral to the...

  11. 10 CFR 52.165 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.165 Section 52.165 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Manufacturing Licenses § 52.165 Referral to the...

  12. 10 CFR 52.87 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.87 Section 52.87 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Combined Licenses § 52.87 Referral to the Advisory Committee...

  13. 10 CFR 52.87 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.87 Section 52.87 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Combined Licenses § 52.87 Referral to the Advisory Committee...

  14. 10 CFR 52.87 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.87 Section 52.87 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Combined Licenses § 52.87 Referral to the Advisory Committee...

  15. 10 CFR 52.23 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.23 Section 52.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Early Site Permits § 52.23 Referral to the Advisory...

  16. 10 CFR 52.87 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.87 Section 52.87 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Combined Licenses § 52.87 Referral to the Advisory Committee...

  17. 10 CFR 52.87 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.87 Section 52.87 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Combined Licenses § 52.87 Referral to the Advisory Committee...

  18. 10 CFR 52.23 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.23 Section 52.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Early Site Permits § 52.23 Referral to the Advisory...

  19. 10 CFR 52.165 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.165 Section 52.165 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Manufacturing Licenses § 52.165 Referral to the...

  20. 10 CFR 52.23 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.23 Section 52.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Early Site Permits § 52.23 Referral to the Advisory...

  1. 10 CFR 52.165 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.165 Section 52.165 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Manufacturing Licenses § 52.165 Referral to the...

  2. 10 CFR 52.165 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.165 Section 52.165 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Manufacturing Licenses § 52.165 Referral to the...

  3. Biofilm formation ability of Salmonella enterica serovar Typhimurium acrAB mutants.

    PubMed

    Schlisselberg, Dov B; Kler, Edna; Kisluk, Guy; Shachar, Dina; Yaron, Sima

    2015-10-01

    Recent studies offer contradictory findings about the role of multidrug efflux pumps in bacterial biofilm development. Thus, the aim of this study was to investigate the involvement of the AcrAB efflux pump in biofilm formation by investigating the ability of AcrB and AcrAB null mutants of Salmonella enterica serovar Typhimurium to produce biofilms. Three models were used to compare the ability of S. Typhimurium wild-type and its mutants to form biofilms: formation of biofilm on polystyrene surfaces; production of biofilm (mat model) on the air/liquid interface; and expression of curli and cellulose on Congo red-supplemented agar plates. All three investigated genotypes formed biofilms with similar characteristics. However, upon exposure to chloramphenicol, formation of biofilms on solid surfaces as well as the production of curli were either reduced or were delayed more significantly in both mutants, whilst there was no visible effect on pellicle formation. It can be concluded that when no selective pressure is applied, S. Typhimurium is able to produce biofilms even when the AcrAB efflux pumps are inactivated, implying that the use of efflux pump inhibitors to prevent biofilm formation is not a general solution and that combined treatments might be more efficient. Other factors that affect the ability to produce biofilms depending on efflux pump activity are yet to be identified. PMID:26260191

  4. 10 CFR 52.23 - Referral to the Advisory Committee on Reactor Safeguards (ACRS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Referral to the Advisory Committee on Reactor Safeguards (ACRS). 52.23 Section 52.23 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSES, CERTIFICATIONS, AND APPROVALS FOR NUCLEAR POWER PLANTS Early Site Permits § 52.23 Referral to the Advisory...

  5. AIR QUALITY CRITERIA FOR PARTICULATE MATTER (Final Report, Oct 2004)

    EPA Science Inventory

    EPA has completed the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic revi...

  6. Multidimensional Adaptive Testing with Optimal Design Criteria for Item Selection

    ERIC Educational Resources Information Center

    Mulder, Joris; van der Linden, Wim J.

    2009-01-01

    Several criteria from the optimal design literature are examined for use with item selection in multidimensional adaptive testing. In particular, it is examined what criteria are appropriate for adaptive testing in which all abilities are intentional, some should be considered as a nuisance, or the interest is in the testing of a composite of the…

  7. Forest Fires in Southwestern Amazonia During 2005: Extent and Distribution in Eastern Acre State, Brazil

    NASA Astrophysics Data System (ADS)

    Brown, I.; Moulard, E. M.; Nakamura, J.; Schroeder, W.; Maldonado, M.; Vasconcelos, S. S.; Selhorst, D.

    2007-05-01

    The extended drought in western Amazonia during 2005 provided the conditions for wild fires that spread in old- growth rain forests and cleared areas of the contiguous areas of Madre de Dios, Peru, Acre, Brazil, and Pando, Bolivia, collectively known as the MAP Region. The greatest extent of the wild fires occurred in eastern Acre State with 60,000 km2 of diverse land uses that range from intensely occupied colonization areas, large cattle ranches, extractive and biological reserves and indigenous areas. At the request of the Public Ministry of Acre and other government agencies we analyzed Landsat 5 and CBERS 2 imagery for forests with canopies affected by fires, using visual interpretation and manual digitalization of polygons. Accuracy assessment was done with 180 aerial photos. The total area of forest with canopies affected by fires was 267,000 ha, roughly five times recent annual deforestation rates for Acre State. Omission and commission errors were 28% and 2%, respectively. Burn scars in non-forest areas were determined using ASTER and CBERS 2 imagery via supervised classification. Total open area with burn scars was 203,000 ha. The total of open area and forests affected by fires exceeded 470,000 ha due to three factors: (1) some images used did not include the last weeks of burning; (2) ground fires in forests that did not affect the canopy and therefore were not detected; and (3) concern of the interpreters to avoid commission errors. Of the twelve municipalities of eastern Acre, most affected were Acrelandia, Placido de Castro, Epitaciolandia with >31%, >19% and >17% of the municipality affected, respectively). The largest impact, >114,000 ha, occurred in the Rio Branco Municipality. Similar patterns of burning occurred in Pando and in Madre de Dios. The environmental, social and economic disaster that these fires produced may be a harbinger of future impacts in southwestern Amazonia if current climate predictions prove to be correct.

  8. Plutonium storage criteria

    SciTech Connect

    Chung, D.; Ascanio, X.

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  9. Comparison of Irrigation Water Use Estimates Calculated from Remotely Sensed Irrigated Acres and State Reported Irrigated Acres in the Lake Altus Drainage Basin, Oklahoma and Texas, 2000 Growing Season

    USGS Publications Warehouse

    Masoner, J.R.; Mladinich, C.S.; Konduris, A.M.; Smith, S. Jerrod

    2003-01-01

    Increased demand for water in the Lake Altus drainage basin requires more accurate estimates of water use for irrigation. The U.S. Geological Survey, in cooperation with the U.S. Bureau of Reclamation, is investigating new techniques to improve water-use estimates for irrigation purposes in the Lake Altus drainage basin. Empirical estimates of reference evapotranspiration, crop evapotranspiration, and crop irrigation water requirements for nine major crops were calculated from September 1999 to October 2000 using a solar radiation-based evapotranspiration model. Estimates of irrigation water use were calculated using remotely sensed irrigated crop acres derived from Landsat 7 Enhanced Thematic Mapper Plus imagery and were compared with irrigation water-use estimates calculated from irrigated crop acres reported by the Oklahoma Water Resources Board and the Texas Water Development Board for the 2000 growing season. The techniques presented will help manage water resources in the Lake Altus drainage basin and may be transferable to other areas with similar water management needs. Irrigation water use calculated from the remotely sensed irrigated acres was estimated at 154,920 acre-feet; whereas, irrigation water use calculated from state reported irrigated crop acres was 196,026 acre-feet, a 23 percent difference. The greatest difference in irrigation water use was in Carson County, Texas. Irrigation water use for Carson County, Texas, calculated from the remotely sensed irrigated acres was 58,555 acrefeet; whereas, irrigation water use calculated from state reported irrigated acres was 138,180 acre-feet, an 81 percent difference. The second greatest difference in irrigation water use occurred in Beckham County, Oklahoma. Differences between the two irrigation water use estimates are due to the differences of irrigated crop acres derived from the mapping process and those reported by the Oklahoma Water Resources Board and Texas Water Development Board.

  10. 77 FR 9707 - Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on Thermal-Hydraulics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on Thermal-Hydraulics... for the ACRS Subcommittee meeting on Thermal-Hydraulics Phenomena scheduled to be held on February...

  11. 78 FR 71639 - Final Environmental Impact Statement for the Soboba Band of Luiseno Indians' Proposed 534-Acre...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ...' Proposed 534-Acre Trust Acquisition and Casino Project, Riverside County, California AGENCY: Bureau of... hotel/casino project to be located in Riverside County, California. This notice also announces that the... Tribe proposes to develop approximately 55 acres into a destination hotel/casino complex...

  12. Aquatic life water quality criteria derived via the UC Davis method: II. Pyrethroid insecticides.

    PubMed

    Fojut, Tessa L; Palumbo, Amanda J; Tjeerdema, Ronald S

    2012-01-01

    Aquatic life water quality criteria were derived for five pyrethroids using a new methodology developed by the University of California, Davis (TenBrook et al.2010). This methodology was developed to provide an updated, flexible, and robust water quality criteria derivation methodology specifically for pesticides. To derive the acute criteria, log-logistic SSDs were fitted to the medium-sized bifenthrin,cyfluthrin, and cypermethrin acute toxicity data sets while the X-cyhalothrin and permethrin acute data sets were larger, and Burr Type III SSDs could be fitted to these data sets. A review of the cyfluthrin acute criterion revealed that it was not protective of the most sensitive species in the data set, H. azteca, so the acute value was adjusted downward to calculate a more protective criterion. Similarly, the cypermethrin criteria were adjusted downward to be protective of H. azteca.Criteria for bifenthrin, X-cyhalothrin, and permethrin were calculated using the median fifth percentile acute values while the cyfluthrin and cypermethrin criteria were calculated with the next lowest acute value (median first percentile). Chronic data sets were limited in all cases, so ACRs were used for chronic criteria calculations, instead of statistical distributions. Sufficient corresponding acute and chronic data were not available for bifenthrin, cypermethrin, or permethrin, so a default ACR was used to calculate these chronic criteria while measured ACRs were used for cyfluthrin and X-cyhalothrin. A numeric scoring system was used to sort the acute and chronic data, based on relevance and reliability, and the individual study scores are included in the Supporting Information.According to the USEPA (1985) method, the data sets gathered for these five pyrethroids would not be sufficient to calculate criteria because they were each missing at least one of the eight taxa required by that method. The USEPA (1985)method generates robust and reliable criteria, and the goal of

  13. Study of helicopterroll control effectiveness criteria

    NASA Technical Reports Server (NTRS)

    Heffley, Robert K.; Bourne, Simon M.; Curtiss, Howard C., Jr.; Hindson, William S.; Hess, Ronald A.

    1986-01-01

    A study of helicopter roll control effectiveness based on closed-loop task performance measurement and modeling is presented. Roll control critieria are based on task margin, the excess of vehicle task performance capability over the pilot's task performance demand. Appropriate helicopter roll axis dynamic models are defined for use with analytic models for task performance. Both near-earth and up-and-away large-amplitude maneuvering phases are considered. The results of in-flight and moving-base simulation measurements are presented to support the roll control effectiveness criteria offered. This Volume contains the theoretical analysis, simulation results and criteria development.

  14. Fire protection design criteria

    SciTech Connect

    1997-03-01

    This Standard provides supplemental fire protection guidance applicable to the design and construction of DOE facilities and site features (such as water distribution systems) that are also provided for fire protection. It is intended to be used in conjunction with the applicable building code, national Fire Protection Association Codes and Standards, and any other applicable DOE construction criteria. This Standard, along with other delineated criteria, constitutes the basic criteria for satisfying DOE fire and life safety objectives for the design and construction or renovation of DOE facilities.

  15. 45 CFR 400.81 - Criteria for appropriate employability services and employment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... service or employment site must not normally exceed 2 hours, not including the transporting of a child to and from a child care facility, unless a longer commuting distance or time is generally accepted in... community standards. (4) When child care is required, the care must meet the standards normally required...

  16. 45 CFR 400.81 - Criteria for appropriate employability services and employment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... basis. Any claim of adverse effect on physical or mental health must be based on adequate medical... the individual's physical or mental health. (3) The total daily commuting time to and from home to...

  17. SU-E-J-27: Appropriateness Criteria for Deformable Image Registration and Dose Propagation

    SciTech Connect

    Papanikolaou, P; Tuohy, Rachel; Mavroidis, P; Eng, T; Gutierrez, A; Stathakis, S

    2014-06-01

    Purpose: Several commercial software packages have been recently released that allow the user to apply deformable registration algorithms (DRA) for image fusion and dose propagation. Although the idea of anatomically tracking the daily patient dose in the context of adaptive radiotherapy or merely adding the dose from prior treatment to the current one is very intuitive, the accuracy and applicability of such algorithms needs to be investigated as it remains somewhat subjective. In our study, we used true anatomical data where we introduced changes in the density, volume and location of segmented structures to test the DRA for its sensitivity and accuracy. Methods: The CT scan of a prostate patient was selected for this study. The CT images were first segmented to define structure such as the PTV, bladder, rectum, intestines and pelvic bone anatomy. To perform our study, we introduced anatomical changes in the reference patient image set in three different ways: (i) we kept the segmented volumes constant and changed the density of rectum and bladder in increments of 5% (ii) we changed the volume of rectum and bladder in increments of 5% and (iii) we kept the segmented volumes constant but changed their location by moving their COM in increments of 3mm. Using the Velocity software, we evaluated the accuracy of the DRA for each incremental change in all three scenarios. Results: The DRA performs reasonably well when the differential density difference against the background is more than 5%. For the volume change study, the DRA results became unreliable for relative volume changes greater than 10%. Finally for the location study, the DRA performance was acceptable for shifts below 9mm. Conclusion: Site specific and patient specific QA for DRA is an important step to evaluate such algorithms prior to their use for dose propagation.

  18. 45 CFR 400.81 - Criteria for appropriate employability services and employment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE... service or employment site must not normally exceed 2 hours, not including the transporting of a child to and from a child care facility, unless a longer commuting distance or time is generally accepted...

  19. The future of imaging screening: proceedings of the Fourth Annual ACR FORUM.

    PubMed

    Hillman, Bruce J; Amis, E Stephen; Weinreb, Jeffrey C; Neiman, Harvey L

    2005-01-01

    The FORUM is an ACR planning activity focused on a specific topic deemed to be of long-range importance to the college. A select panel of multidisciplinary experts met in 2004 to consider the ramifications of imaging screening from diverse perspectives. Considerations included the nature of screening for disease, its technological issues, and biases associated with the perceived success of screening; potential technologies and target diseases; business and economics; insurance coverage; ethics and the law; how imaging screening could be paired with nonimaging screening; and how the lay public perceives screening. The FORUM participants considered how imaging screening might develop over the next 5 to 10 years and made recommendations to the ACR on actions it might take to benefit both the specialty and patients.

  20. Improving olefin tolerance and production in E. coli using native and evolved AcrB

    DOE PAGESBeta

    Mingardon, Florence; Clement, Camille; Hirano, Kathleen; Nhan, Melissa; Luning, Eric G.; Chanal, Angelique; Mukhopadhyay, Aindrila

    2015-01-20

    Microorganisms can be engineered for the production of chemicals utilized in the polymer industry. However many such target compounds inhibit microbial growth and might correspondingly limit production levels. Here, we focus on compounds that are precursors to bioplastics, specifically styrene and representative alpha-olefins; 1-hexene, 1-octene, and 1-nonene. We evaluated the role of the Escherichia coli efflux pump, AcrAB-TolC, in enhancing tolerance towards these olefin compounds. AcrAB-TolC is involved in the tolerance towards all four compounds in E. coli. Both styrene and 1-hexene are highly toxic to E. coli. Styrene is a model plastics precursor with an established route for productionmore » in E. coli (McKenna and Nielsen, 2011). Though our data indicates that AcrAB-TolC is important for its optimal production, we observed a strong negative selection against the production of styrene in E. coli. Thus we used 1-hexene as a model compound to implement a directed evolution strategy to further improve the tolerance phenotype towards this alpha-olefin. We focused on optimization of AcrB, the inner membrane domain known to be responsible for substrate binding, and found several mutations (A279T, Q584R, F617L, L822P, F927S, and F1033Y) that resulted in improved tolerance. Several of these mutations could also be combined in a synergistic manner. Our study shows efflux pumps to be an important mechanism in host engineering for olefins, and one that can be further improved using strategies such as directed evolution, to increase tolerance and potentially production.« less

  1. Using the ACR/NEMA standard with TCP/IP and Ethernet

    NASA Astrophysics Data System (ADS)

    Chimiak, William J.; Williams, Rodney C.

    1991-07-01

    There is a need for a consolidated picture archival and communications system (PACS) in hospitals. At the Bowman Gray School of Medicine of Wake Forest University (BGSM), the authors are enhancing the ACR/NEMA Version 2 protocol using UNIX sockets and TCP/IP to greatly improve connectivity. Initially, nuclear medicine studies using gamma cameras are to be sent to PACS. The ACR/NEMA Version 2 protocol provides the functionality of the upper three layers of the open system interconnection (OSI) model in this implementation. The images, imaging equipment information, and patient information are then sent in ACR/NEMA format to a software socket. From there it is handed to the TCP/IP protocol, which provides the transport and network service. TCP/IP, in turn, uses the services of IEEE 802.3 (Ethernet) to complete the connectivity. The advantage of this implementation is threefold: (1) Only one I/O port is consumed by numerous nuclear medicine cameras, instead of a physical port for each camera. (2) Standard protocols are used which maximize interoperability with ACR/NEMA compliant PACSs. (3) The use of sockets allows a migration path to the transport and networking services of OSIs TP4 and connectionless network service as well as the high-performance protocol being considered by the American National Standards Institute (ANSI) and the International Standards Organization (ISO) -- the Xpress Transfer Protocol (XTP). The use of sockets also gives access to ANSI's Fiber Distributed Data Interface (FDDI) as well as other high-speed network standards.

  2. Improving Olefin Tolerance and Production in E. coli Using Native and Evolved AcrB

    PubMed Central

    Mingardon, Florence; Clement, Camille; Hirano, Kathleen; Nhan, Melissa; Luning, Eric G; Chanal, Angelique; Mukhopadhyay, Aindrila

    2015-01-01

    Microorganisms can be engineered for the production of chemicals utilized in the polymer industry. However many such target compounds inhibit microbial growth and might correspondingly limit production levels. Here, we focus on compounds that are precursors to bioplastics, specifically styrene and representative alpha-olefins; 1-hexene, 1-octene, and 1-nonene. We evaluated the role of the Escherichia coli efflux pump, AcrAB-TolC, in enhancing tolerance towards these olefin compounds. AcrAB-TolC is involved in the tolerance towards all four compounds in E. coli. Both styrene and 1-hexene are highly toxic to E. coli. Styrene is a model plastics precursor with an established route for production in E. coli (McKenna and Nielsen, 2011). Though our data indicates that AcrAB-TolC is important for its optimal production, we observed a strong negative selection against the production of styrene in E. coli. Thus we used 1-hexene as a model compound to implement a directed evolution strategy to further improve the tolerance phenotype towards this alpha-olefin. We focused on optimization of AcrB, the inner membrane domain known to be responsible for substrate binding, and found several mutations (A279T, Q584R, F617L, L822P, F927S, and F1033Y) that resulted in improved tolerance. Several of these mutations could also be combined in a synergistic manner. Our study shows efflux pumps to be an important mechanism in host engineering for olefins, and one that can be further improved using strategies such as directed evolution, to increase tolerance and potentially production. Biotechnol. Bioeng. 2015;112: 879–888. © 2015 The Authors. Biotechnology and Bioengineering Published by John Wiley & Periodicals, Inc. PMID:25450012

  3. The Challenges from Extreme Climate Events for Sustainable Development in Amazonia: the Acre State Experience

    NASA Astrophysics Data System (ADS)

    Araújo, M. D. N. M.

    2015-12-01

    In the past ten years Acre State, located in Brazil´s southwestern Amazonia, has confronted sequential and severe extreme events in the form of droughts and floods. In particular, the droughts and forest fires of 2005 and 2010, the 2012 flood within Acre, the 2014 flood of the Madeira River which isolated Acre for two months from southern Brazil, and the most severe flooding throughout the state in 2015 shook the resilience of Acrean society. The accumulated costs of these events since 2005 have exceeded 300 million dollars. For the last 17 years, successive state administrations have been implementing a socio-environmental model of development that strives to link sustainable economic production with environmental conservation, particularly for small communities. In this context, extreme climate events have interfered significantly with this model, increasing the risks of failure. The impacts caused by these events on development in the state have been exacerbated by: a) limitations in monitoring; b) extreme events outside of Acre territory (Madeira River Flood) affecting transportation systems; c) absence of reliable information for decision-making; and d) bureaucratic and judicial impediments. Our experience in these events have led to the following needs for scientific input to reduce the risk of disasters: 1) better monitoring and forecasting of deforestation, fires, and hydro-meteorological variables; 2) ways to increase risk perception in communities; 3) approaches to involve more effectively local and regional populations in the response to disasters; 4) more accurate measurements of the economic and social damages caused by these disasters. We must improve adaptation to and mitigation of current and future extreme climate events and implement a robust civil defense, adequate to these new challenges.

  4. Improving olefin tolerance and production in E. coli using native and evolved AcrB.

    PubMed

    Mingardon, Florence; Clement, Camille; Hirano, Kathleen; Nhan, Melissa; Luning, Eric G; Chanal, Angelique; Mukhopadhyay, Aindrila

    2015-05-01

    Microorganisms can be engineered for the production of chemicals utilized in the polymer industry. However many such target compounds inhibit microbial growth and might correspondingly limit production levels. Here, we focus on compounds that are precursors to bioplastics, specifically styrene and representative alpha-olefins; 1-hexene, 1-octene, and 1-nonene. We evaluated the role of the Escherichia coli efflux pump, AcrAB-TolC, in enhancing tolerance towards these olefin compounds. AcrAB-TolC is involved in the tolerance towards all four compounds in E. coli. Both styrene and 1-hexene are highly toxic to E. coli. Styrene is a model plastics precursor with an established route for production in E. coli (McKenna and Nielsen, 2011). Though our data indicates that AcrAB-TolC is important for its optimal production, we observed a strong negative selection against the production of styrene in E. coli. Thus we used 1-hexene as a model compound to implement a directed evolution strategy to further improve the tolerance phenotype towards this alpha-olefin. We focused on optimization of AcrB, the inner membrane domain known to be responsible for substrate binding, and found several mutations (A279T, Q584R, F617L, L822P, F927S, and F1033Y) that resulted in improved tolerance. Several of these mutations could also be combined in a synergistic manner. Our study shows efflux pumps to be an important mechanism in host engineering for olefins, and one that can be further improved using strategies such as directed evolution, to increase tolerance and potentially production.

  5. Improving olefin tolerance and production in E. coli using native and evolved AcrB.

    PubMed

    Mingardon, Florence; Clement, Camille; Hirano, Kathleen; Nhan, Melissa; Luning, Eric G; Chanal, Angelique; Mukhopadhyay, Aindrila

    2015-05-01

    Microorganisms can be engineered for the production of chemicals utilized in the polymer industry. However many such target compounds inhibit microbial growth and might correspondingly limit production levels. Here, we focus on compounds that are precursors to bioplastics, specifically styrene and representative alpha-olefins; 1-hexene, 1-octene, and 1-nonene. We evaluated the role of the Escherichia coli efflux pump, AcrAB-TolC, in enhancing tolerance towards these olefin compounds. AcrAB-TolC is involved in the tolerance towards all four compounds in E. coli. Both styrene and 1-hexene are highly toxic to E. coli. Styrene is a model plastics precursor with an established route for production in E. coli (McKenna and Nielsen, 2011). Though our data indicates that AcrAB-TolC is important for its optimal production, we observed a strong negative selection against the production of styrene in E. coli. Thus we used 1-hexene as a model compound to implement a directed evolution strategy to further improve the tolerance phenotype towards this alpha-olefin. We focused on optimization of AcrB, the inner membrane domain known to be responsible for substrate binding, and found several mutations (A279T, Q584R, F617L, L822P, F927S, and F1033Y) that resulted in improved tolerance. Several of these mutations could also be combined in a synergistic manner. Our study shows efflux pumps to be an important mechanism in host engineering for olefins, and one that can be further improved using strategies such as directed evolution, to increase tolerance and potentially production. PMID:25450012

  6. 75 FR 20398 - The ACRS Subcommittee on Planning and Procedures will hold a meeting on May 5, 2010, in Room T...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-19

    ... ACRS meetings were published in the Federal Register on October 14, 2010, (74 FR 58268- 58269... Procedures The ACRS Subcommittee on Planning and Procedures will hold a meeting on May 5, 2010, in Room...

  7. 75 FR 55313 - Record of Decision (ROD) for Conversion of the 3rd Armored Cavalry Regiment (3rd ACR) to a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... 3rd ACR at Fort Hood is being selected because the unit will have maximum time to convert and train... required for an SBCT, and has adequate maneuver space to accommodate SBCT training. The 3rd ACR will...

  8. Discos de acresção em sistemas Be-X

    NASA Astrophysics Data System (ADS)

    Lopes de Oliveira, R.; Janot-Pacheco, E.

    2003-08-01

    Alguns fenômenos de outbursts em Be-X sugerem a existência, mesmo que temporária, de um disco de acresção quando da passagem do objeto compacto pelo periastro orbital. Neste trabalho avaliamos a possibilidade de formação do disco de acresção em sistemas Be+estrela de neutrons e Be+anã branca, e a influência da excentricidade orbital na ocorrência deste fenômeno. Utilizamos a expressão analítica para o momento angular específico da matéria constituinte de um meio em expansão lenta, como é o caso do disco circunstelar das estrelas Be, proposta por Wang(1981), sob a condição básica de que o raio de circularização deva ser maior do que o raio de Alfvén. Concluímos que existe um limite para o período orbital do sistema acima do qual não é possível a formação do disco de acresção, e que este valor aumenta para sistemas com excentricidade orbital maior.

  9. Molecular basis for inhibition of AcrB multidrug efflux pump by novel and powerful pyranopyridine derivatives

    PubMed Central

    Sjuts, Hanno; Vargiu, Attilio V.; Kwasny, Steven M.; Nguyen, Son T.; Kim, Hong-Suk; Ding, Xiaoyuan; Ornik, Alina R.; Ruggerone, Paolo; Bowlin, Terry L.; Nikaido, Hiroshi; Pos, Klaas M.; Opperman, Timothy J.

    2016-01-01

    The Escherichia coli AcrAB-TolC efflux pump is the archetype of the resistance nodulation cell division (RND) exporters from Gram-negative bacteria. Overexpression of RND-type efflux pumps is a major factor in multidrug resistance (MDR), which makes these pumps important antibacterial drug discovery targets. We have recently developed novel pyranopyridine-based inhibitors of AcrB, which are orders of magnitude more powerful than the previously known inhibitors. However, further development of such inhibitors has been hindered by the lack of structural information for rational drug design. Although only the soluble, periplasmic part of AcrB binds and exports the ligands, the presence of the membrane-embedded domain in AcrB and its polyspecific binding behavior have made cocrystallization with drugs challenging. To overcome this obstacle, we have engineered and produced a soluble version of AcrB [AcrB periplasmic domain (AcrBper)], which is highly congruent in structure with the periplasmic part of the full-length protein, and is capable of binding substrates and potent inhibitors. Here, we describe the molecular basis for pyranopyridine-based inhibition of AcrB using a combination of cellular, X-ray crystallographic, and molecular dynamics (MD) simulations studies. The pyranopyridines bind within a phenylalanine-rich cage that branches from the deep binding pocket of AcrB, where they form extensive hydrophobic interactions. Moreover, the increasing potency of improved inhibitors correlates with the formation of a delicate protein- and water-mediated hydrogen bond network. These detailed insights provide a molecular platform for the development of novel combinational therapies using efflux pump inhibitors for combating multidrug resistant Gram-negative pathogens. PMID:26976576

  10. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the transperineal permanent brachytherapy of prostate cancer.

    PubMed

    Rosenthal, Seth A; Bittner, Nathan H J; Beyer, David C; Demanes, D Jeffrey; Goldsmith, Brian J; Horwitz, Eric M; Ibbott, Geoffrey S; Lee, W Robert; Nag, Subir; Suh, W Warren; Potters, Louis

    2011-02-01

    Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for permanent prostate brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachytherapy implant procedure, the importance of dosimetric parameters, and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful prostate brachytherapy program.

  11. Evapotranspiration Cover for the 92-Acre Area Retired Mixed Waste Pits:Interim CQA Report

    SciTech Connect

    The Delphi Groupe, Inc., and J. A. Cesare and Associates, Inc.

    2011-06-20

    This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. This Interim Construction Quality Assurance (CQA) Report is for the 92-Acre Evapotranspiration Cover, Area 5 Waste Management Division (WMD) Retired Mixed Waste Pits, Nevada National Security Site, Nevada for the period of January 20, 2011 to May 12, 2011. Construction was approved by the Nevada Division of Environmental Protection (NDEP) under the Approval of Corrective Action Decision Document/Corrective Action Plan (CADD/CAP) for Corrective Action Unit (CAU) 111: Area 5 WMD Retired Mixed Waste Pits, Nevada National Security Site, Nevada, on January 6, 2011, pursuant to Subpart XII.8a of the Federal Facility Agreement and Consent Order. The project is located in Area 5 of the Radioactive Waste Management Complex (RWMC) at the Nevada National Security Site (NNSS), formerly known as the Nevada Test Site, located in southern Nevada, approximately 65 miles northwest of Las Vegas, Nevada, in Nye County. The project site, in Area 5, is located in a topographically closed basin approximately 14 additional miles north of Mercury Nevada, in the north-central part of Frenchman Flat. The Area 5 RWMS uses engineered shallow-land burial cells to dispose of packaged waste. The 92-Acre Area encompasses the southern portion of the Area 5 RWMS, which has been designated for the first final closure operations. This area contains 13 Greater Confinement Disposal (GCD) boreholes, 16 narrow trenches, and 9 broader pits. With the exception of two active pits (P03 and P06), all trenches and pits in the 92-Acre Area had operational covers approximately 2.4 meters thick, at a minimum, in most areas when this project began. The units within the 92-Acre Area are grouped into the following six informal categories based on physical location

  12. Ghost-Story Telling: Keeping It Appropriate.

    ERIC Educational Resources Information Center

    Weintraub, Jeff

    1996-01-01

    Guidelines for telling ghost stories at camp involve considering children's fears at different ages, telling age appropriate stories, determining appropriate times for telling ghost stories, and minimizing fear when a child becomes frightened by a ghost story. Includes tips on the selection, preparation, and presentation of ghost stories. (LP)

  13. Using Appropriate Tools Strategically for Instruction

    ERIC Educational Resources Information Center

    Sherman, Milan; Cayton, Charity

    2015-01-01

    Students' ability to use appropriate tools strategically is an important skill of mathematically proficient students (SMP 5, CCSSI 2010, p. 7). A parallel practice for teachers is using appropriate tools strategically for mathematics instruction. An important element of this practice is that the use of technology depends on the goals of…

  14. Technology: Appropriate for What? And for Whom?

    ERIC Educational Resources Information Center

    Black, Maggie, Ed.

    1983-01-01

    Included in this issue of UNICEF News are several brief articles focusing on the theme of appropriate technology. Topics discussed include (1) the improvement of family life through the scientific application of appropriate technology; (2) UNICEF and the household fuels crisis; (3) the workload of African women; (4) ways energy, food, health, and…

  15. 2012 Education Appropriations Guide. Issue Brief

    ERIC Educational Resources Information Center

    Delisle, Jason; Cohen, Jennifer

    2012-01-01

    Congress completed the fiscal year 2012 appropriations process on December 17th, 2011, finalizing annual funding for federal education programs through September 30, 2012 at $68.1 billion, down $233 million from the prior year. It is the first year since 2007 that Congress did not increase total appropriations for education programs. This issue…

  16. 2011 Education Appropriations Guide. Issue Brief

    ERIC Educational Resources Information Center

    Delisle, Jason; Cohen, Jennifer

    2011-01-01

    Congress completed the fiscal year 2011 appropriations process on April 14th, 2011, finalizing annual funding for nearly all federal education programs through September 30, 2011 at $68.3 billion, up $4.2 billion from the prior year. Making sense of the federal education budget and the appropriations process can be a frustrating task for education…

  17. Exemplary Practices: Going beyond Appropriate Practices

    ERIC Educational Resources Information Center

    Sims, Sandra; Lambdin, Dolly; VanVolkinburg, Pat; Santos, B. J.; Graham, George; Gorwitz, Crystal

    2010-01-01

    NASPE recently published the newly revised Appropriate Practices documents (elementary, middle and high school), intending to clearly distinguish between teaching practices that "should" and "should not" occur in physical education classes. Good physical education teachers incorporate appropriate practices into their teaching. However, there are…

  18. Tests Appropriate for Use with American Indians.

    ERIC Educational Resources Information Center

    Educational Testing Service, Princeton, NJ. Test Collection.

    The annotated bibliography describes 13 standardized tests appropriate for use with American Indians from preschool through high school levels, furnishing authors, copyright date, appropriate age level, physical format (microfiche), and publisher. A separate listing provides names, addresses, and telephone numbers of 33 major U.S. publishers of…

  19. Molecular Mechanism of MBX2319 Inhibition of Escherichia coli AcrB Multidrug Efflux Pump and Comparison with Other Inhibitors

    PubMed Central

    Vargiu, Attilio V.; Ruggerone, Paolo; Opperman, Timothy J.; Nguyen, Son T.

    2014-01-01

    Efflux pumps of the resistance nodulation division (RND) superfamily, such as AcrB, make a major contribution to multidrug resistance in Gram-negative bacteria. The development of inhibitors of the RND pumps would improve the efficacy of current and next-generation antibiotics. To date, however, only one inhibitor has been cocrystallized with AcrB. Thus, in silico structure-based analysis is essential for elucidating the interaction between other inhibitors and the efflux pumps. In this work, we used computer docking and molecular dynamics simulations to study the interaction between AcrB and the compound MBX2319, a novel pyranopyridine efflux pump inhibitor with potent activity against RND efflux pumps of Enterobacteriaceae species, as well as other known inhibitors (D13-9001, 1-[1-naphthylmethyl]-piperazine, and phenylalanylarginine-β-naphthylamide) and the binding of doxorubicin to the efflux-defective F610A variant of AcrB. We also analyzed the binding of a substrate, minocycline, for comparison. Our results show that MBX2319 binds very tightly to the lower part of the distal pocket in the B protomer of AcrB, strongly interacting with the phenylalanines lining the hydrophobic trap, where the hydrophobic portion of D13-9001 was found to bind by X-ray crystallography. Additionally, MBX2319 binds to AcrB in a manner that is similar to the way in which doxorubicin binds to the F610A variant of AcrB. In contrast, 1-(1-naphthylmethyl)-piperazine and phenylalanylarginine-β-naphthylamide appear to bind to somewhat different areas of the distal pocket in the B protomer of AcrB than does MBX2319. However, all inhibitors (except D13-9001) appear to distort the structure of the distal pocket, impairing the proper binding of substrates. PMID:25114133

  20. The Japanese version of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and the Fibromyalgia Symptom Scale: reliability and validity.

    PubMed

    Usui, Chie; Hatta, Kotaro; Aratani, Satoko; Yagishita, Naoko; Nishioka, Kenya; Kanazawa, Teruhisa; Ito, Kenji; Yamano, Yoshihisa; Nakamura, Hiroyuki; Nakajima, Toshihiro; Nishioka, Kusuki

    2012-02-01

    The aim of this study was to investigate the reliability and the validity of the Japanese version of the 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia (ACR 2010-J), and its quantification scale, the Fibromyalgia Symptom Scale (FS-J). In this study, we divided patients with chronic pain without psychiatric disorders other than depression into two groups according to the 1990 ACR Diagnostic Criteria for Fibromyalgia, a fibromyalgia group and a non-fibromyalgia group (rheumatoid arthritis, osteoarthritis, and gout). Patients in both groups were assessed using the ACR 2010-J and FS-J. Seventy-seven of 94 (82%) patients in the fibromyalgia group met the ACR 2010-J, whereas 9% (4/43) of the non-fibromyalgia group did so, with a sensitivity of 82%, specificity of 91%, positive predictive value of 95%, negative predictive value of 70%, and positive likelihood ratio of 8.8. Mean total scores on the FS-J significantly differentiated the fibromyalgia from the non-fibromyalgia group. The scale had high inter-rater reliability and high internal consistency. With a cutoff score of 10, the positive likelihood ratio was 10.1. Our findings indicate that the ACR 2010-J and FS-J have high reliability and validity, and are useful for assessing fibromyalgia in Japanese populations with chronic pain. As regards the positive likelihood ratio, that of the FS-J might be suitable as a positive test.

  1. Laboratory Equipment Criteria.

    ERIC Educational Resources Information Center

    State Univ. Construction Fund, Albany, NY.

    Requirements for planning, designing, constructing and installing laboratory furniture are given in conjunction with establishing facility criteria for housing laboratory equipment. Furniture and equipment described include--(1) center tables, (2) reagent racks, (3) laboratory benches and their mechanical fixtures, (4) sink and work counters, (5)…

  2. Revisiting Bioaccumulation Criteria

    EPA Science Inventory

    The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

  3. PP2A-3 interacts with ACR4 and regulates formative cell division in the Arabidopsis root

    PubMed Central

    Yue, Kun; Sandal, Priyanka; Williams, Elisabeth L.; Murphy, Evan; Stes, Elisabeth; Nikonorova, Natalia; Ramakrishna, Priya; Czyzewicz, Nathan; Montero-Morales, Laura; Kumpf, Robert; Lin, Zhefeng; van de Cotte, Brigitte; Iqbal, Mudassar; Van Bel, Michiel; Van De Slijke, Eveline; Meyer, Matthew R.; Gadeyne, Astrid; Zipfel, Cyril; De Jaeger, Geert; Van Montagu, Marc; Van Damme, Daniël; Gevaert, Kris; Rao, A. Gururaj; Beeckman, Tom; De Smet, Ive

    2016-01-01

    In plants, the generation of new cell types and tissues depends on coordinated and oriented formative cell divisions. The plasma membrane-localized receptor kinase ARABIDOPSIS CRINKLY 4 (ACR4) is part of a mechanism controlling formative cell divisions in the Arabidopsis root. Despite its important role in plant development, very little is known about the molecular mechanism with which ACR4 is affiliated and its network of interactions. Here, we used various complementary proteomic approaches to identify ACR4-interacting protein candidates that are likely regulators of formative cell divisions and that could pave the way to unraveling the molecular basis behind ACR4-mediated signaling. We identified PROTEIN PHOSPHATASE 2A-3 (PP2A-3), a catalytic subunit of PP2A holoenzymes, as a previously unidentified regulator of formative cell divisions and as one of the first described substrates of ACR4. Our in vitro data argue for the existence of a tight posttranslational regulation in the associated biochemical network through reciprocal regulation between ACR4 and PP2A-3 at the phosphorylation level. PMID:26792519

  4. Structure of the Tripartite Multidrug Efflux Pump AcrAB-TolC Suggests an Alternative Assembly Mode

    PubMed Central

    Kim, Jin-Sik; Jeong, Hyeongseop; Song, Saemee; Kim, Hye-Yeon; Lee, Kangseok; Hyun, Jaekyung; Ha, Nam-Chul

    2015-01-01

    Escherichia coli AcrAB-TolC is a multidrug efflux pump that expels a wide range of toxic substrates. The dynamic nature of the binding or low affinity between the components has impeded elucidation of how the three components assemble in the functional state. Here, we created fusion proteins composed of AcrB, a transmembrane linker, and two copies of AcrA. The fusion protein exhibited acridine pumping activity, suggesting that the protein reflects the functional structure in vivo. To discern the assembling mode with TolC, the AcrBA fusion protein was incubated with TolC or a chimeric protein containing the TolC aperture tip region. Three-dimensional structures of the complex proteins were determined through transmission electron microscopy. The overall structure exemplifies the adaptor bridging model, wherein the funnel-like AcrA hexamer forms an intermeshing cogwheel interaction with the α-barrel tip region of TolC, and a direct interaction between AcrB and TolC is not allowed. These observations provide a structural blueprint for understanding multidrug resistance in pathogenic Gram-negative bacteria. PMID:26013259

  5. Photovoltaic system criteria documents. Volume 2: Quality assurance criteria for photovoltaic applications

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    Quality assurance criteria are described for manufacturers and installers of solar photovoltaic tests and applications. Quality oriented activities are outlined to be pursued by the contractor/subcontractor to assure the physical and operational quality of equipment produced is included. In the broad sense, guidelines are provided for establishing a QA organization if none exists. Mainly, criteria is provided to be considered in any PV quality assurance plan selected as appropriate by the responsible Field Center. A framework is established for a systematic approach to ensure that photovoltaic tests and applications are constructed in a timely and cost effective manner.

  6. Structure of the AcrAB-TolC multidrug efflux pump.

    PubMed

    Du, Dijun; Wang, Zhao; James, Nathan R; Voss, Jarrod E; Klimont, Ewa; Ohene-Agyei, Thelma; Venter, Henrietta; Chiu, Wah; Luisi, Ben F

    2014-05-22

    The capacity of numerous bacterial species to tolerate antibiotics and other toxic compounds arises in part from the activity of energy-dependent transporters. In Gram-negative bacteria, many of these transporters form multicomponent 'pumps' that span both inner and outer membranes and are driven energetically by a primary or secondary transporter component. A model system for such a pump is the acridine resistance complex of Escherichia coli. This pump assembly comprises the outer-membrane channel TolC, the secondary transporter AcrB located in the inner membrane, and the periplasmic AcrA, which bridges these two integral membrane proteins. The AcrAB-TolC efflux pump is able to transport vectorially a diverse array of compounds with little chemical similarity, thus conferring resistance to a broad spectrum of antibiotics. Homologous complexes are found in many Gram-negative species, including in animal and plant pathogens. Crystal structures are available for the individual components of the pump and have provided insights into substrate recognition, energy coupling and the transduction of conformational changes associated with the transport process. However, how the subunits are organized in the pump, their stoichiometry and the details of their interactions are not known. Here we present the pseudo-atomic structure of a complete multidrug efflux pump in complex with a modulatory protein partner from E. coli. The model defines the quaternary organization of the pump, identifies key domain interactions, and suggests a cooperative process for channel assembly and opening. These findings illuminate the basis for drug resistance in numerous pathogenic bacterial species.

  7. Characterization of a Novel Pyranopyridine Inhibitor of the AcrAB Efflux Pump of Escherichia coli

    PubMed Central

    Kwasny, Steven M.; Kim, Hong-Suk; Nguyen, Son T.; Houseweart, Chad; D'Souza, Sanjay; Walker, Graham C.; Peet, Norton P.; Nikaido, Hiroshi; Bowlin, Terry L.

    2014-01-01

    Members of the resistance-nodulation-division (RND) family of efflux pumps, such as AcrAB-TolC of Escherichia coli, play major roles in multidrug resistance (MDR) in Gram-negative bacteria. A strategy for combating MDR is to develop efflux pump inhibitors (EPIs) for use in combination with an antibacterial agent. Here, we describe MBX2319, a novel pyranopyridine EPI with potent activity against RND efflux pumps of the Enterobacteriaceae. MBX2319 decreased the MICs of ciprofloxacin (CIP), levofloxacin, and piperacillin versus E. coli AB1157 by 2-, 4-, and 8-fold, respectively, but did not exhibit antibacterial activity alone and was not active against AcrAB-TolC-deficient strains. MBX2319 (3.13 μM) in combination with 0.016 μg/ml CIP (minimally bactericidal) decreased the viability (CFU/ml) of E. coli AB1157 by 10,000-fold after 4 h of exposure, in comparison with 0.016 μg/ml CIP alone. In contrast, phenyl-arginine-β-naphthylamide (PAβN), a known EPI, did not increase the bactericidal activity of 0.016 μg/ml CIP at concentrations as high as 100 μM. MBX2319 increased intracellular accumulation of the fluorescent dye Hoechst 33342 in wild-type but not AcrAB-TolC-deficient strains and did not perturb the transmembrane proton gradient. MBX2319 was broadly active against Enterobacteriaceae species and Pseudomonas aeruginosa. MBX2319 is a potent EPI with possible utility as an adjunctive therapeutic agent for the treatment of infections caused by Gram-negative pathogens. PMID:24247144

  8. Structure of the AcrAB-TolC multidrug efflux pump

    PubMed Central

    Du, Dijun; Wang, Zhao; James, Nathan R.; Voss, Jarrod E.; Klimont, Ewa; Ohene-Agyei, Thelma; Venter, Henrietta; Chiu, Wah; Luisi, Ben F.

    2015-01-01

    The capacity of numerous bacterial species to tolerate antibiotics and other toxic compounds arises in part from the activity of energy-dependent transporters. In Gram-negative bacteria, many of these transporters form multicomponent ‘pumps’ that span both inner and outer membranes and are driven energetically by a primary or secondary transporter component1-7. A model system for such a pump is the acridine resistance complex of Escherichia coli1. This pump assembly comprises the outer-membrane channel TolC, the secondary transporter AcrB located in the inner membrane, and the periplasmic AcrA, which bridges these two integral membrane proteins. The AcrAB-TolC efflux pump is able to vectorially transport a diverse array of compounds with little chemical similarity, and accordingly confers resistance to a broad spectrum of antibiotics. Homologous complexes are found in many Gram-negative species, including pathogens of animals and plants. Crystal structures are available for the individual pump components2-7 and these have provided insights into substrate recognition, energy coupling and the transduction of conformational changes associated with the transport process. How the subunits are organised in the pump, their stoichiometry and the details of their interactions are not known and are under debate. In this manuscript, we present the pseudoatomic structure of a complete multidrug efflux pump in complex with a modulatory protein partner8. The model defines the quaternary organization of the pump, identifies key domain interactions, and suggests a cooperative process for channel assembly and opening. These findings illuminate the basis for drug resistance in numerous pathogenic bacterial species. PMID:24747401

  9. Percutaneous Coronary Intervention Utilization and Appropriateness across the United States

    PubMed Central

    Thomas, Michael P.; Parzynski, Craig S.; Curtis, Jeptha P.; Seth, Milan; Nallamothu, Brahmajee K.; Chan, Paul S.; Spertus, John A.; Patel, Manesh R.; Bradley, Steven M.; Gurm, Hitinder S.

    2015-01-01

    Background Substantial geographic variation exists in percutaneous coronary intervention (PCI) use across the United States. It is unclear the extent to which high PCI utilization can be explained by PCI for inappropriate indications. The objective of this study was to examine the relationship between PCI rates across regional healthcare markets utilizing hospital referral regions (HRRs) and PCI appropriateness. Methods The number of PCI procedures in each HRR was obtained from the 2010 100% Medicare limited data set. HRRs were divided into quintiles of PCI utilization with increasing rates of utilization progressing to quintile 5. NCDR CathPCI Registry® data were used to evaluate patient characteristics, appropriate use criteria (AUC), and outcomes across the HRR quintiles defined by PCI utilization with the study population restricted to HRRs where ≥ 80% of the PCIs were performed at institutions participating in the registry. PCI appropriateness was defined using 2012 AUC by the American College of Cardiology (ACC)/American Heart Association (AHA)/The Society for Cardiovascular Angiography and Interventions (SCAI). Results Our study cohort comprised of 380,981 patients treated at 178 HRRs. Mean PCI rates per 1,000 increased from 4.6 in Quintile 1 to 10.8 in Quintile 5. The proportion of non-acute PCIs was 27.7% in Quintile 1 increasing to 30.7% in Quintile 5. Significant variation (p < 0.001) existed across the quintiles in the categorization of appropriateness across HRRs of utilization with more appropriate PCI in lower utilization areas (Appropriate: Q1, 76.53%, Q2, 75.326%, Q3, 75.23%, Q4, 73.95%, Q5, 72.768%; Inappropriate: Q1 3.92%, Q2 4.23%, Q3 4.32%, Q4 4.35%, Q5 4.05%; Uncertain: Q1 8.29%, Q2 8.84%, Q3 8.08%, Q4 9.01%, Q5 8.93%; Not Mappable: Q1 11.26%, Q2 11.67%, Q3 12.37%, Q4 12.69%, Q5 14.34%). There was no difference in risk-adjusted mortality across quintiles of PCI utilization. Conclusions Geographic regions with lower PCI rates have a higher

  10. Description of Trichophoromyia ruifreitasi, a new phlebotomine species (Diptera, Psychodidae) from Acre State, Brazilian Amazon

    PubMed Central

    de Oliveira, Arley Faria José; Teles, Carolina Bioni Garcia; Medeiros, Jansen Fernandes; Camargo, Luís Marcelo Aranha; Pessoa, Felipe Arley Costa

    2015-01-01

    Abstract Trichophoromyia ruifreitasi sp. n. is described as a new species of sand fly from the genus Trichophoromyia Barretto. This description is supported with illustrations and photographs that detail the morphological characteristics of male specimens collected in the municipality of Assis Brasil, Acre State, Brazilian Amazon. This species is similar to Trichophoromyia auraensis (Mangabeira), but the two species can be easily differentiated by the distribution of setae on their parameres, and by the presence of a dorsal lobe in the parameres of the new species. PMID:26487825

  11. 22 CFR 223.11 - Appropriate action.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... influence, any oral or written communication to, the Agency on any matter of business for a period not to... such appearance or to accept any such communication; and (b) Taking other appropriate...

  12. Further Additional Continuing Appropriations Amendments, 2011

    THOMAS, 112th Congress

    Rep. Rogers, Harold [R-KY-5

    2011-04-04

    04/09/2011 Became Public Law No: 112-8. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 4/15/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  13. Consolidated and Further Continuing Appropriations Act, 2012

    THOMAS, 112th Congress

    Rep. Kingston, Jack [R-GA-1

    2011-06-03

    11/18/2011 Became Public Law No: 112-55. (TXT | PDF) (All Actions) Notes: Continuing appropriations through 12/16/2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  14. Chautauqua notebook: appropriate technology on radio

    SciTech Connect

    Renz, B.

    1981-01-01

    Experiences in establishing and maintaining a regional call-in information-exchange radio show (Chautauqua) on energy conservation, appropriate technology, renewable energy sources, and self-reliance are discussed. Information is presented on: appropriate technology; the Chautauquaa concept; topics discussed; research performed; guests; interviewing tips; types of listeners; program features; where to find help; promotion and publicity; the technical and engineering aspects; the budget and funding; and station policies. (MCW)

  15. Myalgic encephalomyelitis: International Consensus Criteria

    PubMed Central

    Carruthers, B M; van de Sande, M I; De Meirleir, K L; Klimas, N G; Broderick, G; Mitchell, T; Staines, D; Powles, A C P; Speight, N; Vallings, R; Bateman, L; Baumgarten-Austrheim, B; Bell, D S; Carlo-Stella, N; Chia, J; Darragh, A; Jo, D; Lewis, D; Light, A R; Marshall-Gradisbik, S; Mena, I; Mikovits, J A; Miwa, K; Murovska, M; Pall, M L; Stevens, S

    2011-01-01

    , Japan; A. Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia; Department of Biochemistry & Basic Medical Sciences, Washington State University, Portland, OR; Department of Sports Sciences, University of the Pacific, Stockton, CA USA). Myalgic encephalomyelitis: International Consensus Criteria (Review). J Intern Med 2011; 270: 327–338. The label ‘chronic fatigue syndrome’ (CFS) has persisted for many years because of the lack of knowledge of the aetiological agents and the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term ‘myalgic encephalomyelitis’ (ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer-reviewed publications, diagnosed or treated approximately 50 000 patients with ME, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi-type process. The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the

  16. Myalgic encephalomyelitis: International Consensus Criteria

    PubMed Central

    Carruthers, B M; van de Sande, M I; De Meirleir, K L; Klimas, N G; Broderick, G; Mitchell, T; Staines, D; Powles, A C P; Speight, N; Vallings, R; Bateman, L; Baumgarten-Austrheim, B; Bell, D S; Carlo-Stella, N; Chia, J; Darragh, A; Jo, D; Lewis, D; Light, A R; Marshall-Gradisbik, S; Mena, I; Mikovits, J A; Miwa, K; Murovska, M; Pall, M L; Stevens, S

    2011-01-01

    , Japan; A. Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia; Department of Biochemistry & Basic Medical Sciences, Washington State University, Portland, OR; Department of Sports Sciences, University of the Pacific, Stockton, CA USA). Myalgic encephalomyelitis: International Consensus Criteria (Review). J Intern Med 2011; 270: 327–338. The label ‘chronic fatigue syndrome’ (CFS) has persisted for many years because of the lack of knowledge of the aetiological agents and the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term ‘myalgic encephalomyelitis’ (ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer-reviewed publications, diagnosed or treated approximately 50 000 patients with ME, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi-type process. The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the

  17. Unified nonclassicality criteria

    NASA Astrophysics Data System (ADS)

    Ryl, S.; Sperling, J.; Agudelo, E.; Mraz, M.; Köhnke, S.; Hage, B.; Vogel, W.

    2015-07-01

    In this work we generalize the Bochner criterion addressing the characteristic function, i.e., the Fourier transform, of the Glauber-Sudarshan phase-space function. For this purpose we extend the Bochner theorem by including derivatives of the characteristic function. The resulting necessary and sufficient nonclassicality criteria unify previously known moment-based criteria with those based on the characteristic function. For applications of the generalized nonclassicality probes, we provide direct sampling formulas for balanced homodyne detection. A squeezed vacuum state is experimentally realized and characterized with our method. This complete framework—theoretical unification, sampling approach, and experimental implementation—presents an efficient toolbox to characterize quantum states of light for applications in quantum technology.

  18. Space Tethers: Design Criteria

    NASA Technical Reports Server (NTRS)

    Tomlin, D. D.; Faile, G. C.; Hayashida, K. B.; Frost, C. L.; Wagner, C. Y.; Mitchell, M. L.; Vaughn, J. A.; Galuska, M. J.

    1997-01-01

    This document is prepared to provide a systematic process for the selection of tethers for space applications. Criteria arc provided for determining the strength requirement for tether missions and for mission success from tether severing due to micrometeoroids and orbital debris particle impacts. Background information of materials for use in space tethers is provided, including electricity-conducting tethers. Dynamic considerations for tether selection is also provided. Safety, quality, and reliability considerations are provided for a tether project.

  19. International consensus criteria for the diagnosis of Raynaud's phenomenon.

    PubMed

    Maverakis, Emanual; Patel, Forum; Kronenberg, Daniel G; Chung, Lorinda; Fiorentino, David; Allanore, Yannick; Guiducci, Serena; Hesselstrand, Roger; Hummers, Laura K; Duong, Chris; Kahaleh, Bashar; Macgregor, Alexander; Matucci-Cerinic, Marco; Wollheim, Frank A; Mayes, Maureen D; Gershwin, M Eric

    2014-01-01

    Vasoconstriction accompanied by changes in skin color is a normal physiologic response to cold. The distinction between this normal physiology and Raynaud's phenomenon (RP) has yet to be well characterized. In anticipation of the 9th International Congress on Autoimmunity, a panel of 12 RP experts from 9 different institutes and four different countries were assembled for a Delphi exercise to establish new diagnostic criteria for RP. Relevant investigators with highly cited manuscripts in Raynaud's-related research were identified using the Web of Science and invited to participate. Surveys at each stage were administered to participants via the on-line SurveyMonkey software tool. The participants evaluated the level of appropriateness of statements using a scale of 1 (extremely inappropriate) through 9 (extremely appropriate). In the second stage, panel participants were asked to rank rewritten items from the first round that were scored as "uncertain" for the diagnosis of RP, items with significant disagreement (Disagreement Index > 1), and new items suggested by the panel. Results were analyzed using the Interpercentile Range Adjusted for Symmetry (IPRAS) method. A 3-Step Approach to diagnose RP was then developed using items the panelists "agreed" were "appropriate" diagnostic criteria. In the final stage, the panel was presented with the newly developed diagnostic criteria and asked to rate them against previous models. Following the first two iterations of the Delphi exercise, the panel of 12 experts agreed that 36 of the items were "appropriate", 12 items had "uncertain" appropriateness, and 13 items were "inappropriate" to use in the diagnostic criteria of RP. Using an expert committee, we developed a 3-Step Approach for the diagnosis of RP and 5 additional criteria for the diagnosis of primary RP. The committee came to an agreement that the proposed criteria were "appropriate and accurate" for use by physicians to diagnose patients with RP. PMID:24491823

  20. International consensus criteria for the diagnosis of Raynaud's phenomenon.

    PubMed

    Maverakis, Emanual; Patel, Forum; Kronenberg, Daniel G; Chung, Lorinda; Fiorentino, David; Allanore, Yannick; Guiducci, Serena; Hesselstrand, Roger; Hummers, Laura K; Duong, Chris; Kahaleh, Bashar; Macgregor, Alexander; Matucci-Cerinic, Marco; Wollheim, Frank A; Mayes, Maureen D; Gershwin, M Eric

    2014-01-01

    Vasoconstriction accompanied by changes in skin color is a normal physiologic response to cold. The distinction between this normal physiology and Raynaud's phenomenon (RP) has yet to be well characterized. In anticipation of the 9th International Congress on Autoimmunity, a panel of 12 RP experts from 9 different institutes and four different countries were assembled for a Delphi exercise to establish new diagnostic criteria for RP. Relevant investigators with highly cited manuscripts in Raynaud's-related research were identified using the Web of Science and invited to participate. Surveys at each stage were administered to participants via the on-line SurveyMonkey software tool. The participants evaluated the level of appropriateness of statements using a scale of 1 (extremely inappropriate) through 9 (extremely appropriate). In the second stage, panel participants were asked to rank rewritten items from the first round that were scored as "uncertain" for the diagnosis of RP, items with significant disagreement (Disagreement Index > 1), and new items suggested by the panel. Results were analyzed using the Interpercentile Range Adjusted for Symmetry (IPRAS) method. A 3-Step Approach to diagnose RP was then developed using items the panelists "agreed" were "appropriate" diagnostic criteria. In the final stage, the panel was presented with the newly developed diagnostic criteria and asked to rate them against previous models. Following the first two iterations of the Delphi exercise, the panel of 12 experts agreed that 36 of the items were "appropriate", 12 items had "uncertain" appropriateness, and 13 items were "inappropriate" to use in the diagnostic criteria of RP. Using an expert committee, we developed a 3-Step Approach for the diagnosis of RP and 5 additional criteria for the diagnosis of primary RP. The committee came to an agreement that the proposed criteria were "appropriate and accurate" for use by physicians to diagnose patients with RP.

  1. PML diagnostic criteria

    PubMed Central

    Aksamit, Allen J.; Clifford, David B.; Davis, Larry; Koralnik, Igor J.; Sejvar, James J.; Bartt, Russell; Major, Eugene O.; Nath, Avindra

    2013-01-01

    Objective: To establish criteria for the diagnosis of progressive multifocal leukoencephalopathy (PML). Methods: We reviewed available literature to identify various diagnostic criteria employed. Several search strategies employing the terms “progressive multifocal leukoencephalopathy” with or without “JC virus” were performed with PubMed, SCOPUS, and EMBASE search engines. The articles were reviewed by a committee of individuals with expertise in the disorder in order to determine the most useful applicable criteria. Results: A consensus statement was developed employing clinical, imaging, pathologic, and virologic evidence in support of the diagnosis of PML. Two separate pathways, histopathologic and clinical, for PML diagnosis are proposed. Diagnostic classification includes certain, probable, possible, and not PML. Conclusion: Definitive diagnosis of PML requires neuropathologic demonstration of the typical histopathologic triad (demyelination, bizarre astrocytes, and enlarged oligodendroglial nuclei) coupled with the techniques to show the presence of JC virus. The presence of clinical and imaging manifestations consistent with the diagnosis and not better explained by other disorders coupled with the demonstration of JC virus by PCR in CSF is also considered diagnostic. Algorithms for establishing the diagnosis have been recommended. PMID:23568998

  2. 23 CFR 636.202 - When are two-phase design-build selection procedures appropriate?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false When are two-phase design-build selection procedures... ENGINEERING AND TRAFFIC OPERATIONS DESIGN-BUILD CONTRACTING Selection Procedures, Award Criteria § 636.202 When are two-phase design-build selection procedures appropriate? You may consider the...

  3. Preparing Books for Children from Birth to Age Six: The Approach of Appropriateness for the Child

    ERIC Educational Resources Information Center

    Çer, Ekran

    2016-01-01

    Children's books must primarily be appropriate for children so that they could be a significant stimulus in children's lives. In other words, it is essential that the concepts child reality, literary criteria and artist sensitivity be reflected in books in order to create children's books. From birth to age 6, the fact that children's books are…

  4. Do Picture Books about Starting Kindergarten Portray the Kindergarten Experience in Developmentally Appropriate Ways?

    ERIC Educational Resources Information Center

    Phillips, Eva C.; Sturm, Brian W.

    2013-01-01

    This study examines the illustrations and the texts of thirteen picture books for young children on the topic of preparing for and starting kindergarten to assess whether, and to what extent, they depict forty-nine criteria for developmentally appropriate kindergarten practice. Results show that the books vary in quality and coverage, but they are…

  5. The 2014 ACR annual meeting: a bird's eye view of autoimmunity in 2015.

    PubMed

    Selmi, Carlo; Cantarini, Luca; Kivity, Shaye; Dagaan, Amir; Shovman, Ora; Zandman-Goddard, Gisele; Perricone, Carlo; Amital, Howard; Toubi, Elias; Shoenfeld, Yehuda

    2015-07-01

    Our understanding of the mechanisms leading to rheumatic diseases is growing at unprecedented pace thanks to the worldwide network of clinical and translational researchers who gather at major scientific meetings to share their progresses. Further, these meetings allow the contamination of unrelated research areas and thus the spreading of ideas, hypotheses, and research tools. The annual meeting of the American College of Rheumatology (ACR) serves this purpose by allowing thousands of rheumatologists, immunologists, health care professionals, and basic scientists to attend the same sessions and present their work. The 2014 ACR meeting was held in Boston, MA, and was attended by over 16,000 participants who had the opportunity to directly witness the presentation of over 3000 abstracts. As such is the case, a full attendance of all update opportunities was not feasible. To fill this gap we arbitrarily selected the abstracts the appeared most interesting in a few fields of interest and we herein discuss the presented data and their further implications. In particular, we were intrigued by research advances in biomarkers for rheumatic diseases, and by advances on Sjögren syndrome, neuropsychiatric systemic lupus erythematosus, fibromyalgia, and B cell mechanisms. While we are well aware of the numerous blind spots that are expected in this type of article, we submit that this is far from a comprehensive overview and refer to the abstract book for a more complete analysis of the presented abstracts.

  6. Assigning appropriate and comprehensive diagnosis for scientific report.

    PubMed

    Ngene, N C; Moodley, J

    2014-12-01

    The use of currently available guidelines such as the International Classification of Diseases, 10th Revision (ICD-10) and its clinical modification to assign a principal diagnosis to a patient who has multiple principal diagnoses appears unreliable. This is because these guidelines are complex and uses criteria that are highly subjective. Even when one main diagnosis is selected, the comprehensive list of other diseases that the patient has is often not reported such that the overall clinical condition of the patient is obscured. To address these issues, we have proposed: (i) a simple, potentially reliable and stepwise guide that can be used to assign the single most appropriate main principal diagnosis to each patient and illustrated this with case reports (ii) how to simultaneously report the main and other diagnoses in a scientific paper. It is hoped that our proposal (named NJ model for easy referencing) will help standardize how diagnosis is assigned to patients. PMID:25459133

  7. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria.

    PubMed

    Dubois, Bruno; Feldman, Howard H; Jacova, Claudia; Hampel, Harald; Molinuevo, José Luis; Blennow, Kaj; DeKosky, Steven T; Gauthier, Serge; Selkoe, Dennis; Bateman, Randall; Cappa, Stefano; Crutch, Sebastian; Engelborghs, Sebastiaan; Frisoni, Giovanni B; Fox, Nick C; Galasko, Douglas; Habert, Marie-Odile; Jicha, Gregory A; Nordberg, Agneta; Pasquier, Florence; Rabinovici, Gil; Robert, Philippe; Rowe, Christopher; Salloway, Stephen; Sarazin, Marie; Epelbaum, Stéphane; de Souza, Leonardo C; Vellas, Bruno; Visser, Pieter J; Schneider, Lon; Stern, Yaakov; Scheltens, Philip; Cummings, Jeffrey L

    2014-06-01

    In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD. PMID:24849862

  8. AcrAB-TolC Directs Efflux-Mediated Multidrug Resistance in Salmonella enterica Serovar Typhimurium DT104

    PubMed Central

    Baucheron, Sylvie; Tyler, Shaun; Boyd, David; Mulvey, Michael R.; Chaslus-Dancla, Elisabeth; Cloeckaert, Axel

    2004-01-01

    Multidrug-resistant Salmonella enterica serovar Typhimurium definitive phage type 104 (DT104) strains harbor a genomic island, called Salmonella genomic island 1 (SGI1), which contains an antibiotic resistance gene cluster conferring resistance to ampicillin, chloramphenicol, florfenicol, streptomycin, sulfonamides, and tetracyclines. They may be additionally resistant to quinolones. Among the antibiotic resistance genes there are two, i.e., floR and tet(G), which code for efflux pumps of the major facilitator superfamily with 12 transmembrane segments that confer resistance to chloramphenicol-florfenicol and the tetracyclines, respectively. In the present study we determined, by constructing acrB and tolC mutants, the role of the AcrAB-TolC multidrug efflux system in the multidrug resistance of several DT104 strains displaying additional quinolone resistance or not displaying quinolone resistance. This study shows that the quinolone resistance and the decreased fluoroquinolone susceptibilities of the strains are highly dependent on the AcrAB-TolC efflux system and that single mutations in the quinolone resistance-determining region of gyrA are of little relevance in mediating this resistance. Overproduction of the AcrAB efflux pump, as determined by Western blotting with an anti-AcrA polyclonal antibody, appeared to be the major mechanism of resistance to quinolones. Moreover, chloramphenicol-florfenicol and tetracycline resistance also appeared to be highly dependent on the presence of AcrAB-TolC, since the introduction of mutations in the respective acrB and tolC genes resulted in a susceptible or intermediate resistance phenotype, according to clinical MIC breakpoints, despite the presence of the FloR and Tet(G) efflux pumps. Resistance to other antibiotics, ampicillin, streptomycin, and sulfonamides, was not affected in the acrB and tolC mutants of DT104 strains harboring SGI1. Therefore, AcrAB-TolC appears to direct efflux-mediated resistance to quinolones

  9. The Use and Abuse of Diagnostic/Classification Criteria

    PubMed Central

    June, Rayford R.; Aggarwal, Rohit

    2015-01-01

    In rheumatic diseases, classification criteria have been developed to identify well-defined homogenous cohorts for clinical research. Although, they are commonly used in clinical practice, their use may not be appropriate for routine diagnostic clinical care. Classification criteria are being revised with improved methodology and further understanding of disease pathophysiology, but still may not encompass all unique clinical situations to be applied for diagnosis of heterogeneous, rare, evolving rheumatic diseases. Diagnostic criteria development is challenging primarily due to difficulty for universal application given significant differences in prevalence of rheumatic diseases based on geographical area and clinic settings. Despite these shortcomings, the clinician can still use classification criteria for understanding the disease as well as a guide for diagnosis with a few caveats. We present the limits of current classification criteria, describe their use and abuse in clinical practice, and how they should be used with caution when applied in clinics. PMID:26096094

  10. Performance criteria for dosimeter angular response

    SciTech Connect

    Roberson, P.L.; Fox, R. A.; Cummings, F. M.; McDonald, J. C.; Jones, K.L.

    1988-06-01

    This report provides criteria for evaluating the response of personnel dosimeters to radiation at nonperpendicular incidence. The US Department of Energy Laboratory Accreditation Program (DOELAP) ensures that dosimetry systems at DOE facilities meet acceptable standards for precision and accuracy. In the past, these standards were limited to tests for system variability, energy dependence, and level of detection. The proposed criteria will broaden the scope of DOELAP to include the angular response of personnel dosimeters. Because occupational exposures in the workplace are rarely due to radiation from only one direction, dosimeters must accurately assign individual dose equivalent from irradiation at any forward angle of incidence. Including an angular response criterion in DOELAP would improve the quality of personnel monitoring provided that the criterion is developed from appropriate dose quantities. This report provides guidance for assigning individual dose equivalents for radiation fields at nonperpendicular incidence to the dosimeter. 21 refs., 10 figs., 10 tabs.

  11. Cloning, expression, purification, crystallization and preliminary X-ray diffraction analysis of the regulator AcrR from Escherichia coli

    SciTech Connect

    Li, Ming; Qiu, Xi; Su, Chih-Chia; Long, Feng; Gu, Ruoyu; McDermott, Gerry; Yu, Edward W.

    2006-11-01

    The transcriptional regulator AcrR from Escherichia coli has been cloned, overexpressed, purified and crystallized and X-ray diffraction data have been collected to a resolution of 2.5 Å. This paper describes the cloning, expression, purification and preliminary X-ray data analysis of the AcrR regulatory protein. The Escherichia coli AcrR is a member of the TetR family of transcriptional regulators. It regulates the expression of the AcrAB multidrug transporter. Recombinant AcrR with a 6×His tag at the C-terminus was expressed in E. coli and purified by metal-affinity chromatography. The protein was crystallized using hanging-drop vapor diffusion. X-ray diffraction data were collected from cryocooled crystals at a synchrotron light source. The best crystal diffracted to 2.5 Å. The space group was determined to be P3{sub 2}, with unit-cell parameters a = b = 46.61, c = 166.16 Å.

  12. Identification of critical residues for transport activity of Acr3p, the Saccharomyces cerevisiae As(III)/H+ antiporter.

    PubMed

    Markowska, Katarzyna; Maciaszczyk-Dziubinska, Ewa; Migocka, Magdalena; Wawrzycka, Donata; Wysocki, Robert

    2015-10-01

    Acr3p is an As(III)/H(+) antiporter from Saccharomyces cerevisiae belonging to the bile/arsenite/riboflavin transporter superfamily. We have previously found that Cys151 located in the middle of the fourth transmembrane segment (TM4) is critical for antiport activity, suggesting that As(III) might interact with a thiol group during the translocation process. In order to identify functionally important residues involved in As(III)/H(+) exchange, we performed a systematic alanine-replacement analysis of charged/polar and aromatic residues that are conserved in the Acr3 family and located in putative transmembrane segments. Nine residues (Asn117, Trp130, Arg150, Trp158, Asn176, Arg230, Tyr290, Phe345, Asn351) were found to be critical for proper folding and trafficking of Acr3p to the plasma membrane. In addition, we found that replacement of highly conserved Phe266 (TM7), Phe352 (TM9), Glu353 (TM9) and Glu380 (TM10) with Ala abolished transport activity of Acr3p, while mutation of Ser349 (TM9) to Ala significantly reduced the As(III)/H(+) exchange, suggesting an important role of these residues in the transport mechanism. Detailed mutational analysis of Glu353 and Glu380 revealed that the negatively charged residues located in the middle of transmembrane segments TM9 and TM10 are crucial for antiport activity. We also discuss a hypothetical model of the Acr3p transport mechanism.

  13. Simulated microgravity affects ciprofloxacin susceptibility and expression of acrAB-tolC genes in E. coli ATCC25922

    PubMed Central

    Xu, Bingxin; Li, Chenglin; Zheng, Yanhua; Si, Shaoyan; Shi, Yuhua; Huang, Yuling; Zhang, Jianzhong; Cui, Yan; Cui, Yimin

    2015-01-01

    As a representative fluoroquinolone antibacterial, ciprofloxacin is frequently used to treat infections caused by bacteria such as E. coli. It is much meaningful to explore ciprofloxacin susceptibility and investigate a possible mechanism of drug susceptibility changes in E. coli ATCC25922 exposed to the environmental stress of simulated microgravity. The subculture of E. coli lasted for 7 days under simulated microgravity conditions (SMG) and normal microgravity (NG) conditions. On the 8th day, the cultures were divided into three groups: (1) NG group (continuous NG cultures); (2) SMG group (continuous SMG cultures); (3) SMCNG group (simulated microgravity change into normal gravity cultures). Ciprofloxacin (a final concentration of 0.125 μg/ml) sensitivity and expression of acrAB-tolC genes were detected in E. coli cells. The count and percentage of viable cells in the SMG cultures bacteria exposed to ciprofloxacin were higher than that in NG cultures and reduced to the levels of NG group when they were subcultivated from SMG to NG. The expressions of efflux pump genes (acrA, acrB and tolC) were upregulated in SMG culture and downregulated to the levels of NG group when they were subcultivated from SMG to NG. Susceptibility to ciprofloxacin and expression of acrAB-tolC genes in E. coli could be reversibly affected by SMG conditions. Over expression of efflux pump genes acrAB-tolC perhaps played an important role in decreased CIP susceptibility under SMG. PMID:26339360

  14. The advantages of PD1 activating chimeric receptor (PD1-ACR) engineered lymphocytes for PDL1(+) cancer therapy.

    PubMed

    Tang, Xiaolong; Li, Qingguo; Zhu, Yongqiang; Zheng, Donghui; Dai, Jingjing; Ni, Wenxuan; Wei, Jia; Xue, Yubao; Chen, Ke; Hou, Wei; Zhang, Chao; Feng, Xiaojun; Liang, Yong

    2015-01-01

    Tumors exploit immunoregulatory checkpoints to attenuate T cell responses as a means of circumventing immunologic rejection. By activating the inhibitory costimulatory pathway of Programmed Death 1 (PD1)/PDL1 which provides tumor cells an escape mechanism from immune surveillance, Programmed Death Ligand1 (PDL1)(+) tumors hamper activated tumor-specific T cell functions and render them functionally exhausted. To overcome the inhibitory costimulatory effects of PDL1 on the adoptively transferred T cells, we sought to convert PD1 to a T cell costimulatory receptor by exchanging its transmembrane and cytoplasmic tail with CD28 and 4-1BB signaling domains (PD1-CD28-4-1BB, PD1-ACR), anticipating the genetically modified effector T lymphocytes expressing PD1-ACR would exhibit enhanced functional attributes. And the results showed that PD1-ACR expressed T cells retained the ability to bind PDL1, resulting in T cell activation as evidenced by the elevated activity of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt), the augmentation of cytokine secretion and the increased proliferative capacity. Moreover, when systemically administered in the mouse model of glioblastoma metastases, PD1-ACR T cells localized at the area of U87 invasive tumor, which results in suppressed tumor growth and enhanced survival of mice with established U87 glioblastoma. Together, these data demonstrated that PD1-ACR has a high potential to serve as a novel strategy to overcome PDL1 mediated immunosuppression of T cells for cancer therapy. PMID:26045887

  15. Senate passes energy, water appropriations bill

    NASA Astrophysics Data System (ADS)

    Bush, Susan

    The 21.98 billion energy and water appropriations bill (HR 2427) was passed by the full Senate on July 10, representing an increase of about 1 billion over FY 1991 funding. With a 96-3 vote, HR 2427 was one of the first of 13 spending bills to be approved by the Senate. (See "DOE Funding Up in FY 1991," Eos, July 16.)The Senate appropriated 509 million to begin construction of the controversial Superconducting Super Collider (SSC) in Waxahachie, Texas. Earlier this year, the House voted 434 million for the project, which was $100 million less than requested by the administration.

  16. Magnetic criteria of aromaticity.

    PubMed

    Gershoni-Poranne, Renana; Stanger, Amnon

    2015-09-21

    This review describes the current state of magnetic criteria of aromaticity. The introduction contains the fundamentals of ring currents in aromatic and antiaromatic systems, followed by a brief description of experimental and computational tools: NMR, diamagnetic susceptibility exaltation, current density analyses (CDA) and nucleus independent chemical shifts (NICS). This is followed by more comprehensive chapters: NMR - focusing on the work of R. Mitchell - NICS and CDA - describing the progress and development of the methods to their current state and presenting some examples of representative work. PMID:26035305

  17. Magnetic criteria of aromaticity.

    PubMed

    Gershoni-Poranne, Renana; Stanger, Amnon

    2015-09-21

    This review describes the current state of magnetic criteria of aromaticity. The introduction contains the fundamentals of ring currents in aromatic and antiaromatic systems, followed by a brief description of experimental and computational tools: NMR, diamagnetic susceptibility exaltation, current density analyses (CDA) and nucleus independent chemical shifts (NICS). This is followed by more comprehensive chapters: NMR - focusing on the work of R. Mitchell - NICS and CDA - describing the progress and development of the methods to their current state and presenting some examples of representative work.

  18. Appropriate burnup measurements for transportation burnup credit

    SciTech Connect

    Lancaster, D.; Fuentes, E.

    1997-04-01

    This paper addresses two of the measurement specifications used in analyzing spent fuel packages to gain burnup credit. The philosophy and calculation of rejection criteria and measurement accuracy are discussed. Any assembly for which the declared measured value and reactor record value deviate by more than 10% will be rejected. Measurement accuracy requirements are established for dependent and independent systems. The requirements have been tested and are achievable, ensuring safe operation without extra cost. 6 refs.

  19. Performance Criteria and Evaluation System

    1992-06-18

    The Performance Criteria and Evaluation System (PCES) was developed in order to make a data base of criteria accessible to radiation safety staff. The criteria included in the package are applicable to occupational radiation safety at DOE reactor and nonreactor nuclear facilities, but any data base of criteria may be created using the Criterion Data Base Utiliity (CDU). PCES assists personnel in carrying out oversight, line, and support activities.

  20. A reconnaissance of hydrogeologic conditions in Lehigh Acres and adjacent areas of Lee County, Florida

    USGS Publications Warehouse

    Boggess, Durward Hoye; Missimer, T.M.

    1975-01-01

    Lehigh Acres, a residential community with a population of about 13,500 and comprising an area of about 94 square miles (243 square kilometres) in the eastern part of Lee County, has been under development since 1954. Prior to development the area was poorly drained. By 1974, more than 150 miles (241 kilometres) of drainageways had been constructed to drain the area. The water-bearing formations underlying Lehigh Acres include the water-table, sandstone, lower Hawthorn, and Suwannee aquifers. The water-table aquifer is usually not more than 30 feet (9 metres) thick; it contains water of relatively good quality, except for iron and color. Water levels in this aquifer probably have been affected by construction of drainage canals. The sandstone aquifer, used extensively throughout the area as a source of water supply usually contains water of good quality although the water is hard and in places may contain concentrations of dissolved solids and iron which exceed the recommended limits of the U.S. Public Health Service and the State of Florida for drinking water. The lower Hawthorn and Suwannee aquifers, usually encountered at depths between 440 and 850 feet (135 and 262 metres), contains water with relatively high concentrations of sodium, sulfate, chloride, and dissolved solids. Three streams, the Orange River, Hickey Creek, and Bedman Creek and the canals connected to them, provide drainage of the area. Except for the Orange River, where the water is of good chemical quality, little is known of the water quality. Similarly, little information is available on stream discharge except for the Orange River where the average annual discharge was 41.1 cubic feet per second (11.6 cubic metres per second) between 1935-46. Most lakes and ponds in Lehigh Acres are hydraulically connected to the water-table aquifer such that factors which affect one also affect the other. Theoretical drawdown curves indicate that the drainage canals may affect ground-water levels to a

  1. 7 CFR 2500.053 - Expiring appropriations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Expiring appropriations. 2500.053 Section 2500.053 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT OF AGRICULTURE OAO FEDERAL FINANCIAL ASSISTANCE PROGRAMS-GENERAL AWARD ADMINISTRATIVE...

  2. 7 CFR 2500.053 - Expiring appropriations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Expiring appropriations. 2500.053 Section 2500.053 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT OF AGRICULTURE OAO FEDERAL FINANCIAL ASSISTANCE PROGRAMS-GENERAL AWARD ADMINISTRATIVE...

  3. 7 CFR 2500.053 - Expiring appropriations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Expiring appropriations. 2500.053 Section 2500.053 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF ADVOCACY AND OUTREACH, DEPARTMENT OF AGRICULTURE OAO FEDERAL FINANCIAL ASSISTANCE PROGRAMS-GENERAL AWARD ADMINISTRATIVE...

  4. Developmentally Appropriate Technology for Young Children

    ERIC Educational Resources Information Center

    Finegan, Colleen; Austin, Nancy Jo

    2002-01-01

    Is computer usage appropriate for young children? The manner in which the computer is used can benefit the child, have no effect whatsoever, or actually be detrimental to the child's academic and personal growth. Specific conditions can be instituted to assure that young children benefit from their exposure to or interaction with technology. How…

  5. Teaching Rhythmic Gymnastics: A Developmentally Appropriate Approach.

    ERIC Educational Resources Information Center

    Palmer, Heather C.

    This book is designed to guide teachers through the process of creating a developmentally appropriate rhythmic gymnastics program for children age 5-11. Rhythmic gymnastics programs develop fitness, inspire creativity, and allow all children to work at their own level. The book features 10 chapters in two parts. Part 1, "Getting Started on a…

  6. Teaching Learners to Appropriately Mitigate Requests

    ERIC Educational Resources Information Center

    Uso-Juan, Esther; Martinez-Flor, Alicia

    2008-01-01

    It is commonly recognized that, for lecturers of English as a Foreign Language (EFL) in a university setting, the goal of their teaching is to develop learners' ability to communicate appropriately in this language. This means that teaching practices should pay attention not only to the key features of the linguistic system of English, but also to…

  7. Defining and Operationalizing Appropriation for Science Learning

    ERIC Educational Resources Information Center

    Levrini, Olivia; Fantini, Paola; Tasquier, Giulia; Pecori, Barbara; Levin, Mariana

    2015-01-01

    The goal of this article is to contribute to understanding the interplay between students' disciplinary engagement and their identity construction. The term appropriation, borrowed from scholars in linguistics and education, was chosen to capture this broader sense of productive learning that sits at the nexus of disciplinary engagement and…

  8. 24 CFR 340.3 - Appropriations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Appropriations. 340.3 Section 340.3 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) GOVERNMENT NATIONAL MORTGAGE ASSOCIATION, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FIDUCIARY ACTIVITIES §...

  9. 50 CFR 34.8 - Appropriations authorized.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 9 2012-10-01 2012-10-01 false Appropriations authorized. 34.8 Section 34.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM REFUGE REVENUE SHARING WITH COUNTIES § 34.8...

  10. 50 CFR 34.8 - Appropriations authorized.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Appropriations authorized. 34.8 Section 34.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM REFUGE REVENUE SHARING WITH COUNTIES § 34.8...

  11. 50 CFR 34.8 - Appropriations authorized.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Appropriations authorized. 34.8 Section 34.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM REFUGE REVENUE SHARING WITH COUNTIES § 34.8...

  12. 50 CFR 34.8 - Appropriations authorized.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Appropriations authorized. 34.8 Section 34.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM REFUGE REVENUE SHARING WITH COUNTIES § 34.8...

  13. 50 CFR 34.8 - Appropriations authorized.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 9 2013-10-01 2013-10-01 false Appropriations authorized. 34.8 Section 34.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) THE NATIONAL WILDLIFE REFUGE SYSTEM REFUGE REVENUE SHARING WITH COUNTIES § 34.8...

  14. Earmarks and State Appropriations for Higher Education

    ERIC Educational Resources Information Center

    Delaney, Jennifer A.

    2011-01-01

    This study considers the relationship between federal academic earmarks and state appropriations for higher education. Often referred to as "pork," federal academic earmarks are both controversial and understudied. Using a unique panel dataset which spans 1990-2006, this study conducts a panel analysis with two-way state and year-fixed effects. It…

  15. 32 CFR 3.5 - Appropriate use.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense contractor is participating to a significant extent in the prototype project, but at least one of...

  16. 32 CFR 3.5 - Appropriate use.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense contractor is participating to a significant extent in the prototype project, but at least one of...

  17. 32 CFR 3.5 - Appropriate use.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense contractor is participating to a significant extent in the prototype project, but at least one of...

  18. 32 CFR 3.5 - Appropriate use.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense contractor is participating to a significant extent in the prototype project, but at least one of...

  19. 32 CFR 3.5 - Appropriate use.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense contractor is participating to a significant extent in the prototype project, but at least one of...

  20. Department of Defense Appropriations Act, 2014

    THOMAS, 113th Congress

    Rep. Young, C. W. Bill [R-FL-13

    2013-06-17

    07/30/2013 Received in the Senate and Read twice and referred to the Committee on Appropriations. (All Actions) Notes: For further action, see H.R.3547, which became Public Law 113-76 on 1/17/2014. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  1. SOLIDIFICATION/STABILIZATION: IS IT ALWAYS APPROPRIATE?

    EPA Science Inventory

    The findings of recent research and evaluation efforts are assessed to determine whether solidification/stabilization (S/S) has been properly and appropriately applied for different types of hazardous wastes. Results from these studies are mixed and, as a result, the need for pro...

  2. 7 CFR 3430.63 - Expiring appropriations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Expiring appropriations. 3430.63 Section 3430.63 Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION... other electronic payment system by the awardee or disbursed through any other system or method by...

  3. Culturally Appropriate Education: Insights from Educational Neuroscience

    ERIC Educational Resources Information Center

    Zhou, Jiaxian; Fischer, Kurt W.

    2013-01-01

    Culturally appropriate education focuses on educational competence needed in a global world and respect for different world views of learners and teachers from different cultural contexts. The relationship between gene, brain, and culture is complex and dynamical. Cultural experience and learning sculpts the anatomy and function of the human brain…

  4. Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

    ERIC Educational Resources Information Center

    Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

    2010-01-01

    Purpose: Entrepreneurship can refer to business start-up, but now sometimes has wider connotations. This paper aims to explore what entrepreneurship means for the promoters of entrepreneurship education and what might be appropriate for the students who consume it. Design/methodology/approach: The paper assesses the work of NICENT (The Northern…

  5. Becoming Maya? Appropriation of the White Shaman.

    ERIC Educational Resources Information Center

    Montejo, Victor D.

    1999-01-01

    The history of anthropology among the Maya consists of both the literal exploitation of archaeological finds and the appropriation of Maya culture and history by the Western academic world to construct distorted theories of the Maya past. In the ultimate disgrace, some Mayan priests are training White anthropologists to become shamans themselves…

  6. 12 CFR 367.3 - Appropriate officials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Appropriate officials. 367.3 Section 367.3 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY... (Ethics Section). This part does not modify the responsibility to report allegations of fraud, waste...

  7. Board Seeks $300 Million Increase in Appropriations

    ERIC Educational Resources Information Center

    American Vocational Journal, 1978

    1978-01-01

    The American Vocational Association (AVA) Board of Directors met during the annual convention and took action on several fronts. Given high priority were increasing vocational education appropriations for 1979, improving CETA, increasing AVA membership, and strengthening black vocational education participation. (Editor)

  8. Teaching Physics Using Appropriate Technology Projects

    ERIC Educational Resources Information Center

    Pearce, Joshua M.

    2007-01-01

    Appropriate technologies able to be easily and economically constructed from readily available materials by local craftspeople have a central role in the alleviation of poverty in the developing world. However, research and development of these technologies are generally apportioned relatively modest support by the developed world's institutions,…

  9. Structural optimization using optimality criteria methods

    NASA Technical Reports Server (NTRS)

    Khot, N. S.; Berke, L.

    1984-01-01

    Optimality criteria methods take advantage of some concepts as those of statically determinate or indeterminate structures, and certain variational principles of structural dynamics, to develop efficient algorithms for the sizing of structures that are subjected to stiffness-related constraints. Some of the methods and iterative strategies developed over the last decade for calculations of the Lagrange multipliers in stressand displacement-limited problems, as well as for satisfying the appropriate optimality criterion, are discussed. The application of these methods are illustrated by solving problems with stress and displacement constraints.

  10. Quartic Rotation Criteria and Algorithms.

    ERIC Educational Resources Information Center

    Clarkson, Douglas B.; Jennrich, Robert I.

    1988-01-01

    Most of the current analytic rotation criteria for simple structure in factor analysis are summarized and identified as members of a general symmetric family of quartic criteria. A unified development of algorithms for orthogonal and direct oblique rotation using arbitrary criteria from this family is presented. (Author/TJH)

  11. Criteria for Restructuring Postsecondary Education.

    ERIC Educational Resources Information Center

    Slaughter, Sheila

    1995-01-01

    Criteria most often used by higher education administrators in restructuring higher education in the 1980s and 1990s are outlined. A distinction is made between retrenchment and restructuring. Criteria recommended in the literature are compared with criteria actually used, and the results. Some alternatives are suggested. (MSE)

  12. Sagebrush Rebellion. [Proposed transfer of 175 million acres of Federal lands to states

    SciTech Connect

    Shay, R.

    1980-01-01

    The Sagebrush Rebellion concerns a proposal to transfer 175 million acres of Federally-owned wildlands to state governments, an idea with political appeal for many an opportunity to replace decades of conservation and wilderness planning with development and speculation. The project is seen as a way to grab public lands for private profit, its supporters largely drawn from the group which will gain either financially or politically. The movement grew out of government efforts to cut back on overgrazing on public lands and alert the public to the environmental impacts of grazing policies. Although legislative efforts have not succeeded, the movement has hindered the Bureau of Land Management and has championed private interests to the point where use violations and efforts to discredit government management are flagrant. A concerted lobbying effort is called for to prevent a massive land transfer. (DCK)

  13. Magnetically induced phonon splitting in ACr2O4 spinels from first principles

    DOE PAGESBeta

    Wysocki, Aleksander L.; Birol, Turan

    2016-04-22

    We study the magnetically-induced phonon splitting in cubic ACr2O4 (A=Mg, Zn, Cd) spinels from first principles and demonstrate that the sign of the splitting, which is experimentally observed to be opposite in CdCr2O4 compared to ZnCr2O4 and MgCr2O4, is determined solely by the particular magnetic ordering pattern observed in these compounds. We further show that this interaction between magnetism and phonon frequencies can be fully described by the previously proposed spin-phonon coupling model [C. J. Fennie and K. M. Rabe, Phys. Rev. Lett. 96, 205505 (2006)] that includes only the nearest neighbor exchange. In conclusion, using this model with materialsmore » specific parameters calculated from first principles, we provide additional insights into the physics of spin-phonon coupling in this intriguing family of compounds.« less

  14. VizieR Online Data Catalog: Cape AC Zone Data Reduced to ACRS (Urban+ 1996)

    NASA Astrophysics Data System (ADS)

    Urban, S. E.; Corbin, T. E.

    1995-10-01

    The U.S. Naval Observatory is in the process of making new reductions of the Astrographic Catalogue (AC) using a modern reference system, the ACRS, which represents the system of the FK5. The data from the Cape Zone, whose plates are centered between declinations -41 and -51 degrees (eq. 1900), have been analyzed for scale, rotation, tilt, coma, magnitude equation, radial distortion and distortions introduced by the use of reseaux in the Carte du Ciel program. The result is a positional catalog of over 544,000 stars on eq. J2000.0, epoch of observation. Additionally, all stars have been matched with the Tycho Input Catalog (revised); those numbers have been added for additional identification purposes. (2 data files).

  15. ACR-SNM Task Force on Nuclear Medicine Training: report of the task force.

    PubMed

    Guiberteau, Milton J; Graham, Michael M

    2011-06-01

    The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in physiology and molecular biology. These changes have unmasked weaknesses in current nuclear medicine and radiology training programs. Adding to the impetus for change are the attendant realities of the job market and uncertain employment prospects for physicians trained in nuclear medicine but not also trained in diagnostic radiology. With this background, the ACR and the Society of Nuclear Medicine convened the Task Force on Nuclear Medicine Training to define the issues and develop recommendations for resident training.

  16. Isolation and characterization of Mayaro virus from a human in Acre, Brazil.

    PubMed

    Terzian, Ana Carolina B; Auguste, Albert J; Vedovello, Danila; Ferreira, Marcelo U; da Silva-Nunes, Mônica; Sperança, Márcia A; Suzuki, Rodrigo B; Juncansen, Camila; Araújo, João P; Weaver, Scott C; Nogueira, Maurício L

    2015-02-01

    Mayaro virus (MAYV) is widely distributed throughout South America and is the etiologic agent of Mayaro fever, an acute febrile illness often presenting with arthralgic manifestations. The true incidence of MAYV infection is likely grossly underestimated because the symptomatic presentation is very similar to that of dengue fever and other acute febrile tropical diseases. We report the complete genome sequence of a MAYV isolate detected from an Acrelândia patient presenting with fever, chills, and sweating, but with no arthralgia. Results show that this isolate belongs to genotype D and is closely related to Bolivian strains. Our results suggest that the Acre/Mayaro strain is closely related to the progenitor of these Bolivian strains that were isolated between 2002 and 2006.

  17. ACR-ASNR Practice Parameter for Brain PET/CT Imaging Dementia.

    PubMed

    Frey, Kirk A; Lodge, Martin A; Meltzer, Carolyn Cidis; Peller, Patrick J; Wong, Terence Z; Hess, Christopher P; Petrella, Jeffrey R; Sair, Haris I; Subramaniam, Rathan M

    2016-02-01

    This practice parameter is for both FDG and amyloid brain PET or PET/computed tomography (CT) for patients with cognitive decline, and has been developed collaboratively by the American College of Radiology (ACR) and the American Society for Neuroradiology (ASNR). It is estimated that the number of people with dementia, 36.5 million worldwide in 2010, will increase to 65.7 million in 2030 and to 115 million in 2050. Four primary neurodegenerative etiologies of dementia have been defined: Alzheimer disease (AD), vascular dementia, frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Alzheimer disease is the most common form of dementia, accounting for approximately 60%-80% of all cases. Indications for FDG and amyloid brain PET and qualifications for personnel are discussed in this practice parameter.

  18. In silico and in vivo studies of an Arabidopsis thaliana gene, ACR2, putatively involved in arsenic accumulation in plants.

    PubMed

    Nahar, Noor; Rahman, Aminur; Moś, Maria; Warzecha, Tomasz; Algerin, Maria; Ghosh, Sibdas; Johnson-Brousseau, Sheila; Mandal, Abul

    2012-09-01

    Previously, our in silico analyses identified four candidate genes that might be involved in uptake and/or accumulation of arsenics in plants: arsenate reductase 2 (ACR2), phytochelatin synthase 1 (PCS1) and two multi-drug resistant proteins (MRP1 and MRP2) [Lund et al. (2010) J Biol Syst 18:223-224]. We also postulated that one of these four genes, ACR2, seems to play a central role in this process. To investigate further, we have constructed a 3D structure of the Arabidopsis thaliana ACR2 protein using the iterative implementation of the threading assembly refinement (I-TASSER) server. These analyses revealed that, for catalytic metabolism of arsenate, the arsenate binding-loop (AB-loop) and residues Phe-53, Phe-54, Cys-134, Cys-136, Cys-141, Cys-145, and Lys-135 are essential for reducing arsenate to arsenic intermediates (arsenylated enzyme-substrate intermediates) and arsenite in plants. Thus, functional predictions suggest that the ACR2 protein is involved in the conversion of arsenate to arsenite in plant cells. To validate the in silico results, we exposed a transfer-DNA (T-DNA)-tagged mutant of A. thaliana (mutation in the ACR2 gene) to various amounts of arsenic. Reverse transcriptase PCR revealed that the mutant exhibits significantly reduced expression of the ACR2 gene. Spectrophotometric analyses revealed that the amount of accumulated arsenic compounds in this mutant was approximately six times higher than that observed in control plants. The results obtained from in silico analyses are in complete agreement with those obtained in laboratory experiments. PMID:22562211

  19. Expressing ScACR3 in rice enhanced arsenite efflux and reduced arsenic accumulation in rice grains.

    PubMed

    Duan, Guilan; Kamiya, Takehiro; Ishikawa, Satoru; Arao, Tomohito; Fujiwara, Toru

    2012-01-01

    Arsenic (As) accumulation in rice grain poses a serious health risk to populations with high rice consumption. Extrusion of arsenite [As(III)] by ScAcr3p is the major arsenic detoxification mechanism in Saccharomyces cerevisiae. However, ScAcr3p homolog is absent in higher plants, including rice. In this study, ScACR3 was introduced into rice and expressed under the control of the Cauliflower mosaic virus (CaMV) 35S promoter. In the transgenic lines, As concentrations in shoots and roots were about 30% lower than in the wild type, while the As translocation factors were similar between transgenic lines and the wild type. The roots of transgenic plants exhibited significantly higher As efflux activities than those of the wild type. Within 24 h exposure to 10 μM arsenate [As(V)], roots of ScACR3-expressing plants extruded 80% of absorbed As(V) to the external solution as As(III), while roots of the wild type extruded 50% of absorbed As(V). Additionally, by exposing the As-containing rice plants to an As-lacking solution for 24 h, about 30% of the total As derived from pre-treatment was extruded to the external solution by ScACR3-expressing plants, while about 15% of As was extruded by wild-type plants. Importantly, ScACR3 expression significantly reduced As accumulation in rice straws and grains. When grown in flooded soil irrigated with As(III)-containing water, the As concentration in husk and brown rice of the transgenic lines was reduced by 30 and 20%, respectively, compared with the wild type. This study reports a potential strategy to reduce As accumulation in the food chain by expressing heterologous genes in crops. PMID:22107880

  20. Regulation of the α-Crystallin Gene acr2 by the MprAB Two-Component System of Mycobacterium tuberculosis▿ †

    PubMed Central

    Pang, Xiuhua; Howard, Susan T.

    2007-01-01

    Coordinated regulation of molecular chaperones is an important feature of the bacterial stress response. The small molecular chaperone gene acr2 of Mycobacterium tuberculosis is activated by exposure to several stresses, including heat and the detergent sodium dodecyl sulfate (SDS). In this study, we show that acr2 is directly regulated by the MprAB two-component system, and that MprAB has both positive and negative effects on acr2 expression. mRNA analyses showed that acr2 expression levels were lower under SDS stress and control conditions but higher under heat shock in an mprAB deletion mutant than they were in the parental strain. Parental expression patterns were restored in an mprAB-complemented strain. Western blotting using an anti-Acr2 antibody showed that Acr2 protein synthesis correlated with mRNA levels. Primer extension identified one transcriptional start point (TSP) for acr2 in all three strains under control and stress conditions. Electrophoresis mobility shift assays revealed multiple MprA binding sites in the acr2 promoter, including one downstream and three upstream of the acr2 TSP, with one overlapping the binding sites predicted for SigE, SigH, and HspR. DNA footprinting confirmed that MprA protected large sections of the acr2 promoter region. Expression of several housekeeping genes under SDS stress also was evaluated, revealing the upregulation of large molecular chaperone genes and, unexpectedly, sigA, with slightly lower sigA mRNA levels detected in the mprAB deletion mutant than in the wild type. In contrast to Acr2, SigA protein synthesis did not correlate with mRNA expression. Overall, the data indicated that MprA has complex interactions with the acr2 promoter and indirect effects on major housekeeping genes. PMID:17601788

  1. [Appropriate medication prescribing in older people].

    PubMed

    Blain, H; Rambourg, P; Le Quellec, A; Ayach, L; Biboulet, P; Bismuth, M; Blain, A; Boulenger, J-P; Celton, B; Combe, B; Dauvilliers, Y; Davy, J-M; Geny, C; Hemmi, P; Hillaire-Buys, D; Jalabert, A; Jung, B; Leclercq, F; Léglise, M-S; Morel, J; Mourad, G; Ponrouch, M-P; Puisieux, F; Quantin, X; Quéré, I; Renard, E; Ribstein, J; Roch-Torreilles, I; Rolland, Y; Rosant, D; Terminet, A; Thuret, R; Villiet, M; Deshormières, N; Bourret, R; Bousquet, J; Jonquet, O; Millat, B

    2015-10-01

    Drug-induced adverse effects are one of the main avoidable causes of hospitalization in older people. Numerous lists of potentially inappropriate medications for older people have been published, as national and international guidelines for appropriate prescribing in numerous diseases and for different age categories. The present review describes the general rules for an appropriate prescribing in older people and summarizes, for the main conditions encountered in older people, medications that are too often under-prescribed, the precautions of use of the main drugs that induce adverse effects, and drugs for which the benefit to risk ratio is unfavourable in older people. All these data are assembled in educational tables designed to be printed in a practical pocket format and used in daily practice by prescribers, whether physicians, surgeons or pharmacists.

  2. Improving the appropriateness of physician prescribing.

    PubMed

    Lexchin, J

    1998-01-01

    Appropriate prescribing means that prescribers should try to maximize effectiveness, minimize risks and costs, and respect patients' choices. Evidence from studies on prescribing to individuals and from administrative databases reveals a significant level of inappropriate prescribing by Canadian physicians. Two important reasons for inappropriate prescribing seem to be physicians' level of knowledge and physicians' practice settings. A large number of methods have been tried to improve prescribing behavior, but most are unsuccessful. Academic detailing, and audit and feedback, have both been shown to work but may be difficult to implement in Canada, where most physicians practice in solo fee-for-service settings. Alternative forms of physician payment such as capitation or salary are probably necessary to make prescribing more appropriate.

  3. FY92 Appropriations Bills reach conference committees

    NASA Astrophysics Data System (ADS)

    Bush, Susan

    Further legislative action will be put on hold until after Labor Day, while Congress is in its annual August recess. The FY 92 budget cycle begun in February is in its closing stages. Differing appropriations bills funding the science agencies were passed by both chambers of Congress and must now be passed by a joint committee conference, specially appointed to iron out the differences in the bills before going to President Bush for his approval or veto.The Energy and Water Development appropriations bill (HR2427), which funds the Department of Energy, has gone through the joint conference committee and has been sent to the president. In less than 2 hours of negotiation the House and Senate agreed to the final version of the bill on July 30. The House voted in favor of the measure the next day, and the Senate approved it on August 2 by voice vote.

  4. Department of Defense Appropriations Act, 2010

    THOMAS, 111th Congress

    Rep. Murtha, John P. [D-PA-12

    2009-07-24

    12/19/2009 Became Public Law No: 111-118. (TXT | PDF) (All Actions) Notes: Because the FY2010 DOD Appropriations Act was approved by both chambers by exchanging different versions of H.R. 3326, no conference report was issued. Section 1014 of the final version provides that the explanatory statement inserted in the Congressional Record on December 16... Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  5. Department of Defense Appropriations Act, 2014

    THOMAS, 113th Congress

    Sen. Durbin, Richard [D-IL

    2013-08-01

    11/13/2013 Committee on Appropriations Senate Subcommittee on Department of Defense. Hearings held prior to introduction and/or referral. Hearings printed: S.Hrg. 113-260. (All Actions) Notes: For further action, see H.R.3547, which became Public Law 113-76 on 1/17/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. 40 CFR 228.6 - Specific criteria for site selection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Specific criteria for site selection... selection. (a) In the selection of disposal sites, in addition to other necessary or appropriate factors...) Existence at or in close proximity to the site of any significant natural or cultural features of...

  7. 40 CFR 228.6 - Specific criteria for site selection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Specific criteria for site selection... selection. (a) In the selection of disposal sites, in addition to other necessary or appropriate factors...; (10) Potentiality for the development or recruitment of nuisance species in the disposal site;...

  8. Assessing evidence and testing appropriate hypotheses.

    PubMed

    Fenton, Norman

    2014-12-01

    It is crucial to identify the most appropriate hypotheses if one is to apply probabilistic reasoning to evaluate and properly understand the impact of evidence. Subtle changes to the choice of a prosecution hypothesis can result in drastically different posterior probabilities to a defence hypothesis from the same evidence. To illustrate the problem we consider a real case in which probabilistic arguments assumed that the prosecution hypothesis "both babies were murdered" was the appropriate alternative to the defence hypothesis "both babies died of Sudden Infant Death Syndrome (SIDS)". Since it would have been sufficient for the prosecution to establish just one murder, a more appropriate alternative hypothesis was "at least one baby was murdered". Based on the same assumptions used by one of the probability experts who examined the case, the prior odds in favour of the defence hypothesis over the double murder hypothesis are 30 to 1. However, the prior odds in favour of the defence hypothesis over the alternative 'at least one murder' hypothesis are only 5 to 2. Assuming that the medical and other evidence has a likelihood ratio of 5 in favour of the prosecution hypothesis results in very different conclusions about the posterior probability of the defence hypothesis.

  9. Evaluation Criteria for Solid Waste Processing Research and Technology Development

    NASA Technical Reports Server (NTRS)

    Levri, Julie A.; Hogan, J. A.; Alazraki, M. P.

    2001-01-01

    A preliminary list of criteria is proposed for evaluation of solid waste processing technologies for research and technology development (R&TD) in the Advanced Life Support (ALS) Program. Completion of the proposed list by current and prospective ALS technology developers, with regard to specific missions of interest, may enable identification of appropriate technologies (or lack thereof) and guide future development efforts for the ALS Program solid waste processing area. An attempt is made to include criteria that capture information about the technology of interest as well as its system-wide impacts. Some of the criteria in the list are mission-independent, while the majority are mission-specific. In order for technology developers to respond to mission-specific criteria, critical information must be available on the quantity, composition and state of the waste stream, the wast processing requirements, as well as top-level mission scenario information (e.g. safety, resource recovery, planetary protection issues, and ESM equivalencies). The technology readiness level (TRL) determines the degree to which a technology developer is able to accurately report on the list of criteria. Thus, a criteria-specific minimum TRL for mandatory reporting has been identified for each criterion in the list. Although this list has been developed to define criteria that are needed to direct funding of solid waste processing technologies, this list processes significant overlap in criteria required for technology selection for inclusion in specific tests or missions. Additionally, this approach to technology evaluation may be adapted to other ALS subsystems.

  10. DOE natural phenomenal hazards design and evaluation criteria

    SciTech Connect

    Murray, R.C.; Nelson, T.A.; Short, S.A.; Kennedy, R.P.; Chander, H.; Hill, J.R.; Kimball, J.K.

    1994-10-01

    It is the policy of the Department of Energy (DOE) to design, construct, and operate DOE facilities so that workers, the general public, and the environment are protected from the impacts of natural phenomena hazards (NPH). Furthermore, DOE has established explicit goals of acceptable risk for NPH performance. As a result, natural phenomena hazard (earthquake, extreme wind, and flood) design and evaluation criteria for DOE facilities have been developed based on target probabilistic performance goals. These criteria include selection of design/evaluation NPH input from probabilistic hazard curves combined with commonly practiced deterministic response evaluation methods and acceptance criteria with controlled levels of conservatism. For earthquake considerations, conservatism is intentionally introduced in specification of material strengths and capacities, in the allowance of limited inelastic behavior, and by a seismic scale factor. Criteria have been developed following a graded approach for several performance goals ranging from that appropriate for normal-use facilities to that appropriate for facilities involving hazardous or critical operations. Performance goals are comprised of qualitative expressions of acceptable behavior and of target quantitative probabilities that acceptable limits of behavior are maintained. The criteria are simple procedures but have a rigorous basis. This paper addresses DOE seismic design and evaluation criteria.

  11. Seasonal Variations in CO2 Fluxes in Fluvial Systems in Southstern of Amazonia (acre, Brazil)

    NASA Astrophysics Data System (ADS)

    Sousa, E.; Krusche, A. V.; Salimon, C. I.; Victoria, R. L.; Sawakuchi, H.

    2012-12-01

    Our main objective was to measure the CO2 fluxes in 5 (five) rivers and 2 (two) streams in the Purus Basin. These rivers and streams have different size, water chemical characteristics and type soil, despite all are classified as white-water rivers. We toke measures of pH, electrical conductivity, pCO2, DOC and DIC concentrations and CO2 fluxes in two seasonal periods: Wet Season (dez2010-abr2011 and dez2011-abr2012) and Dry Season (jul2011-set2011). Water samples were taken to DOC (filtered with quartz filters and preserved with hydrochloric acid), DIC (filtered with cellulose acetate filters and preserved with thymol) and δ13C of DIC. These water samples were sent to CENA/USP to be analyzed. EC and pH measurements were made with portable meters. Partial pressure of CO2 (pCO2) was measure with an equilibrator and CO2 fluxes with a floating chamber. Precipitation, water stage and discharge data was obtained by UFAC climatological station and ANA (National Water Agency). Statistical analysis were made using R Program. DOC and DIC concentrations presented significant differences between the periods. In the wet season were observed the highest values to DOC concentrations in all rivers and streams. In the rivers, these concentrations varied between 7.09±3.10 (Acre River) and 9.32±2.31 mg.L-1 (Rôla River). In the dry season, the values observed were 3.15±1.11 (Acre River) and 7.96±0.11 (Caeté River). In the streams, these concentrations also higher in the wet season, with 1.68±0.32 mg.L-1 in the Floresta stream and 3.22±1.08 mg.L-1 in the Escondido stream. To DIC concentrations, this pattern was inverted, with higher concentrations observed in the dry season. Iaco River presented the higher concentration (50.8±4.7 mg.L-1) and Acre River the lower concentration (11.30±2.77 mg.L-1). Despite the DIC concentrations were higher in the dry season, the pCO2 and CO2 fluxes values were higher in the wet season. In the rivers, the pCO2 values varied between 4,189±1

  12. Acceptance Criteria Framework for Autonomous Biological Detectors

    SciTech Connect

    Dzenitis, J M

    2006-12-12

    The purpose of this study was to examine a set of user acceptance criteria for autonomous biological detection systems for application in high-traffic, public facilities. The test case for the acceptance criteria was the Autonomous Pathogen Detection System (APDS) operating in high-traffic facilities in New York City (NYC). However, the acceptance criteria were designed to be generally applicable to other biological detection systems in other locations. For such detection systems, ''users'' will include local authorities (e.g., facility operators, public health officials, and law enforcement personnel) and national authorities [including personnel from the Department of Homeland Security (DHS), the BioWatch Program, the Centers for Disease Control and Prevention (CDC), and the Federal Bureau of Investigation (FBI)]. The panel members brought expertise from a broad range of backgrounds to complete this picture. The goals of this document are: (1) To serve as informal guidance for users in considering the benefits and costs of these systems. (2) To serve as informal guidance for developers in understanding the needs of users. In follow-up work, this framework will be used to systematically document the APDS for appropriateness and readiness for use in NYC.

  13. 25 CFR 214.7 - Operation not permitted until lease approved; 160 acres maximum for single lease.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Operation not permitted until lease approved; 160 acres maximum for single lease. 214.7 Section 214.7 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS §...

  14. 25 CFR 214.7 - Operation not permitted until lease approved; 160 acres maximum for single lease.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Operation not permitted until lease approved; 160 acres maximum for single lease. 214.7 Section 214.7 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS §...

  15. 25 CFR 214.7 - Operation not permitted until lease approved; 160 acres maximum for single lease.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Operation not permitted until lease approved; 160 acres maximum for single lease. 214.7 Section 214.7 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS §...

  16. 25 CFR 214.7 - Operation not permitted until lease approved; 160 acres maximum for single lease.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Operation not permitted until lease approved; 160 acres maximum for single lease. 214.7 Section 214.7 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS §...

  17. 25 CFR 214.7 - Operation not permitted until lease approved; 160 acres maximum for single lease.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Operation not permitted until lease approved; 160 acres maximum for single lease. 214.7 Section 214.7 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS LEASING OF OSAGE RESERVATION LANDS, OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS §...

  18. 75 FR 61227 - Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on Future Plant Designs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-04

    ..., General Electric--Hitachi Nuclear Energy (GEH), and their contractors, pursuant to 5 U.S.C. 552b(c)(4... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Advisory Committee on Reactor Safeguards Meeting of the ACRS Subcommittee on Future Plant...

  19. Criteria evaluation for cleanliness testing phase 0

    SciTech Connect

    Meltzer, Michael; Koester, Carolyn; Stefanni, Chris

    1999-02-04

    The Boeing Company (Boeing) contracted with Lawrence Livermore National Laboratory (LLNL) to develop criteria for evaluating the efficacy of its parts cleaning processes. In particular, LLNL and Boeing are attempting to identify levels of contamination that lead to parts failures. Sufficient contamination to cause impairment of anodizing, alodining, painting, or welding operations is considered a "part failure." In the "Phase 0" part of the project that was recently completed, preliminary analyses of aluminum substrates were performed as a first step in determining suitable cleanliness criteria for actual Boeing parts made from this material. A wide spread of contamination levels was specified for the Phase 0 test coupons, in the hopes of finding a range in which an appropriate cleanliness specification might lie. It was planned that, based on the results of the Phase 0 testing, further more detailed analyses ("Phase 1 testing") would be performed in order to more accurately identify the most appropriate criteria. For the Phase 0 testing, Boeing supplied LLNL with 3" x 6" and 3" x 10" aluminum test panels which LLNL contaminated with measured amounts of typical hydrocarbon substances encountered in Boeing' s fabrication operations. The panels were then subjected by Boeing to normal cleaning procedures, after which they went through one of the following sets of operations: l anodizing and primer painting . alodining (chromating) and primer painting l welding The coatings or welds were then examined by both Boeing and LLNL to determine whether any of the operations were impaired, and whether there was a correlation between contamination level and damage to the parts. The experimental approach and results are described in detail.

  20. The appropriate management of an appendiceal mucocele.

    PubMed

    Lorenzon, Laura; De Dominicis, Chiara; Virgilio, Edoardo; Balducci, Genoveffa

    2015-03-16

    Appendicectomy is one of the most commonly performed surgical procedures. Appendiceal mucocele is a relative rare disease, but appropriate management is critical. Indeed, the intact removal of a mucocele represents a curative treatment; conversely, a rupture may result in the spread of epithelial cells throughout the peritoneal cavity (pseudomyxoma peritonei). We report a case of a 61-year-old woman, admitted to our department, who underwent resection of an appendiceal mucocele, focusing, in the discussion, on the clinical and surgical management of this disease.