Comparison of fluid types for resuscitation after acute blood loss in mallard ducks (Anas platyrhynchos).

PubMed

Lichtenberger, Marla; Orcutt, Connie; Cray, Carolyn; Thamm, Douglas H; DeBehnke, Daniel; Page, Cheryl; Mull, Lori; Kirby, Rebecca

2009-10-01

The purpose of this study was to determine the LD(50) for acute blood loss in mallard ducks (Anas platyrhynchos), compare the mortality rate among 3 fluid resuscitation groups, and determine the time required for a regenerative RBC response. Prospective study. Medical College of Wisconsin Research facility. Eighteen mallard ducks were included for the LD(50) study and 28 for the fluid resuscitation study. Phlebotomy was performed during both the LD(50) and fluid resuscitation studies. Ducks in the fluid resuscitation study received a 5 mL/kg intravenous bolus of crystalloids, hetastarch (HES), or a hemoglobin-based oxygen-carrying solution (HBOCS). The LD(50) for acute blood loss was 60% of total blood volume. This blood volume was removed in the fluid resuscitation study to create a model of acute blood loss. Following fluid administration, 6 birds in the crystalloid group (66%), 4 birds in the HES group (40%), and 2 birds in the HBOCS group (20%) died. No statistical difference in mortality rate was seen among the 3 fluid resuscitation groups. Relative polychromasia evaluated post-phlebotomy demonstrated regeneration starting at 24 hours and continuing through 48 hours. The LD(50) for acute blood loss in mallard ducks was 60% of their total blood volume. Although no statistical difference in mortality rate was appreciated among the 3 fluid resuscitation groups, a trend of decreased mortality rate was observed in the HBOCS group. An early regenerative response was apparent following acute blood loss.

Improved diagnostic testing and malaria treatment practices in Zambia.

PubMed

Hamer, Davidson H; Ndhlovu, Micky; Zurovac, Dejan; Fox, Matthew; Yeboah-Antwi, Kojo; Chanda, Pascalina; Sipilinyambe, Naawa; Simon, Jonathon L; Snow, Robert W

2007-05-23

Improving the accuracy of malaria diagnosis with rapid antigen-detection diagnostic tests (RDTs) has been proposed as an approach for reducing overtreatment of malaria in the current era of widespread implementation of artemisinin-based combination therapy in sub-Saharan Africa. To assess the association between use of microscopy and RDT and the prescription of antimalarials. Cross-sectional, cluster sample survey, carried out between March and May 2006, of all outpatients treated during 1 working day at government and mission health facilities in 4 sentinel districts in Zambia. Proportions of patients undergoing malaria diagnostic procedures and receiving antimalarial treatment. Seventeen percent of the 104 health facilities surveyed had functional microscopy, 63% had RDTs available, and 73% had 1 or more diagnostics available. Of patients with fever (suspected malaria), 27.8% (95% confidence interval [CI], 13.1%-42.5%) treated in health facilities with malaria diagnostics were tested and 44.6% had positive test results. Of patients with negative blood smear results, 58.4% (95% CI, 36.7%-80.2%) were prescribed an antimalaria drug, as were 35.5% (95% CI, 16.0%-55.0%) of those with a negative RDT result. Of patients with fever who did not have diagnostic tests done, 65.9% were also prescribed antimalarials. In facilities with artemether-lumefantrine in stock, this antimalarial was prescribed to a large proportion of febrile patients with a positive diagnostic test result (blood smear, 75.0% [95% CI, 51.7%-98.3%]; RDT, 70.4% [95% CI, 39.3%-100.0%]), but also to some of those with a negative diagnostic test result (blood smear, 30.4% [95% CI, 8.0%-52. 9%]; RDT, 26.7% [95% CI, 5.7%-47.7%]). Despite efforts to expand the provision of malaria diagnostics in Zambia, they continue to be underused and patients with negative test results frequently receive antimalarials. Provision of new tools to reduce inappropriate use of new expensive antimalarial treatments must be accompanied by a major change in clinical treatment of patients presenting with fever but lacking evidence of malaria infection.

[Investigation on current situation of malaria blood examinations in township-level hospitals of Nantong City].

PubMed

Gui-Sheng, Ding; Cai-Qun, Cao; Ping, Miao; Mei-Fang, Gu; Xiao-Bin, Cao

2016-11-18

To understand the quality of malaria blood examinations in township-level hospitals, so as to provide the evidence for continuing the malaria blood examinations in the stage of post-malaria elimination. A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated, and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzed during the period of 2011-2014. For the single indicator, 29.5% of the thick blood films did not reach the standard, and 35.8% of thin blood films did not reach the standard. For the multiple indicators, blood slides with more than 4 indicators below the standard (poor quality) accounted for 32.5%. From malaria blood examinations and malaria situation, the number of slides was 194 635 during the period of 2011-2014, and there were no local vivax malaria casesin 4 consecutive years from 2011 to 2014, and local malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented, the township and village level accounted for 16.3%, and county and higher level accounted for 83.7%. The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

Biomarkers of mercury exposure at a mercury recycling facility in Ukraine.

PubMed

Gibb, Herman Jones; Kozlov, Kostj; Buckley, Jessie Poulin; Centeno, Jose; Jurgenson, Vera; Kolker, Allan; Conko, Kathryn; Landa, Edward; Panov, Boris; Panov, Yuri; Xu, Hanna

2008-08-01

This study evaluates biomarkers of occupational mercury exposure among workers at a mercury recycling operation in Gorlovka, Ukraine. The 29 study participants were divided into three occupational categories for analysis: (1) those who worked in the mercury recycling operation (Group A, n = 8), (2) those who worked at the facility but not in the yard where the recycling was done (Group B, n = 14), and (3) those who did not work at the facility (Group C, n = 7). Urine, blood, hair, and nail samples were collected from the participants, and a questionnaire was administered to obtain data on age, gender, occupational history, smoking, alcohol consumption, fish consumption, tattoos, dental amalgams, home heating system, education, source of drinking water, and family employment in the former mercury mine/smelter located on the site of the recycling facility. Each factor was tested in a univariate regression with total mercury in urine, blood, hair, and nails. Median biomarker concentrations were 4.04 microg/g-Cr (urine), 2.58 microg/L (blood), 3.95 microg/g (hair), and 1.16 microg/g (nails). Occupational category was significantly correlated (p < 0.001) with both blood and urinary mercury concentrations but not with hair or nail mercury. Four individuals had urinary mercury concentrations in a range previously found to be associated with subtle neurological and subjective symptoms (e.g., fatigue, loss of appetite, irritability), and one worker had a urinary mercury concentration in a range associated with a high probability of neurological effects and proteinuria. Comparison of results by occupational category found that workers directly involved with the recycling operation had the highest blood and urinary mercury levels. Those who worked at the facility but were not directly involved with the recycling operation had higher levels than those who did not work at the facility.

Hadfield during BP Reg Experiment Operations

NASA Image and Video Library

2013-04-17

ISS035-E-022360 (17 April 2013) --- In support of the Blood Pressure Regulation Experiment (BP Reg), Expedition 35 Commander Chris Hadfield of the Canadian Space Agency is pictured after having set up the Human Research Facility (HRF) PFS (Pulmonary Function System) and the European Physiology Module (EPM) Cardiolab (CDL) Leg/Arm Cuff System (LACS) and conducting the first ever session of this experiment. The test, which will be repeated using other crew members as well, will help to identify the astronauts who could benefit from countermeasures before returning to Earth. Thus, this method has great potential for astronaut health monitoring during future long-term space flights and it also has important implications for testing of individuals on Earth, especially the elderly, who are at risk for fainting. The research will also allow demonstrating the feasibility of obtaining a set of indicators of overall cardiovascular regulation from the non-invasive measurement of continuous blood pressure.

Hadfield during BP Reg Experiment Operations

NASA Image and Video Library

2013-04-17

ISS035-E-022357 (17 April 2013) --- In support of the Blood Pressure Regulation Experiment (BP Reg), Expedition 35 Commander Chris Hadfield of the Canadian Space Agency is pictured after having set up the Human Research Facility (HRF) PFS (Pulmonary Function System) and the European Physiology Module (EPM) Cardiolab (CDL) Leg/Arm Cuff System (LACS) and conducting the first ever session of this experiment. The test, which will be repeated using other crew members as well, will help to identify the astronauts who could benefit from countermeasures before returning to Earth. Thus, this method has great potential for astronaut health monitoring during future long-term space flights and it also has important implications for testing of individuals on Earth, especially the elderly, who are at risk for fainting. The research will also allow demonstrating the feasibility of obtaining a set of indicators of overall cardiovascular regulation from the non-invasive measurement of continuous blood pressure.

Hadfield during BP Reg Experiment Operations

NASA Image and Video Library

2013-04-17

ISS035-E-022356 (17 April 2013) --- In support of the Blood Pressure Regulation Experiment (BP Reg), Expedition 35 Commander Chris Hadfield of the Canadian Space Agency is pictured after having set up the Human Research Facility (HRF) PFS (Pulmonary Function System) and the European Physiology Module (EPM) Cardiolab (CDL) Leg/Arm Cuff System (LACS) and conducting the first ever session of this experiment. The test, which will be repeated using other crew members as well, will help to identify the astronauts who could benefit from countermeasures before returning to Earth. Thus, this method has great potential for astronaut health monitoring during future long-term space flights and it also has important implications for testing of individuals on Earth, especially the elderly, who are at risk for fainting. The research will also allow demonstrating the feasibility of obtaining a set of indicators of overall cardiovascular regulation from the non-invasive measurement of continuous blood pressure.

Transfusion-related acute lung injury risk mitigation: an update.

PubMed

Otrock, Z K; Liu, C; Grossman, B J

2017-11-01

Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion. Greater understanding of the pathophysiology of this syndrome has much improved during the last two decades. Plasma-containing components from female donors with leucocyte antibodies were responsible for the majority of TRALI fatalities before mitigation strategies were implemented. Over the past 15 years, measures to mitigate risk for TRALI have been implemented worldwide and they continued to evolve with time. The AABB requires that all plasma containing components and whole blood for transfusion must be collected from men, women who have not been pregnant, or women who have tested negative for human leucocyte antigen antibodies. Although the incidence of TRALI has decreased following the institution of TRALI mitigation strategies, TRALI is still the most common cause of transfusion-associated death in the United States. In this review, we focus on TRALI risk mitigation strategies. We describe the measures taken by blood collection facilities to reduce the risk of TRALI in the United States, Canada and European countries. We also review the literature for the effectiveness of these measures. © 2017 International Society of Blood Transfusion.

Economic Analysis of the Reduction of Blood Transfusions during Surgical Procedures While Continuous Hemoglobin Monitoring Is Used

PubMed Central

Ribed-Sánchez, Borja; Varea-Díaz, Sara; Corbacho-Fabregat, Carlos; Pérez-Oteyza, Jaime; Belda-Iniesta, Cristóbal

2018-01-01

Background: Two million transfusions are performed in Spain every year. These come at a high economic price for the health system, increasing the morbidity and mortality rates. The way of obtaining the hemoglobin concentration value is via invasive and intermittent methods, the results of which take time to obtain. The drawbacks of this method mean that some transfusions are unnecessary. New continuous noninvasive hemoglobin measurement technology can save unnecessary transfusions. Methods: A prospective study was carried out with a historical control of two homogeneous groups. The control group used the traditional hemoglobin measurement methodology. The experimental group used the new continuous hemoglobin measurement technology. The difference was analyzed by comparing the transfused units of the groups. The economic savings was calculated by multiplying the cost of a transfusion by the difference in units, taking into account measurement costs. Results: The percentage of patients needing a transfusion decreased by 7.4%, and the number of transfused units per patient by 12.56%. Economic savings per patient were €20.59. At the national level, savings were estimated to be 13,500 transfusions (€1.736 million). Conclusions: Constant monitoring of the hemoglobin level significantly reduces the need for blood transfusions. By using this new measurement technology, health care facilities can significantly reduce costs and improve care quality. PMID:29702617

Acute hepatitis B outbreaks in 2 skilled nursing facilities and possible sources of transmission: North Carolina, 2009-2010.

PubMed

Seña, Arlene C; Moorman, Anne; Njord, Levi; Williams, Roxanne E; Colborn, James; Khudyakov, Yury; Drobenuic, Jan; Xia, Guo-Liang; Wood, Hattie; Moore, Zack

2013-07-01

Acute hepatitis B virus (HBV) infections have been reported in long-term care facilities (LTCFs), primarily associated with infection control breaks during assisted blood glucose monitoring. We investigated HBV outbreaks that occurred in separate skilled nursing facilities (SNFs) to determine factors associated with transmission. Outbreak investigation with case-control studies. Two SNFs (facilities A and B) in Durham, North Carolina, during 2009-2010. Residents with acute HBV infection and controls randomly selected from HBV-susceptible residents during the outbreak period. After initial cases were identified, screening was offered to all residents, with repeat testing 3 months later for HBV-susceptible residents. Molecular testing was performed to assess viral relatedness. Infection control practices were observed. Case-control studies were conducted to evaluate associations between exposures and acute HBV infection in each facility. Six acute HBV cases were identified in each SNF. Viral phylogenetic analysis revealed a high degree of HBV relatedness within, but not between, facilities. No evaluated exposures were significantly associated with acute HBV infection in facility A; those associated with infection in facility B (all odds ratios >20) included injections, hospital or emergency room visits, and daily blood glucose monitoring. Observations revealed absence of trained infection control staff at facility A and suboptimal hand hygiene practices during blood glucose monitoring and insulin injections at facility B. These outbreaks underscore the vulnerability of LTCF residents to acute HBV infection, the importance of surveillance and prompt investigation of incident cases, and the need for improved infection control education to prevent transmission.

Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

PubMed

Tsan, Min-Fu; Grabenbauer, Michael; Nguyen, Yen

2016-01-01

The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs) conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA) has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

PubMed Central

Wittmann, F W; Ring, P A

1984-01-01

In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

21 CFR 606.170 - Adverse reaction file.

Code of Federal Regulations, 2012 CFR

2012-04-01

... maintained of any reports of complaints of adverse reactions regarding each unit of blood or blood product arising as a result of blood collection or transfusion. A thorough investigation of each reported adverse... the manufacturer or collecting facility. (b) When a complication of blood collection or transfusion is...

Quality Assurance of Rapid Diagnostic Tests for Malaria in Routine Patient Care in Rural Tanzania

PubMed Central

McMorrow, Meredith L.; Masanja, M. Irene; Kahigwa, Elizeus; Abdulla, Salim M. K.; Kachur, S. Patrick

2010-01-01

Histidine-rich protein II (HRP2)-based malaria rapid diagnostic tests (RDTs) have shown high sensitivity and specificity for detecting Plasmodium falciparum malaria in a variety of study settings. However, RDTs are susceptible to heat and humidity and variation in individual performance, which may affect their use in field settings. We evaluated sensitivity and specificity of RDTs during routine use for malaria case management in peripheral health facilities. From December 2007 to October 2008, HRP2-based ParaHIT-f RDTs were introduced in 12 facilities without available microscopy in Rufiji District, Tanzania. Health workers received a single day of instruction on how to perform an RDT and thick blood smear. Job aids, Integrated Management of Childhood Illness guidelines, and national malaria treatment algorithms were reviewed. For quality assurance (QA), thick blood smears for reference microscopy were collected for 2 to 3 days per week from patients receiving RDTs; microscopy was not routinely performed at the health facilities. Slides were stained and read centrally within 72 hours of collection by a reference microscopist. When RDT and blood smear results were discordant, blood smears were read by additional reference microscopists blinded to earlier results. Facilities were supervised monthly by the district laboratory supervisor or a member of the study team. Ten thousand six hundred fifty (10,650) patients were tested with RDTs, and 51.5% (5,488/10,650) had a positive test result. Blood smear results were available for 3,914 patients, of whom 40.1% (1,577/3,914) were positive for P. falciparum malaria. Overall RDT sensitivity was 90.7% (range by facility 85.7–96.5%) and specificity was 73.5% (range 50.0–84.3%). Sensitivity increased with increasing parasite density. Successful implementation of RDTs was achieved in peripheral health facilities with adequate training and supervision. Quality assurance is essential to the adequate performance of any laboratory test. Centralized staining and reading of blood smears provided useful monitoring of RDT performance. However, this level of QA may not be sustainable nationwide. PMID:20065013

Biomarkers of mercury exposure at a mercury recycling facility in Ukraine

USGS Publications Warehouse

Gibb, H.J.; Kozlov, K.; Buckley, J.P.; Centeno, J.; Jurgenson, V.; Kolker, A.; Conko, K.; Landa, E.; Panov, B.; Panov, Y.; Xu, H.

2008-01-01

This study evaluates biomarkers of occupational mercury exposure among workers at a mercury recycling operation in Gorlovka, Ukraine. The 29 study participants were divided into three occupational categories for analysis: (1) those who worked in the mercury recycling operation (Group A, n = 8), (2) those who worked at the facility but not in the yard where the recycling was done (Group B, n = 14), and (3) those who did not work at the facility (Group C, n = 7). Urine, blood, hair, and nail samples were collected from the participants, and a questionnaire was administered to obtain data on age, gender, occupational history, smoking, alcohol consumption, fish consumption, tattoos, dental amalgams, home heating system, education, source of drinking water, and family employment in the former mercury mine/smelter located on the site of the recycling facility. Each factor was tested in a univariate regression with total mercury in urine, blood, hair, and nails. Median biomarker concentrations were 4.04 ??g/g-Cr (urine), 2.58 ??g/L (blood), 3.95 ??g/g (hair), and 1.16 ??g/g (nails). Occupational category was significantly correlated (p < 0.001) with both blood and urinary mercury concentrations but not with hair or nail mercury. Four individuals had urinary mercury concentrations in a range previously found to be associated with subtle neurological and subjective symptoms (e.g., fatigue, loss of appetite, irritability), and one worker had a urinary mercury concentration in a range associated with a high probability of neurological effects and proteinuria. Comparison of results by occupational category found that workers directly involved with the recycling operation had the highest blood and urinary mercury levels. Those who worked at the facility but were not directly involved with the recycling operation had higher levels than those who did not work at the facility. Copyright ?? 2008 JOEH, LLC.

40 CFR 792.43 - Test system care facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Test system care facilities. 792.43 Section 792.43 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.43 Test system care facilities...

[Development of a continuous blood pressure monitoring and recording system].

PubMed

Zhang, Yang; Li, Yong; Gao, Shumei; Song, Yilin

2012-09-01

A small experimental system is constructed with working principle of continuous blood pressure monitoring based on the volume compensation method. The preliminary experimental results show that the system can collect blood pressure signals at the radial artery effectively. The digital PID algorithm can track the variation of blood pressure. And the accuracy of continuous blood pressure detecting achieve the level of same kind of product.

40 CFR 60.32c - Designated facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Designated facilities. 60.32c Section 60.32c Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Solid Waste Landfills § 60.32c Designated facilities. (a) The designated facility to which the...

Massive blood transfusion during hospitalization for delivery in New York State, 1998-2007.

PubMed

Mhyre, Jill M; Shilkrut, Alexander; Kuklina, Elena V; Callaghan, William M; Creanga, Andreea A; Kaminsky, Sari; Bateman, Brian T

2013-12-01

To define the frequency, risk factors, and outcomes of massive transfusion in obstetrics. The State Inpatient Dataset for New York (1998-2007) was used to identify all delivery hospitalizations for hospitals that reported at least one delivery-related transfusion per year. Multivariable logistic regression analysis was performed to examine the relationship between maternal age, race, and relevant clinical variables and the risk of massive blood transfusion defined as 10 or more units of blood recorded. Massive blood transfusion complicated 6 of every 10,000 deliveries with cases observed even in the smallest facilities. Risk factors with the strongest independent associations with massive blood transfusion included abnormal placentation (1.6/10,000 deliveries, adjusted odds ratio [OR] 18.5, 95% confidence interval [CI] 14.7-23.3), placental abruption (1.0/10,000, adjusted OR 14.6, 95% CI 11.2-19.0), severe preeclampsia (0.8/10,000, adjusted OR 10.4, 95% CI 7.7-14.2), and intrauterine fetal demise (0.7/10,000, adjusted OR 5.5, 95% CI 3.9-7.8). The most common etiologies of massive blood transfusion were abnormal placentation (26.6% of cases), uterine atony (21.2%), placental abruption (16.7%), and postpartum hemorrhage associated with coagulopathy (15.0%). A disproportionate number of women who received a massive blood transfusion experienced severe morbidity including renal failure, acute respiratory distress syndrome, sepsis, and in-hospital death. Massive blood transfusion was infrequent, regardless of facility size. In the presence of known risk for receipt of massive blood transfusion, women should be informed of this possibility, should deliver in a well-resourced facility if possible, and should receive appropriate blood product preparation and venous access in advance of delivery. : II.

Critical Value Reporting in Transfusion Medicine: A Survey of Communication Practices in US Facilities.

PubMed

Reese, Erika M; Nelson, Randin C; Flegel, Willy A; Byrne, Karen M; Booth, Garrett S

2017-05-01

While critical value procedures have been adopted in most areas of the clinical laboratory, their use in transfusion medicine has not been reviewed in detail. The results of this study present a comprehensive overview of critical value reporting and communication practices in transfusion medicine in the United States. A web-based survey was developed to collect data on the prevalence of critical value procedures and practices of communicating results. The survey was distributed via email to US hospital-based blood banks. Of 123 facilities surveyed, 84 (68.3%) blood banks had a critical value procedure. From a panel of 23 common blood bank results, nine results were selected by more than 70% of facilities as either a critical value or requiring rapid communication as defined by an alternate procedure. There was overlap among results communicated by facilities with and without a critical value procedure. The most frequently communicated results, such as incompatible crossmatch for RBC units issued uncrossmatched, delay in finding compatible blood due to a clinically significant antibody, and transfusion reaction evaluation suggestive of a serious adverse event, addressed scenarios associated with the leading reported causes of transfusion-related fatalities. American Society for Clinical Pathology, 2017. This work is written by US Government employees and is in the public domain in the US.

Facility design consideration for continuous mix production of class 1.3 propellant

NASA Technical Reports Server (NTRS)

Williamson, K. L.; Schirk, P. G.

1994-01-01

In November of 1989, NASA awarded the Advanced Solid Rocket Motor (ASRM) contract to Lockheed Missiles and Space Company (LMSC) for production of advanced solid rocket motors using the continuous mix process. Aerojet ASRM division (AAD) was selected as the facility operator and RUST International Corporation provided the engineering, procurement, and construction management services. The continuous mix process mandates that the mix and cast facilities be 'close-coupled' along with the premix facilities, creating unique and challenging requirements for the facility designer. The classical approach to handling energetic materials-division into manageable quantities, segregation, and isolation-was not available due to these process requirements and quantities involved. This paper provides a description of the physical facilities, the continuous mix process, and discusses the monitoring and detection techniques used to mitigate hazards and prevent an incident.

The implementation of a multinational "walking blood bank" in a combat zone: The experience of a health service team deployed to a medical treatment facility in Afghanistan.

PubMed

Garcia Hejl, Carine; Martinaud, Christophe; Macarez, Remi; Sill, Joshua; Le Golvan, Armelle; Dulou, Renaud; Longin Roche, Celine; De Rudnicki, Stephane

2015-05-01

We present here a description of the experience in whole-blood transfusion of a health service team deployed to a medical treatment facility in Afghanistan from June 2011 to October 2011. The aim of our work was to show how a "walking blood bank" could provide a sufficient supply. We gathered the blood-group types of military personnel deployed to the theater of operations to evaluate our "potential walking blood bank," and we compared these data with our needs. Blood type frequencies among our "potential walking blood bank" were similar to those observed in European or American countries. Our resources could have been limited because of a low frequency of B blood type and negative rhesus in our "potential walking blood bank." Because of the large number of potential donors in the theater of operations, the risk of blood shortage was quite low and we did not face blood shortage despite significant transfusion requirements. Actually, 93 blood bags were collected, including rare blood types like AB and B blood types. In our experience, this international "walking blood bank" provided a quick, safe, and sufficient blood supply. More research in this area is needed, and our results should be confirmed by further prospective trials. Therapeutic study, level V.

9 CFR 71.21 - Tissue and blood testing at slaughter.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Tissue and blood testing at slaughter... GENERAL PROVISIONS § 71.21 Tissue and blood testing at slaughter. (a) Any person moving livestock or... this section 9 within their facility for blood and tissue sample collection; 9 FSIS also has equipment...

9 CFR 71.21 - Tissue and blood testing at slaughter.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Tissue and blood testing at slaughter... GENERAL PROVISIONS § 71.21 Tissue and blood testing at slaughter. (a) Any person moving livestock or... in accordance with paragraph (b) of this section 9 within their facility for blood and tissue sample...

9 CFR 71.21 - Tissue and blood testing at slaughter.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Tissue and blood testing at slaughter... GENERAL PROVISIONS § 71.21 Tissue and blood testing at slaughter. (a) Any person moving livestock or... in accordance with paragraph (b) of this section 9 within their facility for blood and tissue sample...

9 CFR 71.21 - Tissue and blood testing at slaughter.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Tissue and blood testing at slaughter... GENERAL PROVISIONS § 71.21 Tissue and blood testing at slaughter. (a) Any person moving livestock or... in accordance with paragraph (b) of this section 9 within their facility for blood and tissue sample...

Evaluation of lead levels in children living near a Los Angeles county battery recycling facility.

PubMed Central

Wohl, A R; Dominguez, A; Flessel, P

1996-01-01

This cross-sectional study examined the association between environmental lead measurements surrounding a Los Angeles County battery recycling facility and the blood lead levels of the children living nearby. Environmental lead measurements and blood lead levels of young children living in a community adjacent to a stationary lead source were compared to those living in a community without a stationary lead source. Predictors of blood lead level were identified. The blood lead levels of the children living near the secondary lead smelter were within the normal range (< 5 micrograms/dl). The absence of ground cover was associated with slightly increased blood lead levels; however, this increase was not of biological significance. Lead levels in surface soil near the stationary lead source were elevated compared to the control community; however, the soil affected community, which may be due in part to controls recently installed at the stationary lead source. PMID:8919770

Facile surface modification of glass with zwitterionic polymers for improving the blood compatibility

NASA Astrophysics Data System (ADS)

Zhang, Lingling; Chen, Xiaojuan; Liu, Pingsheng; Wang, Jing; Zhu, Haomiao; Li, Li

2018-06-01

A facile procedure to modify glass film with zwitterionic polymers for improving the blood compatibility was introduced. The glass slides were first silanized with 3-methacryloxypropyltrimethoxysilane (MPT) to generate methacrylate groups on the surface. Then, N, N’-dimethyl-N-methacryloxyethyl-N-(3-sulfopropyl) ammonium (DMMSA), a sulfobetaine zwitterionic monomer, was polymerized on the silanized glass substrates by free-radical polymerization in order to graft the zwitterionic polymers onto the substrates. X-ray Photoelectron Spectroscopy (XPS), water contact angle, scanning electron microscope (SEM) and atomic force microscopy (AFM) were utilized to analyze the surface properties of the grafted glass. The blood compatibility of the grafted glass was verified by whole blood contacting and platelet adhesion experiments in vitro. The results showed that the zwitterionic polymers were successfully grafted on the glass surface, and consequently significantly inhibited the platelet adhesion and whole blood cell attachment.

Assessing the residual risk for transfusion-transmitted infections in the Philippine blood supply.

PubMed

Lam, Hilton Y; Belizario, Vicente Y; Juban, Noel R; Alejandria, Marissa M; Castillo-Carandang, Nina; Arcellana-Nuqui, Elizabeth; Mirasol, Ma Angelina; Cordero, Cynthia P; Sison, Olivia T; Rivera, Adovich S

2014-09-01

Due to a USAID-funded study on blood banks, a national policy was instituted in 1994 that set standards for Philippine blood services, promoted voluntary donation, and led to a ban on commercial blood banks. In this follow-up study, we assess the safety of the supply by determining the residual risk for transfusion-transmitted infections (syphilis, hepatitis B and C, HIV). We also identified unsafe facility practices and generated policy recommendations. A 1992 study found that transfusion-ready blood was not safe using the LQAS method (P > 0.05). We found that the 2012 residual risk became 0 to 0.9 percent attributable to the national policy. We noted poor to fair adherence to this policy. We identified unsafe practices such as use of rapid tests and lack of random blood retesting. Training and use of regional networks may improve safety. Despite improvement in safety, facilities complain of funding and logistical issues regarding compliance with the policy.

Physiological effects of a companion robot on blood pressure of older people in residential care facility: a pilot study.

PubMed

Robinson, Hayley; MacDonald, Bruce; Broadbent, Elizabeth

2015-03-01

To investigate the effects of interacting with the companion robot, Paro, on blood pressure and heart rate of older people in a residential care facility. This study used a repeated measures design. Twenty-one residents in rest home and hospital level care had their blood pressure taken three times; before, during and after interacting with the seal robot. Four residents who did not interact with the robot were excluded from the final analysis (final n = 17). The final analysis found that systolic and diastolic blood pressure changed significantly over time as did heart rate. Planned comparisons revealed that systolic and diastolic blood pressure decreased significantly from baseline to when residents had Paro (systolic, P = 0.048; diastolic, P = 0.05). Diastolic blood pressure increased significantly after Paro was withdrawn (P = 0.03). Interacting with Paro has a physiological effect on cardiovascular measures, which is similar to findings with live animals. © 2013 ACOTA.

Influence of the washing program on the blood processing performance of a continuous autotransfusion device.

PubMed

Yoon, Chiyul; Noh, Seungwoo; Lee, Jung Chan; Ko, Sung Ho; Ahn, Wonsik; Kim, Hee Chan

2014-03-01

The continuous autotransfusion system has been widely used in surgical operations. It is known that if oil is added to blood, and this mixture is then processed by an autotransfusion device, the added oil is removed and reinfusion of fat is prevented by the device. However, there is no detailed report on the influence of the particular washing program selected on the levels of blood components including blood fat after continuous autotransfusion using such a system. Fresh bovine blood samples were processed by a commercial continuous autotransfusion device using the "emergency," "quality," and "high-quality" programs, applied in random order. Complete blood count (CBC) and serum chemistry were analyzed to determine how the blood processing performance of the device changes with the washing program applied. There was no significant difference in the CBC results obtained with the three washing programs. Although all of the blood lipids in the processed blood were decreased compared to those in the blood before processing, the levels of triglyceride, phospholipid, and total cholesterol after processing via the emergency program were significantly higher than those present after processing via the quality and high-quality programs. Although the continuous autotransfusion device provided consistent hematocrit quality, the levels of some blood lipid components showed significant differences among the washing programs.

Goodpasture Syndrome

MedlinePlus

... container in a health care provider’s office or commercial facility and can be tested in the same ... blood at a health care provider’s office or commercial facility and sending the sample to a lab ...

The safety of early fresh, whole blood transfusion among severely battle injured at US Marine Corps forward surgical care facilities in Afghanistan.

PubMed

Auten, Jonathan D; Lunceford, Nicole L; Horton, Jaime L; Galarneau, Mike R; Galindo, Roger M; Shepps, Craig D; Zieber, Tara J; Dewing, Chris B

2015-11-01

In Afghanistan, care of the acutely injured trauma patient commonly occurred in facilities with limited blood banking capabilities. Apheresis platelets were often not available. Component therapy consisted of 1:1 packed red blood cells and fresh frozen plasma. Fresh, whole blood transfusion often augmented therapy in the severely injured patient. This study analyzed the safety of fresh, whole blood use in a resource-limited setting. A retrospective analysis was performed on a prospectively collected data set of US battle injuries presenting to three US Marine Corps (USMC) expeditionary surgical care facilities in Helmand Province, Afghanistan, between January 2010 and July 2012. Included in the review were patients with Injury Severity Scores (ISSs) of 15 or higher receiving blood transfusions. Univariate analyses were performed, followed by multivariable logistic regression to describe the relationship between the treatment group and posttreatment complications such as trauma-induced coagulopathy, infection, mortality, venous thromboembolism, and transfusion reaction. Propensity scores were calculated and included in multivariable models to adjust for potential bias in treatment selection. A total of 61 patients were identified; all were male marines with a mean (SD) age of 23.5 (3.6) years. The group receiving fresh, whole blood was noted to have higher ISSs and lower blood pressure, pH, and base deficits on arrival. Traumatic coagulopathy was significantly less common in the group receiving fresh, whole blood (odds ratio, 0.01; 95% confidence interval, 0.00-0.18). Multivariable models found no other significant differences between the treatment groups. The early use of fresh, whole blood in a resource-limited setting seems to confer a benefit in reducing traumatic coagulopathy. This study's small sample size precludes further statement on the overall safety of fresh, whole blood use. Therapy study, level IV.

Screening for Atrial Fibrillation in Patients ≥65 Years Using an Automatic Blood Pressure Monitor in a Skilled Nursing Facility.

PubMed

Wiesel, Joseph; Salomone, Thomas J

2017-10-15

Early detection of asymptomatic atrial fibrillation (AF) provides an opportunity to treat patients to reduce their risk of stroke. Long-term residents of skilled nursing facilities frequently have multiple risk factors for strokes due to AF and may benefit from screening for AF. Patients in a skilled nursing facility 65 years and older, without a history of AF and without a pacemaker or defibrillator, were evaluated using a Microlife WatchBP Home A automatic blood pressure monitor that can detect AF when set to a triple reading mode. Those with readings positive for AF were evaluated with a standard 12-lead electrocardiogram (ECG) or a 30-second single-channel ECG to confirm the presence of AF. A total of 101 patients were screened with an average age of 78 years, and 48 (48%) were female. Nine automatic blood pressure monitor readings were positive for possible AF. Of those, 7 (6.9%, 95% confidence intervals 3.0% to 14.2%) had AF confirmed with ECG. Only 2 (2%, 95% confidence interval 0.3% to 7.7%) were false-positive readings. One-time screening for AF using an automatic blood pressure monitor in a skilled nursing facility resulted in a high number of patients with newly diagnosed AF. Copyright © 2017 Elsevier Inc. All rights reserved.

Blood Pressure Levels and Mortality Risk among Hemodialysis Patients: Results from the Dialysis Outcomes and Practice Patterns Study

PubMed Central

Robinson, Bruce M.; Tong, Lin; Zhang, Jinyao; Wolfe, Robert A.; Goodkin, David A.; Greenwood, Roger N.; Kerr, Peter G.; Morgenstern, Hal; Li, Yun; Pisoni, Ronald L.; Saran, Rajiv; Tentori, Francesca; Akizawa, Tadao; Fukuhara, Shunichi; Port, Friedrich K.

2014-01-01

KDOQI practice guidelines recommend pre-dialysis blood pressure (BP) <140/90 mm Hg. However, most prior hemodialysis studies found elevated mortality with low, not high, systolic blood pressure (SBP), possibly due to unmeasured confounders affecting BP and mortality such as severity of comorbidities. To lessen this bias, we analyzed facility-level BP practices, relating patient-level survival to the fraction of patients in BP categories at each dialysis facility in Cox regression models adjusted for patient and facility characteristics. Analyses included 24,525 patients in the Dialysis Outcomes and Practice Patterns Study. Compared with pre-dialysis SBP 130–159 mm Hg, mortality was 13% higher in facilities with 20% more patients at SBP 110–129 mm Hg and 16% higher in facilities with 20% more patients at SBP ≥160 mm Hg. For patient-level SBP, mortality was elevated at low (<130 mm Hg), not high (up to ≥180 mm Hg) SBP. For pre-dialysis diastolic BP, mortality was lowest at 60–99 mm Hg, a wide range suggesting less chance to improve outcomes. Higher mortality at SBP <130 mm Hg is consistent with prior studies and may be due to excessive BP-lowering during dialysis. The lowest risk facility SBP range of 130–159 mm Hg indicates this range may be optimal, but may have been influenced by unmeasured facility practices. While additional study is needed, the findings contrast with KDOQI BP targets, and provide guidance on optimal BP range in absence of definitive clinical trial data. PMID:22718187

Malaria diagnostic capacity in health facilities in Ethiopia

PubMed Central

2014-01-01

Background Accurate early diagnosis and prompt treatment is one of the key strategies to control and prevent malaria in Ethiopia where both Plasmodium falciparum and Plasmodium vivax are sympatric and require different treatment regimens. Microscopy is the standard for malaria diagnosis at the health centres and hospitals whereas rapid diagnostic tests are used at community-level health posts. The current study was designed to assess malaria microscopy capacity of health facilities in Oromia Regional State and Dire Dawa Administrative City, Ethiopia. Methods A descriptive cross-sectional study was conducted from February to April 2011 in 122 health facilities, where health professionals were interviewed using a pre-tested, standardized assessment tool and facilities’ laboratory practices were assessed by direct observation. Results Of the 122 assessed facilities, 104 (85%) were health centres and 18 (15%) were hospitals. Out of 94 health facilities reportedly performing blood films, only 34 (36%) used both thin and thick smears for malaria diagnosis. The quality of stained slides was graded in 66 health facilities as excellent, good and poor quality in 11(17%), 31 (47%) and 24 (36%) respectively. Quality assurance guidelines and malaria microscopy standard operating procedures were found in only 13 (11%) facilities and 12 (10%) had involved in external quality assessment activities, and 32 (26%) had supportive supervision within six months of the survey. Only seven (6%) facilities reported at least one staff’s participation in malaria microscopy refresher training during the previous 12 months. Although most facilities, 96 (79%), had binocular microscopes, only eight (7%) had the necessary reagents and supplies to perform malaria microscopy. Treatment guidelines for malaria were available in only 38 (31%) of the surveyed facilities. Febrile patients with negative malaria laboratory test results were managed with artemether-lumefantrine or chloroquine in 51% (53/104) of assessed health facilities. Conclusions The current study indicated that most of the health facilities had basic infrastructure and equipment to perform malaria laboratory diagnosis but with significant gaps in continuous laboratory supplies and reagents, and lack of training and supportive supervision. Overcoming these gaps will be critical to ensure that malaria laboratory diagnosis is of high-quality for better patient management. PMID:25073561

Practical considerations for disaster preparedness and continuity management in research facilities.

PubMed

Mortell, Norman; Nicholls, Sam

2013-10-01

Many research facility managers, veterinarians and directors are familiar with the principles of Good Laboratory Practice, requirements of the Association for Assessment and Accreditation of Laboratory Animal Care International, tenets of biosecurity and standards of animal welfare and housing but may be less familiar with the ideas of business continuity. But business continuity considerations are as applicable to research facilities as they are to other institutions. The authors discuss how business continuity principles can be applied in the research context and propose that such application, or 'research continuity management,' enables a focused but wide-reaching approach to disaster preparedness.

Contamination issues in a continuous ethanol production corn wet milling facility

USDA-ARS?s Scientific Manuscript database

Low ethanol yields and poor yeast viability were investigated at a continuous ethanol production corn wet milling facility. Using starch slurries and recycle streams from a commercial ethanol facility, laboratory hydrolysates were prepared by reproducing starch liquefaction and saccharification ste...

Nephrotic Syndrome in Adults

MedlinePlus

... container in a health care provider’s office or commercial facility and can be tested in the same ... blood at a health care provider’s office or commercial facility and sending the sample to a lab ...

Adrenal Insufficiency and Addison's Disease

MedlinePlus

... tests in a health care provider’s office, a commercial facility, or a hospital. Hormonal Blood and Urine ... at a health care provider’s office or a commercial facility and sending the sample to a lab ...

A Fast Multimodal Ectopic Beat Detection Method Applied for Blood Pressure Estimation Based on Pulse Wave Velocity Measurements in Wearable Sensors.

PubMed

Pflugradt, Maik; Geissdoerfer, Kai; Goernig, Matthias; Orglmeister, Reinhold

2017-01-14

Automatic detection of ectopic beats has become a thoroughly researched topic, with literature providing manifold proposals typically incorporating morphological analysis of the electrocardiogram (ECG). Although being well understood, its utilization is often neglected, especially in practical monitoring situations like online evaluation of signals acquired in wearable sensors. Continuous blood pressure estimation based on pulse wave velocity considerations is a prominent example, which depends on careful fiducial point extraction and is therefore seriously affected during periods of increased occurring extrasystoles. In the scope of this work, a novel ectopic beat discriminator with low computational complexity has been developed, which takes advantage of multimodal features derived from ECG and pulse wave relating measurements, thereby providing additional information on the underlying cardiac activity. Moreover, the blood pressure estimations' vulnerability towards ectopic beats is closely examined on records drawn from the Physionet database as well as signals recorded in a small field study conducted in a geriatric facility for the elderly. It turns out that a reliable extrasystole identification is essential to unsupervised blood pressure estimation, having a significant impact on the overall accuracy. The proposed method further convinces by its applicability to battery driven hardware systems with limited processing power and is a favorable choice when access to multimodal signal features is given anyway.

33 CFR 158.120 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., London, SE1 7SR, England. Medical waste means isolation wastes, infectious agents, human blood and blood... or facility which is a base of operations for ships serving the mineral and oil industry. Noxious...

33 CFR 158.120 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., London, SE1 7SR, England. Medical waste means isolation wastes, infectious agents, human blood and blood... or facility which is a base of operations for ships serving the mineral and oil industry. Noxious...

40 CFR 60.190 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Aluminum Reduction Plants § 60.190 Applicability and designation of affected facility. (a) The affected facilities in primary aluminum reduction plants to which this subpart applies are...

29 CFR 1917.17 - Railroad facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Railroad facilities. 1917.17 Section 1917.17 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) MARINE TERMINALS Marine Terminal Operations § 1917.17 Railroad facilities. (a) Work shall be...

Continuous Blood Pressure Monitoring in Daily Life

NASA Astrophysics Data System (ADS)

Lopez, Guillaume; Shuzo, Masaki; Ushida, Hiroyuki; Hidaka, Keita; Yanagimoto, Shintaro; Imai, Yasushi; Kosaka, Akio; Delaunay, Jean-Jacques; Yamada, Ichiro

Continuous monitoring of blood pressure in daily life could improve early detection of cardiovascular disorders, as well as promoting healthcare. Conventional ambulatory blood pressure monitoring (ABPM) equipment can measure blood pressure at regular intervals for 24 hours, but is limited by long measuring time, low sampling rate, and constrained measuring posture. In this paper, we demonstrate a new method for continuous real-time measurement of blood pressure during daily activities. Our method is based on blood pressure estimation from pulse wave velocity (PWV) calculation, which formula we improved to take into account changes in the inner diameter of blood vessels. Blood pressure estimation results using our new method showed a greater precision of measured data during exercise, and a better accuracy than the conventional PWV method.

Notes from the field: deaths from acute hepatitis B virus infection associated with assisted blood glucose monitoring in an assisted-living facility--North Carolina, August-October 2010.

PubMed

2011-02-18

Sharing of blood glucose monitoring equipment in assisted-living facilities has resulted in at least 16 outbreaks of hepatitis B virus (HBV) infection in the United States since 2004. On October 12, 2010, the North Carolina Division of Public Health (NCDPH) and the Wayne County Health Department were notified by a local hospital of four residents of a single assisted-living facility with suspected acute HBV infection. NCDPH requested HBV testing of all persons who had resided in the facility during January 1-October 13, 2010, and defined an outbreak-associated case as either 1) positive hepatitis B surface antigen and core immunoglobulin M (IgM) results or 2) clinical evidence of acute hepatitis (jaundice or serum aminotransferase levels twice the upper limit of normal) with onset ≥6 weeks after admission to the facility. Records were reviewed for potential health-care-associated exposures and HBV-related risk factors. Infection control practices were assessed through observations and interviews with facility staff.

40 CFR 792.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Facilities for handling test, control, and reference substances. 792.47 Section 792.47 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Specimen and data storage facilities. 792.51 Section 792.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

33 CFR 127.201 - Sensing and alarm systems.

Code of Federal Regulations, 2011 CFR

2011-07-01

... vapor or gas may accumulate; and (2) Meet Section 9-4 of NFPA 59A. (c) Fixed sensors that continuously... (CONTINUED) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.201 Sensing and alarm...

33 CFR 127.201 - Sensing and alarm systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... vapor or gas may accumulate; and (2) Meet Section 9-4 of NFPA 59A. (c) Fixed sensors that continuously... (CONTINUED) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.201 Sensing and alarm...

32 CFR 228.12 - Physical protection of facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Physical protection of facilities. 228.12 Section 228.12 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.12 Physical protection of facilities. The willful...

32 CFR 228.12 - Physical protection of facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Physical protection of facilities. 228.12 Section 228.12 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.12 Physical protection of facilities. The willful...

32 CFR 228.12 - Physical protection of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Physical protection of facilities. 228.12 Section 228.12 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.12 Physical protection of facilities. The willful...

32 CFR 228.12 - Physical protection of facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Physical protection of facilities. 228.12 Section 228.12 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.12 Physical protection of facilities. The willful...

32 CFR 228.12 - Physical protection of facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Physical protection of facilities. 228.12 Section 228.12 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS SECURITY PROTECTIVE FORCE § 228.12 Physical protection of facilities. The willful...

40 CFR 60.170 - Applicability and designation of affected facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Zinc Smelters § 60.170 Applicability and designation of affected facility. (a) The...: roaster and sintering machine. (b) Any facility under paragraph (a) of this section that commences...

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F; Abayadeera, Anuja; Belîi, Natalia; Brull, Sorin J; Chibana, Aline; Evans, Faye; Goddia, Cyril; Haylock-Loor, Carolina; Khan, Fauzia; Leal, Sandra; Lin, Nan; Merchant, Richard; Newton, Mark W; Rowles, Jackie S; Sanusi, Arinola; Wilson, Iain; Velazquez Berumen, Adriana

2018-06-01

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a nonprofit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.

PubMed

Gelb, Adrian W; Morriss, Wayne W; Johnson, Walter; Merry, Alan F

2018-05-07

The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving the quality and safety of anesthesia care. The Standards cover professional aspects; facilities and equipment; medications and intravenous fluids; monitoring; and the conduct of anesthesia. HIGHLY RECOMMENDED standards, the functional equivalent of mandatory standards, include (amongst other things): the continuous presence of a trained and vigilant anesthesia provider; continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter; intermittent monitoring of blood pressure; confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection; the use of the WHO Safe Surgery Checklist; and a system for transfer of care at the end of an anesthetic. The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards, preferably exceeding the standards outlined in this document.

Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada.

PubMed

Arain, Mubashir A; Deutschlander, Siegrid; Charland, Paola

2017-05-17

Over the last 10 years, appropriate workforce utilisation has been an important discussion among healthcare practitioners and policy-makers. The role of healthcare aides (HCAs) has also expanded to improve their utilisation. This evolving role of HCAs in Canada has prompted calls for standardised training, education and scope of practice for HCAs. The purpose of this research was to examine the differences in HCAs training and utilisation in continuing care facilities. From June 2014 to July 2015, we conducted a mixed-method study on HCA utilisation in continuing care. This paper presents findings gathered solely from the prospective cross-sectional survey of continuing care facilities (long-term care (LTC) and supportive living (SL)) on HCA utilisation. We conducted this study in a Western Canadian province. The managers of the continuing care facilities (SL and LTC) were eligible to participate in the survey. The pattern of HCAs involvement in medication assistance and other care activities in SL and LTC facilities. We received 130 completed surveys (LTC=64 and SL=52). Our findings showed that approximately 81% of HCAs were fully certified. We found variations in how HCAs were used in SL and LTC facilities. Overall, HCAs in SL were more likely to be involved in medication management such as assisting with inhaled medication and oral medication delivery. A significantly larger proportion of survey respondents from SL facilities reported that medication assistance training was mandatory for their HCAs (86%) compared with the LTC facilities (50%) (p value <0.01). The utilisation of HCAs varies widely between SL and LTC facilities. HCAs in SL facilities may be considered better used according to their required educational training and competencies. Expanding the role of HCAs in LTC facilities may lead to a cost-effective and more efficient utilisation of workforce in continuing care facilities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Critical Value Reporting in Transfusion Medicine

PubMed Central

Reese, Erika M.; Nelson, Randin C.; Flegel, Willy A.; Byrne, Karen M.; Booth, Garrett S.

2017-01-01

Abstract Objectives: While critical value procedures have been adopted in most areas of the clinical laboratory, their use in transfusion medicine has not been reviewed in detail. The results of this study present a comprehensive overview of critical value reporting and communication practices in transfusion medicine in the United States. Methods: A web-based survey was developed to collect data on the prevalence of critical value procedures and practices of communicating results. The survey was distributed via email to US hospital-based blood banks. Results: Of 123 facilities surveyed, 84 (68.3%) blood banks had a critical value procedure. From a panel of 23 common blood bank results, nine results were selected by more than 70% of facilities as either a critical value or requiring rapid communication as defined by an alternate procedure. Conclusions: There was overlap among results communicated by facilities with and without a critical value procedure. The most frequently communicated results, such as incompatible crossmatch for RBC units issued uncrossmatched, delay in finding compatible blood due to a clinically significant antibody, and transfusion reaction evaluation suggestive of a serious adverse event, addressed scenarios associated with the leading reported causes of transfusion-related fatalities. PMID:28371931

Vitamin blood concentration and vitamin supplementation in bottlenose dolphins (Tursiops truncatus) in European facilities.

PubMed

Gimmel, Angela Emilia Ricarda; Baumgartner, Katrin; Liesegang, Annette

2016-09-05

As fish eaters bottlenose dolphins (Tursiops truncatus) in human care need to receive daily vitamin supplementation, because whole thawed fish lacks certain vitamins. However, the exact concentration of supplementation has not been established and is a matter of discussion. To ensure adequate vitamin supplementation in pets, vitamin blood concentrations are measured. This is not a common practice in dolphins. The objective of the present study was to collect information about vitamin supplementation in bottlenose dolphins and on vitamin blood concentrations of healthy animals in European facilities. In addition, these results were compared with blood levels of wild animals. Conclusions on how to provide bottlenose dolphins in human care with an effective vitamin supplementation will then be drawn. Initially, fish-handling techniques and vitamin supplementation were evaluated by questionnaire, which was sent to 25 European facilities that house bottlenose dolphins. Secondly, blood samples from 57 dolphins living in 10 facilities were taken and sent by mail to a reference laboratory. They were analysed for retinol, thiamine pyrophosphate, cobalamin, calcidiol and tocopherol. The blood concentrations were then correlated with vitamin supplementation, fish handling techniques and pre-existing blood concentrations of free-ranging dolphins. Finally, the data was subjected to a standard analysis of variance techniques (ANOVA) and a linear model analysis. Fish was mainly thawed in a refrigerator. Further, the 95 % confidence interval for retinol blood concentrations was 0.048 to 0.059 mg/l and for tocopherol 17.95 to 20.76 mg/l. These concentrations were 27 and 53 %, respectively, higher than those found in free-ranging animals. In contrast, calcidiol concentrations (143.9-174.7 ng/ml) of the dolphins in human care were lower than in blood found for free-ranging animals. Regarding thiamine pyrophosphate and cobalamin, concentrations ranged between 0.42 and 0.55 mg/l and 175.55 and 275.22 pg/ml respectively. No reference concentrations for free-ranging Tursiops truncatus were found. These findings suggest an over-supplementation of retinol (vitamin A) and tocopherol (vitamin E) in bottlenose dolphins (Tursiops truncatus) housed in human care. Therefore, vitamin A supplementation should not exceed 50,000 IU per animal per day and vitamin E supplementation should be around 100 IU per kg fed fish per day.

Development of hypertension after long-term exposure to static magnetic fields among workers from a magnetic resonance imaging device manufacturing facility.

PubMed

Bongers, Suzan; Slottje, Pauline; Kromhout, Hans

2018-07-01

To assess the association between long-term exposure to static magnetic fields (SMF) in a magnetic resonance imaging (MRI)-manufacturing environment and hypertension. In an occupational cohort of male workers (n = 538) of an MRI-manufacturing facility, the first and last available blood pressure measurements from the facility's medical surveillance scheme were associated with modeled cumulative exposure to SMF. Exposure modeling was based on linkage of individual job histories from the facility's personnel records with a facility specific historical job exposure matrix. Hypertension was defined as a systolic pressure of above 140 mm Hg and/or a diastolic blood pressure above 90 mm Hg. Logistic regression models were used to associate cumulative SMF exposure to hypertension while adjusting for age, body mass index and blood pressure at time of first blood pressure measurement. Stratified analysis by exposure duration was performed similarly. High cumulative exposure to SMF (≥ 7.4 K Tesla minutes) was positively associated with development of hypertension (Odds Ratio [OR] 2.32, 95% confidence interval [CI] 1.27 - 4.25, P = 0.006). Stratified analysis showed a stronger association for those with high cumulative SMF exposure within a period up to 10 years (OR 3.96, 95% CI 1.62 - 9.69, P = 0.003), but no significant association was found for (high) cumulative exposure accumulated in a period of 10 or more years. Our findings suggest SMF exposure intensity to be more important than exposure duration for the risk of developing hypertension. Our data revealed that exposure to high levels of MRI-related SMF during MRI-manufacturing might be associated with developing hypertension. Copyright © 2018 Elsevier Inc. All rights reserved.

Use of Telemedicine for Management of Diabetes in Correctional Facilities.

PubMed

Kassar, Kinan; Roe, Cheryl; Desimone, Marisa

2017-01-01

Prisoners can have difficulty obtaining subspecialty consultations. Telemedicine is used to provide diabetes consultations for residents of correctional facilities from our diabetes center. Telemedicine helps improve access to endocrinologists at reduced cost, but little outcome data are available. A retrospective chart review of prisoners from 15 correctional facilities who received televisits for diabetes from 2011 to 2014 was performed. Demographic information, complications, medications, blood pressure, and laboratory results were collected. At baseline (n = 106), mean age was 44 years, duration of diabetes was 15 years, 44% had type 1 diabetes, and all were male. Only 64 of the participants had ≥2 video consultations; 58/64 had follow-up HbA1c results; and 53/58 were insulin requiring. Mean initial HbA1c was 9.3% with an average decrease of 0.5% from initial to final visit (a mean of 3.6 televisits). Patients with an initial HbA1c >9% (n = 28) had an average drop of 1.3%. Twenty-two subjects had initial elevated blood pressure; 20/22 (91%) were prescribed angiotensin-converting-enzyme-inhibitors (ACE-I)/angiotensin II receptor blockers (ARB); and 15 of these 20 (75%) had a final blood pressure <140/90 mm Hg over a mean of 3.3 televisits. 17/20 with high low-density lipoprotein (LDL) were treated with statin drugs; 15/17 (88%) had improved LDL on follow-up. Follow-up was limited by prisoner availability or visit cancellation by prison facility. Improvements in glycemic, blood pressure, and lipid control for prisoners with diabetes can be achieved with teleconsultations to correctional institutions. Given the high costs of transporting prisoners to healthcare facilities, telemedicine should be considered to help improve diabetes care for this vulnerable population.

Non-invasive continuous blood pressure measurement based on mean impact value method, BP neural network, and genetic algorithm.

PubMed

Tan, Xia; Ji, Zhong; Zhang, Yadan

2018-04-25

Non-invasive continuous blood pressure monitoring can provide an important reference and guidance for doctors wishing to analyze the physiological and pathological status of patients and to prevent and diagnose cardiovascular diseases in the clinical setting. Therefore, it is very important to explore a more accurate method of non-invasive continuous blood pressure measurement. To address the shortcomings of existing blood pressure measurement models based on pulse wave transit time or pulse wave parameters, a new method of non-invasive continuous blood pressure measurement - the GA-MIV-BP neural network model - is presented. The mean impact value (MIV) method is used to select the factors that greatly influence blood pressure from the extracted pulse wave transit time and pulse wave parameters. These factors are used as inputs, and the actual blood pressure values as outputs, to train the BP neural network model. The individual parameters are then optimized using a genetic algorithm (GA) to establish the GA-MIV-BP neural network model. Bland-Altman consistency analysis indicated that the measured and predicted blood pressure values were consistent and interchangeable. Therefore, this algorithm is of great significance to promote the clinical application of a non-invasive continuous blood pressure monitoring method.

Challenges in Routine Implementation and Quality Control of Rapid Diagnostic Tests for Malaria–Rufiji District, Tanzania

PubMed Central

McMorrow, Meredith L.; Masanja, M. Irene; Abdulla, Salim M. K.; Kahigwa, Elizeus; Kachur, S. Patrick

2018-01-01

Rapid diagnostic tests (RDTs) represent an alternative to microscopy for malaria diagnosis and have shown high sensitivity and specificity in a variety of study settings. Current World Health Organization (WHO) guidelines for quality control of RDTs provide detailed instructions on pre-field testing, but offer little guidance for quality assurance once RDTs are deployed in health facilities. From September 2006 to April 2007, we introduced a histidine-rich protein II (HRP2)-based RDT (Paracheck) for suspected malaria cases five years of age and older in nine health facilities in Rufiji District, Tanzania, to assess sensitivity and specificity of RDTs in routine use at rural health facilities. Thick blood smears were collected for all patients tested with RDTs and stained and read by laboratory personnel in each facility. Thick smears were subsequently reviewed by a reference microscopist to determine RDT sensitivity and specificity. In all nine health facilities, there were significant problems with the quality of staining and microscopy. Sensitivity and specificity of RDTs were difficult to assess given the poor quality of routine blood smear staining. Mean operational sensitivity of RDTs based on reference microscopy was 64.8%, but varied greatly by health facility, range 18.8–85.9%. Sensitivity of RDTs increased with increasing parasite density. Specificity remained high at 87.8% despite relatively poor slide quality. Institution of quality control of RDTs based on poor quality blood smear staining may impede reliable measurement of sensitivity and specificity and undermine confidence in the new diagnostic. There is an urgent need for the development of alternative quality control procedures for rapid diagnostic tests that can be performed at the facility level. PMID:18784230

Severe Childhood Anaemia and Blood Transfusion in a Nigerian Secondary Level Facility.

PubMed

Ogunlesi, Tinuade; Fetuga, Bolanle; Olowonyo, Michael; Adekoya, Adesola; Adetola, Oluseyi; Ajetunmobi, Adebimpe

2016-04-01

This study aimed to describe the pattern and immediate outcome of severe childhood anaemia requiring blood transfusion at a secondary level of care in Nigeria. A cross-sectional survey of children hospitalized in a secondary health facility in Ogun State, Nigeria, with packed cell volume <20% and who received blood transfusion was done. Of the 253 children admitted between March 2013 and June 2014, 79 (31.2%) had severe anaemia and were transfused with blood. Two-thirds had multiple transfusions. Higher rates of blood transfusion were obtained among underweight children. Fever (98.7%), hypoglycaemia (65.8%) and tender liver (54.4%) were the leading co-morbidities. The case fatality rate was 21.5%. Respiratory distress, convulsions and altered sensorium were significantly associated with mortality. In conclusion, severe anaemia was associated with major morbidities and mortality at the secondary level of paediatric care in Nigeria. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Hazardous Waste Cleanup: Ortho-Clinical Diagnostics, Raritan, New Jersey

EPA Pesticide Factsheets

Ortho-Clinical Diagnostics (OCD) is an administration and manufacturing facility located at 1001 U.S. Route 202 North in Raritan Borough, Somerset County, New Jersey. The facility manufactures hospital and laboratory reagents used primarily for blood

Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

PubMed

Ross, M M; Carswell, A; Dalziel, W B; Aminzadeh, F

2001-01-01

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

Continuous monitoring of blood volume changes in humans

NASA Technical Reports Server (NTRS)

Hinghofer-Szalkay, H.; Greenleaf, J. E.

1987-01-01

Use of on-line high-precision mass densitometry for the continuous monitoring of blood volume changes in humans was demonstrated by recording short-term blood volume alterations produced by changes in body position. The mass density of antecubital venous blood was measured continuously for 80 min per session with 0.1 g/l precision at a flow rate of 1.5 ml/min. Additional discrete plasma density and hematocrit measurements gave linear relations between all possible combinations of blood density, plasma density, and hematocrit. Transient filtration phenomena were revealed that are not amenable to discontinuous measurements.

Adherence to blood pressure measurement guidelines in long-term care facilities: A cross sectional study.

PubMed

Ozone, Sachiko; Sato, Mikiya; Takayashiki, Ayumi; Sakamoto, Naoto; Yoshimoto, Hisashi; Maeno, Tetsuhiro

2018-05-01

To assess the extent to which long-term care facilities in Japan adhere to blood pressure (BP) measurement guidelines. Cross-sectional, observational survey. Japan (nationwide). Geriatric health service facilities that responded to a questionnaire among 701 facilities that provide short-time daycare rehabilitation services in Japan. A written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients' arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered. Proportion of geriatric health service facilities adherent to BP measurement guidelines. The response rate was 63.2% (443/701). Appropriate upper-arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre-measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%). BP measurement guidelines were not necessarily followed by long-term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit-to-visit basis might be needed.

Paramagnetic capture mode magnetophoretic microseparator for high efficiency blood cell separations.

PubMed

Han, Ki-Ho; Frazier, A Bruno

2006-02-01

This paper presents the characterization of continuous single-stage and three-stage cascade paramagnetic capture (PMC) mode magnetophoretic microseparators for high efficiency separation of red and white blood cells from diluted whole blood based on their native magnetic properties. The separation mechanism for both PMC microseparators is based on a high gradient magnetic separation (HGMS) method. This approach enables separation of blood cells without the use of additives such as magnetic beads. Experimental results for the single-stage PMC microseparator show that 91.1% of red blood cells were continuously separated from the sample at a volumetric flow rate of 5 microl h-1. In addition, the three-stage cascade PMC microseparator continuously separated 93.5% of red blood cells and 97.4% of white blood cells from whole blood at a volumetric flow rate of 5 microl h-1.

Uses of inorganic hypochlorite (bleach) in health-care facilities.

PubMed Central

Rutala, W A; Weber, D J

1997-01-01

Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664

Prevalence of peripheral blood parasitaemia, anaemia and low birthweight among pregnant women in a suburban area in coastal Ghana.

PubMed

Stephens, Judith Koryo; Ofori, Michael F; Quakyi, Isabella Akyinbah; Wilson, Mark Lee; Akanmori, Bartholomew Dicky

2014-01-01

Malaria and anaemia have adverse effects in pregnant women and on the birth weight of infants in malaria endemic areas. P. falciparum malaria, the most virulent species continues to be a major health problem in sub-Saharan Africa. This study was carried out to establish the prevalence of pregnancy-associated malaria and its associated consequences including maternal anaemia and low birthweight (LBW) deliveries and placental malaria among pregnant women in a sub-urban area in coastal Ghana. A facility-based investigation was carried out among 320 pregnant women seeking antenatal care in a hospital in suburban coastal Ghana. Information on the use of Insecticide Treated Nets (ITNs) and Intermittent Preventive Treatment in pregnancy (IPTp) were collected using a structured questionnaire at enrollment. Venous blood was collected for microscopy and screening for Glucose 6-phosphate dehydrogenase (G6PD) deficiency. Haemoglobin concentration was obtained from an automatic blood analyzer. Placental smears and birth weight measurements were taken at delivery. The prevalence of Plasmodium falciparum parasitaemia was 5%. The mean haemoglobin (Hb) level at registration was 11.44 g/dL (95% CI 11.29 - 11.80). Placental blood parasitaemia and low birthweight were 2.5% and 3% respectively. ITN possession was 31.6% with 5.4% usage. The IPTp coverage was 55%. The prevalence of malaria and anaemia among the pregnant women were low at enrollment. Placental blood parasitaemia and LBW at delivery were also low. These are clear indications of the high coverage of the IPTp. Increase in ITN use will further improve birthweight outcomes and reduce placental malaria.

Are your employees protected from blood-borne pathogens? OSHA standards charge textile rental companies with responsibility for worker safety.

PubMed

Weller, S C

1991-11-01

Congress is putting pressure on OSHA to finalize its Universal Precaution standards by December. When the standards go into effect, textile rental companies that serve medical, dental, and outpatient care facilities--including private physician and dentist offices--must take steps to protect employees from blood-borne pathogens. Soiled linens, towels, gowns, and other items from any customer in risk categories link a textile rental facility and/or commercial laundry with the OSHA regulations. Read and heed this information.

Smartphone-based Continuous Blood Pressure Measurement Using Pulse Transit Time.

PubMed

Gholamhosseini, Hamid; Meintjes, Andries; Baig, Mirza; Linden, Maria

2016-01-01

The increasing availability of low cost and easy to use personalized medical monitoring devices has opened the door for new and innovative methods of health monitoring to emerge. Cuff-less and continuous methods of measuring blood pressure are particularly attractive as blood pressure is one of the most important measurements of long term cardiovascular health. Current methods of noninvasive blood pressure measurement are based on inflation and deflation of a cuff with some effects on arteries where blood pressure is being measured. This inflation can also cause patient discomfort and alter the measurement results. In this work, a mobile application was developed to collate the PhotoPlethysmoGramm (PPG) waveform provided by a pulse oximeter and the electrocardiogram (ECG) for calculating the pulse transit time. This information is then indirectly related to the user's systolic blood pressure. The developed application successfully connects to the PPG and ECG monitoring devices using Bluetooth wireless connection and stores the data onto an online server. The pulse transit time is estimated in real time and the user's systolic blood pressure can be estimated after the system has been calibrated. The synchronization between the two devices was found to pose a challenge to this method of continuous blood pressure monitoring. However, the implemented continuous blood pressure monitoring system effectively serves as a proof of concept. This combined with the massive benefits that an accurate and robust continuous blood pressure monitoring system would provide indicates that it is certainly worthwhile to further develop this system.

40 CFR 60.290 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Glass Manufacturing Plants § 60.290 Applicability and designation of affected facility. (a...

A continuous silicon-coating facility

NASA Technical Reports Server (NTRS)

Butter, C.; Heaps, J. D.

1979-01-01

Automatic continuous silicon-coating facility is used to process 100 by 10 cm graphite-coated ceramic substrates for silicon solar cells. Process reduces contamination associated with conventional dip-coating processes, improving material service life.

Cuffless Blood Pressure Estimation Based on Data-Oriented Continuous Health Monitoring System

PubMed Central

Kawanaka, Haruki; Oguri, Koji

2017-01-01

Measuring blood pressure continuously helps monitor health and also prevent lifestyle related diseases to extend the expectancy of healthy life. Blood pressure, which is nowadays used for monitoring patient, is one of the most useful indexes for prevention of lifestyle related diseases such as hypertension. However, continuously monitoring the blood pressure is unrealistic because of discomfort caused by the tightening of a cuff belt. We have earlier researched the data-oriented blood pressure estimation without using a cuff. Remarkably, our blood pressure estimation method only uses a photoplethysmograph sensor. Therefore, the application is flexible for sensor locations and measuring situations. In this paper, we describe the implementation of our estimation method, the launch of a cloud system which can collect and manage blood pressure data measured by a wristwatch-type photoplethysmograph sensor, and the construction of our applications to visualize life-log data including the time-series data of blood pressure. PMID:28523074

49 CFR 193.2005 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES..., design, installation, or construction of LNG facilities (including material incorporated by reference in...

Blood transfusion services in Delhi.

PubMed

Makroo, R N; Kumar, N D

1993-04-01

In 1991, approximately 40% of total blood requirement in Delhi was collected from commercial blood donors. The rest was supplied by voluntary and replacement donations in hospital-based blood banks and by voluntary blood recruiting agency (Indian Red Cross Society). This study analyses the standards of working and quality assurance in 26 blood transfusion centers in Delhi. The majority of these centers are ill-equipped and lack trained manpower. Most of these do not have adequate testing facilities and any standardized procedure for blood collection. Quality assurance scheme is not being followed and documentation and record maintenance is grossly inadequate. This reports also gives the recommendations for improvements of blood transfusion services in Delhi.

Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment.

PubMed

2018-01-01

Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0-11.2) to 10.0% (95% confidence interval 6.75-13.25) and decreased the number of severe hypoglycemic events.Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5.Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children. Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use.

Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment

PubMed Central

Vandersluis, Stacey; Kabali, Conrad; Djalalov, Sandjar; Gajic-Veljanoski, Olga; Wells, David; Holubowich, Corinne

2018-01-01

Background Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down. Methods We conducted a health technology assessment, which included an evaluation of clinical benefit, value for money, and patient preferences related to continuous glucose monitoring. We compared continuous glucose monitoring with self-monitoring of blood glucose using a finger-prick and a blood glucose meter. We performed a systematic literature search for studies published since January 1, 2010. We created a Markov model projecting the lifetime horizon of adults with type 1 diabetes, and performed a budget impact analysis from the perspective of the health care payer. We also conducted interviews and focus group discussions with people who self-manage their type 1 diabetes or support the management of a child with type 1 diabetes. Results Twenty studies were included in the clinical evidence review. Compared with self-monitoring of blood glucose, continuous glucose monitoring improved the percentage of time patients spent in the target glycemic range by 9.6% (95% confidence interval 8.0–11.2) to 10.0% (95% confidence interval 6.75–13.25) and decreased the number of severe hypoglycemic events. Continuous glucose monitoring was associated with higher costs and small increases in health benefits (quality-adjusted life-years). Incremental cost-effectiveness ratios (ICERs) ranged from $592,206 to $1,108,812 per quality-adjusted life-year gained in analyses comparing four continuous glucose monitoring interventions to usual care. However, the uncertainty around the ICERs was large. The net budget impact of publicly funding continuous glucose monitoring assuming a 20% annual increase in adoption of continuous glucose monitoring would range from $8.5 million in year 1 to $16.2 million in year 5. Patient engagement surrounding the topic of continuous glucose monitoring was robust. Patients perceived that these devices provided important social, emotional, and medical and safety benefits in managing type 1 diabetes, especially in children. Conclusions Continuous glucose monitoring was more effective than self-monitoring of blood glucose in managing type 1 diabetes for some outcomes, such as time spent in the target glucose range and time spent outside the target glucose range (moderate certainty in this evidence). We were less certain that continuous glucose monitoring would reduce the number of severe hypoglycemic events. Compared with self-monitoring of blood glucose, the costs of continuous glucose monitoring were higher, with only small increases in health benefits. Publicly funding continuous glucose monitoring for the type 1 diabetes population in Ontario would result in additional costs to the health system over the next 5 years. Adult patients and parents of children with type 1 diabetes reported very positive experiences with continuous glucose monitoring. The high ongoing cost of continuous glucose monitoring devices was seen as the greatest barrier to their widespread use. PMID:29541282

Posters as a tool for disseminating health related information in a developing country: a pilot experience.

PubMed

Nishtar, S; Zoka, N; Nishtar, S S; Khan, S Y; Jehan, S; Mirza, Y A

2004-09-01

To investigate the effectiveness of posters as a tool, for imparting information related to high blood pressure. The intervention involved hanging posters conveying information about blood pressure, in the waiting rooms of 339 health facilities. The impact of this intervention was assessed after 30 days of hanging the posters with the main assessment component of the survey aimed at the target audience at the facilities. 1017 people attending the facilities were interviewed. Mean age of this population was 40.4 (SD 11.06) years. There were 79% males and 21% females. 80.2% (n=816) of the respondents had noticed the posters. 84.5% of the people were of the opinion that the poster was good. 63.7% of the people understood the overall message of the poster correctly. Regarding change in behaviour, 96.7% (n=789) of the people thought that the poster was asking them to do something; 85.9% (n=501) of these got their blood pressure checked compared to 60.9% (n=14) of those who did not think the poster was asking them to do anything (p=0.004). Of those who said that the poster was asking them to do something, there were varied responses as to what they thought the poster was asking them to do. If the response was that they should have their blood pressure checked, it was taken as a correct response. 87.3% of those who said that the poster was asking them to get their blood pressure checked, actually got their blood pressure checked compared to 83.7% of those who did not understand this message (p=0.241). Given the limitations of the study it is difficult to assess the effectiveness of the poster in changing people's behaviour regarding blood pressure check up. This experience will serve as a pilot for a larger prospective study to assess poster as a tool for prompting people to get their blood pressure checked.

40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 15 2013-07-01 2013-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 15 2012-07-01 2012-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

40 CFR 63.11164 - What General Provisions apply to primary zinc production facilities?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 15 2014-07-01 2014-07-01 false What General Provisions apply to primary zinc production facilities? 63.11164 Section 63.11164 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED)...

Continuous intra-arterial blood-gas monitoring

NASA Astrophysics Data System (ADS)

Divers, George A.; Riccitelli, Samuel D.; Blais, Maurice; Hui, Henry K.

1993-05-01

Fiber optic technology and optical fluorescence have made the continuous monitoring of arterial blood gases a reality. Practical products that continuously monitor blood gases by use of an invasive sensor are now available. Anesthesiologists and intensive care physicians are beginning to explore the practical implications of this technology. With the advent of intra- arterial blood gas monitors it is possible to assess arterial blood gas values without the labor intensive steps of drawing blood and transporting a blood sample to the lab followed by the actual analysis. These intra-arterial blood gas monitors use new optical sensor technologies that can be reduced in size to the point that the sensor can be inserted into the arterial blood flow through a 20-gauge arterial cannula. In the best of these technologies the sensors accuracy and precision are similar to those in vitro analyzers. This presentation focuses on background technology and in vivo performance of a device developed, manufactured, and marketed by Puritan-Bennett Corporation.

14 CFR 171.205 - Minimum requirements for approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VHF Marker Beacons § 171.205 Minimum... marker beacon facility under this subpart: (1) The facility's performances, as determined by air and...

Barriers to management of cardiovascular risk in a low-resource setting using hypertension as an entry point.

PubMed

Mendis, Shanthi; Abegunde, Dele; Oladapo, Olulola; Celletti, Francesca; Nordet, Porfirio

2004-01-01

Assess capacity of health-care facilities in a low-resource setting to implement the absolute risk approach for assessment of cardiovascular risk in hypertensive patients and effective management of hypertension. A descriptive cross-sectional study in Egbeda and Oluyole local government areas of Oyo State in Nigeria in 56 randomly selected primary- (n = 42) and secondary-level (n = 2) health-care and private health-care (n = 12) facilities. One thousand consecutive, known hypertensives attending the selected facilities for follow-up, and health-care providers working in the above randomly selected facilities, were interviewed. About two-thirds of hypertensives utilized primary-care centers both for diagnosis and for follow-up. Laboratory and other investigations to exclude secondary hypertension or to assess target organ damage were not available in the majority of facilities, particularly in primary care. A considerable knowledge and awareness gap related to hypertension and its complications was found, both among patients and health-care providers. Blood pressure control rates were poor (28% with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not evidence based and cost effective. The majority of patients (73%) in this low socio-economic group (mean monthly income 73 US dollars) had to pay fully, out of their own pocket, for consultations and medications. If the absolute risk approach for assessment of risk and effective management of hypertension is to be implemented in low-resource settings, appropriate policy measures need to be taken to improve the competency of health-care providers, to provide basic laboratory facilities and to develop affordable financing mechanisms.

Take-home lead exposure among children with relatives employed at a battery recycling facility - Puerto Rico, 2011.

PubMed

2012-11-30

The recycling of lead has increased during the past 20 years, with more workers and their families potentially being exposed to lead from recycling facilities, including facilities that recycle lead-acid batteries. During November 2010-May 2011, four voluntary blood lead screening clinics for children of employees of a battery recycling facility in Puerto Rico were conducted. A total of 227 persons from 78 families had blood lead tests. Among 68 children aged <6 years, 11 (16%) had confirmed blood lead levels (BLLs) ≥10 µg/dL, the BLL at which CDC recommended individual intervention to reduce BLLs in 2010, and 39 (57%) children aged <6 years had venous or capillary BLLs ≥5 µg/dL, the reference value for elevated BLLs in children established by CDC in 2012. To determine whether take-home lead exposure contributed to the children's BLLs of ≥10 µg/dL, vehicle and household environmental samples were collected and analyzed. Eighty-five percent of vehicle dust samples and 49% of home dust samples exceeded the U.S. Environmental Protection Agency (EPA) level of concern of ≥40 µg/ft² (430.6 µg/m²) [corrected]. EPA began clean-up of employee homes and vehicles, focusing first on homes with children with BLLs ≥10 µg/dL. EPA also required that the company set up shower facilities, shoe washes, and clean changing areas at the battery recycling facility. Lastly, CDC assigned a case manager to provide education, environmental follow-up, and case management of all children with BLLs ≥5 µg/dL. On average, children's BLLs have decreased 9.9 µg/dL since being enrolled in case management.

Effectiveness of Qigong in promoting the health of wheelchair-bound older adults in long-term care facilities.

PubMed

Kuan, Shu-Chien; Chen, Kuei-Min; Wang, Chi

2012-04-01

Institutional wheelchair-bound older adults often do not get regular exercise and are prone to health problems. The aim of this study was to test the effects of a 12-week qigong exercise program on the physiological and psychological health of wheelchair-bound older adults in long-term care facilities. Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of 72 wheelchair-bound older adults (qigong = 34; control = 38). The qigong group exercised 35 min/day, 5 days/week for 12 weeks. Measures for physical health (blood pressure, heart rate variability, and distal skin temperature) and psychological health (Brief Symptom Rating Scale-5) were collected before and during study Weeks 4, 8, and 12. The qigong group participants' blood pressure, distal skin temperature, and psychological health were significantly improved (all p < .001). These findings suggest that qigong exercise is a suitable daily activity for elderly residents in long-term care facilities and may help in the control of blood pressure among older adults.

40 CFR 745.82 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... child-occupied facilities, except for the following: (1) Renovations in target housing or child-occupied...) Renovations in target housing or child-occupied facilities in which a certified renovator, using an EPA... with significant damage. Interim controls performed in response to an elevated blood lead level in a...

An audit of blood bank services.

PubMed

Kumar, Alok; Sharma, Satish; Ingole, Narayan; Gangane, Nitin

2014-01-01

An audit is a written series of simple, direct questions, which when answered and reviewed, tell whether the laboratory is performing its procedures, activities, and policies correctly and on time. The aim of this study is to briefly highlight the importance of audit in blood bank services. An Audit of Blood Bank Services was carried out in a Blood bank of the tertiary care hospital, Central India by using the tool kit, (comprised of checklists) developed by Directorate General of Health Services, Dhaka WHO, July 2008. After going through these checklists, we observed that there is no system for assessing the training needs of staff in the blood bank. There was no provision for duty doctor's room, expert room, medical technologist room and duty care service. There was no checklist for routine check for observation of hemolysis and deterioration of blood and plasma. There was no facility for separate private interview to exclude sexual disease in the donor. Requisition forms were not properly filled for blood transfusion indications. There was no facility for notification of donors who are permanently deferred. There were no records documented for donors who are either temporarily or permanently deferred on the basis of either clinical examination, history, or serological examination. It was found that wearing of apron, cap, and mask was not done properly except in serology laboratory. When the requisition forms for blood transfusions were audited, it was found that many requisition forms were without indications. Regular audit of blood bank services needs to be initiated in all blood banks and the results needs to be discussed among the managements, colleagues, and staffs of blood bank. These results will provide a good opportunity for finding strategies in improving the blood bank services with appropriate and safe use of blood.

An audit of blood bank services

PubMed Central

Kumar, Alok; Sharma, Satish; Ingole, Narayan; Gangane, Nitin

2014-01-01

Background: An audit is a written series of simple, direct questions, which when answered and reviewed, tell whether the laboratory is performing its procedures, activities, and policies correctly and on time. Aim: The aim of this study is to briefly highlight the importance of audit in blood bank services. Materials and Methods: An Audit of Blood Bank Services was carried out in a Blood bank of the tertiary care hospital, Central India by using the tool kit, (comprised of checklists) developed by Directorate General of Health Services, Dhaka WHO, July 2008. Results: After going through these checklists, we observed that there is no system for assessing the training needs of staff in the blood bank. There was no provision for duty doctor's room, expert room, medical technologist room and duty care service. There was no checklist for routine check for observation of hemolysis and deterioration of blood and plasma. There was no facility for separate private interview to exclude sexual disease in the donor. Requisition forms were not properly filled for blood transfusion indications. There was no facility for notification of donors who are permanently deferred. There were no records documented for donors who are either temporarily or permanently deferred on the basis of either clinical examination, history, or serological examination. It was found that wearing of apron, cap, and mask was not done properly except in serology laboratory. When the requisition forms for blood transfusions were audited, it was found that many requisition forms were without indications. Conclusion: Regular audit of blood bank services needs to be initiated in all blood banks and the results needs to be discussed among the managements, colleagues, and staffs of blood bank. These results will provide a good opportunity for finding strategies in improving the blood bank services with appropriate and safe use of blood. PMID:24741651

Current concepts in blood glucose monitoring

PubMed Central

Khadilkar, Kranti Shreesh; Bandgar, Tushar; Shivane, Vyankatesh; Lila, Anurag; Shah, Nalini

2013-01-01

Blood glucose monitoring has evolved over the last century. The concept of adequate glycemic control and minimum glycemic variability requires an ideal, accurate and reliable glucose monitoring system. The search for an ideal blood glucose monitoring system still continues. This review explains the various blood glucose monitoring systems with special focus on the monitoring systems like self- monitored blood glucose (SMBG) and continuous glucose monitoring system (CGMS). It also focuses on the newer concepts of blood glucose monitoring and their incorporation in routine clinical management of diabetes mellitus. PMID:24910827

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

45 CFR 1309.2 - Approval of the use of Head Start funds to continue purchase of facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Approval of the use of Head Start funds to continue purchase of facilities. 1309.2 Section 1309.2 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE...

49 CFR 599.201 - Identification of salvage auctions and disposal facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities. 599.201 Section 599.201 Transportation Other Regulations Relating to Transportation (Continued... and Disposal Facilities § 599.201 Identification of salvage auctions and disposal facilities. (a... disposal facility identified in paragraph (a)(2) or (a)(3) of this section. (2) A disposal facility listed...

Transmission of hepatitis B virus among persons undergoing blood glucose monitoring in long-term-care facilities--Mississippi, North Carolina, and Los Angeles County, California, 2003-2004.

PubMed

2005-03-11

Regular monitoring of blood glucose levels is an important component of routine diabetes care. Capillary blood is typically sampled with the use of a fingerstick device and tested with a portable glucometer. Because of outbreaks of hepatitis B virus (HBV) infections associated with glucose monitoring, CDC and the Food and Drug Administration (FDA) have recommended since 1990 that fingerstick devices be restricted to individual use. This report describes three recent outbreaks of HBV infection among residents in long-term-care (LTC) facilities that were attributed to shared devices and other breaks in infection-control practices related to blood glucose monitoring. Findings from these investigations and previous reports suggest that recommendations concerning standard precautions and the reuse of fingerstick devices have not been adhered to or enforced consistently in LTC settings. The findings underscore the need for education, training, adherence to standard precautions, and specific infection-control recommendations targeting diabetes-care procedures in LTC settings.

32 CFR 383a.7 - Authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Establish new DeCA facilities or use existing facilities of the Military Departments, as deemed necessary, for improved effectiveness and economy. (f) Exercise the operational and administrative authorities... Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) ORGANIZATIONAL...

49 CFR 193.2001 - Scope of part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES... LNG facilities used in the transportation of gas by pipeline that is subject to the pipeline safety...

Epidermal electronic systems for sensing and therapy

NASA Astrophysics Data System (ADS)

Lu, Nanshu; Ameri, Shideh K.; Ha, Taewoo; Nicolini, Luke; Stier, Andrew; Wang, Pulin

2017-04-01

Epidermal electronic system is a class of hair thin, skin soft, stretchable sensors and electronics capable of continuous and long-term physiological sensing and clinical therapy when applied on human skin. The high cost of manpower, materials, and photolithographic facilities associated with its manufacture limit the availability of disposable epidermal electronics. We have invented a cost and time effective, completely dry, benchtop "cut-and-paste" method for the green, freeform and portable manufacture of epidermal electronics within minutes. We have applied the "cut-and-paste" method to manufacture epidermal electrodes, hydration and temperature sensors, conformable power-efficient heaters, as well as cuffless continuous blood pressure monitors out of metal thin films, two-dimensional (2D) materials, and piezoelectric polymer sheets. For demonstration purpose, we will discuss three examples of "cut-and-pasted" epidermal electronic systems in this paper. The first will be submicron thick, transparent epidermal graphene electrodes that can be directly transferred to human skin like a temporary transfer tattoo and can measure electrocardiogram (ECG) with signal-to-noise ratio and motion artifacts on par with conventional gel electrodes. The second will be a chest patch which houses both electrodes and pressure sensors for the synchronous measurements of ECG and seismocardiogram (SCG) such that beat-to-beat blood pressure can be inferred from the time interval between the R peak of the ECG and the AC peak of the SCG. The last example will be a highly conformable, low power consumption epidermal heater for thermal therapy.

Prevalence of peripheral blood parasitaemia, anaemia and low birthweight among pregnant women in a suburban area in coastal Ghana

PubMed Central

Stephens, Judith Koryo; Ofori, Michael F; Quakyi, Isabella Akyinbah; Wilson, Mark Lee; Akanmori, Bartholomew Dicky

2014-01-01

Introduction Malaria and anaemia have adverse effects in pregnant women and on the birth weight of infants in malaria endemic areas. P. falciparum malaria, the most virulent species continues to be a major health problem in sub-Saharan Africa. This study was carried out to establish the prevalence of pregnancy-associated malaria and its associated consequences including maternal anaemia and low birthweight (LBW) deliveries and placental malaria among pregnant women in a sub-urban area in coastal Ghana. Methods A facility-based investigation was carried out among 320 pregnant women seeking antenatal care in a hospital in suburban coastal Ghana. Information on the use of Insecticide Treated Nets (ITNs) and Intermittent Preventive Treatment in pregnancy (IPTp) were collected using a structured questionnaire at enrolment. Venous blood was collected for microscopy and screening for Glucose 6-phosphate dehydrogenase (G6PD) deficiency. Haemoglobin concentration was obtained from an automatic blood analyzer. Placental smears and birth weight measurements were taken at delivery. Resuls The prevalence of Plasmodium falciparum parasitaemia was 5%. The mean haemoglobin (Hb) level at registration was 11.44g/dL (95% CI 11.29 – 11.80). Placental blood parasitaemia and low birthweight were 2.5% and 3% respectively. ITN possession was 31.6% with 5.4% usage. The IPTp coverage was 55%. Conclusion The prevalence of malaria and anaemia among the pregnant women were low at enrolment. Placental blood parasitaemia and LBW at delivery were also low. These are clear indications of the high coverage of the IPTp. Increase in ITN use will further improve birthweight outcomes and reduce placental malaria. PMID:24624240

Accreditation of ambulatory facilities.

PubMed

Urman, Richard D; Philip, Beverly K

2014-06-01

With the continued growth of ambulatory surgical centers (ASC), the regulation of facilities has evolved to include new standards and requirements on both state and federal levels. Accreditation allows for the assessment of clinical practice, improves accountability, and better ensures quality of care. In some states, ASC may choose to voluntarily apply for accreditation from a recognized organization, but in others it is mandated. Accreditation provides external validation of safe practices, benchmarking performance against other accredited facilities, and demonstrates to patients and payers the facility's commitment to continuous quality improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

40 CFR 61.20 - Designation of facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Designation of facilities. 61.20 Section 61.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.250 - Designation of facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Designation of facilities. 61.250 Section 61.250 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.220 - Designation of facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Designation of facilities. 61.220 Section 61.220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.200 - Designation of facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Designation of facilities. 61.200 Section 61.200 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.250 - Designation of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Designation of facilities. 61.250 Section 61.250 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.20 - Designation of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Designation of facilities. 61.20 Section 61.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.200 - Designation of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Designation of facilities. 61.200 Section 61.200 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

40 CFR 61.220 - Designation of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 8 2011-07-01 2011-07-01 false Designation of facilities. 61.220 Section 61.220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS National Emission Standards for Radon...

7 CFR 56.17 - Equipment and facilities for graders.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Equipment and facilities for graders. 56.17 Section 56.17 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

7 CFR 56.17 - Equipment and facilities for graders.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 3 2012-01-01 2012-01-01 false Equipment and facilities for graders. 56.17 Section 56.17 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

7 CFR 56.17 - Equipment and facilities for graders.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 3 2013-01-01 2013-01-01 false Equipment and facilities for graders. 56.17 Section 56.17 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

7 CFR 56.17 - Equipment and facilities for graders.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Equipment and facilities for graders. 56.17 Section 56.17 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

7 CFR 56.17 - Equipment and facilities for graders.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 3 2014-01-01 2014-01-01 false Equipment and facilities for graders. 56.17 Section 56.17 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

32 CFR 260.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... blind to operate vending facilities; (2) Requirements for satisfactory vending facility sites on DoD-controlled property; and (3) Vending machine income-sharing requirements on DoD-controlled property (b... Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS VENDING...

47 CFR 69.124 - Interconnection charge.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES..., facilities-based rate elements in the future, from the part 69 transport revenue requirement, and dividing by... local exchange carrier anticipates will be reassigned to other, facilities-based rate elements in the...

Continuous haematic pH monitoring in extracorporeal circulation using a disposable florescence sensing element

NASA Astrophysics Data System (ADS)

Ferrari, Luca; Rovati, Luigi; Fabbri, Paola; Pilati, Francesco

2013-02-01

During extracorporeal circulation (ECC), blood is periodically sampled and analyzed to maintain the blood-gas status of the patient within acceptable limits. This protocol has well-known drawbacks that may be overcome by continuous monitoring. We present the characterization of a new pH sensor for continuous monitoring in ECC. This monitoring device includes a disposable fluorescence-sensing element directly in contact with the blood, whose fluorescence intensity is strictly related to the pH of the blood. In vitro experiments show no significant difference between the blood gas analyzer values and the sensor readings; after proper calibration, it gives a correlation of R>0.9887, and measuring errors were lower than the 3% of the pH range of interest (RoI) with respect to a commercial blood gas analyzer. This performance has been confirmed also by simulating a moderate ipothermia condition, i.e., blood temperature 32°C, frequently used in cardiac surgery. In ex vivo experiments, performed with animal models, the sensor is continuously operated in an extracorporeal undiluted blood stream for a maximum of 11 h. It gives a correlation of R>0.9431, and a measuring error lower than the 3% of the pH RoI with respect to laboratory techniques.

Continuous haematic pH monitoring in extracorporeal circulation using a disposable florescence sensing element.

PubMed

Ferrari, Luca; Rovati, Luigi; Fabbri, Paola; Pilati, Francesco

2013-02-01

During extracorporeal circulation (ECC), blood is periodically sampled and analyzed to maintain the blood-gas status of the patient within acceptable limits. This protocol has well-known drawbacks that may be overcome by continuous monitoring. We present the characterization of a new pH sensor for continuous monitoring in ECC. This monitoring device includes a disposable fluorescence-sensing element directly in contact with the blood, whose fluorescence intensity is strictly related to the pH of the blood. In vitro experiments show no significant difference between the blood gas analyzer values and the sensor readings; after proper calibration, it gives a correlation of R>0.9887, and measuring errors were lower than the 3% of the pH range of interest (RoI) with respect to a commercial blood gas analyzer. This performance has been confirmed also by simulating a moderate ipothermia condition, i.e., blood temperature 32°C, frequently used in cardiac surgery. In ex vivo experiments, performed with animal models, the sensor is continuously operated in an extracorporeal undiluted blood stream for a maximum of 11 h. It gives a correlation of R>0.9431, and a measuring error lower than the 3% of the pH RoI with respect to laboratory techniques.

LOSS OF BLOOD AT OPERATION—A Method for Continuous Measurement

PubMed Central

Borden, Fred W.

1957-01-01

A method for continuous measurement of surgical blood loss has been devised and has been used clinically in some 400 cases. The method combines volumetric measure of the suction loss and gravimetric measure of the sponge loss. The volumetric device automatically deducts the volume of rinse water used and thus measures the amount of blood collected in a metering cylinder. The suction loss scale shows continuously the amount of blood in the metering cylinder. The gravimetric device requires counting sponges into the weighing pan, and turning a dial scale to deduct the initial weight of the sponges. The volume of blood in the sponges is then read directly on the dial scale. Use of the instrument, which is under the supervision of the anesthesiologist, adds about two minutes per hour to the time normally required for counting the sponges; and about three minutes per hour is required for tending the volumetric instrument. In clinical use, knowing constantly the amount of blood loss permits the starting of transfusion before serious deficit develops, and then maintaining the patient's blood volume at a predetermined optimum level. In some 400 cases the continuous measurement of the blood loss served as a reliable guide for carrying out the loss-replacement plan within close limits of accuracy. ImagesFigure 2.p97-a PMID:13446754

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

PubMed

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

2011-11-01

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

A novel method to measure regional muscle blood flow continuously using NIRS kinetics information

PubMed Central

Nioka, Shoko; Kime, Ryotaro; Sunar, Ulas; Im, Joohee; Izzetoglu, Meltem; Zhang, Jun; Alacam, Burak; Chance, Britton

2006-01-01

Background This article introduces a novel method to continuously monitor regional muscle blood flow by using Near Infrared Spectroscopy (NIRS). We demonstrate the feasibility of the new method in two ways: (1) by applying this new method of determining blood flow to experimental NIRS data during exercise and ischemia; and, (2) by simulating muscle oxygenation and blood flow values using these newly developed equations during recovery from exercise and ischemia. Methods Deoxy (Hb) and oxyhemoglobin (HbO2), located in the blood ofthe skeletal muscle, carry two internal relationships between blood flow and oxygen consumption. One is a mass transfer principle and the other describes a relationship between oxygen consumption and Hb kinetics in a two-compartment model. To monitor blood flow continuously, we transfer these two relationships into two equations and calculate the blood flow with the differential information of HbO2 and Hb. In addition, these equations are used to simulate the relationship between blood flow and reoxygenation kinetics after cuff ischemia and a light exercise. Nine healthy subjects volunteered for the cuff ischemia, light arm exercise and arm exercise with cuff ischemia for the experimental study. Results Analysis of experimental data of both cuff ischemia and light exercise using the new equations show greater blood flow (four to six times more than resting values) during recovery, agreeing with previous findings. Further, the simulation and experimental studies of cuff ischemia and light exercise agree with each other. Conclusion We demonstrate the accuracy of this new method by showing that the blood flow obtained from the method agrees with previous data as well as with simulated data. We conclude that this novel continuous blood flow monitoring method can provide blood flow information non-invasively with NIRS. PMID:16704736

The blood donation experience: self-reported motives and obstacles for donating blood.

PubMed

Sojka, B Nilsson; Sojka, P

2008-01-01

The aim of the study was to investigate motives for donating blood as well as difficulties and obstacles associated with blood donation as perceived by the donors themselves. Six hundred consecutive blood donors (i.e. all blood donors with a history of at least one previous whole blood donation attending, during nine working days, the Blood Centre of Umeå University Hospital) received a self-administered questionnaire that contained questions aimed at elucidating motives for donating blood (general motives for donating blood, specific motives for the first donation and motives for continuing to be an active blood donor). Questions concerning difficulties and obstacles that had to be overcome in order to continue being a blood donor were also included in the questionnaire. Altogether 531 whole blood donors filled in the questionnaire (88.5%; 322 men and 209 women). No statistically significant differences were found between male and female blood donors concerning general reasons and motives related to donating blood. The most frequently reported reasons for giving blood the first time were 'influence from a friend' (47.2% of donors) and 'request via media' (23.5% of donors). Among general reasons/motives with highest ranking of importance, the most commonly reported motive for donating blood were 'general altruism' (40.3%), 'social responsibility/obligation' (19.7%) and 'influence from friends' (17.9%). General altruism' and 'social responsibility/obligation' were also the most frequent reasons for continuing to donate blood (68.4 and 16.0%, respectively). The most commonly reported obstacle to becoming a regular blood donor was 'laziness' (19.1%) followed by 'fear of needles' (10.5%). Altruism was the most common general motive for donating blood and also for continuing to be an active blood donor. Yet, for the first blood donation, direct 'influence from friends/relatives', 'media appeal' and other types of recruitment were more commonly reported as reasons or motives for donating blood than altruism. The findings support the notion that different strategies should be used/adopted to get people to donate blood the first time (e.g. recruitment through other blood donors using, for example, the 'bring a friend along' method) and to retain these subjects as active blood donors (e.g. by information and by strengthening their sense of being a blood donor or their self-efficacy etc.).

40 CFR 792.41 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true General. 792.41 Section 792.41 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.41 General. Each testing facility shall be of...

40 CFR 60.180 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Lead Smelters § 60.180 Applicability and designation of affected facility. (a) The...: sintering machine, sintering machine discharge end, blast furnace, dross reverberatory furnace, electric...

40 CFR 60.180 - Applicability and designation of affected facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Primary Lead Smelters § 60.180 Applicability and designation of affected facility. (a) The...: sintering machine, sintering machine discharge end, blast furnace, dross reverberatory furnace, electric...

Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

PubMed

Giles Iii, James T

2016-01-01

The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.

42 CFR 493.1100 - Condition: Facility administration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Facility administration. 493.1100... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Facility Administration for Nonwaived Testing § 493.1100 Condition: Facility administration. Each laboratory that performs nonwaived...

Tissue-Informative Mechanism for Wearable Non-invasive Continuous Blood Pressure Monitoring

NASA Astrophysics Data System (ADS)

Woo, Sung Hun; Choi, Yun Young; Kim, Dae Jung; Bien, Franklin; Kim, Jae Joon

2014-10-01

Accurate continuous direct measurement of the blood pressure is currently available thru direct invasive methods via intravascular needles, and is mostly limited to use during surgical procedures or in the intensive care unit (ICU). Non-invasive methods that are mostly based on auscultation or cuff oscillometric principles do provide relatively accurate measurement of blood pressure. However, they mostly involve physical inconveniences such as pressure or stress on the human body. Here, we introduce a new non-invasive mechanism of tissue-informative measurement, where an experimental phenomenon called subcutaneous tissue pressure equilibrium is revealed and related for application in detection of absolute blood pressure. A prototype was experimentally verified to provide an absolute blood pressure measurement by wearing a watch-type measurement module that does not cause any discomfort. This work is supposed to contribute remarkably to the advancement of continuous non-invasive mobile devices for 24-7 daily-life ambulatory blood-pressure monitoring.

42 CFR 483.13 - Resident behavior and facility practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Resident behavior and facility practices. 483.13... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Requirements for Long Term Care Facilities § 483.13 Resident behavior and facility practices. (a) Restraints...

40 CFR 257.3 - Criteria for classification of solid waste disposal facilities and practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR CLASSIFICATION OF SOLID WASTE DISPOSAL FACILITIES AND PRACTICES Classification of Solid Waste Disposal Facilities and Practices § 257.3 Criteria for classification of solid waste disposal facilities and practices. Solid waste disposal facilities or practices...

40 CFR 257.3 - Criteria for classification of solid waste disposal facilities and practices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR CLASSIFICATION OF SOLID WASTE DISPOSAL FACILITIES AND PRACTICES Classification of Solid Waste Disposal Facilities and Practices § 257.3 Criteria for classification of solid waste disposal facilities and practices. Solid waste disposal facilities or practices...

Elevated Blood Lead Levels Among Fire Assay Workers and Their Children in Alaska, 2010–2011

PubMed Central

Kirk, Cassandra; Fearey, Donna; Castrodale, Louisa J.; Verbrugge, David; McLaughlin, Joseph

2015-01-01

In October 2010, an employee at Facility A in Alaska that performs fire assay analysis, an industrial technique that uses lead-containing flux to obtain metals from pulverized rocks, was reported to the Alaska Section of Epidemiology (SOE) with an elevated blood lead level (BLL) ≥10 micrograms per deciliter (μg/dL). The SOE initiated an investigation; investigators interviewed employees, offered blood lead screening to employees and their families, and observed a visit to the industrial facility by the Alaska Occupational Safety and Health Section (AKOSH). Among the 15 employees with known work responsibilities, 12 had an elevated BLL at least once from October 2010 through February 2011. Of these 12 employees, 10 reported working in the fire assay room. Four children of employees had BLLs ≥5 μg/dL. Employees working in Facility A's fire assay room were likely exposed to lead at work and could have brought lead home. AKOSH inspectors reported that they could not share their consultative report with SOE investigators because of the confidentiality requirements of a federal regulation, which hampered Alaska SOE investigators from fully characterizing the lead exposure standards. PMID:26327721

Elevated Blood Lead Levels Among Fire Assay Workers and Their Children in Alaska, 2010-2011.

PubMed

Porter, Kimberly A; Kirk, Cassandra; Fearey, Donna; Castrodale, Louisa J; Verbrugge, David; McLaughlin, Joseph

2015-01-01

In October 2010, an employee at Facility A in Alaska that performs fire assay analysis, an industrial technique that uses lead-containing flux to obtain metals from pulverized rocks, was reported to the Alaska Section of Epidemiology (SOE) with an elevated blood lead level (BLL) ≥10 micrograms per deciliter (μg/dL). The SOE initiated an investigation; investigators interviewed employees, offered blood lead screening to employees and their families, and observed a visit to the industrial facility by the Alaska Occupational Safety and Health Section (AKOSH). Among the 15 employees with known work responsibilities, 12 had an elevated BLL at least once from October 2010 through February 2011. Of these 12 employees, 10 reported working in the fire assay room. Four children of employees had BLLs ≥5 μg/dL. Employees working in Facility A's fire assay room were likely exposed to lead at work and could have brought lead home. AKOSH inspectors reported that they could not share their consultative report with SOE investigators because of the confidentiality requirements of a federal regulation, which hampered Alaska SOE investigators from fully characterizing the lead exposure standards.

Recent developments in cyanide detection: A review

PubMed Central

Ma, Jian; Dasgupta, Purnendu K.

2010-01-01

The extreme toxicity of cyanide and environmental concerns from its continued industrial use continue to generate interest in facile and sensitive methods for cyanide detection. In recent years there is also additional recognition of HCN toxicity from smoke inhalation and potential use of cyanide as a weapon of terrorism. This review summarizes the literature since 2005 on cyanide measurement in different matrices ranging from drinking water and wastewater, to cigarette smoke and exhaled breath to biological fluids like blood, urine and saliva. The dramatic increase in the number of publications on cyanide measurement is indicative of the great interest in this field not only from analytical chemists, but also researchers from diverse environmental, medical, forensic and clinical arena. The recent methods cover both established and emerging analytical disciplines and include naked eye visual detection, spectrophotometry/colorimetry, capillary electrophoresis with optical absorbance detection, fluorometry, chemiluminescence, near-infrared cavity ring down spectroscopy, atomic absorption spectrometry, electrochemical methods (potentiometry/amperometry/ion chromatography-pulsed amperometry), mass spectrometry (selected ion flow tube mass spectrometry, electrospray ionization mass spectrometry, gas chromatography-mass spectrometry), gas chromatography (nitrogen phosphorus detector, electron capture detector) and quartz crystal mass monitors. PMID:20599024

An intelligent remote monitoring system for artificial heart.

PubMed

Choi, Jaesoon; Park, Jun W; Chung, Jinhan; Min, Byoung G

2005-12-01

A web-based database system for intelligent remote monitoring of an artificial heart has been developed. It is important for patients with an artificial heart implant to be discharged from the hospital after an appropriate stabilization period for better recovery and quality of life. Reliable continuous remote monitoring systems for these patients with life support devices are gaining practical meaning. The authors have developed a remote monitoring system for this purpose that consists of a portable/desktop monitoring terminal, a database for continuous recording of patient and device status, a web-based data access system with which clinicians can access real-time patient and device status data and past history data, and an intelligent diagnosis algorithm module that noninvasively estimates blood pump output and makes automatic classification of the device status. The system has been tested with data generation emulators installed on remote sites for simulation study, and in two cases of animal experiments conducted at remote facilities. The system showed acceptable functionality and reliability. The intelligence algorithm also showed acceptable practicality in an application to animal experiment data.

40 CFR 792.15 - Inspection of a testing facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Inspection of a testing facility. 792.15 Section 792.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS General Provisions § 792.15 Inspection...

32 CFR 286.7 - Requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Requirements. 286.7 Section 286.7 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF... Requirements. (a) Reading room. Each DoD Component shall provide an appropriate facility or facilities where...

32 CFR 286.7 - Requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Requirements. 286.7 Section 286.7 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF... Requirements. (a) Reading room. Each DoD Component shall provide an appropriate facility or facilities where...

40 CFR 264.31 - Design and operation of facility.

Code of Federal Regulations, 2014 CFR

2014-07-01

....31 Section 264.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES...-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water which...

40 CFR 264.31 - Design and operation of facility.

Code of Federal Regulations, 2012 CFR

2012-07-01

....31 Section 264.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES...-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water which...

40 CFR 264.31 - Design and operation of facility.

Code of Federal Regulations, 2013 CFR

2013-07-01

....31 Section 264.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES...-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water which...

40 CFR 264.31 - Design and operation of facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

....31 Section 264.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES...-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water which...

40 CFR 265.18 - Location standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Location standards. 265.18 Section 265.18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED... FACILITIES General Facility Standards § 265.18 Location standards. The placement of any hazardous waste in a...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

33 CFR 105.235 - Communications.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Communications. 105.235 Section... MARITIME SECURITY: FACILITIES Facility Security Requirements § 105.235 Communications. (a) The Facility... conditions at the facility. (b) Communication systems and procedures must allow effective and continuous...

42 CFR 442.12 - Provider agreement: General requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STANDARDS FOR PAYMENT TO NURSING FACILITIES AND... nursing facility services nor make Medicaid payments to a facility for those services unless the Secretary...

47 CFR 69.304 - Subscriber line cable and wire facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Subscriber line cable and wire facilities. 69.304 Section 69.304 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.304 Subscriber line cable and wire...

47 CFR 69.305 - Carrier cable and wire facilities (C&WF).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Carrier cable and wire facilities (C&WF). 69.305 Section 69.305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.305 Carrier cable and wire...

47 CFR 69.304 - Subscriber line cable and wire facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Subscriber line cable and wire facilities. 69.304 Section 69.304 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.304 Subscriber line cable and wire...

47 CFR 69.305 - Carrier cable and wire facilities (C&WF).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Carrier cable and wire facilities (C&WF). 69.305 Section 69.305 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) ACCESS CHARGES Apportionment of Net Investment § 69.305 Carrier cable and wire...

40 CFR 60.150 - Applicability and designation of affected facility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Sewage Treatment Plants § 60.150 Applicability and designation of affected facility. (a) The... (dry basis) produced by municipal sewage treatment plants, or each incinerator that charges more than...

A Report of Selected Residential Continuing Education Centers in the United States.

ERIC Educational Resources Information Center

Brown, W. Rex

General information is presented concerning residential continuing education centers affiliated with public institutions of higher education. Attention was directed to those universities considered self-contained with full-service facilities, including conference facilities, housing accommodations, and food services. Based on the latest documents…

Comparison of non-invasive MRI measurements of cerebral blood flow in a large multisite cohort.

PubMed

Dolui, Sudipto; Wang, Ze; Wang, Danny Jj; Mattay, Raghav; Finkel, Mack; Elliott, Mark; Desiderio, Lisa; Inglis, Ben; Mueller, Bryon; Stafford, Randall B; Launer, Lenore J; Jacobs, David R; Bryan, R Nick; Detre, John A

2016-07-01

Arterial spin labeling and phase contrast magnetic resonance imaging provide independent non-invasive methods for measuring cerebral blood flow. We compared global cerebral blood flow measurements obtained using pseudo-continuous arterial spin labeling and phase contrast in 436 middle-aged subjects acquired at two sites in the NHLBI CARDIA multisite study. Cerebral blood flow measured by phase contrast (CBFPC: 55.76 ± 12.05 ml/100 g/min) was systematically higher (p < 0.001) and more variable than cerebral blood flow measured by pseudo-continuous arterial spin labeling (CBFPCASL: 47.70 ± 9.75). The correlation between global cerebral blood flow values obtained from the two modalities was 0.59 (p < 0.001), explaining less than half of the observed variance in cerebral blood flow estimates. Well-established correlations of global cerebral blood flow with age and sex were similarly observed in both CBFPCASL and CBFPC CBFPC also demonstrated statistically significant site differences, whereas no such differences were observed in CBFPCASL No consistent velocity-dependent effects on pseudo-continuous arterial spin labeling were observed, suggesting that pseudo-continuous labeling efficiency does not vary substantially across typical adult carotid and vertebral velocities, as has previously been suggested. Although CBFPCASL and CBFPC values show substantial similarity across the entire cohort, these data do not support calibration of CBFPCASL using CBFPC in individual subjects. The wide-ranging cerebral blood flow values obtained by both methods suggest that cerebral blood flow values are highly variable in the general population. © The Author(s) 2016.

CONCEPTUAL DESIGN ASSESSMENT FOR THE CO-FIRING OF BIO-REFINERY SUPPLIED LIGNIN PROJECT

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

Ted Berglund; Jeffrey T. Ranney; Carol L. Babb

2001-01-01

The major aspects of this project are proceeding toward completion. Prior to this quarter, design criteria, tentative site selection, facility layout, and preliminary facility cost estimates have been completed and issued for review. Processing of bio-solids was completed, providing material for the pilot operations. Pilot facility design, equipment selection, and modification were completed during the fourth quarter. Initial pilot facility shakedown was completed during the fourth quarter. During pilot plant shakedown operations, several production batch test runs were performed. These pilot tests were coupled with laboratory testing to confirm pilot results. In initial batches of operations, cellulose to glucose conversionsmore » of 62.5% and 64.8% were observed in laboratory hydrolysis. As part of this testing, lignin dewatering was tested using laboratory and vendor-supplied filtration equipment. Dewatering tests reported moisture contents in the lignin of between 50% and 60%. Dewatering parameters and options will continue to be investigated during lignin production. After some unavoidable delays, a suitable representative supply of MSW feed material was procured. Shredding of the feed material was completed and final drying of the feed is expected to be completed by late January. Once feed drying is completed, pilot facility production will begin to produce lignin for co-fire testing. Facility modifications are expected to continue to improve facility operations and performance during the first quarter of 2001. The TVA-Colbert facility continues to make progress in evaluating the co-location of the Masada facility on the operation of the power generation facility. The TVA-Colbert fossil plant is fully capable of providing a reliable steam supply. The preferred steam supply connection points and steam pipeline routing have been identified. The environmental review of the pipeline routing has been completed and no major impacts have been identified. Detailed assessment of steam export impacts on the Colbert boiler system continues.« less

42 CFR 493.1101 - Standard: Facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Facilities. 493.1101 Section 493.1101... (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Facility Administration for Nonwaived Testing § 493.1101 Standard: Facilities. (a) The laboratory must be constructed, arranged, and maintained to...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities... emissions from food processing facilities without any accompanying analyses demonstrating that these...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Community facilities. 1942.17 Section 1942.17...) PROGRAM REGULATIONS (CONTINUED) ASSOCIATIONS Community Facility Loans § 1942.17 Community facilities. (a... successor agency under Public Law 103-354 policies and requirements pertaining to loans for community...

40 CFR 52.279 - Food processing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... emissions from food processing facilities without any accompanying analyses demonstrating that these... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Food processing facilities. 52.279... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS California § 52.279 Food processing facilities...

Variation in hematologic and serum biochemical values of belugas (Delphinapterus leucas) under managed care.

PubMed

Norman, Stephanie A; Beckett, Laurel A; Miller, Woutrina A; St Leger, Judy; Hobbs, Roderick C

2013-06-01

Blood analytes are critical for evaluating the general health of cetacean populations, so it is important to understand the intrinsic variability of hematology and serum chemistry values. Previous studies have reported data for follow-up periods of several years in managed and wild populations, but studies over long periods of time (> 20 yr) have not been reported. The study objective was to identify the influences of partitioning characteristics on hematology and serum chemistry analytes of apparently healthy managed beluga (Delphinapterus leucas). Blood values from 31 managed belugas, at three facilities, collected over 22 yr, were assessed for seasonal variation and aging trends, and evaluated for biologic variation among and within individuals. Linear mixed effects models assessed the relationship between the analytes and sex, age, season, facility location, ambient air temperature, and photoperiod. Sex differences in analytes and associations with increasing age were observed. Seasonal variation was observed for hemoglobin, hematocrit, mean corpuscular volume, monocytes, alkaline phosphatase, total bilirubin, cholesterol, and triglycerides. Facilities were associated with larger effects on analyte values compared to other covariates, whereas age, sex, and ambient temperature had smaller effects compared to facility and season. Present findings provide important baseline information for future health monitoring efforts. Interpretation of blood analytes and animal health in managed and wild populations over time is aided by having available typical levels for the species and reference intervals for the degree to which individual animals vary from the species average and from their own baseline levels during long-term monitoring.

The Benefits of Continuous Leisure Participation in Relocation Adjustment Among Residents of Long-Term Care Facilities.

PubMed

Lin, Li-Jung; Yen, Hsin-Yen

2018-03-19

The rising population of older adults is transforming Taiwan society. Although many long-term care facilities now operate for older adults, the transition from the home environment to long-term facilities may cause multiple issues, including relocation stress syndrome, for new residents. Autonomy is a critical element of the human experience. Leisure, as an expression of autonomy, has been shown to enhance self-image and promote feelings of competence and mastery. The aim of this study was to assess the relationship between participation in leisure activities and adjustment to residential care using the continuity theory. One hundred sixty-three qualified individuals from 11 long-term care institutions were recruited and completed the questionnaire. The sampling criteria for the study were age (55+ years), appropriate cognitive skills, and residency (less than 5 years). Interviews conducted by trained interviewers were used to collect data. Measured outcomes included leisure participation; physical, psychological, and social adjustments; and background information. Cluster analysis, descriptive analysis, multivariate analysis of variance, and least significant difference test were used in analysis. Type of admission (voluntary/mandated) and type of leisure participation significantly affected the level of relocation adjustment success. Four leisure behavior categories were identified, including reduced participation, expanded participation, active participation, and continuing participation. The participants in the active and continuing participation categories had significantly higher psychological adjustment than their peers in the reduced participation category. Moreover, the continuing participation category had a significantly better level of social adjustment than their expanded participation category peers. Continuous and active participation categories had a beneficial outcome in relocation adjustment. The findings support that, in general, residents of long-term care facilities who participate continuously in leisure activities adjust better psychologically and socially to their new life in these facilities than individuals in the other participation categories. As continuity of participation in leisure activities is important for successful aging, institutions should facilitate the continuing leisure behavior of new residents.

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2013 CFR

2013-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2011 CFR

2011-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2014 CFR

2014-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2012 CFR

2012-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 80.1452 - What are the requirements related to the EPA Moderated Transaction System (EMTS)?

Code of Federal Regulations, 2014 CFR

2014-07-01

... importer. (2) The EPA company registration number of the renewable fuel producer or foreign ethanol... facility registration number of the facility at which the renewable fuel producer or foreign ethanol... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES...

40 CFR 80.1452 - What are the requirements related to the EPA Moderated Transaction System (EMTS)?

Code of Federal Regulations, 2012 CFR

2012-07-01

... importer. (2) The EPA company registration number of the renewable fuel producer or foreign ethanol... facility registration number of the facility at which the renewable fuel producer or foreign ethanol... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES...

40 CFR 80.1452 - What are the requirements related to the EPA Moderated Transaction System (EMTS)?

Code of Federal Regulations, 2013 CFR

2013-07-01

... importer. (2) The EPA company registration number of the renewable fuel producer or foreign ethanol... facility registration number of the facility at which the renewable fuel producer or foreign ethanol... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES...

40 CFR 141.714 - Requirements for uncovered finished water storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Requirements for uncovered finished water storage facilities. 141.714 Section 141.714 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Treatment for Cryptosporidium Treatment Technique...

32 CFR 644.559 - Civilian component training facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Civilian component training facilities. 644.559 Section 644.559 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Secretary of the Air Force, respectively (Department of Defense Directive 5100.10, dated 16 March 1972). ...

32 CFR 644.559 - Civilian component training facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Civilian component training facilities. 644.559 Section 644.559 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Secretary of the Air Force, respectively (Department of Defense Directive 5100.10, dated 16 March 1972). ...

32 CFR 644.559 - Civilian component training facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Civilian component training facilities. 644.559 Section 644.559 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Secretary of the Air Force, respectively (Department of Defense Directive 5100.10, dated 16 March 1972). ...

32 CFR 644.559 - Civilian component training facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Civilian component training facilities. 644.559 Section 644.559 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Secretary of the Air Force, respectively (Department of Defense Directive 5100.10, dated 16 March 1972). ...

32 CFR 644.559 - Civilian component training facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Civilian component training facilities. 644.559 Section 644.559 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Secretary of the Air Force, respectively (Department of Defense Directive 5100.10, dated 16 March 1972). ...

Sex Differences in Neuropsychological Function and Manganese in Air, Blood, Hair, and Toenails in Ohio Residents

EPA Science Inventory

Background: This study compares manganese (Mn) in air, blood, hair, and toenails and neuropsychological function of 110 women and 76 men, environmentally exposed to Mn in air (Mn-air) in two Ohio towns from a ferromanganese smelter and a soil Mn-packaging facility.Method: Biomark...

Effects of color temperatures (kelvin) of led bulbs on blood physiological variables of broilers grown to heavy weights

USDA-ARS?s Scientific Manuscript database

Light-emitting diode (LED) lighting is being used in the poultry industry to reduce energy usage in broiler production facilities. However, limited data are available comparing efficacy of different spectral distribution of LED bulbs on blood physiological variables of broilers grown to heavy weight...

A simple cell transport device keeps culture alive and functional during shipping.

PubMed

Miller, Paula G; Wang, Ying I; Swan, Glen; Shuler, Michael L

2017-09-01

Transporting living complex cellular constructs through the mail while retaining their full viability and functionality is challenging. During this process, cells often suffer from exposure to suboptimal life-sustaining conditions (e.g. temperature, pH), as well as damage due to shear stress. We have developed a transport device for shipping intact cell/tissue constructs from one facility to another that overcomes these obstacles. Our transport device maintained three different cell lines (Caco2, A549, and HepG2 C3A) individually on transwell membranes with high viability (above 97%) for 48 h under simulated shipping conditions without an incubator. The device was also tested by actual overnight shipping of blood brain barrier constructs consisting of human induced pluripotent brain microvascular endothelial cells and rat astrocytes on transwell membranes to a remote facility (approximately 1200 miles away). The blood brain barrier constructs arrived with high cell viability and were able to regain full barrier integrity after equilibrating in the incubator for 24 h; this was assessed by the presence of continuous tight junction networks and in vivo-like values for trans-endothelial electrical resistance (TEER). These results demonstrated that our cell transport device could be a useful tool for long-distance transport of membrane-bound cell cultures and functional tissue constructs. Studies that involve various cell and tissue constructs, such as the "Multi-Organ-on-Chip" devices (where multiple microscale tissue constructs are integrated on a single microfluidic device) and studies that involve microenvironments where multiple tissue interactions are of interest, would benefit from the ability to transport or receive these constructs. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:1257-1266, 2017. © 2017 American Institute of Chemical Engineers.

Uncontrolled hypertension among patients managed in primary healthcare facilities in Kinshasa, Democratic Republic of the Congo.

PubMed

Kika, T M; Lepira, F B; Kayembe, P K; Makulo, J R; Sumaili, E K; Kintoki, E V; M'Buyamba-Kabangu, J R

Uncontrolled hypertension remains an important issue in daily clinical practice worldwide. Although the majority of patients are treated in primary care, most of the data on blood pressure control originate from population-based studies or secondary healthcare. The aim of this study was to evaluate the frequency of uncontrolled hypertension and associated risk factors among hypertensive patients followed at primary care facilities in Kinshasa, the capital city of Democratic Republic of the Congo. A sample of 298 hypertensive patients seen at primary healthcare facilities, 90 men and 208 women, aged ≥ 18 years, were consecutively included in this cross-sectional study. The majority (66%) was receiving monotherapy, and diuretics (43%) were the most used drugs. According to 2007 European Society of Hypertension/European Society of Cardiology hypertension guidelines, uncontrolled hypertension was defined as blood pressure ≥ 140/90 or ≥ 130/80 mmHg (diabetes or chronic kidney disease). Logistic regression analysis was used to identify the determinants of uncontrolled hypertension. Uncontrolled hypertension was observed in 231 patients (77.5%), 72 men and 159 women. Uncontrolled systolic blood pressure (SBP) was more frequent than uncontrolled diastolic blood pressure (DBP) and increased significantly with advancing age (p = 0.002). The proportion of uncontrolled SBP and DBP was significantly higher in patients with renal failure (p = 0.01) and those with high (p = 0.03) to very high (p = 0.02) absolute cardiovascular risk. The metabolic syndrome (OR 2.40; 95% CI 1.01-5.74; p = 0.04) emerged as the main risk factor associated with uncontrolled hypertension. Uncontrolled hypertension was common in this case series and was associated with factors related to lifestyle and diet, which interact with blood pressure control.

Missed opportunities to improve the health of postpartum women: high rates of untreated hypertension in rural Tanzania

PubMed Central

Larson, Elysia; Rabkin, Miriam; Mbaruku, Godfrey M.; Mbatia, Redempta; Kruk, Margaret E.

2017-01-01

Objectives To assess the prevalence of high blood pressure amongst postpartum women in rural Tanzania, and to explore factors associated with hypertension prevalence, awareness of their own hypertension, treatment, and control. Methods We conducted a cross-sectional study of 1,849 women in Tanzania’s Pwani Region who delivered a child in the prior year. We measured blood pressure, administered a structured questionnaire, and assessed factors associated with hypertension (HTN) prevalence, women’s awareness of their own HTN, treatment, and control of HTN using bivariable and multivariable logistic regressions. Findings 26.7% of women had high blood pressure and/or were taking antihypertensive medication. Women were on average 27.5 years old (range 15–54). Nearly all women (99.5%) reported contact with the health system during their pregnancy and delivery, with 97.0% reporting at least one antenatal care visit, 81.4% reporting facility delivery, and an overall average of 5.2 visits for their own care in the past year. Only 23.5% of those with HTN were aware of their diagnosis, 17.4% were taking medication, and only 10.5% had controlled blood pressure. In multivariable analysis, facility delivery, health insurance, and increased distance from a hospital were associated with increased likelihood of HTN awareness; facility delivery and hospital distance were associated with current hypertensive treatment; younger age and increased hospital distance were associated with control of HTN. Conclusion The prevalence of high blood pressure in this postpartum population was high, and despite frequent recent contacts with the health system, awareness, treatment and control of HTN were low. These findings highlight an important missed opportunity to improve women’s health during antenatal and postnatal care. PMID:28120288

Centrifuge apparatus

DOEpatents

Sartory, Walter K.; Eveleigh, John W.

1976-01-01

A method and apparatus for operating a continuous flow blood separation centrifuge are provided. The hematocrit of the entrant whole blood is continuously maintained at an optimum constant value by the addition of plasma to the entrant blood. The hematocrit of the separated red cells is monitored to indicate the degree of separation taking place, thereby providing a basis for regulating the flow through the centrifuge.

33 CFR 159.201 - Recognition of facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Recognition of facilities. 159.201 Section 159.201 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) POLLUTION MARINE SANITATION DEVICES Recognition of Facilities § 159.201 Recognition of facilities...

7 CFR 51.57 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Facilities. 51.57 Section 51.57 Agriculture... Requirements for Plants Operating Under Continuous Inspection on A Contract Basis § 51.57 Facilities. Each packing plant shall be equipped with adequate sanitary facilities and accommodations, including but not...

33 CFR 126.15 - What conditions must a designated waterfront facility meet?

Code of Federal Regulations, 2011 CFR

2011-07-01

... NFPA 307, chapter 5. (2) Containers. Containers packed with dangerous cargo that are vertically stacked... HOMELAND SECURITY (CONTINUED) WATERFRONT FACILITIES HANDLING OF DANGEROUS CARGO AT WATERFRONT FACILITIES... facility transfers dangerous cargo between sunset and sunrise, it must have outdoor lighting that...

33 CFR 126.15 - What conditions must a designated waterfront facility meet?

Code of Federal Regulations, 2010 CFR

2010-07-01

... NFPA 307, chapter 5. (2) Containers. Containers packed with dangerous cargo that are vertically stacked... HOMELAND SECURITY (CONTINUED) WATERFRONT FACILITIES HANDLING OF DANGEROUS CARGO AT WATERFRONT FACILITIES... facility transfers dangerous cargo between sunset and sunrise, it must have outdoor lighting that...

33 CFR 126.15 - What conditions must a designated waterfront facility meet?

Code of Federal Regulations, 2012 CFR

2012-07-01

... NFPA 307, chapter 5. (2) Containers. Containers packed with dangerous cargo that are vertically stacked... HOMELAND SECURITY (CONTINUED) WATERFRONT FACILITIES HANDLING OF DANGEROUS CARGO AT WATERFRONT FACILITIES... facility transfers dangerous cargo between sunset and sunrise, it must have outdoor lighting that...

33 CFR 126.15 - What conditions must a designated waterfront facility meet?

Code of Federal Regulations, 2014 CFR

2014-07-01

... NFPA 307, chapter 5. (2) Containers. Containers packed with dangerous cargo that are vertically stacked... HOMELAND SECURITY (CONTINUED) WATERFRONT FACILITIES HANDLING OF DANGEROUS CARGO AT WATERFRONT FACILITIES... facility transfers dangerous cargo between sunset and sunrise, it must have outdoor lighting that...

33 CFR 126.15 - What conditions must a designated waterfront facility meet?

Code of Federal Regulations, 2013 CFR

2013-07-01

... NFPA 307, chapter 5. (2) Containers. Containers packed with dangerous cargo that are vertically stacked... HOMELAND SECURITY (CONTINUED) WATERFRONT FACILITIES HANDLING OF DANGEROUS CARGO AT WATERFRONT FACILITIES... facility transfers dangerous cargo between sunset and sunrise, it must have outdoor lighting that...

7 CFR 1735.91 - Location of facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Location of facilities. 1735.91 Section 1735.91 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... All Acquisitions and Mergers § 1735.91 Location of facilities. Telephone facilities to be acquired...

47 CFR 95.1107 - Authorized locations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO... care facility provided the facility is located anywhere a CB station operation is permitted under § 95... associated with a health care facility. ...

Blood Pressure Associates with Standing Balance in Elderly Outpatients

PubMed Central

Pasma, Jantsje H.; Bijlsma, Astrid Y.; Klip, Janneke M.; Stijntjes, Marjon; Blauw, Gerard Jan; Muller, Majon; Meskers, Carel G. M.; Maier, Andrea B.

2014-01-01

Objectives Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment. Materials and Methods In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex. Results Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements. Conclusion Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care. PMID:25222275

Development of a standardized transfusion ratio as a metric for evaluating dialysis facility anemia management practices.

PubMed

Liu, Jiannong; Li, Suying; Gilbertson, David T; Monda, Keri L; Bradbury, Brian D; Collins, Allan J

2014-10-01

Because transfusion avoidance has been the cornerstone of anemia treatment for patients with kidney disease, direct measurement of red blood cell transfusion use to assess dialysis facility anemia management performance is reasonable. We aimed to explore methods for estimating facility-level standardized transfusion ratios (STfRs) to assess provider anemia treatment practices. Retrospective cohort study. Point prevalent US hemodialysis patients on January 1, 2009, with Medicare as primary payer and dialysis duration of 90 days or longer were included (n = 223,901). All dialysis facilities with eligible patients were included (n = 5,345). Dialysis facility assignment. Receiving a red blood cell transfusion in the inpatient or outpatient setting. We evaluated 3 approaches for estimating STfR: ratio of observed to expected numbers of transfusions (STfR(obs)), a Bayesian approach (STfR(Bayes)), and a modified version of the Bayesian approach (STfR(modBayes)). The overall national transfusion rate in 2009 was 23.2 per 100 patient-years. Our model for predicting the expected number of transfusions performed well. For large facilities, all 3 STfRs worked well. However, for small facilities, while the STfR(modBayes) worked well, STfR(obs) values demonstrated instability and the STfR(Bayes) may produce more bias. Administration of transfusions to dialysis patients reflects medical practice both within and outside the dialysis unit. Some transfusions may be deemed unavoidable and transfusion practices are subject to considerable regional variation. Development of an STfR metric is feasible and reasonable for assessing anemia treatment at dialysis facilities. The STfR(obs) is simple to calculate and works well for larger dialysis facilities. The STfR(modBayes) is more analytically complex, but facilitates comparisons across all dialysis facilities, including small facilities. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Combat Casualties and Severe Shock: Risk Factors for Death at Role 3 Military Facilities.

PubMed

Buehner, Michelle F; Eastridge, Brian J; Aden, James K; DuBose, Joseph J; Blackbourne, Lorne H; Cestero, Ramon F

2017-09-01

Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90. Transfers from role 2 facilities were excluded. Data captured included demographics, admission vital signs, laboratory values, blood products, and mortality. Relationships between admission physiology, blood product utilization, and mortality were developed. Independent associations between variables were determined by logistic regression analysis. 1,703 patients were identified who met our inclusion criteria and composite mortality was 23%. Mortality in those receiving a balanced transfusion ratio was 18% versus 27% (p < 0.0001). Hypotensive casualties who survived were significantly more likely to have a higher presenting Glasgow Coma Score (GCS), temperature, SBP, shock index, and pH. In addition, this group was also more likely to have a lower international normalized ratio, pCO2, and base deficit (p < 0.001). Age, heart rate, and pulse pressure were not significantly different between groups. Independent predictors of mortality included Injury Severity Score, presentation GCS, and initial pH value (p < 0.0001). In contrast, independent predictors of survival included those with above-knee amputation and a balanced transfusion (p < 0.0001). Combat casualties hypotensive on arrival to surgical facilities have a significant expected mortality. Those receiving balanced transfusions demonstrated improved survival. Of the five independent risk factors, pH, GCS, and the presence of above-knee amputation are typically available during initial evaluation. These factors may be helpful in determining resource allocation and mortality risk, especially in triage or mass casualty settings. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Health Workers' Use of Malaria Rapid Diagnostic Tests (RDTs) to Guide Clinical Decision Making in Rural Dispensaries, Tanzania

PubMed Central

Masanja, M. Irene; McMorrow, Meredith; Kahigwa, Elizeus; Kachur, S. Patrick; McElroy, Peter D.

2010-01-01

Rapid diagnostic tests (RDTs) were developed as an alternative to microscopy for malaria diagnosis. The RDTs detect malaria parasite antigen(s) in whole blood with high sensitivity and specificity. We assessed health worker malaria treatment practices after the introduction of RDTs in peripheral health facilities without microscopy. From December 2007 to October 2008, we introduced histidine-rich protein II (HRP-2)-based ParaHIT RDTs for routine use in 12 health facilities in Rufiji District, Tanzania. Health workers received training on how to perform RDTs for patients 5 years of age or older with fever or suspected malaria. Children < 5 years of age were to be treated empirically per national guidelines. Among the 30,195 patients seen at these 12 health facilities, 10,737 (35.6%) were tested with an RDT for malaria. 88.3% (9,405/10,648) of tested patients reported fever or history of fever and 2.7% (289/10,677) of all tested individuals were children < 5 years of age. The RDT results were recorded for 10,650 patients (99.2%). Among the 5,488 (51.5%) RDT-positive patients, 5,256 (98.6%) were treated with an appropriate first-line antimalarial per national guidelines (artemether-lumefantrine or quinine). Among the 5,162 RDT-negative patients, only 205 (4.0%) were treated with an antimalarial. Other reported treatments included antibiotics and antipyretics. Implementation of RDTs in rural health facilities resulted in high adherence to national treatment guidelines. Patients testing negative by RDT were rarely treated with antimalarials. Unapproved antimalarials were seldom used. Health workers continued to follow guidelines for the empiric treatment of febrile children. PMID:21118927

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Facilities for handling test, control, and reference substances. 160.47 Section 160.47 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.47 Facilities...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Specimen and data storage facilities. 160.51 Section 160.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space...

7 CFR 1738.12 - Location of facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Location of facilities. 1738.12 Section 1738.12 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Location of facilities. RUS will make broadband loans for facilities which RUS determines are necessary to...

Continuous non-invasive blood glucose monitoring by spectral image differencing method

NASA Astrophysics Data System (ADS)

Huang, Hao; Liao, Ningfang; Cheng, Haobo; Liang, Jing

2018-01-01

Currently, the use of implantable enzyme electrode sensor is the main method for continuous blood glucose monitoring. But the effect of electrochemical reactions and the significant drift caused by bioelectricity in body will reduce the accuracy of the glucose measurements. So the enzyme-based glucose sensors need to be calibrated several times each day by the finger-prick blood corrections. This increases the patient's pain. In this paper, we proposed a method for continuous Non-invasive blood glucose monitoring by spectral image differencing method in the near infrared band. The method uses a high-precision CCD detector to switch the filter in a very short period of time, obtains the spectral images. And then by using the morphological method to obtain the spectral image differences, the dynamic change of blood sugar is reflected in the image difference data. Through the experiment proved that this method can be used to monitor blood glucose dynamically to a certain extent.

Working Out Works for Shawn Kelly | Poster

Cancer.gov

By Nancy Parrish, Staff Writer When Shawn Kelly found out last year that he had high blood pressure, he was determined to do something about it. Luckily for Kelly, an instrumentation technician III, Facilities Maintenance and Engineering, he works at the Advanced Technology Research Facility (ATRF), where he can take advantage of the gym there, known as the Wellness Center.

78 FR 49262 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Sunshine Act Meeting AGENCY: Defense Nuclear Facilities... given of the Defense Nuclear Facilities Safety Board's (Board) public meeting and hearing described... associated with continued operation of aging defense nuclear [[Page 49263

1989 Intercomparison of radon progeny measurement methods and equipment in North America

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

Scofield, P.; George, A.; Tu, Keng.

1990-03-01

At the 1989 {sup 222}Rn progeny intercomparison held at the Environmental Measurements Laboratory (EML), July 10--14, 1989, grab sampling and integrating/continuous {sup 222}Rn progeny methods were evaluated. Sixteen facilities participated in this intercomparison. Twelve facilities used {sup 222}Rn progeny grab sampling methods, and nine facilities used integrating/continuous instruments. Eighty-eight percent of the participants reported grab sample {sup 222}Rn progeny concentrations that were within 20% of the EML reference values. Good agreement between participant and EML grab-sample potential alpha energy concentrations (PAECs) was observed; 92% of the participants had PAECs within 20% of the EML values. For the integrating/continuous PAEC valuesmore » determined with integrating/continuous monitors, 89% of the participants were within 20% of the EML reference values. 9 refs., 3 figs., 4 tabs.« less

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

40 CFR 60.5380 - What standards apply to centrifugal compressor affected facilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 7 2013-07-01 2013-07-01 false What standards apply to centrifugal compressor affected facilities? 60.5380 Section 60.5380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Crude Oil and Natura...

40 CFR 60.5380 - What standards apply to centrifugal compressor affected facilities?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 7 2014-07-01 2014-07-01 false What standards apply to centrifugal compressor affected facilities? 60.5380 Section 60.5380 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Crude Oil and Natura...

40 CFR 60.5375 - What standards apply to gas well affected facilities?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 7 2013-07-01 2013-07-01 false What standards apply to gas well affected facilities? 60.5375 Section 60.5375 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Crude Oil and Natural Gas...

40 CFR 60.5375 - What standards apply to gas well affected facilities?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 7 2014-07-01 2014-07-01 false What standards apply to gas well affected facilities? 60.5375 Section 60.5375 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Crude Oil and Natural Gas...

32 CFR 637.9 - Access to U.S. Army facilities and records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Access to U.S. Army facilities and records. 637.9 Section 637.9 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MILITARY POLICE INVESTIGATION Investigations § 637.9 Access to U.S...

40 CFR 60.5130 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... operated unless a fully trained and qualified SSI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified SSI unit operator may operate the SSI...

40 CFR 60.2070 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... operated unless a fully trained and qualified CISWI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified CISWI unit operator may operate the...

40 CFR 60.2070 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... operated unless a fully trained and qualified CISWI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified CISWI unit operator may operate the...

40 CFR 60.5130 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... operated unless a fully trained and qualified SSI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified SSI unit operator may operate the SSI...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

40 CFR 266.350 - What records must you keep at your facility and for how long?

Code of Federal Regulations, 2014 CFR

2014-07-01

... after the exempted waste is sent for disposal. (e) If you are not already subject to NRC, or NRC... AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Conditional Exemption for Low-Level Mixed Waste...

46 CFR 160.151-45 - Equipment required for servicing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 6 2011-10-01 2011-10-01 false Equipment required for servicing facilities. 160.151-45 Section 160.151-45 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT...) § 160.151-45 Equipment required for servicing facilities. Each servicing facility approved by the Coast...

Using Former Military Installations as Correctional Facilities

DTIC Science & Technology

1990-03-01

Idaho County, in the Clearwater Mountains approximately 60 miles southeast of Lewiston in the Idaho panhandle. Judicial District: 2nd Judicial...57 Naselle Youth Camp - Naselle, Washington .................... 59 North Idaho Correctional Facility...Cottonwood, Idaho ...... 61 County Facility Lancaster Correctional Facility - Lincoln, Nebraska ........ 65 TABLE OF CONTENTS (CONTINUED) PAGE PHOTOS 1

41 CFR 102-74.585 - What Federal facility telework policy must Executive agencies follow?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What Federal facility... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Telework § 102-74.585 What Federal facility telework policy must Executive...

41 CFR 102-74.70 - Are commercial vendors and nonprofit organizations required to operate vending facilities by...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are commercial vendors and nonprofit organizations required to operate vending facilities by permit or contractual...

41 CFR 102-74.270 - Are vehicles required to display parking permits in parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are vehicles required to... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.270 Are vehicles required...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

Evaluation of continuous air monitor placement in a plutonium facility.

PubMed

Whicker, J J; Rodgers, J C; Fairchild, C I; Scripsick, R C; Lopez, R C

1997-05-01

Department of Energy appraisers found continuous air monitors at Department of Energy plutonium facilities alarmed less than 30% of the time when integrated room plutonium air concentrations exceeded 500 DAC-hours. Without other interventions, this alarm percentage suggests the possibility that workers could be exposed to high airborne concentrations without continuous air monitor alarms. Past research has shown that placement of continuous air monitors is a critical component in rapid and reliable detection of airborne releases. At Los Alamos National Laboratory and many other Department of Energy plutonium facilities, continuous air monitors have been primarily placed at ventilation exhaust points. The purpose of this study was to evaluate and compare the effectiveness of exhaust register placement of workplace continuous air monitors with other sampling locations. Polydisperse oil aerosols were released from multiple locations in two plutonium laboratories at Los Alamos National Laboratory. An array of laser particle counters positioned in the rooms measured time-resolved aerosol dispersion. Results showed alternative placement of air samplers generally resulted in aerosol detection that was faster, often more sensitive, and equally reliable compared with samplers at exhaust registers.

Good manufacturing practice (GMP) compliance in the biologics sector: plasma fractionation.

PubMed

Ways, J P; Preston, M S; Baker, D; Huxsoll, J; Bablak, J

1999-12-01

The U.S. blood supply is the safest it has ever been. Due to blood safety and the introduction of viral inactivation/clearance technologies, protein therapies derived from human blood have also in recent years had a history of product safety. Nevertheless, since 1995, the plasma-fractionation industry has experienced increased compliance-related actions by the Food and Drug Administration (FDA), as shown by a substantive increase in the number of FDA 483 inspectional observations, FDA warning letters and other FDA regulatory action. An evaluation of these trends shows that they reflect the implementation by the FDA of increased inspectional interest in the plasma-fractionation industry and an evolution of inspectional practices and standards of current good manufacturing practice (cGMP). Plasma fractionators have responded to FDA actions by carefully evaluating and addressing each inspectional observation, assessing impact to product and taking appropriate actions, including corrective actions to prevent future occurrence. They have made major investments in facilities, quality systems, personnel and training to meet the evolving standards of cGMP and in an effort to implement these standards systemically. Through industry associations, manufacturers have further enhanced product safety by adopting additional voluntary standards for plasma to prevent the entry of potentially unsuitable plasma into the production process. The industry remains committed to application of cGMP and to working with the FDA in further evolution of these standards while striving to assure a continued supply of safe, pure and effective plasma-derived therapies.

Cuffless and Continuous Blood Pressure Estimation from the Heart Sound Signals

PubMed Central

Peng, Rong-Chao; Yan, Wen-Rong; Zhang, Ning-Ling; Lin, Wan-Hua; Zhou, Xiao-Lin; Zhang, Yuan-Ting

2015-01-01

Cardiovascular disease, like hypertension, is one of the top killers of human life and early detection of cardiovascular disease is of great importance. However, traditional medical devices are often bulky and expensive, and unsuitable for home healthcare. In this paper, we proposed an easy and inexpensive technique to estimate continuous blood pressure from the heart sound signals acquired by the microphone of a smartphone. A cold-pressor experiment was performed in 32 healthy subjects, with a smartphone to acquire heart sound signals and with a commercial device to measure continuous blood pressure. The Fourier spectrum of the second heart sound and the blood pressure were regressed using a support vector machine, and the accuracy of the regression was evaluated using 10-fold cross-validation. Statistical analysis showed that the mean correlation coefficients between the predicted values from the regression model and the measured values from the commercial device were 0.707, 0.712, and 0.748 for systolic, diastolic, and mean blood pressure, respectively, and that the mean errors were less than 5 mmHg, with standard deviations less than 8 mmHg. These results suggest that this technique is of potential use for cuffless and continuous blood pressure monitoring and it has promising application in home healthcare services. PMID:26393591

Cuffless and Continuous Blood Pressure Estimation from the Heart Sound Signals.

PubMed

Peng, Rong-Chao; Yan, Wen-Rong; Zhang, Ning-Ling; Lin, Wan-Hua; Zhou, Xiao-Lin; Zhang, Yuan-Ting

2015-09-17

Cardiovascular disease, like hypertension, is one of the top killers of human life and early detection of cardiovascular disease is of great importance. However, traditional medical devices are often bulky and expensive, and unsuitable for home healthcare. In this paper, we proposed an easy and inexpensive technique to estimate continuous blood pressure from the heart sound signals acquired by the microphone of a smartphone. A cold-pressor experiment was performed in 32 healthy subjects, with a smartphone to acquire heart sound signals and with a commercial device to measure continuous blood pressure. The Fourier spectrum of the second heart sound and the blood pressure were regressed using a support vector machine, and the accuracy of the regression was evaluated using 10-fold cross-validation. Statistical analysis showed that the mean correlation coefficients between the predicted values from the regression model and the measured values from the commercial device were 0.707, 0.712, and 0.748 for systolic, diastolic, and mean blood pressure, respectively, and that the mean errors were less than 5 mmHg, with standard deviations less than 8 mmHg. These results suggest that this technique is of potential use for cuffless and continuous blood pressure monitoring and it has promising application in home healthcare services.

A Study to Develop a Methodology Determining the Feasibility of Establishing a Blood Collection Program in an Army Healthcare Facility

DTIC Science & Technology

1985-05-01

minimal. The risk of acquiring syphilis through blood transfusions is so rare that American Association of Blood Bank Standards have dropped the...requirement to test for syphilis , although Federal regulations still require it. Malaria can be effectively screened out by excluding potential donors. 2 9 The...murmur or repair of a congenital defect medical director. Listed below are some does not necessarily disqualify a donor. drugs and medical conditions

Lack of Trypanosoma cruzi Infection in Urban Roof Rats (Rattus rattus) at a Texas Facility Housing Naturally Infected Nonhuman Primates

PubMed Central

Hodo, Carolyn L; Bertolini, Nicole R; Bernal, John C; VandeBerg, John L; Hamer, Sarah A

2017-01-01

The protozoan parasite Trypanosoma cruzi causes Chagas disease, uses kissing bugs as a vector, and is maintained in nature by a variety of wildlife reservoirs. Many natural cases of Chagas disease have been reported in NHP at facilities across the southern United States, where infected vectors and wildlife occur. Infection of NHP with T. cruzi can diminish their value as research models and lead to health problems and death. Identifying the modes of transmission and role of wildlife reservoirs in these facilities is therefore critical to guide interventions to reduce transmission. Here we investigated the role of roof rats (Rattus rattus), the most abundant nuisance species at a primate facility in San Antonio, in the maintenance and transmission of T. cruzi. The hearts and blood from the carcasses of the 145 rats collected underwent 2 independent PCR assays for detection of T. cruzi and other trypanosomes. The 145 hearts and 61 blood samples were all negative for T. cruzi. This population sample of 145 subjects would allow the detection of disease prevalence of 0.020 with a confidence level of 95%. The limited active vector surveillance efforts by our team combined with passive surveillance by facility personnel yielded no kissing bugs during the study period. Our results suggest that roof rats are unlikely to be important local reservoirs of T. cruzi at this facility. Further investigation of transmission dynamics across multiple years and more comprehensive vector surveillance is warranted. PMID:28905716

Lack of Trypanosoma cruzi Infection in Urban Roof Rats (Rattus rattus) at a Texas Facility Housing Naturally Infected Nonhuman Primates.

PubMed

Hodo, Carolyn L; Bertolini, Nicole R; Bernal, John C; VandeBerg, John L; Hamer, Sarah A

2017-01-01

The protozoan parasite Trypanosoma cruzi causes Chagas disease, uses kissing bugs as a vector, and is maintained in nature by a variety of wildlife reservoirs. Many natural cases of Chagas disease have been reported in NHP at facilities across the southern United States, where infected vectors and wildlife occur. Infection of NHP with T. cruzi can diminish their value as research models and lead to health problems and death. Identifying the modes of transmission and role of wildlife reservoirs in these facilities is therefore critical to guide interventions to reduce transmission. Here we investigated the role of roof rats (Rattus rattus), the most abundant nuisance species at a primate facility in San Antonio, in the maintenance and transmission of T. cruzi. The hearts and blood from the carcasses of the 145 rats collected underwent 2 independent PCR assays for detection of T. cruzi and other trypanosomes. The 145 hearts and 61 blood samples were all negative for T. cruzi. This population sample of 145 subjects would allow the detection of disease prevalence of 0.020 with a confidence level of 95%. The limited active vector surveillance efforts by our team combined with passive surveillance by facility personnel yielded no kissing bugs during the study period. Our results suggest that roof rats are unlikely to be important local reservoirs of T. cruzi at this facility. Further investigation of transmission dynamics across multiple years and more comprehensive vector surveillance is warranted.

Contingency plan implementation.

PubMed

Neurath, D; Cober, N; Owens, W; Giulivi, A

2012-06-01

Although the National blood system in Canada reduces the risk of inventory shortages the possibility of a blood supply shortage still exists. The Ontario Ministry of Health and Long-Term Care developed a provincial plan to manage blood transfusion needs and inventory in the event of a National blood shortage. The Ontario plan was developed to align with the National plan as well as other provincial plans in order to ensure consistency in blood management strategies across the country. The Ontario plan was released in 2008, along with a toolkit to aid hospitals in developing their facility specific plans. In the Champlain region of Ontario, a group of 16 hospitals worked collaboratively to develop a regional blood shortage plan. A provincial blood shortage simulation exercise was held in 2010 to test out these plans. The Director of Transfusion Medicine of the largest facility in the group of 16 hospitals (The Ottawa Hospital) took the lead in the development of the regional blood shortage management plan. Working groups from all 16 sites contributed to the plan development. The proposed plan was presented to the Medical Advisory Committee for approval. The plan consists of activities relating to the severity of the supply shortage as defined by Amber, Red, Recovery and Green phases. The plan includes a communication plan for notifying stakeholders including patients whose treatment may be affected. Inventory management and triage guidelines are provided to reduce the demand for blood and to conserve inventory for those patients whose need is prioritized as highest. The regional blood shortage management plan was tested successfully during the provincial simulation exercise. Where regional hospitals work together to provide healthcare, it is beneficial to develop a standardized plan to provide guidance to hospital personnel in response to a blood supply shortage. A consistent plan will ensure patient care is provided in a consistent manner across a health region. Mock or simulation exercises can aid in testing plans and raising the awareness of stakeholders. Copyright © 2012 Elsevier Ltd. All rights reserved.

40 CFR 266.350 - What records must you keep at your facility and for how long?

Code of Federal Regulations, 2010 CFR

2010-07-01

... three years after the exempted waste is sent for disposal. (e) If you are not already subject to NRC, or... AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Conditional Exemption for Low-Level Mixed Waste...

40 CFR 266.350 - What records must you keep at your facility and for how long?

Code of Federal Regulations, 2011 CFR

2011-07-01

... three years after the exempted waste is sent for disposal. (e) If you are not already subject to NRC, or... AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Conditional Exemption for Low-Level Mixed Waste...

32 CFR 766.6 - Approving authority for landings at Navy/Marine Corps aviation facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Corps aviation facilities. 766.6 Section 766.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.6 Approving authority for landings at Navy/Marine Corps aviation facilities. (a) Except as...

32 CFR 766.8 - Procedure for review, approval, execution and distribution of aviation facility licenses.

Code of Federal Regulations, 2014 CFR

2014-07-01

... distribution of aviation facility licenses. 766.8 Section 766.8 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.8 Procedure for review, approval, execution and distribution of aviation facility...

32 CFR 766.8 - Procedure for review, approval, execution and distribution of aviation facility licenses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... distribution of aviation facility licenses. 766.8 Section 766.8 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.8 Procedure for review, approval, execution and distribution of aviation facility...

32 CFR 766.6 - Approving authority for landings at Navy/Marine Corps aviation facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Corps aviation facilities. 766.6 Section 766.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.6 Approving authority for landings at Navy/Marine Corps aviation facilities. (a) Except as...

32 CFR 766.8 - Procedure for review, approval, execution and distribution of aviation facility licenses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... distribution of aviation facility licenses. 766.8 Section 766.8 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.8 Procedure for review, approval, execution and distribution of aviation facility...

32 CFR 766.6 - Approving authority for landings at Navy/Marine Corps aviation facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Corps aviation facilities. 766.6 Section 766.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.6 Approving authority for landings at Navy/Marine Corps aviation facilities. (a) Except as...

32 CFR 766.6 - Approving authority for landings at Navy/Marine Corps aviation facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Corps aviation facilities. 766.6 Section 766.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.6 Approving authority for landings at Navy/Marine Corps aviation facilities. (a) Except as...

32 CFR 766.6 - Approving authority for landings at Navy/Marine Corps aviation facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Corps aviation facilities. 766.6 Section 766.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.6 Approving authority for landings at Navy/Marine Corps aviation facilities. (a) Except as...

32 CFR 766.8 - Procedure for review, approval, execution and distribution of aviation facility licenses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... distribution of aviation facility licenses. 766.8 Section 766.8 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES USE OF DEPARTMENT OF THE NAVY AVIATION FACILITIES BY CIVIL AIRCRAFT § 766.8 Procedure for review, approval, execution and distribution of aviation facility...

41 CFR 102-74.265 - Who must provide for the regulation and policing of parking facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who must provide for the... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.265 Who must provide for...

41 CFR 102-74.55 - Are vending facilities authorized under the Randolph-Sheppard Act operated by permit or contract?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are vending facilities... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Concession Services § 102-74...

40 CFR 122.24 - Concentrated aquatic animal production facilities (applicable to State NPDES programs, see § 123...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EPA ADMINISTERED PERMIT PROGRAMS: THE... animal production facility means a hatchery, fish farm, or other facility which meets the criteria in... any warm or cold water aquatic animal production facility as a concentrated aquatic animal production...

40 CFR 122.24 - Concentrated aquatic animal production facilities (applicable to State NPDES programs, see § 123...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EPA ADMINISTERED PERMIT PROGRAMS: THE... animal production facility means a hatchery, fish farm, or other facility which meets the criteria in... any warm or cold water aquatic animal production facility as a concentrated aquatic animal production...

10 CFR 140.13b - Amount of liability insurance required for uranium enrichment facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... enrichment facilities. 140.13b Section 140.13b Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FINANCIAL... required for uranium enrichment facilities. Each holder of a license issued under Parts 40 or 70 of this chapter for a uranium enrichment facility that involves the use of source material or special nuclear...

33 CFR 154.1240 - Specific requirements for animal fats and vegetable oils facilities that could reasonably be...

Code of Federal Regulations, 2011 CFR

2011-07-01

... fats and vegetable oils facilities that could reasonably be expected to cause substantial harm to the... SECURITY (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1240 Specific requirements for animal fats and vegetable...

21 CFR 610.42 - Restrictions on use for further manufacture of medical devices.

Code of Federal Regulations, 2013 CFR

2013-04-01

... reactivity of the human blood or blood component in the medical device presents no significant health risk... AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Testing Requirements... contains human blood or a blood component as a component of the final device, and the human blood or blood...

21 CFR 610.42 - Restrictions on use for further manufacture of medical devices.

Code of Federal Regulations, 2012 CFR

2012-04-01

... reactivity of the human blood or blood component in the medical device presents no significant health risk... AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Testing Requirements... contains human blood or a blood component as a component of the final device, and the human blood or blood...

21 CFR 610.42 - Restrictions on use for further manufacture of medical devices.

Code of Federal Regulations, 2014 CFR

2014-04-01

... reactivity of the human blood or blood component in the medical device presents no significant health risk... AND HUMAN SERVICES (CONTINUED) BIOLOGICS GENERAL BIOLOGICAL PRODUCTS STANDARDS Testing Requirements... contains human blood or a blood component as a component of the final device, and the human blood or blood...

21 CFR 640.64 - Collection of blood for Source Plasma.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Collection of blood for Source Plasma. 640.64... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.64 Collection of blood for Source Plasma. (a) Supervision. All blood for the collection of Source Plasma shall...

21 CFR 640.64 - Collection of blood for Source Plasma.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Collection of blood for Source Plasma. 640.64... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.64 Collection of blood for Source Plasma. (a) Supervision. All blood for the collection of Source Plasma shall...

21 CFR 640.64 - Collection of blood for Source Plasma.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Collection of blood for Source Plasma. 640.64... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.64 Collection of blood for Source Plasma. (a) Supervision. All blood for the collection of Source Plasma shall...

21 CFR 640.64 - Collection of blood for Source Plasma.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Collection of blood for Source Plasma. 640.64... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.64 Collection of blood for Source Plasma. (a) Supervision. All blood for the collection of Source Plasma shall...

21 CFR 640.64 - Collection of blood for Source Plasma.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Collection of blood for Source Plasma. 640.64... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Source Plasma § 640.64 Collection of blood for Source Plasma. (a) Supervision. All blood for the collection of Source Plasma shall...

21 CFR 640.13 - Collection of the blood.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Collection of the blood. 640.13 Section 640.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.13 Collection of the blood. (a...

Noninvasive continuous blood pressure monitoring by the ClearSight system during robot-assisted laparoscopic radical prostatectomy.

PubMed

Sakai, Yoko; Yasuo M, Tsutsumi; Oyama, Takuro; Murakami, Chiaki; Kakuta, Nami; Tanaka, Katsuya

2018-01-01

Robot-assisted laparoscopic radical prostatectomy (RALRP) is commonly performed in the surgical treatment of prostate cancer. However, the steep Trendelenburg position (25) and pneumoperitoneum required for this procedure can sometimes cause hemodynamic changes. Although blood pressure is traditionally monitored invasively during RALRP, the ClearSight system (BMEYE, Amsterdam, The Netherlands) enables a totally noninvasive and simple continuous blood pressure and cardiac output monitoring based on finger arterial pressure pulse contour analysis. We therefore investigated whether noninvasive continuous arterial blood pressure measurements using the ClearSight system were comparable to those obtained invasively in patients undergoing RALRP. Ten patients scheduled for RALRP with American Society of Anesthesiologists physical status I-II were included in this study. At each of the seven defined time points, noninvasive and invasive blood pressure measurements were documented and compared in each patient using Bland-Altman analysis. Although the blood pressure measured with the ClearSight system correlated with that measured invasively, a large difference between the values obtained by the two devices was noted. The ClearSight system was unable to detect blood pressure accurately during RALRP, suggesting that blood pressure monitoring using this device alone is not feasible in this small patient population. J. Med. Invest. 65:69-73, February, 2018.

Accuracy of continuous noninvasive hemoglobin monitoring for the prediction of blood transfusions in trauma patients.

PubMed

Galvagno, Samuel M; Hu, Peter; Yang, Shiming; Gao, Cheng; Hanna, David; Shackelford, Stacy; Mackenzie, Colin

2015-12-01

Early detection of hemorrhagic shock is required to facilitate prompt coordination of blood component therapy delivery to the bedside and to expedite performance of lifesaving interventions. Standard physical findings and vital signs are difficult to measure during the acute resuscitation stage, and these measures are often inaccurate until patients deteriorate to a state of decompensated shock. The aim of this study is to examine a severely injured trauma patient population to determine whether a noninvasive SpHb monitor can predict the need for urgent blood transfusion (universal donor or additional urgent blood transfusion) during the first 12 h of trauma patient resuscitation. We hypothesize that trends in continuous SpHb, combined with easily derived patient-specific factors, can identify the immediate need for transfusion in trauma patients. Subjects were enrolled if directly admitted to the trauma center, >17 years of age, and with a shock index (heart rate/systolic blood pressure) >0.62. Upon admission, a Masimo Radical-7 co-oximeter sensor (Masimo Corporation, Irvine, CA) was applied, providing measurement of continuous non-invasive hemoglobin (SpHb) levels. Blood was drawn and hemoglobin concentration analyzed and conventional pulse oximetry photopletysmograph signals were continuously recorded. Demographic information and both prehospital and admission vital signs were collected. The primary outcome was transfusion of at least one unit of packed red blood cells within 24 h of admission. Eight regression models (C1-C8) were evaluated for the prediction of blood use by comparing area under receiver operating curve (AUROC) at different time intervals after admission. 711 subjects had continuous vital signs waveforms available, to include heart rate (HR), SpHb and SpO2 trends. When SpHb was monitored for 15 min, SpHb did not increase AUROC for prediction of transfusion. The highest ROC was recorded for model C8 (age, sex, prehospital shock index, admission HR, SpHb and SpO2) for the prediction of blood products within the first 3 h of admission. When data from 15 min of continuous monitoring were analyzed, significant improvement in AUROC occurred as more variables were added to the model; however, the addition of SpHb to any of the models did not improve AUROC significantly for prediction of blood use within the first 3 h of admission in comparison to analysis of conventional oximetry features. The results demonstrate that SpHb monitoring, accompanied by continuous vital signs data and adjusted for age and sex, has good accuracy for the prediction of need for transfusion; however, as an independent variable, SpHb did not enhance predictive models in comparison to use of features extracted from conventional pulse oximetry. Nor was shock index better than conventional oximetry at discriminating hemorrhaging and prediction of casualties receiving blood. In this population of trauma patients, noninvasive SpHb monitoring, including both trends and absolute values, did not enhance the ability to predict the need for blood transfusion.

Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh.

PubMed

Sikder, Shegufta S; Labrique, Alain B; Ali, Hasmot; Hanif, Abu A M; Klemm, Rolf D W; Mehra, Sucheta; West, Keith P; Christian, Parul

2015-01-31

Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access to healthcare and key constraints to EmOC provision. Using data from a large population-based community trial, we identified and surveyed the 14 health facilities (7 public, 7 private) most frequently visited for obstetric complications and near misses as reported by women. Availability of EmOC was based on provision of medical services, assessed through clinician interviews and record review. Levels of EmOC availability were defined as basic or comprehensive. Readiness for EmOC provision was based on scores in four categories: staffing, equipment, laboratory capacity, and medicines. Readiness scores were calculated using unweighted averages. Costs of C-section procedures and geographic locations of facilities were described. Textual analysis was used to identify key constraints. The seven surveyed private facilities offered comprehensive EmOC compared to four of the seven public facilities. With 100% representing full readiness, mean EmOC readiness was 81% (range: 63%-91%) among surveyed private facilities compared to 67% (range: 48%-91%) in public facilities (p = 0.040). Surveyed public clinics had low scores on staffing and laboratory capacity (69%; 50%). The mean cost of the C-section procedure in private clinics was $77 (standard deviation: $16) and free in public facilities. The public sub-district facilities were the only facilities located in rural areas, with none providing comprehensive EmOC. Shortages in specialized staff were listed as the main barrier to EmOC provision in public facilities. Although EmOC availability and readiness was higher among the surveyed seven most commonly visited private clinics, public facilities appeared to be more affordable for C-section and more geographically accessible. Strategies to retain anesthesiologists and surgeons, such as non-financial incentives, are needed to improve EmOC provision in the public sector. Centralized blood banks are recommended to streamline safe blood acquisition for obstetric surgeries.

7 CFR 1220.620 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Facilities. 1220.620 Section 1220.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.620 Facilities. Each county FSA...

14 CFR 171.7 - Performance requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Performance requirements. 171.7 Section 171.7 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VOR Facilities § 171.7 Performance requirements. (a...

14 CFR 171.7 - Performance requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Performance requirements. 171.7 Section 171.7 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VOR Facilities § 171.7 Performance requirements. (a...

14 CFR 171.7 - Performance requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Performance requirements. 171.7 Section 171.7 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VOR Facilities § 171.7 Performance requirements. (a...

14 CFR 171.7 - Performance requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Performance requirements. 171.7 Section 171.7 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES VOR Facilities § 171.7 Performance requirements. (a...

40 CFR 257.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR CLASSIFICATION OF SOLID WASTE DISPOSAL FACILITIES AND PRACTICES Classification of Solid Waste Disposal Facilities... demolition (C&D) landfill means a solid waste disposal facility subject to the requirements of subparts A or...

10 CFR 503.33 - Site limitations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.33... include: (i) Inaccessibility of alternate fuels as a result of a specific physical limitation; (ii) Unavailability of transportation facilities for alternate fuels; (iii) Unavailability of adequate land or...

Quantitative assessment of anthrax vaccine immunogenicity using the dried blood spot matrix.

PubMed

Schiffer, Jarad M; Maniatis, Panagiotis; Garza, Ilana; Steward-Clark, Evelene; Korman, Lawrence T; Pittman, Phillip R; Mei, Joanne V; Quinn, Conrad P

2013-03-01

The collection, processing and transportation to a testing laboratory of large numbers of clinical samples during an emergency response situation present significant cost and logistical issues. Blood and serum are common clinical samples for diagnosis of disease. Serum preparation requires significant on-site equipment and facilities for immediate processing and cold storage, and significant costs for cold-chain transport to testing facilities. The dried blood spot (DBS) matrix offers an alternative to serum for rapid and efficient sample collection with fewer on-site equipment requirements and considerably lower storage and transport costs. We have developed and validated assay methods for using DBS in the quantitative anti-protective antigen IgG enzyme-linked immunosorbent assay (ELISA), one of the primary assays for assessing immunogenicity of anthrax vaccine and for confirmatory diagnosis of Bacillus anthracis infection in humans. We have also developed and validated high-throughput data analysis software to facilitate data handling for large clinical trials and emergency response. Published by Elsevier Ltd.

Flavobacterium meningosepticum sepsis in an infant with a diarrheal prodrome.

PubMed

Springer, S C; Johnson, G M

1999-02-01

A full term, previously normal 2 1/2-month-old black boy was transferred to our hospital from an outlying facility on hospital day 5 for failure to thrive. Three weeks before transfer, the infant was hospitalized for a diarrheal illness with fever. The baby received 3 days of ceftriaxone empirically and was discharged home after the sepsis evaluation was negative. Mild diarrhea and steady weight loss continued and the baby was readmitted. Blood culture done on admission grew Flavobacterium meningosepticum, an organism previously described as an uncommon cause of sepsis in neonates and immunocompromised individuals. As it is water-borne, it has been associated with infection via contaminated water. This organism is usually resistant to antibiotics commonly used for empiric treatment. To our knowledge, this is the first reported case of Flavobacterium bacteremia associated with a prodromal and concurrent diarrheal illness.

Development of Meharry Medical College Prostate Cancer Research Program

DTIC Science & Technology

2010-03-01

breakfast until their blood was drawn the next morning before 9:00 a.m. by a certified phlebotomist/registered nurse. 30 ml fasting venous blood was drawn...for each participnats. Participants were asked to return the next day without taking breakfast , and at the second visit 30 ml fasting venous blood...Ogunkua continue to develop their research laboratories with great success. They have independent funding and their laboratory continues to grow to

Species composition, activity patterns and blood meal analysis of sand fly populations (Diptera: Psychodidae) in the metropolitan region of Thessaloniki, an endemic focus of canine leishmaniasis

USDA-ARS?s Scientific Manuscript database

Species composition, activity patterns and blood meal analysis of sand fly populations were investigated in the metropolitan region of Thessaloniki, North Greece from May to October 2011. Sampling was conducted weekly in 3 different environments (animal facilities, open fields, residential areas) al...

How You Can Help Save a Life | Poster

Cancer.gov

By Carolynne Keenan, Contributing Writer Kevin Zecher, a maintenance mechanic in Facilities Maintenance and Engineering, Leidos Biomedical Research, Inc., hasn’t missed a double-red cell donation at a blood drive at NCI at Frederick in four years. He marks the time by his first granddaughter’s birth—that’s when he first decided to donate more than whole blood.

Metal Exposures at three U.S. electronic scrap recycling facilities.

PubMed

Ceballos, Diana; Beaucham, Catherine; Page, Elena

2017-06-01

Many metals found in electronic scrap are known to cause serious health effects, including but not limited to cancer and respiratory, neurologic, renal, and reproductive damage. The National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention performed three health hazard evaluations at electronic scrap recycling facilities in the U.S. to characterize employee exposure to metals and recommend control strategies to reduce these exposures. We performed air, surface, and biological monitoring for metals. We found one overexposure to lead and two overexposures to cadmium. We found metals on non-production surfaces, and the skin and clothing of workers before they left work in all of the facilities. We also found some elevated blood lead levels (above 10 micrograms per deciliter), however no employees at any facility had detectable mercury in their urine or exceeded 34% of the OELs for blood or urine cadmium. This article focuses on sampling results for lead, cadmium, mercury, and indium. We provided recommendations for improving local exhaust ventilation, reducing the recirculation of potentially contaminated air, using respirators until exposures are controlled, and reducing the migration of contaminants from production to non-production areas. We also recommended ways for employees to prevent taking home metal dust by using work uniforms laundered on-site, storing personal and work items in separate lockers, and using washing facilities equipped with lead-removing cleaning products.

Closed continuous-flow centrifuge rotor

DOEpatents

Breillatt, Jr., Julian P.; Remenyik, Carl J.; Sartory, Walter K.; Thacker, Louis H.; Penland, William Z.

1976-01-01

A blood separation centrifuge rotor having a generally parabolic core disposed concentrically and spaced apart within a housing having a similarly shaped cavity. Blood is introduced through a central inlet and into a central passageway enlarged downwardly to decrease the velocity of the entrant blood. Septa are disposed inside the central passageway to induce rotation of the entrant blood. A separation chamber is defined between the core and the housing wherein the whole blood is separated into red cell, white cell, and plasma zones. The zones are separated by annular splitter blades disposed within the separation chamber. The separated components are continuously removed through conduits communicating through a face seal to the outside of the rotor.

21 CFR 864.9650 - Quality control kit for blood banking reagents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality control kit for blood banking reagents... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9650 Quality control kit for blood banking reagents. (a...

21 CFR 640.17 - Modifications for specific products.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.17 Modifications for specific products. Red Blood Cells Frozen: A cryophylactic substance may be added to the Red... safety, purity, and potency for Red Blood Cells, and that the frozen product will maintain those...

21 CFR 640.17 - Modifications for specific products.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.17 Modifications for specific products. Red Blood Cells Frozen: A cryophylactic substance may be added to the Red... safety, purity, and potency for Red Blood Cells, and that the frozen product will maintain those...

21 CFR 640.17 - Modifications for specific products.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.17 Modifications for specific products. Red Blood Cells Frozen: A cryophylactic substance may be added to the Red... safety, purity, and potency for Red Blood Cells, and that the frozen product will maintain those...

21 CFR 640.17 - Modifications for specific products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.17 Modifications for specific products. Red Blood Cells Frozen: A cryophylactic substance may be added to the Red Blood Cells for extended manufacturers' storage at −65° C or colder, provided the manufacturer submits...

Longitudinal Analysis of Quality of Diabetes Care and Relational Climate in Primary Care.

PubMed

Soley-Bori, Marina; Benzer, Justin K; Burgess, James F

2018-04-01

To assess the influence of relational climate on quality of diabetes care. The study was conducted at the Department of Veterans Affairs (VA). The VA All Employee Survey (AES) was used to measure relational climate. Patient and facility characteristics were gathered from VA administrative datasets. Multilevel panel data (2008-2012) with patients nested into clinics. Diabetic patients were identified using ICD-9 codes and assigned to the clinic with the highest frequency of primary care visits. Multiple quality indicators were used, including an all-or-none process measure capturing guideline compliance, the actual number of tests and procedures, and three intermediate continuous outcomes (cholesterol, glycated hemoglobin, and blood pressure). The study sample included 327,805 patients, 212 primary care clinics, and 101 parent facilities in 2010. Across all study years, there were 1,568,180 observations. Clinics with the highest relational climate were 25 percent more likely to provide guideline-compliant care than those with the lowest relational climate (OR for a 1-unit increase: 1.02, p-value <.001). Among insulin-dependent diabetic veterans, this effect was twice as large. Contrary to that expected, relational climate did not influence intermediate outcomes. Relational climate is positively associated with tests and procedures provision, but not with intermediate outcomes of diabetes care. © Health Research and Educational Trust.

33 CFR 154.1045 - Response plan development and evaluation criteria for facilities that handle, store, or transport...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Response plan development and... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Oil Facilities § 154.1045 Response plan development and evaluation criteria for facilities that handle, store, or...

33 CFR 154.1045 - Response plan development and evaluation criteria for facilities that handle, store, or transport...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Response plan development and... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Oil Facilities § 154.1045 Response plan development and evaluation criteria for facilities that handle, store, or...

33 CFR 154.1045 - Response plan development and evaluation criteria for facilities that handle, store, or transport...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Response plan development and... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Oil Facilities § 154.1045 Response plan development and evaluation criteria for facilities that handle, store, or...

33 CFR 154.1045 - Response plan development and evaluation criteria for facilities that handle, store, or transport...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Response plan development and... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Oil Facilities § 154.1045 Response plan development and evaluation criteria for facilities that handle, store, or...

Continuous imaging of the blood vessels in tumor mouse dorsal skin window chamber model by using SD-OCT

NASA Astrophysics Data System (ADS)

Peng, Xiao; Yang, Shaozhuang; Yu, Bin; Wang, Qi; Lin, Danying; Gao, Jian; Zhang, Peiqi; Ma, Yiqun; Qu, Junle; Niu, Hanben

2016-03-01

Optical Coherence Tomography (OCT) has been widely applied into microstructure imaging of tissues or blood vessels with a series of advantages, including non-destructiveness, real-time imaging, high resolution and high sensitivity. In this study, a Spectral Domain OCT (SD-OCT) system with higher sensitivity and signal-to-noise ratio (SNR) was built up, which was used to observe the blood vessel distribution and blood flow in the dorsal skin window chamber of the nude mouse tumor model. In order to obtain comparable data, the distribution images of blood vessels were collected from the same mouse before and after tumor injection. In conclusion, in vivo blood vessel distribution images of the tumor mouse model have been continuously obtained during around two weeks.

Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil.

PubMed

Truong, Hong-Ha M; Blatyta, Paula F; Santos, Fernanda M; Montebello, Sandra; Esposti, Sandra P D; Hangai, Fatima N; Salles, Nanci Alves; Mendrone, Alfredo; Sabino, Ester C; McFarland, Willi; Gonçalez, Thelma T

2015-09-01

HIV test-seeking behavior among blood donors has been observed worldwide and may pose a threat to the safety of the blood supply. We evaluated current test-seeking motivations and prior alternative HIV testing experiences among blood donors in São Paulo, Brazil. All candidate or potential blood donors were consecutively approached and recruited to participate in the study upon presentation at Fundação Pró-Sangue Hemocentro, the largest blood bank in Brazil. Participants were recruited between August 2012 and May 2013 after they were screened for donor eligibility. Questionnaires were administered through audio computer-assisted self-interview. Among 11,867 donors, 38 % previously tested for HIV apart from blood donation, of whom 47.7 % tested at public facilities and 2.7 % acknowledged getting tested for HIV as the primary reason for donating. Dissatisfaction with prior alternative testing experience was reported by 2.5 % of donors. Current test-seeking motivation was associated with dissatisfaction with prior alternative testing experience and testing at a public alternative facility. The most common reasons for dissatisfaction were too long of a wait to get tested and for results, counseling was too long, lack of privacy, and low confidence in the equipment and accuracy of the test. Lack of awareness about the availability of free and confidential public HIV testing services as well as dissatisfaction with past HIV testing and counseling experiences motivate some individuals to test at blood banks. Test-seeking behavior among blood donors may be best addressed by improving alternative testing programs, particularly with respect to time delays, privacy and perceptions about test accuracy. Educational campaigns on safe blood donation and HIV testing for diagnosis, risk counseling and referral to care are also needed for the general public and for health care providers.

28 CFR 54.410 - Comparable facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

....410 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities...

33 CFR 127.1315 - Preliminary transfer inspection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Hazardous Gas Operations § 127.1315 Preliminary... capacity of each storage tank to or from which LHG will be transferred, to ensure that it is safe for...

33 CFR 127.315 - Preliminary transfer inspection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Operations § 127.315 Preliminary transfer... parts; (b) For each of the vessel's cargo tanks from which cargo will be transferred, note the pressure...

42 CFR 431.105 - Consultation to medical facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

42 CFR 431.105 - Consultation to medical facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

42 CFR 431.105 - Consultation to medical facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

47 CFR 63.22 - Facilities-based international common carriers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Facilities-based international common carriers. 63.22 Section 63.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER... Supplements § 63.22 Facilities-based international common carriers. The following conditions apply to...

47 CFR 63.22 - Facilities-based international common carriers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Facilities-based international common carriers. 63.22 Section 63.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER... Supplements § 63.22 Facilities-based international common carriers. The following conditions apply to...

47 CFR 63.22 - Facilities-based international common carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Facilities-based international common carriers. 63.22 Section 63.22 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER... Supplements § 63.22 Facilities-based international common carriers. The following conditions apply to...

7 CFR 1280.624 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Facilities. 1280.624 Section 1280.624 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Procedures To Request a Referendum Definitions § 1280.624 Facilities. Each county FSA office...

42 CFR 431.105 - Consultation to medical facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Consultation to medical facilities. 431.105 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Administrative Requirements: Provider Relations § 431.105 Consultation to medical facilities. (a) Basis and...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

7 CFR 1735.17 - Facilities financed.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.17 Facilities financed. (a) RUS makes hardship and guaranteed loans to finance the... apparatus owned by the borrower, headquarters facilities, and vehicles not used primarily in construction...

Development of Model Systematic Trilateral Approach to Provide Continuing Education for Nursing Home and Small Hospital Personnel. Final Report.

ERIC Educational Resources Information Center

Schrader, Marvin A.; And Others

The project was designed to determine the feasibility of having a vocational technical adult education (VTAE) district provide continuing education inservice training for health care facilities using videotape equipment so that employees could gain knowledge and skills without leaving the facility or having to involve time outside the normal…

Australian experience with frozen blood products on military operations.

PubMed

Neuhaus, Susan J; Wishaw, Ken; Lelkens, Charles

2010-02-15

Historically, the Australian Defence Force (ADF) has sourced all its blood supplies from the Australian Red Cross Blood Service. Recent ADF operations in the Middle East have highlighted a need to rely on other nations' blood supply systems. In 2008, the ADF embedded a surgical and intensive care team into the Netherlands-led forward health facility at the Uruzgan Medical Centre at Tarin Kowt in Afghanistan. To date, three teams have provided 2-month rotations as part of the North Atlantic Treaty Organization International Security Assistance Force in Afghanistan. The Netherlands armed forces use a sophisticated system for supply of liquid and frozen blood products (frozen red cells, plasma and platelets). We review Australian experience with the Dutch system of supplying blood products for major trauma resuscitation in Afghanistan.

Effect of exhaust emissions on carbon monoxide levels in employees working at indoor car wash facilities

PubMed Central

Topacoglu, H; Katsakoglou, S; Ipekci, A

2014-01-01

Background: Exhaust emissions from motor vehicles threaten the environment and human health. Carbon monoxide (CO) poisoning, especially the use of exhaust gas CO in suicidal attempts is well known in the literature. Recently, indoor car wash facilities established in large shopping malls with closed parking, lots is a new risk area that exposes car wash employees to prolonged periods of high level CO emissions from cars. The aim of this study was to investigate how carboxyhemoglobin (COHb) blood levels of employees get affected in confined areas with relatively poor air circulation. Methods: Twenty male volunteers working in indoor parking car wash facilities were included in the study. Participants were informed about the aim of this study and their consent was obtained. Their pulse COHb levels were measured twice, at the beginning and at the end of the working day using Rad-57 pulse CO-oximeter device, allowing non-invasive measurement of COHb blood levels to compare the changes in their COHb levels before and after work. Results: The mean age of the male volunteers was 29.8 ± 11.9 (range 18-55). While the mean COHb levels measured at the start of the working day was 2.1 ± 2.0 (range 0-9), it was increased to 5.2 ± 3.3 (range 1-15) at the end of work shift (Wilcoxon test, p <0.001). There was a statistically significant difference in COHb levels between the beginning and the end of the work shift in smoker subjects, while the difference was not significant in the non-smoking group (Wilcoxon test, p=0.001, p=0.102, respectively). Conclusion: The COHb blood levels of indoor car wash facility employees is directly impacted and gets elevated by motor vechile exhaust emissions. For the health of the employees at indoor parking car wash facilities, stricter precautions are needed and the government should not give permit to such operations. PMID:25125950

Trends in inequalities in utilization of reproductive health services from 2000 to 2011 in Vietnam.

PubMed

Duc, Nguyen Huu Chau; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko; Rahman, Mosiur

2015-01-01

This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam. Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household's ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients. Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery. More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.

Novel optoacoustic system for noninvasive continuous monitoring of cerebral venous blood oxygenation

NASA Astrophysics Data System (ADS)

Petrov, Yuriy; Petrov, Irene Y.; Prough, Donald S.; Esenaliev, Rinat O.

2012-02-01

Traumatic brain injury (TBI) and spinal cord injury are a major cause of death for individuals under 50 years of age. In the USA alone, 150,000 patients per year suffer moderate or severe TBI. Moreover, TBI is a major cause of combatrelated death. Monitoring of cerebral venous blood oxygenation is critically important for management of TBI patients because cerebral venous blood oxygenation below 50% results in death or severe neurologic complications. At present, there is no technique for noninvasive, accurate monitoring of this clinically important variable. We proposed to use optoacoustic technique for noninvasive monitoring of cerebral venous blood oxygenation by probing cerebral veins such as the superior sagittal sinus (SSS) and validated it in animal studies. In this work, we developed a novel, medical grade optoacoustic system for continuous, real-time cerebral venous blood oxygenation monitoring and tested it in human subjects at normal conditions and during hyperventilation to simulate changes that may occur in patients with TBI. We designed and built a highly-sensitive optoacoustic probe for SSS signal detection. Continuous measurements were performed in the near infrared spectral range and the SSS oxygenation absolute values were automatically calculated in real time using a special algorithm developed by our group. Continuous measurements performed at normal conditions and during hyperventilation demonstrated that hyperventilation resulted in approximately 12% decrease of cerebral venous blood oxygenation.

14 CFR 145.103 - Housing and facilities requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES REPAIR STATIONS Housing, Facilities, Equipment... temperature, humidity, and other climatic conditions sufficient to ensure personnel perform maintenance...

Final report on Weeks Island Monitoring Phase : 1999 through 2004.

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

Ehgartner, Brian L.; Munson, Darrell Eugene

2005-05-01

This Final Report on the Monitoring Phase of the former Weeks Island Strategic Petroleum Reserve crude oil storage facility details the results of five years of monitoring of various surface accessible quantities at the decommissioned facility. The Weeks Island mine was authorized by the State of Louisiana as a Strategic Petroleum Reserve oil storage facility from 1979 until decommissioning of the facility in 1999. Discovery of a sinkhole over the facility in 1992 with freshwater inflow to the facility threatened the integrity of the oil storage and led to the decision to remove the oil, fill the chambers with brine,more » and decommission the facility. Thereafter, a monitoring phase, by agreement between the Department of Energy and the State, addressed facility stability and environmental concerns. Monitoring of the surface ground water and the brine of the underground chambers from the East Fill Hole produced no evidence of hydrocarbon contamination, which suggests that any unrecovered oil remaining in the underground chambers has been contained. Ever diminishing progression of the initial major sinkhole, and a subsequent minor sinkhole, with time was verification of the response of sinkholes to filling of the facility with brine. Brine filling of the facility ostensively eliminates any further growth or new formation from freshwater inflow. Continued monitoring of sinkhole response, together with continued surface surveillance for environmental problems, confirmed the intended results of brine pressurization. Surface subsidence measurements over the mine continued throughout the monitoring phase. And finally, the outward flow of brine was monitored as a measure of the creep closure of the mine chambers. Results of each of these monitoring activities are presented, with their correlation toward assuring the stability and environmental security of the decommissioned facility. The results suggest that the decommissioning was successful and no contamination of the surface environment by crude oil has been found.« less

Facility-level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database.

PubMed

Rehman, Hasan; Akeroyd, Julia M; Ramsey, David; Ahmed, Sarah T; Merchant, Anwar T; Navaneethan, Sankar D; Petersen, Laura A; Virani, Salim S

2017-11-01

Intensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes. We hypothesized that there is suboptimal glycemic and BP control with significant facility-level variation in patients with diabetes. We identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. We assessed facility-level rates of glycemic (hemoglobin [Hb]A1c <7%), BP (BP <140/90 mmHg), and combined glycemic and BP control (HbA1c <7% and BP <140/90 mmHg), and their facility-level variation in using median rate ratios (MRR). Among 1 103 302 patients with diabetes, 50.2% participants had an HbA1c <7%, 77.5% had a BP <140/90 mmHg, and 39.8% had both, HbA1c <7% and BP <140/90 mmHg. Median facility-level rates were 50.3% (interquartile range [IQR], 47.9%-52.4%) for glycemic control, 78.4% (IQR, 75.2%-80.0%) for BP control, and 39.9% (IQR, 38.14%-42.34%) for combined glycemic and BP control. Unadjusted MRR for glycemic control was 1.61 (95% confidence interval [CI]: 1.51-1.70) which decreased to 1.16 (95% CI: 1.14-1.19) after adjusting for patient and facility-level variables, indicating a 16% variation in glycemic control between 2 identical patients receiving care at 2 random facilities. Unadjusted MRR for BP control was 1.49 (95% CI: 1.41-1.56), which decreased to 1.25 (95% CI: 1.21-1.28), whereas unadjusted MRR for combined glycemic and BP control was 1.59 (95% CI: 1.50-1.68), which decreased to 1.15 (95% CI: 1.13-1.17) after adjustment. Facility-level rates for BP control and glycemic control remain low with significant facility-level variation. Much of this is explained by patient and facility-level variables although 16%, 25%, and 15% variation in glycemic, BP, and combined glycemic and BP control remains unexplained. © 2017 Wiley Periodicals, Inc.

Implementation and execution of military forward resuscitation programs.

PubMed

Hooper, Timothy J; Nadler, Roy; Badloe, John; Butler, Frank K; Glassberg, Elon

2014-05-01

Through necessity, military medicine has been the driver of medical innovation throughout history. The battlefield presents challenges, such as the requirement to provide care while under threat, resource limitation, and prolonged evacuation times, which must be overcome to improve casualty survival. Focus must also be placed on identifying the causes, and timing, of death within the battlefield. By doing so, military medical doctrine can be shaped, appropriate goals set, new concepts adopted, and relevant technologies investigated and implemented. The majority of battlefield casualties still die in the prehospital environment, before reaching a medical treatment facility, and hemorrhage remains the leading cause of potentially survivable death. Many countries have adopted policies that push damage control resuscitation forward into the prehospital setting, while understanding the need for timely medical evacuation. Although these policies vary according to country, the majority share many common principles. These include the need for early catastrophic hemorrhage control at point-of-wounding, judicious use of fluid resuscitation, use of blood products as far forward as possible, and early evacuation to a surgical facility. Some countries place medical providers with the ability, and resources, for advanced resuscitation with the forward fighting units (perhaps at company level), whereas others have established en route resuscitation capabilities. If we are to continue to improve battlefield casualty survival, we must continue to work together and learn from each other. We must also carry on working alongside our civilian colleagues so that the benefits of translational experience are not lost. This review describes several countries current military approaches to prehospital trauma care. These approaches, refined through a decade of experience, merit consideration for integration into civilian prehospital care practice.

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... travel time between the remote facility and each facility listed in paragraph (e) of this section; (f...

32 CFR 148.6 - Agency review.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLICY AND IMPLEMENTATION OF RECIPROCITY OF FACILITIES National Policy on Reciprocity of Use and... value added to the process of co-use of facilities by development of electronic data retrieval across government. As this review continues, agencies creating or modifying facilities databases will do so in a...

49 CFR 195.426 - Scraper and sphere facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Scraper and sphere facilities. 195.426 Section 195.426 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS... HAZARDOUS LIQUIDS BY PIPELINE Operation and Maintenance § 195.426 Scraper and sphere facilities. No operator...

40 CFR 60.434 - Monitoring of operations and recordkeeping.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recordkeeping. 60.434 Section 60.434 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... affected facility using waterborne ink systems or solvent-borne ink systems with solvent recovery systems...) If affected facilities share the same raw ink storage/handling system with existing facilities...

40 CFR 60.434 - Monitoring of operations and recordkeeping.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recordkeeping. 60.434 Section 60.434 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... affected facility using waterborne ink systems or solvent-borne ink systems with solvent recovery systems...) If affected facilities share the same raw ink storage/handling system with existing facilities...

47 CFR 32.6410 - Cable and wire facilities expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cable and wire facilities expenses. 32.6410 Section 32.6410 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Cable and wire facilities expenses. Class B telephone companies shall use this account for expenses of...

47 CFR 32.6410 - Cable and wire facilities expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Cable and wire facilities expenses. 32.6410 Section 32.6410 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Cable and wire facilities expenses. Class B telephone companies shall use this account for expenses of...

7 CFR 205.271 - Facility pest management practice standard.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Facility pest management practice standard. 205.271... MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED... Requirements § 205.271 Facility pest management practice standard. (a) The producer or handler of an organic...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

14 CFR 141.45 - Ground training facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Ground training facilities. 141.45 Section 141.45 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... § 141.45 Ground training facilities. An applicant for a pilot school or provisional pilot school...

14 CFR 141.45 - Ground training facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ground training facilities. 141.45 Section 141.45 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED... § 141.45 Ground training facilities. An applicant for a pilot school or provisional pilot school...

21 CFR 870.2100 - Cardiovascular blood flowmeter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular blood flowmeter. 870.2100 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2100 Cardiovascular blood flowmeter. (a) Identification. A cardiovascular blood flowmeter is a device that is...

Transfusion under triple threat: Lessons from Japan's 2011 earthquake, tsunami, and nuclear crisis.

PubMed

Nollet, Kenneth E; Komazawa, Tomoko; Ohto, Hitoshi

2016-10-01

The Great East Japan Earthquake of March 11, 2011 provoked tsunami waves with inland penetration up to 5 km and run-up heights to 40 m. More than 400 km 2 were flooded, mainly along the northeast coast of Japan's largest island, Honshu. Nearly 20,000 human lives were abruptly taken by this natural disaster. Four coastal nuclear facilities went into automatic shutdown; at one, Fukushima Daiichi, cooling system failures resulted in the meltdown of three reactor cores, accompanied by explosive release of radioisotopes. Essentials of modern blood banking and transfusion medicine were lost: roads, vehicles, blood collection venues, and facilities for blood testing and processing. Normal channels of communication were interrupted, not only by physical damage but also due to circuit overload as mobile phone users sought information and tried to exchange messages about their own and others' health, welfare, and whereabouts. The Japanese Red Cross, as a monopoly supplier of allogeneic blood, responded with a nationally coordinated effort that met the transfusion demands of a disaster characterized by immediate mass fatality rather than mass injury. Japan's routine transfusion demands are also met by hospital-based autologous blood programs, which could be pressed into service for emergency allogeneic collections. Herein we report institutional and personal experience in anticipation of future disasters, in which transfusion needs might differ from routine demand. Copyright © 2016 Elsevier Ltd. All rights reserved.

ISBT 128: a global information standard

PubMed Central

2010-01-01

ISBT 128 is the global standard for the identification, labeling and information transfer of human blood, cell, tissue and organ products across international borders and disparate health care systems. The system has been designed and perfected over almost two decades to ensure accuracy, safety and efficiency for the benefit of donors, patients and health care workers worldwide. The use of the ISBT 128 standard has grown steadily since a blood bank in Estonia first implemented it in 1997. Today, more than 3,500 facility identifiers for the use of ISBT 128 have been assigned to organizations in 67 countries on six continents. The standard has been accepted by a variety of international standard setting organizations and government regulators. It is managed by ICCBBA, a not-for-profit organization based in the USA that is governed by an international volunteer board of directors. Members of the Board of Directors represent the fields of practice affected by the standard. Advisory groups comprising international experts guide the ongoing development of the ISBT 128 standard to ensure it continues to meet the needs of its users. While there is a cost associated with the implementation and use of the standard, the clear benefits in terms of improved patient safety and ability to meet regulatory traceability requirements justify the costs. PMID:20652420

Childhood Lead Exposure from Battery Recycling in Vietnam

PubMed Central

Van Tung, Lo; Wallace, Ryan M.; Havens, Deborah J.; Karr, Catherine J.; Bich Diep, Nguyen; Croteau, Gerry A.; Beaudet, Nancy J.; Duy Bao, Nguyen

2015-01-01

Background. Battery recycling facilities in developing countries can cause community lead exposure. Objective. To evaluate child lead exposure in a Vietnam battery recycling craft village after efforts to shift home-based recycling outside the village. Methods. This cross-sectional study evaluated 109 children in Dong Mai village, using blood lead level (BLL) measurement, parent interview, and household observation. Blood samples were analyzed with a LeadCare II field instrument; highest BLLs (≥45 μg/dL) were retested by laboratory analysis. Surface and soil lead were measured at 11 households and a school with X-ray fluorescence analyzer. Results. All children had high BLLs; 28% had BLL ≥45 μg/dL. Younger age, family recycling, and outside brick surfaces were associated with higher BLL. Surface and soil lead levels were high at all tested homes, even with no recycling history. Laboratory BLLs were lower than LeadCare BLLs, in 24 retested children. Discussion. In spite of improvements, lead exposure was still substantial and probably associated with continued home-based recycling, legacy contamination, and workplace take-home exposure pathways. There is a need for effective strategies to manage lead exposure from battery recycling in craft villages. These reported BLL values should be interpreted cautiously, although the observed field-laboratory discordance may reflect bias in laboratory results. PMID:26587532

Childhood Lead Exposure from Battery Recycling in Vietnam.

PubMed

Daniell, William E; Van Tung, Lo; Wallace, Ryan M; Havens, Deborah J; Karr, Catherine J; Bich Diep, Nguyen; Croteau, Gerry A; Beaudet, Nancy J; Duy Bao, Nguyen

2015-01-01

Battery recycling facilities in developing countries can cause community lead exposure. To evaluate child lead exposure in a Vietnam battery recycling craft village after efforts to shift home-based recycling outside the village. This cross-sectional study evaluated 109 children in Dong Mai village, using blood lead level (BLL) measurement, parent interview, and household observation. Blood samples were analyzed with a LeadCare II field instrument; highest BLLs (≥45 μg/dL) were retested by laboratory analysis. Surface and soil lead were measured at 11 households and a school with X-ray fluorescence analyzer. All children had high BLLs; 28% had BLL ≥45 μg/dL. Younger age, family recycling, and outside brick surfaces were associated with higher BLL. Surface and soil lead levels were high at all tested homes, even with no recycling history. Laboratory BLLs were lower than LeadCare BLLs, in 24 retested children. In spite of improvements, lead exposure was still substantial and probably associated with continued home-based recycling, legacy contamination, and workplace take-home exposure pathways. There is a need for effective strategies to manage lead exposure from battery recycling in craft villages. These reported BLL values should be interpreted cautiously, although the observed field-laboratory discordance may reflect bias in laboratory results.

Predictors of death from severe pneumonia among children 2-59 months old hospitalized in Bohol, Philippines: implications for referral criteria at a first-level health facility.

PubMed

Lupisan, S P; Ruutu, P; Erma Abucejo-Ladesma, P; Quiambao, B P; Gozum, L; Sombrero, L T; Romano, V; Herva, E; Riley, I; Simoes, E A F

2007-08-01

To determine predictors of death among children 2-59 months old admitted to hospital with severe pneumonia. Prospective observational study from April 1994 to May 2000 to investigate serious infections in children less than 5 years old admitted to a tertiary care government hospital in a rural province in central Philippines. The quality of clinical and laboratory work was monitored. The WHO classification for severe pneumonia was used for patient enrolment. There were 1249 children with severe pneumonia and no CNS infection. Thirty children died. Using univariate analysis, the following factors were significantly associated with death: age 2-5 months, dense infiltrates on chest radiography and presence of definite bacterial pathogens in the blood. Stepwise logistic regression analysis revealed the following independent predictors of death: age 2-5 months, weight for age z-score less than -2 SD, dense infiltrates on chest radiography and definite pathogens isolated in the blood. When the results of chest radiographs and blood cultures were not included to mimic facilities available at first-level facilities, age 2-5 months and weight for age z-score less than -2 SD remained independent predictors of death. When resources are limited, children with lower chest wall indrawing (severe pneumonia) who are 2-5 months old or moderately to severely malnourished should be referred for immediate higher-level care.

[Assessment of a rapid diagnostic test for malaria in rural health care facilities in Senegal].

PubMed

Munier, A; Diallo, A; Sokhna, C; Chippaux, J P

2009-10-01

The aim of the study was to determine the accuracy of a rapid diagnostic test in confirming presumptive malaria diagnosis in a rural zone of Senegal. Thick blood smear was used as the reference technique for comparison. METHOHDOLOGY: Testing was conducted on children between the ages of 1 and 14 years at three health care facilities located in the Niakhar are from August 2006 to June 2007. If malaria was suspected by the nurse based on clinical findings, two thick smears and one rapid diagnostic test (Core Malaria Pf) were performed. Blood slides were stained in Niakhar and read in Dakar. A total of 474 patients were examined. Three-fourths (75%) of these patients were seen during the rainy season. Malaria was suspected in 335 patients (71%). Rapid tests and thick smears were obtained in 330 of these patients with positive results in 194 (59%) and 180 (55%) respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid test were 96%, 87%, 90% and 95% respectively. Our data show that the rapid diagnostic test used in this study exhibits good sensitivity and positive predictive value. Despite its cost this test could be helpful in confirming malaria diagnosis in outlying health care facilities without the necessary resources to perform blood smears. Confirmation is necessary to avoid unwarranted prescription of malaria treatment due to inaccurate clinical diagnosis

21 CFR 640.13 - Collection of the blood.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Collection of the blood. 640.13 Section 640.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.13 Collection of the...

21 CFR 640.13 - Collection of the blood.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Collection of the blood. 640.13 Section 640.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.13 Collection of the...

21 CFR 640.13 - Collection of the blood.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Collection of the blood. 640.13 Section 640.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.13 Collection of the...

21 CFR 640.13 - Collection of the blood.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Collection of the blood. 640.13 Section 640.13 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.13 Collection of the...

Dissecting gene expression at the blood-brain barrier

PubMed Central

Huntley, Melanie A.; Bien-Ly, Nga; Daneman, Richard; Watts, Ryan J.

2014-01-01

The availability of genome-wide expression data for the blood-brain barrier is an invaluable resource that has recently enabled the discovery of several genes and pathways involved in the development and maintenance of the blood-brain barrier, particularly in rodent models. The broad distribution of published data sets represents a viable starting point for the molecular dissection of the blood-brain barrier and will further direct the discovery of novel mechanisms of blood-brain barrier formation and function. Technical advances in purifying brain endothelial cells, the key cell that forms the critical barrier, have allowed for greater specificity in gene expression comparisons with other central nervous system cell types, and more systematic characterizations of the molecular composition of the blood-brain barrier. Nevertheless, our understanding of how the blood-brain barrier changes during aging and disease is underrepresented. Blood-brain barrier data sets from a wider range of experimental paradigms and species, including invertebrates and primates, would be invaluable for investigating the function and evolution of the blood-brain barrier. Newer technologies in gene expression profiling, such as RNA-sequencing, now allow for finer resolution of transcriptomic changes, including isoform specificity and RNA-editing. As our field continues to utilize more advanced expression profiling in its ongoing efforts to elucidate the blood-brain barrier, including in disease and drug delivery, we will continue to see rapid advances in our understanding of the molecular mediators of barrier biology. We predict that the recently published data sets, combined with forthcoming genomic and proteomic blood-brain barrier data sets, will continue to fuel the molecular genetic revolution of blood-brain barrier biology. PMID:25414634

Continuous and Pulsatile Pediatric Ventricular Assist Device Hemodynamics with a Viscoelastic Blood Model

PubMed Central

Good, Bryan C.; Deutsch, Steven; Manning, Keefe B.

2015-01-01

Purpose To investigate the effects of pulsatile and continuous pediatric ventricular assist (PVAD) flow and pediatric blood viscoelasticity on hemodynamics in a pediatric aortic graft model. Methods Hemodynamic parameters of pulsatility, along with velocity and wall shear stress (WSS), are analyzed and compared between Newtonian and viscoelastic blood models at a range of physiological pediatric hematocrits using computational fluid dynamics. Results Both pulsatile and continuous PVAD flow lead to a decrease in pulsatility (surplus hemodynamic energy (SHE), ergs/cm3) compared to healthy aortic flow but with continuous PVAD pulsatility up to 2.4 times lower than pulsatile PVAD pulsatility at each aortic outlet. Significant differences are also seen between the two flow modes in velocity and WSS. The higher velocity jet during systole with pulsatile flow leads to higher WSSs at the anastomotic toe and at the aortic branch bifurcations. The lower velocity but continuous flow jet leads to a much different flow field and higher WSSs into diastole. Under a range of physiological pediatric hematocrit (20-60%), both velocity and WSS can vary significantly with the higher hematocrit blood model generally leading to higher peak WSSs but also lower WSSs in regions of flow separation. Conclusions The large decrease in pulsatility seen from continuous PVAD flow could lead to complications in pediatric vascular development while the high WSSs during peak systole from pulsatile PVAD flow could lead to blood damage. Both flow modes lead to similar regions prone to intimal hyperplasia (IH) resulting from low time-averaged WSS (TAWSS) and high oscillatory shear index (OSI). PMID:26643646

Method and means of monitoring the effluent from nuclear facilities

DOEpatents

Lattin, Kenneth R.; Erickson, Gerald L.

1976-01-01

Radioactive iodine is detected in the effluent cooling gas from a nuclear reactor or nuclear facility by passing the effluent gas through a continuously moving adsorbent filter material which is then purged of noble gases and conveyed continuously to a detector of radioactivity. The purging operation has little or no effect upon the concentration of radioactive iodine which is adsorbed on the filter material.

Comparison of Risk Factor Control in the Year After Discharge for Ischemic Stroke Versus Acute Myocardial Infarction.

PubMed

Bravata, Dawn M; Daggy, Joanne; Brosch, Jared; Sico, Jason J; Baye, Fitsum; Myers, Laura J; Roumie, Christianne L; Cheng, Eric; Coffing, Jessica; Arling, Greg

2018-02-01

The Veterans Health Administration has engaged in quality improvement to improve vascular risk factor control. We sought to examine blood pressure (<140/90 mm Hg), lipid (LDL [low-density lipoprotein] cholesterol <100 mg/dL), and glycemic control (hemoglobin A1c <9%), in the year post-hospitalization for acute ischemic stroke or acute myocardial infarction (AMI). We identified patients who were hospitalized (fiscal year 2011) with ischemic stroke, AMI, congestive heart failure, transient ischemic attack, or pneumonia/chronic obstructive pulmonary disease. The primary analysis compared risk factor control after incident ischemic stroke versus AMI. Facilities were included if they cared for ≥25 ischemic stroke and ≥25 AMI patients. A generalized linear mixed model including patient- and facility-level covariates compared risk factor control across diagnoses. Forty thousand two hundred thirty patients were hospitalized (n=75 facilities): 2127 with incident ischemic stroke and 4169 with incident AMI. Fewer stroke patients achieved blood pressure control than AMI patients (64%; 95% confidence interval, 0.62-0.67 versus 77%; 95% confidence interval, 0.75-0.78; P <0.0001). After adjusting for patient and facility covariates, the odds of blood pressure control were still higher for AMI than ischemic stroke patients (odds ratio, 1.39; 95% confidence interval, 1.21-1.51). There were no statistical differences for AMI versus stroke patients in hyperlipidemia ( P =0.534). Among patients with diabetes mellitus, the odds of glycemic control were lower for AMI than ischemic stroke patients (odds ratio, 0.72; 95% confidence interval, 0.54-0.96). Given that hypertension control is a cornerstone of stroke prevention, interventions to improve poststroke hypertension management are needed. © 2017 The Authors.

14 CFR 147.37 - Maintenance of facilities, equipment, and material.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS... maintenance technician school shall provide facilities, equipment, and material equal to the standards...

Provision of cellular blood components to CMV-seronegative patients undergoing allogeneic stem cell transplantation in the UK: survey of UK transplant centres.

PubMed

Morton, S; Peniket, A; Malladi, R; Murphy, M F

2017-12-01

To identify current UK practice with regards to provision of blood components for cytomegalovirus (CMV)-seronegative, potential, allogeneic stem cell recipients of seronegative grafts. Infection with CMV remains a major cause of morbidity and mortality after allogeneic stem cell transplantation (aSCT). CMV transmission has been a risk associated with the transfusion of blood components from previously exposed donors, but leucocyte reduction has been demonstrated to minimise this risk. In 2012, the UK Advisory Committee for the Safety of Tissues and Organs (SaBTO) recommended that CMV-unselected components could be safely transfused without increased risk of CMV transmission. We surveyed UK aSCT centres to establish current practice. Fifteen adult and seven paediatric centres (75%) responded; 22·7% continue to provide components from CMV-seronegative donors. Reasons cited include the continued perceived risk of CMV transmission by blood transfusion, its associated morbidity and concerns regarding potential for ambiguous CMV serostatus in seronegative potential transplant recipients due to passive antibody transfer from CMV-seropositive blood donors, leading to erroneous donor/recipient CMV matching at transplant. The survey demonstrated a surprisingly high rate (22.7%) of centres continuing to provide blood components from CMV-seronegative donors despite SaBTO guidance. © 2017 British Blood Transfusion Society.

40 CFR 160.15 - Inspection of a testing facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Inspection of a testing facility. 160.15 Section 160.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS General Provisions § 160.15 Inspection of a testing facility...

10 CFR 60.47 - Facility information and verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Facility information and verification. 60.47 Section 60.47 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Licenses Us/iaea Safeguards Agreement § 60.47 Facility information and verification. (a) In...

46 CFR 160.151-47 - Requirements for owners or operators of servicing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities. 160.151-47 Section 160.151-47 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL LIFESAVING EQUIPMENT Inflatable Liferafts (SOLAS) § 160.151-47 Requirements for owners or operators of servicing facilities. To maintain...

40 CFR 256.42 - Recommendations for assuring facility development.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommendations for assuring facility development. 256.42 Section 256.42 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... Planning and Implementation § 256.42 Recommendations for assuring facility development. (a) The State plan...

15 CFR 923.52 - Consideration of the national interest in facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Coordination, Public..., and managing the coastal zone, including the siting of facilities such as energy facilities which are... to or affect a state's coastal zone. (4) Describe the process for continued consideration of the...

15 CFR 923.52 - Consideration of the national interest in facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Coordination, Public..., and managing the coastal zone, including the siting of facilities such as energy facilities which are... to or affect a state's coastal zone. (4) Describe the process for continued consideration of the...

40 CFR 112.21 - Facility response training and drills/exercises.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Facility response training and drills/exercises. 112.21 Section 112.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Response Requirements § 112.21 Facility response training and drills...

40 CFR 112.21 - Facility response training and drills/exercises.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Facility response training and drills/exercises. 112.21 Section 112.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Response Requirements § 112.21 Facility response training and drills...

40 CFR 112.21 - Facility response training and drills/exercises.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Facility response training and drills/exercises. 112.21 Section 112.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Response Requirements § 112.21 Facility response training and drills...

14 CFR 171.265 - Glide path performance requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... impressed on the microwave carrier of the radiated glide slope signal in the form of a unique summation of... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Interim Standard Microwave... assumption that the aircraft is heading directly toward the facility. (a) The glide slope antenna system must...

14 CFR 171.265 - Glide path performance requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... impressed on the microwave carrier of the radiated glide slope signal in the form of a unique summation of... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Interim Standard Microwave... assumption that the aircraft is heading directly toward the facility. (a) The glide slope antenna system must...

14 CFR 171.265 - Glide path performance requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... impressed on the microwave carrier of the radiated glide slope signal in the form of a unique summation of... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Interim Standard Microwave... assumption that the aircraft is heading directly toward the facility. (a) The glide slope antenna system must...

14 CFR 171.265 - Glide path performance requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... impressed on the microwave carrier of the radiated glide slope signal in the form of a unique summation of... TRANSPORTATION (CONTINUED) NAVIGATIONAL FACILITIES NON-FEDERAL NAVIGATION FACILITIES Interim Standard Microwave... assumption that the aircraft is heading directly toward the facility. (a) The glide slope antenna system must...

40 CFR 112.21 - Facility response training and drills/exercises.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Facility response training and drills/exercises. 112.21 Section 112.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Response Requirements § 112.21 Facility response training and drills...

40 CFR 112.21 - Facility response training and drills/exercises.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Facility response training and drills/exercises. 112.21 Section 112.21 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Response Requirements § 112.21 Facility response training and drills...

40 CFR 792.45 - Test system supply facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Test system supply facilities. 792.45 Section 792.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES... facilities. (a) There shall be storage areas, as needed, for feed, nutrients, soils, bedding, supplies, and...

Professional Development through Organizational Assessment: Using APPA's Facilities Management Evaluation Program

ERIC Educational Resources Information Center

Medlin, E. Lander; Judd, R. Holly

2013-01-01

APPA's Facilities Management Evaluation Program (FMEP) provides an integrated system to optimize organizational performance. The criteria for evaluation not only provide a tool for organizational continuous improvement, they serve as a compelling leadership development tool essential for today's facilities management professional. The senior…

49 CFR 1580.111 - Harmonization of federal regulation of nuclear facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 9 2014-10-01 2014-10-01 false Harmonization of federal regulation of nuclear facilities. 1580.111 Section 1580.111 Transportation Other Regulations Relating to Transportation (Continued... regulation of nuclear facilities. TSA will coordinate activities under this subpart with the Nuclear...

49 CFR 1580.111 - Harmonization of federal regulation of nuclear facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 9 2011-10-01 2011-10-01 false Harmonization of federal regulation of nuclear facilities. 1580.111 Section 1580.111 Transportation Other Regulations Relating to Transportation (Continued... regulation of nuclear facilities. TSA will coordinate activities under this subpart with the Nuclear...

49 CFR 1580.111 - Harmonization of federal regulation of nuclear facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 9 2013-10-01 2013-10-01 false Harmonization of federal regulation of nuclear facilities. 1580.111 Section 1580.111 Transportation Other Regulations Relating to Transportation (Continued... regulation of nuclear facilities. TSA will coordinate activities under this subpart with the Nuclear...

49 CFR 1580.111 - Harmonization of federal regulation of nuclear facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Harmonization of federal regulation of nuclear facilities. 1580.111 Section 1580.111 Transportation Other Regulations Relating to Transportation (Continued... regulation of nuclear facilities. TSA will coordinate activities under this subpart with the Nuclear...

49 CFR 1580.111 - Harmonization of federal regulation of nuclear facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 9 2012-10-01 2012-10-01 false Harmonization of federal regulation of nuclear facilities. 1580.111 Section 1580.111 Transportation Other Regulations Relating to Transportation (Continued... regulation of nuclear facilities. TSA will coordinate activities under this subpart with the Nuclear...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 32 2014-07-01 2014-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 32 2011-07-01 2011-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

33 CFR 154.1210 - Purpose and applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1210 Purpose and applicability. (a) The requirements of this... fats or vegetable oils including— (1) A fixed MTR facility capable of transferring oil in bulk, to or...

33 CFR 154.1210 - Purpose and applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1210 Purpose and applicability. (a) The requirements of this... fats or vegetable oils including— (1) A fixed MTR facility capable of transferring oil in bulk, to or...

40 CFR 160.15 - Inspection of a testing facility.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Inspection of a testing facility. 160.15 Section 160.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS General Provisions § 160.15 Inspection of a testing facility...

38 CFR 21.144 - Vocational course in a sheltered workshop or rehabilitation facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... workshop or rehabilitation facility may be an institutional, on-job, or combination course which has been... sheltered workshop or rehabilitation facility. 21.144 Section 21.144 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

10 CFR 61.32 - Facility information and verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Facility information and verification. 61.32 Section 61.32 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses Us/iaea Safeguards Agreement § 61.32 Facility information and verification. (a) In...

Rising HIV infection through blood transfusion worries Nigerian health experts.

PubMed

Raufu, A

2000-01-01

Blood transfusion is the second largest source of HIV infection in Nigeria, after unprotected sex. The major reason for this problem is the proliferation of illegal and lucrative blood banks that were being established. It has been discovered that most of these blood banks rely on "blood touts" for the supply of blood, which is later sold to needy patients. Lack of modern testing equipment and few private hospitals and government hospitals screening blood that is meant for transfusion compounded this problem. In response to the menace of unscreened blood for transfusion, the Lagos State Government declared a law to regulate blood transfusions and the activities of blood banks in the State. The objectives of this law were to curb the activities of owners of blood banks who were peddling unscreened blood to unsuspecting patients. Among the provisions of the law was that medical laboratories and hospitals that have blood banks should register their blood donors at any of the screening centers in the State. This law further prescribed fines and imprisonment for offenders. The law, however, turned out to be unenforceable because the reagents and testing equipment required were largely unavailable. It is noted that in the absence of a national blood transfusion policy, most blood banks continue to sell unscreened blood; in turn, HIV infections in Nigeria continue to rise.

Dumping Syndrome

MedlinePlus

... test during an office visit or in a commercial facility and sends the blood samples to a ... Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names ...

Clinical diagnosis of uncomplicated malaria in Sri Lanka.

PubMed

van der Hoek, W; Premasiri, D A; Wickremasinghe, A R

1998-06-01

To assess the possibility of developing a protocol for the clinical diagnosis of malaria, a study was done at the regional laboratory of the Anti-Malaria Campaign in Puttalam, Sri Lanka. Of a group of 502 patients, who suspected they were suffering from malaria, 97 had a positive blood film for malaria parasites (71 Plasmodium vivax and 26 P. falciparum). There were no important differences in signs and symptoms between those with positive and those with negative blood films. It is argued that it is unlikely that health workers can improve on the diagnosis of malaria made by the patients themselves, if laboratory facilities are not available. For Sri Lanka the best option is to expand the number of facilities where microscopic examination for malaria parasites can take place.

42 CFR 456.607 - Notification before inspection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.607 Notification before inspection. No facility may be...

38 CFR 21.294 - Selecting the training or rehabilitation facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under... the veteran's preference for a particular training or rehabilitation facility but VA has final...

50 CFR 20.83 - Inspection of premises.

Code of Federal Regulations, 2010 CFR

2010-10-01

... WILDLIFE AND PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Migratory Bird Preservation Facilities § 20.83 Inspection of premises. No migratory bird preservation facility shall prevent any person authorized to...

50 CFR 20.83 - Inspection of premises.

Code of Federal Regulations, 2011 CFR

2011-10-01

... WILDLIFE AND PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Migratory Bird Preservation Facilities § 20.83 Inspection of premises. No migratory bird preservation facility shall prevent any person authorized to...

Continuous blood pressure recordings simultaneously with functional brain imaging: studies of the glymphatic system

NASA Astrophysics Data System (ADS)

Zienkiewicz, Aleksandra; Huotari, Niko; Raitamaa, Lauri; Raatikainen, Ville; Ferdinando, Hany; Vihriälä, Erkki; Korhonen, Vesa; Myllylä, Teemu; Kiviniemi, Vesa

2017-03-01

The lymph system is responsible for cleaning the tissues of metabolic waste products, soluble proteins and other harmful fluids etc. Lymph flow in the body is driven by body movements and muscle contractions. Moreover, it is indirectly dependent on the cardiovascular system, where the heart beat and blood pressure maintain force of pressure in lymphatic channels. Over the last few years, studies revealed that the brain contains the so-called glymphatic system, which is the counterpart of the systemic lymphatic system in the brain. Similarly, the flow in the glymphatic system is assumed to be mostly driven by physiological pulsations such as cardiovascular pulses. Thus, continuous measurement of blood pressure and heart function simultaneously with functional brain imaging is of great interest, particularly in studies of the glymphatic system. We present our MRI compatible optics based sensing system for continuous blood pressure measurement and show our current results on the effects of blood pressure variations on cerebral brain dynamics, with a focus on the glymphatic system. Blood pressure was measured simultaneously with near-infrared spectroscopy (NIRS) combined with an ultrafast functional brain imaging (fMRI) sequence magnetic resonance encephalography (MREG, 3D brain 10 Hz sampling rate).

Modeling and Measurement of Correlation between Blood and Interstitial Glucose Changes

PubMed Central

Shi, Ting; Li, Dachao; Li, Guoqing; Zhang, Yiming; Xu, Kexin; Lu, Luo

2016-01-01

One of the most effective methods for continuous blood glucose monitoring is to continuously measure glucose in the interstitial fluid (ISF). However, multiple physiological factors can modulate glucose concentrations and affect the lag phase between blood and ISF glucose changes. This study aims to develop a compensatory tool for measuring the delay in ISF glucose variations in reference to blood glucose changes. A theoretical model was developed based on biophysics and physiology of glucose transport in the microcirculation system. Blood and interstitial fluid glucose changes were measured in mice and rats by fluorescent and isotope methods, respectively. Computer simulation mimicked curves were fitted with data resulting from fluorescent measurements of mice and isotope measurements of rats, indicating that there were lag times for ISF glucose changes. It also showed that there was a required diffusion distance for glucose to travel from center of capillaries to interstitial space in both mouse and rat models. We conclude that it is feasible with the developed model to continuously monitor dynamic changes of blood glucose concentration through measuring glucose changes in ISF with high accuracy, which requires correct parameters for determining and compensating for the delay time of glucose changes in ISF. PMID:27239479

Mutagen Sensitivity, Apoptosis, and Polymorphism in DNA Repair as Measures of Prostate Cancer Risk

DTIC Science & Technology

2005-02-01

blood tubes are immediately refrigerated and delivered on ice within 6 hours to the GCRC core facility at Georgetown University for processing . Case...is CLIA certified. There is a centrally monitored storage facility with -80’C freezers. The established recruitment and optimized sample processing in...controls. We have established the recruitment procedures, sample collection, processing , repository, and data management. This is a substantial effort

Accelerator-Based Biological Irradiation Facility Simulating Neutron Exposure from an Improvised Nuclear Device

PubMed Central

Xu, Yanping; Randers-Pehrson, Gerhard; Turner, Helen C.; Marino, Stephen A.; Geard, Charles R.; Brenner, David J.; Garty, Guy

2015-01-01

We describe here an accelerator-based neutron irradiation facility, intended to expose blood or small animals to neutron fields mimicking those from an improvised nuclear device at relevant distances from the epicenter. Neutrons are generated by a mixed proton/deuteron beam on a thick beryllium target, generating a broad spectrum of neutron energies that match those estimated for the Hiroshima bomb at 1.5 km from ground zero. This spectrum, dominated by neutron energies between 0.2 and 9 MeV, is significantly different from the standard reactor fission spectrum, as the initial bomb spectrum changes when the neutrons are transported through air. The neutron and gamma dose rates were measured using a custom tissue-equivalent gas ionization chamber and a compensated Geiger-Mueller dosimeter, respectively. Neutron spectra were evaluated by unfolding measurements using a proton-recoil proportional counter and a liquid scintillator detector. As an illustration of the potential use of this facility we present micronucleus yields in single divided, cytokinesis-blocked human peripheral lymphocytes up to 1.5 Gy demonstrating 3- to 5-fold enhancement over equivalent X-ray doses. This facility is currently in routine use, irradiating both mice and human blood samples for evaluation of neutron-specific biodosimetry assays. Future studies will focus on dose reconstruction in realistic mixed neutron/photon fields. PMID:26414507

Accelerator-Based Biological Irradiation Facility Simulating Neutron Exposure from an Improvised Nuclear Device.

PubMed

Xu, Yanping; Randers-Pehrson, Gerhard; Turner, Helen C; Marino, Stephen A; Geard, Charles R; Brenner, David J; Garty, Guy

2015-10-01

We describe here an accelerator-based neutron irradiation facility, intended to expose blood or small animals to neutron fields mimicking those from an improvised nuclear device at relevant distances from the epicenter. Neutrons are generated by a mixed proton/deuteron beam on a thick beryllium target, generating a broad spectrum of neutron energies that match those estimated for the Hiroshima bomb at 1.5 km from ground zero. This spectrum, dominated by neutron energies between 0.2 and 9 MeV, is significantly different from the standard reactor fission spectrum, as the initial bomb spectrum changes when the neutrons are transported through air. The neutron and gamma dose rates were measured using a custom tissue-equivalent gas ionization chamber and a compensated Geiger-Mueller dosimeter, respectively. Neutron spectra were evaluated by unfolding measurements using a proton-recoil proportional counter and a liquid scintillator detector. As an illustration of the potential use of this facility we present micronucleus yields in single divided, cytokinesis-blocked human peripheral lymphocytes up to 1.5 Gy demonstrating 3- to 5-fold enhancement over equivalent X-ray doses. This facility is currently in routine use, irradiating both mice and human blood samples for evaluation of neutron-specific biodosimetry assays. Future studies will focus on dose reconstruction in realistic mixed neutron/photon fields.

76 FR 34999 - Draft Guidance for Industry and Food and Drug Administration Staff; Establishing the Performance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... human specimens or bacterial growth detected by continuous monitoring blood culture systems. This draft... versus SA in either human specimens or bacterial growth detected by continuous monitoring blood culture... devices that detect MRSA by growth in culture media or those devices that test for the protein, penicillin...

Using meta-differential evolution to enhance a calculation of a continuous blood glucose level.

PubMed

Koutny, Tomas

2016-09-01

We developed a new model of glucose dynamics. The model calculates blood glucose level as a function of transcapillary glucose transport. In previous studies, we validated the model with animal experiments. We used analytical method to determine model parameters. In this study, we validate the model with subjects with type 1 diabetes. In addition, we combine the analytic method with meta-differential evolution. To validate the model with human patients, we obtained a data set of type 1 diabetes study that was coordinated by Jaeb Center for Health Research. We calculated a continuous blood glucose level from continuously measured interstitial fluid glucose level. We used 6 different scenarios to ensure robust validation of the calculation. Over 96% of calculated blood glucose levels fit A+B zones of the Clarke Error Grid. No data set required any correction of model parameters during the time course of measuring. We successfully verified the possibility of calculating a continuous blood glucose level of subjects with type 1 diabetes. This study signals a successful transition of our research from an animal experiment to a human patient. Researchers can test our model with their data on-line at https://diabetes.zcu.cz. Copyright © 2016 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

Therapeutic effect of continuous exercise training program on serum creatinine concentration in men with hypertension: a randomized controlled trial.

PubMed

Sikiru, L; Okoye, G C

2014-09-01

Creatinine (Cr) has been implicated as an independent predictor of hypertension and exercise has been reported as adjunct therapy for hypertension. The purpose of the present study was to investigate the effect of continuous training programme on blood pressure and serum creatinine concentration in black African subjects with hypertension. Three hundred and fifty seven male patients with mild to moderate (systolic blood pressure [SBP] between 140-180 & diastolic blood pressure [DBP] between 90-109 mmHg) essential hypertension were age matched and randomly grouped into continuous & control groups. The continuous group involved in an 8 weeks continuous training (60-79% HR reserve) of between 45 minutes to 60 minutes, 3 times per week, while the control group remain sedentary. SBP, DBP, VO2max, serum Cr, body mass index (BMI), waist hip ratio (WHR) and percent (%) body fat. Analysis of covariance (ANCOVA) and Pearson correlation tests were used in data analysis. Findings of the study revealed significant decreased effects of continuous training programme on SBP, DBP, Cr, BMI, WHR, % body fat and significant increase in VO2max at p< 0.05. Serum Cr is significantly and negatively correlated with SBP (-.335), DBP (.194), BMI (.268), WHR (-.258) and % body fat (-.190) at p<0.05. The present study demonstrated a rationale bases for the adjunct therapeutic role of moderate intensity continuous exercise training as a multi-therapy in the down regulation of blood pressure, serum Cr, body size and body fat in hypertension.

10 CFR 75.15 - Facility attachments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Facility attachments. 75.15 Section 75.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) SAFEGUARDS ON NUCLEAR MATERIAL-IMPLEMENTATION OF US/IAEA AGREEMENT Material... under Article 39(b) of the main text of the Safeguards Agreement, do not have Facility Attachments or...

10 CFR 75.15 - Facility attachments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Facility attachments. 75.15 Section 75.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) SAFEGUARDS ON NUCLEAR MATERIAL-IMPLEMENTATION OF US/IAEA AGREEMENT Material... under Article 39(b) of the main text of the Safeguards Agreement, do not have Facility Attachments or...

7 CFR 1610.7 - Acquisition of certain exchange facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 11 2011-01-01 2011-01-01 false Acquisition of certain exchange facilities. 1610.7 Section 1610.7 Agriculture Regulations of the Department of Agriculture (Continued) RURAL TELEPHONE BANK, DEPARTMENT OF AGRICULTURE LOAN POLICIES § 1610.7 Acquisition of certain exchange facilities. In the interest...

15 CFR 712.4 - New Schedule 1 production facility.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.4 New Schedule 1 production facility. (a) Establishment of a...) of the CWCR, and you intend to begin production of Schedule 1 chemicals at your facility in...

41 CFR 102-74.290 - May Federal agencies allow employees to use parking spaces not required for official needs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May Federal agencies...

40 CFR 372.22 - Covered facilities for toxic chemical release reporting.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Covered facilities for toxic chemical... (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS TOXIC CHEMICAL RELEASE REPORTING: COMMUNITY RIGHT-TO-KNOW Reporting Requirements § 372.22 Covered facilities for toxic chemical...

41 CFR 102-74.285 - How must Federal agencies assign priority to parking spaces in controlled areas?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must Federal... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74...

40 CFR 267.151 - Wording of the instruments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... owner or operator of a facility with a standardized permit who uses a financial test to demonstrate... financial officer of an owner or operator of a facility with a standardized permit who use a financial test... (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A STANDARDIZED...

40 CFR 267.151 - Wording of the instruments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... owner or operator of a facility with a standardized permit who uses a financial test to demonstrate... financial officer of an owner or operator of a facility with a standardized permit who use a financial test... (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A STANDARDIZED...

40 CFR 267.151 - Wording of the instruments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... owner or operator of a facility with a standardized permit who uses a financial test to demonstrate... financial officer of an owner or operator of a facility with a standardized permit who use a financial test... (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A STANDARDIZED...

40 CFR 267.151 - Wording of the instruments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... owner or operator of a facility with a standardized permit who uses a financial test to demonstrate... financial officer of an owner or operator of a facility with a standardized permit who use a financial test... (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A STANDARDIZED...

15 CFR 712.4 - New Schedule 1 production facility.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 1 CHEMICALS § 712.4 New Schedule 1 production facility. (a) Establishment of a...) of the CWCR, and you intend to begin production of Schedule 1 chemicals at your facility in...

10 CFR 61.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE General Provisions § 61.... Disposal site means that portion of a land disposal facility which is used for disposal of waste. It... facility means a land disposal facility in which radioactive waste is disposed of in or within the upper 30...

10 CFR 61.81 - Tests at land disposal facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Tests at land disposal facilities. 61.81 Section 61.81 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Records, Reports, Tests, and Inspections § 61.81 Tests at land disposal facilities. (a) Each...

10 CFR 61.81 - Tests at land disposal facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Tests at land disposal facilities. 61.81 Section 61.81 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Records, Reports, Tests, and Inspections § 61.81 Tests at land disposal facilities. (a) Each...

10 CFR 61.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE General Provisions § 61.... Disposal site means that portion of a land disposal facility which is used for disposal of waste. It... facility means a land disposal facility in which radioactive waste is disposed of in or within the upper 30...

10 CFR 61.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE General Provisions § 61.... Disposal site means that portion of a land disposal facility which is used for disposal of waste. It... facility means a land disposal facility in which radioactive waste is disposed of in or within the upper 30...

10 CFR 61.81 - Tests at land disposal facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Tests at land disposal facilities. 61.81 Section 61.81 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Records, Reports, Tests, and Inspections § 61.81 Tests at land disposal facilities. (a) Each...

10 CFR 61.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE General Provisions § 61.... Disposal site means that portion of a land disposal facility which is used for disposal of waste. It... facility means a land disposal facility in which radioactive waste is disposed of in or within the upper 30...

10 CFR 61.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE General Provisions § 61.... Disposal site means that portion of a land disposal facility which is used for disposal of waste. It... facility means a land disposal facility in which radioactive waste is disposed of in or within the upper 30...

41 CFR 102-74.10 - What is the basic facility management policy?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY...

Effects of Epoetin Alfa Titration Practices, Implemented After Changes to Product Labeling, on Hemoglobin Levels, Transfusion Use, and Hospitalization Rates.

PubMed

Molony, Julia T; Monda, Keri L; Li, Suying; Beaubrun, Anne C; Gilbertson, David T; Bradbury, Brian D; Collins, Allan J

2016-08-01

Little is known about epoetin alfa (EPO) dosing at dialysis centers after implementation of the US Medicare prospective payment system and revision of the EPO label in 2011. Retrospective cohort study. Approximately 412,000 adult hemodialysis patients with Medicare Parts A and B as primary payer in 2009 to 2012 to describe EPO dosing and hemoglobin patterns; of these, about 70,000 patients clustered in about 1,300 dialysis facilities to evaluate facility-level EPO titration practices and patient-level outcomes in 2012. Facility EPO titration practices when hemoglobin levels were <10 and >11g/dL (grouped treatment variable) determined from monthly EPO dosing and hemoglobin level patterns. Patient mean hemoglobin levels, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates using a facility-based analysis. Monthly EPO dose and hemoglobin level, red blood cell transfusion rates, and all-cause and cause-specific hospitalization rates. Monthly EPO doses declined across all hemoglobin levels, with the greatest decline in patients with hemoglobin levels < 10g/dL (July-October 2011). In 2012, nine distinct facility titration practices were identified. Across groups, mean hemoglobin levels differed slightly (10.5-10.8g/dL) but within-patient hemoglobin standard deviations were similar (∼0.68g/dL). Patients at facilities implementing greater dose reductions and smaller dose escalations had lower hemoglobin levels and higher transfusion rates. In contrast, patients at facilities that implemented greater dose escalations (and large or small dose reductions) had higher hemoglobin levels and lower transfusion rates. There were no clinically meaningful differences in all-cause or cause-specific hospitalization events across groups. Possibly incomplete claims data; excluded small facilities and those without consistent titration patterns; hemoglobin levels reported monthly; inferred facility practice from observed dosing. Following prospective payment system implementation and labeling revisions, EPO doses declined significantly. Under the new label, facility EPO titration practices were associated with mean hemoglobin levels (but not standard deviations) and transfusion use, but not hospitalization rates. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Continuous downstream processing for high value biological products: A Review.

PubMed

Zydney, Andrew L

2016-03-01

There is growing interest in the possibility of developing truly continuous processes for the large-scale production of high value biological products. Continuous processing has the potential to provide significant reductions in cost and facility size while improving product quality and facilitating the design of flexible multi-product manufacturing facilities. This paper reviews the current state-of-the-art in separations technology suitable for continuous downstream bioprocessing, focusing on unit operations that would be most appropriate for the production of secreted proteins like monoclonal antibodies. This includes cell separation/recycle from the perfusion bioreactor, initial product recovery (capture), product purification (polishing), and formulation. Of particular importance are the available options, and alternatives, for continuous chromatographic separations. Although there are still significant challenges in developing integrated continuous bioprocesses, recent technological advances have provided process developers with a number of attractive options for development of truly continuous bioprocessing operations. © 2015 Wiley Periodicals, Inc.

38 CFR 17.240 - Sharing specialized medical resources.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., public or private hospitals or other medical installations having hospital facilities or organ banks, blood banks, or similar institutions, or medical schools or clinics in a medical community with...

Quality of Malaria Case Management in Malawi: Results from a Nationally Representative Health Facility Survey

PubMed Central

Steinhardt, Laura C.; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-01-01

Background Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. Methods In April–May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. Results At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Conclusions Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have basic case management tools, and health worker performance in diagnosing malaria must be improved. PMID:24586497

Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

PubMed

Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

2014-01-01

Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have basic case management tools, and health worker performance in diagnosing malaria must be improved.

Post-operative blood loss monitoring device: a new tool for nursing activities.

PubMed

Logier, R; Carette, D; Sozanski, J P; Jeanne, M; Jounwaz, R; De Jonckheere, J

2012-01-01

In most medical specialties, after surgery, it is usual to place a drain at the operative site level, in order to assist the blood flow-out if necessary. This drainage allows avoiding the formation of hematomas and contributes to tissues recovery. However, postoperative blood loss can lead to serious consequences. Also, it is necessary to continuously check the blood output volume in order to be able to intervene quickly in case of too significant losses. In daily clinical practice, this task is due to the nursing staff that periodically records the blood level inside the supple bag connected to the drain. However, this method is not accurate about the volume of lost blood and does not reflect the flow of losses which is an important parameter regarding the evolution of the patient setting. We have designed and developed a prototype of a blood loss monitoring device based on the continuous weight measurement of the blood bag connected to the drain. This device is fixed on the bed and is able to instantaneously alert the medical staff in case of abnormal blood flow-out.

[Design and implementation of real-time continuous glucose monitoring instrument].

PubMed

Huang, Yonghong; Liu, Hongying; Tian, Senfu; Jia, Ziru; Wang, Zi; Pi, Xitian

2017-12-01

Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.

Aspirin mono-therapy continuation does not result in more bleeding after knee arthroplasty.

PubMed

Schwab, Pierre-Emmanuel; Lavand'homme, Patricia; Yombi, JeanCyr; Thienpont, Emmanuel

2017-08-01

Current clinical practice guidelines sometimes still recommend stopping aspirin five to seven days before knee arthroplasty surgery. Literature regarding multimodal blood management and continuation of anti-platelet therapy in this type of surgery is scant. The study hypothesis was that knee arthroplasty under low-dose aspirin mono-therapy continuation does not cause more total blood loss than knee arthroplasty performed without aspirin. Blood loss would be measured by haemoglobin (Hb) and haematocrit (HTC) levels drop at day 2 or day 4 for patients who benefit from multimodal bleeding control measures. A database of all patients undergoing knee arthroplasty between 2006 and 2014 was analysed. Demographic, surgical and complete blood workup data were collected. A retrospective comparison study analysed both groups in terms of blood loss, by mean calculated blood loss as haemoglobin or haematocrit drop between the preoperative Nadir value and the postoperative day 2 and 4 value. A group of 198 (44 UKA and 154 TKA) patients underwent surgery without interrupting their aspirin therapy for cardiovascular prevention. Mean (SD) age was 71 (8) and the mean (SD) BMI was 29 (5.5) kg/m 2 . The control group consisted of 403 (102 UKA and 301 TKA) patients who were not under aspirin, or any other anti-platelet agent. Mean (SD) age was 65 (10) (p < 0.05) and the mean (SD) BMI was 29 (5.0) kg/m 2 (n.s.). All patients in the control group were randomly selected. There were no differences in terms of visible (early) or hidden (late) blood loss as measured by Hb drop in between both groups. There is no difference in transfusion rates. Modern multimodal blood management provides sufficient blood loss prevention during and after knee arthroplasty to allow physicians to continue low-dose aspirin mono-therapy for cardiovascular prevention. III.

The Protein Crystallization Facility STS-95

NASA Technical Reports Server (NTRS)

2004-01-01

The Protein Crystallization Facility will be used to grow crystals of human insulin. Insulin is the primary treatment for diabetes, the fourth leading cause of death by disease. Research on STS-95 is aimed at producing crystals of even higher quality, which when combined with new analysis techniques will permit a better understanding of the interaction between insulin and its receptor. This has the potential to aid in the development of a new commercially available insulin product with unique time release properties that could reduce fluctuations in a patient's blood sugar level. The Protein Crystallization Facility supports large-scale commercial investigations.

Jefferson Lab Science: Present and Future

DOE PAGES

McKeown, Robert D.

2015-02-12

The Continuous Electron Beam Accelerator Facility (CEBAF) and associated experimental equipment at Jefferson Lab comprise a unique facility for experimental nuclear physics. Furthermore, this facility is presently being upgraded, which will enable a new experimental program with substantial discovery potential to address important topics in nuclear, hadronic, and electroweak physics. Further in the future, it is envisioned that the Laboratory will evolve into an electron-ion colliding beam facility.

Space weather and cardiovascular system. New findings

NASA Astrophysics Data System (ADS)

Gurfinkel, Yury; Breus, Tamara

2014-05-01

Researches of last two decades have shown that the cardiovascular system represents the most probable target for influence of helio - and geomagnetic activity. Both cardiovascular system and system of blood are connected very closely: one system cannot exist without another. For the same reason the effects perceived by one system, are easily transferred to another. Laboratory tests such as blood coagulation, platelet aggregation, and capillary blood velocity (CBV) performed in Scientific Clinical Center JSC "Russian Railways in patients suffering from coronary heart disease (CHD) revealed a high dependence with a level of geomagnetic activity. Results of these and other findings allow to assume that blood itself can be a sensor of geomagnetic fields variations because erythrocytes, platelets, and leucocytes bearing electric charge on membranes, and in a comparable magnetic field can change as own properties and properties of blood flow. It is interesting that not only geomagnetic disturbances, but also the periods of very quiet geomagnetic conditions affect a capillary blood velocity, slowing down it. It was shown during long-term experiment with isolation named 'MARS-500' in spatial facility of the Institute of Biomedical Problems in Moscow as imitation of an extended space mission to Mars. Using digital capillaroscope 'Russia', two crewmembers - medical doctors made records of microcirculation parameters at themselves and other four participants of 'Martian' team. Capillary records were performed before, during, and after period of isolation in medical module of MARS-500 facility. At the period of experiment nobody of crewmembers knew about real geomagnetic conditions. In days of active geomagnetic conditions average CBV has registered as 389 ± 167 μm/s, that statistically significant (p

Personal Exposure, Behavior, and Work Site Conditions as Determinants of Blood Lead Among Bridge Painters

PubMed Central

Rodrigues, Ema G.; Virji, M. Abbas; McClean, Michael D.; Weinberg, Janice; Woskie, Susan; Pepper, Lewis D.

2009-01-01

Bridge painters are exposed to lead during several job tasks performed during the workday, such as sanding, scraping, and blasting. After the Occupational Safety and Health Administration standard was passed in 1993 to control lead exposures among construction workers including bridge painters, this study was conducted among 84 bridge painters in the New England area to determine the significant predictors of blood lead levels. Lead was measured in personal air and hand wipe samples that were collected during the 2-week study period and in blood samples that were collected at the beginning and at the end of the study period. The personal air and hand wipe data as well as personal behaviors (i.e., smoking, washing, wearing a respirator) and work site conditions were analyzed as potential determinants of blood lead levels using linear mixed effects models. Our results show that the mean air lead levels over the 2-week period were the most predictive exposure measure of blood lead levels. Other individual-level significant predictors of blood lead levels included months worked on bridge painting crews, education, and personal hygiene index. Of the site-level variables investigated, having a containment facility on site was a significant predictor of blood lead levels. Our results also indicate that hand wipe lead levels were significantly associated with higher blood lead levels at the end of the study period compared with the beginning of the study period. Similarly, smoking on site and respirator fit testing were significantly associated with higher blood lead levels at the end of the study period. This study shows that several individual-level and site-level factors are associated with blood lead levels among bridge painters, including lead exposure through inhalation and possible hand-to-mouth contact, personal behaviors such as smoking on site, respirator fit testing, and work site conditions such as the use of better containment facilities. Accordingly, reduction in blood lead levels among bridge painters can be achieved by improving these workplace practices. PMID:19953411

An isogenic blood-brain barrier model comprising brain endothelial cells, astrocytes, and neurons derived from human induced pluripotent stem cells.

PubMed

Canfield, Scott G; Stebbins, Matthew J; Morales, Bethsymarie Soto; Asai, Shusaku W; Vatine, Gad D; Svendsen, Clive N; Palecek, Sean P; Shusta, Eric V

2017-03-01

The blood-brain barrier (BBB) is critical in maintaining a physical and metabolic barrier between the blood and the brain. The BBB consists of brain microvascular endothelial cells (BMECs) that line the brain vasculature and combine with astrocytes, neurons and pericytes to form the neurovascular unit. We hypothesized that astrocytes and neurons generated from human-induced pluripotent stem cells (iPSCs) could induce BBB phenotypes in iPSC-derived BMECs, creating a robust multicellular human BBB model. To this end, iPSCs were used to form neural progenitor-like EZ-spheres, which were in turn differentiated to neurons and astrocytes, enabling facile neural cell generation. The iPSC-derived astrocytes and neurons induced barrier tightening in primary rat BMECs indicating their BBB inductive capacity. When co-cultured with human iPSC-derived BMECs, the iPSC-derived neurons and astrocytes significantly elevated trans-endothelial electrical resistance, reduced passive permeability, and improved tight junction continuity in the BMEC cell population, while p-glycoprotein efflux transporter activity was unchanged. A physiologically relevant neural cell mixture of one neuron: three astrocytes yielded optimal BMEC induction properties. Finally, an isogenic multicellular BBB model was successfully demonstrated employing BMECs, astrocytes, and neurons from the same donor iPSC source. It is anticipated that such an isogenic facsimile of the human BBB could have applications in furthering understanding the cellular interplay of the neurovascular unit in both healthy and diseased humans. Read the Editorial Highlight for this article on page 843. © 2016 International Society for Neurochemistry.

Development of a Knowledge-Based System Approach for Decision Making in Construction Projects

DTIC Science & Technology

1992-05-01

a generic model for an administrative facility and medical facility with predefined fixed building systems based on Air Force criteria and past...MAINTENANCE HANGAR (MEDIUM BAY) CORROSION CONTROL HANGAR (HIGH BAY) FUEL SYSTEM MAINTENANCE HANGAR (MEDIUM BAY) MEDICAL MODEL 82 Table 5-1--continued...BUILDING SUPPORT MEDICAL LOGISTICS MEDICAL TOTAL 85 Table 5-2--continued MISSILE ASSEMBLY AND MAINTENANCE BUILDING TOTAL MISSILE LOADING AND UNLOADING

40 CFR Table Jj-1 to Subpart Jj of... - Animal Population Threshold Level Below Which Facilities Are Not Required To Report Emissions...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 21 2011-07-01 2011-07-01 false Animal Population Threshold Level Below Which Facilities Are Not Required To Report Emissions Under Subpart JJ 1,2 JJ Table JJ-1 to Subpart JJ of Part 98 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) MANDATORY GREENHOUSE GAS REPORTING...

21 CFR 870.1140 - Venous blood pressure manometer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous...

21 CFR 870.1140 - Venous blood pressure manometer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous...

21 CFR 870.1140 - Venous blood pressure manometer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous...

21 CFR 870.1140 - Venous blood pressure manometer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous...

21 CFR 607.65 - Exemptions for blood product establishments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... use, or preparation of red blood cells for transfusion are not acts requiring such transfusion... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Exemptions for blood product establishments. 607.65... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND...

40 CFR 62.9510 - Identification of sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF STATE PLANS FOR DESIGNATED FACILITIES AND POLLUTANTS Oregon Control... sources. The plan applies to all existing MSW landfill facilities in Oregon meeting the requirements as...

49 CFR 193.2101 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES...] Materials ...

A hybrid-system model of the coagulation cascade: simulation, sensitivity, and validation.

PubMed

Makin, Joseph G; Narayanan, Srini

2013-10-01

The process of human blood clotting involves a complex interaction of continuous-time/continuous-state processes and discrete-event/discrete-state phenomena, where the former comprise the various chemical rate equations and the latter comprise both threshold-limited behaviors and binary states (presence/absence of a chemical). Whereas previous blood-clotting models used only continuous dynamics and perforce addressed only portions of the coagulation cascade, we capture both continuous and discrete aspects by modeling it as a hybrid dynamical system. The model was implemented as a hybrid Petri net, a graphical modeling language that extends ordinary Petri nets to cover continuous quantities and continuous-time flows. The primary focus is simulation: (1) fidelity to the clinical data in terms of clotting-factor concentrations and elapsed time; (2) reproduction of known clotting pathologies; and (3) fine-grained predictions which may be used to refine clinical understanding of blood clotting. Next we examine sensitivity to rate-constant perturbation. Finally, we propose a method for titrating between reliance on the model and on prior clinical knowledge. For simplicity, we confine these last two analyses to a critical purely-continuous subsystem of the model.

The quest for quality blood banking program in the new millennium the American way.

PubMed

Kim, Dae Un

2002-08-01

For an industry to succeed and satisfy its customers, "QUALITY" must be a primary goal. Quality has been central to blood banking from its inception, with the evolution of a Quality Program since the opening of the first blood bank in U.S. at the Cook County Hospital in 1937. Over the ensuing decades, continuous scientific progress in blood preservation, filters, viral and blood group testing, crossmatching, automation, and computerization including bar coding, etc. has contributed to the quality and safety of the blood products and transfusion service. However, with the advent of the AIDS era, an increasingly sensitized and informed public is continuously demanding that the highest level of quality be achieved and maintained in all processes involved in providing all blood products. The Food and Drug Administration (FDA) introduced the concept of a "zero risk blood supply" as the industry goal. Furthermore, the cost containment and resource-constrained environment have changed the complexity of the quality practice. Both regulatory agencies such as the FDA, the Health Care Financing Administration [HCFA, which was recently renamed as the Centers for Medicare and Medicaid Services (CMS) in July, 2001], and the State Department of Health, and accrediting agencies, such as the American Association of Blood Banks (AABB), the College of American Pathologists (CAP), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), require blood banks and transfusion services to establish and follow a Quality Control and Quality Assurance Program for their licensing, certification and accreditation. Every laboratory has to comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) quality requirements being implemented by the CMS. The FDA guidelines assist facilities in compliance with Current Good Manufacturing Practices (cGMP). The AABB's Quality System Essentials (QSE) are based on these specifications and provide additional guidance in implementing practices that assure quality and compliance with cGMP. AABB and CAP are granted "deemed status" as accrediting organizations under the CLIA '88 program by CMS, as well as JCAHO and some states. The International Standards Organization (ISO) has established international standards in most fields. The U.S. is represented in ISO by the American National Standards Institute (ANSI), and the National Committee for Clinical Laboratory Standards (NCCLS), as a global organization headquartered in the U.S., is a member of ANSI. The FDA and the AABB had begun incorporating many ISO principles into their own regulations and standards. The AABB's 10 QSEs are rooted in the 20 clauses of ISO 9000 series and compatible with their standards. In a Maslow-type model quality hierarchy by Tsiakals, so far the bottom three of the five progressive levels, Quality Control for method control, Quality Assurance for process control, and Quality System for system control have been implemented just to meet the regulatory and accrediting requirements. The next higher level, Quality Management for financial control, and the ultimate highest level, Total Quality Management for strategic control, should be our quest in this new millennium, and with the help of the AABB, ISO, FDA and all other organizations, we will achieve it. We should change our approach to quality issues from detection to prevention. We should improve the quality in transfusion practice itself by effective utilization of blood as a therapeutic resource with clear indication, maximum surgical blood order schedule, alternative transfusion such as autologous transfusion, hemodilution, and intra/post-operative blood salvage, surgical hemostasis, pharmacological hemostasis, and synthetic erythropoietin. Most importantly, implementation of the Quality Program should be something that we want to do rather than simply a burden that we have to do. A well-managed Quality Program is an effective and cost-efficient operation for the blood banks and transfusion services, and will enable us to better serve the patients for whom we exist.

40 CFR 60.80 - Applicability and designation of affected facility.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Sulfuric Acid Plants § 60.80 Applicability and designation of affected facility. (a) The...

40 CFR 60.80 - Applicability and designation of affected facility.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Sulfuric Acid Plants § 60.80 Applicability and designation of affected facility. (a) The...

42 CFR 441.11 - Continuation of FFP for institutional services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... individuals under age 21. (6) Nursing facility services for individuals under 21. (7) Intermediate care facility services for individuals with intellectual disabilities. [59 FR 56234, Nov. 10, 1994] ...

42 CFR 441.11 - Continuation of FFP for institutional services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... individuals under age 21. (6) Nursing facility services for individuals under 21. (7) Intermediate care facility services for individuals with intellectual disabilities. [59 FR 56234, Nov. 10, 1994] ...

33 CFR 154.1220 - Response plan submission requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SECURITY (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1220 Response plan submission requirements. (a) The owner...

33 CFR 154.1220 - Response plan submission requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SECURITY (CONTINUED) POLLUTION FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Response Plans for Animal Fats and Vegetable Oils Facilities § 154.1220 Response plan submission requirements. (a) The owner...

Requirements Doc for Refurb of JASPER Facility in B131HB

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

Knittel, Kenn M.

The Joint Actinide Shock Physics Experimental Research (JASPER) Program target fabrication facility is currently located in building 131 (B131) of the Lawrence Livermore National Laboratory (LLNL). A portion of this current facility has been committed to another program as part of a larger effort to consolidate LLNL capabilities into newer facilities. This facility assembles precision targets for scientific studies at the Nevada National Security Site (NNSS). B131 is also going through a modernization project to upgrade the infrastructure and abate asbestos. These activities will interrupt the continuous target fabrication efforts for the JASPER Program. Several options are explored to meetmore » the above conflicting requirements, with the final recommendation to prepare a new facility for JASPER target fabrication operations before modernization efforts begin in the current facility assigned to JASPER. This recommendation fits within all schedule constraints and minimizes the disruption to the JASPER Program. This option is not without risk, as it requires moving an aged, precision coordinate measuring machine, which is essential to the JASPER Program’s success. The selected option balances the risk to the machine with continuity of operations.« less

Validation of the Somnotouch-NIBP noninvasive continuous blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010.

PubMed

Bilo, Grzegorz; Zorzi, Cristina; Ochoa Munera, Juan E; Torlasco, Camilla; Giuli, Valentina; Parati, Gianfranco

2015-10-01

The present study aimed to evaluate the accuracy of the Somnotouch-NIBP noninvasive continuous blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adults (11 women, mean age 63.5±11.9 years) using a mercury sphygmomanometer (two observers) and the Somnotouch-NIBP device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the validation requirements were fulfilled. The Somnotouch-NIBP device fulfilled the requirements of the part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 75/99, 90/99, and 96/99, respectively, for systolic blood pressure and 90/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Twenty-seven and 31 participants had at least two of the three device-observers differences less than or equal to 5 mmHg for systolic and diastolic blood pressure, respectively. All three device-observer differences were greater than 5 mmHg in two participants for systolic and in one participant for diastolic blood pressure. The Somnotouch-NIBP noninvasive continuous blood pressure monitor has passed the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure monitoring in adults, at least under conditions corresponding to those investigated in our study.

40 CFR 60.5417 - What are the continuous control device monitoring requirements for my storage vessel or...

Code of Federal Regulations, 2013 CFR

2013-07-01

... monitoring requirements for my storage vessel or centrifugal compressor affected facility? 60.5417 Section 60... requirements for my storage vessel or centrifugal compressor affected facility? You must meet the applicable... standards for your storage vessel or centrifugal compressor affected facility. (a) You must install and...

40 CFR 60.5417 - What are the continuous control device monitoring requirements for my storage vessel or...

Code of Federal Regulations, 2014 CFR

2014-07-01

... monitoring requirements for my storage vessel or centrifugal compressor affected facility? 60.5417 Section 60... requirements for my storage vessel or centrifugal compressor affected facility? You must meet the applicable... standards for your storage vessel or centrifugal compressor affected facility. (a) For each control device...

33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

33 CFR 147.815 - ExxonMobil Hoover Floating OCS Facility safety zone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false ExxonMobil Hoover Floating OCS... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.815 ExxonMobil Hoover Floating OCS Facility safety zone. (a) Description. The ExxonMobil Hoover Floating OCS Facility, Alaminos...

Marketing Sports Facilities: Perspectives from Botswana

ERIC Educational Resources Information Center

Bohutsana, Basuti; Akpata, Dele

2013-01-01

The provision of sports facilities contributes immensely to the growth of sports and leisure activities in the countries where they are provided. In some countries, as was the case in Botswana, the government had to spend millions of dollars to provide new Integrated Sports Facilities (ISF's) as a panacea for the continued poor performance of its…

41 CFR 102-76.60 - To which facilities does the Architectural Barriers Act apply?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false To which facilities does... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Architectural Barriers Act § 102-76.60 To which facilities does the...

41 CFR 102-76.60 - To which facilities does the Architectural Barriers Act apply?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false To which facilities does... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Architectural Barriers Act § 102-76.60 To which facilities does the...

41 CFR 102-76.60 - To which facilities does the Architectural Barriers Act apply?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false To which facilities does... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Architectural Barriers Act § 102-76.60 To which facilities does the...

41 CFR 102-76.60 - To which facilities does the Architectural Barriers Act apply?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false To which facilities does... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 76-DESIGN AND CONSTRUCTION Architectural Barriers Act § 102-76.60 To which facilities does the...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

40 CFR Table 1 to Subpart Cccccc... - Applicability Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000 Gallons of Gasoline or More1... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... Criteria and Management Practices for Gasoline Dispensing Facilities With Monthly Throughput of 100,000...

41 CFR 102-74.305 - How must Federal agencies assign available parking spaces to their employees?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74.305 How must... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must Federal...

41 CFR 102-74.300 - How must space available for employee parking be allocated among occupant agencies?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking Facilities § 102-74... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false How must space available...

41 CFR 102-74.280 - Are privately owned vehicles converted for propane carburetion permitted in underground parking...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Parking... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are privately owned vehicles converted for propane carburetion permitted in underground parking facilities? 102-74.280 Section...

19 CFR 151.24 - Unlading facilities for bulk sugar.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...

19 CFR 151.24 - Unlading facilities for bulk sugar.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Unlading facilities for bulk sugar. 151.24 Section... OF THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.24 Unlading facilities for bulk sugar. When dutiable sugar is to be imported in bulk, a full...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

38 CFR 59.130 - General requirements for all State home facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... all State home facilities. 59.130 Section 59.130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.130 General requirements for all State home facilities. As a condition for receiving a grant and grant funds...

Directory of Nature Centers and Related Environmental Education Facilities. Third Revision.

ERIC Educational Resources Information Center

National Audubon Society, New York, NY.

This directory is part of a continuing effort to identify facilities actively involved in environmental education. Designed as a guide for the casual visitor as well as the professional person, it aims to stimulate interest in nature centers, improve communication among facilities, and encourage development of new and better ones. This third…