Science.gov

Sample records for adjustable maintenance dosing

  1. Effectiveness and safety of adjustable maintenance dosing with budesonide/formoterol turbuhaler compared with traditional fixed doses in bronchial asthma: a multi-centre Nigerian study.

    PubMed

    Ige, O M; Ohaju-Obodo, J O; Chukwu, C; Peters, E J; Okpapi, J; Chukwuka, C

    2010-09-01

    The modern treatment guideline of bronchial asthma recognize that combination of long acting beta2-agonists and inhaled glucocorticoids, enables better control of inflammation and symptoms of asthma than inhaled glucocorticoids only. These guidelines recommended that patients are educated to adjust their medication to their asthma severity using physician-guided self-management plans. However, many patients take a fixed dose of their controller medication and adjust their reliever medication to asthma symptoms Therefore, combination of formoterol and budesonide can be delivered at different dosing level without the need to change inhalers. This study examined whether asthma control improved if patients adjusted the maintenance doses(AMD) ofbudesonide/formoterol (Symbicort, 80/ 4.5 microg and 160/4.5 microg) according to asthma severity compared with traditional fixed dosing (FD) regimens. This was a prospective open randomized trial carried out in five teaching hospitals across Nigeria between 15th July 2002 and 15th July 2003. Patients with bronchial asthma who met the enrollment criteria were randomized to receive either adjustable dosing or fixed dosing for a period of twelve weeks. The results obtained at the start and the end of the study showed that budesonide/formoterol combination effectively achieved and maintained control of asthma. The adjustable dosing achieves more effective control compared to fixed dosing in terms of the number of patients that are redistributed to less severe forms of persistent asthma. The percentage of patients with intermittent asthma increased from 9.3% at randomization to 55.6% at the end of therapy with more patients at the AMD arm of treatment. Also for mild persistent asthma there was an increase from 20.4% to 24.1%. This showed that at the end of treatment, majority (79.7%) of the patients had intermittent and mild persistent asthma. The frequency of use of budesonide/formoterol in the two arms of treatment showed that

  2. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  3. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  4. THE PLANTER--SELECTION, ADJUSTMENT, MAINTENANCE, AND USE.

    ERIC Educational Resources Information Center

    Illinois Univ., Urbana. Coll. of Agriculture.

    RESOURCE MATERIAL ON CORN PLANTERS FOR USE IN HIGH SCHOOL VOCATIONAL AGRICULTURE AND ADULT FARMER CLASSES WAS DESIGNED BY SUBJECT MATTER SPECIALISTS, TEACHER EDUCATORS, SUPERVISORS, AND TEACHERS TO PROVIDE TEXTUAL MATERIAL FOR STUDENTS ON THE SELECTION, OPERATION, ADJUSTMENT, USE, MAINTENANCE, AND PRACTICAL APPLICATION OF CORN PLANTERS. THE…

  5. Predicting Maintenance Doses of Vancomycin for Hospitalized Patients Undergoing Hemodialysis

    PubMed Central

    El Nekidy, Wasim S; El-Masri, Maher M; Umstead, Greg S; Dehoorne-Smith, Michelle

    2016-01-01

    Background Methicillin-resistant Staphylococcus aureus is a leading cause of death in patients undergoing hemodialysis. However, controversy exists about the optimal dose of vancomycin that will yield the recommended pre-hemodialysis serum concentration of 15–20 mg/L. Objective To develop a data-driven model to optimize the accuracy of maintenance dosing of vancomycin for patients undergoing hemodialysis. Methods A prospective observational cohort study was performed with 164 observations obtained from a convenience sample of 63 patients undergoing hemodialysis. All vancomycin doses were given on the floor after completion of a hemodialysis session. Multivariate linear generalized estimating equation analysis was used to examine independent predictors of pre-hemodialysis serum vancomycin concentration. Results Pre-hemodialysis serum vancomycin concentration was independently associated with maintenance dose (B = 0.658, p < 0.001), baseline pre-hemodialysis serum concentration of the drug (B = 0.492, p < 0.001), and interdialytic interval (B = −2.133, p < 0.001). According to the best of 4 models that were developed, the maintenance dose of vancomycin required to achieve a pre-hemodialysis serum concentration of 15–20 mg/L, if the baseline serum concentration of the drug was also 15–20 mg/L, was 5.9 mg/kg with interdialytic interval of 48 h and 7.1 mg/kg with interdialytic interval of 72 h. However, if the baseline pre-hemodialysis serum concentration was 10–14.99 mg/L, the required dose increased to 9.2 mg/kg with an interdialytic interval of 48 h and 10.0 mg/kg with an interdialytic interval of 72 h. Conclusions The maintenance dose of vancomycin varied according to baseline pre-hemodialysis serum concentration of the drug and interdialytic interval. The current practice of targeting a pre-hemodialysis concentration of 15–20 mg/L may be difficult to achieve for the majority of patients undergoing hemodialysis. PMID:27826151

  6. A Meta-Analysis of Retention in Methadone Maintenance by Dose and Dosing Strategy

    PubMed Central

    Bao, Yan-ping; Liu, Zhi-min; Epstein, David H.; Du, Cun; Shi, Jie; Lu, Lin

    2013-01-01

    Objective To estimate, via meta-analysis, the influence of different methadone dose ranges and dosing strategies on retention rates in methadone maintenance treatment (MMT). Methods A systematic literature search identified 18 randomized controlled trials (RCTs) evaluating methadone dose and retention. Retention was defined as the percentage of patients remaining in treatment at a specified time point. After initial univariate analyses of retention by Pearson chi-squares, we used multilevel logistic regression to calculate summary odds ratios (ORs) and 95% confidence intervals for the effects of methadone dose (above or below 60 mg/day), flexible vs. fixed dosing strategy, and duration of follow-up. Results The total number of opioid-dependent participants in the 18 studies was 2831, with 1797 in MMT and 1034 receiving alternative mediations or placebo. Each variable significantly predicted retention with the other variables controlled for. Retention was greater with methadone doses ≥ 60 than with doses <60 (OR: 1.74, 95% CI: 1.43–2.11). Similarly, retention was greater with flexible-dose strategies than with fixed-dose strategies (OR: 1.72, 95% CI: 1.41–2.11). Conclusions Higher doses of methadone and individualization of doses are each independently associated with better retention in MMT. PMID:19152203

  7. [Dosing adjustment and renal function: Which equation(s)?].

    PubMed

    Delanaye, Pierre; Flamant, Martin; Cavalier, Étienne; Guerber, Fabrice; Vallotton, Thomas; Moranne, Olivier; Pottel, Hans; Boffa, Jean-Jacques; Mariat, Christophe

    2016-02-01

    While the CKD-EPI (for Chronic Kidney Disease Epidemiology) equation is now implemented worldwide, utilization of the Cockcroft formula is still advocated by some physicians for drug dosage adjustment. Justifications for this recommendation are that the Cockcroft formula was preferentially used to determine dose adjustments according to renal function during the development of many drugs, better predicts drugs-related adverse events and decreases the risk of drug overexposure in the elderly. In this opinion paper, we discuss the weaknesses of the rationale supporting the Cockcroft formula and endorse the French HAS (Haute Autorité de santé) recommendation regarding the preferential use of the CKD-EPI equation. When glomerular filtration rate (GFR) is estimated in order to adjust drug dosage, the CKD-EPI value should be re-expressed for the individual body surface area (BSA). Given the difficulty to accurately estimate GFR in the elderly and in individuals with extra-normal BSA, we recommend to prescribe in priority monitorable drugs in those populations or to determine their "true" GFR using a direct measurement method.

  8. Timing of maintenance phenytoin therapy after intravenous loading dose.

    PubMed

    Riviello, J J; Roe, E J; Sapin, J I; Grover, W D

    1991-01-01

    The specific timing of maintenance phenytoin therapy in children has not been addressed. Prevention of a subtherapeutic phenytoin level is important for seizure control. We devised a protocol using an 18 mg/kg loading dose of phenytoin with serial levels (obtained after 2,6,12 hours) and analyzed the results in 20 consecutive patients. A therapeutic level (greater than 10 micrograms/ml) was present in all patients at 2 hours, in 16 of 20 at 6 hours, and in 10 of 20 at 12 hours. The patients were divided into 2 groups by the 12-hour levels: group I: therapeutic level; and group II: subtherapeutic level. The mean 2-hour level in group I was 22.7 micrograms/ml versus 15.6 micrograms/ml in group II (P less than 0.001). The mean decline in plasma concentration in individual patients was 0.7 micrograms/ml/hr in group I versus 1.02 micrograms/ml/hr in group II (P less than 0.05). We now use the 2-hour level to decide the timing of maintenance phenytoin therapy and have devised an equation to estimate the duration of the therapeutic range. Phenytoin can be administered at 12 hours when the 2-hour level is satisfactory or earlier when the 2-hour level indicates that a subtherapeutic level will occur.

  9. Warfarin Dose Model for the Prediction of Stable Maintenance Dose in Indian Patients.

    PubMed

    Gaikwad, Tejasvita; Ghosh, Kanjaksha; Avery, Peter; Kamali, Farhad; Shetty, Shrimati

    2017-01-01

    The main aim of this study was to screen various genetic and nongenetic factors that are known to alter warfarin response and to generate a model to predict stable warfarin maintenance dose for Indian patients. The study comprised of 300 warfarin-treated patients. Followed by extensive literature review, 10 single-nucleotide polymorphisms, that is, VKORC1-1639 G>A (rs9923231), CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), FVII R353Q (rs6046), GGCX 12970 C>G (rs11676382), CALU c.*4A>G (rs1043550), EPHX1 c.337T>C (rs1051740), GGCX: c.214+597G>A (rs12714145), GGCX: 8016G>A (rs699664), and CYP4F2 V433M (rs2108622), and 5 nongenetic factors, that is, age, gender, smoking, alcoholism, and diet, were selected to find their association with warfarin response. The univariate analysis was carried out for 15 variables (10 genetic and 5 nongenetic). Five variables, that is, VKORC1-1639 G>A, CYP2C9*2, CYP2C9*3, age, and diet, were found to be significantly associated with warfarin response in univariate analysis. These 5 variables were entered in stepwise and multiple regression analysis to generate a prediction model for stable warfarin maintenance dose. The generated model scored R(2) of .67, which indicates that this model can explain 67% of warfarin dose variability. The generated model will help in prescribing more accurate warfarin maintenance dosing in Indian patients and will also help in minimizing warfarin-induced adverse drug reactions and a better quality of life in these patients.

  10. ADJUSTMENT, MAINTENANCE, AND REPAIR OF SMALL GASOLINE ENGINES. AGRICULTURAL MACHINERY--SERVICE OCCUPATIONS, MODULE NUMBER 12.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center for Vocational and Technical Education.

    ONE OF A SERIES DESIGNED TO HELP TEACHERS PREPARE POSTSECONDARY STUDENTS FOR THE AGRICULTURAL MACHINERY SERVICE OCCUPATIONS AS PARTS MEN, MECHANICS, MECHANIC'S HELPERS, OR SERVICE SUPERVISORS, THIS GUIDE AIMS TO DEVELOP STUDENT COMPETENCY IN THE ADJUSTMENT, MAINTENANCE, AND REPAIR OF SMALL GASOLINE ENGINES. IT WAS DEVELOPED BY A NATIONAL TASK…

  11. 10 CFR 35.2605 - Records of installation, maintenance, adjustment, and repair of remote afterloader units...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Records of installation, maintenance, adjustment, and repair of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.2605 Section 35.2605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records §...

  12. 10 CFR 35.2605 - Records of installation, maintenance, adjustment, and repair of remote afterloader units...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of installation, maintenance, adjustment, and repair of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.2605 Section 35.2605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records §...

  13. Bleeding events and maintenance dose of prasugrel: BLESS pilot study

    PubMed Central

    Parodi, Guido; Marcucci, Rossella; Valenti, Renato; Gori, Anna Maria; Migliorini, Angela; Comito, Vincenzo; Bellandi, Benedetta; Abbate, Rosanna; Gensini, Gian Franco; Antoniucci, David

    2016-01-01

    Objective To evaluate changes in residual platelet reactivity (RPR) over time, and bleeding and ischaemic events rate using 5 vs 10 mg maintenance dose (MD) regimens of prasugrel 1 month after acute coronary syndrome (ACS). Background The optimal level of RPR with prasugrel may change over time after an ACS. Methods After 60 mg loading dose of prasugrel (T0) followed by 10 mg/day for 1 month, patients were randomised to receive prasugrel 10 mg/day (n=95, group A) or 5 mg/day MD (n=98, group B) up to 1 year. RPR was assessed at T0, 37 (T1) and 180 days (T2). The primary end point was Bleeding Academic Research Consortium (BARC) bleeding events ≥2 between 1 and 12 months, and the secondary composite end point was cardiac death, myocardial infarction, stroke and definite/probable stent thrombosis. Results From T0 to T1, RPR significantly increased in both groups A and B and the increase was higher for group B (δ ADP 10 µmol: 13.8%±14.7% vs 23.5%±19.2%, p=0.001). At T2 a lower rate of high RPR patients were found in group A (2.6% vs13.3%; p=0.014). The BARC type ≥2 bleeding occurred in 12.6% of group A versus 4.1% of group B (OR 0.29, 95% CI 0.09 to 0.94) and secondary end point in 2.1% vs 1.0% (p=0.542), respectively, without stent thrombosis. Conclusions RPR increases shifting from 60 mg loading dose to 10 mg/day prasugrel MD with a further increase of RPR reducing prasugrel MD to 5 mg 1 month after ACS. Clinical value of these pharmacodynamic findings should be proved in larger clinical trials. Trial registration number NCT01790854. PMID:27843564

  14. Effects of VKORC1 Genetic Polymorphisms on Warfarin Maintenance Dose Requirement in a Chinese Han Population

    PubMed Central

    Yan, Xiaojuan; Yang, Feng; Zhou, Hanyun; Zhang, Hongshen; Liu, Jianfei; Ma, Kezhong; Li, Yi; Zhu, Jun; Ding, Jianqiang

    2015-01-01

    Background VKORC1 is reported to be capable of treating several diseases with thrombotic risk, such as cardiac valve replacement. Some single-nucleotide polymorphisms (SNPs) in VKORC1 are documented to be associated with clinical differences in warfarin maintenance dose. This study explored the correlations of VKORC1–1639 G/A, 1173 C/T and 497 T/G genetic polymorphisms with warfarin maintenance dose requirement in patients undergoing cardiac valve replacement. Material/Methods A total of 298 patients undergoing cardiac valve replacement were recruited. During follow-up, clinical data were recorded. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was applied to detect VKORC1–1639 G/A, 1173 C/T and 497 T/G polymorphisms, and genotypes were analyzed. Results Correlations between warfarin maintenance dose and baseline characteristics revealed statistical significances of age, gender and operation methods with warfarin maintenance dose (all P<0.05). Warfarin maintenance dose in VKORC1–1639 G/A AG + GG carriers was obviously higher than in AA carriers (P<0.001). As compared with patients with TT genotype in VKORC1 1173 C/T, warfarin maintenance dose was apparently higher in patients with CT genotype (P<0.001). Linear regression analysis revealed that gender, operation method, method for heart valve replacement, as well as VKORC1–1639 G/A and 1173 C/T gene polymorphisms were significantly related to warfarin maintenance dose (all P<0.05). Conclusions VKORC1 gene polymorphisms are key genetic factors to affect individual differences in warfarin maintenance dose in patients undergoing cardiac valve replacement; meanwhile, gender, operation method and method for heart valve replacement might also be correlate with warfarin maintenance dose. PMID:26583785

  15. Effects of VKORC1 Genetic Polymorphisms on Warfarin Maintenance Dose Requirement in a Chinese Han Population.

    PubMed

    Yan, Xiaojuan; Yang, Feng; Zhou, Hanyun; Zhang, Hongshen; Liu, Jianfei; Ma, Kezhong; Li, Yi; Zhu, Jun; Ding, Jianqiang

    2015-11-19

    BACKGROUND VKORC1 is reported to be capable of treating several diseases with thrombotic risk, such as cardiac valve replacement. Some single-nucleotide polymorphisms (SNPs) in VKORC1 are documented to be associated with clinical differences in warfarin maintenance dose. This study explored the correlations of VKORC1-1639 G/A, 1173 C/T and 497 T/G genetic polymorphisms with warfarin maintenance dose requirement in patients undergoing cardiac valve replacement. MATERIAL AND METHODS A total of 298 patients undergoing cardiac valve replacement were recruited. During follow-up, clinical data were recorded. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was applied to detect VKORC1-1639 G/A, 1173 C/T and 497 T/G polymorphisms, and genotypes were analyzed. RESULTS Correlations between warfarin maintenance dose and baseline characteristics revealed statistical significances of age, gender and operation methods with warfarin maintenance dose (all P<0.05). Warfarin maintenance dose in VKORC1-1639 G/A AG + GG carriers was obviously higher than in AA carriers (P<0.001). As compared with patients with TT genotype in VKORC1 1173 C/T, warfarin maintenance dose was apparently higher in patients with CT genotype (P<0.001). Linear regression analysis revealed that gender, operation method, method for heart valve replacement, as well as VKORC1-1639 G/A and 1173 C/T gene polymorphisms were significantly related to warfarin maintenance dose (all P<0.05). CONCLUSIONS VKORC1 gene polymorphisms are key genetic factors to affect individual differences in warfarin maintenance dose in patients undergoing cardiac valve replacement; meanwhile, gender, operation method and method for heart valve replacement might also be correlate with warfarin maintenance dose.

  16. Drug-Induced Nephrotoxicity and Dose Adjustment Recommendations: Agreement Among Four Drug Information Sources

    PubMed Central

    Bicalho, Millena Drumond; Soares, Danielly Botelho; Botoni, Fernando Antonio; Reis, Adriano Max Moreira; Martins, Maria Auxiliadora Parreiras

    2015-01-01

    Hospitalized patients require the use of a variety of drugs, many of which individually or in combination have the potential to cause kidney damage. The use of potentially nephrotoxic drugs is often unavoidable, and the need for dose adjustment should be evaluated. This study is aimed at assessing concordance in information on drug-induced nephrotoxicity and dose adjustment recommendations by comparing four drug information sources (DRUGDEX®, UpToDate®, Medscape® and the Brazilian Therapeutic Formulary) using the formulary of a Brazilian public hospital. A total of 218 drugs were investigated. The global Fleiss’ kappa coefficient was 0.265 for nephrotoxicity (p < 0.001; CI 95%, 0.211–0.319) and 0.346 for recommendations (p < 0.001; CI 95%, 0.292–0.401), indicating fair concordance among the sources. Anti-infectives and anti-hypertensives were the main drugs cited as nephrotoxic by the different sources. There were no clear definitions for qualitative data or quantitative values for dose adjustments among the four information sources. There was no advice for dosing for a large number of the drugs in the international databases. The National Therapeutic Formulary offered imprecise dose adjustment recommendations for many nephrotoxic drugs. Discrepancies among information sources may have a clinical impact on patient care and contribute to drug-related morbidity and mortality. PMID:26371029

  17. Drug-Induced Nephrotoxicity and Dose Adjustment Recommendations: Agreement Among Four Drug Information Sources.

    PubMed

    Bicalho, Millena Drumond; Soares, Danielly Botelho; Botoni, Fernando Antonio; Reis, Adriano Max Moreira; Martins, Maria Auxiliadora Parreiras

    2015-09-09

    : Hospitalized patients require the use of a variety of drugs, many of which individually or in combination have the potential to cause kidney damage. The use of potentially nephrotoxic drugs is often unavoidable, and the need for dose adjustment should be evaluated. This study is aimed at assessing concordance in information on drug-induced nephrotoxicity and dose adjustment recommendations by comparing four drug information sources (DRUGDEX(®), UpToDate(®), Medscape(®) and the Brazilian Therapeutic Formulary) using the formulary of a Brazilian public hospital. A total of 218 drugs were investigated. The global Fleiss' kappa coefficient was 0.265 for nephrotoxicity (p < 0.001; CI 95%, 0.211-0.319) and 0.346 for recommendations (p < 0.001; CI 95%, 0.292-0.401), indicating fair concordance among the sources. Anti-infectives and anti-hypertensives were the main drugs cited as nephrotoxic by the different sources. There were no clear definitions for qualitative data or quantitative values for dose adjustments among the four information sources. There was no advice for dosing for a large number of the drugs in the international databases. The National Therapeutic Formulary offered imprecise dose adjustment recommendations for many nephrotoxic drugs. Discrepancies among information sources may have a clinical impact on patient care and contribute to drug-related morbidity and mortality.

  18. Dose Adjustment for Normal Eating: A Role for the Expert Patient?

    PubMed Central

    2014-01-01

    The Dose Adjustment for Normal Eating (DAFNE) programme of intensive insulin therapy for type 1 diabetes provides a structured educational intervention to improve glycemic control, reduce hypoglycemia and improve quality of life. Enhancement of self-management skills is a key element of DAFNE and patients acquire detailed skills in insulin dose adjustment. Following DAFNE training, patients report improved confidence in their ability to manage their own insulin dosing, but generally still seek and require the assistance of health professionals when making substantial changes to their insulin regimens. Some DAFNE trained patients may be able to assist their peers in aspects of diabetes management within a group environment, but widespread introduction of the expert patient/peer educator role in the self-management of type 1 diabetes, in particular related to insulin dose management, would require formal and detailed evaluation, preferably in randomized controlled clinical trials, before being introduced into routine clinical practice. PMID:24851201

  19. Dose-adjusted Chemotherapy for Untreated c-MYC-positive Lymphoma

    Cancer.gov

    In this trial, adult patients with newly diagnosed Burkitt lymphoma or c-MYC-positive DLBCL will be separated into low-risk and high-risk groups; those in the low-risk group will be treated with at least three cycles of dose-adjusted EPOCH-R

  20. Zuclopenthixol decanoate in maintenance treatment of schizophrenic outpatients. Minimum effective dose and corresponding serum levels.

    PubMed

    Solgaard, T; Kistrup, K; Aaes-Jørgensen, T; Gerlach, J

    1994-05-01

    23 schizophrenic outpatients in maintenance treatment with zuclopenthixol decanoate were included in a study aimed at finding the minimum effective dose and corresponding serum concentration of zuclopenthixol. Every three months the dose was gradually reduced until prodromal symptoms appeared, indicative of an incipient relapse. A slightly higher dose was then promptly reinstituted (the minimum effective dose). At each dose level, two blood samples were drawn to determine the serum concentration. This dose reduction principles proved feasible. Only one patient had a clear-cut relapse. The condition of the remaining patients was acceptably maintained by a dose increase. The minimum effective dose of zuclopenthixol was 200 mg/2 weeks (range 60-400), with a serum concentration of 22 nmol/l (7.1-69.7). There was a significant correlation between the administered dose and the corresponding serum level of the drug (r = 0.66, P < 0.01). A trend towards a positive correlation was found between the serum level at the minimum effective dose and the BPRS score (r = 0.42, P < 0.1). No correlation was found between the serum level and the side-effects or length of neuroleptic treatment. It is concluded that routine serum drug monitoring is hardly indicated in the long-term depot-neuroleptic treatment of schizophrenic patients. A strategy aiming at continually seeking the lowest effective dose on the basis of clinical parameters appears more appropriate, especially in case of depot-neuroleptic treatment.

  1. What is the effect of adjusting epirubicin doses for body surface area?

    PubMed Central

    Dobbs, N. A.; Twelves, C. J.

    1998-01-01

    Doses of cytotoxic drugs are routinely adjusted according to body surface area. We have evaluated this practice in 32 women with advanced breast cancer treated with single-agent epirubicin 12.5-120 mg m(-2). Epirubicin and its metabolites were measured by high-performance liquid chromatography (HPLC). Unadjusted plasma clearance was calculated from dose in mg, and adjusted clearance from dose in mg m(-2). Unadjusted clearance did not correlate with surface area, height, weight, per cent ideal body weight or body mass index. There was no difference in the coefficient of variation (CV) of adjusted and unadjusted clearance (39.4% and 37.7% respectively). The AUC that would have resulted from giving an unadjusted dose was calculated. This predicted AUC was accurate, unbiased and had the same CV as the actual AUC. Similarly, in 11 patients an analysis of actual and predicted neutropenia confirmed that unadjusted dosing would have had no significant effect on the pattern of myelosuppression. Normalization of epirubicin dosage according to surface area appears not to reduce either pharmacokinetic or pharmacodynamic variability. PMID:9744507

  2. Kidney function and clinical recommendations of drug dose adjustment in geriatric patients

    PubMed Central

    2013-01-01

    Background In elderly patients chronic kidney disease often limits drug prescription. As several equations for quick assessment of kidney function by estimating glomerular filtration rate (eGFR) and several different clinical recommendations for drug dose adjustment in renal failure are published, choosing the correct approach for drug dosage is difficult for the practitioner. The aims of our study were to quantify the agreement between eGFR-equations grouped by creatinine-based or cystatin C-based and within the groups of creatinine and cystatin C-based equations and to investigate whether use of various literature and online references results in different recommendations for drug dose adjustment in renal disease in very elderly primary care patients. Methods We included 108 primary care patients aged 80 years and older from 11 family practices into a cross-sectional study. GFR was estimated using two serum creatinine-based equations (Cockroft-Gault, MDRD) and three serum cystatin C-based equations (Grubb, Hoek, Perkins). Concordance between different equations was quantified using intraclass correlation coefficients (ICCs). Essential changes in drug doses or discontinuation of medication were documented and compared in terms of estimated renal function as a consequence of the different eGFR-equations using five references commonly used in the US, Great Britain and Germany. Results In general, creatinine-based equations resulted in lower eGFR-estimation and in higher necessity of drug dose adjustment than cystatin C-based equations. Concordance was high between creatinine-based equations alone (ICCs 0.87) and between cystatin C-based equations alone (ICCs 0.90 to 0.96), and moderate between creatinine-based equations and cystatin C-based equations (ICCs 0.54 to 0.76). When comparing the five different references consulted to identify necessary drug dose adjustments we found that the numbers of drugs that necessitate dose adjustment in the case of renal

  3. Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations

    PubMed Central

    FitzGerald, J; Becker, A; Sears, M; Mink, S; Chung, K; Lee, J

    2004-01-01

    Background: Previous guidelines recommend doubling the daily dose of maintenance inhaled corticosteroid to treat or prevent progression of exacerbations of asthma. Methods: Over a 6 month period a cohort of patients were evaluated prospectively and randomised in a double blind controlled trial to treatment with either a continued maintenance dose (MD) of inhaled corticosteroid or doubling the dose (DD) at the time of an exacerbation. Results: A total of 290 patients were randomised (33% male) and 98 (DD, n = 46) experienced evaluable asthma exacerbations during the study period. Mean (SD) baseline characteristics at randomisation (age 33.5 (14.0) years; forced expiratory volume in 1 second (FEV1) 2.8 (0.7) l; peak expiratory flow (PEF) 422.9 (110.5) l/min) were similar in both groups. In the DD group 41% of patients were considered treatment failures because they either required systemic steroids (n = 12), had an unscheduled visit to a physician (n = 1), or their asthma did not return to baseline (n = 6). This did not differ from the MD group in which 40% were treatment failures (n = 9, 0, and 12, respectively; p = 0.94). Conclusions: In patients who regularly take an inhaled corticosteroid, doubling the maintenance dose may not affect the pattern of the exacerbation. PMID:15223858

  4. [SILDENAFIL CITRATE DOSE ADJUSTMENT FOR MEN WITH ERECTILE DYSFUNCTION: PERSONALIZED APPROACH].

    PubMed

    Korneev, I A

    2015-01-01

    The high prevalence of erectile dysfunction (ED) in men of all age groups with different psychogenic and organic disorders requires a personalized approach to the choice of treatment. Widely prescribed as first-line treatment for ED, sildenafil can be used in various dosages that are selected depending on comorbidities, tolerability and efficacy of the drug. Currently there is a wealth of accumulated experience of sildenafil dose adjustment depending on the severity of ED, its etiology and duration, as well as matched to the individual characteristics of copulatory activity. Divisible tablets Tornetis® ("Sandoz") give the opportunity to choose an effective and safe dose of sildenafil for of all patients with ED.

  5. ANALYSIS OF DOSE RATES DURING REPLACEMENT OF MANIPULATORS IN THE FFTF INTERIM EXAMINATION & MAINTENANCE (IEM) CELL

    SciTech Connect

    NELSON, J.V.

    2002-01-23

    Replacement of a master-slave manipulator in the Interim Examination and Maintenance Cell at the Fast Flux Test Facility was carried out in August 2001. This operation created a 178-mm opening in the thick concrete wall of the hot cell. To aid in radiological work planning, dose rates outside the penetration in the wall were predicted using MCNP{trademark} photon transport calculations. The predicted dose rate was 7.7 mrem/h, which was reasonably close to the value of 10.4 mrem/h inferred from measurements.

  6. High-dose vaginal maintenance metronidazole for recurrent bacterial vaginosis: a pilot study.

    PubMed

    Aguin, Tina; Akins, Robert A; Sobel, Jack D

    2014-05-01

    The purpose of this study was to explore the benefit of high-dose intravaginal metronidazole as a maintenance therapy in reducing recurrence rates of bacterial vaginosis (BV). Eighteen women with a history of recurrent BV and symptomatic BV were treated with metronidazole 750 mg suppository intravaginally daily for 7 days. Those in remission by Amsel criteria received metronidazole 750 mg twice weekly for 3 months with further follow-up for 3 months. High-dose metronidazole intravaginally was associated with rare clinical recurrence during the period of use. After cessation of suppression therapy, recurrence was high.

  7. Outcomes for newly diagnosed patients with acute myeloid leukemia dosed on actual or adjusted body weight

    PubMed Central

    Bivona, Cory; Rockey, Michelle; Henry, Dave; Grauer, Dennis; Abhyankar, Sunil; Aljitawi, Omar; Ganguly, Siddhartha; McGuirk, Joseph; Singh, Anurag; Lin, Tara L.

    2015-01-01

    Purpose Data from solid tumor malignancies suggest that actual body weight (ABW) dosing improves overall outcomes. There is the potential to compromise efficacy when chemotherapy dosages are reduced, but the impact of dose adjustment on clinical response and toxicity in hematologic malignancies is unknown. The purpose of this study was to evaluate the outcomes of utilizing a percent of ABW for acute myeloid leukemia (AML) induction chemotherapy dosing. Methods This retrospective, single-center study included 146 patients who received 7 + 3 induction (cytarabine and anthracycline) for treatment of AML. Study design evaluated the relationship between percentage of ABW dosing and complete response (CR) rates in patients newly diagnosed with AML. Results Percentage of ABW dosing did not influence CR rates in patients undergoing induction chemotherapy for AML (p = 0.83); nor did it influence rate of death at 30 days or relapse at 6 months (p = 0.94). When comparing patients dosed at 90–100 % of ABW compared to <90 % ABW, CR rates were not significantly different in patients classified as poor risk (p = 0.907). All favorable risk category patients obtained CR. Conclusions Preemptive dose reductions for obesity did not influence CR rates for patients with AML undergoing induction chemotherapy and did not influence the composite endpoint of death at 30 days or disease relapse at 6 months. PMID:26231954

  8. Evolving Adjustments to External (Gamma) Slope Factors for CERCLA Risk and Dose Assessments - 12290

    SciTech Connect

    Walker, Stuart

    2012-07-01

    To model the external exposure pathway in risk and dose assessments of radioactive contamination at Superfund sites, the U.S. Environmental Protection Agency (EPA) uses slope factors (SFs), also known as risk coefficients, and dose conversion factors (DCFs). Without any adjustment these external radiation exposure pathways effectively assumes that an individual is exposed to a source geometry that is effectively an infinite slab. The concept of an 'infinite slab' means that the thickness of the contaminated zone and its aerial extent are so large that it behaves as if it were infinite in its physical dimensions. EPA has been making increasingly complex adjustments to account for the extent of the contamination and its corresponding radiation field to provide more accurate risk and dose assessment modeling when using its calculators. In most instances, the more accurate modeling results derived from these gamma adjustments are less conservative. The notable exception are for some radionuclides in rooms with contaminated walls, ceiling, and floors, and the receptor is in location of the room with the highest amount of radiation exposure, usually the corner of small rooms and the center of large conference rooms. (authors)

  9. Dose-Weighted Adjusted Mantel-Haenszel Tests for Numeric Scaled Strata in a Randomized Trial

    PubMed Central

    Gansky, Stuart A.; Cheng, Nancy F.; Koch, Gary G.

    2011-01-01

    A recent three-arm parallel groups randomized clinical prevention trial had a protocol deviation causing participants to have fewer active doses of an in-office treatment than planned. The original statistical analysis plan stipulated a minimal assumption randomization-based extended Mantel-Haenszel (EMH) trend test of the high frequency, low frequency, and zero frequency treatment groups and a binary outcome. Thus a dose-weighted adjusted EMH (DWAEMH) test was developed with an extra set of weights corresponding to the number of active doses actually available, in the spirit of a pattern mixture model. The method can easily be implemented using standard statistical software. A set of Monte Carlo simulations using a logistic model was undertaken with (and without) actual dose-response effects through 1000 replicates for empirical power estimates (and 2100 for empirical size). Results showed size was maintained and power was improved for DWAEMH versus EMH and logistic regression Wald tests in the presence of a dose effect and treatment by dose interaction. PMID:21709814

  10. Anticancer Dose Adjustment for Patients with Renal and Hepatic Dysfunction: From Scientific Evidence to Clinical Application.

    PubMed

    Hendrayana, Tomi; Wilmer, André; Kurth, Verena; Schmidt-Wolf, Ingo Gh; Jaehde, Ulrich

    2017-02-27

    Most anticancer agents exhibit a narrow therapeutic index, i.e., a small change in plasma concentrations can lead to a less efficacious treatment or an unacceptable degree of toxicity. This study aimed at providing health professionals with a feasible and time-saving tool to adapt the dose of anticancer agents for patients with renal or hepatic dysfunction. A guideline for anticancer agents was developed based on a literature search. An algorithm was generated to enhance the efficiency of the dose adaptation process. Finally, the dosing guideline was converted into an easy-to-use Excel(TM) tool. The concept was applied to a total of 105 adult patients at the Centre for Integrated Oncology, Bonn, Germany. In total, 392 recommendations for dose adaptation were made and 320 (81.6%) recommendations were responded to by the oncologists. 98.4% of the recommendations were accepted. The algorithm simplifies the decision and screening process for high-risk patients. Moreover, it provides the possibility to quickly decide which laboratory tests are required and whether a dose adjustment for a particular anticancer drug is needed. The Excel(TM) tool provides a recommended individual dose for patients with renal or hepatic dysfunction. The effectiveness of this strategy to reduce toxicity should be investigated in further studies before being adopted for routine use.

  11. Dose-response trend tests for tumorigenesis, adjusted for body weight.

    PubMed

    Gaylor, D W; Kodell, R L

    1999-06-01

    Several studies have demonstrated a relationship between rodent body weight and tumor incidence for some tissue/organ sites. It is not uncommon for a chemical tested for carcinogenicity to also affect body weight. In such cases, comparisons of tumor incidence may be biased by body-weight differences across dose groups. A simple procedure was investigated for reducing this bias. This procedure divides the animals into a few groups based on body weight. Body weight at 12 months was used, before the appearance of a tumor was likely to affect body weight. Statistics for dose-response trend tests are calculated within body weight strata and pooled to obtain an overall dose-response trend test. This procedure is analogous to that currently used, of stratifying animals, based on their age at the time of removal from a study. Age stratification is used to account for differences in animal age across dose groups, which can affect comparisons of tumor incidence. Several examples were investigated where the high-dose group had reduced body weights and associated reductions in tumor incidence. When the data were analyzed by body-weight strata, some positive dose-response trends for tumor incidence were demonstrated. In one case, the weight-adjusted analysis indicated that a negative dose-response trend in tumor incidence was a real effect, in addition to a body weight reduction. These examples indicate that it is important to consider the effects of body weight changes as low as 10%, and perhaps below, that were caused by chemicals in 2-year bioassays for carcinogenesis. The simple procedure of analyzing tumor incidence within body-weight strata can reduce the bias introduced by weight differences across dose groups.

  12. Dialysis Dose Scaled to Body Surface Area and Size-Adjusted, Sex-Specific Patient Mortality

    PubMed Central

    Kapke, Alissa; Port, Friedrich K.; Wolfe, Robert A.; Saran, Rajiv; Pearson, Jeffrey; Hirth, Richard A.; Messana, Joseph M.; Daugirdas, John T.

    2012-01-01

    Summary Background and objectives When hemodialysis dose is scaled to body water (V), women typically receive a greater dose than men, but their survival is not better given a similar dose. This study sought to determine whether rescaling dose to body surface area (SA) might reveal different associations among dose, sex, and mortality. Design, setting, participants, & measurements Single-pool Kt/V (spKt/V), equilibrated Kt/V, and standard Kt/V (stdKt/V) were computed using urea kinetic modeling on a prevalent cohort of 7229 patients undergoing thrice-weekly hemodialysis. Data were obtained from the Centers for Medicare & Medicaid Services 2008 ESRD Clinical Performance Measures Project. SA-normalized stdKt/V (SAN-stdKt/V) was calculated as stdKt/V × ratio of anthropometric volume to SA/17.5. Patients were grouped into sex-specific dose quintiles (reference: quintile 1 for men). Adjusted hazard ratios (HRs) for 1-year mortality were calculated using Cox regression. Results spKt/V was higher in women (1.7±0.3) than in men (1.5±0.2; P<0.001), but SAN-stdKt/V was lower (women: 2.3±0.2; men: 2.5±0.3; P<0.001). For both sexes, mortality decreased as spKt/V increased, until spKt/V was 1.6–1.7 (quintile 4 for men: HR, 0.62; quintile 3 for women: HR, 0.64); no benefit was observed with higher spKt/V. HR for mortality decreased further at higher SAN-stdKt/V in both sexes (quintile 5 for men: HR, 0.69; quintile 5 for women: HR, 0.60). Conclusions SA-based dialysis dose results in dose-mortality relationships substantially different from those with volume-based dosing. SAN-stdKt/V analyses suggest women may be relatively underdosed when treated by V-based dosing. SAN-stdKt/V as a measure for dialysis dose may warrant further study. PMID:22977208

  13. Safety of allergen immunotherapy: a review of premedication and dose adjustment.

    PubMed

    Morris, A Erika; Marshall, Gailen D

    2012-03-01

    From the first allergen immunotherapy proposed in the early 1900s to the present day, numerous studies have proven the efficacy of allergen immunotherapy for the treatment of allergic rhinitis, allergic conjunctivitis, allergic asthma and stinging insect hypersensitivity. The major risk, however small, with allergen immunotherapy is anaphylaxis. There has been considerable interest and debate regarding risk factors for immunotherapy reactions (local and systemic) and interventions to reduce the occurrence of these reactions. One of these interventions that is especially debated regards dose adjustment for various reasons, but in particular for local reactions. In this review, we discuss the safety of immunotherapy and provide a comprehensive review of the literature regarding immunotherapy schedules and doses.

  14. Negative Relationship between Erythropoietin Dose and Blood Lead Level in Patients Undergoing Maintenance Hemodialysis

    PubMed Central

    Huang, Wen-Hung; Hsu, Ching-Wei; Weng, Cheng-Hao; Lin-Tan, Dan-Tzu; Yen, Tzung-Hai

    2016-01-01

    The adverse effects of increased blood lead levels have been well discussed. Several antioxidant agents have been reported to offer protection from lead toxicity and to reduce blood lead levels (BLL). Given that erythropoietin (EPO) also has antioxidant properties, the aim of this cross-sectional study was to assess the role of EPO and other clinical variables on BLL in hemodialysis (HD) patients. We recruited 931 maintenance hemodialysis (MHD) patients who had undergone HD for at least 6 months and who had ever received blood lead level (BLL) study. Use of erythropoiesis-stimulating agents followed the The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) Clinical Practice Guideline. We estimated demographic, hematological, nutritional, inflammatory, biochemical, and dialysis-related data based on this study. In the group with EPO, 7% had high BLL. In the group without EPO, 22% had high BLL. From the stepwise liner regression, urban areas, hemodialysis duration, and clearance of urea (KT/Vurea) were positively associated with log BLL. In contrast, diabetes (DM), and monthly EPO dose were negatively associated with log BLL. This study showed that EPO dose might be negatively associated with blood lead levels in patients on maintenance hemodialysis. PMID:27680289

  15. ADJUSTMENT, MAINTENANCE, AND REPAIR OF CROP HARVESTING MACHINERY. AGRICULTURAL MACHINERY--SERVICE OCCUPATIONS, MODULE NUMBER 11.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center for Vocational and Technical Education.

    ONE OF A SERIES DESIGNED FOR HELPING TEACHERS PREPARE POSTSECONDARY-LEVEL STUDENTS FOR AGRICULTURAL MACHINERY SERVICE OCCUPATIONS AS PARTS MEN, MECHANICS, MECHANIC'S HELPERS, AND SERVICE SUPERVISORS, THIS GUIDE AIMS TO DEVELOP STUDENT COMPETENCY IN ADJUSTING, REPAIRING, AND MAINTAINING CROP HARVESTING MACHINERY. SUGGESTIONS FOR INTRODUCTION OF THE…

  16. Practical considerations for the dosing and adjustment of continuous renal replacement therapy in the intensive care unit.

    PubMed

    Galvagno, Samuel M; Hong, Caron M; Lissauer, Matthew E; Baker, Andrew K; Murthi, Sarah B; Herr, Daniel L; Stein, Deborah M

    2013-12-01

    Familiarity with the initiation, dosing, adjustment, and termination of continuous renal replacement therapy (CRRT) is a core skill for contemporary intensivists. Guidelines for how to administer CRRT in the intensive care unit are not well documented. The purpose of this review is to discuss the modalities, terminology, and components of CRRT, with an emphasis on the practical aspects of dosing, adjustments, and termination. Management of electrolyte and acid-base derangements commonly encountered with acute renal failure is emphasized. Knowledge regarding the practical aspects of managing CRRT in the intensive care unit is a prerequisite for achieving desired physiological end points.

  17. Multiple confidence intervals for selected parameters adjusted for the false coverage rate in monotone dose-response microarray experiments.

    PubMed

    Peng, Jianan; Liu, Wei; Bretz, Frank; Shkedy, Ziv

    2016-12-26

    Benjamini and Yekutieli () introduced the concept of the false coverage-statement rate (FCR) to account for selection when the confidence intervals (CIs) are constructed only for the selected parameters. Dose-response analysis in dose-response microarray experiments is conducted only for genes having monotone dose-response relationship, which is a selection problem. In this paper, we consider multiple CIs for the mean gene expression difference between the highest dose and control in monotone dose-response microarray experiments for selected parameters adjusted for the FCR. A simulation study is conducted to study the performance of the method proposed. The method is applied to a real dose-response microarray experiment with 16, 998 genes for illustration.

  18. Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation

    PubMed Central

    Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran

    2016-01-01

    Purpose To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (<8 years), 0.53±0.12 g/kg/d (8 to <12 years), and 0.36±0.05 g/kg/d (12 to 15 years). The dose of lactulose was 1.99±0.43 mL/kg/d (<8 years) or 1.26±0.25 mL/kg/d (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation. PMID:27738600

  19. Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight

    PubMed Central

    Rosenbaum, Michael; Goldsmith, Rochelle; Bloomfield, Daniel; Magnano, Anthony; Weimer, Louis; Heymsfield, Steven; Gallagher, Dympna; Mayer, Laurel; Murphy, Ellen; Leibel, Rudolph L.

    2005-01-01

    Maintenance of a reduced body weight is accompanied by decreased energy expenditure that is due largely to increased skeletal muscle work efficiency. In addition, decreased sympathetic nervous system tone and circulating concentrations of leptin, thyroxine, and triiodothyronine act coordinately to favor weight regain. These “weight-reduced” phenotypes are similar to those of leptin-deficient humans and rodents. We examined metabolic, autonomic, and neuroendocrine phenotypes in 10 inpatient subjects (5 males, 5 females [3 never-obese, 7 obese]) under 3 sets of experimental conditions: (a) maintaining usual weight by ingesting a liquid formula diet; (b) maintaining a 10% reduced weight by ingesting a liquid formula diet; and (c) receiving twice-daily subcutaneous doses of leptin sufficient to restore 8 am circulating leptin concentrations to pre–weight-loss levels and remaining on the same liquid formula diet required to maintain a 10% reduced weight. During leptin administration, energy expenditure, skeletal muscle work efficiency, sympathetic nervous system tone, and circulating concentrations of thyroxine and triiodothyronine returned to pre–weight-loss levels. These responses suggest that the weight-reduced state may be regarded as a condition of relative leptin insufficiency. Prevention of weight regain might be achievable by strategies relevant to reversing this leptin-insufficient state. PMID:16322796

  20. High-Dose 131I-Tositumomab (Anti-CD20) Radioimmunotherapy for Non-Hodgkin's Lymphoma: Adjusting Radiation Absorbed Dose to Actual Organ Volumes

    SciTech Connect

    Rajendran, Joseph G.; Fisher, Darrell R.; Gopal, A K.; Durack, L. D.; Press, O. W.; Eary, Janet F.

    2004-06-01

    Radioimmunotherapy (RIT) using 131I-tositumomab has been used successfully to treat relapsed or refractory B-cell non-Hodgin's lymphoma (NHL). Our approach to treatment planning has been to determine limits on radiation absorbed close to critical nonhematopoietic organs. This study demonstrates the feasibility of using CT to adjust for actual organ volumes in calculating organ-specific absorbed dose estimates. Methods: Records of 84 patients who underwent biodistribution studies after a trace-labeled infusion of 131I-tositumomab for RIT (January 1990 and April 2003) were reviewed. Serial planar -camera images and whole-body Nal probe counts were obtained to estimate 131I-antibody source-organ residence times as recommended by the MIRD Committee. The source-organ residence times for standard man or woman were adjusted by the ratio of the MIRD phantom organ mass to the CT-derived organ mass. Results: The mean radiation absorbed doses (in mGy/MBq) for our data using the MIRD model were lungs= 1.67; liver= 1.03; kidneys= 1.08; spleen= 2.67; and whole body= 0.3; and for CT volume-adjusted organ volumes (in mGy/MBq) were lungs= 1.30; liver= 0.92; kidneys= 0.76; spleen= 1.40; and whole body= 0.22. We determined the following correlation coefficients between the 2 methods for the various organs; lungs, 0.49; (P= 0.0001); liver, 0.64 (P= 0.004); kidneys, 0.45 (P= 0.0001), for the residence times. For therapy, patients received mean 131I administered activities of 19.2 GBq (520 mCi) after adjustment for CT-derived organ mass compared with 16.0 GBq (433 mCi) that would otherwise have been given had therapy been based only using standard MIRD organ volumes--a statistically significant difference (P= 0.0001). Conclusion: We observed large variations in organ masses among our patients. Our treatments were planned to deliver the maximally tolerated radiation dose to the dose-limiting normal organ. This work provides a simplified method for calculating patient-specific radiation

  1. Pharmacokinetic/Pharmacodynamic Modeling and Simulation of Cefiderocol, a Parenteral Siderophore Cephalosporin, for Dose Adjustment Based on Renal Function.

    PubMed

    Katsube, Takayuki; Wajima, Toshihiro; Ishibashi, Toru; Arjona Ferreira, Juan Camilo; Echols, Roger

    2017-01-01

    Cefiderocol, a novel parenteral siderophore cephalosporin, exhibits potent efficacy against most Gram-negative bacteria, including carbapenem-resistant strains. Since cefiderocol is excreted primarily via the kidneys, this study was conducted to develop a population pharmacokinetics (PK) model to determine dose adjustment based on renal function. Population PK models were developed based on data for cefiderocol concentrations in plasma, urine, and dialysate with a nonlinear mixed-effects model approach. Monte-Carlo simulations were conducted to calculate the probability of target attainment (PTA) of fraction of time during the dosing interval where the free drug concentration in plasma exceeds the MIC (Tf>MIC) for an MIC range of 0.25 to 16 μg/ml. For the simulations, dose regimens were selected to compare cefiderocol exposure among groups with different levels of renal function. The developed models well described the PK of cefiderocol for each renal function group. A dose of 2 g every 8 h with 3-h infusions provided >90% PTA for 75% Tf>MIC for an MIC of ≤4 μg/ml for patients with normal renal function, while a more frequent dose (every 6 h) could be used for patients with augmented renal function. A reduced dose and/or extended dosing interval was selected for patients with impaired renal function. A supplemental dose immediately after intermittent hemodialysis was proposed for patients requiring intermittent hemodialysis. The PK of cefiderocol could be adequately modeled, and the modeling-and-simulation approach suggested dose regimens based on renal function, ensuring drug exposure with adequate bactericidal effect.

  2. Design of a desipramine dosing regimen for the rapid induction and maintenance of maximal cortical beta-adrenoceptor downregulation.

    PubMed

    Argenti, D; D'Mello, A P

    1994-09-01

    Chronic administration of desipramine to rats causes a gradual reduction in cortical beta-adrenoceptor density. We examined the relationship between the duration of treatment with desipramine, and the rate and intensity of cortical beta-adrenoceptor downregulation. Male Sprague-Dawley rats were administered a 3.75 mg/kg/12 hr dose of desipramine for 4, 8 or 16 days. After 4 and 8 days of treatment, cortical beta-adrenoceptor density was reduced by 14 and 26% respectively. After 16 days of treatment, cortical beta-adrenoceptor density was maximally reduced by 36%. In our next series of experiments, we tested the hypothesis that the dose of desipramine required to rapidly induce maximal beta-adrenoceptor downregulation was higher than the dose required to maintain maximal beta-adrenoceptor downregulation. Initially, cortical beta-adrenoceptors were rapidly, and maximally downregulated with a four day, 10 mg/kg/12 hr induction regimen of desipramine. Trough, steady-state brain/cortical concentrations of desipramine plus desmethyldesipramine at the end of this regimen were approx 4000 ng/gm. Subsequently, maintenance desipramine regimens of 3.75 mg/kg/12 hr and 1.87 mg/kg/12 hr or vehicle were initiated for the next four days. Inspite of a 20-fold drop in brain/cortical concentrations of desipramine plus its metabolite, the 3.75 mg/kg maintenance regimen sustained maximal cortical beta-adrenoceptor downregulation. The 1.87 mg/kg maintenance regimen did result in a marked (25%) but non-significant recovery in the density of beta-adrenoceptors. Animals administered a vehicle maintenance regimen showed a large (50%) and statistically significant recovery of cortical beta-adrenoceptor density.

  3. Calculating the Dose of Subcutaneous Immunoglobulin for Primary Immunodeficiency Disease in Patients Switched From Intravenous to Subcutaneous Immunoglobulin Without the Use of a Dose-Adjustment Coefficient

    PubMed Central

    Fadeyi, Michael; Tran, Tin

    2013-01-01

    Primary immunodeficiency disease (PIDD) is an inherited disorder characterized by an inadequate immune system. The most common type of PIDD is antibody deficiency. Patients with this disorder lack the ability to make functional immunoglobulin G (IgG) and require lifelong IgG replacement therapy to prevent serious bacterial infections. The current standard therapy for PIDD is intravenous immunoglobulin (IVIG) infusions, but IVIG might not be appropriate for all patients. For this reason, subcutaneous immunoglobulin (SCIG) has emerged as an alternative to IVIG. A concern for physicians is the precise SCIG dose that should be prescribed, because there are pharmacokinetic differences between IVIG and SCIG. Manufacturers of SCIG 10% and 20% liquid (immune globulin subcutaneous [human]) recommend a dose-adjustment coefficient (DAC). Both strengths are currently approved by the FDA. This DAC is to be used when patients are switched from IVIG to SCIG. In this article, we propose another dosing method that uses a higher ratio of IVIG to SCIG and an incremental adjustment based on clinical status, body weight, and the presence of concurrent diseases. PMID:24391400

  4. Characterization of the role of Fhit in maintenance of genomic integrity following low dose radiation, in vivo and in vitro

    SciTech Connect

    Wang, Ya

    2010-05-14

    The major goal of this study is to determine the effects of the Fhit pathway on low dose (< 0.1 Gy) ionizing radiation (IR)-induced genetic instability. Reduction of Fhit protein expression is observed in most solid tumors particularly in those tumors resulting from exposure to environmental carcinogens. Therefore, characterization of the role of the Fhit-dependent pathway in preventing low dose IR-induced genetic instability will provide useful parameters for evaluating the low dose IR-induced risk of mutagenesis and carcinogenesis. We pursued 3 specific aims to study our hypothesis that the Fhit-dependent pathways maintain genomic integrity through adjusting checkpoint response and repair genes expression following low dose IR. Aim 1: Determine whether Fhit interaction with RPA is necessary for Fhit to affect the cellular response to low dose IR. We combined the approaches of in vitro (GST pull-down and site-directed mutagenesis) and in vivo (observing the co-localization and immunoprecipitation of Fhit and RPA in Fhit knock out mouse cells transfected with mutant Fhit which has lost ability to interact with RPA in vitro). Aim 2: Determine the role of genes whose expression is affected by Fhit in low dose irradiated cells. We analyzed the distinct signature of gene expression in low dose irradiated Fhit-/- cells compared with Fhit+/+ cells by combining microarray, gene transfection and siRNA approaches. Aim 3: Determine the role of Fhit in genetic susceptibility to low dose IR in vivo. We compared the gene mutation frequency and the fragile site stability in the cells isolated from the Fhit+/+ and Fhit-/- mice at 1.5 years following low dose IR. These results determine the role of the Fhit-dependent pathway in maintaining genomic integrity in vitro and in vivo, which provide a basis for choosing surrogate markers in the Fhit-dependent pathway to evaluate low dose IR-induced risk of mutagenesis and carcinogenesis.

  5. Characterization of the role of Fhit in maintenance of genomic integrity following low dose radiation, in vivo and in vitro

    SciTech Connect

    Ya Wang

    2010-05-31

    The major goal of this study is to determine the effects of the Fhit pathway on low dose ({le} 0.1 Gy) ionizing radiation (IR)-induced genetic instability. Reduction of Fhit protein expression is observed in most solid tumors particularly in those tumors resulting from exposure to environmental carcinogens. Therefore, characterization of the role of the Fhit-dependent pathway in preventing low dose IR-induced genetic instability will provide useful parameters for evaluating the low dose IR-induced risk of mutagenesis and carcinogenesis. We pursued 3 specific aims to study our hypothesis that the Fhit-dependent pathways maintain genomic integrity through adjusting checkpoint response and repair genes expression following low dose IR. Aim 1: Determine whether Fhit interaction with RPA is necessary for Fhit to affect the cellular response to low dose IR. We combined the approaches of in vitro (GST pull-down and site-directed mutagenesis) and in vivo (observing the co-localization and immunoprecipitation of Fhit and RPA in Fhit knock out mouse cells transfected with mutant Fhit which has lost ability to interact with RPA in vitro). Aim 2: Determine the role of genes whose expression is affected by Fhit in low dose irradiated cells. We analyzed the distinct signature of gene expression in low dose irradiated Fhit-/- cells compared with Fhit+/+ cells by combining microarray, gene transfection and siRNA approaches. Aim 3: Determine the role of Fhit in genetic susceptibility to low dose IR in vivo. We compared the gene mutation frequency and the fragile site stability in the cells isolated from the Fhit+/+ and Fhit-/- mice at 1.5 years following low dose IR. These results determine the role of the Fhit-dependent pathway in maintaining genomic integrity in vitro and in vivo, which provide a basis for choosing surrogate markers in the Fhit-dependent pathway to evaluate low dose IR-induced risk of mutagenesis and carcinogenesis.

  6. Dose Adjustment Strategy of Cyclosporine A in Renal Transplant Patients: Evaluation of Anthropometric Parameters for Dose Adjustment and C0 vs. C2 Monitoring in Japan, 2001-2010

    PubMed Central

    Kokuhu, Takatoshi; Fukushima, Keizo; Ushigome, Hidetaka; Yoshimura, Norio; Sugioka, Nobuyuki

    2013-01-01

    The optimal use and monitoring of cyclosporine A (CyA) have remained unclear and the current strategy of CyA treatment requires frequent dose adjustment following an empirical initial dosage adjusted for total body weight (TBW). The primary aim of this study was to evaluate age and anthropometric parameters as predictors for dose adjustment of CyA; and the secondary aim was to compare the usefulness of the concentration at predose (C0) and 2-hour postdose (C2) monitoring. An open-label, non-randomized, retrospective study was performed in 81 renal transplant patients in Japan during 2001-2010. The relationships between the area under the blood concentration-time curve (AUC0-9) of CyA and its C0 or C2 level were assessed with a linear regression analysis model. In addition to age, 7 anthropometric parameters were tested as predictors for AUC0-9 of CyA: TBW, height (HT), body mass index (BMI), body surface area (BSA), ideal body weight (IBW), lean body weight (LBW), and fat free mass (FFM). Correlations between AUC0-9 of CyA and these parameters were also analyzed with a linear regression model. The rank order of the correlation coefficient was C0 > C2 (C0; r=0.6273, C2; r=0.5562). The linear regression analyses between AUC0-9 of CyA and candidate parameters indicated their potential usefulness from the following rank order: IBW > FFM > HT > BSA > LBW > TBW > BMI > Age. In conclusion, after oral administration, C2 monitoring has a large variation and could be at high risk for overdosing. Therefore, after oral dosing of CyA, it was not considered to be a useful approach for single monitoring, but should rather be used with C0 monitoring. The regression analyses between AUC0-9 of CyA and anthropometric parameters indicated that IBW was potentially the superior predictor for dose adjustment of CyA in an empiric strategy using TBW (IBW; r=0.5181, TBW; r=0.3192); however, this finding seems to lack the pharmacokinetic rationale and thus warrants further basic and clinical

  7. Clinical and genetic factors associated with warfarin maintenance dose in northern Chinese patients with mechanical heart valve replacement.

    PubMed

    Liu, Rui; Cao, Jian; Zhang, Qian; Shi, Xin-Miao; Pan, Xiao-Dong; Dong, Ran

    2017-01-01

    The effects of genetic variants on warfarin dosing vary among different ethnic groups, especially in the Chinese population. The objective of this study was to recruit patients through a rigorous experimental design and to perform a comprehensive screen to identify gene polymorphisms that may influence warfarin dosing in northern Han Chinese patients with mechanical heart valve replacement. Consenting patients (n = 183) with a stable warfarin dose were included in this study. Ninety-six single nucleotide polymorphisms (SNPs) in 30 genes involved in warfarin pharmacological pathways were genotyped using the Illumina SNP GoldenGate Assay, and their associations with warfarin dosing were assessed using univariate regression analysis with post hoc comparison using least significant difference analysis. Multiple linear regression was performed by incorporating patients' clinical and genetic data to create a new algorithm for warfarin dosing. From the 96 SNPs analyzed, VKORC1 rs9923231, CYP1A2 rs2069514, CYP3A4 rs28371759, and APOE rs7412 were associated with higher average warfarin maintenance doses, whereas CYP2C9 rs1057910, EPHX1 rs2260863, and CYP4F2 rs2189784 were associated with lower warfarin doses (P < 0.05). Multiple linear regression analysis could estimate 44.4% of warfarin dose variability consisting of, in decreasing order, VKORC1 rs9923231 (14.2%), CYP2C9*3 (9.6%), body surface area (6.7%), CYP1A2 rs2069514 (3.7%), age (2.7%), CYP3A4 rs28371759 (2.5%), CYP4F2 rs2108622 (1.9%), APOE rs7412 (1.7%), and VKORC1 rs2884737 (1.4%). In the dosing algorithm we developed, we confirmed the strongest effects of VKORC1, CYP2C9 on warfarin dosing. In the limited sample set, we also found that novel genetic predictors (CYP1A2, CYP3A4, APOE, EPHX1, CYP4F2, and VKORC1 rs2884737) may be associated with warfarin dosing. Further validation is needed to assess our results in larger independent northern Chinese samples.

  8. Clinical and genetic factors associated with warfarin maintenance dose in northern Chinese patients with mechanical heart valve replacement

    PubMed Central

    Liu, Rui; Cao, Jian; Zhang, Qian; Shi, Xin-Miao; Pan, Xiao-Dong; Dong, Ran

    2017-01-01

    Abstract The effects of genetic variants on warfarin dosing vary among different ethnic groups, especially in the Chinese population. The objective of this study was to recruit patients through a rigorous experimental design and to perform a comprehensive screen to identify gene polymorphisms that may influence warfarin dosing in northern Han Chinese patients with mechanical heart valve replacement. Consenting patients (n = 183) with a stable warfarin dose were included in this study. Ninety-six single nucleotide polymorphisms (SNPs) in 30 genes involved in warfarin pharmacological pathways were genotyped using the Illumina SNP GoldenGate Assay, and their associations with warfarin dosing were assessed using univariate regression analysis with post hoc comparison using least significant difference analysis. Multiple linear regression was performed by incorporating patients’ clinical and genetic data to create a new algorithm for warfarin dosing. From the 96 SNPs analyzed, VKORC1 rs9923231, CYP1A2 rs2069514, CYP3A4 rs28371759, and APOE rs7412 were associated with higher average warfarin maintenance doses, whereas CYP2C9 rs1057910, EPHX1 rs2260863, and CYP4F2 rs2189784 were associated with lower warfarin doses (P < 0.05). Multiple linear regression analysis could estimate 44.4% of warfarin dose variability consisting of, in decreasing order, VKORC1 rs9923231 (14.2%), CYP2C9∗3 (9.6%), body surface area (6.7%), CYP1A2 rs2069514 (3.7%), age (2.7%), CYP3A4 rs28371759 (2.5%), CYP4F2 rs2108622 (1.9%), APOE rs7412 (1.7%), and VKORC1 rs2884737 (1.4%). In the dosing algorithm we developed, we confirmed the strongest effects of VKORC1, CYP2C9 on warfarin dosing. In the limited sample set, we also found that novel genetic predictors (CYP1A2, CYP3A4, APOE, EPHX1, CYP4F2, and VKORC1 rs2884737) may be associated with warfarin dosing. Further validation is needed to assess our results in larger independent northern Chinese samples. PMID:28079798

  9. The use of estimated glomerular filtration rate for dose adjustment of medications in the elderly.

    PubMed

    Elinder, Carl-Gustaf; Bárány, Peter; Heimbürger, Olof

    2014-07-01

    Adverse drug effects as a consequence of inappropriate dosage are a common cause of hospitalization among the elderly. Older individuals are at a particular risk of overdosing because their kidney function decreases with advancing age and the elderly are often prescribed several pharmaceutical drugs. In addition, serum creatinine levels decrease owing to a reduction in muscle mass with age. Therefore, drug dosing based on the serum creatinine level only, instead of using assessment of the renal function, may result in overdosing of frail elderly patients. Renal function, i.e., the glomerular filtration rate can, with simple formulas, be estimated from analysis of creatinine and/or plasma cystatin C (eGFR). Such estimations performed with modern and validated formulas, as a rule present renal function normalized to the body surface area (mL/min/1.73 m(2)). A good estimation of how much the normal dosing interval should be prolonged, or the dose reduced, to obtain a desired plasma concentration of drugs that are mainly eliminated by glomerular filtration can be obtained by calculating the ratio between the patient's eGFR and the normal renal function (about 90-125 mL/min/1.73 m(2)). Increased knowledge and use of eGFR by prescribing physicians will reduce the risk of overdosing drugs in the elderly.

  10. Pharmacokinetic characterization of baclofen in patients with chronic kidney disease: dose adjustment recommendations.

    PubMed

    Vlavonou, Raphaël; Perreault, Marc M; Barrière, Olivier; Shink, Eric; Tremblay, Pierre-Olivier; Larouche, Richard; Pichette, Vincent; Tanguay, Mario

    2014-05-01

    The pharmacokinetics of baclofen is well delineated in subjects with normal kidney function (KF); however, pharmacokinetics data in patients with chronic kidney disease (CKD) are not and dosage recommendations remain empirical. The effects of CKD on baclofen pharmacokinetics were assessed through a multi-center, open-label, single 5-mg dose, pharmacokinetics study. The KF was measured as the creatinine clearance (CrCL) calculated with the Cockroft-Gault (C-G) equation or as the estimated glomerular filtration rate (eGFR) using subjects' CKD-EPI equation. Subjects were assigned to 1 of 4 groups based on their CrCL (>80 mL/min, 50-80 mL/min; 30-50 mL/min and <30 mL/min). Cmax was not statistically different between the groups, while AUC and T1/2el increased, and CL/F decreased, with increasing severity of CKD. Baclofen's oral clearance and CrCL were statistically significantly correlated, and the trend was the same when classifying subjects either with the CKD-EPI or C-G equations. Linear equations using KF as variable were set to recommend individual dose reduction in CKD patients. Results suggest a mean dose reduction of 1/3, 1/2, and 2/3 in patients with mild, moderate, and severe CKD respectively, in order to achieve baclofen exposure comparable to that observed in healthy subjects.

  11. Insulin dose adjustments with add-on glucagon-like peptide-1 receptor (GLP-1R) agonists in clinical practice.

    PubMed

    Artigas, Carla Francés; Stokes, Victoria; Tan, Garry D; Theodorakis, Michael J

    2015-01-01

    Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining ground as therapeutic modalities in combination with insulin in patients with type 2 diabetes mellitus. Exploiting the multiple benefits of incretin-based therapies in certain patient populations, especially in those who would benefit most from potential weight loss or prevention of body weight gain, has provided a valuable add-on option in diabetes management. However, caution needs to be exercised when initiating such a double injectable therapy, as evidence indicates that, in most instances, the insulin dose needs to be re-adjusted. The majority of published studies suggest reduction of insulin dose, especially related to the 'bolus' component; however, some have also recommended that insulin dose should actually be increased, but we found no credible evidence to support the latter. An important determinant of the titration process is the insulin formulation already in use at baseline. As more potent and long-acting GLP-1RAs are introduced, optimal insulin dose scaling is a major challenge, especially in a primary setting. We provide an overview of the current knowledge in this rapidly changing field. Based on currently reported evidence, a reduction of basal insulin by 10% and a decrease of prandial insulin by 30 - 40% is recommended on addition of GLP-1RAs.

  12. Maintenance dose of warfarin in sheep and effect of diet: a preliminary report.

    PubMed

    Sasaki, Takashi; Tsuda, Shoichi; Trujillo, Mario; Kirk Riemer, R; Reinhartz, Olaf

    2012-02-01

    Sheep models are widely used to evaluate the feasibility of various cardiac assist devices. Anticoagulation therapy postoperatively, however, is seldomly reported on. Continuous heparin infusion is often used, but is cumbersome due to long-term line management with the risk of infection and dislodgement. We contemplated using warfarin instead and started a pilot dose-finding study. Three sheep were given oral warfarin between 0.1 and 0.3 mg/kg/day. Prothrombin time was monitored and INR was calculated daily. If the INR did not reach a target of 2.5-3.5, warfarin dose was doubled. We found that sheep required a dose of warfarin between 1.6 and 2.4 mg/kg/day to raise the INR to the target zone. In a subsequent study to evaluate the effect of diet on INR in sheep, three sheep were fed alfalfa hay or alfalfa pellets in a crossover design. All the animals were given warfarin at the dose of 1.6 mg/kg. The diet was switched when the INR reached the target zone of 2.5-3.5. Hay-fed animals reached the target INR on days 6 and 7. On the other hand, pellet-fed animals did not reach the target value by day 7 with the initial dose and required 2.4 mg/kg of warfarin to achieve the goal. Hay raised the INR faster and higher than pellets with the same warfarin dose. Hay may be advantageous when using oral warfarin therapy in sheep.

  13. Low-dose budesonide for maintenance of clinical remission in collagenous colitis: a randomised, placebo-controlled, 12-month trial

    PubMed Central

    Münch, Andreas; Bohr, Johan; Miehlke, Stephan; Benoni, Cecilia; Olesen, Martin; Öst, Åke; Strandberg, Lars; Hellström, Per M; Hertervig, Erik; Armerding, Peter; Stehlik, Jiri; Lindberg, Greger; Björk, Jan; Lapidus, Annika; Löfberg, Robert; Bonderup, Ole; Avnström, Sören; Rössle, Martin; Dilger, Karin; Mueller, Ralph; Greinwald, Roland; Tysk, Curt; Ström, Magnus

    2016-01-01

    Objective This 1-year study aimed to assess low-dose budesonide therapy for maintenance of clinical remission in patients with collagenous colitis. Design A prospective, randomised, placebo-controlled study beginning with an 8-week open-label induction phase in which patients with histologically confirmed active collagenous colitis received budesonide (Budenofalk, 9 mg/day initially, tapered to 4.5 mg/day), after which 92 patients in clinical remission were randomised to budesonide (mean dose 4.5 mg/day; Budenofalk 3 mg capsules, two or one capsule on alternate days) or placebo in a 12-month double-blind phase with 6 months treatment-free follow-up. Primary endpoint was clinical remission throughout the double-blind phase. Results Clinical remission during open-label treatment was achieved by 84.5% (93/110 patients). The median time to remission was 10.5 days (95% CI (9.0 to 14.0 days)). The maintenance of clinical remission at 1 year was achieved by 61.4% (27/44 patients) in the budesonide group versus 16.7% (8/48 patients) receiving placebo (treatment difference 44.5% in favour of budesonide; 95% CI (26.9% to 62.7%), p<0.001). Health-related quality of life was maintained during the 12-month double-blind phase in budesonide-treated patients. During treatment-free follow-up, 82.1% (23/28 patients) formerly receiving budesonide relapsed after study drug discontinuation. Low-dose budesonide over 1 year resulted in few suspected adverse drug reactions (7/44 patients), all non-serious. Conclusions Budesonide at a mean dose of 4.5 mg/day maintained clinical remission for at least 1 year in the majority of patients with collagenous colitis and preserved health-related quality of life without safety concerns. Treatment extension with low-dose budesonide beyond 1 year may be beneficial given the high relapse rate after budesonide discontinuation. Trial registration numbers http://www.clinicaltrials.gov (NCT01278082) and http

  14. Pharmacokinetics of Low and Maintenance Dose Valganciclovir in Kidney Transplant Recipients

    PubMed Central

    Chamberlain, C. E.; Penzak, S. R.; Alfaro, R. M.; Wesley, R.; Daniels, C. E.; Hale, D.; Kirk, A. D.; Mannon, R. B.

    2008-01-01

    Valganciclovir is commonly used for cytomegalovirus (CMV) prophylaxis in renal transplant patients. A fixed dose of 900 mg daily is typically recommended, however, there has never been a formal pharmacokinetic study comparing various doses in renal transplant patients. We therefore compared the pharmacokinetic characteristics of intravenous ganciclovir (IV GCV) and oral ganciclovir (GCV) with two different doses of valganciclovir (VGCV) in an open-label crossover study. Ten adult kidney recipients participated in a four-phase crossover treatment schedule of IV GCV (2.5 mg/kg every 12 h), VGCV (900 mg daily), VGCV (450 mg daily) and oral GCV (1000 mg Q8 H). IV GCV and oral VGCV 900 mg daily achieved similar values for AUC0–24 (median 60.63 vs. 62.86 μg/h/mL). Oral VGCV 450 mg achieved comparable AUC0–24 values as oral GCV 1000 mg Q8 H (median AUC0–24 35.9 vs. 29.04 μg/h/mL). Oral VGCV 900 mg daily provided systemic GCV exposure similar to IV GCV and confirms PV 16 000 study results. Further, VGCV 450 mg daily provided comparable systemic exposure versus oral GCV. Due to its favorable pharmacokinetic profile, data herein suggest that VGCV can be used in the early post-kidney transplant period, and that 450 mg daily provides ample drug exposure for effective CMV prophylaxis in kidney transplant patients. PMID:18444933

  15. Application and experience of a two-dosimeter algorithm for better estimation of effective dose during maintenance periods at Korea nuclear power plants.

    PubMed

    Kim, Hee Geun; Kong, Tae Young

    2009-01-01

    The application of a two-dosimeter and its algorithm and a test of its use in an inhomogeneous high radiation field are described. The goal was to develop an improved method for estimating the effective dose during maintenance periods at Korean nuclear power plants (NPPs). The application and experience to KNPPs was evaluated using data for each algorithm from two-dosimeter results for an inhomogeneous high radiation field during maintenance periods at Korean NPPs.

  16. Effects of high-dose methadone maintenance on cocaine place conditioning, cocaine self-administration, and mu-opioid receptor mRNA expression in the rat brain.

    PubMed

    Leri, Francesco; Zhou, Yan; Goddard, Benjamin; Cummins, Erin; Kreek, Mary Jeanne

    2006-07-01

    Methadone maintenance at appropriate doses can effectively reduce cocaine abuse in heroin-dependent individuals. In the present studies, we investigated the effect of high-dose methadone maintenance cocaine conditioned place preference (CPP) and cocaine intravenous self-administration. Rats implanted with methadone-filled osmotic mini-pumps (20 and 55 mg/kg/day, SC) and conditioned with cocaine (1, 5, and 20 mg/kg, i.p.) did not express cocaine CPP. Similarly, rats implanted with methadone pumps (55 mg/kg/day) after cocaine conditioning (20 mg/kg) displayed neither spontaneous nor cocaine-precipitated (20 mg/kg, i.p.) CPP. In contrast, methadone maintenance (30 and 55 mg/kg/day, SC) did not alter the intravenous self-administration (continuous schedule of reinforcement) of various doses of cocaine (0.1, 0.5, and 2.0 mg/kg/inf). To explore neuropharmacological interactions between methadone maintenance and cocaine conditioning, we quantitatively measured mRNA levels of mu-opioid receptor (MOR) and proopiomelanocortin genes 10 days after methadone maintenance. MOR mRNA levels in both the nucleus accumbens core and frontal cortex were significantly elevated in rats exposed to cocaine during CPP conditioning. However, upregulation of MOR mRNA levels in the nucleus accumbens core were reduced by methadone maintenance in a dose-dependent manner. In conclusion, our results suggest that high-dose methadone maintenance does not alter the direct reinforcing effect of cocaine, but blocks spontaneous and cocaine-precipitated cocaine-seeking, possibly by preventing MOR alterations in the nucleus accumbens core induced by cocaine conditioning.

  17. Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction.

    PubMed

    Candemir, Basar; Kilickap, Mustafa; Ozcan, Ozgur Ulas; Kaya, Cansin Tulunay; Gerede, Menekse; Ozdemir, Aydan Ongun; Ozdol, Cagdas; Kumbasar, Deniz; Erol, Cetin

    2012-07-01

    We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.

  18. Occupational Exposure to Diesel Motor Exhaust and Lung Cancer: A Dose-Response Relationship Hidden by Asbestos Exposure Adjustment? The ICARE Study

    PubMed Central

    Matrat, Mireille; Guida, Florence; Cénée, Sylvie; Févotte, Joelle; Carton, Matthieu; Cyr, Diane; Menvielle, Gwenn; Paget-Bailly, Sophie; Radoï, Loredana; Schmaus, Annie; Bara, Simona; Velten, Michel; Luce, Danièle; Stücker, Isabelle; The Icare Study Group

    2015-01-01

    Background. In a French large population-based case-control study we investigated the dose-response relationship between lung cancer and occupational exposure to diesel motor exhaust (DME), taking into account asbestos exposure. Methods. Exposure to DME was assessed by questionnaire. Asbestos was taken into account through a global indicator of exposure to occupational carcinogens or by a specific JEM. Results. We found a crude dose response relationship with most of the indicators of DME exposure, including with the cumulative exposure index. All results were affected by adjustment for asbestos exposure. The dose response relationships between DME and lung cancer were observed among subjects never exposed to asbestos. Conclusions. Exposure to DME and to asbestos is frequently found among the same subjects, which may explain why dose-response relationships in previous studies that adjusted for asbestos exposure were inconsistent. PMID:26425123

  19. Functional Genetic Polymorphisms in CYP2C19 Gene in Relation to Cardiac Side Effects and Treatment Dose in a Methadone Maintenance Cohort

    PubMed Central

    Wang, Sheng-Chang; Ho, Ing-Kang; Tsou, Hsiao-Hui; Liu, Sheng-Wen; Hsiao, Chin-Fu; Chen, Chia-Hui; Tan, Happy Kuy-Lok; Lin, Linen; Wu, Chi-Shin; Su, Lien-Wen; Huang, Chieh-Liang; Yang, Yi-Hong; Liu, Ming-Lun; Lin, Keh-Ming; Liu, Shu Chih; Wu, Hsiao-Yu; Kuo, Hsiang-Wei; Chen, Andrew C.H.; Chang, Yao-Sheng

    2013-01-01

    Abstract Methadone maintenance therapy is an established treatment for heroin dependence. This study tested the influence of functional genetic polymorphisms in CYP2C19 gene encoding a CYP450 enzyme that contributes to methadone metabolism on treatment dose, plasma concentration, and side effects of methadone. Two single nucleotide polymorphisms (SNPs), rs4986893 (exon 4) and rs4244285 (exon 5), were selected and genotyped in 366 patients receiving methadone maintenance therapy in Taiwan. The steady-state plasma concentrations of both methadone and its EDDP metabolite enantiomers were measured. SNP rs4244285 allele was significantly associated with the corrected QT interval (QTc) change in the electrocardiogram (p=0.021), and the Treatment Emergent Symptom Scale (TESS) total score (p=0.021) in patients who continued using heroin, as demonstrated with a positive urine opiate test. Using the gene dose (GD) models where the CYP2C19 SNPs were clustered into poor (0 GD) versus intermediate (1 GD) and extensive (2 GD) metabolizers, we found that the extensive metabolizers required a higher dose of methadone (p=0.035), and showed a lower plasma R-methadone/methadone dose ratio (p=0.007) in urine opiate test negative patients, as well as a greater QTc change (p=0.008) and higher total scores of TESS (p=0.018) in urine opiate test positive patients, than poor metabolizers. These results in a large study sample from Taiwan suggest that the gene dose of CYP2C19 may potentially serve as an indicator for the plasma R-methadone/methadone dose ratio and cardiac side effect in patients receiving methadone maintenance therapy. Further studies of pharmacogenetic variation in methadone pharmacokinetics and pharmacodynamics are warranted in different world populations. PMID:24016178

  20. Functional genetic polymorphisms in CYP2C19 gene in relation to cardiac side effects and treatment dose in a methadone maintenance cohort.

    PubMed

    Wang, Sheng-Chang; Ho, Ing-Kang; Tsou, Hsiao-Hui; Liu, Sheng-Wen; Hsiao, Chin-Fu; Chen, Chia-Hui; Tan, Happy Kuy-Lok; Lin, Linen; Wu, Chi-Shin; Su, Lien-Wen; Huang, Chieh-Liang; Yang, Yi-Hong; Liu, Ming-Lun; Lin, Keh-Ming; Liu, Shu Chih; Wu, Hsiao-Yu; Kuo, Hsiang-Wei; Chen, Andrew C H; Chang, Yao-Sheng; Liu, Yu-Li

    2013-10-01

    Abstract Methadone maintenance therapy is an established treatment for heroin dependence. This study tested the influence of functional genetic polymorphisms in CYP2C19 gene encoding a CYP450 enzyme that contributes to methadone metabolism on treatment dose, plasma concentration, and side effects of methadone. Two single nucleotide polymorphisms (SNPs), rs4986893 (exon 4) and rs4244285 (exon 5), were selected and genotyped in 366 patients receiving methadone maintenance therapy in Taiwan. The steady-state plasma concentrations of both methadone and its EDDP metabolite enantiomers were measured. SNP rs4244285 allele was significantly associated with the corrected QT interval (QTc) change in the electrocardiogram (p=0.021), and the Treatment Emergent Symptom Scale (TESS) total score (p=0.021) in patients who continued using heroin, as demonstrated with a positive urine opiate test. Using the gene dose (GD) models where the CYP2C19 SNPs were clustered into poor (0 GD) versus intermediate (1 GD) and extensive (2 GD) metabolizers, we found that the extensive metabolizers required a higher dose of methadone (p=0.035), and showed a lower plasma R-methadone/methadone dose ratio (p=0.007) in urine opiate test negative patients, as well as a greater QTc change (p=0.008) and higher total scores of TESS (p=0.018) in urine opiate test positive patients, than poor metabolizers. These results in a large study sample from Taiwan suggest that the gene dose of CYP2C19 may potentially serve as an indicator for the plasma R-methadone/methadone dose ratio and cardiac side effect in patients receiving methadone maintenance therapy. Further studies of pharmacogenetic variation in methadone pharmacokinetics and pharmacodynamics are warranted in different world populations.

  1. Initial Results of a Phase I Dose-Escalation Trial of Concurrent and Maintenance Erlotinib and Reirradiation for Recurrent and New Primary Head-and-Neck Cancer

    SciTech Connect

    Rusthoven, Kyle E.; Feigenberg, Steven J.; Raben, David; Kane, Madeleine; Song, John I.; Nicolaou, Nicos; Mehra, Ranee; Burtness, Barbara; Ridge, John; Swing, Robyn; Lango, Miriam; Cohen, Roger; Jimeno, Antonio; Chen Changhu

    2010-11-15

    Purpose: To present the first report of a Phase I trial evaluating concurrent and maintenance erlotinib and reirradiation in patients with recurrent or secondary primary head-and-neck cancer (HNC). Methods and Materials: Patients with recurrent or new primary HNC with an interval of at least 6 months since prior radiation were eligible. Patients were treated in 3 sequential cohorts: Cohort I, 100 mg of erlotinib daily with reirradiation at 61.6 Gy in 28 fractions; Cohort II, 150 mg of erlotinib with 61.6 Gy in 28 fractions; and Cohort III, 150 mg of erlotinib with 66 Gy in 30 fractions. Maintenance erlotinib started immediately after reirradiation at 150 mg daily and was continued for 2 years or until disease progression or dose-limiting toxicity. Dose-limiting toxicities were defined as any Grade 4 or 5 toxicity or a toxicity-related delay in radiation therapy of greater than 7 days. Results: Fourteen patients were accrued, 3 to Cohort I, 4 to Cohort II, and 7 to Cohort III. Thirteen patients were evaluable for toxicity. Median follow-up was 8.4 months overall and 15.1 months for surviving patients. One patient had a dose-limiting toxicity in Cohort III. This patient declined initial percutaneous endoscopic gastrostomy tube placement, was hospitalized with Grade 3 dysphagia and aspiration, and required a delay in radiation therapy of greater than 7 days. No Grade 4 acute toxicity was observed. Acute Grade 3 toxicity occurred in 9 of 13 patients. No erlotinib-related toxicity of Grade 3 or greater was observed during maintenance therapy. One patient had Grade 5 carotid hemorrhage 6 months after reirradiation, and another patient had Grade 3 osteoradionecrosis. Conclusions: Reirradiation (66 Gy in 2.2 Gy fractions) with concurrent and maintenance erlotinib (150 mg daily) for recurrent or new primary HNC is feasible.

  2. A study of high-dose lenalidomide induction and low-dose lenalidomide maintenance therapy for patients with hypomethylating agent refractory myelodysplastic syndrome.

    PubMed

    Cherian, Mathew A; Tibes, Raoul; Gao, Feng; Fletcher, Theresa; Fiala, Mark; Uy, Geoffrey L; Westervelt, Peter; Jacoby, Meagan A; Cashen, Amanda F; Stockerl-Goldstein, Keith; DiPersio, John F; Vij, Ravi

    2016-11-01

    Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by bone marrow failure which frequently progress to acute myeloid leukemia. Patients who fail to respond to, or progress on first-line DNA hypomethylating agents (HMA) have a poor prognosis. Conventionally dosed lenalidomide has activity in 5q-MDS. In other subtypes, it may reduce RBC transfusion requirements but does not result in cytogenetic responses. We previously reported that high-dose lenalidomide induction (50 mg/day) results in complete remissions in a high fraction of patients. We, therefore, conducted a Phase 2 trial of the same regimen in MDS refractory to HMA. Marrow complete remissions were seen in 33% of patients and hematological improvement in 8% of patients. Significant infections complicated more than 50% of cases. Future trials to explore alternative dosing schedules of high-dose lenalidomide to increase efficacy while decreasing toxicity are warranted.

  3. An analysis of the radiation field characteristics for extremity dose assessment during maintenance periods at nuclear power plants in Korea.

    PubMed

    Kim, Hee Geun; Kong, Tae Young

    2012-12-01

    Workers who maintain the water chambers of steam generators during maintenance periods in nuclear power plants (NPPs) have a higher likelihood of high radiation exposure, even if they are exposed for a short period of time. In particular, it is expected that the hands of workers would receive the highest radiation exposure as a consequence of hand contact with radioactive materials. In this study, a characteristic analysis of inhomogeneous radiation fields for contact operations was conducted using thermoluminescent dosemeters for the whole body and extremities during maintenance periods at Korean NPPs. It was observed that inhomogeneous radiation fields for contact operations at NPPs were dominated by high-energy photons.

  4. Successful Intrathecal Chemotherapy Combined with Radiotherapy Followed by Pomalidomide and Low-Dose Dexamethasone Maintenance Therapy for a Primary Plasma Cell Leukemia Patient

    PubMed Central

    Yamashita, Yusuke; Tamura, Shinobu; Oiwa, Takehiro; Kobata, Hiroshi; Kuriyama, Kodai; Mushino, Toshiki; Murata, Shogo; Hosoi, Hiroki; Nishikawa, Akinori; Hanaoka, Nobuyoshi; Sonoki, Takashi

    2017-01-01

    Primary plasma cell leukemia (PPCL) is a rare aggressive variant of plasma cell disorder and frequently presents with extramedullary disease. Central nervous system (CNS) involvement with PPCL has an extremely poor prognosis. We describe a 46-year-old man with PPCL treated with a combination of lenalidomide, bortezomib, and dexamethasone as induction therapy following upfront allogeneic stem cell transplantation (allo-SCT). Despite achieving a very good partial response, the patient suffered from an isolated CNS relapse 12 months after allo-SCT. He was immediately started on concurrent intrathecal chemotherapy (IT) and cranial irradiation (RT). Subsequently, pomalidomide and low-dose dexamethasone (Pd) were given as maintenance therapy. He has been without CNS recurrence for more than 18 months. Our case suggests that concurrent IT and RT followed by Pd maintenance therapy may be an effective option to control CNS relapse of PPCL after allo-SCT. PMID:28286633

  5. Impact of β-lactam antibiotic therapeutic drug monitoring on dose adjustments in critically ill patients undergoing continuous renal replacement therapy.

    PubMed

    Economou, Caleb J P; Wong, Gloria; McWhinney, Brett; Ungerer, Jacobus P J; Lipman, Jeffrey; Roberts, Jason A

    2017-03-21

    The objective of this study was to describe the effect of therapeutic drug monitoring (TDM) and dose adjustments of β-lactam antibiotics administered to critically ill patients undergoing continuous renal replacement therapy (CRRT) in a 30-bed tertiary intensive care unit (ICU). β-Lactam TDM data in our tertiary referral ICU were retrospectively reviewed. Clinical, demographic and dosing data were collected for patients administered β-lactam antibiotics while undergoing CRRT. The target trough concentration range was 1-10× the minimum inhibitory concentration (MIC). A total of 111 TDM samples from 76 patients (46 male) with a mean ± standard deviation age of 56.6 ± 15.9 years and weight of 89.1 ± 25.8 kg were identified. The duration of antibiotic therapy was between 2 days and 42 days. TDM identified a need for dose modification of β-lactam antibiotics in 39 (35%) instances; in 27 (24%) samples, TDM values resulted in decreasing the prescribed dose of β-lactam antibiotic whereas an increase in the prescribed dose occurred in 12 (11%) cases. In patients treated for hospital-acquired pneumonia and primary or secondary bacteraemia, the dose was required to be decreased in 10/25 (40%) and 7/46 (15%) cases, respectively, to attain target concentrations. β-Lactam TDM is a useful tool for guiding drug dosing in complex patients such as those receiving CRRT. Although over one-third of patients manifested concentrations outside the therapeutic range, most of these CRRT patients had excessive β-lactam concentrations.

  6. Adjustment function among antioxidant substances in acatalasemic mouse brain and its enhancement by low-dose X-ray irradiation.

    PubMed

    Yamaoka, Kiyonori; Nomura, Takaharu; Wang, Da-Hong; Mori, Shuji; Taguchi, Takehito; Ishikawa, Tetsuya; Hanamoto, Katsumi; Kira, Shohei

    2002-01-01

    The catalase activities in blood and organs of the acatalasemic (C3H/AnLCsbCsb) mouse of the C3H strain are lower than those of the normal (C3H/AnLCsaCsa) mouse. We conducted a study to examine changes in the activities of antioxidant enzymes, such as catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPX), the total gluathione content, and the lipid peroxide level in the brain, which is more sensitive to oxidative stress than other organs, at 3, 6, or 24 hr following X-ray irradiation at doses of 0.25, 0.5, or 5.0 Gy to the acatalasemic and the normal mice. No significant change in the lipid peroxide level in the acatalasemic mouse brain was seen under non-irradiation conditions. However, the acatalasemic mouse brain was more damaged than the normal mouse brain by excessive oxygen stress, such as a high-dose (5.0 Gy) X-ray. On the other hand, we found that, unlike 5.0 Gy X-ray, a relatively low-dose (0.5 Gy) irradiation specifically increased the activities of both catalase and GPX in the acatalasemic mouse brain making the activities closer to those in the normal mouse brain. These findings may indicate that the free radical reaction induced by the lack of catalase is more properly neutralized by low dose irradiation.

  7. Pharmacokinetic evaluation of doxorubicin plasma levels in normal and overweight patients with breast cancer and simulation of dose adjustment by different indexes of body mass.

    PubMed

    Barpe, Deise Raquel; Rosa, Daniela Dornelles; Froehlich, Pedro Eduardo

    2010-11-20

    Although being used for decades in the treatment of several types of cancer, either alone or in association, only a few data about the pharmacokinetics of doxorubicin (DOX) in humans are available. DOX is frequently used in association with other anticancer drugs in the management of breast cancer. Pharmacokinetic data available in the literature show that after i.v. administration DOX follows a two-compartment open model, with a fast distribution phase followed by a very slow elimination phase. The objective of this work is to perform a pilot study in order to verify if the usual dose adjustment based on body surface area (BSA) would be producing the same plasma concentration-time profiles in patients with normal (<25) and above normal (>25) body mass index (BMI). In order to assess the pharmacokinetics of DOX after a short-term i.v. infusion of 60mg/m(2) of BSA, an experimental design using only five plasma samples of each patient was applied. Samples were collected at 0.00, 0.66 (right after the end of infusion), 1.66, 8.66, and 24.66h. DOX pharmacokinetic profiles were evaluated after quantification of DOX using a new HPLC method developed and validated. Pharmacokinetic parameters (AUC(0-24.66) and C(max)) were analyzed by non-compartmental and compartmental approaches. Significant differences (α=0.05) between overweight and normal weight groups were found with respect to AUC and C(max). After adjustment of dose by weight and by BMI, the compartmental model was used to simulate plasma concentrations and new values for C(max) and AUC(0-24.66) were calculated. The new values obtained using both body weight (BW) and BMI were closer to the normal group than those obtained with BSA. According to the simulation, the differences of AUC and C(max) between the overweight group and the group of patients with normal weight were lower when the dose was adjusted by BW and BMI. These results suggest that more studies must be conducted, with more patients, in order to

  8. Unmasking of Partial Diabetes Insipidus during Stress but Not Maintenance Dosing of Glucocorticoids in an Infant with Septo-Optic Dysplasia

    PubMed Central

    2011-01-01

    Background. It is well acknowledged that glucocorticoid (GC) replacement can unmask diabetes insipidus (DI) in subjects with hypopituitarism. Objective. To increase the awareness and monitoring for transient and symptomatic DI in children with partial hypopituitarism during periods in which increased GC needs are required. Methods/Case. A 2-month-old female infant with septo-optic dysplasia (SOD; on thyroid and maintenance GC replacement therapy at 8 mg/m2/day) developed transient DI during 2 separate episodes of stress (one hypothermia, one febrile) when stress dosing of GC (25 mg/m2/day) was instituted. Conclusion. Children not diagnosed with DI during initial evaluation for hypopituitarism may benefit from rescreening of serum sodium levels during acute periods of stress that demand "stress" GC dosing. This will permit treatment and/or increased vigilance for ensuing permanent DI. PMID:21603211

  9. Exposure-safety-efficacy analysis of single-agent ixazomib, an oral proteasome inhibitor, in relapsed/refractory multiple myeloma: dose selection for a phase 3 maintenance study.

    PubMed

    Gupta, Neeraj; Labotka, Richard; Liu, Guohui; Hui, Ai-Min; Venkatakrishnan, Karthik

    2016-06-01

    Background Ixazomib is the first oral, small molecule proteasome inhibitor to reach phase 3 trials. The current analysis characterized the exposure-safety and exposure-efficacy relationships of ixazomib in patients with relapsed/refractory multiple myeloma (MM) with a purpose of recommending an approach to ixazomib dosing for maintenance therapy. Methods Logistic regression was used to investigate relationships between ixazomib plasma exposure (area under the curve/day; derived from individual apparent clearance values from a published population pharmacokinetic analysis) and safety/efficacy outcomes (hematologic [grade ≥ 3 vs ≤ 2] or non-hematologic [grade ≥ 2 vs ≤ 1] adverse events [AEs], and clinical benefit [≥stable disease vs progressive disease]) using phase 1 data in relapsed/refractory MM (NCT00963820; N = 44). Results Significant relationships to ixazomib exposure were observed for five AEs (neutropenia, thrombocytopenia, rash, fatigue, and diarrhea) and clinical benefit (p < 0.05). Dose-response relationships indicated a favorable benefit/risk ratio at 3 mg and 4 mg weekly, which are below the maximum tolerated dose of 5.5 mg. At 3 mg, the model predicted that: 37 % of patients will achieve clinical benefit; incidence of grade ≥ 3 neutropenia and thrombocytopenia will be 10 % and 23 %, respectively; and incidence of grade ≥ 2 rash, fatigue, and diarrhea will be 8 %, 19 %, and 19 %, respectively. Conclusions Based on the findings, patients in the phase 3 maintenance trial will initiate ixazomib at a once-weekly dose of 3 mg, increasing to 4 mg if acceptable tolerability after 4 cycles, to provide maximum clinical benefit balanced with adequate tolerability.

  10. An open randomized active-controlled clinical trial with low-dose SKA cytokines versus DMARDs evaluating low disease activity maintenance in patients with rheumatoid arthritis

    PubMed Central

    Martin-Martin, LS; Giovannangeli, F; Bizzi, E; Massafra, U; Ballanti, E; Cassol, M; Migliore, A

    2017-01-01

    Background Biologic agents are currently the strongest immunosuppressive drugs able to induce remission in rheumatoid arthritis (RA). One of the objectives of the medical scientific community now is how to maintain remission or low disease activity (LDA). The aim of this trial is to evaluate the contribution of low-dose sequential kinetic activation (SKA) IL-4, IL-10, and anti-IL-1 antibodies (10 fg/mL) in patients affected by RA in maintaining LDA or remission obtained after biological therapy. Method This is a randomized, open, active-controlled, prospective, Phase IV trial. Disease activity score (DAS28), clinical disease activity index, simplified disease activity index, erythrocyte sedimentation rate and C-reactive protein levels, global health assessment, and pain visual analog scale were evaluated at baseline visit and then every 3 months together with an assessment of side effects till 12 months. Thirty-nine RA patients were enrolled and randomized to continue disease-modifying antirheumatic drugs (DMARDs) therapy or to receive a combination of SKA low-dose cytokines formulated in concentration of 10 fg/mL orally administered at a dose of 20 drops/d for 12 consecutive months. Results The rate of maintenance of LDA at 12 months was superior in the group treated with low-dose cytokines compared with patients treated with DMARDs, 66.7% and 42.1%, respectively; however, the difference between the groups was not statistically significant. No side effects were reported in both groups. Conclusion This is the first study using a combination of three low-dose cytokines in RA, after data published on psoriasis. These data suggest that the use of a combination of low-dose SKA cytokines may be an opportunity to explore in the management of RA.

  11. Comparison of C-reactive protein levels with delivered dose of Kt/V in patients with end-stage renal disease on maintenance hemodialysis.

    PubMed

    Rashid, Humayun

    2015-01-01

    The objective of our study is to compare the C-reactive protein (CRP) levels with the delivered dose of dialysis in terms of Kt/V in patients undergoing maintenance hemodialysis (HD). This is a comparative, cross-sectional survey. The study was conducted at the HD unit of the Shaikh Zayed Hospital, Lahore, Pakistan. Patients who fulfilled the inclusion and exclusion criteria were enrolled in this study. The delivered dose of HD (Kt/V) was assessed by an online clearance module (OCM) in Fresenius machines at the end of every dialysis session and the weekly Kt/V was determined by adding all three Kt/V values. The serum CRP sample was taken after each session of HD and the mean CRP was calculated and considered elevated if it was >6 mg/dL. Both weekly Kt/V and CRP values were entered in a pre-designed proforma. Data were analyzed by using statistical software SPSS and P-value £0.05 was considered significant. Of 100 patients on maintenance HD, high serum CRP level (>6 mg/dL) was found in 38 patients. When the Kt/V was compared with the CRP level, there was a negative correlation between the two parameters (r = 0.212, P = 0.032). Low Kt/V means dialysis inadequacy, which is associated with chronic inflammatory state, resulting in high CRP levels. We suggest that the quality of life of dialysis patients can be improved by offering an adequate dose of HD reflected by Kt/V ≥3.6/week.

  12. Model-based estimates of the effects of efavirenz on bedaquiline pharmacokinetics and suggested dose adjustments for patients coinfected with HIV and tuberculosis.

    PubMed

    Svensson, Elin M; Aweeka, Francesca; Park, Jeong-Gun; Marzan, Florence; Dooley, Kelly E; Karlsson, Mats O

    2013-06-01

    Safe, effective concomitant treatment regimens for tuberculosis (TB) and HIV infection are urgently needed. Bedaquiline (BDQ) is a promising new anti-TB drug, and efavirenz (EFV) is a commonly used antiretroviral. Due to EFV's induction of cytochrome P450 3A4, the metabolic enzyme responsible for BDQ biotransformation, the drugs are expected to interact. Based on data from a phase I, single-dose pharmacokinetic study, a nonlinear mixed-effects model characterizing BDQ pharmacokinetics and interaction with multiple-dose EFV was developed. BDQ pharmacokinetics were best described by a 3-compartment disposition model with absorption through a dynamic transit compartment model. Metabolites M2 and M3 were described by 2-compartment models with clearance of BDQ and M2, respectively, as input. Impact of induction was described as an instantaneous change in clearance 1 week after initialization of EFV treatment and estimated for all compounds. The model predicts average steady-state concentrations of BDQ and M2 to be reduced by 52% (relative standard error [RSE], 3.7%) with chronic coadministration. A range of models with alternative structural assumptions regarding onset of induction effect and fraction metabolized resulted in similar estimates of the typical reduction and did not offer a markedly better fit to data. Simulations to investigate alternative regimens mitigating the estimated interaction effect were performed. The results suggest that simple adjustments of the standard regimen during EFV coadministration can prevent reduced exposure to BDQ without increasing exposures to M2. However, exposure to M3 would increase. Evaluation in clinical trials of adjusted regimens is necessary to ensure appropriate dosing for HIV-infected TB patients on an EFV-based regimen.

  13. Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

    PubMed Central

    Hirano, Ryuichi; Sakamoto, Yuichi; Kitazawa, Junichi; Yamamoto, Shoji; Tachibana, Naoki

    2016-01-01

    Background Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Materials and methods The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation) and from April 2012 to December 2014 (postimplementation), 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51). In 65 patients (pre, n=15; post, n=50), 24-hour area under the concentration–time curve (AUC 0–24 h)/minimum inhibitory concentration (MIC) ratios were calculated. Results Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33). The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL) was significantly higher during postimplementation (84%, 43/51) than during preimplementation (39%, 11/28) (P<0.01). The percentage of patients who attained target PK/PD parameters (AUC 0–24 h/MIC >400) was significantly higher during postimplementation (84%, 42/50) than during preimplementation (53%, 8/15; P=0.013). There were no significant differences in nephrotoxicity or mortality rate. Conclusion Our ASP increased the percentage of patients that attained optimal VCM trough concentrations and PK/PD parameters, which contributed to the

  14. Estimation of plasma area under the curve for etanidazole (SR 2508) in toxicity prediction and dose adjustment

    SciTech Connect

    Workman, P.; Ward, R.; Maughan, T.S.; Newman, H.F.; Bleehen, N.M.

    1989-07-01

    The hydrophilic 2-nitroimidazole radiosensitizer etanidazole is currently undergoing clinical evaluation. Although considerably less neurotoxic than misonidazole because of its rapid renal clearance and partial exclusion from the nervous system, total dose is limited by peripheral neuropathy. Monitoring plasma etanidazole concentration in patients to determine the area under the curve (AUC0-infinity) has been proposed as a method of predicting patients at risk, and of providing a quantitative basis for dose reduction in such patients. Successful application of this policy requires accurate assessment of AUC0-infinity. We have analyzed plasma data for 18 patients receiving 2 g/m2 etanidazole to determine the errors introduced in the estimation of AUC0-infinity caused by omitting selected time points from the analysis. A 'baseline' AUC0-infinity value was calculated by integration of the rate equation for the 2-compartment model using data points at 0, 15, and 30 min and 1, 2, 4, 8, 12, and 24 hr after the end of infusion. The mean +/- SD area for AUC0-infinity was 502 +/- 152 micrograms ml-1 h (2.35 +/- 0.71 mM.h). Omitting the zero or the 24 hr time point, the average errors were quite small (2.5% in both cases), but errors of up to 16.4 and 7.3%, respectively, were seen for individual patients. Leaving out both the 8 hr and 12 hr points at the same time gave a similar low average error of 2.9%, with a highest error of 7.3%. Omitting all data points after 4 hr, the mean error was 24.7% and 15 of 18 patients had errors in excess of 10%. In addition, failure to correct for infusion time results in an underestimation of AUC0-infinity averaging 4.5% (range 1.9-8.7%). The choice of sampling times for toxicological monitoring will depend upon the accuracy with which the AUC0-infinity must be known. Including all data points between 0 and 24 hr will minimize errors.

  15. No Need for Lopinavir Dose Adjustment during Pregnancy: a Population Pharmacokinetic and Exposure-Response Analysis in Pregnant and Nonpregnant HIV-Infected Subjects

    PubMed Central

    Jones, Aksana Kaefer; Santini-Oliveira, Marilia; Taylor, Graham P.; Patterson, Kristine B.; Nilius, Angela M.; Klein, Cheri Enders

    2015-01-01

    Lopinavir-ritonavir is frequently prescribed to HIV-1-infected women during pregnancy. Decreased lopinavir exposure has been reported during pregnancy, but the clinical significance of this reduction is uncertain. This analysis aimed to evaluate the need for lopinavir dose adjustment during pregnancy. We conducted a population pharmacokinetic analysis of lopinavir and ritonavir concentrations collected from 84 pregnant and 595 nonpregnant treatment-naive and -experienced HIV-1-infected subjects enrolled in six clinical studies. Lopinavir-ritonavir doses in the studies ranged between 400/100 and 600/150 mg twice daily. In addition, linear mixed-effect analysis was used to compare the area under the concentration-time curve from 0 to 12 h (AUC0–12) and concentration prior to dosing (Cpredose) in pregnant women and nonpregnant subjects. The relationship between lopinavir exposure and virologic suppression in pregnant women and nonpregnant subjects was evaluated. Population pharmacokinetic analysis estimated 17% higher lopinavir clearance in pregnant women than in nonpregnant subjects. Lopinavir clearance values postpartum were 26.4% and 37.1% lower than in nonpregnant subjects and pregnant women, respectively. As the tablet formulation was estimated to be 20% more bioavailable than the capsule formulation, no statistically significant differences between lopinavir exposure in pregnant women receiving the tablet formulation and nonpregnant subjects receiving the capsule formulation were identified. In the range of lopinavir AUC0–12 or Cpredose values observed in the third trimester, there was no correlation between lopinavir exposure and viral load or proportion of subjects with virologic suppression. Similar efficacy was observed between pregnant women and nonpregnant subjects receiving lopinavir-ritonavir at 400/100 mg twice daily. The pharmacokinetic and pharmacodynamic results support the use of a lopinavir-ritonavir 400/100-mg twice-daily dose during pregnancy

  16. Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer.

    PubMed

    Bernhard, J; Zahrieh, D; Zhang, J J; Martinelli, G; Basser, R; Hürny, C; Forbes, J F; Aebi, S; Yeo, W; Thürlimann, B; Green, M D; Colleoni, M; Gelber, R D; Castiglione-Gertsch, M; Price, K N; Goldhirsch, A; Coates, A S

    2008-01-15

    Quality of life (QL) is an important consideration when comparing adjuvant therapies for early breast cancer, especially if they differ substantially in toxicity. We evaluated QL and Q-TWiST among patients randomised to adjuvant dose-intensive epirubicin and cyclophosphamide administered with filgrastim and progenitor cell support (DI-EC) or standard-dose anthracycline-based chemotherapy (SD-CT). We estimated the duration of chemotherapy toxicity (TOX), time without disease symptoms and toxicity (TWiST), and time following relapse (REL). Patients scored QL indicators. Mean durations for the three transition times were weighted with patient reported utilities to obtain mean Q-TWiST. Patients receiving DI-EC reported worse QL during TOX, especially treatment burden (month 3: P<0.01), but a faster recovery 3 months following chemotherapy than patients receiving SD-CT, for example, less coping effort (P<0.01). Average Q-TWiST was 1.8 months longer for patients receiving DI-EC (95% CI, -2.5 to 6.1). Q-TWiST favoured DI-EC for most values of utilities attached to TOX and REL. Despite greater initial toxicity, quality-adjusted survival was similar or better with dose-intensive treatment as compared to standard treatment. Thus, QL considerations should not be prohibitive if future intensive therapies show superior efficacy.

  17. Selection of the most appropriate two-dosemeter algorithm for estimating effective dose equivalent during maintenance periods in Korean nuclear power plants.

    PubMed

    Kim, Hee Geun; Kong, Tae Young

    2010-07-01

    The application of a two-dosemeter system with its algorithm, as well as a test of its use in an inhomogeneous high-radiation field, is described in this study. The goal was to improve the method for estimating the effective dose equivalent during maintenance periods at Korean Nuclear Power Plants (NPPs). The use of this method in Korean and international NPPs, including those NPPs in the USA and Canada, was also investigated. The algorithms used by the the American National Standards Institute, Lakshmanan, the National Council on Radiation Protection and Measurements (NCRP), the Electric Power Research Institute and Kim were extensively analysed as two-dosemeter algorithms. Their possible application to NPPs was evaluated using data for each algorithm from two-dosemeter results that were obtained from an inhomogeneous high-radiation field during maintenance periods at Korean NPPs. The NCRP algorithm (55:50) was selected as an optimal two-dosemeter algorithm for Korean NPPs by taking into account the field test results and the convenience of wearing two dosemeters.

  18. Low-dose add-on memantine treatment may improve cognitive performance and self-reported health conditions in opioid-dependent patients undergoing methadone-maintenance-therapy

    PubMed Central

    Chang, Yun-Hsuan; Chen, Shiou-Lan; Lee, Sheng-Yu; Chen, Po See; Wang, Tzu-Yun; Lee, I. Hui; Chen, Kao Chin; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2015-01-01

    An important interaction between opioid and dopamine systems has been indicated, and using opioids may negatively affect cognitive functioning. Memantine, a medication for Alzheimer's disease, increasingly is being used for several disorders and maybe important for cognitive improvement. Opioid-dependent patients undergoing methadone-maintenance-therapy (MMT) and healthy controls (HCs) were recruited. Patients randomly assigned to the experimental (5 mg/day memantine (MMT+M) or placebo (MMT+P) group: 57 in MMT+M, 77 in MMT+P. Those completed the cognitive tasks at the baseline and after the 12-week treatment were analyzed. Thirty-seven age- and gender-matched HCs, and 42 MMT+P and 39 MMT+M patients were compared. The dropout rates were 49.4% in the MMT+P and 26.3% in the MMT+M. Both patient groups' cognitive performances were significantly worse than that of the HCs. After the treatment, both patient groups showed improved cognitive performance. We also found an interaction between the patient groups and time which indicated that the MMT+M group's post-treatment improvement was better than that of the MMT+P group. Memantine, previously reported as neuroprotective may attenuate chronic opioid-dependence-induced cognitive decline. Using such low dose of memantine as adjuvant treatment for improving cognitive performance in opioid dependents; the dose of memantine might be a worthy topic in future studies. PMID:25989606

  19. Low-dose add-on memantine treatment may improve cognitive performance and self-reported health conditions in opioid-dependent patients undergoing methadone-maintenance-therapy.

    PubMed

    Chang, Yun-Hsuan; Chen, Shiou-Lan; Lee, Sheng-Yu; Chen, Po See; Wang, Tzu-Yun; Lee, I Hui; Chen, Kao Chin; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2015-05-19

    An important interaction between opioid and dopamine systems has been indicated, and using opioids may negatively affect cognitive functioning. Memantine, a medication for Alzheimer's disease, increasingly is being used for several disorders and maybe important for cognitive improvement. Opioid-dependent patients undergoing methadone-maintenance-therapy (MMT) and healthy controls (HCs) were recruited. Patients randomly assigned to the experimental (5 mg/day memantine (MMT+M) or placebo (MMT+P) group: 57 in MMT+M, 77 in MMT+P. Those completed the cognitive tasks at the baseline and after the 12-week treatment were analyzed. Thirty-seven age- and gender-matched HCs, and 42 MMT+P and 39 MMT+M patients were compared. The dropout rates were 49.4% in the MMT+P and 26.3% in the MMT+M. Both patient groups' cognitive performances were significantly worse than that of the HCs. After the treatment, both patient groups showed improved cognitive performance. We also found an interaction between the patient groups and time which indicated that the MMT+M group's post-treatment improvement was better than that of the MMT+P group. Memantine, previously reported as neuroprotective may attenuate chronic opioid-dependence-induced cognitive decline. Using such low dose of memantine as adjuvant treatment for improving cognitive performance in opioid dependents; the dose of memantine might be a worthy topic in future studies.

  20. Effects of Recombinant Human Bone Morphogenetic Protein-2 Dose and Ceramic Composition on New Bone Formation and Space Maintenance in a Canine Mandibular Ridge Saddle Defect Model

    PubMed Central

    Talley, Anne D.; Kalpakci, Kerem N.; Shimko, Daniel A.; Zienkiewicz, Katarzyna J.; Cochran, David L.

    2016-01-01

    Treatment of mandibular osseous defects is a significant clinical challenge. Maintenance of the height and width of the mandibular ridge is essential for placement of dental implants and restoration of normal dentition. While guided bone regeneration using protective membranes is an effective strategy for maintaining the anatomic contour of the ridge and promoting new bone formation, complications have been reported, including wound failure, seroma, and graft exposure leading to infection. In this study, we investigated injectable low-viscosity (LV) polyurethane/ceramic composites augmented with 100 μg/mL (low) or 400 μg/mL (high) recombinant human bone morphogenetic protein-2 (rhBMP-2) as space-maintaining bone grafts in a canine mandibular ridge saddle defect model. LV grafts were injected as a reactive paste that set in 5–10 min to form a solid porous composite with bulk modulus exceeding 1 MPa. We hypothesized that compression-resistant LV grafts would enhance new bone formation and maintain the anatomic contour of the mandibular ridge without the use of protective membranes. At the rhBMP-2 dose recommended for the absorbable collagen sponge carrier in dogs (400 μg/mL), LV grafts maintained the width and height of the host mandibular ridge and supported new bone formation, while at suboptimal (100 μg/mL) doses, the anatomic contour of the ridge was not maintained. These findings indicate that compression-resistant bone grafts with bulk moduli exceeding 1 MPa and rhBMP-2 doses comparable to that recommended for the collagen sponge carrier support new bone formation and maintain ridge height and width in mandibular ridge defects without protective membranes. PMID:26800574

  1. Maintenance of remission following 2 years of standard treatment then dose reduction with abatacept in patients with early rheumatoid arthritis and poor prognosis

    PubMed Central

    Westhovens, Rene; Robles, Manuel; Ximenes, Antonio Carlos; Wollenhaupt, Jurgen; Durez, Patrick; Gomez-Reino, Juan; Grassi, Walter; Haraoui, Boulos; Shergy, William; Park, Sung-Hwan; Genant, Harry; Peterfy, Charles; Becker, Jean-Claude; Murthy, Bindu

    2015-01-01

    Objectives To evaluate maintenance of response while reducing intravenous abatacept dose from ∼10 mg/kg to ∼5 mg/kg in patients with early rheumatoid arthritis (RA) who achieved disease activity score (DAS)28 (erythrocyte sedimentation rate, ESR) <2.6. Methods This 1-year, multinational, randomised, double-blind substudy evaluated the efficacy and safety of ∼10 mg/kg and ∼5 mg/kg abatacept in patients with early RA with poor prognosis who had reached DAS28 (ESR) <2.6 at year 2 of the AGREE study. The primary outcome was time to disease relapse (defined as additional disease-modifying antirheumatic drugs, ≥2 courses high-dose steroids, return to open-label abatacept ∼10 mg/kg, or DAS28 (C reactive protein) ≥3.2 at two consecutive visits). Results 108 patients were randomised (∼10 mg/kg, n=58; ∼5 mg/kg, n=50). Three and five patients, respectively, discontinued, and four per group returned to open-label abatacept. Relapse over time and the proportion of patients relapsing were similar in both groups (31% (∼10 mg/kg) vs 34% (∼5 mg/kg); HR: 0.87 (95% CI 0.45 to 1.69)). Mean steady-state trough serum concentration for the ∼10 mg/kg group was 20.3–24.1 µg/mL, compared with 8.8–12.0 µg/mL for the ∼5 mg/kg group. Conclusions This exploratory study suggests that abatacept dose reduction may be an option in patients with poor prognosis early RA who achieve DAS28 (ESR) <2.6 after ≥1 year on abatacept (∼10 mg/kg). Trial registration number NCT00989235. PMID:25550337

  2. Improved in silico prediction of carcinogenic potency (TD50) and the risk specific dose (RSD) adjusted Threshold of Toxicological Concern (TTC) for genotoxic chemicals and pharmaceutical impurities.

    PubMed

    Contrera, Joseph F

    2011-02-01

    The Threshold of Toxicological Concern (TTC) is a level of exposure to a genotoxic impurity that is considered to represent a negligible risk to humans. The TTC was derived from the results of rodent carcinogenicity TD50 values that are a measure of carcinogenic potency. The TTC currently sets a default limit of 1.5 μg/day in food contact substances and pharmaceuticals for all genotoxic impurities without carcinogenicity data. Bercu et al. (2010) used the QSAR predicted TD50 to calculate a risk specific dose (RSD) which is a carcinogenic potency adjusted TTC for genotoxic impurities. This promising approach is currently limited by the software used, a combination of MC4PC (www.multicase.com) and a Lilly Inc. in-house software (VISDOM) that is not available to the public. In this report the TD50 and RSD were predicted using a commercially available software, SciQSAR (formally MDL-QSAR, www.scimatics.com) employing the same TD50 training data set and external validation test set that was used by Bercu et al. (2010). The results demonstrate the general applicability of QSAR predicted TD50 values to determine the RSDs for genotoxic impurities and the improved performance of SciQSAR for predicting TD50 values.

  3. A Randomized Phase III Trial of IV Carboplatin and Paclitaxel x 3 Courses Followed by Observation Versus Weekly Maintenance Low Dose Paclitaxel in Patients with Early Stage Ovarian Carcinoma: a Gynecologic Oncology Group Study

    PubMed Central

    Mannel, Robert S; Brady, Mark F; Kohn, Elise C.; Hanjani, Parviz; Hiura, Masamichi; Lee, Roger; DeGeest, Koen; Cohn, David E; Monk, Bradley J.; Michael, Helen

    2011-01-01

    Purpose To compare the recurrence-free interval (RFI), and safety profile in patients with completely resected high-risk early-stage ovarian cancer patients treated with intravenous (IV) carboplatin and paclitaxel with or without maintenance low-dose paclitaxel for 24 weeks. Methods Eligibility was limited to patients with Stage I-A/B (Grade 3 or clear cell), all I-C or II epithelial ovarian cancer. All patients were to receive carboplatin AUC 6 and paclitaxel 175 mg/m2 q 3 wks × 3 courses with random assignment to either observation or maintenance paclitaxel 40 mg/m2/wk × 24 wks. Recurrence required clinical or radiological evidence of new tumor. Results There were 571 patients enrolled onto this study, of whom 29 were deemed ineligible due to inappropriate stage or pathology, leaving 542 patients. At least 3 cycles of treatment were administered to 524/542 (97%) of patients, and among those assigned to maintenance paclitaxel, 80% completed the regimen. The incidence of grade 2 or worse peripheral neuropathy (15.5% vs 6%), infection/fever (19.9% vs 8.7%), and dermatologic events (70.8% vs 52.1%) were higher on the maintenance regimen (p<0.001). The cumulative probability of recurring within 5 years for the maintenance paclitaxel regimen is 20% vs. 23% for surveillance (hazard ratio 0.807; 95% CI: 0.565–1.15). The probability of surviving 5 years was 85.4% and 86.2%, respectively. Conclusion Maintenance paclitaxel at 40 mg/m2/wk × 24 wks added to standard dose AUC6 and paclitaxel 175 mg/m2 × 3 doses provides no significant increase in RFI. PMID:21529904

  4. Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy

    PubMed Central

    Pinto, Duane S.; Chi, Gerald; Arbetter, Douglas; Yee, Megan; Mehran, Roxana; Bode, Christoph; Halperin, Jonathan; Verheugt, Freek W.A.; Wildgoose, Peter; Burton, Paul; van Eickels, Martin; Korjian, Serge; Daaboul, Yazan; Jain, Purva; Lip, Gregory Y.H.; Cohen, Marc; Peterson, Eric D.; Fox, Keith A.A.

    2017-01-01

    Background: Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. Methods: Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2.5 mg twice daily with stratification to a prespecified duration of DAPT of 1, 6, or 12 months (group 2); or the reference arm of dose-adjusted VKA daily with a similar DAPT stratification (group 3). The present post hoc analysis assessed the end point of all-cause mortality or recurrent hospitalization for an adverse event, which was further classified as the result of bleeding, a cardiovascular cause, or another cause blinded to treatment assignment. Results: The risk of all-cause mortality or recurrent hospitalization was 34.9% in group 1 (hazard ratio=0.79; 95% confidence interval, 0.66–0.94; P=0.008 versus group 3; number needed to treat=15), 31.9% in group 2 (hazard ratio=0.75; 95% confidence interval, 0.62–0.90; P=0.002 versus group 3; number needed to treat=10), and 41.9% in group 3 (VKA+DAPT). Both all-cause death plus hospitalization potentially resulting from bleeding (group 1=8.6% [P=0.032 versus group 3], group 2=8.0% [P=0.012 versus group 3], and group 3=12.4%) and all-cause death plus rehospitalization potentially resulting from a cardiovascular cause (group 1=21.4% [P=0.001 versus group 3], group 2=21.7% [P=0.011 versus group 3], and group 3=29.3%) were reduced in the rivaroxaban arms compared with the VKA arm, but other forms of rehospitalization were not. Conclusions: Among patients with

  5. MO-E-17A-08: Attenuation-Based Size Adjusted, Scanner-Independent Organ Dose Estimates for Head CT Exams: TG 204 for Head CT

    SciTech Connect

    McMillan, K; Bostani, M; Cagnon, C; McNitt-Gray, M; Zankl, M; DeMarco, J

    2014-06-15

    Purpose: AAPM Task Group 204 described size specific dose estimates (SSDE) for body scans. The purpose of this work is to use a similar approach to develop patient-specific, scanner-independent organ dose estimates for head CT exams using an attenuation-based size metric. Methods: For eight patient models from the GSF family of voxelized phantoms, dose to brain and lens of the eye was estimated using Monte Carlo simulations of contiguous axial scans for 64-slice MDCT scanners from four major manufacturers. Organ doses were normalized by scannerspecific 16 cm CTDIvol values and averaged across all scanners to obtain scanner-independent CTDIvol-to-organ-dose conversion coefficients for each patient model. Head size was measured at the first slice superior to the eyes; patient perimeter and effective diameter (ED) were measured directly from the GSF data. Because the GSF models use organ identification codes instead of Hounsfield units, water equivalent diameter (WED) was estimated indirectly. Using the image data from 42 patients ranging from 2 weeks old to adult, the perimeter, ED and WED size metrics were obtained and correlations between each metric were established. Applying these correlations to the GSF perimeter and ED measurements, WED was calculated for each model. The relationship between the various patient size metrics and CTDIvol-to-organ-dose conversion coefficients was then described. Results: The analysis of patient images demonstrated the correlation between WED and ED across a wide range of patient sizes. When applied to the GSF patient models, an exponential relationship between CTDIvol-to-organ-dose conversion coefficients and the WED size metric was observed with correlation coefficients of 0.93 and 0.77 for the brain and lens of the eye, respectively. Conclusion: Strong correlation exists between CTDIvol normalized brain dose and WED. For the lens of the eye, a lower correlation is observed, primarily due to surface dose variations. Funding

  6. Impact of dose calculation models on radiotherapy outcomes and quality adjusted life years for lung cancer treatment: do we need to measure radiotherapy outcomes to tune the radiobiological parameters of a normal tissue complication probability model?

    PubMed Central

    Docquière, Nicolas; Bondiau, Pierre-Yves; Balosso, Jacques

    2016-01-01

    Background The equivalent uniform dose (EUD) radiobiological model can be applied for lung cancer treatment plans to estimate the tumor control probability (TCP) and the normal tissue complication probability (NTCP) using different dose calculation models. Then, based on the different calculated doses, the quality adjusted life years (QALY) score can be assessed versus the uncomplicated tumor control probability (UTCP) concept in order to predict the overall outcome of the different treatment plans. Methods Nine lung cancer cases were included in this study. For the each patient, two treatments plans were generated. The doses were calculated respectively from pencil beam model, as pencil beam convolution (PBC) turning on 1D density correction with Modified Batho’s (MB) method, and point kernel model as anisotropic analytical algorithm (AAA) using exactly the same prescribed dose, normalized to 100% at isocentre point inside the target and beam arrangements. The radiotherapy outcomes and QALY were compared. The bootstrap method was used to improve the 95% confidence intervals (95% CI) estimation. Wilcoxon paired test was used to calculate P value. Results Compared to AAA considered as more realistic, the PBCMB overestimated the TCP while underestimating NTCP, P<0.05. Thus the UTCP and the QALY score were also overestimated. Conclusions To correlate measured QALY’s obtained from the follow-up of the patients with calculated QALY from DVH metrics, the more accurate dose calculation models should be first integrated in clinical use. Second, clinically measured outcomes are necessary to tune the parameters of the NTCP model used to link the treatment outcome with the QALY. Only after these two steps, the comparison and the ranking of different radiotherapy plans would be possible, avoiding over/under estimation of QALY and any other clinic-biological estimates. PMID:28149761

  7. Influence of dose, cigarette smoking, age, sex, and metabolic activity on plasma clozapine concentrations: a predictive model and nomograms to aid clozapine dose adjustment and to assess compliance in individual patients.

    PubMed

    Rostami-Hodjegan, Amin; Amin, Ajmal M; Spencer, Edgar P; Lennard, Martin S; Tucker, Geoffrey T; Flanagan, Robert J

    2004-02-01

    The measurement of plasma clozapine concentrations is useful in assessing compliance, optimizing therapy, and minimizing toxicity. We measured plasma clozapine and norclozapine (N-desmethylclozapine) concentrations in samples from 3782 patients (2648 male, 1127 female). No clozapine was detected in 291 samples (227 patients, median prescribed dose 300 mg/d). In 4963 (50.2 %) samples (2222 patients); plasma clozapine concentration ranged from 10 to 350 ng/mL.Step-wise backward multiple regression analysis (37 % of the total samples) of log10 plasma clozapine concentration against log10 clozapine dose (mg/d), age (year), sex (male = 0, female = 1), cigarette smoking habit (nonsmokers = 0; smokers = 1), body weight (kg), and plasma clozapine/norclozapine ratio (clozapine metabolic ratio, MR) showed that these covariates explained 48% of the observed variation in plasma clozapine concentration (C = ng/mL x 10-3) (P < 0.001) according to the following equation: log 10 (C) = 0.811 log 10 (dose) + 0.332 (MR) + 69.42 X 10 (-3) (sex) + 2.263 x 10 (-3) (age) + 1.976 x 10(-3) (weight) - 0.171 (smoking habit) - 3.180. This model and its associated confidence intervals were used to develop nomograms of plasma clozapine concentration versus dose for male and female smokers and nonsmokers. Predicted plasma clozapine changes by +48% in nonsmokers, +17% in females, +/-8 % for every 0.1 change in MR (reference 1.32), +/-4% for every 5 years (reference 40 years), and +/-5 % for every 10 kg body weight (reference 80 kg). The nomograms can be used (i) to individualize dosage to achieve a given target plasma clozapine concentration, and (ii) for quantitative evaluation of adherence by estimating the likelihood of an observed concentration being achieved by a given dosage regimen. The model has been validated against published data.

  8. Long-term follow-up of tandem high-dose therapy with autologous stem cell support for adults with high-risk age-adjusted international prognostic index aggressive non-Hodgkin Lymphomas: a GOELAMS pilot study.

    PubMed

    Monjanel, Hélène; Deconinck, Eric; Perrodeau, Elodie; Gastinne, Thomas; Delwail, Vincent; Moreau, Anne; François, Sylvie; Berthou, Christian; Gyan, Emmanuel; Milpied, Noël

    2011-06-01

    Single high-dose therapy (HDT) followed by autologous peripheral blood stem cell (PBSC) support improves complete response and overall survival (OS) in untreated aggressive non-Hodgkin's lymphoma (NHL). However, patients with a high age-adjusted international prognostic index (aa-IPI equal to 3) still have poor clinical outcome despite high dose intensity regimen. To improve complete response in this subgroup, the French Groupe Ouest-Est des Leucémies et Autres Maladies du Sang (GOELAMS) conducted a pilot phase II trial (073) evaluating tandem HDT with PBSC support in a series of 45 patients with aa-IPI equal to 3 untreated aggressive non-Hodgkin's lymphoma. After induction with an anthracyclin-containing regimen, responders underwent tandem HDT conditioned by high-dose mitoxantrone plus cytarabine for the first HDT and total-body irradiation (TBI), carmustine, etoposide, and cyclophosphamide for the second HDT. Thirty-one patients out of 41 evaluable patients completed the program. There were 4 toxic deaths. The complete response rate was 49%. With a median follow-up of 114 months for surviving patients, the OS was 51%, and 19 out of the 22 patients (86%) who reached a complete response are alive and relapse-free. Recent prospective evaluation of quality of life and comorbidities of surviving patients does not reveal long-term toxicities of the procedure. In the era of monoclonal antibodies and response-adapted therapy, the role of tandem HDT still need to be determined.

  9. Preventative Maintenance.

    ERIC Educational Resources Information Center

    Migliorino, James

    Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…

  10. Software Maintenance.

    ERIC Educational Resources Information Center

    Cannon, Glenn; Jobe, Holly

    Proper cleaning and storage of audiovisual aids is outlined in this brief guide. Materials and equipment needed for first line maintenance are listed, as well as maintenance procedures for records, audio and video tape, film, filmstrips, slides, realia, models, prints, graphics, maps, and overhead transparencies. A 15-item quiz on software…

  11. Chiropractic Adjustment

    MedlinePlus

    ... structural alignment and improve your body's physical function. Low back pain, neck pain and headache are the most common ... treated. Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only ...

  12. Adjustment disorder

    MedlinePlus

    ... from other people Skipped heartbeats and other physical complaints Trembling or twitching To have adjustment disorder, you ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  13. Intravenous high-dose interferon with or without maintenance treatment in melanoma at high risk of recurrence: meta-analysis of three trials.

    PubMed

    Malczewski, Agnieszka; Marshall, Andrea; Payne, Miranda J; Mao, Lili; Bafaloukos, Dimitrios; Si, Lu; Pectasides, Dimitrios; Fountzilas, George; Guo, Jun; Gogas, Helen; Middleton, Mark R

    2016-01-01

    Resected stage IIB-IIIC malignant melanoma has a poor prognosis with a high risk of relapse and death. Treatment with adjuvant interferon alfa-2b (IFN-α-2b) is associated with improved relapse-free and overall survivals (OS), but the most appropriate dose and duration of treatment are unknown. In this article, we present an individual patient data random effects meta-analysis of melanoma patients from the U.K., Greek, and Chinese randomized trials. All patients were randomized either to IFN-α-2b 15-20 MIU/m(2) IV daily 5 days per week for 4 weeks (IV) or to the same regimen followed by IFN-α-2b 9-10 MIU/m(2) administered three times per week for 48 weeks (IV and SC). Allowing for dose interruptions and reductions, an equivalent total dose of IFN-α-2b was delivered in all three studies. We assessed whether IV was noninferior to IV and SC in terms of relapse-free survival (RFS) and investigated tumor and patient characteristics that impacted on outcomes. Median follow-up of 716 stage IIB-IIIC patients was 5.4 years. Noninferiority of IV compared to IV and SC could not be conferred for RFS (hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.89-1.52; noninferior P = 0.17). Stage (P < 0.0001), site (acral vs. other, P < 0.0001), and Breslow thickness (P = 0.02) were significant predictors of RFS. The HR for death was 1.13 for IV compared to IV and SC, (95% CI 0.91-1.39). Stage (P < 0.0001) and Breslow thickness (P = 0.001) were significant independent predictors of OS. The available data suggest that where adjuvant high-dose interferon is being considered there is no evidence to deviate from the year long regimen described in the Eastern Cooperative Oncology Group and Intergroup studies.

  14. Quality of life-adjusted survival analysis of high-dose therapy with autologous bone marrow transplantation versus sequential chemotherapy for patients with aggressive lymphoma in first complete remission. Groupe d'Etude les Lymphomes de l'Adulte (GELA).

    PubMed

    Mounier, N; Haioun, C; Cole, B F; Gisselbrecht, C; Sebban, C; Morel, P; Marit, G; Bouabdallah, R; Ravoet, C; Salles, G; Reyes, F; Lepage, E

    2000-06-15

    Evaluating high-dose therapy (HDT) with autologous stem cell transplantation (ASCT) in term of both duration and quality of life (QOL) presents major interests for patients with non-Hodgkin lymphoma. The quality-adjusted time without symptom and toxicity (Q-TWiST) methodology was applied to the LNH87-2 trial comparing HDT with ASCT versus sequential chemotherapy in 541 patients in first complete remission (CR). Overall survival (OS) and disease-free survival (DFS) curves were used to estimate duration of 4 health states: acute short-term toxicity (Tox1), secondary toxicity (Tox2), time without symptom and toxicity (TWiST), and relapse (Rel). Areas under survival curves (AUC) were retrospectively weighted according to QOL coefficients. HDT increased, but not significantly, TWiST (+2. 4 months in AUC, P =.17) and decreased Rel (-3 months, P <.01). Survival estimates did not differ between the 2 treatments (AUC 47.7 months for OS, 39.7 months for DFS). High-risk patients treated by HDT versus chemotherapy had a significant benefit in DFS (AUC 28.8 versus 24.9 months, P <.01) but not in OS (AUC 37.3 versus 36 months, P =.27). Sensitivity analysis, performed by varying QOL coefficients, demonstrated significant quality-adjusted survival gain in high-risk patients treated by HDT. In low-risk patients, a diagram provided an aid to clinical decision-making. This analysis supports the use of HDT in these patients with adverse prognostic factors in the first CR, even after adjusting for QOL using the Q-TWiST method. (Blood. 2000;95:3687-3692)

  15. Interferon beta-1a for the maintenance of remission in patients with Crohn's disease: results of a phase II dose-finding study

    PubMed Central

    2009-01-01

    Background Crohn's disease (CD) and multiple sclerosis (MS) share common pathogenic processes. Interferon (IFN) beta-1a is effective and generally well tolerated in patients with MS and has been shown to down-regulate the expression of interleukin-12, a cytokine that is thought to be involved in mucosal degeneration in CD. IFN beta-1a therefore offers promise as a treatment for CD. Methods In this multicentre, double-blind, placebo-controlled, phase II, dose-finding study, patients with steroid-induced clinical remissions of CD were randomized 1:1:1:1 to subcutaneous IFN beta-1a: 66 mcg three times weekly (tiw), 44 mcg tiw, 44 mcg twice weekly (biw), or matching placebo tiw with steroid tapering. The primary endpoint was the proportion of patients relapse-free at Week 26. Safety was also assessed. Results This study was terminated early following a planned interim analysis at 26 weeks. Of the planned 192 patients, 67 were randomized to treatment: placebo (n = 16), or IFN beta-1a 44 mcg biw (n = 17), 44 mcg tiw (n = 16) or 66 mcg tiw (n = 18). In total, 20/67 patients (29.9%) completed 26 weeks and 7 patients (10.4%) completed 52 weeks. The proportion of patients who remained relapse-free at Week 26 did not differ significantly between the placebo group (5/16, 31%) and the IFN beta-1a 44 mcg biw (6/17, 35%; p = 0.497), 44 mcg tiw (7/16, 44%; p = 0.280) or 66 mcg tiw (2/18, 11%; p = 0.333) groups. There was little difference between treatment groups in secondary efficacy endpoints. IFN beta-1a was generally well tolerated at all doses. Adverse events (AEs) were generally mild or moderate in IFN beta-1a-treated patients, with the most common AEs (influenza-like symptoms, headache, injection-site reactions) being similar to those reported with IFN beta-1a in MS. Conclusion There was no difference in efficacy between patients with CD receiving IFN beta-1a or placebo. However, these results should be considered in the context of the low patient numbers and high dropout

  16. Mercaptopurine/Methotrexate maintenance therapy of childhood acute lymphoblastic leukemia: clinical facts and fiction.

    PubMed

    Schmiegelow, Kjeld; Nielsen, Stine N; Frandsen, Thomas L; Nersting, Jacob

    2014-10-01

    The antileukemic mechanisms of 6-mercaptopurine (6MP) and methotrexate (MTX) maintenance therapy are poorly understood, but the benefits of several years of myelosuppressive maintenance therapy for acute lymphoblastic leukemia are well proven. Currently, there is no international consensus on drug dosing. Because of significant interindividual and intraindividual variations in drug disposition and pharmacodynamics, vigorous dose adjustments are needed to obtain a target degree of myelosuppression. As the normal white blood cell counts vary by patients' ages and ethnicity, and also within age groups, identical white blood cell levels for 2 patients may not reflect the same treatment intensity. Measurements of intracellular levels of cytotoxic metabolites of 6MP and MTX can identify nonadherent patients, but therapeutic target levels remains to be established. A rise in serum aminotransferase levels during maintenance therapy is common and often related to high levels of methylated 6MP metabolites. However, except for episodes of hypoglycemia, serious liver dysfunction is rare, the risk of permanent liver damage is low, and aminotransferase levels usually normalize within a few weeks after discontinuation of therapy. 6MP and MTX dose increments should lead to either leukopenia or a rise in aminotransferases, and if neither is experienced, poor treatment adherence should be considered. The many genetic polymorphisms that determine 6MP and MTX disposition, efficacy, and toxicity have precluded implementation of pharmacogenomics into treatment, the sole exception being dramatic 6MP dose reductions in patients who are homozygous deficient for thiopurine methyltransferase, the enzyme that methylates 6MP and several of its metabolites. In conclusion, maintenance therapy is as important as the more intensive and toxic earlier treatment phases, and often more challenging. Ongoing research address the applicability of drug metabolite measurements for dose adjustments

  17. Shaft adjuster

    DOEpatents

    Harry, H.H.

    1988-03-11

    Abstract and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus. 3 figs.

  18. Shaft adjuster

    DOEpatents

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  19. Rituximab with dose-adjusted EPOCH as first-line treatment in patients with highly aggressive diffuse large B-cell lymphoma and autologous stem cell transplantation in selected patients

    PubMed Central

    Pejša, Vlatko; Prka, Željko; Lucijanić, Marko; Mitrović, Zdravko; Piršić, Mario; Jakšić, Ozren; Ajduković, Radmila; Kušec, Rajko

    2017-01-01

    Aim To assess the benefit of rituximab with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R-DA-EPOCH) regimen as a first-line treatment for patients with diffuse large B-cell lymphoma (DLBCL) presenting with unfavorable or aggressive features, and autologous stem cell transplantation (ASCT) as a part of the first-line treatment for selected DLBCL patients with additional aggressive features. Methods We retrospectively analyzed 75 newly diagnosed DLBCL patients with Ki-67+≥80% or International Prognostic Index ≥2 who were treated with R-DA-EPOCH between 2005 and 2015. Of 24 DLBCL patients with additional aggressive features (Ki-67+≥90% or age-adjusted IPI≥2) who were planned to receive consolidation with ASCT, 17 patients underwent the procedure. We determined the overall response rate (ORR), complete remission (CR), partial remission (PR), 5-year overall survival (OS), and progression free survival (PFS) in all DLBCL patients and specifically those planned to receive ASCT. Results All 75 patients included in the analysis started one or more cycles of therapy. The ORR, CR, and PR rates were 80%, 55%, and 25%, respectively. The response was non-evaluable in 10 of 75 patients due to treatment discontinuation. The OS and PFS rates for all 75 patients were 70% and 61%, respectively, and 80% and 79%, respectively, for 24 planned-to-receive-ASCT patients. Age (≤65 vs >65 years) had no prognostic impact on OS and PFS (P = 0.994 and P = 0.827, respectively). Conclusion Our retrospective analysis of one of the largest DLBCL patient cohorts outside the US National Cancer Institute showed that R-DA-EPOCH is a very effective therapeutic option as a first-line treatment of DLBCL patients with unfavorable prognostic features irrespective of their age. ASCT provided additional benefit for DLBCL patients with additional aggressive features. PMID:28252874

  20. Qualitative Maintenance Experience Handbook

    DTIC Science & Technology

    1975-10-20

    rdme hinge nonression springn. 7. Rem~ove 3 nuts, 1w- ashers , and bolts holding hinge pin halvers together. 8. Remove piD pin senuring iury strut and...bolt, nut. i,, asher , and pin. ONSTALLATTON: I. Reverse )’F -emov,,I. P. Aotuator is pr c-ad;Iusted to lenth and probably does not need adjust 3. TI...time in that syst-m and also permits malfunctions to be induces in a system not directly associated with the maintenance. [ ITI I - ___ ~ JaI , FLIGHT

  1. No dose adjustment on coadministration of the PDE4 inhibitor roflumilast with a weak CYP3A, CYP1A2, and CYP2C19 inhibitor: an investigation using cimetidine.

    PubMed

    Böhmer, Gabriele M; Gleiter, Christoph H; Mörike, Klaus; Nassr, Nassr; Walz, Antje; Lahu, Gezim

    2011-04-01

    This nonrandomized, fixed-sequence, 2-period crossover study investigated potential pharmacokinetic interactions between the phosphodiesterase 4 inhibitor roflumilast, currently in clinical development for the treatment of chronic obstructive pulmonary disease, and the histamine 2 agonist cimetidine. Participants received roflumilast, 500 µg once daily, on days 1 and 13. Cimetidine, 400 mg twice daily, was administered from days 6 to 16. Pharmacokinetic analysis of roflumilast and its active metabolite roflumilast N-oxide was performed, and the ratio of geometric means for roflumilast alone and concomitantly with steady-state cimetidine was calculated. The effect of cimetidine on the total PDE4 inhibitory activity (tPDE4i; total exposure to roflumilast and roflumilast N-oxide) was also calculated. Coadministration of steady-state cimetidine increased mean tPDE4i of roflumilast and roflumilast N-oxide by about 47%. The maximum plasma concentration (C(max)) of roflumilast increased by about 46%, with no effect on C(max) of roflumilast N-oxide. The increase in tPDE4i of roflumilast and roflumilast N-oxide following coadministration with cimetidine was mainly due to the inhibitory effect of cimetidine on cytochrome P450 (CYP) isoenzymes CYP1A2, CYP3A, and CYP2C19. These moderate changes indicate that dose adjustment of roflumilast is not required when coadministered with a weak inhibitor of CYP1A2, CYP3A, and CYP2C19, such as cimetidine.

  2. Periodontal maintenance.

    PubMed

    Tan, A E S

    2009-09-01

    The main goal of periodontal therapy is to establish an oral environment compatible with periodontal health by the physical disruption of the plaque biofilm and adjunctive chemical means if required. Implicit in this objective is the ongoing requirement of detection and interception of new and recurrent disease, which continues at selected intervals for the life of the dentition after the initial ("active") phase of periodontal treatment. This concept of ongoing periodontal maintenance therapy has been embraced as the mandatory requirement for favourable periodontal outcomes based on institutional clinical trials and in practice-based studies in various parts of the world. This review examines the ramifications of periodontal maintenance therapy based upon a multi-level assessment of logistic issues and risk factors at three levels: (1) The patient level - treatment time; patient attendance compliance; and homecare measures, antiseptics/antibiotics and smoking. (2) The level of the individual tooth - tooth loss; and evaluation of success versus survival. (3) The level of each tooth surface ("site") - probing depth, loss of attachment and bleeding on probing; and changes in clinical attachment levels. In spite of the diversity of studies conducted, there is agreement on the efficacy of periodontal maintenance therapy when compared with studies on untreated populations and in treated cases that were not maintained.

  3. Adjustment of Eculizumab Dosage Pattern in Patients with Atypical Hemolytic Uremic Syndrome with Suboptimal Response to Standard Treatment Pattern

    PubMed Central

    Peralta Roselló, Carmen; Baltar Martín, José María; Castillo Eraso, Lorena; de Álvaro Moreno, Fernando; Martínez Vea, Alberto; Visus-Fernández de Manzanos, María Teresa

    2016-01-01

    In patients with atypical hemolytic uremic syndrome (aHUS), complement blocking by eculizumab rapidly halts the process of thrombotic microangiopathy and it is associated with clear long-term hematologic and renal improvements. Eculizumab treatment consists of a 4-week initial phase with weekly IV administration of 900 mg doses, followed by a maintenance phase with a 1,200 mg dose in the fifth week and every 14 ± 2 days thereafter. We present three patients with aHUS and suboptimal response to eculizumab treatment at the usual administration dosage who showed hematologic and renal improvements after an adjustment in the eculizumab treatment protocol. PMID:28025630

  4. Phase II Study of Dose-Adjusted EPOCH-Rituximab in Untreated Diffuse Large B-cell Lymphoma with Analysis of Germinal Center and Post-Germinal Center Biomarkers

    PubMed Central

    Wilson, Wyndham H.; Dunleavy, Kieron; Pittaluga, Stefania; Hegde, Upendra; Grant, Nicole; Steinberg, Seth M.; Raffeld, Mark; Gutierrez, Martin; Chabner, Bruce A.; Staudt, Louis; Jaffe, Elaine S.; Janik, John E.

    2008-01-01

    Purpose To assess the clinical outcome and the influence of biomarkers associated with apoptosis inhibition (Bcl-2), tumor proliferation (MIB-1) and cellular differentiation on the outcome with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin and rituximab (DA-EPOCH-R) infusional therapy in diffuse large B-cell lymphoma and analysis of germinal center B-cell (GCB) and post-GCB subtypes by immunohistochemistry. Patients and Methods Phase II study of 72 patients with untreated de novo DLBCL who were at least 18 years of age and stage II or higher. Radiation consolidation was not permitted. Results Patients had a median age of 50 (range: 19-85) years and 40% had a high-intermediate or high International Prognostic Index (IPI). At five-years, progression-free (PFS) and overall survival (OS) were 79% and 80%, respectively, with a median potential follow-up of 54 months. PFS was 91%, 90%, 67% and 47%, and OS was 100%, 90%, 74% and 37%, for 0-1, 2, 3 and 4-5 IPI factors, respectively, at five-years. The Bcl-2 and MIB-1 biomarkers were not associated with PFS or OS. Based on DA-EPOCH historical controls, rituximab only benefited Bcl-2 positive tumors. Bcl-6 expression was associated with higher PFS whereas GCB exhibited a marginally significant higher PFS compared to post-GCB DLBCL. Conclusion DA-EPOCH-R outcome was not affected by tumor proliferation and rituximab appeared to overcome the adverse effect of Bcl-2. Bcl-6 may identify a biological program associated with a superior outcome. Overall, DA-EPOCH-R shows promising outcome in low and intermediate IPI groups. A molecular model of treatment outcome with rituximab and chemotherapy is presented. PMID:18378569

  5. Diazepam and methadone interactions in methadone maintenance.

    PubMed

    Preston, K L; Griffiths, R R; Stitzer, M L; Bigelow, G E; Liebson, I A

    1984-10-01

    Survey study data and high rates of diazepam use/abuse in methadone maintenance suggest that acute administration of diazepam with daily methadone doses may enhance methadone effects. Acute subjective and physiologic effects of single oral doses of placebo, diazepam (20 and 40 mg), methadone (100%, 150%, and 200% of the maintenance dose), and four diazepam-methadone dose combinations (20 and 40 mg diazepam in combination with 100% and 150% of the maintenance dose) were assessed under double-blind conditions. The subjects were five adult male patients on methadone maintenance with histories of diazepam abuse who were receiving 50 to 60 mg methadone a day. Physiologic measures were continuously monitored for 30 min before and for 2 hr after dosing. Pupil diameter and subjective responses were measured 15 min before dosing and 15, 30, 45, 60, 90, and 120 min after dosing. Methadone induced dose-dependent increases in pupil constriction and scores on a subjective opioid effects rating scale, but diazepam had no significant effect on either. The combination of methadone at 150% of the maintenance dose with 40 mg diazepam induced increases in these measures greater than those induced by either drug dose alone. Drug combinations, however, were more frequently identified as being benzodiazepine/barbiturate-like than as methadone-like. Thus although the subjective effects of the drug combination are distinguishable from those of methadone alone, diazepam with methadone in methadone maintenance appears to increase some physiologic and subjective opioid effects that may be related to the relatively great use/abuse of diazepam in this population.

  6. DOSE-RESPONSE RELATIONSHIP BETWEEN METHADONE DOSE AND ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG HIV-POSITIVE PERSONS WHO USE ILLICIT OPIOIDS

    PubMed Central

    Lappalainen, Leslie; Nolan, Seonaid; Dobrer, Sabina; Puscas, Cathy; Montaner, Julio; Ahamad, Keith; Dong, Huiru; Kerr, Thomas; Wood, Evan; Milloy, M-J

    2015-01-01

    Background and Aims For HIV-positive individuals who use illicit opioids, engagement in methadone maintenance therapy (MMT) can contribute to improved HIV treatment outcomes. However, to our knowledge, the role of methadone dosing in adherence to antiretroviral therapy (ART) has not yet been investigated. We sought to examine the relationship between methadone dose and ART adherence among a cohort of persons who use illicit opioids. Design and Setting We used data from the ACCESS study, an ongoing prospective observational cohort of HIV-positive persons who use illicit drugs in Vancouver, Canada, confidentially linked to comprehensive HIV treatment data in a setting of universal no-cost medical care including medications. We evaluated the longitudinal relationship between methadone dose and the likelihood of ≥ 95% adherence to ART among ART-exposed participants during periods of engagement in MMT. Participants 297 ART-exposed individuals on MMT were recruited between December 2005 and May 2013 and followed for a median of 42.1 months. Measurements We measured methadone dose at ≥ 100 vs < 100 mg/day and the likelihood of ≥ 95% adherence to ART. Findings In adjusted generalized estimating equation (GEE) analyses, MMT dose ≥ 100 mg/day was independently associated with optimal adherence to ART (adjusted odds ratio [AOR] = 1.38; 95% confidence interval [CI]: 1.08 – 1.77, p = 0.010). In a sub-analysis, we observed a dose-response relationship between increasing MMT dose and ART adherence (AOR = 1.06 per 20 mg/day increase, 95% CI: 1.00 – 1.12, p = 0.041). Conclusion Among HIV-positive individuals in methadone maintenance therapy, those receiving higher doses of methadone (≥ 100 mg/day) are more likely to achieve ≥ 95% adherence to antiretroviral therapy than those receiving lower doses. PMID:25940906

  7. Antibiotic dosing in multiple organ dysfunction syndrome.

    PubMed

    Ulldemolins, Marta; Roberts, Jason A; Lipman, Jeffrey; Rello, Jordi

    2011-05-01

    Although early and appropriate antibiotic therapy remains the cornerstone of success for the treatment of septic shock, few data exist to guide antibiotic dose optimization in critically ill patients, particularly those with multiple organ dysfunction syndrome (MODS). It is well known that MODS significantly alters the patient's physiology, but the effects of these variations on pharmacokinetics have not been reviewed concisely. Therefore, the aims of this article are to summarize the disease-driven variations in pharmacokinetics and pharmacodynamics and to provide antibiotic dosing recommendations for critically ill patients with MODS. The main findings of this review are that the two parameters that vary with greatest significance in critically ill patients with MODS are drug volume of distribution and clearance. Disease- and clinician-driven changes lead to an increased volume of distribution and lower-than-expected plasma drug concentrations during the first day of therapy at least. Decreased antibiotic clearance is common and can lead to drug toxicity. In summary, "front-loaded" doses of antibiotic during the first 24 h of therapy should account for the likely increases in the antibiotic volume of distribution. Thereafter, maintenance dosing must be guided by drug clearance and adjusted to the degree of organ dysfunction.

  8. Maintenance Business Plans.

    ERIC Educational Resources Information Center

    Adams, Matt

    2002-01-01

    Discusses maintenance business plans, statements which provide accountability for facilities maintenance organizations' considerable budgets. Discusses the plan's components: statement of plan objectives, macro and detailed description of the facility assets, maintenance function descriptions, description of key performance indicators, milestone…

  9. Maintenance Management Update.

    ERIC Educational Resources Information Center

    Sternloff, Robert E.

    1987-01-01

    Current trends in park maintenance are overviewed, including maintenance impact statements, avoidance of cost through efficient use and national resource conservation, horticultural accomplishments that influence maintenance management, and vandalism prevention. (CB)

  10. [Occupational radiation exposures during maintenance activities at nuclear power plants].

    PubMed

    Imahori, A

    1987-11-01

    Occupational exposures at nuclear power plants occur mostly during maintenance activities rather than during routine reactor operation. In this paper, statistical summaries of occupational exposures during routine maintenance activities for the years 1982-84 at nuclear power plants in Japan are presented, including comparison of the exposure levels by reactor type and by plant age. Average annual collective doses per reactor for BWRs and PWRs are 7.30 man-Sv and 2.84 man-Sv, respectively, and 78% and 89% of annual doses are incurred during maintenance activities. Average annual outage days of BWRs and PWRs for routine maintenance are 102 d and 97 d. Annual collective doses per reactor, most of which occur during maintenance activities, usually increase with plant age. Higher collective doses are observed for routine maintenance performed on older reactors as compared to newer reactors, especially in BWRs. Collective doses accrued during respective routine maintenance activities have a significant correlation with duration of maintenance and number of workers involved in maintenance.

  11. Cryogenics maintenance strategy

    NASA Astrophysics Data System (ADS)

    Cruzat, Fabiola

    2012-09-01

    ALMA is an interferometer composed of 66 independent systems, with specific maintenance requirements for each subsystem. To optimize the observation time and reduce downtime maintenance, requirements are very demanding. One subsystem with high maintenance efforts is cryogenics and vacuum. To organize the maintenance, the Cryogenic and Vacuum department is using and implementing different tools. These are monitoring and problem reporting systems and CMMS. This leads to different maintenance approaches: Preventive Maintenance, Corrective Maintenance and Condition Based Maintenance. In order to coordinate activities with other departments the preventive maintenance schedule is kept as flexible as systems allow. To cope with unavoidable failures, the team has to be prepared to work under any condition with the spares on time. Computerized maintenance management system (CMMS) will help to manage inventory control for reliable spare part handling, the correct record of work orders and traceability of maintenance activities. For an optimized approach the department is currently evaluating where preventive or condition based maintenance applies to comply with the individual system demand. Considering the change from maintenance contracts to in-house maintenance will help to minimize costs and increase availability of parts. Due to increased number of system and tasks the cryo team needs to grow. Training of all staff members is mandatory, in depth knowledge must be built up by doing complex maintenance activities in the Cryo group, use of advanced computerized metrology systems.

  12. 40 CFR 94.1004 - Maintenance, repair, adjustment, and recordkeeping.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... be performed, using good engineering judgment, in such a manner that the engine continues (after the... Book of Engine Parameters, and bunker delivery notes that are required by the Annex VI Technical...

  13. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance...

  14. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Methodology and Procedures for Life Cycle Cost Analyses § 436.22 Adjusted internal rate of return. The adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... yearly net savings in energy or water and non-fuel or non-water operation and maintenance...

  15. Establishing maintenance performance indicators

    SciTech Connect

    Baca, B.

    1994-10-01

    Maintenance Performance Indicators (PI) specify where the maintenance department is and which direction it is going allowing for a quick and accurate assessment of the performance of the Maintenance Management Program (MMP). Establishing PI`s for the maintenance department will allow a measure of productivity and a means of feedback for methods improvement. Effective performance of the maintenance department directly effects plant profitability. Improvements in the quality and productivity of the maintenance work force will significantly reduce maintenance costs. The level of performance attained by the maintenance work force is usually guessed at. Guessing will not identify areas needing improvement or help to initiate a corrective action. Maintenance PI`s are required for maintenance departments whose goal is to control maintenance costs while increasing productivity. The application of basic statistical methods will allow a maintenance department to know where they are and which direction they are going. The data presented in this paper is a representation of indicators used in industry as well as developed indicators to establish a complete maintenance performance indicator program. The methodology used in developing this program can be used as a way to manage a cost effective maintenance management program.

  16. Alaska School Facilities Preventive Maintenance Handbook. 1997 Edition.

    ERIC Educational Resources Information Center

    Mearig, Tim; Crittenden, Edwin; Morgan, Michael

    The State of Alaska has issued preventive maintenance guidelines for educational facilities designed to prevent premature failure, or to maximize or extend the useful life of a facility and its components, including roofing inspections, repainting, and door hardware adjustments. The handbook examines preventive maintenance state legislation, and…

  17. Facilities maintenance handbook

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This handbook is a guide for facilities maintenance managers. Its objective is to set minimum facilities maintenance standards. It also provides recommendations on how to meet the standards to ensure that NASA maintains its facilities in a manner that protects and preserves its investment in the facilities in a cost-effective manner while safely and efficiently performing its mission. This handbook implements NMI 8831.1, which states NASA facilities maintenance policy and assigns organizational responsibilities for the management of facilities maintenance activities on all properties under NASA jurisdiction. It is a reference for facilities maintenance managers, not a step-by-step procedural manual. Because of the differences in NASA Field Installation organizations, this handbook does not assume or recommend a typical facilities maintenance organization. Instead, it uses a systems approach to describe the functions that should be included in any facilities maintenance management system, regardless of its organizational structure. For documents referenced in the handbook, the most recent version of the documents is applicable. This handbook is divided into three parts: Part 1 specifies common definitions and facilities maintenance requirements and amplifies the policy requirements contained in NMI 8831. 1; Part 2 provides guidance on how to meet the requirements of Part 1, containing recommendations only; Part 3 contains general facilities maintenance information. One objective of this handbook is to fix commonality of facilities maintenance definitions among the Centers. This will permit the application of uniform measures of facilities conditions, of the relationship between current replacement value and maintenance resources required, and of the backlog of deferred facilities maintenance. The utilization of facilities maintenance system functions will allow the Centers to quantitatively define maintenance objectives in common terms, prepare work plans, and

  18. Microform Reader Maintenance.

    ERIC Educational Resources Information Center

    Hall, Hal W.; Michaels, George H.

    1985-01-01

    Describes experiences in organizing a program of microform reader and reader/printer maintenance at Texas A & M's Sterling C. Evans Library and offers guidelines for regular machine maintenance and repair. Guidelines discussed relate to maintenance philosophy, general machine cleaning, troubleshooting, service contracts, supplies,…

  19. Asphalt in Pavement Maintenance.

    ERIC Educational Resources Information Center

    Asphalt Inst., College Park, MD.

    Maintenance methods that can be used equally well in all regions of the country have been developed for the use of asphalt in pavement maintenance. Specific information covering methods, equipment and terminology that applies to the use of asphalt in the maintenance of all types of pavement structures, including shoulders, is provided. In many…

  20. Light Vehicle Preventive Maintenance.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    This correspondence course, originally developed for the Marine Corps, is designed to instruct students in the performance of preventive maintenance on motor vehicles. Instructional materials are presented in three chapters as follows: (1) Major Maintenance Areas (maintenance system, tires, batteries, cooling systems, and vehicle lubrication; (2)…

  1. Defer Maintenance, Invite Disaster

    ERIC Educational Resources Information Center

    Bowman, William W.

    1977-01-01

    An AGB- and NACUBO-sponsored survey showed that "wish lists" are accumulating overdue major maintenance projects because energy costs are consuming physical plant budgets. Problem areas are discussed: budget "guesstimation," preventive maintenance, deferred maintenance inventory, the APPA accounting format, resource allocation,…

  2. Maintenance Management System

    DTIC Science & Technology

    1990-06-01

    maintenance opera- tions. d. Available national maintenance management system (MMS) software be utilized to develop the planning, organizing...portland cement concrete pavements to level and realign faulted areas between slabs or craks within the slab by grinding the high side. MAINTENANCE ITEM

  3. Innovation for maintenance technology improvements

    NASA Technical Reports Server (NTRS)

    Shives, T. R. (Editor); Willard, W. A. (Editor)

    1982-01-01

    A group of 34 submitted entries (32 papers and 2 abstracts) from the 33rd meeting of the Mechanical Failures Prevention Group whose subject was maintenance technology improvement through innovation. Areas of special emphasis included maintenance concepts, maintenance analysis systems, improved maintenance processes, innovative maintenance diagnostics and maintenance indicators, and technology improvements for power plant applications.

  4. Role of Osmotic Adjustment in Plant Productivity

    SciTech Connect

    Gebre, G.M.

    2001-01-11

    Successful implementation of short rotation woody crops requires that the selected species and clones be productive, drought tolerant, and pest resistant. Since water is one of the major limiting factors in poplar (Populus sp.) growth, there is little debate for the need of drought tolerant clones, except on the wettest of sites (e.g., lower Columbia River delta). Whether drought tolerance is compatible with productivity remains a debatable issue. Among the many mechanisms of drought tolerance, dehydration postponement involves the maintenance of high leaf water potential due to, for example, an adequate root system. This trait is compatible with productivity, but requires available soil moisture. When the plant leaf water potential and soil water content decline, the plant must be able to survive drought through dehydration tolerance mechanisms, such as low osmotic potential or osmotic adjustment. Osmotic adjustment and low osmotic potential are considered compatible with growth and yield because they aid in the maintenance of leaf turgor. However, it has been shown that turgor alone does not regulate cell expansion or stomatal conductance and, therefore, the role of osmotic adjustment is debated. Despite this finding, osmotic adjustment has been correlated with grain yield in agronomic crop species, and gene markers responsible for osmotic adjustment are being investigated to improve drought tolerance in productive progenies. Although osmotic adjustment and low osmotic potentials have been investigated in several forest tree species, few studies have investigated the relationship between osmotic adjustment and growth. Most of these studies have been limited to greenhouse or container-grown plants. Osmotic adjustment and rapid growth have been specifically associated in Populus and black spruce (Picea mariuna (Mill.) B.S.P.) progenies. We tested whether these relationships held under field conditions using several poplar clones. In a study of two hybrid poplar

  5. Weldon Spring historical dose estimate

    SciTech Connect

    Meshkov, N.; Benioff, P.; Wang, J.; Yuan, Y.

    1986-07-01

    This study was conducted to determine the estimated radiation doses that individuals in five nearby population groups and the general population in the surrounding area may have received as a consequence of activities at a uranium processing plant in Weldon Spring, Missouri. The study is retrospective and encompasses plant operations (1957-1966), cleanup (1967-1969), and maintenance (1969-1982). The dose estimates for members of the nearby population groups are as follows. Of the three periods considered, the largest doses to the general population in the surrounding area would have occurred during the plant operations period (1957-1966). Dose estimates for the cleanup (1967-1969) and maintenance (1969-1982) periods are negligible in comparison. Based on the monitoring data, if there was a person residing continually in a dwelling 1.2 km (0.75 mi) north of the plant, this person is estimated to have received an average of about 96 mrem/yr (ranging from 50 to 160 mrem/yr) above background during plant operations, whereas the dose to a nearby resident during later years is estimated to have been about 0.4 mrem/yr during cleanup and about 0.2 mrem/yr during the maintenance period. These values may be compared with the background dose in Missouri of 120 mrem/yr.

  6. Examining maintenance responsibilities.

    PubMed

    Lam, K C

    2001-06-01

    This paper has examined the important responsibilities of the two organisations involved in the provision of maintenance service for the vital building services in many of our highly serviced buildings. The issues raised could be put to beneficial use in both clients and maintenance providers. All in all, the clients should work closely with their maintenance providers. Engineering services in buildings will not perform satisfactorily and efficiently if both parties do not work together and understand the maintenance tasks based on a business partnering mode. Put forward is the view that the management of the activities involved in the operation and maintenance process is a "shared commitment/involvement" between the client and the maintenance provider. It is obvious that many factors can influence the continued effectiveness of a quality maintenance scheme set up by client and provider. Some of these factors are: Change in key personnel Updates in technology Amendments to engineering practice Implementation of legislative requirements Changes in operation by client or provider Change of use of building Passage of time These factors must be fully reviewed by both parties from time to time, and necessary actions taken. A cooperative team working relationship and improved communication should be fostered by the client and his provider for the best management of services maintenance. This arrangement will contribute to better building services systems with continuous improvement; improved value for clients and higher return for the maintenance provider.

  7. [Medical Equipment Maintenance Methods].

    PubMed

    Liu, Hongbin

    2015-09-01

    Due to the high technology and the complexity of medical equipment, as well as to the safety and effectiveness, it determines the high requirements of the medical equipment maintenance work. This paper introduces some basic methods of medical instrument maintenance, including fault tree analysis, node method and exclusive method which are the three important methods in the medical equipment maintenance, through using these three methods for the instruments that have circuit drawings, hardware breakdown maintenance can be done easily. And this paper introduces the processing methods of some special fault conditions, in order to reduce little detours in meeting the same problems. Learning is very important for stuff just engaged in this area.

  8. Dose reduction at nuclear power plants

    SciTech Connect

    Baum, J.W.; Dionne, B.J.

    1983-01-01

    The collective dose equivalent at nuclear power plants increased from 1250 rem in 1969 to nearly 54,000 rem in 1980. This rise is attributable primarily to an increase in nuclear generated power from 1289 MW-y to 29,155 MW-y; and secondly, to increased average plant age. However, considerable variation in exposure occurs from plant to plant depending on plant type, refueling, maintenance, etc. In order to understand the factors influencing these differences, an investigation was initiated to study dose-reduction techniques and effectiveness of as low as reasonably achievable (ALARA) planning at light water plants. Objectives are to: identify high-dose maintenance tasks and related dose-reduction techniques; investigate utilization of high-reliability, low-maintenance equipment; recommend improved radioactive waste handling equipment and procedures; examine incentives for dose reduction; and compile an ALARA handbook.

  9. Fixing Maintenance Productivity.

    ERIC Educational Resources Information Center

    Fickes, Michael

    2003-01-01

    Describes how one university's facility managers use Nextel communications technology in conjunction with a Famis Software maintenance management system to improve the productivity of its maintenance technicians. The system uses a wireless Internet connection to automate the flow of work order information to and from technicians. The key to these…

  10. Progressive Planned Maintenance.

    ERIC Educational Resources Information Center

    Lewis, Mary Jo; Jacobs, Richard S.

    A planned maintenance system, which was implemented at Washington State University (WSU), uniquely integrates functions of equipment inventory, scheduling, time reporting, project management, materials inventory, and billing. Management now has immediate access to equipment data, maintenance status, and costs. Staff requirements are readily…

  11. Maintenance of School Gymnasiums.

    ERIC Educational Resources Information Center

    Finchum, R. N.

    1965-01-01

    Procedures are suggested that may be helpful to those responsible for the operation and maintenance of school buildings and gymnasiums. Most schools with gymnasiums utilize them for both instructional and sports purposes. Maintenance of the multipurpose gym are discussed under four subject areas--(1) floors, (2) lighting, (3) sanitation, and (4)…

  12. Maintenance Trades Guidelines

    ERIC Educational Resources Information Center

    Weidner, Theodore J.

    2008-01-01

    In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

  13. No maintenance -- no energy efficiency

    SciTech Connect

    Szydlowski, R.F.; Schliesing, J.S.; Winiarski, D.W.

    1994-12-01

    Field investigations illustrate that it is not realistic to expect new high-tech equipment to function for a full life expectancy at high efficiency without significant operations and maintenance (O&M). A simple walk through inspection of most buildings reveals extensive equipment that is being operated on manual override, is incorrectly adjusted and operating inefficiently, or is simply inoperative. This point is illustrated with two examples at Robins Air Force Base, Georgia. The first describes development of a comprehensive, base-wide, steam trap maintenance program. The second describes a measured evaluation from a typical office building. The objective of both examples was to assess the importance of proper O&M. The proposed ``O&M First`` philosophy will result in more efficient building HVAC operation, provide improved services to the building occupants, and reduce energy consumption and unscheduled equipment repair/replacement. Implementation of a comprehensive O&M program will result in a 15--25% energy savings. The O&M foundation that is established will allow other energy conservation activities such is demand side management or energy management and control systems, to achieve and maintain their expected energy savings.

  14. Maintenance Process Strategic Analysis

    NASA Astrophysics Data System (ADS)

    Jasiulewicz-Kaczmarek, M.; Stachowiak, A.

    2016-08-01

    The performance and competitiveness of manufacturing companies is dependent on the availability, reliability and productivity of their production facilities. Low productivity, downtime, and poor machine performance is often linked to inadequate plant maintenance, which in turn can lead to reduced production levels, increasing costs, lost market opportunities, and lower profits. These pressures have given firms worldwide the motivation to explore and embrace proactive maintenance strategies over the traditional reactive firefighting methods. The traditional view of maintenance has shifted into one of an overall view that encompasses Overall Equipment Efficiency, Stakeholders Management and Life Cycle assessment. From practical point of view it requires changes in approach to maintenance represented by managers and changes in actions performed within maintenance area. Managers have to understand that maintenance is not only about repairs and conservations of machines and devices, but also actions striving for more efficient resources management and care for safety and health of employees. The purpose of the work is to present strategic analysis based on SWOT analysis to identify the opportunities and strengths of maintenance process, to benefit from them as much as possible, as well as to identify weaknesses and threats, so that they could be eliminated or minimized.

  15. Remotely Adjustable Hydraulic Pump

    NASA Technical Reports Server (NTRS)

    Kouns, H. H.; Gardner, L. D.

    1987-01-01

    Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.

  16. Adjustable Pitot Probe

    NASA Technical Reports Server (NTRS)

    Ashby, George C., Jr.; Robbins, W. Eugene; Horsley, Lewis A.

    1991-01-01

    Probe readily positionable in core of uniform flow in hypersonic wind tunnel. Formed of pair of mating cylindrical housings: transducer housing and pitot-tube housing. Pitot tube supported by adjustable wedge fairing attached to top of pitot-tube housing with semicircular foot. Probe adjusted both radially and circumferentially. In addition, pressure-sensing transducer cooled internally by water or other cooling fluid passing through annulus of cooling system.

  17. Prolonged remission maintenance in acute myeloid leukaemia.

    PubMed

    Spiers, A S; Goldman, J M; Catovsky, D; Costello, C; Galton, D A; Pitcher, C S

    1977-08-27

    Twenty-five patients with acute myeloid leukaemia were treated with three quadruple drug combinations in predetermined rotation: TRAP (thioguanine, daunorubicin, cytarabine, prednisolone); COAP (cyclophosphamide, vincristine, cytarabine, prednisolone); and POMP (prednisolone, vincristine, methotrexate, mercaptopurine). Fifteen patients (60%) achieved complete remission and five (20%) partial remission. For maintenance, five-day courses of drugs were administered every 14 to 21 days and doses were increased to tolerance. The median length of complete remission was 66 weeks. In eight patients remission maintenance treatment was discontinued and some remained in complete remission for over two years. In this series the remission induction rate was comparable with that reported for other regimens and complete remission lasted longer with this intensive maintenance regimen than with others. Nevertheless, the TRAP programme must still be regarded as only palliative treatment for acute myeloid leukaemia.

  18. Prolonged remission maintenance in acute myeloid leukaemia.

    PubMed Central

    Spiers, A S; Goldman, J M; Catovsky, D; Costello, C; Galton, D A; Pitcher, C S

    1977-01-01

    Twenty-five patients with acute myeloid leukaemia were treated with three quadruple drug combinations in predetermined rotation: TRAP (thioguanine, daunorubicin, cytarabine, prednisolone); COAP (cyclophosphamide, vincristine, cytarabine, prednisolone); and POMP (prednisolone, vincristine, methotrexate, mercaptopurine). Fifteen patients (60%) achieved complete remission and five (20%) partial remission. For maintenance, five-day courses of drugs were administered every 14 to 21 days and doses were increased to tolerance. The median length of complete remission was 66 weeks. In eight patients remission maintenance treatment was discontinued and some remained in complete remission for over two years. In this series the remission induction rate was comparable with that reported for other regimens and complete remission lasted longer with this intensive maintenance regimen than with others. Nevertheless, the TRAP programme must still be regarded as only palliative treatment for acute myeloid leukaemia. PMID:268229

  19. Factors Influencing Army Maintenance

    DTIC Science & Technology

    1989-01-01

    ARI Research Note 89-11 (N 00 Factors Influencing Army Maintenance LOloD Debra C. Evans and J. Thomas Roth Applied Science Associates, Inc. for...1.2.7 .2.7.C.1 11. TITLE (Include Security ClassifIcarIon) Factors Influencing Army Maintenance i2. FERSONAL AuTtiOR(S) Evans, Debra C., and Roth, J...y • ’ Factors and variables that influence maintenance for systems and related manpower, per- sonnel, and training (MPT) characteristics were

  20. Weighted triangulation adjustment

    USGS Publications Warehouse

    Anderson, Walter L.

    1969-01-01

    The variation of coordinates method is employed to perform a weighted least squares adjustment of horizontal survey networks. Geodetic coordinates are required for each fixed and adjustable station. A preliminary inverse geodetic position computation is made for each observed line. Weights associated with each observed equation for direction, azimuth, and distance are applied in the formation of the normal equations in-the least squares adjustment. The number of normal equations that may be solved is twice the number of new stations and less than 150. When the normal equations are solved, shifts are produced at adjustable stations. Previously computed correction factors are applied to the shifts and a most probable geodetic position is found for each adjustable station. Pinal azimuths and distances are computed. These may be written onto magnetic tape for subsequent computation of state plane or grid coordinates. Input consists of punch cards containing project identification, program options, and position and observation information. Results listed include preliminary and final positions, residuals, observation equations, solution of the normal equations showing magnitudes of shifts, and a plot of each adjusted and fixed station. During processing, data sets containing irrecoverable errors are rejected and the type of error is listed. The computer resumes processing of additional data sets.. Other conditions cause warning-errors to be issued, and processing continues with the current data set.

  1. Pain Among High-Risk Patients on Methadone Maintenance Treatment.

    PubMed

    Voon, Pauline; Hayashi, Kanna; Milloy, M-J; Nguyen, Paul; Wood, Evan; Montaner, Julio; Kerr, Thomas

    2015-09-01

    The complexity of treating concurrent pain and opioid dependence among many methadone-maintained individuals presents a major challenge in many clinical settings. Furthermore, recent expert guidelines have called for increased research on the safety of methadone in the context of chronic pain. This study explores the prevalence and correlates of pain among a prospective cohort of people who use illicit drugs in Vancouver, British Columbia, Canada, who reported enrollment in methadone maintenance treatment (MMT) between 2011 and 2014. Among the 823 participants eligible for this analysis, 338 (40.9%) reported moderate pain and 91 (11.1%) reported extreme pain at the first study visit. In multivariable, generalized, linear mixed model analyses, higher pain severity was positively and independently associated with self-managing pain (adjusted odds ratio [AOR] 2.15, 95% confidence interval [CI] 1.77-2.60), patient perception of methadone dose being too low (AOR 1.82, 95% CI 1.41-2.34), older age (AOR 1.31, 95% CI 1.13-1.51), having a physical disability (AOR 4.59, 95% CI 3.73-5.64), having ever been diagnosed with a mental illness (AOR 1.44, 95% CI 1.13-1.84), white ethnicity (AOR 1.42, 95% CI 1.10-1.83), and marijuana use (AOR 1.25, 95% CI 1.02-1.52). These findings suggest several areas for clinical intervention, particularly related to patient education and alternative analgesic approaches for MMT patients experiencing pain. Perspective: To better understand the complexity of concurrent pain and opioid dependency among individuals on methadone maintenance treatment, this article describes the prevalence and correlates of higher pain severity among methadone-maintained people who use illicit drugs. Patients on methadone with comorbid pain may benefit from education and alternative analgesic approaches.

  2. Woodwind Instrument Maintenance.

    ERIC Educational Resources Information Center

    Sperl, Gary

    1980-01-01

    The author presents a simple maintenance program for woodwind instruments which includes the care of tendon corks, the need for oiling keys, and methods of preventing cracks in woodwind instruments. (KC)

  3. Care and Maintenance.

    ERIC Educational Resources Information Center

    Hampton, Carolyn H.; Hampton, Carol D.

    1979-01-01

    The classroom care and maintenance of terrestrial isopods is described. Includes illustrations of isopod external anatomy, a potato trap for collecting isopods, and a constructed habitat for raising isopods. (MA)

  4. Carpet Maintenance Guide.

    ERIC Educational Resources Information Center

    Griffin, William R.

    1999-01-01

    Discusses ways to make carpet maintenance in schools easier and effective for keeping carpeted areas in schools attractive and long lasting. Covers cleaning tips for basic spills, ideas for staying on top of stains, and suggestions for eliminating odors. (GR)

  5. Automating Preventive Maintenance.

    ERIC Educational Resources Information Center

    Oshier, Michael J.

    1984-01-01

    Describes the following aspects of the State University of New York-Brockport's preventive maintenance computerization project: (1) software selection, (2) project implementation; and (3) problems and benefits of the system. (MCG)

  6. Automated preventive maintenance program

    NASA Technical Reports Server (NTRS)

    Cea, E. J.; Grieger, T. H.

    1971-01-01

    Maintenance program which is concise and inexpensive to operate adapts to almost any system that has a FORTRAN compiler. Program operates on a stored data base with an output consisting of scheduling information and various management reports.

  7. Timpani Repair and Maintenance.

    ERIC Educational Resources Information Center

    Combs, F. Michael

    1980-01-01

    Rather than focusing on specific brands of timpani, these guidelines for repair cover mechanical problems of a general nature: pedals, dents, unclear tone, and squeaking. Preventive maintenance is discussed. (Author/SJL)

  8. Installation, maintenance and operating manual for the Lucas-type fuel injection system of the 3 B rotary engine

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The installation procedure, maintenance, adjustment and operation of a Lucas type fuel injection system for 13B rotary racing engine is outlined. Components of the fuel injection system and installation procedure and notes are described. Maintenance, adjustment, and operation are discussed.

  9. 38 CFR 39.7 - Line item adjustment to grants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Line item adjustment to grants. 39.7 Section 39.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND MAINTENANCE, OF...

  10. 38 CFR 39.7 - Line item adjustment to grants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Line item adjustment to grants. 39.7 Section 39.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND MAINTENANCE, OF...

  11. 38 CFR 39.7 - Line item adjustment to grants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Line item adjustment to grants. 39.7 Section 39.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND MAINTENANCE,...

  12. 38 CFR 39.7 - Line item adjustment to grants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Line item adjustment to grants. 39.7 Section 39.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND MAINTENANCE, OF...

  13. 75 FR 9087 - Trade Adjustment Assistance for Farmers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... implements the Trade Adjustment Assistance (TAA) for Farmers program as reauthorized by the American Recovery...) 720-0638; or by fax at (202) 720-8461. SUPPLEMENTARY INFORMATION: Background The American Recovery and... Maintenance of records, audits, and compliance. 1580.503 Recovery of overpayments. 1580.504...

  14. Data-Acquisition System With Remotely Adjustable Amplifiers

    NASA Technical Reports Server (NTRS)

    Nurge, Mark A.; Larson, William E.; Hallberg, Carl G.; Thayer, Steven W.; Ake, Jeffrey C.; Gleman, Stuart M.; Thompson, David L.; Medelius, Pedro J.; Crawford, Wayne A.; Vangilder, Richard M.; Kerce, Johnny L.; Fairbanks, Joey S.

    1994-01-01

    Improved data-acquisition system has both centralized and decentralized characteristics developed. Provides infrastructure for automation and standardization of operation, maintenance, calibration, and adjustment of many transducers. Increases efficiency by reducing need for diminishing work force of highly trained technicians to perform routine tasks. Large industrial and academic laboratory facilities benefit from systems like this one.

  15. Recirculating valve lash adjuster

    SciTech Connect

    Stoody, R.R.

    1987-02-24

    This patent describes an internal combustion engine with a valve assembly of the type including overhead valves supported by a cylinder head for opening and closing movements in a substantially vertical direction and a rotatable overhead camshaft thereabove lubricated by engine oil pumped by an engine oil pump. A hydraulic lash adjuster with an internal reservoir therein is solely supplied with run-off lubricating oil from the camshaft which oil is pumped into the internal reservoir of the lash adjuster by self-pumping operation of the lash adjuster produced by lateral forces thereon by the rotative operation of the camshaft comprising: a housing of the lash adjuster including an axially extending bore therethrough with a lower wall means of the housing closing the lower end thereof; a first plunger member being closely slidably received in the bore of the housing and having wall means defining a fluid filled power chamber with the lower wall means of the housing; and a second plunger member of the lash adjuster having a portion being loosely slidably received and extending into the bore of the housing for reciprocation therein. Another portion extends upwardly from the housing to operatively receive alternating side-to-side force inputs from operation of the camshaft.

  16. FGD maintenance guidelines. Volume 2: FGD maintenance information. Final report

    SciTech Connect

    Davidson, L.N.; Miller, G.P.; Wedig, C.P.

    1986-07-01

    The ''FGD Maintenance Guidelines'' was written to fill the need for maintenance information that applies specifically to flue gas desulfurization (FGD) systems. Previously there was no single source of data describing FGD maintenance. Usually maintenance managers relied on suppliers' operating and maintenance manuals, past FGD experience, or procedures from other areas of a power plant. There are two volumes in the Guidelines intended to assist utility personnel in planning and performing maintenance for FGD systems. Different aspects of maintenance are emphasized in each volume. Volume 1, FGD Maintenance Programs, provides guidance for supervisory personnel involved in planning maintenance. It describes the utility industry's experience with FGD maintenance programs, a procedure for organizing and managing maintenance programs, and ways to design FGD systems for maintainability. The section about implementing a maintenance program contains a detailed example to illustrate the procedure, based on experience of an actual operating FGD system. Volume 2, FGD Maintenance Information, has practical information, useful in understanding FGD systems and their maintenance needs. It describes the major types of FGD systems operating in the US and typical maintenance associated with each. Also, in this volume, there is information about maintenance needs and procedures for the most common types of FGD equipment. 21 refs., 48 figs., 3 tabs.

  17. Dose adjustment and supportive care before and during treatment.

    PubMed

    Brunello, Antonella; Loaldi, Elena; Balducci, Lodovico

    2009-10-01

    Though elderly patients represent a majority of cancer patients, their treatment of is still inadequate, mainly due to the lack of data deriving from randomized clinical trials. Factors limiting the use of standard chemotherapy regimens in elderly cancer patients are the fear of toxicity and unexpected side effects. The assessment of comorbidity and the multidimensional geriatric assessment are of major importance in the decision plan. All supportive measures must be adopted in order to successfully treat vulnerable and unfit elderly patients with cancer, and in particular, the use of growth factors when chemotherapy is given with curative intent; rule out anemia and possible causes of anemia, and correct them whenever possible; choose cytotoxics according to expected adverse events and possible interference with concomitant medications. Particular attention must be paid to treatment of pain in the elderly with cancer. Caregivers must be involved in the treatment plan, and phone contacts with the patient and caregivers are needed to verify physical conditions and compliance to prescriptions.

  18. Capping risk adjustment?

    PubMed

    Eugster, Patrick; Sennhauser, Michèle; Zweifel, Peter

    2010-07-01

    When premiums are community-rated, risk adjustment (RA) serves to mitigate competitive insurers' incentive to select favorable risks. However, unless fully prospective, it also undermines their incentives for efficiency. By capping its volume, one may try to counteract this tendency, exposing insurers to some financial risk. This in term runs counter the quest to refine the RA formula, which would increase RA volume. Specifically, the adjuster, "Hospitalization or living in a nursing home during the previous year" will be added in Switzerland starting 2012. This paper investigates how to minimize the opportunity cost of capping RA in terms of increased incentives for risk selection.

  19. Building Maintenance, Management, and Budgeting.

    ERIC Educational Resources Information Center

    Pawsey, M. R.

    1982-01-01

    Australian methods and formulas for funding building maintenance and management are outlined and found to be haphazard. Discussed are: ultimate costs of deferred maintenance, major plant replacements, life cycle costing, types of maintenance programs (including full preventive maintenance), use of computer programs for planning, and organization…

  20. Psychological Adjustment and Homosexuality.

    ERIC Educational Resources Information Center

    Gonsiorek, John C.

    In this paper, the diverse literature bearing on the topic of homosexuality and psychological adjustment is critically reviewed and synthesized. The first chapter discusses the most crucial methodological issue in this area, the problem of sampling. The kinds of samples used to date are critically examined, and some suggestions for improved…

  1. Self Adjusting Sunglasses

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Corning Glass Works' Serengeti Driver sunglasses are unique in that their lenses self-adjust and filter light while suppressing glare. They eliminate more than 99% of the ultraviolet rays in sunlight. The frames are based on the NASA Anthropometric Source Book.

  2. Self adjusting inclinometer

    DOEpatents

    Hunter, Steven L.

    2002-01-01

    An inclinometer utilizing synchronous demodulation for high resolution and electronic offset adjustment provides a wide dynamic range without any moving components. A device encompassing a tiltmeter and accompanying electronic circuitry provides quasi-leveled tilt sensors that detect highly resolved tilt change without signal saturation.

  3. 7 CFR 1580.502 - Maintenance of records, audits and compliance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.502 Maintenance... Internal Revenue Service Form 990-C, Farmers' Cooperative Association Income Tax Return; Form 1040,...

  4. Reliability Centered Maintenance - Methodologies

    NASA Technical Reports Server (NTRS)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  5. Adjustable Autonomy Testbed

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Schrenkenghost, Debra K.

    2001-01-01

    The Adjustable Autonomy Testbed (AAT) is a simulation-based testbed located in the Intelligent Systems Laboratory in the Automation, Robotics and Simulation Division at NASA Johnson Space Center. The purpose of the testbed is to support evaluation and validation of prototypes of adjustable autonomous agent software for control and fault management for complex systems. The AA T project has developed prototype adjustable autonomous agent software and human interfaces for cooperative fault management. This software builds on current autonomous agent technology by altering the architecture, components and interfaces for effective teamwork between autonomous systems and human experts. Autonomous agents include a planner, flexible executive, low level control and deductive model-based fault isolation. Adjustable autonomy is intended to increase the flexibility and effectiveness of fault management with an autonomous system. The test domain for this work is control of advanced life support systems for habitats for planetary exploration. The CONFIG hybrid discrete event simulation environment provides flexible and dynamically reconfigurable models of the behavior of components and fluids in the life support systems. Both discrete event and continuous (discrete time) simulation are supported, and flows and pressures are computed globally. This provides fast dynamic simulations of interacting hardware systems in closed loops that can be reconfigured during operations scenarios, producing complex cascading effects of operations and failures. Current object-oriented model libraries support modeling of fluid systems, and models have been developed of physico-chemical and biological subsystems for processing advanced life support gases. In FY01, water recovery system models will be developed.

  6. Precision adjustable stage

    DOEpatents

    Cutburth, Ronald W.; Silva, Leonard L.

    1988-01-01

    An improved mounting stage of the type used for the detection of laser beams is disclosed. A stage center block is mounted on each of two opposite sides by a pair of spaced ball bearing tracks which provide stability as well as simplicity. The use of the spaced ball bearing pairs in conjunction with an adjustment screw which also provides support eliminates extraneous stabilization components and permits maximization of the area of the center block laser transmission hole.

  7. Electrical Maintenance Technician.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document contains 30 units to consider for use in a tech prep competency profile for the occupation of electrical maintenance technician. All the units listed will not necessarily apply to every situation or tech prep consortium, nor will all the competencies within each unit be appropriate. Several units appear within each specific…

  8. Floors: Care and Maintenance.

    ERIC Educational Resources Information Center

    Post Office Dept., Washington, DC.

    Guidelines, methods and policies regarding the care and maintenance of post office building floors are overviewed in this handbook. Procedures outlined are concerned with maintaining a required level of appearance without wasting manpower. Flooring types and characteristics and the particular cleaning requirements of each type are given along with…

  9. Horticulture: Grounds Maintenance Employee.

    ERIC Educational Resources Information Center

    Sims, James; And Others

    The unit of individualized learning activities is designed to provide training in grounds maintenance. The materials in the unit are divided into two sections. The developmental or preliminary phase (15 pages) is for use by the instructor and includes brief descriptions of the job and of the student population, along with listings of the specific…

  10. Operations and maintenance philosophy

    SciTech Connect

    DUNCAN, G.P.

    1999-10-28

    This Operations and Maintenance (O&M) Philosophy document is intended to establish a future O&M vision, with an increased focus on minimizing worker exposure, ensuring uninterrupted retrieval operations, and minimizing operation life-cycle cost. It is intended that this document would incorporate O&M lessons learned into on-going and future project upgrades.

  11. Floors: Selection and Maintenance.

    ERIC Educational Resources Information Center

    Berkeley, Bernard

    Flooring for institutional, commercial, and industrial use is described with regard to its selection, care, and maintenance. The following flooring and subflooring material categories are discussed--(1) resilient floor coverings, (2) carpeting, (3) masonry floors, (4) wood floors, and (5) "formed-in-place floors". The properties, problems,…

  12. Maintenance Crisis vs Solutions.

    ERIC Educational Resources Information Center

    Haggard, Susie

    Industrial maintenance in Northeast Georgia is facing an acute crisis. Contributing factors are economic development that is depleting the work force, aging of the population, downsizing of the military, and lack of technical school graduates. Solutions to the crisis fall into three categories: short-term, mid-term, and long-term. For short-term…

  13. Playground Inspection & Maintenance.

    ERIC Educational Resources Information Center

    Leeds, Gerard

    People today demand a safer work environment and a safer play environment for children. Accidents such as broken arms are no longer accepted as an inevitable part of growing up. This paper presents recommendations for the maintenance of safe playground areas and equipment, covering three main areas: (1) inspections, which should follow a specified…

  14. School Maintenance Needs

    ERIC Educational Resources Information Center

    Erickson, Paul W.

    2011-01-01

    The United States is full of schools built in the 1950s and 60s that supported the boomer school-age enrollment increase. These schools, once beacons of the neighborhood, are 50 to 60 years old and susceptible to becoming the community "eyesore." Budgeting for maintenance was fairly systematic for school districts for the first 10 to 20…

  15. Care and Maintenance.

    ERIC Educational Resources Information Center

    Hampton, Carol D.; Hampton, Carolyn H.

    1980-01-01

    Described is a method for bringing the sea into the classroom by setting up a saltwater aquarium. Included is selection of an aquarium, filtering systems, water (whether natural salt or synthetic sea salts), bottom materials, setting up an aquarium, system stabilization, stocking an aquarium, and maintenance of the aquarium. (DS)

  16. Preventive Maintenance Process

    NASA Technical Reports Server (NTRS)

    Ciaruffoli, Veronica; Bramley, Craig; Matteson, Mike

    2001-01-01

    The Preventive Maintenance (PM) program at Stennis Space Center (SSC) evolved from an ineffective and poorly organized state to a highly organized state in which it became capable of tracking equipment, planning jobs with man hour estimates, and supporting outsourcing. This viewgraph presentation traces the steps the program took to improve itself.

  17. Diesel Vehicle Maintenance Competencies.

    ERIC Educational Resources Information Center

    Braswell, Robert; And Others

    Designed to provide a model set of competencies, this manual presents tasks which were identified by employers, employees, and teachers as important in a postsecondary diesel vehicle maintenance curriculum. The tasks are divided into seven major component areas of instruction: chassis and suspension, diesel engines, diesel fuel, electrical,…

  18. AUTOMOTIVE DIESEL MAINTENANCE 1. UNIT XXX, I--CATERPILLAR DIESEL ENGINE MAINTENANCE SUMMARY, II--REIEWING FACTS ABOUT ALTERNATORS.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Education, St. Paul. Div. of Vocational and Technical Education.

    THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO PROVIDE A SUMMARY OF DIESEL ENGINE MAINTENANCE FACTORS AND A REVIEW OF DIESEL ENGINE ALTERNATOR OPERATION. THE SEVEN SECTIONS COVER DIESEL ENGINE TROUBLESHOOTING AND THE OPERATION, TESTING, AND ADJUSTING OF ALTERNATORS. THE MODULE CONSISTS OF A SELF-INSTRUCTIONAL BRANCH PROGRAMED TRAINING FILM…

  19. Benchmark Dose Software Development and Maintenance Ten Berge Cxt Models

    EPA Science Inventory

    This report is intended to provide an overview of beta version 1.0 of the implementation of a concentration-time (CxT) model originally programmed and provided by Wil ten Berge (referred to hereafter as the ten Berge model). The recoding and development described here represent ...

  20. Practical applications of internal dose calculations

    SciTech Connect

    Carbaugh, E.H.

    1994-06-01

    Accurate estimates of intake magnitude and internal dose are the goal for any assessment of an actual intake of radioactivity. When only one datum is available on which to base estimates, the choices for internal dose assessment become straight-forward: apply the appropriate retention or excretion function, calculate the intake, and calculate the dose. The difficulty comes when multiple data and different types of data become available. Then practical decisions must be made on how to interpret conflicting data, or how to adjust the assumptions and techniques underlying internal dose assessments to give results consistent with the data. This article describes nine types of adjustments which can be incorporated into calculations of intake and internal dose, and then offers several practical insights to dealing with some real-world internal dose puzzles.

  1. DARHT operations and maintenance manual

    SciTech Connect

    Not Available

    1991-12-01

    The Dual Axis Radiographic Hydrodynamic Test (DARHT) injector system was designed, constructed and tested in the dummy load configuration at Pulse Sciences, Inc. (PSI), San Leandro, CA for Los Alamos National Laboratories (LANL) during the period from September 1989 through December 1990. The injector was installed and its operation was demonstrated in the dummy load configuration at LANL from January 1991 through April 1991. Testing of the system configuration into a diode load began in June 1991. Cross-sectional views of the injector in both the dummy load and system configurations are shown. The injector is designed to produce a 4 MV, flat-top ({plus_minus} 1%), 65 nsec (99--99%) acceleration pulse into a 150 ohm load with a command fire jitter of less than 3 nsec (3{sigma}). The load consists of an adjustable sodium thiosulfate solution resistor located at the vacuum tube interface in parallel with an {approximately}1 k{Omega} electron beam diode. This manual describes the injector and its ancillary systems and gives operating, maintenance and assembly instructions for the system in the dummy load configuration.

  2. Adjusting rations for climate.

    PubMed

    Ames, D R

    1988-11-01

    Cold conditions resulting from a combination of temperature, wind, and wetness result in increased energy required for maintenance. Constant levels of intake reduce energy available for production. Direct effects of cold include reduced rate and efficiency of growth and milk production. Indirect effects on measures of reproductive efficiency are well documented. Impacts on health and longevity are perhaps less obvious but are no doubt affected. Energy supplementation is an obvious need for cold-stressed animals. For maximum effectiveness, efforts should incorporate a systems approach and integrate the expertise of many disciplines into a logical decision-making process. The entire spectrum of animal response, not just short-term acute response, must be included in environmental management.

  3. Adjustable Reeds For Weaving

    NASA Technical Reports Server (NTRS)

    Farley, Gary L.

    1994-01-01

    Local characteristics of fabrics varied to suit special applications. Adjustable reed machinery proposed for use in weaving fabrics in various net shapes, widths, yarn spacings, and yarn angles. Locations of edges of fabric and configuration of warp and filling yarns varied along fabric to obtain specified properties. In machinery, reed wires mounted in groups on sliders, mounted on lengthwise rails in reed frame. Mechanisms incorporated to move sliders lengthwise, parallel to warp yarns, by sliding them along rails; move sliders crosswise by translating reed frame rails perpendicular to warp yarns; and crosswise by spreading reed rails within group. Profile of reed wires in group on each slider changed.

  4. Single daily dosing of aminoglycosides.

    PubMed

    Preston, S L; Briceland, L L

    1995-01-01

    To evaluate the rationale behind dosing aminoglycosides as a single daily dose versus traditional dosing approaches, we conducted a MEDLINE search to identify all pertinent articles, and also reviewed the references of all articles. Single daily dosing of aminoglycosides is not a new concept, having been examined since 1974. The advantages of this regimen include optimum concentration-dependent bactericidal activity, longer dosing intervals due to the postantibiotic effect (PAE), and prevention of bacterial adaptive resistance. Because of longer dosing intervals, toxicity may also be delayed or reduced. Costs may be reduced due to decreased monitoring and administration. Clinically, the regimen has been implemented in various patient populations with reported success. Questions remain, however, about optimum dose, peak and trough serum concentrations, and dose adjustment in patients with renal impairment or neutropenia. More clinical experience with this method in large numbers of patients has to be published. Pharmacists can be instrumental in monitoring patients receiving once-daily therapy and by educating health care professionals as to the rationale behind the therapy.

  5. Terminal automation system maintenance

    SciTech Connect

    Coffelt, D.; Hewitt, J.

    1997-01-01

    Nothing has improved petroleum product loading in recent years more than terminal automation systems. The presence of terminal automation systems (TAS) at loading racks has increased operational efficiency and safety and enhanced their accounting and management capabilities. However, like all finite systems, they occasionally malfunction or fail. Proper servicing and maintenance can minimize this. And in the unlikely event a TAS breakdown does occur, prompt and effective troubleshooting can reduce its impact on terminal productivity. To accommodate around-the-clock loading at racks, increasingly unattended by terminal personnel, TAS maintenance, servicing and troubleshooting has become increasingly demanding. It has also become increasingly important. After 15 years of trial and error at petroleum and petrochemical storage and transfer terminals, a number of successful troubleshooting programs have been developed. These include 24-hour {open_quotes}help hotlines,{close_quotes} internal (terminal company) and external (supplier) support staff, and {open_quotes}layered{close_quotes} support. These programs are described.

  6. CFB refractory maintenance

    SciTech Connect

    Johnson, R.C.

    1994-12-31

    The CFB maintenance manager has to make rapid-fire decisions regarding refractory maintenance during short or unscheduled turnarounds. This presentation offers a hands-on approach to expedient refractory failure analyses with specific repair recommendations. Photographs of most typical CFB refractory failures and their structural repairs are discussed. The most reliable repairs can be expected by using the latest state-of-the-art refractory materials and installation techniques. Refractory materials are consumable; therefore minor repairs should always be conducted at the first opportunity; this will preclude future major repairs. During a short or unscheduled outage, major repairs should be confined to the specific structural repair site; the removal of good, serviceable refractory is unnecessary under these conditions.

  7. Maintenance Therapy in IBD

    MedlinePlus

    ... to use the enema a few times each week. Antibiotics Antibiotics are effective as chronic (long-term) ... often get three doses over an initial six-week period. Many patients respond quickly, usually within one ...

  8. Maintenance Therapy in IBD

    MedlinePlus

    ... Infliximab is given as a single-dose intravenous infusion, and many patients may be able to wait ... is recommended to wait at least for two infusions to see infliximab's effectiveness. Adalimumab Adalimumab (Humira®) is ...

  9. Flight Crew Health Maintenance

    NASA Technical Reports Server (NTRS)

    Gullett, C. C.

    1970-01-01

    The health maintenance program for commercial flight crew personnel includes diet, weight control, and exercise to prevent heart disease development and disability grounding. The very high correlation between hypertension and overweight in cardiovascular diseases significantly influences the prognosis for a coronary prone individual and results in a high rejection rate of active military pilots applying for civilian jobs. In addition to physical fitness the major items stressed in pilot selection are: emotional maturity, glucose tolerance, and family health history.

  10. Satisfaction With Methadone Among Heroin-Dependent Patients With Current Substance Use Disorders During Methadone Maintenance Treatment.

    PubMed

    Perez de Los Cobos, Jose; Trujols, Joan; Siñol, Núria; Duran-Sindreu, Santiago; Batlle, Francesca

    2016-04-01

    Methadone maintenance treatment (MMT) has long been used to treat heroin-dependent patients. However, satisfaction with methadone in this patient population is unknown. The aim of this cross-sectional case-control study was to evaluate satisfaction with methadone in heroin-dependent patients with current substance use disorders (SUDs). Cases included 152 methadone-maintained patients with current SUD, requiring inpatient detoxification treatment, and controls included 33 methadone-maintained patients in sustained full remission for SUD. Satisfaction with methadone as a medication to treat heroin addiction was measured by using the Scale to Assess Satisfaction with Medications for Addiction Treatment-methadone for heroin addiction (SASMAT-METHER). The SASMAT-METHER subscales assess the following domains: personal functioning and well-being, antiaddictive effect on heroin, and antiaddictive effect on other substances. Compared with patients with remitted SUD, patients with current SUD scored lower on all SASMAT-METHER assessments. In such patients, overall SASMAT-METHER scores were independently and negatively associated with downward desired adjustment of methadone dose and days of heroin use during last month; although various sets of factors were independently associated with each of the SASMAT-METHER subscales, the only determinant of dissatisfaction on all subscales was the desire for downward adjustment of methadone dose. In summary, MMT patients with current SUD are less satisfied with methadone than MMT patients with remitted SUD. In patients with current SUD, downward desired adjustment of methadone dose and days of heroin use during last month are independently associated with overall dissatisfaction with methadone.

  11. Continuously adjustable Pulfrich spectacles

    NASA Astrophysics Data System (ADS)

    Jacobs, Ken; Karpf, Ron

    2011-03-01

    A number of Pulfrich 3-D movies and TV shows have been produced, but the standard implementation has inherent drawbacks. The movie and TV industries have correctly concluded that the standard Pulfrich 3-D implementation is not a useful 3-D technique. Continuously Adjustable Pulfrich Spectacles (CAPS) is a new implementation of the Pulfrich effect that allows any scene containing movement in a standard 2-D movie, which are most scenes, to be optionally viewed in 3-D using inexpensive viewing specs. Recent scientific results in the fields of human perception, optoelectronics, video compression and video format conversion are translated into a new implementation of Pulfrich 3- D. CAPS uses these results to continuously adjust to the movie so that the viewing spectacles always conform to the optical density that optimizes the Pulfrich stereoscopic illusion. CAPS instantly provides 3-D immersion to any moving scene in any 2-D movie. Without the glasses, the movie will appear as a normal 2-D image. CAPS work on any viewing device, and with any distribution medium. CAPS is appropriate for viewing Internet streamed movies in 3-D.

  12. Management Aspects of Software Maintenance.

    DTIC Science & Technology

    1984-09-01

    TRADITIONAl METHODS ..... ............. 50 C. PARAMETRIC MODELS ..... .............. 53 D. ESTIMATING MAINTENANCE COSTS ... ......... 57 1. Planning...maintenance. 10 10A 4 7he extensive research dcne cn software development and on the management of the development process is only ncw begin- ning to...and external factors. C. GENEEAL PROCEDURE The procedure used was to research literature concerning software maintenance. Particular emphasis was

  13. PREVENTIVE MAINTENANCE. HONEYWELL PLANNING GUIDE.

    ERIC Educational Resources Information Center

    Honeywell, Inc., Minneapolis, Minn.

    THIS HONEYWELL PAMPHLET DISCUSSES SOME ASPECTS OF PREVENTIVE MAINTENANCE OF AUTOMATIC CONTROLS, HEATING, VENTILATING, AND AIR CONDITIONING, AND COMPARES IN-PLANT WITH CONTRACT SERVICE, CONCLUDING THAT CONTRACT SERVICE IS PREFERABLE AND DESCRIBING A NUMBER OF MAINTENANCE PLANS WHICH THEY FURNISH. PREVENTIVE MAINTENANCE PROVIDES--(1) MORE EFFICIENT…

  14. AUTOMOTIVE DIESEL MAINTENANCE. PROGRAM OUTLINE.

    ERIC Educational Resources Information Center

    Human Engineering Inst., Cleveland, OH.

    INFORMATIONAL TOPICS COVERED IN THE TEXT MATERIALS AND SELF-INSTRUCTIONAL BRANCH PROGRAMED TRAINING FILMS FOR A 2-YEAR, 55 MODULE PROGRAM IN AUTOMOTIVE DIESEL MAINTENANCE ARE GIVEN. THE 30 MODULES FOR "AUTOMOTIVE DIESEL MAINTENANCE 1" ARE AVAILABLE AS VT 005 655 - VT 005 684, AND THE 25 MODULES FOR "AUTOMOTIVE DIESEL MAINTENANCE 2" ARE AVAILABLE…

  15. HIV transmission and the cost-effectiveness of methadone maintenance.

    PubMed Central

    Zaric, G S; Barnett, P G; Brandeau, M L

    2000-01-01

    OBJECTIVES: This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic. METHODS: We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%. RESULTS: Additional methadone maintenance capacity costs $8200 per QALY gained in the high-prevalence community and $10,900 per QALY gained in the low-prevalence community. More than half of the benefits are gained by individuals who do not inject drugs. Even if the benefits realized by treated and untreated injection drug users are ignored, methadone maintenance expansion costs between $14,100 and $15,200 per QALY gained. Additional capacity remains cost-effective even if it is twice as expensive and half as effective as current methadone maintenance slots. CONCLUSIONS: Expansion of methadone maintenance is cost-effective on the basis of commonly accepted criteria for medical interventions. Barriers to methadone maintenance deny injection drug users access to a cost-effective intervention that generates significant health benefits for the general population. PMID:10897189

  16. Maintenance treatment of renal anaemia in haemodialysis patients with methoxy polyethylene glycol-epoetin beta versus darbepoetin alfa administered monthly: a randomized comparative trial

    PubMed Central

    Carrera, Fernando; Lok, Charmaine E.; de Francisco, Angel; Locatelli, Francesco; Mann, Johannes F.E.; Canaud, Bernard; Kerr, Peter G.; Macdougall, Iain C.; Besarab, Anatole; Villa, Giuseppe; Kazes, Isabelle; Van Vlem, Bruno; Jolly, Shivinder; Beyer, Ulrich; Dougherty, Frank C.

    2010-01-01

    Background. Several studies with erythropoiesis-stimulating agents claim that maintenance therapy of renal anaemia may be possible at extended dosing intervals; however, few studies were randomized, results varied, and comparisons between agents were absent. We report results of a multi-national, randomized, prospective trial comparing haemoglobin maintenance with methoxy polyethylene glycol-epoetin beta and darbepoetin alfa administered once monthly. Methods. Haemodialysis patients (n = 490) on stable once-weekly intravenous darbepoetin alfa were randomized to methoxy polyethylene glycol-epoetin beta once monthly or darbepoetin alfa every 2 weeks for 26 weeks, with dose adjustment for individual haemoglobin target (11–13 g/dL; maximum decrease from baseline 1 g/dL). Subsequently, patients entered a second 26-week period of once-monthly methoxy polyethylene glycol-epoetin beta and darbepoetin alfa. The primary endpoint was the proportion of patients who maintained average haemoglobin ≥10.5 g/dL, with a decrease from baseline ≤1 g/dL, in Weeks 50–53; the secondary endpoint was dose change over time. The trial is registered at www.ClinicalTrials.gov, number NCT00394953. Results. Baseline characteristics were similar between groups. One hundred and fifty-seven of 245 patients treated with methoxy polyethylene glycol-epoetin beta and 99 of 245 patients with darbepoetin alfa met the response definition (64.1% and 40.4%; P < 0.0001). Doses increased by 6.8% with methoxy polyethylene glycol-epoetin beta and 58.8% with darbepoetin alfa during once-monthly treatment. Death rates were equal between treatments (5.7%). Most common adverse events included hypertension, procedural hypotension, nasopharyngitis and muscle spasms, with no differences between groups. Conclusions. Methoxy polyethylene glycol-epoetin beta maintained target haemoglobin more successfully than darbepoetin alfa at once-monthly dosing intervals despite dose increases with darbepoetin alfa

  17. General aviation avionics equipment maintenance

    NASA Technical Reports Server (NTRS)

    Parker, C. D.; Tommerdahl, J. B.

    1978-01-01

    Maintenance of general aviation avionics equipment was investigated with emphasis on single engine and light twin engine general aviation aircraft. Factors considered include the regulatory agencies, avionics manufacturers, avionics repair stations, the statistical character of the general aviation community, and owners and operators. The maintenance, environment, and performance, repair costs, and reliability of avionics were defined. It is concluded that a significant economic stratification is reflected in the maintenance problems encountered, that careful attention to installations and use practices can have a very positive impact on maintenance problems, and that new technologies and a general growth in general aviation will impact maintenance.

  18. Paranal maintenance and CMMS experience

    NASA Astrophysics Data System (ADS)

    Montano, Nelson

    2004-10-01

    During the last four years of operations, low technical downtime has been one of the relevant records of the Paranal Observatory. From the beginning of the Very Large Telescope (VLT) project, European Southern Observatory (ESO) has considered the implementation of a proper maintenance strategy a fundamental point in order to ensure low technical down time and preserve the Observatory's assets. The implementation of the maintenance strategy was based on the following aspects: - Strong maintenance sense during the design stage. Line Replacement Unit (LRU) concept, standardization and modularity of the Observatory equipment - Creation of a dedicated team for Maintenance - The implementation of a Computerized Maintenance Management System After four operational years, the result of these aspects has exceeded the expectations; the Observatory has been operating with high availability under a sustainable strategy. The strengths of the maintenance strategy have been based on modern maintenance concepts applied by regular production companies, where any minute of down time involves high cost. The operation of the actual Paranal Maintenance System is based mainly on proactive activities, such as regular inspections, preventive maintenance (PM) and predictive maintenance (PdM) plans. Nevertheless, it has been necessary to implement a strong plan for corrective maintenance (CM). The Spare Parts Strategy has also been an important point linked to the Maintenance Strategy and CMMS implementation. At present, almost 4,000 items related to the Observatory spare parts are loaded into the CMMS database. Currently, we are studying the implementation of a Reliability Centered Maintenance (RCM) project in one of our critical systems The following document presents the actual status of the Paranal Maintenance Strategy and which have been the motivations to implement the established strategy.

  19. 14 CFR 43.9 - Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in..., PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.9 Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in accordance...

  20. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., preventive maintenance, rebuilding, and alterations. 43.3 Section 43.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.3 Persons authorized to perform maintenance, preventive maintenance, rebuilding,...

  1. 14 CFR 43.9 - Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in..., PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.9 Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in accordance...

  2. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., preventive maintenance, rebuilding, and alterations. 43.3 Section 43.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.3 Persons authorized to perform maintenance, preventive maintenance, rebuilding,...

  3. 14 CFR 43.9 - Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in..., PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.9 Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in accordance...

  4. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., preventive maintenance, rebuilding, and alterations. 43.3 Section 43.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.3 Persons authorized to perform maintenance, preventive maintenance, rebuilding,...

  5. 14 CFR 43.3 - Persons authorized to perform maintenance, preventive maintenance, rebuilding, and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., preventive maintenance, rebuilding, and alterations. 43.3 Section 43.3 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.3 Persons authorized to perform maintenance, preventive maintenance, rebuilding,...

  6. 14 CFR 43.9 - Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in..., PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.9 Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in accordance...

  7. 14 CFR 43.9 - Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in..., PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.9 Content, form, and disposition of maintenance, preventive maintenance, rebuilding, and alteration records (except inspections performed in accordance...

  8. Towards automated traceability maintenance.

    PubMed

    Mäder, Patrick; Gotel, Orlena

    2012-10-01

    Traceability relations support stakeholders in understanding the dependencies between artifacts created during the development of a software system and thus enable many development-related tasks. To ensure that the anticipated benefits of these tasks can be realized, it is necessary to have an up-to-date set of traceability relations between the established artifacts. This goal requires the creation of traceability relations during the initial development process. Furthermore, the goal also requires the maintenance of traceability relations over time as the software system evolves in order to prevent their decay. In this paper, an approach is discussed that supports the (semi-) automated update of traceability relations between requirements, analysis and design models of software systems expressed in the UML. This is made possible by analyzing change events that have been captured while working within a third-party UML modeling tool. Within the captured flow of events, development activities comprised of several events are recognized. These are matched with predefined rules that direct the update of impacted traceability relations. The overall approach is supported by a prototype tool and empirical results on the effectiveness of tool-supported traceability maintenance are provided.

  9. Maintenance and supply options

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The object of the Maintenance and Supply Option was to develop a high level operational philosophy related to maintenance and supply operations and incorporate these concepts into the Lunar Base Study. Specific products to be generated during this task were three trade studies and a conceptual design of the Logistic Supply Module. The crew size study was performed to evaluate crew sizes from the baseline size of four to a crew size of eight and determine the preferred crew size. The second trade study was to determine the impact of extending surface stay times and recommend a preferred duration of stay time as a function of crew, consumables, and equipment support capabilities. The third trade study was an evaluation of packaging and storage methods to determine the preferred logistics approach to support the lunar base. A modified scenario was developed and served as the basis of the individual trade studies. Assumptions and guidelines were also developed from experience with Apollo programs, Space Shuttle operations, and Space Station studies. With this information, the trade studies were performed and a conceptual design for the Logistic Supply Module was developed.

  10. Optimization of dosing regimens and dosing in special populations.

    PubMed

    Sime, F B; Roberts, M S; Roberts, J A

    2015-10-01

    Treatment of infectious diseases is becoming increasingly challenging with the emergence of less-susceptible organisms that are poorly responsive to existing antibiotic therapies, and the unpredictable pharmacokinetic alterations arising from complex pathophysiologic changes in some patient populations. In view of this fact, there has been a progressive work on novel dose optimization strategies to renew the utility of forgotten old antibiotics and to improve the efficacy of those currently in use. This review summarizes the different approaches of optimization of antibiotic dosing regimens and the special patient populations which may benefit most from these approaches. The existing methods are based on monitoring of antibiotic concentrations and/or use of clinical covariates. Measured concentrations can be correlated with predefined pharmacokinetic/pharmacodynamic targets to guide clinicians in predicting the necessary dose adjustment. Dosing nomograms are also available to relate observed concentrations or clinical covariates (e.g. creatinine clearance) with optimal dosing. More precise dose prediction based on observed covariates is possible through the application of population pharmacokinetic models. However, the most accurate estimation of individualized dosing requirements is achieved through Bayesian forecasting which utilizes both measured concentration and clinical covariates. Various software programs are emerging to ease clinical application. Whilst more studies are warranted to clarify the clinical outcomes associated with the different dose optimization approaches, severely ill patients in the course of marked infections and/or inflammation including those with sepsis, septic shock, severe trauma, burns injury, major surgery, febrile neutropenia, cystic fibrosis, organ dysfunction and obesity are those groups which may benefit most from individualized dosing.

  11. Delay Adjusted Incidence

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  12. Nonlinear Hydrostatic Adjustment.

    NASA Astrophysics Data System (ADS)

    Bannon, Peter R.

    1996-12-01

    The final equilibrium state of Lamb's hydrostatic adjustment problem is found for finite amplitude heating. Lamb's problem consists of the response of a compressible atmosphere to an instantaneous, horizontally homogeneous heating. Results are presented for both isothermal and nonisothermal atmospheres.As in the linear problem, the fluid displacements are confined to the heated layer and to the region aloft with no displacement of the fluid below the heating. The region above the heating is displaced uniformly upward for heating and downward for cooling. The amplitudes of the displacements are larger for cooling than for warming.Examination of the energetics reveals that the fraction of the heat deposited into the acoustic modes increases linearly with the amplitude of the heating. This fraction is typically small (e.g., 0.06% for a uniform warming of 1 K) and is essentially independent of the lapse rate of the base-state atmosphere. In contrast a fixed fraction of the available energy generated by the heating goes into the acoustic modes. This fraction (e.g., 12% for a standard tropospheric lapse rate) agrees with the linear result and increases with increasing stability of the base-state atmosphere.The compressible results are compared to solutions using various forms of the soundproof equations. None of the soundproof equations predict the finite amplitude solutions accurately. However, in the small amplitude limit, only the equations for deep convection advanced by Dutton and Fichtl predict the thermodynamic state variables accurately for a nonisothermal base-state atmosphere.

  13. CANISTER HANDLING FACILITY WORKER DOSE ASSESSMENT

    SciTech Connect

    D.T. Dexheimer

    2004-02-27

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Canister Handling Facility (CHF) performing operations to receive transportation casks, transfer wastes, prepare waste packages, perform associated equipment maintenance. The specific scope of work contained in this calculation covers individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation. The results of this calculation will be used to support the design of the CHF and provide occupational dose estimates for the License Application.

  14. Harnessing the power of maintenance

    SciTech Connect

    Toomey, G.

    2006-03-15

    More electric utilities are realizing that structured, comprehensive and proactive maintenance strategies deliver uptime to their bottom line. The article presents four case studies illustrating some of the available solutions to coal and gas-fired plant maintenance. These were: a maintenance strategy review of five coal fired and 22 gas-fired units to identify the importance of equipment along with maintenance tasks; a predictive maintenance program monitoring vibration to detect machine fault conditions including bearing condition; setting up a network to monitor data from several coal- and gas-fired plants at one central location; and creating a maintenance strategy to cushion against the possibility of unscheduled downtime and imposed penalties. 2 photos.

  15. AGING FACILITY WORKER DOSE ASSESSMENT

    SciTech Connect

    R.L. Thacker

    2005-03-24

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Aging Facility performing operations to transfer aging casks to the aging pads for thermal and logistical management, stage empty aging casks, and retrieve aging casks from the aging pads for further processing in other site facilities. Doses received by workers due to aging cask surveillance and maintenance operations are also included. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation from normal operation. There are no Category 1 event sequences associated with the Aging Facility (BSC 2004 [DIRS 167268], Section 7.2.1). The results of this calculation will be used to support the design of the Aging Facility and to provide occupational dose estimates for the License Application. The calculations contained in this document were developed by Environmental and Nuclear Engineering of the Design and Engineering Organization and are intended solely for the use of the Design and Engineering Organization in its work regarding facility operation. Yucca Mountain Project personnel from the Environmental and Nuclear Engineering should be consulted before use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in Environmental and Nuclear Engineering.

  16. Risk-based maintenance modeling. Prioritization of maintenance importances and quantification of maintenance effectiveness

    SciTech Connect

    Vesely, W.E.; Rezos, J.T.

    1995-09-01

    This report describes methods for prioritizing the risk importances of maintenances using a Probabilistic Risk Assessment (PRA). Approaches then are described for quantifying their reliability and risk effects. Two different PRA importance measures, minimal cutset importances and risk reduction importances, were used to prioritize maintenances; the findings show that both give similar results if appropriate criteria are used. The justifications for the particular importance measures also are developed. The methods developed to quantify the reliability and risk effects of maintenance actions are extensions of the usual reliability models now used in PRAs. These extended models consider degraded states of the component, and quantify the benefits of maintenance in correcting degradations and preventing failures. The negative effects of maintenance, including downtimes, also are included. These models are specific types of Markov models. The data for these models can be obtained from plant maintenance logs and from the Nuclear Plant Reliability Data System (NPRDS). To explore the potential usefulness of these models, the authors analyzed a range of postulated values of input data. These models were used to examine maintenance effects on a components reliability and performance for various maintenance programs and component data. Maintenance schedules were analyzed to optimize the component`s availability. In specific cases, the effects of maintenance were found to be large.

  17. Buildings Lean Maintenance Implementation Model

    NASA Astrophysics Data System (ADS)

    Abreu, Antonio; Calado, João; Requeijo, José

    2016-11-01

    Nowadays, companies in global markets have to achieve high levels of performance and competitiveness to stay "alive".Within this assumption, the building maintenance cannot be done in a casual and improvised way due to the costs related. Starting with some discussion about lean management and building maintenance, this paper introduces a model to support the Lean Building Maintenance (LBM) approach. Finally based on a real case study from a Portuguese company, the benefits, challenges and difficulties are presented and discussed.

  18. Boiler Combustion Control Maintenance Manual.

    DTIC Science & Technology

    1983-03-01

    controller and the final control element, as shown in Figure 6-1. The maintenance basically involves the inspection of the poppet valve in the relay...routine maintenance of this component basically involves placing a few drops of light machine oil on the ball bearing fulcrum. The poppet valve should... Valve /Air Damper Positioners ................................ 6-2 7.0 ELECTRIC PARALLEL POSITIONING CONTROL MAINTENANCE ................ 7-1 8.0 MOBILE

  19. TCMS operations and maintenance philosophy

    NASA Technical Reports Server (NTRS)

    Buehler, David P.; Griffin, Rock E.

    1992-01-01

    The purpose is to describe the basic philosophies of operating and maintaining the Test, Control, and Monitor System (TCMS) equipment. TCMS is a complex and sophisticated checkout system. Operations and maintenance processes developed to support it will be based upon current experience, but will be focused on the specific needs of TCMS in support of Space Station Freedom Program (SSFP) and related activities. An overview of the operations and maintenance goals and philosophies are presented. The assumptions, roles and responsibilities, concepts and interfaces for operation, on-line maintenance, off-line support, and Operations and Maintenance (O&M) personnel training on all TCMS equipment located at KSC are described.

  20. Towards Agile Ontology Maintenance

    NASA Astrophysics Data System (ADS)

    Luczak-Rösch, Markus

    Ontologies are an appropriate means to represent knowledge on the Web. Research on ontology engineering reached practices for an integrative lifecycle support. However, a broader success of ontologies in Web-based information systems remains unreached while the more lightweight semantic approaches are rather successful. We assume, paired with the emerging trend of services and microservices on the Web, new dynamic scenarios gain momentum in which a shared knowledge base is made available to several dynamically changing services with disparate requirements. Our work envisions a step towards such a dynamic scenario in which an ontology adapts to the requirements of the accessing services and applications as well as the user's needs in an agile way and reduces the experts' involvement in ontology maintenance processes.

  1. DCSP hardware maintenance system

    SciTech Connect

    Pazmino, M.

    1995-11-01

    This paper discusses the necessary changes to be implemented on the hardware side of the DCSP database. DCSP is currently tracking hardware maintenance costs in six separate databases. The goal is to develop a system that combines all data and works off a single database. Some of the tasks that will be discussed in this paper include adding the capability for report generation, creating a help package and preparing a users guide, testing the executable file, and populating the new database with data taken from the old database. A brief description of the basic process used in developing the system will also be discussed. Conclusions about the future of the database and the delivery of the final product are then addressed, based on research and the desired use of the system.

  2. Insect maintenance and transmission.

    PubMed

    Kingdom, Heather

    2013-01-01

    Phytoplasmas are plant pathogens of huge economic importance due to responsibility for crop yield losses worldwide. Institutions around the world are trying to understand and control this yield loss at a time when food security is high on government agendas. In order to fully understand the mechanisms of phytoplasma infection and spread, more insect vector and phytoplasma colonies will need to be established for research worldwide. Rearing and study of these colonies is essential in the research and development of phytoplasma control measures. This chapter highlights general materials and methods for raising insect vector colonies and maintenance of phytoplasmas. Specific methods of rearing the maize leafhopper and maize bushy stunt phytoplasma and the aster leafhopper and aster yellows phytoplasma strain witches' broom are also included.

  3. Illinois Occupational Skill Standards: Industrial Maintenance General Maintenance Cluster.

    ERIC Educational Resources Information Center

    Illinois Occupational Skill Standards and Credentialing Council, Carbondale.

    These skill standards for the industrial maintenance general maintenance cluster are intended to be a guide to workforce preparation program providers in defining content for their programs and to employers to establish the skills and standards necessary for job acquisition. An introduction provides the Illinois perspective; Illinois Occupational…

  4. 14 CFR 121.367 - Maintenance, preventive maintenance, and alterations programs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.367 Maintenance, preventive maintenance, and alterations..., preventive maintenance, and alterations that ensures that— (a) Maintenance, preventive......

  5. 14 CFR 135.433 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance and preventive maintenance... SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.433 Maintenance and preventive maintenance training program. Each certificate holder or a person performing maintenance or...

  6. 14 CFR 121.367 - Maintenance, preventive maintenance, and alterations programs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.367 Maintenance, preventive maintenance, and alterations..., preventive maintenance, and alterations that ensures that— (a) Maintenance, preventive......

  7. 14 CFR 121.367 - Maintenance, preventive maintenance, and alterations programs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.367 Maintenance, preventive maintenance, and alterations..., preventive maintenance, and alterations that ensures that— (a) Maintenance, preventive......

  8. 14 CFR 121.367 - Maintenance, preventive maintenance, and alterations programs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.367 Maintenance, preventive maintenance, and alterations..., preventive maintenance, and alterations that ensures that— (a) Maintenance, preventive......

  9. 14 CFR 121.367 - Maintenance, preventive maintenance, and alterations programs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.367 Maintenance, preventive maintenance, and alterations..., preventive maintenance, and alterations that ensures that— (a) Maintenance, preventive......

  10. Radiation Phantom with Humanoid Shape and Adjustable Thickness (RPHAT)

    SciTech Connect

    Lehmann, J; Stern, R L; Levy, J; Daly, T; Hartmann-Siantar, C L; Goldberg, Z

    2003-08-11

    A new radiation phantom with humanoid shape and adjustable thickness (RPHAT) has been developed. Unlike the RANDO{reg_sign} Phantom which is a fixed thickness, this newly designed phantom has adjustable thickness to address the variable thickness of real-world patients. RPHAT allows adjustment of the body thickness by being sliced in the coronal direction (as opposed to axial). Center slices are designed such that more sections can be added or removed while maintaining the anthropomorphic shape. A prototype of the new phantom has been successfully used in a study investigating peripheral dose delivery, where the amount of scatter within the patient, and therefore the patient thickness, plays a critical role in dose deposition. This newly designed phantom is an important tool to improve the quality of radiation therapy.

  11. Risk-oriented maintenance.

    PubMed

    Capuano, M; Koritko, S

    1996-01-01

    Responding to information has become the most critical aspect of technology management. With ROMSYS we gain significant ability to exercise this ideology. Accessing reports in real-time provides instant knowledge of any aspect concerning equipment support. This kind of resource can give management the confidence of having a system that virtually takes care of itself. Managers can spend their time making informed decisions rather than wasting it searching for information. The philosophy of doing only what needs to be done, when it needs to be done, becomes reality when systems such as PM Interval Adjustment, PM Index, and % PM Effectiveness are utilized. These elements of ROMSYS also prevent the tying up of expensive expertise (biomedical equipment technicians) in mundane activities that are primarily ineffective. The system helps to enhance the pride of work among BMETs by elevating the importance of the PM inspection. The health care facility stands to gain from a system that monitors itself and continues to adjust to improve the process. This is the fundamental principle of total quality management, where the goal is to improve patient outcome while being cost-effective.

  12. New colistin population pharmacokinetic data in critically ill patients suggesting an alternative loading dose rationale.

    PubMed

    Grégoire, N; Mimoz, O; Mégarbane, B; Comets, E; Chatelier, D; Lasocki, S; Gauzit, R; Balayn, D; Gobin, P; Marchand, S; Couet, W

    2014-12-01

    Colistin is an old antibiotic that has recently gained a considerable renewal of interest as the last-line defense therapy against multidrug-resistant Gram-negative bacteria. It is administered as colistin methanesulfonate (CMS), an inactive prodrug, and it was shown that due to slow CMS conversion, colistin plasma concentrations increase very slowly after treatment initiation, which constitutes the rationale for a loading dose in critically ill patients. However, faster CMS conversion was observed in healthy volunteers but using a different CMS brand, which may also have a major impact on colistin pharmacokinetics. Seventy-three critically ill patients not undergoing dialysis received multiple doses of CMS. The CMS concentrations were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and a pharmacokinetic analysis was conducted using a population approach. We confirmed that CMS renal clearance and colistin concentrations at steady state are mostly governed by creatinine clearance, but we predict a typical maximum concentration of drug in serum (Cmax) of colistin close to 2 mg/liter, occurring 3 h after an initial dose of 2 million international units (MIU) of CMS. Accordingly, the estimated colistin half-life (t1/2) was relatively short (3.1 h), with rapid attainment of steady state. Our results are only partially consistent with other recently published results. We confirm that the CMS maintenance dose should be adjusted according to renal function in critically ill patients. However, much higher than expected colistin concentrations were observed after the initial CMS dose, with rapid steady-state achievement. These discrepancies challenge the pharmacokinetic rationale for a loading dose, which may still be appropriate for rapid bacterial eradication and an improved clinical cure rate.

  13. Longitudinal dose and type of immunosuppression in a national cohort of Australian liver, heart, and lung transplant recipients, 1984-2006.

    PubMed

    Na, Renhua; Laaksonen, Maarit A; Grulich, Andrew E; Webster, Angela C; Meagher, Nicola S; McCaughan, Geoffrey W; Keogh, Anne M; Vajdic, Claire M

    2015-11-01

    Unconfounded comparative data on the type and dose of immunosuppressive agents among solid organ transplant recipients are sparse, as are data on longitudinal immunosuppressive therapy since transplantation. We addressed this issue in a population-based cohort of Australian liver (n = 1895), heart (n = 1220), and lung (n = 1059) transplant recipients, 1984-2006. Data on immunosuppressive therapy were retrospectively collected at discharge, three months, and one, five, 10, and 15 yr after first transplant. We computed unadjusted and adjusted estimates for the association between the type and dose of immunosuppressive therapy and organ type. After adjustment for confounders, use of induction antibody and maintenance corticosteroids was more common in heart and lung compared to liver recipients (p < 0.001), and antibody therapy for rejection more common in liver recipients (p < 0.001). Liver recipients were more likely to receive calcineurin inhibitor monotherapy, with or without corticosteroids, compared to heart and lung recipients (p < 0.001). Liver recipients consistently received lower doses of azathioprine than heart and lung recipients (p < 0.001). These differences in immunosuppression may partly explain variations in immunosuppression-related morbidity by transplanted organ, for example, malignancy risk. Longitudinal changes in the type and the dose of immunosuppressive therapy over time since transplantation also demonstrate the need for time-dependent data in observational research.

  14. Spousal Adjustment to Myocardial Infarction.

    ERIC Educational Resources Information Center

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  15. Landscaping With Maintenance in Mind.

    ERIC Educational Resources Information Center

    Sorensen, Randy

    2000-01-01

    Examines school ground landscape design that enhances attractive of the school and provides for easier maintenance. Landscape design issues discussed include choice of grass, trees, and shrubs; irrigation; and safety and access. Other considerations for lessening maintenance problems for facility managers are also highlighted. (GR)

  16. Automated System Programs Preventive Maintenance.

    ERIC Educational Resources Information Center

    Locke, Richard C.

    1987-01-01

    A preventive maintenance system provides for the monitoring and inspection of school building elements in a programmed way through an automatic checklist. Utility cost savings are expected along with reduction of travel and wait time, and measurable standards of performance for all maintenance and repair work. (MLF)

  17. Preventive Maintenance Handbook. Audiovisual Equipment.

    ERIC Educational Resources Information Center

    Educational Products Information Exchange Inst., Stony Brook, NY.

    The preventive maintenance system for audiovisual equipment presented in this handbook is designed by specialists so that it can be used by nonspecialists in school sites. The report offers specific advice on saftey factors and also lists major problems that should not be handled by nonspecialists. Other aspects of a preventive maintenance system…

  18. Modern Method for Preventive Maintenance

    ERIC Educational Resources Information Center

    Wilson, Howard D.

    1974-01-01

    Describes a system at Michigan State University that comprises 16 separate programs and schedules 25,000 manhours of preventive maintenance. With information about preventive maintenance for over 100,000 units stored in its computer, the university saves personnel, time, and energy. (Author/MLF)

  19. Ozone-induced increase in bean leaf maintenance respiration

    SciTech Connect

    Amthor, J.S.

    1987-01-01

    Rates of respiration by unifoliate leaves of pinto bean (Phaseolus vulgaris) plants, exposed to low levels of ozone, were partitioned into growth and maintenance components using a popular model of plant respiration. The mode can be written as R/W = G/sub R/(dW/dt)/W + m, where R/W is the leaf specific respiration rate, (dW/dt)/W is the leaf specific growth rate, G/sub R/ is the growth coefficient, and m is the maintenance coefficient. In controlled environment growth chamber experiments, plants were treated with one of two levels of ozone: 90 parts per billion (p.p.b., i.e., nl liter/sup -1/), for 6 h d/sup -1/ (+ ozone), or less than 15 p.p.b. (-ozone). The growth coefficient was not affected by ozone. The maintenance coefficient, however, was 10-15% larger in leaves of plants from the + ozone treatment, compared to the-ozone treatment. This difference in the maintenance coefficient was statistically significant. Open-top field chamber experiments were also conducted. As in the growth chamber experiments, ozone dose did not affect the growth coefficient, but increases in ozone resulted in significant increases in the maintenance coefficient. The results of these experiments suggest that one reason ozone inhibits plant growth and productivity is that maintenance respiration increases, probably in order to repair injury.

  20. Magnetically Attached Multifunction Maintenance Rover

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Yoseph; Joffe, Benjamin

    2005-01-01

    A versatile mobile telerobot, denoted the magnetically attached multifunction maintenance rover (MAGMER), has been proposed for use in the inspection and maintenance of the surfaces of ships, tanks containing petrochemicals, and other large ferromagnetic structures. As its name suggests, this robot would utilize magnetic attraction to adhere to a structure. As it moved along the surface of the structure, the MAGMER would perform tasks that could include close-up visual inspection by use of video cameras, various sensors, and/or removal of paint by water-jet blasting, laser heating, or induction heating. The water-jet nozzles would be mounted coaxially within compressed-air-powered venturi nozzles that would collect the paint debris dislodged by the jets. The MAGMER would be deployed, powered, and controlled from a truck, to which it would be connected by hoses for water, compressed air, and collection of debris and by cables for electric power and communication (see Figure 1). The operation of the MAGMER on a typical large structure would necessitate the use of long cables and hoses, which can be heavy. To reduce the load of the hoses and cables on the MAGMER and thereby ensure its ability to adhere to vertical and overhanging surfaces, the hoses and cables would be paid out through telescopic booms that would be parts of a MAGMER support system. The MAGMER would move by use of four motorized, steerable wheels, each of which would be mounted in an assembly that would include permanent magnets and four pole pieces (see Figure 2). The wheels would protrude from between the pole pieces by only about 3 mm, so that the gap between the pole pieces and the ferromagnetic surface would be just large enough to permit motion along the surface but not so large as to reduce the magnetic attraction excessively. In addition to the wheel assemblies, the MAGMER would include magnetic adherence enhancement fixtures, which would comprise arrays of permanent magnets and pole pieces

  1. Cell Maintenance Systems

    NASA Technical Reports Server (NTRS)

    Morrison, D. R.

    1985-01-01

    Living human cells require attachment to a suitable surface and special culture conditions in order to grow. These requirements are modified and amplified when cells are taken into a weightless environment. Special handling and maintenance systems are required for routine laboratory procedures conducted in the Orbiter and in the Spacelab. Methods were developed to maintain cells in special incubators designed for the Orbiter middeck, however, electrophoresis and other experiments require cells to be harvested off of the culture substrate before they can be processed or used. The cell transport assembly (CTA) was flown on STS-8, and results show that improvements are required to maintain adequate numbers of cells in this device longer than 48 hours. The life sciences middeck centrifuge probably can be used, but modifications will be required to transfer cells from the CTA and keep the cells sterile. Automated systems such as the Skylab SO-15 flight hardware and crew operated systems are being evaluated for use on the Space Shuttle, Spacelab, and Space Station research modules.

  2. Robots for Aircraft Maintenance

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Marshall Space Flight Center charged USBI (now Pratt & Whitney) with the task of developing an advanced stripping system based on hydroblasting to strip paint and thermal protection material from Space Shuttle solid rocket boosters. A robot, mounted on a transportable platform, controls the waterjet angle, water pressure and flow rate. This technology, now known as ARMS, has found commercial applications in the removal of coatings from jet engine components. The system is significantly faster than manual procedures and uses only minimal labor. Because the amount of "substrate" lost is minimal, the life of the component is extended. The need for toxic chemicals is reduced, as is waste disposal and human protection equipment. Users of the ARMS work cell include Delta Air Lines and the Air Force, which later contracted with USBI for development of a Large Aircraft Paint Stripping system (LARPS). LARPS' advantages are similar to ARMS, and it has enormous potential in military and civil aircraft maintenance. The technology may also be adapted to aircraft painting, aircraft inspection techniques and paint stripping of large objects like ships and railcars.

  3. TRUPACT-II procedures and maintenance instructions

    SciTech Connect

    1994-01-14

    The purpose of this document is to provide the technical requirements for operation, inspection and maintenance of a TRUPACT-II Shipping Package and directly related components. This document shall supply the minimum requirements as specified in the TRUPACT-II Safety Analysis Report for Packaging (SARP) and Certificate of Compliance (C of C) 9218. In the event there is a conflict between this document and the TRUPACT-II SARP (NRC Certificate of Compliance No. 9218), the TRUPACT-II SARP shall govern. This document details the operations, maintenance, repair, replacement of components, as well as the documentation required and the procedures to be followed to maintain the integrity of the TRUPACT-II container. These procedures may be modified for site use, but as a minimum all parameters and format listed herein must be included in any site modified version. For convenience and where applicable steps may be performed out of sequence. Packaging and payload handling equipment and transport trailers have been specifically designed for use with the TRUPACT-II Packaging. This document discusses the minimum required procedures for use of the adjustable center of gravity lift fixture and the TRUPACT-II transport trailer in conjunction with the TRUPACT-II Packaging.

  4. 14 CFR 91.417 - Maintenance records.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance... specified in paragraph (b) of this section: (1) Records of the maintenance, preventive maintenance, and... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Maintenance records. 91.417 Section...

  5. 14 CFR 91.417 - Maintenance records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance... specified in paragraph (b) of this section: (1) Records of the maintenance, preventive maintenance, and... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Maintenance records. 91.417 Section...

  6. 14 CFR 91.417 - Maintenance records.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance... specified in paragraph (b) of this section: (1) Records of the maintenance, preventive maintenance, and... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Maintenance records. 91.417 Section...

  7. 14 CFR 91.417 - Maintenance records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance... specified in paragraph (b) of this section: (1) Records of the maintenance, preventive maintenance, and... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Maintenance records. 91.417 Section...

  8. Optimization of Continuous Maintenance Availability Scheduling

    DTIC Science & Technology

    2014-09-01

    CONTINUOUS MAINTENANCE AVAILABILITY SCHEDULING by Cyrus K. Anderson September 2014 Thesis Advisor: Javier Salmeron Second Reader: Michael...DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE OPTIMIZATION OF CONTINUOUS MAINTENANCE AVAILABILITY SCHEDULING 5. FUNDING NUMBERS 6. AUTHOR(S...major maintenance that cannot be conducted at sea. These maintenance periods are called Continuous Maintenance Availability (CMAV) periods. All CMAV

  9. MO-PIS-Exhibit Hall-01: Imaging: CT Dose Optimization Technologies I

    SciTech Connect

    Denison, K; Smith, S

    2014-06-15

    Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Dose Optimization Capabilities of GE Computed Tomography Scanners Presentation Time: 11:15 – 11:45 AM GE Healthcare is dedicated to the delivery of high quality clinical images through the development of technologies, which optimize the application of ionizing radiation. In computed tomography, dose management solutions fall into four categories: employs projection data and statistical modeling to decrease noise in the reconstructed image - creating an opportunity for mA reduction in the acquisition of diagnostic images. Veo represents true Model Based Iterative Reconstruction (MBiR). Using high-level algorithms in tandem with advanced computing power, Veo enables lower pixel noise standard deviation and improved spatial resolution within a single image. Advanced Adaptive Image Filters allow for maintenance of spatial resolution while reducing image noise. Examples of adaptive image space filters include Neuro 3-D filters and Cardiac Noise Reduction Filters. AutomA adjusts mA along the z-axis and is the CT equivalent of auto exposure control in conventional x-ray systems. Dynamic Z-axis Tracking offers an additional opportunity for dose reduction in helical acquisitions while SmartTrack Z-axis Tracking serves to ensure beam, collimator and detector alignment during tube rotation. SmartmA provides angular mA modulation. ECG Helical Modulation reduces mA during the systolic phase of the heart cycle. SmartBeam optimization uses bowtie beam-shaping hardware and software to filter off-axis x-rays - minimizing dose and reducing x-ray scatter. The

  10. 340 Facility maintenance implementation plan

    SciTech Connect

    1995-03-01

    This Maintenance Implementation Plan (MIP) has been developed for maintenance functions associated with the 340 Facility. This plan is developed from the guidelines presented by Department of Energy (DOE) Order 4330.4B, Maintenance Management Program (DOE 1994), Chapter II. The objective of this plan is to provide baseline information for establishing and identifying Westinghouse Hanford Company (WHC) conformance programs and policies applicable to implementation of DOE order 4330.4B guidelines. In addition, this maintenance plan identifies the actions necessary to develop a cost-effective and efficient maintenance program at the 340 Facility. Primary responsibility for the performance and oversight of maintenance activities at the 340 Facility resides with Westinghouse Hanford Company (WHC). Maintenance at the 340 Facility is performed by ICF-Kaiser Hanford (ICF-KH) South Programmatic Services crafts persons. This 340 Facility MIP provides interface requirements and responsibilities as they apply specifically to the 340 Facility. This document provides an implementation schedule which has been developed for items considered to be deficient or in need of improvement. The discussion sections, as applied to implementation at the 340 Facility, have been developed from a review of programs and practices utilizing the graded approach. Biennial review and additional reviews are conducted as significant programmatic and mission changes are made. This document is revised as necessary to maintain compliance with DOE requirements.

  11. Operational Interventions to Maintenance Error

    NASA Technical Reports Server (NTRS)

    Kanki, Barbara G.; Walter, Diane; Dulchinos, VIcki

    1997-01-01

    A significant proportion of aviation accidents and incidents are known to be tied to human error. However, research of flight operational errors has shown that so-called pilot error often involves a variety of human factors issues and not a simple lack of individual technical skills. In aircraft maintenance operations, there is similar concern that maintenance errors which may lead to incidents and accidents are related to a large variety of human factors issues. Although maintenance error data and research are limited, industry initiatives involving human factors training in maintenance have become increasingly accepted as one type of maintenance error intervention. Conscientious efforts have been made in re-inventing the team7 concept for maintenance operations and in tailoring programs to fit the needs of technical opeRAtions. Nevertheless, there remains a dual challenge: 1) to develop human factors interventions which are directly supported by reliable human error data, and 2) to integrate human factors concepts into the procedures and practices of everyday technical tasks. In this paper, we describe several varieties of human factors interventions and focus on two specific alternatives which target problems related to procedures and practices; namely, 1) structured on-the-job training and 2) procedure re-design. We hope to demonstrate that the key to leveraging the impact of these solutions comes from focused interventions; that is, interventions which are derived from a clear understanding of specific maintenance errors, their operational context and human factors components.

  12. Adjustable Induction-Heating Coil

    NASA Technical Reports Server (NTRS)

    Ellis, Rod; Bartolotta, Paul

    1990-01-01

    Improved design for induction-heating work coil facilitates optimization of heating in different metal specimens. Three segments adjusted independently to obtain desired distribution of temperature. Reduces time needed to achieve required temperature profiles.

  13. 14 CFR 135.437 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... maintenance, preventive maintenance, and alterations. 135.437 Section 135.437 Aeronautics and Space FEDERAL... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.437 Authority to perform and approve maintenance, preventive maintenance, and...

  14. 14 CFR 121.379 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... maintenance, preventive maintenance, and alterations. 121.379 Section 121.379 Aeronautics and Space FEDERAL... OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.379 Authority to perform and approve maintenance, preventive maintenance, and alterations. (a) A certificate holder may perform, or it may...

  15. 14 CFR 121.379 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... maintenance, preventive maintenance, and alterations. 121.379 Section 121.379 Aeronautics and Space FEDERAL... OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.379 Authority to perform and approve maintenance, preventive maintenance, and alterations. (a) A certificate holder may perform, or it may...

  16. 14 CFR 135.423 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.423 Maintenance, preventive maintenance, and alteration organization. (a) Each certificate holder that performs any of...

  17. 14 CFR 121.365 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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  18. 14 CFR 135.437 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... maintenance, preventive maintenance, and alterations. 135.437 Section 135.437 Aeronautics and Space FEDERAL... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.437 Authority to perform and approve maintenance, preventive maintenance, and...

  19. 14 CFR 135.423 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.423 Maintenance, preventive maintenance, and alteration organization. (a) Each certificate holder that performs any of...

  20. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425 Maintenance, preventive maintenance, and alteration programs. Each certificate holder shall have an inspection program...

  1. 14 CFR 121.377 - Maintenance and preventive maintenance personnel duty time limitations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance and preventive maintenance..., Preventive Maintenance, and Alterations § 121.377 Maintenance and preventive maintenance personnel duty time limitations. Within the United States, each certificate holder (or person performing maintenance or...

  2. 14 CFR 121.377 - Maintenance and preventive maintenance personnel duty time limitations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance and preventive maintenance..., Preventive Maintenance, and Alterations § 121.377 Maintenance and preventive maintenance personnel duty time limitations. Within the United States, each certificate holder (or person performing maintenance or...

  3. 14 CFR 135.437 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... maintenance, preventive maintenance, and alterations. 135.437 Section 135.437 Aeronautics and Space FEDERAL... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.437 Authority to perform and approve maintenance, preventive maintenance, and...

  4. 14 CFR 121.375 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance and preventive maintenance... OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.375 Maintenance and preventive maintenance training program....

  5. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425 Maintenance, preventive maintenance, and alteration programs. Each certificate holder shall have an inspection program...

  6. 14 CFR 121.379 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maintenance, preventive maintenance, and alterations. 121.379 Section 121.379 Aeronautics and Space FEDERAL... OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.379 Authority to perform and approve maintenance, preventive maintenance, and alterations. (a) A certificate holder may perform, or it may...

  7. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425 Maintenance, preventive maintenance, and alteration programs. Each certificate holder shall have an inspection program...

  8. 14 CFR 135.437 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maintenance, preventive maintenance, and alterations. 135.437 Section 135.437 Aeronautics and Space FEDERAL... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.437 Authority to perform and approve maintenance, preventive maintenance, and...

  9. 14 CFR 121.365 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.365 Maintenance, preventive maintenance, and alteration...), preventive maintenance, or alterations, and each person with whom it arranges for the performance of...

  10. 14 CFR 135.437 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... maintenance, preventive maintenance, and alterations. 135.437 Section 135.437 Aeronautics and Space FEDERAL... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.437 Authority to perform and approve maintenance, preventive maintenance, and...

  11. 14 CFR 121.375 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance and preventive maintenance... OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.375 Maintenance and preventive maintenance training program....

  12. 14 CFR 121.379 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... maintenance, preventive maintenance, and alterations. 121.379 Section 121.379 Aeronautics and Space FEDERAL... OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.379 Authority to perform and approve maintenance, preventive maintenance, and alterations. (a) A certificate holder may perform, or it may...

  13. 14 CFR 135.423 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.423 Maintenance, preventive maintenance, and alteration organization. (a) Each certificate holder that performs any of...

  14. 14 CFR 121.377 - Maintenance and preventive maintenance personnel duty time limitations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance and preventive maintenance..., Preventive Maintenance, and Alterations § 121.377 Maintenance and preventive maintenance personnel duty time limitations. Within the United States, each certificate holder (or person performing maintenance or...

  15. 14 CFR 121.365 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.365 Maintenance, preventive maintenance, and alteration...), preventive maintenance, or alterations, and each person with whom it arranges for the performance of...

  16. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425 Maintenance, preventive maintenance, and alteration programs. Each certificate holder shall have an inspection program...

  17. 14 CFR 121.365 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.365 Maintenance, preventive maintenance, and alteration...), preventive maintenance, or alterations, and each person with whom it arranges for the performance of...

  18. 14 CFR 121.375 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance and preventive maintenance... OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.375 Maintenance and preventive maintenance training program....

  19. 14 CFR 135.423 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.423 Maintenance, preventive maintenance, and alteration organization. (a) Each certificate holder that performs any of...

  20. 14 CFR 121.379 - Authority to perform and approve maintenance, preventive maintenance, and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... maintenance, preventive maintenance, and alterations. 121.379 Section 121.379 Aeronautics and Space FEDERAL... OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.379 Authority to perform and approve maintenance, preventive maintenance, and alterations. (a) A certificate holder may perform, or it may...

  1. 14 CFR 135.425 - Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.425 Maintenance, preventive maintenance, and alteration programs. Each certificate holder shall have an inspection program...

  2. 14 CFR 121.375 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance and preventive maintenance... OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.375 Maintenance and preventive maintenance training program....

  3. 14 CFR 121.365 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance, preventive maintenance, and..., Preventive Maintenance, and Alterations § 121.365 Maintenance, preventive maintenance, and alteration...), preventive maintenance, or alterations, and each person with whom it arranges for the performance of...

  4. 14 CFR 121.375 - Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance and preventive maintenance... OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Maintenance, Preventive Maintenance, and Alterations § 121.375 Maintenance and preventive maintenance training program....

  5. 14 CFR 121.377 - Maintenance and preventive maintenance personnel duty time limitations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Maintenance and preventive maintenance..., Preventive Maintenance, and Alterations § 121.377 Maintenance and preventive maintenance personnel duty time limitations. Within the United States, each certificate holder (or person performing maintenance or...

  6. 14 CFR 135.423 - Maintenance, preventive maintenance, and alteration organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance, preventive maintenance, and... ON BOARD SUCH AIRCRAFT Maintenance, Preventive Maintenance, and Alterations § 135.423 Maintenance, preventive maintenance, and alteration organization. (a) Each certificate holder that performs any of...

  7. 14 CFR 121.377 - Maintenance and preventive maintenance personnel duty time limitations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance and preventive maintenance..., Preventive Maintenance, and Alterations § 121.377 Maintenance and preventive maintenance personnel duty time limitations. Within the United States, each certificate holder (or person performing maintenance or...

  8. [Psychotropic drug therapy using maintenance dosage pumps].

    PubMed

    Smulevich, A B; Vorob'ev, V Iu; Tarasova, T P; Abrosimov, A I

    1987-01-01

    The article deals with questions related to the use of paracorporal automatic drug-administering devices designed for the prolonged administration of psychotropic drugs. This is the first ever experience with the use of artificial systems for drug administration in psychiatry. The authors have developed a scheme of drug administration and determined the optimal rate of injection and daily doses. Possible complications and side effects associated with this method of treatment, as well as the methods for their prevention and control are described in detail. According to preliminary data the administration of psychotropic drugs with the help of automatic devices may contribute significantly to the improvement of social adaptation of patients with minor mental disturbances and make easier the provision of psychotherapy, in particular it may considerably simplify functional training of patients with phobic abnormalities. The method appears to be especially promising with regard to maintenance therapy.

  9. Genetic variation and its maintenance

    SciTech Connect

    Roberts, D.F.; De Stefano, G.F.

    1986-01-01

    This book contains several papers divided among three sections. The section titles are: Genetic Diversity--Its Dimensions; Genetic Diversity--Its Origin and Maintenance; and Genetic Diversity--Applications and Problems of Complex Characters.

  10. Maintenance and Monitoring of BMPS

    EPA Science Inventory

    Two best management practice (BMP) sites in the Staten Island Bluebelt in Richmond Creek Watershed are Richmond Creek 5 (RC-5) and Richmond Creek 4 (RC-4). This presentation includes site description, briefing of initial monitoring activity, representative maintenance activity, ...

  11. Managing Custodial and Maintenance Staffs.

    ERIC Educational Resources Information Center

    Fickes, Michael

    2001-01-01

    Presents some basic maintenance management techniques that can help schools meet their budgets, preserve staffing levels, meet productivity needs, and sustain quality services. Tips for staff recruitment, training, and retention are explored. (GR)

  12. Contract Service for School Maintenance

    ERIC Educational Resources Information Center

    Modern Schools, 1976

    1976-01-01

    Preventive maintenance can extend useful equipment life in a school building and keep systems running more efficiently. Points to consider before selecting a comprehensive energy management package are listed. (Author/MLF)

  13. How to Get a Maintenance Program Underway

    ERIC Educational Resources Information Center

    Lundy, Lyndall L.

    1975-01-01

    The article describes the development of a comprehensive maintenance program for the school shop. A general maintenance management outline provides direction for planning, execution, and evaluation. (MW)

  14. 33 CFR 127.401 - Maintenance: General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Maintenance § 127.401 Maintenance: General. The...

  15. Dune Grass Fertilization and Maintenance

    DTIC Science & Technology

    1982-12-01

    plants often suffer, thereafter, from neglect. PURPOSE: To recommend a fertilization and maintenance program to sustain healthy dune grasses in coastal...TYPE 3. DATES COVERED 00-00-1982 to 00-00-1982 4. TITLE AND SUBTITLE Dune Grass Fertilization and Maintenance 5a. CONTRACT NUMBER 5b. GRANT...TO APPLY: Apply a granular or pelletized agricultural type fertilizer . It need not be a costly, slow- release material. A.t\\!OUNT OF FERTILIZER TO

  16. Operation and maintenance, fire rescue air-pack. Volume 2: Communications

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The operation and maintenance procedures are described for the development model of the fire rescue air pack (FRAP) voice amplifier assembly, including the battery charger. Operational instructions include a general description of the assembly, specifications, and installation and operation. Maintenance instructions include theory of operation, preventive maintenance, repair, adjustment, and a parts list. The FRAP is intended to permit fire rescue personnel to enter a smoke-filled, toxic or oxygen depleted environment carrying their own source of breathing air. The voice amplifier assembly permits the wearer to communicate by voice with other persons in the vicinity. The battery charger assembly provides a means of keeping the amplifier batteries fully charged.

  17. Respirators, internal dose, and Oyster Creek

    SciTech Connect

    Michal, R.

    1996-06-01

    This article looks at the experience of Oyster Creek in relaxing the requirements for the use of respirators in all facets of plant maintenance, on the overall dose received by plant maintenance personnel. For Roger Shaw, director of radiological controls for three years at GPU Nuclear Corporation`s Oyster Creek nuclear plant the correct dose balance is determined on a job-by-job basis: Does the job require a respirator, which is an effective means of decreasing worker inhalation of airborne radioactive particles? Will wearing a respirator slow down a worker, consequently increasing whole body radiation exposure by prolonging the time spent in fields of high external radiation? How does respiratory protection affect worker safety and to what degree? While changes to the Nuclear Regulatory Commission`s 10CFR20 have updated the radiation protection requirements for the nuclear industry, certain of the revisions have been directed specifically at reducing worker dose, Shaw said. {open_quotes}It basically delineates that dose is dose,{close_quotes} Shaw said, {open_quotes}regardless of whether it is acquired externally or internally.{close_quotes} The revision of Part 20 changed the industry`s attitude toward internal dose, which had always been viewed negatively. {open_quotes}Internal dose was always seen as preventable by wearing respirators and by using engineering techniques such as ventilation control and decontamination,{close_quotes} Shaw said, {open_quotes}whereas external dose, although reduced where practical, was seen as a fact of the job.{close_quotes}

  18. Assessing maintenance of evaporative cooling systems in legionellosis outbreaks.

    PubMed

    Rangel, Kelly M; Delclos, George; Emery, Robert; Symanski, Elaine

    2011-04-01

    This study was designed to conduct systematic reviews of existing evaporative cooling system maintenance guidelines and of published Legionnaires' disease outbreaks to determine what, if any, maintenance practices were in place at the time of the disease outbreaks and then to contrast the reported practices with the published guidelines for evaporative cooling systems. For the first review, similarities in the reported recommendations were assessed; in the second review, any reported information about the state of the evaporative cooling system during the outbreak investigation was summarized. The systematic reviews yielded 38 current guidelines for evaporative cooling systems and 38 published outbreak investigations. The guidelines varied regarding the recommended type and dose of biocides, frequency of general inspections and total system maintenance, the preferred disinfection and cleaning procedures when testing a system for microbiological contamination, the type and frequency of testing procedures, and interpretation of test results. Overall, the maintenance guidelines did not contain sufficiently detailed procedures to prevent the problems that were observed in the outbreak investigations. These maintenance procedures included lack or improper use of a biocide; infrequent testing for microbiological contamination; improper use or maintenance of drift eliminators; and lack of a total system cleaning within 6 months of the outbreak for cooling systems that were either under continuous use, recently started up, or frequently switched on and off. This study suggests that more specific and standardized maintenance guidelines for the control of Legionella bacteria are needed and that these guidelines must be properly implemented to help reduce further Legionnaires' disease outbreaks associated with evaporative cooling systems.

  19. Acoustic dose and acoustic dose-rate.

    PubMed

    Duck, Francis

    2009-10-01

    Acoustic dose is defined as the energy deposited by absorption of an acoustic wave per unit mass of the medium supporting the wave. Expressions for acoustic dose and acoustic dose-rate are given for plane-wave conditions, including temporal and frequency dependencies of energy deposition. The relationship between the acoustic dose-rate and the resulting temperature increase is explored, as is the relationship between acoustic dose-rate and radiation force. Energy transfer from the wave to the medium by means of acoustic cavitation is considered, and an approach is proposed in principle that could allow cavitation to be included within the proposed definitions of acoustic dose and acoustic dose-rate.

  20. Automated Gamma Knife dose planning

    NASA Astrophysics Data System (ADS)

    Leichtman, Gregg S.; Aita, Anthony L.; Goldman, H. W.

    1998-06-01

    The Gamma Knife (Elekta Instruments, Inc., Atlanta, GA), a neurosurgical, highly focused radiation delivery device, is used to eradicate deep-seated anomalous tissue within the human brain by delivering a lethal dose of radiation to target tissue. This dose is the accumulated result of delivering sequential `shots' of radiation to the target where each shot is approximately 3D Gaussian in shape. The size and intensity of each shot can be adjusted by varying the time of radiation exposure and by using one of four collimator sizes ranging from 4 - 18 mm. Current dose planning requires that the dose plan be developed manually to cover the target, and only the target, with a desired minimum radiation intensity using a minimum number of shots. This is a laborious and subjective process which typically leads to suboptimal conformal target coverage by the dose. We have used adaptive simulated annealing/quenching followed by Nelder-Mead simplex optimization to automate the selection and placement of Gaussian-based `shots' to form a simulated dose plane. In order to make the computation of the problem tractable, the algorithm, based upon contouring and polygon clipping, takes a 2 1/2-D approach to defining the cost function. Several experiments have been performed where the optimizers have been given the freedom to vary the number of shots and the weight, collimator size, and 3D location of each shot. To data best results have been obtained by forcing the optimizers to use a fixed number of unweighted shots with each optimizer set free to vary the 3D location and collimator size of each shot. Our preliminary results indicate that this technology will radically decrease planning time while significantly increasing accuracy of conformal target coverage and reproducibility over current manual methods.

  1. 42 CFR 417.594 - Computation of adjusted community rate (ACR).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Computation of adjusted community rate (ACR). 417.594 Section 417.594 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS,...

  2. External dose-rate conversion factors for calculation of dose to the public

    SciTech Connect

    Not Available

    1988-07-01

    This report presents a tabulation of dose-rate conversion factors for external exposure to photons and electrons emitted by radionuclides in the environment. This report was prepared in conjunction with criteria for limiting dose equivalents to members of the public from operations of the US Department of Energy (DOE). The dose-rate conversion factors are provided for use by the DOE and its contractors in performing calculations of external dose equivalents to members of the public. The dose-rate conversion factors for external exposure to photons and electrons presented in this report are based on a methodology developed at Oak Ridge National Laboratory. However, some adjustments of the previously documented methodology have been made in obtaining the dose-rate conversion factors in this report. 42 refs., 1 fig., 4 tabs.

  3. Adjusting to Chronic Health Conditions.

    PubMed

    Helgeson, Vicki S; Zajdel, Melissa

    2017-01-03

    Research on adjustment to chronic disease is critical in today's world, in which people are living longer lives, but lives are increasingly likely to be characterized by one or more chronic illnesses. Chronic illnesses may deteriorate, enter remission, or fluctuate, but their defining characteristic is that they persist. In this review, we first examine the effects of chronic disease on one's sense of self. Then we review categories of factors that influence how one adjusts to chronic illness, with particular emphasis on the impact of these factors on functional status and psychosocial adjustment. We begin with contextual factors, including demographic variables such as sex and race, as well as illness dimensions such as stigma and illness identity. We then examine a set of dispositional factors that influence chronic illness adjustment, organizing these into resilience and vulnerability factors. Resilience factors include cognitive adaptation indicators, personality variables, and benefit-finding. Vulnerability factors include a pessimistic attributional style, negative gender-related traits, and rumination. We then turn to social environmental variables, including both supportive and unsupportive interactions. Finally, we review chronic illness adjustment within the context of dyadic coping. We conclude by examining potential interactions among these classes of variables and outlining a set of directions for future research.

  4. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    SciTech Connect

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-11-15

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose estimates

  5. Retention and HIV seroconversion among drug users on methadone maintenance treatment in Yunnan, China

    PubMed Central

    Duo, L.; Kumar, A. M. V.; Achanta, S.; Xue, H-M.; Satyanarayana, S.; Ananthakrishnan, R.; Srivastava, S.; Qi, W.; Hu, S-Y.

    2014-01-01

    Setting: Thirteen methadone maintenance treatment (MMT) clinics across Yunnan, the province with the highest human immunodeficiency virus (HIV) burden in China. Objectives: To determine, among HIV-negative participants on MMT, the proportion lost to follow-up (defined as those who missed the 6-monthly follow-up examination), factors associated with loss to follow-up (LFU), HIV seroconversion rate and factors associated with seroconversion. Design: Prospective cohort study from October 2008 to April 2011. All participants were administered a pre-tested structured questionnaire to capture associated factors and offered HIV testing every 6 months. χ2 test and log-binomial regression were used for data analysis. Results: Of 1146 participants, 541 (47%) were lost to follow-up in 2.5 years. Factors associated with higher LFU proportion include <6 months of previous MMT, inconvenient location of the MMT clinic and average methadone dose ⩽60 mg/day, with adjusted relative risks (RRs) of respectively 1.4 (95%CI 1.2–1.5), 1.2 (95%CI 1.0–1.4) and 1.1 (95%CI 1.0–1.3). The overall HIV seroconversion rate was 6.6 (95%CI 3.7–11.0) per 1000 person-years. Not living with a partner contributed to higher HIV rates, with an adjusted RR of 3.6 (95%CI 1.0–12.8). Conclusion: The retention rate of MMT participants in Yunnan was not satisfactory. Decentralising service delivery in the community and making directly observed treatment more convenient has the potential to improve retention. PMID:26423758

  6. Absorbed Dose and Dose Equivalent Calculations for Modeling Effective Dose

    NASA Technical Reports Server (NTRS)

    Welton, Andrew; Lee, Kerry

    2010-01-01

    While in orbit, Astronauts are exposed to a much higher dose of ionizing radiation than when on the ground. It is important to model how shielding designs on spacecraft reduce radiation effective dose pre-flight, and determine whether or not a danger to humans is presented. However, in order to calculate effective dose, dose equivalent calculations are needed. Dose equivalent takes into account an absorbed dose of radiation and the biological effectiveness of ionizing radiation. This is important in preventing long-term, stochastic radiation effects in humans spending time in space. Monte carlo simulations run with the particle transport code FLUKA, give absorbed and equivalent dose data for relevant shielding. The shielding geometry used in the dose calculations is a layered slab design, consisting of aluminum, polyethylene, and water. Water is used to simulate the soft tissues that compose the human body. The results obtained will provide information on how the shielding performs with many thicknesses of each material in the slab. This allows them to be directly applicable to modern spacecraft shielding geometries.

  7. MCCB warm adjustment testing concept

    NASA Astrophysics Data System (ADS)

    Erdei, Z.; Horgos, M.; Grib, A.; Preradović, D. M.; Rodic, V.

    2016-08-01

    This paper presents an experimental investigation in to operating of thermal protection device behavior from an MCCB (Molded Case Circuit Breaker). One of the main functions of the circuit breaker is to assure protection for the circuits where mounted in for possible overloads of the circuit. The tripping mechanism for the overload protection is based on a bimetal movement during a specific time frame. This movement needs to be controlled and as a solution to control this movement we choose the warm adjustment concept. This concept is meant to improve process capability control and final output. The warm adjustment device design will create a unique adjustment of the bimetal position for each individual breaker, determined when the testing current will flow thru a phase which needs to trip in a certain amount of time. This time is predetermined due to scientific calculation for all standard types of amperages and complies with the IEC 60497 standard requirements.

  8. Comparable-Worth Adjustments: Yes--Comparable-Worth Adjustments: No.

    ERIC Educational Resources Information Center

    Galloway, Sue; O'Neill, June

    1985-01-01

    Two essays address the issue of pay equity and present opinions favoring and opposing comparable-worth adjustments. Movement of women out of traditionally female jobs, the limits of "equal pay," fairness of comparable worth and market-based wages, implementation and efficiency of comparable worth system, and alternatives to comparable…

  9. 22 CFR 120.38 - Maintenance levels.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Maintenance levels. 120.38 Section 120.38 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.38 Maintenance levels. (a) Organizational-level maintenance (or basic-level maintenance) is...

  10. 49 CFR 193.2605 - Maintenance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Maintenance procedures. 193.2605 Section 193.2605...: FEDERAL SAFETY STANDARDS Maintenance § 193.2605 Maintenance procedures. (a) Each operator shall determine... maintenance standards prescribed by this subpart. (b) Each operator shall follow one or more manuals...

  11. 46 CFR 122.702 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Maintenance. 122.702 Section 122.702 Shipping COAST..., Maintenance, and Inspection of Lifesaving Equipment § 122.702 Maintenance. (a) The manufacturer's instructions for onboard maintenance of survival craft, rescue boats, and launching appliances, manufactured on...

  12. 18 CFR 367.81 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Maintenance. 367.81... Expense Instructions § 367.81 Maintenance. (a) The cost of maintenance chargeable to the various operating... maintenance work. A list of work operations applicable generally to service company property is included...

  13. 23 CFR 633.208 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Maintenance. 633.208 Section 633.208 Highways FEDERAL... PROVISIONS Federal-Aid Contracts (Appalachian Contracts) § 633.208 Maintenance. Maintenance of all highway... responsibility of the State. The State may arrange for maintenance of such roads or portions thereof,...

  14. 46 CFR 185.702 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Maintenance. 185.702 Section 185.702 Shipping COAST...) OPERATIONS Operational Readiness, Maintenance, and Inspection of Lifesaving Equipment § 185.702 Maintenance. (a) The manufacturer's instructions for onboard maintenance of survival craft, rescue boats,...

  15. 14 CFR 145.217 - Contract maintenance.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... product following contract maintenance, preventive maintenance, or alterations. ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Contract maintenance. 145.217 Section 145...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.217 Contract maintenance....

  16. 14 CFR 91.405 - Maintenance required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.405 Maintenance required. Each owner or operator of an aircraft— (a) Shall have... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Maintenance required. 91.405 Section...

  17. 14 CFR 91.405 - Maintenance required.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.405 Maintenance required. Each owner or operator of an aircraft— (a) Shall have... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Maintenance required. 91.405 Section...

  18. 14 CFR 91.405 - Maintenance required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.405 Maintenance required. Each owner or operator of an aircraft— (a) Shall have... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Maintenance required. 91.405 Section...

  19. 14 CFR 91.405 - Maintenance required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.405 Maintenance required. Each owner or operator of an aircraft— (a) Shall have... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Maintenance required. 91.405 Section...

  20. Fast Flux Test Facility (FFTF) maintenance provisions

    SciTech Connect

    Marshall, J.L.

    1981-05-01

    The Fast Flux Test Facility (FFTF) was designed with maintainability as a primary parameter, and facilities and provisions were designed into the plant to accommodate the maintenance function. This paper describes the FFTF and its systems. Special maintenance equipment and facilities for performing maintenance on radioactive components are discussed. Maintenance provisions designed into the plant to enhance maintainability are also described.

  1. 46 CFR 122.702 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Maintenance. 122.702 Section 122.702 Shipping COAST..., Maintenance, and Inspection of Lifesaving Equipment § 122.702 Maintenance. (a) The manufacturer's instructions for onboard maintenance of survival craft, rescue boats, and launching appliances, manufactured on...

  2. 18 CFR 367.81 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Maintenance. 367.81... Expense Instructions § 367.81 Maintenance. (a) The cost of maintenance chargeable to the various operating... maintenance work. A list of work operations applicable generally to service company property is included...

  3. 14 CFR 91.417 - Maintenance records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Maintenance records. 91.417 Section 91.417... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.417 Maintenance records. (a) Except for work performed in accordance with §§...

  4. 23 CFR 633.208 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Maintenance. 633.208 Section 633.208 Highways FEDERAL... PROVISIONS Federal-Aid Contracts (Appalachian Contracts) § 633.208 Maintenance. Maintenance of all highway... responsibility of the State. The State may arrange for maintenance of such roads or portions thereof,...

  5. 14 CFR 91.405 - Maintenance required.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Maintenance required. 91.405 Section 91.405... AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.405 Maintenance required. Each owner or operator of an aircraft— (a) Shall...

  6. 46 CFR 185.702 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Maintenance. 185.702 Section 185.702 Shipping COAST...) OPERATIONS Operational Readiness, Maintenance, and Inspection of Lifesaving Equipment § 185.702 Maintenance. (a) The manufacturer's instructions for onboard maintenance of survival craft, rescue boats,...

  7. 75 FR 33379 - Railroad Cost Recovery Procedures-Productivity Adjustment; Quarterly Rail Cost Adjustment Factor

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... Surface Transportation Board Railroad Cost Recovery Procedures--Productivity Adjustment; Quarterly Rail... Railroads that the Board restate the previously published productivity adjustment for the 2003-2007 averaging period (2007 productivity adjustment) so that it tracks the 2007 productivity adjustment...

  8. Motives for using Facebook, patterns of Facebook activities, and late adolescents' social adjustment to college.

    PubMed

    Yang, Chia-chen; Brown, B Bradford

    2013-03-01

    Previous studies have confirmed that Facebook, the leading social networking site among young people, facilitates social connections among college students, but the specific activities and motives that foster social adjustment remain unclear. This study examined associations between patterns of Facebook activity, motives for using Facebook, and late adolescents' social adjustment to the college environment. Anonymous self-report survey data from 193 mostly European American students (M age = 20.32; 54 % female) attending a major Midwestern university indicated that motives and activity patterns were associated directly with social adjustment, but the association between one activity, status updating, and social adjustment also was moderated by the motive of relationship maintenance. Findings provide a more comprehensive portrait of how Facebook use may foster or inhibit social adjustment in college.

  9. Baclofen in the short-term maintenance treatment of benzodiazepine dependence

    PubMed Central

    Shukla, Lekhansh; Kandasamy, Arun; Kesavan, Muralidharan; Benegal, Vivek

    2014-01-01

    Benzodiazepine (BZD) dependence is a significant public health problem. Apart from the long-term tapering doses of BZD, no others drugs are available for the maintenance treatment of BZD dependence. Baclofen has been used in alcohol and other drug dependence as long-term anti-craving agent. Since alcohol and BZD act through the GABA receptor, we attempted to study the effect of Baclofen as maintenance treatment in a series of five cases with BZD dependence. PMID:25540541

  10. NASA Critical Facilities Maintenance Assessment

    NASA Technical Reports Server (NTRS)

    Oberhettinger, David J.

    2006-01-01

    Critical Facilities Maintenance Assessment (CFMA) was first implemented by NASA following the March 2000 overtest of the High Energy Solar Spectroscopic Imager (HESSI) spacecraft. A sine burst dynamic test using a 40 year old shaker failed. Mechanical binding/slippage of the slip table imparted 10 times the planned force to the test article. There was major structural damage to HESSI. The mechanical "health" of the shaker had not been assessed and tracked to assure the test equipment was in good working order. Similar incidents have occurred at NASA facilities due to inadequate maintenance (e.g., rainwater from a leaky roof contaminated an assembly facility that housed a spacecraft). The HESSI incident alerted NASA to the urgent need to identify inadequacies in ground facility readiness and maintenance practices. The consequences of failures of ground facilities that service these NASA systems are severe due to the high unit value of NASA products.

  11. Development of preventive maintenance procedures.

    PubMed

    Ben-Zvi, S

    1984-01-01

    A large number of in-house preventive maintenance (PM) programs, which call for varying degrees of thoroughness in the checkout of patient care instrumentation, are currently in existence throughout the country. This paper discusses the types of preventive maintenance, or PM procedures, which can be used by a clinical engineering department; the rationale for drafting different types of PM procedures in-house; and some long-term considerations affecting hospital-based inspection programs. Three types of PM procedures are described and compared: general checks; generic procedures; and, specific procedures. An outline is provided for writing a PM procedure; and, a call is made for a national guideline for writing preventive maintenance procedures.

  12. Maintenance Therapy with Decitabine after Allogeneic Stem Cell Transplantation for Acute Myelogenous Leukemia and Myelodysplastic Syndrome.

    PubMed

    Pusic, Iskra; Choi, Jaebok; Fiala, Mark A; Gao, Feng; Holt, Matthew; Cashen, Amanda F; Vij, Ravi; Abboud, Camille N; Stockerl-Goldstein, Keith E; Jacoby, Meghan A; Uy, Geoffrey L; Westervelt, Peter; DiPersio, John F

    2015-10-01

    Decitabine is a hypomethylating agent that irreversibly inhibits DNA methyltransferase I, inducing leukemic differentiation and re-expression of epigenetically silenced putative tumor antigens. We assessed safety and efficacy of decitabine maintenance after allogeneic transplantation for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Decitabine maintenance may help eradicate minimal residual disease, decrease the incidence of graft-versus-host disease (GVHD), and facilitate a graft-versus-leukemia effect by enhancing the effect of T regulatory lymphocytes. Patients with AML/MDS in complete remission (CR) after allotransplantation started decitabine between day +50 and +100. We investigated 4 decitabine doses in cohorts of 4 patients: 5, 7.5, 10, and 15 mg/m(2)/day × 5 days every 6 weeks, for a maximum 8 cycles. The maximum tolerated dose (MTD) was defined as the maximum dose at which ≤ 25% of people experience dose-limiting toxicities during the first cycle of treatment. Twenty-four patients were enrolled and 22 were evaluable. All 4 dose levels were completed and no MTD was reached. Overall, decitabine maintenance was well tolerated. Grade 3 and 4 hematological toxicities were experienced by 75% of patients, including all patients treated at the highest dose level. Nine patients completed all 8 cycles and 8 of them remain in CR. Nine patients died from relapse (n = 4), infectious complications (n = 3), and GVHD (n = 2). Most occurrences of acute GVHD were mild and resolved without interruption of treatment; 1 patient died of acute gut GVHD. Decitabine maintenance did not clearly impact the rate of chronic GVHD. Although there was a trend of increased FOXP3 expression, results were not statistically significant. In conclusion, decitabine maintenance is associated with acceptable toxicities when given in the post-allotransplantation setting. Although the MTD was not reached, the dose of 10 mg/m(2) for 5 days every 6 weeks appeared to be the

  13. METHAMPHETAMINE SELF-ADMINISTRATION IN HUMANS DURING D-AMPHETAMINE MAINTENANCE

    PubMed Central

    Pike, Erika; Stoops, William W.; Hays, Lon R.; Glaser, Paul E. A.; Rush, Craig R.

    2014-01-01

    Agonist replacement may be a viable treatment approach for managing stimulant use disorders. This study sought to determine the effects of d-amphetamine maintenance on methamphetamine self-administration in stimulant using human participants. We predicted d-amphetamine maintenance would reduce methamphetamine self-administration. Eight participants completed the protocol, which tested two d-amphetamine maintenance conditions in counter-balanced order (0 and 40 mg/day). Participants completed 4 experimental sessions under each maintenance condition in which they first sampled one of four doses of intranasal methamphetamine (0, 10, 20, or 30 mg). Participants then had the opportunity to respond on a computerized progressive ratio task to earn portions of the sampled methamphetamine dose. Subject-rated drug-effect and physiological measures were completed at regular intervals prior to and after sampling methamphetamine. Methamphetamine was self-administered as an orderly function of dose regardless of the maintenance condition. Methamphetamine produced prototypical subject-rated effects on 13 items of the drug-effects questionnaires, 10 of which were attenuated by d-amphetamine maintenance (e.g., increased ratings were attenuated on items such as Any Effect, Like Drug, and Willing to Take Again on the Drug Effect Questionnaire). Methamphetamine produced significant increases in systolic blood pressure, which were attenuated by d-amphetamine maintenance compared to placebo maintenance. Methamphetamine was well tolerated during d-amphetamine maintenance and no adverse events occurred. Although d-amphetamine attenuated some subject-rated effects of methamphetamine, the self-administration results are concordant with those of clinical trials showing that d-amphetamine did not reduce methamphetamine use. Unique pharmacological approaches may be needed for treating amphetamine use disorders. PMID:25154010

  14. Adjustable Optical-Fiber Attenuator

    NASA Technical Reports Server (NTRS)

    Buzzetti, Mike F.

    1994-01-01

    Adjustable fiber-optic attenuator utilizes bending loss to reduce strength of light transmitted along it. Attenuator functions without introducing measurable back-reflection or insertion loss. Relatively insensitive to vibration and changes in temperature. Potential applications include cable television, telephone networks, other signal-distribution networks, and laboratory instrumentation.

  15. Dyadic Adjustment: An Ecosystemic Examination.

    ERIC Educational Resources Information Center

    Wilson, Stephan M.; Larson, Jeffry H.; McCulloch, B. Jan; Stone, Katherine L.

    1997-01-01

    Examines the relationship of background, individual, and family influences on dyadic adjustment, using an ecological perspective. Data from 102 married couples were used. Age at marriage for husbands, emotional health for wives, and number of marriage and family problems as well as family life satisfaction for both were related to dyadic…

  16. Problems of Adjustment to School.

    ERIC Educational Resources Information Center

    Bartolini, Leandro A.

    This paper, one of several written for a comprehensive policy study of early childhood education in Illinois, examines and summarizes the literature on the problems of young children in adjusting to starting school full-time and describes the nature and extent of their difficulties in relation to statewide educational policy. The review of studies…

  17. Economic Pressures and Family Adjustment.

    ERIC Educational Resources Information Center

    Haccoun, Dorothy Markiewicz; Ledingham, Jane E.

    The relationships between economic stress on the family and child and parental adjustment were examined for a sample of 199 girls and boys in grades one, four, and seven. These associations were examined separately for families in which both parents were present and in which mothers only were at home. Economic stress was associated with boys'…

  18. Advanced servomanipulator remote maintenance demonstration

    SciTech Connect

    Ray, T.L.; Bradley, E.C.

    1989-03-01

    The advanced servomanipulator (ASM) is a dual-arm, force-reflecting, master/slave servomanipulator that was designed for remote maintenance applications and is digitally controlled. The ASM is installed in the Maintenance Systems Test Area (MSTA) of the Fuel Recycle Division at the Oak Ridge National Laboratory. The unique aspect of ASM is that the slave arms were designed to be remotely maintainable, using a similar remote manipulator system, to maximize availability and minimize downtime. This test report describes the results of the maintenance testing conducted on ASM. Demonstration of the ability to maintain ASM remotely is an important precursor to the ultimate application of ASM in a totally remote facility. The approach taken in the design of ASM was for the manipulator slave arms to be composed of modules capable of being removed and replaced by another manipulator system of similar capabilities. The ASM incorporates gear and torque tube drives with drive couplings that facilitate remote maintenance. Although the use of special fixtures is normally discouraged for remote maintenance, special fixtures were required for this demonstration due to the complex nature of the slave arms. This test was performed to demonstrate that the ASM slave arms could be completely disassembled and reassembled remotely. Maintenance of ASM was successfully demonstrated using the M-2 servomanipulator and special fixtures. The entire disassembly process took about 4 h, and the assembly took about 3 1/2 h. Although there were some problems, in general, the arm modules were adequately designed for remote removal and replacement. Recommendations, which are documented in this report, have been made for improvements. 5 refs., 22 figs., 1 tab.

  19. 14 CFR 125.245 - Organization required to perform maintenance, preventive maintenance, and alteration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... maintenance, preventive maintenance, and alteration. 125.245 Section 125.245 Aeronautics and Space FEDERAL..., preventive maintenance, and alteration. The certificate holder must ensure that each person with whom it arranges for the performance of maintenance, preventive maintenance, alteration, or required...

  20. 14 CFR 125.245 - Organization required to perform maintenance, preventive maintenance, and alteration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... maintenance, preventive maintenance, and alteration. 125.245 Section 125.245 Aeronautics and Space FEDERAL..., preventive maintenance, and alteration. The certificate holder must ensure that each person with whom it arranges for the performance of maintenance, preventive maintenance, alteration, or required...

  1. 14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Operation after maintenance, preventive... OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.407 Operation after maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft...

  2. 14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Operation after maintenance, preventive... OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.407 Operation after maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft...

  3. 14 CFR 91.1425 - CAMP: Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false CAMP: Maintenance, preventive maintenance... RULES Fractional Ownership Operations Program Management § 91.1425 CAMP: Maintenance, preventive... have an inspection program and a program covering other maintenance, preventive maintenance,...

  4. 14 CFR 125.245 - Organization required to perform maintenance, preventive maintenance, and alteration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... maintenance, preventive maintenance, and alteration. 125.245 Section 125.245 Aeronautics and Space FEDERAL..., preventive maintenance, and alteration. The certificate holder must ensure that each person with whom it arranges for the performance of maintenance, preventive maintenance, alteration, or required...

  5. 14 CFR 91.1425 - CAMP: Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false CAMP: Maintenance, preventive maintenance... RULES Fractional Ownership Operations Program Management § 91.1425 CAMP: Maintenance, preventive... have an inspection program and a program covering other maintenance, preventive maintenance,...

  6. 14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Operation after maintenance, preventive... OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.407 Operation after maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft...

  7. 14 CFR 125.245 - Organization required to perform maintenance, preventive maintenance, and alteration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... maintenance, preventive maintenance, and alteration. 125.245 Section 125.245 Aeronautics and Space FEDERAL..., preventive maintenance, and alteration. The certificate holder must ensure that each person with whom it arranges for the performance of maintenance, preventive maintenance, alteration, or required...

  8. 14 CFR 91.1425 - CAMP: Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false CAMP: Maintenance, preventive maintenance... RULES Fractional Ownership Operations Program Management § 91.1425 CAMP: Maintenance, preventive... have an inspection program and a program covering other maintenance, preventive maintenance,...

  9. 14 CFR 91.1425 - CAMP: Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false CAMP: Maintenance, preventive maintenance... RULES Fractional Ownership Operations Program Management § 91.1425 CAMP: Maintenance, preventive... have an inspection program and a program covering other maintenance, preventive maintenance,...

  10. 14 CFR 145.205 - Maintenance, preventive maintenance, and alterations performed for certificate holders under...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Maintenance, preventive maintenance, and...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.205 Maintenance, preventive.... (a) A certificated repair station that performs maintenance, preventive maintenance, or...

  11. 14 CFR 125.245 - Organization required to perform maintenance, preventive maintenance, and alteration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maintenance, preventive maintenance, and alteration. 125.245 Section 125.245 Aeronautics and Space FEDERAL..., preventive maintenance, and alteration. The certificate holder must ensure that each person with whom it arranges for the performance of maintenance, preventive maintenance, alteration, or required...

  12. 14 CFR 145.205 - Maintenance, preventive maintenance, and alterations performed for certificate holders under...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Maintenance, preventive maintenance, and...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.205 Maintenance, preventive.... (a) A certificated repair station that performs maintenance, preventive maintenance, or...

  13. 14 CFR 145.205 - Maintenance, preventive maintenance, and alterations performed for certificate holders under...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Maintenance, preventive maintenance, and...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.205 Maintenance, preventive.... (a) A certificated repair station that performs maintenance, preventive maintenance, or...

  14. 14 CFR 145.205 - Maintenance, preventive maintenance, and alterations performed for certificate holders under...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Maintenance, preventive maintenance, and...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.205 Maintenance, preventive.... (a) A certificated repair station that performs maintenance, preventive maintenance, or...

  15. 14 CFR 91.1425 - CAMP: Maintenance, preventive maintenance, and alteration programs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false CAMP: Maintenance, preventive maintenance... RULES Fractional Ownership Operations Program Management § 91.1425 CAMP: Maintenance, preventive... have an inspection program and a program covering other maintenance, preventive maintenance,...

  16. 14 CFR 91.407 - Operation after maintenance, preventive maintenance, rebuilding, or alteration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Operation after maintenance, preventive... OPERATING AND FLIGHT RULES Maintenance, Preventive Maintenance, and Alterations § 91.407 Operation after maintenance, preventive maintenance, rebuilding, or alteration. (a) No person may operate any aircraft...

  17. An Adaptive Staggered Dose Design for a Normal Endpoint.

    PubMed

    Wu, Joseph; Menon, Sandeep; Chang, Mark

    2015-01-01

    In a clinical trial where several doses are compared to a control, a multi-stage design that combines both the selection of the best dose and the confirmation of this selected dose is desirable. An example is the two-stage drop-the-losers or pick-the-winner design, where inferior doses are dropped after interim analysis. Selection of target dose(s) can be based on ranking of observed effects, hypothesis testing with adjustment for multiplicity, or other criteria at interim stages. A number of methods have been proposed and have made significant gains in trial efficiency. However, many of these designs started off with all doses with equal allocation and did not consider prioritizing the doses using existing dose-response information. We propose an adaptive staggered dose procedure that allows explicit prioritization of doses and applies error spending scheme that favors doses with assumed better responses. This design starts off with only a subset of the doses and adaptively adds new doses depending on interim results. Using simulation, we have shown that this design performs better in terms of increased statistical power than the drop-the-losers design given strong prior information of dose response.

  18. A computerized hospital maintenance system.

    PubMed

    Kresch, E; Katz, P; Schwartz, H; Hamarman, H

    1985-01-01

    The Biomedical Instrumentation Department at Thomas Jefferson University Hospital maintains most of the clinical equipment owned by the hospital and provides support to six other hospitals, as well. In order to document these services, a computerized support system has been developed. This system maintains the inventory of equipment, documents the occurrence of repair and preventive maintenance procedures, generates lists of items due for maintenance and inspection, and prints reports and summaries of all activities performed by department staff. The system was designed for ease of use and requires a minimum of training for personnel who use it.

  19. Thermography instruments for predictive maintenance

    SciTech Connect

    Palko, E.

    1993-08-12

    Thermography (infrared imaging, or IR scanning) is not only the most versatile predictive maintenance technology available today; it is, in general, the most cost-effective. Plant engineering can apply a virtually unlimited variety of predictive maintenance instruments, but all are restricted regarding the types of existing and incipient problems they can detect. Inplant applications of thermography, however, are truly limited only by the extent of the plant engineer's imagination. Here are ways that thermography can be used to fight downtime in plants, and factors to consider when selecting the best instrument for particular circumstances.

  20. TRUPACT-II Operating and Maintenance Instructions

    SciTech Connect

    Westinghouse Electric Corporation, Waste Isolation Division

    1999-12-31

    ) Attaching a site-specific cover page/letter to this document stating that these are the instructions to be used at their location, or (3) Sites may prepare their own document using the steps in this document word-for-word, in-sequence, including Notes and Cautions. Site specific information may be included as deemed necessary. Submit the document to WID National TRU Programs for approval. Any revision made subsequent to WID TRU Program's approval shall be reviewed and approved by WID TRU Programs. A copy of the approval letter from WID National TRU Programs should be available for audit purposes. Users shall develop site-specific procedures addressing leak testing, preoperational activities, quality assurance, hoisting and rigging, and radiation health physics to be used in conjunction with the instructions contained in this document. Users desiring to recommend changes to this document may submit their recommendations to the WID National TRU Programs for evaluation. If approved, the change(s) will be incorporated into this document for use by all TRUPACT-II users. User sites will be audited to this document to ensure compliance within one year from the effective date of this revision. This document discusses operating instructions, required inspections and maintenance for the following: TRUPACT-II packaging, and Miscellaneous packaging, special tools, and equipment. Packaging and payload handling equipment and transport trailers have been specifically designed for use with the TRUPACT-II Packaging. This document discusses the required instructions for use of the following equipment in conjunction with the TRUPACT-II Packaging: TRUPACT-II Mobile Loading Unit (MLU), Adjustable Center-of-Gravity Lift Fixture (ACGLF), and TRUPACT-II Transport Trailer. Attachment E contains the various TRUPACT-II packaging interface control drawings, leak-test and vent-port tool drawings, ACGLF drawings, and tie-down drawings that identify the various system components.

  1. 7 CFR 1580.502 - Maintenance of records, audits, and compliance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Maintenance of records, audits, and compliance. 1580.502 Section 1580.502 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.502...

  2. Computer-Assisted School Maintenance

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2012-01-01

    At thousands of schools and universities, years of economic troubles have led to repeated budget cuts. The reductions typically fall disproportionately on maintenance departments, where cuts are viewed as less critical than those that directly affect classroom instruction. And so nearly every facility manager at an education institution faces a…

  3. School Facilities Maintenance and Operations.

    ERIC Educational Resources Information Center

    Association of School Business Officials of the United States and Canada, Park Ridge, IL. Research Corp.

    This publication presents a series of field-proven school energy conservation, management, maintenance, and operations practices and ideas. Also included are the names, addresses, and phone numbers of individuals and organizations to contact for more detailed information. The brief summaries are grouped into six sections. "Planning and…

  4. Avionics Maintenance Technology Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide presents the avionics maintenance technology curriculum for technical institutes in Georgia. The general information section contains the following for both the diploma program and the associate degree program: purpose and objectives; program description, including admissions, typical job titles, and accreditation and…

  5. New Directions in Maintenance Simulation.

    ERIC Educational Resources Information Center

    Miller, Gary G.

    A two-phase effort was conducted to design and evaluate a maintenance simulator which incorporated state-of-the-art information in simulation and instructional technology. The particular equipment selected to be simulated was the 6883 Convert/Flight Controls Test Station. Phase I included a generalized block diagram of the computer-trainer, the…

  6. Methods to much improve maintenance.

    PubMed

    Lam, K C

    2004-11-01

    The benefits to be gained from the application of both value engineering (VE) and quality systems--e.g. quality assurance (QA), and total quality management (TQM)--to the management of building services maintenance have yet to be realised by the building services industry. These concepts are particularly applicable to complex hospital engineering services.

  7. Who's doing coal plant maintenance?

    SciTech Connect

    Oldani, R.

    2008-02-15

    POWER has reported on several EUCG bench marking studies over the past several years. This paper examines the maintenance staffing of 45 coal plants reported by 13 EUCG member utilities. If you benchmark your plants or fleet, as you should, some of the study's results challenge what is considered conventional wisdom.

  8. Maintenance therapy in multiple myeloma

    PubMed Central

    Mewawalla, Prerna; Chilkulwar, Abhishek

    2016-01-01

    Despite recent advances, multiple myeloma remains an incurable disease. Induction therapy followed by autologous transplantation has become the standard of care. The idea of maintenance therapy in multiple myeloma is not new. Starting with chemotherapy in 1975, to interferon in 1998, to novel agents recently, a multitude of agents have been explored in patients with multiple myeloma. In spite of the novel agents, multiple myeloma continues to be an incurable disease with the progression-free survival after autologous transplant rarely exceeding 3 years. The goal of using maintenance therapy has been to improve the outcomes following autologous transplantation by increasing the progression-free survival, deepening remissions and perhaps increasing overall survival. It has been shown that patients with a stringent complete response (CR) have a better outcome [Kapoor et al. 2013]. It is becoming increasingly common to check minimal residual disease (MRD) as a means of assessing depth of response. It has also been shown that patients with no MRD have not only a better progression-free survival but also a better overall survival compared with patients who are MRD positive. This makes it even more important to find agents for maintenance therapy, which can further deepen and maintain responses. Here, we present a comprehensive review of the agents studied as maintenance for multiple myeloma and their efficacy, both in terms of overall survival, progression-free survival and toxicity. PMID:28203343

  9. Integration, Resegregation and Integration Maintenance.

    ERIC Educational Resources Information Center

    Peterman, William A.

    Recent increases in black migration to the suburbs and the continuing existence of discrimination in housing have emphasized the issues of integration and resegregation in suburban municipalities. To prevent resegregation, many integrated municipalities have adopted integration maintenance measures such as efforts to inform people that racial…

  10. Checklist for School Maintenance Surveys.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This document is a simple 34-category checklist to be used by technicians conducting maintenance surveys. Categories includes: roadways & parking lots; site appearance; site utilities; exterior appearance; playground equipment; exterior structural conditions; gutters and downspouts; windows and caulking; sidewalks; entryways and exit doors;…

  11. Building Maintenance. Student Learning Guide.

    ERIC Educational Resources Information Center

    Palm Beach County Board of Public Instruction, West Palm Beach, FL.

    This student learning guide contains one module for completing a course in building maintenance. It is designed especially for use in secondary schools in Palm Beach County, Florida. The module covers one task, and consists of a purpose, performance objective, enabling objectives, learning activities keyed to resources, information sheets, student…

  12. The Benefits of Health Maintenance.

    ERIC Educational Resources Information Center

    Rosenstein, Alan H.

    1987-01-01

    The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

  13. Maintenance Sessions Prolong Cigarette Abstinence.

    ERIC Educational Resources Information Center

    Brandon, Thomas H.; And Others

    Recent smoking treatment programs have shifted emphasis from initial cessation rates to long-term abstinence, with aversion therapy and coping response training having had the most success. A smoking cessation treatment consisting of rapid smoking and behavioral counseling was supplemented with two maintenance treatments. After completing the…

  14. Laboratory maintenance of Rickettsia rickettsii.

    PubMed

    Ammerman, Nicole C; Beier-Sexton, Magda; Azad, Abdu F

    2008-11-01

    This unit includes protocols for the laboratory maintenance of the obligate intracellular bacterium Rickettsia rickettsii, including propagation in mammalian cell cultures, as well as isolation, counting, and storage procedures. Regulations for working with R. rickettsii in biosafety level 3 containment are also discussed.

  15. Electrical Mechanical Maintenance. Instructor's Guide.

    ERIC Educational Resources Information Center

    Santa Clara County Superintendent of Schools, San Jose, CA.

    This instructor's guide describes the development of a sixteen-week postsecondary course in electrical mechanical maintenance. Following introductory sections that provide background information and a course summary, the third section describes the instructional model used in the course. Section 4 presents an overview of instructional media used…

  16. Circassian Language Maintenance in Jordan

    ERIC Educational Resources Information Center

    Rannut, Ulle

    2009-01-01

    The central goal of this research is to explore the language policy aspects in Jordan by focusing on the Circassian language maintenance issues and to provide measures for language revitalisation in the current demographic, linguistic and political situation. Research is based on multiple sources of information, but primarily on the empirical data…

  17. Drive alignment pays maintenance dividends

    SciTech Connect

    Fedder, R.

    2008-12-15

    Proper alignment of the motor and gear drive on conveying and processing equipment will result in longer bearing and coupling life, along with lower maintenance costs. Selecting an alignment free drive package instead of a traditional foot mounted drive and motor is a major advancement toward these goals. 4 photos.

  18. Maintenance Sourcebook: A Caretaker's Manual.

    ERIC Educational Resources Information Center

    Yeatts, G. Dewey; Stoverink, Al; Conry, Terry; Goulet, Nicole; Wilson, Joe; Ryan, Rob

    2002-01-01

    Discusses five areas of custodial maintenance caretaking in which facility managers need continual education: first aid and safety, hazardous materials, products and supplies, chemicals and their intended use, and cleaning procedures. Includes an annotated list of resources related to these areas. (EV)

  19. Locker Room Maintenance Made Easy.

    ERIC Educational Resources Information Center

    Theel, James

    1998-01-01

    Provides examples on ways to make locker room maintenance easier and their use more student-friendly. Improvements include use of indoor-outdoor carpeting with numerous floor drains to cut mildew buildup, adequate ventilation to reduce musty smells, better hot water management, ceramic tiles to reduce water-damage repair and painting needs, and…

  20. Maintenance of photovoltaic power systems

    NASA Astrophysics Data System (ADS)

    Hall, M. R.

    1984-08-01

    This publication establishes standard practices for inspection, testing, and maintenance of photovoltaic power systems at Dept. of the Navy installations. The practices and procedures are recommended to ensure reliable operation of the power systems. The manual covers photovoltaic-array, battery, voltage-regulator, inverter, and wiring subsystems. In addition, this manual provides a troubleshooting guide and self-study questions and answers.

  1. Maintenance as a safety issue.

    PubMed

    White, Jim

    2008-11-01

    Because safety is related to electrical power systems maintenance, it seems reasonable to assume there could be legal issues if maintenance is not performed. OSHA has not yet taken the stand that not performing maintenance as required by the manufacturer, NFPA 70B, or ANSI/NETA MTS-07 constitutes a willful violation. OSHA defines a willful citation as one where: "the employer knowingly commits with plain indifference to the law. The employer either knows that what he or she is doing constitutes a violation, or is aware that a hazardous condition existed and made no reasonable effort to eliminate it". However, NFPA 70E 2009 requires this maintenance, and OSHA has stated on its Web site that NFPA 70E is "a guide for meeting the requirements of the OSHA electrical regulations". In addition, federal courts have found that NFPA 70E is "standard industry practice." Once a company receives and accepts a willful citation, especially if received as the result of an accident investigation, its worker's compensation protection no longer shields it. One definition given by a trial attorney for a willful citation was that it is equal to negligent behavior. Be smart: Maintain that equipment and save yourself major problems, including unscheduled shutdowns and possible litigation.

  2. Oral anticancer drugs: how limited dosing options and dose reductions may affect outcomes in comparative trials and efficacy in patients.

    PubMed

    Prasad, Vinay; Massey, Paul R; Fojo, Tito

    2014-05-20

    Historically, cancer medicine has avoided the problem of unequal dosing by comparing maximum-tolerated doses of intravenous regimens with proportionate dose reductions for toxicity. However, in recent years, with the development of numerous oral anticancer agents, dosing options are arbitrarily and increasingly limited by the size of pills. We contend that an underappreciated consequence of pill size is unequal dosing in comparative clinical trials and that this can have an impact on outcomes. We discuss how comparative effectiveness trials can be unbalanced and how the use of doses that are not sustainable might affect outcomes, especially marginal ones. We further argue that because of their poor tolerability and their limited dosing options, which often result in large dose adjustments in response to toxicity, the real-world clinical effectiveness of oral anticancer agents may be diminished and may not emulate results achieved in registration trials.

  3. Oral Anticancer Drugs: How Limited Dosing Options and Dose Reductions May Affect Outcomes in Comparative Trials and Efficacy in Patients

    PubMed Central

    Prasad, Vinay; Massey, Paul R.; Fojo, Tito

    2014-01-01

    Historically, cancer medicine has avoided the problem of unequal dosing by comparing maximum-tolerated doses of intravenous regimens with proportionate dose reductions for toxicity. However, in recent years, with the development of numerous oral anticancer agents, dosing options are arbitrarily and increasingly limited by the size of pills. We contend that an underappreciated consequence of pill size is unequal dosing in comparative clinical trials and that this can have an impact on outcomes. We discuss how comparative effectiveness trials can be unbalanced and how the use of doses that are not sustainable might affect outcomes, especially marginal ones. We further argue that because of their poor tolerability and their limited dosing options, which often result in large dose adjustments in response to toxicity, the real-world clinical effectiveness of oral anticancer agents may be diminished and may not emulate results achieved in registration trials. PMID:24711558

  4. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount of each civil money penalty within the OCC's jurisdiction is adjusted in accordance with the...

  5. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b)...

  6. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b)...

  7. Adjusting to University: The Hong Kong Experience

    ERIC Educational Resources Information Center

    Yau, Hon Keung; Sun, Hongyi; Cheng, Alison Lai Fong

    2012-01-01

    Students' adjustment to the university environment is an important factor in predicting university outcomes and is crucial to their future achievements. University support to students' transition to university life can be divided into three dimensions: academic adjustment, social adjustment and psychological adjustment. However, these…

  8. Pharmacological maintenance treatments of opiate addiction

    PubMed Central

    Bell, James

    2014-01-01

    For people seeking treatment, the course of heroin addiction tends to be chronic and relapsing, and longer duration of treatment is associated with better outcomes. Heroin addiction is strongly associated with deviant behaviour and crime, and the objectives in treating heroin addiction have been a blend of humane support, rehabilitation, public health intervention and crime control. Reduction in street heroin use is the foundation on which all these outcomes are based. The pharmacological basis of maintenance treatment of dependent individuals is to minimize withdrawal symptoms and attenuate the reinforcing effects of street heroin, leading to reduction or cessation of street heroin use. Opioid maintenance treatment can be moderately effective in suppressing heroin use, although deviations from evidence-based approaches, particularly the use of suboptimal doses, have meant that treatment as delivered in practice may have resulted in poorer outcomes than predicted by research. Methadone treatment has been ‘programmatic’, with a one-size-fits-all approach that in part reflects the perceived need to impose discipline on deviant individuals. However, differences in pharmacokinetics and in side-effects mean that many patients do not respond optimally to methadone. Injectable diamorphine (heroin) provides a more reinforcing medication for some ‘nonresponders’ and can be a valuable option in the rehabilitation of demoralized, socially excluded individuals. Buprenorphine, a partial agonist, is a less reinforcing medication with different side-effects and less risk of overdose. Not only is it a different medication, but also it can be used in a different paradigm of treatment, office-based opioid treatment, with less structure and offering greater patient autonomy. PMID:23210630

  9. Pharmacological maintenance treatments of opiate addiction.

    PubMed

    Bell, James

    2014-02-01

    For people seeking treatment, the course of heroin addiction tends to be chronic and relapsing, and longer duration of treatment is associated with better outcomes. Heroin addiction is strongly associated with deviant behaviour and crime, and the objectives in treating heroin addiction have been a blend of humane support, rehabilitation, public health intervention and crime control. Reduction in street heroin use is the foundation on which all these outcomes are based. The pharmacological basis of maintenance treatment of dependent individuals is to minimize withdrawal symptoms and attenuate the reinforcing effects of street heroin, leading to reduction or cessation of street heroin use. Opioid maintenance treatment can be moderately effective in suppressing heroin use, although deviations from evidence-based approaches, particularly the use of suboptimal doses, have meant that treatment as delivered in practice may have resulted in poorer outcomes than predicted by research. Methadone treatment has been 'programmatic', with a one-size-fits-all approach that in part reflects the perceived need to impose discipline on deviant individuals. However, differences in pharmacokinetics and in side-effects mean that many patients do not respond optimally to methadone. Injectable diamorphine (heroin) provides a more reinforcing medication for some 'nonresponders' and can be a valuable option in the rehabilitation of demoralized, socially excluded individuals. Buprenorphine, a partial agonist, is a less reinforcing medication with different side-effects and less risk of overdose. Not only is it a different medication, but also it can be used in a different paradigm of treatment, office-based opioid treatment, with less structure and offering greater patient autonomy.

  10. A system for the calculation and visualisation of radiation field for maintenance support in nuclear power plants.

    PubMed

    Ohga, Yukiharu; Fukuda, Mitsuko; Shibata, Kiyotaka; Kawakami, Takashi; Matsuzaki, Tomokazu

    2005-01-01

    A system has been developed to improve the efficiency of maintenance work while decreasing the radiation exposure of maintenance personnel in nuclear power plants. The input data for dose rate calculation are automatically generated by using computer-aided design data. Changes for the input data corresponding to the progress of maintenance work, such as installation of a radiation shield and removal of a component, are easily input interactively on a graphical user interface (GUI). A new method was proposed which searches the sets of source and detector points between which gamma-ray attenuation is changed by the component movement. The calculation is performed only for the changed sets, so that the change of the three-dimensional dose rate distribution is calculated rapidly according to the work progress. The dose rate distribution and the radiation exposure of maintenance personnel are displayed three-dimensionally in colour with plant components and pipes on the GUI.

  11. Coverage-adjusted entropy estimation.

    PubMed

    Vu, Vincent Q; Yu, Bin; Kass, Robert E

    2007-09-20

    Data on 'neural coding' have frequently been analyzed using information-theoretic measures. These formulations involve the fundamental and generally difficult statistical problem of estimating entropy. We review briefly several methods that have been advanced to estimate entropy and highlight a method, the coverage-adjusted entropy estimator (CAE), due to Chao and Shen that appeared recently in the environmental statistics literature. This method begins with the elementary Horvitz-Thompson estimator, developed for sampling from a finite population, and adjusts for the potential new species that have not yet been observed in the sample-these become the new patterns or 'words' in a spike train that have not yet been observed. The adjustment is due to I. J. Good, and is called the Good-Turing coverage estimate. We provide a new empirical regularization derivation of the coverage-adjusted probability estimator, which shrinks the maximum likelihood estimate. We prove that the CAE is consistent and first-order optimal, with rate O(P)(1/log n), in the class of distributions with finite entropy variance and that, within the class of distributions with finite qth moment of the log-likelihood, the Good-Turing coverage estimate and the total probability of unobserved words converge at rate O(P)(1/(log n)(q)). We then provide a simulation study of the estimator with standard distributions and examples from neuronal data, where observations are dependent. The results show that, with a minor modification, the CAE performs much better than the MLE and is better than the best upper bound estimator, due to Paninski, when the number of possible words m is unknown or infinite.

  12. Methadone maintenance and drug-related crime.

    PubMed

    Bell, J; Mattick, R; Hay, A; Chan, J; Hall, W

    1997-01-01

    Using data from an evaluation of methadone maintenance treatment, this study investigated factors associated with continued involvement in crime during treatment, and in particular whether there appeared to be differences in effectiveness of treatment between different methadone clinics. The methodology was an observational study, in which 304 patients attending three low-intervention, private methadone clinics in Sydney were interviewed on three occasions over a twelve month period. Outcome measures were self-reported criminal activity and police department records of convictions. By self-report, crime dropped promptly and substantially on entry to treatment, to a level of acquisitive crime about one-eighth that reported during the last addiction period. Analysis of official records indicated that rates of acquisitive convictions were significantly lower in the in-treatment period compared to prior to entry to treatment, corroborating the changes suggested by self-report. Persisting involvement in crime in treatment was predicted by two factors: the cost of persisting use of illicit drugs, particularly cannabis, and ASPD symptom count. Treatment factors also were independently predictive of continued involvement in crime. By both self-report and official records, and adjusting for subject factors, treatment at one clinic was associated with greater involvement in crime. This clinic operated in a chaotic and poorly organized way. It is concluded that crime during methadone treatment is substantially lower than during street addiction, although the extent of reduction depends on the quality of treatment being delivered.

  13. Dose optimization tool

    NASA Astrophysics Data System (ADS)

    Amir, Ornit; Braunstein, David; Altman, Ami

    2003-05-01

    A dose optimization tool for CT scanners is presented using patient raw data to calculate noise. The tool uses a single patient image which is modified for various lower doses. Dose optimization is carried out without extra measurements by interactively visualizing the dose-induced changes in this image. This tool can be used either off line, on existing image(s) or, as a pre - requisite for dose optimization for the specific patient, during the patient clinical study. The algorithm of low-dose simulation consists of reconstruction of two images from a single measurement and uses those images to create the various lower dose images. This algorithm enables fast simulation of various low dose (mAs) images on a real patient image.

  14. Consolidating Air Force Maintenance Occupational Specialties

    DTIC Science & Technology

    2016-01-01

    MDS mission design series MOB main operating base MQTP Maintenance Qualification Training Program MSgt Master Sergeant Mx maintenance MXS...dictates]). Within the contiguous United States main operating base ( MOB ) structure, each MOB has all required support functions to maintain

  15. Mining Surveillance and Maintenance Dollars

    SciTech Connect

    MARTINEZ, R.

    2000-02-01

    Accelerating site cleanup to reduce facility risks to the workers, the public and the environment during a time of declining federal budgets represents a significant technical and economic challenge to U.S. Department of Energy (DOE) Operations Offices and their respective contractors. A significant portion of a facility's recurring annual expenses are associated with routine, long-term surveillance and maintenance (S&M) activities. However, ongoing S&M activities do nothing to reduce risks and basically spend money that could be reallocated towards facility deactivation. This paper discusses the background around DOE efforts to reduce surveillance and maintenance costs, one approach used to perform cost reviews, lessons learned from field implementation and what assistance is available to assist DOE sites in performing these evaluations.

  16. Space surveillance satellite catalog maintenance

    NASA Astrophysics Data System (ADS)

    Jackson, Phoebe A.

    1990-04-01

    The United States Space Command (USSPACECOM) is a Unified Command of the Department of Defense with headquarters at Peterson Air Force Base, Colorado Springs, Co. One of the responsibilities of USSPACECOM is to detect, track, identify, and maintain a catalog of all manmade objects in earth orbit. This satellite catalog is the most important tool for space surveillance. The purpose of this paper is threefold. First, to identify why the command does the job of satellite catalog maintenance. Second, to describe what the satellite catalog is and how it is maintained. Third, and finally, to identify the questions that must be addressed if this command is to track small space object debris. This paper's underlying rationale is to describe our catalog maintenance services so that the members of our community can use them with assurance.

  17. Artificial intelligence for turboprop engine maintenance

    SciTech Connect

    1995-01-01

    Long-term maintenance operations, causing the unit to out of action, may seem economical - but they result in reduced operating readiness. Offsetting that concern, careless, hurried maintenance reduces margins of safety and reliability. Any tool that improves maintenance without causing a sharp increase in cost is valuable. Artificial intelligence (AI) is one of the tools. Expert system and neural networks are two different areas of AI that show promise for turboprop engine maintenance.

  18. Rebuilding a Maintenance Program After Deployment

    DTIC Science & Technology

    2011-12-01

    experience came a lack of oversight of subordinate unit maintenance programs, which led to errors in initial data entry into unit Standard Army Maintenance...unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 September–December...what leaders should be checking during command maintenance, demonstrated capabilities, and reinforced maintenance standards . Classes ranged from 10 to

  19. Ground Vehicle Condition Based Maintenance

    DTIC Science & Technology

    2010-10-04

    average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed...shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1 ...UNCLASSIFIED 4 RCM and CBM are core processes for CBM+ System Development • Army Regulation 750- 1 , 20 Sep 2007, p. 79 - Reliability Centered Maintenance (RCM

  20. Orbital assembly and maintenance study

    NASA Technical Reports Server (NTRS)

    Gorman, D.; Grant, C.; Kyrias, G.; Lord, C.; Rombach, J.; Salis, M.; Skidmore, R.; Thomas, R.

    1975-01-01

    The requirements, conceptual design, tradeoffs, procedures, and techniques for orbital assembly of the support structure of the microwave power transmission system and the radio astronomy telescope are described. Thermal and stress analyses, packaging, alignment, and subsystems requirements are included along with manned vs. automated and transportation tradeoffs. Technical and operational concepts for the manned and automated maintenance of satellites were investigated and further developed results are presented.

  1. The Minichromosome Maintenance Replicative Helicase

    PubMed Central

    Bell, Stephen D.; Botchan, Michael R.

    2013-01-01

    The eukaryotic replicative helicase, the minichromosome maintenance (MCM) complex, is composed of six distinct, but related, subunits MCM(2–7). The relationship between the sequences of the subunits indicates that they are derived from a common ancestor and indeed, present-day archaea possess a homohexameric MCM. Recent progress in the biochemical and structural studies of both eukaryal and archaeal MCM complexes are beginning to shed light on the mechanisms of action of this key component of the replisome. PMID:23881943

  2. Corrosion Maintenance and Experimental Design

    DTIC Science & Technology

    1987-01-01

    drawings, specifications, or other data are used for any purpose other than in connection with a definitely related Government procurement operation...furnished, or in any way supplied the said drawings, specifications, or other data , is not to be re- garded by implication or otherwise as in any manner...in ) evaluation of corrosion inhibitor effectiveness for aircraft rinsing, (2) improvements o AFLC’s Maintenance Data Collection System (MDCS), (3

  3. Designing a scrubber for maintenance

    SciTech Connect

    Mahlmeister, M.E.; Baron, E.S.; Watts, J.

    1996-12-01

    Under Round 4 of the U.S. Department of Energy`s (DOE) Clean Coal Technology program, New York State Electric & Gas Corporation (NYSEG), in partnership with Saarberg-Holter-Umwelttechnik (SHU), Consolidation Coal Company and Stebbins Engineering and Manufacturing Company, has retrofitted a formic acid enhanced forced oxidation wet limestone scrubber on Units I and 2 at the Milliken Steam Electric Station. Units I and 2 are 1950s vintage Combustion Engineering tangentially fired pulverized coal units, which are rated at nominal 150 MW each and operate in balanced draft mode. The Flue Gas Desulfurization (FGD) system for Unit 2 was placed into operation in January 1995 and the Unit I system in June 1995. The project incorporates several unique aspects: low pH operation; a ceramic tile-lined cocurrent/countercurrent, split module absorber; a wet stack supported on the roof of the FGD building; and closed loop, zero liquid discharge operation that produces commercial grade gypsum and calcium chloride brine. The project objectives include 98% SO{sub 2} removal efficiency while burning high sulfur coal, the production of marketable byproducts to minimize solid waste disposal, zero wastewater discharge, space-saving design, and minimization of maintenance requirements of a wet scrubber. The paper provides a brief overview of the project scrubber design relating to maintenance considerations. A discussion of the early results of the maintenance history is also provided. Repair techniques that have been developed and tested for ceramic tile lined modules are included. 1 fig.

  4. Inflation Adjustments for Defense Acquisition

    DTIC Science & Technology

    2014-10-01

    Harmon Daniel B. Levine Stanley A. Horowitz, Project Leader INSTITUTE FOR DEFENSE ANALYSES 4850 Mark Center Drive Alexandria, Virginia 22311-1882 Approved...T U T E F O R D E F E N S E A N A L Y S E S IDA Document D-5112 Inflation Adjustments for Defense Acquisition Bruce R. Harmon Daniel B. Levine...might do a better job? The focus of the study is on aircraft procurement. By way of terminology , “cost index,” “price index,” and “deflator” are used

  5. Adjustable extender for instrument module

    DOEpatents

    Sevec, J.B.; Stein, A.D.

    1975-11-01

    A blank extender module used to mount an instrument module in front of its console for repair or test purposes has been equipped with a rotatable mount and means for locking the mount at various angles of rotation for easy accessibility. The rotatable mount includes a horizontal conduit supported by bearings within the blank module. The conduit is spring-biased in a retracted position within the blank module and in this position a small gear mounted on the conduit periphery is locked by a fixed pawl. The conduit and instrument mount can be pulled into an extended position with the gear clearing the pawl to permit rotation and adjustment of the instrument.

  6. 49 CFR 260.39 - Maintenance standards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Maintenance standards. 260.39 Section 260.39... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Standards for Maintenance of Facilities Involved in the Project § 260.39 Maintenance standards. (a) When the proceeds of a direct loan or an obligation guaranteed...

  7. 33 CFR 127.401 - Maintenance: General.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Maintenance: General. 127.401 Section 127.401 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... Waterfront Facilities Handling Liquefied Natural Gas Maintenance § 127.401 Maintenance: General. The...

  8. 30 CFR 57.5066 - Maintenance standards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Maintenance standards. 57.5066 Section 57.5066... Maintenance standards. (a) Any diesel powered equipment operated at any time in underground areas must meet the following maintenance standards: (1) The operator must maintain any approved engine in...

  9. 47 CFR 80.96 - Maintenance tests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Maintenance tests. 80.96 Section 80.96... MARITIME SERVICES Operating Requirements and Procedures Operating Procedures-General § 80.96 Maintenance tests. Stations are authorized to engage in test transmissions necessary for maintenance of the...

  10. 23 CFR 1.27 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Maintenance. 1.27 Section 1.27 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GENERAL MANAGEMENT AND ADMINISTRATION GENERAL § 1.27 Maintenance... maintenance of projects shall be carried out in accordance with policies and procedures issued by...

  11. 14 CFR 91.1111 - Maintenance training.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Maintenance training. 91.1111 Section 91... Operations Program Management § 91.1111 Maintenance training. The program manager must ensure that all employees who are responsible for maintenance related to program aircraft undergo appropriate initial...

  12. 49 CFR 195.420 - Valve maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Valve maintenance. 195.420 Section 195.420 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Operation and Maintenance § 195.420 Valve maintenance. (a) Each operator shall maintain each...

  13. 5 CFR 850.302 - Record maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Record maintenance. 850.302 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Records § 850.302 Record maintenance. (a) The retirement and..., for the initiation and maintenance of records, evidence, or other information described in this...

  14. 14 CFR 145.217 - Contract maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Contract maintenance. 145.217 Section 145...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.217 Contract maintenance. (a) A certificated repair station may contract a maintenance function pertaining to an article to...

  15. 47 CFR 87.69 - Maintenance tests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Maintenance tests. 87.69 Section 87.69... Operating Requirements and Procedures Operating Requirements § 87.69 Maintenance tests. The licensee may make routine maintenance tests on equipment other than emergency locator transmitters if there is...

  16. 49 CFR 192.749 - Vault maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Vault maintenance. 192.749 Section 192.749 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Maintenance § 192.749 Vault maintenance. (a) Each...

  17. 40 CFR 1033.125 - Maintenance instructions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Maintenance instructions. 1033.125... Maintenance instructions. Give the owner of each new locomotive written instructions for properly maintaining... emission-related maintenance instructions also apply to any service accumulation on your...

  18. Laboratory services series: a programmed maintenance system

    SciTech Connect

    Tuxbury, D.C.; Srite, B.E.

    1980-01-01

    The diverse facilities, operations and equipment at a major national research and development laboratory require a systematic, analytical approach to operating equipment maintenance. A computer-scheduled preventive maintenance program is described including program development, equipment identification, maintenance and inspection instructions, scheduling, personnel, and equipment history.

  19. Computerizing Maintenance Management Improves School Processes.

    ERIC Educational Resources Information Center

    Conroy, Pat

    2002-01-01

    Describes how a Computerized Maintenance Management System (CMMS), a centralized maintenance operations database that facilitates work order procedures and staff directives, can help individual school campuses and school districts to manage maintenance. Presents the benefits of CMMS and things to consider in CMMS selection. (EV)

  20. 47 CFR 87.69 - Maintenance tests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Maintenance tests. 87.69 Section 87.69... Operating Requirements and Procedures Operating Requirements § 87.69 Maintenance tests. The licensee may make routine maintenance tests on equipment other than emergency locator transmitters if there is...

  1. 41 CFR 101-39.303 - Maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Maintenance. In order to ensure uninterrupted operation of GSA Interagency Fleet Management System (IFMS) vehicles, safety and preventive maintenance inspections will be performed at regularly scheduled intervals... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Maintenance....

  2. 41 CFR 101-39.303 - Maintenance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Maintenance. In order to ensure uninterrupted operation of GSA Interagency Fleet Management System (IFMS) vehicles, safety and preventive maintenance inspections will be performed at regularly scheduled intervals... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Maintenance....

  3. Maintenance Staffing Guidelines For Educational Facilities.

    ERIC Educational Resources Information Center

    APPA: Association of Higher Education Facilities Officers, Alexandria, VA.

    The purpose of this publication is to provide a resource or guide for educational facilities in establishing or developing a maintenance trades organization that is sufficient to accomplish basic facilities maintenance functions. The guidelines are intended to suggest staffing levels for those routine facilities maintenance activities that are…

  4. 41 CFR 101-39.303 - Maintenance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Maintenance. In order to ensure uninterrupted operation of GSA Interagency Fleet Management System (IFMS) vehicles, safety and preventive maintenance inspections will be performed at regularly scheduled intervals... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Maintenance....

  5. 41 CFR 101-39.303 - Maintenance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Maintenance. In order to ensure uninterrupted operation of GSA Interagency Fleet Management System (IFMS) vehicles, safety and preventive maintenance inspections will be performed at regularly scheduled intervals... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Maintenance....

  6. 14 CFR 145.217 - Contract maintenance.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Contract maintenance. 145.217 Section 145...) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Operating Rules § 145.217 Contract maintenance. (a) A certificated repair station may contract a maintenance function pertaining to an article to...

  7. 23 CFR 1.27 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Maintenance. 1.27 Section 1.27 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GENERAL MANAGEMENT AND ADMINISTRATION GENERAL § 1.27 Maintenance... maintenance of projects shall be carried out in accordance with policies and procedures issued by...

  8. 47 CFR 87.69 - Maintenance tests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Maintenance tests. 87.69 Section 87.69... Operating Requirements and Procedures Operating Requirements § 87.69 Maintenance tests. The licensee may make routine maintenance tests on equipment other than emergency locator transmitters if there is...

  9. [Experience of preventive maintenance of medical equipment].

    PubMed

    Li, Wei-jia; Quan, Jian-guo

    2009-03-01

    Preventive maintenance of medical equipment can be helpful in improving the efficiency of medical devices, establishing a standardized management and plan, a classification of maintenance of medical devices, inspection tour of devices and operating condition of dynamic monitoring devices. It has benefit in prolonging the useful life of medical devices, reducing maintenance cost and improving management and service quality.

  10. 40 CFR 1042.125 - Maintenance instructions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Maintenance instructions. 1042.125... Standards and Related Requirements § 1042.125 Maintenance instructions. Give the ultimate purchaser of each... control system, as described in this section. The maintenance instructions also apply to...

  11. 40 CFR 1033.125 - Maintenance instructions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Maintenance instructions. 1033.125... Maintenance instructions. Give the owner of each new locomotive written instructions for properly maintaining... emission-related maintenance instructions also apply to any service accumulation on your...

  12. 41 CFR 101-39.303 - Maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Maintenance. 101-39.303... Maintenance. In order to ensure uninterrupted operation of GSA Interagency Fleet Management System (IFMS) vehicles, safety and preventive maintenance inspections will be performed at regularly scheduled...

  13. 47 CFR 80.96 - Maintenance tests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Maintenance tests. 80.96 Section 80.96... MARITIME SERVICES Operating Requirements and Procedures Operating Procedures-General § 80.96 Maintenance tests. Stations are authorized to engage in test transmissions necessary for maintenance of the...

  14. 30 CFR 57.5066 - Maintenance standards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maintenance standards. 57.5066 Section 57.5066... Maintenance standards. (a) Any diesel powered equipment operated at any time in underground areas must meet the following maintenance standards: (1) The operator must maintain any approved engine in...

  15. 49 CFR 195.420 - Valve maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Valve maintenance. 195.420 Section 195.420 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Operation and Maintenance § 195.420 Valve maintenance. (a) Each operator shall maintain each...

  16. 49 CFR 192.749 - Vault maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Vault maintenance. 192.749 Section 192.749 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Maintenance § 192.749 Vault maintenance. (a) Each...

  17. 49 CFR 260.39 - Maintenance standards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Maintenance standards. 260.39 Section 260.39... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Standards for Maintenance of Facilities Involved in the Project § 260.39 Maintenance standards. (a) When the proceeds of a direct loan or an obligation guaranteed...

  18. 5 CFR 850.302 - Record maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Record maintenance. 850.302 Section 850... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Records § 850.302 Record maintenance. (a) The retirement and..., for the initiation and maintenance of records, evidence, or other information described in this...

  19. e-Learning Application for Machine Maintenance Process using Iterative Method in XYZ Company

    NASA Astrophysics Data System (ADS)

    Nurunisa, Suaidah; Kurniawati, Amelia; Pramuditya Soesanto, Rayinda; Yunan Kurnia Septo Hediyanto, Umar

    2016-02-01

    XYZ Company is a company based on manufacturing part for airplane, one of the machine that is categorized as key facility in the company is Millac 5H6P. As a key facility, the machines should be assured to work well and in peak condition, therefore, maintenance process is needed periodically. From the data gathering, it is known that there are lack of competency from the maintenance staff to maintain different type of machine which is not assigned by the supervisor, this indicate that knowledge which possessed by maintenance staff are uneven. The purpose of this research is to create knowledge-based e-learning application as a realization from externalization process in knowledge transfer process to maintain the machine. The application feature are adjusted for maintenance purpose using e-learning framework for maintenance process, the content of the application support multimedia for learning purpose. QFD is used in this research to understand the needs from user. The application is built using moodle with iterative method for software development cycle and UML Diagram. The result from this research is e-learning application as sharing knowledge media for maintenance staff in the company. From the test, it is known that the application make maintenance staff easy to understand the competencies.

  20. Comparison of Physician-, Biomarker-, and Symptom-Based Strategies for Adjustment of Inhaled Corticosteroid Therapy in Adults With Asthma

    PubMed Central

    Calhoun, William J.; Ameredes, Bill T.; King, Tonya S.; Icitovic, Nikolina; Bleecker, Eugene R.; Castro, Mario; Cherniack, Reuben M.; Chinchilli, Vernon M.; Craig, Timothy; Denlinger, Loren; DiMango, Emily A.; Engle, Linda L.; Fahy, John V.; Grant, J. Andrew; Israel, Elliot; Jarjour, Nizar; Kazani, Shamsah D.; Kraft, Monica; Kunselman, Susan J.; Lazarus, Stephen C.; Lemanske, Robert F.; Lugogo, Njira; Martin, Richard J.; Meyers, Deborah A.; Moore, Wendy C.; Pascual, Rodolfo; Peters, Stephen P.; Ramsdell, Joe; Sorkness, Christine A.; Sutherland, E. Rand; Szefler, Stanley J.; Wasserman, Stephen I.; Walter, Michael J.; Wechsler, Michael E.; Boushey, Homer A.

    2013-01-01

    Context No consensus exists for adjusting inhaled corticosteroid therapy in patients with asthma. Approaches include adjustment at outpatient visits guided by physician assessment of asthma control (symptoms, rescue therapy, pulmonary function), based on exhaled nitric oxide, or on a day-to-day basis guided by symptoms. Objective To determine if adjustment of inhaled corticosteroid therapy based on exhaled nitric oxide or day-to-day symptoms is superior to guideline-informed, physician assessment–based adjustment in preventing treatment failure in adults with mild to moderate asthma. Design, Setting, and Participants A randomized, parallel, 3-group, placebo-controlled, multiply-blinded trial of 342 adults with mild to moderate asthma controlled by low-dose inhaled corticosteroid therapy (n=114 assigned to physician assessment–based adjustment [101 completed], n=115 to biomarker-based [exhaled nitric oxide] adjustment [92 completed], and n=113 to symptom-based adjustment [97 completed]), the Best Adjustment Strategy for Asthma in the Long Term (BASALT) trial was conducted by the Asthma Clinical Research Network at 10 academic medical centers in the United States for 9 months between June 2007 and July 2010. Interventions For physician assessment–based adjustment and biomarker-based (exhaled nitric oxide) adjustment, the dose of inhaled corticosteroids was adjusted every 6 weeks; for symptom-based adjustment, inhaled corticosteroids were taken with each albuterol rescue use. Main Outcome Measure The primary outcome was time to treatment failure. Results There were no significant differences in time to treatment failure. The 9-month Kaplan-Meier failure rates were 22% (97.5% CI, 14%-33%; 24 events) for physician assessment–based adjustment, 20% (97.5% CI, 13%-30%; 21 events) for biomarker-based adjustment, and 15% (97.5% CI, 9%-25%; 16 events) for symptom-based adjustment. The hazard ratio for physician assessment–based adjustment vs biomarker

  1. Themes from a Camp Maintenance Network: Camp Maintenance and Property Personnel Share Their Insights and Challenges.

    ERIC Educational Resources Information Center

    Whyman, Wynne

    2003-01-01

    A camp maintenance survey was completed by maintenance personnel from 99 camps. Results highlighted several important considerations: ensuring sufficient maintenance funds for aging infrastructure, including camp/property personnel in decision making, publicizing completed maintenance projects, examining long-term needs of the land, and adopting…

  2. 14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false CAMP: Maintenance and preventive... RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... performing maintenance or preventive maintenance functions for it must have a training program to ensure...

  3. 14 CFR 145.213 - Inspection of maintenance, preventive maintenance, or alterations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Inspection of maintenance, preventive... Rules § 145.213 Inspection of maintenance, preventive maintenance, or alterations. (a) A certificated repair station must inspect each article upon which it has performed maintenance, preventive...

  4. 14 CFR 145.213 - Inspection of maintenance, preventive maintenance, or alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Inspection of maintenance, preventive... Rules § 145.213 Inspection of maintenance, preventive maintenance, or alterations. (a) A certificated repair station must inspect each article upon which it has performed maintenance, preventive...

  5. 14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false CAMP: Maintenance and preventive... RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... performing maintenance or preventive maintenance functions for it must have a training program to ensure...

  6. 14 CFR 145.213 - Inspection of maintenance, preventive maintenance, or alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Inspection of maintenance, preventive... Rules § 145.213 Inspection of maintenance, preventive maintenance, or alterations. (a) A certificated repair station must inspect each article upon which it has performed maintenance, preventive...

  7. 14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false CAMP: Maintenance and preventive... RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... performing maintenance or preventive maintenance functions for it must have a training program to ensure...

  8. 14 CFR 145.213 - Inspection of maintenance, preventive maintenance, or alterations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Inspection of maintenance, preventive... Rules § 145.213 Inspection of maintenance, preventive maintenance, or alterations. (a) A certificated repair station must inspect each article upon which it has performed maintenance, preventive...

  9. 14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false CAMP: Maintenance and preventive... RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... performing maintenance or preventive maintenance functions for it must have a training program to ensure...

  10. 14 CFR 91.1433 - CAMP: Maintenance and preventive maintenance training program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false CAMP: Maintenance and preventive... RULES Fractional Ownership Operations Program Management § 91.1433 CAMP: Maintenance and preventive... performing maintenance or preventive maintenance functions for it must have a training program to ensure...

  11. Sexuality Talk During Adolescent Health Maintenance Visits

    PubMed Central

    Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.

    2015-01-01

    Importance Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. Objective To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. Design, Setting, and Participants Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. Main Outcomes and Measures Total time per visit during which sexuality issues were discussed. Results One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant

  12. A risk-related preventive maintenance system.

    PubMed

    Anderson, J T

    1992-01-01

    Recent changes in attitudes concerning medical equipment maintenance place more responsibility for planning appropriate levels of maintenance on the clinical engineer and biomedical equipment technician. A system is described in which maintenance decisions are based on the effects of equipment failure on quality of patient care and potential for injury to patients and staff. It is hoped that development of an acceptable classification scheme will simplify maintenance decisions. Such a system will provide levels of maintenance appropriate to the equipment function in patient care.

  13. Analyzing machine noise for real time maintenance

    NASA Astrophysics Data System (ADS)

    Yamato, Yoji; Fukumoto, Yoshifumi; Kumazaki, Hiroki

    2017-02-01

    Recently, IoT technologies have been progressed and applications of maintenance area are expected. However, IoT maintenance applications are not spread in Japan yet because of one-off solution of sensing and analyzing for each case, high cost to collect sensing data and insufficient maintenance automation. This paper proposes a maintenance platform which analyzes sound data in edges, analyzes only anomaly data in cloud and orders maintenance automatically to resolve existing technology problems. We also implement a sample application and compare related work.

  14. Reinforcement Learning for Scheduling of Maintenance

    NASA Astrophysics Data System (ADS)

    Knowles, Michael; Baglee, David; Wermter, Stefan

    Improving maintenance scheduling has become an area of crucial importance in recent years. Condition-based maintenance (CBM) has started to move away from scheduled maintenance by providing an indication of the likelihood of failure. Improving the timing of maintenance based on this information to maintain high reliability without resorting to over-maintenance remains, however, a problem. In this paper we propose Reinforcement Learning (RL), to improve long term reward for a multistage decision based on feedback given either during or at the end of a sequence of actions, as a potential solution to this problem. Several indicative scenarios are presented and simulated experiments illustrate the performance of RL in this application.

  15. Adjusting the Contour of Reflector Panels

    NASA Technical Reports Server (NTRS)

    Palmer, W. B.; Giebler, M. M.

    1984-01-01

    Postfabrication adjustment of contour of panels for reflector, such as parabolic reflector for radio antennas, possible with simple mechanism consisting of threaded stud, two nuts, and flexure. Contours adjusted manually.

  16. 48 CFR 1450.103 - Contract adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract adjustments. 1450.103 Section 1450.103 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR CONTRACT... Contract adjustments....

  17. First Year Adjustment in the Secondary School.

    ERIC Educational Resources Information Center

    Loosemore, Jean Ann

    1978-01-01

    This study investigated the relationship between adjustment to secondary school and 17 cognitive and noncognitive variables, including intelligence (verbal and nonverbal reasoning), academic achievement, extraversion-introversion, stable/unstable, social adjustment, endeavor, age, sex, and school form. (CP)

  18. DRY TRANSFER FACILITY WORKER DOSE ASSESSMENT

    SciTech Connect

    J.S. Tang

    2004-09-23

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Dry Transfer Facility No.1 (DTF-1) performing operations to receive transportation casks, transfer wastes, prepare waste packages, and ship out loaded waste packages and empty casks. Doses received by workers due to maintenance operations are also included in this revision. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation from normal operation, excluding the remediation area of the building. The results of this calculation will be used to support the design of the DTF-1 and to provide occupational dose estimates for the License Application. The calculations contained in this document were developed by Environmental and Nuclear Engineering of the Design and Engineering Organization and are intended solely for the use of the Design and Engineering Organization in its work regarding facility operation. Yucca Mountain Project personnel from the Environmental and Nuclear Engineering should be consulted before use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in the Environmental and Nuclear Engineering.

  19. 38 CFR 1.478 - Disclosures to prevent multiple enrollments in detoxification and maintenance treatment programs...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... narcotic drug in decreasing doses to an individual in order to reduce or eliminate adverse physiological or psychological effects incident to withdrawal from the sustained use of a narcotic drug. (3) Maintenance treatment means the dispensing of a narcotic drug in the treatment of an individual for dependence...

  20. 38 CFR 1.478 - Disclosures to prevent multiple enrollments in detoxification and maintenance treatment programs...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... narcotic drug in decreasing doses to an individual in order to reduce or eliminate adverse physiological or psychological effects incident to withdrawal from the sustained use of a narcotic drug. (3) Maintenance treatment means the dispensing of a narcotic drug in the treatment of an individual for dependence...

  1. Generalized adjustment by least squares ( GALS).

    USGS Publications Warehouse

    Elassal, A.A.

    1983-01-01

    The least-squares principle is universally accepted as the basis for adjustment procedures in the allied fields of geodesy, photogrammetry and surveying. A prototype software package for Generalized Adjustment by Least Squares (GALS) is described. The package is designed to perform all least-squares-related functions in a typical adjustment program. GALS is capable of supporting development of adjustment programs of any size or degree of complexity. -Author

  2. 49 CFR 393.53 - Automatic brake adjusters and brake adjustment indicators.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... brake adjustment indicators. (a) Automatic brake adjusters (hydraulic brake systems). Each commercial motor vehicle manufactured on or after October 20, 1993, and equipped with a hydraulic brake...

  3. The Impact Of Occupational Hazards In Workplaces - Maintenance, A Main Target For Ensuring The Safety Of Working Equipment

    NASA Astrophysics Data System (ADS)

    Antonov, Anca Elena; Buica, Georgeta; Darabont, Doru Costin; Beiu, Constantin

    2015-07-01

    For use of work equipment having the economic performance and the highest level of safety, it must be ensured that it complies with the conditions set by the manufacturer in terms of putting into service, use and maintenance operations, ensuring appropriate technical and environmental requirements, including appropriate measures and means of protection. The research aimed to identify and analyze the occupational hazards associated to maintenance operations, in terms of the history of the adjustments, maintenance, cleaning and repair, including the case that occur after the incidents, capital repairs and upgrades. The results of the research consisted in the development of recommendations on the effective management of maintenance activities of work equipment and a software model to enable an efficient management of maintenance, as a tool for occupational hazards in companies - premise for increasing the competitiveness of employers in the market economy.

  4. Adjusting prednisone using blood eosinophils reduces exacerbations and improves asthma control in difficult patients with asthma.

    PubMed

    Wark, Peter Ab; McDonald, Vanessa M; Gibson, Peter G

    2015-11-01

    Severe or therapy-resistant asthma represents a major problem, and despite advanced treatment, many patients require oral corticosteroids (OCS). We aimed to determine if patients with severe asthma and elevated peripheral blood eosinophils (PBE) could have treatment with OCS adjusted using an algorithm that controlled PBE (<0.2 × 10(9) /L). In 11 patients, the OCS dose was adjusted to suppress PBE, leading to a reduced exacerbation frequency and improvement in asthma symptoms with an overall lower OCS dose.

  5. Pharmacokinetics and dose proportionality of ceftibuten in men.

    PubMed Central

    Lin, C; Lim, J; Radwanski, E; Marco, A; Affrime, M

    1995-01-01

    The pharmacokinetics and dose proportionality of ceftibuten were evaluated in healthy male volunteers receiving single oral doses of 200, 400, and 800 mg of ceftibuten. The drug was absorbed with similar times to the maximum concentration of drug in plasma for all three doses. Concentrations of ceftibuten in plasma increased with increasing dose. Analysis of variance was carried out on the dose-adjusted values for the maximum concentration of drug in plasma and the area under the plasma concentration-time curve; the results indicated that the concentrations in plasma after the 200- and 400-mg doses were dose proportional, and after the 800-mg of dose they were less than dose proportional. The elimination half-life from plasma ranged from 2.0 to 2.3 h and was independent of dose. The total excretion of unchanged ceftibuten in urine accounted for 53 to 68% of the dose, and the renal clearance was estimated to be 53 to 61 ml/min after all doses. The amount of ceftibuten-trans, the major in vitro and in vivo conversion product of ceftibuten, was low in both plasma and urine. PMID:7726498

  6. A 3D isodose manipulation tool for interactive dose shaping

    NASA Astrophysics Data System (ADS)

    Kamerling, C. P.; Ziegenhein, P.; Heinrich, H.; Oelfke, U.

    2014-03-01

    The interactive dose shaping (IDS) planning paradigm aims to perform interactive local dose adaptations of an IMRT plan without compromising already established valuable dose features in real-time. In this work we introduce an interactive 3D isodose manipulation tool which enables local modifications of a dose distribution intuitively by direct manipulation of an isodose surface. We developed an in-house IMRT TPS framework employing an IDS engine as well as a 3D GUI for dose manipulation and visualization. In our software an initial dose distribution can be interactively modified through an isodose surface manipulation tool by intuitively clicking on an isodose surface. To guide the user interaction, the position of the modification is indicated by a sphere while the mouse cursor hovers the isodose surface. The sphere's radius controls the locality of the modification. The tool induces a dose modification as a direct change of dose in one or more voxels, which is incrementally obtained by fluence adjustments. A subsequent recovery step identifies voxels with violated dose features and aims to recover their original dose. We showed a proof of concept study for the proposed tool by adapting the dose distribution of a prostate case (9 beams, coplanar). Single dose modifications take less than 2 seconds on an actual desktop PC.

  7. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from...

  8. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 11 2012-01-01 2012-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from...

  9. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 11 2013-01-01 2013-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from...

  10. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from...

  11. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in a budget account, the borrower may request RUS's approval of a budget adjustment to use funds from...

  12. 24 CFR 5.611 - Adjusted income.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income...

  13. 24 CFR 5.611 - Adjusted income.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income...

  14. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  15. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  16. 12 CFR 313.55 - Salary adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay...

  17. 12 CFR 313.55 - Salary adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay...

  18. 12 CFR 313.55 - Salary adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay...

  19. 12 CFR 313.55 - Salary adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay...

  20. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  1. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  2. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  3. 12 CFR 313.55 - Salary adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Salary adjustments. 313.55 Section 313.55 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE PROCEDURES FOR CORPORATE DEBT COLLECTION Salary Offset § 313.55 Salary adjustments. Any negative adjustment to pay...

  4. 12 CFR 1780.80 - Inflation adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within...

  5. 12 CFR 1780.80 - Inflation adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within...

  6. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  7. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  8. Patient-specific dose calculation methods for high-dose-rate iridium-192 brachytherapy

    NASA Astrophysics Data System (ADS)

    Poon, Emily S.

    In high-dose-rate 192Ir brachytherapy, the radiation dose received by the patient is calculated according to the AAPM Task Group 43 (TG-43) formalism. This table-based dose superposition method uses dosimetry parameters derived with the radioactive 192Ir source centered in a water phantom. It neglects the dose perturbations caused by inhomogeneities, such as the patient anatomy, applicators, shielding, and radiographic contrast solution. In this work, we evaluated the dosimetric characteristics of a shielded rectal applicator with an endocavitary balloon injected with contrast solution. The dose distributions around this applicator were calculated by the GEANT4 Monte Carlo (MC) code and measured by ionization chamber and GAFCHROMIC EBT film. A patient-specific dose calculation study was then carried out for 40 rectal treatment plans. The PTRAN_CT MC code was used to calculate the dose based on computed tomography (CT) images. This study involved the development of BrachyGUI, an integrated treatment planning tool that can process DICOM-RT data and create PTRAN_CT input initialization files. BrachyGUI also comes with dose calculation and evaluation capabilities. We proposed a novel scatter correction method to account for the reduction in backscatter radiation near tissue-air interfaces. The first step requires calculating the doses contributed by primary and scattered photons separately, assuming a full scatter environment. The scatter dose in the patient is subsequently adjusted using a factor derived by MC calculations, which depends on the distances between the point of interest, the 192Ir source, and the body contour. The method was validated for multicatheter breast brachytherapy, in which the target and skin doses for 18 patient plans agreed with PTRAN_CT calculations better than 1%. Finally, we developed a CT-based analytical dose calculation method. It corrects for the photon attenuation and scatter based upon the radiological paths determined by ray tracing

  9. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  10. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  11. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  12. 14 CFR 91.1423 - CAMP: Maintenance organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... required inspections), preventive maintenance, or alterations, and each person with whom it arranges for... that work. (c) Each person performing required inspections in addition to other maintenance, preventive... inspection functions from the other maintenance, preventive maintenance, or alteration functions....

  13. Methadone maintenance: some client opinions.

    PubMed

    Brown, B S; Benn, G J; Jansen, D R

    1975-06-01

    The authors found similar attitudes toward methadone and methadone treatment programs in 75 detoxification and 115 methadone maintenance clients. Both groups expressed considerable ambivalence--although they viewed methadone as capable of helping them end their herioin addiction, they were concerned about possible methadone dependence and about side effects, both real and imagined. The authors stress the societal context of such concern and suggest that, althought they are not easily allayed, limiting the duration of methadone maintenace from the outset of treatment may be an ameliorative factor.

  14. Autonomous Spacecraft Maintenance Study Group.

    DTIC Science & Technology

    1981-02-01

    ADOAIOO 318 JETOPROPULSION LAB PASADENA CA F/G 9/2 AUTONOMOUS SPACECRAFT MAINTENANCE STUDY GROUP(U) FEB 81 M H MARSHALL, G D LOW NAS7-100...for pUblio release AW AIR 1912a(T) D1etribution 13 Umlalt~ d , (7b). A. D . BLOSE -7 The research described in this pubi’cation was carried out by the Jet...Rettriek (Jill I Academic Assessment Committee iKDAMac (~jf.IIht~i~srtt D I I I I1. ), ’I ,lil I. I 1 i i t: c; Jill I h-0 K IfItt,1 fIIlkc I IV

  15. Low maintenance hydrocarbon soil & groundwater

    SciTech Connect

    Seabolt, L.K. Jr.; Ryckman, M.D.

    1995-12-31

    This paper illustrates practical methods to control remedial system life cycle costs for pump and treat and biovent systems through the use of low maintenance treatment systems. Cost control factors will be illustrated through the presentation of three case histories: a groundwater free product recovery system at an Air Force P.O.L. (Petroleum, Oil, and Lubricant) storage area, a free product recovery and bioventing system at a beverage fleet distribution facility, and a free product recovery and ventilation system at a publication facility.

  16. Psychiatric components of a Health Maintenance Facility (HMF) on Space Station

    NASA Technical Reports Server (NTRS)

    Santy, Patricia A.

    1987-01-01

    The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

  17. Neutron dose equivalent meter

    DOEpatents

    Olsher, Richard H.; Hsu, Hsiao-Hua; Casson, William H.; Vasilik, Dennis G.; Kleck, Jeffrey H.; Beverding, Anthony

    1996-01-01

    A neutron dose equivalent detector for measuring neutron dose capable of accurately responding to neutron energies according to published fluence to dose curves. The neutron dose equivalent meter has an inner sphere of polyethylene, with a middle shell overlying the inner sphere, the middle shell comprising RTV.RTM. silicone (organosiloxane) loaded with boron. An outer shell overlies the middle shell and comprises polyethylene loaded with tungsten. The neutron dose equivalent meter defines a channel through the outer shell, the middle shell, and the inner sphere for accepting a neutron counter tube. The outer shell is loaded with tungsten to provide neutron generation, increasing the neutron dose equivalent meter's response sensitivity above 8 MeV.

  18. Rituximab Maintenance Therapy After Autologous Stem-Cell Transplantation in Patients With Relapsed CD20+ Diffuse Large B-Cell Lymphoma: Final Analysis of the Collaborative Trial in Relapsed Aggressive Lymphoma

    PubMed Central

    Gisselbrecht, Christian; Schmitz, Norbert; Mounier, Nicolas; Singh Gill, Devinder; Linch, David C.; Trneny, Marek; Bosly, Andre; Milpied, Noel J.; Radford, John; Ketterer, Nicolas; Shpilberg, Ofer; Dührsen, Ulrich; Hagberg, Hans; Ma, David D.; Viardot, Andreas; Lowenthal, Ray; Brière, Josette; Salles, Gilles; Moskowitz, Craig H.; Glass, Bertram

    2012-01-01

    Purpose The standard treatment for relapsed diffuse large B-cell lymphoma (DLBCL) is salvage chemotherapy followed by high-dose therapy and autologous stem-cell transplantation (ASCT). The impact of maintenance rituximab after ASCT is not known. Patients and Methods In total, 477 patients with CD20+ DLBCL who were in their first relapse or refractory to initial therapy were randomly assigned to one of two salvage regimens. After three cycles of salvage chemotherapy, the responding patients received high-dose chemotherapy followed by ASCT. Then, 242 patients were randomly assigned to either rituximab every 2 months for 1 year or observation. Results After ASCT, 122 patients received rituximab, and 120 patients were observed only. The median follow-up time was 44 months. The 4-year event-free survival (EFS) rates after ASCT were 52% and 53% for the rituximab and observation groups, respectively (P = .7). Treatment with rituximab was associated with a 15% attributable risk of serious adverse events after day 100, with more deaths (six deaths v three deaths in the observation arm). Several factors affected EFS after ASCT (P < .05), including relapsed disease within 12 months (EFS: 46% v 56% for relapsed disease after 12 months), secondary age-adjusted International Prognostic Index (saaIPI) more than 1 (EFS: 37% v 61% for saaIPI < 1), and prior treatment with rituximab (EFS: 47% v 59% for no prior rituximab). A significant difference in EFS between women (63%) and men (46%) was also observed in the rituximab group. In the Cox model for maintenance, the saaIPI was a significant prognostic factor (P < .001), as was male sex (P = .01). Conclusion In relapsed DLBCL, we observed no difference between the control group and the rituximab maintenance group and do not recommend rituximab after ASCT. PMID:23091101

  19. Multilateral analysis of increasing collective dose and new ALARA programme.

    PubMed

    Oumi, Tadashi; Morii, Yasuki; Imai, Toshirou

    2011-07-01

    JAPC (The Japan Atomic Power Company) is the only electric power company that operates different types of nuclear reactors in Japan; it operates two BWRs (boiling water reactors), one pressurised water reactor and one gas cooled reactor. JAPC has been conducting various activities aimed at reducing radiation dose received by workers for over 45 y. Recently, the collective dose resulting from periodic maintenance has increased at each plant because of the replacement of large equipment and the unexpected extension of the outage period. In particular, the collective dose at Tokai-2 is one of the highest among Japanese BWR plants((1)), owing to the replacement and strengthening of equipment to meet earthquake-proof requirements. In this study, the authors performed a multilateral analysis of unacceptably a large collective dose and devised a new ALARA programme that includes a 3D dose prediction map and the development of machines to assist workers.

  20. Assessment of changes in insulin requirement in patients of type 2 diabetes mellitus on maintenance hemodialysis

    PubMed Central

    Sudha, M. J.; Salam, Halma S.; Viveka, S.; Udupa, A. L.

    2017-01-01

    Background: Hemodialysis improves insulin sensitivity. Currently, there is no recommendation for the adjustment of insulin dose on dialysis day and nondialysis day in diabetic patients. This study was undertaken to determine the variations in insulin requirement based on blood glucose levels on dialysis days and nondialysis days in type 2 diabetic patients with chronic kidney disease on maintenance hemodialysis. Methodology: Twenty-eight diabetic patients on hemodialysis were recruited into the study after obtaining written informed consent and approval from Azeezia Ethics Committee. Capillary blood glucose levels, just before dialysis and 2 h after dialysis, were checked and compared with fasting and postprandial glucose levels on–off dialysis days. Results: Mean age of the patients was 59.5 (±2.3) years. The average duration of dialysis was 20.2 months. There was significant (35.8%) decrease in blood glucose levels 2 h after dialysis in comparison to predialysis levels (from mean level of 258–165 mg/dl). The decrease in the blood glucose levels from predialysis level to 2 h postdialysis level was statistically significant (P < 0.001). Both sets of data showed “strong” positive correlation with r = 0.657 and 0.849. The blood glucose levels on the day of dialysis were significantly lower than the off-day values. Conclusions: Diabetic patients with end-stage renal disease on hemodialysis have lower capillary blood glucose levels postdialysis. This has to be addressed clinically to prevent hypoglycemic episodes by reducing exogenous insulin administration on the day of dialysis.