29 CFR 2520.104-50 - Short plan years, deferral of accountant's examination and report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Short plan years, deferral of accountant's examination and... Reporting and Disclosure Requirements § 2520.104-50 Short plan years, deferral of accountant's examination... year begins is changed. (b) Deferral of accountant's report. A plan administrator is not required to...

Evidence-Based Policy and Practice Leads to Changes in the Criteria for MSM to Donate Blood.

PubMed

Slowther, Anne; Watkins, Nicholas A; Kelly, Deirdre

2013-06-01

On November 7, 2011, the permanent deferral from blood donation of men who have sex with men (MSM) changed in England, Scotland and Wales, to a 12-month deferral since last relevant sexual contact. This change was made following an evidence-based policy review by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO). The review concluded that the available evidence supported the introduction of a 12-month fixed period deferral and that the risks associated with a 12-month deferral of MSM were equivalent to a permanent deferral. The permanent deferral for MSM was introduced in 1985 in response to the spread of acquired immunodeficiency syndrome (AIDS) caused by HIV. The change was supported by new data on the level of compliance with the permanent deferral, advances in the testing and processing of donated blood, changes in the epidemiology of sexually transmitted infections (STIs) and improved scientific knowledge. This review discusses how the decision to change the deferral period was reached and highlights some of the remaining issues relating to this contentious matter.

Evaluation of blood donor deferral causes in the Trinidad and Tobago National Blood Transfusion Service.

PubMed

Charles, K S; Hughes, P; Gadd, R; Bodkyn, C J; Rodriguez, M

2010-02-01

The majority of blood donations in Trinidad and Tobago are made as replacement by family members or friends. National Blood Transfusion Policy was drafted in 2007 to promote voluntary, repeated donation. The objective of this study is to assess the current rate and reasons for donor deferral, and the aim is to guide the proposed donor education and recruitment programme. A retrospective study of pre-donation deferral of prospective blood donors at the National Blood Transfusion Centre, Port of Spain, Trinidad and Tobago, was conducted. Records of all pre-donation deferrals over a 12-month period were studied. As many as 11,346 pre-donation screening interviews were conducted. There were 4043 (35.6%) deferrals. The most common reasons for donor deferral were exposure to high-risk sexual activity (27.6%), low haemoglobin 22.2% and hypertension 17.5%. Other reasons such as medication, chronic medical illness, tattoos, travel history, recent pregnancy, surgery or presentation outside the accepted age limit caused 33.8% of all deferrals and the majority (34.7%) of male deferrals. Low haemoglobin (44.5%) was the most common reason among females. The rate of deferral of voluntary donors was not significantly different from that for replacement donors (31.7 vs. 35.4%, P = 0.25). This study exposed a lack of public awareness as the principal reason for an unacceptably high rate of donor deferral. Donor education about selection criteria needs to be urgently addressed as an objective of the National Policy. Monitoring and evaluation of deferral rates and reasons could be used as one indicator of the effectiveness of the Policy.

77 FR 60133 - Agency Information Collection Activities: Deferral of Duty on Large Yachts Imported for Sale

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... Activities: Deferral of Duty on Large Yachts Imported for Sale AGENCY: U.S. Customs and Border Protection... collection requirement concerning Deferral of Duty on Large Yachts Imported for Sale. This request for...: Title: Deferral of Duty on Large Yachts Imported for Sale. OMB Number: 1651-0080. Form Number: None...

Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons.

PubMed

Al Shaer, Laila; Sharma, Ranjita; AbdulRahman, Mahera

2017-01-01

To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai. This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted. Among 142,431 individuals presenting during the study period, 114,827 (80.6%) were accepted for donation, and 27,604 (19.4%) were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P <0.000), females (44% were deferred compared to 15% of males, P <0.0001), and first-time donors (22% were deferred vs 14% of repeat donors, P <0.0001). The main causes for a temporary deferral were low hemoglobin and high blood pressure. The deferral rate among blood donors in Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply.

34 CFR 386.41 - Under what circumstances does the Secretary grant a deferral or exception to performance or...

Code of Federal Regulations, 2012 CFR

2012-07-01

... deferral or exception to performance or repayment under a scholarship agreement? 386.41 Section 386.41... grant a deferral or exception to performance or repayment under a scholarship agreement? A deferral or... or result in death; or (2) Has died. (b) Repayment of a scholarship may be deferred during the time...

34 CFR 386.41 - Under what circumstances does the Secretary grant a deferral or exception to performance or...

Code of Federal Regulations, 2013 CFR

2013-07-01

... deferral or exception to performance or repayment under a scholarship agreement? 386.41 Section 386.41... grant a deferral or exception to performance or repayment under a scholarship agreement? A deferral or... or result in death; or (2) Has died. (b) Repayment of a scholarship may be deferred during the time...

34 CFR 386.41 - Under what circumstances does the Secretary grant a deferral or exception to performance or...

Code of Federal Regulations, 2014 CFR

2014-07-01

... deferral or exception to performance or repayment under a scholarship agreement? 386.41 Section 386.41... grant a deferral or exception to performance or repayment under a scholarship agreement? A deferral or... or result in death; or (2) Has died. (b) Repayment of a scholarship may be deferred during the time...

34 CFR 386.41 - Under what circumstances does the Secretary grant a deferral or exception to performance or...

Code of Federal Regulations, 2010 CFR

2010-07-01

... deferral or exception to performance or repayment under a scholarship agreement? 386.41 Section 386.41... grant a deferral or exception to performance or repayment under a scholarship agreement? A deferral or... or result in death; or (2) Has died. (b) Repayment of a scholarship may be deferred during the time...

34 CFR 386.41 - Under what circumstances does the Secretary grant a deferral or exception to performance or...

Code of Federal Regulations, 2011 CFR

2011-07-01

... deferral or exception to performance or repayment under a scholarship agreement? 386.41 Section 386.41... grant a deferral or exception to performance or repayment under a scholarship agreement? A deferral or... or result in death; or (2) Has died. (b) Repayment of a scholarship may be deferred during the time...

26 CFR 1.457-4 - Annual deferrals, deferral limitations, and deferral agreements under eligible plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the next, so that in any single year an employee may have a maximum of four weeks' vacation time. At... agreement providing for the deferral), the value of any unused vacation time from the prior year in excess... amount is the lesser of two times the basic annual limitation ($30,000) or the sum of the basic annual...

26 CFR 1.457-4 - Annual deferrals, deferral limitations, and deferral agreements under eligible plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the next, so that in any single year an employee may have a maximum of four weeks' vacation time. At... agreement providing for the deferral), the value of any unused vacation time from the prior year in excess... amount is the lesser of two times the basic annual limitation ($30,000) or the sum of the basic annual...

Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons

PubMed Central

Al Shaer, Laila; Sharma, Ranjita; AbdulRahman, Mahera

2017-01-01

Background To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai. Materials and methods This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted. Results Among 142,431 individuals presenting during the study period, 114,827 (80.6%) were accepted for donation, and 27,604 (19.4%) were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P<0.000), females (44% were deferred compared to 15% of males, P<0.0001), and first-time donors (22% were deferred vs 14% of repeat donors, P<0.0001). The main causes for a temporary deferral were low hemoglobin and high blood pressure. Discussion The deferral rate among blood donors in Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply. PMID:28579846

26 CFR 1.409A-1 - Definitions and covered plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the deferral of recognition of income until the later of the following: (i) The exercise or... feature for the deferral of compensation other than the deferral of recognition of income until the...

Haemophilus influenzae Type b Disease and Vaccine Booster Dose Deferral, United States, 1998–2009

PubMed Central

Briere, Elizabeth C.; Jackson, Michael; Shah, Shetul G.; Cohn, Amanda C.; Anderson, Raydel D.; MacNeil, Jessica R.; Coronado, Fatima M.; Mayer, Leonard W.; Clark, Thomas A.; Messonnier, Nancy E.

2015-01-01

BACKGROUND Since the introduction of effective vaccines, the incidence of invasive Haemophilus influenzae type b (Hib) disease among children <5 years of age has decreased by 99% in the United States. In response to a limited vaccine supply that began in 2007, Hib booster doses were deferred for 18 months. METHODS We reviewed national passive and active surveillance (demographic and serotype) and vaccination status data for invasive H. influenzae disease in children aged <5 years before (1998–2007) and during (2008–2009) the vaccine shortage years to assess the impact of the vaccine deferral on Hib disease. We estimated the average annual number of Hib cases misclassified as unknown (not completed or missing) serotype. RESULTS From 1998 to 2007 and 2008 to 2009, the annual average incidence of Hib disease per 100 000 population was 0.2 and 0.18, respectively; no significant difference in incidence was found by age group, gender, or race. Among Hib cases in both time periods, most were unvaccinated or too young to have received Hib vaccine. During 2001 to 2009, there were <53 Hib cases per year, with an estimated 6 to 12 Hib cases misclassified as unknown serotype. CONCLUSIONS The booster deferral did not have a significant impact on the burden of invasive Hib disease in children <5 years of age. Continued surveillance and serotype data are important to monitor changes in Hib incidence, especially during vaccine deferrals. Hib booster deferral is a reasonable short-term approach to a Hib vaccine shortage. PMID:22869828

19 CFR Appendix C to Part 113 - Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Bond for Deferral of Duty on Large Yachts Imported... Appendix C to Part 113—Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows ____, as...

19 CFR Appendix C to Part 113 - Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Bond for Deferral of Duty on Large Yachts Imported... Appendix C to Part 113—Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows ____, as...

Externalizing religious health beliefs and health and well-being outcomes.

PubMed

Hayward, R David; Krause, Neal; Ironson, Gail; Pargament, Kenneth I

2016-10-01

Certain religious beliefs related to perceptions of internal or external health control (including belief in the existence of miraculous healing, and beliefs deferring responsibility for health outcomes from the self and onto God) may be related to health behaviors and in turn to health outcomes. Using data from a nationally representative US survey of religion and health (N = 2948) this study evaluates a series of two structural equation models of the relationships between religious activity, externalizing religious health beliefs (belief in healing miracles and divine health deferral), health outcomes, and life satisfaction. Believing in healing miracles was related to greater divine health deferral. Greater divine health deferral was associated with poorer symptoms of physical health. Belief in miracles was related to greater life satisfaction. Comparison of coefficients across models indicated that externalizing beliefs had a significant suppressor effect on the relationship between religious activity and physical symptoms, but did not significantly mediate its relationship with life satisfaction. Religious beliefs emphasizing divine control over health outcomes may have negative consequences for health outcomes, although the same beliefs may contribute to a better sense of life satisfaction.

Epidemiologic Analysis of Elective Operative Procedures in Infants Less Than 6 Months of Age in the United States.

PubMed

Einhorn, Lisa M; Young, Brian J; Routh, Jonathan C; Allori, Alexander C; Tracy, Elisabeth T; Greene, Nathaniel H

2017-11-01

This study uses publicly available data to analyze the total number of elective, potentially deferrable operative procedures involving infants <6 months of age in the United States. We investigated the factors associated with the performance of these procedures in this population. The State Ambulatory Surgery Database was used to identify patients in California, North Carolina, New York, and Utah during the years of 2007-2010 who were younger than 6 months of age at the time that they underwent outpatient (ambulatory) surgery. Operations that could reasonably be postponed until 6 months of age were classified as potentially deferrable procedures. Hernia repairs were analyzed separately from other deferrable procedures. Primary outcomes included the total number of elective procedures and the number and rates of potentially deferrable procedures per state per year in this population. Over the study period, a total of 27,540 procedures were identified as meeting inclusion criteria; of those, 7832 (28%) were classified as potentially deferrable, 4315 of which were hernia repairs. The average rates of potentially deferrable nonhernia procedures in California, North Carolina, New York, and Utah were 8.3, 43.8, 30.0, and 11.7 per 10,000 person-years, respectively. In multivariable analysis, private insurance (odds ratio [OR] = 1.36), self-pay status (OR = 1.50), and treatment in a different state (OR = 0.48-3.16) were independent predictors of a potentially deferrable procedure being performed on an infant younger than 6 months. Potentially deferrable procedures are still performed in infants <6 months of age. There appears to be significant variation in timing of these procedures among states. Insurance status and geography may be independent predictors of a procedure being potentially deferrable.

The rates, perceptions, and willingness of men who have sex with men to donate blood.

PubMed

Liszewski, Walter; Becerril, Jordan; Terndrup, Christopher; West, Nathan; Lavin, Bridget C; Schieffler, Danny; Van Sickels, Nicholas

2014-07-01

Since 1983 in the United States, any man who has had sex with another man (MSM) at any time since 1977 has been deferred from donating blood for life. Although there has been a push to change the deferral, there is a paucity of information on both the rates of MSM blood donation and the willingness of MSMs to donate if the deferral were changed. A 15-question survey was given at two lesbian, gay, bisexual, and transgender festivals in Chicago and New Orleans. Participants were asked about a previous history of blood donation and whether they would be willing to donate were the lifetime deferral changed. Participants were also asked to determine whether it was safe for hypothetical MSMs with varying sexual practices to donate blood and whether they believed that it was safe for them to donate their own blood. Our study found that 42.0% of all participants had not complied with the deferral policy and have donated blood at least once, with a mean number of donations of 4.84. Additionally, 85.9% of participants would be willing to donate blood if the deferral were changed. Despite the lifetime deferral, many MSMs have previously donated blood, and many more are willing to donate. Given this, along with the safe implementation of temporary deferral policies in other nations, the United States should consider adopting a temporary deferral policy for MSMs. © 2014 AABB.

What weighs more-low compliance with self-deferral or minor medical procedures? Explaining the high rate of hepatitis C virus window-period donations in Poland.

PubMed

Czerwinski, Michal; Grabarczyk, Piotr; Stepien, Malgorzata; Kubicka-Russel, Dorota; Tkaczuk, Katarzyna; Brojer, Ewa; Rosinska, Magdalena

2017-08-01

Since the introduction of nucleic acid testing (NAT) for routine blood donor screening, hepatitis C virus (HCV) RNA-only detection rates reported from Poland have been higher than in most other European countries. To examine factors that likely contribute to these window-period donations, we conducted a case-control study among 47 recently HCV-infected blood donors (cases), who gave blood between July 2002 and June 2014, and 141 controls matched by age, sex, and donation dates. Firth-corrected, conditional logistic regression models were fitted to estimate adjusted odds ratios and 95% confidence intervals. Adjusted population-attributable fractions were calculated based on the distribution of exposure among the cases. On multivariate analysis, recent exposures in health care environments not routinely ascertained through predonation questionnaires were strongly associated with recently acquired HCV infection. These exposures included minor medical and dental procedures in the preceding 6 months (adjusted odds ratio, 5.77; 95 % confidence interval, 2.01-18.53). However, based on the population-attributable fraction, more important were behavioral deferrable risks that went unreported at the time of donation, such as high-risk sexual behaviors in the preceding 6 months (population-attributable fraction, 34%) or lifetime histories of drug use (population-attributable fraction, 28%). This study raises questions about the effectiveness of deferral policy in excluding high-risk individuals. In addition, it provides further evidence supporting short, temporal deferrals for small medical procedures and dental treatments in Poland. © 2017 AABB.

47 CFR 1.1166 - Waivers, reductions and deferrals of regulatory fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fees. 1.1166 Section 1.1166 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND... deferrals of regulatory fees. The fees established by sections 1.1152 through 1.1156 may be waived, reduced... waiver, reduction or deferral of the fee would promote the public interest. Requests for waivers...

45 CFR 201.15 - Deferral of claims for Federal financial participation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES GRANTS TO STATES FOR PUBLIC ASSISTANCE PROGRAMS Review and Audits § 201.15 Deferral of claims for... (AABD), of the Social Security Act. (b) Definitions. (1) Deferral Action means the process of suspending... audit exception or financial management review. If a subsequent disallowance should occur, the State...

45 CFR 201.15 - Deferral of claims for Federal financial participation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES GRANTS TO STATES FOR PUBLIC ASSISTANCE PROGRAMS Review and Audits § 201.15 Deferral of claims for... (AABD), of the Social Security Act. (b) Definitions. (1) Deferral Action means the process of suspending... audit exception or financial management review. If a subsequent disallowance should occur, the State...

20 CFR 606.41 - High unemployment deferral.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false High unemployment deferral. 606.41 Section... UNDER THE FEDERAL UNEMPLOYMENT TAX ACT; ADVANCES UNDER TITLE XII OF THE SOCIAL SECURITY ACT Relief from Interest Payment § 606.41 High unemployment deferral. (a) Applicability. Subsection (b)(3)(C) of section...

20 CFR 606.41 - High unemployment deferral.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false High unemployment deferral. 606.41 Section... UNDER THE FEDERAL UNEMPLOYMENT TAX ACT; ADVANCES UNDER TITLE XII OF THE SOCIAL SECURITY ACT Relief from Interest Payment § 606.41 High unemployment deferral. (a) Applicability. Subsection (b)(3)(C) of section...

20 CFR 606.41 - High unemployment deferral.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 3 2014-04-01 2014-04-01 false High unemployment deferral. 606.41 Section... UNDER THE FEDERAL UNEMPLOYMENT TAX ACT; ADVANCES UNDER TITLE XII OF THE SOCIAL SECURITY ACT Relief from Interest Payment § 606.41 High unemployment deferral. (a) Applicability. Subsection (b)(3)(C) of section...

20 CFR 606.41 - High unemployment deferral.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false High unemployment deferral. 606.41 Section... UNDER THE FEDERAL UNEMPLOYMENT TAX ACT; ADVANCES UNDER TITLE XII OF THE SOCIAL SECURITY ACT Relief from Interest Payment § 606.41 High unemployment deferral. (a) Applicability. Subsection (b)(3)(C) of section...

20 CFR 606.41 - High unemployment deferral.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false High unemployment deferral. 606.41 Section... UNDER THE FEDERAL UNEMPLOYMENT TAX ACT; ADVANCES UNDER TITLE XII OF THE SOCIAL SECURITY ACT Relief from Interest Payment § 606.41 High unemployment deferral. (a) Applicability. Subsection (b)(3)(C) of section...

Donor understanding and attitudes about current and potential deferral criteria for high-risk sexual behavior.

PubMed

Goldman, Mindy; Yi, Qi-Long; Ye, Xibiao; Tessier, Lorna; O'Brien, Sheila F

2011-08-01

Few donor criteria are as contentious as the deferral of men who have had sex with men (MSM). We performed an anonymous donor survey to determine attitudes toward current screening and the feasibility and acceptability of adoption of alternate donor criteria for MSM. Donors who had successfully donated to Canadian Blood Services were randomly mailed an anonymous questionnaire several weeks after donation; there were 40,000 donors sampled, evenly split between first-time and repeat donors. The response rate was 45.5%. The vast majority of donors found the current screening questions and clinic environment acceptable. Attention to clinic educational materials was poor. A total of 53% felt that the MSM criteria should be changed; many were supportive of criteria based on specific behaviors rather than a period of abstinence. Gender-neutral questions such as number of sexual partners would result in deferral of large numbers of donors. Many donors would support a change in MSM deferral policy. Implementation of strategies based on donor attention to additional material would be challenging. Universal use of simple gender-neutral questions would result in very high donor loss and are therefore not an acceptable option. The acceptability and feasibility of various screening approaches should be explored further with both donors and advocacy groups. © 2011 American Association of Blood Banks.

A population management system for improving colorectal cancer screening in a primary care setting.

PubMed

Wu, Charlotte A; Mulder, Amara L; Zai, Adrian H; Hu, Yuanshan; Costa, Manuela; Tishler, Lori Wiviott; Saltzman, John R; Ellner, Andrew L; Bitton, Asaf

2016-06-01

Provision of colorectal cancer (CRC) screening in primary care is suboptimal; failure to observe screening guidelines poses unnecessary risks to patients and doctors. Implement a population management system for CRC screening; evaluate impact on compliance with evidence-based guidelines. A quasi-experimental, prospective quality improvement study design using pre-post-analyses with concurrent controls. Six suites within an academic primary care practice. 5320 adults eligible for CRC screening treated by 70 doctors. In three intervention suites, doctors reviewed real-time rosters of patients due for CRC screening and chose practice delegate outreach or default reminder letter. Delegates tracked overdue patients, made outreach calls, facilitated test ordering, obtained records and documented patient deferral, exclusion or decline. In three control suites, doctors followed usual preventive care practices. CRC screening compliance (including documented decline, deferral or exclusion) and CRC screening completion rates over 5 months. At baseline, there was no significant difference in CRC screening compliance (I: 80.4% and C: 79.6%, P = 0.439) and CRC screening completion rates (I: 78.3% and C: 77.3%, P = 0.398) between intervention and control groups. Post-intervention, compliance rates (I: 88.1% and C: 80.5%, P < 0.01) and completion rates (I: 81.0% and C: 78.1%, P < 0.05) were significantly higher in the intervention group. A population management system using closed-loop communication may improve CRC screening compliance and completion rates within academic primary care practices. Team-based care using well-designed IT systems can enable sharing of patient care responsibilities and improve patient outcomes. © 2015 John Wiley & Sons, Ltd.

31 CFR 339.4 - Exchanges without tax deferral.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Exchanges without tax deferral. 339.4... SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT EXCHANGE OFFERING OF UNITED STATES SAVINGS BONDS, SERIES H § 339.4 Exchanges without tax deferral. Exchanges by owners who: (a) Report the interest...

27 CFR 41.114a - Qualification for extended deferral.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Qualification for extended... Qualification for extended deferral. Note: This section applies only to removals made before January 1, 1983. (a... of the extended deferral permitted by § 41.114 shall file with the appropriate TTB officer an...

27 CFR 41.114a - Qualification for extended deferral.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Qualification for extended... Qualification for extended deferral. Note: This section applies only to removals made before January 1, 1983. (a... of the extended deferral permitted by § 41.114 shall file with the appropriate TTB officer an...

27 CFR 41.114a - Qualification for extended deferral.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Qualification for extended... Qualification for extended deferral. Note: This section applies only to removals made before January 1, 1983. (a... of the extended deferral permitted by § 41.114 shall file with the appropriate TTB officer an...

Blood donation and institutional trust: risk, policy rhetoric, and the men who have sex with men lifetime deferral policy in Canada.

PubMed

Smith, André; Fiddler, Jay; Walby, Kevin; Hier, Sean

2011-11-01

This article examines the process of rebuilding institutional trust in the Canadian blood system in the aftermath of the tainted blood scandal. Our focus is the policy of lifetime deferral from donating blood for men who have sex with men. Drawing on findings from interviews with representatives of Health Canada's Expert Advisory Committee on Blood Regulation, the National Liaison Committee, Canadian Blood Services, and blood consumer groups, we demonstrate how claims making about rights, discrimination, science, and risk contribute to policy continuity. We also examine the link between policy continuity and the management of reputational risk.

Blood donation, deferral, and discrimination: FDA donor deferral policy for men who have sex with men.

PubMed

Galarneau, Charlene

2010-02-01

U.S. Food and Drug Administration (FDA) policy prohibits blood donation from men who have had sex with men (MSM) even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy.

Self-Deferral, HIV Infection, and the Blood Supply: Evaluating an AIDS Intervention.

ERIC Educational Resources Information Center

Kaplan, Edward H.; Novick, Alvin

1990-01-01

This paper evaluates the effectiveness of self-deferral, a social screen implemented to protect the U.S. blood supply from human immunodeficiency virus (HIV) infection prior to the advent of laboratory testing. Mathematical models are developed to estimate the number of infectious transfusions ultimately leading to AIDS prior to self-deferral.…

77 FR 73671 - Agency Information Collection Activities: Deferral of Duty on Large Yachts Imported for Sale

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... Activities: Deferral of Duty on Large Yachts Imported for Sale AGENCY: U.S. Customs and Border Protection... of Duty on Large Yachts Imported for Sale. This is a proposed extension of an information collection... information collection: Title: Deferral of Duty on Large Yachts Imported for Sale. OMB Number: 1651-0080. Form...

Attitudes, perceptions and knowledge among men who have sex with men towards the blood donation deferral policy in Israel

PubMed Central

Olmer, Liraz; Livnat, Yuval; Yanko, Adir; Shinar, Eilat

2017-01-01

Background Men who have sex with men (MSM) are permanently deferred from donating blood in Israel. Pressure to change this policy exists, despite data showing higher prevalence and incidence of HIV in MSM. A survey was conducted to evaluate current knowledge, attitudes, perceptions and compliance if deferral was changed. Study design and methods Anonymous survey was published in a gay-oriented website, collecting demographic information, history of blood donation, attitudes, knowledge and compliance with permanent versus temporary deferral. Responses were analyzed given 1 point for every "yes" response (0–7 points). Student’s t-test was applied to compare differences between continuous variables. Correlations were described with the Pearson correlation coefficient. Results Responses from 492 MSM were analyzed. Average age was 31±9 years. 76% donated blood at least once, mostly for social solidarity (score of 3.2 on 1–5 scale). Tests seeking or protest scores were 1.7 and 1.6, respectively. 66% were unaware of the higher risk of HIV transmission by MSM, or the potential to infect 3 recipients. Knowledge regarding HIV transmission by blood positively correlated with knowledge regarding other routes of HIV transmission (r = 0.11; p = 0.03), age (r = 0.10; p = 0.04), and higher rate of non-compliance with the current deferral policy (OR = 1.9; p = 0.02). Activism for LGBT rights was associated with lower risk for non-adherence (OR = 0.5; p = 0.03). If temporary deferral is introduced 66% will comply with the new policy, but 23% will continue to donate as long as MSM deferral policy is in place. Conclusion A high proportion of MSM do not comply with the current lifetime deferral. This may partially change if temporary deferral is introduced. PMID:28152072

Attitudes, perceptions and knowledge among men who have sex with men towards the blood donation deferral policy in Israel.

PubMed

Levy, Itzchak; Olmer, Liraz; Livnat, Yuval; Yanko, Adir; Shinar, Eilat

2017-01-01

Men who have sex with men (MSM) are permanently deferred from donating blood in Israel. Pressure to change this policy exists, despite data showing higher prevalence and incidence of HIV in MSM. A survey was conducted to evaluate current knowledge, attitudes, perceptions and compliance if deferral was changed. Anonymous survey was published in a gay-oriented website, collecting demographic information, history of blood donation, attitudes, knowledge and compliance with permanent versus temporary deferral. Responses were analyzed given 1 point for every "yes" response (0-7 points). Student's t-test was applied to compare differences between continuous variables. Correlations were described with the Pearson correlation coefficient. Responses from 492 MSM were analyzed. Average age was 31±9 years. 76% donated blood at least once, mostly for social solidarity (score of 3.2 on 1-5 scale). Tests seeking or protest scores were 1.7 and 1.6, respectively. 66% were unaware of the higher risk of HIV transmission by MSM, or the potential to infect 3 recipients. Knowledge regarding HIV transmission by blood positively correlated with knowledge regarding other routes of HIV transmission (r = 0.11; p = 0.03), age (r = 0.10; p = 0.04), and higher rate of non-compliance with the current deferral policy (OR = 1.9; p = 0.02). Activism for LGBT rights was associated with lower risk for non-adherence (OR = 0.5; p = 0.03). If temporary deferral is introduced 66% will comply with the new policy, but 23% will continue to donate as long as MSM deferral policy is in place. A high proportion of MSM do not comply with the current lifetime deferral. This may partially change if temporary deferral is introduced.

26 CFR 1.706-1 - Taxable years of partner and partnership.

Code of Federal Regulations, 2010 CFR

2010-04-01

... a taxable year elected under section 444, or establishes a business purpose for such taxable year...: Test 12/31 Year end Interest inpartnership profits Months of deferral for 12/31 year end Interest×deferral Partner A 12/31 .5 0 0 Partner B 11/30 .5 11 5.5 Aggregate deferral 5.5 Test 11/30 Year end...

If the permanent deferral were lifted would men who have sex with men want to donate blood, and if so, who would be eligible?

PubMed

Belanger, Geoffrey A; McFarland, Willi; Raymond, H Fisher; Custer, Brian

2013-11-01

The deferral of men who have sex with men (MSM) from blood donation is controversial worldwide, with national policies varying from no explicit deferral to permanent deferral. This study assesses whether MSM have donated and would be interested in donating if the US exclusion policy were removed and who would be eligible to donate if the policy were modified to a temporary or lower-risk deferral criterion. Questions about previous blood donation and interest in future donation were added to the National HIV Behavioral Surveillance survey questionnaire, which periodically gathers risk behavior information from MSM in San Francisco. Overall, 77.3% of 475 MSM respondents expressed interest in donating. By lower-risk criteria, 10.1% had no sexual contact in the past 6 months (2.3% in the past 12 months) and 1.9% had only lower-risk sexual contact in the past 6 months (1.5% in the past 12 months). Of the 23.4% who answered yes to having donated in the past, at least 25.2% did not comply with the current deferral of no male-male sex since 1977. The majority of MSM are interested in donating blood. Depending on how the policy would be changed (i.e., either a temporary or a behavior-based deferral criterion), substantial numbers of MSM would be eligible. © 2013 American Association of Blood Banks.

Eligibility and willingness to donate blood in men who have (had) sex with men.

PubMed

Romeijn, Bas; Merz, Eva-Maria; Kok, Gerjo; de Kort, Wim; van Dongen, Anne

2018-03-01

Several countries have changed, or are reevaluating, their blood donor policies for men who have had sex with men (MSM). Changing policies has consequences for donor recruitment and the donor pool. In this study, we investigated whether MSM are eligible and willing to donate blood. Members of a research panel (n = 4422) in the Netherlands were invited to participate in an online survey. We asked questions about male-to-male sex and risk behavior that are also asked during the predonation screening of a blood donor. Furthermore, we asked questions about willingness to donate. The total response rate was 60% (n = 2654). Of MSM nondonors (n = 230), 32.2% would be eligible to donate under a 12-month deferral policy, according to their reported risk history and last male-to-male sex. In other scenarios, 42.6% (4-month deferral), 38.7% (6-month deferral), and 18.7% (5-year deferral) would be eligible to donate. When not taking their last male-to-male sex into account (n = 203), 47.8% of MSM reported a moderate or high willingness to donate. A 12-month deferral after last male-to-male sex is a commonly used criterion by blood services. Approximately one-third of the MSM in our study would be eligible to donate under this deferral policy. Higher proportions of MSM would be eligible to donate in shorter deferral scenarios. Almost half of MSM are willing to donate blood. Targeting MSM by donor recruitment campaigns could therefore prove fruitful. © 2017 AABB.

19 CFR Appendix C to Part 113 - Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows

Code of Federal Regulations, 2014 CFR

2014-04-01

... for Sale at United States Boat Shows C Appendix C to Part 113 Customs Duties U.S. CUSTOMS AND BORDER... Appendix C to Part 113—Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows ____, as...

19 CFR Appendix C to Part 113 - Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows

Code of Federal Regulations, 2013 CFR

2013-04-01

... for Sale at United States Boat Shows C Appendix C to Part 113 Customs Duties U.S. CUSTOMS AND BORDER... Appendix C to Part 113—Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows ____, as...

19 CFR Appendix C to Part 113 - Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows

Code of Federal Regulations, 2012 CFR

2012-04-01

... for Sale at United States Boat Shows C Appendix C to Part 113 Customs Duties U.S. CUSTOMS AND BORDER... Appendix C to Part 113—Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows Bond for Deferral of Duty on Large Yachts Imported for Sale at United States Boat Shows ____, as...

The Prevalence and Antecedents of Religious Beliefs About Health Control in the US Population: Variations by Race and Religious Background.

PubMed

Hayward, R David; Krause, Neal; Pargament, Kenneth

2017-12-01

The ways in which religious beliefs influence beliefs about health have important implications for motivation to engage in positive health behaviors and comply with medical treatment. This study examines the prevalence of two health-related religious beliefs: belief in healing miracles and deferral of responsibility for health outcomes to God. Data came from a representative nationwide US survey of religion and health (N = 3010). Full-factorial ANOVA indicated that there were significant differences in both dimensions of belief by race, by religious background, and by the interaction between the two. Black people believed religion played the largest role in health regardless of religious background. Among White and Hispanic groups, Evangelical Protestants placed more responsibility for their health on God in comparison with other religious groups. ANCOVA controlling for background factors socioeconomic status, health, and religious involvement partially explained these group differences.

Changes in the Whole Blood Donor Population in South-West Germany: 2010 versus 2016

PubMed Central

Müller-Steinhardt, Michael; Weidmann, Christian; Klüter, Harald

2017-01-01

Background In the recent past, the discrepancy between blood supply and future demand may have been overestimated. As medical progress develops rapidly, it will be essential to monitor ongoing demographic changes in the donor population regularly and to re-evaluate retention and recruiting strategies. The aim of the current study was to compare first-time donor (FTD) characteristics and their return rates. We therefore compared whole blood (WB) donations in total and the annual donation frequencies in 2010 and in 2015/2016. Furthermore, we evaluated whether over the same observation period, medical reasons for deferral underwent a change (2010 vs. 2015). Methods The return probability of FTD within 12 months was analysed in 2010 and 2015 with respect to successful donation versus deferral and with regard to age. The total number of WB donations was investigated, and age distribution was compared between 2010, 2013 and 2016. WB donation frequencies were calculated with respect to age and gender in 2010 and 2016. In a second analysis, medical reasons for deferral were differentiated into 14 categories and a possible impact of time (2010 vs. 2015) on the respective percentage was studied. Results We observed a significant decline of the FTD return rate from 42.5% to 38.8% in donors that successfully donated WB while the rate remained unchanged in deferred FTD. At the same time the mean FTD age decreased from 29.1 ± 11.6 to 28.5 ± 11.7 years in 2016. Analysis of total WB donations revealed an increase of all donations from donors ≥60 years, a constant percentage from donors <30 years but a declining proportion of donors aged 30–59 years from 2010 to 2013 to 2016. In parallel, annual mean WB donation frequencies decreased over time. Deferrals due to travel history increased significantly from 2010 to 2015 both in FTD and repeat donors. Conclusion There is ongoing demographic change in our WB donor population. Our data prove a need for a re-evaluation of retention and recruitment strategies since previous marketing campaigns seem to have neglected the age group 30–59 years. This must be addressed in further studies as this age group will be highly relevant for assuring future blood supplies since donor recruitment from adolescents will be limited due to declining birth rates. Furthermore, deferral due to travel history is increasing significantly. Thus we will require further studies on the possible impact on donor retention. PMID:28924426

10 CFR 626.8 - Deferrals of contractually scheduled deliveries.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PETROLEUM FOR THE STRATEGIC PETROLEUM RESERVE § 626.8 Deferrals of contractually scheduled deliveries. (a) General. (1) DOE prefers to take deliveries of petroleum for the SPR at times scheduled under applicable...

10 CFR 626.8 - Deferrals of contractually scheduled deliveries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PETROLEUM FOR THE STRATEGIC PETROLEUM RESERVE § 626.8 Deferrals of contractually scheduled deliveries. (a) General. (1) DOE prefers to take deliveries of petroleum for the SPR at times scheduled under applicable...

Postoperative Radiotherapy Patterns of Care and Survival Implications for Medulloblastoma in Young Children.

PubMed

Kann, Benjamin H; Park, Henry S; Lester-Coll, Nataniel H; Yeboa, Debra N; Benitez, Viviana; Khan, Atif J; Bindra, Ranjit S; Marks, Asher M; Roberts, Kenneth B

2016-12-01

Postoperative radiotherapy to the craniospinal axis is standard-of-care for pediatric medulloblastoma but is associated with long-term morbidity, particularly in young children. With the advent of modern adjuvant chemotherapy strategies, postoperative radiotherapy deferral has gained acceptance in children younger than 3 years, although it remains controversial in older children. To analyze recent postoperative radiotherapy national treatment patterns and implications for overall survival in patients with medulloblastoma ages 3 to 8 years. Using the National Cancer Data Base, patients ages 3 to 8 years diagnosed as having histologically confirmed medulloblastoma in 2004 to 2012, without distant metastases, who underwent surgery and adjuvant chemotherapy with or without postoperative radiotherapy at facilities nationwide accredited by the Commission on Cancer were identified. Patients were designated as having "postoperative radiotherapy upfront" if they received radiotherapy within 90 days of surgery or "postoperative radiotherapy deferred" otherwise. Factors associated with postoperative radiotherapy deferral were identified using multivariable logistic regression. Overall survival (OS) was compared using Kaplan-Meier analysis with log-rank tests and multivariable Cox regression. Statistical tests were 2-sided. Postoperative radiotherapy utilization and overall survival. Among 816 patients, 123 (15.1%) had postoperative radiotherapy deferred, and 693 (84.9%) had postoperative radiotherapy upfront; 36.8% of 3-year-olds and 4.1% of 8-year-olds had postoperative radiotherapy deferred (P < .001). On multivariable logistic regression, variables associated with postoperative radiotherapy deferral were age (odds ratio [OR], 0.57 per year; 95% CI, 0.49-0.67 per year) and year of diagnosis (OR, 1.18 per year; 95% CI, 1.08-1.29 per year). On survival analysis, with median follow-up of 4.8 years, OS was improved for those receiving postoperative radiotherapy upfront vs postoperative radiotherapy deferred (5-year OS: 82.0% vs 63.4%; P < .001). On multivariable analysis, variables associated with poorer OS were postoperative radiotherapy deferral (hazards ratio [HR], 1.95; 95% CI, 1.15-3.31); stage M1-3 disease (HR, 1.86; 95% CI, 1.10-3.16), and low facility volume (HR, 1.75; 95% CI, 1.04-2.94). Our national database analysis reveals a higher-than-expected and increasing rate of postoperative radiotherapy deferral in children with medulloblastoma ages 3 to 8 years. The analysis suggests that postoperative radiotherapy deferral is associated with worse survival in this age group, even in the modern era of chemotherapy.

Blood Donor Deferral among Students in Northern Japan: Challenges Ahead

PubMed Central

Ngoma, Alain Mayindu; Goto, Aya; Nollet, Kenneth E.; Sawamura, Yoshihiro; Ohto, Hitoshi; Yasumura, Seiji

2014-01-01

Summary Background As Japan's aging society needs more blood, young students comprise a progressively smaller portion of the donor pool. To ensure a safe and sustainable blood supply, it is crucial to select suitable donors. This study aims to evaluate donor deferral rates, causes of deferral, and characteristics of deferred Japanese students. Methods Computerized records of blood centers in northern Japan (Miyagi and Fukushima Prefectures) from March 2010 through March 2011 were retrospectively analyzed. Results Among 231,361 individuals visiting during the 12-month period, 24,778 were students. Of these, 19,193 (77%) attempted donation, and 5,585 (23%) were deferred. Low hemoglobin, questionnaire-based interview decisions, and medication were the main reasons for temporary deferral. Age, sex, and blood center location were associated with low hemoglobin; donation history and blood center location were associated with medication-based deferral. The odds ratio among female students deferred for low hemoglobin was 35.48 with a 95% CI of 27.74–45.38. Conclusions These results suggest that continued efforts are needed to motivate deferred potential donors to return, to prevent low hemoglobin especially among females, and to review medical interview decisions, while paying close attention to regional differences. PMID:25254020

31 CFR 800.403 - Deferral, rejection, or disposition of certain voluntary notices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS PERTAINING TO MERGERS, ACQUISITIONS, AND TAKEOVERS BY FOREIGN PERSONS Notice § 800.403 Deferral... acquisition by Company A, a foreign person, of the entire interest in Company X, a U.S. business. The notice...

An end to lifetime blood donation ban in Israel for MSM would be a major step toward a science-based policy that reduces stigma.

PubMed

Cahill, Sean; Wang, Timothy

2017-01-01

In recent years, countries around the world have revised their blood donation policies regarding gay and bisexual men, and other men who have sex with men (MSM). The United States lifted the lifetime ban on MSM from donating blood in 2015, replacing it with a 1 year deferral policy allowing MSM to donate if they abstain from sex for 12 months. Other countries followed suit, while Italy and Spain have implemented deferral policies based on individual risk assessments regardless of sexual orientation. If Israel were to adopt a one year deferral policy for MSM, as recommended by Drs. Ginsberg et al. in this issue, the increase in risk to the blood supply would be minimal. Moving to a 1 year deferral policy would be an important step forward, but it could still be seen as stigmatizing to gay and bisexual men. We recommend that Israel consider a deferral policy based on individual risk assessment rather than a blanket deferral for all MSM. MSM can engage in low- and high-risk sexual behaviors. Those who consistently engage in low-risk behaviors, such as using condoms and pre-exposure prophylaxis consistently, pose little risk to the blood supply. An individual risk assessment policy would screen potential donors of all sexual orientations for low-, medium-, and high-risk behaviors. Potential donors identified as high-risk, such as injection drug users, would justifiably be subject to lengthy or permanent bans. MSM who engage in low-risk sexual behaviors would be allowed to donate without deferral. Medium-risk donors, such as men who have recently had unprotected anal sex with another man, would be subject to a deferral period of 1 month, which is in line with the window period of current HIV screening technology. Most fourth generation HIV tests can detect HIV within a month, and the nucleic acid test used to screen blood can detect HIV in just 9-11 days. Various studies have developed questions for ascertaining HIV risk among MSM which could be used in blood donor questionnaires. Using tablets or other technology that enhances privacy to conduct the blood donor questionnaire could improve collection of this sensitive information.

Should Men who have sex with Men be allowed to donate blood in Israel?

PubMed

Ginsberg, Gary Michael; Shinar, Eilat; Kopel, Eran; Chemtob, Daniel

2016-01-01

The present permanent deferral policy in Israel for MSM was established in 1977 and was based on the previous (now outdated) USA Food and Drug Administration standards. This study analyses epidemiological data regarding blood donations among MSM, in order to estimate the risk for HIV transfusion transmitted infection (TTI) if the policy is changed to allow at-risk MSM to donate blood. An Excel based spreadsheet model integrated demographic, epidemiological data from the HIV National Register, laboratory, blood donation and testing data in order to calculate TTI due to false-negatives in known HIV+ donors, windows period donations, asymptomatic carriers and laboratory misclassification errors. A sensitivity analysis of our estimated TTIs for deferral periods for MSM was performed based on a literature review regarding this overall policy issue worldwide. MSM in Israel have a considerably higher relative risk (RR) of both prevalence (115) and incidence (143) of being HIV+ than persons without a risk factor. Allowing MSM to donate blood, without any deferral period, will add an additional five HIV TTI cases over the next decade. Imposition of a 1 or 5 years deferral of abstinence will increase the number of HIV TTI cases only by 0.10 and 0.05 cases, respectively. A 1 year deferral period for blood donations from MSM in Israel is recommended.

Is a Dream Deferred a Dream Denied? College Enrollment and Labor Market Search. Working Paper

ERIC Educational Resources Information Center

Perez-Arce, Francisco

2011-01-01

A public college in Mexico City randomly assigns applicants into a group that can immediately enroll and a group that can only do so after one year. The author shows that the standard model of educational decisions predicts no (or minimal) effect of deferral on educational attainment. He surveyed the applicants to this college for the 2007/2008…

A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India.

PubMed

Arora, Disha; Garg, Ketan; Kaushik, Ankit; Sharma, Richa; Rawat, D S; Mandal, A K

2016-11-01

With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Records of single donor apheresis were retrospectively analysed from 1 st January 2010 to 31 st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included - age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors.

Factors associated with a second deferral among donors eligible for re-entry after a false-positive screening test for syphilis, HCV, HBV and HIV.

PubMed

Grégoire, Y; Germain, M; Delage, G

2018-05-01

Since 25 May 2010, all donors at our blood centre who tested false-positive for HIV, HBV, HCV or syphilis are eligible for re-entry after further testing. Donors who have a second false-positive screening test, either during qualification for or after re-entry, are deferred for life. This study reports on factors associated with the occurrence of such deferrals. Rates of second false-positive results were compared by year of deferral, transmissible disease marker, gender, age, donor status (new or repeat) and testing platform (same or different) both at qualification for re-entry and afterwards. Chi-square tests were used to compare proportions. Cox regression was used for multivariate analyses. Participation rates in the re-entry programme were 42·1%: 25·6% failed to qualify for re-entry [different platform: 2·7%; same platform: 42·9% (P < 0·0001)]. After re-entry, rates of deferral for second false-positive results were 8·4% after 3 years [different platform: 1·8%; same platform: 21·4% (P < 0·0001)]. Deferral rates were higher for HIV and HCV than for HBV at qualification when tested on the same platform. The risk, when analysed by multivariate analyses, of a second deferral for a false-positive result, both at qualification and 3 years after re-entry, was lower for donors deferred on a different platform; this risk was higher for HIV, HCV and syphilis than for HBV and for new donors if tested on the same platform. Re-entry is more often successful when donors are tested on a testing platform different from the one on which they obtained their first false-positive result. © 2018 International Society of Blood Transfusion.

20 CFR 1002.262 - When is the employer required to make the plan contribution that is attributable to the employee...

Code of Federal Regulations, 2010 CFR

2010-04-01

... allowed (but not required) to make up his or her missed contributions or elective deferrals. These makeup..., with the repayment period not to exceed five years. Makeup contributions or elective deferrals may only...

34 CFR 200.9 - Deferral of assessments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Deferral of assessments. 200.9 Section 200.9 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic...

34 CFR 200.9 - Deferral of assessments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Deferral of assessments. 200.9 Section 200.9 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic...

34 CFR 200.9 - Deferral of assessments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Deferral of assessments. 200.9 Section 200.9 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic...

Predictors of low haematocrit among repeat donors in São Paulo, Brazil: eleven year longitudinal analysis.

PubMed

Almeida, Fernanda N; Sabino, Ester C; Tunes, Gisela; Schreiber, George B; da Silva, Pedro Paulo S B; Carneiro-Proietti, Anna Barbara F; Ferreira, João Eduardo; Mendrone, Alfredo

2013-12-01

Few longitudinal studies have examined the long-term effect on deferral for low haematocrit (Hct) or haemoglobin, indicators of presence of anaemia. This study retrospectively analysed 11 years of donation history to examine predictors related to such deferrals among repeat blood donors. We included 385,357 donors with at least two visits to the blood centre between January 1996 and December 2006 who were not deferred due to haematocrit at their first visit. We evaluated variables related to the development of low Hct (LHct-below 38% for females and 39% for males) after whole blood donations. Over the 11-year period, 3,850 (1.5%) of the 252,301 males and 18,104 (13.6%) of the 133,056 females were deferred due to LHct at some point after their first donation. Genders, age, baseline Hct, Hct at the visit immediately before deferral due to LHct, and interval between donations, were associated with higher rates of development of LHct in repeat donors. Our analysis showed that deferral due to low Hct levels in repeat blood donors is highly prevalent in Brazil. Assigning longer donations intervals based on the Hct levels at the qualifying donation or supplementing iron to donors at risk may decrease deferral rate of donors with low Hct. Copyright © 2013 Elsevier Ltd. All rights reserved.

26 CFR 1.409A-0 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... unforeseeable emergency. (4) Disability. (i) In general. (ii) Limited plan definition of disability. (iii) Determination of disability. (5) Change in the ownership or effective control of a corporation, or a change in... upon income inclusion under section 409A. (viii) Cancellation of deferrals following an unforeseeable...

76 FR 71707 - Revising Underground Storage Tank Regulations-Revisions to Existing Requirements and New...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... Equipment C. Addressing Deferrals 1. Emergency Power Generator UST Systems 2. Airport Hydrant Fuel.... Maintain Deferral for USTs Containing Radioactive Material and Emergency Generator UST Systems at Nuclear... (air, water, 481, 483-486, 48811. truck, transit, pipeline, and airport operations). Communications and...

78 FR 50421 - Guidance for Industry: Recommendations for Donor Questioning, Deferral, Reentry, and Product...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

..., Reentry, and Product Management To Reduce the Risk of Transfusion-Transmitted Malaria; Availability AGENCY... Questioning, Deferral, Reentry and Product Management to Reduce the Risk of Transfusion-Transmitted Malaria... their reentry, and product management to reduce the risk of transfusion-transmitted malaria. This...

45 CFR 201.15 - Deferral of claims for Federal financial participation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Deferral of claims for Federal financial participation. 201.15 Section 201.15 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...

45 CFR 201.15 - Deferral of claims for Federal financial participation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Deferral of claims for Federal financial participation. 201.15 Section 201.15 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...

45 CFR 201.15 - Deferral of claims for Federal financial participation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Deferral of claims for Federal financial participation. 201.15 Section 201.15 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...

76 FR 60029 - Notice of Issuance Technical Bulletin 2011-2, Extended Deferral of the Effective Date of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Issuance Technical Bulletin 2011-2, Extended Deferral of the Effective Date of Technical Bulletin 2006-1 AGENCY: Federal Accounting Standards Advisory... hereby given that the Federal Accounting Standards Advisory Board (FASAB) has issued Technical Bulletin...

29 CFR 1601.13 - Filing; deferrals to State and local agencies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State and local agencies. The Commission shall endeavor to maintain close communication with the State... deemed to be filed with the Commission as follows: (A) Where the document on its face constitutes a... 29 Labor 4 2010-07-01 2010-07-01 false Filing; deferrals to State and local agencies. 1601.13...

78 FR 48230 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

... provide rules regarding the deferral of gain on a partnership's sale of qualified small business stock and deferral of gain on a partner's sale of qualified small business stock distributed by a partnership. The... functions of the agency, including whether the information shall have practical utility; (b) the accuracy of...

76 FR 40908 - Notice of Issuance of Statement of Federal Financial Accounting Standards 41, Deferral of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Issuance of Statement of Federal Financial Accounting Standards 41, Deferral of the Effective Date of SFFAS 38, Accounting for Federal Oil and Gas Resources, and Issuance of Final Technical Bulletin 2011-1, Accounting for Federal Natural Resources Other...

75 FR 8367 - Proposed Collection; Comment Request; REDS-II-Does Pre-Donation Behavioral Deferral Increase the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

... on sexual behavior deferrals and their impact on blood safety. The two main study aims are: (1) To assess infectious disease marker prevalence in donors who are deferred for higher risk sexual and non... Officer, NHLBI, Two Rockledge Center, Suite 10042, 6701 Rockledge Drive, Bethesda, MD 20892-7950, or call...

75 FR 25268 - Submission for OMB Review; Comment Request; REDS-II-Does Pre-Donation Behavioral Deferral...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... on sexual behavior deferrals and their impact on blood safety. The two main study aims are: (1) To assess infectious disease marker prevalence in donors who are deferred for higher risk sexual and non.... George Nemo, Project Officer, NHLBI, Two Rockledge Center, Suite 10042, 6701 Rockledge Drive, Bethesda...

26 CFR 1.402(g)-1 - Limitation on exclusion for elective deferrals.

Code of Federal Regulations, 2012 CFR

2012-04-01

....402(g)-1 Section 1.402(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-1 Limitation on exclusion for elective deferrals. (a) In general. The excess of an... income for the taxable year on account of section 402(a)(8) (before applying the limits of section 402(g...

34 CFR 386.42 - What must a scholar do to obtain a deferral or exception to performance or repayment under a...

Code of Federal Regulations, 2014 CFR

2014-07-01

... to performance or repayment under a scholarship agreement? 386.42 Section 386.42 Education... performance or repayment under a scholarship agreement? To obtain a deferral or exception to performance or repayment under a scholarship agreement, a scholar shall provide the following: (a) Written application. A...

34 CFR 386.42 - What must a scholar do to obtain a deferral or exception to performance or repayment under a...

Code of Federal Regulations, 2010 CFR

2010-07-01

... exception to performance or repayment under a scholarship agreement? 386.42 Section 386.42 Education... performance or repayment under a scholarship agreement? To obtain a deferral or exception to performance or repayment under a scholarship agreement, a scholar shall provide the following: (a) Written application. A...

34 CFR 386.42 - What must a scholar do to obtain a deferral or exception to performance or repayment under a...

Code of Federal Regulations, 2011 CFR

2011-07-01

... to performance or repayment under a scholarship agreement? 386.42 Section 386.42 Education... performance or repayment under a scholarship agreement? To obtain a deferral or exception to performance or repayment under a scholarship agreement, a scholar shall provide the following: (a) Written application. A...

34 CFR 386.42 - What must a scholar do to obtain a deferral or exception to performance or repayment under a...

Code of Federal Regulations, 2012 CFR

2012-07-01

... exception to performance or repayment under a scholarship agreement? 386.42 Section 386.42 Education... performance or repayment under a scholarship agreement? To obtain a deferral or exception to performance or repayment under a scholarship agreement, a scholar shall provide the following: (a) Written application. A...

34 CFR 386.42 - What must a scholar do to obtain a deferral or exception to performance or repayment under a...

Code of Federal Regulations, 2013 CFR

2013-07-01

... exception to performance or repayment under a scholarship agreement? 386.42 Section 386.42 Education... performance or repayment under a scholarship agreement? To obtain a deferral or exception to performance or repayment under a scholarship agreement, a scholar shall provide the following: (a) Written application. A...

75 FR 23265 - Submission for OMB Review; Comment Request; Investigating the Causes of Post Donation Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... displays a current valid OMB control number. Proposed Collection: Title: Investigating the causes of post...; Comment Request; Investigating the Causes of Post Donation Information (PDI): Errors in the Donor... Post Donation Information (PDI). While this deferral risk may be at the next donation event, many...

Deconstructing the risk for malaria in United States donors deferred for travel to Mexico.

PubMed

Spencer, Bryan; Kleinman, Steven; Custer, Brian; Cable, Ritchard; Wilkinson, Susan L; Steele, Whitney; High, Patrick M; Wright, David

2011-11-01

More than 66,000 blood donors are deferred annually in the United States due to travel to malaria-endemic areas of Mexico. Mexico accounts for the largest share of malaria travel deferrals, yet it has extremely low risk for malaria transmission throughout most of its national territory, suggesting a suboptimal balance between blood safety and availability. This study sought to determine whether donor deferral requirements might be relaxed for parts of Mexico without compromising blood safety. Travel destination was recorded from a representative sample of presenting blood donors deferred for malaria travel from six blood centers during 2006. We imputed to these donors reporting Mexican travel a risk for acquiring malaria equivalent to Mexican residents in the destination location, adjusted for length of stay. We extrapolated these results to the overall US blood donor population. Risk for malaria in Mexico varies significantly across endemic areas and is greatest in areas infrequently visited by study donors. More than 70% of blood donor deferrals were triggered by travel to the state of Quintana Roo on the Yucatán Peninsula, an area of very low malaria transmission. Eliminating the travel deferral requirement for all areas except the state of Oaxaca might result in the recovery of almost 65,000 blood donors annually at risk of approximately one contaminated unit collected every 20 years. Deferral requirements should be relaxed for presenting donors who traveled to areas within Mexico that confer exceptionally small risks for malaria, such as Quintana Roo. © 2011 American Association of Blood Banks.

Deconstructing the Risk for Malaria in United States Donors Deferred for Travel to Mexico

PubMed Central

Spencer, Bryan; Kleinman, Steven; Custer, Brian; Cable, Ritchard; Wilkinson, Susan L; Steele, Whitney; High, Patrick M; Wright, David

2013-01-01

Background More than 66,000 blood donors are deferred annually in the U.S. due to travel to malaria-endemic areas of Mexico. Mexico accounts for the largest share of malaria travel deferrals, yet it has extremely low risk for malaria transmission throughout most of its national territory, suggesting a suboptimal balance between blood safety and availability. This study sought to determine whether donor deferral requirements might be relaxed for parts of Mexico without compromising blood safety. Study Design and Methods Travel destination was recorded from a representative sample of presenting blood donors deferred for malaria travel from six blood centers during 2006. We imputed to these donors reporting Mexican travel a risk for acquiring malaria equivalent to Mexican residents in the destination location, adjusted for length of stay. We extrapolated these results to the overall U.S. blood donor population. Results Risk for malaria in Mexico varies significantly across endemic areas and is greatest in areas infrequently visited by study donors. Over 70% of blood donor deferrals were triggered by travel to the state of Quintana Roo on the Yucatán Peninsula, an area of very low malaria transmission. Eliminating the travel deferral requirement for all areas except the state of Oaxaca might result in the recovery of almost 65,000 blood donors annually at risk of approximately one contaminated unit collected every 20 years. Conclusion Deferral requirements should be relaxed for presenting donors who travelled to areas within Mexico that confer exceptionally small risks for malaria, such as Quintana Roo. PMID:21564102

Assessment of a self-deferral form for screening blood donors, Chiang Mai University Hospital, Thailand.

PubMed

Thaikruea, Lakkana; Nantachit, Niwes; Leetrakool, Nipapan; Fongsatitkul, Ladda; Sompan, Prakai; Heaton, Andrew; Nelson, Kenrad E

2008-09-01

A self-deferral form has been used to screen Chiang Mai University Hospital blood donors and was improved in 2005. It has never been evaluated. The study aimed to assess the self-deferral form procedures in detecting infected donors. Sera from 5,083 donors, who passed the self-deferral screening form, were tested with the routine immuno-assays (serology) for HIV 1 and 2 antibodies, P24 antigen, HCV antibodies, HBV surface antigen, and syphilis. Antibody negative sera were also tested individually with the the Procleix Ultrio Assay for HIV-1 DNA, HCV RNA, and HBV DNA. The donors who had discrepant results between serology and NAT were evaluated with additional tests, including a more sensitive Alternative Nucleic Acid Test, AntiBcore IgM, AntiBcore IgG, HBsAg and Anti HBs. Among 5,083 donors, 331 (6.5%) had at least one positive marker. In multiple logistic regression analysis, the statistically significant factors (adjusted odds ratio and 95% CI) for infection were age 30 years or below [1.45 (1.03, 2.03)], male gender [2.73 (1.64, 4.56)], primary school or lower education [1.56 (1.09, 2.23)], first-time donation [1.82 (1.25, 2.67)], and frequent donation [0.80 (0.70, 0.92)]. The safest donors were females, older than 30 years, with an education more than primary school, and frequent donation. Because of missing responses to some sensitive questions, there remains a need for further improvement of the self-deferral form.

77 FR 68721 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... Implementation Plan (SIP) that would incorporate EPA's ``Biomass Deferral'' into the Maryland SIP. At the request... comments. B. Email: cox[email protected] . C. Mail: EPA-R03-OAR-2012-0305, Ms. Kathleen Cox, Associate Director, Office of Permits and Air Toxics, Mailcode 3AP10, U.S. Environmental Protection Agency, Region...

26 CFR 1.402(g)-1 - Limitation on exclusion for elective deferrals.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... 1.402(g)-1 Section 1.402(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-1 Limitation on exclusion for elective deferrals. (a) In general. The excess of an... income for the taxable year on account of section 402(a)(8) (before applying the limits of section 402(g...

26 CFR 1.402(g)-1 - Limitation on exclusion for elective deferrals.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... 1.402(g)-1 Section 1.402(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-1 Limitation on exclusion for elective deferrals. (a) In general. The excess of an... income for the taxable year on account of section 402(a)(8) (before applying the limits of section 402(g...

26 CFR 1.402(g)-1 - Limitation on exclusion for elective deferrals.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... 1.402(g)-1 Section 1.402(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-1 Limitation on exclusion for elective deferrals. (a) In general. The excess of an... income for the taxable year on account of section 402(a)(8) (before applying the limits of section 402(g...

26 CFR 1.402(g)-0 - Limitation on exclusion for elective deferrals, table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., table of contents. 1.402(g)-0 Section 1.402(g)-0 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Plans, Etc. § 1.402(g)-0 Limitation on exclusion for elective deferrals, table of contents. This section contains the captions that appear in § 1.402(g)-1. § 1.402(g)-1Limitation on exclusion for elective...

26 CFR 1.402(g)-0 - Limitation on exclusion for elective deferrals, table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., table of contents. 1.402(g)-0 Section 1.402(g)-0 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT..., Stock Bonus Plans, Etc. § 1.402(g)-0 Limitation on exclusion for elective deferrals, table of contents. This section contains the captions that appear in § 1.402(g)-1. § 1.402(g)-1Limitation on exclusion for...

26 CFR 1.402(g)-0 - Limitation on exclusion for elective deferrals, table of contents.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., table of contents. 1.402(g)-0 Section 1.402(g)-0 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT..., Stock Bonus Plans, Etc. § 1.402(g)-0 Limitation on exclusion for elective deferrals, table of contents. This section contains the captions that appear in § 1.402(g)-1. § 1.402(g)-1Limitation on exclusion for...

26 CFR 1.402(g)-0 - Limitation on exclusion for elective deferrals, table of contents.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., table of contents. 1.402(g)-0 Section 1.402(g)-0 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT..., Stock Bonus Plans, Etc. § 1.402(g)-0 Limitation on exclusion for elective deferrals, table of contents. This section contains the captions that appear in § 1.402(g)-1. § 1.402(g)-1Limitation on exclusion for...

26 CFR 1.402(g)-0 - Limitation on exclusion for elective deferrals, table of contents.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., table of contents. 1.402(g)-0 Section 1.402(g)-0 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT..., Stock Bonus Plans, Etc. § 1.402(g)-0 Limitation on exclusion for elective deferrals, table of contents. This section contains the captions that appear in § 1.402(g)-1. § 1.402(g)-1Limitation on exclusion for...

Understanding noncompliance with selective donor deferral criteria for high-risk behaviors in Australian blood donors.

PubMed

Lucky, Tarana T A; Seed, Clive R; Waller, Daniel; Lee, June F; McDonald, Ann; Wand, Handan; Wroth, Stephen; Shuttleworth, Glen; Keller, Anthony J; Pink, Joanne; Wilson, David P

2014-07-01

Using a predonation screening questionnaire, potential blood donors are screened for medical or behavioral factors associated with an increased risk for transfusion-transmissible infection. After disclosure of these risks, potential donors are deferred from donating. Understanding the degree of failure to disclose full and truthful information (termed noncompliance) is important to determine and minimize residual risk. This study estimates the prevalence of, and likely reasons for, noncompliance among Australian donors with the deferrals for injecting drug use, sex with an injecting drug user, male-to-male sex, sex worker activity or contact, and sex with a partner from a high-HIV-prevalence country. An anonymous, online survey of a nationally representative sample of Australian blood donors was conducted. Prevalence of noncompliance with deferrable risk categories was estimated. Factors associated with noncompliance were determined using unadjusted and adjusted odds ratios. Of 98,044 invited donors, 30,790 donors completed the survey. The estimated prevalence of overall noncompliance (i.e., to at least one screening question) was 1.65% (95% confidence interval CI, 1.51%-1.8%). Noncompliance with individual deferrals ranged from 0.05% (sex work) to 0.54% (sex with an injecting drug user). The prevalences of the disclosed exclusionary risk behaviors were three to 14 times lower than their estimated prevalence in the general population. The prevalence of noncompliance is relatively low but our estimate is likely to be a lower bound. The selected high-risk behaviors were substantially less common in blood donors compared to the general population suggesting that self-deferral is effective. Nevertheless, a focus on further minimization should improve the blood safety. © 2014 AABB.

Saving lives, maintaining safety, and science-based policy: qualitative interview findings from the Blood Donation Rules Opinion Study (Blood DROPS).

PubMed

Hughes, Shana; Sheon, Nicolas; Siedle-Khan, Bob; Custer, Brian

2015-12-01

Indefinite deferral from donation for any man who discloses having had sex with another man even once since 1977 (MSM77) is the US FDA's standing policy. This qualitative component of the Blood Donation Rules and Opinion Study was designed to provide insight into the perceptions and practices of current or previous donors with MSM history. Forty human immunodeficiency virus (HIV)-negative MSM completed an online survey, indicating that they had donated blood and were willing to be interviewed. Semistructured, individual interviews with these key informants covered donation experience and motivations, perceptions of MSM77, policy change preferences, and possible impact of a change to a time-limited deferral. Transcripts were coded deductively and inductively, following a modified Grounded Theory approach. Analysis identified recurrent and divergent themes. Ninety-five percent of participants endorsed modifying MSM77. Preferred deferral length ranged from none to 5 years; a common opinion was that a science-based deferral period would be less than 1 year. Other policy change recommendations included incorporating questions about specific HIV risk behaviors to the donor questionnaire for all potential donors. Interviewees recognized HIV infection rates are higher in MSM than the general US population, but participants considered themselves low-risk for HIV, donated blood "to save lives," and justified their recommendations as being more effective ways to identify donors at risk for HIV. Results suggest that MSM donors are concerned with blood safety; they can be appealed to as such. Communications about a new deferral policy should include scientific explanations and acknowledge altruistic motivations of potential donors. © 2015 AABB.

19 CFR 113.75 - Bond conditions for deferral of duty on large yachts imported for sale at United States boat shows.

Code of Federal Regulations, 2010 CFR

2010-04-01

... yachts imported for sale at United States boat shows. 113.75 Section 113.75 Customs Duties U.S. CUSTOMS... Customs Bond Conditions § 113.75 Bond conditions for deferral of duty on large yachts imported for sale at....C. 1484b for a dutiable large yacht imported for sale at a United States boat show must conform to...

19 CFR 113.75 - Bond conditions for deferral of duty on large yachts imported for sale at United States boat shows.

Code of Federal Regulations, 2011 CFR

2011-04-01

... yachts imported for sale at United States boat shows. 113.75 Section 113.75 Customs Duties U.S. CUSTOMS... Customs Bond Conditions § 113.75 Bond conditions for deferral of duty on large yachts imported for sale at....C. 1484b for a dutiable large yacht imported for sale at a United States boat show must conform to...

Analysis of Blood Transfusion Data Using Bivariate Zero-Inflated Poisson Model: A Bayesian Approach.

PubMed

Mohammadi, Tayeb; Kheiri, Soleiman; Sedehi, Morteza

2016-01-01

Recognizing the factors affecting the number of blood donation and blood deferral has a major impact on blood transfusion. There is a positive correlation between the variables "number of blood donation" and "number of blood deferral": as the number of return for donation increases, so does the number of blood deferral. On the other hand, due to the fact that many donors never return to donate, there is an extra zero frequency for both of the above-mentioned variables. In this study, in order to apply the correlation and to explain the frequency of the excessive zero, the bivariate zero-inflated Poisson regression model was used for joint modeling of the number of blood donation and number of blood deferral. The data was analyzed using the Bayesian approach applying noninformative priors at the presence and absence of covariates. Estimating the parameters of the model, that is, correlation, zero-inflation parameter, and regression coefficients, was done through MCMC simulation. Eventually double-Poisson model, bivariate Poisson model, and bivariate zero-inflated Poisson model were fitted on the data and were compared using the deviance information criteria (DIC). The results showed that the bivariate zero-inflated Poisson regression model fitted the data better than the other models.

Cogeneration deferral rate and preemption under PURPA: a legal note

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spiewak, S.

The Public Utility Regulatory Policies Act (PURPA) is designed to benefit the ratepayer by using utility facilities as efficiently as possible. It does not ask states to encourage cogeneration or small power projects at the expense of utility efficiency. A legal analysis of the wording of PURPA shows that a deferral rate designed to retain customers who would otherwise turn to cogeneration or independent power supplies is legally consistent with PURPA's intent.

19 CFR 113.75 - Bond conditions for deferral of duty on large yachts imported for sale at United States boat shows.

Code of Federal Regulations, 2014 CFR

2014-04-01

... yachts imported for sale at United States boat shows. 113.75 Section 113.75 Customs Duties U.S. CUSTOMS... United States boat shows. A bond for the deferral of entry completion and duty deposit pursuant to 19 U.S.C. 1484b for a dutiable large yacht imported for sale at a United States boat show must conform to...

19 CFR 113.75 - Bond conditions for deferral of duty on large yachts imported for sale at United States boat shows.

Code of Federal Regulations, 2012 CFR

2012-04-01

... yachts imported for sale at United States boat shows. 113.75 Section 113.75 Customs Duties U.S. CUSTOMS... United States boat shows. A bond for the deferral of entry completion and duty deposit pursuant to 19 U.S.C. 1484b for a dutiable large yacht imported for sale at a United States boat show must conform to...

19 CFR 113.75 - Bond conditions for deferral of duty on large yachts imported for sale at United States boat shows.

Code of Federal Regulations, 2013 CFR

2013-04-01

... yachts imported for sale at United States boat shows. 113.75 Section 113.75 Customs Duties U.S. CUSTOMS... United States boat shows. A bond for the deferral of entry completion and duty deposit pursuant to 19 U.S.C. 1484b for a dutiable large yacht imported for sale at a United States boat show must conform to...

The risk of transfusion-transmitted HIV from blood donations of men who have sex with men, 12 months after last sex with a man: 2005-2007 estimates from England and Wales.

PubMed

Davison, K L; Conti, S; Brailsford, S R

2013-07-01

The risk of transfusion-transmitted HIV infection under (i) permanent exclusion and (ii) 12-month deferral of MSM in England and Wales during 2005-2007 was estimated. Assuming equal compliance with both scenarios, estimated risk under a 12-month deferral (0.228/million donations [range 0·168-0·306/million donations]) was only marginally greater (0·5%) than that under lifetime exclusion (0·227/million donations [range 0·157-0.318/million donations]), with one extra-HIV infectious donation every 455 years. Poorer compliance of MSM with a 12-month deferral would be expected to increase the estimated risk, whereas improved compliance could decrease risk by up to 29·1%. © 2013 International Society of Blood Transfusion.

Oral or parenteral iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors.

PubMed

Smith, Graham A; Fisher, Sheila A; Doree, Carolyn; Di Angelantonio, Emanuele; Roberts, David J

2014-07-03

Iron deficiency is a significant cause of deferral in people wishing to donate blood. If iron removed from the body through blood donation is not replaced, then donors may become iron deficient. All donors are screened at each visit for low haemoglobin (Hb) levels. However, some deferred blood donors do not return to donate. Deferred first-time donors are even less likely to return. Interventions that reduce the risk of provoking iron deficiency and anaemia in blood donors will therefore increase the number of blood donations. Currently, iron supplementation for blood donors is not a standard of care in many blood services. A systematic review is required to answer specific questions regarding the efficacy and safety of iron supplementation in blood donors. To assess the efficacy and safety of iron supplementation to reduce deferral, iron deficiency and/or anaemia in blood donors. We ran the search on 18 November 2013. We searched Cochrane Injuries Group Specialised Register, CENTRAL, PubMed, MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EBSCO Host) and six other databases. We also searched clinical trials registers and screened guidelines reference lists. Randomised controlled trials (RCTs) comparing iron supplementation versus placebo or control, oral versus parenteral iron supplementation, iron supplementation versus iron-rich food supplements, and different doses, treatment durations and preparations of iron supplementation in healthy blood donors. Autologous blood donors were excluded. We combined data using random-effects meta-analyses. We evaluated heterogeneity using the I(2) statistic; we explored considerable heterogeneity (I(2) > 75%) in subgroup analyses. We carried out sensitivity analyses to assess the impact of trial quality on the results. Thirty RCTs (4704 participants) met the eligibility criteria, including 19 comparisons of iron supplementation and placebo or control; one comparison of oral and parenteral iron supplementation; four comparisons of different doses of iron supplementation; one comparison of different treatment durations of iron supplementation; and 12 comparisons of different iron supplementation preparations.Many studies were of low or uncertain methodological quality and therefore at high or uncertain risk of bias. We therefore rated the quality of the evidence for our outcomes as moderate. There was a statistically significant reduction in deferral due to low haemoglobin in donors who received iron supplementation compared with donors who received no iron supplementation, both at the first donation visit after commencement of iron supplementation (risk ratio (RR) 0.34; 95% confidence interval (CI) 0.21 to 0.55; four studies; 1194 participants; P value < 0.0001) and at subsequent donations (RR 0.25; 95% CI 0.15 to 0.41; three studies; 793 participants; P value < 0.00001). Supplementation also resulted in significantly higher haemoglobin levels (mean difference (MD) 2.36 g/L; 95% CI 0.06 to 4.66; eight studies; 847 participants, P value =0.04), and iron stores, including serum ferritin (MD 13.98 ng/mL; 95% CI 8.92 to 19.03; five studies; 640 participants; P value < 0.00001) and transferrin saturation (MD 3.91%; 95% CI 2.02 to 5.80; four studies; 344 participants; P value < 0.0001) prior to further donation. The differences were maintained after subsequent donation(s).Adverse effects were widely reported and were more frequent in donors who received iron supplementation (RR 1.60; 95% CI 1.23 to 2.07; four studies; 1748 participants; P value = 0.0005). Adverse effects included constipation, diarrhoea, nausea, vomiting and taste disturbances, and some participants stopped treatment due to side effects. There is moderate quality evidence that rates of donor deferral due to low haemoglobin are considerably less in those taking iron supplements compared with those without iron supplementation, both at the first donation visit and at subsequent donation. Iron-supplemented donors also show elevated haemoglobin and iron stores. These beneficial effects are balanced by more frequent adverse events in donors who receive iron supplementation than in those who do not; this is likely to limit acceptability and compliance. The long-term effects of iron supplementation without measurement of iron stores are unknown. These considerations are likely to preclude widespread use of iron supplementation by tablets. Blood services may consider targeted use of supplementation in those at greatest risk of iron deficiency, personalised donation intervals and providing dietary advice.

Relative risk of reducing the lifetime blood donation deferral for men who have had sex with men versus currently tolerated transfusion risks.

PubMed

Vamvakas, Eleftherios C

2011-01-01

The risks of known and emerging transfusion-transmitted infections (TTIs) from reducing the current lifetime blood donation deferral for men who have had sex with men (MSM) to 1 or 5 years were compared to the risk from continuing to transfuse in the United States 12.5% of platelet doses as pooled whole-blood-derived (rather than single-donor) platelets. Assumptions made in mathematical models and blood donor/transfusion studies of the risks of TTIs since 2000 were evaluated. The number of HIV, hepatitis B virus, or hepatitis C virus TTIs from reducing the MSM deferral to 1 year is, respectively, 0.88, 2.94, or 66.9, many more than 10 times smaller than the risk from pooled platelets. If erroneous release of HIV-positive units (a risk independent of a donor's source of infection) is not considered, the MSM risk is 1 HIV-infectious donation per 17 to 56 million MSM donations. Any purportedly increased risk of human herpesvirus-8 transmission from MSM donors is far smaller than the risk of transfusion-associated sepsis from pooled platelets. Single-donor platelets from MSM after 5 years' abstinence are as safe or 5 times safer than our current pooled platelets--if the next TTI to emerge were transmitted, respectively, sexually or by another route. Thus, acceptance of MSM as blood donors after 1 or 5 years' abstinence may result in a postulated increase in risk that is so much smaller than the currently tolerated transfusion risk and so small in absolute terms that the ethical question of fairness to the MSM group justifies the change in policy. Copyright © 2011 Elsevier Inc. All rights reserved.

Space and Naval Warfare Systems Command and Overall Navy Needs to Improve Management of Waiver and Deferral Requests

DTIC Science & Technology

2015-10-08

Management of Waiver and Deferral Requests Visit us at www.dodig.mil Objective Our objective for this audit was to evaluate the Space and Naval Warfare...We conducted this audit in accordance with generally accepted government auditing standards. We considered management comments on a draft of...OFFICIAL USE ON Y Introduction DODIG-2016-003 │ 1 Introduction Objective Our objective for this audit was to evaluate the Space and Naval Warfare

77 FR 22480 - Guidance Under Section 267(f); Deferral of Loss on Transactions Between Members of a Controlled...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-16

... either of two events. The deferred loss is taken into account to the extent of any corresponding gain... regulations provided that a deferred loss is taken into account to the extent of any corresponding gain that... extent of P1's $10 of gain recognized. Accordingly, S takes into account $10 of loss as a result of the...

Bridge therapy or standard treatment for urgent surgery after coronary stent implantation: Analysis of 314 patients.

PubMed

De Servi, Stefano; Morici, Nuccia; Boschetti, Enrico; Rossini, Roberta; Martina, Paola; Musumeci, Giuseppe; D'Urbano, Maurizio; Lazzari, Ludovico; La Vecchia, Carlo; Senni, Michele; Klugmann, Silvio; Savonitto, Stefano

2016-05-01

Intravenous administration of a short acting glycoprotein IIb/IIIa inhibitor has been proposed as a bridge to surgery in patients on dual antiplatelet treatment, but data in comparison with other treatment options are not available. We conducted a retrospective analysis of consecutive patients who underwent un-deferrable, non-emergency surgery after coronary stenting. The bridge therapy was performed after discontinuation of the oral P2Y12 inhibitor by using i.v. tirofiban infusion. Net Adverse Clinical Events (NACE) was the primary outcome. We analyzed 314 consecutive patients: the bridge strategy was performed in 87 patients, whereas 227 were treated with other treatment options and represent the control group. Thirty-day NACE occurred in 8% of patients in the bridge group and in 22.5% in the control group (p < 0.01). Bridge therapy was associated with decreased 30-day NACE rate [Odds ratio (OR) 0.30; 95% confidence interval (CI) 0.13-0.39; p < 0.01], particularly when the time interval between stenting and surgery was ≤ 60 days (OR 0.09, 95% CI 0.01-0.72; p = 0.02). There were no cases of stent thrombosis in the bridge group and 3 (1.3%) in the control group. Bridge therapy was associated with decreased events rates as compared to both patients with and without P2Y12 inhibitors discontinuation in the control group. After adjustment for the most relevant covariates, the favorable effect of the bridge therapy was not materially modified. In conclusion, perioperative bridge therapy using tirofiban was associated with reduced 30-day NACE rate, particularly when surgery was performed within 60 days after stent implantation.

An initial trial of a prototype telepathology system featuring static imaging with discrete control of the remote microscope.

PubMed

Winokur, T S; McClellan, S; Siegal, G P; Reddy, V; Listinsky, C M; Conner, D; Goldman, J; Grimes, G; Vaughn, G; McDonald, J M

1998-07-01

Routine diagnosis of pathology images transmitted over telecommunications lines remains an elusive goal. Part of the resistance stems from the difficulty of enabling image selection by the remote pathologist. To address this problem, a telepathology microscope system (TelePath, TeleMedicine Solutions, Birmingham, Ala) that has features associated with static and dynamic imaging systems was constructed. Features of the system include near real time image transmission, provision of a tiled overview image, free choice of any fields at any desired optical magnification, and automated tracking of the pathologist's image selection. All commands and images are discrete, avoiding many inherent problems of full motion video and continuous remote control. A set of 64 slides was reviewed by 3 pathologists in a simulated frozen section environment. Each pathologist provided diagnoses for all 64 slides, as well as qualitative information about the system. Thirty-one of 192 diagnoses disagreed with the reference diagnosis that had been reached before the trial began. Qf the 31, 13 were deferrals and 12 were diagnoses of cases that had a deferral as the reference diagnosis. In 6 cases, the diagnosis disagreed with the reference diagnosis yielding an overall accuracy of 96.9%. Confidence levels in the diagnoses were high. This trial suggests that this system provides high-quality anatomic pathology services, including intraoperative diagnoses, over telecommunications lines.

Impact of Deferring Radiation Therapy in Patients With Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Who Develop Brain Metastases.

PubMed

Magnuson, William J; Yeung, Jacky T; Guillod, Paul D; Gettinger, Scott N; Yu, James B; Chiang, Veronica L

2016-06-01

To perform a retrospective analysis of patients with epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who developed brain metastases (BM) to evaluate our hypothesis that the use of upfront EGFR-tyrosine kinase inhibitors (TKIs), and deferral of radiation therapy (RT), would result in inferior intracranial progression-free survival but similar overall survival (OS). Of 202 patients diagnosed with EGFR-mutant NSCLC between July 1, 2008, and December 31, 2014, 71 developed BM. Twenty-one patients were excluded owing to prior EGFR-TKI use, EGFR-TKI resistance mutation, failure to receive EGFR-TKI after whole-brain radiation therapy (WBRT)/stereotactic radiosurgery (SRS) or <6 months' follow-up. Of the remaining 50 patients, 17 received upfront EGFR-TKI followed by SRS or WBRT, 17 WBRT then EGFR-TKI, and 16 SRS followed by EGFR-TKI. Disease-specific-graded prognostic assessment was similar among all 3 groups. The median OS was longer in the upfront RT group compared with the upfront EGFR-TKI group (34.1 vs 19.4 months; P=.01). On subgroup analysis, the SRS group had longer OS than the upfront EGFR-TKI group (58.4 vs 19.4 months; P=.01), but the WBRT group did not (29.9 vs 19.4 months; P=.09). Intracranial progression-free survival was improved in patients receiving upfront RT compared with those receiving upfront EGFR-TKI (37.9 vs 10.6 months; P<.001). The present study suggests that the use of upfront EGFR-TKI, and the deferral of SRS or WBRT, may result in inferior OS in patients with EGFR-mutant NSCLC who develop brain metastases. A prospective, multi-institutional, randomized trial of upfront EGFR-TKI with RT at intracranial progression versus upfront RT followed by EGFR-TKI is urgently needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of Deferring Radiation Therapy in Patients With Epidermal Growth Factor Receptor–Mutant Non-Small Cell Lung Cancer Who Develop Brain Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Magnuson, William J., E-mail: william.magnuson@yale.edu; Yeung, Jacky T.; Guillod, Paul D.

Purpose: To perform a retrospective analysis of patients with epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who developed brain metastases (BM) to evaluate our hypothesis that the use of upfront EGFR–tyrosine kinase inhibitors (TKIs), and deferral of radiation therapy (RT), would result in inferior intracranial progression-free survival but similar overall survival (OS). Methods and Materials: Of 202 patients diagnosed with EGFR-mutant NSCLC between July 1, 2008, and December 31, 2014, 71 developed BM. Twenty-one patients were excluded owing to prior EGFR-TKI use, EGFR-TKI resistance mutation, failure to receive EGFR-TKI after whole-brain radiation therapy (WBRT)/stereotactic radiosurgery (SRS) or <6 months' follow-up. Of themore » remaining 50 patients, 17 received upfront EGFR-TKI followed by SRS or WBRT, 17 WBRT then EGFR-TKI, and 16 SRS followed by EGFR-TKI. Disease-specific-graded prognostic assessment was similar among all 3 groups. Results: The median OS was longer in the upfront RT group compared with the upfront EGFR-TKI group (34.1 vs 19.4 months; P=.01). On subgroup analysis, the SRS group had longer OS than the upfront EGFR-TKI group (58.4 vs 19.4 months; P=.01), but the WBRT group did not (29.9 vs 19.4 months; P=.09). Intracranial progression-free survival was improved in patients receiving upfront RT compared with those receiving upfront EGFR-TKI (37.9 vs 10.6 months; P<.001). Conclusions: The present study suggests that the use of upfront EGFR-TKI, and the deferral of SRS or WBRT, may result in inferior OS in patients with EGFR-mutant NSCLC who develop brain metastases. A prospective, multi-institutional, randomized trial of upfront EGFR-TKI with RT at intracranial progression versus upfront RT followed by EGFR-TKI is urgently needed.« less

Geographic exposure risk of variant Creutzfeldt-Jakob disease in US blood donors: a risk-ranking model to evaluate alternative donor-deferral policies.

PubMed

Yang, Hong; Huang, Yin; Gregori, Luisa; Asher, David M; Bui, Travis; Forshee, Richard A; Anderson, Steven A

2017-04-01

Variant Creutzfeldt-Jakob disease (vCJD) has been transmitted by blood transfusion (TTvCJD). The US Food and Drug Administration (FDA) recommends deferring blood donors who resided in or traveled to 30 European countries where they may have been exposed to bovine spongiform encephalopathy (BSE) through beef consumption. Those recommendations warrant re-evaluation, because new cases of BSE and vCJD have markedly abated. The FDA developed a risk-ranking model to calculate the geographic vCJD risk using country-specific case rates and person-years of exposure of US blood donors. We used the reported country vCJD case rates, when available, or imputed vCJD case rates from reported BSE and UK beef exports during the risk period. We estimated the risk reduction and donor loss should the deferral be restricted to a few high-risk countries. We also estimated additional risk reduction by leukocyte reduction (LR) of red blood cells (RBCs). The United Kingdom, Ireland, and France had the greatest vCJD risk, contributing approximately 95% of the total risk. The model estimated that deferring US donors who spent extended periods of time in these three countries, combined with currently voluntary LR (95% of RBC units), would reduce the vCJD risk by 89.3%, a reduction similar to that achieved under the current policy (89.8%). Limiting deferrals to exposure in these three countries would potentially allow donations from an additional 100,000 donors who are currently deferred. Our analysis suggests that a deferral option focusing on the three highest risk countries would achieve a level of blood safety similar to that achieved by the current policy. © 2016 AABB.

Battery Storage Evaluation Tool, version 1.x

DOE Office of Scientific and Technical Information (OSTI.GOV)

2015-10-02

The battery storage evaluation tool developed at Pacific Northwest National Laboratory is used to run a one-year simulation to evaluate the benefits of battery storage for multiple grid applications, including energy arbitrage, balancing service, capacity value, distribution system equipment deferral, and outage mitigation. This tool is based on the optimal control strategies to capture multiple services from a single energy storage device. In this control strategy, at each hour, a lookahead optimization is first formulated and solved to determine the battery base operating point. The minute-by-minute simulation is then performed to simulate the actual battery operation.

Is having sex with other men a risk factor for transfusion-transmissible infections in male blood donors in Western countries? A systematic review.

PubMed

De Buck, Emmy; Dieltjens, Tessa; Compernolle, Veerle; Vandekerckhove, Philippe

2015-01-01

Although increased prevalence of transfusion transmissible infections (TTI) among "men who have sex with men" (MSM) has been well documented, the exclusion of MSM as blood donors is contested. The aim of this systematic review is to find studies that describe the risk of TTI in MSM blood donors. We searched MEDLINE, Embase, The Cochrane Central Register of Controlled Trials, Cinahl, and Web of Science, and used GRADE for determining evidence quality. We included studies comparing MSM and non-MSM blood donors (or people eligible to give blood), living in areas most relevant for our Blood Service. Out of 18 987 articles, 14 observational studies were included. Two studies directly compared MSM with non-MSM donors showing that MSM donors have a statistically significant higher risk of HIV-1 infections. In one of these studies it was shown that this was related to recent (< 12 months) MSM contact. In two additional studies no evidence was shown in favour of a certain deferral period for MSM. Ten studies, applying permanent deferral for MSM, compared infected versus non-infected donors. One study found that MSM is a statistically significant risk factor for HIV-1 infection in blood donors. For other TTI such as HBV or HCV, an increased risk of infection could not be demonstrated, because the precision of the results was affected by the low numbers of donors with MSM as risk factor, or because of risk of bias in the included studies. All studies included low level evidence, because of risk of bias and imprecision of the results. High-quality studies investigating the risk of TTI in MSM who donate blood are scarce. The available evidence suggests a link between MSM blood donors and HIV-1 infection, but is too limited to be able to unambiguously/clearly recommend a certain deferral policy.

Is Having Sex with Other Men a Risk Factor for Transfusion-Transmissible Infections in Male Blood Donors in Western Countries? A Systematic Review

PubMed Central

De Buck, Emmy; Dieltjens, Tessa; Compernolle, Veerle; Vandekerckhove, Philippe

2015-01-01

Background Although increased prevalence of transfusion transmissible infections (TTI) among “men who have sex with men” (MSM) has been well documented, the exclusion of MSM as blood donors is contested. The aim of this systematic review is to find studies that describe the risk of TTI in MSM blood donors. Methods We searched MEDLINE, Embase, The Cochrane Central Register of Controlled Trials, Cinahl, and Web of Science, and used GRADE for determining evidence quality. We included studies comparing MSM and non-MSM blood donors (or people eligible to give blood), living in areas most relevant for our Blood Service. Results Out of 18 987 articles, 14 observational studies were included. Two studies directly compared MSM with non-MSM donors showing that MSM donors have a statistically significant higher risk of HIV-1 infections. In one of these studies it was shown that this was related to recent (< 12 months) MSM contact. In two additional studies no evidence was shown in favour of a certain deferral period for MSM. Ten studies, applying permanent deferral for MSM, compared infected versus non-infected donors. One study found that MSM is a statistically significant risk factor for HIV-1 infection in blood donors. For other TTI such as HBV or HCV, an increased risk of infection could not be demonstrated, because the precision of the results was affected by the low numbers of donors with MSM as risk factor, or because of risk of bias in the included studies. All studies included low level evidence, because of risk of bias and imprecision of the results. Conclusions High-quality studies investigating the risk of TTI in MSM who donate blood are scarce. The available evidence suggests a link between MSM blood donors and HIV-1 infection, but is too limited to be able to unambiguously/clearly recommend a certain deferral policy. PMID:25875812

Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial

PubMed Central

McCormack, Sheena; Dunn, David T; Desai, Monica; Dolling, David I; Gafos, Mitzy; Gilson, Richard; Sullivan, Ann K; Clarke, Amanda; Reeves, Iain; Schembri, Gabriel; Mackie, Nicola; Bowman, Christine; Lacey, Charles J; Apea, Vanessa; Brady, Michael; Fox, Julie; Taylor, Stephen; Antonucci, Simone; Khoo, Saye H; Rooney, James; Nardone, Anthony; Fisher, Martin; McOwan, Alan; Phillips, Andrew N; Johnson, Anne M; Gazzard, Brian; Gill, Owen N

2016-01-01

Summary Background Randomised placebo-controlled trials have shown that daily oral pre-exposure prophylaxis (PrEP) with tenofovir–emtricitabine reduces the risk of HIV infection. However, this benefit could be counteracted by risk compensation in users of PrEP. We did the PROUD study to assess this effect. Methods PROUD is an open-label randomised trial done at 13 sexual health clinics in England. We enrolled HIV-negative gay and other men who have sex with men who had had anal intercourse without a condom in the previous 90 days. Participants were randomly assigned (1:1) to receive daily combined tenofovir disoproxil fumarate (245 mg) and emtricitabine (200 mg) either immediately or after a deferral period of 1 year. Randomisation was done via web-based access to a central computer-generated list with variable block sizes (stratified by clinical site). Follow-up was quarterly. The primary outcomes for the pilot phase were time to accrue 500 participants and retention; secondary outcomes included incident HIV infection during the deferral period, safety, adherence, and risk compensation. The trial is registered with ISRCTN (number ISRCTN94465371) and ClinicalTrials.gov (NCT02065986). Findings We enrolled 544 participants (275 in the immediate group, 269 in the deferred group) between Nov 29, 2012, and April 30, 2014. Based on early evidence of effectiveness, the trial steering committee recommended on Oct 13, 2014, that all deferred participants be offered PrEP. Follow-up for HIV incidence was complete for 243 (94%) of 259 patient-years in the immediate group versus 222 (90%) of 245 patient-years in the deferred group. Three HIV infections occurred in the immediate group (1·2/100 person-years) versus 20 in the deferred group (9·0/100 person-years) despite 174 prescriptions of post-exposure prophylaxis in the deferred group (relative reduction 86%, 90% CI 64–96, p=0·0001; absolute difference 7·8/100 person-years, 90% CI 4·3–11·3). 13 men (90% CI 9–23) in a similar population would need access to 1 year of PrEP to avert one HIV infection. We recorded no serious adverse drug reactions; 28 adverse events, most commonly nausea, headache, and arthralgia, resulted in interruption of PrEp. We detected no difference in the occurrence of sexually transmitted infections, including rectal gonorrhoea and chlamydia, between groups, despite a suggestion of risk compensation among some PrEP recipients. Interpretation In this high incidence population, daily tenofovir–emtricitabine conferred even higher protection against HIV than in placebo-controlled trials, refuting concerns that effectiveness would be less in a real-world setting. There was no evidence of an increase in other sexually transmitted infections. Our findings strongly support the addition of PrEP to the standard of prevention for men who have sex with men at risk of HIV infection. Funding MRC Clinical Trials Unit at UCL, Public Health England, and Gilead Sciences. PMID:26364263

Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial.

PubMed

McCormack, Sheena; Dunn, David T; Desai, Monica; Dolling, David I; Gafos, Mitzy; Gilson, Richard; Sullivan, Ann K; Clarke, Amanda; Reeves, Iain; Schembri, Gabriel; Mackie, Nicola; Bowman, Christine; Lacey, Charles J; Apea, Vanessa; Brady, Michael; Fox, Julie; Taylor, Stephen; Antonucci, Simone; Khoo, Saye H; Rooney, James; Nardone, Anthony; Fisher, Martin; McOwan, Alan; Phillips, Andrew N; Johnson, Anne M; Gazzard, Brian; Gill, Owen N

2016-01-02

Randomised placebo-controlled trials have shown that daily oral pre-exposure prophylaxis (PrEP) with tenofovir-emtricitabine reduces the risk of HIV infection. However, this benefit could be counteracted by risk compensation in users of PrEP. We did the PROUD study to assess this effect. PROUD is an open-label randomised trial done at 13 sexual health clinics in England. We enrolled HIV-negative gay and other men who have sex with men who had had anal intercourse without a condom in the previous 90 days. Participants were randomly assigned (1:1) to receive daily combined tenofovir disoproxil fumarate (245 mg) and emtricitabine (200 mg) either immediately or after a deferral period of 1 year. Randomisation was done via web-based access to a central computer-generated list with variable block sizes (stratified by clinical site). Follow-up was quarterly. The primary outcomes for the pilot phase were time to accrue 500 participants and retention; secondary outcomes included incident HIV infection during the deferral period, safety, adherence, and risk compensation. The trial is registered with ISRCTN (number ISRCTN94465371) and ClinicalTrials.gov (NCT02065986). We enrolled 544 participants (275 in the immediate group, 269 in the deferred group) between Nov 29, 2012, and April 30, 2014. Based on early evidence of effectiveness, the trial steering committee recommended on Oct 13, 2014, that all deferred participants be offered PrEP. Follow-up for HIV incidence was complete for 243 (94%) of 259 patient-years in the immediate group versus 222 (90%) of 245 patient-years in the deferred group. Three HIV infections occurred in the immediate group (1·2/100 person-years) versus 20 in the deferred group (9·0/100 person-years) despite 174 prescriptions of post-exposure prophylaxis in the deferred group (relative reduction 86%, 90% CI 64-96, p=0·0001; absolute difference 7·8/100 person-years, 90% CI 4·3-11·3). 13 men (90% CI 9-23) in a similar population would need access to 1 year of PrEP to avert one HIV infection. We recorded no serious adverse drug reactions; 28 adverse events, most commonly nausea, headache, and arthralgia, resulted in interruption of PrEp. We detected no difference in the occurrence of sexually transmitted infections, including rectal gonorrhoea and chlamydia, between groups, despite a suggestion of risk compensation among some PrEP recipients. In this high incidence population, daily tenofovir-emtricitabine conferred even higher protection against HIV than in placebo-controlled trials, refuting concerns that effectiveness would be less in a real-world setting. There was no evidence of an increase in other sexually transmitted infections. Our findings strongly support the addition of PrEP to the standard of prevention for men who have sex with men at risk of HIV infection. MRC Clinical Trials Unit at UCL, Public Health England, and Gilead Sciences. Copyright © 2016 McCormack et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Analysis of Blood Transfusion Data Using Bivariate Zero-Inflated Poisson Model: A Bayesian Approach

PubMed Central

Mohammadi, Tayeb; Sedehi, Morteza

2016-01-01

Recognizing the factors affecting the number of blood donation and blood deferral has a major impact on blood transfusion. There is a positive correlation between the variables “number of blood donation” and “number of blood deferral”: as the number of return for donation increases, so does the number of blood deferral. On the other hand, due to the fact that many donors never return to donate, there is an extra zero frequency for both of the above-mentioned variables. In this study, in order to apply the correlation and to explain the frequency of the excessive zero, the bivariate zero-inflated Poisson regression model was used for joint modeling of the number of blood donation and number of blood deferral. The data was analyzed using the Bayesian approach applying noninformative priors at the presence and absence of covariates. Estimating the parameters of the model, that is, correlation, zero-inflation parameter, and regression coefficients, was done through MCMC simulation. Eventually double-Poisson model, bivariate Poisson model, and bivariate zero-inflated Poisson model were fitted on the data and were compared using the deviance information criteria (DIC). The results showed that the bivariate zero-inflated Poisson regression model fitted the data better than the other models. PMID:27703493

Systems and methods for energy cost optimization in a building system

DOEpatents

Turney, Robert D.; Wenzel, Michael J.

2016-09-06

Methods and systems to minimize energy cost in response to time-varying energy prices are presented for a variety of different pricing scenarios. A cascaded model predictive control system is disclosed comprising an inner controller and an outer controller. The inner controller controls power use using a derivative of a temperature setpoint and the outer controller controls temperature via a power setpoint or power deferral. An optimization procedure is used to minimize a cost function within a time horizon subject to temperature constraints, equality constraints, and demand charge constraints. Equality constraints are formulated using system model information and system state information whereas demand charge constraints are formulated using system state information and pricing information. A masking procedure is used to invalidate demand charge constraints for inactive pricing periods including peak, partial-peak, off-peak, critical-peak, and real-time.

HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study.

PubMed

Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

2016-02-15

To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. The ED of a large east African national referral hospital. This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Characteristics of donors who do or do not return to give blood and barriers to their return

PubMed Central

Wevers, Anne; Wigboldus, Daniël H.J.; de Kort, Wim L.A.M.; van Baaren, Rick; Veldhuizen, Ingrid J.T.

2014-01-01

Background In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. Materials and methods A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Results Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Discussion Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further. PMID:23522891

Characteristics of donors who do or do not return to give blood and barriers to their return.

PubMed

Wevers, Anne; Wigboldus, Daniël H J; de Kort, Wim L A M; van Baaren, Rick; Veldhuizen, Ingrid J T

2014-01-01

In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further.

Clinical utility of the Prostate Health Index (phi) for biopsy decision management in a large group urology practice setting.

PubMed

White, Jay; Shenoy, B Vittal; Tutrone, Ronald F; Karsh, Lawrence I; Saltzstein, Daniel R; Harmon, William J; Broyles, Dennis L; Roddy, Tamra E; Lofaro, Lori R; Paoli, Carly J; Denham, Dwight; Reynolds, Mark A

2018-04-01

Deciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4-10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice. An IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire. Physician recommendations were recorded before and after receiving the phi test result. A historical control group was queried from each site's electronic medical records for eligible men who were seen by the same participating urologists prior to the implementation of the phi test in their practice. 506 men receiving a phi test were prospectively enrolled and 683 men were identified for the historical control group (without phi). Biopsy and pathological findings were also recorded for both groups. Men receiving a phi test showed a significant reduction in biopsy procedures performed when compared to the historical control group (36.4% vs. 60.3%, respectively, P < 0.0001). Based on questionnaire responses, the phi score impacted the physician's patient management plan in 73% of cases, including biopsy deferrals when the phi score was low, and decisions to perform biopsies when the phi score indicated an intermediate or high probability of prostate cancer (phi ≥36). phi testing significantly impacted the physician's biopsy decision for men with tPSA in the 4-10 ng/ml range and non-suspicious DRE findings. Appropriate utilization of phi resulted in a significant reduction in biopsy procedures performed compared to historical patients seen by the same participating urologists who would have met enrollment eligibility but did not receive a phi test.

19 CFR 181.44 - Calculation of drawback.

Code of Federal Regulations, 2010 CFR

2010-04-01

... TREASURY (CONTINUED) NORTH AMERICAN FREE TRADE AGREEMENT Restrictions on Drawback and Duty-Deferral... is repaired in the United States using imported parts from Korea on which $160.00 in duties have been...

Assessment of Energy Storage Alternatives in the Puget Sound Energy System Volume 2: Energy Storage Evaluation Tool

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Di; Jin, Chunlian; Balducci, Patrick J.

2013-12-01

This volume presents the battery storage evaluation tool developed at Pacific Northwest National Laboratory (PNNL), which is used to evaluate benefits of battery storage for multiple grid applications, including energy arbitrage, balancing service, capacity value, distribution system equipment deferral, and outage mitigation. This tool is based on the optimal control strategies to capture multiple services from a single energy storage device. In this control strategy, at each hour, a look-ahead optimization is first formulated and solved to determine battery base operating point. The minute by minute simulation is then performed to simulate the actual battery operation. This volume provide backgroundmore » and manual for this evaluation tool.« less

Is there a right to donate blood? Patient rights; donor responsibilities.

PubMed

Franklin, Ian M

2007-06-01

The objective of this study was to analyse and assess critically whether there is a right to donate blood in the UK. The aim was to provide a basis for blood services, in particular within the UK and European Union (EU), to address claims from deferred donors that there is a right to donate. Recent and ongoing campaigns to change the current life-long deferral from blood donation in the UK, Canada and USA of men who have/have had sex with men (MSM) have highlighted issues over whether individuals have a right to donate blood. The issue is complicated by allegations of discriminatory behaviour, and in some countries politicians have contributed to the argument. As anti-discrimination and equality legislation is strengthened in the UK, other groups in addition to MSM may wish to claim a right to donate blood. The methods adopted included discussions with colleagues in UK and European blood services and a review of the medical literature and wider sources using Internet search engines. No clear right to donate blood is apparent, although it is recommended that donor deferral criteria should have a sound basis of evidence. Potential donors have a right to expect a clear explanation of the reason(s) for refusing a donation. Legal safeguards for recipients to receive safe blood transfusions exist. It is concluded that blood recipients in the EU have a right to receive safe blood, and that this should be viewed as the overriding responsibility of blood services.

Dignity and deferral narratives as strategies in facilitated technology-based support groups for people with advanced cancer.

PubMed

Street, Annette F; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

PubMed Central

Street, Annette F.; Wakelin, Kate; Hordern, Amanda; Bruce, Nicola; Horey, Dell

2012-01-01

This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated. PMID:22530115

21 CFR 610.41 - Donor deferral.

Code of Federal Regulations, 2010 CFR

2010-04-01

... infection due to hepatitis B surface antigen (HBsAg) when previously tested under § 610.40(a), (b), and (e) subsequently may donate Source Plasma for use in the preparation of Hepatitis B Immune Globulin (Human...

26 CFR 1.641(a)-0 - Scope of subchapter J.

Code of Federal Regulations, 2011 CFR

2011-04-01

... rules relating to trusts which distribute current income only (subpart B), estates and trusts which may... mitigation of (i) the progressive rates of tax (including mitigation as a result of deferral of tax) or (ii...

77 FR 4567 - Blood Products Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-30

... appropriate advisory committee hot line/ phone line to learn about possible modifications before coming to the... activities related to the evaluation of the donor deferral policy for men who have had sex with other men...

75 FR 28328 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-20

... of gain on a partnership's sale of qualified small business stock and deferral of gain on a partner's... information is necessary for the proper performance of the functions of the agency, including whether the...

76 FR 43489 - Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

.... 221320 Sewage treatment facilities. 562212 Solid waste landfills. Fermentation processes......... 325193... processors burning agricultural biomass residues, using fermentation processes, or producing/using biogas... treatment or manure management processes; CO 2 from fermentation during ethanol production or other...

Facile deferration of commercial fertilizers containing iron chelates for their NMR analysis.

PubMed

Laghi, Luca; Alcañiz, Sara; Cerdán, Mar; Gomez-Gallego, Mar; Sierra, Miguel Angel; Placucci, Giuseppe; Cremonini, Mauro Andrea

2009-06-24

Ethylenediamine-N,N'-bis(o-hydroxyphenylacetic) acid (o,o-EDDHA) is widely used in commercial formulations as a Fe(3+) chelating agent to remedy iron shortage in calcareous and alkaline soils. Commercially available o,o-EDDHA-Fe(3+) formulations contain a mixture of EDDHA regioisomers (o,p-EDDHA and p,p-EDDHA), together with other, still uncharacterized, products. NMR spectroscopy can be applied to their study as long as iron is accurately removed prior to the observation. This paper shows that it is possible to obtain a deferrated solution of the organic ligands present in commercial fertilizers containing the EDDHA-Fe(3+) chelate by treating the chelate with ferrocyanide, thus forming Prussian Blue that can be easily removed by centrifugation. This iron removal process does not cause significant losses of the o,o-EDDHA ligand or its minor structural isomers.

Mitigation of the threat posed to transfusion by donors traveling to Zika-affected areas: a Canadian risk-based approach.

PubMed

Germain, Marc; Delage, Gilles; O'Brien, Sheila F; Grégoire, Yves; Fearon, Margaret; Devine, Dana

2017-10-01

The recent spread of the Zika virus to the Americas and the recognition that it can cause severe disease in the developing fetus has prompted the adoption of measures to mitigate the risk that this virus might pose to transfusion safety. In nonendemic countries, the risk to transfusion results from donors traveling to an endemic region. Canada implemented a 21-day temporary deferral for prospective donors who traveled to such regions. We present the rationale for this policy, including a quantitative risk assessment supported by a Monte Carlo simulation. The model considered the following parameters, each with specified values and ranges: the probability that a donor recently returned from a Zika-endemic region, the duration of travel to this region, the daily risk of acquiring Zika while in an endemic region, and the incubation and viremic periods. We ran the simulation 20 times, each with 10 million iterations. In the absence of any travel deferral, 32 donors (range, 20-46 donors) would be able to donate while still being at risk of transmitting Zika, corresponding to a rate of 1:312,500 (range, 1:217,000 to 1:500,000). None of these donors would be viremic beyond 21 days after returning from their travel, with a risk estimated at less than 1:200,000,000. A 21-day temporary travel deferral offers an extremely wide margin of safety for the possible transmission of Zika by a donation obtained from someone who recently returned from a country where the virus is circulating. © 2017 AABB.

Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study.

PubMed

Cable, Ritchard G; Glynn, Simone A; Kiss, Joseph E; Mast, Alan E; Steele, Whitney R; Murphy, Edward L; Wright, David J; Sacher, Ronald A; Gottschall, Jerry L; Tobler, Leslie H; Simon, Toby L

2012-04-01

Blood donors are at risk of iron deficiency. We evaluated the effects of blood donation intensity on iron and hemoglobin (Hb) in a prospective study. Four cohorts of frequent and first-time or reactivated (FT/RA) blood donors (no donation in 2 years), female and male, totaling 2425, were characterized and followed as they donated blood frequently. At enrollment and the final visit, ferritin, soluble transferrin receptor (sTfR), and Hb were determined. Models to predict iron deficiency and Hb deferral were developed. Iron depletion was defined at two levels: iron deficiency erythropoiesis (IDE) [log(sTfR/ferritin) ≥ 2.07] and absent iron stores (AIS; ferritin < 12 ng/mL). Among returning female FT and RA donors, 20 and 51% had AIS and IDE at their final visit, respectively; corresponding proportions for males were 8 and 20%. Among female frequent donors who returned, 27 and 62% had AIS and IDE, respectively, while corresponding proportions for males were 18 and 47%. Predictors of IDE and/or AIS included a higher frequency of blood donation in the past 2 years, a shorter interdonation interval, and being female and young; conversely, taking iron supplements reduced the risk of iron depletion. Predictors of Hb deferral included female sex, black race, and a shorter interdonation interval. There is a high prevalence of iron depletion in frequent blood donors. Increasing the interdonation interval would reduce the prevalence of iron depletion and Hb deferral. Alternatively, replacement with iron supplements may allow frequent donation without the adverse outcome of iron depletion. © 2011 American Association of Blood Banks.

76 FR 38667 - Transmissible Spongiform Encephalopathies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-01

...: The committee will discuss donor deferral for time spent in Saudi Arabia to reduce the risk of variant Creutzfeldt-Jakob disease (vCJD) by blood and blood products and human cells, tissues and cellular and tissue...

77 FR 20643 - Blood Products Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

..., you should always check the Agency's Web site and call the appropriate advisory committee hot line... activities related to the evaluation of the donor deferral policy for men who have had sex with other men; a...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

38 CFR 21.42 - Deferral or extension of the basic period of eligibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... will begin or resume on the date a Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) notifies the veteran in writing that the CP or VRC has determined, based on the evidence of...

78 FR 23524 - Approval and Promulgation of Implementation Plans; North Carolina: Deferral of Carbon Dioxide (CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... treatment, or manure management processes; CO 2 from fermentation during ethanol production or other industrial fermentation processes; CO 2 from combustion of the biological fraction of municipal solid waste...

75 FR 78726 - Agency Information Collection Activities: North American Free Trade Agreement Duty Deferral

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... information technology; and (e) the annual costs burden to respondents or record keepers from the collection.... Estimated Time per Response: 12 minutes. Estimated Total Annual Burden Hours: 280. Dated: December 13, 2010...

Subspecialty surgical pathologist's performances as triage pathologists on a telepathology-enabled quality assurance surgical pathology service: A human factors study

PubMed Central

Braunhut, Beth L.; Graham, Anna R.; Lian, Fangru; Webster, Phyllis D.; Krupinski, Elizabeth A.; Bhattacharyya, Achyut K.; Weinstein, Ronald S.

2014-01-01

Background: The case triage practice workflow model was used to manage incoming cases on a telepathology-enabled surgical pathology quality assurance (QA) service. Maximizing efficiency of workflow and the use of pathologist time requires detailed information on factors that influence telepathologists’ decision-making on a surgical pathology QA service, which was gathered and analyzed in this study. Materials and Methods: Surgical pathology report reviews and telepathology service logs were audited, for 1862 consecutive telepathology QA cases accrued from a single Arizona rural hospital over a 51 month period. Ten university faculty telepathologists served as the case readers. Each telepathologist had an area of subspecialty surgical pathology expertise (i.e. gastrointestinal pathology, dermatopathology, etc.) but functioned largely as a general surgical pathologist while on this telepathology-enabled QA service. They handled all incoming cases during their individual 1-h telepathology sessions, regardless of the nature of the organ systems represented in the real-time incoming stream of outside surgical pathology cases. Results: The 10 participating telepathologists’ postAmerican Board of pathology examination experience ranged from 3 to 36 years. This is a surrogate for age. About 91% of incoming cases were immediately signed out regardless of the subspecialty surgical pathologists’ area of surgical pathology expertise. One hundred and seventy cases (9.13%) were deferred. Case concurrence rates with the provisional surgical pathology diagnosis of the referring pathologist, for incoming cases, averaged 94.3%, but ranged from 88.46% to 100% for individual telepathologists. Telepathology case deferral rates, for second opinions or immunohistochemistry, ranged from 4.79% to 21.26%. Differences in concordance rates and deferral rates among telepathologists, for incoming cases, were significant but did not correlate with years of experience as a practicing pathologist. Coincidental overlaps of the area of subspecialty surgical pathology expertise with organ-related incoming cases did not influence decisions by the telepathologists to either defer those cases or to agree or disagree with the referring pathologist's provisional diagnoses. Conclusions: Subspecialty surgical pathologists effectively served as general surgical pathologists on a telepathology-based surgical pathology QA service. Concurrence rates with incoming surgical pathology report diagnoses, and case deferral rates, varied significantly among the 10 on-service telepathologists. We found no evidence that the higher deferral rates correlated with improving the accuracy or quality of the surgical pathology reports. PMID:25057432

75 FR 25839 - Foreign-Trade Zone 26 Atlanta, Georgia, Application for Subzone, Yates Bleachery Company (Textile...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

...), high thread count (180 threads per inch and higher) fabrics under FTZ procedures based on a tolling... process any other customer- owned fabric under FTZ procedures. Subzone status would allow for deferral of...

76 FR 30430 - Proposed Collection; Comment Request for Form 5713 and Schedules A, B, and C (Form 5713)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... of income of a domestic international sales corporation, or deferral of income of a foreign sales... of automated collection techniques or other forms of information technology; and (e) estimates of...

26 CFR 1.409A-0 - Table of contents.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... (ii) Participation by nonresident aliens, certain resident aliens, and bona fide residents of.... (iii) Tax equalization agreements. (iv) Certain limited deferrals of a nonresident alien. (v...) Alternative methods of compliance. (7) Nonresident alien employees. (8) Elections affecting the identification...

26 CFR 1.409A-0 - Table of contents.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... (ii) Participation by nonresident aliens, certain resident aliens, and bona fide residents of.... (iii) Tax equalization agreements. (iv) Certain limited deferrals of a nonresident alien. (v...) Alternative methods of compliance. (7) Nonresident alien employees. (8) Elections affecting the identification...

26 CFR 1.409A-0 - Table of contents.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... (ii) Participation by nonresident aliens, certain resident aliens, and bona fide residents of.... (iii) Tax equalization agreements. (iv) Certain limited deferrals of a nonresident alien. (v...) Alternative methods of compliance. (7) Nonresident alien employees. (8) Elections affecting the identification...

26 CFR 1.409A-0 - Table of contents.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... (ii) Participation by nonresident aliens, certain resident aliens, and bona fide residents of.... (iii) Tax equalization agreements. (iv) Certain limited deferrals of a nonresident alien. (v...) Alternative methods of compliance. (7) Nonresident alien employees. (8) Elections affecting the identification...

29 CFR 1420.8 - FMCS deferral to parties' own private factfinding procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... responsibilities under the Act. The Service will decline to appoint a BoI and leave the selection and appointment... there can be no strike or lockout and no changes in conditions of employment (except by mutual agreement...

29 CFR 1420.8 - FMCS deferral to parties' own private factfinding procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... responsibilities under the Act. The Service will decline to appoint a BoI and leave the selection and appointment... there can be no strike or lockout and no changes in conditions of employment (except by mutual agreement...

77 FR 40068 - Draft Guidance for Industry: Recommendations for Donor Questioning, Deferral, Reentry, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... scientific workshop. In addition, FDA is aware that dengue viruses are endemic in Quintana Roo and Jalisco. FDA is currently evaluating the risk of dengue virus infections in U.S. blood donors that are acquired...

Personal Identity in Italy

ERIC Educational Resources Information Center

Crocetti, Elisabetta; Rabaglietti, Emanuela; Sica, Luigia Simona

2012-01-01

This chapter discusses specifics of identity formation in Italian adolescents and emerging adults. We review consistent evidence illustrating that, in Italy, a progressive deferral of transition to adulthood strongly impacts youth identity development by stimulating identity exploration and postponement of identity commitments. We also consider…

[Contributions of the Council of Europe's Blood Transfusion Steering Committee to the determination of rules for the selection of donors of blood and blood components and the study of sexual behaviors having an impact on blood safety].

PubMed

Behr-Gross, M-E; Heiden, M; Norda, R

2013-05-01

In November 2009, the Council of Europe's Blood Transfusion Steering Committee created a group of experts to explore the problem of behaviors having an impact on the management of donors of blood and blood components and on blood transfusion safety in Europe. This ad hoc group sought a harmonised interpretation of temporary exclusion (or temporary deferral), as opposed to permanent exclusion (or permanent deferral), in the context of the selection of donors of blood and blood components. It was also given the mandate to assess, on the basis of available data, the possibility of differentiating "at risk" behaviours from behaviours "at high risk" of contamination by serious infectious diseases transmitted by blood, blood components or derived therapeutic products. The primary objective of this work was to ensure the safety of blood, blood components and derived therapeutic products for future recipients by promoting a risk analysis-based approach, given that some countries envisaged amending their provisions for donor selection. However, a risk analysis can only be performed on groups, not individuals, which may give the impression of a discriminatory approach, so it needed to be justified in the context of transfusion safety. A collaborative project, which included an investigation phase, led to the drafting of a technical memorandum that summarised the data collected in ten Council of Europe member states on the selection criteria for blood donors and the epidemiology of infectious diseases (with a focus on human immunodeficiency virus) in the general population and among blood donors. The technical memorandum was published in 2011 on the European Directorate for the Quality of Medicines and Healthcare website dedicated to this project. A draft resolution of the Committee of Ministers of the Council of Europe was then developed by the Council of Europe's Blood Transfusion Steering Committee. This text was circulated among member and observer states of the Council of Europe for review and comments. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

21 CFR 610.41 - Donor deferral.

Code of Federal Regulations, 2012 CFR

2012-04-01

... §§ 610.46 and 610.47 when a donor tests reactive by a screening test for HIV or HCV required under § 610... evidence of HIV or HCV infection. [66 FR 31164, June 11, 2001, as amended at 72 FR 48798, Aug. 24, 2007] ...

21 CFR 610.41 - Donor deferral.

Code of Federal Regulations, 2014 CFR

2014-04-01

... §§ 610.46 and 610.47 when a donor tests reactive by a screening test for HIV or HCV required under § 610... evidence of HIV or HCV infection. [66 FR 31164, June 11, 2001, as amended at 72 FR 48798, Aug. 24, 2007] ...

21 CFR 610.41 - Donor deferral.

Code of Federal Regulations, 2011 CFR

2011-04-01

... §§ 610.46 and 610.47 when a donor tests reactive by a screening test for HIV or HCV required under § 610... evidence of HIV or HCV infection. [66 FR 31164, June 11, 2001, as amended at 72 FR 48798, Aug. 24, 2007] ...

21 CFR 610.41 - Donor deferral.

Code of Federal Regulations, 2013 CFR

2013-04-01

... §§ 610.46 and 610.47 when a donor tests reactive by a screening test for HIV or HCV required under § 610... evidence of HIV or HCV infection. [66 FR 31164, June 11, 2001, as amended at 72 FR 48798, Aug. 24, 2007] ...

An Energy Storage Assessment: Using Optimal Control Strategies to Capture Multiple Services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Di; Jin, Chunlian; Balducci, Patrick J.

2015-09-01

This paper presents a methodology for evaluating benefits of battery storage for multiple grid applications, including energy arbitrage, balancing service, capacity value, distribution system equipment deferral, and outage mitigation. In the proposed method, at each hour, a look-ahead optimization is first formulated and solved to determine battery base operating point. The minute by minute simulation is then performed to simulate the actual battery operation. This methodology is used to assess energy storage alternatives in Puget Sound Energy System. Different battery storage candidates are simulated for a period of one year to assess different value streams and overall benefits, as partmore » of a financial feasibility evaluation of battery storage projects.« less

Target Population of Non-deferrable Surgery and Uncontrolled Severe Bleeding Related to Dabigatran.

PubMed

Calabria, Silvia; Forcesi, Emanuele; Dondi, Letizia; Pedrini, Antonella; Maggioni, Aldo Pietro; Martini, Nello

2018-06-04

This observational study was aimed to identify patients who experienced non-deferrable surgery and/or uncontrolled severe bleeding following dabigatran administration and then are potentially eligible to the use of the specific antidote idarucizumab in a real-world setting. From the big Italian real-world database ARCO, a cohort of adult patients treated with dabigatran and hospitalized due to diagnoses attributable to urgent interventions and/or major bleeding was selected in 2014. Baseline characteristics and all-cause hospitalizations, specialist/diagnostic outpatient services, and healthcare costs over the 1-year follow-up were described. Out of 16,756,843 Italian citizens, 271,540 (1.9%) were prescribed with oral anticoagulants, and specifically, 17,450 with dabigatran. Patients identified to be hospitalized for non-deferrable surgery (n = 106) and/or uncontrolled severe bleeding (n = 190) following dabigatran use were 289 (1.7%) [mean age (± SD) 79 ± 7, 50% of female sex]. On average, patients stayed in hospital 13.7 and 17.0 days, respectively. The per patient and per year cost to the Italian National Health System was on average 19,708€ (specifically 1487€ for drugs, of which 311€ for dabigatran, 17,353€ for all-cause hospitalizations, and 869€ for outpatient care), about four times more than the mean healthcare integrated cost of a single patient treated with dabigatran (4775€). This analysis of the ARCO database reliably describes the population potentially eligible to the dabigatran reversal agent, idarucizumab. These data may be useful for Healthcare Decision Makers to organize, define, and improve present and future emergency healthcare, mainly as starting point for cost-effectiveness analyses of new reversal agents.

lbtA and lbtB Are Required for Production of the Legionella pneumophila Siderophore Legiobactin

PubMed Central

Allard, Kimberly A.; Viswanathan, V. K.; Cianciotto, Nicholas P.

2006-01-01

Under iron stress, Legionella pneumophila secretes legiobactin, a nonclassical siderophore that is reactive in the chrome azurol S (CAS) assay. Here, we have optimized conditions for legiobactin expression, shown its biological activity, and identified two genes, lbtA and lbtB, which are involved in legiobactin production. lbtA appears to be iron repressed and encodes a protein that has significant homology with siderophore synthetases, and FrgA, a previously described iron-regulated protein of L. pneumophila. lbtB encodes a protein homologous with members of the major facilitator superfamily of multidrug efflux pumps. Mutants lacking lbtA or lbtB were defective for legiobactin, producing 40 to 70% less CAS reactivity in deferrated chemically defined medium (CDM). In bioassays, mutant CDM culture supernatants, unlike those of the wild type, did not support growth of iron-limited wild-type bacteria in 2′,2′-dipyridyl-containing buffered charcoal yeast extract (BCYE) agar and a ferrous iron transport mutant on BCYE agar without added iron. The lbtA mutant was modestly defective for growth in deferrated CDM containing the iron chelator citrate, indicating that legiobactin is required in conditions of severe iron limitation. Complementation of the lbt mutants restored both siderophore expression, as measured by the CAS assay and bioassays, and bacterial growth in deferrated, citrate-containing media. The lbtA mutant replicated as the wild type did in macrophages, amoebae, and the lungs of mice. However, L. pneumophila expresses lbtA in the macrophage, suggesting that legiobactin, though not required, may play a dispensable role in intracellular growth. The discovery of lbtAB represents the first identification of genes required for L. pneumophila siderophore expression. PMID:16452417

20 CFR 633.315 - Replacement, corrective action, termination.

Code of Federal Regulations, 2012 CFR

2012-04-01

... subrecipient agreements, development of and compliance with corrective action plans, etc. (c) In cases where..., section 402 programs by reason of congressional action, whether by authorization, appropriation, deferral... onsite, seize bank accounts relating to the program, arrange for the payment of legitimate bills and...

20 CFR 633.315 - Replacement, corrective action, termination.

Code of Federal Regulations, 2011 CFR

2011-04-01

... subrecipient agreements, development of and compliance with corrective action plans, etc. (c) In cases where..., section 402 programs by reason of congressional action, whether by authorization, appropriation, deferral... onsite, seize bank accounts relating to the program, arrange for the payment of legitimate bills and...

The Time Line Technique Teaching Tool in Accounting

ERIC Educational Resources Information Center

Eisner, Emanuel

1977-01-01

Graphic examples of the use of the time line in accounting are presented in five problems statements (with comments) in the following areas: Depreciation expense vs. the contra asset, accumulated depreciation; adjusting entries (deferrals, accruals); discounting notes receivable; bond accounting; and compound interest concepts. (TA)

76 FR 15249 - Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-21

... Agency FR Federal Register GHG Greenhouse gas GWP Global warming potential HFC Hydrofluorocarbon ICR... year, weighted by the global warming potential (GWP) of the particular GHG pollutant, normalized to the... global GHG. Carbon dioxide emissions from a subset of bioenergy sources are reported as information items...

7 CFR 766.105 - Agency consideration of servicing requests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... each eligible borrower who requests servicing: (1) Conservation Contract, if requested; (2) Consolidation and rescheduling or reamortization; (3) Deferral; (4) Writedown; and (5) Current market value... develop a feasible plan; (ii) The borrower will be offered current market value buyout. (2) The borrower's...

Facility Accounting: Hammering Out a Capital Replacement Budget.

ERIC Educational Resources Information Center

Readinger, Jay

1996-01-01

Most facility and finance managers cannot adequately handle school infrastructure issues because they lack the tools to describe the problem appropriately. Facility accounting gives managers accurate deferral and projected replacement costs, using nationally recognized life-cycle and cost data. Facility accounting enables proper management of…

77 FR 39468 - Proposed Information Collection; Comment Request; Capital Construction Fund-Deposit/Withdrawal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... Collection; Comment Request; Capital Construction Fund--Deposit/Withdrawal Report AGENCY: National Oceanic... be commercial fishing industry individuals, partnerships, and corporations which entered into Capital Construction Fund agreements with the Secretary of Commerce allowing deferral of Federal taxation on fishing...

The Logic of Deferral: Educational Aims and Intellectual Disability

ERIC Educational Resources Information Center

Taylor, Ashley

2018-01-01

The educational aims described by educational philosophers rarely embrace the full range of differences in intellectual ability, adaptive behavior, or communication that children exhibit. Because envisioned educational aims have significant consequences for how educational practices, pedagogy, and curricula are conceptualized, the failure to…

12 CFR 190.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... be made on the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. ...

12 CFR 190.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... be made on the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. ...

12 CFR 190.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... be made on the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. ...

24 CFR 880.603 - Selection and admission of assisted tenants.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.603 Selection and admission of assisted tenants. (a) Application. The owner must accept... concerning deferral of termination of assistance. (Approved by the Office of Management and Budget under...

24 CFR 880.603 - Selection and admission of assisted tenants.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.603 Selection and admission of assisted tenants. (a) Application. The owner must accept... concerning deferral of termination of assistance. (Approved by the Office of Management and Budget under...

26 CFR 1.457-2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of section 414(j), the annual deferral for a taxable year is the present value of the increase during... value must be determined using actuarial assumptions and methods that are reasonable (both individually... paying length of service awards to bona fide volunteers (and their beneficiaries) on account of qualified...

26 CFR 1.457-2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of section 414(j), the annual deferral for a taxable year is the present value of the increase during... value must be determined using actuarial assumptions and methods that are reasonable (both individually... paying length of service awards to bona fide volunteers (and their beneficiaries) on account of qualified...

26 CFR 1.457-2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... of section 414(j), the annual deferral for a taxable year is the present value of the increase during... value must be determined using actuarial assumptions and methods that are reasonable (both individually... paying length of service awards to bona fide volunteers (and their beneficiaries) on account of qualified...

Tuition Tax Credits. Issuegram 19.

ERIC Educational Resources Information Center

Augenblick, John; McGuire, Kent

Approaches for using the federal income tax system to aid families of pupils attending private schools include: tax credits, tax deductions, tax deferrals, and education savings incentives. Tax credit structures can be made refundable and made sensitive to taxpayers' income levels, the level of education expenditures, and designated costs.…

42 CFR 457.202 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 457.202 Section 457.202 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.202 Audits. (a) Purpose. The Department's Office of Inspector General (OIG...

18 CFR 367.2550 - Account 255, Accumulated deferred investment tax credits.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Accumulated deferred investment tax credits. 367.2550 Section 367.2550 Conservation of Power and Water... 255, Accumulated deferred investment tax credits. This account must be credited with all investment tax credits deferred by companies that have elected to follow deferral accounting, partial or full...

31 CFR 206.8 - Appeals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.8 Appeals. (a) An agency that chooses to file an... reduced charge, deferral of the charge, an alternative solution to cash management improvement, or a... Commissioner, Federal Finance, of the Service. The temporary board member will be a cash management official...

Who should donate blood? Policy decisions on donor deferral criteria should protect recipients and be fair to donors.

PubMed

Brailsford, S R; Kelly, D; Kohli, H; Slowther, A; Watkins, N A

2015-08-01

An important element in the development of voluntary blood donation schemes throughout the world has been the attention given to minimising the risk to recipients of donated blood, primarily the risk of transfusion transmitted infections. In response to the appearance of human immunodeficiency virus (HIV) in the 1980s a range of national policies emerged that excluded populations at high risk of contracting HIV from donating blood, with a particular focus on men who have sex with men (MSM), the primary reason being the protection of recipients of donated blood. Recently some countries, including the UK, have revised their policies, informed by advances in screening tests, epidemiological evidence of transmission rates and an increasing concern about unfair discrimination of specific groups in society. Policy makers face a difficult task of balancing safety of recipients; an adequate blood supply for those who require transfusion; and societal/legal obligations to treat everyone fairly. Given that no transfusion is risk free, the question is what degree of risk is acceptable in order to meet the needs of recipients and society. Decisions about acceptance of risk are complex and policy makers who set acceptable risk levels must provide ethically justifiable reasons for their decisions. We suggest it is possible to provide a set of reasons that stakeholders could agree are relevant based on careful evaluation of the evidence of all relevant risks and explicit acknowledgement of other morally relevant values. We describe using such a process in the Safety of Blood Tissue and Organs (SaBTO) review of donor deferral criteria related to sexual behaviour. © 2015 British Blood Transfusion Society.

75 FR 55803 - Transmissible Spongiform Encephalopathies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... Creutzfeldt-Jakob disease (vCJD) agent in U.S.-licensed plasma-derived Factor VIII and (2) labeling of blood and blood components and plasma-derived products, including plasma-derived albumin and products..., the Committee will hear informational presentations related to FDA's geographic donor deferral policy...

15 CFR Appendix B to Part 30 - AES Filing Codes

Code of Federal Regulations, 2014 CFR

2014-01-01

... charity FS—Foreign Military Sales ZD—North American Free Trade Agreements (NAFTA) duty deferral shipments...—Validated End User Authorization C58CCD—Consumer Communication Devices C59STA—Strategic Trade Authorization Department of Energy/National Nuclear Security Administration (DOE/NNSA) Codes E01—DOE/NNSA Nuclear...

78 FR 13497 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... defers until July 21, 2014 the application of the Prevention of Significant Deterioration (PSD... Other Biogenic Sources Under the Prevention of Significant Deterioration Program AGENCY: Environmental... July 21, 2014 the application of PSD permitting requirements to biogenic CO 2 emissions from bioenergy...

12 CFR 226.47 - Content of disclosures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... a covered educational institution may have school-specific education loan benefits and terms not... will be higher if the loan is not co-signed or guaranteed. (2) Fees and default or late payment costs... payment deferral option applicable while the student is enrolled at a covered educational institution: (A...

77 FR 65627 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... program delegation, authorization or approval.'' Virginia's Immunity law, Va. Code Sec. 10.1-1199..., regulation, permit, or administrative order is granted immunity from administrative or civil penalty. The... inapplicable to enforcement of any Federally authorized programs, since ``no immunity could be afforded from...

Deferring Totality: An Anti-Dialectic Theory of Identity

ERIC Educational Resources Information Center

Powell, David M.; Noel, Jana

2010-01-01

Using Derrida's concept of deferring totality, Deleuze's concept of the logic of multiplicities, and Butler's "sliding scale," this paper presents an anti-dialectic theory of identity, one that recognizes the permanent deferral of the very concept of identity--a non-synthesized, non-resolved identity--that values the hybridity of identities.…

47 CFR 0.401 - Location of Commission offices.

Code of Federal Regulations, 2012 CFR

2012-10-01

... exemption, waiver or deferral from the fee requirement), should be delivered to one of the following... Commission, P.O. Box IT-70, Gettysburg, PA 17326. (4) The locations of the field offices of the Compliance... boxes for the receipt of different types of applications. It will also establish special post office...

42 CFR 457.236 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 457.236 Section 457.236 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records on...

78 FR 30208 - Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Prevention of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2011-0467; EPA-R05-OAR-2012-0538; FRL-9808-9] Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Prevention of Significant Deterioration Greenhouse Gas Tailoring and Biomass Deferral Rule AGENCY: Environmental Protection...

29 CFR 1640.11 - EEOC review of deferred charges.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 4 2014-07-01 2014-07-01 false EEOC review of deferred charges. 1640.11 Section 1640.11 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR... EEOC review of deferred charges. (a) Deferral by the EEOC. When it is determined that a section 504...

29 CFR 1640.11 - EEOC review of deferred charges.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false EEOC review of deferred charges. 1640.11 Section 1640.11 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR... EEOC review of deferred charges. (a) Deferral by the EEOC. When it is determined that a section 504...

29 CFR 1640.11 - EEOC review of deferred charges.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false EEOC review of deferred charges. 1640.11 Section 1640.11 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR... EEOC review of deferred charges. (a) Deferral by the EEOC. When it is determined that a section 504...

29 CFR 1640.11 - EEOC review of deferred charges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false EEOC review of deferred charges. 1640.11 Section 1640.11 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR... EEOC review of deferred charges. (a) Deferral by the EEOC. When it is determined that a section 504...

Empirical Investigations of the Opportunity Limits of Automatic Residential Electric Load Shaping

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cruickshank, Robert F.; Henze, Gregor P.; Balaji, Rajagopalan

Residential electric load shaping is often modeled as infrequent, utility-initiated, short-duration deferral of peak demand through direct load control. In contrast, modeled herein is the potential for frequent, transactive, intraday, consumer-configurable load shaping for storage-capable thermostatically controlled electric loads (TCLs), including refrigerators, freezers, and hot water heaters. Unique to this study are 28 months of 15-minute-interval observations of usage in 101 homes in the Pacific Northwest United States that specify exact start, duration, and usage patterns of approximately 25 submetered loads per home. The magnitudes of the load shift from voluntarily-participating TCL appliances are aggregated to form hourly upper andmore » lower load-shaping limits for the coordination of electrical generation, transmission, distribution, storage, and demand. Empirical data are statistically analyzed to define metrics that help quantify load-shaping opportunities.« less

Empirical Investigations of the Opportunity Limits of Automatic Residential Electric Load Shaping: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cruickshank, Robert F.; Henze, Gregor P.; Balaji, Rajagopalan

Residential electric load shaping is often modeled as infrequent, utility-initiated, short-duration deferral of peak demand through direct load control. In contrast, modeled herein is the potential for frequent, transactive, intraday, consumer-configurable load shaping for storage-capable thermostatically controlled electric loads (TCLs), including refrigerators, freezers, and hot water heaters. Unique to this study are 28 months of 15-minute-interval observations of usage in 101 homes in the Pacific Northwest United States that specify exact start, duration, and usage patterns of approximately 25 submetered loads per home. The magnitudes of the load shift from voluntarily-participating TCL appliances are aggregated to form hourly upper andmore » lower load-shaping limits for the coordination of electrical generation, transmission, distribution, storage, and demand. Empirical data are statistically analyzed to define metrics that help quantify load-shaping opportunities.« less

46 CFR 390.12 - Liquidated damages.

Code of Federal Regulations, 2013 CFR

2013-10-01

... requires that the party repay the time value of the deferral of Federal Income Tax which the party has... trading restrictions, add (A) the sum of qualified withdrawals for the vessel which have been made from... subject to 5-yr trading restriction = 1.469328 (value of $1 compounded at 8 pct for 20, 10, and 5 yr...

46 CFR 390.12 - Liquidated damages.

Code of Federal Regulations, 2012 CFR

2012-10-01

... requires that the party repay the time value of the deferral of Federal Income Tax which the party has... trading restrictions, add (A) the sum of qualified withdrawals for the vessel which have been made from... subject to 5-yr trading restriction = 1.469328 (value of $1 compounded at 8 pct for 20, 10, and 5 yr...

46 CFR 390.12 - Liquidated damages.

Code of Federal Regulations, 2010 CFR

2010-10-01

... requires that the party repay the time value of the deferral of Federal Income Tax which the party has... trading restrictions, add (A) the sum of qualified withdrawals for the vessel which have been made from... subject to 5-yr trading restriction = 1.469328 (value of $1 compounded at 8 pct for 20, 10, and 5 yr...

46 CFR 390.12 - Liquidated damages.

Code of Federal Regulations, 2014 CFR

2014-10-01

... requires that the party repay the time value of the deferral of Federal Income Tax which the party has... trading restrictions, add (A) the sum of qualified withdrawals for the vessel which have been made from... subject to 5-yr trading restriction = 1.469328 (value of $1 compounded at 8 pct for 20, 10, and 5 yr...

26 CFR 1.402A-1 - Designated Roth Accounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... gross income as an amount allocable to investment in the contract is determined under section 72(e)(8... portion not includible in gross income as an amount allocable to investment in the contract is determined... preceding, however, a contribution that is returned as an excess deferral or excess contribution does not...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2010 CFR

2010-04-01

... not include an election as to the medium of payment (for example, an election between a payment of... provision providing for a differing treatment of such compensation may not be effective for 12 months from... (a)(13), a plan that was adopted and effective before December 31, 2007, whether written or unwritten...

Out of Weakness: The "Educational Good" in Late Antiquity

ERIC Educational Resources Information Center

Allen, Ansgar

2016-01-01

This paper explores the nature of the educational good as it appears in late antiquity, arguing that the "good" variously promised by education is in a state of perpetual deferral. This extends the tradition of ancient Greek philosophy where wisdom is to be forever approached but never realised. Three exemplary cases are considered: the…

77 FR 55171 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... consider your comment. Electronic files should avoid the use of special characters, any form of encryption... copy form. Publicly available docket materials are available either electronically in www.regulations... biologically-based materials other than fossil fuels and mineral sources of carbon. Examples of ``biogenic CO 2...

19 CFR 181.45 - Goods eligible for full drawback.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-Deferral Programs § 181.45 Goods eligible for full drawback. (a) Goods originating in Canada or Mexico. A... originating good is: (1) Subsequently exported to Canada or Mexico; (2) Used as a material in the production of another good that is subsequently exported to Canada or Mexico; or (3) Substituted by a good of...

19 CFR 181.45 - Goods eligible for full drawback.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-Deferral Programs § 181.45 Goods eligible for full drawback. (a) Goods originating in Canada or Mexico. A... originating good is: (1) Subsequently exported to Canada or Mexico; (2) Used as a material in the production of another good that is subsequently exported to Canada or Mexico; or (3) Substituted by a good of...

Facing the Issue of Facilities Maintenance in California Public Higher Education.

ERIC Educational Resources Information Center

California State Postsecondary Education Commission, Sacramento.

The decision to defer facilities maintenance obligations in California higher education and the extent to which maintenance has been deferred are discussed. Attention is also directed to the educational and fiscal context in which this decision has been made nationally. The policies and procedures governing facilities maintenance and deferral in…

75 FR 28619 - Meeting of the Advisory Committee on Blood Safety and Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... began prior to the availability of tests for HIV in early 1985. The deferral has existed in its current form since September 1985. This and other related FDA policies are designed to address the major... screened using highly sensitive tests, screening tests can be falsely negative during the ``window period...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2014 CFR

2014-04-01

... during successive service periods each of which comprises less than 12 months (for example, a teacher... recipients with respect to the time and form of payment to beneficiaries. An election to change the identity... election changes the identity of the recipient of the payment, if the time and form of the payment is not...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2012 CFR

2012-04-01

... during successive service periods each of which comprises less than 12 months (for example, a teacher... recipients with respect to the time and form of payment to beneficiaries. An election to change the identity... election changes the identity of the recipient of the payment, if the time and form of the payment is not...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2011 CFR

2011-04-01

... during successive service periods each of which comprises less than 12 months (for example, a teacher... recipients with respect to the time and form of payment to beneficiaries. An election to change the identity... election changes the identity of the recipient of the payment, if the time and form of the payment is not...

26 CFR 1.409A-2 - Deferral elections.

Code of Federal Regulations, 2013 CFR

2013-04-01

... during successive service periods each of which comprises less than 12 months (for example, a teacher... recipients with respect to the time and form of payment to beneficiaries. An election to change the identity... election changes the identity of the recipient of the payment, if the time and form of the payment is not...

22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

Code of Federal Regulations, 2014 CFR

2014-04-01

...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after such... petition is not otherwise actionable, or an intervention is not appropriate, the Regional Director may...

22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

Code of Federal Regulations, 2010 CFR

2010-04-01

...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after such... petition is not otherwise actionable, or an intervention is not appropriate, the Regional Director may...

22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

Code of Federal Regulations, 2013 CFR

2013-04-01

...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after such... petition is not otherwise actionable, or an intervention is not appropriate, the Regional Director may...

22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

Code of Federal Regulations, 2012 CFR

2012-04-01

...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after such... petition is not otherwise actionable, or an intervention is not appropriate, the Regional Director may...

22 CFR 1422.6 - Withdrawal, dismissal or deferral of petitions; consolidation of cases; denial of intervention...

Code of Federal Regulations, 2011 CFR

2011-04-01

...; consolidation of cases; denial of intervention; review of action by Regional Director. 1422.6 Section 1422.6... intervention; review of action by Regional Director. (a) If the Regional Director determines, after such... petition is not otherwise actionable, or an intervention is not appropriate, the Regional Director may...

29 CFR 2520.104-50 - Short plan years, deferral of accountant's examination and report.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Financial statements and accompanying schedules prepared in conformity with the requirements of section 103... respect to the financial statements and accompanying schedules for both of the two plan years. (2) The annual report for the second of the two consecutive plan years shall include: (i) Financial statements...

18 CFR 367.4112 - Account 411.2, Provision for deferred income taxes-Credit, other income and deductions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., Provision for deferred income taxes-Credit, other income and deductions. 367.4112 Section 367.4112... deferred taxes and deferrals of taxes, credit, that relate to other income and deductions. ... Accounts Service Company Operating Income § 367.4112 Account 411.2, Provision for deferred income taxes...

Benefit/cost framework for evaluating modular energy storage : a study for the DOE energy storage systems program.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eyer, James M.; Schoenung, Susan M.

2008-02-01

The work documented in this report represents another step in the ongoing investigation of innovative and potentially attractive value propositions for electricity storage by the United States Department of Energy (DOE) and Sandia National Laboratories (SNL) Energy Storage Systems (ESS) Program. This study uses updated cost and performance information for modular energy storage (MES) developed for this study to evaluate four prospective value propositions for MES. The four potentially attractive value propositions are defined by a combination of well-known benefits that are associated with electricity generation, delivery, and use. The value propositions evaluated are: (1) transportable MES for electric utilitymore » transmission and distribution (T&D) equipment upgrade deferral and for improving local power quality, each in alternating years, (2) improving local power quality only, in all years, (3) electric utility T&D deferral in year 1, followed by electricity price arbitrage in following years; plus a generation capacity credit in all years, and (4) electric utility end-user cost management during times when peak and critical peak pricing prevail.« less

Innovative applications of energy storage in a restructured electricity marketplace : Phase III final report : a study for the DOE Energy Storage Systems Program.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eyer, James M.; Erdman, Bill; Iannucci, Joseph J., Jr.

2005-03-01

This report describes Phase III of a project entitled Innovative Applications of Energy Storage in a Restructured Electricity Marketplace. For this study, the authors assumed that it is feasible to operate an energy storage plant simultaneously for two primary applications: (1) energy arbitrage, i.e., buy-low-sell-high, and (2) to reduce peak loads in utility ''hot spots'' such that the utility can defer their need to upgrade transmission and distribution (T&D) equipment. The benefits from the arbitrage plus T&D deferral applications were estimated for five cases based on the specific requirements of two large utilities operating in the Eastern U.S. A numbermore » of parameters were estimated for the storage plant ratings required to serve the combined application: power output (capacity) and energy discharge duration (energy storage). In addition to estimating the various financial expenditures and the value of electricity that could be realized in the marketplace, technical characteristics required for grid-connected distributed energy storage used for capacity deferral were also explored.« less

Reevaluating Canada's policy for blood donations from men who have sex with men (MSM).

PubMed

Jubran, Bellal; Billick, Maxime; Devlin, Gabriel; Cygler, Jeremy; Lebouché, Bertrand

2016-12-01

During the HIV/AIDS epidemic of the 1980s, most of the developed world instituted a permanent ban on blood donations from men who have sex with men (MSM). In recent years, public health agencies across Europe and North America are reconsidering and rescinding these restrictions. We examine the Canadian climate, where MSM may donate blood only after a 5-year deferral period. We review circumstances of the initial ban on MSM blood donations and recent social, legal, and economic changes that have encouraged Canadian public health officials to consider policy reform. We also review international evidence about the impact of reforming MSM blood donations. Given improvements in HIV screening technology, results from mathematical modeling studies, and empirical data from Italy, the UK, and Australia, we conclude that changing Canada's MSM blood donation policy from a 5- to a 1-year deferral would not increase the number of transfusion-transmitted HIV infections. We provide empirical support to the recently elected Liberal Canadian government's political promise to decrease restrictions on MSM blood donations.

Women as whole blood donors: offers, donations and deferrals in the province of Huelva, south-western Spain.

PubMed

Prados Madrona, Dalmiro; Fernández Herrera, María Dolores; Prados Jiménez, Dalmiro; Gómez Giraldo, Sonsoles; Robles Campos, Rita

2014-01-01

Women seem more willing to donate blood than men despite the limitations that affect their donation rate. The aim of our study was to determine the role of women in altruistic donation of blood in Huelva, a province in south-western Spain. We registered 87,601 offers to donate whole blood between January 1st, 2005 and December 31st, 2009. We statistically analysed variables such as sex, age, offers, deferrals and donations, problems in venous access, vasovagal reactions, weight and blood pressure to establish their significance according to donor gender. With regards to gender, 52.3% of donors were women and 47.7% men. Of the 87,601 offers to donate blood, 46.5% were from females and 53.5% from males. More females than males made their first donation during the study period. However, 43.9 % of donations were from women, whereas 56.1% were from men. Overall 8.7% of offers were deferred, 62.7% of which due to a low haemoglobin concentration, which was the most frequent cause of deferral in women. Difficulties in venous access and vasovagal reactions were also more frequent in female donors than in male donors. By the end of the study period, donor fidelity was 58.6% for men and 48.6% for women. In the province of Huelva, women are more altruistically inclined than men to give blood, with the percentages of donors and first-time donors being higher among females. However, there are restrictions to women giving blood, especially low haemoglobin concentration, which reduce the number of female blood donations. Women also have more difficulty when blood is withdrawn and are more susceptible to vasovagal reactions, which negatively affect their experience as donors. Measures should be taken to reduce these barriers to encourage women to continue to offer to donate blood, thereby ensuring that they become regular donors, which is a key factor in guaranteeing an adequate supply of blood within the region of Andalusia.

Blood donor deferral policies across Europe and characteristics of men whohave sex with men screened for human immunodeficiency virus in bloodestablishments: data from the European Men-who-have-sex-with-men Internet Survey (EMIS)

PubMed Central

Schink, Susanne B.; Offergeld, Ruth; Schmidt, Axel J.; Marcus, Ulrich

2018-01-01

Background The predominant mode of transmission of human immunodeficiency virus (HIV) in Europe is male-to-male transmission. Men who have sex with men (MSM) are deferred from donating blood in many countries, but nevertheless do donate blood. Based on data from 34 countries, we estimated the proportion of MSM screened for HIV in the context of a blood donation and identified individual factors associated with this HIV screening in order to propose possible public health interventions. Materials and methods In 2010, the first European MSM Internet Survey (EMIS) collected self-reported data on HIV testing from >180,000 MSM in 38 European countries. Using logistic regression, demographic and behavioural factors associated with screening for HIV in blood establishments were identified. Stratified by European sub-region, we analysed the proportion of MSM screening in blood establishments by time elapsed since last negative HIV test. Results Donor eligibility criteria for MSM vary across Europe with most countries using permanent deferral. The Western region had the lowest (2%) proportion of MSM screened in blood establishments and the Northeastern region had the highest (14%). Being <25 years old, not disclosing sexual attraction to men, never having had anal intercourse with a man, having a female partner, living in a rural area, and certain European sub-regions or countries of residence increased the likelihood of being screened in blood establishments. Discussion In spite of deferral policies, MSM are screened for HIV in the context of blood donations. Gay-friendly testing services are rare in rural areas, and young men might be reluctant to disclose their sexual orientation. Recent developments, such as home sampling, might offer new testing possibilities for those not reached by established services yet wishing to know their HIV status. Donor selection procedures should be improved. Both interventions might help to further reduce the risk of transfusion-transmitted infections. PMID:28488974

The welfare effects of integrating renewable energy into electricity markets

NASA Astrophysics Data System (ADS)

Lamadrid, Alberto J.

The challenges of deploying more renewable energy sources on an electric grid are caused largely by their inherent variability. In this context, energy storage can help make the electric delivery system more reliable by mitigating this variability. This thesis analyzes a series of models for procuring electricity and ancillary services for both individuals and social planners with high penetrations of stochastic wind energy. The results obtained for an individual decision maker using stochastic optimization are ambiguous, with closed form solutions dependent on technological parameters, and no consideration of the system reliability. The social planner models correctly reflect the effect of system reliability, and in the case of a Stochastic, Security Constrained Optimal Power Flow (S-SC-OPF or SuperOPF), determine reserve capacity endogenously so that system reliability is maintained. A single-period SuperOPF shows that including ramping costs in the objective function leads to more wind spilling and increased capacity requirements for reliability. However, this model does not reflect the inter temporal tradeoffs of using Energy Storage Systems (ESS) to improve reliability and mitigate wind variability. The results with the multiperiod SuperOPF determine the optimum use of storage for a typical day, and compare the effects of collocating ESS at wind sites with the same amount of storage (deferrable demand) located at demand centers. The collocated ESS has slightly lower operating costs and spills less wind generation compared to deferrable demand, but the total amount of conventional generating capacity needed for system adequacy is higher. In terms of the total system costs, that include the capital cost of conventional generating capacity, the costs with deferrable demand is substantially lower because the daily demand profile is flattened and less conventional generation capacity is then needed for reliability purposes. The analysis also demonstrates that the optimum daily pattern of dispatch and reserves is seriously distorted if the stochastic characteristics of wind generation are ignored.

HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study

PubMed Central

Sawe, Hendry R; Mfinanga, Juma A; Ringo, Faith H; Mwafongo, Victor; Reynolds, Teri A; Runyon, Michael S

2016-01-01

Objectives To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. Setting The ED of a large east African national referral hospital. Participants This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. Primary and secondary outcome measures The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Results Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Conclusions Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. PMID:26880672

Passing, Protesting, and the Arts of Resistance: Infiltrating the Ritual Space of Blood Donation

ERIC Educational Resources Information Center

Bennett, Jeffrey A.

2008-01-01

This essay critically engages challenges made against the federally mandated deferral policies which prohibit "men who have sex with other men" from donating blood. I argue that "passing" and "protest" are dialogically dependent on one another as two separate but related tactics of resistance. Drawing on interview materials from men who have both…

12 CFR 590.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. [54 FR 49715, Nov. 30, 1989, as amended at 61 FR 50984, Sept. 30, 1996...

12 CFR 590.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. [54 FR 49715, Nov. 30, 1989, as amended at 61 FR 50984, Sept. 30, 1996...

12 CFR 590.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. [54 FR 49715, Nov. 30, 1989, as amended at 61 FR 50984, Sept. 30, 1996...

12 CFR 590.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. [54 FR 49715, Nov. 30, 1989, as amended at 61 FR 50984, Sept. 30, 1996...

12 CFR 590.4 - Federally-related residential manufactured housing loans-consumer protection provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... first lien on a residential mobile home if a creditor covered by this part complies with the consumer... the final scheduled installment. (g) Deferral fees. (1) With respect to mobile home credit... money order; do not send cash. [54 FR 49715, Nov. 30, 1989, as amended at 61 FR 50984, Sept. 30, 1996...

77 FR 23178 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Deferral for CO2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... other than fossil fuels and mineral sources of carbon. Examples of ``biogenic CO 2 emissions'' include... biomass can be part of the national strategy to reduce dependence on fossil fuels. Efforts are underway at.... In that event, Virginia may revise its SIP accordingly. For stationary sources co-firing fossil fuel...

27 CFR 25.175 - Prepayment of tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF THE TREASURY LIQUORS BEER Tax on Beer Prepayment of Tax § 25.175 Prepayment of tax. (a) General..., is insufficient for deferral of payment of tax on beer to be removed for consumption or sale, or if a... tax before any beer is removed for consumption or sale, or taken out of the brewery for removal for...

27 CFR 25.175 - Prepayment of tax.

Code of Federal Regulations, 2013 CFR

2013-04-01

... OF THE TREASURY ALCOHOL BEER Tax on Beer Prepayment of Tax § 25.175 Prepayment of tax. (a) General..., is insufficient for deferral of payment of tax on beer to be removed for consumption or sale, or if a... tax before any beer is removed for consumption or sale, or taken out of the brewery for removal for...

27 CFR 25.175 - Prepayment of tax.

Code of Federal Regulations, 2014 CFR

2014-04-01

... OF THE TREASURY ALCOHOL BEER Tax on Beer Prepayment of Tax § 25.175 Prepayment of tax. (a) General..., is insufficient for deferral of payment of tax on beer to be removed for consumption or sale, or if a... tax before any beer is removed for consumption or sale, or taken out of the brewery for removal for...

27 CFR 25.175 - Prepayment of tax.

Code of Federal Regulations, 2012 CFR

2012-04-01

... OF THE TREASURY LIQUORS BEER Tax on Beer Prepayment of Tax § 25.175 Prepayment of tax. (a) General..., is insufficient for deferral of payment of tax on beer to be removed for consumption or sale, or if a... tax before any beer is removed for consumption or sale, or taken out of the brewery for removal for...

34 CFR 304.31 - Requirements for obtaining an exception or deferral to performance or repayment under an agreement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION SERVICE OBLIGATIONS UNDER SPECIAL EDUCATION-PERSONNEL DEVELOPMENT TO IMPROVE SERVICES AND RESULTS... institution of higher education; (2) Is serving on active duty as a member of the armed services of the United...

34 CFR 304.31 - Requirements for obtaining an exception or deferral to performance or repayment under an agreement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION SERVICE OBLIGATIONS UNDER SPECIAL EDUCATION-PERSONNEL DEVELOPMENT TO IMPROVE SERVICES AND RESULTS... institution of higher education; (2) Is serving on active duty as a member of the armed services of the United...

76 FR 43330 - Notice of Release of the Exposure Draft of Technical Bulletin 2011-2, Extended Deferral of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Release of the Exposure Draft of Technical... Accounting Standards Advisory Board. ACTION: Notice. Board Action: Pursuant to 31 U.S.C. 3511(d), the Federal... October, 2010, notice is hereby given that the Federal Accounting Standards Advisory Board (FASAB) has...

26 CFR 1.402(g)-1 - Limitation on exclusion for elective deferrals.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 1.402(g)-1 Section 1.402(g)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)-1... section 402(a)(8) (before applying the limits of section 402(g) or this section). (2) Any employer...

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Canada or Mexico. Example. Company N imports tea into the United States and makes a Class 6 warehouse entry. Company N manufactures sweetened ice tea mix by combining the imported tea with refined cane sugar and other flavorings and packaging it in retail size canisters. Upon withdrawal of the ice tea mix...

45 CFR 158.270 - Effect of rebate payments on solvency.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., superintendent, or other responsible official may request that the Secretary defer all or a portion of the rebate... the Company Action Level RBC. (d) When the Secretary determines that the payment of rebates by an... deferral of all or a portion of the rebates owed, but only for a period determined by the Secretary in...

45 CFR 158.270 - Effect of rebate payments on solvency.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., superintendent, or other responsible official may request that the Secretary defer all or a portion of the rebate... the Company Action Level RBC. (d) When the Secretary determines that the payment of rebates by an... deferral of all or a portion of the rebates owed, but only for a period determined by the Secretary in...

45 CFR 158.270 - Effect of rebate payments on solvency.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., superintendent, or other responsible official may request that the Secretary defer all or a portion of the rebate... the Company Action Level RBC. (d) When the Secretary determines that the payment of rebates by an... deferral of all or a portion of the rebates owed, but only for a period determined by the Secretary in...

45 CFR 158.270 - Effect of rebate payments on solvency.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., superintendent, or other responsible official may request that the Secretary defer all or a portion of the rebate... the Company Action Level RBC. (d) When the Secretary determines that the payment of rebates by an... deferral of all or a portion of the rebates owed, but only for a period determined by the Secretary in...

The Challenges of the Ontario Secondary School Literacy Test for Second Language Students

ERIC Educational Resources Information Center

Cheng, Liying; Klinger, Don A.; Zheng, Ying

2007-01-01

Results from the Ontario Secondary School Literacy Test (OSSLT) indicate that English as a Second Language (ESL) and English Literacy Development (ELD) students have comparatively low success and high deferral rates. This study examined the 2002 and 2003 OSSLT test performances of ESL/ELD and non-ESL/ELD students in order to identify and…

78 FR 68735 - Reduction or Suspension of Safe Harbor Contributions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... forth in section 401(k)(3), called the actual deferral percentage (ADP) test, or one of the design-based... design-based safe harbor method under which a CODA is treated as satisfying the ADP test if the... the design-based alternatives in section 401(m)(10), 401(m)(11), or 401(m)(12). The ACP test in...

78 FR 78720 - Deferral of Compliance Date: Full-Service Intelligent Mail Barcode Requirement To Qualify for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

...The Postal Service gives notice that it is deferring the previously-announced compliance date of January 26, 2014, for mailers to use full-service Intelligent Mail[supreg] to qualify for automation prices when mailing First-Class Mail[supreg], Standard Mail[supreg]; Periodicals[supreg], and Bound Printed Matter[supreg] mailpieces.

26 CFR 1.1001-3 - Modifications of debt instruments.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., interest will compound at a rate of 12 percent. The exercise of the option, which results in the deferral... deferred, interest will compound at a rate 150 basis points greater than the stated rate of interest. (ii... annual resetting of the interest rate based on the value of an index or a specified increase in the...

78 FR 21065 - Approval and Promulgation of Implementation Plans; Georgia: New Source Review-Prevention of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-09

... (NAAQS) and the deferral of, until July 21, 2014, PSD applicability to biogenic carbon dioxide (CO 2... regarding NSR permitting. EPA is also responding to comments received on the January 14, 2012, proposed... SILs or SMC portions of that rule. Further, EPA's January 14, 2013, proposed rule did not include a...

26 CFR 1.403(b)-0 - Taxability under an annuity purchased by a section 501(c)(3) organization or a public school.

Code of Federal Regulations, 2010 CFR

2010-04-01

... plans that permit in-service distributions. (f) Special rule for life insurance contracts. (g) Special...) contracts. (a) Exclusion for section 403(b) contracts. (b) Application of requirements. (c) Special rules...) Section 403(b) elective deferrals. (d) Employer contributions for former employees. (e) Special rules for...

37 CFR 1.103 - Suspension of action by the Office.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Code. A request for deferral of examination under this paragraph must include the publication fee set... include: (1) A showing of good and sufficient cause for suspension of action; and (2) The fee set forth in... the period of suspension, and include the processing fee set forth in § 1.17(i). (c) Limited...

27 CFR 25.175 - Prepayment of tax.

Code of Federal Regulations, 2011 CFR

2011-04-01

... OF THE TREASURY LIQUORS BEER Tax on Beer Prepayment of Tax § 25.175 Prepayment of tax. (a) General..., is insufficient for deferral of payment of tax on beer to be removed for consumption or sale, or if a... tax before any beer is removed for consumption or sale, or taken out of the brewery for removal for...

26 CFR 1.401(k)-2 - ADP test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false ADP test. 1.401(k)-2 Section 1.401(k)-2 Internal... TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.401(k)-2 ADP test. (a) Actual deferral percentage (ADP) test—(1) In general—(i) ADP test formula. A cash or deferred arrangement...

26 CFR 1.401(k)-2 - ADP test.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false ADP test. 1.401(k)-2 Section 1.401(k)-2 Internal... TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.401(k)-2 ADP test. (a) Actual deferral percentage (ADP) test—(1) In general—(i) ADP test formula. A cash or deferred arrangement satisfies the ADP...

26 CFR 1.401(k)-2 - ADP test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 5 2014-04-01 2014-04-01 false ADP test. 1.401(k)-2 Section 1.401(k)-2 Internal... TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.401(k)-2 ADP test. (a) Actual deferral percentage (ADP) test—(1) In general—(i) ADP test formula. A cash or deferred arrangement...

77 FR 71419 - Notice of Appointment of New FASAB Member and Release of the Exposure Draft Regarding Deferral of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-30

... FEDERAL ACCOUNTING STANDARDS ADVISORY BOARD Notice of Appointment of New FASAB Member and Release... Information AGENCY: Federal Accounting Standards Advisory Board. ACTION: Notice. Board Action: Pursuant to 31... appointed to a five-year term as a member of the Federal Accounting Standards Advisory Board (FASAB...

19 CFR 351.518 - Exemption, remission, or deferral upon export of prior-stage cumulative indirect taxes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... prior-stage cumulative indirect taxes. 351.518 Section 351.518 Customs Duties INTERNATIONAL TRADE... indirect taxes. (a) Benefit—(1) Exemption of prior-stage cumulative indirect taxes. In the case of a... production of an exported product, a benefit exists to the extent that the exemption extends to inputs that...

75 FR 51980 - Hand Trucks and Certain Parts Thereof from the People's Republic of China; Extension of Time...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... Parts Thereof from the People's Republic of China; Extension of Time Limit for Preliminary Results of... review of the antidumping duty order on hand trucks and certain parts thereof from the People's Republic... Antidumping and Countervailing Duty Administrative Reviews and Request for Revocation in Part, and Deferral of...

26 CFR 1.403(b)-4 - Contribution limitations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... described in section 415(c)(3)(E). Any age 50 catch-up contributions under paragraph (c)(2) of this section...) elective deferrals made on his or her behalf. (2) Age 50 catch-up—(i) In general. In accordance with... contributions for a participant who is age 50 by the end of the year, provided that such age 50 catch-up...

29 CFR 1420.9 - FMCS deferral to parties' own private interest arbitration procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... regulations are a part of the Service's overall approach to implementing the health care amendments of 1974 in... to be flexible and to tailor its approach so as to accommodate the needs of the parties in the..., both unions and management, to take advantage of these and other options and to work with the Service...

29 CFR 1420.9 - FMCS deferral to parties' own private interest arbitration procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulations are a part of the Service's overall approach to implementing the health care amendments of 1974 in... to be flexible and to tailor its approach so as to accommodate the needs of the parties in the..., both unions and management, to take advantage of these and other options and to work with the Service...

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... required filing date. The person required to file shall file Customs Form 7501 no later than 10 working days after the date of exportation to Canada or Mexico or 10 working days after being entered into a... sugar and other flavorings and packaging it in retail size canisters. Upon withdrawal of the ice tea mix...

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... required filing date. The person required to file shall file Customs Form 7501 no later than 10 working days after the date of exportation to Canada or Mexico or 10 working days after being entered into a... sugar and other flavorings and packaging it in retail size canisters. Upon withdrawal of the ice tea mix...

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... required filing date. The person required to file shall file Customs Form 7501 no later than 10 working days after the date of exportation to Canada or Mexico or 10 working days after being entered into a... sugar and other flavorings and packaging it in retail size canisters. Upon withdrawal of the ice tea mix...

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... required filing date. The person required to file shall file Customs Form 7501 no later than 10 working days after the date of exportation to Canada or Mexico or 10 working days after being entered into a... sugar and other flavorings and packaging it in retail size canisters. Upon withdrawal of the ice tea mix...

75 FR 22814 - Guidance for Industry: Nucleic Acid Testing (NAT) for Human Immunodeficiency Virus Type 1 (HIV-1...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-30

... Immunodeficiency Virus Type 1 (HIV-1) and Hepatitis C Virus (HCV): Testing, Product Disposition, and Donor Deferral... Industry: Nucleic Acid Testing (NAT) for Human Immunodeficiency Virus Type 1 (HIV-1) and Hepatitis C Virus... Acid Test (NAT) and Hepatitis C Virus (HCV) NAT, on testing individual samples or pooled samples from...

Getting the Horse to Drink.

PubMed

Patterson, Jerry

2016-01-01

Most employers understand the frustration of seeing their employees pass up retirement savings opportunities. This article reviews the problem of insufficient retirement savings and describes simple plan design features that can make it easier for employees to do what's best for their financial futures. The author provides a case example showing what impact such changes can have on participation, deferral rates and account balances.

Iron balance in the red blood cell donor.

PubMed

Brittenham, G M

2005-01-01

Phlebotomy of a unit of blood produces a loss of 200 to 250 mg of iron in haemoglobin. Because of physiological differences in iron balance between women of childbearing age and men, the loss of similar amounts of iron at donation has divergent consequences for committed donors. Women of childbearing age have an increased risk of iron deficiency if they donate more than one unit per year while men are usually able to maintain iron balance while donating four or more units of blood per year. Lack of iron is the most important medical reason for deferral from repeat donation and primarily affects women of childbearing age. Deferral of these women discourages them from further donation and may lead to their loss as donors. Provisions for blood donation should protect those who give blood from adverse consequences of their altruism. Safe and effective approaches to iron replacement after donation have been developed that can prevent iron deficiency in women who give blood repeatedly. Blood centres should consider incorporating programmes of iron replacement for women of childbearing age who give blood repeatedly to protect these donors against iron deficiency and to enhance their retention and commitment as dedicated donors.

The Views of Mental Health Manager Towards the Use of a Family Work Model for Psychosis in Guangzhou, China.

PubMed

Dixon, Jeremy; Lei, Jie; Huang, Wanyi; Sin, Jacqueline; Smith, Gina

2018-02-21

Family Interventions in Psychosis (FIP) have been promoted internationally but have been criticised for being based on western cultural models. This paper reports on a focus group study with 10 Integrated Mental Health Service Managers in Guangzhou, China using thematic analysis. Managers believed FIP might benefit families but identified potential difficulties due to (a) families avoiding services due to the 'shame' of mental illness (b) unrealistic expectations of services amongst families (c) deferral to 'key decision-makers' within families when discussing family issues with workers. The findings indicate that FIP work should focus on interaction between carers in the first instance with service users being introduced into sessions at a later date and that more attention needs to be given by the research community to how FIP may be adapted to cultural norms within China.

Incorporation — A Solution to the Veterinarian's Income Tax Miseries?

PubMed Central

Rowan-Legg, P.K.

1980-01-01

This series of three articles discusses the new income tax rules regarding the incorporation of professionals in general and veterinarians in particular. It points out that while there may be some degree of tax saving or deferral achieved by incorporating, many provincial veterinary associations may not yet permit its members to incorporate. The incorporation of the nonprofessional aspects, however, should be carefully considered. PMID:7427853

27 CFR 41.114a - Qualification for extended deferral.

Code of Federal Regulations, 2010 CFR

2010-04-01

... bond or file a strengthening bond to increase the total amount of the bonds then in force to a..., as amended, 907, as amended; 26 U.S.C. 7101, 7652(a); 26 U.S.C. 7805) [T.D. ATF-5, 38 FR 19688, July 23, 1973. Redesignated at 40 FR 16835, Apr. 15, 1975, and amended by T.D. ATF-48, 44 FR 55855, Sept...

27 CFR 41.114a - Qualification for extended deferral.

Code of Federal Regulations, 2011 CFR

2011-04-01

... bond or file a strengthening bond to increase the total amount of the bonds then in force to a..., as amended, 907, as amended; 26 U.S.C. 7101, 7652(a); 26 U.S.C. 7805) [T.D. ATF-5, 38 FR 19688, July 23, 1973. Redesignated at 40 FR 16835, Apr. 15, 1975, and amended by T.D. ATF-48, 44 FR 55855, Sept...

34 CFR 386.43 - What are the consequences of a scholar's failure to meet the terms and conditions of a...

Code of Federal Regulations, 2011 CFR

2011-07-01

... the terms and conditions of a scholarship agreement? 386.43 Section 386.43 Education Regulations of... terms and conditions of a scholarship agreement? In the event of a failure to meet the terms and conditions of a scholarship agreement or to obtain a deferral or an exception as provided in § 386.41, the...

34 CFR 386.43 - What are the consequences of a scholar's failure to meet the terms and conditions of a...

Code of Federal Regulations, 2013 CFR

2013-07-01

... meet the terms and conditions of a scholarship agreement? 386.43 Section 386.43 Education Regulations... terms and conditions of a scholarship agreement? In the event of a failure to meet the terms and conditions of a scholarship agreement or to obtain a deferral or an exception as provided in § 386.41, the...

34 CFR 386.43 - What are the consequences of a scholar's failure to meet the terms and conditions of a...

Code of Federal Regulations, 2014 CFR

2014-07-01

... the terms and conditions of a scholarship agreement? 386.43 Section 386.43 Education Regulations of... terms and conditions of a scholarship agreement? In the event of a failure to meet the terms and conditions of a scholarship agreement or to obtain a deferral or an exception as provided in § 386.41, the...

34 CFR 386.43 - What are the consequences of a scholar's failure to meet the terms and conditions of a...

Code of Federal Regulations, 2012 CFR

2012-07-01

... meet the terms and conditions of a scholarship agreement? 386.43 Section 386.43 Education Regulations... terms and conditions of a scholarship agreement? In the event of a failure to meet the terms and conditions of a scholarship agreement or to obtain a deferral or an exception as provided in § 386.41, the...

34 CFR 386.43 - What are the consequences of a scholar's failure to meet the terms and conditions of a...

Code of Federal Regulations, 2010 CFR

2010-07-01

... meet the terms and conditions of a scholarship agreement? 386.43 Section 386.43 Education Regulations... terms and conditions of a scholarship agreement? In the event of a failure to meet the terms and conditions of a scholarship agreement or to obtain a deferral or an exception as provided in § 386.41, the...

7 CFR 1951.25 - Review of limited resource FO, OL, and SW loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., reamortization or deferral is taken. The interest rate may not be changed more often than quarterly. (b) Method... effective date of the change in interest rate will be the effective date on Exhibit B. The borrower must be... promissory note for this change in interest rate. [50 FR 45764, Nov. 1, 1985, as amended at 53 FR 35717, Sept...

Women as whole blood donors: offers, donations and deferrals in the province of Huelva, south-western Spain

PubMed Central

Madrona, Dalmiro Prados; Herrera, María Dolores Fernández; Jiménez, Dalmiro Prados; Giraldo, Sonsoles Gómez; Campos, Rita Robles

2014-01-01

Background Women seem more willing to donate blood than men despite the limitations that affect their donation rate. The aim of our study was to determine the role of women in altruistic donation of blood in Huelva, a province in south-western Spain. Materials and methods We registered 87,601 offers to donate whole blood between January 1st, 2005 and December 31st, 2009. We statistically analysed variables such as sex, age, offers, deferrals and donations, problems in venous access, vasovagal reactions, weight and blood pressure to establish their significance according to donor gender. Results With regards to gender, 52.3% of donors were women and 47.7% men. Of the 87,601 offers to donate blood, 46.5% were from females and 53.5% from males. More females than males made their first donation during the study period. However, 43.9 % of donations were from women, whereas 56.1% were from men. Overall 8.7% of offers were deferred, 62.7% of which due to a low haemoglobin concentration, which was the most frequent cause of deferral in women. Difficulties in venous access and vasovagal reactions were also more frequent in female donors than in male donors. By the end of the study period, donor fidelity was 58.6% for men and 48.6% for women. Discussion In the province of Huelva, women are more altruistically inclined than men to give blood, with the percentages of donors and first-time donors being higher among females. However, there are restrictions to women giving blood, especially low haemoglobin concentration, which reduce the number of female blood donations. Women also have more difficulty when blood is withdrawn and are more susceptible to vasovagal reactions, which negatively affect their experience as donors. Measures should be taken to reduce these barriers to encourage women to continue to offer to donate blood, thereby ensuring that they become regular donors, which is a key factor in guaranteeing an adequate supply of blood within the region of Andalusia. PMID:23245721

Knowledge of HIV Testing Guidelines Among US Internal Medicine Residents: A Decade After the Centers for Disease Control and Prevention's Routine HIV Testing Recommendations.

PubMed

Dandachi, Dima; Dang, Bich N; Wilson Dib, Rita; Friedman, Harvey; Giordano, Thomas

2018-05-01

Ten years after the Centers for Disease Control and Prevention recommended universal HIV screening, rates remain low. Internal medicine residents are the front-line medical providers for large groups of patients. We evaluated the knowledge of internal medicine residents about HIV testing guidelines and examined adherence to universal HIV testing in an outpatient setting. A cross-sectional survey of internal medicine residents at four residency programs in Chicago was conducted from January to March 2016. Aggregate data on HIV screening were collected from 35 federally qualified community health centers in the Chicago area after inclusion of an HIV testing best practice alert in patients' electronic medical records. Of the 192 residents surveyed, 130 (68%) completed the survey. Only 58% were aware of universal HIV screening and 49% were aware that Illinois law allows for an opt-out HIV testing strategy. Most of the residents (64%) ordered no more than 10 HIV tests in 6 months. The most frequently reported barriers to HIV testing were deferral because of urgent care issues, lack of time, and the perception that patients were uncomfortable discussing HIV testing. From July 2015 to February 2016, the average HIV testing adherence rate in the 35 health centers was 18.2%. More effort is needed to change HIV testing practices among internal medicine residents so that they will adopt this approach in their future clinical practice. Improving knowledge about HIV testing and addressing other HIV testing barriers are essential for such a successful change.

26 CFR 1.7519-1T - Required payments for entities electing not to have required year (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Example 1. D, a partnership, is owned 10 percent by a C corporation with a September 30 taxable year and... $10,000 are deductible during the deferral period of the base year. Based on these facts, D has net... year $10,000 $5,000 Net base year income $40,000 Example 4. E is a C corporation that has historically...

26 CFR 1.402(g)(3)-1 - Employer contributions to purchase a section 403(b) contract under a salary reduction agreement.

Code of Federal Regulations, 2013 CFR

2013-04-01

...(b) contract under a salary reduction agreement. 1.402(g)(3)-1 Section 1.402(g)(3)-1 Internal Revenue... (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)(3)-1 Employer contributions to... purposes of section 402(g)(3)(C), an elective deferral does not include a contribution that is made...

26 CFR 1.402(g)(3)-1 - Employer contributions to purchase a section 403(b) contract under a salary reduction agreement.

Code of Federal Regulations, 2014 CFR

2014-04-01

...(b) contract under a salary reduction agreement. 1.402(g)(3)-1 Section 1.402(g)(3)-1 Internal Revenue... (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)(3)-1 Employer contributions to... purposes of section 402(g)(3)(C), an elective deferral does not include a contribution that is made...

26 CFR 1.402(g)(3)-1 - Employer contributions to purchase a section 403(b) contract under a salary reduction agreement.

Code of Federal Regulations, 2012 CFR

2012-04-01

...(b) contract under a salary reduction agreement. 1.402(g)(3)-1 Section 1.402(g)(3)-1 Internal Revenue... (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)(3)-1 Employer contributions to... purposes of section 402(g)(3)(C), an elective deferral does not include a contribution that is made...

26 CFR 1.402(g)(3)-1 - Employer contributions to purchase a section 403(b) contract under a salary reduction agreement.

Code of Federal Regulations, 2010 CFR

2010-04-01

...(b) contract under a salary reduction agreement. 1.402(g)(3)-1 Section 1.402(g)(3)-1 Internal Revenue... Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)(3)-1 Employer contributions to purchase a... purposes of section 402(g)(3)(C), an elective deferral does not include a contribution that is made...

26 CFR 1.402(g)(3)-1 - Employer contributions to purchase a section 403(b) contract under a salary reduction agreement.

Code of Federal Regulations, 2011 CFR

2011-04-01

...(b) contract under a salary reduction agreement. 1.402(g)(3)-1 Section 1.402(g)(3)-1 Internal Revenue... (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.402(g)(3)-1 Employer contributions to... purposes of section 402(g)(3)(C), an elective deferral does not include a contribution that is made...

75 FR 53274 - Initiation of Antidumping and Countervailing Duty Administrative Reviews and Deferral of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... through June 30, 2010 administrative review of the antidumping duty order on Certain Pasta from Italy with..., A-533- 7/1/09-6/30/10 824 Ester Industries Limited SRF Limited Italy: Certain Pasta, A-475-818 7/1... 1820 SpA P.A.P. SNC Di Pazienza G.B. & C. Premiato Pastificio Afeltra S.r.L. Pasta Zara SpA Pastificio...

Demand-side management: Why ratemaking should`nt control tax policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haney, J.D.

1995-01-01

As utilities spend money on demand-side management (DSM) programs, they usually deduct their costs currently as ordinary and necessary business expenses. However, state regulators may force deferral of DSM costs for ratemaking purposes, with possible consequences on tax returns. When regulators defer DSM costs, the Internal Revenue Service (IRS) has offered several theories to challenge current tax deductions. One theory requires capitilization instead of a current deduction if regulators include the DSM cost in rate base and provide for a rate of return on the balance. The IRS explained this theory two years ago in a White Paper on conservationmore » expenses: The direct relationship between a rate of return allowed by the Regulator for conservation expenditures allowed in rate base and future profits establishes a prima facie case for capitalization under the future benefit standard. The authors believe that IRS policy should not be linked to ratemaking decisions.« less

Intrinsic religiousness and well-being among cancer patients: the mediating role of control-related religious coping and self-efficacy for coping with cancer.

PubMed

Pérez, John E; Rex Smith, Amy

2015-04-01

We examined the relationship between intrinsic religiousness and well-being, with control-related religious coping and self-efficacy for coping with cancer as potential mediators of this relationship among cancer patients. In a cross-sectional design, 179 ambulatory cancer patients completed measures of intrinsic religiousness, religious coping, self-efficacy for coping with cancer, well-being, and demographic variables. Type of cancer, stage of cancer, and time since diagnosis were collected from electronic medical charts. In a path model, the positive association between intrinsic religiousness and three types of well-being--physical, functional, and social-was fully mediated by active religious surrender and self-efficacy for coping with cancer. In addition, the negative association between passive religious deferral and all four types of well-being--physical, functional, social, and emotional--was fully mediated by self-efficacy for coping with cancer. Finally, there was a negative direct association between pleading for God's direct intercession and emotional well-being. These findings suggest pathways by which intrinsic religiousness and control-related religious coping are linked to various dimensions of well-being among cancer patients.

Identification and Characterization of Functional Domains of the Diphtheria Toxin Repressor (DtxR)

DTIC Science & Technology

1995-01-01

Jobling, Leslie M. Palmer, Brenda Talley, Edda M. Twiddy, Sankaran Krishnan, for your knowledge, guidance, and friendship. My friends and colleagues...was made low-iron by the addition of an iron chelator, ethelenediamine-di-o-hydroxyphenyl acetic acid ( EDDA ) (Sigma Chemical Co., St. Louis, Mo...at 500 ~gJrn1 ; and LB agar medium was made iron-deficient by adding EDDA at 40 ~gJml (Schmitt et al., 199Ib). EDDA was deferrated by the method of

A systematic review and meta-analysis of antecedents of blood donation behavior and intentions.

PubMed

Bednall, Timothy C; Bove, Liliana L; Cheetham, Ali; Murray, Andrea L

2013-11-01

This meta-analysis sought to identify the strongest antecedents of blood donation behavior and intentions. It synthesized the results of 24 predictive correlational studies of donation behavior and 37 studies of donation intentions. The antecedents were grouped into six research programs: (1) the Theory of Planned Behavior (TPB) and its extensions, (2) prosocial motivation, (3) affective expectations, (4) donor site experience, (5) past donation behavior, and (6) donor demographics. Antecedent categories were cross-validated by multiple coders, and combined effect sizes were analyzed using a random-effects model. For donation behavior, medium positive associations were found with five of the constructs from the extended TPB: intentions to donate, perceived behavioral control, attitude toward donation, self-efficacy and donor role identity. Other antecedents displaying a positive association with donation behavior included anticipated regret for not donating, number of past donations and donor age. Donor experiences at the collection site in the form of temporary deferral or adverse reactions had a medium negative association with behavior. For donation intentions, strong positive associations were observed for perceived behavioral control, attitude, self-efficacy, role identity and anticipated regret. Medium positive associations were observed for personal moral norm, subjective norm, satisfaction, and service quality. All other potential antecedents had weak or non-significant associations with behavior and intentions. Several of these associations were moderated by between-study differences, including donor experience, the period of data collection in which donation behavior was observed, and the use of a nominal (yes/no return) versus a ratio measure of donation behavior. Collectively, the results underscore the importance of enhancing donors' attitudes towards donation and building their perceived behavioral control and self-efficacy to donate. Further, minimizing the risk of adverse reactions and enacting re-recruitment policies for temporarily deferred donors will help protect future donation behavior. Implications of these findings for blood collection agencies and researchers are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ethical assessment of hepatitis C virus treatment: The lesson from first generation protease inhibitors.

PubMed

Sacchini, Dario; Craxì, Lucia; Refolo, Pietro; Minacori, Roberta; Cicchetti, Americo; Gasbarrini, Antonio; Cammà, Calogero; Spagnolo, Antonio G

2015-05-01

Since chronic hepatitis C has mostly become curable, issues concerning choice and allocation of treatment are of major concern. We assessed the foremost ethical issues in hepatitis C virus therapy with 1st generation protease inhibitors using the personalist ethical framework within the health technology assessment methodology. Our aim was to identify values at stake/in conflict and to support both the physicians' choices in hepatitis C therapy and social (macro-) allocation decision-making. The ethical assessment indicates that: (1) safety/effectiveness profile of treatment is guaranteed if its use is restricted to the patients subgroups who may benefit from it; (2) patients should be carefully informed, particularly on treatment deferral, and widespread information on these therapies should be implemented; (3) since treatment was proven to be cost-effective, its use is acceptable respecting resource macro-allocation. Concerning individual (micro-) location criteria: (a) criteria for eligibility to treatment should be clearly identified and updated periodically; (b) information on criteria for eligibility/deferral to treatment for specific patients' subgroups should be made widely known. Interferon-based regimens will disappear from use within the next year, with the introduction of highly effective/tolerable combination regimens of direct-acting antivirals, thus profoundly changing social choices. Nonetheless, our model could support future ethical assessment since the evaluation pertaining ethical domains remains generally applicable. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Transfusion-related transmission of yellow fever vaccine virus--California, 2009.

PubMed

2010-01-22

In the United States, yellow fever (YF) vaccination is recommended for travelers and active duty military members visiting endemic areas of sub-Saharan Africa and Central/South America. The American Red Cross recommends that recipients of YF vaccine defer blood product donation for 2 weeks because of the theoretical risk for transmission from a viremic donor. On April 10, 2009, a hospital blood bank supervisor learned that, on March 27, blood products had been collected from 89 U.S. active duty trainees who had received YF vaccine 4 days before donation. This report summarizes the subsequent investigation by the hospital and CDC to identify lapses in donor deferral and to determine whether transfusion-related transmission of YF vaccine virus occurred. The investigation found that a recent change in the timing of trainee vaccination had occurred and that vaccinees had not reported recent YF vaccination status at time of donation. Despite a prompt recall, six units of blood products were transfused into five patients. No clinical evidence or laboratory abnormalities consistent with a serious adverse reaction were identified in four recipients within the first month after transfusion; the fifth patient, who had prostate cancer and end-stage, transfusion-dependent, B-cell lymphoma, died while in hospice care. Three of the four surviving patients had evidence of serologic response to YF vaccine virus. This report provides evidence that transfusion-related transmission of YF vaccine virus can occur and underscores the need for careful screening and deferral of recently vaccinated blood donors.

Blood donation history and eligibility assessment in a community-based sample of men who have sex with men.

PubMed

Custer, Brian; Murcia, Karla; Robinson, William T; McFarland, Willi; Raymond, Henry Fisher

2018-04-01

In 2016, the US Food and Drug Administration changed the regulation from a permanent deferral from donation for men who have sex with men (MSM) to a 1-year deferral since last sexual contact. It is unknown what proportions of MSM try to donate and if they would be willing to answer individual risk-based questions to assess their current eligibility. The National HIV Behavioral Surveillance surveys periodically measure human immunodeficiency virus (HIV) prevalence and risk behaviors among MSM using a venue-based, time-location sampling method. In the 2014 cycle, that is, before the policy change, investigators in San Francisco and New Orleans added questions about blood donation. Questions inquired into three domains: donation history, policy awareness, and knowledge about HIV testing of donations. There were 404 and 557 respondents in San Francisco and New Orleans, respectively. Nearly one in three MSM in San Francisco (27.4%) and New Orleans (31.4%) tried to donate after their first MSM contact. A majority (63.1% in San Francisco, 58.8% in New Orleans) somewhat or strongly agreed that they would be willing to be asked detailed questions for donation eligibility assessment. The proportion of MSM who reported trying to donate was similar in the two cities. However, a substantial proportion did not agree to be asked more detailed risk behavior questions to assess eligibility. In these two geographic locations, prominent regional differences were not evident. © 2018 AABB.

A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6.

PubMed

Scott, Ingrid U; Ip, Michael S; VanVeldhuisen, Paul C; Oden, Neal L; Blodi, Barbara A; Fisher, Marian; Chan, Clement K; Gonzalez, Victor H; Singerman, Lawrence J; Tolentino, Michael

2009-09-01

To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with standard care (grid photocoagulation in eyes without dense macular hemorrhage and deferral of photocoagulation until hemorrhage clears in eyes with dense macular hemorrhage) for eyes with vision loss associated with macular edema secondary to branch retinal vein occlusion (BRVO). Multicenter, randomized clinical trial of 411 participants. Main Outcome Measure Gain in visual acuity letter score of 15 or more from baseline to month 12. Twenty-nine percent, 26%, and 27% of participants achieved the primary outcome in the standard care, 1-mg, and 4-mg groups, respectively. None of the pairwise comparisons between the 3 groups was statistically significant at month 12. The rates of elevated intraocular pressure and cataract were similar for the standard care and 1-mg groups, but higher in the 4-mg group. There was no difference identified in visual acuity at 12 months for the standard care group compared with the triamcinolone groups; however, rates of adverse events (particularly elevated intraocular pressure and cataract) were highest in the 4-mg group. Application to Clinical Practice Grid photocoagulation as applied in the SCORE Study remains the standard care for patients with vision loss associated with macular edema secondary to BRVO who have characteristics similar to participants in the SCORE-BRVO trial. Grid photocoagulation should remain the benchmark against which other treatments are compared in clinical trials for eyes with vision loss associated with macular edema secondary to BRVO. Trial Registration clinicaltrials.gov Identifier: NCT00105027.

Title V Deferrals and Exemptions for Area Sources

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Tax-deferred annuity plans: meeting the IRS audit challenge.

PubMed

Schussler, M

1997-01-01

A growing number of nonprofit organizations are being fined for violations of IRS regulations following IRS audits of their tax-deferred annuity (TDA) plans. To ensure that their organizations can withstand the scrutiny of an IRS audit, TDA plan administrators must ensure that plans meet IRS regulations and be prepared for IRS audits. Documentation--particularly of the TDA plan itself, and procedures related to salary reduction programs, compensation limits, excess deferrals and other excess contributions, loans, and distributions--must be comprehensive and in compliance with IRS regulations.

Blood center practice and education for blood donors with anemia

PubMed Central

Delaney, Meghan; Schellhase, Kenneth G.; Young, Staci; Geiger, Susan; Fink, Arlene; Mast, Alan E.

2013-01-01

BACKGROUND Anemia is an early indicator of many diseases, yet blood donors with low hematocrit (Hct) often receive inadequate information about its medical importance. We sought to understand the types of information that are and should be provided to these donors. STUDY DESIGN AND METHODS Two companion studies were performed. The first investigated blood center practices for care of donors with low Hct including deferral length, information provided, and cutoff values used when referring donors for medical attention. The second was a randomized prospective pilot study comparing behavior of deferred donors receiving an “older” pamphlet providing a list of iron-rich foods or a “newer” pamphlet providing descriptions of common causes of anemia and advice for seeking medical attention. RESULTS More than 70% of centers defer donors for 1 day. Only 6% defer donors for more than 2 weeks. Most centers provide written and/or verbal information about low Hct. Only 35% have a cutoff value defining significant anemia that requires additional medical attention. In the study of donors with low Hct, significant disease was identified within 3 months after deferral in 2 of 104 subjects: metastatic lung cancer and acute lymphocytic leukemia. Only donors receiving the newer pamphlet reported that it “definitely improved” their ability to speak with their doctor about anemia. CONCLUSIONS The diagnosis of anemia in blood donors may be an indicator of significant undiagnosed disease. There are wide variations in how centers care for and educate donors with anemia. Donors with anemia should be provided improved and consistent educational information. PMID:20977487

Blood donations from previously transfused or pregnant donors: a multicenter study to determine the frequency of alloexposure.

PubMed

Rios, Jorge A; Schlumpf, Karen S; Kakaiya, Ram M; Triulzi, Darrell J; Roback, John D; Kleinman, Steve H; Murphy, Edward L; Gottschall, Jerome L; Carey, Patricia M

2011-06-01

Transfusion-related acute lung injury (TRALI) mitigation strategies include the deferral of female donors from apheresis platelet (PLT) donations and the distribution of plasma for transfusion from male donors only. We studied the implications of these policies in terms of component loss at six blood centers in the United States. We collected data from allogeneic blood donors making whole blood and blood component donations during calendar years 2006 through 2008. We analyzed the distribution of donations in terms of the sex, transfusion and pregnancy histories, and blood type. A TRALI mitigation policy that would not allow plasma from female whole blood donors to be prepared into transfusable plasma components would result in nearly a 50% reduction in the units of whole blood available for plasma manufacturing and would decrease the number of type AB plasma units that could be made from whole blood donations by the same amount. Deferral of all female apheresis PLT donors, all female apheresis PLT donors with histories of prior pregnancies, or all female apheresis PLT donors with histories of prior pregnancies and positive screening test results for antibodies to human leukocyte antigens (HLAs) will result in a loss of 37.1, 22.5, and 5.4% of all apheresis PLT donations, respectively. A TRALI mitigation policy that only defers female apheresis PLT donors with previous pregnancies and HLAs would result in an approximately 5% decrease in the inventory of apheresis PLTs, but would eliminate a large proportion of components that are associated with TRALI. © 2010 American Association of Blood Banks.

Donating blood for research: a potential method for enhancing customer satisfaction of permanently deferred blood donors.

PubMed

Waller, Daniel; Thijsen, Amanda; Garradd, Allira; Hayman, Jane; Smith, Geoff

2017-01-01

Each year, a large number of individuals in Australia are deferred from donating blood. A deferral may have a negative impact on donor satisfaction and subsequent word-of-mouth communication. The Australian Red Cross Blood Service (the Blood Service) is, therefore, investigating options for managing service interactions with deferred donors to maintain positive relationships. While public research institutes in Australia have established independent research donor registries, other countries provide programmes allowing deferred donors to donate blood for research via blood collection agencies. This study examined attitudes towards donating blood for research use in a sample of permanently deferred Australian donors. Donors permanently deferred because of a risk of variant Creutzfeldt-Jakob disease (n=449) completed a postal survey that examined attitudes towards research donation. The majority of participants were interested in donating blood for research (96%), and joining a registry of research donors (93%). Participants preferred to donate for transfusion or clinical research, and were willing to travel large distances. Results indicated that positive attitudes towards the Blood Service would be extended if the opportunity to donate blood was provided. These findings indicate a desire for continued engagement with the Blood Service despite deferral. Donating blood for research is a potential way of maintaining positive relationships with permanently deferred donors which also benefits the health research community. Through maintaining positive relationships with deferred donors, positive word-of-mouth activity can be stimulated. Further work is needed to determine the feasibility of implementing research donation through the Blood Service in Australia.

Donating blood for research: a potential method for enhancing customer satisfaction of permanently deferred blood donors

PubMed Central

Waller, Daniel; Thijsen, Amanda; Garradd, Allira; Hayman, Jane; Smith, Geoff

2017-01-01

Background Each year, a large number of individuals in Australia are deferred from donating blood. A deferral may have a negative impact on donor satisfaction and subsequent word-of-mouth communication. The Australian Red Cross Blood Service (the Blood Service) is, therefore, investigating options for managing service interactions with deferred donors to maintain positive relationships. While public research institutes in Australia have established independent research donor registries, other countries provide programmes allowing deferred donors to donate blood for research via blood collection agencies. This study examined attitudes towards donating blood for research use in a sample of permanently deferred Australian donors. Materials and methods Donors permanently deferred because of a risk of variant Creutzfeldt-Jakob disease (n=449) completed a postal survey that examined attitudes towards research donation. Results The majority of participants were interested in donating blood for research (96%), and joining a registry of research donors (93%). Participants preferred to donate for transfusion or clinical research, and were willing to travel large distances. Results indicated that positive attitudes towards the Blood Service would be extended if the opportunity to donate blood was provided. These findings indicate a desire for continued engagement with the Blood Service despite deferral. Discussion Donating blood for research is a potential way of maintaining positive relationships with permanently deferred donors which also benefits the health research community. Through maintaining positive relationships with deferred donors, positive word-of-mouth activity can be stimulated. Further work is needed to determine the feasibility of implementing research donation through the Blood Service in Australia. PMID:26674813

U.S. vaccine and immune globulin product shortages, 2001-15.

PubMed

Ziesenitz, Victoria C; Mazer-Amirshahi, Maryann; Zocchi, Mark S; Fox, Erin R; May, Larissa S

2017-11-15

Trends in shortages of vaccines and immune globulin products from 2001 through 2015 in the United States are described. Drug shortage data from January 2001 through December 2015 were obtained from the University of Utah Drug Information Service. Shortage data for vaccines and immune globulins were analyzed, focusing on the type of product, reason for shortage, shortage duration, shortages requiring vaccine deferral, and whether the drug was a single-source product. Inclusion of the product into the pediatric vaccination schedule was also noted. Of the 2,080 reported drug shortages, 59 (2.8%) were for vaccines and immune globulin products. Of those, 2 shortages (3%) remained active at the end of the study period. The median shortage duration was 16.8 months. The most common products on shortage were viral vaccines (58%), especially hepatitis A, hepatitis B, rabies, and varicella vaccines (4 shortages each). A vaccine deferral was required for 21 shortages (36%), and single-source products were on shortage 30 times (51%). The most common reason for shortage was manufacturing problems (51%), followed by supply-and-demand issues (7%). Thirty shortages (51%) were for products on the pediatric schedule, with a median duration of 21.7 months. Drug shortages of vaccines and immune globulin products accounted for only 2.8% of reported drug shortages within a 15-year period, but about half of these shortages involved products on the pediatric vaccination schedule, which may have significant public health implications. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Radiofrequency denervation of the inguinal ligament for the treatment of 'Sportsman's Hernia': a pilot study.

PubMed

Comin, Jules; Obaid, Haron; Lammers, Greg; Moore, James; Wotherspoon, Mark; Connell, David

2013-04-01

Chronic groin pain is a common and debilitating condition in highly active athletes. Symptoms are often ascribed to the so-called Sportsman's Hernia, and these patients frequently undergo prolonged and often painful remedial physiotherapy, or, if the condition is refractory, surgery to repair the posterior inguinal wall. We hypothesised that radiofrequency denervation (RFD) of both the ilioinguinal nerve and inguinal ligament could be used to desensitise the groin region and enable the athlete to become pain-free. A prospective randomised controlled trial of three groups of patients with chronic groin pain. Thirty-six patients with chronic groin pain of greater than 6 months duration, with no identifiable structural cause and which was refractory to conservative treatment, were randomised into two groups. Group 1 was treated with RFD (n=18), while group 2 was treated with local anaesthetic (Bupivicaine) and steroid (Trimacinolone) injection (n=18). A further 10 patients with previous failed surgery for the same condition were treated with RFD without randomisation. All patients then underwent a standardised physiotherapy regimen. The Visual Analogue Scale at rest (VASr) and with activity (VASa) was used to assess pain, and London Adductor and Abdominal Groin Score was used to assess function, at baseline and at 1 week, 3 months and 6 months post-treatment. RFD treatment resulted in a significant improvement above baseline in all measures and at each time intervals up to 6 months, in both the randomised Group 1 and in the postsurgery group (p values ranging from <0.001 to 0.001). Injection of local anaesthetic and steroid resulted in a significant improvement above baseline in all measures, but only at 1 week (p values ranging from 0.001 to 0.021), and not at any of the later intervals. Improvements in all measures was significantly greater in Group 1 than in Group 2 at all follow-up intervals (p values ranging from <0.001 to 0.003). No persistent adverse events were recorded. The use of RFD in the treatment of refractory Sportsman's Hernia is safe and efficacious at least in the short term, and is superior to anaesthetic/steroid injection. The results suggest that symptoms are related to tendon inflammation and ilioinguinal nerve compression, and can be abolished with pharmacological or radiofrequency treatment, without the need for surgery. This novel technique could help athletes suffering from chronic groin pain return to play more quickly, both facilitating and allowing deferral of remedial physiotherapy treatments, and potentially avoiding the need for surgery.

Optimal control of M/M/1 two-phase queueing system with state-dependent arrival rate, server breakdowns, delayed repair, and N-policy

NASA Astrophysics Data System (ADS)

Rao, Hanumantha; Kumar, Vasanta; Srinivasa Rao, T.; Srinivasa Kumar, B.

2018-04-01

In this paper, we examine a two-stage queueing system where the arrivals are Poisson with rate depends on the condition of the server to be specific: vacation, pre-service, operational or breakdown state. The service station is liable to breakdowns and deferral in repair because of non-accessibility of the repair facility. The service is in two basic stages, the first being bulk service to every one of the customers holding up on the line and the second stage is individual to each of them. The server works under N-policy. The server needs preliminary time (startup time) to begin batch service after a vacation period. Startup times, uninterrupted service times, the length of each vacation period, delay times and service times follows an exponential distribution. The closed form of expressions for the mean system size at different conditions of the server is determined. Numerical investigations are directed to concentrate the impact of the system parameters on the ideal limit N and the minimum base expected unit cost.

Medical therapeutic itineraries of women with breast cancer diagnosis affiliated to the People's Health Insurance in San Luis Potosí, central Mexico.

PubMed

Tejada-Tayabas, Luz María; Salcedo, Liseth Amell; Espino, Joel Monárrez

2015-01-01

This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.

[Timing of Brain Radiation Therapy Impacts Outcomes in Patients with 
Non-small Cell Lung Cancer Who Develop Brain Metastases].

PubMed

Wang, Yang; Fang, Jian; Nie, Jun; Dai, Ling; Hu, Weiheng; Zhang, Jie; Ma, Xiangjuan; Han, Jindi; Chen, Xiaoling; Tian, Guangming; Wu, Di; Han, Sen; Long, Jieran

2016-08-20

Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease specific-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group. Median overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 months vs 12.6 months; P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 months vs 3.0 months; P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy after the diagnosis of brain metastases as any line therapy improved the OS (20.0 months vs 10.7 months; P<0.01), whereas receiving TKI as first line therapy did not (17.9 months vs 15.2 months; P=0.289). Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospective multi-central randomized study is imminently needed.

Area Source Deferrals and Exemptions from Title V Permitting

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Summary Analysis: Hanford Site Composite Analysis Update

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nichols, W. E.; Lehman, L. L.

2017-06-05

The Hanford Site’s currently maintained Composite Analysis, originally completed in 1998, requires an update. A previous update effort was undertaken by the U.S. Department of Energy (DOE) in 2001-2005, but was ended before completion to allow the Tank Closure & Waste Management Environmental Impact Statement (TC&WM EIS) (DOE/EIS-0391) to be prepared without potential for conflicting sitewide models. This EIS was issued in 2012, and the deferral was ended with guidance in memorandum “Modeling to Support Regulatory Decision Making at Hanford” (Williams, 2012) provided with the aim of ensuring subsequent modeling is consistent with the EIS.

Right Ventricular Outflow Tract Stenting in Tetralogy of Fallot Infants With Risk Factors for Early Primary Repair.

PubMed

Sandoval, Juan Pablo; Chaturvedi, Rajiv R; Benson, Lee; Morgan, Gareth; Van Arsdell, Glen; Honjo, Osami; Caldarone, Christopher; Lee, Kyong-Jin

2016-12-01

Tetralogy of Fallot with cyanosis requiring surgical repair in early infancy reflects poor anatomy and is associated with more clinical instability and longer hospitalization than those who can be electively repaired later. We bridged symptomatic infants with risk factors for early primary repair by right ventricular outflow tract stenting (stent). Four groups of tetralogy of Fallot with confluent central pulmonary arteries were studied: stent group (n=42), primary repair (aged <3 months) with pulmonary stenosis (early-PS group; n=44), primary repair (aged <3 months) with pulmonary atresia (early-PA group; n=49), and primary repair between 3 and 11 months of age (surg>3mo group; n=45). Stent patients had the smallest pulmonary arteries with a median (95% credible intervals) Nakata index (mm 2 /m 2 ) of 79 (66-85) compared with the early-PA 139 (129-154), early-PS 136 (121-153), and surg>3mo 167 (153-200) groups. Only stent infants required unifocalization of aortopulmonary collaterals (17%). Stent and early-PA infants had younger age and lower weight than early-PS infants. Stent infants had the most multiple comorbidities. Stenting allowed deferral of complete surgical repair to an age (6 months), weight (6.3 [5.8-7.0] kg), and Nakata index (147 [132-165]) similar to the low-risk surg>3mo group. The 3 early treatment groups had similar intensive care unit/hospital stays and high reintervention rates in the first 12 months after repair, compared with the surg>3mo group. Right ventricular outflow tract stenting of symptomatic tetralogy of Fallot with poor anatomy (small pulmonary arteries) and adverse factors (multiple comorbidities, low weight) relieves cyanosis and defers surgical repair. This allowed pulmonary arterial and somatic growth with clinical results comparable to early surgical repair in more favorable patients. © 2016 American Heart Association, Inc.

Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature

PubMed Central

Piersma, Tjeerd W.; Bekkers, René; Klinkenberg, Elisabeth F.; de Kort, Wim L.A.M.; Merz, Eva-Maria

2017-01-01

Background The ageing population and recent migration flows may negatively affect the blood supply in the long term, increasing the importance of targeted recruitment and retention strategies to address donors. This review sought to identify individual, network and contextual characteristics related to blood donor status and behaviour, to systematically discuss differences between study results, and to identify possible factors to target in recruitment and retention efforts. Methods The systematic review was conducted in accordance with a predefined PROSPERO protocol (CRD42016039591). After quality assessments by multiple independent raters, a final set of 66 peer-reviewed papers, published between October 2009 and January 2017, were included for review. Results Individual and contextual characteristics of blood donor status and behaviour were categorised into five main lines of research: donor demographics, motivations and barriers, adverse reactions and deferral, contextual factors, and blood centre factors. Results on donor demographics, motivations and barriers, and contextual factors were inconclusive, differing between studies, countries, and sample characteristics. Adverse reactions and deferral were negatively related to blood donor behaviour. Blood centre factors play an important role in donor management, e.g., providing information, reminders, and (non-)monetary rewards. No studies were found on network characteristics of (non-)donors. Discussion Although individual and contextual characteristics strongly relate to blood donor status and behaviour, mechanisms underlying these relations have not been studied sufficiently. We want to stress the importance of longitudinal studies in donor behaviour, exploring the role of life events and network characteristics within blood donor careers. Increased understanding of donor behaviour will assist policy makers of blood collection agencies, with the ultimate goal of safeguarding a sufficient and matching blood supply. PMID:28686151

Contribution of the Retrovirus Epidemiology Donor Study (REDS) to research on blood transfusion safety in Brazil.

PubMed

Loureiro, Paula; de Almeida-Neto, Cesar; Proietti, Anna Bárbara Carneiro; Capuani, Ligia; Gonçalez, Thelma Terezinha; de Oliveira, Claudia Di Lorenzo; Leão, Silvana Carneiro; Lopes, Maria Inês; Sampaio, Divaldo; Patavino, Giuseppina Maria; Ferreira, João Eduardo; Blatyta, Paula Fraiman; Lopes, Maria Esther Duarte; Mendrone-Junior, Alfredo; Salles, Nanci Alves; King, Melissa; Murphy, Edward; Busch, Michael; Custer, Brian; Sabino, Ester Cerdeira

2014-03-01

The Retrovirus Epidemiology Donor Study (REDS) program was established in the United States in 1989 with the purpose of increasing blood transfusion safety in the context of the HIV/AIDS and human T-lymphotropic virus epidemics. REDS and its successor, REDS-II were at first conducted in the US, then expanded in 2006 to include international partnerships with Brazil and China. In 2011, a third wave of REDS renamed the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) was launched. This seven-year research program focuses on both blood banking and transfusion medicine research in the United States of America, Brazil, China, and South Africa. The main goal of the international programs is to reduce and prevent the transmission of HIV/AIDS and other known and emerging infectious agents through transfusion, and to address research questions aimed at understanding global issues related to the availability of safe blood. This article describes the contribution of REDS-II to transfusion safety in Brazil. Articles published from 2010 to 2013 are summarized, including database analyses to characterize blood donors, deferral rates, and prevalence, incidence and residual risk of the main blood-borne infections. Specific studies were developed to understand donor motivation, the impact of the deferral questions, risk factors and molecular surveillance among HIV-positive donors, and the natural history of Chagas disease. The purpose of this review is to disseminate the acquired knowledge and briefly summarize the findings of the REDS-II studies conducted in Brazil as well as to introduce the scope of the REDS-III program that is now in progress and will continue through 2018.

Surveillance of risk profiles among new and repeat blood donors with transfusion-transmissible infections from 1995 through 2003 in the Netherlands.

PubMed

Van der Bij, Akke K; Coutinho, Roel A; Van der Poel, Cees L

2006-10-01

To evaluate the effectiveness of blood donor selection, this study reports risk profiles of donors with transfusion-transmissible infections as obtained by ongoing surveillance, 1995 through 2003, in the Netherlands. A surveillance program was installed to monitor risk profiles among new and repeat donors infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), or human T-lymphotropic virus (HTLV), or positive for the presence of syphilis antibodies. At posttest counseling, a physician interviewed donors to clarify possible sources of infection. A total of 167 repeat donors and 404 new donors were interviewed: 33 with HIV, 123 with HCV, 279 with HBV, 21 with HTLV, and 112 with syphilis antibodies. Most HBV, HCV, and HTLV infections were among new donors (80, 85, and 67%), whereas most HIV infections were among repeat donors (79%). Nearly 25 percent of the donors did not report factors at screening that would have deferred them from donating blood. At posttest interviews, new donors with HCV often reported injecting drug use (19%). Repeat donors with HIV often reported male-to-male sex (8/26, 31%). A significant level of deferrable behavioral risks was found among donors with confirmed transfusion-transmissible infections that persist despite current donor selection. Reporting such behavior at initial donor selection would have eliminated a substantial part of the infections found. This study argues against relaxing the existing donor deferral of persons practicing male-to-male sex, given their significant proportion of HIV infections among repeat donors. Systematic surveillance of risk factors among infected blood donors provides ongoing information about the effectivity of donor selection and is recommended to evaluate and optimize blood policies.

Improvement in Herpes Zoster Vaccination in Patients with Rheumatoid Arthritis: A Quality Improvement Project.

PubMed

Sheth, Heena; Moreland, Larry; Peterson, Hilary; Aggarwal, Rohit

2017-01-01

To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase. The electronic best practice alert (BPA) for HZ vaccination was developed; it appeared on electronic medical records during registration and medication reconciliation of the eligible patient by the medical assistant. The BPA was designed to electronically identify patient eligibility and to enable the physician to order the vaccine or to document refusal or deferral reason. Education regarding vaccine guidelines, BPA, vaccination process, and feedback were crucial components of the project interventions. The vaccination rates were compared using the chi-square test. We evaluated 1823 and 1554 eligible patients with RA during the pre-intervention and post-intervention phases, respectively. The HZ vaccination rates, reported as patients vaccinated among all eligible patients, improved significantly from the pre-intervention period of 10.1% (184/1823) to 51.7% (804/1554) during the intervention phase (p < 0.0001). The documentation rates (vaccine received, vaccine ordered, patient refusal, and deferral reasons) increased from 28% (510/1823) to 72.9% (1133/1554; p < 0.0001). The HZ infection rates decreased significantly from 2% to 0.3% (p = 0.002). Electronic identification of vaccine eligibility and BPA significantly improved HZ vaccination rates. The process required minimal modification of clinic work flow and did not burden the physician's time, and has the potential for self-sustainability and generalizability.

Blood donor deferral for men who have sex with men: the Blood Donation Rules Opinion Study (Blood DROPS)

PubMed Central

Custer, Brian; Sheon, Nicolas; Siedle-Khan, Bob; Pollack, Lance; Spencer, Bryan; Bialkowski, Walter; D'Andrea, Pam; Sullivan, Marian; Glynn, Simone; Williams, Alan

2015-01-01

Background In the US, any man who discloses having had sex with another man (MSM) even once since 1977 is currently deferred from donating blood. A study was conducted to assess noncompliance with the policy at four geographically dispersed blood centers. Methods Male donors 18+ years of age with email addresses were randomly selected and invited to complete a confidential online survey between Aug – Oct 2013. No additional recruitment emails were sent. Survey content included: demographics, sexual history, donation history, compliance with the policy, and opinions about current and modified policies. Results Response rate was 11.5% overall but varied by center (6.3 to 21.7%). Of 3183 completed surveys, 2.6% of respondents (95% Confidence Interval 2.1 – 3.2%) reported donation after male-male sex. Noncompliance was not statistically different among the centers [p=0.1], but was related to age with 5.7%, 4.6%, 2.5%, and 1.0% of donors 18-24, 25-34, 35-54, and 50+ years of age, respectively, reporting noncompliance [p<0.001]. Of all respondents, 6.8% reported ≥6 female sex partners and 0.3% reported ≥6 male sex partners in the last five years. Opinions about the current MSM policy were mixed with noncomplying donors more supportive of change than complying donors. About half of noncompliers indicated they would adhere to a 1-year deferral policy. Conclusion Noncompliance with the MSM policy is evident and may be increasing compared to earlier data. It is expected that any change from the current policy will require close monitoring to determine whether it affects residual risk of HIV in the US blood supply. PMID:26202349

Cost-effectiveness of alternative changes to a national blood collection service.

PubMed

Willis, S; De Corte, K; Cairns, J A; Zia Sadique, M; Hawkins, N; Pennington, M; Cho, G; Roberts, D J; Miflin, G; Grieve, R

2018-05-16

To evaluate the cost-effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter-donation interval for donors attending static centres. Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. This study estimated the effect of changes to the blood collection service in England on the annual number of whole-blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost-effective. In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter-donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost-effective change is to extend opening hours for blood collection at static centres. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

Undisclosed Human Immunodeficiency Virus Risk Factors Identified through a Computer-based Questionnaire Program among Blood Donors in Brazil

PubMed Central

Blatyta, Paula Fraiman; Custer, Brian; Gonçalez, Thelma Terezinha; Birch, Rebecca; Lopes, Maria Esther; Ferreira, Maria Ines Lopes; Proietti, Anna Barbara Carneiro; Sabino, Ester Cerdeira; Page, Kimberly; de Almeida Neto, Cesar

2013-01-01

Background HIV risk factor screening among blood donors remains a cornerstone for the safety of blood supply and is dependent on prospective donor self-disclosure and an attentive predonation interview. Residual risk of HIV transmission through blood transfusion is higher in Brazil than in many other countries. Audio computer-assisted structured-interview (ACASI) has been shown to increase self-reporting of risk behaviors. Study design and methods This cross-sectional study was conducted between January 2009 and March 2011 at four Brazilian blood centers to identify the population of HIV-negative eligible blood donors that answered face-to-face interviews without disclosing risks, but subsequently disclosed deferrable risk factors by ACASI. Compared to the donor interview, the ACASI contained expanded content on demographics, sexual behavior and other HIV risk factors questions. Results 901 HIV-negative blood donors were interviewed. On the ACASI, 13% of donors (N=120) declared a risk factor that would have resulted in deferral that was not disclosed during the face-to-face assessment. The main risk factors identified were recent unprotected sex with an unknown or irregular partner (49 donors), sex with a person with exposure to blood/ fluids (26 donors), multiple sexual partners (19 donors), and male-male sexual behavior (10 donors). Independent factors associated with the disclosure of any risk factor for HIV were age (≥40 years vs. 18–25 years, AOR=0.45; 95% CI 0.23–0.88) and blood center (Hemope vs. Hemominas, AOR=2.51; 95% CI 1.42–4.44). Conclusion ACASI elicited increased disclosure of HIV risk factors among blood donors. ACASI may be a valuable modality of interview to be introduced in Brazilian blood banks. PMID:23521083

Analyzing actual risk in malaria-deferred donors through selective serologic testing.

PubMed

Nguyen, Megan L; Goff, Tami; Gibble, Joan; Steele, Whitney R; Leiby, David A

2013-08-01

Approximately 150,000 US blood donors are deferred annually for travel to malaria-endemic areas. However, the majority do not travel to the high-risk areas of Africa associated with transfusion-transmitted malaria (TTM) but visit low-risk areas such as Mexico. This study tests for Plasmodium infection among malaria-deferred donors, particularly those visiting Mexico. Blood donors deferred for malaria risk (travel, residence, or previous infection) provided blood samples and completed a questionnaire. Plasma was tested for Plasmodium antibodies by enzyme immunoassay (EIA); repeat-reactive (RR) samples were considered positive and tested by real-time polymerase chain reaction (PCR). Accepted donors provided background testing data. During 2005 to 2011, a total of 5610 malaria-deferred donors were tested by EIA, including 5412 travel deferrals. Overall, 88 (1.6%) were EIA RR; none were PCR positive. Forty-nine (55.7%) RR donors previously had malaria irrespective of deferral category, including 34 deferred for travel. Among 1121 travelers to Mexico, 90% visited Quintana Roo (no or very low risk), but just 2.2% visited Oaxaca/Chiapas (moderate or high risk). Only two Mexican travelers tested RR; both previously had malaria not acquired in Mexico. Travel to Mexico represents a large percentage of US donors deferred for malaria risk; however, these donors primarily visit no- or very-low-risk areas. No malaria cases acquired in Mexico were identified thereby supporting previous risk estimates. Consideration should be given to allowing blood donations from U.S. donors who travel to Quintana Roo and other low-risk areas in Mexico. A more effective approach to preventing TTM would be to defer all donors with a history of malaria, even if remote. © 2012 American Association of Blood Banks.

Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature.

PubMed

Piersma, Tjeerd W; Bekkers, René; Klinkenberg, Elisabeth F; De Kort, Wim L A M; Merz, Eva-Maria

2017-09-01

The ageing population and recent migration flows may negatively affect the blood supply in the long term, increasing the importance of targeted recruitment and retention strategies to address donors. This review sought to identify individual, network and contextual characteristics related to blood donor status and behaviour, to systematically discuss differences between study results, and to identify possible factors to target in recruitment and retention efforts. The systematic review was conducted in accordance with a predefined PROSPERO protocol (CRD42016039591). After quality assessments by multiple independent raters, a final set of 66 peer-reviewed papers, published between October 2009 and January 2017, were included for review. Individual and contextual characteristics of blood donor status and behaviour were categorised into five main lines of research: donor demographics, motivations and barriers, adverse reactions and deferral, contextual factors, and blood centre factors. Results on donor demographics, motivations and barriers, and contextual factors were inconclusive, differing between studies, countries, and sample characteristics. Adverse reactions and deferral were negatively related to blood donor behaviour. Blood centre factors play an important role in donor management, e.g., providing information, reminders, and (non-)monetary rewards. No studies were found on network characteristics of (non-)donors. Although individual and contextual characteristics strongly relate to blood donor status and behaviour, mechanisms underlying these relations have not been studied sufficiently. We want to stress the importance of longitudinal studies in donor behaviour, exploring the role of life events and network characteristics within blood donor careers. Increased understanding of donor behaviour will assist policy makers of blood collection agencies, with the ultimate goal of safeguarding a sufficient and matching blood supply.

Social context, the struggle with uncertainty, and subjective risk as meaning-rich constructs for explaining HBP noncompliance.

PubMed

Proulx, Michelle; Leduc, Nicole; Vandelac, Louise; Grégoire, Jean-Pierre; Collin, Johanne

2007-09-01

To identify the reasons for which people fail to take blood-pressure-lowering medication regularly, a qualitative study was conducted. Interviews lasting approximately 90 min were conducted with 27 patients (15 women, 12 men) aged 40-70. The verbatim of the 27 interviews was first read and divided into segments with explanatory value. This was followed by the production of a final text in vignette form for all interviews. An integrative, analytical phase consisted of identifying trends, significant central themes, regularities, and divergences in the vignettes. Analysis revealed the explanatory power that 3 broad groups of subjective meanings could hold for given medication noncompliance scenarios. These scenarios are expressing the role of: (1) stress and living conditions in the occasional skipping or deferral of medication-taking; (2) doubt as the motivating factor for transitory, irregular medication use; (3) subjective risk as the motivating factor for persistent irregular use. Life and social contexts, doubt and risk subsume extremely meaning-rich constructs that can help identify dilemmas facing people about medication-taking. By discussing these dimensions with their patients, health professionals will be better able to understand patient medication behaviors that sometimes run counter to their recommendations.

Prognostic Value of Transthoracic Doppler Echocardiography Coronary Flow Velocity Reserve in Patients with Nonculprit Stenosis of Intermediate Severity Early after Primary Percutaneous Coronary Intervention.

PubMed

Tesic, Milorad; Djordjevic-Dikic, Ana; Giga, Vojislav; Stepanovic, Jelena; Dobric, Milan; Jovanovic, Ivana; Petrovic, Marija; Mehmedbegovic, Zlatko; Milasinovic, Dejan; Dedovic, Vladimir; Zivkovic, Milorad; Juricic, Stefan; Orlic, Dejan; Stojkovic, Sinisa; Vukcevic, Vladan; Stankovic, Goran; Nedeljkovic, Milan; Ostojic, Miodrag; Beleslin, Branko

2018-04-03

Treatment of nonculprit coronary stenosis during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction may be beneficial, but the mode and timing of the intervention are still controversial. The aim of this study was to examine the significance and prognostic value of preserved coronary flow velocity reserve (CFVR) in patients with nonculprit intermediate stenosis early after primary percutaneous coronary intervention. Two hundred thirty patients with remaining intermediate (50%-70%) stenosis of non-infarct-related arteries, in whom CFVR was performed within 7 days after primary percutaneous coronary intervention, were prospectively enrolled. Twenty patients with reduced CFVR and positive results on stress echocardiography or impaired fractional flow reserve underwent revascularization and were not included in further analysis. The final study population of 210 patients (mean age, 58 ± 10 years; 162 men) was divided into two groups on the basis of CFVR: group 1, CFVR > 2 (n = 174), and group 2, CFVR ≤ 2 (n = 36). Cardiac death, nonfatal myocardial infarction, and revascularization of the evaluated vessel were considered adverse events. Mean follow-up duration was 47 ± 16 months. Mean CFVR for the whole group was 2.36 ± 0.40. There were six adverse events (3.4%) related to the nonculprit coronary artery in group 1, including one cardiac death, one ST-segment elevation myocardial infarction, and four revascularizations. In group 2, there were 30 adverse events (83.3%, P < .001 vs group 1), including two cardiac deaths, two ST-segment elevation myocardial infarctions, and 26 revascularizations. In patients with CFVR > 2 of the intermediate nonculprit coronary lesion, deferral of revascularization is safe and associated with excellent long-term clinical outcomes. Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

A European survey on donor deferral for allergy: Rationale and initial results of a survey in 35 countries.

PubMed

Garraud, O; Martin, C; Haddad, A; Bagge Hansen, M; Rautmann, G; MacLennan, S; Norda, R

2017-02-01

Allergy accounts to near 0.5% of all reported transfusion adverse events. The responsibility of blood components themselves and - therefore - of blood donors is still questioned. The European Community undertook a large international survey to address the consistency and homogeneity of medical selection of blood donors with regard to the risk of allergy, and especially of transferring allergy to recipients. This short report presents the salient points of the survey, stressing that there is inconsistency in addressing the allergy question within countries or systems, with paths of improvement. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Human-machine interface (HMI) report for 241-SY-101 data acquisition [and control] system (DACS) upgrade study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Truitt, R.W.

1997-10-22

This report provides an independent evaluation of information for a Windows based Human Machine Interface (HMI) to replace the existing DOS based Iconics HMI currently used in the Data Acquisition and Control System (DACS) used at Tank 241-SY-101. A fundamental reason for this evaluation is because of the difficulty of maintaining the system with obsolete, unsupported software. The DACS uses a software operator interface (Genesis for DOS HMI) that is no longer supported by its manufacturer, Iconics. In addition to its obsolescence, it is complex and difficult to train additional personnel on. The FY 1997 budget allocated $40K for phasemore » 1 of a software/hardware upgrade that would have allowed the old DOS based system to be replaced by a current Windows based system. Unfortunately, budget constraints during FY 1997 has prompted deferral of the upgrade. The upgrade needs to be performed at the earliest possible time, before other failures render the system useless. Once completed, the upgrade could alleviate other concerns: spare pump software may be able to be incorporated into the same software as the existing pump, thereby eliminating the parallel path dilemma; and the newer, less complex software should expedite training of future personnel, and in the process, require that less technical time be required to maintain the system.« less

[Ethics and blood transfusion].

PubMed

Tissot, J-D; Garraud, O; Danic, B; Cabaud, J-J; Lefrère, J-J

2013-09-01

Blood donation is an act of solidarity. Most often, this act is done on a volunteer basis and, depending on countries and circumstances, is not remunerated. The increase in need, the always-greater number of deferral criteria, the safety issues and the changes in the structures of our societies are among the many subjects for ethical debates. Taking these into account, the actors of the transfusion must analyze certain parameters: the value of a donation, the meaning of volunteering, the appropriateness of remunerating the act of giving a part of one's self, no longer as a donation or an expression of altruism and solidarity, but as a commercial act regimented by economic laws. Copyright © 2013. Published by Elsevier SAS.

[Parental representations of children's cough and expectations on its management].

PubMed

Ventaja, G; Steyer, E; Machu, J-L; Boivin, J-M

2016-04-01

Providing medications for the management of acute cough in infants less than 24 months, a frequent reason for medical consultation, has recently been reduced by the contraindication of various antitussive specialties in France. The objective of this study was to assess the expectations and fears of coughing infants' parents, to determine their representations of coughing, and to quantify the use of self-medication and the risk of a deferral requests to prescribe other drug classes. An opinion and cross-survey was carried out with parents of infants under 24 months of age. A multiple-choice questionnaire was proposed to them in day care centers and Mother and Infant Welfare centers. The data collected were analyzed descriptively and using the Chi(2) test. Logistic regression enabled us to interpret some of the results. Sixty-four percent of parents expect an antitussive treatment from the doctor. For most parents, lifestyle modifications are well integrated (nasal irrigation, considered effective cough relief, hydration, smoking cessation). For 33 % of parents, corticosteroids are an alternative therapy to stop cough. Nearly half (43 %) of parents have sought treatment from their doctor, usually nasal suspensions, corticosteroids, and saline irrigation. Regarding self-medication, 30 % of parents have already given cough syrup or an antitussive suppository without a prescription, in order to stop the cough rapidly for 66 % of them. These parents seem more worried by coughing than other parents (P=0.0110, CI: 0.217; 1.751) as did those who had only one child (P=0.0029, CI: 0.120; 0.582). This study suggests that a large majority of parents understand and accept the new recommendations. But one-third of parents are still worried, not knowing what to do without prescribed medications, which led them to give nonprescription cough syrups and ask for inappropriate treatments. It seems essential to inform parents about the natural history of infant coughing and educate them on lifestyle rules to reduce the risk of deferral prescription. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

DSM for transmission and distribution deferral in Queensland, Australia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gishkariany, G.; Hoch, L.; King, M.

1995-12-01

The South East Queensland Electricity Board (SEQEB) is a distributor of electricity serving the greater Brisbane area. The service area is characterized by relatively high growth, which is creating pressure on the adequacy of transmission and distribution capacity in the area. The utility has embarked on two initial efforts to assess the ability of DSM to provide cost-effective deferral of these capital projects. In both cases, the timing of the need for new transmission and/or distribution capacity has made it imperative that the DSM programs selected for implementation be capable of penetrating the market and achieving results quickly. SEQEB`s Southmore » Gold Coast area is characterized by an affluent customer base with an increasing concern for the environment. In 1990, SEQEB undertook a Value Management Study, and produced an integrated supply-and demand-side plan for the area for the next ten years. The plan that was developed identified the potential for saving Australian $7 million (NPV) over five years through targeted DSM initiatives. To achieve these savings it was also determined that the DSM programs would have to reduce area peak demand by at least 2 MW per year for a period of ten years altogether. Three programs were implemented in the 1991-1992 program year, and achieved the targeted level of peak demand reduction. Results for the first half of the 1992-1993 program also look encouraging. In the utility`s Beaudesert Branch, the customer base is more rural, with significant numbers of farms, although one area is characterized by significant new suburban residential development. In this study, (which began in the second half of 1992), the planning methodology has been refined along the lines of that used in Pacific Gas and Electric`s Delta Project. Because the Beaudesert area contains only approximately 10,000 customers, it has proven important to undertake a significant amount of customer and end-use research in order to understand.« less

[Demography and donation frequencies of blood and plasma donor populations in Germany].

PubMed

Ritter, Sabine; Willand, L; Reinhard, B; Offergeld, R; Hamouda, O

2008-08-01

According to Article 22 of the Transfusion Act, the Robert Koch Institute collects and evaluates nationwide data on the prevalence and incidence of transfusion-relevant infections among blood and plasma donors in Germany. Due to revision of the Transfusion Act in 2005 not only the number of donations but also the number of donors has become available for analysis. Here we give a detailed account on the demographic profile and donation frequencies of German whole blood, plasma and platelet donors in 2006. Overall, 4 % of the German population eligible to donate were active as repeat whole blood donors in 2006; 0.3 % repeatedly donated plasma or platelets. Irrespective of the type of donation, the percentage of donors among the general population was highest among the youngest age group (18 to 24 years). While the age distribution of whole blood repeat donors roughly resembled that of the general population, with the greatest number among those aged 35 to 44, younger age groups were overrepresented among repeat plasma donors. Donation frequency varied depending on donor age and sex, with an average of 1.9 per year for whole blood donations, 11.9 for plasmapheresis and 4.0 for plateletpheresis. With the exception of the latter, men donated more frequently than women. For both sexes, donation frequency increased with age. Detailed knowledge of the demographic profile and changes in the composition of donor populations are essential for planning adequate blood supply. The data presented may serve as reference for assessing the consequences of measures that affect the number of donors and/or donations (for example changing deferral criteria) in Germany.

The psychology of doing nothing: forms of decision avoidance result from reason and emotion.

PubMed

Anderson, Christopher J

2003-01-01

Several independent lines of research bear on the question of why individuals avoid decisions by postponing them, failing to act, or accepting the status quo. This review relates findings across several different disciplines and uncovers 4 decision avoidance effects that offer insight into this common but troubling behavior: choice deferral, status quo bias, omission bias, and inaction inertia. These findings are related by common antecedents and consequences in a rational-emotional model of the factors that predispose humans to do nothing. Prominent components of the model include cost-benefit calculations, anticipated regret, and selection difficulty. Other factors affecting decision avoidance through these key components, such as anticipatory negative emotions, decision strategies, counterfactual thinking, and preference uncertainty, are also discussed.

Iron deficiency and iron deficiency anaemia in women.

PubMed

Percy, Laura; Mansour, Diana; Fraser, Ian

2017-04-01

Iron deficiency (ID) is the most common micronutrient deficiency worldwide with >20% of women experiencing it during their reproductive lives. Hepcidin, a peptide hormone mostly produced by the liver, controls the absorption and regulation of iron. Understanding iron metabolism is pivotal in the successful management of ID and iron deficiency anaemia (IDA) using oral preparations, parenteral iron or blood transfusion. Oral preparations vary in their iron content and can result in gastrointestinal side effects. Parenteral iron is indicated when there are compliance/tolerance issues with oral iron, comorbidities which may affect absorption or ongoing iron losses that exceed absorptive capacity. It may also be the preferred option when rapid iron repletion is required to prevent physiological decompensation or given preoperatively for non-deferrable surgery. As gynaecologists, we focus on managing women's heavy menstrual bleeding (HMB) and assume that primary care clinicians are treating the associated ID/IDA. We now need to take the lead in diagnosing, managing and initiating treatment for ID/IDA and treating HMB simultaneously. This dual management will significantly improve their quality of life. In this chapter we will summarise the importance of iron in cellular functioning, describe how to diagnose ID/IDA and help clinicians choose between the available treatment options. Copyright © 2016. Published by Elsevier Ltd.

Positive consequences of conflict on decision making: when a conflict mindset facilitates choice.

PubMed

Savary, Jennifer; Kleiman, Tali; Hassin, Ran R; Dhar, Ravi

2015-02-01

Much research has shown that conflict is aversive and leads to increased choice deferral. In contrast, we have proposed that conflict can be beneficial. Specifically, exposure to nonconscious goal conflict can activate a mindset (a set of cognitive procedures) that facilitates the systematic processing of information without triggering the associated costs, such as negative affect and stress. In a conflict mindset, people should be better able to make tradeoffs and resolve choice conflict. We tested this proposition in 4 experiments, and demonstrated that priming conflicting goals before a decision increases choice in domains unrelated to the primed conflict. We further demonstrated that increased choice occurs because people in a conflict mindset process choice information more systematically, and we rule out several alternative explanations for the results.

Interruption or deferral of antiretroviral therapy reduces markers of bone turnover compared with continuous therapy: the SMART Body Composition Substudy

PubMed Central

Hoy, Jennifer; Grund, Birgit; Roediger, Mollie; Ensrud, Kristine E.; Brar, Indira; Colebunders, Robert; De Castro, Nathalie; Johnson, Margaret; Sharma, Anjali; Carr, Andrew

2013-01-01

Bone mineral density (BMD) declines significantly in HIV patients on antiretroviral therapy (ART). We compared the effects of intermittent versus continuous ART on markers of bone turnover in the Body Composition substudy of the Strategies for Management of AntiRetroviral Therapy (SMART) trial and determined whether early changes in markers predicted subsequent change in BMD. For 202 participants (median age 44 years, 17% female, 74% on ART) randomised to continuous or intermittent ART, plasma markers of inflammation and bone turnover were evaluated at baseline, months 4 and 12; BMD at the spine (dual X-ray absorptiometry [DXA] and computed tomography) and hip (DXA) was evaluated annually. Compared to the continuous ART group, mean bone-specific alkaline phosphatase (bALP), osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), N-terminal cross-linking telopeptide of type 1 collagen (NTX), and C-terminal cross-linking telopeptide of type 1 collagen (βCTX) decreased significantly in the intermittent ART group, whereas RANKL and the RANKL:osteoprotegerin (OPG) ratio increased (all p≤0.002 at month 4 and month 12). Increases in bALP, osteocalcin, P1NP, NTX, and βCTX at month 4 predicted decrease in hip BMD at month 12, while increases in RANKL and the RANKL:OPG ratio at month 4 predicted increase in hip and spine BMD at month 12. This study has shown that compared with continuous ART, interruption of ART results in a reduction in markers of bone turnover and increase in BMD at hip and spine, and that early changes in markers of bone turnover predict BMD changes at 12 months. PMID:23299909

Surgical Resection of Brain Metastases and the Risk of Leptomeningeal Recurrence in Patients Treated With Stereotactic Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Matthew D., E-mail: Matthewjohnson@beaumont.edu; Avkshtol, Vladimir; Baschnagel, Andrew M.

Purpose: Recent prospective data have shown that patients with solitary or oligometastatic disease to the brain may be treated with upfront stereotactic radiosurgery (SRS) with deferral of whole-brain radiation therapy (WBRT). This has been extrapolated to the treatment of patients with resected lesions. The aim of this study was to assess the risk of leptomeningeal disease (LMD) in patients treated with SRS to the postsurgical resection cavity for brain metastases compared with patients treated with SRS to intact metastases. Methods and Materials: Four hundred sixty-five patients treated with SRS without upfront WBRT at a single institution were identified; 330 ofmore » these with at least 3 months' follow-up were included in this analysis. One hundred twelve patients had undergone surgical resection of at least 1 lesion before SRS compared with 218 treated for intact metastases. Time to LMD and overall survival (OS) time were estimated from date of radiosurgery, and LMD was analyzed by the use of cumulative incidence method with death as a competing risk. Univariate and multivariate analyses were performed with competing risk regression to determine whether various clinical factors predicted for LMD. Results: With a median follow-up time of 9.0 months, 39 patients (12%) experienced LMD at a median of 6.0 months after SRS. At 1 year, the cumulative incidence of LMD, with death as a competing risk, was 5.2% for the patients without surgical resection versus 16.9% for those treated with surgery (Gray test, P<.01). On multivariate analysis, prior surgical resection (P<.01) and breast cancer primary (P=.03) were significant predictors of LMD development. The median OS times for patients undergoing surgery compared with SRS alone were 12.9 and 10.6 months, respectively (log-rank P=.06). Conclusions: In patients undergoing SRS with deferral of upfront WBRT for intracranial metastatic disease, prior surgical resection and breast cancer primary are associated with an increased risk for the development of LMD.« less

Risk factors for retrovirus and hepatitis virus infections in accepted blood donors.

PubMed

Custer, Brian; Kessler, Debra; Vahidnia, Farnaz; Leparc, German; Krysztof, David E; Shaz, Beth; Kamel, Hany; Glynn, Simone; Dodd, Roger Y; Stramer, Susan L

2015-05-01

Risk factor surveillance among infected blood donors provides information on the effectiveness of eligibility assessment and is critical for reducing risk of transfusion-transmitted infection. American Red Cross, Blood Systems, Inc., New York Blood Center, and OneBlood participated in a case-control study from 2010 to 2013. Donors with serologic and nucleic acid testing (NAT) or NAT-only confirmed human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), or serology-confirmed human T-lymphotropic virus (HTLV) infections (cases) and donors with false-positive results (controls) were interviewed for putative behavioral and demographic risks. Frequencies and adjusted odds ratios (AORs) from multivariable logistic regression analyses for each exposure in cases compared to controls are reported. In the study, 196 HIV, 292 HBV, 316 HCV, and 198 HTLV cases, and 1587 controls were interviewed. For HIV, sex with an HIV+ person (AOR, 132; 95% confidence interval [CI], 27-650) and male-male sex (AOR, 62; 95% CI, 27-140) were primary risk factors. For HBV, first-time donor status (AOR, 16; 95% CI, 10-27), sex with an injection drug user (IDU; AOR, 11; 95% CI, 5-28), and black race (AOR, 11; 95% CI, 6-19) were primary. For HCV, IDU (AOR, 42; 95% CI, 13-136), first time (AOR, 18; 95% CI, 10-30), and a family member with hepatitis (AOR, 15; 95% CI, 6-40) were primary. For HTLV, sex with an IDU (AOR, 22; 95% CI, 10-48), 55 years old or more (AOR, 21; 95% CI, 8-52], and first time (AOR, 15; 95% CI, 9-24) were primary. Despite education efforts and risk screening, individuals with deferrable risks still donate; they may fail to understand or ignore or do not believe they have risk. Recipients have potential transfusion-transmitted infection risk because of nondisclosure by donors. © 2014 AABB.

From mad cows to sensible blood transfusion: the risk of prion transmission by labile blood components in the United Kingdom and in France.

PubMed

Lefrère, Jean-Jacques; Hewitt, Patricia

2009-04-01

Transfusion transmission of the prion, the agent of variant Creutzfeldt-Jakob disease (vCJD), is now established. Subjects infected through food may transmit the disease through blood donations. The two nations most affected to date by this threat are the United Kingdom (UK) and France. The first transfusion cases have been observed in the UK over the past 5 years. In France, a few individuals who developed vCJD had a history of blood donation, leading to a risk of transmission to recipients, some of whom could be incubating the disease. In the absence of a large-scale screening test, it is impossible to establish the prevalence of infection in the blood donor population and transfused patients. This lack of a test also prevents specific screening of blood donations. Thus, prevention of transfusion transmission essentially relies at present on deferral of "at-risk" individuals. Because prions are present in both white blood cells and plasma, leukoreduction is probably insufficient to totally eliminate the transfusion risk. In the absence of a screening test for blood donations, recently developed prion-specific filters could be a solution. Furthermore, while the dietary spread of vCJD seems efficiently controlled, uncertainty remains as to the extent of the spread of prions through blood transfusion and other secondary routes.

Immune control of HIV-1 infection after therapy interruption: immediate versus deferred antiretroviral therapy

PubMed Central

2009-01-01

Background The optimal stage for initiating antiretroviral therapies in HIV-1 bearing patients is still a matter of debate. Methods We present computer simulations of HIV-1 infection aimed at identifying the pro et contra of immediate as compared to deferred Highly Active Antiretroviral Therapy (HAART). Results Our simulations highlight that a prompt specific CD8+ cytotoxic T lymphocytes response is detected when therapy is delayed. Compared to very early initiation of HAART, in deferred treated patients CD8+ T cells manage to mediate the decline of viremia in a shorter time and, at interruption of therapy, the virus experiences a stronger immune pressure. We also observe, however, that the immunological effects of the therapy fade with time in both therapeutic regimens. Thus, within one year from discontinuation, viral burden recovers to the value at which it would level off in the absence of therapy. In summary, simulations show that immediate therapy does not prolong the disease-free period and does not confer a survival benefit when compared to treatment started during the chronic infection phase. Conclusion Our conclusion is that, since there is no therapy to date that guarantees life-long protection, deferral of therapy should be preferred in order to minimize the risk of adverse effects, the occurrence of drug resistances and the costs of treatment. PMID:19840392

Optimal Sizing Tool for Battery Storage in Grid Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

2015-09-24

The battery storage sizing tool developed at Pacific Northwest National Laboratory can be used to evaluate economic performance and determine the optimal size of battery storage in different use cases considering multiple power system applications. The considered use cases include i) utility owned battery storage, and ii) battery storage behind customer meter. The power system applications from energy storage include energy arbitrage, balancing services, T&D deferral, outage mitigation, demand charge reduction etc. Most of existing solutions consider only one or two grid services simultaneously, such as balancing service and energy arbitrage. ES-select developed by Sandia and KEMA is able tomore » consider multiple grid services but it stacks the grid services based on priorities instead of co-optimization. This tool is the first one that provides a co-optimization for systematic and local grid services.« less

Giving blood and enrolling on the stem cell donor registry: ranking of obstacles and motives in Switzerland.

PubMed

Bart, Thomas; Volken, Thomas; Fischer, Yvonne; Taleghani, Behrouz Mansouri

2014-07-01

To obtain a better understanding of factors affecting blood and blood stem cell donation behavior in Switzerland, a series of studies has been performed. In the recent study of this series, which is described here, motivators and barriers in the field of blood and blood stem cell donation were identified. Web-based survey data from a non-random sample of the Swiss population 2012/2013 (n = 3,153) were used to describe and compare the ranking of motives and obstacles to donate blood and to enroll on the Swiss blood stem cell registry. Wilcoxon rank-sum test and Spearman's rank correlations were used to assess differences and associations between ranks and groups. The prospect of saving lives and solidarity were the top two motives to donate blood or to enroll on the blood stem cell registry. The top two obstacles to enroll on the blood stem cell registry were lack of general information on blood stem cell donation and on its risks, whereas the top two obstacles to donate blood were the lack of information where and when to donate and deferral of or exclusion from blood donation. Classical altruistic motives are top drivers for giving blood as well as registering for blood stem cell donation. Recruitment campaigns should focus on these motivators. Similarities in motivational factors as well as in obstacles regarding blood and blood stem cell donation can be found.

Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training.

PubMed

Williams, Bethany Jill; Hanby, Andrew; Millican-Slater, Rebecca; Nijhawan, Anju; Verghese, Eldo; Treanor, Darren

2018-03-01

To train and individually validate a group of breast pathologists in specialty-specific digital primary diagnosis by using a novel protocol endorsed by the Royal College of Pathologists' new guideline for digital pathology. The protocol allows early exposure to live digital reporting, in a risk-mitigated environment, and focuses on patient safety and professional development. Three specialty breast pathologists completed training in the use of a digital microscopy system, and were exposed to a training set of 20 challenging cases, designed to help them identify personal digital diagnostic pitfalls. Following this, the three pathologists viewed a total of 694 live, entire breast cases. All primary diagnoses were made on digital slides, with immediate glass slide review and reconciliation before final case sign-out. There was complete clinical concordance between the glass and digital impression of the case in 98.8% of cases. Only 1.2% of cases had a clinically significant difference in diagnosis/prognosis on glass and digital slide reads. All pathologists elected to continue using the digital microscope as the standard for breast histopathology specimens, with deferral to glass for a limited number of clinical/histological scenarios as a safety net. Individual training and validation for digital primary diagnosis allows pathologists to develop competence and confidence in their digital diagnostic skills, and aids safe and responsible transition from the light microscope to the digital microscope. © 2017 John Wiley & Sons Ltd.

A Stochastic Simulator of a Blood Product Donation Environment with Demand Spikes and Supply Shocks

PubMed Central

An, Ming-Wen; Reich, Nicholas G.; Crawford, Stephen O.; Brookmeyer, Ron; Louis, Thomas A.; Nelson, Kenrad E.

2011-01-01

The availability of an adequate blood supply is a critical public health need. An influenza epidemic or another crisis affecting population mobility could create a critical donor shortage, which could profoundly impact blood availability. We developed a simulation model for the blood supply environment in the United States to assess the likely impact on blood availability of factors such as an epidemic. We developed a simulator of a multi-state model with transitions among states. Weekly numbers of blood units donated and needed were generated by negative binomial stochastic processes. The simulator allows exploration of the blood system under certain conditions of supply and demand rates, and can be used for planning purposes to prepare for sudden changes in the public's health. The simulator incorporates three donor groups (first-time, sporadic, and regular), immigration and emigration, deferral period, and adjustment factors for recruitment. We illustrate possible uses of the simulator by specifying input values for an -week flu epidemic, resulting in a moderate supply shock and demand spike (for example, from postponed elective surgeries), and different recruitment strategies. The input values are based in part on data from a regional blood center of the American Red Cross during –. Our results from these scenarios suggest that the key to alleviating deficit effects of a system shock may be appropriate timing and duration of recruitment efforts, in turn depending critically on anticipating shocks and rapidly implementing recruitment efforts. PMID:21814550

Forecasting Ontario's blood supply and demand.

PubMed

Drackley, Adam; Newbold, K Bruce; Paez, Antonio; Heddle, Nancy

2012-02-01

Given an aging population that requires increased medical care, an increasing number of deferrals from the donor pool, and a growing immigrant population that typically has lower donation rates, the purpose of this article is to forecast Ontario's blood supply and demand. We calculate age- and sex-specific donation and demand rates for blood supply based on 2008 data and project demand between 2008 and 2036 based on these rates and using population data from the Ontario Ministry of Finance. Results indicate that blood demand will outpace supply as early as 2012. For instance, while the total number of donations made by older cohorts is expected to increase in the coming years, the number of red blood cell (RBC) transfusions in the 70+ age group is forecasted grow from approximately 53% of all RBC transfusions in 2008 (209,515) in 2008 to 68% (546,996) by 2036. A series of alternate scenarios, including projections based on a 2% increase in supply per year and increased use of apheresis technology, delays supply shortfalls, but does not eliminate them without active management and/or multiple methods to increase supply and decrease demand. Predictions show that demand for blood products will outpace supply in the near future given current age- and sex-specific supply and demand rates. However, we note that the careful management of the blood supply by Canadian Blood Services, along with new medical techniques and the recruitment of new donors to the system, will remove future concerns. © 2012 American Association of Blood Banks.

A stochastic simulator of a blood product donation environment with demand spikes and supply shocks.

PubMed

An, Ming-Wen; Reich, Nicholas G; Crawford, Stephen O; Brookmeyer, Ron; Louis, Thomas A; Nelson, Kenrad E

2011-01-01

The availability of an adequate blood supply is a critical public health need. An influenza epidemic or another crisis affecting population mobility could create a critical donor shortage, which could profoundly impact blood availability. We developed a simulation model for the blood supply environment in the United States to assess the likely impact on blood availability of factors such as an epidemic. We developed a simulator of a multi-state model with transitions among states. Weekly numbers of blood units donated and needed were generated by negative binomial stochastic processes. The simulator allows exploration of the blood system under certain conditions of supply and demand rates, and can be used for planning purposes to prepare for sudden changes in the public's health. The simulator incorporates three donor groups (first-time, sporadic, and regular), immigration and emigration, deferral period, and adjustment factors for recruitment. We illustrate possible uses of the simulator by specifying input values for an 8-week flu epidemic, resulting in a moderate supply shock and demand spike (for example, from postponed elective surgeries), and different recruitment strategies. The input values are based in part on data from a regional blood center of the American Red Cross during 1996-2005. Our results from these scenarios suggest that the key to alleviating deficit effects of a system shock may be appropriate timing and duration of recruitment efforts, in turn depending critically on anticipating shocks and rapidly implementing recruitment efforts.

NASA's Plans for Developing Life Support and Environmental Monitoring and Control Systems

NASA Technical Reports Server (NTRS)

Lawson, B. Michael; Jan, Darrell

2006-01-01

Life Support and Monitoring have recently been reworked in response to the Vision for Space Exploration. The Exploration Life Support (ELS) Project has replaced the former Advanced Life Support Element of the Human Systems Research and Technology Office. Major differences between the two efforts include: the separation of thermal systems into a new stand alone thermal project, deferral of all work in the plant biological systems, relocation of food systems to another organization, an addition of a new project called habitation systems, and overall reduction in the number of technology options due to lower funding. The Advanced Environmental Monitoring and Control (AEMC) Element is retaining its name but changing its focus. The work planned in the ELS and AEMC projects is organized around the three major phases of the Exploration Program. The first phase is the Crew Exploration Vehicle (CEV). The ELS and AEMC projects will develop hardware for this short duration orbital and trans-lunar vehicle. The second phase is sortie landings on the moon. Life support hardware for lunar surface access vehicles including upgrades of the CEV equipment and technologies which could not be pursued in the first phase due to limited time and budget will be developed. Monitoring needs will address lunar dust issues, not applicable to orbital needs. The ELS and AEMC equipment is of short duration, but has different environmental considerations. The third phase will be a longer duration lunar outpost. This will consist of a new set of hardware developments better suited for long duration life support and associated monitoring needs on the lunar surface. The presentation will show the planned activities and technologies that are expected to be developed by the ELS and AEMC projects for these program phases.

Assessment of Energy Storage Alternatives in the Puget Sound Energy System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balducci, Patrick J.; Jin, Chunlian; Wu, Di

2013-12-01

As part of an ongoing study co-funded by the Bonneville Power Administration, under its Technology Innovation Grant Program, and the U.S. Department of Energy, the Pacific Northwest National Laboratory (PNNL) has developed an approach and modeling tool for assessing the net benefits of using energy storage located close to the customer in the distribution grid to manage demand. PNNL in collaboration with PSE and Primus Power has evaluated the net benefits of placing a zinc bromide battery system at two locations in the PSE system (Baker River / Rockport and Bainbridge Island). Energy storage can provide a number of benefitsmore » to the utility through the increased flexibility it provides to the grid system. Applications evaluated in the assessment include capacity value, balancing services, arbitrage, distribution deferral and outage mitigation. This report outlines the methodology developed for this study and Phase I results.« less

Tax Reform Act of 1986: implications and trends.

PubMed

Harris, R F

1988-10-01

The Tax Reform Act of 1986 contains several changes that substantially reduce economic flexibility for not-for-profit hospitals and healthcare systems. These changes, involving limited partnerships, investment tax credit, depreciation, and income deferral plans, among other items, carry several implications. Tax-motivated joint ventures will no longer be attractive to physician investors, donations to hospitals are expected to decline by up to 15 percent, and flexibility in attracting and retaining high-caliber employees is reduced. Efforts to reduce the federal budget deficit and renewed scrutiny of unrelated business income further jeopardize economic flexibility. Another threat is intensified Internal Revenue Service scrutiny of Form 990, which is filed by all not-for-profit organizations with $25,000 or more in annual gross receipts, and Form 990T, which is used to report unrelated business income. Measures to protect facilities' economic flexibility include careful return preparation, alternative recruitment tactics, objective opinions, refusal of high-risk deals, and outside appraisals.

Primary HIV infection: a medical and public health emergency requiring rapid specialist management.

PubMed

Fidler, Sarah; Fox, Julie

2016-04-01

Primary HIV infection (PHI) refers to the first six months following HIV acquisition and represents a unique opportunity for expedited diagnosis, and consideration of rapid antiretroviral therapy (ART) initiation to improve immune function, reduce the size of the viral reservoir and limit the risk of onward viral transmission. Failure to diagnose and rapidly treat individuals with PHI has significant individual and public health implications. The Strategic Timing of AntiRetroviral Treatment trial recently identified a clinical benefit of immediate ART over deferral of treatment according to CD4 count threshold, and has led to rapid changes in World Health Organization and specialist national guidelines. For all individuals living with HIV, the offer of immediate therapy irrespective of CD4 count is now recommended. This paper summarises the presentation and management of PHI, incorporating current research and guideline changes and discusses the role of PHI in onward transmission. © 2016 Royal College of Physicians.

Hodgkin Lymphoma in Pregnancy

PubMed Central

Bachanova, Veronika

2017-01-01

The peak incidence of Hodgkin lymphoma (HL) coincides with reproductive years, and as many as 3 % of all HL patients present with concurrent pregnancy. The management of a pregnant patient with HL requires a multidisciplinary approach combining expertise in medical oncology, high-risk obstetrics, and neonatology, as well as effective communication with the patient and her family. The goal is to optimize the mother’s chance of a cure while allowing for delivery of a healthy child. A pregnant patient with HL should be staged by clinical examination and judicious use of non-radiation imaging such as ultrasound, balancing the need for accurate disease assessment with the need to minimize invasive procedures. The treatment strategy is individualized to the symptoms, lymphoma stage, gestational age and the patients’ wishes. Therapeutic options include treatment deferral or single-agent vinblastine with reservation of multi-agent chemotherapy until the second or third trimester for the small minority of patients with aggressive clinical presentation. PMID:23749243

10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial.

PubMed

Halliday, Alison; Harrison, Michael; Hayter, Elizabeth; Kong, Xiangling; Mansfield, Averil; Marro, Joanna; Pan, Hongchao; Peto, Richard; Potter, John; Rahimi, Kazem; Rau, Angela; Robertson, Steven; Streifler, Jonathan; Thomas, Dafydd

2010-09-25

If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3-2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6-11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7% versus 4·8% at 1 year (and 92·1%vs 16·5% at 5 years). Perioperative risk of stroke or death within 30 days was 3·0% (95% CI 2·4-3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1% versus 10·0% at 5 years (gain 5·9%, 95% CI 4·0-7·8) and 10·8% versus 16·9% at 10 years (gain 6·1%, 2·7-9·4); ratio of stroke incidence rates 0·54, 95% CI 0·43-0·68, p<0·0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6·9% versus 10·9% at 5 years (gain 4·1%, 2·0-6·2) and 13·4% versus 17·9% at 10 years (gain 4·6%, 1·2-7·9). Medication was similar in both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits were significant both for those on lipid-lowering therapy and for those not, and both for men and for women up to 75 years of age at entry (although not for older patients). Successful CEA for asymptomatic patients younger than 75 years of age reduces 10-year stroke risks. Half this reduction is in disabling or fatal strokes. Net benefit in future patients will depend on their risks from unoperated carotid lesions (which will be reduced by medication), on future surgical risks (which might differ from those in trials), and on whether life expectancy exceeds 10 years. UK Medical Research Council, BUPA Foundation, Stroke Association. Copyright © 2010 Elsevier Ltd. All rights reserved.

Establishing the first institutional animal care and use committee in Egypt.

PubMed

Fahmy, Sohair R; Gaafar, Khadiga

2016-04-09

Although animal research ethics committees (AREC) are well established in Western countries, this field is weakly developed and its concept is poorly understood in the Middle East and North Africa region. Our main objective was to introduce the concept and requirements of ethical approaches in dealing with experimental animal in research and teaching in Egypt. Due to its very recent inception, Cairo University, Faculty of Science IACUC decided to operate in accordance with Guide for the Care and Use of Laboratory Animals 8th Edition 2011 (the Guide) since Egypt has not yet compiled its own guide. Fifty protocols were reviewed in 2013-2014. Only ten protocols were reviewed in 2013, but in 2014, forty protocols were reviewed. In 2013 all protocols were approved and in 2014, number of approvals were 35, the number of deferrals were 4, and one refused protocol. Master's theses (MSc) research protocols constituted the majority of the total reviewed protocols. This is attributed to the decision of the Board of the Faculty of Science, Cairo University in September, 2013 that the approval of the IACUC is mandatory before conducting any research involving animals or theses registration. The first IACUC was established in the Cairo University, Faculty of Science, since 2012. The challenges encountered by the committee were diverse, such as the absence of laws that control the use of animal models in scientific research, lack of guidelines (protocols for experimental animals in research) and, mandatory ethical approval for any experimental animal research.

High-dose intravenously administered iron versus orally administered iron in blood donors with iron deficiency: study protocol for a randomised, controlled trial.

PubMed

Macher, Susanne; Drexler, Camilla; Lindenau, Ines; Sareban, Nazanin; Schlenke, Peter; Amrein, Karin

2016-10-28

About 2-3 % of the population participates in blood donation programmes. Each whole blood donation or ten apheresis donations cause a loss of 200-250 mg of iron. As a result, one of the most common risks of regular blood donors is iron deficiency. Although this has been known for decades, in most countries, iron status is currently not assessed or treated in this population. Premenopausal women are particularly affected, as they have lower iron reserves and higher daily requirements. Besides anaemia, iron deficiency may lead to fatigue and impaired cognitive and physical performance. Current iron preparations for intravenous administration are well tolerated and allow for application of large doses up to 1 g in one visit. Our hypothesis is that in blood donors with iron deficiency, intravenously administered iron is more efficient and as safe as oral iron supplementation. Since anaemia is one of the most frequent reasons for permanent or intermittent donor deferral, maintaining an iron-replete donor pool may help to prevent shortages in blood supply and to avoid iron deficiency-related comorbidities. In this randomised clinical trial we include male and female blood donors aged ≥18 and ≤65 years with a ferritin value of ≤30 ng/ml. Stratified by gender, participants are randomized with a web-based randomisation tool in a 1:1 ratio to either 1 g of intravenously administered ferric carboxymaltose or 10 g of iron fumarate supplements at one to two daily doses of 100 mg each. Eight to 12 weeks after the first visit, iron status, blood count and symptoms are assessed in both groups. The primary endpoint is the difference in transferrin saturation (%) following the intervention between both groups. Secondary endpoints include other parameters of iron metabolism and red blood cell count, the number of patients with drug-related adverse events, and subjective symptoms including those of the restless legs syndrome, quality of life, and fatigue. Iron supplementation administered intravenously in non-anaemic but iron-deficient blood donors could represent an effective strategy to protect blood donors from comorbidities related with iron deficiency and therefore improve blood donor wellbeing. Furthermore, iron supplementation will help to maintain an iron-replete blood donor pool. EudraCT: 2013-000327-14, Clinical Trials Identifier: NCT01787526 . Registered on 6 February 2013.

Prediction of hemoglobin in blood donors using a latent class mixed-effects transition model.

PubMed

Nasserinejad, Kazem; van Rosmalen, Joost; de Kort, Wim; Rizopoulos, Dimitris; Lesaffre, Emmanuel

2016-02-20

Blood donors experience a temporary reduction in their hemoglobin (Hb) value after donation. At each visit, the Hb value is measured, and a too low Hb value leads to a deferral for donation. Because of the recovery process after each donation as well as state dependence and unobserved heterogeneity, longitudinal data of Hb values of blood donors provide unique statistical challenges. To estimate the shape and duration of the recovery process and to predict future Hb values, we employed three models for the Hb value: (i) a mixed-effects models; (ii) a latent-class mixed-effects model; and (iii) a latent-class mixed-effects transition model. In each model, a flexible function was used to model the recovery process after donation. The latent classes identify groups of donors with fast or slow recovery times and donors whose recovery time increases with the number of donations. The transition effect accounts for possible state dependence in the observed data. All models were estimated in a Bayesian way, using data of new entrant donors from the Donor InSight study. Informative priors were used for parameters of the recovery process that were not identified using the observed data, based on results from the clinical literature. The results show that the latent-class mixed-effects transition model fits the data best, which illustrates the importance of modeling state dependence, unobserved heterogeneity, and the recovery process after donation. The estimated recovery time is much longer than the current minimum interval between donations, suggesting that an increase of this interval may be warranted. Copyright © 2015 John Wiley & Sons, Ltd.

Changes in Cardiovascular Disease Risk Factors With Immediate Versus Deferred Antiretroviral Therapy Initiation Among HIV-Positive Participants in the START (Strategic Timing of Antiretroviral Treatment) Trial.

PubMed

Baker, Jason V; Sharma, Shweta; Achhra, Amit C; Bernardino, Jose Ignacio; Bogner, Johannes R; Duprez, Daniel; Emery, Sean; Gazzard, Brian; Gordin, Jonathan; Grandits, Greg; Phillips, Andrew N; Schwarze, Siegfried; Soliman, Elsayed Z; Spector, Stephen A; Tambussi, Giuseppe; Lundgren, Jens

2017-05-22

HIV infection and certain antiretroviral therapy (ART) medications increase atherosclerotic cardiovascular disease risk, mediated, in part, through traditional cardiovascular disease risk factors. We studied cardiovascular disease risk factor changes in the START (Strategic Timing of Antiretroviral Treatment) trial, a randomized study of immediate versus deferred ART initiation among HIV-positive persons with CD4 + cell counts >500 cells/mm 3 . Mean change from baseline in risk factors and the incidence of comorbid conditions were compared between groups. The characteristics among 4685 HIV-positive START trial participants include a median age of 36 years, a CD4 cell count of 651 cells/mm 3 , an HIV viral load of 12 759 copies/mL, a current smoking status of 32%, a median systolic/diastolic blood pressure of 120/76 mm Hg, and median levels of total cholesterol of 168 mg/dL, low-density lipoprotein cholesterol of 102 mg/dL, and high-density lipoprotein cholesterol of 41 mg/dL. Mean follow-up was 3.0 years. The immediate and deferred ART groups spent 94% and 28% of follow-up time taking ART, respectively. Compared with patients in the deferral group, patients in the immediate ART group had increased total cholesterol and low-density lipoprotein cholesterol and higher use of lipid-lowering therapy (1.2%; 95% CI, 0.1-2.2). Concurrent increases in high-density lipoprotein cholesterol with immediate ART resulted in a 0.1 lower total cholesterol to high-density lipoprotein cholesterol ratio (95% CI, 0.1-0.2). Immediate ART resulted in 2.3% less BP-lowering therapy use (95% CI, 0.9-3.6), but there were no differences in new-onset hypertension or diabetes mellitus. Among HIV-positive persons with preserved immunity, immediate ART led to increases in total cholesterol and low-density lipoprotein cholesterol but also concurrent increases in high-density lipoprotein cholesterol and decreased use of blood pressure medications. These opposing effects suggest that, in the short term, the net effect of early ART on traditional cardiovascular disease risk factors may be clinically insignificant." URL: http://www.clinicaltrials.gov. Unique identifier: NCT00867048. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Ebola Virus and Marburg Virus in Human Milk Are Inactivated by Holder Pasteurization.

PubMed

Hamilton Spence, Erin; Huff, Monica; Shattuck, Karen; Vickers, Amy; Yun, Nadezda; Paessler, Slobodan

2017-05-01

Potential donors of human milk are screened for Ebola virus (EBOV) using standard questions, but testing for EBOV and Marburg virus (MARV) is not part of routine serological testing performed by milk banks. Research aim: This study tested the hypothesis that EBOV would be inactivated in donor human milk (DHM) by standard pasteurization techniques (Holder) used in all North American nonprofit milk banks. Milk samples were obtained from a nonprofit milk bank. They were inoculated with EBOV (Zaire strain) and MARV (Angola strain) and processed by standard Holder pasteurization technique. Plaque assays for EBOV and MARV were performed to detect the presence of virus after pasteurization. Neither EBOV nor MARV was detectable by viral plaque assay in DHM or culture media samples, which were pasteurized by the Holder process. EBOV and MARV are safely inactivated in human milk by standard Holder pasteurization technique. Screening for EBOV or MARV beyond questionnaire and self-deferral is not needed to ensure safety of DHM for high-risk infants.

Modeling Insights into Haemophilus influenzae Type b Disease, Transmission, and Vaccine Programs

PubMed Central

Rose, Charles E.; Cohn, Amanda; Coronado, Fatima; Clark, Thomas A.; Wenger, Jay D.; Bulkow, Lisa; Bruce, Michael G.; Messonnier, Nancy E.; Hennessy, Thomas W.

2012-01-01

In response to the 2007–2009 Haemophilus influenzae type b (Hib) vaccine shortage in the United States, we developed a flexible model of Hib transmission and disease for optimizing Hib vaccine programs in diverse populations and situations. The model classifies population members by age, colonization/disease status, and antibody levels, with movement across categories defined by differential equations. We implemented the model for the United States as a whole, England and Wales, and the Alaska Native population. This model accurately simulated Hib incidence in all 3 populations, including the increased incidence in England/Wales beginning in 1999 and the change in Hib incidence in Alaska Natives after switching Hib vaccines in 1996. The model suggests that a vaccine shortage requiring deferral of the booster dose could last 3 years in the United States before loss of herd immunity would result in increasing rates of invasive Hib disease in children <5 years of age. PMID:22257582

Systems biology of stored blood cells: can it help to extend the expiration date?

PubMed

Paglia, Giuseppe; Palsson, Bernhard Ø; Sigurjonsson, Olafur E

2012-12-05

With increasingly stringent regulations regarding deferral and elimination of blood donors it will become increasingly important to extend the expiration date of blood components beyond the current allowed storage periods. One reason for the storage time limit for blood components is that platelets and red blood cells develop a condition called storage lesions during their storage in plastic blood containers. Systems biology provides comprehensive bio-chemical descriptions of organisms through quantitative measurements and data integration in mathematical models. The biological knowledge for a target organism can be translated in a mathematical format and used to compute physiological properties. The use of systems biology represents a concrete solution in the study of blood cell storage lesions, and it may open up new avenues towards developing better storage methods and better storage media, thereby extending the storage period of blood components. This article is part of a Special Issue entitled: Integrated omics. Copyright © 2012 Elsevier B.V. All rights reserved.

Evaluation of four rapid methods for hemoglobin screening of whole blood donors in mobile collection settings.

PubMed

Gómez-Simón, Antonia; Navarro-Núñez, Leyre; Pérez-Ceballos, Elena; Lozano, María L; Candela, María J; Cascales, Almudena; Martínez, Constantino; Corral, Javier; Vicente, Vicente; Rivera, José

2007-06-01

Predonation hemoglobin measurement is a problematic requirement in mobile donation settings, where accurate determination of venous hemoglobin by hematology analyzers is not available. We have evaluated hemoglobin screening in prospective donors by the semiquantitative copper sulphate test and by capillary blood samples analyzed by three portable photometers, HemoCue, STAT-Site MHgb, and the CompoLab HB system. Capillary blood samples were obtained from 380 donors and tested by the copper sulphate test and by at least one of the named portable photometers. Predonation venous hemoglobin was also determined in all donors using a Coulter Max-M analyzer. The three photometers provided acceptable reproducibility (CV below 5%), and displayed a significant correlation between the capillary blood samples and the venous hemoglobin (R2 0.5-0.8). HemoCue showed the best agreement with venous hemoglobin determination, followed by STAT-Site MHgb, and the CompoLab HB system. The copper sulphate test provided the highest rate of donors acceptance (83%) despite unacceptable hemoglobin levels, and the lowest rate for donor deferral (1%) despite acceptable hemoglobin levels. The percentage of donors correctly categorized for blood donation by the portable hemoglobinometers was 85%, 82%, and 76% for CompoLab HB system, HemoCue and STAT-Site, respectively. Our data suggest that hemoglobin determination remains a conflictive issue in donor selection in the mobile setting. Without appropriate performance control, capillary hemoglobin screening by either the copper sulphate method or by the novel portable hemoglobinometers could be inaccurate, thus potentially affecting both donor safety and the blood supply.

Zika virus RNA polymerase chain reaction on the utility channel of a commercial nucleic acid testing system.

PubMed

Boujnan, Mohamed; Duits, Ashley J; Koppelman, Marco H G M

2018-03-01

Several countries have implemented safety strategies to reduce the risk of Zika virus (ZIKV) transmission through blood transfusion. These strategies have included nucleic acid amplification testing (NAT) of blood donations. In this study, a new real-time polymerase chain reaction (PCR) assay including internal control for the detection of ZIKV on the cobas omni Utility Channel (UC) on the cobas 6800 system is presented. PCR conditions and primer/probe concentrations were optimized on the LightCycler 480 instrument. Optimized conditions were transferred to the cobas omni UC on the cobas 6800 system. Subsequently, the limit of detection (LOD) in plasma and urine, genotype inclusivity, specificity, cross-reactivity, and clinical sensitivity were determined. The 95% LOD of the ZIKV PCR assay on the cobas 6800 system was 23.0 IU/mL (95% confidence interval [CI], 16.5-37.5) in plasma and 24.5 IU/mL (95% CI, 13.4-92.9) in urine. The assay detected African and Asian lineages of ZIKV. The specificity was 100%. The clinical concordance between the newly developed ZIKV PCR assay and the investigational Roche cobas Zika NAT test was 83% (24/29). We developed a sensitive ZIKV PCR assay on the cobas omni UC on the cobas 6800 system. The assay can be used for large-scale screening of blood donations for ZIKV or for testing of blood donors returning from areas with ZIKV to avoid temporal deferral. This study also demonstrates that the cobas omni UC on the cobas 6800 system can be used for in-house-developed PCR assays. © 2018 AABB.

The revision of the European blood directives: A major challenge for transfusion medicine.

PubMed

Folléa, G; Aranko, K

2015-08-01

Using both patient-focused and donor-focused perspectives, to review the current EU blood directives, in order to derive proposals, in principle, for what should evolve during the revision process of these directives. Review of the EU blood directives in the light of scientific literature, related reports from the Directorate General Health and Consumers (DG SANTÉ), and from the Council of Europe (CoE). The analyses led us to present the main following proposals: developing voluntary unpaid donations: the directives should consider taking into consideration ethically acceptable forms of compensation consistent with altruistic donation (including plasma donations for fractionation); current expertise: more extensive utilization of the expertise of blood establishments and their consultants should be considered; donor selection: an evidence-based approach for basing donor deferral criteria on sound scientific evidence should be promoted; donor reactions: measures to prevent donor reactions and to make donations safer for the donors should also be included; quality control: The quality control requirements should relate to the Council of Europe Blood Guide specifications: these should become minimum standards (as is the case with monographs of the European Pharmacopeia), facilitating regular update of blood component lists and related specifications and compliance with the specifications; haemovigilance: because of reporting difficulties (e.g. lack of number of blood products transfused), the effectiveness of haemovigilance has so far been limited. This should lead appropriate bodies to investigate alternative or complementary ways to help improve patient safety, taking into consideration, in principle, patient blood management and the appropriate use of blood products. Furthermore, donor vigilance, which is still absent from the current directive should be included in a revised directive. These proposals for revising the current EU blood directives (if taken into account and given appropriate regulatory formulation) should help to optimize patient safety and donor care, progress the compliance with the ethical principles for donors and improve the efficiency of the healthcare systems dedicated to transfusion medicine. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Risk factors for human immunodeficiency virus among blood donors in Cameroon: evidence for the design of an Africa-specific donor history questionnaire.

PubMed

Tagny, Claude T; Nguefack-Tsague, Georges; Fopa, Diderot; Ashu, Celestin; Tante, Estel; Ngo Balogog, Pauline; Donfack, Olivier; Mbanya, Dora; Laperche, Syria; Murphy, Edward

2017-08-01

In sub-Saharan Africa improving the deferral of at-risk blood donors would be a cost-effective approach to reducing transfusion-transmitted human immunodeficiency virus (HIV) infections. We performed a pilot case-control study to identify the risk factors for HIV infection and to develop an adapted donor history questionnaire (DHQ) for sub-Saharan Africa. We recruited 137 HIV-positive donors (cases) and 256 HIV-negative donors (controls) and gathered risk factor data using audio computer-assisted self-interview. Variables with univariate associations were entered into a logistic regression model to assess independent associations. A scoring scheme to distinguish between HIV-positive and HIV-negative donors was developed using receiver operating characteristics curves. We identified 16 risk factors including sex with sex worker, past history or treatment for sexually transmitted infections, and having a partner who used injected or noninjected illegal drugs. Two novel risks were related to local behavior: polygamy (odds ratio [OR], 22.7; 95% confidence interval [CI], 5.9-86.7) and medical or grooming treatment on the street (OR, 1.8; 95% CI, 1.0-3.0). Using the 16 selected items the mean scores (>100) were 82.6 ± 6.7 (range, 53.2-95.1) and 85.1 ± 5.2 for HIV-negative donors versus 77.9 ± 6.8 for HIV-positive ones (p = 0.000). Donors who scored between 80 and 90 were more likely to be HIV negative than those who scored less (OR, 31.4; 95% CI, 3.1-313.9). We identified both typical and novel HIV risk factors among Cameroonian blood donors. An adapted DHQ and score that discriminate HIV-negative donors may be an inexpensive means of reducing transfusion-transmitted HIV through predonation screening. © 2017 AABB.

Shillapoo Wildlife Area, Annual Report 2007-2008.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calkins, Brian

This report summarizes accomplishments, challenges and successes on WDFW's Shillapoo Wildlife Area funded under Bonneville Power Administration's (BPA) Wildlife Mitigation Program (BPA project No.2003-012-00) during the Fiscal Year 08 contract period October 1, 2007-September 30, 2008. The information presented here is intended to supplement that contained in BPA's PISCES contract development and reporting system. The organization below is by broad categories of work but references are made to individual work elements in the PISCES Statement of Work as appropriate. Significant progress was realized in almost all major work types. Of particular note was progress made in tree plantings and pasturemore » rehabilitation efforts. This year's tree planting effort included five sites detailed below and in terms of the number of plants was certainly the largest effort on the wildlife area to date in one season. The planting itself took a significant amount of time, which was anticipated. However, installation of mats and tubes took much longer than expected which impacted planned fence projects in particular. Survival of the plantings appears to be good. Improvement to the quality of waterfowl pasture habitats is evident on a number of sites due to replanting and weed control efforts. Continuing long-term weed control efforts will be key in improving this particular type of habitat. A prolonged cold, wet spring and a number of equipment breakdowns presented stumbling blocks that impacted schedules and ultimately progress on planned activities. The unusual spring weather delayed fieldwork on pasture planting projects as well as weed control and slowed the process of maintaining trees and shrubs. This time lag also caused the continued deferral of some of our fencing projects. The large brush hog mower had the driveline break twice and the smaller tractor had an engine failure that caused it to be down for over a month. We have modified our budget plan for next year to include a temporary employee that will work primarily on tree maintenance and fencing projects to make sure that we make progress in these areas and we will be investigating whether a heavier duty driveline can be obtained for the mower.« less

Battery energy-storage systems — an emerging market for lead/acid batteries

NASA Astrophysics Data System (ADS)

Cole, J. F.

Although the concept of using batteries for lead levelling and peak shaving has been known for decades, only recently have these systems become commercially viable. Changes in the structure of the electric power supply industry have required these companies to seek more cost-effective ways of meeting the needs of their customers. Through experience gained, primarily in the USA, batteries have been shown to provide multiple benefits to electric utilities. Also, lower maintenance batteries, more reliable electrical systems, and the availability of methods to predict costs and benefits have made battery energy-storage systems more attractive. Technology-transfer efforts in the USA have resulted in a willingness of electric utilities to install a number of these systems for a variety of tasks, including load levelling, peak shaving, frequency regulation and spinning reserve. Additional systems are being planned for several additional locations for similar applications, plus transmission and distribution deferral and enhanced power quality. In the absence of US champions such as the US Department of Energy and the Electric Power Research Institute, ILZRO is attempting to mount a technology-transfer programme to bring the benefits of battery energy-storage to European power suppliers. As a result of these efforts, a study group on battery energy-storage systems has been established with membership primarily in Germany and Austria. Also, a two-day workshop, prepared by the Electric Power Research Institute was held in Dublin. Participants included representatives of several European power suppliers. As a result, ESB National Grid of Ireland has embarked upon a detailed analysis of the costs and benefits of a battery energy-storage system in their network. Plans for the future include continuation of this technology-transfer effort, assistance in the Irish effort, and a possible approach to the European Commission for funding.

Distributed Smart Grid Asset Control Strategies for Providing Ancillary Services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalsi, Karanjit; Zhang, Wei; Lian, Jianming

2013-10-30

With large-scale plans to integrate renewable generation driven mainly by state-level renewable portfolio requirements, more resources will be needed to compensate for the uncertainty and variability associated with intermittent generation resources. Distributed assets can be used to mitigate the concerns associated with renewable energy resources and to keep costs down. Under such conditions, performing primary frequency control using only supply-side resources becomes not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in primary frequency control to maintain the stability of the system atmore » an acceptable cost. The main objective of this project is to develop a novel hierarchical distributed framework for frequency based load control. The framework involves two decision layers. The top decision layer determines the optimal gain for aggregated loads for each load bus. The gains are computed using decentralized robust control methods, and will be broadcast to the corresponding participating loads every control period. The second layer consists of a large number of heterogeneous devices, which switch probabilistically during contingencies so that aggregated power change matches the desired amount according to the most recently received gains. The simulation results show great potential to enable systematic design of demand-side primary frequency control with stability guarantees on the overall power system. The proposed design systematically accounts for the interactions between the total load response and bulk power system frequency dynamics. It also guarantees frequency stability under a wide range of time varying operating conditions. The local device-level load response rules fully respect the device constraints (such as temperature setpoint, compressor time delays of HVACs, or arrival and departure of the deferrable loads), which are crucial for implementing real load control programs. The promise of autonomous, Grid Friendly™ response by smart appliances in the form of under-frequency load shedding was demonstrated in the GridWise Olympic Peninsula Demonstration in 2006. Each controller monitored the power grid voltage signal and requested that electrical load be shed by its appliance whenever electric power-grid frequency fell below 59.95 Hz. The controllers and their appliances responded reliably to each shallow under-frequency event, which was an average of one event per day and shed their loads for the durations of these events. Another objective of this project was to perform extensive simulation studies to investigate the impact of a population of Grid Friendly™ Appliances (GFAs) on the bulk power system frequency stability. The GFAs considered in this report are represented as demonstration units with water heaters individually modeled.« less

Revised congressional budget request, FY 1982. Conservation and renewable energy program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1981-03-01

Programs dealing with conservation and renewable energy are reprinted from the Revised Congressional Budget Request FY 1982. From Volume 7, Energy Conservation, information is presented on: buildings and community systems; industrial programs; transportation programs; state and local programs; inventor's program energy conversion technology; energy impact assistance; and residential/commercial retrofit. From Volume 2, Energy Supply Research and Development, information and data are presented on: solar building applications; solar industrial applications; solar power applications; solar information systems; SERI facility; solar international activities; alcohol fuels; geothermal; and hydropower. From Volume 6, Energy Production, Demonstration, and Distribution, information and data on solar energy production,more » demonstration, and distribution are presented. From Volume 3, Energy Supply and R and D Appropriation, information and data on electric energy systems and energy storage systems are included. From Volume 4, information and data are included on geothermal resources development fund. In Volume 5, Power Marketing Administrations, information and data are presented on estimates by appropriations, positions and staff years by appropriation, staffing distribution, and power marketing administrations. Recissions and deferrals for FY 1981 are given. (MCW)« less

Conservation and solar energy program: congressional budget request, FY 1982

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1981-01-01

Funding summaries are presented for the Conservation and Solar Energy Program funding information and program overview on energy conservation (Volume 7 of 7, DOE/CR-0011/2) are included for the Buildings and Community Systems, Industrial, Transportation; State and Local, Multi-Sector, Energy Impact Assistance, and Residential/Commercial retrofit programs. Funding information and program overviews on solar technology (Volume 2 of 7, DOE/CR-011/2) are included for Active and Passive Solar Heating and Cooling, Photovoltaics Energy Systems, Solar Thermal Power Systems, Biomass Energy Systems, Wind Energy Conversion Systems, Ocean Systems, Solar International Activities, Solar Information Systems, SERI Facility, MX-RES, Program Direction, and Alcohol Fuels programs. Informationmore » and overviews on energy production, demonstration, and distribution (Volume 6 of 7, DOE/CR-0011/2) are given for the solar program. A funding summary and a program overview are included for electrochemical and physical and chemical storage systems as appearing in DOE/CR-0011/2, Volume 3 of 7. Relevant tabulated data from the FY 1981. Request to the Congress are presented for Supplementals, Rescissions, and Deferrals. (MCW)« less

Stage-specific integration of maternal and embryonic peroxisome proliferator-activated receptor delta signaling is critical to pregnancy success.

PubMed

Wang, Haibin; Xie, Huirong; Sun, Xiaofei; Tranguch, Susanne; Zhang, Hao; Jia, Xiangxu; Wang, Dingzhi; Das, Sanjoy K; Desvergne, Béatrice; Wahli, Walter; DuBois, Raymond N; Dey, Sudhansu K

2007-12-28

Successful pregnancy depends on well coordinated developmental events involving both maternal and embryonic components. Although a host of signaling pathways participate in implantation, decidualization, and placentation, whether there is a common molecular link that coordinates these processes remains unknown. By exploiting genetic, molecular, pharmacological, and physiological approaches, we show here that the nuclear transcription factor peroxisome proliferator-activated receptor (PPAR) delta plays a central role at various stages of pregnancy, whereas maternal PPARdelta is critical to implantation and decidualization, and embryonic PPARdelta is vital for placentation. Using trophoblast stem cells, we further elucidate that a reciprocal relationship between PPARdelta-AKT and leukemia inhibitory factor-STAT3 signaling pathways serves as a cell lineage sensor to direct trophoblast cell fates during placentation. This novel finding of stage-specific integration of maternal and embryonic PPARdelta signaling provides evidence that PPARdelta is a molecular link that coordinates implantation, decidualization, and placentation crucial to pregnancy success. This study is clinically relevant because deferral of on time implantation leads to spontaneous pregnancy loss, and defective trophoblast invasion is one cause of preeclampsia in humans.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Duchaineau, M.; Wolinsky, M.; Sigeti, D.E.

Terrain visualization is a difficult problem for applications requiring accurate images of large datasets at high frame rates, such as flight simulation and ground-based aircraft testing using synthetic sensor stimulation. On current graphics hardware, the problem is to maintain dynamic, view-dependent triangle meshes and texture maps that produce good images at the required frame rate. We present an algorithm for constructing triangle meshes that optimizes flexible view-dependent error metrics, produces guaranteed error bounds, achieves specified triangle counts directly, and uses frame-to-frame coherence to operate at high frame rates for thousands of triangles per frame. Our method, dubbed Real-time Optimally Adaptingmore » Meshes (ROAM), uses two priority queues to drive split and merge operations that maintain continuous triangulations built from pre-processed bintree triangles. We introduce two additional performance optimizations: incremental triangle stripping and priority-computation deferral lists. ROAM execution time is proportionate to the number of triangle changes per frame, which is typically a few percent of the output mesh size, hence ROAM performance is insensitive to the resolution and extent of the input terrain. Dynamic terrain and simple vertex morphing are supported.« less

Behavioral finance and retirement plan contributions: how participants behave, and prescriptive solutions.

PubMed

DiCenzo, Jodi

2007-01-01

Behavioral research has made important, relevant contributions to retirement saving and investing. This work has cast a new light on participant behavior and its underpinnings: By and large, individuals are inert--with good intentions, poor follow-through, and bounded rationality. Loss aversion and decision-making biases often lead to unfortunate outcomes, including a poorly funded retirement. Further, behavioral economists have demonstrated that education and communication programs alone may not be effective in changing behavior. Instead, with their behavioral insights, they have offered new retirement plan design alternatives and empirically tested their efficacy in overcoming identified suboptimal behavior. These efforts are helping to pave a path of least resistance that should lead to greater retirement security. The Pension Protection Act of 2006 appears to support these alternatives by providing incentives to plan sponsors that implement automatic features such as automatic enrollment and deferral rate escalation. It also allows plan sponsors to choose more aggressive investment defaults. Perhaps implicit in this support is some advice to sponsors to accept participant behavior and to think more about changing their own by embracing automatic plan features.

Sepsis in Poland: Why Do We Die?

PubMed Central

Rorat, Marta; Jurek, Tomasz

2015-01-01

Objective To investigate the adverse events and potential risk factors in patients who develop sepsis. Subjects and Methods Fifty-five medico-legal opinion forms relating to sepsis cases issued by the Department of Forensic Medicine, Wroclaw, Poland, between 2004 and 2013 were analyzed for medical errors and risk factors for adverse events. Results The most common causes of medical errors were a lack of knowledge in recognition, diagnosis and therapy as well as ignorance of risk. The common risk factors for adverse events were deferral of a diagnostic or therapeutic decision, high-level anxiety of patients or their families about the patient's health and actively seeking for help. The most significant risk factors were communication errors, not enough medical staff, stereotype-based thinking about diseases and providing easy explanations for serious symptoms. Conclusion The most common cause of adverse events related to sepsis in the Polish health-care system was a lack of knowledge about the symptoms, diagnosis and treatment as well as the ignoring of danger. A possible means of improving safety might be through spreading knowledge and creating medical management algorithms for all health-care workers, especially physicians. PMID:25501966

The INTERVAL trial to determine whether intervals between blood donations can be safely and acceptably decreased to optimise blood supply: study protocol for a randomised controlled trial.

PubMed

Moore, Carmel; Sambrook, Jennifer; Walker, Matthew; Tolkien, Zoe; Kaptoge, Stephen; Allen, David; Mehenny, Susan; Mant, Jonathan; Di Angelantonio, Emanuele; Thompson, Simon G; Ouwehand, Willem; Roberts, David J; Danesh, John

2014-09-17

Ageing populations may demand more blood transfusions, but the blood supply could be limited by difficulties in attracting and retaining a decreasing pool of younger donors. One approach to increase blood supply is to collect blood more frequently from existing donors. If more donations could be safely collected in this manner at marginal cost, then it would be of considerable benefit to blood services. National Health Service (NHS) Blood and Transplant in England currently allows men to donate up to every 12 weeks and women to donate up to every 16 weeks. In contrast, some other European countries allow donations as frequently as every 8 weeks for men and every 10 weeks for women. The primary aim of the INTERVAL trial is to determine whether donation intervals can be safely and acceptably decreased to optimise blood supply whilst maintaining the health of donors. INTERVAL is a randomised trial of whole blood donors enrolled from all 25 static centres of NHS Blood and Transplant. Recruitment of about 50,000 male and female donors started in June 2012 and was completed in June 2014. Men have been randomly assigned to standard 12-week versus 10-week versus 8-week inter-donation intervals, while women have been assigned to standard 16-week versus 14-week versus 12-week inter-donation intervals. Sex-specific comparisons will be made by intention-to-treat analysis of outcomes assessed after two years of intervention. The primary outcome is the number of blood donations made. A key secondary outcome is donor quality of life, assessed using the Short Form Health Survey. Additional secondary endpoints include the number of 'deferrals' due to low haemoglobin (and other factors), iron status, cognitive function, physical activity, and donor attitudes. A comprehensive health economic analysis will be undertaken. The INTERVAL trial should yield novel information about the effect of inter-donation intervals on blood supply, acceptability, and donors' physical and mental well-being. The study will generate scientific evidence to help formulate blood collection policies in England and elsewhere. Current Controlled Trials ISRCTN24760606, 25 January 2012.

Re-examining blood donor deferral criteria relating to injecting drug use.

PubMed

Quinn, Brendan; Seed, Clive; Keller, Anthony; Maher, Lisa; Wilson, David; Farrell, Michael; Caris, Sharon; Williams, Jennifer; Madden, Annie; Thompson, Alexander; Pink, Joanne; Hellard, Margaret E

2017-10-01

Potential Australian blood donors are deferred indefinitely if they report a history of injecting drug use (IDU), or for 12 months if they report having engaged in sexual activity with someone who might have ever injected. Given incremental improvements in blood safety, this study sought to examine whether Australia's IDU-related eligibility criteria reflected current scientific evidence, were consistent with international best practice and, if current IDU-related policies were to be changed, how this should happen. An expert committee was formed to review relevant literature with a focus on issues including: the epidemiology of IDU in Australia and key transfusion-transmissible infections (TTIs) among Australian people who inject drugs (PWID); and, 'non-compliance' among PWID regarding IDU-related blood donation guidelines. International policies relating to blood donation and IDU were also reviewed. Modelling with available data estimated the risk of TTIs remaining undetected if the Blood Service's IDU-related guidelines were changed. Very few (<1%) Australians engage in IDU, and IDU risk practices are reported by only a minority of PWID. However, the prevalence of HCV remains high among PWID, and IDU remains a key transmission route for various TTIs. Insufficient data were available to inform appropriate estimates of cessation and relapse among Australian PWID. Modelling findings indicated that the risk of not detecting HIV becomes greater than the reference group at a threshold of non-admission of being an active PWID of around 1.8% (0.5-5.1%). Excluding Japan, all Organisation for the Economic Co-operation and Development member countries permanently exclude individuals with a history of IDU from donating. Numerous research gaps meant that the study's expert Review Committee was unable to recommend altering Australia's current IDU-related blood donation guidelines. However, having identified critical knowledge gaps and future areas of research, the review made important steps toward changing the criteria. Copyright © 2017 Elsevier B.V. All rights reserved.

Environmental Baseline Survey Report for the Title Transfer of Parcel ED-9 at the East Tennessee Technology Park, Oak Ridge, Tennessee

DOE Office of Scientific and Technical Information (OSTI.GOV)

SAIC

2010-05-01

This environmental baseline survey (EBS) report documents the baseline environmental conditions of the U. S. Department of Energy's (DOE's) Parcel ED-9 at the East Tennessee Technology Park (ETTP). Parcel ED-9 consists of about 13 acres that DOE proposes to transfer to Heritage Center, LLC (hereafter referred to as 'Heritage Center'), a subsidiary of the Community Reuse Organization of East Tennessee (CROET). The 13 acres include two tracts of land, referred to as ED-9A (7.06 acres) and ED-9B (5.02 acres), and a third tract consisting of about 900 linear feet of paved road and adjacent right-of-way, referred to as ED-9C (0.98more » acres). Transfer of the title to ED-9 will be by deed under a Covenant Deferral Request (CDR) pursuant to Section 120(h)(3)(C) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). This report provides a summary of information to support the transfer of this government-owned property at ETTP to a non-federal entity.« less

Choosing a software design method for real-time Ada applications: JSD process inversion as a means to tailor a design specification to the performance requirements and target machine

NASA Technical Reports Server (NTRS)

Withey, James V.

1986-01-01

The validity of real-time software is determined by its ability to execute on a computer within the time constraints of the physical system it is modeling. In many applications the time constraints are so critical that the details of process scheduling are elevated to the requirements analysis phase of the software development cycle. It is not uncommon to find specifications for a real-time cyclic executive program included to assumed in such requirements. It was found that prelininary designs structured around this implementation abscure the data flow of the real world system that is modeled and that it is consequently difficult and costly to maintain, update and reuse the resulting software. A cyclic executive is a software component that schedules and implicitly synchronizes the real-time software through periodic and repetitive subroutine calls. Therefore a design method is sought that allows the deferral of process scheduling to the later stages of design. The appropriate scheduling paradigm must be chosen given the performance constraints, the largest environment and the software's lifecycle. The concept of process inversion is explored with respect to the cyclic executive.

Fractional Flow Reserve: Does a Cut-off Value add Value?

PubMed Central

Mohdnazri, Shah R; Keeble, Thomas R

2016-01-01

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI. PMID:29588700

Keratoprosthesis: Current global scenario and a broad Indian perspective

PubMed Central

Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta; Talele, Deepti; Rishi, Ekta; Rishi, Pukhraj; Krishnamurthy, Sripriya; Vijaya, Lingam; Subramanian, Nirmala; Somasundaram, Shanmugasundaram

2018-01-01

Keratoprosthesis (Kpro) forms the last resort for bilateral end-stage corneal blindness. The Boston Type 1 and 2 Kpros, the modified osteo-odonto Kpro and the osteo-Kpro are the more frequently and commonly performed Kpros, and this review attempts to compile the current data available on these Kpros worldwide from large single-center studies and compare the indications and outcomes with Kpros in the Indian scenario. Although the indications have significantly expanded over the years and the complications have reduced with modifications in design and postoperative regimen, these are procedures that require an exclusive setup, and a commitment toward long-term follow-up and post-Kpro care. The last decade has seen a surge in the number of Kpro procedures performed worldwide as well as in India. There is a growing need in our country among ophthalmologists to be aware of the indications for Kpro to facilitate appropriate referral as well as of the procedure to enable basic evaluation during follow-ups in case the need arises, and among corneal specialists interested to pursue the field of Kpros in understanding the nuances of these surgeries and to make a judicious decision regarding patient and Kpro selection and more importantly deferral. PMID:29676302

How parents whose children have been conceived with donor gametes make their disclosure decision: contexts, influences, and couple dynamics.

PubMed

Shehab, Dena; Duff, Julia; Pasch, Lauri A; Mac Dougall, Kirstin; Scheib, Joanna E; Nachtigall, Robert D

2008-01-01

To describe parents' disclosure decision-making process. In-depth ethnographic interviews. Participants were recruited from 11 medical infertility practices and 1 sperm bank in Northern California. One hundred forty-one married couples who had conceived a child using donor gametes (62 with donor sperm, 79 with donor oocytes). Husbands and wives were interviewed together and separately. Thematic analysis of interview transcripts. Ninety-five percent of couples came to a united disclosure decision, some "intuitively," but most after discussions influenced by the couples' local sociopolitical environment, professional opinion, counseling, religious and cultural background, family relationships, and individual personal, psychological, and ethical beliefs. Couples who were not initially in agreement ultimately came to a decision after one partner deferred to the wishes or opinions of the other. Deferral could reflect the result of a prior agreement, one partner's recognition of the other's experiential or emotional expertise, or direct persuasion. In disclosing couples, men frequently deferred to their wives, whereas, in nondisclosing couples, women always deferred to their husbands. Although the majority of couples were in initial agreement about disclosure, for many the disclosure decision was a complex, negotiated process reflecting a wide range of influences and contexts.

The Pharmaceutical Commons

PubMed Central

Lezaun, Javier

2015-01-01

In the last decade, the organization of pharmaceutical research on neglected tropical diseases has undergone transformative change. In a context of perceived “market failure,” the development of new medicines is increasingly handled by public-private partnerships. This shift toward hybrid organizational models depends on a particular form of exchange: the sharing of proprietary assets in general and of intellectual property rights in particular. This article explores the paradoxical role of private property in this new configuration of global health research and development. Rather than a tool to block potential competitors, proprietary assets function as a lever to attract others into risky collaborative ventures; instead of demarcating public and private domains, the sharing of property rights is used to increase the porosity of that boundary. This reimagination of the value of property is connected to the peculiar timescape of global health drug development, a promissory orientation to the future that takes its clearest form in the centrality of “virtual” business models and the proliferation of strategies of deferral. Drawing on the anthropological literature on inalienable possessions, we reconsider property’s traditional exclusionary role and discuss the possibility that the new pharmaceutical “commons” proclaimed by contemporary global health partnerships might be the precursor of future enclosures. PMID:25866425

Social protection and public policy for vulnerable populations: an assessment of the Continuous Cash Benefit Program of Welfare in Brazil.

PubMed

Duarte, Cristina Maria Rabelais; Marcelino, Miguel Abud; Boccolini, Cristiano Siqueira; Boccolini, Patrícia de Moraes Mello

2017-11-01

This paper describes the historical development and profile of Continuous Cash Benefit (BPC) applicants, intended for poor elderly and people with disabilities, which, since 2009, uses eligibility criteria based on the International Classification of Functioning, Disability and Health (ICF) of the WHO and is aligned with the UN Convention on the Rights of Persons with Disabilities. The behavior of benefits was determined from the analysis the coefficients of the general and non-judicial grants between 1998 and 2014. The profile was established for the years 2010 and 2014 according to situation of acceptance, age, gender and ICF components. The average annual growth of the coefficient was higher from 2000 to 2010, prior to the adoption of the biopsychosocial eligibility model, and the coefficient of non-judicial grants increased until 2010, falling thereafter. The deferrals acceptance /rejections ratio was higher among children and among those facing severe or total environmental barriers, limitations, constraints and bodily changes. The implementation of the biopsychosocial evaluation model did not cause an increased rate of grants and results evidence the need for flexibility in the eligibility criteria.

Dynamic Appliances Scheduling in Collaborative MicroGrids System

PubMed Central

Bilil, Hasnae; Aniba, Ghassane; Gharavi, Hamid

2017-01-01

In this paper a new approach which is based on a collaborative system of MicroGrids (MG’s), is proposed to enable household appliance scheduling. To achieve this, appliances are categorized into flexible and non-flexible Deferrable Loads (DL’s), according to their electrical components. We propose a dynamic scheduling algorithm where users can systematically manage the operation of their electric appliances. The main challenge is to develop a flattening function calculus (reshaping) for both flexible and non-flexible DL’s. In addition, implementation of the proposed algorithm would require dynamically analyzing two successive multi-objective optimization (MOO) problems. The first targets the activation schedule of non-flexible DL’s and the second deals with the power profiles of flexible DL’s. The MOO problems are resolved by using a fast and elitist multi-objective genetic algorithm (NSGA-II). Finally, in order to show the efficiency of the proposed approach, a case study of a collaborative system that consists of 40 MG’s registered in the load curve for the flattening program has been developed. The results verify that the load curve can indeed become very flat by applying the proposed scheduling approach. PMID:28824226

Embryonic Cleavage Cycles: How Is a Mouse Like a Fly?

PubMed Central

O’Farrell, Patrick H.; Stumpff, Jason; Su, Tin Tin

2009-01-01

The evolutionary advent of uterine support of embryonic growth in mammals is relatively recent. Nonetheless, striking differences in the earliest steps of embryogenesis make it difficult to draw parallels even with other chordates. We suggest that use of fertilization as a reference point misaligns the earliest stages and masks parallels that are evident when development is aligned at conserved stages surrounding gastrulation. In externally deposited eggs from representatives of all the major phyla, gastrulation is preceded by specialized extremely rapid cleavage cell cycles. Mammals also exhibit remarkably fast cell cycles in close association with gastrulation, but instead of beginning development with these rapid cycles, the mammalian egg first devotes itself to the production of extraembryonic structures. Previous attempts to identify common features of cleavage cycles focused on post-fertilization divisions of the mammalian egg. We propose that comparison to the rapid peri-gastrulation cycles is more appropriate and suggest that these cycles are related by evolutionary descent to the early cleavage stages of embryos such as those of frog and fly. The deferral of events in mammalian embryogenesis might be due to an evolutionary shift in the timing of fertilization. PMID:14711435

Minority donation in the United States: challenges and needs.

PubMed

Shaz, Beth H; Hillyer, Christopher D

2010-11-01

In the United States, blood donation rates of African-Americans are 25-50% of that of white individuals. As African-Americans make up an ever increasing and now substantial minority, and African-American recipients of blood transfusion, both specialized, such as sickle cell disease patients, and general hospitalized patients, have a better chance of receiving phenotype-matched or appropriate red blood cell units when there is a significant percentage of products in the inventory from African-American donors, it is important to understand the reason for the observed difference. Possible reasons for this discrepancy in donation rates include increased rates of donor deferral and ineligibility; increased barriers to donation, such as fear and distrust; and different marketing and education strategies. Thus, to increase the blood availability to African-American recipients, the reasons for these donation rate differences must be better understood and subsequently addressed through improved blood donor recruitment programs. The majority of African-American donor recruitment programs have focused on donating for sickle cell disease patients, particularly children, which have been of limited success. Significant improvements in African-American donor recruitment are needed to adequately meet the demand of African-American patients as well as the entire population.

The global financial crisis and Australian general practice.

PubMed

McRae, Ian S; Paolucci, Francesco

2011-02-01

To explore the potential effects of the global financial crisis (GFC) on the market for general practitioner (GP) services in Australia. We estimate the impact of changes in unemployment rates on demand for GP services and the impact of lost asset values on GP retirement plans and work patterns. Combining these supply and demand effects, we estimate the potential effect of the GFC on the market for GP services under various scenarios. If deferral of retirement increases GP availability by 2%, and historic trends to reduce GP working hours are halved, at the current level of ~5.2% unemployment average fees would decline by $0.23 per GP consultation and volumes of GP services would rise by 2.53% with almost no change in average GP gross earnings over what would otherwise have occurred. With 8.5% unemployment, as initially predicted by Treasury, GP fees would increase by $0.91 and GP income by nearly 3%. The GFC is likely to increase activity in the GP market and potentially to reduce fee levels relative to the pre-GFC trends. Net effects on average GP incomes are likely to be small at current unemployment levels.

Low immunisation uptake: Is the process the problem?

PubMed Central

Harrington, P.; Woodman, C.; Shannon, W.

2000-01-01

OBJECTIVE—To examine mothers' satisfaction with the process of immunisation and its possible contribution to suboptimal immunisation uptake.
DESIGN—In depth interviews with mothers.
SETTING—Two Community Care Areas, Dublin city, Ireland.
PARTICIPANTS—In depth interviews of 23 mothers of children 1-2 years old, recruited purposively from a birth cohort born in 1994.
MAIN RESULTS—Mothers preferred general practice to Health Centre immunisation (11:5) for predominantly emotional compared with practical reasons (4:1). Health Centre immunisation was seen, at times, as unacceptably rough and inhuman. Many mothers experienced severe emotional distress at the prospect of inflicting the pain of immunisation on their babies. The non-empathic stance of some immunising doctors was unacceptable to mothers. They valued attempts by health professionals to acknowledge the pain of immunisation and to engage with their baby. Adverse experiences contributed to deferral of future visits and to defaulting behaviour.
CONCLUSIONS—Low empathy mass immunisation in clinic type settings may be unacceptable to mothers in the 1990s, and may in part explain suboptimal uptake in health care systems that use such clinics.


Keywords: immunisation; health behaviour; immunisation uptake PMID:10814662

Covenant Deferral Request for the Proposed Transfer of Land Parcel ED-8 at the East Tennessee Technology Park, Oak Ridge, Tennessee - Final - May 2009

DOE Office of Scientific and Technical Information (OSTI.GOV)

SAIC

2009-05-01

The United States Department of Energy (DOE) is proposing to transfer a land parcel (hereinafter referred to as 'the Property') designated as Land Parcel ED-8 at the East Tennessee Technology Park (ETTP) in Oak Ridge, Tennessee, by deed, and is submitting this Covenant Deferral Request (CDR) pursuant to Section 120(h)(3)(C) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended, and applicable U. S. Environmental Protection Agency (EPA) guidance. The Oak Ridge Reservation (ORR), which includes ETTP, was placed on the National Priorities List (NPL) in November 1989. Environmental investigation and cleanup activities are continuing at ETTP inmore » accordance with CERCLA, the National Contingency Plan (NCP), and the Federal Facility Agreement (FFA). The FFA was entered into by the DOE-Oak Ridge Office (ORO), EPA Region 4, and the Tennessee Department of Environment and Conservation (TDEC) in 1991. The FFA establishes the schedule and milestones for environmental remediation of the ORR. The proposed property transfer is a key component of the Oak Ridge Performance Management Plan (ORPMP) for accelerated cleanup of the ORR. DOE, using its authority under Section 161(g) of the Atomic Energy Act of 1954 (AEA), proposes to transfer the Property to Heritage Center, LLC, a subsidiary of the Community Reuse Organization of East Tennessee (CROET), hereafter referred to as 'Heritage Center.' CROET is a 501(c)(3) not-for-profit corporation established to foster the diversification of the regional economy by re-utilizing DOE property for private-sector investment and job creation. The Property is located in the southern portion of ETTP and consists of approximately 84 acres proposed as the potential site for new facilities to be used for office space, industrial activities, or other commercial uses. The parcel contains both grassy fields located outside the ETTP 'main plant' area and infrastructure located inside the 'main plant' area. No buildings are included in the proposed ED-8 transfer. The buildings in ED-8 have already been transferred (Buildings K-1007, K-1580, K-1330, and K-1000). These buildings are not included in the transfer footprint of Land Parcel ED-8. A number of temporary structures, such as trailers and tents (non-real property), are located within the footprint. These temporary structures are not included in the transfer. DOE would continue to be responsible for any contamination resulting from DOE activities that is present on the property at the time of transfer but found after the date of transfer. The deed transferring the Property contains various restrictions and prohibitions on the use of the Property that are subject to enforcement pursuant to State Law Tennessee Code Annotated (T.C.A.) 68-212-225 and state real property law. These restrictions and prohibitions are designed to ensure protection of human health and the environment.« less

A vital fluid: risk, controversy and the politics of blood donation in the era of "mad cow disease".

PubMed

O'Neill, Kate

2003-10-01

This article examines the reasons for, and likely impact of, the decision by the US and other countries to permanently defer blood donors who have spent time in Britain or Europe, for fear they may transmit new variant Creutzfeldt-Jakob disease (vCJD), the human form of "mad cow disease". It begins by discussing how vCJD and blood transfusion are linked, and how these have been translated into policy. First, maintaining a safe and stable supply of blood entails not only maintaining the trust of recipients in the system, but also that of donors, who need to be assured that their blood will be welcomed and used. Often, the balance, once upset, is regained by sacrificing donors, but accompanying costs might also be high. Second, the article highlights the impact of various forms of globalization -of commerce, disease and travel, and immigration- on blood policies and public and policy attitudes. Third, it assesses the decision by the US to restrict blood donations from Europeans and travelers to combat such a pervasive risk. The conclusion discusses how donor deferral policies may be interpreted by the public in the light of earlier discussions, and raises issues for future research.

Intra-hospital use of a telepathology system.

PubMed

Ongürü, O; Celasun, B

2000-01-01

Utilization of telepathology systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for closer distances does not seem to be widely appreciated. In this study, we present data on the use of a simple telepathology system connecting the pathology department and the intra-operative consultation room within the operating theaters of the hospital. Ninety-eight frozen section cases from a past period have been re-evaluated using a real-time setup. Forty-eight of the cases have been re-evaluated in the customary fashion; allowing both ends to communicate and cooperate freely. Fifty of the cases, however, were evaluated by the consultant while the operating room end behaved like a robot; moving the stage of the microscope, changing and focusing the objectives. The deferral rate was lower than the original frozen section evaluations. Overall, the sensitivity was 100%, specificity 98%, negative predictive value 96, 5% and positive predictive value 100%. No significant difference was found for the diagnostic performances between the cooperative and robotic simulation methods.Our results strengthen the belief that telepathology is a valuable tool in offering pathology services to remote areas. The far side of a hospital building can also be a remote area and a low cost system can be helpful for intraoperative consultations. Educational value of such a system is also commendable.

An analysis of baseline data from the PROUD study: an open-label randomised trial of pre-exposure prophylaxis.

PubMed

Dolling, David I; Desai, Monica; McOwan, Alan; Gilson, Richard; Clarke, Amanda; Fisher, Martin; Schembri, Gabriel; Sullivan, Ann K; Mackie, Nicola; Reeves, Iain; Portman, Mags; Saunders, John; Fox, Julie; Bayley, Jake; Brady, Michael; Bowman, Christine; Lacey, Charles J; Taylor, Stephen; White, David; Antonucci, Simone; Gafos, Mitzy; McCormack, Sheena; Gill, Owen N; Dunn, David T; Nardone, Anthony

2016-03-24

Pre-exposure prophylaxis (PrEP) has proven biological efficacy to reduce the sexual acquisition of the human immunodeficiency virus (HIV). The PROUD study found that PrEP conferred higher protection than in placebo-controlled trials, reducing HIV incidence by 86 % in a population with seven-fold higher HIV incidence than expected. We present the baseline characteristics of the PROUD study population and place the findings in the context of national sexual health clinic data. The PROUD study was designed to explore the real-world effectiveness of PrEP (tenofovir-emtricitabine) by randomising HIV-negative gay and other men who have sex with men (GMSM) to receive open-label PrEP immediately or after a deferral period of 12 months. At enrolment, participants self-completed two baseline questionnaires collecting information on demographics, sexual behaviour and lifestyle in the last 30 and 90 days. These data were compared to data from HIV-negative GMSM attending sexual health clinics in 2013, collated by Public Health England using the genitourinary medicine clinic activity database (GUMCAD). The median age of participants was 35 (IQR: 29-43). Typically participants were white (81 %), educated at a university level (61 %) and in full-time employment (72 %). Of all participants, 217 (40 %) were born outside the UK. A sexually transmitted infection (STI) was reported to have been diagnosed in the previous 12 months in 330/515 (64 %) and 473/544 (87 %) participants reported ever having being diagnosed with an STI. At enrolment, 47/280 (17 %) participants were diagnosed with an STI. Participants reported a median (IQR) of 10 (5-20) partners in the last 90 days, a median (IQR) of 2 (1-5) were condomless sex acts where the participant was receptive and 2 (1-6) were condomless where the participant was insertive. Post-exposure prophylaxis had been prescribed to 184 (34 %) participants in the past 12 months. The number of STI diagnoses was high compared to those reported in GUMCAD attendees. The PROUD study population are at substantially higher risk of acquiring HIV infection sexually than the overall population of GMSM attending sexual health clinics in England. These findings contribute to explaining the extraordinary HIV incidence rate during follow-up and demonstrate that, despite broad eligibility criteria, the population interested in PrEP was highly selective. Current Controlled Trials ISRCTN94465371 . Date of registration: 28 February 2013.

Restoration of On-Time Embryo Implantation Corrects the Timing of Parturition in Cytosolic Phospholipase A2 Group IVA Deficient Mice1

PubMed Central

Brown, Naoko; Morrow, Jason D.; Slaughter, James C.; Paria, Bibhash C.; Reese, Jeff

2009-01-01

Cytosolic phospholipase A2 (cPLA2, PLA2G4A) catalyzes the release of arachidonic acid for prostaglandin synthesis by cyclooxygenase 1 (PTGS1) and cyclooxygenase 2 (PTGS2). Mice with Pla2g4a deficiency have parturition delay and other reproductive deficits, including deferred onset of implantation, crowding of implantation sites, and small litters. In this study, we examined the contribution of PLA2G4A to parturition in mice. Pla2g4a mRNA and protein expression were discretely localized in the term and preterm uterine luminal epithelium and colocalized with Ptgs1, but not Ptgs2, expression. The levels of PGE2, PGF2alpha, 6-keto-PGF1alpha, and TxB2 were significantly decreased in Pla2g4a-null uterine tissues, similar to Ptgs1-null uteri, consistent with predominance of PLA2G4A-PTGS1-mediated prostaglandin synthesis in preparation for murine parturition. Litter size was strongly associated with the timing of parturition in Pla2g4a-null mice but could not fully account for the parturition delay. Pla2g4a-null females that received PGE2 + carbaprostacyclin at the time of implantation delivered earlier (20.5 ± 0.2 days vs. 21.6 ± 0.2 days, P < 0.01), although litter size was not improved (4.6 vs. 4.4 pups per litter, P = 0.6). After correction for small litter size, multivariate analysis indicated that Pla2g4a-null mice given prostaglandin treatment to improve implantation timing had gestational length that was similar to wild-type and Pla2g4a heterozygous mice. These results indicate that, despite specific Pla2g4a expression and function in term gestation uteri, the delayed parturition phenotype in Pla2g4a-null mice is primarily due to deferral of implantation. The role of PLA2G4A in timely parturition appears to be critically related to its actions in early pregnancy. PMID:19684335

Long-term follow-up after deferral of coronary intervention based on myocardial fractional flow reserve measurement.

PubMed

Mates, Martin; Hrabos, Vladimir; Hajek, Petr; Rataj, Ondrej; Vojacek, Jan

2005-05-01

To assess long-term results after deferring coronary intervention (percutaneous coronary intervention (PCI)) of an intermediate lesion with a value of myocardial fractional flow reserve (FFR) > or = 0.75 in a 'real life' patient population with no respect to results of stress tests (if performed) or coronary disease extent. PCI of an intermediate lesion was deferred in a group of 85 consecutive patients (54 men, 61+/-10 years) on the basis of the result of FFR > or = 0.75 (mean FFR, 0.89+/-0.06%). FFR was measured in 111 stenoses (mean diameter stenosis, 54+/-8%, left anterior descending coronary artery, 65 (58%), left circumflex coronary artery, 24 (22%), right coronary artery, 22 (20%). Multi-vessel disease (defined as visually assessed diameter reduction of more than 50% in at least two arteries of more than 1.5 mm diameter, supplying at least two of the three major coronary artery perfusion territories) was present in 67% of patients (one-vessel disease, 28 patients (33%), two-vessel disease, 39 patients (46%), three-vessel disease, 18 patients (21%). Recorded events during follow-up were as follows: all-cause death, cardiac death, non-fatal myocardial infarction, ischemia-driven target lesion transcatheter revascularization (TLR) and coronary artery bypass graft (CABG). Angina class (Canadian Cardiovascular Society (CCS) classification) and the need for anti-anginal drugs were recorded. Follow-up was completed in 85 patients (100%). Mean duration of follow-up was 22.6+/-6.6 months (range 4-33 months). Events occurred in 11 patients (13%). Seven patients died; this included two cardiac deaths. A non-fatal myocardial infarction occurred in one patient, one patient needed TLR and three patients underwent CABG. Estimated 33 month cardiac-event-free survival (Kaplan-Meier) was 91+/-4%. Angina class decreased [1.6+/-1.2 compared with 0.8+/-0.8 (P < 0.0001)] without difference with respect to the use of anti-anginal drugs (1.7+/-0.8 compared with 1.7+/-0.9, P = NS). Deferring coronary interventions of intermediate stenosis based on FFR measurement is safe with respect to long-term follow-up, irrespective of the extent of coronary artery disease.

SIM Lite Astrometric Observatory progress report

NASA Astrophysics Data System (ADS)

Marr, James C., IV; Shao, Michael; Goullioud, Renaud

2010-07-01

The SIM Lite Astrometric Observatory (aka SIM Lite), a micro-arcsecond astrometry space mission, has been developed in response to NASA's indefinite deferral of the SIM PlanetQuest mission. The SIM Lite mission, while significantly more affordable than the SIM PlanetQuest mission concept, still addresses the full breadth of SIM science envisioned by two previous National Research Council (NRC) Astrophysics Decadal Surveys at the most stringent "Goal" level of astrometric measurement performance envisioned in those surveys. Over the past two years, the project has completed the conceptual design of the SIM Lite mission using only the completed SIM technology; published a 250 page book describing the science and mission design (available at the SIM website: http://sim.jpl.nasa.gov); been subject to an independent cost and technical readiness assessment by the Aerospace Corporation; and submitted a number of information responses to the NRC Astro2010 Decadal Survey. The project also conducted an exoplanet-finding capability double blind study that clearly demonstrated the ability of the mission to survey 60 to 100 nearby sun-like dwarf stars for terrestrial, habitable zone planets in complex planetary systems. Additionally, the project has continued Engineering Risk Reduction activities by building brassboard (form, fit & function to flight) version of key instrument elements and subjecting them to flight qualification environmental and performance testing. This paper summarizes the progress over the last two years and the current state of the SIM Lite project.

Can peptide receptor radionuclide therapy be safely applied in florid bone metastases? A pilot analysis of late stage osseous involvement.

PubMed

Sabet, A; Khalaf, F; Yong-Hing, C J; Sabet, A; Haslerud, T; Ahmadzadehfar, H; Guhlke, S; Grünwald, F; Biersack, H-J; Ezziddin, S

2014-01-01

Highly advanced metastatic bone disease with extensive osseous infiltration of neuroendocrine tumours (NET) may preclude patients from treatment with peptide receptor radionuclide therapy (PRRT) in concern about haematotoxicity. This study aims to assess the safety and efficacy of PRRT with 177Lu-octreotate in a patient cohort with this condition. 41 PRRT courses were performed in 11 patients with gastroenteropancreatic neuroendocrine tumours (GEP-NET) and florid bone metastases (severely advanced widespread metastatic bone disease). A mean activity of 6.95 GBq 177Lu-octreotate was administered per treatment cycle, aimed at four courses with standard intervals of 3 months. Haematological parameters were determined prior to each treatment course, in 2-4 weeks intervals between the courses, 8-12 weeks after the last course of PRRT and in 3 monthly intervals thereafter. Toxicity was recorded using Common Terminology Criteria for Adverse Events v3.0. Restaging was performed 3 months after termination of PRRT with CT/MRI and functional imaging (modified MDA criteria). Significant (grade III-IV), reversible haematotoxicity occurred in 4 (35%) patients and after 10 (24%) administrations. It either resolved spontaneously (1 patient) or was controlled by supportive measures (3 patients), such as blood transfusions (3 patients) or deferral of the subsequent therapy cycle (1 patient). Patients returned to baseline blood values within up to 23 months after termination of PRRT. The observed treatment response of bone metastases consisted of a partial response in 2, a minor response in 1, stable disease in 7, and progressive disease in 1 patient. Of the 4 patients with metastatic bone pain, 1 experienced complete and 3 partial resolution of symptoms within 3-10 weeks after commencement of PRRT. These preliminary data indicate that PRRT with 177Lu-octreotate can be safely applied even in florid bone metastases with extensive, severely advanced osseous replacement. The higher myelosuppression rate was not associated with serious complications and should not preclude patients from being treated and potentially experiencing remarkable treatment efficacy despite the very advanced stage.

--No Title--

Science.gov Websites

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40 CFR 798.2650 - Oral toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If... vehicle control groups are required. (3) Satellite group. (Rodent) A satellite group of 20 animals (10...

40 CFR 798.2650 - Oral toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If... vehicle control groups are required. (3) Satellite group. (Rodent) A satellite group of 20 animals (10...

40 CFR 798.2650 - Oral toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If... vehicle control groups are required. (3) Satellite group. (Rodent) A satellite group of 20 animals (10...

40 CFR 798.2650 - Oral toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If... vehicle control groups are required. (3) Satellite group. (Rodent) A satellite group of 20 animals (10...

40 CFR 798.2650 - Oral toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If... vehicle control groups are required. (3) Satellite group. (Rodent) A satellite group of 20 animals (10...

[Effects of the renal blood flow at different levels by transcutaneous electrical acupoint stimulation combined general anesthesia induced controlled hypotension].

PubMed

Fang, Jian-Qiao; Zhang, Le-Le; Shao, Xiao-Mei

2012-11-01

To observe the intervention of transcutaneous electrical acupoint stimulation (TEAS) on the renal blood flow at different levels of mean arterial pressure (MAP) in controlled hypotension. Forty-two male beagle dogs were randomly divided into seven groups, i. e., the general anesthesia group, the 50% controlled group, the 40% controlled group, the 30% controlled group, the 50% experimental group, the 40% experimental group, and the 30% experimental group, 6 in each group. Beagles in the general anesthesia group were not treated with controlled hypotension, and the target MAP was achieved in those of the rest groups and maintained for 60 min. In the experimental groups, TEAS was applied to bilateral Hegu (LI4), Zusanli (ST36), Sanyinjiao (SP6), and Quchi (LI11) at 2/100 Hz with the stimulation strength of (4 +/- 1) mA starting from the stability of their physiological conditions to 60 min of maintaining the target MAP level. The changes of the renal blood flow were monitored at different time points using laser Doppler. From starting pressure control to the target MAP level, the renal blood flow was significantly lower in the 30% controlled group than in the general anesthesia group and the basic level of the same group (P < 0.05), while there was no obvious change in the 30% experimental group. In maintaining the blood pressure, the renal blood flow was significantly lower in the 50% controlled group, the 40% controlled group, the 30% controlled group, and the 30% experimental group than in the general anesthesia group (P < 0.05), while there was no obvious change in the 50% experimental group or the 40% experimental group. By the end of blood pressure recovery, the renal blood flow restored to the basic level in the 50% controlled group, the 50% experimental group, and the 40% experimental group (P > 0.05), while it was not restored to the basic level in the 40% controlled group, the 30% controlled group, and the 30% experimental group (P < 0.05). TEAS combined general anesthesia in controlled hypotension could effectively improve the renal blood flow, thus protecting the kidney.

40 CFR 798.2450 - Inhalation toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group. Except for treatment with the test substance, animals in the control group... generate an appropriate concentration of the substance in the atmosphere, a vehicle control group shall be...

40 CFR 798.2450 - Inhalation toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group. Except for treatment with the test substance, animals in the control group... generate an appropriate concentration of the substance in the atmosphere, a vehicle control group shall be...

40 CFR 798.2450 - Inhalation toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group. Except for treatment with the test substance, animals in the control group... generate an appropriate concentration of the substance in the atmosphere, a vehicle control group shall be...

40 CFR 798.2450 - Inhalation toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group. Except for treatment with the test substance, animals in the control group... generate an appropriate concentration of the substance in the atmosphere, a vehicle control group shall be...

40 CFR 798.2450 - Inhalation toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group. Except for treatment with the test substance, animals in the control group... generate an appropriate concentration of the substance in the atmosphere, a vehicle control group shall be...

Essential considerations in developing attention control groups in behavioral research.

PubMed

Aycock, Dawn M; Hayat, Matthew J; Helvig, Ashley; Dunbar, Sandra B; Clark, Patricia C

2018-06-01

Attention control groups strengthen randomized controlled trials of behavioral interventions, but researchers need to give careful consideration to the attention control activities. A comparative effectiveness research framework provides an ideal opportunity for an attention control group as a supplement to standard care, so participants potentially receive benefit regardless of group assignment. The anticipated benefit of the control condition must be independent of the study outcome. Resources needed for attention control activities need to be carefully considered and ethical considerations carefully weighed. In this paper we address nine considerations for the design and implementation of attention control groups: (1) ensure attention control activities are not associated with the outcome; (2) avoid contamination of the intervention or control group; (3) design comparable control and intervention activities; (4) ensure researcher training to adequately administer both treatment arms; (5) design control activities to be interesting and acceptable to participants; (6) evaluate attention control activities; (7) consider additional resources needed to implement attention control activities; (8) quantifying the effects of attention control and intervention groups; and (9) ethical considerations with attention control groups. Examples from the literature and ongoing research are presented. Careful planning for the attention control group is as important as for the intervention group. Researchers can use the considerations presented here to assist in planning for the best attention control group for their study. © 2018 Wiley Periodicals, Inc.

[Osteogenic potential of bone marrow mesenchymal stem cells from ovariectomied osteoporotic rat].

PubMed

Li, Dong-ju; Ge, Dong-xia; Wu, Wen-chao; Wu, Jiang; Li, Liang

2005-05-01

To investigate the difference of osteogenic potential of bone marrow mesenchymal stem cells (MSCs) between healthy rats and osteoporotic rats. We established the animal model of osteoporosis by performing ovariectom on the 3-month-old female Sprague-Dawley rats. Bone marrow mesenchymal stem cells(MSCs) were isolated from the rats of control group and of ovariectomized (ovx) group by means of the density-gradient centrifugation method, and the 3rd-4th passage MSCs were used in all the experiments. The experiments comprised 4 groups: (1) Marrow mesenchymal stem cells control group (MSCs control group); (2) Marrow mesenchymal stem cells ovx group (MSCs ovx group); (3) Osteogenesis induction control group (OSI control group); (4) Osteogenesis induction ovx group (OSI ovx group). Cell cycle and proliferation index (PI) of MSCs were detected by flow cytometry. The expression of alkaline phosphatase (ALP) was detected by dynamics method with substrate of phosphoric acid para-Nitro benzene. The levels of osteocalcin were detected with the isotope labelling method. (1) PI of MSCs was lower in MSCs ovx group than in MSCs control group. (2) The expression of alkaline phosphatase (ALP) was much higher in OSI control group than in the MSCs control group; the expression of alkaline phosphatase (ALP) was much higher in the OSI control group than in OSI ovx group after 7-day and 14-day osteogenic induction. (3) The level of osteocalcin was much higher in the OSI control group than in the MSCs control group after 14-day, 21-day, 28-day osteogenic induction. The level of osteocalcin was much higher in the OSI control group than in the OSI ovx group. Both the proliferative potential and the osteogenic potential of bone marrow mesenchymal stem cells (MSCs) from the ovariectomized osteoporotic rat are decreased.

Outcomes 18 years after implementation of a nonoperative caries preventive program--the Nexö-method--on children in Moscow, Russia.

PubMed

Kuzmina, Irina; Ekstrand, Kim R

2015-08-01

To report the long-term effect (18 years) of the Nexö-method, initially implemented in groups of children in Moscow in 1994. Three groups of children were included in the initial study in 1994. This study is a follow-up study of two of the three initial groups: a group of 6-year-olds (test group6 ; control group6 ) and a group of 11-year-olds (test group11 , control group11) , n = 50 individuals in each of the four subgroups. In 2012, >80% of the participants in the two groups (now aged 24 and 28 years old) were re-examined by the original examiner, who was blinded to which group the patients had belonged in the initial study. After re-examination, the participants were interviewed by a person not otherwise attached to the study. Finally, caries data were collected from 100 24-year-olds and 100 28-year-olds who attended the dental school (50%) and private clinic (50%) in Moscow (External control groups24,28 ). The outcome variables of the study were plaque and gingival status, and DMFT/S. In 2012, the control groups24,28 displayed significantly higher plaque scores than the test groups24,28 (P-values < 0.05). No differences were seen regarding gingivitis scores (P-values > 0.41). Mean DMFT/S in 2012 was test group24 = 6.98/10.51, control group24 = 8.84/13.14 (P = 0.02/0.06). External control group24 = 8.89/15.86 (test24 versus external control group24 , P = 0.01/0.007; control24 versus external control group24 , P = 0.94/0.16). Test group28 = 6.74/10.83, control group28 = 8.70/14.48 (P = 0.02/0.008). External control group28 = 9.03/18.06 (test28 versus external control28 , P = 0.03/0.001; control28 versus external control28 , P = 0.68/0.07). The interview indicated that the participants in the test groups were more aware of factors that are considered important for control of caries than participants in the control groups. The data from this group of Moscow citizens suggest a long-term positive effect of the Nexö-method implemented during childhood. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The use of control groups in artificial grammar learning.

PubMed

Reber, Rolf; Perruchet, Pierre

2003-01-01

Experimenters assume that participants of an experimental group have learned an artificial grammar if they classify test items with significantly higher accuracy than does a control group without training. The validity of such a comparison, however, depends on an additivity assumption: Learning is superimposed on the action of non-specific variables-for example, repetitions of letters, which modulate the performance of the experimental group and the control group to the same extent. In two experiments we were able to show that this additivity assumption does not hold. Grammaticality classifications in control groups without training (Experiments 1 and 2) depended on non-specific features. There were no such biases in the experimental groups. Control groups with training on randomized strings (Experiment 2) showed fewer biases than did control groups without training. Furthermore, we reanalysed published research and demonstrated that earlier experiments using control groups without training had produced similar biases in control group performances, bolstering the finding that using control groups without training is methodologically unsound.

Striving for group agency: threat to personal control increases the attractiveness of agentic groups.

PubMed

Stollberg, Janine; Fritsche, Immo; Bäcker, Anna

2015-01-01

When their sense of personal control is threatened people try to restore perceived control through the social self. We propose that it is the perceived agency of ingroups that provides the self with a sense of control. In three experiments, we for the first time tested the hypothesis that threat to personal control increases the attractiveness of being part or joining those groups that are perceived as coherent entities engaging in coordinated group goal pursuit (agentic groups) but not of those groups whose agency is perceived to be low. Consistent with this hypothesis we found in Study 1 (N = 93) that threat to personal control increased ingroup identification only with task groups, but not with less agentic types of ingroups that were made salient simultaneously. Furthermore, personal control threat increased a sense of collective control and support within the task group, mediated through task-group identification (indirect effects). Turning to groups people are not (yet) part of, Study 2 (N = 47) showed that personal control threat increased relative attractiveness ratings of small groups as possible future ingroups only when the relative agency of small groups was perceived to be high. Perceived group homogeneity or social power did not moderate the effect. Study 3 (N = 78) replicated the moderating role of perceived group agency for attractiveness ratings of entitative groups, whereas perceived group status did not moderate the effect. These findings extend previous research on group-based control, showing that perceived agency accounts for group-based responses to threatened control.

Financial analysis of technology acquisition using fractionated lasers as a model.

PubMed

Jutkowitz, Eric; Carniol, Paul J; Carniol, Alan R

2010-08-01

Ablative fractional lasers are among the most advanced and costly devices on the market. Yet, there is a dearth of published literature on the cost and potential return on investment (ROI) of such devices. The objective of this study was to provide a methodological framework for physicians to evaluate ROI. To facilitate this analysis, we conducted a case study on the potential ROI of eight ablative fractional lasers. In the base case analysis, a 5-year lease and a 3-year lease were assumed as the purchase option with a $0 down payment and 3-month payment deferral. In addition to lease payments, service contracts, labor cost, and disposables were included in the total cost estimate. Revenue was estimated as price per procedure multiplied by total number of procedures in a year. Sensitivity analyses were performed to account for variability in model assumptions. Based on the assumptions of the model, all lasers had higher ROI under the 5-year lease agreement compared with that for the 3-year lease agreement. When comparing results between lasers, those with lower operating and purchase cost delivered a higher ROI. Sensitivity analysis indicates the model is most sensitive to purchase method. If physicians opt to purchase the device rather than lease, they can significantly enhance ROI. ROI analysis is an important tool for physicians who are considering making an expensive device acquisition. However, physicians should not rely solely on ROI and must also consider the clinical benefits of a laser. (c) Thieme Medical Publishers.

The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations

PubMed Central

Lin, Andrew H; Cole, Jacob H; Chin, John C; Mahnke, Chirstopher Becket

2016-01-01

Introduction: The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. Methods: A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. Results: From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Discussion: Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system. PMID:26985390

An extension of the Lighthill theory of jet noise to encompass refraction and shielding

NASA Technical Reports Server (NTRS)

Ribner, Herbert S.

1995-01-01

A formalism for jet noise prediction is derived that includes the refractive 'cone of silence' and other effects; outside the cone it approximates the simple Lighthill format. A key step is deferral of the simplifying assumption of uniform density in the dominant 'source' term. The result is conversion to a convected wave equation retaining the basic Lighthill source term. The main effect is to amend the Lighthill solution to allow for refraction by mean flow gradients, achieved via a frequency-dependent directional factor. A general formula for power spectral density emitted from unit volume is developed as the Lighthill-based value multiplied by a squared 'normalized' Green's function (the directional factor), referred to a stationary point source. The convective motion of the sources, with its powerful amplifying effect, also directional, is already accounted for in the Lighthill format: wave convection and source convection are decoupled. The normalized Green's function appears to be near unity outside the refraction dominated 'cone of silence', this validates our long term practice of using Lighthill-based approaches outside the cone, with extension inside via the Green's function. The function is obtained either experimentally (injected 'point' source) or numerically (computational aeroacoustics). Approximation by unity seems adequate except near the cone and except when there are shrouding jets: in that case the difference from unity quantifies the shielding effect. Further extension yields dipole and monopole source terms (cf. Morfey, Mani, and others) when the mean flow possesses density gradients (e.g., hot jets).

The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations.

PubMed

Lin, Andrew H; Cole, Jacob H; Chin, John C; Mahnke, Chirstopher Becket

2016-01-01

The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system.

[Gastric dynamics analysis of TEAS combined SNP induced general anesthesia when controlled hypotension dropped to 60% of the MAP baseline].

PubMed

Zhang, Le-Le; Fang, Jian-Qiao; Shao, Xiao; Lian, Lin-Li; Yu, Xiao-Jing; Dong, Zhen-Hua; Mo, Ya-Di

2015-01-01

To observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension. Eighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment. As for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group. EGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids.

PubMed

Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

2013-08-14

To identify a more effective treatment protocol for circumferential mixed hemorrhoids. A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings.

Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection for circumferential mixed hemorrhoids

PubMed Central

Lu, Ming; Shi, Guang-Ying; Wang, Guo-Qiang; Wu, Yan; Liu, Yang; Wen, Hao

2013-01-01

AIM: To identify a more effective treatment protocol for circumferential mixed hemorrhoids. METHODS: A total of 192 patients with circumferential mixed hemorrhoids were randomized into the treatment group, where they underwent Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection, or the control group, where traditional external dissection and internal ligation were performed. Postoperative recovery and complications were monitored. RESULTS: The time to wound healing was 12.96 ± 2.25 d in the treatment group shorter than 19.58 ± 2.71 d in the control group. Slight pain rate was 58.3% in the treatment group higher than 22.9% in the control group; moderate pain rate was 33.3% in the treatment group lower than 56.3% in the control group severe pain rate was 8.4% in the treatment group lower than 20.8% in the control group. No edema rate was 70.8% in the treatment group higher than 43.8% in the control group; mild local edema rate was 26% in the treatment group lower than 39.6% in the control group obvious local edema was 3.03% in the treatment group lower than 16.7% in the control group. No stenosis rate was 85.4% in the treatment group higher than 63.5% in the control group; moderate stenosis rate was 14.6% in the treatment group Lower than 27.1% in the control group severe anal stenosis rate was 0% in the treatment group lower than 9.4% in the control group. CONCLUSION: Milligan-Morgan hemorrhoidectomy with anal cushion suspension and partial internal sphincter resection is the optimal treatment for circumferential mixed hemorrhoids and can be widely applied in clinical settings. PMID:23946609

Striving for group agency: threat to personal control increases the attractiveness of agentic groups

PubMed Central

Stollberg, Janine; Fritsche, Immo; Bäcker, Anna

2015-01-01

When their sense of personal control is threatened people try to restore perceived control through the social self. We propose that it is the perceived agency of ingroups that provides the self with a sense of control. In three experiments, we for the first time tested the hypothesis that threat to personal control increases the attractiveness of being part or joining those groups that are perceived as coherent entities engaging in coordinated group goal pursuit (agentic groups) but not of those groups whose agency is perceived to be low. Consistent with this hypothesis we found in Study 1 (N = 93) that threat to personal control increased ingroup identification only with task groups, but not with less agentic types of ingroups that were made salient simultaneously. Furthermore, personal control threat increased a sense of collective control and support within the task group, mediated through task-group identification (indirect effects). Turning to groups people are not (yet) part of, Study 2 (N = 47) showed that personal control threat increased relative attractiveness ratings of small groups as possible future ingroups only when the relative agency of small groups was perceived to be high. Perceived group homogeneity or social power did not moderate the effect. Study 3 (N = 78) replicated the moderating role of perceived group agency for attractiveness ratings of entitative groups, whereas perceived group status did not moderate the effect. These findings extend previous research on group-based control, showing that perceived agency accounts for group-based responses to threatened control. PMID:26074832

40 CFR Appendix C to Part 300 - Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Toxicity Test, and...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., if two groups (product A and a non-nutrient control) are tested at each of three points in time (day... groups: Group 1: Non-nutrient Control Group 2: Nutrient Control Group 3: Test Product 4.7.4.2The raw data... different from those of both the nutrient control (group 2) and the non-nutrient control (group 1) for those...

40 CFR Appendix C to Part 300 - Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Toxicity Test, and...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., if two groups (product A and a non-nutrient control) are tested at each of three points in time (day... groups: Group 1: Non-nutrient Control Group 2: Nutrient Control Group 3: Test Product 4.7.4.2The raw data... different from those of both the nutrient control (group 2) and the non-nutrient control (group 1) for those...

40 CFR Appendix C to Part 300 - Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Toxicity Test, and...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., if two groups (product A and a non-nutrient control) are tested at each of three points in time (day... groups: Group 1: Non-nutrient Control Group 2: Nutrient Control Group 3: Test Product 4.7.4.2The raw data... different from those of both the nutrient control (group 2) and the non-nutrient control (group 1) for those...

40 CFR Appendix C to Part 300 - Swirling Flask Dispersant Effectiveness Test, Revised Standard Dispersant Toxicity Test, and...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., if two groups (product A and a non-nutrient control) are tested at each of three points in time (day... groups: Group 1: Non-nutrient Control Group 2: Nutrient Control Group 3: Test Product 4.7.4.2The raw data... different from those of both the nutrient control (group 2) and the non-nutrient control (group 1) for those...

47 CFR 24.720 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... vertical ownership chain. (e) Control Group. A control group is an entity, or a group of individuals or... assure de facto control, such as for example, when the voting stock of the control group is widely... member of the applicant's (or licensee's) control group and whose gross revenues and total assets, when...

47 CFR 24.720 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... vertical ownership chain. (e) Control Group. A control group is an entity, or a group of individuals or... assure de facto control, such as for example, when the voting stock of the control group is widely... member of the applicant's (or licensee's) control group and whose gross revenues and total assets, when...

47 CFR 24.720 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... vertical ownership chain. (e) Control Group. A control group is an entity, or a group of individuals or... assure de facto control, such as for example, when the voting stock of the control group is widely... member of the applicant's (or licensee's) control group and whose gross revenues and total assets, when...

47 CFR 24.720 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... vertical ownership chain. (e) Control Group. A control group is an entity, or a group of individuals or... assure de facto control, such as for example, when the voting stock of the control group is widely... member of the applicant's (or licensee's) control group and whose gross revenues and total assets, when...

47 CFR 24.720 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... vertical ownership chain. (e) Control Group. A control group is an entity, or a group of individuals or... assure de facto control, such as for example, when the voting stock of the control group is widely... member of the applicant's (or licensee's) control group and whose gross revenues and total assets, when...

Association between ABO blood/rhesus grouping and hepatitis B and C: a case-control study.

PubMed

Pourhassan, Abolfazl

2014-06-01

During past decades, a connection between hepatitis and the host ABO/Rh blood groups has been always under dispute, with no appropriately designed study yet. This study aimed to investigate possible association between ABO blood/Rh groups with both hepatitis B and C. In this case-control setting, 200 healthy individuals (controls), 200 patients with chronic Hepatitis-B infection (HB) and 200 patients with chronic Hepatitis-C infection (HC) were recruited from 2010 to 2013 in Tabriz Sina Hospital. ABO blood and Rh grouping was performed and the results were compared between the case and control groups. Both pair of the control and HB groups and the control and HC groups were matched for their subjects' age and sex. In the control group, 178 subjects (89%) were Rh+ and 22 subjects (11%) were Rh-. In the HB group, there were 180 Rh+ (90%) and 20 Rh- (10%) patients. In the HC group there were 168 Rh+ (84%) and 32 Rh-negative (16%) patients. Both pair of the control and HB groups (p = 0.74), as well as the control and HC groups (p = 0.14) were comparable for the status of Rh. In the control group there were 84 (42%), 32 (16%), 66 (33%) and 18 (9%) subjects with A, B, O and AB blood groups, respectively. The corresponding figures were 84 (42%), 34 (17%), 58 (29%) and 24 (12%) for the HB patients; and 80 (40%), 29 (14.5%), 85 (42.5%) and 6 (3%) for the HC patients. Comparing between the control and HB groups showed no significant difference in terms of the frequency of ABO blood groups (p = 0.70). However, with comparing the control and HC groups, the rate of O blood group was significantly higher in the HC group and concomitantly, the rate of AB blood group was significantly higher in the control group (p = 0.04). Although, there is not a significant association between ABO blood groups and HB, this association is significant between certain ABO blood groups and HC.

40 CFR 799.9630 - TSCA developmental neurotoxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... (2) Control group. A concurrent control group is required. This group must be a sham-treated group or, if a vehicle is used in administering the test substance, a vehicle control group. The vehicle must neither be developmentally toxic nor have effects on reproduction. Animals in the control group must be...

40 CFR 799.9630 - TSCA developmental neurotoxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... (2) Control group. A concurrent control group is required. This group must be a sham-treated group or, if a vehicle is used in administering the test substance, a vehicle control group. The vehicle must neither be developmentally toxic nor have effects on reproduction. Animals in the control group must be...

40 CFR 799.9630 - TSCA developmental neurotoxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... (2) Control group. A concurrent control group is required. This group must be a sham-treated group or, if a vehicle is used in administering the test substance, a vehicle control group. The vehicle must neither be developmentally toxic nor have effects on reproduction. Animals in the control group must be...

26 CFR 1.414(b)-1 - Controlled group of corporations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Controlled group of corporations. 1.414(b)-1...(b)-1 Controlled group of corporations. (a) Defintion of controlled group of corporations. For purposes of this section, the term “controlled group of corporations” has the same meaning as is assigned...

26 CFR 1.414(b)-1 - Controlled group of corporations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Controlled group of corporations. 1.414(b)-1...(b)-1 Controlled group of corporations. (a) Defintion of controlled group of corporations. For purposes of this section, the term “controlled group of corporations” has the same meaning as is assigned...

26 CFR 1.414(b)-1 - Controlled group of corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Controlled group of corporations. 1.414(b)-1...(b)-1 Controlled group of corporations. (a) Defintion of controlled group of corporations. For purposes of this section, the term “controlled group of corporations” has the same meaning as is assigned...

26 CFR 1.414(b)-1 - Controlled group of corporations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Controlled group of corporations. 1.414(b)-1...(b)-1 Controlled group of corporations. (a) Defintion of controlled group of corporations. For purposes of this section, the term “controlled group of corporations” has the same meaning as is assigned...

26 CFR 1.414(b)-1 - Controlled group of corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Controlled group of corporations. 1.414(b)-1... Controlled group of corporations. (a) Defintion of controlled group of corporations. For purposes of this section, the term “controlled group of corporations” has the same meaning as is assigned to the term in...

40 CFR 798.3320 - Combined chronic toxicity/oncogenicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... concurrent control for those groups not intended for early sacrifice. At least 40 rodents (20 females and 20 males) should be used for satellite dose group(s) and the satellite control group. The purpose of the... percent at the time of termination. (2) Control groups. (i) A concurrent control group (50 females and 50...

40 CFR 798.3320 - Combined chronic toxicity/oncogenicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... concurrent control for those groups not intended for early sacrifice. At least 40 rodents (20 females and 20 males) should be used for satellite dose group(s) and the satellite control group. The purpose of the... percent at the time of termination. (2) Control groups. (i) A concurrent control group (50 females and 50...

40 CFR 798.3320 - Combined chronic toxicity/oncogenicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... concurrent control for those groups not intended for early sacrifice. At least 40 rodents (20 females and 20 males) should be used for satellite dose group(s) and the satellite control group. The purpose of the... percent at the time of termination. (2) Control groups. (i) A concurrent control group (50 females and 50...

40 CFR 798.3320 - Combined chronic toxicity/oncogenicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... concurrent control for those groups not intended for early sacrifice. At least 40 rodents (20 females and 20 males) should be used for satellite dose group(s) and the satellite control group. The purpose of the... percent at the time of termination. (2) Control groups. (i) A concurrent control group (50 females and 50...

40 CFR 798.3320 - Combined chronic toxicity/oncogenicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... concurrent control for those groups not intended for early sacrifice. At least 40 rodents (20 females and 20 males) should be used for satellite dose group(s) and the satellite control group. The purpose of the... percent at the time of termination. (2) Control groups. (i) A concurrent control group (50 females and 50...

Control group design: enhancing rigor in research of mind-body therapies for depression.

PubMed

Kinser, Patricia Anne; Robins, Jo Lynne

2013-01-01

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research.

Control Group Design: Enhancing Rigor in Research of Mind-Body Therapies for Depression

PubMed Central

Kinser, Patricia Anne; Robins, Jo Lynne

2013-01-01

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research about mind-body therapies, we suggest that researchers should consider 4 key questions: whether the study design matches the research question; whether the control group addresses performance, expectation, and detection bias; whether the control group is ethical, feasible, and attractive; and whether the control group is designed to adequately control for nonspecific intervention effects. Based on these questions, we provide specific recommendations about control group design with the goal of minimizing bias and maximizing validity in future research. PMID:23662111

Heterogenic control groups in randomized, controlled, analgesic trials of total hip and knee arthroplasty.

PubMed

Karlsen, Anders P; Mathiesen, Ole; Dahl, Jørgen B

2018-03-01

Postoperative analgesic interventions are often tested adjunct to basic non-opioid analgesics in randomized controlled trials (RCTs). Consequently, treatment in control groups, and possible assay sensitivity, differs between trials. We hypothesized that postoperative opioid requirements and pain intensities vary between different control groups in analgesic trials. Control groups from RCTs investigating analgesic interventions after total hip and knee arthroplasty were categorized based on standardized basic analgesic treatment. Morphine consumption 0 to 24 hours postoperatively, and resting pain scores at 6 and 24 hours for subgroups of basic treatments, were compared with ANOVA. In an additional analysis, we compared pain and opioid requirements in trials where a non-steroidal anti-inflammatory drug (NSAID) was administered as an intervention with trial where NSAID was administered in a control group. We included 171 RCTs employing 28 different control groups with large variability in pain scores and opioid requirements. Four types of control groups (comprising 78 trials) were eligible for subgroup comparisons. These subgroups received "opioid" alone, "NSAID + opioid", "acetaminophen + opioid", or "NSAID + acetaminophen + opioid", respectively. Morphine consumption and pain scores varied substantially between these groups, with no consistent superior efficacy in any subgroup. Additionally, trials administering NSAID as an intervention demonstrated lower pain scores and opioid requirements than trials where NSAID was administered in a control group. Analgesic treatment in RCT control groups varies considerably. Control groups receiving various combinations of opioid, NSAID and acetaminophen did not differ consistently in pain and opioid requirements. Pain and opioid requirements were lower in trials administering NSAID as an intervention compared with trials administering NSAID in a control group.

Consensus definitions and application guidelines for control groups in cerebrospinal fluid biomarker studies in multiple sclerosis.

PubMed

Teunissen, Charlotte; Menge, Til; Altintas, Ayse; Álvarez-Cermeño, José C; Bertolotto, Antonio; Berven, Frode S; Brundin, Lou; Comabella, Manuel; Degn, Matilde; Deisenhammer, Florian; Fazekas, Franz; Franciotta, Diego; Frederiksen, Jette L; Galimberti, Daniela; Gnanapavan, Sharmilee; Hegen, Harald; Hemmer, Bernhard; Hintzen, Rogier; Hughes, Steve; Iacobaeus, Ellen; Kroksveen, Ann C; Kuhle, Jens; Richert, John; Tumani, Hayrettin; Villar, Luisa M; Drulovic, Jelena; Dujmovic, Irena; Khalil, Michael; Bartos, Ales

2013-11-01

The choice of appropriate control group(s) is critical in cerebrospinal fluid (CSF) biomarker research in multiple sclerosis (MS). There is a lack of definitions and nomenclature of different control groups and a rationalized application of different control groups. We here propose consensus definitions and nomenclature for the following groups: healthy controls (HCs), spinal anesthesia subjects (SASs), inflammatory neurological disease controls (INDCs), peripheral inflammatory neurological disease controls (PINDCs), non-inflammatory neurological controls (NINDCs), symptomatic controls (SCs). Furthermore, we discuss the application of these control groups in specific study designs, such as for diagnostic biomarker studies, prognostic biomarker studies and therapeutic response studies. Application of these uniform definitions will lead to better comparability of biomarker studies and optimal use of available resources. This will lead to improved quality of CSF biomarker research in MS and related disorders.

[MAPK signaling pathways involved in aluminum-induced apoptosis and necroptosis in SH-SY5Y cells].

PubMed

Jia, Xiaofang; Zhang, Qinli; Niu, Qiao

2014-11-01

To explore the role of MAPK signaling pathway in apoptosis and necroptosis induced by aluminum in SH-SY5Y cells. To imitate neural cell death induced by aluminium, AlCl3 x 6H2O (4 mmol/L) was used to treat SH-SY5Y cells. Necrostatin-1 (Nec-1,60 μmol/L), the specific inhibitor for necroptosis, and zVAD-fmk (20 μmol/L), the specific inhibitor for apoptosis, were added into cultures for inhibiting the occurrence of necroptosis and apoptosis. CCK-8 was performed to measure cell viability, flow cytometry was used to test the difference of apoptosis rate and necrosis rate between groups, and western-blot was used to detect the change of MAPK protein. Compared with blank control group, solvent control group, Nec-1 control group and zVAD-fmk control group, cell viabiligy of Al(3+) exposed group, Al(3+) plus Nec-1 group and Al(3+) plus zVAD-fmk group decreaced (P < 0.05). Compared with Al(3+) exposed group, cell viability of Al(3+) plus Nec-1 group and Al(3+) plus zVAD-fmk group increased (P < 0.05). Necrotic rate and apoptotic rate in Al(3+) exposed group, Al(3+) plus Nec-1 group and Al(3+) plus zVAD-fmk group obviously increased compared with blank control group, solvent control group, Nec-1 control group and zVAD-fmk control group (P < 0.05). Compared with Al(3+) exposed group, necrotic and apaptotic rate of Al(3+) plus zVAD-fmk group and Al(3+) plus Nec-1 group were statistically significant decreased (P < 0.05). Compared with blank control group, solvent control group, Nec-1 control group and zVAD-fmk control group, expression of p-p38 in Al(3+) exposed group, Al(3+) plus Nec-1 group and Al(3+) plus zVAD-fmk group increased obviously (P < 0.05), and expression of p-ERK decreased significantly (P < 0.05). Compared with Al(3+) exposed group, expression of p-p38 decreased (P < 0.05), but p-ERK increased in Al(3+) plus Nec-1 group (P < 0.05). The ERK and p38 MAPK signaling pathways are involved in aluminum-induced necroptosis in SH-SY5Y cells, but only ERK signaling pathway is involved in aluminum-induced apoptosis, and JNK signaling pathway is not involved in aluminum-induced cell death.

Improved Decision Making Through Group Composition

DTIC Science & Technology

1991-09-01

design for this research was actually a quasiexperimental design , because equivalent experimental and control groups could not be guaranteed...The Nonequivalent Control Group Design (25:126) O1 X 02 03 04 control group after the simulation exercise. Final game scores were collected from 02... Control Group Design ...... 88 20. Data Analysis Techniques ............. 98 21. The Control and Treatment Team Members’

Effects of Dietary Fermented Seaweed and Seaweed Fusiforme on Growth Performance, Carcass Parameters and Immunoglobulin Concentration in Broiler Chicks

PubMed Central

Choi, Y. J.; Lee, S. R.; Oh, J-W.

2014-01-01

This study was conducted to investigate the effects of brown seaweed (Undaria pinnatifida) by-product and seaweed fusiforme (Hizikia fusiformis) by-product supplementation on growth performance and blood profiles including serum immunoglobulin (Ig) in broilers. Fermentation of seaweeds was conducted by Bacillus subtilis and Aspergillus oryzae. In a 5-wk feeding trial, 750 one-d-old broiler chicks were divided into 5 groups, and were assigned to the control diet or experimental diets including control+0.5% brown seaweed (BS) by-product, control+0.5% seaweed fusiforme (SF) by-product, control+0.5% fermented brown seaweed (FBS) by-product, and control+0.5% fermented seaweed fusiforme (FSF) by-product. As a consequence, body weight gain (BWG) and gain:feed of seaweed by-product groups were clearly higher, when compared to those of control diet group from d 18 to 35 and the entire experimental period (p<0.05). In mortality rate, seaweed by-product groups were significantly lower when compared to control diet group during entire experimental period (p<0.05). However, Feed Intake of experimental diets group was not different from that of the control group during the entire experimental period. Whereas, Feed Intake of fermented seaweed by-product groups was lower than that of non-fermented seaweed groups (p<0.05). Total organ weights, lipids, and glutamic oxalacetic transaminase (GOT) of all treatment groups were not different from those of control group. However, glutamic pyruvate transaminase (GPT) of all treatment groups was higher than that of control group at d 17 (p<0.05). In case of serum Igs concentration, the concentration of IgA antibody in BS, SF, FSF treatment groups was significantly higher than in control group at d 35 (p<0.01). IgA concentration in FBS supplementation groups was negligibly decreased when compared to the control group. IgM concentration in the serums of all treatment groups was significantly higher than in control group (p<0.05) and in fermented seaweed by-product groups were much higher than in non-fermented seaweed groups (p<0.05). On the other hand, IgG concentrations in all treatment groups were lower than in control group (p<0.05). Taken together, our results suggest that by-product dietary supplementation of BS, SF, FBS, and FSF in poultry may provide positive effects of growth performance and immune response. PMID:25050025

Improving the quality of randomized controlled trials in Chinese herbal medicine, part II: control group design.

PubMed

Bian, Zhao-Xiang; Moher, David; Dagenais, Simon; Li, You-Ping; Liu, Liang; Wu, Tai-Xiang; Miao, Jiang-Xia

2006-03-01

To discuss the types of control groups in randomized controlled trials (RCTs) of Chinese herbal medicine (CHM), and to provide suggestions for improving the design of control group in future clinical studies in this therapeutic area. A search of the Cochrane Library was conducted in July 2005 to identify RCTs of CHM, and 66 RCTs with CHM for type 2 diabetes mellitus were obtained as the basis for further analysis. Of 66 RCTs with CHM for type 2 diabetes mellitus, 61 (92.4%) trials had both a treatment group and a control group. Twenty-seven (40.9%) RCTs compared CHM plus conventional drug vs conventional drug, 24 (36.4%) compared CHM vs conventional drug, 5 (7.6%) compared CHM vs placebo, 3 (4.5%) compared CHM plus conventional drug vs conventional drug plus placebo, 3 (4.5%) compared CHM plus conventional drug vs other CHM, 1 (1.5%) compared CHM vs no treatment, 1 (1.5%) compared CHM plus placebo vs conventional drug plus placebo, 1 (1.5%) compared CHM vs CHM plus conventional drug vs conventional drug vs placebo, and 1 (1.5%) compared CHM vs conventional drug vs CHM plus conventional drug. A variety of control groups were used in RCTs of CHM for type 2 diabetes mellitus, including placebo, active, and no treatment control groups. Justification for selecting particular types of control groups were not provided in the trials reviewed in this study. Different control groups may be appropriate according to the study objectives, and several factors should be considered prior to selecting control groups in future RCTs of CHM. (1) Investigators of CHM who design clinical trials should understand the rationale for selecting different types of control groups; (2) Control groups for RCTs should be selected according to study objectives; (3) Active control groups should select interventions for comparisons that have the strongest evidence of efficacy and prescribe them as recommended; (4) Placebo control groups should select a placebo that mimics the physical characteristics of test intervention as closely as possible and is completely inert; (5) No treatment control groups should only be used when withholding treatment is ethical and objectives outcomes will not be subject to bias due to absent blinding; (6) Crossover control groups may be appropriate in chronic and stable conditions.

40 CFR 798.3260 - Chronic toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... dose groups and in the controls should be low to permit a meaningful evaluation of the results. For non... meaningful and valid statistical evaluation of chronic effects. (2) Control groups. (i) A concurrent control group is suggested. This group should be an untreated or sham treated control group or, if a vehicle is...

40 CFR 798.2250 - Dermal toxicity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... animals scheduled to be sacrificed before completion of the study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If the toxic properties of the...

40 CFR 798.3260 - Chronic toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dose groups and in the controls should be low to permit a meaningful evaluation of the results. For non... meaningful and valid statistical evaluation of chronic effects. (2) Control groups. (i) A concurrent control group is suggested. This group should be an untreated or sham treated control group or, if a vehicle is...

40 CFR 798.2250 - Dermal toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... animals scheduled to be sacrificed before completion of the study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If the toxic properties of the...

40 CFR 798.2250 - Dermal toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... animals scheduled to be sacrificed before completion of the study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If the toxic properties of the...

40 CFR 798.2250 - Dermal toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... animals scheduled to be sacrificed before completion of the study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If the toxic properties of the...

40 CFR 798.2250 - Dermal toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... animals scheduled to be sacrificed before completion of the study. (2) Control groups. A concurrent control group is required. This group shall be an untreated or sham-treated control group or, if a vehicle is used in administering the test substance, a vehicle control group. If the toxic properties of the...

40 CFR 798.3260 - Chronic toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dose groups and in the controls should be low to permit a meaningful evaluation of the results. For non... meaningful and valid statistical evaluation of chronic effects. (2) Control groups. (i) A concurrent control group is suggested. This group should be an untreated or sham treated control group or, if a vehicle is...

40 CFR 798.3260 - Chronic toxicity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... dose groups and in the controls should be low to permit a meaningful evaluation of the results. For non... meaningful and valid statistical evaluation of chronic effects. (2) Control groups. (i) A concurrent control group is suggested. This group should be an untreated or sham treated control group or, if a vehicle is...

40 CFR 798.3260 - Chronic toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... dose groups and in the controls should be low to permit a meaningful evaluation of the results. For non... meaningful and valid statistical evaluation of chronic effects. (2) Control groups. (i) A concurrent control group is suggested. This group should be an untreated or sham treated control group or, if a vehicle is...

Women's experiences as members of attention control and experimental intervention groups in a randomized controlled trial.

PubMed

Beal, Claudia C; Stuifbergen, Alexa; Volker, Deborah; Becker, Heather

2009-12-01

Attention control groups are often used in research testing the efficacy of psychosocial and behavioural interventions in order to control for placebo effects. The authors conducted a descriptive qualitative study to investigate how participants viewed their experiences in attention control and experimental intervention groups following a randomized controlled trial for women with fibromyalgia syndrome. Moderately structured interviews were conducted with 18 women (12 from the experimental intervention group and 6 from the attention control group). Members of the control group reported some benefits but few behavioural changes as a result of participating in the RCT, and some participants expressed disappointment at not receiving the intervention. Perceptions of changes in attitudes towards fibromyalgia syndrome and behaviours reported by the intervention group appear to be consistent with the theory underlying the intervention. Possible placebo effects identified in both groups include negative and positive social interactions with other participants.

29 CFR 4001.3 - Trades or businesses under common control; controlled groups.

Code of Federal Regulations, 2012 CFR

2012-07-01

... CORPORATION GENERAL TERMINOLOGY § 4001.3 Trades or businesses under common control; controlled groups. For... control with such person. (2) Persons are under common control if they are members of a “controlled group... 29 Labor 9 2012-07-01 2012-07-01 false Trades or businesses under common control; controlled...

29 CFR 4001.3 - Trades or businesses under common control; controlled groups.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CORPORATION GENERAL TERMINOLOGY § 4001.3 Trades or businesses under common control; controlled groups. For... control with such person. (2) Persons are under common control if they are members of a “controlled group... 29 Labor 9 2010-07-01 2010-07-01 false Trades or businesses under common control; controlled...

29 CFR 4001.3 - Trades or businesses under common control; controlled groups.

Code of Federal Regulations, 2014 CFR

2014-07-01

... CORPORATION GENERAL TERMINOLOGY § 4001.3 Trades or businesses under common control; controlled groups. For... control with such person. (2) Persons are under common control if they are members of a “controlled group... 29 Labor 9 2014-07-01 2014-07-01 false Trades or businesses under common control; controlled...

29 CFR 4001.3 - Trades or businesses under common control; controlled groups.

Code of Federal Regulations, 2013 CFR

2013-07-01

... CORPORATION GENERAL TERMINOLOGY § 4001.3 Trades or businesses under common control; controlled groups. For... control with such person. (2) Persons are under common control if they are members of a “controlled group... 29 Labor 9 2013-07-01 2013-07-01 false Trades or businesses under common control; controlled...

29 CFR 4001.3 - Trades or businesses under common control; controlled groups.

Code of Federal Regulations, 2011 CFR

2011-07-01

... CORPORATION GENERAL TERMINOLOGY § 4001.3 Trades or businesses under common control; controlled groups. For... control with such person. (2) Persons are under common control if they are members of a “controlled group... 29 Labor 9 2011-07-01 2011-07-01 false Trades or businesses under common control; controlled...

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas.

PubMed

Yuan, X; Tao, Y; Zhao, J P; Liu, X S; Xiong, W N; Xie, J G; Ni, W; Xu, Y J; Liu, H G

2015-11-01

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study

PubMed Central

2012-01-01

Background Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Methods Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. Results 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. Conclusions There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis. PMID:22873682

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study.

PubMed

Waters, Lauren; George, Alexis S; Chey, Tien; Bauman, Adrian

2012-08-08

Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis.

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

40 CFR 799.9130 - TSCA acute inhalation toxicity.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the substance in the atmosphere, a vehicle control group should be used when historical data are... system to assign animals to test groups and control groups randomly is required. (2) Control groups. A concurrent untreated control group is not necessary. Where a vehicle other than water is used to generate an...

40 CFR 798.6560 - Subchronic delayed neuro-toxicity of organophosphorus substances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employed. (2) Number of animals. Ten hens should be used for each treatment and control group. (3) Control group—(i) General. A concurrent control group should be used. This group should be treated in a manner... control group(s). The highest dose level should result in toxic effects, preferably delayed neurotoxicity...

40 CFR 798.6560 - Subchronic delayed neuro-toxicity of organophosphorus substances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... employed. (2) Number of animals. Ten hens should be used for each treatment and control group. (3) Control group—(i) General. A concurrent control group should be used. This group should be treated in a manner... control group(s). The highest dose level should result in toxic effects, preferably delayed neurotoxicity...

40 CFR 798.6560 - Subchronic delayed neuro-toxicity of organophosphorus substances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... employed. (2) Number of animals. Ten hens should be used for each treatment and control group. (3) Control group—(i) General. A concurrent control group should be used. This group should be treated in a manner... control group(s). The highest dose level should result in toxic effects, preferably delayed neurotoxicity...

40 CFR 798.6560 - Subchronic delayed neuro-toxicity of organophosphorus substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... employed. (2) Number of animals. Ten hens should be used for each treatment and control group. (3) Control group—(i) General. A concurrent control group should be used. This group should be treated in a manner... control group(s). The highest dose level should result in toxic effects, preferably delayed neurotoxicity...

40 CFR 798.6560 - Subchronic delayed neuro-toxicity of organophosphorus substances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... employed. (2) Number of animals. Ten hens should be used for each treatment and control group. (3) Control group—(i) General. A concurrent control group should be used. This group should be treated in a manner... control group(s). The highest dose level should result in toxic effects, preferably delayed neurotoxicity...

Evaluation of clinical curative effects of disposable stitching instrument in redundant prepuce patients

PubMed Central

Wang, Haitao; Chen, Ningjie; Huo, Ran; Yang, Jincun; Li, Xia; Xing, Nan

2017-01-01

The present study aimed to investigate the clinical curative effect of disposable stitching instrument operation in patients with redundant prepuce or phimosis. A total of 102 cases of patients with circumcision were randomly selected (from June 2013 to December 2014) from the department of plastic and aesthetic surgery of our hospital and were randomly divided into control and observation groups (n=51). Patients in the control group were treated by traditional circumcision operation, while patients in the observation group were treated by novel disposable circumcision stitching instrument. Operation time, bleeding volume, incision healing time, postoperative complications and incision aesthetic satisfaction in the groups were observed. As a result, intraoperative bleeding volume of patients in the observation group was significantly less in comparison to the control group. Operation time and incision healing time of patients in the observation group was shorter than that of the control group. Additionally, the incidence of postoperative complications of patients in the observation group was noted to be lower than that of the control group. On the other hand, the incision aesthetic satisfaction of patients in the observation group was higher than that of the control group. Blood vessel counting and nerve fiber counting of tissue specimen in the observation group were more than those of the control group. Postoperative VAS scores of patients in the observation group were significantly lower than that of the control group. Each rating scale scores of EPQ of patients in the observation group improved significantly compared with that of the control group. In conclusion, the present findings show that disposable circumcision stitching instrument operation is more advantageous in comparison to the traditional procedure along with minimal compilations and better post surgery health condition of patients. PMID:28672929