Sample records for eqiac operating procedures

  1. Obtaining accreditation by the pharmacy compounding accreditation board, part 2: developing essential standard operating procedures.

    PubMed

    Cabaleiro, Joe

    2007-01-01

    A key component of qualifying for accreditation with the Pharmacy Compounding Accreditation Board is having a set of comprehensive standard operating procedures that are being used by the pharmacy staff. The three criteria in standard operating procedures for which the Pharmacy Compounding Accreditation Board looks are: (1)written standard operating procedures; (2)standard operating procedures that reflect what the organization actualy does; and (3) whether the written standard operating procedures are implemented. Following specified steps in the preparation of standard operating procedures will result in procedures that meet Pharmacy Compounding Accreditation Board Requirements, thereby placing pharmacies one step closer to qualifying for accreditation.

  2. 40 CFR 792.81 - Standard operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

  3. 40 CFR 792.81 - Standard operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

  4. 40 CFR 792.81 - Standard operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 32 2014-07-01 2014-07-01 false Standard operating procedures. 792.81... operating procedures. (a) A testing facility shall have standard operating procedures in writing, setting... data generated in the course of a study. All deviations in a study from standard operating procedures...

  5. 8 CFR 1003.40 - Local operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

  6. 8 CFR 1003.40 - Local operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Local operating procedures. 1003.40 Section... PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Immigration Court-Rules of Procedure § 1003.40 Local... establish local operating procedures, provided that: (a) Such operating procedure(s) shall not be...

  7. 49 CFR 193.2503 - Operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2013-10-01 2013-10-01 false Operating procedures. 193.2503 Section 193.2503...

  8. 49 CFR 193.2503 - Operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2011-10-01 2011-10-01 false Operating procedures. 193.2503 Section 193.2503...

  9. 49 CFR 193.2503 - Operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2014-10-01 2014-10-01 false Operating procedures. 193.2503 Section 193.2503...

  10. 49 CFR 193.2503 - Operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: FEDERAL SAFETY STANDARDS Operations § 193.2503 Operating procedures. Each operator shall follow one or more manuals of written procedures to provide safety in normal operation and in responding to an... 49 Transportation 3 2012-10-01 2012-10-01 false Operating procedures. 193.2503 Section 193.2503...

  11. 40 CFR 160.81 - Standard operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

  12. 40 CFR 160.81 - Standard operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

  13. 40 CFR 160.81 - Standard operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

  14. Representing operations procedures using temporal dependency networks

    NASA Technical Reports Server (NTRS)

    Fayyad, Kristina E.; Cooper, Lynne P.

    1993-01-01

    DSN Link Monitor & Control (LMC) operations consist primarily of executing procedures to configure, calibrate, test, and operate a communications link between an interplanetary spacecraft and its mission control center. Currently the LMC operators are responsible for integrating procedures into an end-to-end series of steps. The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks (TDN's) to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures. Results of operational tests of this concept, as implemented in the LMC Operator Assistant Prototype (LMCOA), are also presented.

  15. The procedure execution manager and its application to Advanced Photon Source operation

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

    Borland, M.

    1997-06-01

    The Procedure Execution Manager (PEM) combines a complete scripting environment for coding accelerator operation procedures with a manager application for executing and monitoring the procedures. PEM is based on Tcl/Tk, a supporting widget library, and the dp-tcl extension for distributed processing. The scripting environment provides support for distributed, parallel execution of procedures along with join and abort operations. Nesting of procedures is supported, permitting the same code to run as a top-level procedure under operator control or as a subroutine under control of another procedure. The manager application allows an operator to execute one or more procedures in automatic, semi-automatic,more » or manual modes. It also provides a standard way for operators to interact with procedures. A number of successful applications of PEM to accelerator operations have been made to date. These include start-up, shutdown, and other control of the positron accumulator ring (PAR), low-energy transport (LET) lines, and the booster rf systems. The PAR/LET procedures make nested use of PEM`s ability to run parallel procedures. There are also a number of procedures to guide and assist tune-up operations, to make accelerator physics measurements, and to diagnose equipment. Because of the success of the existing procedures, expanded use of PEM is planned.« less

  16. 34 CFR 602.23 - Operating procedures all agencies must have.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

  17. 34 CFR 602.23 - Operating procedures all agencies must have.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

  18. 34 CFR 602.23 - Operating procedures all agencies must have.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

  19. 34 CFR 602.23 - Operating procedures all agencies must have.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

  20. D0 Central Tracking Solenoid Energization, Controls, Interlocks and Quench Protection Operating Procedures

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

    Hance, R.; /Fermilab

    1998-08-26

    This procedure is used when it is necessary to operate the solenoid energization, controls, interlocks and quench detection system. Note that a separate procedure exists for operating the solenoid 'cryogenic' systems. Only D0 Control Room Operators or the Project Electrical Engineer are qualified to execute these procedures or operate the solenoid system. This procedure assumes that the operator is familiar with using the Distributed Manufacturing Automation and Control Software (DMACS).

  1. Formalizing procedures for operations automation, operator training and spacecraft autonomy

    NASA Technical Reports Server (NTRS)

    Lecouat, Francois; Desaintvincent, Arnaud

    1994-01-01

    The generation and validation of operations procedures is a key task of mission preparation that is quite complex and costly. This has motivated the development of software applications providing support for procedures preparation. Several applications have been developed at MATRA MARCONI SPACE (MMS) over the last five years. They are presented in the first section of this paper. The main idea is that if procedures are represented in a formal language, they can be managed more easily with a computer tool and some automatic verifications can be performed. One difficulty is to define a formal language that is easy to use for operators and operations engineers. From the experience of the various procedures management tools developed in the last five years (including the POM, EOA, and CSS projects), MMS has derived OPSMAKER, a generic tool for procedure elaboration and validation. It has been applied to quite different types of missions, ranging from crew procedures (PREVISE system), ground control centers management procedures (PROCSU system), and - most relevant to the present paper - satellite operation procedures (PROCSAT developed for CNES, to support the preparation and verification of SPOT 4 operation procedures, and OPSAT for MMS telecom satellites operation procedures).

  2. 40 CFR 63.7733 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

  3. 40 CFR 63.7733 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits? (a...-specific operating limits in your operation and maintenance plan according to the procedures in paragraphs... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

  4. 40 CFR 63.7733 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

  5. 40 CFR 63.7733 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

  6. Representing Operations Procedures Using Temporal Dependency Algorithms

    NASA Technical Reports Server (NTRS)

    Fayyad, K.; Cooper, L.

    1992-01-01

    The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures.

  7. Orbital operations study. Appendix B: Operational procedures

    NASA Technical Reports Server (NTRS)

    Galvin, D. M.; Mattson, H. L.; True, D. M.; Anderson, N. R.; Mehrbach, E.; Gianformaggio, A.; Steinwachs, W. L.; Turkel, S. H.

    1972-01-01

    Operational procedures for each alternate approach for each interfacing activity of the orbital operations study are presented. The applicability of the procedures to interfacing element pairs is identified.

  8. Test Operations Procedure (TOP) 03-2-827 Test Procedures for Video Target Scoring Using Calibration Lights

    DTIC Science & Technology

    2016-04-04

    Final 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Test Operations Procedure (TOP) 03-2-827 Test Procedures for Video Target Scoring Using...ABSTRACT This Test Operations Procedure (TOP) describes typical equipment and procedures to setup and operate a Video Target Scoring System (VTSS) to...lights. 15. SUBJECT TERMS Video Target Scoring System, VTSS, witness screens, camera, target screen, light pole 16. SECURITY

  9. In-office vs. operating room procedures for recurrent respiratory papillomatosis.

    PubMed

    Miller, Anya J; Gardner, Glendon M

    2017-01-01

    We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

  10. 76 FR 80261 - National Emission Standards for Hazardous Air Pollutants: Area Source Standards for Prepared...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ... specifications and operating instructions, if available, or standard operating procedures must be developed by... manufacturer's specifications and operating instructions, if available, or standard operating procedures must... operating specifications or standard operating procedures developed by the prepared feeds manufacturer be...

  11. Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

    PubMed

    Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

    2017-05-08

    Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

  12. 21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... accordance with its standard operating procedure of the information identified in paragraphs (a)(1), (a)(2... shall establish a written standard operating procedure for the collection, maintenance, and auditing of... standard operating procedure: (1) Data collection and recording procedures, which shall include a procedure...

  13. 40 CFR 160.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  14. 40 CFR 160.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  15. 40 CFR 160.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  16. 40 CFR 160.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  17. 40 CFR 160.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (b) The written standard operating procedures required under § 160.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  18. Philosophy, policies, and procedures - The three P's of flight-deck operations

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl L.

    1991-01-01

    Standard operating procedures are drafted and provided to flightcrews to dictate the manner in which tasks are carried out. Failure to conform to Standard Operating Procedures (SOP) is frequently listed as the cause of violations, incidents, and accidents. However, procedures are often designed piecemeal, rather than being based on a sound philosophy of operations and policies that follow from such a philosophy. A framework of philosophy, policies, and procedures is proposed.

  19. 40 CFR 63.7323 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

  20. 40 CFR 63.7323 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

  1. 40 CFR 63.7323 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you elect the operating...-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1) and (2) of this... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

  2. 40 CFR 63.7323 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

  3. 40 CFR 63.7323 - What procedures must I use to establish operating limits?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

  4. 40 CFR 792.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  5. 40 CFR 792.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  6. 21 CFR 58.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  7. 40 CFR 792.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  8. 21 CFR 58.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  9. 21 CFR 58.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  10. 21 CFR 58.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  11. 40 CFR 792.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  12. 40 CFR 792.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... standardized. (b) The written standard operating procedures required under § 792.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  13. 21 CFR 58.63 - Maintenance and calibration of equipment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... standardized. (b) The written standard operating procedures required under § 58.81(b)(11) shall set forth in... maintenance operations were routine and followed the written standard operating procedures. Written records... operating procedures shall designate the person responsible for the performance of each operation. (c...

  14. 40 CFR 68.54 - Training.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

  15. 40 CFR 68.54 - Training.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

  16. 40 CFR 68.54 - Training.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

  17. 40 CFR 68.54 - Training.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

  18. 40 CFR 68.54 - Training.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... covered process have been trained or tested competent in the operating procedures provided in § 68.52 that... safely carry out the duties and responsibilities as provided in the operating procedures. (b) Refresher... operating procedures of the process. The owner or operator, in consultation with the employees operating the...

  19. 40 CFR 63.1547 - Monitoring requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

  20. 40 CFR 63.1547 - Monitoring requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

  1. Automated procedure execution for space vehicle autonomous control

    NASA Technical Reports Server (NTRS)

    Broten, Thomas A.; Brown, David A.

    1990-01-01

    Increased operational autonomy and reduced operating costs have become critical design objectives in next-generation NASA and DoD space programs. The objective is to develop a semi-automated system for intelligent spacecraft operations support. The Spacecraft Operations and Anomaly Resolution System (SOARS) is presented as a standardized, model-based architecture for performing High-Level Tasking, Status Monitoring and automated Procedure Execution Control for a variety of spacecraft. The particular focus is on the Procedure Execution Control module. A hierarchical procedure network is proposed as the fundamental means for specifying and representing arbitrary operational procedures. A separate procedure interpreter controls automatic execution of the procedure, taking into account the current status of the spacecraft as maintained in an object-oriented spacecraft model.

  2. 29 CFR 1915.508 - Training.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

  3. 29 CFR 1915.508 - Training.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

  4. 29 CFR 1915.508 - Training.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

  5. 29 CFR 1915.508 - Training.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

  6. 29 CFR 1915.508 - Training.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... responsibilities at all times; (2) Keep written standard operating procedures that address anticipated emergency... the employer's standard operating procedures; (5) Train new fire response employees before they engage in emergency operations; (6) At least quarterly, provide training on the written operating procedures...

  7. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  8. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  9. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  10. 21 CFR 58.81 - Standard operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

  11. 76 FR 80314 - National Emission Standards for Hazardous Air Pollutants: Area Source Standards for Prepared...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ... operating instructions, if available, or standard operating procedures must be developed by the facility... operating instructions, if available, or standard operating procedures must be developed by the facility... standard operating procedures developed by the prepared feeds manufacturer be required as part of the...

  12. 40 CFR 63.1547 - Monitoring requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

  13. 40 CFR 63.1547 - Monitoring requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

  14. 40 CFR 63.1547 - Monitoring requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... according to, a standard operating procedures manual that describes in detail the procedures for inspection...) The standard operating procedures manual for baghouses required by paragraph (a) of this section must... specified in the standard operating procedures manual for inspections and routine maintenance must, at a...

  15. Apollo Operations Handbook Lunar Module (LM 11 and Subsequent) Vol. 2 Operational Procedures

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The Apollo Operations Handbook (AOH) is the primary means of documenting LM descriptions and procedures. The AOH is published in two separately bound volumes. This information is useful in support of program management, engineering, test, flight simulation, and real time flight support efforts. This volume contains crew operational procedures: normal, backup, abort, malfunction, and emergency. These procedures define the sequence of actions necessary for safe and efficient subsystem operation.

  16. 47 CFR 36.412 - Apportionment procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Operating Taxes § 36.412... groups as follows: (1) Operating Federal, State and local income taxes and (2) all other operating taxes...

  17. Procedures in complex systems: the airline cockpit.

    PubMed

    Degani, A; Wiener, E L

    1997-05-01

    In complex human-machine systems, successful operations depend on an elaborate set of procedures which are specified by the operational management of the organization. These procedures indicate to the human operator (in this case the pilot) the manner in which operational management intends to have various tasks done. The intent is to provide guidance to the pilots and to ensure a safe, logical, efficient, and predictable (standardized) means of carrying out the objectives of the job. However, procedures can become a hodge-podge. Inconsistent or illogical procedures may lead to noncompliance by operators. Based on a field study with three major airlines, the authors propose a model for procedure development called the "Four P's": philosophy, policies, procedures, and practices. Using this model as a framework, the authors discuss the intricate issue of designing flight-deck procedures, and propose a conceptual approach for designing any set of procedures. The various factors, both external and internal to the cockpit, that must be considered for procedure design are presented. In particular, the paper addresses the development of procedures for automated cockpits--a decade-long, and highly controversial issue in commercial aviation. Although this paper is based on airline operations, we assume that the principles discussed here are also applicable to other high-risk supervisory control systems, such as space flight, manufacturing process control, nuclear power production, and military operations.

  18. 40 CFR 63.548 - Monitoring requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

  19. 40 CFR 63.548 - Monitoring requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

  20. 40 CFR 63.548 - Monitoring requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) You must prepare, and at all times operate according to, a standard operating procedures manual that...) You must submit the standard operating procedures manual for baghouses required by paragraph (a) of... that you specify in the standard operating procedures manual for inspections and routine maintenance...

  1. 40 CFR 63.1549 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

  2. 40 CFR 63.1549 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

  3. 40 CFR 63.1549 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

  4. 49 CFR 193.2713 - Training: operations and maintenance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

  5. 49 CFR 193.2713 - Training: operations and maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

  6. 49 CFR 193.2713 - Training: operations and maintenance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

  7. 49 CFR 193.2713 - Training: operations and maintenance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

  8. 49 CFR 193.2713 - Training: operations and maintenance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... maintenance activities; and (iii) To carry out aspects of the operating and maintenance procedures under... instructions on the facility operations, including controls, functions, and operating procedures; and (ii) To understand the LNG transfer procedures provided under § 193.2513. (b) A written plan of continuing...

  9. 49 CFR 325.39 - Measurement procedure; highway operations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 5 2014-10-01 2014-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

  10. 49 CFR 325.39 - Measurement procedure; highway operations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 5 2012-10-01 2012-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

  11. 49 CFR 325.39 - Measurement procedure; highway operations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

  12. Operational Control Procedures for the Activated Sludge Process, Part III-A: Calculation Procedures.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This is the second in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. This document deals exclusively with the calculation procedures, including simplified mixing formulas, aeration tank…

  13. 46 CFR 130.480 - Test procedure and operations manual.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Test procedure and operations manual. 130.480 Section... VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Automation of Unattended Machinery Spaces § 130.480 Test procedure and operations manual. (a) A procedure for tests to be conducted on automated...

  14. NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (G01)

    EPA Science Inventory

    The purpose of this SOP is to develop a consistent method and style for all Emory University/Harvard University/Johns Hopkins University standard operating procedures. SOPs are necessary to document all procedures, methods, and techniques used in the NHEXAS investigations. Deve...

  15. Operative record using intraoperative digital data in neurosurgery.

    PubMed

    Houkin, K; Kuroda, S; Abe, H

    2000-01-01

    The purpose of this study was to develop a new method for more efficient and accurate operative records using intra-operative digital data in neurosurgery, including macroscopic procedures and microscopic procedures under an operating microscope. Macroscopic procedures were recorded using a digital camera and microscopic procedures were also recorded using a microdigital camera attached to an operating microscope. Operative records were then recorded digitally and filed in a computer using image retouch software and database base software. The time necessary for editing of the digital data and completing the record was less than 30 minutes. Once these operative records are digitally filed, they are easily transferred and used as database. Using digital operative records along with digital photography, neurosurgeons can document their procedures more accurately and efficiently than by the conventional method (handwriting). A complete digital operative record is not only accurate but also time saving. Construction of a database, data transfer and desktop publishing can be achieved using the intra-operative data, including intra-operative photographs.

  16. A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

    ERIC Educational Resources Information Center

    Perley, Gordon F.

    This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

  17. On the design of flight-deck procedures

    DOT National Transportation Integrated Search

    1994-06-01

    In complex human-machine systems, operations, training, and standardization depend on an elaborate set of procedures which are specified and mandated by the operational management of the organization. These procedures indicate to the human operator (...

  18. 14 CFR 61.87 - Solo requirements for student pilots.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

  19. 14 CFR 61.87 - Solo requirements for student pilots.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

  20. 14 CFR 61.87 - Solo requirements for student pilots.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

  1. 14 CFR 61.87 - Solo requirements for student pilots.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

  2. 14 CFR 61.87 - Solo requirements for student pilots.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... flight preparation procedures, including preflight planning and preparation, powerplant operation, and...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...) Proper flight preparation procedures, including preflight planning and preparation, powerplant operation...

  3. 47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

  4. 47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

  5. 47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

  6. 47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

  7. 47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

  8. Basics of compounding: considerations for implementing United States pharmacopeia chapter 797 pharmaceutical compounding-sterile preparations, part 16: suggested standard operating procedures.

    PubMed

    Okeke, Claudia C; Allen, Loyd V

    2009-01-01

    The standard operating procedures suggested in this article are presented to compounding pharmacies to ensure the quality of the environment in which a CSP is prepared. Since United States Pharmacopeia Chapter 797 provides minimum standards, each facility should aim for best practice gold standard. The standard operating procedures should be tailored to meet the expectations and design of each facility. Compounding personnel are expected to know and understand each standard operating procedure to allow for complete execution of the procedures.

  9. Test Operations Procedure (TOP) 08-2-188 Chemical Point Detector Vapor Testing

    DTIC Science & Technology

    2018-04-27

    Evaluation Command 6617 Aberdeen Boulevard Aberdeen Proving Ground, MD 21005-5001 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S...AND EVALUATION COMMAND TEST OPERATIONS PROCEDURE *Test Operations Procedure 08-2-188 27 April 2018 DTIC AD No. CHEMICAL POINT DETECTOR VAPOR...188 27 April 2018 2 1. SCOPE. This Test Operations Procedure (TOP), which has been endorsed by the Test and Evaluation Capabilities and

  10. Designing Flight-Deck Procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, L.; Shafto, Mike (Technical Monitor)

    1995-01-01

    A complex human-machine system consists of more than merely one or more human operators and a collection of hardware components. In order to operate a complex system successfully, the human-machine system must be supported by an organizational infrastructure of operating concepts, rules, guidelines, and documents. The coherency of such operating concepts, in terms of consistency and logic, is vitally important for the efficiency and safety of any complex system. In high-risk endeavors such as aircraft operations, space flight, nuclear power production, manufacturing process control, and military operations, it is essential that such support be flawless, as the price of operational error can be high. When operating rules are not adhered to, or the rules are inadequate for the task at hand, not only will the system's goals be thwarted, but there may also be tragic human and material consequences. To ensure safe and predictable operations, support to the operators, in this case flight crews, often comes in the form of standard operating procedures. These provide the crew with step-by-step guidance for carrying out their operations. Standard procedures do indeed promote uniformity, but they do so at the risk of reducing the role of human operators to a lower level. Management, however, must recognize the danger of over-procedurization, which fails to exploit one of the most valuable assets in the system, the intelligent operator who is "on the scene." The alert system designer and operations manager recognize that there cannot be a procedure for everything, and the time will come in which the operators of a complex system will face a situation for which there is no written procedure. Procedures, whether executed by humans or machines, have their place, but so does human cognition.

  11. Apollo-Soyuz test project. Operations handbook command/service/docking modules (CSM 119/DM 1): Operational procedures reference issue

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Operational and configuration checks for the Apollo-Soyuz Test Project are presented. The checks include: backup crew prelaunch, prime crew prelaunch, boost and insertion, G and C reference data, G and N reference modes, rendezvous, navigation, Apollo-Soyuz operations, abort procedures, and emergency procedures.

  12. Future of operating rooms.

    PubMed

    Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

    2005-01-01

    Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

  13. 40 CFR 68.52 - Operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.52 Operating procedures. (a) The... for safely conducting activities associated with each covered process consistent with the safety information for that process. Operating procedures or instructions provided by equipment manufacturers or...

  14. Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

    PubMed

    Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

    2017-06-20

    Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

    PubMed

    Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

    2012-11-01

    To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. Number of procedures needed to become sufficient was demonstrated in the current study.

  16. 14 CFR 125.287 - Initial and recurrent pilot testing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS... air navigation aids appropriate to the operation of pilot authorization, including, when applicable, instrument approach facilities and procedures; (5) Air traffic control procedures, including IFR procedures...

  17. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  18. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  19. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  20. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  1. 7 CFR 610.23 - State Technical Committee meetings.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Technical Committee member. (b) NRCS will establish and maintain national standard operating procedures... standard operating procedures will outline items such as: The best practice approach to establishing... standard operating procedures established under paragraph (b) of this section, the State Conservationist...

  2. Computerized procedures system

    DOEpatents

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

    2010-10-12

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

  3. A prospective outcomes analysis of palliative procedures performed for malignant intestinal obstruction due to recurrent ovarian cancer.

    PubMed

    Chi, Dennis S; Phaëton, Rebecca; Miner, Thomas J; Kardos, Steven V; Diaz, John P; Leitao, Mario M; Gardner, Ginger; Huh, Jae; Tew, William P; Konner, Jason A; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Jaques, David P

    2009-08-01

    To obtain prospective outcomes data on patients (pts) undergoing palliative operative or endoscopic procedures for malignant bowel obstruction due to recurrent ovarian cancer. An institutional study was conducted from July 2002 to July 2003 to prospectively identify pts who underwent an operative or endoscopic procedure to palliate the symptoms of advanced cancer. This report focuses on pts with malignant bowel obstruction due to recurrent ovarian cancer. Procedures performed with an upper or lower gastrointestinal (GI) endoscope were considered "endoscopic." All other cases were classified as "operative." Following the procedure, the presence or absence of symptoms was determined and followed over time. All pts were followed until death. Palliative interventions were performed on 74 gynecologic oncology pts during the study period, of which 26 (35%) were for malignant GI obstruction due to recurrent ovarian cancer. The site of obstruction was small bowel in 14 (54%) cases and large bowel in 12 (46%) cases. Palliative procedures were operative in 14 (54%) pts and endoscopic in the other 12 (46%). Overall, symptomatic improvement or resolution within 30 days was achieved in 23 (88%) of 26 patients, with 1 (4%) postprocedure mortality. At 60 days, 10 (71%) of 14 pts who underwent operative procedures and 6 (50%) of 12 pts who had endoscopic procedures had symptom control. Median survival from the time of the palliative procedure was 191 days (range, 33-902) for those undergoing an operative procedure and 78 days (range, 18-284) for those undergoing an endoscopic procedure. Patients with malignant bowel obstructions due to recurrent ovarian cancer have a high likelihood of experiencing relief of symptoms with palliative procedures. Although recurrence of symptoms is common, durable palliation and extended survival are possible, especially in those patients selected for operative intervention.

  4. 40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

  5. 40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

  6. 40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

  7. 40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

  8. 40 CFR 63.9622 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-specific operating limits according to the procedures in paragraphs (a)(1) through (3) of this section. (1... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this... site-specific operating limit according to the procedures in paragraphs (c)(1) or (2) of this section...

  9. 21 CFR 680.1 - Allergenic Products.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

  10. 21 CFR 680.1 - Allergenic Products.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

  11. 21 CFR 680.1 - Allergenic Products.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

  12. 21 CFR 680.1 - Allergenic Products.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Mold manufacturers shall maintain written standard operating procedures, developed by a qualified... representative species of mold subject to the standard operating procedures. The tests shall be performed at each manufacturing step during and subsequent to harvest, as specified in the standard operating procedures. Before...

  13. 14 CFR 23.1585 - Operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Operating procedures. 23.1585 Section 23.1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information Airplane Flight Manual and Approved Manual Material § 23.1585 Operating procedures. (a) For all...

  14. 10 CFR 455.62 - Contents of a technical assistance program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

  15. 10 CFR 455.62 - Contents of a technical assistance program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

  16. 10 CFR 455.62 - Contents of a technical assistance program.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

  17. 10 CFR 455.62 - Contents of a technical assistance program.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

  18. 40 CFR 63.550 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... recordkeeping required as part of the practices described in the standard operating procedures manual for... part of the practices described in the standard operating procedures manual for baghouses required... period, including an explanation of the periods when the procedures outlined in the standard operating...

  19. 40 CFR 63.550 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... recordkeeping required as part of the practices described in the standard operating procedures manual for... part of the practices described in the standard operating procedures manual for baghouses required... period, including an explanation of the periods when the procedures outlined in the standard operating...

  20. 10 CFR 455.62 - Contents of a technical assistance program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and document energy conservation maintenance and operating procedure changes and energy conservation... operating procedure changes, if any, and energy conservation measures selected in accordance with the State... conservation maintenance and operating procedure change and an estimate of the costs of adopting such energy...

  1. Technical Operating Procedures for Resource Documentation Under the Oil Pollution Act of 1990

    DOT National Transportation Integrated Search

    1996-06-01

    Technical Operating Procedures (TOPs) for Resource Documentation under the Oil Pollution Act of 1990 (P.L.101-380) have been developed to provide guidance to users operating as, or in support of, the Federal On-Scene Coordinator(FOSC). The procedures...

  2. 47 CFR 1.957 - Procedure with respect to amateur radio operator license.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Procedure with respect to amateur radio... AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each candidate for an amateur...

  3. 47 CFR 1.957 - Procedure with respect to amateur radio operator license.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2013-10-01 2013-10-01 false Procedure with respect to amateur radio...

  4. 47 CFR 1.957 - Procedure with respect to amateur radio operator license.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each candidate for an amateur... 47 Telecommunication 1 2011-10-01 2011-10-01 false Procedure with respect to amateur radio...

  5. 47 CFR 1.957 - Procedure with respect to amateur radio operator license.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2014-10-01 2014-10-01 false Procedure with respect to amateur radio...

  6. 47 CFR 1.957 - Procedure with respect to amateur radio operator license.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2012-10-01 2012-10-01 false Procedure with respect to amateur radio...

  7. Operational Control Procedures for the Activated Sludge Process, Part III-B: Calculation Procedures for Step-Feed Process Responses and Addendum No. 1.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This is the third in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. This document deals with the calculation procedures associated with a step-feed process. Illustrations and examples are included to…

  8. Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

    PubMed

    El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

    2017-07-01

    Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

  9. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., implement, and maintain written standard operating procedures for each assay performed for drug and specimen... facility shall develop, implement, and maintain written standard operating procedures for each test. The...; (2) Preparation of reagents, standards, and controls; (3) Calibration procedures; (4) Derivation of...

  10. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., implement, and maintain written standard operating procedures for each assay performed for drug and specimen... facility shall develop, implement, and maintain written standard operating procedures for each test. The...; (2) Preparation of reagents, standards, and controls; (3) Calibration procedures; (4) Derivation of...

  11. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., implement, and maintain written standard operating procedures for each assay performed for drug and specimen... facility shall develop, implement, and maintain written standard operating procedures for each test. The...; (2) Preparation of reagents, standards, and controls; (3) Calibration procedures; (4) Derivation of...

  12. Imaging System for Vaginal Surgery.

    PubMed

    Taylor, G Bernard; Myers, Erinn M

    2015-12-01

    The vaginal surgeon is challenged with performing complex procedures within a surgical field of limited light and exposure. The video telescopic operating microscope is an illumination and imaging system that provides visualization during open surgical procedures with a limited field of view. The imaging system is positioned within the surgical field and then secured to the operating room table with a maneuverable holding arm. A high-definition camera and Xenon light source allow transmission of the magnified image to a high-definition monitor in the operating room. The monitor screen is positioned above the patient for the surgeon and assistants to view real time throughout the operation. The video telescopic operating microscope system was used to provide surgical illumination and magnification during total vaginal hysterectomy and salpingectomy, midurethral sling, and release of vaginal scar procedures. All procedures were completed without complications. The video telescopic operating microscope provided illumination of the vaginal operative field and display of the magnified image onto high-definition monitors in the operating room for the surgeon and staff to simultaneously view the procedures. The video telescopic operating microscope provides high-definition display, magnification, and illumination during vaginal surgery.

  13. 49 CFR 192.605 - Procedural manual for operations, maintenance, and emergencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... operations and maintenance activities are conducted. (b) Maintenance and normal operations. The manual... personnel to determine the effectiveness, and adequacy of the procedures used in normal operation and... or flow rate outside normal operating limits; (iii) Loss of communications; (iv) Operation of any...

  14. 21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... manufacturer of a tracked device shall keep current records in accordance with its standard operating procedure... this section. A manufacturer shall make this standard operating procedure available to FDA upon request. A manufacturer shall incorporate the following into the standard operating procedure: (1) Data...

  15. 40 CFR 63.1549 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the practices described in the standard operating procedures manual required under § 63.1544(a) for... described in the standard operating procedures manual for baghouses required under § 63.1547(a). (6) If an... in the standard operating procedures manual for baghouses required under § 63.1547(a), including an...

  16. 40 CFR 63.545 - Standards for fugitive dust sources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... according to a standard operating procedures manual that describes in detail the measures that will be put... standard operating procedures manual shall be submitted to the Administrator or delegated authority for review and approval. (c) The controls specified in the standard operating procedures manual shall at a...

  17. 40 CFR 63.545 - Standards for fugitive dust sources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... according to a standard operating procedures manual that describes in detail the measures that will be put... standard operating procedures manual shall be submitted to the Administrator or delegated authority for review and approval. (c) The controls specified in the standard operating procedures manual shall at a...

  18. 40 CFR 63.1549 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the practices described in the standard operating procedures manual required under § 63.1544(a) for... described in the standard operating procedures manual for baghouses required under § 63.1547(a). (6) If an... in the standard operating procedures manual for baghouses required under § 63.1547(a), including an...

  19. 21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... manufacturer of a tracked device shall keep current records in accordance with its standard operating procedure... this section. A manufacturer shall make this standard operating procedure available to FDA upon request. A manufacturer shall incorporate the following into the standard operating procedure: (1) Data...

  20. 40 CFR 63.550 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

  1. 21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... manufacturer of a tracked device shall keep current records in accordance with its standard operating procedure... this section. A manufacturer shall make this standard operating procedure available to FDA upon request. A manufacturer shall incorporate the following into the standard operating procedure: (1) Data...

  2. 40 CFR 63.550 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

  3. 21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... manufacturer of a tracked device shall keep current records in accordance with its standard operating procedure... this section. A manufacturer shall make this standard operating procedure available to FDA upon request. A manufacturer shall incorporate the following into the standard operating procedure: (1) Data...

  4. 40 CFR 63.550 - Recordkeeping and reporting requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

  5. 76 FR 54528 - Standard Operating Procedures (SOP) of the Aircraft Certification Service (AIR) Process for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ...) of the Aircraft Certification Service (AIR) Process for the Sequencing of Certification and... on the Aircraft Certification Service (AIR) standard operating procedure (SOP) describing the process... comments on the SOP : AIR-100-001; Standard Operating Procedure--Aircraft Certification Service Project...

  6. 42 CFR 35.15 - Consent to operative procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

  7. 42 CFR 35.15 - Consent to operative procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

  8. 42 CFR 35.15 - Consent to operative procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

  9. 42 CFR 35.15 - Consent to operative procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

  10. 42 CFR 35.15 - Consent to operative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

  11. "Knife to skin" time is a poor marker of operating room utilization and efficiency in cardiac surgery.

    PubMed

    Luthra, Suvitesh; Ramady, Omar; Monge, Mary; Fitzsimons, Michael G; Kaleta, Terry R; Sundt, Thoralf M

    2015-06-01

    Markers of operation room (OR) efficiency in cardiac surgery are focused on "knife to skin" and "start time tardiness." These do not evaluate the middle and later parts of the cardiac surgical pathway. The purpose of this analysis was to evaluate knife to skin time as an efficiency marker in cardiac surgery. We looked at knife to skin time, procedure time, and transfer times in the cardiac operational pathway for their correlation with predefined indices of operational efficiency (Index of Operation Efficiency - InOE, Surgical Index of Operational Efficiency - sInOE). A regression analysis was performed to test the goodness of fit of the regression curves estimated for InOE relative to the times on the operational pathway. The mean knife to skin time was 90.6 ± 13 minutes (23% of total OR time). The mean procedure time was 282 ± 123 minutes (71% of total OR time). Utilization efficiencies were highest for aortic valve replacement and coronary artery bypass grafting and least for complex aortic procedures. There were no significant procedure-specific or team-specific differences for standard procedures. Procedure times correlated the strongest with InOE (r = -0.98, p < 0.01). Compared to procedure times, knife to skin is not as strong an indicator of efficiency. A statistically significant linear dependence on InOE was observed with "procedure times" only. Procedure times are a better marker of OR efficiency than knife to skin in cardiac cases. Strategies to increase OR utilization and efficiency should address procedure times in addition to knife to skin times. © 2015 Wiley Periodicals, Inc.

  12. Comparable operative times with and without surgery resident participation.

    PubMed

    Uecker, John; Luftman, Kevin; Ali, Sadia; Brown, Carlos

    2013-01-01

    Both physicians and patients may perceive that having surgical residents participate in operative procedures may prolong operations and worsen outcomes. We hypothesized that resident participation would prolong operative times and potentially adversely affect postoperative outcomes. To evaluate the effect of general surgery resident participation in surgical procedures on operative times and postoperative patient outcomes. Retrospective study of general surgery procedures performed during two 1-year time periods, 2007 without residents and 2011 with residents. Procedures included laparoscopic appendectomy and cholecystectomy, thyroidectomy, breast procedure, hernia repair, lower extremity amputation, tunneled venous catheter, and percutaneous endoscopic gastrostomy. The primary outcome was operative time and secondary outcomes included length of stay (LOS) and mortality. Academic general surgery residency program. There were 2280 operative procedures performed during the 2 periods: 1150 with resident involvement (RES group) and 1130 without residents (NORES group). The RES and NORES groups were similar for patient age (42 vs 41, p = 0.14) and male gender (46% vs 45%, p = 0.68), and there was no difference in overall operative time (68min vs 66min, p = 0.58). More specifically there was no difference in operative time (minutes) for specific procedures including laparoscopic appendectomy (67 vs 71, p = 0.8), thyroidectomy (125 vs 109, p = 0.16), breast procedure (38 vs 26, p = 0.79), hernia repair (61 vs 60, p = 0.74), lower extremity amputation (65 vs 77, p = 0.16), tunneled venous catheter (49 vs 47, p = 0.75), and percutaneous endoscopic gastrostomy (49 vs 46, p = 0.76). However, laparoscopic cholecystectomy took slightly longer in the RES group (71 vs 66, p = 0.02). LOS was shorter during the year with resident involvement (2.6 days vs 3.7 days, p = 0.0004) and there was no difference in mortality (0.17% vs 0.35%, p = 0.45). There is no difference in operative time for common general surgery procedures with or without resident involvement. In addition, resident involvement is associated with a decrease in LOS. This information should be used to change physician and patient negative perceptions regarding resident involvement while performing surgical procedures. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. 47 CFR 36.374 - Telephone operator services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.374 Telephone operator services. (a) Expenses in this classification include costs incurred for operators in call completion service and number services. This includes...

  14. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  15. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Survey procedures. 272.14 Section 272.14 Shipping... OPERATORS REQUIREMENTS AND PROCEDURES FOR CONDUCTING CONDITION SURVEYS AND ADMINISTERING MAINTENANCE AND... Survey procedures. (a) Prior to survey. Unless otherwise directed by MARAD, the Operator of a vessel...

  16. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  17. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  18. 46 CFR 272.14 - Survey procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  19. 14 CFR 93.309 - General operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

  20. 14 CFR 93.309 - General operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

  1. 14 CFR 93.309 - General operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

  2. 14 CFR 93.309 - General operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

  3. 14 CFR 93.309 - General operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

  4. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION, MAINTENANCE AND OPERATION OF ELECTRONIC BALANCES (BCO-L-23.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures to be followed for the operation, calibration and maintenance of electronic balances. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Border" study. Keywords: ...

  5. 5 CFR 9701.406 - Setting and communicating performance expectations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... apply to all employees, such as standard operating procedures, handbooks, or other operating... organizational level; (2) Organizational, occupational, or other work requirements, such as standard operating procedures, operating instructions, administrative manuals, internal rules and directives, and/or other...

  6. 5 CFR 9701.406 - Setting and communicating performance expectations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... apply to all employees, such as standard operating procedures, handbooks, or other operating... organizational level; (2) Organizational, occupational, or other work requirements, such as standard operating procedures, operating instructions, administrative manuals, internal rules and directives, and/or other...

  7. 5 CFR 9701.406 - Setting and communicating performance expectations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... apply to all employees, such as standard operating procedures, handbooks, or other operating... organizational level; (2) Organizational, occupational, or other work requirements, such as standard operating procedures, operating instructions, administrative manuals, internal rules and directives, and/or other...

  8. 5 CFR 9701.406 - Setting and communicating performance expectations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... apply to all employees, such as standard operating procedures, handbooks, or other operating... organizational level; (2) Organizational, occupational, or other work requirements, such as standard operating procedures, operating instructions, administrative manuals, internal rules and directives, and/or other...

  9. 40 CFR 240.200-3 - Recommended procedures: Operations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

  10. 40 CFR 240.200-3 - Recommended procedures: Operations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

  11. Preliminary Investigation of Time Remaining Display on the Computer-based Emergency Operating Procedure

    NASA Astrophysics Data System (ADS)

    Suryono, T. J.; Gofuku, A.

    2018-02-01

    One of the important thing in the mitigation of accidents in nuclear power plant accidents is time management. The accidents should be resolved as soon as possible in order to prevent the core melting and the release of radioactive material to the environment. In this case, operators should follow the emergency operating procedure related with the accident, in step by step order and in allowable time. Nowadays, the advanced main control rooms are equipped with computer-based procedures (CBPs) which is make it easier for operators to do their tasks of monitoring and controlling the reactor. However, most of the CBPs do not include the time remaining display feature which informs operators of time available for them to execute procedure steps and warns them if the they reach the time limit. Furthermore, the feature will increase the awareness of operators about their current situation in the procedure. This paper investigates this issue. The simplified of emergency operating procedure (EOP) of steam generator tube rupture (SGTR) accident of PWR plant is applied. In addition, the sequence of actions on each step of the procedure is modelled using multilevel flow modelling (MFM) and influenced propagation rule. The prediction of action time on each step is acquired based on similar case accidents and the Support Vector Regression. The derived time will be processed and then displayed on a CBP user interface.

  12. What is the safety of nonemergent operative procedures performed at night? A study of 10,426 operations at an academic tertiary care hospital using the American College of Surgeons national surgical quality program improvement database.

    PubMed

    Turrentine, Florence E; Wang, Hongkun; Young, Jeffrey S; Calland, James Forrest

    2010-08-01

    Ever-increasing numbers of in-house acute care surgeons and competition for operating room time during normal daytime business hours have led to an increased frequency of nonemergent general and vascular surgery procedures occurring at night when there are fewer residents, consultants, nurses, and support staff available for assistance. This investigation tests the hypothesis that patients undergoing such procedures after hours are at increased risk for postoperative morbidity and mortality. Clinical data for 10,426 operative procedures performed over a 5-year period at a single academic tertiary care hospital were obtained from the American College of Surgeons National Surgical Quality Improvement Program Database. The prevalence of preoperative comorbid conditions, postoperative length of stay, morbidity, and mortality was compared between two cohorts of patients: one who underwent nonemergent operative procedures at night and other who underwent similar procedures during the day. Subsequent statistical comparisons utilized chi tests for comparisons of categorical variables and F-tests for continuous variables. Patients undergoing procedures at night had a greater prevalence of serious preoperative comorbid conditions. Procedure complexity as measured by relative value unit did not differ between groups, but length of stay was longer after night procedures (7.8 days vs. 4.3 days, p < 0.0001). Patients undergoing nonemergent general and vascular surgery procedures at night in an academic medical center do not seem to be at increased risk for postoperative morbidity or mortality. Performing nonemergent procedures at night seems to be a safe solution for daytime overcrowding of operating rooms.

  13. Kernel and System Procedures in Flex.

    DTIC Science & Technology

    1983-08-01

    System procedures on which the operating system for the Flex computer is based. These are the low level rOCedures Whbich are used to implement the compilers, file-store* coummand interpreters etc on Flex. 168 ... System procedures on which the operating system for the Flex computer is based. These are the low level procedures which are used to implement the...privileged mode. They form the interface between the user and a particular operating system written on top of the Kernel.

  14. 12 CFR 1271.33 - Book-entry procedure for Financing Corporation obligations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Book-entry procedure for Financing Corporation... MISCELLANEOUS FEDERAL HOME LOAN BANK OPERATIONS AND AUTHORITIES Financing Corporation Operations § 1271.33 Book... have authority to apply book-entry procedure to Financing Corporation obligations. (b) Procedure. The...

  15. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND INITIALIZATION OF THE MAGELLAN GPS SATELLITE NAVIGATOR (UA-F-22.1)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures for the operation and initialization of the Magellan Global Positioning System (GPS) Satellite Navigator. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the Borde...

  16. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  17. 76 FR 49286 - Third Party Testing for Certain Children's Products; Notice of Requirements for Accreditation of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... tested in accordance with CPSC-CH-C1001-09.3, Standard Operating Procedure for Determination of...-C1001-09.3, Standard Operating Procedure for Determination of Phthalates, issued on April 1, 2010...-C1001-09.3, Standard Operating Procedure for Determination of Phthalates, and GB/T 22048-2008, Toys and...

  18. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  19. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  20. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  1. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  2. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION AND MAINTENANCE OF FIXED AND ADJUSTABLE VOLUME PIPETTE GUNS (BCO-L-9.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures for the operation, calibration, and maintenance of fixed- and adjustable-volume pipette guns. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Border" study. Ke...

  3. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND INITIALIZATION OF THE MAGELLAN GPS SATELLITE NAVIGATOR (UA-F-22.1)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures for the operation and initialization of the Magellan Global Positioning System (GPS) Satellite Navigator. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Bord...

  4. OCCUPATIONAL RADIATION DOSES TO OPERATORS PERFORMING FLUOROSCOPICALLY-GUIDED PROCEDURES

    PubMed Central

    Kim, Kwang Pyo; Miller, Donald L.; de Gonzalez, Amy Berrington; Balter, Stephen; Kleinerman, Ruth A.; Ostroumova, Evgenia; Simon, Steven L.; Linet, Martha S.

    2012-01-01

    In the past 30 years, the numbers and types of fluoroscopically-guided (FG) procedures have increased dramatically. The objective of the present study is to provide estimated radiation doses to physician specialists, other than cardiologists, who perform FG procedures. We searched Medline to identify English-language journal articles reporting radiation exposures to these physicians. We then identified several primarily therapeutic FG procedures that met specific criteria: well-defined procedures for which there were at least five published reports of estimated radiation doses to the operator, procedures performed frequently in current medical practice, and inclusion of physicians from multiple medical specialties. These procedures were percutaneous nephrolithotomy (PCNL), vertebroplasty, orthopedic extremity nailing for treatment of fractures, biliary tract procedures, transjugular intrahepatic portosystemic shunt creation (TIPS), head/neck endovascular therapeutic procedures, and endoscopic retrograde cholangiopancreatography (ERCP). We abstracted radiation doses and other associated data, and estimated effective dose to operators. Operators received estimated doses per patient procedure equivalent to doses received by interventional cardiologists. The estimated effective dose per case ranged from 1.7 – 56μSv for PCNL, 0.1 – 101 μSv for vertebroplasty, 2.5 – 88μSv for orthopedic extremity nailing, 2.0 – 46μSv for biliary tract procedures, 2.5 – 74μSv for TIPS, 1.8 – 53μSv for head/neck endovascular therapeutic procedures, and 0.2 – 49μSv for ERCP. Overall, mean operator radiation dose per case measured over personal protective devices at different anatomic sites on the head and body ranged from 19 – 800 (median = 113) μSv at eye level, 6 – 1180 (median = 75)μSv at the neck, and 2 – 1600 (median = 302) μSv at the trunk. Operators’ hands often received greater doses than the eyes, neck or trunk. Large variations in operator doses suggest that optimizing procedure protocols and proper use of protective devices and shields might reduce occupational radiation dose substantially. PMID:22647920

  5. Surgeon specialization and operative mortality in United States: retrospective analysis

    PubMed Central

    Dalton, Maurice; Cutler, David M; Birkmeyer, John D; Chandra, Amitabh

    2016-01-01

    Objective To measure the association between a surgeon’s degree of specialization in a specific procedure and patient mortality. Design Retrospective analysis of Medicare data. Setting US patients aged 66 or older enrolled in traditional fee for service Medicare. Participants 25 152 US surgeons who performed one of eight procedures (carotid endarterectomy, coronary artery bypass grafting, valve replacement, abdominal aortic aneurysm repair, lung resection, cystectomy, pancreatic resection, or esophagectomy) on 695 987 patients in 2008-13. Main outcome measure Relative risk reduction in risk adjusted and volume adjusted 30 day operative mortality between surgeons in the bottom quarter and top quarter of surgeon specialization (defined as the number of times the surgeon performed the specific procedure divided by his/her total operative volume across all procedures). Results For all four cardiovascular procedures and two out of four cancer resections, a surgeon’s degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure. Conclusion For several common procedures, surgeon specialization was an important predictor of operative mortality independent of volume in that specific procedure. When selecting a surgeon, patients, referring physicians, and administrators assigning operative workload may want to consider a surgeon’s procedure specific volume as well as the degree to which a surgeon specializes in that procedure. PMID:27444190

  6. Impact of the 80-hour work week on resident emergency operative experience.

    PubMed

    Feanny, Mark A; Scott, Bradford G; Mattox, Kenneth L; Hirshberg, Asher

    2005-12-01

    The goal of this study was to analyze the impact of the 80-hour work week on the emergency operative experience of surgical residents. A 2-year retrospective comparison of the operative experience in emergency abdominal procedures of postgraduate year 4 and 5 residents in a city hospital before (group 1) and after (group 2) duty hour restriction. There was no difference between groups in the mean number of procedures performed as the primary surgeon, but group 2 showed a 40% decrease in technically advanced procedures with a 44% increase in basic procedures. The study also demonstrated a 54% decrease in the operative volume as first assistant. Operative continuity of care by residents decreased from 60% to 26% of cases. The ACGME regulatory environment is adversely affecting the emergency operative experience of surgical residents. Our findings underscore the need to develop alternative methods to augment the residents' operative experience.

  7. Operative experience of residents in US general surgery programs: a gap between expectation and experience.

    PubMed

    Bell, Richard H; Biester, Thomas W; Tabuenca, Arnold; Rhodes, Robert S; Cofer, Joseph B; Britt, L D; Lewis, Frank R

    2009-05-01

    The purpose of the study was to identify a group of operations which general surgery residency program directors believed residents should be competent to perform by the end of 5 years of training and then ascertain actual resident experience with these procedures during their training. There is concern about the adequacy of training of general surgeons in the United States. The American Board of Surgery and the Association of Program Directors in Surgery undertook a study to determine what operative procedures residency program directors consider to be essential to the practice of general surgery and then we measured the actual operative experience of graduating residents in those procedures, as reported to the Residency Review Committee for Surgery (RRC). An electronic survey was sent to residency program directors at the 254 general surgery programs in the US accredited by the RRC as of spring 2006. The program directors were presented with a list of 300 types of operations. Program directors graded the 300 procedures "A," "B," or "C" using the following criteria: A--graduating general surgery residents should be competent to perform the procedure independently; B--graduating residents should be familiar with the procedure, but not necessarily competent to perform it; and C--graduating residents neither need to be familiar with nor competent to perform the procedure. After ballots were tallied, the actual resident operative experience reported to the RRC by all residents finishing general surgery training in June 2005 was reviewed. One hundred twenty-one of the 300 operations were considered A level procedures by a majority of program directors (PDs). Graduating 2005 US residents (n = 1022) performed only 18 of the 121 A procedures, an average of more than 10 times during residency; 83 of 121 procedures were performed on an average less than 5 times and 31 procedures less than once. For 63 of the 121 procedures, the mode (most commonly reported) experience was 0. In addition, there was significant variation between residents in operative experience for specific procedures. In virtually all cases, the mean reported experience exceeded the mode, suggesting that the mean is a poor measure of typical experience. These data pose important problems for surgical educators. Methods will have to be developed to allow surgeons to reach a basic level of competence in procedures which they are likely to experience only rarely during residency. Even for more commonly performed procedures, the numbers of repetitions are not very robust, stressing the need to determine objectively whether residents are actually achieving basic competency in these operations. Finally, the large variations in experience between individuals in our residency system need to be explored, understood, and remedied.

  8. Towards Verification of Operational Procedures Using Auto-Generated Diagnostic Trees

    NASA Technical Reports Server (NTRS)

    Kurtoglu, Tolga; Lutz, Robyn; Patterson-Hine, Ann

    2009-01-01

    The design, development, and operation of complex space, lunar and planetary exploration systems require the development of general procedures that describe a detailed set of instructions capturing how mission tasks are performed. For both crewed and uncrewed NASA systems, mission safety and the accomplishment of the scientific mission objectives are highly dependent on the correctness of procedures. In this paper, we describe how to use the auto-generated diagnostic trees from existing diagnostic models to improve the verification of standard operating procedures. Specifically, we introduce a systematic method, namely the Diagnostic Tree for Verification (DTV), developed with the goal of leveraging the information contained within auto-generated diagnostic trees in order to check the correctness of procedures, to streamline the procedures in terms of reducing the number of steps or use of resources in them, and to propose alternative procedural steps adaptive to changing operational conditions. The application of the DTV method to a spacecraft electrical power system shows the feasibility of the approach and its range of capabilities

  9. Human factors research plan for instrument procedures : FY12 version 1.1

    DOT National Transportation Integrated Search

    2012-06-19

    This research will support the development of instrument procedures for performance-based navigation (PBN) operations. These procedures include, but are not limited to, area navigation (RNAV) and required navigation performance (RNP) operations. The ...

  10. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION AND MAINTENANCE OF FIXED AND ADJUSTABLE VOLUME PIPETTE GUNS (BCO-L-9.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures for the operation, calibration, and maintenance of fixed- and adjustable-volume pipette guns. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the Border study. Keyw...

  11. A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

    ERIC Educational Resources Information Center

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

  12. A Guide for Developing Standard Operating Job Procedures for the Grit Removal Process Wastewater Treatment Facility. SOJP No. 2.

    ERIC Educational Resources Information Center

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the grit removal process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up, continuous operation, and shut-down procedures. A description of the equipment used in the process is given. Some theoretical material is presented. (BB)

  13. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION AND ROUTINE USE OF THE SPECTRACE 9000 FIELD PORTABLE X-RAY FLUORESCENCE ANALYZER (UA-L-10.1)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures for operating and calibrating the Spectrace 9000 field portable X-ray fluorescence analyzer. This procedure applies to the determination of metal concentrations in samples during the Arizona NHEXAS project and the "Border" st...

  14. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION AND MAINTENANCE OF THE PERKIN-ELMER 1100B ATOMIC ABSORPTION SPECTROMETER (BCO-L-5.1)

    EPA Science Inventory

    The purpose of this SOP is to outline the start-up, calibration, operation, and maintenance procedures for the Perkin-Elmer 5100 PC Atomic Absorption Spectrophotometer (PE 5100). These procedures are used for the determination of the target trace metal, as in soil, house dust, f...

  15. [A project to improve the validity rate for nursing staff operating single door autoclave sterilizers].

    PubMed

    Chen, Chun-Hung; Li, Cheng-Chang; Chou, Chuan-Yu; Chen, Shu-Hwa

    2009-08-01

    This project was designed to improve the low validity rate for nurses responsible to operate single door autoclave sterilizers in the operating room. By investigating the current status, we found that the nursing staff validity rate of cognition on the autoclave sterilizer was 85%, and the practice operating check validity rate was only 80%. Such was due to a lack of in-service education. Problems with operation included: 1. Unsafe behaviors - not following standard procedure, lacking relevant operating knowledge and absence of a check form; 2. Unsafe environment - the conveying steam piping was typically not covered and lacked operation marks. Recommended improvement measures included: 1. holding in-service education; 2. generating an operation procedure flow chart; 3. implementing obstacle eliminating procedures; 4. covering piping to prevent fire and burns; 5. performing regular checks to ensure all procedures are followed. Following intervention, nursing staff cognition rose from 85% to 100%, while the operation validity rate rose from 80% to 100%. These changes ensure a safer operating room environment, and helps facilities move toward a zero accident rate in the healthcare environment.

  16. 40 CFR 264.1201 - Design and operating standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Design and operating standards. 264... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1201 Design and operating standards. (a... Operating Procedure specifying procedures to ensure safety, security, and environmental protection. If these...

  17. 40 CFR 264.1201 - Design and operating standards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Design and operating standards. 264... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1201 Design and operating standards. (a... Operating Procedure specifying procedures to ensure safety, security, and environmental protection. If these...

  18. 40 CFR 264.1201 - Design and operating standards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Design and operating standards. 264... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1201 Design and operating standards. (a... Operating Procedure specifying procedures to ensure safety, security, and environmental protection. If these...

  19. 40 CFR 265.1201 - Design and operating standards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... be stored in accordance with a Standard Operating Procedure specifying procedures to ensure safety... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Design and operating standards. 265... operating standards. (a) Hazardous waste munitions and explosives storage units must be designed and...

  20. 40 CFR 265.1201 - Design and operating standards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be stored in accordance with a Standard Operating Procedure specifying procedures to ensure safety... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Design and operating standards. 265... operating standards. (a) Hazardous waste munitions and explosives storage units must be designed and...

  1. 40 CFR 265.1201 - Design and operating standards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be stored in accordance with a Standard Operating Procedure specifying procedures to ensure safety... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Design and operating standards. 265... operating standards. (a) Hazardous waste munitions and explosives storage units must be designed and...

  2. 40 CFR 265.1201 - Design and operating standards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... be stored in accordance with a Standard Operating Procedure specifying procedures to ensure safety... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Design and operating standards. 265... operating standards. (a) Hazardous waste munitions and explosives storage units must be designed and...

  3. 40 CFR 264.1201 - Design and operating standards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Design and operating standards. 264... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1201 Design and operating standards. (a... Operating Procedure specifying procedures to ensure safety, security, and environmental protection. If these...

  4. Situation awareness and trust in computer-based procedures in nuclear power plant operations

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

    Throneburg, E. B.; Jones, J. M.

    2006-07-01

    Situation awareness and trust are two issues that need to be addressed in the design of computer-based procedures for nuclear power plants. Situation awareness, in relation to computer-based procedures, concerns the operators' knowledge of the plant's state while following the procedures. Trust concerns the amount of faith that the operators put into the automated procedures, which can affect situation awareness. This paper first discusses the advantages and disadvantages of computer-based procedures. It then discusses the known aspects of situation awareness and trust as applied to computer-based procedures in nuclear power plants. An outline of a proposed experiment is then presentedmore » that includes methods of measuring situation awareness and trust so that these aspects can be analyzed for further study. (authors)« less

  5. Ultrashort-Pulse Laser System: Theory of Operation and Operating Procedures

    DTIC Science & Technology

    1992-07-01

    Nov 89 - Jul 92 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Ultrashort-Pulse Laser System : Theory of Operation and C - F33615-88-C-0631 Operating...i ’IR~A&, D2;" T.&B [E] al uicod [] j 0 Avhi lp.bilty C: oded’ Avail i Qiv ULTRASHORT-PULSE LASER SYSTEM : THEORY OF OPERATION AND OPERATING PROCEDURES

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

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremitymore » dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.« less

  7. New image-processing and noise-reduction software reduces radiation dose during complex endovascular procedures.

    PubMed

    Kirkwood, Melissa L; Guild, Jeffrey B; Arbique, Gary M; Tsai, Shirling; Modrall, J Gregory; Anderson, Jon A; Rectenwald, John; Timaran, Carlos

    2016-11-01

    A new proprietary image-processing system known as AlluraClarity, developed by Philips Healthcare (Best, The Netherlands) for radiation-based interventional procedures, claims to lower radiation dose while preserving image quality using noise-reduction algorithms. This study determined whether the surgeon and patient radiation dose during complex endovascular procedures (CEPs) is decreased after the implementation of this new operating system. Radiation dose to operators, procedure type, reference air kerma, kerma area product, and patient body mass index were recorded during CEPs on two Philips Allura FD 20 fluoroscopy systems with and without Clarity. Operator dose during CEPs was measured using optically stimulable, luminescent nanoDot (Landauer Inc, Glenwood, Ill) detectors placed outside the lead apron at the left upper chest position. nanoDots were read using a microStar ii (Landauer Inc) medical dosimetry system. For the CEPs in the Clarity group, the radiation dose to surgeons was also measured by the DoseAware (Philips Healthcare) personal dosimetry system. Side-by-side measurements of DoseAware and nanoDots allowed for cross-calibration between systems. Operator effective dose was determined using a modified Niklason algorithm. To control for patient size and case complexity, the average fluoroscopy dose rate and the dose per radiographic frame were adjusted for body mass index differences and then compared between the groups with and without Clarity by procedure. Additional factors, for example, physician practice patterns, that may have affected operator dose were inferred by comparing the ratio of the operator dose to procedural kerma area product with and without Clarity. A one-sided Wilcoxon rank sum test was used to compare groups for radiation doses, reference air kermas, and operating practices for each procedure type. The analysis included 234 CEPs; 95 performed without Clarity and 139 with Clarity. Practice patterns of operators during procedures with and without Clarity were not significantly different. For all cases, procedure radiation dose to the patient and the primary and assistant operators were significantly decreased in the Clarity group by 60% compared with the non-Clarity group. By procedure type, fluorography dose rates decreased from 44% for fenestrated endovascular repair and up to 70% with lower extremity interventions. Fluoroscopy dose rates also significantly decreased, from about 37% to 47%, depending on procedure type. The AlluraClarity system reduces the patient and primary operator's radiation dose by more than half during CEPs. This feature appears to be an effective tool in lowering the radiation dose while maintaining image quality. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  8. Lageos assembly operation plan

    NASA Technical Reports Server (NTRS)

    Brueger, J.

    1975-01-01

    Guidelines and constraints procedures for LAGEOS assembly, operation, and design performance are given. Special attention was given to thermal, optical, and dynamic analysis and testing. The operation procedures illustrate the interrelation and sequence of tasks in a flow diagram. The diagram also includes quality assurance functions for verification of operation tasks.

  9. Use of National Burden to Define Operative Emergency General Surgery.

    PubMed

    Scott, John W; Olufajo, Olubode A; Brat, Gabriel A; Rose, John A; Zogg, Cheryl K; Haider, Adil H; Salim, Ali; Havens, Joaquim M

    2016-06-15

    Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. To define a set of procedures accounting for at least 80% of the national burden of operative EGS. A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample. Adults (age, ≥18 years) with primary EGS diagnoses consistent with the American Association for the Surgery of Trauma definition, admitted urgently or emergently, who underwent an operative procedure within 2 days of admission were included in the analyses. Procedures were ranked to account for national mortality and complication burden. Among ranked procedures, contributions to total EGS frequency, mortality, and hospital costs were assessed. The data query and analysis were performed between November 15, 2015, and February 16, 2016. Overall procedure frequency, in-hospital mortality, major complications, and inpatient costs calculated per 3-digit International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. The study identified 421 476 patient encounters associated with operative EGS, weighted to represent 2.1 million nationally over the 4-year study period. The overall mortality rate was 1.23% (95% CI, 1.18%-1.28%), the complication rate was 15.0% (95% CI, 14.6%-15.3%), and mean cost per admission was $13 241 (95% CI, $12 957-$13 525). After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, a final set of 7 operative EGS procedures were identified, which collectively accounted for 80.0% of procedures, 80.3% of deaths, 78.9% of complications, and 80.2% of inpatient costs nationwide. These 7 procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Only 7 procedures account for most admissions, deaths, complications, and inpatient costs attributable to the 512 079 EGS procedures performed in the United States each year. National quality benchmarks and cost reduction efforts should focus on these common, complicated, and costly EGS procedures.

  10. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION, AND ROUTINE USE OF THE SPECTRACE 9000 FIELD PORTABLE X-RAY FLUORESCENCE ANALYZER (UA-L-10.1)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures for operating and calibrating the Spectrace 9000 field portable X-ray fluorescence analyzer. This procedure applies to the determination of metal concentrations in samples during the Arizona NHEXAS project and the Border stud...

  11. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND MAINTENANCE OF THE ECOCHEM REAL-TIME AMBIENT AIR PAH MONITOR (UA-F-24.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the general procedures to be followed for the operation and maintenance of the EcoChem real-time ambient air PAH monitor. This procedure was followed to ensure consistent data retrieval of PAH measurements during the Arizona NHEXAS project ...

  12. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION, AND MAINTENANCE OF THE PERKIN-ELMER 5100 PC ATOMIC ABSORPTION SPECTROMETER (BCO-L-5.1)

    EPA Science Inventory

    The purpose of this SOP is to outline the start-up, calibration, operation, and maintenance procedures for the Perkin-Elmer 5100 PC Atomic Absorption Spectrophotometer (PE 5100). These procedures are used for the determination of the target trace metal, as in soil, house dust, f...

  13. Operational procedures for ground station operation: ATS-3 Hawaii-Ames satellite link experiment

    NASA Technical Reports Server (NTRS)

    Nishioka, K.; Gross, E. H.

    1979-01-01

    Hardware description and operational procedures for the ATS-3 Hawaii-Ames satellite computer link are presented in basic step-by-step instructions. Transmit and receive channels and frequencies are given. Details such as switch settings for activating the station to the sequence of turning switches on are provided. Methods and procedures for troubleshooting common problems encountered with communication stations are also provided.

  14. 40 CFR 60.4244 - What test methods and other procedures must I use if I am an owner or operator of a stationary SI...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 7 2013-07-01 2013-07-01 false What test methods and other procedures... Internal Combustion Engines Testing Requirements for Owners and Operators § 60.4244 What test methods and...? Owners and operators of stationary SI ICE who conduct performance tests must follow the procedures in...

  15. 40 CFR 60.4244 - What test methods and other procedures must I use if I am an owner or operator of a stationary SI...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What test methods and other procedures... Internal Combustion Engines Testing Requirements for Owners and Operators § 60.4244 What test methods and...? Owners and operators of stationary SI ICE who conduct performance tests must follow the procedures in...

  16. 40 CFR 60.4244 - What test methods and other procedures must I use if I am an owner or operator of a stationary SI...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 7 2014-07-01 2014-07-01 false What test methods and other procedures... Internal Combustion Engines Testing Requirements for Owners and Operators § 60.4244 What test methods and...? Owners and operators of stationary SI ICE who conduct performance tests must follow the procedures in...

  17. 40 CFR 60.4244 - What test methods and other procedures must I use if I am an owner or operator of a stationary SI...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 6 2011-07-01 2011-07-01 false What test methods and other procedures... Internal Combustion Engines Testing Requirements for Owners and Operators § 60.4244 What test methods and...? Owners and operators of stationary SI ICE who conduct performance tests must follow the procedures in...

  18. 40 CFR 60.4244 - What test methods and other procedures must I use if I am an owner or operator of a stationary SI...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 7 2012-07-01 2012-07-01 false What test methods and other procedures... Internal Combustion Engines Testing Requirements for Owners and Operators § 60.4244 What test methods and...? Owners and operators of stationary SI ICE who conduct performance tests must follow the procedures in...

  19. SATS HVO Concept Validation Experiment

    NASA Technical Reports Server (NTRS)

    Consiglio, Maria; Williams, Daniel; Murdoch, Jennifer; Adams, Catherine

    2005-01-01

    A human-in-the-loop simulation experiment was conducted at the NASA Langley Research Center s (LaRC) Air Traffic Operations Lab (ATOL) in an effort to comprehensively validate tools and procedures intended to enable the Small Aircraft Transportation System, Higher Volume Operations (SATS HVO) concept of operations. The SATS HVO procedures were developed to increase the rate of operations at non-towered, non-radar airports in near all-weather conditions. A key element of the design is the establishment of a volume of airspace around designated airports where pilots accept responsibility for self-separation. Flights operating at these airports, are given approach sequencing information computed by a ground based automated system. The SATS HVO validation experiment was conducted in the ATOL during the spring of 2004 in order to determine if a pilot can safely and proficiently fly an airplane while performing SATS HVO procedures. Comparative measures of flight path error, perceived workload and situation awareness were obtained for two types of scenarios. Baseline scenarios were representative of today s system utilizing procedure separation, where air traffic control grants one approach or departure clearance at a time. SATS HVO scenarios represented approaches and departure procedures as described in the SATS HVO concept of operations. Results from the experiment indicate that low time pilots were able to fly SATS HVO procedures and maintain self-separation as safely and proficiently as flying today's procedures.

  20. 47 CFR 36.391 - General.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Corporate Operations Expense § 36.391 General. Corporate Operations Expenses are included in the following account: General and...

  1. 47 CFR 1.83 - Applications for radio operator licenses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Applications for radio operator licenses. 1.83... Rules of Practice and Procedure Miscellaneous Proceedings § 1.83 Applications for radio operator licenses. (a) Application filing procedures for amateur radio operator licenses are set forth in part 97 of...

  2. 18 CFR 376.209 - Procedures during periods of emergency requiring activation of the Continuity of Operations Plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... periods of emergency requiring activation of the Continuity of Operations Plan. 376.209 Section 376.209... GENERAL RULES ORGANIZATION, MISSION, AND FUNCTIONS; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.209 Procedures during periods of emergency requiring activation...

  3. 14 CFR 93.71 - General operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

  4. 14 CFR 93.71 - General operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

  5. 14 CFR 93.71 - General operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

  6. Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

    PubMed

    Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

    2016-06-01

    We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the inclusion of nursing-related standard operating procedures in certification/accreditation standards. © 2016 International Council of Nurses.

  7. Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital.

    PubMed

    Ahmad, Arif; Carleton, Jared D; Ahmad, Zoha F; Agarwala, Ashish

    2016-09-01

    The purpose of this study was to compare the operative and early perioperative outcomes of laparoscopic versus robotic-assisted Roux-en-Y gastric bypass procedures performed in a community hospital setting. The study was a chart review and analysis of the early perioperative outcomes of a total of 345 Roux-en-Y gastric bypass procedures performed by a single surgeon in a community hospital setting from January 2011 to October 2014. Of these, 173 procedures were performed laparoscopically and 172 were performed with robotic assistance utilizing the daVinci(®) surgical platform. Factors such as baseline patient characteristics, operative time, estimated blood loss (EBL), conversions to open procedure, complication rates, adverse events, length of stay (LOS), and return to the operating room for the two groups were retrospectively analyzed from a prospectively maintained database. Student's t test with unequal variances was used for statistical analysis, and a p value <0.05 was used for significance. There were no statistically significant differences in complication rates, EBL, or LOS between the two groups. There was a significant difference between the total operative times (135.30 ± 37.60 min for the laparoscopic procedure versus 154.84 ± 38.44 min for the robotic procedure, p < 0.05). There were no adverse intraoperative events, conversions to open procedures, leaks, strictures, returns to the operating room within 30 days, or mortalities in either group. Our study, which is the first of its kind to analyze the operative and early perioperative outcomes between laparoscopic and robotic-assisted Roux-en-Y gastric bypass procedures in the US community hospital setting, indicates that both are comparable in terms of safety, efficacy, and operative and early perioperative outcomes.

  8. Review and meta-analysis of prospective randomized controlled trials (RCTs) comparing laparo-endoscopic single site and multiport laparoscopy in gynecologic operative procedures.

    PubMed

    Pontis, Alessandro; Sedda, Federica; Mereu, Liliana; Podda, Mauro; Melis, Gian Benedetto; Pisanu, Adolfo; Angioni, Stefano

    2016-09-01

    To critically appraise published randomized controlled trials (RCTs) comparing laparo-endoscopic single site (LESS) and multi-port laparoscopic (MPL) in gynecologic operative surgery; the aim was to assess feasibility, safety, and potential benefits of LESS in comparison to MPL. A systematic review and meta-analysis of eleven RCTs. Women undergoing operative LESS and MPL gynecologic procedure (hysterectomy, cystectomy, salpingectomy, salpingo-oophorectomy, myomectomy). Outcomes evaluated were as follows: postoperative overall morbidity, postoperative pain evaluation at 6, 12, 24 and 48 h, cosmetic patient satisfaction, conversion rate, body mass index (BMI), operative time, blood loss, hemoglobin drop, postoperative hospital stay. Eleven RCTs comprising 956 women with gynecologic surgical disease randomized to either LESS (477) or MPL procedures (479) were analyzed systematically. The LESS approach is a surgical procedure with longer operative and better cosmetic results time than MPL but without statistical significance. Operative outcomes, postoperative recovery, postoperative morbidity and patient satisfaction are similar in LESS and MPL. LESS may be considered an alternative to MPL with comparable feasibility and safety in gynecologic operative procedures. However, it does not offer the expected advantages in terms of postoperative pain and cosmetic satisfaction.

  9. Evaluation of noise pollution level in the operating rooms of hospitals: A study in Iran.

    PubMed

    Giv, Masoumeh Dorri; Sani, Karim Ghazikhanlou; Alizadeh, Majid; Valinejadi, Ali; Majdabadi, Hesamedin Askari

    2017-06-01

    Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter. The gathered data were compared with national and international standards. Statistical analysis was performed using descriptive statistics and one-way ANOVA, t -test, and Pearson's correlation test. Noise pollution level at majority of surgical procedures is higher than national and international documented standards. The highest level of noise pollution is related to orthopedic procedures, and the lowest one related to laparoscopic and heart surgery procedures. The highest and lowest registered sound level during the operation was 93 and 55 dB, respectively. Sound level generated by equipments (69 ± 4.1 dB), trolley movement (66 ± 2.3 dB), and personnel conversations (64 ± 3.9 dB) are the main sources of noise. The noise pollution of operating rooms are higher than available standards. The procedure needs to be corrected for achieving the proper conditions.

  10. 42 CFR 422.202 - Participation procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... procedures. (a) Notice and appeal rights. An MA organization that operates a coordinated care plan or network... of groups of physicians, through reasonable procedures that include the following: (1) Written notice... guidelines. (c) Subcontracted groups. An MA organization that operates an MA plan through subcontracted...

  11. Procedural Portfolio Planning in Plastic Surgery, Part 2: Collaboration Between Surgeons and Hospital Administrators to Develop a Funds Flow Model for Procedures Performed at an Academic Medical Center.

    PubMed

    Hultman, Charles Scott

    2016-06-01

    Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption. Outcome measures included: facility charges, hospital collections, contribution margin, operating margin, and operating room times. We also studied the top 50 Current Procedural Terminology codes (total case number × charge/case), ranking procedures for profitability, as determined by operating margin. During the 2-year study period, we had no turnover in faculty; did not pursue any formal marketing; did not change our surgical fees, billing system, or payer mix; and maintained our commitment to indigent care. After rebalancing our case mix, through procedural portfolio planning, average hospital operating income/procedure increased from $-79 to $+816. Volume and diversity of cases increased, with no change in payer mix. Although charges/case decreased, both contribution margin and operating margin increased, due to improved throughput and decreased operating room times. The 5 most profitable procedures for the hospital were hernia repair, mandibular osteotomy, hand skin graft, free fibula flap, and head and neck flap, whereas the 5 least profitable were latissimus breast reconstruction, craniosynostosis repair, free-flap breast reconstruction, trunk skin graft, and cutaneous free flap. Total operating income for the hospital, from plastic surgery procedures, increased from $-115,103 to $+1,277,040, of which $350,000 (25%) was returned to the practice plan as enterprise funds to support program development. Through focused strategic initiatives, plastic surgeons and hospital administrators can work together to unlock the latent value of a plastic surgery service to an AMC. Specific financial benefits to the hospital include increased contribution margin and operating income, the latter of which can be reinvested in the plastic surgery service through a gain-sharing model.

  12. Improving Small Signal Stability through Operating Point Adjustment

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

    Huang, Zhenyu; Zhou, Ning; Tuffner, Francis K.

    2010-09-30

    ModeMeter techniques for real-time small signal stability monitoring continue to mature, and more and more phasor measurements are available in power systems. It has come to the stage to bring modal information into real-time power system operation. This paper proposes to establish a procedure for Modal Analysis for Grid Operations (MANGO). Complementary to PSS’s and other traditional modulation-based control, MANGO aims to provide suggestions such as increasing generation or decreasing load for operators to mitigate low-frequency oscillations. Different from modulation-based control, the MANGO procedure proactively maintains adequate damping for all time, instead of reacting to disturbances when they occur. Effectmore » of operating points on small signal stability is presented in this paper. Implementation with existing operating procedures is discussed. Several approaches for modal sensitivity estimation are investigated to associate modal damping and operating parameters. The effectiveness of the MANGO procedure is confirmed through simulation studies of several test systems.« less

  13. 47 CFR 36.373 - Services-Account 6620.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Customer Operations... among the operations for groups of exchanges. A group of exchanges may include all exchanges in the...

  14. Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

    PubMed

    van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

    2013-08-01

    INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

  15. 47 CFR 36.376 - All other.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS, REVENUES, EXPENSES, TAXES AND RESERVES FOR TELECOMMUNICATIONS COMPANIES 1 Operating Expenses and Taxes Customer Operations...

  16. Function Allocation in Complex Socio-Technical Systems: Procedure usage in nuclear power and the Context Analysis Method for Identifying Design Solutions (CAMIDS) Model

    NASA Astrophysics Data System (ADS)

    Schmitt, Kara Anne

    This research aims to prove that strict adherence to procedures and rigid compliance to process in the US Nuclear Industry may not prevent incidents or increase safety. According to the Institute of Nuclear Power Operations, the nuclear power industry has seen a recent rise in events, and this research claims that a contributing factor to this rise is organizational, cultural, and based on peoples overreliance on procedures and policy. Understanding the proper balance of function allocation, automation and human decision-making is imperative to creating a nuclear power plant that is safe, efficient, and reliable. This research claims that new generations of operators are less engaged and thinking because they have been instructed to follow procedures to a fault. According to operators, they were once to know the plant and its interrelations, but organizationally more importance is now put on following procedure and policy. Literature reviews were performed, experts were questioned, and a model for context analysis was developed. The Context Analysis Method for Identifying Design Solutions (CAMIDS) Model was created, verified and validated through both peer review and application in real world scenarios in active nuclear power plant simulators. These experiments supported the claim that strict adherence and rigid compliance to procedures may not increase safety by studying the industry's propensity for following incorrect procedures, and when it directly affects the outcome of safety or security of the plant. The findings of this research indicate that the younger generations of operators rely highly on procedures, and the organizational pressures of required compliance to procedures may lead to incidents within the plant because operators feel pressured into following the rules and policy above performing the correct actions in a timely manner. The findings support computer based procedures, efficient alarm systems, and skill of the craft matrices. The solution to the problems facing the industry include in-depth, multiple fault failure training which tests the operator's knowledge of the situation. This builds operator collaboration, competence and confidence to know what to do, and when to do it in response to an emergency situation. Strict adherence to procedures and rigid compliance to process may not prevent incidents or increase safety; building operators' fundamental skills of collaboration, competence and confidence will.

  17. Surgeon specialization and operative mortality in United States: retrospective analysis.

    PubMed

    Sahni, Nikhil R; Dalton, Maurice; Cutler, David M; Birkmeyer, John D; Chandra, Amitabh

    2016-07-21

     To measure the association between a surgeon's degree of specialization in a specific procedure and patient mortality.  Retrospective analysis of Medicare data.  US patients aged 66 or older enrolled in traditional fee for service Medicare.  25 152 US surgeons who performed one of eight procedures (carotid endarterectomy, coronary artery bypass grafting, valve replacement, abdominal aortic aneurysm repair, lung resection, cystectomy, pancreatic resection, or esophagectomy) on 695 987 patients in 2008-13.  Relative risk reduction in risk adjusted and volume adjusted 30 day operative mortality between surgeons in the bottom quarter and top quarter of surgeon specialization (defined as the number of times the surgeon performed the specific procedure divided by his/her total operative volume across all procedures).  For all four cardiovascular procedures and two out of four cancer resections, a surgeon's degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure.  For several common procedures, surgeon specialization was an important predictor of operative mortality independent of volume in that specific procedure. When selecting a surgeon, patients, referring physicians, and administrators assigning operative workload may want to consider a surgeon's procedure specific volume as well as the degree to which a surgeon specializes in that procedure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Predicting in-hospital mortality after redo cardiac operations: development of a preoperative scorecard.

    PubMed

    Launcelott, Sebastian; Ouzounian, Maral; Buth, Karen J; Légaré, Jean-Francois

    2012-09-01

    The present study generated a risk model and an easy-to-use scorecard for the preoperative prediction of in-hospital mortality for patients undergoing redo cardiac operations. All patients who underwent redo cardiac operations in which the initial and subsequent procedures were performed through a median sternotomy were included. A logistic regression model was created to identify independent preoperative predictors of in-hospital mortality. The results were then used to create a scorecard predicting operative risk. A total of 1,521 patients underwent redo procedures between 1995 and 2010 at a single institution. Coronary bypass procedures were the most common previous (58%) or planned operations (54%). The unadjusted in-hospital mortality for all redo cases was higher than for first-time procedures (9.7% vs. 3.4%; p<0.001). Independent predictors of in-hospital mortality were a composite urgency variable (odds ratio [OR], 3.47), older age (70-79 years, OR, 2.74; ≥80 years, OR, 3.32), more than 2 previous sternotomies (OR, 2.69), current procedure other than isolated coronary or valve operation (OR, 2.64), preoperative renal failure (OR, 1.89), and peripheral vascular disease (PVD) (OR, 1.55); all p<0.05. A scorecard was generated using these independent predictors, stratifying patients undergoing redo cardiac operations into 6 risk categories of in-hospital mortality ranging from <5% risk to >40%. Reoperation represents a significant proportion of modern cardiac surgical procedures and is often associated with significantly higher mortality than first-time operations. We created an easy-to-use scorecard to assist clinicians in estimating operative mortality to ensure optimal decision making in the care of patients facing redo cardiac operations. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Identifying gaps in the surgical training curriculum in Rwanda through evaluation of operative activity at a teaching hospital.

    PubMed

    Rickard, Jennifer L; Ntakiyiruta, Georges; Chu, Kathryn M

    2015-01-01

    To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION, AND MAINTENANCE OF THE THERMO JARRELL ASH ICAP 61-975 PLASMA ATOMCOMP EMISSION SPECTROMETER (BCO-L-8.0)

    EPA Science Inventory

    The purpose of this SOP is to detail the procedures for the start-up, operation, calibration, shut-down, and maintenance of the Thermo Jarrell Ash ICAP 61-975 Plasma AtomComp Emission Spectrometer. These procedures were used in determining the trace target metals Al, As, Ba, Cd,...

  1. 40 CFR 63.7824 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this.... (3) Establish revised operating limits according to the applicable procedures in paragraphs (a) and... 40 Protection of Environment 14 2014-07-01 2014-07-01 false What test methods and other procedures...

  2. 40 CFR 63.7824 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this.... (3) Establish revised operating limits according to the applicable procedures in paragraphs (a) and... 40 Protection of Environment 14 2012-07-01 2011-07-01 true What test methods and other procedures...

  3. 40 CFR 136.7 - Quality assurance and quality control.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

  4. 40 CFR 136.7 - Quality assurance and quality control.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

  5. 40 CFR 136.7 - Quality assurance and quality control.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

  6. Re-operative thyroid surgery: a 20-year prospective cohort study at a tertiary referral centre.

    PubMed

    Hardman, John C; Smith, J A; Nankivell, P; Sharma, N; Watkinson, J C

    2015-06-01

    Re-operative thyroid surgery is a relatively uncommon procedure complicated by distorted anatomy and post-operative tissue changes. Surgery may follow initial benign or malignant pathology. Published outcomes vary widely in the literature. This study aims to report our outcomes from re-operative thyroid surgery. Patient demographics and complication rates for consecutive thyroidectomies performed by a single surgeon at a tertiary centre were collected between 1993 and 2013. Outcomes in re-operative surgery are analysed and compared with local and national data. Cases of re-operative surgery following benign disease are further analysed for histology, re-presenting symptoms and time between procedures. Our cohort comprised 1,657 cases including 164 re-operative procedures (101 malignant, 63 benign). Within our cohort re-operative cases were on average 4 years older (mean 49.9 vs 45.9 years, p = 0.001) and had a higher incidence of haematoma formation (4.3 vs 1.7 %, p = 0.033) and transient recurrent laryngeal nerve palsy (5.5 vs 2.5 %, p = 0.044) compared to primary surgery. Rates of permanent hypocalcaemia (2.4 vs 1.8 %, p = 0.540) and permanent RLN palsy (1.8 vs 0.4 %, p = 0.051) were higher in the re-operative group but did not reach significance. Comparison of complications following re-operation for benign and malignant disease revealed no significant differences. Mean interval to re-operation for benign cases was 17.4 years with 74.6 % found to have multinodular goitre at repeat procedure. Re-operative procedures comprised around 10 % of thyroid surgery at our centre. Re-operative cases experienced more complications than primary surgery but permanent rates were low. Re-operative surgery may therefore be safely considered in experienced hands.

  7. 30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... during drilling operations? 250.408 Section 250.408 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or equipment...

  8. 30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

  9. 30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

  10. 30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

  11. Writing standard operating procedures (SOPs) for cryostorage protocols: using shoot meristem cryopreservation as an example.

    PubMed

    Harding, Keith; Benson, Erica E

    2015-01-01

    Standard operating procedures are a systematic way of making sure that biopreservation processes, tasks, protocols, and operations are correctly and consistently performed. They are the basic documents of biorepository quality management systems and are used in quality assurance, control, and improvement. Methodologies for constructing workflows and writing standard operating procedures and work instructions are described using a plant cryopreservation protocol as an example. This chapter is pertinent to other biopreservation sectors because how methods are written, interpreted, and implemented can affect the quality of storage outcomes.

  12. Network Operations Support Plan for the Spot 2 mission (revision 1)

    NASA Technical Reports Server (NTRS)

    Werbitzky, Victor

    1989-01-01

    The purpose of this Network Operations Support Plan (NOSP) is to indicate operational procedures and ground equipment configurations for the SPOT 2 mission. The provisions in this document take precedence over procedures or configurations in other documents.

  13. Electronic Procedures for Medical Operations

    NASA Technical Reports Server (NTRS)

    2015-01-01

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

  14. 37 CFR 203.4 - Methods of operation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Methods of operation. 203.4 Section 203.4 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT OFFICE AND PROCEDURES FREEDOM OF INFORMATION ACT: POLICIES AND PROCEDURES Procedures § 203.4 Methods of...

  15. 40 CFR 63.543 - What are my standards for process vents?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... available. You must develop and follow standard operating procedures designed to minimize emissions of total... the manufacturer's recommended procedures, if available, and the standard operating procedures... 40 Protection of Environment 10 2013-07-01 2013-07-01 false What are my standards for process...

  16. 40 CFR 63.543 - What are my standards for process vents?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... available. You must develop and follow standard operating procedures designed to minimize emissions of total... the manufacturer's recommended procedures, if available, and the standard operating procedures... 40 Protection of Environment 10 2012-07-01 2012-07-01 false What are my standards for process...

  17. 76 FR 9024 - Agency Information Collection Activities; Proposed Collection; Comment Request; Electronic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-16

    ....300) require the following standard operating procedures to assure appropriate use of, and precautions for, systems using electronic records and signatures: (1) Sec. 11.10 specifies procedures and controls... burden associated with the creation of standard operating procedures, validation, and certification. The...

  18. Operational and Medical Procedures for a Declared Contingency Shuttle (CSCS) Shuttle Mission Due to a Failure that Precludes a Safe Return

    NASA Technical Reports Server (NTRS)

    Adams, Adrien; Patlach, Bob; Duchense, Ted; Chandler, Mike; Stepaniak, Philip C.

    2011-01-01

    This poster paper outlines the operational and medical procedures for a shuttle mission that has a failure that precludes a safe return to Earth. Information about the assumptions, procedures and limiting consumables is included.

  19. Operative Landscape at Canadian Neurosurgery Residency Programs.

    PubMed

    Tso, Michael K; Dakson, Ayoub; Ahmed, Syed Uzair; Bigder, Mark; Elliott, Cameron; Guha, Daipayan; Iorio-Morin, Christian; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Wang, Bill; Winkler-Schwartz, Alexander; Sankar, Tejas; Christie, Sean D

    2017-07-01

    Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

  20. Survival and re-operation rates after neurosurgical procedures in Scotland: implications for targeted surveillance of sub-clinical variant Creutzfeldt-Jakob disease.

    PubMed

    Bird, Sheila M; Merrall, Elizabeth L C; Ward, Hester J T; Will, Robert G

    2009-01-01

    To assess the feasibility of post-mortem surveillance for subclinical variant Creutzfeldt-Jakob disease (vCJD) at least 5 years after neurosurgical procedures. Using Scottish record linkage, we estimated 5-year survival and re-operation rates after 4 neurosurgical procedures performed during 1993-2001 and identified as high or medium risk for transmitting vCJD: [B] drainage of extra- or subdural haematoma, [E] primary or revisional decompression operations and [H] creation of other ventricular shunts were classified as high risk; [C] operations on cerebral aneurysm (clipping) were classified as medium risk. Fatality rate at 1 year depended strongly on procedure, weakly or not at all on sex and era, and increased with age. Procedure rates differed by sex. The rate of subsequent neurosurgical operations was highest for procedure [H] (sole: 21%; multiple: 28%). Each year, the UK has a new cohort of some 5,000 5-year survivors after a high- or medium-risk neurosurgical procedure, whose subsequent annual mortality is at least 3%. Even if half the surviving 5-year survivors of neurosurgery since 1996 gave consent-in-life for vCJD-informative testing at post-mortem, there would be too few relevant post-mortems in 2008-2010 (around 1,600) for 'nil detections' to exclude a 1 in 1,000 subclinical vCJD rate. Autopsy surveillance beyond 2010, or among 5-year survivors of non-neurosurgical at-risk operations, would be needed. (c) 2009 S. Karger AG, Basel.

  1. Surface Area Analysis Using the Brunauer-Emmett-Teller (BET) Method: Standard Operating Procedure Series: SOP-C

    DTIC Science & Technology

    2016-09-01

    Method Scientific Operating Procedure Series : SOP-C En vi ro nm en ta l L ab or at or y Jonathon Brame and Chris Griggs September 2016...BET) Method Scientific Operating Procedure Series : SOP-C Jonathon Brame and Chris Griggs Environmental Laboratory U.S. Army Engineer Research and...response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing

  2. 30 CFR 795.5 - Grant application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....5 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR SMALL OPERATOR ASSISTANCE PERMANENT REGULATORY PROGRAM-SMALL OPERATOR ASSISTANCE PROGRAM § 795.5 Grant application procedures. A State intending to administer a Small Operator Assistance Program under a grant from...

  3. 29 CFR 1915.505 - Fire response.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... written standard operating procedures for each type of fire response at the employer's facility; (v) The... suppression operations established by written standard operating procedures for each particular type of fire...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Fire Protection in Shipyard Employment § 1915...

  4. 29 CFR 1915.505 - Fire response.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... written standard operating procedures for each type of fire response at the employer's facility; (v) The... suppression operations established by written standard operating procedures for each particular type of fire...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Fire Protection in Shipyard Employment § 1915...

  5. 29 CFR 1915.505 - Fire response.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... written standard operating procedures for each type of fire response at the employer's facility; (v) The... suppression operations established by written standard operating procedures for each particular type of fire...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Fire Protection in Shipyard Employment § 1915...

  6. 29 CFR 1915.505 - Fire response.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... written standard operating procedures for each type of fire response at the employer's facility; (v) The... suppression operations established by written standard operating procedures for each particular type of fire...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Fire Protection in Shipyard Employment § 1915...

  7. 29 CFR 1915.505 - Fire response.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... written standard operating procedures for each type of fire response at the employer's facility; (v) The... suppression operations established by written standard operating procedures for each particular type of fire...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Fire Protection in Shipyard Employment § 1915...

  8. Acquisition of Formal Operations: The Effects of Two Training Procedures.

    ERIC Educational Resources Information Center

    Rosenthal, Doreen A.

    1979-01-01

    A study of 11- and 12-year-old girls indicates that either of two training procedures, method training or dimension training, can aid in the transition from concrete operational to formal operational thought by promoting a hypothesis-testing attitude. (BH)

  9. Efficacy of RADPAD® protection drape in reducing radiation exposure to the primary operator during Transcatheter Aortic Valve Implantation (TAVI).

    PubMed

    Sharma, Divyesh; Ramsewak, Adesh; Manoharan, Ganesh; Spence, Mark S

    2016-02-01

    The efficacy of RADPAD® (a sterile, lead-free drape) has been demonstrated to reduce the scatter radiation to the primary operator during fluoroscopic procedures. However, the use of the RADPAD® during TAVI procedures has not been studied. Transcatheter aortic valve implantation (TAVI) is now an established treatment for patients with symptomatic severe aortic stenosis who are deemed inoperable or at high risk for conventional surgical aortic valve replacement (AVR). Consequently the radiation exposure to the patient and the interventional team from this procedure has become a matter of interest and importance. Methods to reduce radiation exposure to the interventional team during this procedure should be actively investigated. In this single center prospective study, we determined the radiation dose during this procedure and the efficacy of RADPAD® in reducing the radiation dose to the primary operator. Fifty consecutive patients due to undergo elective TAVI procedures were identified. Patients were randomly assigned to undergo the procedure with or without the use of a RADPAD® drape. There were 25 patients in each group and dosimetry was performed at the left eye level of the primary operator. The dosimeter was commenced at the start of the procedure, and the dose was recorded immediately after the end of the procedure. Fluoroscopy times and DAP were also recorded prospectively. Twenty-five patients underwent transfemoral TAVI using a RADPAD® and 25 with no-RADPAD®. The mean primary operator radiation dose was significantly lower in the RADPAD group at 14.8 mSv vs. 24.3 mSv in the no-RADPAD group (P=0.008). There was no significant difference in fluoroscopy times or dose-area products between the two patient groups. The dose to the primary operator relative to fluoroscopy time (RADPAD: slope=0.325; no RADPAD: slope=1.148; analysis of covariance F=7.47, P=0.009) and dose area product (RADPAD: slope=0.0007; no RADPAD: slope=0.002; analysis of covariance F=7.38; P=0.009) was smaller in the RADPAD group compared to no-RADPAD group. Use of a RADPAD® significantly reduces radiation exposure to the primary operator during TAVI procedures.

  10. Increasingly automated procedure acquisition in dynamic systems

    NASA Technical Reports Server (NTRS)

    Mathe, Nathalie; Kedar, Smadar

    1992-01-01

    Procedures are widely used by operators for controlling complex dynamic systems. Currently, most development of such procedures is done manually, consuming a large amount of paper, time, and manpower in the process. While automated knowledge acquisition is an active field of research, not much attention has been paid to the problem of computer-assisted acquisition and refinement of complex procedures for dynamic systems. The Procedure Acquisition for Reactive Control Assistant (PARC), which is designed to assist users in more systematically and automatically encoding and refining complex procedures. PARC is able to elicit knowledge interactively from the user during operation of the dynamic system. We categorize procedure refinement into two stages: diagnosis - diagnose the failure and choose a repair - and repair - plan and perform the repair. The basic approach taken in PARC is to assist the user in all steps of this process by providing increased levels of assistance with layered tools. We illustrate the operation of PARC in refining procedures for the control of a robot arm.

  11. RECOMMENDED OPERATING PROCEDURE NO. 56: COLLECTION OF GASEOUS GRAB SAMPLES FROM COMBUSTION SOURCES FOR NITROUS OXIDE MEASUREMENT

    EPA Science Inventory

    The document is a recommended operating procedure, prepare or use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). The procedure applies to the collection of gaseous grab samples from fossil fuel combustion sources for subsequent a...

  12. Test Operations Procedure (TOP) 10-2-400 Open End Compressed Gas Driven Shock Tube

    DTIC Science & Technology

    gas-driven shock tube. Procedures are provided for instrumentation, test item positioning, estimation of key test parameters, operation of the shock...tube, data collection, and reporting. The procedures in this document are based on the use of helium gas and Mylar film diaphragms.

  13. RECOMMENDED OPERATING PROCEDURE NO. 45: ANALYSIS OF NITROUS OXIDE FROM COMBUSTION SOURCES

    EPA Science Inventory

    The recommended operating procedure (ROP) has been prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he procedure applies to the measurement of nitrous oxide (N2O) in dry gas samples extracted from gas streams where...

  14. 40 CFR 63.543 - What are my standards for process vents?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... develop and follow standard operating procedures designed to minimize emissions of total hydrocarbon for... manufacturer's recommended procedures, if available, and the standard operating procedures designed to minimize... 40 Protection of Environment 10 2014-07-01 2014-07-01 false What are my standards for process...

  15. 76 FR 18645 - Third Party Testing for Certain Children's Products; Notice of Requirements for Accreditation of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ... referenced: The existing CPSC Standard Operating Procedure for Determining Lead (Pb) in Paint and Other... explicitly require the use of a particular standard operating procedure. Additionally, the following....'' It is still based on standard test procedures, such as ASTM International (formerly the American...

  16. Radiation dose of nurses during IR procedures: a controlled trial evaluating operator alerts before nursing tasks.

    PubMed

    Komemushi, Atsushi; Suzuki, Satoshi; Sano, Akira; Kanno, Shohei; Kariya, Shuji; Nakatani, Miyuki; Yoshida, Rie; Kono, Yumiko; Ikeda, Koshi; Utsunomiya, Keita; Harima, Yoko; Komemushi, Sadao; Tanigawa, Noboru

    2014-08-01

    To compare radiation exposure of nurses when performing nursing tasks associated with interventional procedures depending on whether or not the nurses called out to the operator before approaching the patient. In a prospective study, 93 interventional radiology procedures were randomly divided into a call group and a no-call group; there were 50 procedures in the call group and 43 procedures in the no-call group. Two monitoring badges were used to calculate effective dose of nurses. In the call group, the nurse first told the operator she was going to approach the patient each time she was about to do so. In the no-call group, the nurse did not say anything to the operator when she was about to approach the patient. In all the nursing tasks, the equivalent dose at the umbilical level inside the lead apron was below the detectable limit. The equivalent dose at the sternal level outside the lead apron was 0.16 μSv ± 0.41 per procedure in the call group and 0.51 μSv ± 1.17 per procedure in the no-call group. The effective dose was 0.018 μSv ± 0.04 per procedure in the call group and 0.056 μSv ± 0.129 per procedure in the no-call group. The call group had a significantly lower radiation dose (P = .034). Radiation doses of nurses were lower in the group in which the nurse called to the operator before she approached the patient. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  17. Retroperitoneal laparoscopic nephrectomy: the effect of the learning curve, and concentrating expertise, on operating times.

    PubMed

    Skinner, Adrian; Maoate, Kiki; Beasley, Spencer

    2010-05-01

    Laparoscopic nephrectomy is an accepted alternative to open nephrectomy. We analyzed our first 80 procedures of laparoscopic nephrectomy to evaluate the effect of experience and configuration of service on operative times. A retrospective review of 80 consecutive children who underwent retroperitoneal laparoscopic nephrectomy or heminephrectomy during an 11-year period from 1997 at Christchurch Hospital (Christchurch, New Zealand) was conducted. Operative times, in relation to the experience of the surgeon for this procedure, were analyzed. Four surgeons, assisted by an annually rotating trainee registrar, performed the procedure in 26 girls and 54 boys (range, 8 months to 15 years). Operating times ranged from 38 to 225 minutes (mean, 104). The average operative time fell from 105 to 90 minutes. One surgeon performed 40% of the procedures and assisted with a further 55%. The operative times for all surgeons showed a tendency to reduce, but this was not marked. Most procedures were performed by two surgeons working together, although one surgeon was involved in the majority of cases. The lead surgeon is often assisted by a fellow consultant colleague. Operative times were influenced by experience, but not markedly so. The shorter operative times and minimal "learning curve," compared with other reported series, may, in part, be due to the involvement of two surgeons experienced in laparoscopy for the majority of cases.

  18. 40 CFR 63.310 - Requirements for startups, shutdowns, and malfunctions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... plan, the owner or operator may use the standard operating procedures manual for the battery, provided... startup, shutdown, and malfunction plan that describes procedures for operating the battery, including... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  19. 40 CFR 63.310 - Requirements for startups, shutdowns, and malfunctions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... plan, the owner or operator may use the standard operating procedures manual for the battery, provided... startup, shutdown, and malfunction plan that describes procedures for operating the battery, including... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  20. 40 CFR 63.310 - Requirements for startups, shutdowns, and malfunctions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... plan, the owner or operator may use the standard operating procedures manual for the battery, provided... startup, shutdown, and malfunction plan that describes procedures for operating the battery, including... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  1. 40 CFR 63.310 - Requirements for startups, shutdowns, and malfunctions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... plan, the owner or operator may use the standard operating procedures manual for the battery, provided... startup, shutdown, and malfunction plan that describes procedures for operating the battery, including... (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  2. 27 CFR 24.136 - Procedure for alternating proprietors.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Procedure for alternating proprietors. (a) General. Wine premises, or parts thereof, may be operated... limited to parts of the wine premises, the application will describe areas, buildings, floors, or rooms... wine premises will be operated. Once the qualifying documents have been approved, and operations...

  3. Learning neuroendoscopy with an exoscope system (video telescopic operating monitor): Early clinical results.

    PubMed

    Parihar, Vijay; Yadav, Y R; Kher, Yatin; Ratre, Shailendra; Sethi, Ashish; Sharma, Dhananjaya

    2016-01-01

    Steep learning curve is found initially in pure endoscopic procedures. Video telescopic operating monitor (VITOM) is an advance in rigid-lens telescope systems provides an alternative method for learning basics of neuroendoscopy with the help of the familiar principle of microneurosurgery. The aim was to evaluate the clinical utility of VITOM as a learning tool for neuroendoscopy. Video telescopic operating monitor was used 39 cranial and spinal procedures and its utility as a tool for minimally invasive neurosurgery and neuroendoscopy for initial learning curve was studied. Video telescopic operating monitor was used in 25 cranial and 14 spinal procedures. Image quality is comparable to endoscope and microscope. Surgeons comfort improved with VITOM. Frequent repositioning of scope holder and lack of stereopsis is initial limiting factor was compensated for with repeated procedures. Video telescopic operating monitor is found useful to reduce initial learning curve of neuroendoscopy.

  4. Safety in the operating room during orthopedic trauma surgery-incidence of adverse events related to technical equipment and logistics.

    PubMed

    van Delft, E A K; Schepers, T; Bonjer, H J; Kerkhoffs, G M M J; Goslings, J C; Schep, N W L

    2018-04-01

    Safety in the operating room is widely debated. Adverse events during surgery are potentially dangerous for the patient and staff. The incidence of adverse events during orthopedic trauma surgery is unknown. Therefore, we performed a study to quantify the incidence of these adverse events. Primary objective was to determine the incidence of adverse events related to technical equipment and logistics. The secondary objective was to evaluate the consequences of these adverse events. We completed a cross-sectional observational study to assess the incidence, consequences and preventability of adverse events related to technical equipment and logistics during orthopedic trauma surgery. During a 10 week period, all orthopedic trauma operations were evaluated by an observer. Six types of procedures were differentiated: osteosynthesis; arthroscopy; removal of hardware; joint replacement; bone grafting and other. Adverse events were divided in six categories: staff dependent factors; patient dependent factors; anaesthesia; imaging equipment; operation room equipment and instruments and implants. Adverse events were defined as any factor affecting the surgical procedure in a negative way. Hundred-fifty operative procedures were included. In 54% of the procedures, at least one adverse event occurred. In total, 147 adverse events occurred, with a range of 1-5 per procedure. Most adverse events occurred during joint replacement procedures. Thirty-seven percent of the incidents concerned defect, incorrect connected or absent instruments. In 36% of the procedures adverse events resulted in a prolonged operation time with a median prolongation of 10.0 min. In more than half of orthopedic trauma surgical procedures adverse events related to technical equipment and logistics occurred, most of them could easily be prevented. These adverse events could endanger the safety of the patient and staff and should therefore be reduced. 4.

  5. Long-term clinical and radiographic outcome of patello-femoral realignment procedures: a minimum of 15-year follow-up.

    PubMed

    Vivod, Gregor; Verdonk, Peter; Drobnič, Matej

    2014-11-01

    A retrospective single-centre study was focused on the long-term outcome after different patello-femoral (PF) realignment procedures. Thirty-nine patients treated for recurrent PF instability were examined after a mean post-operative time of 22.5 years. Their 78 knees were divided into: non-operated knees (NON-OPERATED)-N = 24, isolated proximal procedures (PROXIMAL)-N = 22, isolated distal procedures (DISTAL)-N = 10, and combined procedures (COMBINED)-N = 22. PF-related medical history together with clinical, subjective (KOOS and Kujala scores), and radiographic (Caton-Deschamps PF height index, Kellgren-Lawrence scale for tibio-femoral OA, and Iwano classification for PF OA) evaluation was conducted. PF re-dislocation rate was comparable between PROXIMAL (36%), DISTAL (20%), and COMBINED (32%). Isolated proximal procedures revealed less central patella positions (PROXIMAL 64%; DISTAL 90%; COMBINED 95%) and more frequent PF apprehension test (PROXIMAL 82%; DISTAL 40%, COMBINED 50%). KOOS and Kujala scores were similar in all three surgical subgroups, but significantly lower than in NON-OPERATED. Patellas were positioned lower after DISTAL, 0.8 (0.5-1.0) or COMBINED, 0.9 (0.4-1.3). Kellgren-Lawrence scores ≥2 were found in 42% NON-OPERATED, 37% PROXIMAL, 70% DISTAL, and 59% COMBINED, whereas Iwano classification ≥2 was confirmed in 46% NON-OPERATED, 64% PROXIMAL, 80% DISTAL, and 86% COMBINED. High PF re-dislocation rates together with a very high incidence of PF OA indicate that PF realignment strategies used traditionally had failed to reach their long-term expectations. The transfer of tibial tuberosity resulted in more constrained PF joints than isolated proximal procedures which allowed for more residual PF instability. Distal procedures additionally increased the likelihood for tibio-femoral OA. III.

  6. [Standard operating procedures in ethic committees].

    PubMed

    Czarkowski, Marek

    2006-02-01

    Polish ethic committees should have to work together in order to maintain and develop high quality standards in the protection of human subjects. Exchanging knowledge, know-how and information polish ethic committees should have to implement standard operating procedures. Procedures should improve quality and proficiency of all types of ethic committee's activities. Standard operating procedures should cover as important problems as conflict of interest, trial's insurance or elections of ethic committees. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. Governmental initiatives and creation of forum for polish ethic committees are essential in the effective standardisation, coordination and implementation of procedures in regional ethic committees. These projects need support via public funding from our authorities.

  7. Justifying scale type for a latent variable: Formative or reflective?

    NASA Astrophysics Data System (ADS)

    Liu, Hao; Bahron, Arsiah; Bagul, Awangku Hassanal Bahar Pengiran

    2015-12-01

    The study attempted to explore the possibilities to create a procedure at the experimental level to double confirm whether manifest variables scale type is formative or reflective. Now, the criteria of making such a decision are heavily depended on researchers' judgment at the conceptual and operational level. The study created an experimental procedure that seems could double confirm the decisions from the conceptual and operational level judgments. The experimental procedure includes the following tests, Variance Inflation Factor (VIF), Tolerance (TOL), Ridge Regression, Cronbach's alpha, Dillon-Goldstein's rho, and first and second eigenvalue. The procedure considers manifest variables' both multicollinearity and consistency. As the result, the procedure received the same judgment with the carefully established decision making at the concept and operational level.

  8. Salvage reconstruction of failed interposition arthroplasty at the base of the thumb.

    PubMed

    Braun, Richard M; Rechnic, Mark; Shah, Kalpit N

    2012-12-01

    We present an operative procedure designed to revise a failed arthroplasty at the base of the thumb. This report describes a reliable operation that corrects residual instability and malignment which results in thumbs that are weak and painful despite a previous procedure. The operation has also been used as a primary procedure for arthritis of the trapeziometacarpal joint where instability and subluxation was a major component of the problem requiring joint reconstruction. The unique features of this procedure include a reinforced double-thickness tendon graft, a unique tendon anchor, and a fascia lata allograft spacer. Significant functional improvement is anticipated when joint reconstruction provides increased proximal stability. Pinch and grip measurements improve. Pain scores also diminish after the operation. Hand function and patient satisfaction can be substantially improved with revision arthroplasty when the initial operation has failed to provide a thumb that is mobile, stable, and pain free. The technical features of the procedure address reduction of malignment, restoring of anatomic balance, and secure fixation of the proximal apex of the thumb metacarpal which restores thumb reduction position and digital balance.

  9. Development of use of an Operational Procedure Information System (OPIS) for future space missions

    NASA Technical Reports Server (NTRS)

    Illmer, N.; Mies, L.; Schoen, A.; Jain, A.

    1994-01-01

    A MS-Windows based electronic procedure system, called OPIS (Operational Procedure Information System), was developed. The system consists of two parts, the editor, for 'writing' the procedure and the notepad application, for the usage of the procedures by the crew during training and flight. The system is based on standardized, structured procedure format and language. It allows the embedding of sketches, photos, animated graphics and video sequences and the access to off-nominal procedures by linkage to an appropriate database. The system facilitates the work with procedures of different degrees of detail, depending on the training status of the crew. The development of a 'language module' for the automatic translation of the procedures, for example into Russian, is planned.

  10. 14 CFR 23.1585 - Operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... multiengine airplanes, information identifying each operating condition in which the fuel system independence... fuel system in a configuration used to show compliance with that section. (h) For each airplane showing compliance with § 23.1353 (g)(2) or (g)(3), the operating procedures for disconnecting the battery from its...

  11. 40 CFR 63.1382 - Emission standards

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... complete corrective actions in a timely manner according to the procedures in the operations, maintenance... or operator must initiate corrective action within 1 hour of an alarm from a bag leak detection system and complete corrective actions in a timely manner according to the procedures in the operations...

  12. 33 CFR 209.141 - Coordination of hydroelectric power operations with power marketing agencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.141... establishes policies and procedures for coordinating the operation of the Corps of Engineers' hydroelectric... civil works field operating agencies (FOA) having generating facilities producing marketable electric...

  13. 33 CFR 209.141 - Coordination of hydroelectric power operations with power marketing agencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.141... establishes policies and procedures for coordinating the operation of the Corps of Engineers' hydroelectric... civil works field operating agencies (FOA) having generating facilities producing marketable electric...

  14. 33 CFR 209.141 - Coordination of hydroelectric power operations with power marketing agencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.141... establishes policies and procedures for coordinating the operation of the Corps of Engineers' hydroelectric... civil works field operating agencies (FOA) having generating facilities producing marketable electric...

  15. 33 CFR 209.141 - Coordination of hydroelectric power operations with power marketing agencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE ADMINISTRATIVE PROCEDURE § 209.141... establishes policies and procedures for coordinating the operation of the Corps of Engineers' hydroelectric... civil works field operating agencies (FOA) having generating facilities producing marketable electric...

  16. Operational Control Procedures for the Activated Sludge Process: Appendix.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This document is the appendix for a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. Categories discussed include: control test data, trend charts, moving averages, semi-logarithmic plots, probability…

  17. 40 CFR 63.2852 - What is a startup, shutdown, and malfunction plan?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may come from plans you developed for other purposes such as a Standard Operating Procedure manual or... source is operational. The SSM plan provides detailed procedures for operating and maintaining your...) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  18. 40 CFR 63.2852 - What is a startup, shutdown, and malfunction plan?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... may come from plans you developed for other purposes such as a Standard Operating Procedure manual or... source is operational. The SSM plan provides detailed procedures for operating and maintaining your...) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  19. 10 CFR 34.81 - Copies of operating and emergency procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

  20. 10 CFR 34.81 - Copies of operating and emergency procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

  1. 10 CFR 34.81 - Copies of operating and emergency procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

  2. 10 CFR 34.81 - Copies of operating and emergency procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

  3. 10 CFR 34.81 - Copies of operating and emergency procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

  4. 49 CFR 1180.8 - Operational data.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Operational data. 1180.8 Section 1180.8..., TRACKAGE RIGHTS, AND LEASE PROCEDURES General Acquisition Procedures § 1180.8 Operational data. (a... chart. Data shown in the density chart shall be for the latest available full calendar year preceding...

  5. 49 CFR 1180.8 - Operational data.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Operational data. 1180.8 Section 1180.8..., TRACKAGE RIGHTS, AND LEASE PROCEDURES General Acquisition Procedures § 1180.8 Operational data. (a... chart. Data shown in the density chart shall be for the latest available full calendar year preceding...

  6. Implementation of a near-zero fluoroscopy approach in interventional electrophysiology: impact of operator experience.

    PubMed

    Wannagat, Severin; Loehr, Lena; Lask, Sebastian; Völk, Katharina; Karaköse, Tamer; Özcelik, Cemil; Mügge, Andreas; Wutzler, Alexander

    2018-04-01

    Catheter ablation is performed under fluoroscopic guidance. Reduction of radiation dose for patients and staff is emphasized by current recommendations. Previous studies have shown that lower operator experience leads to increased radiation dose. On the other hand, less experienced operators may depend even more on fluoroscopic guidance. Our study aimed to evaluate feasibility and efficacy of a non-fluoroscopic approach in different training levels. From January 2017, a near-zero fluoroscopy approach was established in two centers. Four operators (beginner, 1st year fellow, 2nd year fellow, expert) were instructed to perform the complete procedure with the use of a 3-D mapping system without fluoroscopy. A historical cohort that underwent procedures with fluoroscopy use served as control group. Dose area product (DPA), procedure duration, acute procedural success, and complications were compared between the groups and for each operator. Procedures were performed in 157 patients. The first 100 patients underwent procedures with fluoroscopic guidance, the following 57 procedures were performed with the near-zero fluoroscopy approach. The results show a significant reduction in DPA for all operators immediately after implementation of the near-zero fluoroscopy protocol (control 637 ± 611 μGy/m 2 ; beginner 44.1 ± 79.5 μGy/m 2 , p = 0.002; 1st year fellow 24.3 ± 46.4.5 μGy/m 2 , p = 0.001; 2nd year fellow 130.3 ± 233.3 μGy/m 2 , p = 0.003; expert 9.3 ± 37.4 μGy/m 2 , P < 0.001). Procedure duration, acute success, and complications were not significantly different between the groups. Our results show a 90% reduction of DPA shortly after implementation of a near-zero fluoroscopy approach in interventional electrophysiology even in operators in training.

  7. How to develop a Standard Operating Procedure for sorting unfixed cells

    PubMed Central

    Schmid, Ingrid

    2012-01-01

    Written Standard Operating Procedures (SOPs) are an important tool to assure that recurring tasks in a laboratory are performed in a consistent manner. When the procedure covered in the SOP involves a high-risk activity such as sorting unfixed cells using a jet-in-air sorter, safety elements are critical components of the document. The details on sort sample handling, sorter set-up, validation, operation, troubleshooting, and maintenance, personal protective equipment (PPE), and operator training, outlined in the SOP are to be based on careful risk assessment of the procedure. This review provides background information on the hazards associated with sorting of unfixed cells and the process used to arrive at the appropriate combination of facility design, instrument placement, safety equipment, and practices to be followed. PMID:22381383

  8. Development of a list of high-risk operations for patients 65 years and older.

    PubMed

    Schwarze, Margaret L; Barnato, Amber E; Rathouz, Paul J; Zhao, Qianqian; Neuman, Heather B; Winslow, Emily R; Kennedy, Gregory D; Hu, Yue-Yung; Dodgion, Christopher M; Kwok, Alvin C; Greenberg, Caprice C

    2015-04-01

    No consensus exists regarding the definition of high-risk surgery in older adults. An inclusive and precise definition of high-risk surgery may be useful for surgeons, patients, researchers, and hospitals. To develop a list of high-risk operations. Retrospective cohort study and modified Delphi procedure. The setting included all Pennsylvania acute care hospitals (Pennsylvania Health Care Cost Containment Council [PHC4] April 1, 2001, to December 31, 2007) and a nationally representative sample of US acute care hospitals (Nationwide Inpatient Sample [NIS], Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality January 1, 2001, to December 31, 2006). Patients included were those 65 years and older admitted to PHC4 hospitals and those 18 years and older admitted to NIS hospitals. We identified International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes associated with at least 1% inpatient mortality in the PHC4. We used a modified Delphi procedure with 5 board-certified surgeons to further refine this list by excluding nonoperative procedures and operations that were unlikely to be the proximate cause of mortality and were instead a marker of critical illness (eg, tracheostomy). We then cross-validated this list of ICD-9-CM codes in the NIS. Modified Delphi procedure consensus of at least 4 of 5 panelists and proportion agreement in the NIS. Among 4,739,522 admissions of patients 65 years and older in the PHC4, a total of 2,569,589 involved a procedure, encompassing 2853 unique procedures. Of 1130 procedures associated with a crude inpatient mortality of at least 1%, 264 achieved consensus as high-risk operations by the modified Delphi procedure. The observed inpatient mortality in the NIS was at least 1% for 227 of 264 procedures (86%) in patients 65 years and older. The pooled inpatient mortality for these identified high-risk procedures performed on patients 65 years and older was double the pooled inpatient mortality for correspondingly identified high-risk operations for patients younger than 65 years (6% vs 3%). We developed a list of procedure codes to identify high-risk surgical procedures in claims data. This list of high-risk operations can be used to standardize the definition of high-risk surgery in quality and outcomes-based studies and to design targeted clinical interventions.

  9. 40 CFR 267.112 - What procedures must I follow?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false What procedures must I follow? 267.112 Section 267.112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Closure § 267.112 What procedures...

  10. 49 CFR 194.121 - Response plan review and update procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Response plan review and update procedures. 194... SAFETY RESPONSE PLANS FOR ONSHORE OIL PIPELINES Response Plans § 194.121 Response plan review and update procedures. (a) Each operator shall update its response plan to address new or different operating conditions...

  11. 49 CFR 194.121 - Response plan review and update procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Response plan review and update procedures. 194... SAFETY RESPONSE PLANS FOR ONSHORE OIL PIPELINES Response Plans § 194.121 Response plan review and update procedures. (a) Each operator shall update its response plan to address new or different operating conditions...

  12. 49 CFR 194.121 - Response plan review and update procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Response plan review and update procedures. 194... SAFETY RESPONSE PLANS FOR ONSHORE OIL PIPELINES Response Plans § 194.121 Response plan review and update procedures. (a) Each operator shall update its response plan to address new or different operating conditions...

  13. 49 CFR 194.121 - Response plan review and update procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Response plan review and update procedures. 194... SAFETY RESPONSE PLANS FOR ONSHORE OIL PIPELINES Response Plans § 194.121 Response plan review and update procedures. (a) Each operator shall update its response plan to address new or different operating conditions...

  14. 49 CFR 194.121 - Response plan review and update procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Response plan review and update procedures. 194... SAFETY RESPONSE PLANS FOR ONSHORE OIL PIPELINES Response Plans § 194.121 Response plan review and update procedures. (a) Each operator shall update its response plan to address new or different operating conditions...

  15. 40 CFR 60.54 - Test methods and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operator may use either of the following procedures to determine the adjusted CO2 concentration. (1) The... owner or operator shall use as reference methods and procedures the test methods in appendix A of this... follows: (1) The concentration (c12) of particulate matter, corrected to 12 percent CO2, shall be computed...

  16. 40 CFR 60.54 - Test methods and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... operator may use either of the following procedures to determine the adjusted CO2 concentration. (1) The... owner or operator shall use as reference methods and procedures the test methods in appendix A of this... follows: (1) The concentration (c12) of particulate matter, corrected to 12 percent CO2, shall be computed...

  17. 40 CFR 60.54 - Test methods and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (c) The owner or operator may use either of the following procedures to determine the adjusted CO2... owner or operator shall use as reference methods and procedures the test methods in appendix A of this... follows: (1) The concentration (c12) of particulate matter, corrected to 12 percent CO2, shall be computed...

  18. A Procedure Using Calculators to Express Answers in Fractional Form.

    ERIC Educational Resources Information Center

    Carlisle, Earnest

    A procedure is described that enables students to perform operations on fractions with a calculator, expressing the answer as a fraction. Patterns using paper-and-pencil procedures for each operation with fractions are presented. A microcomputer software program illustrates how the answer can be found using integer values of the numerators and…

  19. 76 FR 40378 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ..., 11.50, and 11.300) require the following standard operating procedures to assure appropriate use of... this regulation is a one-time burden associated with the creation of standard operating procedures... procedures and controls for persons who use closed systems to create, modify, maintain, or transmit...

  20. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

    EPA Science Inventory

    The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

  1. [The hybrid operating room. Home of high-end intraoperative imaging].

    PubMed

    Gebhard, F; Riepl, C; Richter, P; Liebold, A; Gorki, H; Wirtz, R; König, R; Wilde, F; Schramm, A; Kraus, M

    2012-02-01

    A hybrid operating room must serve the medical needs of different highly specialized disciplines. It integrates interventional techniques for cardiovascular procedures and allows operations in the field of orthopaedic surgery, neurosurgery and maxillofacial surgery. The integration of all steps such as planning, documentation and the procedure itself saves time and precious resources. The best available imaging devices and user interfaces reduce the need for extensive personnel in the OR and facilitate new minimally invasive procedures. The immediate possibility of postoperative control images in CT-like quality enables the surgeon to react to problems during the same procedure without the need for later revision.

  2. Patterns and operative treatment of recurrent Crohn's disease: a prospective longitudinal study.

    PubMed

    Fichera, Alessandro; Lovadina, Stefano; Rubin, Michele; Cimino, Fabrizio; Hurst, Roger D; Michelassi, Fabrizio

    2006-10-01

    It is believed commonly that Crohn's recurrences always occur at the site of a previous intestinal anastomosis; yet this concept is probably inaccurate and not mindful of the panintestinal nature of the disease. Between October, 1984 and March, 2003, we carried out 1,132 procedures (464 for primary and 668 for recurrent disease) on 981 consecutive patients. Patients in whom we carried out both the original procedure as well as the procedure for recurrent disease constitute this study population. Operative procedures for perineal complications were excluded from this analysis. Data were accrued prospectively. Seventy-eight patients met the study inclusion criteria. They had a total of 149 sites of disease (duodenum, n = 3; jejunum/ileum, n = 53; terminal ileum/neo terminal ileum, n = 67; colon and rectum, n = 26). One hundred thirty-four sites required operative intervention (85 resections and 49 strictureplasties) and 15 did not. Crohn's disease recurred in 79 sites after a mean of 48.4 months (range, 1-161 months, median, 41 months). Site of operative intervention and operative technique influenced patterns of recurrence: when an anastomosis or strictureplasty was constructed with small bowel, the majority of recurrences were limited to the anastomotic line (17/29, 59%); when it was constructed with small bowel and colon, the majority of recurrences extended to the proximal limb (29/35, 83%). The difference in recurrence pattern is significant (P < .01). In addition, fewer recurrences occurred at strictureplasty than resection sites (22/49, 45%, vs 57/85, 70%, respectively, P < .05). At the time of the second procedure, 40 additional recurrences were identified distant from the original operative site. Four of these represented progression of disease at the 15 sites that did not originally need operative intervention. Of 119 total recurrences, 115 required 73 resections, 40 strictureplasties, and 2 other procedures. The site of the original operative intervention is the most common site for recurrence, although as many as one-third of recurrences occur separate from it. Pattern of recurrence is influenced by site of the operative intervention (anastomotic for small bowel, proximal limb for ileocolonic) and by operative technique (fewer recurrences occurred at strictureplasty than resection sites). Disease progression occurred in 25% of the sites not addressed operatively at the original procedure. The operative strategy applied to Crohn's complications in different intestinal sites was similar for primary and recurrent disease.

  3. 14 CFR 93.352 - Hudson River Exclusion specific operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Hudson River Exclusion specific operating procedures. 93.352 Section 93.352 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES New York Class B...

  4. 14 CFR 93.353 - East River Exclusion specific operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false East River Exclusion specific operating procedures. 93.353 Section 93.353 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES New York Class B...

  5. 10 CFR 36.53 - Operating and emergency procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

  6. 10 CFR 36.53 - Operating and emergency procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

  7. 10 CFR 36.53 - Operating and emergency procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

  8. 40 CFR 63.2852 - What is a startup, shutdown, and malfunction plan?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the procedures may come from plans you developed for other purposes such as a Standard Operating... as long as the source is operational. The SSM plan provides detailed procedures for operating and...) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  9. 40 CFR 63.11550 - What are my standards and management practices?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

  10. 40 CFR 63.2852 - What is a startup, shutdown, and malfunction plan?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the procedures may come from plans you developed for other purposes such as a Standard Operating... as long as the source is operational. The SSM plan provides detailed procedures for operating and...) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  11. 40 CFR 63.11550 - What are my standards and management practices?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

  12. 40 CFR 63.2852 - What is a startup, shutdown, and malfunction plan?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the procedures may come from plans you developed for other purposes such as a Standard Operating... as long as the source is operational. The SSM plan provides detailed procedures for operating and...) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE...

  13. 40 CFR 63.11550 - What are my standards and management practices?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

  14. 40 CFR 63.11550 - What are my standards and management practices?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

  15. 40 CFR 63.11550 - What are my standards and management practices?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

  16. 78 FR 15876 - Activation of Ice Protection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... procedures in the Airplane Flight Manual for operating in icing conditions must be initiated. (2) Visual cues... procedures in the Airplane Flight Manual for operating in icing conditions must be initiated. (3) If the... operating rules for flight in icing conditions. This document corrects an error in the amendatory language...

  17. 49 CFR 232.609 - Handling of defective equipment with ECP brake systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and appropriate operating and inspection personnel; and (3) An electronic or written record of the... operating freight cars equipped with ECP brake systems shall adopt and comply with specific procedures... this subpart. These procedures shall be made available to FRA upon request. (2) Each railroad operating...

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

    NASA Technical Reports Server (NTRS)

    1985-01-01

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

  19. Nuclear Powerplant Safety: Operations.

    ERIC Educational Resources Information Center

    Department of Energy, Washington, DC. Nuclear Energy Office.

    Powerplant systems and procedures that ensure the day-to-day health and safety of people in and around the plant is referred to as operational safety. This safety is the result of careful planning, good engineering and design, strict licensing and regulation, and environmental monitoring. Procedures that assure operational safety at nuclear…

  20. Quantifying Nanoparticle Release from Nanotechnology: Scientific Operating Procedure Series: SOP C 3

    DTIC Science & Technology

    2017-02-01

    Operating Procedure Series : SOP-C-3 En vi ro nm en ta l L ab or at or y David P. Martin, Aimee R. Poda, and Anthony J. Bednar February 2017...Operating Procedure Series : SOP-C-3 David P. Martin, Aimee R. Poda, and Anthony J. Bednar Environmental Laboratory U.S. Army Engineer Research and...so designated by other authorized documents. DESTROY THIS REPORT WHEN NO LONGER NEEDED. DO NOT RETURN IT TO THE ORIGINATOR. ERDC/EL SR-17-1 iii

  1. Coordinate Measuring Machine Pit Artifact Inspection Procedure

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

    Montano, Joshua D.

    2012-07-31

    The goal of this document is to outline a procedure for dimensional measurement of Los Alamos National Laboratory's CMM Pit Artifact. This procedure will be used by the Manufacturing Practice's Inspection Technology Subgroup of the Interagency Manufacturing Operations Group and Joint Operations Weapon Operations Group (IMOG/JOWOG 39) round robin participants. The intent is to assess the state of industry within the Nuclear Weapons Complex for measurements made on this type of part and find which current measurement strategies and techniques produce the best results.

  2. What To Do, What To Do? Determining a Course of Action at the Operational Level of War

    DTIC Science & Technology

    1992-05-18

    and making choices can expand the limits of human rationality . 5 Where decisions involve the lives of soldiers and the future of nations, any edge or...ANALYSIS 15. N5Iu,,3E•a -r PAGES115 OPERATIONAL DECISION - MAKING MISSION ANALYSIS 115 COURSE OF ACTION SELECTION STAFF ESTIMATES I1. SECUlPIT... decision - making procedures for the operational level of war. These doctrinal procedures are found in emerging joint doctrine. For these procedures to be

  3. Impact of the European Working Time Directive (EWTD) on the operative experience of surgery residents.

    PubMed

    Hopmans, Cornelis J; den Hoed, Pieter T; van der Laan, Lijckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; Timman, Reinier; Wijnhoven, Bas P L; IJzermans, Jan N M

    2015-04-01

    In Europe and the United States, work hour restrictions are considered to be particularly burdensome for residents in surgery specialties. The aim of this study was to examine whether reduction of the work week to 48 hours resulting from the implementation of the European Working Time Directive has affected the operative experience of surgery residents. This study was conducted in a general surgery training region in the Netherlands, consisting of 1 university hospital and 6 district training hospitals. Operating records summarizing the surgical procedures performed as "primary surgeon" in the operating theater for different grades of surgeons were retrospectively analyzed for the period 2005-2012 by the use of linear regression models. Operative procedures performed by residents were considered the main outcome measure. In total, 235,357 operative procedures were performed, including 47,458 (20.2%) in the university hospital and 187,899 (79.8%) in the district training hospitals (n = 5). For residents in the university hospital, the mean number of operative procedures performed per 1.0 full-time equivalent increased from 128 operations in 2005 to 204 operations in 2012 (P = .001), whereas for residents in district training hospitals, no substantial differences were found over time. The mean (±SD) operative caseload of 64 residents who completed the 6-year training program between 2005 and 2012 was 1,391 ± 226 (range, 768-1856). A comparison of the operative caseload according to year of board-certification showed no difference. Implementation of the European Working Time Directive has not affected adversely the number of surgical procedures performed by residents within a general surgical training region in the Netherlands. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Modal Analysis for Grid Operation

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

    MANGO software is to provide a solution for improving small signal stability of power systems through adjusting operator-controllable variables using PMU measurement. System oscillation problems are one of the major threats to the grid stability and reliability in California and the Western Interconnection. These problems result in power fluctuations, lower grid operation efficiency, and may even lead to large-scale grid breakup and outages. This MANGO software aims to solve this problem by automatically generating recommended operation procedures termed Modal Analysis for Grid Operation (MANGO) to improve damping of inter-area oscillation modes. The MANGO procedure includes three steps: recognizing small signalmore » stability problems, implementing operating point adjustment using modal sensitivity, and evaluating the effectiveness of the adjustment. The MANGO software package is designed to help implement the MANGO procedure.« less

  5. Analysis of verbal communication during teaching in the operating room and the potentials for surgical training.

    PubMed

    Blom, E M; Verdaasdonk, E G G; Stassen, L P S; Stassen, H G; Wieringa, P A; Dankelman, J

    2007-09-01

    Verbal communication in the operating room during surgical procedures affects team performance, reflects individual skills, and is related to the complexity of the operation process. During the procedural training of surgeons (residents), feedback and guidance is given through verbal communication. A classification method based on structural analysis of the contents was developed to analyze verbal communication. This study aimed to evaluate whether a classification method for the contents of verbal communication in the operating room could provide insight into the teaching processes. Eight laparoscopic cholecystectomies were videotaped. Two entire cholecystectomies and the dissection phase of six additional procedures were analyzed by categorization of the communication in terms of type (4 categories: commanding, explaining, questioning, and miscellaneous) and content (9 categories: operation method, location, direction, instrument handling, visualization, anatomy and pathology, general, private, undefinable). The operation was divided into six phases: start, dissection, clipping, separating, control, closing. Classification of the communication during two entire procedures showed that each phase of the operation was dominated by different kinds of communication. A high percentage of explaining anatomy and pathology was found throughout the whole procedure except for the control and closing phases. In the dissection phases, 60% of verbal communication concerned explaining. These explaining communication events were divided as follows: 27% operation method, 19% anatomy and pathology, 25% location (positioning of the instrument-tissue interaction), 15% direction (direction of tissue manipulation), 11% instrument handling, and 3% other nonclassified instructions. The proposed classification method is feasible for analyzing verbal communication during surgical procedures. Communication content objectively reflects the interaction between surgeon and resident. This information can potentially be used to specify training needs, and may contribute to the evaluation of different training methods.

  6. Improving the review of standard operating procedures: a novel electronic system for compounding pharmacies.

    PubMed

    Brensel, Robert; Brensel, Scott; Ng, Amy

    2013-01-01

    Since the New England Compounding Center disaster in 2012, the importance of following correct procedures during every phase of customized pharmacy has been a focus of governmental interest and action as well as public scrutiny. Many pharmacies rely on the rote review of standard operating procedures to ensure that staff members understand and follow protocols that ensure the safety and potency of all compounds prepared, but that approach to continuing education can be cumbersome and needlessly time-consuming. In addition, documenting and retrieving evidence of employee competence can be difficult. In this article, we describe our use of online technology to improve our methods of educating staff about the full range of standard operating procedures that must be followed in our pharmacy. The system we devised and implemented has proven to be effective, easy to update and maintain, very inexpensive, and user friendly. Its use has reduced the time previously required for a read-over review of standard operating procedures from 30 or 40 minutes to 5 or 10 minutes in weekly staff meetings, and we can now easily document and access proof of employees' comprehension of that content. It is our hope that other small compounding pharmacies will also find this system of online standard operating procedure review helpful.

  7. The Small Aircraft Transportation System (SATS), Higher Volume Operations (HVO) Off-Nominal Operations

    NASA Technical Reports Server (NTRS)

    Baxley, B.; Williams, D.; Consiglio, M.; Conway, S.; Adams, C.; Abbott, T.

    2005-01-01

    The ability to conduct concurrent, multiple aircraft operations in poor weather, at virtually any airport, offers an important opportunity for a significant increase in the rate of flight operations, a major improvement in passenger convenience, and the potential to foster growth of charter operations at small airports. The Small Aircraft Transportation System, (SATS) Higher Volume Operations (HVO) concept is designed to increase traffic flow at any of the 3400 nonradar, non-towered airports in the United States where operations are currently restricted to one-in/one-out procedural separation during Instrument Meteorological Conditions (IMC). The concept's key feature is pilots maintain their own separation from other aircraft using procedures, aircraft flight data sent via air-to-air datalink, cockpit displays, and on-board software. This is done within the Self-Controlled Area (SCA), an area of flight operations established during poor visibility or low ceilings around an airport without Air Traffic Control (ATC) services. The research described in this paper expands the HVO concept to include most off-nominal situations that could be expected to occur in a future SATS environment. The situations were categorized into routine off-nominal operations, procedural deviations, equipment malfunctions, and aircraft emergencies. The combination of normal and off-nominal HVO procedures provides evidence for an operational concept that is safe, requires little ground infrastructure, and enables concurrent flight operations in poor weather.

  8. A simulator study for the development and evaluation of operating procedures on a supersonic cruise research transport to minimize airport-community noise

    NASA Technical Reports Server (NTRS)

    Grantham, W. D.; Smith, P. M.; Deal, P. L.

    1980-01-01

    Piloted-simulator studies were conducted to determine takeoff and landing operating procedures for a supersonic cruise research transport concept that result in predicted noise levels which meet current Federal Aviation Administration (FAA) certification standards. With the use of standard FAA noise certification test procedures, the subject simulated aircraft did not meet the FAA traded-noise-level standards during takeoff and landing. However, with the use of advanced procedures, this aircraft meets the traded-noise-level standards for flight crews with average skills. The advanced takeoff procedures developed involved violating some of the current Federal Aviation Regulations (FAR), but it was not necessary to violate any FAR noise-test conditions during landing approach. Noise contours were also determined for some of the simulated takeoffs and landings in order to indicate the noise-reduction advantages of using operational procedures other than standard.

  9. General surgery workloads and practice patterns in the United States, 2007 to 2009: a 10-year update from the American Board of Surgery.

    PubMed

    Valentine, R James; Jones, Andrew; Biester, Thomas W; Cogbill, Thomas H; Borman, Karen R; Rhodes, Robert S

    2011-09-01

    To assess changes in general surgery workloads and practice patterns in the past decade. Nearly 80% of graduating general surgery residents pursue additional training in a surgical subspecialty. This has resulted in a shortage of general surgeons, especially in rural areas. The purpose of this study is to characterize the workloads and practice patterns of general surgeons versus certified surgical subspecialists and to compare these data with those from a previous decade. The surgical operative logs of 4968 individuals recertifying in surgery 2007 to 2009 were reviewed. Data from 3362 (68%) certified only in Surgery (GS) were compared with 1606 (32%) with additional American Board of Medical Specialties certificates (GS+). Data from GS surgeons were also compared with data from GS surgeons recertifying 1995 to 1997. Independent variables were compared using factorial ANOVA. GS surgeons performed a mean of 533 ± 365 procedures annually. Women GS performed far more breast operations and fewer abdomen, alimentary tract and laparoscopic procedures compared to men GS (P < 0.001). GS surgeons recertifying at 10 years performed more abdominal, alimentary tract and laparoscopic procedures compared to those recertifying at 20 or 30 years (P < 0.001). Rural GS surgeons performed far more endoscopic procedures and fewer abdominal, alimentary tract, and laparoscopic procedures than urban counterparts (P < 0.001). The United States medical school graduates had similar workloads and distribution of operations to international medical graduates. Compared to 1995 to 1997, GS surgeons from 2007 to 2009 performed more procedures, especially endoscopic and laparoscopic. GS+ surgeons performed 15% to 33% of all general surgery procedures. GS practice patterns are heterogeneous; gender, age, and practice setting significantly affect operative caseloads. A substantial portion of general surgery procedures currently are performed by GS+ surgeons, whereas GS surgeons continue to perform considerable numbers of specialty operations. Reduced general surgery operative experience in GS+ residencies may negatively impact access to general surgical care. Similarly, narrowing GS residency operative experience may impair specialty operation access.

  10. [Comparison of the Bologna and Ingelman-Sundberg procedures for stress incontinence associated with genital prolapse: ten-year follow-up of a prospective randomized study].

    PubMed

    Debodinance, P

    2000-04-01

    Our purpose was to evaluate and compare the long-term results of the Bologna and the Ingelman-Sundberg procedures for the treatment of stress urinary incontinence in women with genital prolapse. Forty-seven women underwent surgery at the gynecologic division at Dunkirk Hospital, France between January 1989 and August 1990. All patients presented a genital prolapse with a cystocele of at least degree 2 associated with urinary stress incontinence. The subjects were randomly allocated to one of the two procedures. In the clinical incontinence group (28 patients), 12 procedures were Bologna operations and 16 were Ingelman-Sundberg operations. In the potential incontinence group (19 patients), 11 procedures were Bologna operations and 8 were Ingelman-Sundberg operations. Physical examination and urodynamic explorations were performed preoperatively, and 3 months and 1 year postoperatively. A questionnaire was sent to all participating women during the tenth year of follow-up. We obtained 46 answers. Mean follow-up was 9.7 years. The result of the 1-year postoperative evaluation has been previously published. At 1 year, complete cure was achieved in 91.7% of the patients who underwent the Bologna procedure and 93.7% in those who had the Ingelman-Sundberg procedure. At 10 years, the cure rate was 72.7% and 56.2% (p<0.05) respectively. After the first year, the decline in cure rate was twice as fast with the Ingelman-Sundberg procedure than with the Bologna operation. The longevity of the Bologna procedure is greater than that of the Ingelman-Sundberg procedure. Recovery rate declines by 20% in 9 years. All results of urinary stress incontinence surgery were good after the first year. One has to wait 5 to 10 years before reliable informative results can be obtained. This fact should be taken into consideration before accepting to use of new procedures.

  11. Risk of Venous Thromboembolism and Operative Duration in Patients Undergoing Neurosurgical Procedures.

    PubMed

    Bekelis, Kimon; Labropoulos, Nicos; Coy, Shannon

    2017-05-01

    The association of operative duration with the risk of venous thromboembolism (VTE) has not been quantified in neurosurgery. To investigate the association of surgical duration for several neurosurgical procedures and the incidence of VTE. We performed a retrospective cohort study involving patients who underwent neurosurgical procedures from 2005 to 2012 and were registered in the American College of Surgeons National Quality Improvement Project registry. In order to control for confounding, we used multivariable regression models, and propensity score conditioning. During the study period, there were 94 747 patients, who underwent neurosurgical procedures, and met the inclusion criteria. Of these, 1358 (1.0%) developed VTE within 30 days postoperatively. Multivariable logistic regression demonstrated an association of longer operative duration with higher 30-day incidence of VTE (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.19-1.25). Compared with procedures of moderate duration (third quintile, 40-60th percentile), patients undergoing the longest procedures (>80th percentile) had higher odds (OR, 3.15; 95% CI, 2.49-3.99) of developing VTE. The shortest procedures (<20th percentile) were associated with a decreased incidence of VTE (OR, 0.51; 95% CI, 0.27-0.76) in comparison to those of moderate duration. The same associations were present in propensity score-adjusted models, and models stratified by subgroups of cranial, spinal, peripheral nerve, and carotid procedures. In a cohort of patients from a national prospective surgical registry, increased operative duration was associated with increased incidence of VTE for neurosurgical procedures. These results can be used by neurosurgeons to inform operative management, and to stratify patients with regard to VTE risk. Copyright © 2016 by the Congress of Neurological Surgeons

  12. Use of Semi-Autonomous Tools for ISS Commanding and Monitoring

    NASA Technical Reports Server (NTRS)

    Brzezinski, Amy S.

    2014-01-01

    As the International Space Station (ISS) has moved into a utilization phase, operations have shifted to become more ground-based with fewer mission control personnel monitoring and commanding multiple ISS systems. This shift to fewer people monitoring more systems has prompted use of semi-autonomous console tools in the ISS Mission Control Center (MCC) to help flight controllers command and monitor the ISS. These console tools perform routine operational procedures while keeping the human operator "in the loop" to monitor and intervene when off-nominal events arise. Two such tools, the Pre-positioned Load (PPL) Loader and Automatic Operators Recorder Manager (AutoORM), are used by the ISS Communications RF Onboard Networks Utilization Specialist (CRONUS) flight control position. CRONUS is responsible for simultaneously commanding and monitoring the ISS Command & Data Handling (C&DH) and Communications and Tracking (C&T) systems. PPL Loader is used to uplink small pieces of frequently changed software data tables, called PPLs, to ISS computers to support different ISS operations. In order to uplink a PPL, a data load command must be built that contains multiple user-input fields. Next, a multiple step commanding and verification procedure must be performed to enable an onboard computer for software uplink, uplink the PPL, verify the PPL has incorporated correctly, and disable the computer for software uplink. PPL Loader provides different levels of automation in both building and uplinking these commands. In its manual mode, PPL Loader automatically builds the PPL data load commands but allows the flight controller to verify and save the commands for future uplink. In its auto mode, PPL Loader automatically builds the PPL data load commands for flight controller verification, but automatically performs the PPL uplink procedure by sending commands and performing verification checks while notifying CRONUS of procedure step completion. If an off-nominal condition occurs during procedure execution, PPL Loader notifies CRONUS through popup messages, allowing CRONUS to examine the situation and choose an option of how PPL loader should proceed with the procedure. The use of PPL Loader to perform frequent, routine PPL uplinks offloads CRONUS to better monitor two ISS systems. It also reduces procedure performance time and decreases risk of command errors. AutoORM identifies ISS communication outage periods and builds commands to lock, playback, and unlock ISS Operations Recorder files. Operation Recorder files are circular buffer files of continually recorded ISS telemetry data. Sections of these files can be locked from further writing, be played back to capture telemetry data that occurred during an ISS loss of signal (LOS) period, and then be unlocked for future recording use. Downlinked Operation Recorder files are used by mission support teams for data analysis, especially if failures occur during LOS. The commands to lock, playback, and unlock Operations Recorder files are encompassed in three different operational procedures and contain multiple user-input fields. AutoORM provides different levels of automation for building and uplinking the commands to lock, playback, and unlock Operations Recorder files. In its automatic mode, AutoORM automatically detects ISS LOS periods, then generates and uplinks the commands to lock, playback, and unlock Operations Recorder files when MCC regains signal with ISS. AutoORM also features semi-autonomous and manual modes which integrate CRONUS more into the command verification and uplink process. AutoORMs ability to automatically detect ISS LOS periods and build the necessary commands to preserve, playback, and release recorded telemetry data greatly offloads CRONUS to perform more high-level cognitive tasks, such as mission planning and anomaly troubleshooting. Additionally, since Operations Recorder commands contain numerical time input fields which are tedious for a human to manually build, AutoORM's ability to automatically build commands reduces operational command errors. PPL Loader and AutoORM demonstrate principles of semi-autonomous operational tools that will benefit future space mission operations. Both tools employ different levels of automation to perform simple and routine procedures, thereby offloading human operators to perform higher-level cognitive tasks. Because both tools provide procedure execution status and highlight off-nominal indications, the flight controller is able to intervene during procedure execution if needed. Semi-autonomous tools and systems that can perform routine procedures, yet keep human operators informed of execution, will be essential in future long-duration missions where the onboard crew will be solely responsible for spacecraft monitoring and control.

  13. Computer-aided placement of deep brain stimulators: from planning to intraoperative guidance

    NASA Astrophysics Data System (ADS)

    D'Haese, Pierre-Francois; Pallavaram, Srivatsan; Kao, Chris; Konrad, Peter E.; Dawant, Benoit M.

    2005-04-01

    The long term objective of our research is to develop a system that will automate as much as possible DBS implantation procedures. It is estimated that about 180,000 patients/year would benefit from DBS implantation. Yet, only 3000 procedures are performed annually. This is so because the combined expertise required to perform the procedure successfully is only available at a limited number of sites. Our goal is to transform this procedure into a procedure that can be performed by a general neurosurgeon at a community hospital. In this work we report on our current progress toward developing a system for the computer-assisted pre-operative selection of target points and for the intra-operative adjustment of these points. The system consists of a deformable atlas of optimal target points that can be used to select automatically the pre-operative target, of an electrophysiological atlas, and of an intra-operative interface. The atlas is deformed using a rigid then a non-rigid registration algorithm developed at our institution. Results we have obtained show that automatic prediction of target points is an achievable goal. Our results also indicate that electrophysiological information can be used to resolve structures not visible in anatomic images, thus improving both pre-operative and intra-operative guidance. Our intra-operative system has reached the stage of a working prototype that is clinically used at our institution.

  14. Changing trends in abdominal surgical complications following cardiac surgery in an era of advanced procedures. A retrospective cohort study.

    PubMed

    Ashfaq, Awais; Johnson, Daniel J; Chapital, Alyssa B; Lanza, Louis A; DeValeria, Patrick A; Arabia, Francisco A

    2015-03-01

    Abdominal complications following cardiopulmonary bypass (CPB) procedures may have mortality rates as high as 25%. Advanced procedures such as ventricular assist devices, artificial hearts and cardiac transplantation are being increasingly employed, changing the complexity of interventions. This study was undertaken to examine the changing trends in complications and the impact of cardiac surgery on emergency general surgery (EGS) coverage. A retrospective review was conducted of all CPB procedures admitted to our ICU between Jan. 2007 and Mar. 2010. The procedures included coronary bypass (CABG), valve, combination (including adult congenital) and advanced heart failure (AHF) procedures. The records were reviewed to obtain demographics, need for EGS consult/procedure and outcomes. Mean age of the patients was 66 ± 8.5 years, 71% were male. There were 945 CPB procedures performed on 914 patients during this study period. Over 39 months, 23 EGS consults were obtained, resulting in 10 operations and one hospital death (10% operative mortality). CABG and valve procedures had minimal impact on EGS workload while complex cardiac and AHF procedures accounted for significantly more EGS consultations (p < 0.005) and operations (p < 0.005). The majority of consultations were for small bowel obstruction/ileus (n = 4, 17%), cholecystitis (n = 3, 13%) and to rule out ischemia (n = 2, 9%) In the era of modern critical care and cardiac surgery, advanced technology has increased the volume of complex CPB procedures increasing the EGS workload. Emergency general surgeons working in institutions that perform advanced procedures should be aware of the potential for general surgical complications perioperatively and the resultant nuances that are associated with operative management in this patient population. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Safety validation test equipment operation

    NASA Astrophysics Data System (ADS)

    Kurosaki, Tadaaki; Watanabe, Takashi

    1992-08-01

    An overview of the activities conducted on safety validation test equipment operation for materials used for NASA manned missions is presented. Safety validation tests, such as flammability, odor, offgassing, and so forth were conducted in accordance with NASA-NHB-8060.1C using test subjects common with those used by NASA, and the equipment used were qualified for their functions and performances in accordance with NASDA-CR-99124 'Safety Validation Test Qualification Procedures.' Test procedure systems were established by preparing 'Common Procedures for Safety Validation Test' as well as test procedures for flammability, offgassing, and odor tests. The test operation organization chaired by the General Manager of the Parts and Material Laboratory of NASDA (National Space Development Agency of Japan) was established, and the test leaders and operators in the organization were qualified in accordance with the specified procedures. One-hundred-one tests had been conducted so far by the Parts and Material Laboratory according to the request submitted by the manufacturers through the Space Station Group and the Safety and Product Assurance for Manned Systems Office.

  16. Procedure and information displays in advanced nuclear control rooms: experimental evaluation of an integrated design.

    PubMed

    Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan

    2017-08-01

    In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.

  17. Standard Operating Procedure for the Grinding and Extraction of Lead in Paint using Nitric Acid and a Rotor/Stator System Powered by a High Speed Motor

    EPA Science Inventory

    This Standard Operating Procedure (SOP) describes a new, rapid, and relatively inexpensive one step procedure which grinds the paint samples removed from the substrate and simultaneously quantitatively extracts the Pb from the paint in only one step in preparation for quantitativ...

  18. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (SOPS) (UA-G-1.0)

    EPA Science Inventory

    The purpose of this SOP is to establish a uniform format for the preparation of SOPs. Use of these protocols ensures consistent implementation of project tasks, documents the preparation and implementation of the procedures used, describes quality control measures and the limits...

  19. 76 FR 62072 - Center for Devices and Radiological Health; Standard Operating Procedures for Network of Experts...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-06

    ...] Center for Devices and Radiological Health; Standard Operating Procedures for Network of Experts; Request... procedures (SOPs) for a new ``Network of Experts.'' The draft SOPs describe a new process for staff at the... FDA is announcing the availability of two draft SOPs, one entitled, ``Network of Experts--Expert...

  20. Design Guidance for Computer-Based Procedures for Field Workers

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

    Oxstrand, Johanna; Le Blanc, Katya; Bly, Aaron

    Nearly all activities that involve human interaction with nuclear power plant systems are guided by procedures, instructions, or checklists. Paper-based procedures (PBPs) currently used by most utilities have a demonstrated history of ensuring safety; however, improving procedure use could yield significant savings in increased efficiency, as well as improved safety through human performance gains. The nuclear industry is constantly trying to find ways to decrease human error rates, especially human error rates associated with procedure use. As a step toward the goal of improving field workers’ procedure use and adherence and hence improve human performance and overall system reliability, themore » U.S. Department of Energy Light Water Reactor Sustainability (LWRS) Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with computer-based procedures (CBPs). PBPs have ensured safe operation of plants for decades, but limitations in paper-based systems do not allow them to reach the full potential for procedures to prevent human errors. The environment in a nuclear power plant is constantly changing, depending on current plant status and operating mode. PBPs, which are static by nature, are being applied to a constantly changing context. This constraint often results in PBPs that are written in a manner that is intended to cover many potential operating scenarios. Hence, the procedure layout forces the operator to search through a large amount of irrelevant information to locate the pieces of information relevant for the task and situation at hand, which has potential consequences of taking up valuable time when operators must be responding to the situation, and potentially leading operators down an incorrect response path. Other challenges related to use of PBPs are management of multiple procedures, place-keeping, finding the correct procedure for a task, and relying on other sources of additional information to ensure a functional and accurate understanding of the current plant status (Converse, 1995; Fink, Killian, Hanes, and Naser, 2009; Le Blanc, Oxstrand, and Waicosky, 2012). This report provides design guidance to be used when designing the human-system interaction and the design of the graphical user interface for a CBP system. The guidance is based on human factors research related to the design and usability of CBPs conducted by Idaho National Laboratory, 2012 - 2016.« less

  1. Locality-preserving logical operators in topological stabilizer codes

    NASA Astrophysics Data System (ADS)

    Webster, Paul; Bartlett, Stephen D.

    2018-01-01

    Locality-preserving logical operators in topological codes are naturally fault tolerant, since they preserve the correctability of local errors. Using a correspondence between such operators and gapped domain walls, we describe a procedure for finding all locality-preserving logical operators admitted by a large and important class of topological stabilizer codes. In particular, we focus on those equivalent to a stack of a finite number of surface codes of any spatial dimension, where our procedure fully specifies the group of locality-preserving logical operators. We also present examples of how our procedure applies to codes with different boundary conditions, including color codes and toric codes, as well as more general codes such as Abelian quantum double models and codes with fermionic excitations in more than two dimensions.

  2. 14 CFR 91.503 - Flying equipment and operating information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... operating the airplane: (1) Before starting engines. (2) Before takeoff. (3) Cruise. (4) Before landing. (5... instruments and controls. (3) Engine inoperative procedures. (4) Any other procedures necessary for safety. (d...

  3. 14 CFR 91.503 - Flying equipment and operating information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... operating the airplane: (1) Before starting engines. (2) Before takeoff. (3) Cruise. (4) Before landing. (5... instruments and controls. (3) Engine inoperative procedures. (4) Any other procedures necessary for safety. (d...

  4. 14 CFR 91.503 - Flying equipment and operating information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... operating the airplane: (1) Before starting engines. (2) Before takeoff. (3) Cruise. (4) Before landing. (5... instruments and controls. (3) Engine inoperative procedures. (4) Any other procedures necessary for safety. (d...

  5. How to develop a standard operating procedure for sorting unfixed cells.

    PubMed

    Schmid, Ingrid

    2012-07-01

    Written standard operating procedures (SOPs) are an important tool to assure that recurring tasks in a laboratory are performed in a consistent manner. When the procedure covered in the SOP involves a high-risk activity such as sorting unfixed cells using a jet-in-air sorter, safety elements are critical components of the document. The details on sort sample handling, sorter set-up, validation, operation, troubleshooting, and maintenance, personal protective equipment (PPE), and operator training, outlined in the SOP are to be based on careful risk assessment of the procedure. This review provides background information on the hazards associated with sorting of unfixed cells and the process used to arrive at the appropriate combination of facility design, instrument placement, safety equipment, and practices to be followed. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. New fixation method for maxillary distraction osteogenesis using locking attachments.

    PubMed

    Suzuki, Eduardo Yugo; Buranastidporn, Boonsiva; Ishii, Masatoshi

    2006-10-01

    The external traction hooks of the intraoral splint used in the rigid external distraction (RED) system for maxillary distraction osteogenesis interfere with the surgical procedures. The purpose of this study is to introduce an innovative splint fixation method for maxillary distraction osteogenesis with Locking Attachments and evaluate their advantages, such as reduction of operating time compared with the traditional intraoral splint method. Retrospective comparison of operative times of maxillary Le Fort I osteotomy procedures was carried out with the traditional protocol using the intraoral splint cemented to the maxillary dentition (n = 14), and a removable intraoral splint that is inserted postsurgically (n = 14). Operative procedure times were compared and analyzed statistically using the data extracted from the surgical records. There were no complications inserting the removable splint postsurgically, including pain, discomfort, or time-consuming procedure. Stable and secure splint fixation was obtained before the distraction procedure and the desired treatment goals were obtained in all patients. The total operative procedure times were significantly reduced in the Locking Attachments group by 24% to 41% (approximately 65 minutes) compared with earlier operations involving the conventional splints (P < .05). Maxillary distraction osteogenesis with the Locking Attachments is a highly effective fixation approach to manage severe hypoplastic maxilla, eliminating lip constraints resulting from scarring and allowing for easier, more deliberate and careful dissection. The use of the Locking Attachments is reliable in craniofacial surgery and has proved to be advantageous in the reduction of the operating time and surgical risks.

  7. Field Operations and Enforcement Manual for Air Pollution Control. Volume III: Inspection Procedures for Specific Industries.

    ERIC Educational Resources Information Center

    Weisburd, Melvin I.

    The Field Operations and Enforcement Manual for Air Pollution Control, Volume III, explains in detail the following: inspection procedures for specific sources, kraft pulp mills, animal rendering, steel mill furnaces, coking operations, petroleum refineries, chemical plants, non-ferrous smelting and refining, foundries, cement plants, aluminum…

  8. 40 CFR 63.7736 - How do I demonstrate initial compliance with the operation and maintenance requirements that...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... will inspect, operate, and maintain each capture system according to the procedures in the plan. (2... will inspect, operate, and maintain each control device according to the procedures in the plan. (c... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS...

  9. 31 CFR 1028.520 - Special information sharing procedures to deter money laundering and terrorist activity for...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to deter money laundering and terrorist activity for operators of credit card systems. 1028.520...) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY RULES FOR OPERATORS OF CREDIT CARD SYSTEMS... information sharing procedures to deter money laundering and terrorist activity for operators of credit card...

  10. 31 CFR 1028.520 - Special information sharing procedures to deter money laundering and terrorist activity for...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to deter money laundering and terrorist activity for operators of credit card systems. 1028.520...) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY RULES FOR OPERATORS OF CREDIT CARD SYSTEMS... information sharing procedures to deter money laundering and terrorist activity for operators of credit card...

  11. 31 CFR 1028.520 - Special information sharing procedures to deter money laundering and terrorist activity for...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to deter money laundering and terrorist activity for operators of credit card systems. 1028.520...) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY RULES FOR OPERATORS OF CREDIT CARD SYSTEMS... information sharing procedures to deter money laundering and terrorist activity for operators of credit card...

  12. 31 CFR 1028.520 - Special information sharing procedures to deter money laundering and terrorist activity for...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to deter money laundering and terrorist activity for operators of credit card systems. 1028.520...) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY RULES FOR OPERATORS OF CREDIT CARD SYSTEMS... information sharing procedures to deter money laundering and terrorist activity for operators of credit card...

  13. Joint Operations. Change 1

    DTIC Science & Technology

    2008-02-13

    procedures not ratified by the United States, commanders should evaluate and follow the multinational command’s doctrine and procedures, where applicable... human intelligence sources to be effective and implementation of appropriate force protection measures regardless of the operational...intelligence requirements needed to support the anticipated operation. Human intelligence often may provide the most useful source of information. Even

  14. 40 CFR 63.924 - Standards-Container Level 3 controls.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... selected by the owner or operator: (1) The enclosure shall be designed and operated in accordance with the criteria for a permanent total enclosure as specified in “Procedure T—Criteria for and Verification of a... enclosure. The owner or operator shall perform the verification procedure for the enclosure as specified in...

  15. 40 CFR 63.924 - Standards-Container Level 3 controls.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... selected by the owner or operator: (1) The enclosure shall be designed and operated in accordance with the criteria for a permanent total enclosure as specified in “Procedure T—Criteria for and Verification of a... enclosure. The owner or operator shall perform the verification procedure for the enclosure as specified in...

  16. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION AND OPERATION OF BALANCES (UA-L-1.2)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures used when calibrating and operating balances during the Arizona NHEXAS project and the "Border" study. Keywords: lab; equipment; balances.

    The National Human Exposure Assessment Survey (NHEXAS) is a federal interagency rese...

  17. Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room.

    PubMed

    Michel Foehn, Esther R

    2015-08-01

    This review presents current trends of safe and efficient anesthesia and sedation for adults and children for gastrointestinal procedures outside of the operating room with a special focus on total intravenous anesthesia (TIVA), target-controlled infusion (TCI), intravenous or topical lidocaine, and the use of the video laryngoscope. The concepts of a well tolerated and adequate anesthesia or sedation for gastrointestinal procedures outside of the operating room have to meet the needs of the adult and pediatric patients and the special requests of the gastroenterologists. Anesthesia and sedation of adults for gastrointestinal procedures with TIVA or TCI and spontaneous breathing is well established. Many institutions perform anesthesia for pediatric patients undergoing gastrointestinal procedures with an inhalational agent, especially in young children and for short procedures. Unlike adults, in young children the airways frequently must be secured with a tracheal tube or laryngeal mask. Respiration may be spontaneous, assisted, or controlled. TIVA and TCI are increasingly chosen for older children and longer procedures. A local anesthetic administered intravenously or topically to the upper airways and the use of the video laryngoscope can facilitate the insertion of the endoscope. Both anesthesiologists and nonanesthesiologists have to achieve a consensus and develop quality-improvement strategies to provide safe and efficient anesthesia and sedation for gastrointestinal procedures outside of the operating room for pediatric and adult patients. Techniques using TIVA, TCI, intravenous or topical application of lidocaine, and the video laryngoscope may improve and facilitate gastrointestinal procedures for the patients, the anesthesiologists, and the gastroenterologists.

  18. TVT and TVT-Obturator: comparison of two operative procedures.

    PubMed

    Neuman, Menahem

    2007-03-01

    To compare two anti-incontinence operations: the tension-free vaginal tape (TVT) and the TVT-Obturator for the first two 75-patient groups. One surgeon operated on two patient groups with urodynamically proven urinary stress incontinence. The first 75-patient group in 1998 included the first TVT procedures performed according to Ulmsten [Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996;7:81-6]. Follow-up lasted for 5-6 years. The second 75-patient group in 2004 included the first TVT-Obturator operations performed according to [De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur. Urol. 2003;44:724-30]. Follow-up lasted for 6-13 months. The two patient groups were similar from the demographic and therapeutic points of view. The TVT-Obturator procedure required neither bladder catheterization nor intra-operative diagnostic cystoscopy. TVT-related bladder penetration (8.0%), post-operative voiding difficulties (5.0%), intra-operative bleeding (4.0%), post-operative field infection (2.7%), and post-operative pelvic floor relaxation (1.3%) were not noted with the TVT-Obturator. The early therapeutic failure rates were 2.7% for the TVT and 1.3% for the TVT-Obturator, and neither bowel nor urethral injuries were recorded. The surgeons' learning curves of these two minimally invasive surgical procedures for the treatment of female urinary stress incontinence are comparable. The safety and cost-effectiveness of the TVT are well-established. The TVT-Obturator, a novel mid-urethral sling, was designed to overcome some of the TVT-related operative complications. The TVT-Obturator patients seem to have less intra-operative and post-operative surgical complications than the TVT patients. However, long-term comparative data collection is required prior to drawing solid conclusions concerning the superiority of one of these two operative techniques.

  19. Operator procedure verification with a rapidly reconfigurable simulator

    NASA Technical Reports Server (NTRS)

    Iwasaki, Yumi; Engelmore, Robert; Fehr, Gary; Fikes, Richard

    1994-01-01

    Generating and testing procedures for controlling spacecraft subsystems composed of electro-mechanical and computationally realized elements has become a very difficult task. Before a spacecraft can be flown, mission controllers must envision a great variety of situations the flight crew may encounter during a mission and carefully construct procedures for operating the spacecraft in each possible situation. If, despite extensive pre-compilation of control procedures, an unforeseen situation arises during a mission, the mission controller must generate a new procedure for the flight crew in a limited amount of time. In such situations, the mission controller cannot systematically consider and test alternative procedures against models of the system being controlled, because the available simulator is too large and complex to reconfigure, run, and analyze quickly. A rapidly reconfigurable simulation environment that can execute a control procedure and show its effects on system behavior would greatly facilitate generation and testing of control procedures both before and during a mission. The How Things Work project at Stanford University has developed a system called DME (Device Modeling Environment) for modeling and simulating the behavior of electromechanical devices. DME was designed to facilitate model formulation and behavior simulation of device behavior including both continuous and discrete phenomena. We are currently extending DME for use in testing operator procedures, and we have built a knowledge base for modeling the Reaction Control System (RCS) of the space shuttle as a testbed. We believe that DME can facilitate design of operator procedures by providing mission controllers with a simulation environment that meets all these requirements.

  20. Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency

    NASA Technical Reports Server (NTRS)

    Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

    2006-01-01

    International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.

  1. Operational Improvements From the In-Trail Procedure in the North Atlantic Organized Track System

    NASA Technical Reports Server (NTRS)

    Chartrand, Ryan C.; Bussink, Frank J. L.; Graff, Thomas J.; Murdoch, Jennifer L.; Jones, Kenneth M.

    2008-01-01

    This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System (NATOTS). This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. The ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The data collected were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

  2. Operational Improvements From Using the In-Trail Procedure in the North Atlantic Organized Track System

    NASA Technical Reports Server (NTRS)

    Chartrand, Ryan C.; Bussink, Frank J.; Graff, Thomas J.; Jones, Kenneth M.

    2009-01-01

    This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System. This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The collected data were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

  3. Operative vaginal delivery and invasive procedures in pregnancy among women living with HIV.

    PubMed

    Peters, Helen; Francis, Kate; Harding, Kate; Tookey, Pat A; Thorne, Claire

    2017-03-01

    To describe the use and outcomes of operative delivery and invasive procedures in pregnancy amongst women living with HIV. The National Study of HIV in Pregnancy and Childhood (NSHPC) is a comprehensive population-based surveillance study in the UK and Ireland. The NSHPC has collected data on operative delivery since 2008, and invasive procedures in pregnancy (amniocentesis, cordocentesis, chorionic villus sampling) from 2012. Descriptive analyses were conducted on 278 pregnancies expected to deliver from 1 January 2008 with outcome reported to the NSHPC by 31 March 2016. Among 9372 pregnancies in 2008-2016, there were 9072 livebirths with 251 operative deliveries and 27 invasive procedures in pregnancy reported. Information was available for 3023/3490 vaginal deliveries, and use of forceps or vacuum reported in 251deliveries (8.2%), increasing over calendar time to almost 10% by 2014-16. Forceps were used twice as often as vacuum delivery, and forceps use increased over time. One infant delivered operatively is known to have acquired HIV. From 2012 there were 4063 pregnancies resulting in 3952 livebirths, 83 terminations and 28 stillbirths. 2163/4063 had information on use (or not) of invasive procedures in pregnancy. Amniocentesis was reported in 25/2163 pregnancies, there was one report of chorionic villus sampling and one of cordocentesis. There were no reported transmissions following invasive procedures in pregnancy. This is the largest study to date to report on operative delivery in women living with HIV on combined antiretroviral therapy (cART), and provides an up-to-date picture of invasive procedures during pregnancy in this group. Findings from this comprehensive national study are reassuring but numbers are currently low; on-going monitoring is crucial as obstetric care of women with HIV becomes normalised. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

    PubMed

    Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

    2009-01-01

    Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

  5. 14 CFR 93.71 - General operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude...

  6. Screwworm Eradication Data System (SEDS) operational manual, part 3

    NASA Technical Reports Server (NTRS)

    1976-01-01

    All phases of SEDS operation as well as utility routines, error messages, and system disk maintenance procedures are described. Display layouts and examples of runs are included as additional explanation to SEDS program procedures.

  7. 21 CFR 111.103 - What are the requirements under this subpart F for written procedures?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Production and Process Control... quality control operations, including written procedures for conducting a material review and making a...

  8. The current status of emergency operations at a high-volume cancer center.

    PubMed

    Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Natsume, Seiji; Kawai, Ryosuke; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Tsutsuyama, Masayuki; Shigeyoshi, Itaru; Shimizu, Yasuhiro

    2014-01-01

    This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.

  9. A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus

    PubMed Central

    Meyr, Andrew J; Singh, Salil; Chen, Oliver; Ali, Sayed

    2015-01-01

    This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or “bunion” deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the distal metatarsal, metatarsal shaft, metatarsal base, and phalangeal osteotomies are described in detail. Additional explanations of arthrodesis of the first metatarsal-phalangeal and metatarsal-cuneiform joints are also provided. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed. PMID:26622935

  10. Description of basic mining legal principles.

    PubMed

    Schmidt, Reinhard

    2014-01-01

    The Federal Mining Act manages access, via the system of mining concessions, to areas free for mining natural resources that do not belong to the surface property and deposits' owner. These cover especially important natural resources for the economy, including coal, ore, salt, crude oil and natural gas, and also terrestrial heat. For mining operations there exist, however, the same decrees for natural resources in the property of the surface owners, which are predominantly higher-value industrial minerals such as roofing slate, basalt, quartz sand, and clays for the fireproofing industry. In the case of mining laws, administrative procedures such as issuing mining concessions, approving operating plans, and issuing permits or licenses to explore according to water rights or the Federal Immission Control Act, those authorities and departments in whose remit the projects fall are dealt with by the Mining Authority. This means that the Mining Authority is the only state point of contact for the applicant, essentially an "all-in-one" service as it will itself instigate any further participation procedures required. The classic licensing procedure of mining is the operations plan procedure, whereby the operator submits an operating plan to the Mining Authority, which then examines it to ensure it fulfills mandatory legal safety objectives. If necessary these safety objectives can be met during licensing of the operating plans by stipulating additional requirements, Depending on the subject and validity period there are overall operating plans having the widest possible remit with comprehensive participation by the authorities and basic operating plans that form the basis for every mining works. There are also special operating plans, which owing to the dynamics of mining, resolve matters that suddenly become necessary or when the basic operating plans as originally conceived were not relevant. The closing-down operating plan is the designated tool for closing down works and for the rehabilitation of the land; in the case of underground mining and mine boreholes an operating history must also be submitted. For those projects that have a significant effect on the environment, an obligatory overall operations plan with mining law project approval procedure and integrated Environmental Risk Assessment (UVP) are necessary. The point at which this is required is stipulated in the UVP-mining decree, for example if the mining area of an open-cast pit is more than 25 ha. Alongside the UVP, the procedure is also equipped with public participation and through its "concentrating effect" replaces further licensing procedures according to other laws. The Mining Authority combines supervision and licensing, which are usually inseparable due to the operations plan procedure, as well as aspects of occupational safety and of the protection of the environment. In view of this administrative concentration these should not be fragmented. The "all-in-one" service meets the requirements of a modern public-oriented administration, has only a few points of contact, and can therefore work efficiently.

  11. On the design of flight-deck procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl L.

    1994-01-01

    In complex human-machine systems, operations, training, and standardization depend on a elaborate set of procedures which are specified and mandated by the operational management of the organization. The intent is to provide guidance to the pilots, to ensure a logical, efficient, safe, and predictable means of carrying out the mission objectives. In this report the authors examine the issue of procedure use and design from a broad viewpoint. The authors recommend a process which we call 'The Four P's:' philosophy, policies, procedures, and practices. We believe that if an organization commits to this process, it can create a set of procedures that are more internally consistent, less confusing, better respected by the flight crews, and that will lead to greater conformity. The 'Four-P' model, and the guidelines for procedural development in appendix 1, resulted from cockpit observations, extensive interviews with airline management and pilots, interviews and discussion at one major airframe manufacturer, and an examination of accident and incident reports. Although this report is based on airline operations, we believe that the principles may be applicable to other complex, high-risk systems, such as nuclear power production, manufacturing process control, space flight, and military operations.

  12. Current surgical treatment for chronic pancreatitis.

    PubMed

    Aimoto, Takayuki; Uchida, Eiji; Nakamura, Yoshiharu; Yamahatsu, Kazuya; Matsushita, Akira; Katsuno, Akira; Cho, Kazumitsu; Kawamoto, Masao

    2011-01-01

    Chronic pancreatitis (CP) is a painful, yet benign inflammatory process of the pancreas. Surgical management should be individualized because the pain is multifactorial and its mechanisms vary from patient to patient. Two main pathogenetic theories for the mechanisms of pain in CP have been proposed: the neurogenic theory and the theory of increased intraductal/intraparenchymal pressures. The latter theory is strongly supported by the good results of drainage procedures in the surgical management of CP. Other possible contributing factors include pancreatic ischemia; a centrally sensitized pain state; and the development of complications, such as pseudocysts and stenosis of the duodenum or common bile duct. Common indications for surgery include intractable pain, suspicion of neoplasm, and complications that cannot be resolved with radiological or endoscopic treatments. Operative procedures have been historically classified into 4 categories: decompression procedures for diseased and obstructed pancreatic ducts; resection procedures for the proximal, distal, or total pancreas; denervation procedures of the pancreas; and hybrid procedures. Pancreaticoduodenectomy and pylorus-preserving pancreaticoduodenectomy, once the standard operations for patients with CP, have been replaced by hybrid procedures, such as duodenum-preserving pancreatic head resection, the Frey procedure, and their variants. These procedures are safe and effective in providing long-term pain relief and in treating CP-related complications. Hybrid procedures should be the operations of choice for patients with CP.

  13. Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study.

    PubMed

    Ajmal, Muhammad; Power, Susan; Smith, Tim; Shorten, George D

    2011-02-01

    To apply ergonomic task analysis to the performance of ultrasound-guided (US-guided) femoral nerve block (FNB) in an acute hospital setting. Pilot prospective observational study. Orthopedic operating room of a regional trauma hospital. 15 anesthesiologists of various levels of experience in US-guided FNB (estimated minimum experience < 10 procedures; maximum about 50 procedures, and from basic trainees to consultants); and 15 patients (5 men and 10 women), aged 77 ± 15 (mean ± SD yrs) years. MEASUREMENTS/OBSERVATIONS: A data capture "tool", which was modified from one previously developed for ergonomic study of spinal anesthesia, was studied. Patient, operator, and heterogeneous environmental factors related to ergonomic performance of US-guided FNB were identified. The observation period started immediately before commencement of positioning the patient and ended on completion of perineural injection. Data were acquired using direct observations, photography, and application of a questionnaire. The quality of ergonomic performance was generally suboptimal and varied greatly among operators. Eight (experience < 10 procedures) of 15 operators excessively rotated their head, neck, and/or back to visualize the image on the ultrasound machine. Eight operators (experience < 10 procedures) performed the procedure with excessive thoracolumbar flexion. Performance of US-guided FNB presents ergonomic challenges and was suboptimal during most of the procedures observed. Formal training in US-guided peripheral nerve blockade should include reference to ergonomic factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Microbial ecology laboratory procedures manual NASA/MSFC

    NASA Technical Reports Server (NTRS)

    Huff, Timothy L.

    1990-01-01

    An essential part of the efficient operation of any microbiology laboratory involved in sample analysis is a standard procedures manual. The purpose of this manual is to provide concise and well defined instructions on routine technical procedures involving sample analysis and methods for monitoring and maintaining quality control within the laboratory. Of equal importance is the safe operation of the laboratory. This manual outlines detailed procedures to be followed in the microbial ecology laboratory to assure safety, analytical control, and validity of results.

  15. Operating manual for the Bulk Shielding Reactor

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

    Not Available

    1983-04-01

    The BSR is a pool-type reactor. It has the capabilities of continuous operation at a power level of 2 MW or at any desired lower power level. This manual presents descriptive and operational information. The reactor and its auxillary facilities are described from physical and operational viewpoints. Detailed operating procedures are included which are applicable from source-level startup to full-power operation. Also included are procedures relative to the safety of personnel and equipment in the areas of experiments, radiation and contamination control, emergency actions, and general safety. This manual supercedes all previous operating manuals for the BSR.

  16. Operating manual for the Bulk Shielding Reactor

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

    Not Available

    1987-03-01

    The BSR is a pool-type reactor. It has the capabilities of continuous operation at a power level of 2 MW or at any desired lower power level. This manual presents descriptive and operational information. The reactor and its auxiliary facilities are described from physical and operational viewpoints. Detailed operating procedures are included which are applicable from source-level startup to full-power operation. Also included are procedures relative to the safety of personnel and equipment in the areas of experiments, radiation and contamination control, emergency actions, and general safety. This manual supersedes all previous operating manuals for the BSR.

  17. A guide to safe field operations

    USGS Publications Warehouse

    Yobbi, D.K.; Yorke, T.H.; Mycyk, R.T.

    1996-01-01

    Most functions of the U.S. Geological Survey (USGS), Water Resources Division (WRD) require employees to participate in numerous field activities ranging from routine meetings with cooperators, other federal and public officials, and private citizens to potentially hazardous assignments, such as making flood measurements and scuba diving to service underwater instruments. It is paramount that each employee be aware of safety procedures and operational policies of the WRD to ensure that (1) their activities avoid or minimize personal injury to the employee, coworkers, or anyone in the vicinity of the field activity, and (2) their conduct does not infringe on the personal or property rights of any individual or organization. The purpose of the guide is to familiarize employees with the operational and safety procedures expected to be followed by each employee as a representative of the WRD. It is also intended as a training tool for all new employees and a document to be reviewed by each employee before undertaking a field assignment. It includes general procedures that are standard and applicable to all field operations, such as communication, vehicle operation, and adequate preparation for anticipated weather conditions. It also includes a discussion of specific procedures and safety considerations for most of the routine field assignments undertaken by hydrologists and hydrologic technicians of the WRD. The guide is not intended to be a technical handbook outlining step-by-step procedures for performing specific tasks or a comprehensive discussion of every possible activity that may be undertaken by a USGS employee. Employees are referred to the Techniques for Water-Resources Investigations (TWRI) series for specific technical procedures and to the U.S. Geological Survey Safety and Environmental Health Handbook 445-1-H (USGS, August 1989), USGS Occupational Hazards and Safety Procedures Handbook 445-2-H (December 1993), the WRD notebook on Safety Policy and Guidance Memoranda, and other references for procedures and safety issues related to nonroutine activities, such as operations on large vessels and aircraft.

  18. The impact of resident involvement on post-operative morbidity and mortality following orthopaedic procedures: a study of 43,343 cases.

    PubMed

    Schoenfeld, Andrew J; Serrano, Jose A; Waterman, Brian R; Bader, Julia O; Belmont, Philip J

    2013-11-01

    Few studies have addressed the role of residents' participation in morbidity and mortality after orthopaedic surgery. The present study utilized the 2005-2010 National Surgical Quality Improvement Program (NSQIP) dataset to assess the risk of 30-day post-operative complications and mortality associated with resident participation in orthopaedic procedures. The NSQIP dataset was queried using codes for 12 common orthopaedic procedures. Patients identified as having received one of the procedures had their records abstracted to obtain demographic data, medical history, operative time, and resident involvement in their surgical care. Thirty-day post-operative outcomes, including complications and mortality, were assessed for all patients. A step-wise multivariate logistic regression model was constructed to evaluate the impact of resident participation on mortality- and complication-risk while controlling for other factors in the model. Primary analyses were performed comparing cases where the attending surgeon operated alone to all other case designations, while a subsequent sensitivity analysis limited inclusion to cases where resident participation was reported by post-graduate year. In the NSQIP dataset, 43,343 patients had received one of the 12 orthopaedic procedures queried. Thirty-five percent of cases were performed with resident participation. The mortality rate, overall, was 2.5 and 10 % sustained one or more complications. Multivariate analysis demonstrated a significant association between resident participation and the risk of one or more complications [OR 1.3 (95 % CI 1.1, 1.4); p < 0.001] as well as major systemic complications [OR 1.6 (95 % CI 1.3, 2.0); p < 0.001] for primary joint arthroplasty procedures only. These findings persisted even after sensitivity testing. A mild to moderate risk for complications was noted following resident involvement in joint arthroplasty procedures. No significant risk of post-operative morbidity or mortality was appreciated for the other orthopaedic procedures studied. II (Prognostic).

  19. EPA Library Disaster Response and Continuity of Operations (COOP) Procedures

    EPA Pesticide Factsheets

    To establish Agency-wide procedures for the EPA National Library Network libraries to mitigate, prepare for, respond to, and recover from disasters in EPA libraries and provide continuing operations during and after a disaster.

  20. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION AND OPERATION OF NHEXAS BALANCES (UA-L-1.2)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures used when calibrating and operating balances during the Arizona NHEXAS project and the Border study. Keywords: lab; equipment; balances.

    The U.S.-Mexico Border Program is sponsored by the Environmental Health Workgroup of t...

  1. Operational Control Procedures for the Activated Sludge Process, Part I - Observations, Part II - Control Tests.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This is the first in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. Part I of this document deals with physical observations which should be performed during each routine control test. Part II…

  2. 40 CFR 63.1565 - What are my requirements for organic HAP emissions from catalytic cracking units?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... according to the procedures in the plan. (4) The emission limitations and operating limits for organic HAP... work practice standards? You must: (1) Install, operate, and maintain a continuous monitoring system... operating limit in Table 9 of this subpart that applies to you according to the procedures in Table 11 of...

  3. 40 CFR 63.1565 - What are my requirements for organic HAP emissions from catalytic cracking units?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... according to the procedures in the plan. (4) The emission limitations and operating limits for organic HAP... work practice standards? You must: (1) Install, operate, and maintain a continuous monitoring system... operating limit in Table 9 of this subpart that applies to you according to the procedures in Table 11 of...

  4. Beyond Compliance: How Do Your School Business Operations Measure Up?

    ERIC Educational Resources Information Center

    Rowman & Littlefield Education, 2005

    2005-01-01

    This handbook was developed as a means for self-assessment to assist school business officials in determining the efficiency of the business office's planning, procedures, and operations. It does not include every possible procedure or task performed in the business office. It is intended, rather, as a broad-based checklist of those operations and…

  5. Operator's manual on the visual-accumulation tube method for sedimentation analysis of sands

    USGS Publications Warehouse

    Colby, V.C.; Witzgman, F.W.

    1958-01-01

    The personnel who will be operating these units may have little or no previous knowledge of either the principles involved or the details of opera.ting procedure. This manual is intended as an aid to them in setting up the apparatus, learning the analytical procedure, interpreting the results, and understanding the primary principles encountered.

  6. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND MAINTENANCE OF COMPUTER EQUIPMENT FOR IIT NHEXAS (IIT-A-1.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures for using and maintaining the related microcomputer equipment at the Illinois Institute of Technology (IIT)/NHEXAS site. These methods were used in all data operations and maintenance routines during the NHEXAS project and th...

  7. The Joanna Briggs Institute Best Practice Information Sheet: music as an intervention in hospitals.

    PubMed

    2011-03-01

    This Best Practice Information Sheet aims to synthesize the best-available evidence on music as a therapeutic intervention for the management of anxiety or pain related to procedural or operative interventions. The information that is contained in this sheet has been derived from studies that were included in a systematic review that was conducted by The Joanna Briggs Institute. The original references can be sourced from the systematic review. Music as a therapeutic intervention is a development largely of the mid-20th century; however, it has existed in various forms in most cultures for many centuries. The Best Practice Information Sheet includes music-listening before a procedure or operation, during a procedure or operation, and after a procedure or operation. It excludes other forms of music therapy. Several recommendations for practice are made. © 2011 Blackwell Publishing Asia Pty Ltd.

  8. Is the bipolar vessel sealer device an effective tool in robotic surgery? A retrospective analysis of our experience and a meta-analysis of the literature about different robotic procedures by investigating operative data and post-operative course.

    PubMed

    Ortenzi, Monica; Ghiselli, Roberto; Baldarelli, Maddalena; Cardinali, Luca; Guerrieri, Mario

    2018-04-01

    The latest robotic bipolar vessel sealing tools have been described to be effective allowing to perform procedures with reduced blood loss and shorter operative times. The aim of this study was to assess the efficacy and reliability of these devices applied in different robotic procedures. All robotic operations, between 2014 and 2016, were performed using the EndoWrist One VesselSealer (EWO, Intuitive Surgical, Sunnyvale, CA), a bipolar fully wristed device. Data, including age, gender, body mass index (BMI), were collected. Robot docking time, intraoperative blood loss, robot malfunctioning and overall operative time were analyzed. A meta-analysis of the literature was carried out to point the attention to three different parameters (mean blood loss, operating time and hospital stay) trying to identify how different coagulation devices may affect them. In 73 robotic procedures, the mean operative time was 118.2 minutes (75-125 minutes). Mean hospital stay was four days (2-10 days). There were two post-operative complications (2.74%). The bipolar vessel sealer offers the efficacy of bipolar diathermy and the advantages of a fully wristed instrument. It does not require any change of instruments for coagulation or involvement of the bedside assistant surgeon. These characteristics lead to a reduction in operative time.

  9. Operant ethanol self-administration in ethanol dependent mice.

    PubMed

    Lopez, Marcelo F; Becker, Howard C

    2014-05-01

    While rats have been predominantly used to study operant ethanol self-administration behavior in the context of dependence, several studies have employed operant conditioning procedures to examine changes in ethanol self-administration behavior as a function of chronic ethanol exposure and withdrawal experience in mice. This review highlights some of the advantages of using operant conditioning procedures for examining the motivational effects of ethanol in animals with a history of dependence. As reported in rats, studies using various operant conditioning procedures in mice have demonstrated significant escalation of ethanol self-administration behavior in mice rendered dependent via forced chronic ethanol exposure in comparison to nondependent mice. This paper also presents a summary of these findings, as well as suggestions for future studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Location of the levator veli palatini insertion following levator retropositioning, palatal pushback, and pharyngeal flap procedures.

    PubMed

    Mulliken, J B; Giargiana, F A; Claybaugh, G J; Hoopes, J E

    1975-07-01

    A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.

  11. The costs and quality of operative training for residents in tympanoplasty type I.

    PubMed

    Wang, Mao-Che; Yu, Eric Chen-Hua; Shiao, An-Suey; Liao, Wen-Huei; Liu, Chia-Yu

    2009-05-01

    A teaching hospital would incur more operation room costs on training surgical residents. To evaluate the increased operation time and the increased operation room costs of operations performed by surgical residents. As a model we used a very common surgical otology procedure -- tympanoplasty type I. From January 1, 2004 to December 31, 2004, we included in this study 100 patients who received tympanoplasty type I in Taipei Veterans General Hospital. Fifty-six procedures were performed by a single board-certified surgeon and 44 procedures were performed by residents. We analyzed the operation time and surgical outcomes in these two groups of patients. The operation room cost per minute was obtained by dividing the total operation room expenses by total operation time in the year 2004. The average operation time of residents was 116.47 min, which was significantly longer (p<0.0001) than that of the board-certified surgeon (average 81.07 min). It cost USD $40.36 more for each operation performed by residents in terms of operation room costs. The surgical success rate of residents was 81.82%, which was significantly lower (p=0.016) than that of the board-certified surgeon (96.43%).

  12. A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

    PubMed

    Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

    2016-06-01

    To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retrospective review of billing records. Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. NA Laryngoscope, 126:1385-1389, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Shuttle remote manipulator system mission preparation and operations

    NASA Technical Reports Server (NTRS)

    Smith, Ernest E., Jr.

    1989-01-01

    The preflight planning, analysis, procedures development, and operations support for the Space Transportation System payload deployment and retrieval missions utilizing the Shuttle Remote Manipulator System are summarized. Analysis of the normal operational loads and failure induced loads and motion are factored into all procedures. Both the astronaut flight crews and the Mission Control Center flight control teams receive considerable training for standard and mission specific operations. The real time flight control team activities are described.

  14. 77 FR 39321 - Air Traffic Procedures Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Air Traffic Procedures Advisory... INFORMATION CONTACT: Ms. Lee Kyker, Environmental Specialist, Air Traffic Eastern Service Center, Operations... Manager, Operations Support Group, FAA, Air Traffic, Eastern Service Center. [FR Doc. 2012-16100 Filed 6...

  15. Clinical Experiences in Athletic Training.

    ERIC Educational Resources Information Center

    Knight, Kenneth L.

    This book offers a systematic approach to teaching athletic training. Modules are separated into 10 content areas: direct clinical experience; policies and procedures; emergency procedures; modality operation; advanced modality operation; taping, wrapping, bracing, and padding; management of specific injuries; examination; supervision; and…

  16. 46 CFR 252.42 - Appeals procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Appeals procedures. 252.42 Section 252.42 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS AFFECTING SUBSIDIZED VESSELS AND OPERATORS OPERATING-DIFFERENTIAL SUBSIDY FOR BULK CARGO VESSELS ENGAGED IN WORLDWIDE SERVICES Subsidy...

  17. Maintenance and operations cost model for DSN subsystems

    NASA Technical Reports Server (NTRS)

    Burt, R. W.; Lesh, J. R.

    1977-01-01

    A procedure is described which partitions the recurring costs of the Deep Space Network (DSN) over the individual DSN subsystems. The procedure results in a table showing the maintenance, operations, sustaining engineering and supportive costs for each subsystems.

  18. Amniotic Constriction Bands: Secondary Deformities and Their Treatments.

    PubMed

    Drury, Benjamin T; Rayan, Ghazi M

    2018-01-01

    The purpose of this study was to report the surgical treatment experience of patients with amniotic constriction bands (ACB) over a 35-year interval and detail consequential limb deformities with emphasis on hands and upper extremities, along with the nature and frequency of their surgical treatment methods. Fifty-one patients were identified; 26 were males and 25 females. The total number of deformities was listed. The total number of operations, individual procedures, and operations plus procedures that were done for each patient and their frequency were recorded. The total number of operations was 117, and total number of procedures was 341. More procedures were performed on the upper extremity (85%) than the lower extremity (15%). Including the primary deformity ACB, 16 different hand deformities secondary to ACB were encountered. Sixteen different surgical methods for the upper extremity were utilized; a primary procedure for ACB and secondary reconstructions for all secondary deformities. Average age at the time of the first procedure was 9.3 months. The most common procedures performed, in order of frequency, were excision of ACB plus Z-plasty, release of partial syndactyly, release of fenestrated syndactyly, full-thickness skin grafts, resection of digital bony overgrowth from amputation stumps, and deepening of first and other digital web spaces. Many hand and upper extremity deformities secondary to ACB are encountered. Children with ACB may require more than one operation including multiple procedures. Numerous surgical methods of reconstruction for these children's secondary deformities are necessary in addition to the customary primary procedure of excision of ACB and Z-plasty.

  19. Study of airborne science experiment management concepts for application to space shuttle. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    Mulholland, D. R.; Reller, J. O., Jr.; Neel, C. B.; Haughney, L. C.

    1973-01-01

    The management concepts and operating procedures are documented as they apply to the planning of shuttle spacelab operations. Areas discussed include: airborne missions; formulation of missions; management procedures; experimenter involvement; experiment development and performance; data handling; safety procedures; and applications to shuttle spacelab planning. Characteristics of the airborne science experience are listed, and references and figures are included.

  20. Differential Acquisition of Lever Pressing in Inbred and Outbred Mice: Comparison of One-Lever and Two-Lever Procedures and Correlation with Differences in Locomotor Activity

    ERIC Educational Resources Information Center

    McKerchar, Todd L.; Zarcone, Troy J.; Fowler, Stephen C.

    2005-01-01

    Recent progress in mouse genetics has led to an increased interest in developing procedures for assessing mouse behavior, but relatively few of the behavioral procedures developed involve positively reinforced operant behavior. When operant methods are used, nose poking, not lever pressing, is the target response. In the current study differential…

  1. 40 CFR 60.45b - Compliance and performance test methods and procedures for sulfur dioxide.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... or operator obtains fuel receipts as described in § 60.49b(r). (k) The owner or operator of an...(k)(3) (when not burning coal) shall follow the applicable procedures in § 60.49b(r). [72 FR 32742... following the procedures listed below, except as provided under paragraph (d) and (k) of this section. (1...

  2. 40 CFR 60.45b - Compliance and performance test methods and procedures for sulfur dioxide.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or operator obtains fuel receipts as described in § 60.49b(r). (k) The owner or operator of an...(k)(3) (when not burning coal) shall follow the applicable procedures in § 60.49b(r). [72 FR 32742... following the procedures listed below, except as provided under paragraph (d) and (k) of this section. (1...

  3. 40 CFR 60.45b - Compliance and performance test methods and procedures for sulfur dioxide.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... or operator obtains fuel receipts as described in § 60.49b(r). (k) The owner or operator of an...(k)(3) (when not burning coal) shall follow the applicable procedures in § 60.49b(r). [72 FR 32742... following the procedures listed below, except as provided under paragraph (d) and (k) of this section. (1...

  4. 40 CFR 60.45b - Compliance and performance test methods and procedures for sulfur dioxide.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... or operator obtains fuel receipts as described in § 60.49b(r). (k) The owner or operator of an...(k)(3) (when not burning coal) shall follow the applicable procedures in § 60.49b(r). [72 FR 32742... following the procedures listed below, except as provided under paragraph (d) and (k) of this section. (1...

  5. 40 CFR 60.45b - Compliance and performance test methods and procedures for sulfur dioxide.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... or operator obtains fuel receipts as described in § 60.49b(r). (k) The owner or operator of an...(k)(3) (when not burning coal) shall follow the applicable procedures in § 60.49b(r). [72 FR 32742... following the procedures listed below, except as provided under paragraph (d) and (k) of this section. (1...

  6. What is the learning curve for the anterior approach for total hip arthroplasty?

    PubMed

    de Steiger, Richard Noel; Lorimer, Michelle; Solomon, Michael

    2015-12-01

    There are many factors that may affect the learning curve for total hip arthroplasty (THA) and surgical approach is one of these. There has been renewed interest in the direct anterior approach for THA with variable outcomes reported, but few studies have documented a surgeon's individual learning curve when using this approach. (1) What was the revision rate for all surgeons adopting the anterior approach for placement of a particular implant? (2) What was the revision rate for surgeons who performed > 100 cases in this fashion? (3) Is there a minimum number of cases required to complete a learning curve for this procedure? The Australian Orthopaedic Association National Joint Replacement Registry prospectively collects data on all primary and revision joint arthroplasty surgery. We analyzed all conventional THAs performed up to December 31, 2013, with a primary diagnosis of osteoarthritis using a specific implant combination and secondarily those associated with surgeons performing more than 100 procedures. Ninety-five percent of these procedures were performed through the direct anterior approach. Procedures using this combination were ordered from earliest (first procedure date) to latest (last procedure date) for each individual surgeon. Using the order number for each surgeon, five operation groups were defined: one to 15 operations, 16 to 30 operations, 31 to 50 operations, 51 to 100 operations, and > 100 operations. The primary outcome measure was time to first revision using Kaplan-Meier estimates of survivorship. Sixty-eight surgeons performed 5499 THAs using the specified implant combination. The cumulative percent revision at 4 years for all 68 surgeons was 3% (95% confidence interval [CI], 2.5-3.8). For surgeons who had performed over 100 operations, the cumulative revision rate was 3% (95% CI, 2.0-3.5). It was not until surgeons had performed over 50 operations that there was no difference in the cumulative percent revision compared with over 100 operations. The cumulative percent revision for surgeons performing 51 to 100 operations at 4 years was 3% (95% CI, 1.5-5.4) and over 100 operations 2% (95% CI, 1.2-2.7; hazard ratio, 1.40 [95% CI, 0.7-2.7]; p = 0.33). There is a learning curve for the anterior approach for THA even when using a prosthesis combination specifically marketed for that approach. We found that 50 or more procedures need to be performed by a surgeon before the rate of revision is no different from performing 100 or more procedures. Surgeons should be aware of this initial higher rate of revision when deciding which approach delivers the best outcome for their patients.

  7. Trends in Utilization of Vocal Fold Injection Procedures.

    PubMed

    Rosow, David E

    2015-11-01

    Office-based vocal fold injections have become increasingly popular over the past 15 years. Examination of trends in procedure coding for vocal fold injections in the United States from 2000 to 2012 was undertaken to see if they reflect this shift. The US Part B Medicare claims database was queried from 2000 through 2012 for multiple Current Procedural Terminology codes. Over the period studied, the number of nonoperative laryngoscopic injections (31513, 31570) and operative medialization laryngoplasties (31588) remained constant. Operative vocal fold injection (31571) demonstrated marked linear growth over the 12-year study period, from 744 procedures in 2000 to 4788 in 2012-an increase >640%. The dramatic increased incidence in the use of code 31571 reflects an increasing share of vocal fold injections being performed in the operating room and not in an office setting, running counter to the prevailing trend toward awake, office-based injection procedures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  8. Can Particulate Air Sampling Predict Microbial Load in Operating Theatres for Arthroplasty?

    PubMed Central

    Cristina, Maria Luisa; Spagnolo, Anna Maria; Sartini, Marina; Panatto, Donatella; Gasparini, Roberto; Orlando, Paolo; Ottria, Gianluca; Perdelli, Fernanda

    2012-01-01

    Several studies have proposed that the microbiological quality of the air in operating theatres be indirectly evaluated by means of particle counting, a technique derived from industrial clean-room technology standards, using airborne particle concentration as an index of microbial contamination. However, the relationship between particle counting and microbiological sampling has rarely been evaluated and demonstrated in operating theatres. The aim of the present study was to determine whether particle counting could predict microbiological contamination of the air in an operating theatre during 95 surgical arthroplasty procedures. This investigation was carried out over a period of three months in 2010 in an orthopedic operating theatre devoted exclusively to prosthetic surgery. During each procedure, the bacterial contamination of the air was determined by means of active sampling; at the same time, airborne particulate contamination was assessed throughout the entire procedure. On considering the total number of surgical operations, the mean value of the total bacterial load in the center of the operating theatre proved to be 35 CFU/m3; the mean particle count was 4,194,569 no./m3 for particles of diameter ≥0.5 µm and 13,519 no./m3 for particles of diameter ≥5 µm. No significant differences emerged between the median values of the airborne microbial load recorded during the two types of procedure monitored. Particulates with a diameter of ≥0.5 µm were detected in statistically higher concentrations (p<0.001) during knee-replacement procedures. By contrast, particulates with a diameter of ≥5 µm displayed a statistically higher concentration during hip-replacement procedures (p<0.05). The results did not reveal any statistically significant correlation between microbial loads and particle counts for either of the particle diameters considered (≥0.5 µm and ≥5 µm). Consequently, microbiological monitoring remains the most suitable method of evaluating the quality of air in operating theatres. PMID:23285189

  9. A cadaveric procedural anatomy course enhances operative competence.

    PubMed

    Sharma, Gaurav; Aycart, Mario A; Najjar, Peter A; van Houten, Trudy; Smink, Douglas S; Askari, Reza; Gates, Jonathan D

    2016-03-01

    Inadequate anatomy training has been cited as a major contributor to declines in surgical resident operative competence and confidence. We report the impact of a procedurally oriented general surgery cadaveric dissection course on trainee-operative confidence and competence. After obtaining institutional review board approval, postgraduate year 2 and 3 general surgery residents were prospectively enrolled into two cohorts: (1) an intervention group (n = 7) participating in an 8-wk procedurally oriented cadaver course and (2) controls (n = 7) given access to course materials without participation in cadaver dissection. At both the beginning and end of the study, we used two evaluation instruments: (1) an oral examination using standardized templates and (2) a questionnaire assessing operative confidence. There were no intergroup differences in baseline characteristics, including number of operative procedures performed to date. Residents who took the anatomy course had significantly higher improvements in examination scores on common bile duct exploration (mean ± standard error, 33 ± 8% versus 10 ± 7%, P = 0.04), femoral endarterectomy (43 ± 5% versus 11 ± 7%, P = 0.003), fasciotomies (55 ± 10% versus 22 ± 9%, P = 0.04), inguinal hernia repair (20 ± 9% versus -14 ± 5%, P = 0.005), superior mesenteric artery embolectomy (38 ± 10% versus 2 ± 11%, P = 0.04), and in overall examination scores (31 ± 4% versus 8% ± 3%, P = 0.0006). In addition, they reported higher operative confidence on common bile duct exploration (P = 0.008) and superior mesenteric artery embolectomy (P = 0.02), and a trend toward higher overall operative confidence (P = 0.06). In this study, we demonstrate that a procedurally oriented cadaver course covering a wide range of essential general surgery procedures resulted in significant improvements in self-reported operative confidence and competence as assessed by oral examination. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Can particulate air sampling predict microbial load in operating theatres for arthroplasty?

    PubMed

    Cristina, Maria Luisa; Spagnolo, Anna Maria; Sartini, Marina; Panatto, Donatella; Gasparini, Roberto; Orlando, Paolo; Ottria, Gianluca; Perdelli, Fernanda

    2012-01-01

    Several studies have proposed that the microbiological quality of the air in operating theatres be indirectly evaluated by means of particle counting, a technique derived from industrial clean-room technology standards, using airborne particle concentration as an index of microbial contamination. However, the relationship between particle counting and microbiological sampling has rarely been evaluated and demonstrated in operating theatres. The aim of the present study was to determine whether particle counting could predict microbiological contamination of the air in an operating theatre during 95 surgical arthroplasty procedures. This investigation was carried out over a period of three months in 2010 in an orthopedic operating theatre devoted exclusively to prosthetic surgery. During each procedure, the bacterial contamination of the air was determined by means of active sampling; at the same time, airborne particulate contamination was assessed throughout the entire procedure. On considering the total number of surgical operations, the mean value of the total bacterial load in the center of the operating theatre proved to be 35 CFU/m(3); the mean particle count was 4,194,569 no./m(3) for particles of diameter ≥0.5 µm and 13,519 no./m(3) for particles of diameter ≥5 µm. No significant differences emerged between the median values of the airborne microbial load recorded during the two types of procedure monitored. Particulates with a diameter of ≥0.5 µm were detected in statistically higher concentrations (p<0.001) during knee-replacement procedures. By contrast, particulates with a diameter of ≥5 µm displayed a statistically higher concentration during hip-replacement procedures (p<0.05). The results did not reveal any statistically significant correlation between microbial loads and particle counts for either of the particle diameters considered (≥0.5 µm and ≥5 µm). Consequently, microbiological monitoring remains the most suitable method of evaluating the quality of air in operating theatres.

  11. 30 CFR 761.15 - Procedures for waiving the prohibition on surface coal mining operations within the buffer zone...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Procedures for waiving the prohibition on surface coal mining operations within the buffer zone of an occupied dwelling. 761.15 Section 761.15... surface coal mining operations within the buffer zone of an occupied dwelling. (a) This section does not...

  12. 30 CFR 761.15 - Procedures for waiving the prohibition on surface coal mining operations within the buffer zone...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Procedures for waiving the prohibition on surface coal mining operations within the buffer zone of an occupied dwelling. 761.15 Section 761.15... surface coal mining operations within the buffer zone of an occupied dwelling. (a) This section does not...

  13. 30 CFR 761.15 - Procedures for waiving the prohibition on surface coal mining operations within the buffer zone...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Procedures for waiving the prohibition on surface coal mining operations within the buffer zone of an occupied dwelling. 761.15 Section 761.15... surface coal mining operations within the buffer zone of an occupied dwelling. (a) This section does not...

  14. 30 CFR 761.15 - Procedures for waiving the prohibition on surface coal mining operations within the buffer zone...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Procedures for waiving the prohibition on surface coal mining operations within the buffer zone of an occupied dwelling. 761.15 Section 761.15... surface coal mining operations within the buffer zone of an occupied dwelling. (a) This section does not...

  15. 30 CFR 761.15 - Procedures for waiving the prohibition on surface coal mining operations within the buffer zone...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Procedures for waiving the prohibition on surface coal mining operations within the buffer zone of an occupied dwelling. 761.15 Section 761.15... surface coal mining operations within the buffer zone of an occupied dwelling. (a) This section does not...

  16. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND MAINTENANCE OF RELATED COMPUTER EQUIPMENT FOR IIT NHEXAS (IIT-A-1.0)

    EPA Science Inventory

    The purpose of this SOP is to describe the procedures for using and maintaining the related microcomputer equipment at the Illinois Institute of Technology (IIT)/NHEXAS site. These methods were used in all data operations and maintenance routines during the Arizona NHEXAS projec...

  17. A Guide for Developing Standard Operating Job Procedures for the Digestion Process Wastewater Treatment Facility. SOJP No. 10.

    ERIC Educational Resources Information Center

    Schwing, Carl M.

    This guide describes standard operating job procedures for the digestion process of wastewater treatment facilities. This process is for reducing the volume of sludge to be treated in subsequent units and to reduce the volatile content of sludge. The guide gives step-by-step instructions for pre-startup, startup, continuous operating, shutdown,…

  18. A Guide for Developing Standard Operating Job Procedures for the Tertiary Multimedia Filtration Process Wastewater Treatment Facility. SOJP No. 7.

    ERIC Educational Resources Information Center

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary multimedia filtration process of wastewater treatment plants. The major objective of the filtration process is the removal of suspended solids from the reclaimed wastewater. The guide gives step-by-step instructions for pre-start up, start-up, continuous operation, and…

  19. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION, CALIBRATION AND MAINTENANCE OF THE PERKIN-ELMER ZEEMAN/5000 SYSTEM ATOMIC ABSORPTION SPECTROMETER (BCO-L-6.0)

    EPA Science Inventory

    The purpose of this SOP is to outline the start-up, calibration, operation, and maintenance procedures for the Perkin-Elmer 5000 atomic absorption spectrophotometer (PE 5000 AA), and the Perkin Elmer 5000 Zeeman graphite furnace atomic absorption spectrophotometer (PE 5000Z GFAA)...

  20. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND MAINTENANCE OF THE LAN AND RELATED MICROCOMPUTER ENVIRONMENT (UA-D-1.1)

    EPA Science Inventory

    The purpose of this SOP is to describe procedures for using and maintaining the local area network (LAN) and related microcomputer equipment at the HRP Site of the Arizona Prevention Center. These methods were used for all data operations and maintenance routines during the Ariz...

  1. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND MAINTENANCE OF THE LAN AND RELATED MICROCOMPUTER ENVIRONMENT (UA-D-1.1)

    EPA Science Inventory

    The purpose of this SOP is to describe procedures for using and maintaining the local area network (LAN) and related microcomputer equipment at the Health Related Professions site at the University of Arizona. These methods were used for all data operations and maintenance routi...

  2. Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective.

    PubMed

    Chandran, D; Woods, C M; Schar, M; Ma, N; Ooi, E H; Athanasiadis, T

    2018-02-01

    To conduct a cost analysis of injection laryngoplasty performed in the operating theatre under local anaesthesia and general anaesthesia. The retrospective study included patients who had undergone injection laryngoplasty as day cases between July 2013 and March 2016. Cost data were obtained, along with patient demographics, anaesthetic details, type of injectant, American Society of Anesthesiologists score, length of stay, total operating theatre time and surgeon procedure time. A total of 20 cases (general anaesthesia = 6, local anaesthesia = 14) were included in the cost analysis. The mean total cost under general anaesthesia (AU$2865.96 ± 756.29) was significantly higher than that under local anaesthesia (AU$1731.61 ± 290.29) (p < 0.001). The mean operating theatre time, surgeon procedure time and length of stay were all significantly lower under local anaesthesia compared to general anaesthesia. Time variables such as operating theatre time and length of stay were the most significant predictors of the total costs. Procedures performed under local anaesthesia in the operating theatre are associated with shorter operating theatre time and length of stay in the hospital, and provide significant cost savings. Further savings could be achieved if local anaesthesia procedures were performed in the office setting.

  3. Evaluation of a new very low dose imaging protocol: feasibility and impact on X-ray dose levels in electrophysiology procedures

    PubMed Central

    Bourier, Felix; Reents, Tilko; Ammar-Busch, Sonia; Buiatti, Alessandra; Kottmaier, Marc; Semmler, Verena; Telishevska, Marta; Brkic, Amir; Grebmer, Christian; Lennerz, Carsten; Kolb, Christof; Hessling, Gabriele; Deisenhofer, Isabel

    2016-01-01

    Aims This study presents and evaluates the impact of a new lowest-dose fluoroscopy protocol (Siemens AG), especially designed for electrophysiology (EP) procedures, on X-ray dose levels. Methods and results From October 2014 to March 2015, 140 patients underwent an EP study on an Artis zee angiography system. The standard low-dose protocol was operated at 23 nGy (fluoroscopy) and at 120 nGy (cine-loop), the new lowest-dose protocol was operated at 8 nGy (fluoroscopy) and at 36 nGy (cine-loop). Procedural data, X-ray times, and doses were analysed in 100 complex left atrial and in 40 standard EP procedures. The resulting dose–area products were 877.9 ± 624.7 µGym² (n = 50 complex procedures, standard low dose), 199 ± 159.6 µGym² (n = 50 complex procedures, lowest dose), 387.7 ± 36.0 µGym² (n = 20 standard procedures, standard low dose), and 90.7 ± 62.3 µGym² (n = 20 standard procedures, lowest dose), P < 0.01. In the low-dose and lowest-dose groups, procedure times were 132.6 ± 35.7 vs. 126.7 ± 34.7 min (P = 0.40, complex procedures) and 72.3 ± 20.9 vs. 85.2 ± 44.1 min (P = 0.24, standard procedures), radiofrequency (RF) times were 53.8 ± 26.1 vs. 50.4 ± 29.4 min (P = 0.54, complex procedures) and 10.1 ± 9.9 vs. 12.2 ± 14.7 min (P = 0.60, standard procedures). One complication occurred in the standard low-dose and lowest-dose groups (P = 1.0). Conclusion The new lowest-dose imaging protocol reduces X-ray dose levels by 77% compared with the currently available standard low-dose protocol. From an operator standpoint, lowest X-ray dose levels create a different, reduced image quality. The new image quality did not significantly affect procedure or RF times and did not result in higher complication rates. Regarding radiological protection, operating at lowest-dose settings should become standard in EP procedures. PMID:26589627

  4. Perioperative hypoxemia is common with horizontal positioning during general anesthesia and is associated with major adverse outcomes: a retrospective study of consecutive patients

    PubMed Central

    2014-01-01

    Background Reported perioperative pulmonary aspiration (POPA) rates have substantial variation. Perioperative hypoxemia (POH), a manifestation of POPA, has been infrequently studied beyond the PACU, for patients undergoing a diverse array of surgical procedures. Methods Consecutive adult patients with ASA I-IV and pre-operative pulmonary stability who underwent a surgical procedure requiring general anesthesia were investigated. Using pulse oximetry, POH was documented in the operating room and during the 48 hours following PACU discharge. POPA was the presence of an acute pulmonary infiltrate with POH. Results The 500 consecutive, eligible patients had operative body-positions of prone 13%, decubitus 8%, sitting 1%, and supine/lithotomy 78%, with standard practice of horizontal recumbency. POH was found in 150 (30%) patients. Post-operative stay with POH was 3.7 ± 4.7 days and without POH was 1.7 ± 2.3 days (p < 0.0001). POH rate varied from 14% to 58% among 11 of 12 operative procedure-categories. Conditions independently associated with POH (p < 0.05) were acute trauma, BMI, ASA level, glycopyrrolate administration, and duration of surgery. POPA occurred in 24 (4.8%) patients with higher mortality (8.3%), when compared to no POPA (0.2%; p = 0.0065). Post-operative stay was greater with POPA (7.7 ± 5.7 days), when compared to no POPA (2.0 ± 2.9 days; p = 0.0001). Conditions independently associated with POPA (p < 0.05) were cranial procedure, ASA level, and duration of surgery. POPA, acute trauma, duration of surgery, and inability to extubate in the OR were independently associated with post-operative stay (p < 0.05). POH, gastric dysmotility, acute trauma, cranial procedure, emergency procedure, and duration of surgery had independent correlations with post-operative length of stay (p < 0.05). Conclusions Adult surgical patients undergoing general anesthesia with horizontal recumbency have substantial POH and POPA rates. Hospital mortality was greater with POPA and post-operative stay was increased for POH and POPA. POH rates were noteworthy for virtually all categories of operative procedures and POH and POPA were independent predictors of post-operative length of stay. A study is needed to determine if modest reverse-Trendelenburg positioning during general anesthesia has a relationship with reduced POH and POPA rates. PMID:24940115

  5. Ear, nose and throat day-case surgery at a district general hospital.

    PubMed

    Pézier, T; Stimpson, P; Kanegaonkar, R G; Bowdler, D A

    2009-03-01

    In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.

  6. 43 CFR 418.32 - Cooperative programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... THE INTERIOR OPERATING CRITERIA AND PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Water... cooperatively to develop a water management and conservation program to promote efficient management of water in..., to improve the District's operations and procedures for greater water delivery conservation. (b) The...

  7. 43 CFR 418.32 - Cooperative programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... INTERIOR OPERATING CRITERIA AND PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Water Management... cooperatively to develop a water management and conservation program to promote efficient management of water in..., to improve the District's operations and procedures for greater water delivery conservation. (b) The...

  8. 43 CFR 418.32 - Cooperative programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... THE INTERIOR OPERATING CRITERIA AND PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Water... cooperatively to develop a water management and conservation program to promote efficient management of water in..., to improve the District's operations and procedures for greater water delivery conservation. (b) The...

  9. 43 CFR 418.32 - Cooperative programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... THE INTERIOR OPERATING CRITERIA AND PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Water... cooperatively to develop a water management and conservation program to promote efficient management of water in..., to improve the District's operations and procedures for greater water delivery conservation. (b) The...

  10. 43 CFR 418.32 - Cooperative programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... THE INTERIOR OPERATING CRITERIA AND PROCEDURES FOR THE NEWLANDS RECLAMATION PROJECT, NEVADA Water... cooperatively to develop a water management and conservation program to promote efficient management of water in..., to improve the District's operations and procedures for greater water delivery conservation. (b) The...

  11. 40 CFR 68.69 - Operating procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

  12. 40 CFR 68.69 - Operating procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

  13. 40 CFR 68.69 - Operating procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

  14. 40 CFR 68.69 - Operating procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

  15. 40 CFR 68.69 - Operating procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

  16. 7 CFR 610.25 - Subcommittees and Local Working Groups.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

  17. 46 CFR 162.060-24 - Test Plan requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (including the test facility's standard operating procedures for achieving such conditions). (9) Sampling.... Test Plans must include an examination of all the manufacturer's stated requirements and procedures for... potential environmental, health, and safety issues; unusual operating requirements; and any issues related...

  18. 40 CFR 792.35 - Quality assurance unit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

  19. 40 CFR 792.35 - Quality assurance unit.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

  20. 40 CFR 792.35 - Quality assurance unit.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

  1. 46 CFR 162.060-24 - Test Plan requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (including the test facility's standard operating procedures for achieving such conditions). (9) Sampling.... Test Plans must include an examination of all the manufacturer's stated requirements and procedures for... potential environmental, health, and safety issues; unusual operating requirements; and any issues related...

  2. 40 CFR 792.35 - Quality assurance unit.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

  3. 40 CFR 792.35 - Quality assurance unit.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... from approved protocols or standard operating procedures were made without proper authorization and... standard operating procedures, and that the reported results accurately reflect the raw data of the study... ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 792.35 Quality...

  4. 7 CFR 610.25 - Subcommittees and Local Working Groups.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

  5. 7 CFR 610.25 - Subcommittees and Local Working Groups.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

  6. 7 CFR 610.25 - Subcommittees and Local Working Groups.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

  7. 46 CFR 162.060-24 - Test Plan requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (including the test facility's standard operating procedures for achieving such conditions). (9) Sampling.... Test Plans must include an examination of all the manufacturer's stated requirements and procedures for... potential environmental, health, and safety issues; unusual operating requirements; and any issues related...

  8. 7 CFR 610.25 - Subcommittees and Local Working Groups.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... communicated to NRCS in accordance with the standard operating procedures described in § 610.23(b). (b) Local... conservation activities and programs; and (3) Local Working Groups will follow the standard operating procedures described in § 610.23(b). ...

  9. 47 CFR 36.379 - Message processing expense.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... JURISDICTIONAL SEPARATIONS PROCEDURES; STANDARD PROCEDURES FOR SEPARATING TELECOMMUNICATIONS PROPERTY COSTS... Customer Operations Expenses § 36.379 Message processing expense. (a) This classification includes the... exchange operation. (1) Effective July 1, 2001 through June 30, 2011, study areas subject to price cap...

  10. Mission description and in-flight operations of ERBE instruments on ERBS and NOAA 9 spacecraft, November 1984 - January 1986

    NASA Technical Reports Server (NTRS)

    Weaver, William L.; Bush, Kathryn A.; Harris, Chris J.; Howerton, Clayton E.; Tolson, Carol J.

    1991-01-01

    Instruments of the Earth Radiation Budget Experiment (ERBE) are operating on three different Earth orbiting spacecrafts: the Earth Radiation Budget Satellite (ERBS), NOAA-9, and NOAA-10. An overview is presented of the ERBE mission, in-orbit environments, and instrument design and operational features. An overview of science data processing and validation procedures is also presented. In-flight operations are described for the ERBE instruments aboard the ERBS and NOAA-9. Calibration and other operational procedures are described, and operational and instrument housekeeping data are presented and discussed.

  11. Ground Software Maintenance Facility (GSMF) user's manual

    NASA Technical Reports Server (NTRS)

    Aquila, V.; Derrig, D.; Griffith, G.

    1986-01-01

    Instructions for the Ground Software Maintenance Facility (GSMF) system user is provided to operate the GSMF in all modes. The GSMF provides the resources for the Automatic Test Equipment (ATE) computer program maintenance (GCOS and GOAL). Applicable reference documents are listed. An operational overview and descriptions of the modes in terms of operator interface, options, equipment, material utilization, and operational procedures are contained. Test restart procedures are described. The GSMF documentation tree is presented including the user manual.

  12. AMO EXPRESS: A Command and Control Experiment for Crew Autonomy Onboard the International Space Station

    NASA Technical Reports Server (NTRS)

    Stetson, Howard K.; Haddock, Angie T.; Frank, Jeremy; Cornelius, Randy; Wang, Lui; Garner, Larry

    2015-01-01

    NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control experiment on-board the International Space Station that demonstrated single action intelligent procedures for crew command and control. The target problem was to enable crew initialization of a facility class rack with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as initialization of a medical facility to respond to a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). Utilization of Draper Laboratory's Timeliner software, deployed on-board the ISS within the Command and Control (C&C) computers and the Payload computers, allowed development of the automated procedures specific to ISS without having to certify and employ novel software for procedure development and execution. The procedures contained the ground procedure logic and actions as possible to include fault detection and recovery capabilities. The autonomous operations concept includes a reduction of the amount of data a crew operator is required to verify during activation or de-activation, as well as integration of procedure execution status and relevant data in a single integrated display. During execution, the auto-procedures (via Timerliner) provide a step-by-step messaging paradigm and a high-level status upon termination. This messaging and high-level status is the only data generated for operator display. To enhance situational awareness of the operator, the Web-based Procedure Display (WebPD) provides a novel approach to the issues of procedure display and execution tracking. WebPD is a web based application that serves as the user interface for electronic procedure execution. It incorporates several aspects of the HTML5 standard. Procedures are written in a dialect of XML called Procedure Representation Language (PRL). WebPD tracks execution status in the procedure or procedures being displayed. WebPD aggregates and simplifies the auto-sequence execution status information, and formatted to be easily followed and understood by an operator who is not dedicated to actively monitoring the task. WebPD also provides an integrated data and control interface to pause or halt the execution in order to provide a check point of operation and to examine progress before starting the next sequence of activities. For this demonstration, the procedure was initiated and monitored from the ground. As the Timeliner sequences executed, their high-level execution status was written to PLMDM memory. This memory is read and downlinked via Ku-Band at a 1 Hz rate. The data containing the high-level execution status is de-commutated on the ground, and rebroadcast for WebPD consumption. A future demonstration will be performed onboard, with ISS astronauts initiating the operations instead of ground controllers. The AMO EXPRESS experiment demonstrated activation and de-activation of EXPRESS rack 7, providing the capability of future single button activations and deactivations of facility class racks. The experiment achieved numerous technical and operations 'firsts' for the ISS

  13. Advanced laparoscopic bariatric surgery Is safe in general surgery training.

    PubMed

    Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

    2017-05-01

    Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

  14. Reversal of Hartmann's procedure: a high-risk operation?

    PubMed

    Schmelzer, Thomas M; Mostafa, Gamal; Norton, H James; Newcomb, William L; Hope, William W; Lincourt, Amy E; Kercher, Kent W; Kuwada, Timothy S; Gersin, Keith S; Heniford, B Todd

    2007-10-01

    Patients who undergo Hartmann's procedure often do not have their colostomy closed based on the perceived risk of the operation. This study evaluated the outcome of reversal of Hartmann's procedure based on preoperative risk factors. We retrospectively reviewed adult patients who underwent reversal of Hartmann's procedure at our tertiary referral institution. Patient outcomes were compared based on identified risk factors (age >60 years, American Society of Anesthesiologists [ASA] score >2, and >2 preoperative comorbidities). One-hundred thirteen patients were included. Forty-four patients (39%) had an ASA score of >or=3. The mean hospital duration of stay was 6.8 days. There were 28 (25%) postoperative complications and no mortality. Patients >60 years old had significantly longer LOS compared with the rest of the group (P = .02). There were no differences in outcomes between groups based on ASA score or the presence of multiple preoperative comorbidities. An albumin level of <3.5 was the only significant predictor of postoperative complications (P = .04). The reversal of Hartmann's operation appears to be a safe operation with acceptable morbidity rates and can be considered in patients, including those with significant operative risk factors.

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

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  16. Crew operations

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The requirements for the activities involved, and the procedures used by the crew in the operations of the modular space station are presented. All crew-related characteristics of the station and its operations are indicated. The interior configuration and arrangement of each of the space station modules, the facilities and equipment in the module and their operation are described as related to crew habitability. The crew activities and procedures involved in the operation of the station in the accomplishment of its primary mission are defined. The operations involved in initial station buildup, and the on-orbit operation and maintenance of the station and its subsystems to support the experimental program are included. A general description of experiment operations is also given.

  17. Early Australian experience in robotic sleeve gastrectomy: a single site series.

    PubMed

    Silverman, Candice D; Ghusn, Michael A

    2017-05-01

    The use of robotic platforms in bariatric surgery has recently gained relevance. With an increased use of this technology come concerns regarding learning curve effects during the initial implementation phase. The sleeve gastrectomy though may represent an ideal training procedure for introducing the robot into bariatric surgical practice. The present review of the first 10 consecutive robotic sleeve gastrectomy procedures performed in an Australian bariatric programme by a single surgeon describes the evolution of the technique, learning curve and initial patient outcomes. Between 2014 and 2015, robotic sleeve gastrectomies were performed as primary and revisional procedures by a consistent surgeon-assistant team. Technique evolution and theatre set-up were documented. Patient demographics, operative time (robot docking and total operation time), additional operative procedures performed, operative and post-operative complications at 1, 3 and 6 months post-procedure and weight loss achieved at 6 months were retrospectively reviewed from a prospectively maintained database. Ten robotic sleeve gastrectomies were performed without significant operative complications. One patient was treated as an outpatient with oral antibiotics for a superficial wound infection. The median total operative time was 123 min (interquartile range (IQR) 108.8-142.5), with a median incision to docking time of 19 min (IQR 15.0-31.8). Length of stay in hospital was 2-3 days. Median excess weight loss achieved at 6 months was 50% (IQR 33.9-66.5). This study describes a method of safely introducing the da Vinci robot into bariatric surgical practice. © 2016 Royal Australasian College of Surgeons.

  18. Ibuprofen timing for hand surgery in ambulatory care

    PubMed Central

    Giuliani, Enrico; Bianchi, Anna; Marcuzzi, Augusto; Landi, Antonio; Barbieri, Alberto

    2015-01-01

    OBJECTIVE: To evaluate the effect of pre-operative administration of ibuprofen on post-operative pain control vs. early post-operative administration for hand surgery procedures performed under local anaesthesia in ambulatory care. METHODS: Candidates to trigger finger release by De Quervain tenosynovitis and carpal tunnel operation under local anesthesia were enrolled in the study. Group A received 400 mg ibuprofen before the operation and placebo after the procedure; group B received placebo before the operation and ibuprofen 400 mg at the end of the procedure; both groups received ibuprofen 400 mg every 6h thereafter. Visual analogue scale (VAS) was measured at fixed times before and every 6h after surgery, for a total follow-up of 18h. RESULTS: Groups were similar according to age, gender and type of surgery. Median VAS values did not produce any statistical significance, while there was a statistically significant difference on pre-operative and early post-operative VAS values between groups (A -8.53 mm vs. B 3.36 mm, p=0.0085). CONCLUSION: Average pain levels were well controlled by local anesthesia and post-operative ibuprofen analgesia. Pre-operative ibuprofen administration can contribute to improve early pain management. Level of Evidence II, Therapeutic Studies. PMID:26327799

  19. 47 CFR 13.209 - Examination procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.209 Examination procedures. (a) Each examination for a commercial radio operator license must be administered at a... examinee to comply with its instructions. (b) Each examinee, when taking an examination for a commercial...

  20. 40 CFR 243.201-2 - Recommended procedures: Operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... equipment should meet the applicable provisions of the Occupational Safety and Health Administration... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.201-2 Section 243.201-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

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